Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies

Overview of attention for article published in British Medical Journal, August 2015
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  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#29 of 31,624)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

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289 Mendeley
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5 CiteULike
Title
Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies
Published in
British Medical Journal, August 2015
DOI 10.1136/bmj.h3978
Pubmed ID
Authors

Russell J de Souza, Andrew Mente, Adriana Maroleanu, Adrian I Cozma, Vanessa Ha, Teruko Kishibe, Elizabeth Uleryk, Patrick Budylowski, Holger Schünemann, Joseph Beyene, Sonia S Anand, de Souza, Russell J, Mente, Andrew, Maroleanu, Adriana, Cozma, Adrian I, Ha, Vanessa, Kishibe, Teruko, Uleryk, Elizabeth, Budylowski, Patrick, Schünemann, Holger, Beyene, Joseph, Anand, Sonia S

Abstract

To systematically review associations between intake of saturated fat and trans unsaturated fat and all cause mortality, cardiovascular disease (CVD) and associated mortality, coronary heart disease (CHD) and associated mortality, ischemic stroke, and type 2 diabetes. Systematic review and meta-analysis. Medline, Embase, Cochrane Central Registry of Controlled Trials, Evidence-Based Medicine Reviews, and CINAHL from inception to 1 May 2015, supplemented by bibliographies of retrieved articles and previous reviews. Observational studies reporting associations of saturated fat and/or trans unsaturated fat (total, industrially manufactured, or from ruminant animals) with all cause mortality, CHD/CVD mortality, total CHD, ischemic stroke, or type 2 diabetes. Two reviewers independently extracted data and assessed study risks of bias. Multivariable relative risks were pooled. Heterogeneity was assessed and quantified. Potential publication bias was assessed and subgroup analyses were undertaken. The GRADE approach was used to evaluate quality of evidence and certainty of conclusions. For saturated fat, three to 12 prospective cohort studies for each association were pooled (five to 17 comparisons with 90 501-339 090 participants). Saturated fat intake was not associated with all cause mortality (relative risk 0.99, 95% confidence interval 0.91 to 1.09), CVD mortality (0.97, 0.84 to 1.12), total CHD (1.06, 0.95 to 1.17), ischemic stroke (1.02, 0.90 to 1.15), or type 2 diabetes (0.95, 0.88 to 1.03). There was no convincing lack of association between saturated fat and CHD mortality (1.15, 0.97 to 1.36; P=0.10). For trans fats, one to six prospective cohort studies for each association were pooled (two to seven comparisons with 12 942-230 135 participants). Total trans fat intake was associated with all cause mortality (1.34, 1.16 to 1.56), CHD mortality (1.28, 1.09 to 1.50), and total CHD (1.21, 1.10 to 1.33) but not ischemic stroke (1.07, 0.88 to 1.28) or type 2 diabetes (1.10, 0.95 to 1.27). Industrial, but not ruminant, trans fats were associated with CHD mortality (1.18 (1.04 to 1.33) v 1.01 (0.71 to 1.43)) and CHD (1.42 (1.05 to 1.92) v 0.93 (0.73 to 1.18)). Ruminant trans-palmitoleic acid was inversely associated with type 2 diabetes (0.58, 0.46 to 0.74). The certainty of associations between saturated fat and all outcomes was "very low." The certainty of associations of trans fat with CHD outcomes was "moderate" and "very low" to "low" for other associations. Saturated fats are not associated with all cause mortality, CVD, CHD, ischemic stroke, or type 2 diabetes, but the evidence is heterogeneous with methodological limitations. Trans fats are associated with all cause mortality, total CHD, and CHD mortality, probably because of higher levels of intake of industrial trans fats than ruminant trans fats. Dietary guidelines must carefully consider the health effects of recommendations for alternative macronutrients to replace trans fats and saturated fats.

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Mendeley readers

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Geographical breakdown

Country Count As %
United Kingdom 5 2%
United States 5 2%
Brazil 3 1%
Spain 3 1%
Australia 2 <1%
Netherlands 2 <1%
Indonesia 1 <1%
Poland 1 <1%
Finland 1 <1%
Other 6 2%
Unknown 260 90%

Demographic breakdown

Readers by professional status Count As %
Student > Master 62 21%
Student > Bachelor 49 17%
Researcher 45 16%
Student > Ph. D. Student 36 12%
Other 25 9%
Other 72 25%
Readers by discipline Count As %
Medicine and Dentistry 140 48%
Agricultural and Biological Sciences 72 25%
Nursing and Health Professions 20 7%
Biochemistry, Genetics and Molecular Biology 12 4%
Chemistry 9 3%
Other 36 12%

Attention Score in Context

This research output has an Altmetric Attention Score of 1256. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 March 2017.
All research outputs
#788
of 7,430,338 outputs
Outputs from British Medical Journal
#29
of 31,624 outputs
Outputs of similar age
#25
of 225,253 outputs
Outputs of similar age from British Medical Journal
#3
of 920 outputs
Altmetric has tracked 7,430,338 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 31,624 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.9. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 225,253 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 920 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 99% of its contemporaries.