Guidelines Dietary - Eat For Health

3.1.2 The evidence for ‘limit intake of foods high in saturated fat’The early work on dietary fats and heart disease focused on the type of fat in the overall diet, with the fat beingcontributed by a wide range of foods. The evidence that replacing saturated fats with polyunsaturated fats affectsserum cholesterol levels has been accumulating for the last 60 years, 36,666 and the relationship has been confirmedin a recent review of human intervention trials and other studies. 94,667-670The intake of trans fats is low in Australia and consequently there is no specific recommendation to limit theirintake compared to current intake. 671 However, it is important to ensure that intake remains at its current low level.The evidence for associations between foods high in fat and the development of type 2 diabetes, hypertension,cancer and poor mental health has been reviewed in detail.The Guidelines recommend some caution in choosing foods high in fat (in particular saturated fat) because ofthe implications for weight management and cardiovascular disease risk. Fat-rich foods are energy (kilojoule)dense, heightening the risk of excess energy intake 672 as shown by dietary modelling. 9 Additionally, there is ampleevidence of the relationship between dietary patterns and disease risk at the population level. 94 Fat content is animportant component of dietary quality and it may be that the evidence for limiting saturated fat in the diet is bestconsidered from a whole-of-diet perspective, with additional reference to overall nutritional quality.Scientific evidence on the effect of dietary fat on health comes from studies that address dietary variables in anumber of ways. These include whole-of-diet studies examining the proportion of fat in the diet (relative to proteinand carbohydrate), the type of fat in the diet (relative to other types of fat), the effects of specific fatty acids inthe diet, and the effects of individual foods in which fat is a significant component. For example, studies couldexamine the effects of:• a low fat diet• a diet with a modified dietary fat ratio – for example, a high polyunsaturated:saturated fat ratio• a diet enriched with specific fatty acids (e.g. omega-3 fatty acids)• oils and fats (e.g. olive oil, spreads) in a defined dietary pattern.Methodological issues arise when considering the effects of fats and of dietary fat in the total diet. The difficultyin designing studies that address the effect of dietary fat on disease risk is reflected in several recent reviewson the topic. 94,667-670 It is important to note that inconsistency in results affects the strength of the evidencestatements below.Guideline 3Table 3.1: Evidence statements for ‘limit intake of foods high in saturated fat’Established evidenceSaturated fat is the strongest dietary determinant of plasma LDL concentration.Replacing saturated fat with polyunsaturated and monounsaturated fats is associated with improved blood lipids related tocardiovascular disease.Evidence statementHigher consumption of omega-3 LCPUFA fat (intake amount not specified) is associated with reduced risk of dementia.GradeCNotes: Grades – A: convincing association, B: probable association, C: suggestive associationIncludes evidence statements and gradings from the Evidence Report (literature from years 2002–2009). Does not include evidence fromother sources, such as the 2003 edition of the dietary guidelines (in which individual studies were classified according to their design aslevel I, II or III but overall grades for relationships were not derived), although these sources have been used to inform these Guidelines.Grade C evidence statements showing no association and all Grade D statements can be found in Appendix E.Limit intake of foods containing saturated fat, added salt, added sugars and alcoholNational Health and Medical Research Council69