Saturated fat, carbohydrates and cardiovascular disease.

The total body of evidence suggests that attention should be shifted from the harmful effects of dietary SAFA per se, to the prevention of the accumulation of SAFA in body lipids. This shift would emphasise the importance of reducing dietary CHO, especially CHO with a high glycaemic index, rather than reducing dietary SAFA.

The chronic interaction of SAFA with our immune system elicits so-called chronic systemic low-grade inflammation, which underlies the metabolic changes referred to as the (atherogenic) dyslipidaemia of the metabolic syndrome or the lipidaemia of sepsis. The ultimate goal of the ensuing insulin resistance is the re-allocation of energy-rich substrates, such as glucose, to the immune system while the change in our lipoprotein profile aims at the limitation of the inflammatory responses and the repair of the resulting tissue damage.

Dietary SAFA belong to the many false triggers of inflammation that result from the conflict between our slowly adapting genome and our rapidly changing lifestyle, but among these many factors they are not the most important.

A reduction in the consumption of CHO with a high glycaemic index, trans-fatty acids and linoleic acid, and an increased consumption of fish, vegetables and fruit, and a reduction of inactivity, sleep deprivation and chronic stress seem more realistic approaches to fight the current pandemic of cardiovascular disease resulting from chronic systemic low grade inflammation.

Graham

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