Adv Nutr. 2026 Oct 7:100746. doi: 10.1016/j.advnut.2026.100746. Online ahead of print.
ABSTRACT
The recommendation to limit intake of saturated fatty acids (SFA) remains part of dietary guidelines issued by numerous national and international organizations. We performed a search of previous systematic reviews and meta-analyses on the relationship between SFA intake and cardiovascular disease (CVD) incidence and mortality, including coronary heart disease (CHD) and stroke, and total mortality. We screened 3285 records and included 31 publications (32 systematic reviews/meta-analyses: 23 observational and 9 RCT-based) published between 2001 and 2025. The duration of primary studies ranged from 0.4 to 32 years. The number of assessments included 34 of disease incidence, 39 of mortality, and 2 of composite cardiac endpoints. Most systematic reviews and meta-analyses found no significant relationship between intake of SFA and CVD outcomes. Two found a harmful effect (1 each for CHD and peripheral artery disease), whereas 3 found a beneficial effect (all on stroke in East Asian cohorts). Several others showed mixed results: six observational modeling studies suggested harm with SFA vs. polyunsaturated fatty acids (PUFA) for CVD incidence or mortality, while two RCT-based reviews found increased CVD incidence but no effect on mortality. We conclude that the currently available evidence does not demonstrate a consistent association between dietary SFA intake and cardiovascular events or mortality. Replacing SFA with PUFA appears to be associated with favorable cardiovascular outcomes in observational and well-conducted short-duration clinical research studies. Overall, these findings suggest that recommendations on SFA intake may be more effective when considered within the broader context of dietary patterns rather than replacement of single nutrients.
PMID:42843567 | DOI:10.1016/j.advnut.2026.100746