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expert reaction to final SACN report on the role of saturated fats and health

The report into saturated fats and health is published by the Scientific Advisory Committee on Nutrition (SACN). It makes the recommendation that saturated fat intake should be less than 10% of dietary energy intake.

 

Prof Christine Williams, Emeritus Professor Human Nutrition, University of Reading, said:

“The SACN recommendation that UK adults should continue to restrict saturated fats in their diets – and to replace saturated fats with unsaturated fats – is based on a rigorous review of the evidence.  The evidence is consistent in showing that the changes would reduce cholesterol levels in blood and risk of cardiovascular disease.  This report refutes recent claims that saturated fat is not harmful to health and outlines a number of simple changes that can be made to achieve further improvement in the UK diet.  The dietary changes the committee recommends, including using oils in place of butter, yogurt in place of cream, reducing red meat and eating more vegetables, pulses and nuts, are consistent with recommendations for other health outcomes e.g. some cancers.  Recent research showing that it is possible to replace saturated fat in dairy products with unsaturated fats will further reinforce the feasibility of achieving the desired targets for saturated fats.

“This is not a fad diet with a fancy name, but a diet that is feasible, reduces risk of premature ill health and contributes to a more sustainable environment.”

 

Tracy Parker, Senior Dietitian, British Heart Foundation, said:

“This report confirms the importance of following existing recommendations that we get no more than 10% of our food energy from saturated fat.

“Reducing saturated fat reduces the risk of a heart attack or stroke.  It also lowers the total, LDL and HDL cholesterol, and improves markers of blood glucose control.

“Avoiding foods high in saturated fat, such as butter, cheese and fatty meat, and eating more sources of unsaturated fat, such as oily fish, nuts and seeds, can help to lower cholesterol levels, a risk factor for heart and circulatory diseases.

“The review has some limits.  The report does not look at how specific foods, such as dairy, can affect your cholesterol levels.  This is an area that needs more clarity.

“This highlights that it is important to look at your diet as a whole, rather than eating specific foods or nutrients.  The Mediterranean-style diet can help keep your heart healthy and reduce the risk of you having a heart attack or stroke.  Our official dietary guidelines reflect this approach, so our advice hasn’t changed to recommend that you avoid fatty meat and instead choose low-fat dairy and foods containing unsaturated fats such as nuts, seeds and oily fish.”

 

Prof Tom Sanders, Professor emeritus of Nutrition and Dietetics, King’s College London, said:

“These guidelines are similar to the US guidelines.  It is well established that certain saturated fatty acids, but not all (notably stearic and short chain fatty acids are exceptions), have a modest effects raising low density lipoprotein cholesterol (LDL, or ‘bad’ cholesterol) compared with unsaturated fatty acids and carbohydrates.  The evidence for a lower risk of coronary heart disease is based on early trials where large amounts of saturated fats were mainly replaced with polyunsaturated fats.

“More recent data from prospective cohort studies show no direct relationship between saturated fatty acid intake and risk – however, both the intake as well as the proportion of polyunsaturated fatty acids seems to be associated with lower risk of cardiovascular disease.  It seems likely that is the combination of a high intake of saturated fatty acid with a low intake of polyunsaturated fatty acids (rather than a high intake of saturated fatty acids per se) that increases risk of heart disease.

“The simplistic view that the level of saturated fat in food is linked to CHD has been nuanced by new data, for example nuts and oily fish are high in saturated fat but associated with lower risk.

“Food labelling with regard to saturated fatty acids is currently confusing to the consumer with the healthier vegetable oils (olive oil, rapeseed oil), oily fish and nuts being labelled as high in saturated fatty acids.”

 

Prof Judith Buttriss, Director General, British Nutrition Foundation, said:

“There has been much debate on the health effects of saturated fat in recent years but the SACN report published today underlines that we have robust evidence to uphold existing recommendations to reduce intake (at a population level) to no more than 10% of our calorie intake.  What is really important when it comes to reducing saturated fat is what you eat instead.  We know from many studies that replacing saturated with unsaturated fat has a beneficial effect on blood cholesterol and risk of heart disease.  From a practical point of view, this needs to be considered in the context of the diet and lifestyle overall.  We know that healthy dietary patterns, such as the Mediterranean diet, are low in saturated fat but they are also low in added sugar and salt, high in fibre and provide plenty of fruit and vegetables, wholegrains, pulses and oily fish.  It’s our diet as a whole, in the context of a healthy lifestyle, that is likely to be most important in supporting good health.”

 

Prof Susan Jebb, Professor of Diet and Population Health, University of Oxford, said:

“This authoritative report updates and confirms evidence from other national and international expert groups which suggest that reducing saturated fat to less than 10% of dietary energy would lead to reductions in the incidence of heart disease.  The scope of the review was pre-published and the evidence has been systematically reviewed, there is no cherry-picking of evidence here.  The outstanding challenge is how do we help people to make this change?  And since people purchase and eat foods rather than nutrients, which foods should they eat less of?

“This is where the report is likely to be criticised because it has not considered the effects of specific types of saturated fatty acids; but this was not part of the scope of the report – which is already a huge piece of work.  Some experimental evidence, not reviewed here, has suggested that the saturated fatty acids in dairy have less effect on LDL cholesterol than some other saturated fatty acids.  However, even if this is the case, most of the clinical trials have included reductions in all the major sources of saturated fatty acids, including dairy.

“The fact is that if we are to succeed in reducing saturated fat intakes from current levels around 13.5% to 10% it is going to be extremely hard to do so without reducing saturated fat from dairy or meat.  Data from the National Diet and Nutrition Survey shows that milk and milk products provide between 20 and 30% (depending on age) of all the saturated fat in our diet.  Cereals and cereal products (biscuits, cakes, desserts, pastries etc.) between 20 and 30%.  Meat and meat products about 15-25%.  ‘Fat spreads’ (including butter, margarine etc.) about 10%.

“Dairy does contain important nutrients such as calcium, so swapping to a lower fat type of milk or from cream to yogurt is a relatively easy change that most people can make to reduce saturated fat without losing the healthy parts of dairy products.  Others will point to the nutritional value of meat.  While no-meat diets increase the risk of iron deficiency anaemia, it’s clear that they are associated with a lower risk of bowel cancer and heart disease.  By limiting meat to just small amounts we can balance the risks and benefits.  And a reduction in meat production and consumption is key to creating more sustainable diet that is healthier for the planet too.

“But it’s vital we don’t overlook one of the simplest messages from the report on which I hope everyone who cares about healthy food can agree.  We need to cut down our consumption of cakes, biscuits, pastries and desserts which account for a very large proportion of total saturated fat intake.  Doing so would also cut sugar and our total calorie intake bringing much wider health benefits.”

 

Prof Naveed Sattar, Professor of Metabolic Medicine, University of Glasgow, said:

“The saturated fat question continues to be debated and so it is nice to see an updated impartial and objective look at the best available evidence, including from randomised trials.  This is what the committee were tasked to do, never an easy task, but an important and painstakingly onerous one.

“That the evidence continues to suggest saturated fats increase cholesterol and the risk of heart disease remains clear, and there is no evidence for the opposite view.  For this reason, their recommendation to maintain the current advice to cut saturated intake to under 10% of total energy seems entirely sensible.

“The SACN report also helpfully suggests replacing foods rich in saturated fats with intake of foods richer in unsaturated fats, for which evidence suggests lower risks of heart disease.  This also seems sensible and fits with the evidence.

“Whilst some complain that some specific types of saturated fats might not be as harmful as others, there is negligible evidence to support this point of view and such commentators should push for further trials to test their hypothesis.  Without such evidence currently, the best advice to lessen health risks remains the same – cut intake of foods richer in saturated fats and replace with unsaturated foods or other healthier options.”

 

‘Saturated fats and health’ is published by SACN (the Scientific Advisory Committee on Nutrition):

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/814995/SACN_report_on_saturated_fat_and_health.pdf

https://www.gov.uk/government/publications/saturated-fats-and-health-sacn-report

https://www.gov.uk/government/news/reducing-saturated-fat-lowers-blood-cholesterol-and-risk-of-cvd

 

Declared interests

Prof Christine Williams: “Trustee of the BNF and Scottish Rural University College Boards; Chair World Cancer Research Fund Grant Panel.”

Prof Tom Sanders: “Honorary Nutritional Director of HEART UK.  Scientific Governor of the British Nutrition Foundation.  He is now emeritus but when he was doing research at King’s College London, the following applied: Tom does not hold any grants or have any consultancies with companies involved in the production or marketing of sugar-sweetened drinks.  In reference to previous funding to Tom’s institution: £4.5 million was donated to King’s College London by Tate & Lyle in 2006; this funding finished in 2011.  This money was given to the College and was in recognition of the discovery of the artificial sweetener sucralose by Prof Hough at the Queen Elizabeth College (QEC), which merged with King’s College London.  The Tate & Lyle grant paid for the Clinical Research Centre at St Thomas’ that is run by the Guy’s & St Thomas’ Trust, it was not used to fund research on sugar.  Tate & Lyle sold their sugar interests to American Sugar so the brand Tate & Lyle still exists but it is no longer linked to the company Tate & Lyle PLC, which gave the money to King’s College London in 2006.  Tom also used to work for Ajinomoto on aspartame about 8 years ago.  Tom was a member of the FAO/WHO Joint Expert Committee that recommended that trans fatty acids be removed from the human food chain.  Tom has previously acted as a member of the Global Dairy Platform Scientific Advisory Panel and Tom is a member of the Programme Advisory Committee of the Malaysian Palm Oil Board.  In the past Tom has acted as a consultant to Archer Daniel Midland Company and received honoraria for meetings sponsored by Unilever PLC.  Tom’s research on fats was funded by Public Health England/Food Standards Agency.”

Prof Judith Buttriss: “Professor Buttriss has been a member of UK government expert/advisory committees considering topics such as nutrient profiling, food based dietary guidelines and dietary surveys.  As Director General of the British Nutrition Foundation (BNF – a UK charity that engages with healthcare professionals, academics, schools, government, the food industry and the media), she provides advice on a variety of nutrition and food related matters to stakeholders across the nutrition sector, including a range of food/beverage companies (all fees are paid directly to BNF).  BNF’s funding comes from a variety of sources including EU projects; contracts with national government departments and agencies; conferences, publications and training; membership subscriptions; donations and project grants from food producers and manufacturers, retailers and food service companies; and funding from grant providing bodies, trusts and other charities.  BNF is not a lobbying organisation nor does it endorse any products or engage in food advertising campaigns.  More details about BNF’s work, funding and governance can be found at www.nutrition.org.uk/aboutbnf.”

Prof Susan Jebb: “My salary is paid by the University of Oxford with current research funding from the National Institute of Health Research, Wellcome Trust and the British Heart Foundation.  Susan Jebb joined the Scientific Advisory Committee on Nutrition in 2018 but was not part of the working group on saturated fat.  She is co-Director of the Livestock, Environment and People programme (www.leap.ox.ac.uk).”

Prof Naveed Sattar: “None.”

None others received.

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