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Cardiovascular disease (CVD) remains the leading cause of death in the US and worldwide, despite evidence that it can be mitigated with simple dietary changes. Current health guidelines recommend a low-fat diet, containing less than 10 percent saturated fat, to reduce the risk of CVD, yet these dated recommendations have not been successful in reducing the risk of disease. In fact, recent large-scale studies conducted in North America and Europe have found no association, or even a lower associated disease risk, when examining the link between saturated fat intake and CVD.
One of these studies, the Prospective Urban Rural Epidemiology study, also known as PURE, investigated the association of fat and carbohydrate intake on CVD events, such as heart attack and stroke, and mortality. The PURE study included more than 135,000 people between the ages of 35 and 70 from 18 countries and followed them for an average of 7.4 years. Contrary to popular dietary advice, total fat intake was not associated with CVD events and mortality, and in fact, was associated with a lower risk of overall mortality; higher saturated fat intake in particular was associated with a lower risk of stroke. Additionally, higher carbohydrate intake was associated with an increased risk of death. The researchers wrote: “High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality… Global dietary guidelines should be reconsidered in light of these findings.”
Other recent research has highlighted the importance of the omega-3 fats EPA and DHA for reducing CVD. A meta-analysis published in the Journal of the American Heart Association, including 13 randomized controlled trials and more than 127,000 participants, examined the effects of omega-3 supplementation on CVD risk and events. The study found a statistically significant reduction for total CVD events for those taking omega-3 supplements. Additionally, the reduction of CVD events was dose-dependent, meaning those taking higher doses had the greatest benefit.
Finally, a 2020 study investigated the association of vitamin K status and CVD risk factors, including arterial stiffness, hypertension, obesity, and history of CVD. The study examined vitamin K-dependent proteins in 291 Danish adults and found that low vitamin K status was positively associated with CVD risk factors, supporting the importance of vitamin K intake in reducing CVD risk. Other research has shown that K2 in particular is associated with a decreased risk of coronary heart disease and all-cause mortality. Vascular calcification, a cause of cardiovascular disease and death, is an actively regulated process involving vitamin K-dependent proteins.
These recent studies provide new evidence that should help shape public health recommendations—especially dietary recommendations—to reduce CVD risk, including reducing carbohydrate intake and eating more fat, not less, to reduce the burden of CVD. Additionally, simple recommendations like taking a high-dose fish oil supplement and ensuring adequate vitamin K intake from diet and supplements are easy and affordable interventions that may be game changers for improving the health of our nation, and the world.