Editor—The finding of He et al that intake of total fat, cholesterol, or specific types of fat are not associated with stroke does not surprise those who have followed the scientific literature about the diet-heart idea from the very beginning.1 What surprises me is their statement that there is strong evidence that type of dietary fat predicts risk of coronary heart disease.
Except for trans fat there is no such evidence at all. In a review2 of the relevant ecological, dynamic population, cross sectional, case-control, and cohort studies almost all of them were inconclusive or, most often, contradictive, and in two meta-analyses of the dietary trials2-4 the number of deaths in treatment and control groups were identical.
There is no support either from the study used as evidence by He et al because the weak association found between intake of saturated fat and coronary heart disease in that study disappeared after adjustment for other risk factors.5
Competing interests: None declared.
References
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