BMJ  2003;327:1348 (6 December), doi:10.1136/bmj.327.7427.1348-b

Letter

Dietary fat intake and risk of stroke

Allegations about dietary fat are unfounded

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 trials^2-4 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

Magle Stora Kyrkogata 9, S-22350 Lund, Sweden ravnskov{at}tele2.se

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Competing interests: None declared.

References

1. He K, Merchant A, Rimm EB, Rosner BA, Stampfer MJ, Willet WC, et al. Dietary fat intake and risk of stroke in male US healthcare professionals: 14 year prospective cohort study. BMJ 2003;327: 777-82. (4 October)[Abstract/Free Full Text]
2. Ravnskov U The questionable role of saturated and polyunsaturated fatty acids in cardiovascular disease. J Clin Epidemiol 1998;51: 443-60.[CrossRef][ISI][Medline]
3. Hooper L, Summerbell CD, Higgins JPT, Thompson RL, Capps NE, Davey Smith G, et al. Dietary fat intake and prevention of cardiovascular disease: systematic review. BMJ 2001;322: 757-63.[Abstract/Free Full Text]
4. Ravnskov U. Diet-heart disease hypothesis is wishful thinking. BMJ 2002;324: 238.[Free Full Text]
5. Hu FB, Stampfer MJ, Manson JE, Rimm E, Colditz GA, Rosner BA, et al. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 1997;337: 1491-9.[Abstract/Free Full Text]

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