Tropical Oil Consumption and Cardiovascular Disease: An Umbrella Review of Systematic Reviews and Meta Analyses

The health effects of saturated fat, particularly tropical oil, on cardiovascular disease are unclear. We investigated the effect of tropical oil (palm and coconut oils), lard, and other common vegetable oils (soybean and rice bran oils) that are widely used in tropical and Asian countries on lipid profiles. We performed an umbrella review of meta-analyses and systematic reviews. Electronic databases (Medline, Scopus, Embase, and Cochrane) were searched up to December 2018 without language restriction. We identified nine meta-analyses that investigated the effect of dietary oils on lipid levels. Replacement of polyunsaturated fatty-acid-rich oils (PUFAs) and monounsaturated FA-rich oils (MUFAs) with palm oil significantly increased low-density lipoprotein cholesterol (LDL-c), by 3.43 (0.44–6.41) mg/dL and 9.18 (6.90–11.45) mg/dL, respectively, and high-density lipoprotein cholesterol (HDL-c), by 1.89 (1.23–2.55) mg/dL and 0.94 (−0.07–1.97) mg/dL, respectively. Replacement of PUFAs with coconut oil significantly increased HDL-c and total cholesterol –by 2.27 (0.93–3.6) mg/dL and 5.88 (0.21–11.55) mg/dL, respectively—but not LDL-c. Substituting lard for MUFAs and PUFAs increased LDL-c–by 8.39 (2.83–13.95) mg/dL and 9.85 (6.06–13.65) mg/dL, respectively—but not HDL-c. Soybean oil substituted for other PUFAs had no effect on lipid levels, while rice bran oil substitution decreased LDL-c. Our findings show the deleterious effect of saturated fats from animal sources on lipid profiles. Replacement of unsaturated plant-derived fats with plant-derived saturated fats slightly increases LDL-c but also increases HDL-c, which in turn may exert a neutral effect on cardiovascular health.

[1]  A. Hoes,et al.  Update on cardiovascular prevention in clinical practice: A position paper of the European Association of Preventive Cardiology of the European Society of Cardiology* , 2019, European journal of preventive cardiology.

[2]  A. Khera,et al.  2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. , 2019, Journal of the American College of Cardiology.

[3]  S. Faghih,et al.  Comparison of blood lipid-lowering effects of olive oil and other plant oils: A systematic review and meta‐analysis of 27 randomized placebo‐controlled clinical trials , 2019, Critical reviews in food science and nutrition.

[4]  Wenqiao Wang,et al.  Plant-sourced and animal-sourced monounsaturated fatty acid intakes in relation to mortality: a prospective nationwide cohort study , 2019, European Journal of Nutrition.

[5]  W. Willett,et al.  Associations of Monounsaturated Fatty Acids From Plant and Animal Sources With Total and Cause-Specific Mortality in Two US Prospective Cohort Studies , 2019, Circulation research.

[6]  A. Bumrungpert,et al.  Rice Bran Oil Containing Gamma-Oryzanol Improves Lipid Profiles and Antioxidant Status in Hyperlipidemic Subjects: A Randomized Double-Blind Controlled Trial. , 2019, Journal of alternative and complementary medicine.

[7]  Mohammad Hossein Khosravi,et al.  Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017 , 2018, Lancet.

[8]  Mohammad Hosein Farzaei,et al.  Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 , 2018, Lancet.

[9]  S. Faghih,et al.  Effects of Canola Oil Consumption on Lipid Profile: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials , 2018, Journal of the American College of Nutrition.

[10]  P. Barbillon,et al.  Patterns of plant and animal protein intake are strongly associated with cardiovascular mortality: the Adventist Health Study-2 cohort. , 2018, International journal of epidemiology.

[11]  M. Garg,et al.  Differential effects of medium- and long-chain saturated fatty acids on blood lipid profile: a systematic review and meta-analysis. , 2018, The American journal of clinical nutrition.

[12]  H. Boeing,et al.  Effects of oils and solid fats on blood lipids: a systematic review and network meta-analysis[S] , 2018, Journal of Lipid Research.

[13]  S. Khan,et al.  Trends in Obesity and Risk of Cardiovascular Disease , 2018, Current Epidemiology Reports.

[14]  R. Mensink,et al.  Fats in Foods: Current Evidence for Dietary Advice , 2018, Annals of Nutrition and Metabolism.

[15]  W. Willett,et al.  Monounsaturated fats from plant and animal sources in relation to risk of coronary heart disease among US men and women. , 2018, The American journal of clinical nutrition.

[16]  Azizan Ali,et al.  Systematic review of palm oil consumption and the risk of cardiovascular disease , 2018, PloS one.

[17]  P. Tugwell,et al.  AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both , 2017, British Medical Journal.

[18]  Steven Hamley The effect of replacing saturated fat with mostly n-6 polyunsaturated fat on coronary heart disease: a meta-analysis of randomised controlled trials , 2017, Nutrition Journal.

[19]  Mingyang Song,et al.  Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality. , 2016, JAMA internal medicine.

[20]  H. Szajewska,et al.  Saturated Fat Controversy: Importance of Systematic Reviews and Meta-analyses , 2016, Critical reviews in food science and nutrition.

[21]  Matilda Steiner-Asiedu,et al.  Coconut oil and palm oil's role in nutrition, health and national development: A review. , 2016, Ghana medical journal.

[22]  F. Siassi,et al.  Rice Bran Oil Decreases Total and LDL Cholesterol in Humans: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials , 2016, Hormone and Metabolic Research.

[23]  R. Mensink,et al.  Role of cis-Monounsaturated Fatty Acids in the Prevention of Coronary Heart Disease , 2016, Current Atherosclerosis Reports.

[24]  M. Eyres,et al.  Coconut oil consumption and cardiovascular risk factors in humans. , 2016, Nutrition reviews.

[25]  Hanan Khalil,et al.  Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach , 2015, International journal of evidence-based healthcare.

[26]  R. V. van Dam,et al.  Palm Oil Consumption Increases LDL Cholesterol Compared with Vegetable Oils Low in Saturated Fat in a Meta-Analysis of Clinical Trials. , 2015, The Journal of nutrition.

[27]  D. Mozaffarian,et al.  The 2015 US Dietary Guidelines: Lifting the Ban on Total Dietary Fat. , 2015, JAMA.

[28]  Jiri Mlcek,et al.  Fatty Acids Composition of Vegetable Oils and Its Contribution to Dietary Energy Intake and Dependence of Cardiovascular Mortality on Dietary Intake of Fatty Acids , 2015, International journal of molecular sciences.

[29]  C. Bosetti,et al.  Palm oil and blood lipid-related markers of cardiovascular disease: a systematic review and meta-analysis of dietary intervention trials. , 2014, The American journal of clinical nutrition.

[30]  Nathan D. Wong,et al.  Epidemiological studies of CHD and the evolution of preventive cardiology , 2014, Nature Reviews Cardiology.

[31]  D. Pieper,et al.  Systematic review finds overlapping reviews were not mentioned in every other overview. , 2014, Journal of clinical epidemiology.

[32]  G. N. Gabrial,et al.  Rice Bran Oil Compared to Atorvastatin for Treatment of Dyslipidemia in Patients with Type 2 Diabetes , 2014 .

[33]  F. Obahiagbon A Review: Aspects of the African Oil Palm (Elaeis guineesis jacq.) and the Implications of its Bioactives in Human Health , 2012 .

[34]  J. Farquhar,et al.  Multi-Country analysis of palm oil consumption and cardiovascular disease mortality for countries at different stages of economic development: 1980-1997 , 2011, Globalization and health.

[35]  F. Hu,et al.  Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. , 2010, The American journal of clinical nutrition.

[36]  John P.A. Ioannidis,et al.  Integration of evidence from multiple meta-analyses: a primer on umbrella reviews, treatment networks and multiple treatments meta-analyses , 2009, Canadian Medical Association Journal.

[37]  J. Harland An assessment of the economic and heart health benefits of replacing saturated fat in the diet with monounsaturates in the form of rapeseed (canola) oil , 2009 .

[38]  C. Skeaff,et al.  Approaches to removing trans fats from the food supply in industrialized and developing countries , 2009, European Journal of Clinical Nutrition.

[39]  D. Mozaffarian,et al.  Quantitative effects on cardiovascular risk factors and coronary heart disease risk of replacing partially hydrogenated vegetable oils with other fats and oils , 2009, European Journal of Clinical Nutrition.

[40]  T. Sanders,et al.  The solid fat content of stearic acid-rich fats determines their postprandial effects. , 2007, The American journal of clinical nutrition.

[41]  C. Juliano,et al.  Antioxidant activity of gamma-oryzanol: mechanism of action and its effect on oxidative stability of pharmaceutical oils. , 2005, International journal of pharmaceutics.

[42]  T. Sanders,et al.  Influence of triacylglycerol structure of stearic acid-rich fats on postprandial lipaemia , 2005, Proceedings of the Nutrition Society.

[43]  S. Yusuf,et al.  Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study , 2004, The Lancet.

[44]  D. Altman,et al.  Measuring inconsistency in meta-analyses , 2003, BMJ : British Medical Journal.

[45]  P. Kris-Etherton,et al.  Individual fatty acid effects on plasma lipids and lipoproteins: human studies. , 1997, The American journal of clinical nutrition.

[46]  U. Bracco Effect of triglyceride structure on fat absorption. , 1994, The American journal of clinical nutrition.

[47]  J. Ordovás,et al.  Rice bran oil consumption and plasma lipid levels in moderately hypercholesterolemic humans. , 1994, Arteriosclerosis and thrombosis : a journal of vascular biology.

[48]  M. Katan,et al.  Impact of myristic acid versus palmitic acid on serum lipid and lipoprotein levels in healthy women and men. , 1994, Arteriosclerosis and thrombosis : a journal of vascular biology.

[49]  C. Salmond,et al.  Cholesterol, coconuts, and diet on Polynesian atolls: a natural experiment: the Pukapuka and Tokelau island studies. , 1981, The American journal of clinical nutrition.

[50]  S. McGuire,et al.  Scientific Report of the 2015 Dietary Guidelines Advisory Committee. Washington, DC: US Departments of Agriculture and Health and Human Services, 2015. , 2016, Advances in nutrition.