The impact of replacing saturated fatty acid intake by monounsaturated fatty acids, polyunsaturated fatty acids or carbohydrates on coronary heart disease (CHD) was investigated in 11 pooled prospective studies. For a 5% reduction of saturated fatty acids replaced by polyunsaturated fatty acids, the hazard ratio of coronary events was 0.87 (95% CI: 0.77-0.97). When replaced by carbohydrates, the hazard ratio was 1.07 (95% CI: 1.01-1.14) There was no relationship between monounsaturated fatty acids and CHD. Sex and age did not modify the associations. In his editorial, Martin B. Katan briefly summarized data from the study by Jakobsen et al. in light of previous publications. He particularly emphasized that the present study reinforces the dietary recommendation made by the American Heart Association 40 years ago to replace saturated fatty acids with polyunsaturated fatty acids.
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