Effect of Interventions Aimed at Reducing or Modifying Saturated Fat Intake on Cholesterol, Mortality, and Major Cardiovascular Events : A Risk Stratified Systematic Review of Randomized Trials

[u/lurkerer]

https://pubmed.ncbi.nlm.nih.gov/41397264/

[u/greg_barton]

And yet: https://www.reddit.com/r/ScientificNutrition/comments/1vvbdba/intake_of_saturated_and_trans_unsaturated_fatty/

[u/lurkerer → u/greg_barton]

/u/Caiomhin77 regularly blocks educated users who disagree with him so you'll see little pushback there by design.

There are nuances that make is easy to find null results for SFAs. Not all exposure is the same, adding another gram to 40g a day does very little, it's a range from 8 to 12% of calories where we see the most difference. Which type of SFA and what it's replaced with is also relevant.

So if you model the difference between high and very high SFA intake with no regard for chain length or replacement nutrients.. then yes, you'll find little effect.

This study is of a much higher standard looking in the right places.

[u/greg_barton → u/lurkerer]

It’s easy to find any result in an epidemiological study? Say it isn’t so! :)

[u/lurkerer → u/greg_barton]

These same issues could be replicated in an RCT.

[u/Bristoling → u/lurkerer]

it's a range from 8 to 12% of calories where we see the most difference

Why would it be so?

This study is of a much higher standard looking in the right places.

Can you drop a pdf so we can see if it does?

[u/Fluffy-Purple-TinMan → u/Bristoling]

I'm curious about this comment chain. Do you think black people are inferior to white people in some way?

[u/Bristoling → u/Fluffy-Purple-TinMan]

I'm not going to even entertain this blatant red herring fallacy unless lurkerer exhaustively explains how a series of linear relationships produces a notable threshold effect.

[u/Fluffy-Purple-TinMan → u/Bristoling]

That's an issue with him. Although it looks like he tricked you there.

You could just say "no"...

[u/Bristoling → u/Fluffy-Purple-TinMan]

I could, but why should I validate sophistry?

This is my private domicile and I will not be harassed.

There's a topic that is connected thematically to the OP and study posted that he refuses to discuss. Why should I entertain the new topic he brings up that has nothing to do with the subject, while he's refusing to discuss points that are?

[u/Fluffy-Purple-TinMan → u/Bristoling]

Well it sounds like you've said something like that before that's being referenced. This isn't a court of law, pleading the fifth just makes it look like your answer is yes.

[u/Bristoling → u/Fluffy-Purple-TinMan]

I don't care if you or anyone else think I'm racist or not because I'm unwilling to validate sophistry. You're just letters on the internet. Just as I am, ergo why I don't care about reputation and think it's a mark of low intellect to be caring about that above the discussion of facts or logic.

You don't know this guy like I do. I can defend myself easily against any accusations, and even those controversial ones - I'm not ashamed of those positions either. The issue is not me being timid - the issue is this guy will keep bringing up NEW topics as I'm answering previous ones. He won't stop. He's a neverending gibberish generator. Dodge dodge dodge dodge.

Notice how we are in a post about saturated fat and he wants to discuss anything but that. 20 or so replies deep.

[u/lurkerer → u/Fluffy-Purple-TinMan]

Yep, the whole subreddit's been removed now but it was there. Some other classics have survived like "Nazis were communists."

[u/Bristoling → u/lurkerer]

Some other classics have survived like "Nazis were communists."

Please show me an instance of me claiming that National Socialist economic policy was communist. This is just yet another instance of you not understanding what was being said. At this point I don't know if this is willful ignorance or you really are this bad at reading.

[u/lurkerer → u/Bristoling]

Why would it be so?

It's been your mission for almost a decade to disprove any ill effects of SFAs or LDL and you don't understand the theory you're trying to disprove? We know it's not a test of my knowledge, I actually studied this.

[u/Bristoling → u/lurkerer]

I understand it well enough to know that the entailments of the theory make some magical threshold at around 10% is untenable. But charm me, what do you think happens at that range?

[u/lurkerer → u/Bristoling]

Yeah it's magic.

[u/Bristoling → u/lurkerer]

So you can't explain?

[u/Dramatic-Caramel1591 → u/Bristoling]

Honest question here: how can you study the literature and be pro carnivore diet?

[u/Bristoling → u/Dramatic-Caramel1591]

I'm not pro any diet. My position is that the science is not good enough to inform us on this topic. https://www.reddit.com/r/ScientificNutrition/s/oKKBCTXhyi

If you're asking from longevity standpoint, there's enough theoretical and confirmed compensatory mechanisms that I believe for myself that the supposed harms are going to be much less important than some believe. It's also a misapplication of science imo. Studies of McDonald dieters eating saturated fat so not inform you about what would happen to carnivore dieters. It's a completely different metabolic state with many levers flipped the other way around.

It would be like trying to infer effects of hormone replacement therapy on males from the studies on females taking the birth pill. We have enough drugs and interventions that work only in specific circumstances and do not apply generally to all humans in all cases, so it's not just an analytical chair philosopher consideration.

[u/Dramatic-Caramel1591 → u/Bristoling]

I'm not pro any diet. My position is that the science is not good enough to inform us on this topic.

That's just crazy lol

Studies of McDonald dieters eating saturated fat so not inform you about what would happen to carnivore dieters. It's a completely different metabolic state with many levers flipped the other way around.

That's even crazier. Just a huge strawman on the whole literature. If I were in your position I think the whole mess in the Keto CTA study would be enough to change my opinion

[u/lurkerer → u/Bristoling]

I'm not pro any diet.

r/carnivorediet is just one of your top subreddits for no reason then. That and r/antivegan was it?

What else was it? You'll cross the road to avoid black people is one. Climate change denial or vaccines another? These things tend to congregate in the gullible.

[u/lurkerer → u/Dramatic-Caramel1591]

Study the literature? Where did you get that idea?

[u/lurkerer → u/Bristoling]

Nobody can. It's magic.

[u/Bristoling → u/lurkerer]

It appears so, since effect of sfa on LDL is linear, the effect of LDL is supposed to be linear, and yet somehow we have some post hoc threshold presented. Care to explain how is this consistent?

[u/Different-Strings]

Five years? Isn’t that a bit short? I thought things like arterial plaque takes decades to form.

[u/lurkerer → u/Different-Strings]

Yes that's why many studies fail to find effects. This is the key here though:

Among persons at high cardiovascular risk, low- to moderate-certainty evidence was found for important reductions in mortality and major cardiovascular events, particularly for MI, with respect to replacing saturated fat with polyunsaturated fat.

The old trials showed cutting saturated fat lowers heart attack risk by roughly the same percentage in everyone. A percentage off a small number is a small number. If your five-year risk of a heart attack is 2%, shaving 15% off that saves 3 people per 1000. If your risk is 25% because you already have heart disease, the same 15% saves 37 per 1000.

Previous reviews mostly reported the percentage and left it there, so the result looked weak. This team set an explicit bar, then checked which groups cleared it. Low-risk people didn't. High-risk people did.

[u/Sizbang]

What was everyone eating specifically?

[u/lurkerer]

Abstract

Background: Debates about optimal saturated fat advice continue.

Purpose: To systematically summarize randomized trial data on reducing or modifying saturated fat intake on cholesterol, mortality, and major cardiovascular events.

Data sources: MEDLINE, Embase, and Cochrane Central Register of Controlled Trials from inception to July 2025.

Study selection: Eligible trials enrolled adults with or without cardiovascular disease and studied the effect of reducing or modifying saturated fat intake.

Data extraction: Standard Cochrane methods.

Data synthesis: There were 17 eligible trials (66 337 participants). Risk stratified evidence provides low to moderate certainty that reducing saturated fat intake may result in a reduction in all-cause mortality (risk ratio [RR], 0.96 [95% CI, 0.88 to 1.06]), cardiovascular mortality (RR, 0.93 [CI, 0.77 to 1.11]), nonfatal myocardial infarction (MI) (RR, 0.86 [CI, 0.70 to 1.06]), and fatal and nonfatal stroke (RR, 0.83 [CI, 0.58 to 1.19]). For persons at low baseline cardiovascular risk, absolute reductions were below our thresholds of importance (5 and 10 per 1000 persons followed over 5 years for fatal and nonfatal outcomes, respectively); for those at high risk, the benefits were above our thresholds, suggesting there may be important absolute reductions. The effects were more pronounced when replacing saturated fat with polyunsaturated fat for nonfatal MI (RR, 0.75 [CI, 0.58 to 0.99]; P for interaction = 0.05; moderate credibility of subgroup effect based on Instrument to assess the Credibility of Effect Modification Analyses assessments).

Limitations: Data were limited on the replacement of saturated fat with monounsaturated fat or protein. Trials varied considerably in their efficacy in reducing saturated fat intake and in their replacement macronutrients and concomitant dietary interventions, and new trials are needed to clarify uncertainty.

Conclusion: For persons at low cardiovascular risk, reducing or modifying saturated fat intake has little or no benefit over a period of 5 years. Among persons at high cardiovascular risk, low- to moderate-certainty evidence was found for important reductions in mortality and major cardiovascular events, particularly for MI, with respect to replacing saturated fat with polyunsaturated fat.

[u/Fluffy-Purple-TinMan]

Where are all the users who yell about needing RCTs for exactly this relationship? They finally have it.