a1 Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading, UK
a2 Institute for Cardiovascular and Metabolic Research (ICMR), University of Reading, Reading, UK
a3 Department of Mathematics and Statistics, University of Reading, Reading, UK
Vascular dysfunction is recognised as an integrative marker of CVD. While dietary strategies aimed at reducing CVD risk include reductions in the intake of SFA, there are currently no clear guidelines on what should replace SFA. The purpose of this review was to assess the evidence for the effects of total dietary fat and individual fatty acids (SFA, MUFA and n-6 PUFA) on vascular function, cellular microparticles and endothelial progenitor cells. Medline was systematically searched from 1966 until November 2010. A total of fifty-nine peer-reviewed publications (covering fifty-six studies), which included five epidemiological, eighteen dietary intervention and thirty-three test meal studies, were identified. The findings from the epidemiological studies were inconclusive. The limited data available from dietary intervention studies suggested a beneficial effect of low-fat diets on vascular reactivity, which was strongest when the comparator diet was high in SFA, with a modest improvement in measures of vascular reactivity when high-fat, MUFA-rich diets were compared with SFA-rich diets. There was consistent evidence from the test meal studies that high-fat meals have a detrimental effect on postprandial vascular function. However, the evidence for the comparative effects of test meals rich in MUFA or n-6 PUFA with SFA on postprandial vascular function was limited and inconclusive. The lack of studies with comparable within-study dietary fatty acid targets, a variety of different study designs and different methods for determining vascular function all confound any clear conclusions on the impact of dietary fat and individual fatty acids on vascular function.
(Received April 01 2011)
(Revised July 25 2011)
(Accepted July 25 2011)
(Online publication December 19 2011)
† Joint first authors.
Abbreviations: %E, percentage of energy; ALNA, α-linolenic acid; COMA, Committee on Medical Aspects of Food Policy; DVP, digital volume pulse; EDV, endothelium-dependent vasodilation; FBF, forearm blood flow; FMD, flow-mediated dilatation; LDI, laser Doppler imaging with iontophoresis; NDNS, National Diet and Nutrition Survey; PWA, pulse wave analysis; PWV, pulse wave velocity