Skip to main content
Log in

Can dietary saturated fat be beneficial in prevention of stroke risk? A meta-analysis

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

We conducted a meta-analysis to summarize available evidence regarding the relation between saturated fatty acid (SFA) intake and stroke risk. We searched multiple electronic databases through February 2016. Log relative risks (RRs) with 95 % confidence intervals (CIs) of the highest versus the lowest for cohort studies were weighed by the inverse variance method to obtain combined RRs. 15 prospective studies including 476,569 individuals and 11,074 strokes were included. Higher SFA intake was associated with reduced overall stroke risk [RR = 0.89 (95 % CI 0.82–0.96)] and fatal stroke risk [RR = 0.75 (95 % CI 0.59–0.94)]. Subgroup analysis indicated that higher SFA intake was associated with reduced stroke risks for East-Asians [RR = 0.79 (95 % CI 0.69–0.90)], for dose <25 g/day [RR = 0.81 (95 % CI 0.71–0.92)], for males [RR = 0.85 (95 % CI 0.75–0.96)], and for individuals with body mass index (BMI) <24 [RR = 0.75 (95 % CI 0.65–0.87)], but not for non East-Asians, females, and individuals with dose ≥25 g/day and BMI ≥24. This meta-analysis reveals that higher SFA intake is inversely associated with risk of stroke morbidity and mortality with race, sex, and BMI as key factors influencing this risk. There seems to be a threshold of SFA intake for inverse relation of SFA intake with stroke. However, the stroke-reducing or -increasing effects for specific subtypes and specific food sources of SFA can be concealed. Functions of specific subtypes of SFA (e.g. lignoceric acid) and specific food sources of SFA (i.e. plant vs. animal) in relation to stroke need to be clarified in further studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Chowdhury R, Warnakula S, Kunutsor S, Crowe F, Ward HA, Johnson L et al (2014) Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. Ann Intern Med 160(6):398–406

    Article  PubMed  Google Scholar 

  2. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM (2010) Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr 91(3):535–546

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Micha R, Mozaffarian D (2010) Saturated fat and cardiometabolic risk factors, coronary heart disease, stroke, and diabetes: a fresh look at the evidence. Lipids 45(10):893–905

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Yamagishi K, Iso H, Yatsuya H, Tanabe N, Date C, Kikuchi S et al (2010) Dietary intake of saturated fatty acids and mortality from cardiovascular disease in Japanese: the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC) Study. Am J Clin Nutr 92(4):759–765

    Article  CAS  PubMed  Google Scholar 

  5. Atkinson C, Whitley E, Ness A, Baker I (2011) Associations between types of dietary fat and fish intake and risk of stroke in the Caerphilly Prospective Study (CaPS). Public Health 125(6):345–348

    Article  CAS  PubMed  Google Scholar 

  6. Larsson SC, Virtamo J, Wolk A (2012) Dietary fats and dietary cholesterol and risk of stroke in women. Atherosclerosis 221(1):282–286

    Article  CAS  PubMed  Google Scholar 

  7. Wallstrom P, Sonestedt E, Hlebowicz J, Ericson U, Drake I, Persson M et al (2012) Dietary fiber and saturated fat intake associations with cardiovascular disease differ by sex in the Malmo Diet and Cancer Cohort: a prospective study. PLoS One 7(2):e31637. doi:10.1371/journal.pone.0031637

    Article  PubMed  PubMed Central  Google Scholar 

  8. Yaemsiri S, Sen S, Tinker L, Rosamond W, Wassertheil-Smoller S, He K (2012) Trans fat, aspirin, and ischemic stroke in postmenopausal women. Ann Neurol 72(5):704–715

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Yamagishi K, Iso H, Kokubo Y, Saito I, Yatsuya H, Ishihara J et al (2013) Dietary intake of saturated fatty acids and incident stroke and coronary heart disease in Japanese communities: the JPHC Study. Eur Heart J 34(16):1225–1232

    Article  CAS  PubMed  Google Scholar 

  10. de Souza RJ, Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T et al (2015) Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ 351:h3978

    Article  PubMed  PubMed Central  Google Scholar 

  11. Stang A (2010) Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25(9):603–605

    Article  PubMed  Google Scholar 

  12. Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21(11):1539–1558

    Article  PubMed  Google Scholar 

  13. Mcgee DL, Reed DM, Yano K, Kagan A, Tillotson J (1984) Ten-year incidence of coronary heart disease in the honolulu heart program relationship to nutrient intake. Am J Epidemiol 119(5):667–676

    CAS  PubMed  Google Scholar 

  14. Goldbourt U, Yaari S, Medalie JH (1993) Factors predictive of long-term coronary heart disease mortality among 10,059 male Israeli civil servants and municipal employees. Cardiology 82(2–3):100–121

    Article  CAS  PubMed  Google Scholar 

  15. Gillman MW, Cupples LA, Millen BE, Ellison RC, Wolf PA (1997) Inverse association of dietary fat with development of ischemic stroke in men. JAMA 278(24):2145–2150

    Article  CAS  PubMed  Google Scholar 

  16. Seino F, Date C, Nakayama T, Yoshiike N, Yokoyama T, Yamaguchi M et al (1997) Dietary lipids and incidence of cerebral infarction in a Japanese rural community. J Nutr Sci Vitaminol (Tokyo) 43(1):83–99

    Article  CAS  Google Scholar 

  17. Iso H, Stampfer MJ, Manson JE, Rexrode K, Hu F, Hennekens CH et al (2001) Prospective study of fat and protein intake and risk of intraparenchymal hemorrhage in women. Circulation 103(6):856–863

    Article  CAS  PubMed  Google Scholar 

  18. He K, Merchant A, Rimm EB, Rosner BA, Stampfer MJ, Willett WC et al (2003) Dietary fat intake and risk of stroke in male US healthcare professionals: 14 year prospective cohort study. BMJ 327(7418):777–782

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Iso H, Sato S, Kitamura A, Naito Y, Shimamoto T, Komachi Y (2003) Fat and protein intakes and risk of intraparenchymal hemorrhage among middle-aged Japanese. Am J Epidemiol 157(1):32–39

    Article  PubMed  Google Scholar 

  20. Sauvaget C, Nagano J, Hayashi M, Yamada M (2004) Animal protein, animal fat, and cholesterol intakes and risk of cerebral infarction mortality in the adult health study. Stroke 35(7):1531–1537

    Article  CAS  PubMed  Google Scholar 

  21. Misirli G, Benetou V, Lagiou P, Bamia C, Trichopoulos D, Trichopoulou A (2012) Relation of the traditional Mediterranean diet to cerebrovascular disease in a Mediterranean population. Am J Epidemiol 176(12):1185–1192

    Article  PubMed  Google Scholar 

  22. Leosdottir M, Nilsson PM, Nilsson J-Å, Berglund G (2007) Cardiovascular event risk in relation to dietary fat intake in middle-aged individuals: data from The Malmö Diet and Cancer Study. Eur J Cardiovasc Prev Rehabil 14(5):701–706

    Article  PubMed  Google Scholar 

  23. Labreuche J, Deplanque D, Touboul P-J, Bruckert E, Amarenco P (2010) Association between change in plasma triglyceride levels and risk of stroke and carotid atherosclerosis: systematic review and meta-regression analysis. Atherosclerosis 212(1):9–15

    Article  CAS  PubMed  Google Scholar 

  24. Sacco RL, Benson RT, Kargman DE, Boden-Albala B, Tuck C, Lin I-F et al (2001) High-density lipoprotein cholesterol and ischemic stroke in the elderly: the Northern Manhattan Stroke Study. JAMA 285(21):2729–2735

    Article  CAS  PubMed  Google Scholar 

  25. Forouhi NG, Koulman A, Sharp SJ, Imamura F, Kröger J, Schulze MB et al (2014) Differences in the prospective association between individual plasma phospholipid saturated fatty acids and incident type 2 diabetes: the EPIC-InterAct case-cohort study. Lancet Diabetes Endo 2(10):810–818

    Article  CAS  Google Scholar 

  26. Lemaitre RN, Fretts AM, Sitlani CM, Biggs ML, Mukamal K, King IB et al (2015) Plasma phospholipid very-long-chain saturated fatty acids and incident diabetes in older adults: the Cardiovascular Health Study. Am J Clin Nutr 101(5):1047–1054

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Malik VS, Chiuve SE, Campos H, Rimm EB, Mozaffarian D, Hu FB et al (2015) Circulating very-long chain saturated fatty acids and incident coronary heart disease in US men and women. Circulation 132(4):260–268. doi:10.1161/CIRCULATIONAHA.114.014911

    Article  CAS  PubMed  Google Scholar 

  28. Fretts AM, Mozaffarian D, Siscovick DS, Djousse L, Heckbert SR, King IB et al (2014) Plasma phospholipid saturated fatty acids and incident atrial fibrillation: the Cardiovascular Health Study. J Am Heart Assoc 3(3):e000889

    Article  PubMed  PubMed Central  Google Scholar 

  29. Jakobsson A, Westerberg R, Jacobsson A (2006) Fatty acid elongases in mammals: their regulation and roles in metabolism. Prog Lipid Res 45(3):237–249

    Article  CAS  PubMed  Google Scholar 

  30. Guillou H, Zadravec D, Martin PG, Jacobsson A (2010) The key roles of elongases and desaturases in mammalian fatty acid metabolism: insights from transgenic mice. Prog Lipid Res 49(2):186–199

    Article  CAS  PubMed  Google Scholar 

  31. Garg ML, Blake RJ, Wills RB (2003) Macadamia nut consumption lowers plasma total and LDL cholesterol levels in hypercholesterolemic men. J Nutr 133(4):1060–1063

    CAS  PubMed  Google Scholar 

  32. Lam C, Wong D, Cederbaum S, Lim B, Qu Y (2012) Peanut consumption increases levels of plasma very long chain fatty acids in humans. Mol Genet Metab 107(3):620–622

    Article  CAS  PubMed  Google Scholar 

  33. Zhang Z, Xu G, Wei Y, Zhu W, Liu X (2015) Nut consumption and risk of stroke. Eur J Epidemiol 30(3):189–196

    Article  CAS  PubMed  Google Scholar 

  34. Kihara A (2012) Very long-chain fatty acids: elongation, physiology and related disorders. J Biochem 152(5):387–395

    Article  CAS  PubMed  Google Scholar 

  35. Yamazaki Y, Kondo K, Maeba R, Nishimukai M, Nezu T, Hara H (2014) The proportion of nervonic acid in serum lipids is associated with serum plasmalogen levels and metabolic syndrome. J Oleo Sci 63(5):527–537

    Article  CAS  PubMed  Google Scholar 

  36. Kromhout D, Menotti A, Bloemberg B, Aravanis C, Blackburn H, Buzina R et al (1995) Dietary saturated and transfatty acids and cholesterol and 25-year mortality from coronary heart disease: the seven countries study. Prev Med 24(3):308–315

    Article  CAS  PubMed  Google Scholar 

  37. Petrea RE, Beiser AS, Seshadri S, Kelly-Hayes M, Kase CS, Wolf PA (2009) Gender differences in stroke incidence and poststroke disability in the Framingham heart study. Stroke 40(4):1032–1037

    Article  PubMed  PubMed Central  Google Scholar 

  38. Strazzullo P, D’Elia L, Cairella G, Garbagnati F, Cappuccio FP, Scalfi L (2010) Excess body weight and incidence of stroke meta-analysis of prospective studies with 2 million participants. Stroke 41(5):e418–e426

    Article  PubMed  Google Scholar 

  39. Choo V (2002) WHO reassesses appropriate body-mass index for Asian populations. Lancet 360(9328):235

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by the National Natural Science Foundation of China (Grant no. 31300881).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Pengfei Cheng.

Ethics declarations

Conflict of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cheng, P., Wang, J., Shao, W. et al. Can dietary saturated fat be beneficial in prevention of stroke risk? A meta-analysis. Neurol Sci 37, 1089–1098 (2016). https://doi.org/10.1007/s10072-016-2548-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-016-2548-3

Keywords

Navigation