Nonetheless, a summary evaluation of the epidemiologic evidence to date provides important information as to the basis for relating dietary saturated fat to CVD risk. However, such studies have caveats, including a reliance on nutritional assessment methods whose validity and reliability may vary ( 25), the assumption that diets remain similar over the long term ( 26) and variable adjustment for covariates by different investigators. Large prospective cohort studies can provide statistical power to adjust for covariates, thereby enabling the evaluation of the effects of a specific nutrient on disease risk. The goal of this study was to conduct a meta-analysis of well-designed prospective epidemiologic studies to estimate the risk of CHD and stroke and a composite risk score for both CHD and stroke, or total cardiovascular disease (CVD), that was associated with increased dietary intakes of saturated fat. The studies that showed beneficial effects of diets reduced in saturated fat replaced saturated fat with polyunsaturated fat, with the implication that the CVD benefit observed could have been due to an increase in polyunsaturated fat or in the ratio of polyunsaturated fat to saturated fat (P:S), a hypothesis supported by a recent pooling analysis conducted by Jakobsen et al ( 24). Whereas some studies have shown beneficial effects of reduced dietary saturated fat ( 19вЂ“ 21), others have shown no effects of such diets on CVD risk ( 22, 23). More recent epidemiologic studies have shown positive ( 4вЂ“ 10), inverse ( 11, 12), or no ( 4, 13вЂ“ 18) associations of dietary saturated fat with CVD morbidity and/or mortality.ДЄ limited number of randomized clinical interventions have been conducted that have evaluated the effects of saturated fat on risk of CVD. These findings were supported by associations in humans in which dietary saturated fat correlated with coronary heart disease (CHD) risk ( 2, 3). See corresponding editorial on page 497 INTRODUCTIONД®arly animal studies showed that high dietary saturated fat and cholesterol intakes led to increased plasma cholesterol concentrations as well as atherosclerotic lesions ( 1). More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat. Consideration of age, sex, and study quality did not change the results.Д¬onclusions: A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. Intake of saturated fat was not associated with an increased risk of CHD, stroke, or CVD. Results: During 5вЂ“23 y of follow-up of 347,747 subjects, 11,006 developed CHD or stroke. A random-effects model was used to derive composite relative risk estimates for CHD, stroke, and CVD. Objective: The objective of this meta-analysis was to summarize the evidence related to the association of dietary saturated fat with risk of coronary heart disease (CHD), stroke, and cardiovascular disease (CVD CHD inclusive of stroke) in prospective epidemiologic studies.Дesign: Twenty-one studies identified by searching MEDLINE and EMBASE databases and secondary referencing qualified for inclusion in this study. Background: A reduction in dietary saturated fat has generally been thought to improve cardiovascular health.

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