The extended analysis of components of diet does not include saturated fat beyond its replacement by polyunsaturated fats. Ecological studies suggest that saturated fat intake is a significant risk factor for mortality from ischaemic heart disease.191 However, observational studies indicate that there might be no benefits if saturated fat reduction is associated with an increase in carbohydrates,91 which is also supported by the absence of benefits from a low fat diet in the Women’s Health Initiative.192 Together with data for seafood omega-3 fatty acids, these findings show the complexity of the relation between dietary fat and health and suggest that the traditional health education message focused on lowering saturated fat alone needs to be expanded greatly to encompass several other key components of diet, including increased consumption of healthy foods that are presently missing from most diets.
