Low-Fat Diet: No Proof Of Positive Health Effects

Dr James J DiNicolantonio PharmD Ithaca, New York
MedicalResearch.com Interview with:

Dr James J DiNicolantonio PharmD
Ithaca, New York


MedicalResearch.com: What are the main findings of the study?

Dr. DiNicolantonio:  The increase in the prevalence of diabetes and obesity in the United States occurred with an increase in the consumption of carbohydrate not saturated fat.  There is no conclusive proof that a low-fat diet has any positive effects on health (good or bad).  The public fear that saturated fat raises cholesterol is completely unfounded as the low-density lipoprotein (LDL) particle size distribution is worsened when fat is replaced with carbohydrate. A public health campaign is drastically needed to educate on the harms of a diet high in carbohydrate/sugar.

The potential harms of replacing saturated fat with carbohydrates include,

  1. An increase in small, dense LDL particles.
  2. Shift to an overall atherogenic lipid profile (lower HDL-C, increase in triglycerides, and an increase in the ApoB/ApoA-1 ratio).
  3. Smaller improvements in glucose tolerance, body fatness, weight, inflammation, and thrombogenic markers, and
  4. Increased incidence of diabetes and obesity.The potential harms of replacing saturated fat with omega-6 polyunsaturated fat include:
  • Increased risk of cancer.
  • Increased risk of coronary heart disease, cardiovascular events, death due to heart disease and overall mortality.
  • Increased oxidized LDL-C, and
  • Reduction in HDL-C.Dietary Guideline recommendations suggesting the replacement of saturated fat with carbohydrates/omega-6 polyunsaturated fats do not reflect the current evidence in the literature.  A change in these recommendations is drastically needed as public health could be at risk.

MedicalResearch.com: Were any of the findings unexpected?

Dr. DiNicolantonio: The results were unexpected from the view that the literature does not match up with dietary guideline advice.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. DiNicolantonio: Patients and clinicians a like should not fall into the “trap” that saturated fat is harmful and that polyunsaturated (omega-6) fat/carbohydrate is a better alternative.  There is simply no proof to this notion.  Also, patients and clinicians alike should consider reducing their consumption of omega-6 polyunsaturated fats (particularly form processed vegetable oils such as corn and safflower), and especially avoid cooking with these oils as they are prone to oxidation, as well as sugar, high fructose corn syrup, refined carbohydrates and start eating real food.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. DiNicolantonio: More research should test specific foods against one another to determine health outcomes, after all, we eat food, not a single type of fat (i.e. saturated fat).


The cardiometabolic consequences of replacing saturated fats with carbohydrates or omega 6 polyunsaturated fats:  Do the dietary guidelines have it wrong?
James J DiNicolantonio

Open Heart 2014;1:1 e000032 doi:10.1136/openhrt-2013-000032


Last Updated on March 6, 2014 by Marie Benz MD FAAD