Chapter 5 – A systematic review of the epidemiological evidence available at the time of the introduction of dietary fat recommendations

Introduction

Chapters Three and Four respectively reviewed the randomised controlled trial (RCT) evidence available at the time dietary fat guidelines were introduced and currently available. This chapter will report on a systematic review to assess if the published epidemiological evidence available to the dietary committees supported their recommendations on dietary fat.

While the UK nutritional guidelines [16] made reference to epidemiological studies, the US committee document [15] did not. The UK guidelines referenced the Seven countries Study [20]. The UK document also referenced studies in Framingham, Hawaii/Honolulu, London and Puerto Rico [21-23].

In this chapter, the hypothesis that the epidemiological evidence available to the US and UK committees endorsed their recommendations to reduce dietary fat intake to 30% of total calories and saturated fat intake to 10% of total calories, with the intention of reducing CHD mortality, will be tested.

Methods

Pre­ferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) is the Cochrane methodology for systematic review and meta-analysis of randomised controlled trials (RCTs) [3]. The best-practice methodology for systematic review and meta-analysis of observational studies is Meta-analysis Of Observational Studies in Epidemiology methodology (MOOSE) [8]. MOOSE is the methodology used in this chapter. MOOSE builds upon the Pre­ferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology and uses parts of PRISMA as appropriate, for example the figure for presenting search methodology [3].

 

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