BHF joins calls for caution on controversial back-to-the-80s fat study

The focus of a controversial review on randomised control trials ‘oversimplifies the difficult and complex task of developing evidence-based guidelines on nutrition’, the British Heart Foundation (BHF) has warned. 

The meta-analysis of the evidence available at the time of the UK’s 1983 and 1977 US guidelines, which recommended the public limit its overall fat consumption to 30% of total energy intake of which no more than 10% should be saturated fat, claimed these recommendations "should not have been introduced" due to a lack of solid supporting evidence. 

Yet the BHF has urged caution, saying the review published in the BMJ journal Open Heart only showed part of the health picture. 

BHF senior dietitian Victoria Taylor joined other critics who said the review design meant its findings and implications were limited. “Understanding the true relationship between diet and our health is not simple. Unlike drug trials, studies on diet and disease are difficult to conduct. It would be all but impossible to carry out a research trial where you controlled the diets of thousands of people over many years. That’s why guidance in the UK is based on a consensus of the evidence available not just on randomised controlled trials.” 

Talking withFoodNavigator, heart health dietitian for the BHF Tracy Parker told us the UK organisation had been “a bit disappointed” with the results. 

“We don’t think the guidance needs to change. We need to make sure people are on the right track.” 

Impacting guidelines and public opinion 

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She said it was unlikely that we would see changes to the guidance as a result of these findings, meaning the impact for the general public in this sense would be limited. However she added it was “unhelpful” in making sure the right message got across, particularly when considering the growing concern around obesity and cardiovascular disease. 

“The public will thinking will be: ‘What should we be doing?’” 

The BHF said it would be standing firm on its recommendation of switching saturated for unsaturated fat, in line with Mediterranean-style diets and research around the impact of saturated fat on cholesterol levels. 

What’s the bigger picture?

Taylor added that there was a danger of too much focus being put on individual components of the diet. 

When so much attention is placed on the role of fats in our diet it’s vital we remember that dietary advice on preventing and managing coronary heart disease doesn’t begin and end with it. 

“Coronary heart disease is a multifactorial condition and no single food or nutrient is solely responsible for addressing our risk through diet. As well as the fats we eat we also need to pay attention to our diet as a whole and the balance of foods within it.” 

Parker added that debate around guidelines was healthy and this helped them clarify what their message was. 

“Science is up for debate and discussion, but at the moment there will be no change to guidance.” 

She said it was important to remember that guidance was just that, and that “we’ve got to start from somewhere”.