The consumption of saturated fatty acids (SFAs) elevates the concentration of low-density lipoprotein (LDL) cholesterol in plasma and contributes to an increased risk of ischemic heart disease (IHD). Reducing the occurrence of atherogenic dyslipidemia (includes a higher content of small LDL particles, reduced HDL-C and increased triglycerides) can be achieved by lowering the consumption of carbohydrates in the diet or by weight loss while altering the content of total or saturated fat has only minimal effect.
A low-fat and high-carbohydrate diet results in reduced concentrations of LDL-C compared to a high-fat and low-carbohydrate diet, particularly in individuals with lipoprotein phenotype B. From what is mentioned above, it is not entirely clear which type of diet (whether one with low or with high content of carbohydrates) is of greater benefit in terms of cardiovascular risk.
Observational epidemiological and randomized controlled studies evaluating the incidence of IHD have contributed to the establishment of dietary guidelines focused on a controlled and restricted intake of SFAs in order to prevent IHD. Critically, it can be stated that evidence from cohort and randomized controlled studies has its limitations.