As a case-study, the science on dietary fat and cardiovascular disease is complicated, therefore research communications and dietary recommendations should be made that accurately interpret the complexity of the evidence. Diabetes Care. In a recent analysis, Li, et al. The relationship was dose-responsive (Fig. For people with chronic Obarzanek E, et al. When all these lines of evidence are considered, the role of saturated fat in CHD is controversial, including among the writing group of the present manuscript. Decreasing consumption of sugar-sweetened beverages will help children and adolescents reduce their intake of added sugars and achieve a healthy dietary pattern. The new research suggests that rather than focusing on total carbohydrate, the guidance should be on specific foods: limiting foods rich in refined starch and sugars, while eating more of other carbohydrate-containing foods such as fruits, legumes, and fiber-rich whole grains. Low-fat dietary pattern and risk of colorectal cancer: the Women's Health Initiative randomized controlled dietary modification trial. Google Scholar. Food and Drug Administration. Accessed 21Aug 2017. 80 FR 34650-34670. Milk and dairy consumption and incidence of cardiovascular diseases and all-cause mortality: dose-response meta-analysis of prospective cohort studies. Report from the Commission to the European Parliament and the Council. 2015;131(4):e29322. The focus on reducing total fat resulted in increased consumption of refined carbohydrates and added sugars, and avoidance of nutrient-dense foods rich in healthy unsaturated fats such as nuts, seeds, avocados and vegetable oils. WebPeople with healthy eating patterns live longer and are at lower risk for serious health problems such as heart disease, type 2 diabetes, and obesity. Studies specifically modeling the comparison of saturated fat to total carbohydrate have shown saturated fat to have similar associations with cardiovascular risk compared to total carbohydrate [30, 31]. Google Scholar. It can account for the synergy and/or antagonism between various foods and beverages ( van Dam, 2005 ). U.S. Department of Health and Human Services and U.S. Department of Agriculture; 2015. Lancet Diabetes Endocrinol; 2015;3(8):5868. A clinical trial of the effects of dietary patterns on blood pressure. Overall, the report identified that a healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or nonfat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meat; and low in sugar-sweetened foods and drinks and refined grains. A hallmark of the DGA is the importance placed on healthy dietary patterns as a wholerather than on individual nutrients or foods in isolation. We have presented evidence that the types of foods consumed and the overall dietary pattern followed are far more important for reducing CVD risk than total fat. 2014 [41]. JAMA. Recently, an AHA Presidential Advisory reviewed the scientific evidence and concluded that lowering intake of saturated fat and replacing it with unsaturated fats, especially polyunsaturated fats will lower the incidence of cardiovascular disease [33]. Intake of carbohydrates compared with intake of saturated fatty acids and risk of myocardial infarction: importance of the glycemic index. 2023 BioMed Central Ltd unless otherwise stated. PubMed Central Have a few (e.g. A food diary can be a useful tool in this process. 2010;91(3):535-46. Butter and whole milk increase total cholesterol and LDL-C [72]. Zong G, et al. These studies complement a previous observational study, which found an inverse association between olive oil consumption and both systolic and diastolic blood pressure [64]. 2011;93(1):15871. Cochrane Database Syst Rev. BMC Med. Ogden CL, et al. But what is a dietary pattern? Ann Intern Med. Article For processed red meats, there is clear evidence of increased associations with cardiometabolic diseases, whereas for unprocessed red meats, there is evidence for increased stroke and diabetes risk [74]. Dietary fats have complex and sometimes divergent effects on these different contributors to CVD risk. JAMA. Boosts immunity. 2002, Washington D.C: The National Academies Press. However, by attributing their effects to single nutrients, foods with very different physiological effects can become conflated and contribute to consumer confusion. These studies assessed the association of variations in saturated fat intake in the population, rather than modeling the specific substitution of saturated fat with other macronutrients. Article Further research is needed to better determine how different approaches to food processing, technology, stability/oxidation, and breeding/engineering of plants or animals may alter the overall health effects of PUFA and MUFAs. Decades of recommendations to consume low-fat diets and the proliferation of low-fat products have greatly influenced consumer perceptions of fat. Dietary guidelines from the World Health Organization and the Dietary Reference Intakes recommend a total fat intake between 20 and 35% of total calories [12, 13]. Meta-analyses of randomized controlled trials investigating the effects of chocolate or cocoa products have found inverse associations between cocoa consumption and total cholesterol, LDL-C, blood pressure, and serum insulin [68,69,70]. Mitchell L. U.S. and EU Consumption Comparison. The original DASH diet emphasized vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, and nuts while limiting sweets and red meats, and was generally higher in carbohydrates and lower in total fats. Few individuals can accurately estimate their daily calorie consumption, much less their intake of total fat or specific fatty acids [78, 79]. A recent publication of women from the Nurses Health Study and men from the Health Professionals Follow-up Study found that replacing carbohydrates with saturated fat was not associated with CHD mortality, while replacing carbohydrates with unsaturated fats significantly reduced CHD death [35]. This pattern is characterized on the basis of eating behavior ( Hu, 2002 ). Epidemiology and Genomics Research Program website. Consumption of the DASH diet also resulted in lower total cholesterol, LDL-C, and HDL-C levels with no changes in triglycerides or total cholesterol:HDL-C ratio [56]. Office of the Assistant Secretary for Health, Office of the Secretary. mental health. Health.gov,Scientific report of the 2015 dietary guidelines advisory committee. Many lines of evidence support CHD benefits PUFA consumption, whether as a replacement for saturated fat or carbohydrate. Health and Human Services Federal Register, June 17, 2015. Meta-analyses of foods and coronary heart disease, stroke, and diabetes mellitus. Penny M. Kris-Etherton. For example, palmitic acid, the major saturated fatty acid in the diet, is synthesized in the liver from starch and sugar via de novo lipogenesis, and it is the predominant fatty acid present in dairy and meats [25]. Jia L, et al. A new study [36] reported that substituting plant protein for long chain SFA decreased risk of CHD. Nutrition scientists are trusted content experts [1]. Furthermore, substituting unsaturated fats for saturated fats (5% energy) reduced total mortality and mortality from CHD, cancer and neurodegenerative diseases (Fig. PubMed Central However, evidence from observational studies and randomized clinical trials demonstrates that replacing saturated fat with carbohydrates, specifically refined, has no benefit on CVD risk, while substituting polyunsaturated fats for either saturated fat or carbohydrate reduces risk. In recent decades, we have gained substantial knowledge regarding the role of broad classes of nutrients and foods in major chronic diseases. At the end of the eight-week dietary intervention, systolic and diastolic blood pressure were significantly reduced by 5.5 and 3.0mmHg compared to the control diet [55]. Lancet. Cite this article. 2010;45(10):893-905. In such models, the observed effects can be due to reduced intake of one nutrient, increased intake of the other, or both. Gallop Press; 2014. Participants who consumed a Mediterranean diet supplemented with extra-virgin olive oil or nuts also had a 52% reduction in diabetes incidence compared to the control group (hazard ratio: 0.47; 95% CI: 0.25, 0.97 and hazard ratio: 0.48; 95% CI: 0.24, 0.96) [54]. Am J Clin Nutr. found that replacing saturated fat with high quality carbohydrates such as whole grains was associated with lower risk of CHD, but replacing saturated fat by total carbohydrates or refined starch/added sugars was not associated with CHD risk [31]. Rizos EC, et al. Google Scholar. 2013;11:207. This reflects high levels of consumption of these items by consumers. Reproduced with permission from Mozaffarian et al. How to messages should inform the public of specific foods that are sources of healthy fats. 2015 [cited 2016 Feb 17]; Available from: https://www.heartandstroke.ca/-/media/pdf-files/canada/position-statement/saturatedfat-eng-final.ashx. 2010;170(9):8217. Special Considerations for Older Adults. Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial. The decrease in total and saturated fat intake (as a %) since the 1980s haslargely reflected a corresponding increase in energy from dietary carbohydrate. Intake of individual saturated fatty acids and risk of coronary heart disease in US men and women: two prospective longitudinal cohort studies. Though views of the original diet-heart hypothesis continue to evolve, they have had long-lasting effects on nutrition policy and consumer perceptions of fat. UpdatedApril 22, 2016. Simple, easily understood messages focused on overall dietary patterns and foods rather than single nutrients are important. Progress and challenges in translating the biology of atherosclerosis. Effects of isocaloric substitution of specific fatty acids for saturated fatty acids in the Nurses Health Study and Health Professional Follow-up Study on a.) WebThough nutrition is a lifestyle factor implicated in prevention of HF, little is known about the effects of macro- and micronutrients as well as dietary patterns on the progression and treatment of HF. For years, an emphasis of nutrition communication was to balance calorie intake and energy expenditure and decrease dietary fat. Indeed, new studies rarely negate previous findings or alter fundamental paradigms, but rather add new information to what was known before [86]. PLoS One. Furthermore, for whole milk, there is insufficient evidence for meaningful conclusions. PubMed Central Effects on CHD risk of consuming PUFA, carbohydrate, or MUFA in place of saturated fat. This study aims to identify and characterize major dietary patterns in the target-population from general adult NL residents and assess the associations with selected demographic factors. Jensen MD, et al. PubMedGoogle Scholar. However, the role of saturated fat in heart disease is complex because of the heterogeneous biological effects of the different saturated fatty acids and the diversity of food sources [26]. Consumers estimation of calorie content at fast food restaurants: cross sectional observational study. Moderate consumption of olive oil by healthy European men reduces systolic blood pressure in non-Mediterranean participants. Therefore, following a healthy dietary pattern and making every bite count is particularly important to this age group. three) key messages that consumers can remember and reinforce with a strong bottom line. CAS Consequently, it is essential that they effectively communicate research findings to policy makers, authoritative bodies and the general public in order for consumers to make sound, evidence-based dietary decisions. They are not required in the diet; thus no Adequate Intake or Recommended Dietary Allowance has been set [13]. Nature. 2012;107(Suppl 2):S17184. Br J Nutr. As dietary guidance is shifting away from volume16, Articlenumber:53 (2017) When consumers were asked the same question using the terms monounsaturated fatty acids and polyunsaturated fatty acids, only 16% believed they were healthful, illustrating how the chemistry terms for categorizing fats do not resonate with consumers [18]. This was reflected in the Dietary Guidelines for Americans 20152020, which emphasizes types of fat within the context of a healthy dietary pattern [18]. Wu JH, et al. Google Scholar. Pooling across different types of evidence, consistent beneficial effects are seen when PUFA is increased, but not when SFA is replaced with carbohydrate or MUFA (Fig. Ecological and migration studies including the seminal Seven Countries Study by Ancel Keys have found strong positive correlations between saturated fat intake and CHD rates [10]. The minimum of 20% is to ensure adequate consumption of total energy, essential fatty acids, and fat-soluble vitamins [12] and prevent atherogenic dyslipidemia (low high-density lipoprotein cholesterol (HDL-C), high triglyceride-rich lipoproteins) which occurs with low-fat, high carbohydrate diets and increases risk of coronary heart disease [13]. The results of recent randomized controlled trials of n-3 PUFA supplements on cardiovascular outcomes have been disappointing; theorized reasons include the possibility that n-3 PUFA have little additional effect on top of modern drug therapies for CVD, as well as the study designs employed [47, 48]. The importance of healthy dietary patterns in chronic disease prevention Marian L Neuhouser Add to Mendeley https://doi.org/10.1016/j.nutres.2018.06.002 Get Am J Clin Nutr. The 2015 US dietary guidelines: lifting the ban on Total dietary fat. Methods 1 cup-equivalent of dairy equals: 1 cup yogurt. Of note, the 2015 Dietary Guidelines Advisory Committee placed emphasis on the types and quality of foods consumed and did not set an upper limit for total fat based on the lack of supporting evidence [14]. Cis-polyunsaturated fatty acids (PUFA) include essential fatty acids and have beneficial roles in human health. Dietary intake of saturated fat by food source and incident cardiovascular disease: the multi-ethnic study of atherosclerosis. The physical, mental, and emotional changes that occur as children transition from pre-school to school age and into adolescence come with diverse opportunities to support a healthy dietary pattern. Most people, especially women, associate fat intake with obesity while older men are more likely to associate it with heart health [75]. 2014;63(25 Pt B):29853023. Harris WS. As described above, PREDIMED demonstrated reductions in CVD events with either mixed nuts or extra-virgin olive oil. JAMA. Remember to put research findings in context within the prevailing body of evidence and avoid sensational headlines [86]. 2012;96(2):397404. The way consumers obtain nutrition information has changed substantially in the past two decades. PubMed By using this website, you agree to our Psaltopoulou T, et al. Siri-Tarino PW, et al. 2015 Food and Health Survey: consumer attitudes towards food safety, nutrition and health. While the public is very aware of total dietary fat, they do not have a good understanding of the importance of fat quality or of the different sources of dietary fat. 2015;38(Suppl 1):S193. Brussels COM 619 3.12.2015. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Springer Nature. National Cancer Institute. BMC Med. Mozaffarian D, et al. Reductions in total dietary fat were recommended to reduce saturated fat as well as due to the energy density of lipids and the overall goal to reduce caloric intake [4]. As a poor diet can predispose to the development of metabolic abnormalities, the aims of this review are to clarify: 1) the dietary patterns of patients with schizophrenia, 2) the association of these dietary patterns with a worse metabolic profile, and 3) the possible factors influencing these dietary patterns. In cohort studies modeling specific replacement nutrients, there is consistent evidence that polyunsaturated fatty acids are the most beneficial replacement nutrient for CVD risk reduction as compared to either saturated fat or total carbohydrate. There are additional materials that you can use to reinforce these messages: This site is coordinated by the Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, U.S. Department of Health and Human Services. Short-term effect of cocoa product consumption on lipid profile: a meta-analysis of randomized controlled trials. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. Curr Opin Clin Nutr Metab Care. PubMed Goldberg SL. AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association task force on practice guidelines and the Obesity Society. A healthy approach to dietary fats: understanding the science and taking action to reduce consumer confusion. Sacks FM, et al. Prevalence of childhood and adult obesity in the United States, 2011-2012. Prospective cohort studies provide better evidence for dietary habits and CHD because adjustments are made for individual-level differences in major risk factors, lifestyle habits, and other confounding factors. This is reflected in a lack of nutrition recommendations in all major HF scientific guidelines. Dietary patterns should be the starting Eckel RH, et al. Am J Clin Nutr. Reduction in the incidence of type 2 diabetes with the Mediterranean diet: results of the PREDIMED-Reus nutrition intervention randomized trial. Both studies are in agreement with the large body of epidemiological evidence showing an association between increased nut consumption and decreased risk of CHD [60, 61]. UpdatedApril 22, 2016. PubMed J Nutr. Your privacy choices/Manage cookies we use in the preference centre. Dairy consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. BMI indicates body mass index; CHD, coronary heart disease; CI, confidence interval; CVD, cardiovascular disease; PC, prospective cohort; RCT, randomized clinical trial; and RR, relative risk. While all diets improved blood pressure and LDL compared to baseline, the diets that replaced saturated fat with protein or especially vegetable unsaturated fats (principally olive oil) resulted in greater improvements in CVD risk factors compared to the carbohydrate-rich diet [57]. Prentice RL, et al. Are n-3 fatty acids still cardioprotective? Mediterranean-type diets commonly emphasize consumption of fruits, vegetables, legumes, fish, nuts, and olive oil [15]. Dietary fats and cardiovascular disease: a presidential advisory from the American Heart Association. Its important for parents, guardians, and caregivers of young children to know that it can take up to 10 exposures before children accept a new type of food. 2006;145(5):33341. Huth PJ, Park KM. JAMA. However, this finding needs to be confirmed in future studies. A growing body of literature suggests that both n-6 and n-3 fatty acids confer benefits for a wide range of conditions, in particular CVD, and also possibly diabetes, cancer, and autoimmune diseases [30, 41, 43,44,45,46]. For example, studies utilizing objective circulating biomarkers of fat intake identify protective associations of odd-chain saturated fats, largely consumed from dairy saturated fat, and risk of CHD [29]. These results complement previous findings from a pooled analysis of intervention trials examining the relationship between nut consumption and blood lipid levels [59]. 2014;130(18):156878. Article Farvid MS, et al. Likewise, the new research suggests that rather than focusing on total saturated fat, the guidance also could be on specific foods, as saturated fat from different major food sources is associated with higher risk, no risk, or even lower risk of CHD, depending on the food source [38, 39]. The effects of replacing saturated fat with different types of carbohydrates require further investigation. 2006;295(6):62942. Mediterranean diet reduces 24-hour ambulatory blood pressure, blood glucose, and lipids: one-year randomized, clinical trial. found no significant relationship between total saturated fat or total polyunsaturated fat consumption and risk of CHD [29]. Diet is a leading contributor to morbidity and mortality worldwide according to the Global Burden of Disease Study carried out in 188 countries. The term fat is particularly confusing because 90% of survey respondents associate something negative with fat [9]. Omega-3 fatty acids and incident type 2 diabetes: a systematic review and meta-analysis. 2007;370(9602):182939. 2008;168(14):150011. Some strategies to increase food acceptance include: Since childrens dietary patterns often resemble those of their household, there are multiple strategies that health professionals can share to support families. WebDietary pattern analysis has been used to fill in the gap between diet as a whole and health outcomes. J Am Coll Cardiol. Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: a systematic review and meta-analysis. Consistent with this, the large Womens Health Initiative trial demonstrated no benefits of lowering total fat from 36 to 29% of energy on risk for CVD, diabetes, or cancers; while the OmniHeart and PREDIMED trials demonstrated significant CVD and other benefits from increasing healthful fats to greater than 35% of energy [50, 57, 81,82,83,84]. The Dietary Approaches to Stop Hypertension (DASH) dietary pattern is also beneficial for reducing CVD risk. Nutrition Journal In addition, another recent study has shown that replacement of saturated fat with MUFA (principally from plant sources) decreases CHD risk [36]. Effective communication of dietary fats: an exploration of language. Saturated and monounsaturated fatty acids are synthesized in the body for energetic, physiological, and structural functions, and they are present in many foods. The similar associations of total carbohydrate vs. saturated fat with CHD (or in the largest studies, actually beneficial associations of saturated fat compared with total carbohydrate) might suggest that guidelines could include a limit on the sum of total carbohydrate plus saturated fat. 2015. Mozaffarian D, Micha R, Wallace S. Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. Future dietary recommendations should focus on healthful dietary patterns to help consumers identify and choose foods that are good sources of healthy fats. Moreover, conclusions are complicated by dietary substitutions underscoring the importance of considering the replacement nutrient. These dietary trends are not unique to the U.S. Data from the Australian Health Survey 20112013 show dietary trends mirroring those observed in the U.S. [23]. Ried K, et al. By LT Dennis Anderson-Villaluz, MBA, RD, LDN, FAND, nutrition advisor, Office of Disease Prevention and Health Promotion. This may result in a total fat intake that exceeds 35% of calories [80], but the majority of the fats in such a dietary pattern would be healthy fats. Focusing on total diet quality and food patterns provides easily actionable messages for consumers rather than talking about percentages of specific fats. Eight trials met inclusion criteria and encompassed 13,614 participants and 1042 coronary events (myocardial infarction or cardiac death) [30]. Reproduced with permission from Wang, et al. The Institute of Medicine determined that there is no safe level of consumption of industrial trans fats from partially hydrogenated oils. The best messages are actionable, easy to implement, and easy to visualize. Am J Clin Nutr. Such models also raise complexities in understanding the biological effects of individual fatty acids within the context of food matrices and dietary patterns, which each provide a milieu of nutrients, bioactive compounds, and other constituents that may modulate the effects of the fatty acids. After a mean follow-up of 4.8years, consumption of a Mediterranean diet supplemented with either extra-virgin olive oil or nuts resulted in a 30% reduction in risk of myocardial infarction, stroke, or death (hazard ratio: 0.70; 95% CI: 0.54, 0.92 and hazard ratio: 0.72; 95% CI: 0.54, 0.96) [50]. Gillingham LG, Harris-Janz S, Jones PJ. Some scientists believe that reduction in saturated fat must continue to be prioritized, based on its LDL-raising effectsand causality for CVD, on the benefits of replacing saturated fat with PUFA, and on concerns that in the absence of recommendations to limit saturated fat, ingredients high in saturated fat (e.g., palm oil) could be added to foods. The Healthy Eating Index (HEI) measures diet quality based on the Dietary Guidelines on a scale of 0 to 100 and the scores show that children and adolescents are not meeting the recommendations. Strengthens bones. Indeed, excess consumption of calories has greater effects on weight and energy balance than the amount and type of fat consumed [17]. Jakobsen et al. DHA-enriched high-oleic acid canola oil improves lipid profile and lowers predicted cardiovascular disease risk in the canola oil multicenter randomized controlled trial. Adapted with permission from Circulation [74]. While single nutrient targets have worked well for treating diseases of deficiency, this has been problematic for addressing chronic diseases [7]. JAMA Intern Med. Lowers risk of heart disease, type 2 diabetes, and some cancers. Work with reporters to make sure your comments and quotes are correct. Nut consumption (average 67g/day) significantly reduced total cholesterol, LDL-C, and total cholesterol to HDL-C ratio [59]. After all, every parent, guardian, or caregiver wants their children to have the best chance of success as they grow older. 2015;313(24):24212. Despite consumer perceptions, research supports the use of higher-fat diets such as Mediterranean-style diets for weight loss and reducing CVD risk [17, 50]. Effect of the Mediterranean diet on blood pressure in the PREDIMED trial: results from a randomized controlled trial. 2002;288(20):256978. statement and Additionally, a report by the USDA Economic Research Service compared food availability and dietary preferences and behavior between the U.S. and the European Union and concluded that the diets are more similar, than not and both the U.S and EU have reduced fat consumption over time [24]. The CanolaDHA blend had the greatest systolic and diastolic pressure-lowering effect. Australian Health Survey: Nutrition First Results - Food and Nutrients, 20112012. 2017;135(15):e86784. Health professionals, parents, caregivers, and guardians are uniquely positioned to guide children during the earlier life stages and give them the opportunity to have a healthy start as they grow., Measuring Dietary Quality Through the Healthy Eating Index. The human brain is dependent on a sufficient supply of nutrients to support its morphological development, neurochemistry, and neurophysiology ().Adequate nutrition is important especially during pregnancy and the first few years of life, because it is during the prenatal and early postnatal period that the brain grows most rapidly and the Virtanen JK, et al. 2014 Food and Health Survey: consumer attitudes towards food safety, nutrition and health. Br J Nutr. 2013;16(2):1419. For prevention of chronic diseases, nutrient-based recommendations are more difficult to translate to the public. The committee recommended healthy dietary pattern options that: 1) emphasize vegetables, fruits, whole grains, seafood, legumes, and nuts, 2) include moderate amounts of low-fat dairy products and alcohol (among adults, if consumed), 3) are lower in red and processed meats, 4) limit refined grains and sugar-sweetened foods and beverages [14]. evaluated the effect of increased PUFA consumption, as a replacement for saturated fat, on CHD in a meta-analysis of randomized controlled trials [30]. Austin GL, Ogden LG, Hill JO. These US Dietary Reference Intakes, based on evidence published prior to 2000, have not been updated. Youth have diverse calorie and nutrient needs based on age and patterns of growth, development, and physical activity. NAF is an employee of the Hass Avocado Board. In addition, communicating scientific findings can be viewed as a civic duty [2] and has been suggested to be included in formal academic training [2]. 4. 3) [30, 34, 42]. 2016;176(8):113445. DASH collaborative research group. 2017;136(3):e1e23. Dietary patterns, foods, and nutrients are inexorability linked: dietary patterns comprise foods, and foods deliver nutrients. More recently, the United Nations Food and Agriculture Organization set new target Acceptable Macronutrient Distribution Ranges for adults for linoleic acid (2.59% of energy), total n-3 PUFA (0.52% of energy), and EPA+DHA (250 to 2000mg/d) [12]. 2007;137(1):847. Low-fat dietary pattern and risk of treated diabetes mellitus in postmenopausal women: the Women's Health Initiative randomized controlled dietary modification trial. 2012;107(Suppl 2):S22839. Yet, scientists ability to communicate is less than other professionals [1]. Libby P, Ridker PM, Hansson GK. J Am Coll Cardiol.
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