%0 Journal Article
%T Effects of saturated fatty acid consumption on lipoprotein(a): a systematic review and meta-analysis of randomized controlled trials.
%A Riley TM
%A Sapp PA
%A Kris-Etherton P
%A Petersen K
%J Am J Clin Nutr
%V 0
%N 0
%D 2024 Jul 2
%M 38964657
%F 8.472
%R 10.1016/j.ajcnut.2024.06.019
%X <B>BACKGROUND: </B>An inverse relationship between saturated fatty acid (SFA) intake and Lp(a) concentration has been observed; however, there has been no quantification of this effect.<BR><B>OBJECTIVE: </B>The objective was to determine if SFA consumption alters Lp(a) levels among adults without atherosclerotic cardiovascular disease (ASCVD).<BR><B>METHODS: </B>A systematic review and meta-analysis of randomized controlled trials contrasting a lower SFA diet(s) with a higher SFA diet(s) among adults without ASCVD was conducted. PubMed, Cochrane Central Register of Clinical Trials, ClinicalTrials.gov, and Web of Science databases and registers were searched through October 2023. The standardized mean difference in Lp(a) between diets lower vs. higher in SFA (percent of energy [%E]) was determined using random-effects meta-analysis. Analyses were also conducted to examine the effect of replacing SFA with carbohydrates (CHO), monounsaturated (MUFA), polyunsaturated (PUFA), or trans fatty acids (TFAs).<BR><B>RESULTS: </B>In total, 6,255 publications were identified in the systematic search. Twenty-six publications reporting 27 randomized controlled trials, including 1,325 participants and 49 diet comparisons, were included. The mean difference in SFA between lower vs. higher SFA diets was 7.6% E (3.7% - 17.8% E). After lower SFA diets, Lp(a) concentration was higher (SMD 0.14 [95%CI: 0.03, 0.24]) compared to higher SFA diets. Subgroup analyses showed higher Lp(a) following diets where SFA was replaced by CHO (trials=8, n=539; SMD 0.21 [95%CI: 0.02, 0.40]) or TFAs (trials=8, n=300; SMD 0.32 [95%CI: 0.17, 0.48]). No differences in Lp(a) were observed when MUFA (trials=16, n=641; SMD 0.04 [95%CI: -0.08, 0.16]) or PUFA (trials=8, n=415; SMD 0.09 [-0.04, 0.22]) replaced SFA.<BR><B>CONCLUSIONS: </B>Lower SFA diets modestly increase Lp(a) compared to higher SFA diets among individuals without ASCVD. This effect appeared to be driven by replacement of SFA with CHO or TFA. Research investigating the atherogenicity of diet induced Lp(a) changes is needed to inform dietary management of lipid/lipoprotein disorders. (PROSPERO Registration number: CRD42020154169).