Is the advice on saturated fat finally clear?

Is the advice on saturated fat finally clear?

In recent years, there has been much debate about whether the government are providing the correct advice for saturated fats in the diet. We have seen many claims that saturated fats may in fact be good for us, with recent headlines causing confusion including:

“Is butter back and is sat fat good?”
“‘Saturated fat good for you’, expert claims”
“Saturated fat link with heart disease questioned”

So we are very pleased to have the much-anticipated Scientific Advisory Committee on Nutrition (SACN) draft review into saturated fat published this week.

SACN’s draft recommendations are:

  • The population average contribution of saturated fat to total calorie intake should be no more than 10%. This means no more than 30g of saturated fat for men, no more than 20g for women and less for children.
  • Dietary saturated fats should be substituted with unsaturated fats. Foods like fish (especially oily fish such as mackerel, salmon and trout), unsalted nuts, seeds and avocado are sources of unsaturated fat.

The rationale behind this is the wealth of evidence linking saturated fats to an increased risk of high blood cholesterol, which can increase the risk of cardiovascular disease (CVD).

SACN advise that reducing saturated fats can help improve blood lipids and also blood glucose control. There is also no evidence that reducing intake of saturated fat increases risk of any of the outcomes considered: cardiovascular disease, blood lipids, blood pressure, diabetes, dementia and some cancers.

This new review from SACN helps support advice that we should not be promoting regular use of coconut oil (another trend of recent years: see our coconut oil blog). Indeed, coconut oil is made up of around 85% saturated fats, with 1 tablespoon providing a hefty 12g of saturated fat.

How does this compare to previous guidance?
The previous review was undertaken by SACN’s predecessor Committee on Medical Aspects of Food Policy in 1994 and concluded that saturated fat intake should be no more than 10% of total calories for adults and children aged five and older.

SACN have come to the conclusion that the new evidence supports and strengths the above original recommendation and hence there are no changes to the current government advice.

How much saturated fat do we eat in the UK?
In the UK, average saturated fat intakes are at around 12% of calories. There are improvements to be made to meet the 10% target.

Most of our intake comes from milk products (such as whole milk and cheese), cereal products and meat products.

What are the best saturated fat substitutes?
The review considers what we substitute saturated fat with and the effects on our health. It concludes that the best is to replace saturated fats with monounsaturated fats and polyunsaturated fats.

This fully supports recent consensus on saturated fat reductions from the World Health Organisation 2016 meta-analysis focusing on impact on serum lipids, and the 2015 Cochrane review by Hooper focusing on cardiovascular disease outcomes. Both come to more or less the same conclusions. (If you’re interested in the basic chemistry of fats, do read the WHO analysis, it’s particularly interesting!)

When discussing substitution of saturated with carbohydrates, they highlighted that there is ‘adequate’ evidence that when saturated fats are replaced with carbohydrates alone, this is linked with an increased risk of heart disease.

However, SACN states there was a lack of good quality evidence that differentiated between types of carbohydrates and their resulting effects on heart disease. Different carbohydrates can have different effects on the body (for example, due to varying fibre content). Further research that differentiates between the types of carbohydrates is clearly needed.

Takeaway message
In a nutshell, the draft guidelines support current advice that we need to reduce saturated fat intake and replace it with unsaturated fats.

For more information on how to lower your saturated fats intake, see Heart UK’s website.

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Protein & energy balls: A Nutrilicious health check

Protein & energy balls: A Nutrilicious health check

The ‘clean eating’ and protein trends have spawned a new type of snack – energy and protein balls. Foodie blogs and Instagram are packed with pictures and accompanying recipes. There’s also a wide range being sold in health food stores and supermarkets.

They are billed as a healthy energy boost, targeted especially at gym-goers, young adults and busy mums (try searching for #energyball, it will almost always also be tagged #healthy).

But behind the obvious hype, do they offer any real nutritional health benefits?

At Nutrilicious we under undertook a full nutrition and health analysis to answer this question. Our team of dietitians assessed seven brands currently on sale in the UK – a total of 44 balls.

A summary of our assessment

Protein and energy balls trade on a healthy image that isn’t always deserved.

  • One protein ball, three times a week = 26,000kcal a year, at an average cost of £312.
  • None of the balls tested were low in sugars, very few were low in saturated fat – especially the balls with added coconut.
  • Replacing part of the calories we burn off at the gym with a protein/energy ball negates the benefits of physical activity.
  • More protein is not necessarily better. We generally don’t need more protein in our diet, rather we need to spread our intake through the day.
  • Consumers would be better off tucking into alternative, cheaper snacks that provide a lower saturated fat, lower sugar, tasty protein/energy boost, such as a reduced fat hummus with red pepper crudités or a small prawn or chicken salad sandwich.

The analysis in depth

  1. Protein

Are the balls ‘protein rich’?
By law, to be permitted to claim ‘a source of’ protein a product must provide at least 12 per cent of energy from this nutrient. To be a ‘rich’ source means that the product must provide at least 20% of energy as protein.

Of the 22 protein balls analysed, the majority are indeed ‘rich’ in protein, providing 20-28% energy as protein. Only five are just ‘a source of’ protein. The protein in these products comes often from whey protein, but also (especially in vegan friendly options) from the likes of hemp, pea protein, almonds, and so on, providing a source of plant protein.

However, despite being able to claim they are rich in protein, per serving they provide on average just 8.5g. The protein quantity varies significantly between brands, with some providing as little as 2.6g while others provide as much as 13g per serve.

Do we actually need more protein?
Even if the balls are providing a high level of protein, it’s not necessarily a good thing. Protein intakes in the UK are already above recommendations of 1g per kg body weight and excess protein consumed will simply be converted to fat in the body.

It’s not about more protein, but rather optimising our protein intakes. Rather than having more, we need to spread our protein intake better through the day, so our bodies can process it.

  1. Calories

All the balls we analysed are energy dense – in other words, they pack in a lot of calories.

The average 40g protein ball provides 166kcals; the average 33g energy ball provides 129kcals. These are similar in calories to:

  • A 330ml can of lemon or cola based drink (around 138kcal)
  • 2 chocolate digestives (142kcal)
  • ¾ standard Mars Bar (165kcal)

Some marketers use the term ‘energy boost’ to sell their product, knowing consumers do not tend to associate this with extra unnecessary calories that will more than likely turn to body fat. With 60% of the population overweight or obese, and an average national BMI of 27, the reality is that the majority people don’t need this added ‘energy boost’ – they already consume too many calories.

This is even true of the target audience of those who do regular exercise. Adding further calories from an energy ball would just counter all the hard work done at the gym. In order to burn off the calories from just one 40g protein ball (which can be consumed in a single bite), it would require the average UK female (BMI of 27, weighing around 70.3kg) to undertake one of the following:

  • 35 mins brisk walking (where you’re slightly out of breath)
  • 34 mins leisurely bike ride
  • 21 mins moderate to high impact aerobics
  • 19 mins on a rowing machine – moderate intensity
  • 14 mins breast stroke
  • 10 mins running fast up the stairs
  1. Sugars

None of the products in our analysis scored green (<=5%) for sugars.

In fact, it’s not uncommon to find a sugars content that’s more than 40% – higher than sugary cereals. The highest we found was in an energy ball with 54.9%, providing 26.4g sugars per ball serve.

In many cases, the sugars are added. For the majority of the balls on the market, much of the sugar is the ‘free’ type, with date, agave and malt syrups being popular choices of added sugar. These sweeteners are often erroneously thought to be a healthier choice than ‘refined’ sugar and manufacturers can (and do) capitalise on this misconception, allowing their high sugar products to seem more wholesome than they are.

In a few products, sugars come only from dried fruit – which seems like a good thing. However, breaking down of the structure of the dried fruit during processing will result in the normally ‘intact’ sugars becoming ‘free’ and affect the body and teeth no differently to table sugar. If the aim is to increase fruit and vegetable intake, the best option is for fresh, frozen or canned.

Energy balls on average provide 11.3g sugars; protein balls provide 12.7g sugars per serve. This is 38% to 42% of the recommended daily free sugars intakes for adults and teens.

  1. Saturated fats

In all but a handful of cases, the energy/protein balls score either amber or red in the traffic light system for cholesterol-raising saturated fat.

Only 6/44 (14%) products analysed scored green (<=1.5%) for saturated fats.

An average portion provides 1.7g saturated fat – 8.5 % of the Recommended Intake (RI). Highest levels tend to be found in protein balls that contain a lot of desiccated coconut – the highest we found (in a product weighing 45g) was 4.95g saturates, or 25% of the RI.

  1. Price

With most protein/energy balls costing nearly £2 per serving, they are an expensive snack.

What should change?

Our calorie and protein consumption: and where it comes from
a.  Manufacturers are trading on the expectation from many consumers – frequently young women – that energy/protein balls are more wholesome, more ‘energising’ and more satiating than other snacks.

But we already get enough energy (calories) and protein in our diet. And if we do need more, we could be sourcing them from foods that are a lot cheaper and that can provide a more rounded nutrient profile. These healthier and cheaper equivalent protein sources are an example:

  • 1¼ medium eggs 44% fewer calories, no added sugars: 18p
  • 35g chicken (about 1/5 of a chicken breast) 76% fewer calories, less saturated fat, no added sugars: 28p
  • 170g serving of low fat yogurt 34% fewer calories, no added sugars, lower in saturated fats: 33p
  • 200g individual can of baked beans same calories, no saturated fat, lower in added sugars: 18p

b. To help optimise the body’s natural muscle protein synthesis, we should actually be reducing our overall protein intake and spreading the load more evenly throughout the day. We need to add more protein to breakfast and cut back on the protein at lunch and dinnertime.

  1. Marketing the products

Responsible marketing is needed to ensure consumers who can afford this luxury use energy or protein balls as a replacement and not an addition to their current intakes. It is well known that the term ‘energy’ does not translate to calories for consumers, and the ongoing misuse of this term can only contribute to the ongoing overconsumption of energy dense foods in the UK.

Manufacturers should target consumers who are most likely to benefit from these products: elite athletes; those with poor appetites or higher than average requirements; and amateur sports individuals during periods of strenuous exercising/training. But even the International Society for Sports Nutrition emphasises every day foods first and foremost rather than ‘super bars’.


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Coffee in pregnancy: Nutrilicious news digest

Coffee in pregnancy: Nutrilicious news digest

This week in the news there are reports on whether coffee consumption in pregnancy could increase the chances of having an overweight child. This was picked up by the Daily Mail, The Telegraph and The Express.

The report is based on a study published this month in the British Medical Journal where it was found that any caffeine consumption during pregnancy was associated with a higher risk of excess infant growth and of being overweight in childhood.

Our opinion in brief
The study has limitations. It was not controlled and being a single study alone, we cannot say there is conclusive evidence to support the theory that drinking coffee in pregnancy leads to overweight children.

Nevertheless, current advice for pregnant women is to avoid high intakes of caffeine and stick to no more than 200mg per day.

Details of the study and findings

  • 51,000 mother and infant pairs in Norway between 2002 and 2008 were studied.
  • Expectant mother’s daily intake of caffeine (found in coffee, chocolate, tea and soft drinks) was measured at 22 weeks of pregnancy.
  • The results were divided into the following categories:
    • 1) ‘Low caffeine intake’ – less than 50mg/day (equivalent of half a cup of coffee/two thirds of a cup of tea) just less than 50% were in this group.
    • 2) ‘Average caffeine intake’ – 50-199mg/day (equivalent of up to two cups of coffee/tea per day), over 40% were in this group.
    • 3) ‘High caffeine intake’ – 200-299mg/day (equivalent of up to three cups of coffee/four cups of tea per day), 7% were in this group.
    • 4) ‘Very high caffeine intake’ – more than 300mg/day (equivalent of three or more cups of coffee/four or more cups of tea per day), 3% were in this group.
  • Children’s weight and height were measured at six weeks of age, at three, six, eight, 12 and 18 months and then at two years and every year thereafter up to the age of eight.
  • The prevalence of excess growth in infancy increased from 23% to 29% as prenatal caffeine intake increased from low to very high.
  • The prevalence of overweight increased by 5% at age 3 years, by 6% at age 5 years and by 3% at age 8 years with increasing prenatal caffeine exposure from low to very high.

The original study shows all the detailed findings.

Behind the headlines: the Nutrilicious dietetic view

What do we know already about caffeine in pregnancy?
High intakes of caffeine during pregnancy (more than 200mg per day or two cups of coffee or tea) can result in low birth weight babies, which can increase the chances of health problems in later life. Too much caffeine can also cause a miscarriage.

Source: National Health Service

The study, however, focuses on excessive weight gain during infancy and childhood, which is currently not a known effect associated with high caffeine intakes. We must consider the strengths and weaknesses of this study.

Strengths and weaknesses of the study
Strengths include the very large sample size on which the study was based (51,000 mother-child pairs) and also that maternal caffeine intake was estimated from all possible food sources (not just coffee).

A major weakness of the study, as with many other dietary studies, is that the data is self-reported. It relies on the honesty and accuracy of the mother reporting their caffeine intake. Additionally, measurements of height and weight after 2 years were self-reported by the mother, again reducing the accuracy of the findings.

Importantly, this study was not a controlled trial and thus we cannot prove or be certain that the caffeine intake during pregnancy was the cause of the children being overweight. There are many factors which could interfere with the results including the other attributes or lifestyles and dietary choices that the mothers may have that were in the high caffeine intake groups.

For example, it was reported that women who were in the ‘high caffeine intake’ group were more likely to have been obese before pregnancy and to have partners who were obese and smokers.

Current advice
We would strongly advise that pregnant women stick to the advice from the Foods Standards Agency, which is to limit caffeine to no more than 200mg per day.

This is equivalent to about

  • two mugs of instant coffee (100mg each)
  • one mug of filter coffee (140mg each)
  • two mugs of tea (75mg each)
  • five cans of cola (up to 40mg each)
  • two cans of energy drinks (up to 80mg each) or
  • four (50g) bars of plain chocolate (up to 50 mg each).

Many of the headlines focus on coffee even though, as shown above, other food and drinks contain caffeine. All sources of caffeine should be considered and to ensure maximum limits are not exceeded.


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Fruit juice and sugar: the truth?

Fruit juice and sugar: the truth?

The new sugar tax on soft drinks excludes fruit juices, as they are legally labelled as having ‘no added sugar’. With child obesity levels ever-increasing, especially among lower socio-economic groups, this worries us.

It also highlights the increasingly frequent and often damaging disconnect between legislation, nutrition science and public health guidance.

Fruit juice is a liquid form of ‘free sugars’, with little of the fibre naturally found in fruit. Additionally, some of the essential vitamins present in fruit juice such as B vitamins, folate and vitamin C are added to fruit juice at the end of processing. So the perception of it as a ‘naturally healthy’ drink is misleading.

Here’s why and when we’re concerned about fruit juice…

Confusing labelling: no added sugar, one of your five a day

‘Added’ vs ‘free’ sugars
With fruit juice packaging labelled with ‘no added sugars’ and the government’s ‘counts as one of your five a day,’ it’s not surprising that consumers perceive fruit juice as better for you than sweetened soft drinks.

EU law permits 100% fruit juice that does not contain any other forms of ‘added sugars’ to be labelled as having ‘no added sugars’.

That sounds logical, right? Except it clashes with the World Health Organisation (WHO) and Public Health England (PHE), who both classify fruit juice as a source of ‘free’ sugars. This is because structure of the fruit has been broken down to release sugars in their free form, which behave in the same way in the body as other forms of more commonly understood ‘free’ sugars, for example table sugar. Like fruit juice, table sugar is simply a result of extracting/freeing naturally occurring sugars from the structure of the beet or cane plant.

The most recent PHE publication in March this year makes things crystal clear, ‘[Free sugars are] all monosaccharides and disaccharides added to foods by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and unsweetened fruit juices.

Vitamins, minerals and fibre in fruit juice
Despite this clear scientific reasoning on sugar, PHE continues to permit 150ml daily allowance of fruit juice to count as one of your five a day.

This is based on the fact that the UK continues to under-consume whole fruit and vegetables, which are critical to meet our essential vitamin C and potassium requirements.

150ml orange juice is equivalent to a medium orange for vitamins, minerals and total sugars. It will provide vitamin C in excess of our requirements and 7-30% of our potassium needs (depending on age), plus vitamin B1 (thiamine). However:

  • Fibre: fruit juice 0.1 – 0.9g per 150ml (even one with ‘bits’) vs a medium orange at 1.9g.
  • Free sugars: fruit juice 12.3g vs none in a medium orange.

The truth about fruit juice sugars

In terms of free sugars, weight for weight there’s little difference between fruit juice and soft drinks.

Amount of free sugars % daily free sugars max. recommendations
2-3 yr olds (14g) 4-6 yr olds
7-10 yr old
11 yr olds and older
1 medium (160g) orange 0 0% 0% 0% 0%
150ml pure orange juice 12.3g 88% 65% 51% 41%
150ml cola drink 16.4g 117% 86% 68% 55%
150ml lemonade 8.7g 62% 46% 36% 29%

Studies looking at fruit juice intakes and impact on health proved challenging for SACN when reviewing their recommendations. Evidence for fruit juice and impact on health was found to be lacking, inconsistent and / or of poor quality.

The problem of portion size
If everyone was to keep to 150ml of a sweetened liquid per day, there would be no issue with fruit juice or sweetened beverages. The problem is, this official advice is given to a nation where it has been found that only 1% of the UK population achieve healthy eating recommendations.This 150ml of sweetened liquid per day will in reality not be followed or achieved by the majority. Not least because it’s difficult to keep to 150ml of fruit juice when, in the main, it is sold in 200ml and 1litre cartons, and most household glasses are around 200-250ml.

Fruit juice is the top contributor to free sugars’ intake for young people
According to the government’s 2018 National Diet and Nutrition Survey, fruit juice remains the number one free sugars contributor for 1½ to 10 year olds. This is highly indicative of mum’s perception that fruit juice, unlike sweetened soft drinks, is ‘natural’, has ‘no added sugars’ and therefore good for their children.

During teen years, sweetened beverages takes prominent first place. Fruit juice drops down to third position but still contributing to almost 10%.

Dental decay

It’s not just weight that’s an issue. The UK has one of the highest incidence of dental caries globally. Dental health is dependent on multiple factors, including the frequency and timing of sugar consumption and length of time teeth and gums are exposed to acidic and sugary foods.

Both fruit juice and sweetened beverages are acidic and contain large amounts of ‘free sugars’. They are therefore not recommended by the British Dental Association (BDA). If fruit juice is to be consumed, the BDA recommends diluting it – 1 part juice to 10 parts water. Despite a common misconception around whole fruit, the BDA highlights that fruit, although acidic, is not a risk to dental health except when consumed in unusually large quantities.

The bottom line is that consumers need to be aware that there is little difference between sweetened beverages and fruit juice when it comes to tooth decay. The recommended drink by all health organisations is either water or milk for optimum health.

What would we like to see?

Free sugars are not essential for human health. Due to our over-consumption, they have become a major contributor to our calorie over-consumption.

However, it would be unrealistic to avoid them altogether, and if consumed in moderation as part of a healthy, balanced diet and lifestyle, there should be no problem at all. The government has set maximum recommended intakes for all ages.

  • 0-1 year = no free sugars should be introduced
  • 2-3 years = no more than 14g / 3½ tsp per day
  • 4-6 years = no more than 19g / 4½ tsp per day
  • 7-10 years = no more than 24g / 6 tsp per day
  • 11 years plus = no more than 30g / 7 tsp per day

In the context of the current health state of our nation, consumers are struggling with the ‘in moderation’ and ‘balanced diet’ (otherwise obesity and obesity-related diseases would not continue to escalate).We are at crisis point with our unhealthy choices, which are having untold preventable health and economic impacts.

People need clearer advice and support to stop over-consumption and have a healthier understanding and relationship with food and drink.

When it comes to fruit juice, we believe it’s time to start promoting the benefits of consuming real fruit, which provide so much more nutrition, contain no free sugars and very unlikely to be over-consumed.

The law should change to take into consideration international and national classifications of ‘free’ and ‘added’ sugars.

What do you think? Join our discussion on LinkedIn

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Will the new sugar tax work?

Will the new sugar tax work?

This month, the much anticipated sugar tax came into force in the UK. So what it is, why was it introduced and – most importantly – will it have any impact?

The tax
Soft drinks companies are now required to pay a levy on drinks with certain levels of added sugar:

  • 18p per litre of drink if the product contains more than 5g of sugar per 100ml
  • 24p per litre if it contains 8g of sugar per 100ml.

The tax does not apply to milk-based drinks, due to their calcium content. It also excludes fruit juice or vegetable juice that don’t have added sugar.

Foods such as cakes, biscuits and other sugar containing foods aren’t covered, but there is a separate initiative to reduce their sugar content by 20% by 2020.

Why was it introduced?
The tax has been introduced in an effort to tackle childhood obesity. The latest National Diet and Nutrition Survey (NDNS) showed that sugar-sweetened drinks are the single highest source of free sugars for children and teenagers. This is why soft drinks have been targeted.

Action already taken by the industry
An estimated 50 per cent of manufacturers have already reduced the sugar content of their drinks to avoid the new tax, including leading brands:

  • Fanta – reduced sugar from 6.9g (a little under 2 tsp) to 4.6g (just over 1 tsp) per 100ml.
  • Ribena – from 10g (2.5 tsp) to less than 4.5g (just over 1 tsp) per 100ml.
  • Lucozade – from 13g (just over 3 tsp) to less than 4.5g (just over 1 tsp) per 100ml.
  • Irn Bru – from 10.3g (2.5 tsp) to 4.7g (just over 1 tsp) per 100ml.

Others remain the same, for example Coca-Cola (10.6g per 100ml, just over 2.5 tsp) and Pepsi (11g per 100ml, just under 3 tsp). These manufacturers have to decide whether to bear the cost of the tax increase themselves, or pass it on to consumers.

In one leading supermarket, the cost of a 2L bottle of Pepsi went up by 45p when the tax was introduced. By contrast, Coca Cola kept the price the same but reduced the portion size: a 1.75L bottle has shrunk to 1.5L bottle.

Will it work?
A survey by Mintel of 2,000 people found that just under half (47%) of Brits say that a tax making unhealthy food or drink more expensive would encourage them to cut down on these items. So the measure will hopefully have some effect.

It’s extremely positive that some food manufacturers have already taken action to reduce the sugar content of their recipes. However, the feedback hasn’t always been positive about the new taste of much-loved products (reduced sugar Lucozade and Irn Bru, for example). And a significant proportion of people will simply pay more for the same recipe high-sugar drink they’ve always enjoyed.

We’re also concerned that drinks that fell outside of taxable products, such as fruit juice, often still have high levels of free sugars. The National Health Service discusses maximum intakes of free sugars for all ages.

What happens now?
Drinks manufacturers have made an initial decision on whether to reduce sugar levels to avoid the new taxation or to leave sugar levels unaltered. They’ll be closely monitoring orders from retailers to assess the effectiveness of their initial decision. If it proves that sales of reduced-sugar drinks increases, other manufacturers may be keen to follow suit.

Drinks retailers will need to carefully monitor demand for those reduced-sugar drinks vs unaltered recipes that are subject to the tax, to satisfy any changes in demand.

The Mintel research found that three quarters of consumers say that easier-to-understand nutritional information on product packaging would encourage them to cut down on unhealthy food/drink. We’d love to see improved labelling too, to see what the impact could be.

Takeaway message
It’s going to take months and years to assess the impact the tax has on the nation’s health. And, of course, obesity is caused by many factors. Clearly multiple strategies including education will be needed to combat the problem. We’ll be monitoring closely to see whether the action has any impact on those most affected by obesity – those in the lower socio-economic bracket and children.

Do you agree it’s a step in the right direction? Should the Government be focussing on something else to better address the problem?

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Can nuts and seeds reduce the risk of premature death?

Can nuts and seeds reduce the risk of premature death?

This week, the Daily Mail and the Express reported on the benefits of nuts and seeds, stating that snacking on them could halve the risk of premature death.

This comes following a study published in the American Journal of Clinical Nutrition into omega-6 fatty acid linoleic acid, for which nuts and seeds are a good source.

Study background and findings
The study was carried out following debate about the health effects of linoleic acid.

On the one hand, there was the view that it can reduce cholesterol levels and can increase the production of anti-inflammatory compounds, therefore helping reduce disease.

On the other hand, there was speculation that it may actually cause inflammation when it gets converted in the body into arachindonic acid, thereby increasing the risk of several chronic diseases.

The research aimed to clarify matters…

  • 2,480 men aged between 42 and 62 years were followed for 22 years.
  • Blood levels of the linoleic acid were taken during the study. These levels are determined by your diet.
  • By the end of the study, 1,143 deaths due to disease had occurred.
    • When grouped according to blood linoleic acid levels, the risk of premature death was 43% lower in the group with the highest linoleic acid levels, compared to the group with the lowest level. There was also a lower risk of death due to cardiovascular diseases, as well as for death due to reasons other than cardiovascular diseases or cancer.
    • No specific association between omega-6 levels and death due to cancer was found.
    • The researchers support the current dietary recommendations to increase linoleic acid intake for cardiovascular disease prevention.


Behind the headlines: the Nutrilicious dietetic view

Was it a valuable study?

The study had a few weaknesses:

  • Only a single baseline fatty acid measurement was taken for all men. Dietary habits can change during such a long follow up period and this could alter the results.
  • Higher levels of blood linoleic acid were associated with a more healthy lifestyle and diet. This could influence the results, meaning we cannot be absolutely sure it is just the levels of linoleic acid causing the effects.
  • Only white middle-aged and older men were included in the study. We don’t know whether the findings would be the same for women and other races/ethnicities.

However, it also has considerable strengths:

  • Large sample size
  • No participants dropped out
  • The researchers used an objective biomarker – blood levels of linoleic acid – rather than using dietary recall or assessment measures, which are not very reliable.

Translating the findings into practical guidance

To help prevent cardiovascular disease, current guidelines are that we should be limiting our intakes of saturated fats to 20g per day for women and 30g per day for men.

They should be replaced with unsaturated fats including monounsaturated and polyunsaturated fats, which provide essential fatty acids and fat-soluble vitamins.

Linoleic acid is the most common type of polyunsaturated omega-6 fatty acid, so we’d recommend unsalted nuts as a daily snack. Indeed, HEART UK state: “Nuts are packed full of heart-healthy nutrients such as protein, soluble fibres, plant sterols, vitamin E, magnesium, potassium, zinc and copper. Because they are also naturally rich in unsaturated fats and low in saturated fat they can help lower cholesterol as part of a diet low in saturated fats.”

A portion of nuts would be considered around 30-35g, which is about one handful (about 175-200 calories).

Nuts are quite high in calories, so those watching their weight may need to consider how and where this fits into a calorie controlled eating plan.

Remember the full picture

While the headlines focus on nuts and seeds, vegetable oils and plant-based spreads are also good sources of linoleic acid.

The shift from saturated to unsaturated fats should form part of an overall healthy diet, such as DASH (Dietary Approaches to Stop Hypertension) or the Mediterranean diet.

More detailed advice into dietary fats can be found from:

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