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Comparison of long-term low-fat versus high-fat diets on blood lipids: a systematic review and meta-analysis

Dietary fat plays an important role in the primary prevention of cardiovascular disease, but long-term effects of different percentages of fat in the diet on blood lipids as biomarkers of cardiovascular risk remain to be established. In the present systematic review, randomized controlled intervention trials (RCTs) investigating the long-term effects of low fat (LF) diets as compared to diets with high amounts of fat (HF) on blood lipids were analyzed. Three electronic databases (MEDLINE, EMBASE, and the Cochrane Trial Register) were searched for RCTs with no restriction to calendar date or language. Moreover, reference lists from retrieved articles as well as systematic reviews and meta-analysis were reviewed. RCTs reporting mean post or mean differences with their standard deviation for effects of LF vs. HF diets on blood lipids were included according to the Cochrane Handbook. Both authors independently extracted data and assessed study quality with the Jadad Score. Study specific weighted mean differences were pooled using a random effect model (REVIEW MANAGER 5.1.0). For RCTs with a quality score ‡ 3, an additional sensitivity analysis was performed. By using the metareg function of STATA 12.0 a random effect meta-regression was calculated to investigate high heterogeneity.