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Good fats, bad fats, polyunsaturated fatty acids, and cognition in the elderly

Dietary fat may have an important influence on the risk of cognitive decline in the elderly, but it is inappropriate to categorize polyunsaturated fatty acids (PUFA) as ‘‘good’’ fats, with no reference to the fact that they comprise 2 clearly distinct families: omega-6 and omega-3 PUFA. Insufficient fish or omega-3 PUFA intake is predictive of cognitive decline in the elderly, but no such relationship has been reported for omega-6 PUFA intake. Indeed, at the levels presently consumed in the USA, some argue linoleic acid is actually a ‘‘bad’’ fat. If the authors intend to go on to assess whether there are distinct effects of omega-6 compared to omega-3 PUFA intake on cognitive outcomes in the Women’s Health Study, their follow-up results will quite likely contradict their present conclusion, in which they claim no effect of total PUFA intake. The resulting confusion will be aggravated by the fact that they misname the dominant PUFA in the diet as linolenic acid (omega-3) when they mean linoleic acid (omega-6). The authors say there is a ‘‘central relation between elevated cholesterol and fat intake’’ yet report lower prevalence of hypercholesterolemia in elderly women consuming more saturated fatty acids (SFA) and monounsaturated fatty acids (MUFA) combined. As with mixing omega-6 and omega-3 PUFA and calling them good fats, what message is intended when a lower prevalence of hypercholesterolemia on higher SFA and MUFA intake is observed—that SFA and MUFA are both good fats or both bad fats? Apolipoprotein E genotype was not among the many factors that were adjusted for, yet is well established as a key parameter in the association between components of dietary fat intake and risk of cognitive decline.