Total Dietary Fat Intake, Fat Quality, and Health Outcomes: A Scoping Review of Systematic Reviews of Prospective Studies

Ann Nutr Metab. 2021;77(1):4-15. doi: 10.1159/000515058. Epub 2021 Mar 31.


Introduction: We conducted a scoping review of systematic reviews (SRs) on dietary fat intake and health outcomes in human adults within the context of a position paper by the "International Union of Nutritional Sciences Task force on Dietary Fat Quality" tasked to summarize the available evidence and provide dietary recommendations.

Methods: We systematically searched several databases for relevant SRs of randomized controlled trials (RCTs) and/or prospective cohort studies published between 2015 and 2019 assessing the association between dietary fat and health outcomes.

Results: Fifty-nine SRs were included. The findings from SRs of prospective cohort studies, which frequently compare the highest versus lowest intake categories, found mainly no association of total fat, monounsaturated fatty acid (MUFA), polyunsaturated fatty acid (PUFA), and saturated fatty acid (SFA) with risk of chronic diseases. SRs of RCTs applying substitution analyses indicate that SFA replacement with PUFA and/or MUFA improves blood lipids and glycemic control, with the effect of PUFA being more pronounced. A higher intake of total trans-fatty acid (TFA), but not ruminant TFA, was probably associated with an increased risk of mortality and cardiovascular disease based on existing SRs.

Conclusion: Overall, the available published evidence deems it reasonable to recommend replacement of SFA with MUFA and PUFA and avoidance of consumption of industrial TFA.

Keywords: Dietary fat; Fat quality; Health outcomes; Scoping review; Systematic reviews.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Diet / adverse effects
  • Diet, Healthy / methods*
  • Dietary Fats / analysis*
  • Eating*
  • Fatty Acids, Monounsaturated / analysis*
  • Fatty Acids, Unsaturated / analysis*
  • Humans
  • Lipids / blood
  • Prospective Studies
  • Recommended Dietary Allowances
  • Systematic Reviews as Topic


  • Dietary Fats
  • Fatty Acids, Monounsaturated
  • Fatty Acids, Unsaturated
  • Lipids