Widely promoted guidelines to reduce fat intake could be unhealthy for people in low- and middle- income countries whose diets are already too starchy, researchers said today.
Health authorities in Europe and North America recommend eating more fruits and vegetables while curtailing consumption of fatty foods, advice also adopted by the United Nations and globally.
But people in poor nations cutting back on fat may wind up piling on more carbohydrates -- such as potatoes, rice or bread -- because fruits and vegetable are more expensive, the authors point out.
"The current focus on promoting low-fat diets ignores the fact that most people's diets in low- and middle-income countries are very high in carbohydrates, which seem to be linked to worse health outcomes," said Mahshid Dehghan, a researcher at McMaster University in Ontario, Canada and lead author of a study in The Lancet.
Meanwhile, a companion study, also published in The Lancet, concludes that the rich-world guidelines -- backed by the World Health Organization (WHO) -- on fruit and vegetable consumption could be safely cut back from five to a more affordable three portions per day.
Dehghan and colleagues sifted through the health data of 135,000 volunteers from 18 countries across six continents, aged 35-70, who were monitored for a seven-and-half years.
People who met three-quarters or more of their daily energy needs with carbs were 28 percent more likely to die over that period that those who ate fewer starchy foods (46 per cent or less of energy needs).
Surprisingly, the findings also challenged assumptions on fat intake: diets high in fat (35 per cent of energy) were linked with a 23 per cent lower risk of death compared to low-fat diets (11 per cent of energy).
"Contrary to popular belief, increased consumption of dietary fats is associated with a lower risk of death," Dehghan told AFP.
That covered a mix of saturated fats (from meats and milk products), along with monounsaturated and polyunsaturated fats (from vegetable oils, olive oil, nuts and fish), she added.
The study did not look at so-called "trans fats" from processed foods because "the evidence is clear that these are unhealthy," Dehghan said.
The best diets include a balance of 50-55 percent carbohydrates and around 35 percent total fat, according to the authors, who presented their findings at the European Society of Cardiology Congress in Barcelona.
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