Systematic review of palm oil consumption and the risk of cardiovascular disease

Abstract

BackgroundThe high amount of saturated fatty acids (SFA) coupled with the rising availability and consumption of palm oil have lead to the assumption that palm oil contributes to the increased prevalence of cardiovascular diseases worldwide. We aimed at systematically synthesising the association of palm oil consumption with cardiovascular disease risk and cardiovascular disease-specific mortality.MethodsWe systematically searched Central, Medline and Embase databases up to June 2017 without restriction on setting or language. We performed separate searches based on the outcomes: coronary heart disease and stroke, using keywords related to these outcomes and palm oil. We searched for published interventional and observational studies in adults (Age: >18 years old). Two investigators extracted data and a consensus was reached with involvement of a third. Only narrative synthesis was performed for all of the studies, as the data could not be pooled.ResultsOur search retrieved 2,738 citations for stroke with one included study and 1,777 citations for coronary heart disease (CHD) with four included studies. Palmitic acid was reported to be associated with risk of myocardial infarction (MI) (OR 2.76; 95%CI = 1.39–5.47). Total SFA intake was reported to be not significant for risk of MI. Varying intake of fried foods, highest contributor to total SFA with 36% of households using palm oil for frying, showed no significant associations to risk of MI. Odds of developing first non-fatal acute MI was higher in palm oil compared to soybean oil with 5% trans-fat (OR = 1.33; 95%CI = 1.09–1.62) than palm oil compared to soybean oil with 22% trans-fat (OR = 1.16; 95%CI = 0.86–1.56). Nevertheless, these risk estimates were non-significant and imprecise. The trend amongst those taking staple pattern diet (characterised by higher palm oil, red meat and added sugar consumption) was inconsistent across the factor score quintiles. During the years of 1980 and 1997, for every additional kilogram of palm oil consumed per-capita annually, CHD mortality risk was 68 deaths per 100,000 (95% CI = 21–115) in developing countries and 17 deaths per 100,000 (95%CI = 5.3–29) in high-income countries, whereas stroke was associated with 19 deaths per 100,000 (95%CI = -12–49) and 5.1 deaths per 100,000 (95% CI: -1.2–11) respectively.The evidence for the outcomes of this review were all graded as very low. The findings of this review should be interpreted with some caution, owing to the lack of a pooled effect estimate of the association, significant bias in selection criteria and confounding factors, inclusion of other food items together with palm oil, and the possible out-dated trend in the ecological study.ConclusionIn view of the abundance of palm oil in the market, quantifying its true association with CVD outcomes is challenging. The present review could not establish strong evidence for or against palm oil consumption relating to cardiovascular disease risk and cardiovascular disease-specific mortality. Further studies are needed to establish...

Introductory Chapter: Multifaceted Perspectives of Palm Oil

“…Cardiovascular diseases (CVD) are responsible for 31% of global deaths [18]. This disease is a group of diseases of the heart and blood vessels including coronary heart disease (CHD), cerebrovascular disease, peripheral arterial disease, rheumatic heart disease, congenital heart disease, deep vein thrombosis and also pulmonary embolism [19]. The high proportion of saturated FAs, especially palmitic acid, in palm oil has been linked to the increased risk of atherosclerosis [20,21].…”

“…The high proportion of saturated FAs, especially palmitic acid, in palm oil has been linked to the increased risk of atherosclerosis [20,21]. However, findings of the systematic review by Ismail et al [19] indicated that there is no evidence of a clear association between palm oil consumption and risk or mortality of CVD. Furthermore, Ismail et al [19] observed that the effect seen between association of palm oil consumption and risk of coronary heart disease were not unique to only palm oil, especially since other food items were also included in the analysis, therefore rendering the association to be insignificant.…”

Safety and Neuroprotective Efficacy of Palm Oil and Tocotrienol-Rich Fraction from Palm Oil: A Systematic Review

“…Palm oil is an edible oil that is extracted from the palm plant fruit (Elaeis guineensis) and is one of the most produced and highest consumed edible oils worldwide. This is despite being harvested from the smallest global percentage of all the cultivated land for oils and fats [11]. For such reasons, the phytochemistry of palm oil fruit has been extensively studied and is well established as comprising several bioactive compounds, including a palmitic-oleic-rich semi-solid fat (the main bulk of the oil, with 95% triglycerides and fatty acids in the form of palmitic, myristic, stearic, oleic and linoleic acids), vitamin E fraction (30% tocopherols and 70% tocotrienols), carotenoids, polyphenols and phytosterols [12].…”

“…In this regard, the neuroprotective effects of the tocopherols have been more extensively studied than those of the tocotrienols [13]. Interestingly, several reviews have outlined the pharmacological properties of palm oil and its bioactives in several health conditions [11,[14][15][16][17][18]. In this regard, several preclinical and clinical studies have been conducted on the neuroprotective effects of palm oil and its bioactives, although these have not been systematically reviewed anywhere, to the best of our knowledge.…”

The Moral Minefield of Ethical Oil Palm and Sustainable Development

“…There are topics we don't address. For example, we avoid the debate around palm oil and health (these issues appear well-documented, see, e.g., McNamara, 2010;Odia et al, 2015;Ismail et al, 2018;Kadandale et al, 2019). Furthermore, we are not philosophers-we will not examine the theory or axiology of moral judgement-however it is worth highlighting that philosophers generally concede that there is no one theory or framework that can guide or resolve every ethical situation satisfactorily.…”