Implementation of a Low-Fat Dietary Regimen in Nursing Practice
Abstract
Background: Cardiovascular disease, cancer, and obesity remain leading global health concerns, with dietary fat intake identified as a major modifiable risk factor. Traditional low-fat diets have been widely recommended; however, emerging evidence questions their effectiveness and highlights unintended consequences of fat reduction strategies.
Aim: This study aims to evaluate the clinical significance, controversies, and implications of implementing low-fat dietary regimens in nursing practice.
Methods: A comprehensive review of epidemiological, clinical, and guideline-based evidence was conducted to assess the impact of low-fat diets on cardiovascular health, cancer risk, and obesity, alongside practical considerations for nursing and interprofessional interventions.
Results: Findings reveal that indiscriminate fat reduction, particularly when replaced by refined carbohydrates, may worsen lipid profiles and metabolic outcomes. Evidence supports prioritizing fat quality—favoring unsaturated fats—over total fat reduction. Interprofessional strategies, including patient-centered counseling and lifestyle interventions, are essential for effective implementation.
Conclusion: Low-fat diets alone are insufficient for optimal health outcomes. Nursing practice should emphasize balanced dietary patterns, fat quality, and individualized counseling within a collaborative care model.
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References
Mann J. Complex carbohydrates: replacement energy for fat or useful in their own right? The American journal of clinical nutrition. 1987 May:45(5 Suppl):1202-6. doi: 10.1093/ajcn/45.5.1202.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001 May 16:285(19):2486-97
Sacks FM, Lichtenstein AH, Wu JHY, Appel LJ, Creager MA, Kris-Etherton PM, Miller M, Rimm EB, Rudel LL, Robinson JG, Stone NJ, Van Horn LV, American Heart Association. Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association. Circulation. 2017 Jul 18:136(3):e1-e23. doi: 10.1161/CIR.0000000000000510.
Andraski AB, Singh SA, Lee LH, Higashi H, Smith N, Zhang B, Aikawa M, Sacks FM. Effects of Replacing Dietary Monounsaturated Fat With Carbohydrate on HDL (High-Density Lipoprotein) Protein Metabolism and Proteome Composition in Humans. Arteriosclerosis, thrombosis, and vascular biology. 2019 Nov:39(11):2411-2430. doi: 10.1161/ATVBAHA.119.312889.
Berglund L, Lefevre M, Ginsberg HN, Kris-Etherton PM, Elmer PJ, Stewart PW, Ershow A, Pearson TA, Dennis BH, Roheim PS, Ramakrishnan R, Reed R, Stewart K, Phillips KM, DELTA Investigators. Comparison of monounsaturated fat with carbohydrates as a replacement for saturated fat in subjects with a high metabolic risk profile: studies in the fasting and postprandial states. The American journal of clinical nutrition. 2007 Dec:86(6):1611-20
Bolla AM, Caretto A, Laurenzi A, Scavini M, Piemonti L. Low-Carb and Ketogenic Diets in Type 1 and Type 2 Diabetes. Nutrients. 2019 Apr 26:11(5):. doi: 10.3390/nu11050962.
Ginsberg HN, Kris-Etherton P, Dennis B, Elmer PJ, Ershow A, Lefevre M, Pearson T, Roheim P, Ramakrishnan R, Reed R, Stewart K, Stewart P, Phillips K, Anderson N. Effects of reducing dietary saturated fatty acids on plasma lipids and lipoproteins in healthy subjects: the DELTA Study, protocol 1. Arteriosclerosis, thrombosis, and vascular biology. 1998 Mar:18(3):441-9
Mensink RP, Katan MB. Effect of dietary fatty acids on serum lipids and lipoproteins. A meta-analysis of 27 trials. Arteriosclerosis and thrombosis : a journal of vascular biology. 1992 Aug:12(8):911-9
Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Houston Miller N, Hubbard VS, Lee IM, Lichtenstein AH, Loria CM, Millen BE, Nonas CA, Sacks FM, Smith SC Jr, Svetkey LP, Wadden TA, Yanovski SZ, American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology. 2014 Jul 1:63(25 Pt B):2960-84. doi: 10.1016/j.jacc.2013.11.003.
Jahns L, Davis-Shaw W, Lichtenstein AH, Murphy SP, Conrad Z, Nielsen F. The History and Future of Dietary Guidance in America. Advances in nutrition (Bethesda, Md.). 2018 Mar 1:9(2):136-147. doi: 10.1093/advances/nmx025.
Nettleton JA, Brouwer IA, Geleijnse JM, Hornstra G. Saturated Fat Consumption and Risk of Coronary Heart Disease and Ischemic Stroke: A Science Update. Annals of nutrition & metabolism. 2017:70(1):26-33. doi: 10.1159/000455681.
Tsoupras A, Lordan R, Zabetakis I. Inflammation, not Cholesterol, Is a Cause of Chronic Disease. Nutrients. 2018 May 12:10(5):. doi: 10.3390/nu10050604.
Upadhyay RK. Emerging risk biomarkers in cardiovascular diseases and disorders. Journal of lipids. 2015:2015():971453. doi: 10.1155/2015/971453.
Cromwell WC, Otvos JD, Keyes MJ, Pencina MJ, Sullivan L, Vasan RS, Wilson PW, D'Agostino RB. LDL Particle Number and Risk of Future Cardiovascular Disease in the Framingham Offspring Study - Implications for LDL Management. Journal of clinical lipidology. 2007 Dec:1(6):583-92. doi: 10.1016/j.jacl.2007.10.001.
Siri-Tarino PW, Chiu S, Bergeron N, Krauss RM. Saturated Fats Versus Polyunsaturated Fats Versus Carbohydrates for Cardiovascular Disease Prevention and Treatment. Annual review of nutrition. 2015:35():517-43. doi: 10.1146/annurev-nutr-071714-034449.
Tholstrup T, Vessby B, Sandstrom B. Difference in effect of myristic and stearic acid on plasma HDL cholesterol within 24 h in young men. European journal of clinical nutrition. 2003 Jun:57(6):735-42
Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fatty acids and risk of coronary heart disease: modulation by replacement nutrients. Current atherosclerosis reports. 2010 Nov:12(6):384-90. doi: 10.1007/s11883-010-0131-6.
Dhaka V, Gulia N, Ahlawat KS, Khatkar BS. Trans fats-sources, health risks and alternative approach - A review. Journal of food science and technology. 2011 Oct:48(5):534-41. doi: 10.1007/s13197-010-0225-8.
Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fat, carbohydrate, and cardiovascular disease. The American journal of clinical nutrition. 2010 Mar:91(3):502-9. doi: 10.3945/ajcn.2008.26285.
Briggs MA, Petersen KS, Kris-Etherton PM. Saturated Fatty Acids and Cardiovascular Disease: Replacements for Saturated Fat to Reduce Cardiovascular Risk. Healthcare (Basel, Switzerland). 2017 Jun 21:5(2):. doi: 10.3390/healthcare5020029.
Donaldson MS. Nutrition and cancer: a review of the evidence for an anti-cancer diet. Nutrition journal. 2004 Oct 20:3():19
Holmes MD, Willett WC. Does diet affect breast cancer risk? Breast cancer research : BCR. 2004:6(4):170-8
Ayala A, Muñoz MF, Argüelles S. Lipid peroxidation: production, metabolism, and signaling mechanisms of malondialdehyde and 4-hydroxy-2-nonenal. Oxidative medicine and cellular longevity. 2014:2014():360438. doi: 10.1155/2014/360438.
Herman JP, McKlveen JM, Ghosal S, Kopp B, Wulsin A, Makinson R, Scheimann J, Myers B. Regulation of the Hypothalamic-Pituitary-Adrenocortical Stress Response. Comprehensive Physiology. 2016 Mar 15:6(2):603-21. doi: 10.1002/cphy.c150015.
Di Sebastiano KM, Mourtzakis M. The role of dietary fat throughout the prostate cancer trajectory. Nutrients. 2014 Dec 22:6(12):6095-109. doi: 10.3390/nu6126095.
Ocvirk S, O'Keefe SJ. Influence of Bile Acids on Colorectal Cancer Risk: Potential Mechanisms Mediated by Diet - Gut Microbiota Interactions. Current nutrition reports. 2017 Dec:6(4):315-322. doi: 10.1007/s13668-017-0219-5.
Liu AG, Ford NA, Hu FB, Zelman KM, Mozaffarian D, Kris-Etherton PM. A healthy approach to dietary fats: understanding the science and taking action to reduce consumer confusion. Nutrition journal. 2017 Aug 30:16(1):53. doi: 10.1186/s12937-017-0271-4.
Engin A. The Definition and Prevalence of Obesity and Metabolic Syndrome. Advances in experimental medicine and biology. 2017:960():1-17. doi: 10.1007/978-3-319-48382-5_1.
Lavie CJ, De Schutter A, Parto P, Jahangir E, Kokkinos P, Ortega FB, Arena R, Milani RV. Obesity and Prevalence of Cardiovascular Diseases and Prognosis-The Obesity Paradox Updated. Progress in cardiovascular diseases. 2016 Mar-Apr:58(5):537-47. doi: 10.1016/j.pcad.2016.01.008.
Meldrum DR, Morris MA, Gambone JC. Obesity pandemic: causes, consequences, and solutions-but do we have the will? Fertility and sterility. 2017 Apr:107(4):833-839. doi: 10.1016/j.fertnstert.2017.02.104.
Cetin D, Lessig BA, Nasr E. Comprehensive Evaluation for Obesity: Beyond Body Mass Index. The Journal of the American Osteopathic Association. 2016 Jun 1:116(6):376-82. doi: 10.7556/jaoa.2016.078.
Satija A, Yu E, Willett WC, Hu FB. Understanding nutritional epidemiology and its role in policy. Advances in nutrition (Bethesda, Md.). 2015 Jan:6(1):5-18. doi: 10.3945/an.114.007492.
Galgani J, Ravussin E. Energy metabolism, fuel selection and body weight regulation. International journal of obesity (2005). 2008 Dec:32 Suppl 7(Suppl 7):S109-19. doi: 10.1038/ijo.2008.246.
Bergouignan A, Kealey EH, Schmidt SL, Jackman MR, Bessesen DH. Twenty-four hour total and dietary fat oxidation in lean, obese and reduced-obese adults with and without a bout of exercise. PloS one. 2014:9(4):e94181. doi: 10.1371/journal.pone.0094181.
Lichtenstein AH, Kennedy E, Barrier P, Danford D, Ernst ND, Grundy SM, Leveille GA, Van Horn L, Williams CL, Booth SL. Dietary fat consumption and health. Nutrition reviews. 1998 May:56(5 Pt 2):S3-19; discussion S19-28
Authors
Copyright (c) 2025 Maytha Ali Aldosari, Noor Ahmed Yahya Almudyir, Tahani Mohammed Basher, Laila Mohammed Hawi Alnashri, Salihah Ibrahim Ahmed Mawkili, Norah Hmoud Alahmari, Maryam Naser Abdullah Albdullah, Essam Essa Mansour Alajam, Fadiah Naja Almutiri, Ahood Obeed Alanazi, Ameinah Mousem Almutairi, Ahlam Muteb Almutairi

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