{"id":417,"date":"2021-01-18T08:00:58","date_gmt":"2021-01-18T07:00:58","guid":{"rendered":"https:\/\/hjerteforeningen.dk\/fagnet\/?p=2273"},"modified":"2025-12-18T14:10:12","modified_gmt":"2025-12-18T14:10:12","slug":"maettet-fedt-hjoernesten-forebyggelse-hjerte-kar-sygdom","status":"publish","type":"artikel","link":"https:\/\/hjerteforeningen.dk\/fagnet\/artikler\/alle-artikler\/maettet-fedt-hjoernesten-forebyggelse-hjerte-kar-sygdom\/","title":{"rendered":"M\u00e6ttet fedt \u2013 en hj\u00f8rnesten i forebyggelse af hjerte-kar-sygdom"},"content":{"rendered":"\t\t
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Reduktion af m\u00e6ttet fedt har v\u00e6ret en hj\u00f8rnesten i forebyggelsen af hjerte-kar-sygdomme igennem \u00e5rtier. I de seneste \u00e5r er der s\u00e5et tvivl om evidensen bag disse anbefalinger. Bliv opdateret p\u00e5 den nyeste evidens om m\u00e6ttet fedt, den dertilh\u00f8rende debat og hvad Hjerteforeningen anbefaler.<\/h2>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Siden 1960 har anbefalingen om at reducere indtaget af m\u00e6ttet fedt v\u00e6ret anbefalet internationalt.\u00a0<\/span>Den samlede evidens<\/span>\u00a0vis<\/span>er<\/span>\u00a0en<\/span>\u00a0<\/span>sammenh\u00e6ng mellem et h\u00f8jt indtag af m\u00e6ttet fedt og en \u00f8get risiko for at udvikle hjerte-kar-sygdomme. Reduktion af m\u00e6ttet fedt har derfor v\u00e6ret en hj\u00f8rnesten i forebyggelsen af hjerte-kar-sygdomme. De officielle kostanbefalinger ang\u00e5ende m\u00e6ttet fedt har i adskillige lande, herunder Danmark og\u00a0<\/span>if\u00f8lge<\/span>\u00a0WHO (World Health Organization), p\u00e5 baggrund af disse studier anbefalet, at max. 10% af energien\u00a0<\/span>b\u00f8r<\/span>\u00a0stamme fra m\u00e6ttet fedt.<\/span>\u00a0<\/span><\/p>

De senere \u00e5r er der dog\u00a0<\/span>blandt en r\u00e6kke forskere\u00a0<\/span>s\u00e5et tvivl om evidensen bag disse anbefalinger, og om m\u00e6ttet fedt er s\u00e5 skadeligt, som man tidligere har troet i forhold til at \u00f8ge risikoen for hjerte-kar-sygdomme. Ern\u00e6ringsforskningen er et dynamisk felt og \u00e5bner hele tiden op for nye fund. Hjerteforeningen f\u00f8lger n\u00f8je med i forskningen p\u00e5 omr\u00e5det<\/span>\u00a0og vil i denne artikel fors\u00f8ge at samle op p\u00e5 evidensen<\/span>,\u00a0<\/span>de videnskabelige kontroverser<\/span>,<\/span>\u00a0men ogs\u00e5 hvor der er konsensus<\/span>.<\/span>\u00a0<\/span><\/p>

Konklusionen er dog forsat<\/span>,<\/span>\u00a0at\u00a0<\/span>s<\/span>elv om der de seneste \u00e5r er publiceret en r\u00e6kke studier, der viser at m\u00e6ttet fedt fra nogle f\u00f8devarer ikke er s\u00e5 skadeligt som hidtil\u00a0<\/span>antaget<\/span>\u00a0mangler vi stadig viden.\u00a0<\/span>Gennem de sidste 50-60 \u00e5r har studier st\u00f8ttet anbefalingen om at reducere m\u00e6ttet fedt i kampen mod hjerte-kar-sygdom<\/span>me<\/span>.\u00a0<\/span>Der er\u00a0<\/span>derfor<\/span>\u00a0forsat brug for tung<\/span>t<\/span>vejende og konsistent evidens til at underkende at\u00a0<\/span>m\u00e6ttet<\/span>\u00a0fedt har en betydning for udviklingen af hjerte-kar-sygdom<\/span>me<\/span>\u00a0og\u00a0<\/span>f<\/span>\u00f8rend et s\u00e5dant skift kan have betydning for anbefalingerne<\/span>. D<\/span>er\u00a0<\/span>er\u00a0<\/span>dermed<\/span>\u00a0behov for mere robuste og konsistente resultater, kontrollerede randomiserede studier og\u00a0<\/span>meta<\/span>–<\/span>a<\/span>nalyser heraf,\u00a0<\/span>s\u00e5ledes at<\/span>\u00a0den samlede litteratur p\u00e5 omr\u00e5det peger i den samme retning. S\u00e5 l\u00e6nge det ikke er tilf\u00e6ldet, f\u00f8lger vi i Hjerteforeningen\u00a0<\/span>debatten<\/span>\u00a0med stor opm\u00e6rksomhed, men finder endnu ikke\u00a0<\/span>tilstr\u00e6kkeligt<\/span>\u00a0grundlag for at \u00e6ndre\u00a0<\/span>p\u00e5 mange \u00e5rs solide<\/span>\u00a0anbefalinger.<\/span>\u00a0<\/span><\/p>

Den samlede litteratur st\u00f8tter stadig op om de officielle kostr\u00e5d og andre nationale og internationale instansers anbefalinger om at sk\u00e6re ned p\u00e5\u00a0<\/span>m\u00e6ttet fedt\u00a0<\/span>til fordel for um\u00e6ttet fedt<\/span>\u00a0<\/span>(<\/span>Mozaffarian<\/span>\u00a0et al. 2010<\/span>,<\/span>\u00a0<\/span>Kris-<\/span>Etherton<\/span>\u00a0<\/span>et al<\/span>.<\/span>\u00a02018<\/span>,\u00a0<\/span>Schwingshackl<\/span>\u00a0et al<\/span>.<\/span>\u00a02018,\u00a0<\/span>Arnett<\/span>\u00a0et al.\u00a0<\/span>\u00a02019<\/span>,\u00a0<\/span>Mazidi<\/span>\u00a0et al. 2020<\/span>).<\/span>\u00a0<\/span><\/p>

Hjerteforeningens anbefalinger l\u00e6gger sig op af de internationale og nationale anbefalinger om at reducere m\u00e6ttet fedt ned til max 10 E% og erstatte det med um\u00e6ttede fedtsyrer og fuldkorn.<\/span><\/p>

\u00a0<\/span><\/p>

Hvad er\u00a0<\/span>kontroverserne<\/span>?
<\/span><\/h3>

Siden offentligg\u00f8relsen af de nationale officielle kostr\u00e5d <\/span>om at reducere m\u00e6ttet fedt\u00a0<\/span>har<\/span>\u00a0nyere videnskabelige studier\u00a0<\/span>sat sp\u00f8rgsm\u00e5lstegn ved<\/span>, om m\u00e6ttet fedt er s\u00e5 skadeligt, som man tidligere har troet. Et af de studier, der har s\u00e5et tvivl om sammenh\u00e6ngen mellem indtag af m\u00e6ttet fedt og risiko for hjerte-kar-sygdom<\/span>me<\/span>, er gennemf\u00f8rt p\u00e5 baggrund af 21\u00a0<\/span>observationelle<\/span>\u00a0studier og konkluderer, at der ikke er nogle sammenh\u00e6ng mellem et h\u00f8j indtag af m\u00e6ttet fedt og risikoen for at udvikle hjerte-kar-sygdom (Siri-<\/span>Tarino<\/span> et al. 2010). En r\u00e6kke andre syste- matiske <\/span>reviews<\/span>\u00a0og\u00a0<\/span>meta<\/span>-analyser har ligeledes stillet sig kritiske over for kostr\u00e5det om at begr\u00e6nse m\u00e6ttet fedt i forhold til udvikling af d\u00f8d af alle \u00e5rsager, d\u00f8d af hjerte-kar-sygdom, isk\u00e6misk hjertesygdom, hjerte-kar-sygdom, og diabetes 2<\/span>\u00a0(de\u00a0<\/span>Souza<\/span>\u00a0el al. 2015<\/span>,\u00a0<\/span>Ramsden<\/span>\u00a0et al. 2016,\u00a0<\/span>Harcombe<\/span>\u00a0et al<\/span>.<\/span>\u00a02017<\/span>, Astrup et al<\/span>.<\/span>2019<\/span>)<\/span>.<\/span>\u00a0Der er enighed om<\/span>,<\/span>\u00a0at\u00a0<\/span>m\u00e6ttet fedt f\u00f8rer til en stigning i LDL<\/span>–<\/span>kolesterol<\/span>\u00a0og at LDL-<\/span>\u00a0<\/span>kolesterol har en kausal rolle i\u00a0<\/span>forhold til\u00a0<\/span>hjerte-kar patogenesen<\/span>\u00a0<\/span>(<\/span>Ference<\/span>\u202f<\/span>et al<\/span>.<\/span>\u00a02017)<\/span>. En<\/span>\u00a0direkte<\/span>\u00a0sammenh\u00e6ng mellem<\/span>\u00a0et h\u00f8jt indtag<\/span>\u00a0af m\u00e6ttet fedt\u00a0<\/span>som \u00e5rsag til en<\/span>\u00a0\u00f8get risiko<\/span>\u00a0for hjerte-kar-sygdom<\/span>me<\/span>\u00a0er\u00a0<\/span>dog\u00a0<\/span>ikke fuldt etablere<\/span>t<\/span>.\u00a0<\/span>Der er alts\u00e5 uenighed om i hvilken grad<\/span>\u00a0den kolesterols\u00e6nkende effekt p\u00e5 LDL-<\/span>\u00a0<\/span>kolesterol via reduktion af m\u00e6tte<\/span>t<\/span>\u00a0fedt er\u00a0<\/span>pr\u00e6diktiv<\/span>\u00a0for en reduceret risiko for hjerte-kar-sygdom<\/span>me<\/span>.<\/span>\u00a0<\/span>\u00a0<\/span><\/p>

Nogle studier indikere<\/span>r<\/span>\u00a0<\/span>ligeledes<\/span>,<\/span>\u00a0<\/span>at en reduktion udelukkende\u00a0<\/span>vil\u00a0<\/span>f\u00f8re til en reduktion i\u00a0<\/span>store<\/span>\u00a0LDL<\/span>-partikler<\/span>\u00a0<\/span>som\u00a0<\/span>har vist en mindre st\u00e6rk sammenh\u00e6ng\u00a0<\/span>med risikoen for hjerte-kar-sygdomme<\/span>\u00a0<\/span>sammenlignet med<\/span>\u00a0sm\u00e5 LDL-partikler<\/span>.<\/span>\u00a0<\/span>Samtidig med<\/span>\u00a0at de sm\u00e5 LDL-<\/span>\u00a0<\/span>partikler er mindre p\u00e5virkelige af m\u00e6ttet fedt\u00a0<\/span>fra<\/span>\u00a0kosten\u00a0<\/span>(<\/span>A<\/span>strup et al<\/span>.<\/span>\u00a02020<\/span>,\u00a0<\/span>Krauss<\/span>\u00a0& Kris-<\/span>Etherton<\/span>, 2020<\/span>).<\/span>\u00a0<\/span>Selv om store LDL-<\/span>\u00a0<\/span>partikler er mere kolesterolrige<\/span>\u00a0<\/span>har de\u00a0<\/span>if\u00f8lge studierne\u00a0<\/span>alts\u00e5\u00a0<\/span>den svageste association til risikoen for hjerte-kar-sygdom<\/span>\u00a0<\/span>(<\/span>Boren<\/span>\u00a0et al<\/span>.<\/span>\u00a02020)<\/span>.\u00a0<\/span>Studier indikere<\/span>r at<\/span>\u00a0<\/span>Apo<\/span>-B\u00a0<\/span>kan v\u00e6re en<\/span>\u00a0bedre pr\u00e6diktor for hjerte-kar-sygdom<\/span>. Denne stiger ogs<\/span>\u00e5 ved et \u00f8get indtag af m\u00e6ttet fedt<\/span>\u00a0(<\/span>Grundy<\/span>\u00a0et al<\/span>.<\/span>\u00a02018,\u00a0<\/span>Sniderman<\/span>\u00a0et al<\/span>.<\/span>\u00a02019)<\/span>.<\/span>\u00a0<\/span>\u00a0<\/span><\/p>

Nogle forskere mener<\/span>,<\/span>\u00a0<\/span>der er store individuelle forskelle p\u00e5\u00a0<\/span>effekten af en reduktion af m\u00e6ttet fedt\u00a0<\/span>og at\u00a0<\/span>det kun er\u00a0<\/span>hos<\/span>\u00a0<\/span>individer med\u00a0<\/span>dyslipid\u00e6mi<\/span>\u00a0og\u00a0<\/span>i\u00a0<\/span>h\u00f8j risi<\/span>ko for hjerte-kar-sygdom<\/span>me<\/span>\u00a0<\/span>som vil\u00a0<\/span>have fordel<\/span>\u00a0af\u00a0<\/span>en reduktion af m\u00e6ttet fedt\u00a0<\/span>i forhold til risikoen for hjerte-kar-sygdom\u00a0<\/span>(<\/span>Krauss<\/span>\u00a0<\/span>&<\/span>\u00a0Kris-<\/span>Etherton<\/span>\u00a02020<\/span>).<\/span>\u00a0<\/span><\/p>

Kritikerne af de g\u00e6ldende anbefalinger\u00a0<\/span>peger\u00a0<\/span>ogs\u00e5\u00a0<\/span>p\u00e5<\/span>,<\/span>\u00a0at der ikke er robust nok evidens for de g\u00e6l<\/span>d<\/span>ende anbefalinger om en reduktion p\u00e5<\/span>\u00a0<\/span>ned til<\/span>\u00a0<\/span>10\u00a0<\/span>E<\/span>%<\/span>\u00a0og der\u00a0<\/span>p\u00e5g\u00e5r<\/span>\u00a0dermed en diskussion om hvor langt\u00a0<\/span>ned og ved hvilken gr\u00e6nse den generelle anbefaling skal v\u00e6re<\/span>\u00a0(<\/span>Krauss<\/span>\u00a0et al<\/span>.<\/span>\u00a02020<\/span>)<\/span>. Desuden p\u00e5peges det<\/span>,<\/span>\u00a0at nogle studier indikere<\/span>r<\/span>\u00a0en beskyttende effekt\u00a0<\/span>af m\u00e6ttet fedt\u00a0<\/span>p\u00e5 fx slagtilf\u00e6lde<\/span>\u00a0<\/span>(<\/span>Kang<\/span>\u00a0<\/span>et al<\/span>.<\/span>\u00a02020, Zhu et al<\/span>.<\/span>\u00a02019<\/span>)<\/span>.<\/span>\u00a0<\/span>\u00a0<\/span><\/p>

De fleste af ovenst\u00e5ende studier er dog\u00a0<\/span>meta<\/span>–<\/span>analyser af prospektive\u00a0<\/span>observationelle<\/span>\u00a0studier, hvor man har set p\u00e5 effekten af m\u00e6ttet fedt p\u00e5 risikoen for hjerte-kar-sygdom og ikke samtidig har set p\u00e5, hvad det udskiftes med, hvilket er muligt i kliniske studier, og vil fejlagtigt konkludere, at der ikke er nogen effekt af m\u00e6ttet fedt p\u00e5 risiko for hjerte-kar-sygdom (Jakobsen et al. 2009,\u00a0<\/span>Chowdhury<\/span>\u00a0et al. 2014).<\/span>\u00a0<\/span><\/p>

De<\/span>t ser ud til<\/span>,<\/span>\u00a0at det er typen af fedtsyrer og det der tr\u00e6der i stedet for m\u00e6ttet fedt\u00a0<\/span>ved en reduktion,\u00a0<\/span>der har betydning for\u00a0<\/span>studiernes konklusioner om hvorvidt m\u00e6ttet fedt\u00a0<\/span>er skadeligt eller ej.<\/span><\/p>

\u00a0<\/span><\/p>

Typen af fedtsyrer<\/span>\u00a0og effekten p\u00e5 hjerte-kar-sygdomme
<\/span><\/h3>

Det har vist sig, at typen af fedtsyrer fremfor det totale fedtindtag har en st\u00f8rre betydning ift. at forebygge hjerte-kar-sygdomme. <\/span>Dietary<\/span>\u00a0Guidelines\u00a0<\/span>Advisory<\/span>\u00a0<\/span>Committee<\/span>\u00a0i USA afsluttede i 2015 en stor rapport, som konkluderede, at der ikke er bel\u00e6g for at reducere kostens totale indhold af fedt. Dette st\u00f8ttes op i andre instansers guidelines<\/span>\u00a0\u2013 ogs\u00e5 de nordiske<\/span>\u00a0<\/span>(<\/span>Piepoli<\/span>\u00a0et al. 2016,\u00a0<\/span>Sacks<\/span>\u00a02017, National r\u00e5d for ern\u00e6ring 2017). Her peges p\u00e5, at gevinsten opn\u00e5s ved at reducere indtaget af m\u00e6ttet fedt, specielt\u00a0<\/span>laurinsyre<\/span>,\u00a0<\/span>myristinsyre<\/span>\u00a0og\u00a0<\/span>palmitinsyre<\/span>. Det totale fedtindtag b\u00f8r dog ikke overstige 35 E%, da det er associeret til et st\u00f8rre indtag af m\u00e6ttet fedt og kalorier (<\/span>Piepoli<\/span>\u00a0et al. 2016).<\/span>\u00a0<\/span><\/p>

I de nordiske n\u00e6ringsstofanbefalinger fra 2012 er der af samme grund mere fokus p\u00e5 typen af de enkelte fedtsyrer fremfor det totale fedtindtag (NNR 2012).\u00a0<\/span>\u00a0<\/span><\/p>

Hjerteforeningen f\u00f8lger de nordiske n\u00e6ringsstofanbefalinger, dvs. at kostens fedtindhold af hensyn til reduktionen af risikoen for hjerte-kar-sygdom b\u00f8r f\u00f8lge\u00a0<\/span><\/span>nedenst\u00e5ende<\/span><\/span>\u00a0anbefalinger.<\/span><\/span>\u00a0<\/span><\/p>
Fedt<\/strong><\/td>NNR 2012<\/strong><\/td>Danskernes indtag (2003-2008)<\/strong><\/td><\/tr>
Fedt, totalt<\/td>25-40 E%<\/td>36<\/td><\/tr>
M\u00e6ttet<\/td><10 E%<\/td>14-15<\/td><\/tr>
Transfedt<\/td>Minimum<\/td>0,6<\/td><\/tr>
Enkeltum\u00e6ttet<\/td>10-20 E%<\/td>12<\/td><\/tr>
Flerum\u00e6ttet<\/td>5-10 E%<\/td>5<\/td><\/tr>
–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Heraf n-3<\/td>> 1 E%<\/td>\u00a0<\/td><\/tr><\/tbody><\/table>

L\u00e6s mere om de forskellige fedtsyrer\u00a0<\/span>her<\/span><\/a>\u00a0<\/span><\/p>

Et\u00a0<\/span>observationelt<\/span>\u00a0studie publiceret i Lancet viste, at et h\u00f8jt indtag af kulhydrater var associeret med en h\u00f8jere risiko for d\u00f8d, mens total fedt og de enkelte typer af fedtsyrer var forbundet med en lavere risiko (<\/span>Dehghan<\/span>\u00a0et al<\/span>.<\/span>\u00a02017). Studiet viser, at man f\u00e5r en bedre beskyttelse mod hjerte-kar-sygdomme, hvis man f\u00e5r begr\u00e6nsede m\u00e6ngder af m\u00e6ttet fedt, end hvis man bytter dette ud med simple kulhydrater som ris, hvidt br\u00f8d og sukker. Begr\u00e6nsningen ved dette studie er<\/span>,<\/span>\u00a0at der ikke er skelnes mellem typen af kulhydrater og dermed om det er fuldkorn eller andre typer kulhydrater som raffinerede kulhydrater.<\/span>\u00a0<\/span><\/p>

N\u00e5r man skal vurdere sundhedseffekterne af forskellige typer fedt, ser man blandt andet p\u00e5, hvordan fedtet p\u00e5virker kroppens kolesterol, og hvordan det h\u00e6nger sammen med risikoen for at f\u00e5 hjerte-kar-sygdomme. Og endelig fokuserer man i den videnskabelige diskussion om m\u00e6ttet fedt i h\u00f8j grad p\u00e5, hvad der b\u00f8r erstatte det m\u00e6ttede fedt. Virkningen p\u00e5 hjerte-kar-sygdom<\/span>me<\/span>\u00a0vil sandsynligvis afh\u00e6nge af kilderne til m\u00e6ttet fedt, og hvad man v\u00e6lger at spise i stedet for \u2013 alts\u00e5 hvad m\u00e6ttet fedt erstattes med, hvis man reducerer indtaget.<\/span>\u00a0<\/span>\u00a0<\/span><\/p>

\u00a0<\/span><\/p>

Erstatning ved reduktion af m\u00e6ttet fedt<\/span>\u00a0og effekten p\u00e5 hjerte-kar-sygdomme<\/span><\/h3>

En r\u00e6kke studier peger p\u00e5, at gevinsten ved at reducere indtaget af m\u00e6ttet fedt i h\u00f8j grad afh\u00e6nger af, hvad der spises i stedet for. <\/span>Udskiftning af m\u00e6ttet fedt med kulhydrater \u2013 specielt raffinerede\u00a0<\/span>reducerede ikke<\/span>\u00a0<\/span>risikoen<\/span>\u00a0for at udvikle hjerte-kar-sygdom<\/span>me<\/span>, hvorfor<\/span>\u00a0reduktion i indtaget af m\u00e6ttet fedt ikke b\u00f8r erstattes af raffinerede kulhydrater<\/span>\u00a0og tilsat sukker<\/span>, men med en kombination af polyum\u00e6ttede n-6 og n-3 fedtsyrer samt fuldkornsprodukter<\/span>. D<\/span>og uden at overskride energibehovet<\/span>\u00a0(<\/span>Farvid<\/span>\u00a0et al. 2014, Li et al. 2015,\u00a0<\/span>Hooper<\/span>\u00a0et al.<\/span>\u00a02015,\u00a0<\/span>Mensink<\/span>\u00a0et al.\u00a0<\/span>2016<\/span>,\u00a0<\/span>Piepoli<\/span>\u00a0et al. 2016, National r\u00e5d for ern\u00e6ring 2017,\u00a0<\/span>Sacks<\/span>\u00a0<\/span>et al.\u00a0<\/span>2017,\u00a0<\/span>Clifton<\/span>\u00a0et al. 2017,\u00a0<\/span>Forouhi<\/span>\u00a0et al<\/span>.<\/span>\u00a02018)<\/span>.<\/span>\u00a0<\/span><\/p>

Meta<\/span>–<\/span>analyser, der evaluerer effekten af udskiftning af m\u00e6ttet fedt med polyum\u00e6ttede fedtsyrer (PUFA), fandt signifikante fordele.\u00a0<\/span>Ovenst\u00e5ende figur viser\u00a0<\/span>\u00e6ndringer i total<\/span>\u00a0d\u00f8delighed ved\u00a0<\/span>isokalorisk<\/span>\u00a0udskiftning\u00a0<\/span>fra forskellige typer fedt.\u00a0<\/span>S<\/span>\u00e6rligt udskiftning med\u00a0<\/span>PUFA<\/span>\u00a0<\/span>har en kolesterols\u00e6nkende effekt<\/span>\u00a0og en positiv effekt p\u00e5 d\u00f8deligheden<\/span>\u00a0n\u00e5r man udskifter\u00a0<\/span>5<\/span>\u00a0% af<\/span>\u00a0energien\u00a0<\/span>fra m\u00e6ttet fedt med\u00a0<\/span>5<\/span>\u00a0% af energien fra\u00a0<\/span>PUFA<\/span>\u00a0<\/span>–\u00a0<\/span>efterfulgt af<\/span>\u00a0monoum\u00e6ttede fedtsyrer<\/span>\u00a0(MUFA)<\/span>\u00a0(<\/span>Jakobsen et al. 2015, Wang et al<\/span>.<\/span>\u00a02016;\u00a0<\/span>Mensink<\/span>\u00a0et al. 2016<\/span>)<\/span>.<\/span>\u00a0<\/span>Studiet viser en 25<\/span>\u00a0<\/span>% reduktion for PUFA,<\/span>\u00a010 % for MUFA<\/span>\u00a0og 9 % for udskiftning med fuldkorn<\/span>\u00a0(<\/span>Wang et al<\/span>.<\/span>\u00a02016).<\/span>\u00a0<\/span><\/p>

Nogle forskere<\/span>\u00a0pointere<\/span>r<\/span>\u00a0dog<\/span>,<\/span>\u00a0at det ikke er vist om\u00a0<\/span>det er m\u00e6ttet fedt der er skadeligt,\u00a0<\/span>eller<\/span>\u00a0<\/span>om det er\u00a0<\/span>den \u00f8gede\u00a0<\/span>m\u00e6ngde\u00a0<\/span>PUFA der giver\u00a0<\/span>\u00e6ndringer i risiko og total<\/span>\u00a0d\u00f8delighed<\/span>\u00a0<\/span>og derved virker beskyttende, samtidigt med at\u00a0<\/span>m\u00e6ttet fedt<\/span>s effekt p\u00e5 hjerte-kar-sygdom<\/span>me<\/span>\u00a0er neutral<\/span>.<\/span>\u00a0Alts\u00e5 om de fordele der ses skyldes stigningen i indtaget af PUFA fremfor reduktionen af m\u00e6ttet fedt<\/span>\u00a0per se<\/span>\u00a0(<\/span>Krauss<\/span>\u00a0et al<\/span>.<\/span>\u00a02020)<\/span>.<\/span>\u00a0<\/span>Der er s\u00e5ledes god evidens for<\/span>,<\/span>\u00a0at en reduktion i m\u00e6ttet fedt til fordel for PUFA har en\u00a0<\/span>positiv\u00a0<\/span>effekt p\u00e5 hjerte-kar-sygdom<\/span>me<\/span>\u00a0og d\u00f8d. Men at denne sammenh\u00e6ng mul<\/span>i<\/span>gvis er mindre for slagtilf\u00e6lde og hjertesvigt (<\/span>Dietary<\/span>\u00a0Guidelines\u00a0<\/span>Advisory<\/span>\u00a0<\/span>Committee<\/span>,<\/span>\u00a02020)<\/span>.<\/span>\u00a0<\/span>I e<\/span>t nyere systematisk Cochrane\u00a0<\/span>review<\/span>\u00a0fandt man<\/span>,<\/span>\u00a0at en\u00a0<\/span>reduktion af m\u00e6ttet fedt til fordel for um\u00e6ttede fedtsyrer hos raske<\/span>\u00a0personer<\/span>\u00a0gav en reduceret risiko for hjerte-kar-sygdom<\/span>me<\/span>\u00a0\u2013 om end man ikke s\u00e5 en\u00a0<\/span>reduceret<\/span>\u00a0risiko p\u00e5 d\u00f8d og der ikke var en sammenh\u00e6ng mellem\u00a0<\/span>blodprop<\/span>\u00a0og s<\/span>lagtilf\u00e6lde<\/span>\u00a0(Hooper et al<\/span>.<\/span>\u00a02020).\u00a0<\/span>\u00a0<\/span><\/p>

Polyum\u00e6ttede fedtsyrer<\/span><\/i><\/b>
<\/span>Studier viser en overbevisende dokumentation for, at n-6\u00a0<\/span>(omega-6 fedtsyrer)\u00a0<\/span>s\u00e6nker risikoen for korornar hjertesygdom, mens n-3<\/span>\u00a0(omega-3 fed<\/span>tsyrer<\/span>)<\/span>\u00a0s\u00e6nker risikoen for d\u00f8d af hjerteinfarkt. Der er\u00a0<\/span>generel\u00a0<\/span>evidens for, at reduktion af m\u00e6ttet fedt i kosten udskiftes med\u00a0<\/span>PUFA<\/span>, og at det reducerer LDL og d\u00f8d af alle \u00e5rsager (<\/span>Farvid<\/span>\u00a0et al<\/span>.<\/span>\u00a02014,\u00a0<\/span>Tapsell<\/span>\u00a0et al<\/span>.<\/span>\u00a02016, Wang et al<\/span>.<\/span>\u00a02016).\u00a0<\/span>\u00a0<\/span>\u00a0<\/span><\/p>

P\u00e5 trods af, at tidligere studier har vist, at erstatning af m\u00e6ttet fedt med n-6, reducerer risikoen for hjerte-kar-sygdomme (prim\u00e6rt ved at have en gavnlig effekt p\u00e5 lipidprofilen), s\u00e5 er der sidenhen blevet s\u00e5et tvivl om validiteten og konklusionerne af nogle af de oprindelige studier (<\/span>Ramsden<\/span>\u00a0et al. 2013,\u00a0<\/span>Ramsden<\/span>\u00a0et al. 2016)<\/span>, da<\/span>\u00a0<\/span>e<\/span>n re-analyse af data<\/span>\u00a0fra disse studier<\/span>\u00a0 vist<\/span>e<\/span>, at et h\u00f8jt indtag af n-6 \u00f8ger risikoen for hjerte-kar-sygdomme (<\/span>Ramsden<\/span>\u00a0et al. 2010,\u00a0<\/span>Ramsden<\/span>\u00a0et al. 2013,\u00a0<\/span>Ramsden<\/span>\u00a0et al. 2016). Dette fund sammenholdt med mangel p\u00e5 randomiserede studier der har kunne p\u00e5vise en sundhedsm\u00e6ssig gevins<\/span>t<\/span>\u00a0<\/span>a<\/span>f n-6 har f\u00f8rt til debat om hvorvidt man skulle anbefale et reduceret indtag af n-6. <\/span><\/p>

Den samlede evidens peger dog p\u00e5, at et h\u00f8jt indtag af n-6 har en gavnlig eller neutral effekt p\u00e5 risikoen for udvikling af hjerte-kar-sygdom<\/span>me<\/span>. Der er en tendens til, at de\u00a0<\/span>observationelle<\/span>\u00a0studier finder en association mellem et h\u00f8jt indtag af n-6 og en reduceret risiko for hjerte-kar-sygdom<\/span>me<\/span>\u00a0og d\u00f8d af hjerte-kar-sygdom<\/span>me<\/span>\u00a0(Marklund et al. 2019, Li et al. 2020). Omvendt er der en tendens til, at de kliniske studier ikke finder nogle sammenh\u00e6nge mellem et \u00f8get indtag af n-6 og risiko for hjerte-kar-sygdom<\/span>me<\/span>\u00a0(<\/span>Hamley<\/span>\u00a02017, Hooper et al. 2019). Dog ses der en\u00a0<\/span>generel\u00a0<\/span>bedring af lipidprofilen i form af et reduceret niveau af kolesterol i blodet (Hooper et al. 2019). Samtidigt er nationale og internationale instanser enige om, at der ikke er evidens for\u00a0<\/span>at \u00e6ndre anbefalingerne for n-6 p\u00e5 nuv\u00e6rende tidspunkt og at der ikke er evidens for en skadelig effekt<\/span>\u00a0<\/span>(<\/span>Mach et al. 2020<\/span>,<\/span>\u00a0<\/span>Sacks<\/span>\u00a0et al. 2017<\/span>)<\/span>.\u00a0<\/span>\u00a0<\/span><\/p>

Noget tyder p\u00e5, at de potentielle gavnlige effekter ved et h\u00f8jt indtag af n-6 prim\u00e6rt f\u00e5s ved et h\u00f8jt indtag af linolsyre<\/span>, som\u00a0<\/span>hovedsageligt<\/span>\u00a0<\/span>findes\u00a0<\/span>i vegetabilske olier, som fx rapsolie, solsikkeolie, etc.<\/span>\u00a0Andre vegetabilske olier, som d<\/span>e<\/span>\u00a0<\/span>tropiske planteolier\u00a0<\/span>(<\/span>kokosolie, palmekerneolie mv.<\/span>)<\/span>\u00a0anbefales ikke, da de har et meget h\u00f8jt indhold af m\u00e6ttet fedt (90 %), ingen n-3 fedtsyrer og et meget lavt indhold af n-6 fedtsyrer.\u00a0<\/span>\u00a0<\/span><\/p>

Blandt PUFA<\/span>\u00a0skelnes\u00a0<\/span>der<\/span>\u00a0mellem langk\u00e6dede fedtsyrer (linolsyre,\u00a0<\/span>linolensyre<\/span>,\u00a0<\/span>arachidonsyre<\/span>) og meget langk\u00e6dede fedtsyrer (<\/span>eicosapentaensyre<\/span>\u00a0og\u00a0<\/span>docosahexaensyre<\/span>), hvor sidstn\u00e6vnte kun f\u00e5s fra fisk<\/span>\u00a0og\u00a0<\/span>marine\u00a0<\/span>alger<\/span>\u00a0(herunder tang)<\/span>. Disse fedtsyrer kan neds\u00e6tte risikoen for pludselig d\u00f8d som f\u00f8lge af blodprop i hjertet og blodprop i hjernen (slagtilf\u00e6lde). Holdepunkterne herfor er bedst hos personer, der allerede har symptomer p\u00e5 \u00e5reforkalkning og svagere hos raske personer. Det anbefales if\u00f8lge Hjerteforeningen og de officielle kostr\u00e5d at alle spiser <\/span>350 gram fisk om ugen<\/span>, hvor<\/span>\u00a0200 gram<\/span>\u00a0heraf b\u00f8r<\/span>\u00a0v\u00e6re fede fisk, da de har et h\u00f8jt indhold af n-3<\/span>. Har du f\u00e5et konstateret en hjerte-kar-sygdom, anbefales det imidlertid, at du spiser 300 gram fed fisk om ugen.<\/span>\u00a0<\/span>\u00a0<\/span><\/p>

Der er i dag blandt nationale og internationale instanser overvejende enighed om, at der p\u00e5 nuv\u00e6rende tidspunkt ikke er evidens for at anbefale en optimal ratio for n-3\/n-6 PUFA. Hvorfor der hellere b\u00f8r fokuseres p\u00e5 at opn\u00e5 et h\u00f8jt indtag af b\u00e5de n-3 og n-6 fremfor at fokusere p\u00e5 at opn\u00e5 en bestemt ratio<\/span>\u00a0<\/span>(<\/span>NNR 2012<\/span>,<\/span>\u00a0<\/span>Mach et al. 2020<\/span>)<\/span>.<\/span>\u00a0<\/span><\/p>

Monoum\u00e6ttede fedtsyrer<\/span><\/i><\/b>
<\/span>Studier viser generelt, at MUFA har en positiv effekt p<\/span>\u00e5<\/span>\u00a0<\/span>ko<\/span>lesterolniveaet, hvor\u00a0<\/span>HDL-niveauet<\/span>\u00a0<\/span>stiger<\/span>\u00a0og LDL-niveauet<\/span>\u00a0falder<\/span>, n<\/span>\u00e5<\/span>r de erstatter m<\/span>\u00e6<\/span>ttet fedt og\u00a0<\/span>simple\u00a0<\/span>kulhydrater (<\/span>Mensink<\/span>\u00a0et al 1992<\/span>;\u00a0<\/span>Sacks<\/span>\u00a0et al. 2017<\/span>), men der er lille evidens for, at MUFA reducerer risikoen for at udvikle\u00a0<\/span>hjerte-kar-<\/span>sy<\/span>gdom<\/span>me<\/span>\u00a0(<\/span>Piepoli<\/span>\u00a0et al. 2016<\/span>;\u00a0<\/span>Hooper et al. 2020; Zhu, Bo, and Liu 2019<\/span>).\u00a0<\/span>Indtaget af MUFA korrelerer ofte med indtaget af m<\/span>\u00e6<\/span>ttet fedt, da en af kilderne til MUFA er animalsk fedt. Studier fremh<\/span>\u00e6<\/span>ver dog, at der er evidens for, at MUFA fra planter, fx olivenolie og n<\/span>\u00f8<\/span>dder, er forbundet med en\u00a0<\/span>reduceret\u00a0<\/span>\u00a0risiko<\/span>\u00a0for hjerte-kar-sygdom<\/span>me<\/span>\u00a0(Zong et al. 2018;\u00a0<\/span>Zhuang<\/span>\u00a0et al. 2019;\u00a0<\/span>Guasch-Ferr\u00e9<\/span>\u00a0et al. 2019)<\/span>, jf. den forebyggende effekt af\u00a0<\/span>middelhavskosten<\/span>\u00a0<\/span>(<\/span>Estruch<\/span>\u00a0et al.\u00a0<\/span>2018)<\/span>.<\/span>\u00a0P\u00e5 denne baggrund se<\/span>s det<\/span>, at der blandt internationale instanser i nogen grad stadig anbefale<\/span>s<\/span>\u00a0erstatning af m\u00e6ttet fedt med MUFA, men samtidigt anerkender de, at effekten i forhold til\u00a0<\/span>risiko for at udvikle eller d\u00f8 af<\/span>\u00a0hjerte-kar-sygdomme<\/span>\u00a0er mindre, sammenlignet med fx PUFA (<\/span>Piepoli<\/span>\u00a0et al. 2016;\u00a0<\/span>Sacks<\/span>\u00a0et al. 2017). I forl\u00e6ngelse\u00a0<\/span>heraf<\/span>\u00a0peger et nyt Cochrane\u00a0<\/span>review<\/span>\u00a0p\u00e5, at der ikke er\u00a0<\/span>tilstr\u00e6kkelige<\/span>\u00a0data til at konkludere noget omkring effekten af erstatning af m\u00e6ttet fedt med MUFA p\u00e5 risikoen for at udvikle hjerte-kar-sygdomme (Hooper et al. 2020). Dette kan forklare hvorfor\u00a0<\/span>anbefalinger om indtag af\u00a0<\/span>MUFA\u00a0<\/span>ikke er s\u00e5 fremtr\u00e6dende i\u00a0<\/span>de internationale <\/span>anbefalinger.<\/span>\u00a0<\/span>P\u00e5 baggrund af konsistent<\/span>\u00a0dokumentatio<\/span>n\u00a0<\/span>for<\/span>\u00a0<\/span>den positive\u00a0<\/span>effekt af <\/span>mid<\/span>d<\/span>elhavskosten<\/span>\u00a0p\u00e5 hjerte-kar-sygdomme og de<\/span>\u00a0f\u00f8devarer med et h\u00f8jt indhold af MUFA som<\/span>\u00a0<\/span>indg\u00e5r som en del af\u00a0<\/span>middelhavskosten<\/span>,<\/span>\u00a0anbefaler Hjerteforeningen\u00a0<\/span>at m\u00e6ttet fedt begr\u00e6nses til fordel for<\/span>\u00a0dels<\/span>\u00a0f\u00f8devarer rige p\u00e5 PUFA, men ogs\u00e5 f\u00f8devarer rige p\u00e5 MUFA<\/span>\u00a0<\/span>som\u00a0<\/span>n\u00f8dder, mandler, avocado, fr\u00f8 og kerner og olier \u2013 is\u00e6r i olivenolie<\/span>.<\/span>\u00a0<\/span><\/p>

\u00a0<\/span><\/p>

Forskellige k<\/span>ilder<\/span>\u00a0til m\u00e6ttet fedt<\/span>\u00a0og effekt<\/span>en<\/span>\u00a0<\/span>p\u00e5 hjerte-kar-sygdom<\/span>me
<\/span><\/h3>

Nye studier peger p\u00e5, at det kan v\u00e6re relevant ikke\u00a0<\/span>kun<\/span>\u00a0<\/span>at se p\u00e5 m\u00e6ttet fedt som en gruppe. Det ser ud til, at m\u00e6ttet fedt har forskellig virkning p\u00e5 risikoen for at udvikle hjerte-kar-sygdom<\/span>me<\/span>\u00a0afh\u00e6ngig af hvilken type fedtsyrer, der er tale om og afh\u00e6ngig af, hvilke f\u00f8devarer fedtsyrerne optr\u00e6der i (Astrup et al. 20<\/span>20<\/span>).<\/span>\u00a0<\/span><\/p>

Man skal alts\u00e5 se p\u00e5 den hele f\u00f8devare og dens sammens\u00e6tning af fedtsyrer samt \u00f8vrige indholdsstoffer og hvordan den samlede f\u00f8devare har effekt p\u00e5 risikoen for hjerte-kar-sygdom<\/span>me<\/span>. En del forskning foresl\u00e5r, at forskellige typer af m\u00e6ttet fedt kan have forskellig effekt p\u00e5 din risiko for\u00a0<\/span>at udvikle hjerte-kar-sygdom<\/span>me<\/span>. Fx viser nyere studier, at m\u00f8rk chokolade, p\u00e5 trods af et h\u00f8jt indhold af m\u00e6ttet fedt, har en positiv indvirkning p\u00e5 risikoen for at udvikle hjerte-kar-sygdomme.<\/span>\u00a0Her mener man at det er\u00a0<\/span>den m\u00e6ttede fedtsyrer\u00a0<\/span>stearinsyren der\u00a0<\/span>i den m\u00f8rke chokolade bidrager til den positive effekt.<\/span>\u00a0Man skal dog v\u00e6re opm\u00e6rksom p\u00e5, at alle f\u00f8devarer indeholder mange forskellige typer af m\u00e6ttet fedt, samt at det ikke n\u00f8dvendigvis er m\u00e6ttet fedt per se, men m\u00e5ske andre indholdsstoffer, der i samspil med eller alene, har betydning for risikoen for udvikling af hjerte-kar-sygdom<\/span>me<\/span>. Et h\u00f8jt indtag af \u00e6g anses for at have en neutral indvirkning, mens uforarbejdet k\u00f8d synes at have en neutral eller negativ virkning. Indholdet af forskellige typer af m\u00e6ttede fedtsyrer er alts\u00e5 forskelligt fra f\u00f8devare til f\u00f8devare og der er videnskabelig dokumentation for, at forskellige typer af m\u00e6ttede fedtsyrer har divergerende effekter p\u00e5 hjerte-kar-sygdom<\/span>me<\/span>\u00a0(Wang & Hu, 2014)<\/span>.<\/span>\u00a0<\/span><\/p>

E<\/span>nkelte studier har unders\u00f8gt sammenh\u00e6ngen mellem indtag af m\u00e6ttet fedt fra forskellige f\u00f8devarekilder og helbred<\/span>\u00a0<\/span>(de\u00a0<\/span>Oliveira<\/span>\u00a0Otto et al<\/span>.<\/span>\u00a02012,\u00a0<\/span>Praagman<\/span>\u00a0et al<\/span>.<\/span>\u00a02016a,\u00a0<\/span>Praagman<\/span>\u00a0et al<\/span>.<\/span>\u00a02016b, Liu et al. 2018)<\/span>.<\/span>\u00a0Fortolkningen af resultaterne fra disse studier er imidlertid ikke klar, da effekten af m\u00e6ttet fedt ikke kan adskilles fra effekten af de \u00f8vrige n\u00e6ringsstoffer i den p\u00e5g\u00e6ldende f\u00f8devarekilde.\u00a0<\/span>Vi ved alts\u00e5\u00a0<\/span>endnu ikke pr\u00e6cist hvad det er for nogle sammenh\u00e6nge der er mellem kostkomponenterne i f\u00f8devarerne<\/span>.<\/span>\u00a0<\/span>Der mangler derfor flere underbyggende studier for endeligt at underst\u00f8tte dette. Lige nu er der derfor ikke grundlag for at fremh\u00e6ve noget m\u00e6ttet fedt frem for andet. Det er\u00a0<\/span>dog\u00a0<\/span>bedre at udskifte fx k\u00f8d med fede fisk og udskifte chokolade med n\u00f8dder.<\/span>\u00a0<\/span><\/p>

[hjf-shortcodes_factbox title=”F\u00f8devarematricer”]Mad best\u00e5r af forskellige n\u00e6ringsstoffer som en del af en kompleks struktur af vand, fiber, vitaminer, mineraler osv. Dette bliver kaldt madvarens food-matrix eller f\u00f8devarematricer. I tidligere studier har man fors\u00f8gt at knytte enkelte n\u00e6ringsstoffer til sundhedseffekter, som begrundelse for den fundne effekt p\u00e5 diverse udfald.
De seneste \u00e5r har ern\u00e6ringsforskningen imidlertid flyttet fokus fra effekten\u00a0af indtag af enkelte n\u00e6ringsstoffer p\u00e5 helbredet til effekten af indtag af hele f\u00f8devarer. Effekten af en f\u00f8devare er sandsynligvis ikke kun bestemt af f\u00f8devarens sammens\u00e6tning (fx indholdet af m\u00e6ttet fedt og andre n\u00e6ringsstoffer), men ogs\u00e5 af f\u00f8devarens struktur (fx fast struktur versus flydende), der har betydning for ford\u00f8jelse og absorption af n\u00e6ringsstofferne og andre indholdsstoffer. Det betyder at en f\u00f8devares effekt p\u00e5 helbredet sandsynligvis ikke bestemmes alene ud fra indholdet af n\u00e6ringsstoffer og andre indholdsstoffer. I nyere studier er man derfor begyndt at se p\u00e5 effekten af hele f\u00f8devarer, i stedet for n\u00e6ringsstoffer hver is\u00e6r og hvilken betydning samspillet af de forskellige kostkomponenter har ift. til sundhedseffekterne.\u00a0[\/hjf-shortcodes_factbox]<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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\n F\u00f8devarematricer <\/div>\n\n
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Mad best\u00e5r af forskellige n\u00e6ringsstoffer som en del af en kompleks struktur af vand, fiber, vitaminer, mineraler osv. Dette bliver kaldt madvarens food-matrix eller f\u00f8devarematricer. I tidligere studier har man fors\u00f8gt at knytte enkelte n\u00e6ringsstoffer til sundhedseffekter, som begrundelse for den fundne effekt p\u00e5 diverse udfald.
De seneste \u00e5r har ern\u00e6ringsforskningen imidlertid flyttet fokus fra effekten\u00a0af indtag af enkelte n\u00e6ringsstoffer p\u00e5 helbredet til effekten af indtag af hele f\u00f8devarer. Effekten af en f\u00f8devare er sandsynligvis ikke kun bestemt af f\u00f8devarens sammens\u00e6tning (fx indholdet af m\u00e6ttet fedt og andre n\u00e6ringsstoffer), men ogs\u00e5 af f\u00f8devarens struktur (fx fast struktur versus flydende), der har betydning for ford\u00f8jelse og absorption af n\u00e6ringsstofferne og andre indholdsstoffer. Det betyder at en f\u00f8devares effekt p\u00e5 helbredet sandsynligvis ikke bestemmes alene ud fra indholdet af n\u00e6ringsstoffer og andre indholdsstoffer. I nyere studier er man derfor begyndt at se p\u00e5 effekten af hele f\u00f8devarer, i stedet for n\u00e6ringsstoffer hver is\u00e6r og hvilken betydning samspillet af de forskellige kostkomponenter har ift. til sundhedseffekterne.\u00a0<\/p> <\/div>\n <\/div>\n <\/div>\n \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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For at vurdere en f\u00f8devares p\u00e5virkning og betydning for hjerte-kar-sygdom<\/span>me<\/span>\u00a0b\u00f8r hele f\u00f8devaren og kostm\u00f8nsteret tages i betragtning og ikke kun en enkelt komponent som fx m\u00e6ttet fedt.\u00a0<\/span>\u00a0<\/span><\/p>

M<\/span>\u00e6ttet fedt er\u00a0<\/span>kun\u00a0<\/span>en del af \u00e5rsagen eller bidraget til kolesterolstigningen, men det handler\u00a0<\/span>alts\u00e5\u00a0<\/span>ikke\u00a0<\/span>kun\u00a0<\/span>om n\u00e6ringsstoffer og enkelte f\u00f8devarer, men om den samlede dagskost. En kost med lavt indhold af frugt, gr\u00f8nt, fisk og fuldkorn og h\u00f8jt indhold af salt, sukker og alkohol vil<\/span>\u00a0<\/span>ogs\u00e5 udg\u00f8re en risiko for hjerte-kar-<\/span>sygdom<\/span>me<\/span>.<\/span>\u00a0Der er ikke noget forbudt i kosten \u2013 alt handler om m\u00e6ngder.\u00a0<\/span>M<\/span>\u00e6ttet fedt kan\u00a0<\/span>alts\u00e5\u00a0<\/span>godt indg\u00e5 i hjertekosten, men i begr\u00e6nset m\u00e6ngde.<\/span><\/p>

\u00a0<\/span><\/p>

Hjerteforeningen anbefaler<\/span><\/h3>

Hjerteforeningen f\u00f8lger naturligvis forskningen og debatten p\u00e5 omr\u00e5det. Hjerteforeningen mener, at der er behov for flere studier og et st\u00e6rkere videnskabeligt grundlag f\u00f8r en evt. revision af de g\u00e6ldende anbefalinger<\/span>\u00a0i forhold til indtaget af m\u00e6ttet fedt<\/span>. Der er alts\u00e5 behov for mere nuanceret og underst\u00f8ttende forskning samt samstemmende udmeldinger fra de store instanser fx ESC, AHA og F\u00f8devarestyrelsens kostr\u00e5d, f\u00f8r Hjerteforeningen \u00e6ndrer p\u00e5 anbefalinge<\/span>rne<\/span>.<\/span><\/p>

\u00a0<\/span><\/p>

Sammenfatning<\/span><\/p>
Do<\/span><\/td>Don\u2019ts<\/span><\/td><\/tr>
Olivenolie og rapsolie<\/td>Fl\u00f8de<\/td><\/tr>
N\u00f8dder og mandler<\/td>S\u00f8dm\u00e6lk<\/td><\/tr>
Avocado<\/td>Sm\u00f8r<\/td><\/tr>
Fede fisk<\/td>Bacon<\/td><\/tr>
Fr\u00f8 og kerner<\/td>Fedt k\u00f8d og k\u00f8dp\u00e5l\u00e6g<\/td><\/tr>
M\u00f8rk chokolade (70 %)<\/td>Tropiske olier<\/td><\/tr>
Fedtfattige mejeriprodukter (skummet-, k\u00e6rne- og minim\u00e6lk og ost maks. 30 +)<\/td>\u00a0<\/span><\/td><\/tr><\/tbody><\/table>

Faktaboks – NNR 2012
<\/span><\/p>

Litteraturliste<\/span><\/p>

Rapporter og guidelines<\/em><\/span><\/p>

Kostr\u00e5d om\u00a0<\/span><\/i><\/span>fett<\/span><\/i><\/span>\u00a0\u2013 en\u00a0<\/span><\/i><\/span>oppdatering<\/span><\/i><\/span>\u00a0og vurdering av\u00a0<\/span><\/i><\/span>kunnskapsgrunnlaget<\/span><\/i><\/span>,\u00a0<\/span>Nasjonalt<\/span>\u00a0r\u00e5d for ern\u00e6ring, 2017, Helsedirektoratet 2017<\/span><\/a>\u00a0<\/span><\/p>

2019 ACC\/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines<\/span><\/a>\u00a0<\/span><\/p>

AHA Dietary Fats and Cardiovascular Disease: A Presidential Advisory\u00a0<\/span><\/i><\/span>From<\/span><\/i><\/span>\u00a0the American Heart Association<\/span><\/i><\/span>, 2017<\/span><\/i><\/span>\u00a0<\/span><\/a><\/p>

Dietary Guidelines Advisory Committee. 2020.\u202fScientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services.\u202fU.S. Department of Agriculture, Agricultural Research Service, Washington, DC.<\/span><\/a>\u00a0<\/span><\/p>

2019 ESC\/EAS Guidelines for the management of\u00a0<\/span><\/span>dyslipidaemias<\/span><\/span>:\u202f<\/span><\/span>lipid modification to reduce cardiovascular risk<\/span><\/span>: The Task Force for the management of\u00a0<\/span><\/span>dyslipidaemias<\/span><\/span>\u00a0of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS)<\/span><\/span><\/a>\u00a0<\/span><\/p>

\u00a0<\/span><\/p>

Referencer<\/em><\/span><\/p>

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Zhuang<\/span>, Pan, Yu Zhang, Wei He,\u00a0<\/span>Xiaoqian<\/span>\u00a0Chen,\u00a0<\/span>Jingnan<\/span>\u00a0Chen,\u00a0<\/span>Lilin<\/span>\u00a0He, Lei Mao, Fei Wu, and\u00a0<\/span>Jingjing<\/span>\u00a0Jiao. \u201cDietary Fats in Relation to Total and Cause-Specific Mortality in a Prospective Cohort of 521 120 Individuals with 16 Years of Follow-Up.\u201d\u00a0<\/span>Circulation Research<\/i>\u00a0<\/span>2019<\/span>;\u00a0<\/span>124 (5): 757\u201368.\u00a0<\/span>\u00a0<\/span><\/p>

Zong<\/span>,\u00a0<\/span>Geng<\/span>,\u00a0<\/span>Yanping<\/span>\u00a0Li, Laura Sampson, Lauren W. Dougherty, Walter C. Willett, Anne J. Wanders,\u00a0<\/span>Marjan<\/span>\u00a0<\/span>Alssema<\/span>, Peter L.\u00a0<\/span>Zock<\/span>, Frank B. Hu, and Qi Sun. \u201cMonounsaturated Fats from Plant and Animal Sources in Relation to Risk of Coronary Heart Disease among US Men and Women.\u201d\u00a0<\/span>American Journal of Clinical Nutrition<\/i>\u00a0<\/span>2018<\/span>;\u00a0<\/span>107 (3): 445\u201353.\u00a0<\/span>\u00a0<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

Reduktion af m\u00e6ttet fedt har v\u00e6ret en hj\u00f8rnesten i forebyggelsen af hjerte-kar-sygdomme igennem \u00e5rtier. I de seneste \u00e5r er der s\u00e5et tvivl om evidensen bag disse anbefalinger. Bliv opdateret p\u00e5 den nyeste evidens om m\u00e6ttet fedt, den dertilh\u00f8rende debat og hvad Hjerteforeningen anbefaler. <\/p>\n","protected":false},"author":21,"featured_media":611,"template":"","meta":{"_acf_changed":false},"global-tag":[104,35,32],"class_list":["post-417","artikel","type-artikel","status-publish","has-post-thumbnail","hentry","global-tag-ernaering","global-tag-forebyggelse","global-tag-kost"],"yoast_head":"\nM\u00e6ttet fedt \u2013 en hj\u00f8rnesten i forebyggelse af hjerte-kar-sygdom - For fagfolk<\/title>\n<meta name=\"description\" content=\"Reduktion af m\u00e6ttet fedt har v\u00e6ret en hj\u00f8rnesten i forebyggelsen af hjerte-kar-sygdomme igennem \u00e5rtier.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/hjerteforeningen.dk\/fagnet\/artikler\/alle-artikler\/maettet-fedt-hjoernesten-forebyggelse-hjerte-kar-sygdom\/\" \/>\n<meta property=\"og:locale\" content=\"da_DK\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"M\u00e6ttet fedt \u2013 en hj\u00f8rnesten i forebyggelse af hjerte-kar-sygdom - 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