Cholesterol, saturated fats and trans fats: Burden, epidemiology and priority interventions

Abstract

High blood cholesterol and a high dietary intake of trans fats are strong risk factors for atherosclerosis and cardiovascular disease, and they collectively contribute to more than five million deaths globally. The disease burden attributable to these risks exceeds five million deaths worldwide, but differs markedly across country income regions and over time. Unfavourable blood lipid levels (e.g. LDL-cholesterol, HDL-cholesterol and trigylcerides) are related to an unhealthy diet but also to other conditions such as a high body mass index, physical inactivity and tobacco use. This chapter describes measures in multiple sectors to promote a healthy diet and healthy lifestyles, as well as measures to reduce dietary trans fats in processed foods (e.g. the WHO REPLACE package). Interventions at the individual level are also described, including the role of blood cholesterol screening, the importance of assessing an individual’s cardiovascular risk to guide blood lipid treatment, different options for pharmacological therapy, as well as treatment targets and subsequent monitoring.