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Search Plan and Results


What is the association between dietary stearic acid and LDL cholesterol? (DGAC 2010)

Date Searched

05-05-2009 - 05-12-2009

Inclusion Criteria


Age: 2 years to Adult

Setting: US and International

Health Status: Healthy and those with elevated chronic risk (CHD/CVD, Type 2 DM, Metabolic Syndrome, and Obesity.)

Search Criteria

Study design preferences: RCT or Clinical Controlled Studies, Large nonrandomized observational studies, Met-analysis and Systematic reviews.

Size of study groups: Sample size >10 subjects per study group.

 Study drop out rate: Less than 20%; preference for smaller dropout rates

Year Range 2000 - April 2010

Languages: Limited to articles in English

Other: Article must be published in peer-reviewed journal

 Diet: Experimental fat from natural sources; feeding period greater than 4 weeks

Exclusion Criteria


Age: infants less than 2 yrs

Setting: Inpatients

Health Status: None


Search Criteria

Study Designs: Cross sectional; Feeding periods less than 4 weeks.

Diet: Experimental fat must be from natural sources

Size of study groups: Sample sizes < 10

Study Drop out rate: If the dropout rate in a study is 20% or greater, the study will be rejected.

Year Range: Prior to January 2000

Authorship: Studies by same author similar in content.

Languages: Articles not in English

Other: Animal studies; Abstracts or presentations

Search Terms & Electronic Databases Used

dietary stearic acid and: LDL; HDL; blood; dosage; metabolism; ldl:hdl ratio; intake; cardiovascular disease; thrombosis; hemostasis; serum lipoproteins; cholesterol


PubMed, Medline

Total hits from all electronic database searches: 140

Total articles identified to review from electronic databases: 41

Articles identified via handsearch or other means:


Summary of Articles Identified to Review

Number of Primary Articles Identified: 0

Number of Review Articles Identified: 1

Total Number of Articles Identified: 1

Number of Articles Reviewed but Excluded: 40


List of Included Articles for Evidence Analysis

Included Systematic Review:

Hunter JE, Zhang J, Kris-Etherton PM. Cardiovascular disease risk of dietary stearic acid compared with trans, other saturated, and unsaturated fatty acids: a systematic review.Am J Clin Nutr. 2010 Jan;91(1):46-63. Epub 2009 Nov 25. Review.PMID: 19939984

List of Excluded Articles with Reason




Reason for Exclusion 

Abia R, Pacheco YM, Montero E, Ruiz-Gutierrez V, Muriana FJ. Distribution of fatty acids from dietary oils into phospholipid classes of triacylglycerol-rich lipoproteins in healthy subjects. Life Sci. 2003 Feb 21;72(14):1643-54. PubMedPMID: 12551753.

Variable studied does not address question

Baer DJ, Judd JT, Clevidence BA, Tracy RP. Dietary fatty acids affect plasma  markers of inflammation in healthy men fed controlled diets: a randomized crossover study. Am J Clin Nutr. 2004 Jun;79(6):969-73. PubMed PMID: 15159225.  Excluded from previously approved list.

Does not address question specifically. Measures markers of inflammation.

Baer DJ, Judd JT, Kris-Etherton PM, Zhao G, Emken EA. Stearic acid absorption and its metabolizable energy value are minimally lower than those of other fatty acids in healthy men fed mixed diets.J Nutr. 2003 Dec;133(12):4129-34. PubMed PMID: 14652360.

Does not address question. Reports on absorption of Stearic acid.

Berry SE, Tucker S, Banerji R, Jiang B, Chowienczyk PJ, Charles SM, Sanders TA. Impaired postprandial endothelial function depends on the type of fat consumed by healthy men.   J Nutr. 2008 Oct;138(10):1910-4. PubMed PMID: 18806100.

Does not address question. Investigates effect on lipemia (TG).

Berry SE, Miller GJ, Sanders TA. The solid fat content of stearic acid-rich fats determines their postprandial effects. Am J Clin Nutr. 2007Jun;85(6):1486-94. PubMed PMID: 17556683.

Study involves other risk factors that do not address the question.

Burdge GC, Wootton SA. Conversion of alpha-linolenic acid to palmitic, palmitoleic, stearic and oleic acids in men and women. Prostaglandins Leukot Essent Fatty Acids. 2003 Oct;69(4):283-90. PubMed PMID: 12907139.

Studies ALA conversion and does not address question.

Bysted A, Hølmer G, Lund P, Sandström B, Tholstrup T. Effect of dietary fatty acids on the postprandial fatty acid composition of triacylglycerol-rich lipoproteins in healthy male subjects. Eur J Clin Nutr. 2005 Jan;59(1):24-34. PubMed PMID: 15305178.

Does not address question. Investigates effect of trans fatty acid on postprandial lipemia.

Cheng HH, Wen YY, Chen C. Serum fatty acid composition in primary    school children is associated with serum cholesterol levels and dietary fat intake.  Eur J Clin Nutr. 2003 Dec;57(12):1613-20. PubMed PMID: 14647227.

Does not address question. Examines serum fatty acid composition.

Ding EL, Hutfless SM, Ding X, Girotra S. Chocolate and prevention of cardiovascular disease: a systematic review. Nutr Metab (Lond). 2006 Jan 3;3:2.PubMed PMID: 16390538; PubMed Central PMCID: PMC1360667.

Does not address questions. Emphasis on beneficial effect of Chocolate

DiRienzo MA, Lemke SL, Petersen BJ, Smith KM. Effect of substitution of high stearic low linolenic acid soybean oil for hydrogenated soybean oil on fatty acid intake. Lipids. 2008 May;43(5):451-6. Epub 2008 Mar 26. PubMed PMID: 18365266.

Involves substitution studies that do not address question.

Edionwe AO, Kies C. Comparison of palm and mixtures of refined palm and soybean oils on serum lipids and fecal fat and fatty acid excretions of adult humans. Plant Foods Hum Nutr. 2001;56(2):157-65. PubMed PMID: 11318504.  

Excretion studies that do not address question.

Habán P, Zideková E, Klvanová J.  Oleic acid serum phospholipid content  is  linked with the serum total- and LDL-cholesterol in elderly subjects. Med Sci Monit. 2000 Nov-Dec;6(6):1093-7. PubMed PMID: 11208461.

Studies oleaic acid and Pl and does not address question

Hac-Wydro K, Wydro P.The influence of fatty acids on model cholesterol/phospholipid membranes. Chem Phys Lipids. 2007 Nov;150(1):66-81. Epub 2007 Jun 21. PubMed PMID: 17651712.

Does not address question.

 Hodge AM, English DR, O'Dea K, Sinclair AJ, Makrides M, Gibson RA, Giles GG. Plasma phospholipid and dietary fatty acids as predictors of type 2 diabetes: interpreting the role of linoleic acid. Am J Clin Nutr. 2007 Jul;86(1):189-97.PubMed PMID: 17616780.

Studies plasma PL and does not address question.

Hunter KA, Crosbie LC, Horgan GW, Miller GJ, Dutta-Roy AK. Effect of diets rich in oleic acid, stearic acid and linoleic acid on postprandial haemostatic factors in young healthy men. Br J Nutr. 2001 Aug;86(2):207-15. PubMed PMID:11502234. 

Does not address question. Investigated effect on postprandial haemostasis.

Jensen J, Bysted A, Dawids S, Hermansen K, Hølmer G. The effect of palm oil, lard, and puff-pastry margarine on postprandial lipid and hormone responses in normal-weight and obese young women. Br J Nutr. 1999 Dec;82(6):469-79. PubMedPMID: 10690162. 

Does not study stearic acid.

Judd JT, Baer DJ, Clevidence BA, Kris-Etherton P, Muesing RA, Iwane M. Dietary cis and trans monounsaturated and saturated FA and plasma lipids and lipoproteins in men. Lipids. 2002 Feb;37(2):123-31. PubMed PMID: 11908904.

Captured by Hunter et al 2010 - Review.

Kabagambe EK, Baylin A, Siles X, Campos H.  Individual saturated fatty acids and nonfatal acute myocardial infarction in Costa Rica. Eur J Clin Nutr. 2003Nov;57(11):1447-57. PubMed PMID: 14576758.  

Does not address question. Studies effect on MI.

Kelly FD, Sinclair AJ, Mann NJ, Turner AH, Raffin FL, Blandford MV, Pike MJ.  Short-term diets enriched in stearic or palmitic acids do not alter plasma lipids, platelet aggregation or platelet activation status. Eur J Clin Nutr. 2002Jun;56(6):490-9. PubMed PMID: 12032647.

Studies outcomes not of interest and do not address the question

Kelly FD, Sinclair AJ, Mann NJ, Turner AH, Abedin L, Li D. A stearic acid-rich diet improves thrombogenic and atherogenic risk factor profiles in healthy males. Eur J Clin Nutr. 2001 Feb;55(2):88-96. PubMed PMID: 11305631.

Studies outcomes not of interest and do not address the question

Li D. Relationship between the concentrations of plasma phospholipid stearic acid and plasma lipoprotein lipids in healthy men.Clin Sci (Lond). 2001 Jan;100(1):25-32. PubMed PMID: 11115414.

Does not meet inclusion criteria. Cross sectional study

Mensink RP. Effects of stearic acid on plasma lipid and lipoproteins in humans.2005 Dec;40(12):1201-5. REVIEW PubMed PMID: 16477803. Excluded from previously approved list.  

No new data. Cites data already cited and addressed in  the larger 2002 review.

Mensink RP. Effects of products made from a high-palmitic acid, trans-free semiliquid fat or a high-oleic acid, low-trans semiliquid fat on the serum lipoprotein profile and on C-reactive protein concentrations in humans.  Eur J Clin Nutr. 2008 May;62(5):617-24. Epub 2007 Apr 18. PubMed PMID: 17440525.  

Studies variables not normally consumed. Does not address question

Mensink RP, Zock PL, Kester AD, Katan MB. Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials.  Am J Clin Nutr. 2003 May;77(5):1146-55. PubMed PMID: 12716665 Captured by Hunter et al 2010 - Review

Müller H, Kirkhus B, Pedersen JI. Serum cholesterol predictive equations with special emphasis on trans and saturated fatty acids. an analysis from designed controlled studies. Lipids. 2001 Aug;36(8):783-91. PubMed PMID: 11592728.

Study invoves predictive equations and do not address question

Nydahl MC, Smith RD, Kelly CN, Fielding BA, Williams CM. Achievement of dietary fatty acid intakes in long-term controlled intervention studies: approach and methodology. Public Health Nutr. 2003 Feb;6(1):31-40. PubMed PMID: 12581463.

Outcomes studied do not address question

Robinson DM, Martin NC, Robinson LE, Ahmadi L, Marangoni AG, Wright AJ. Influence of interesterification of a stearic Acid-rich spreadable fat on acute metabolic risk factors. Lipids. 2009 Jan;44(1):17-26. Epub 2008 Nov 4. PubMedPMID: 18982377.

Variable studied not consumed normally. Does not address question.

Sacks FM, Katan M. Randomized clinical trials on the effects of dietary fat and carbohydrate on plasma lipoproteins and cardiovascular disease. Am J Med. 2002 Dec 30;113 Suppl 9B:13S-24S. Review. PMID: 12566134  Excluded from previously approved list.

Does not address question. Not a systematic review and emphasizes is on clinical outcomes

Sanders TA, Berry SE. Influence of stearic acid on postprandial lipemia and hemostatic function. Lipids. 2005 Dec;40(12):1221-7. PubMed PMID: 16477806.

Does not address question. Looks at postprandial lipemia and hemostatic function.

Sanders TA, Berry SE, Miller GJ. Influence of triacylglycerol structure on the postprandial response of factor VII to stearic acid-rich fats. Am J ClinNutr. 2003 Apr;77(4):777-82. PubMed PMID: 12663272.

Studies postprandial lipemia. Does not address question.

Sanders TA, Oakley FR, Cooper JA, Miller GJ. Influence of a stearic acid-rich structured triacylglycerol on postprandial lipemia, factor VII concentrations, and fibrinolytic activity in healthy subjects. Am J Clin Nutr. 2001Apr;73(4):715-21. PubMed PMID: 11273845.

Studied structured fats not normally consumed. Experiment fats.

Sundram K, Karupaiah T, Hayes KC. Stearic acid-rich interesterified fat and trans-rich fat raise the LDL/HDL ratio and plasma glucose relative to palm olein in humans. Nutr Metab (Lond). 2007 Jan 15;4:3. PubMed PMID: 17224066; PubMed Central PMCID: PMC1783656.

Structured fatty acids used, not natural. Experimental fats/diets

Thijssen MA, Hornstra G, Mensink RP. Stearic, oleic, and linoleic acids have comparable effects on markers of thrombotic tendency in healthy human subjects. JNutr. 2005 Dec;135(12):2805-11. PubMed PMID: 16317124.

Does not address question. Studied thrombogenic effects.

Thijssen MA, Mensink RP. Small differences in the effects of stearic acid, oleic acid, and linoleic acid on the serum lipoprotein profile of humans.Am J Clin Nutr. 2005 Sep;82(3):510-6. PubMed PMID: 16155261 Captured by Hunter et al 2010. - Review

Tholstrup T. Influence of stearic acid on hemostatic risk factors in humans. Lipids. 2005 Dec;40(12):1229-35. PubMed PMID: 16477807.  

Does not addressquestion. Study looks at thrombogenic effects.

Tholstrup T, Samman S. Postprandial lipoprotein(a) is affected differently by specific individual dietary fatty acids in healthy young men.   J Nutr. 2004 Oct;134(10):2550-5. PubMed PMID: 15465746.

Does not address question. Study looks at thrombogenic effects.

Tholstrup T, Vessby B, Sandstrom B. Difference in effect of myristic and stearic acid on plasma HDL cholesterol within 24 h in young men.Eur J Clin Nutr. 2003 Jun;57(6):735-42. PubMed PMID: 12792657.

Intervention was less than 4 weeks.

Tholstrup T, Sandström B, Bysted A, Hølmer G. Effect of 6 dietary fatty acids on the postprandial lipid profile, plasma fatty acids, lipoprotein lipase, and cholesterol ester transfer activities in healthy young men. Am J Clin Nutr. 2001 Feb;73(2):198-208. PubMed PMID: 11157314.

Variables studied do not address question.

Wang L, Folsom AR, Eckfeldt JH. Plasma fatty acid composition and incidence of diabetes in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study. Nutr Metab Cardiovasc Dis. 2003 Oct;13(5):256-66. PubMed PMID: 14717057.

Variables studied do not not address question.

Wang L, Folsom AR, Zheng ZJ, Pankow JS, Eckfeldt JH; ARIC Study Investigators. Plasma fatty acid composition and incidence of coronary heart disease in middle aged adults: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Clin Nutr. 2003 Jul;78(1):91-8. PubMed PMID: 12816776.

Variables studied do not address question.