"Limiting total fat consumption is unlikely to improve health in populations, and a total fat intake of about 35 percent of energy with concomitant lowering of carbohydrate intake may lower risk of total mortality", Dehghan said.
"It's also worth pointing out that the majority of the people who participated in this study were from low and middle-income countries where people eat loads of processed carbohydrates, so the underlying theme of carbohydrate quality also counts, too", says Ansel.
In light of the findings, lead author Dr Mahshid Dehghan at McMaster University, Canada would like the carbohydrate recommendation reduced.
Over the course of about seven years, diets with roughly 35 percent of calories from fats were tied to a lower mortality rate than diets with about 60 percent of calories from carbohydrates.
Dehghan suggested that "the best diets will include a balance of carbohydrates and fats, approximately 50 to 55 percent carbohydrates and around 35 percent total fat, including both saturated and unsaturated fats". Polyunsaturated fat is found in walnuts, sunflower and flax seeds, fish, corn, soybean and safflower oils.
British nutrition expert Professor Susan Jebb, from Oxford University, pointed out that United Kingdom health guidelines already recommended obtaining up to 35% of dietary energy from fat, and an average of 50% from carbohydrates.
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Dehghan and colleagues write in The Lancet that cardiovascular disease is a global epidemic, with 80 percent of the burden being found in low- and middle-income countries.
Researchers in the study, called PURE (Prospective Urban Rural Epidemiology), recorded the food intake of over 135,000 people from 18 different countries, including high-, medium-, and low-income nations.
"We're not advocating an extreme diet", agreed co-author Andrew Mente.
On the flip side, PURE found that high carb diets were associated with a significant increase in the risk of premature death.
A new, huge global study of more than 135,000 people from 18 countries is a big step in paving the way for staunchly held negative beliefs about fat to dissipate.
In a linked commentary in the journal, Drs.
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Clinical investigator with the US National Institute on Aging Christopher Ramsden is skeptical that this study is the answer to the ongoing debate.
"Furthermore, the study did not take trans fats into account, which hold heavy evidence of being unhealthy and contributing to cardiovascular disease", she pointed out. Initial PURE findings challenge conventional diet-disease tenets that are largely based on observational associations in European and North American populations, adding to the uncertainty about what constitutes a healthy diet.
The research also found that eating fruits, vegetables and legumes can lower your risk of dying prematurely. "There's no added benefit with consuming more than four servings". Fruits and vegetables are, too, and when it came to those, more was always considered better.
Lower-income Canadians may also be unable to afford the five to 10 daily servings of fruits and vegetables recommended in the country's Food Guide.
If you do want to cut back on carbs, Ansel says: "Your number-one goal should be to switch out [processed carbs] to less processed whole grains, fruits, vegetables, and beans".
"We would hope that independent thinkers perhaps reconsider the guidelines and look at our data, and perhaps rather than putting limits on total fat and saturated fat, perhaps we should be putting limits on the amount of carbohydrates that people consume".
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