A multilipid score (MLS), reflecting the effects of replacing saturated fat with unsaturated fat on 45 lipid metabolite concentrations, was associated with significantly lower risk of cardiovascular diseases (CVD) and type 2 diabetes (T2D). The MLS was based on lipidomics data from a randomized controlled dietary intervention trial, replacing specific saturated fats (primarily medium- and long-chain saturated fatty acids from dairy) with unsaturated fats (mainly plant-based oils and nuts). A higher MLS, indicative of better dietary fat quality, was associated with a significant reduction in risk of CVD (−32%) and T2D (−26%) in a prospective German cohort.The associations of MLS with diet and disease risk are stronger than established surrogate markers with larger estimated benefits. A simplified score (reduced MLS, rMLS) that tracked changes in dietary fat quality over 10 years indicated that improved rMLS was associated with lower T2D risk (−24%) in a US cohort. Moreover, post hoc analyses of a Spanish trial of Mediterranean diet intervention primarily reduced T2D incidence among participants with unfavorable preintervention rMLS levels, suggested that adverse preintervention levels of the rMLS score may predict a stronger T2D risk reduction by the healthy Mediterranean diet intervention. The findings corroborate current cardiometabolic disease prevention guidelines recommend increasing dietary unsaturated fat intake while reducing saturated fats, and highlight the impact of dietary fat quality on the lipidome and its potential for predicting health outcomes. Source: https://www.nature.com/
