Skip to main content
    • Aa
    • Aa

Recommended dietary reference intakes, nutritional goals and dietary guidelines for fat and fatty acids: a systematic review

  • Javier Aranceta (a1) (a2) and Carmen Pérez-Rodrigo (a2)

Dietary fat and its effects on health and disease has attracted interest for research and Public Health. Since the 1980s many bodies and organizations have published recommendations regarding fat intake. In this paper different sets of recommendations are analyzed following a systematic review process to examine dietary reference intakes, nutritional goals and dietary guidelines for fat and fatty acids. A literature search was conducted in relevant literature databases along a search for suitable grey literature reports. Documents were included if they reported information on either recommended intake levels or dietary reference values or nutritional objectives or dietary guidelines regarding fat and/or fatty acids and/or cholesterol intake or if reported background information on the process followed to produce the recommendations. There is no standard approach for deriving nutrient recommendations. Recommendations vary between countries regarding the levels of intake advised, the process followed to set the recommendations. Recommendations on fat intake share similar figures regarding total fat intake, saturated fats and trans fats. Many sets do not include a recommendation about cholesterol intake. Most recent documents provide advice regarding specific n-3 fatty acids. Despite efforts to develop evidence based nutrient recommendations and dietary guidelines that may contribute to enhance health, there are still many gaps in research. It would be desirable that all bodies concerned remain transparent about the development of dietary recommendations. In order to achieve this, the type of evidence selected to base the recommendations should be specified and ranked. Regular updates of such recommendations should be planned.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Recommended dietary reference intakes, nutritional goals and dietary guidelines for fat and fatty acids: a systematic review
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Recommended dietary reference intakes, nutritional goals and dietary guidelines for fat and fatty acids: a systematic review
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Recommended dietary reference intakes, nutritional goals and dietary guidelines for fat and fatty acids: a systematic review
      Available formats
Corresponding author
*Corresponding author: J. Aranceta, fax +34 94 4001090, email
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1D Gifford (2002) Dietary Fats, Eating Guides and Public Policy: History, Critique, and Recommendations. Am J Med 113, 89S106S, 9B.

4AA Yates (1998) Overview of Key Nutrients: Energy and Macronutrient Aspects. Nutr Rev 56, S29S33.

5Institutes of Medicine (IOM) (2002/2005)Panel on Macronutrients, Panel on the Definition of Dietary Fiber, Subcommittee on Upper Reference Levels of Nutrients, Subcommittee on Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. DRI Dietary reference intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: The National Academies Press.

8FAO-WHO (2010) Fats and Fatty Acids in Human Nutrition. Rome: FAO Food and nutrition paper # 91. Report of an expert consultation. Geneva, November 10–14, 2008.

9LA Smit , D Mozaffarian & W Willett (2009) Review of Fat and Fatty Acid Requirements and Criteria for Developing Dietary Guidelines. Ann Nutr Metab 55, 4455.

10D Moher , A Liberati , J Tetzlaff & DG Altman , The PRISMA Group (2009) Group Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6, e1000097. doi:10·1371/journal.pmed1000097.

13B Koletzko , E Lien , C Agostoni , (2008) The roles of longchain polyunsaturated fatty acids in pregnancy, lactation and infancy: review of current knowledge and consensus recommendations. J Perinat Med 36, 514.

14American Heart Association Nutrition Committee, AH Lichtenstein , LJ Appel , M Brands , (2006) Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation 114, 8296.

15WS Harris , D Mozaffarian , E Rimm , (2009) Omega-6 Fatty Acids and Risk for Cardiovascular Disease: A Science Advisory From the American Heart Association Nutrition Subcommittee of the Council on Nutrition, Physical Activity, and Metabolism; Council on Cardiovascular Nursing; and Council on Epidemiology and Prevention. Circulation 119, 902907.

17SS Gidding , BA Dennison , LL Birch , (2006) Dietary Recommendations for Children and Adolescents: A Guide for Practitioners. Pediatrics 117, 544.

18U.S. Department of Agriculture, U.S. Department of Health and Human Services (2010) Dietary Guidelines for Americans, 2010, 7th EditionWashington, DC: U.S. Government Printing Office, December.

19EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA) (2010) Scientific Opinion on Dietary Reference Values for fats, including saturated fatty acids, polyunsaturated fatty acids, monounsaturated fatty acids, trans fatty acids, and cholesterol. The EFSA Journal 8, 1461.

20Fourth Joint Task Force of the European Society of Cardiology (2007) European guidelines on cardiovascular disease prevention in clinical practice. Eur J Cardiovasc Prev Rehab 14, suppl 2, S1S113.

21EL Doets , LS de Wit , RAM Dhonukshe-Rutten , (2008) Current micronutrient recommendations in Europe: towards understanding their differences and similarities. Eur J Nutr 47, Suppl. 1, 1740.

22M Pavlovic , A Prentice , I Thörsdottir , (2007) Challenges in Harmonizing Energy and Nutrient Recommendations in Europe. Ann Nutr Metab 51, 108114.

24I Iglesia , EL Doets , S Bel-Serrat , (2010) Physiological and public health basis for assessing micronutrient requirements in children and adolescents. The EURRECA network. Maternal & Child Nutr 6, 8499.

26American Diabetes Association (2008) Nutrition Recommendations and Interventions for Diabetes. A position statement of the American Diabetes Association. Diabetes Care 31, Suppl, S61S78.

27A Ferroluzzi & WPT James (2001) European diet and public health: The continuing challenge. Public Health Nutr 4, 2A 275292.

29Gezondheidsraad; Health Council of the Netherlands (2002) Dietary reference intakes. Energy, proteins, fats, and digestible carbohydrates. The Hague, NL: The Health Council of the Netherlands.

30Health Council of the Netherlands (2006) Guidelines to a healthy diet 2006. The Hague: Health Council of the Netherlands: publication no: 2006/21E.

31A Martin (Editor) (2001) Apports nutritionnels conseilles pour la population Française, 3rd ed.France: Tech. & Doc Lavoisier.

33W Becker , N Lyhne , AN Pedersen , (2004) Nordic Nutrition Recommendations 2004/integrating nutrition and physical activity. Scan J Nutr 48, 178187.

40I Elmadfa & M Kornsteiner (2009) Fats and Fatty Acid Requirements for Adults. Ann Nutr Metab 55, 5675.

41R Uauy (2009) Dietary Fat Quality for Optimal Health and Well-Being: Overview of Recommendations. Ann Nutr Metab 54, Suppl. 1, 27.

42PR Marantz , ED Bird & MH Alderman (2008) A Call for Higher Standards of Evidence for Dietary Guidelines. Am J Prev Med 34, 234240.

44AJ Nordmann , A Nordmann , M Briel , (2006) Effects of low-carbohydrate vs. low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials. Arch Intern Med 166, 285293.

45BV Howard , L Van Horn , J Hsia , (2006) Low-Fat Dietary Pattern and Risk of Cardiovascular Disease. The Women's Health Initiative Randomized Controlled Dietary Modification Trial. JAMA 295, 655666.

46EL Melanson , A Astrup & WT Donahoo (2009) The relationship between dietary fat and fatty acid intake and body weight, diabetes, and the metabolic syndrome. Ann Nutr Metab 55, 229243.

47RM Krauss , RH Eckel , B Howard , (2000) AHA Dietary Guidelines : Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association. Circulation 102, 22842299.

48P Kris-Etherton , SR Daniels , RH Eckel , (2001) AHA Scientific Statement: Summary of the Scientific Conference on Dietary Fatty Acids and Cardiovascular Health. J Nutr 131, 13221326.

49FB Hu & W Willet (2002) Optimal Diets for Prevention of Coronary Heart Disease. JAMA 288, 25692578.

50U Wahrburg (2004) What are the health effects of fat? Eur J Nutr 43, Suppl. 1, I/6I/11.

51SK Gebauer , TL Psota , WS Harris , (2006) n-3 Fatty acid dietary recommendations and food sources to achieve essentiality and cardiovascular benefits. Am J Clin Nutr 83, Suppl, 1526S1535S.

55JI Mann (2002) Diet and risk of coronary heart disease and type 2 diabetes. Lancet 360, 783789.

58MU Jakobsen , EJ O'Reilly , BL Heitmann , (2009) Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. Am J Clin Nutr 89, 14251432.

59CM Skeaff & J Miller (2009) Dietary fat and coronary heart disease: summary of evidence from prospective cohort and randomized controlled trials. Ann Nutr Metab 55, 173201.

61D Mozaffarian & EB Rimm (2006) Fish intake, contaminants, and human health: evaluating the risks and the benefits. JAMA 296, 18851899.

63WE Connor (2000) Importance of n-3 fatty acids in health and disease. Am J Clin Nutr 71, Suppl, 171S175S.

64WS Harris , D Mozaffarian , M Lefevre , (2009) Towards Establishing Dietary Reference Intakes for Eicosapentaenoic and Docosahexaenoic Acids. J Nutr 139, 804S819S.

65L Hooper , RL Thompson , RA Harrison , (2006) Risk and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: a systematic review. BMJ (Epub ahead of print; doi:10·1136/bmj.38755·366331·2F).

66LA Horrocks & YK Yeo (1999) Health benefits of Docosahexaenoic acid (DHA). Pharmacol Res 40, 211225.

68AP Simopoulos (2001) n-3 Fatty Acids and Human Health: Defining Strategies for Public Policy. Lipids 36, S83S89.

69GISSI-HF Investigators (2008) Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial. Lancet 372, 12231230.

70JT Brenna (2009) Background Paper on Fat and Fatty Acid Requirements during Pregnancy and Lactation. Ann Nutr Metab 55, 97122.

73A Lapillonne & CL Jensen (2009) Reevaluation of the DHA requirement for the premature infant. Prostaglandins Leukot Essent Fatty Acids 81, 143150.

74H Le , JA Meisel , VE deMeijer , (2009) The essentiality of arachidonic acid and docosahexaenoic acid. Prostaglandins Leukot Essent Fatty Acids 81, 165170.

75M Makrides (2009) Is there a dietary requirement for DHA in pregnancy? Prostaglandins Leukot Essent Fatty Acids 81, 171174.

77R Uauy & AD Dangour (2009) Fat and Fatty Acid Requirements and Recommendations for Infants of 0–2 Years and Children of 2–18 Years. Ann Nutr Metab 55, 7696.

78M Gil-Campos , Dalmau-Serra J Comite de Nutricion Asociacion Española de Pediatrıa (2010) Importancia del ácido docosahexaenoico (DHA): funciones y recomendaciones para su ingesta en la infancia. An Pediatr (Barc) 73, 142e1142e8.

79G Wolfram (Ed.) (2005) The Nutrition Report 2004. Summary. Bonn: German Nutrition Society/Deutsche Gesellschaft für Ernährung e.V.

81 CE Ramsden , JR Hibbeln , SF Majchrzak , (2010) n-6 Fatty acid-specific and mixed polyunsaturate dietary interventions have different effects on CHD risk: a meta-analysis of randomized controlled trials. Br J Nutr 104, 15861600.

82PC Calder & RJ Deckelbaum (2011) Harmful, harmless or helpful? The n-6 fatty acid debate goes on. Curr Opin Clin Nutr Metab Care 14, 113114.

83RJ Deckelbaum & PC Calder (2010) Dietary n-3 and n-6 fatty acids: are there ‘bad’ polyunsaturated fatty acids? Curr Opin Clin Nutr Metab Care 13, 123124.

84O Molendi-Coste , V Legry & IA Leclercq (2011) Why and How Meet n-3 PUFA Dietary Recommendations? Gastroenterol Res Pract, 2011,364040 (Epub December 8, 2010).

85PM Kris-Etherton , JA Grieger & TD Etherton (2009) Dietary reference intakes for DHA and EPA. Prostaglandins, Leukot Essent Fatty Acids 81, 99104.

87AR Ness , J Hughes , PC Elwood , (2002) The long-term effect of dietary advice in men with coronary disease: follow-up of the Diet and Reinfarction Trial (DART). Eur J Clin Nutr 56, 512518.

88M Yokoyama , H Origasa , M Matsuzaki , (2007) Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 369, 10901098.

89PE Marik & J Varon (2009) Omega-3 Dietary Supplements and the Risk of Cardiovascular Events: A Systematic Review. Clin. Cardiol 32, 7, 365372.

90ML Burr , FDJ Dunstan & CH George (2005) Is Fish Oil Good or Bad for Heart Disease? Two Trials with Apparently Conflicting Results. J. Membrane Biol. 206, 155163.

91B Rauch , R Schiele , S Schneider , (2010) OMEGA, a randomized, placebo-controlled trial to test the effect of highly purified omega-3 fatty acids on top of modern guideline-adjusted therapy after myocardial infarction. Circulation 122, 21, 2152-9 (Epub November 8, 2010).

92D Kromhout , EJ Giltay & JM Geleijnse for the Alpha Omega Trial Group (2010) n-3 Fatty Acids and Cardiovascular Events after Myocardial Infarction. N Engl J Med 363, 20152026.

93KB Filion , F El Khoury , M Bielinski , (2010) Omega- 3 fatty acids in high-risk cardiovascular patients: a meta-analysis of randomized controlled trials. BMC Cardiovasc Disord 10, 24.

94S Nodari , M Triggiani , U Campia , (2011) n-3 Polyunsaturated fatty acids in the prevention of atrial fibrillation recurrences after electrical cardioversion. A prospective, randomized study. Circulation 124, 1100-6 (Epub August 15, 2011).

95T Liu , P Korantzopoulos , M Shehata , (2011) Prevention of atrial fibrillation with omega-3 fatty acids: a meta-analysis of randomised clinical trials. Heart 97, 13, 1034-1040 doi:10.1136/hrt.2010.215350 (Epub April 8, 2011)

96MA Crawford , RP Bazinet & AJ Sinclair (2009) Fat intake and CNS functioning: ageing and disease. Ann Nutr Metab 55, 202228.

97M Kornsteiner , I Singer & I Elmadfa (2008) Very low n-3 long-chain polyunsaturated fatty acid status in Austrian vegetarians and vegans. Ann Nutr Metab 52, 3747.

100V Wijendran & KC Hayes (2004) Dietary n-6 and n-3 fatty acid balance and cardiovascular health. Annu Rev Nutr 24, 597615.

102JR Hibbeln & JM Davis (2009) Considerations regarding neuropsychiatric nutritional requirements for intakes of omega-3 highly unsaturated fatty acids. Prostaglandins, Leukot Essent Fatty Acids 81, 179186.

103WC Willett (2007) The role of dietary n-6 fatty acids in the prevention of cardiovascular disease. J Cardiovasc Med (Hagerstown) 8, Suppl. 1, S42S45.

105D Mozaffarian & WC Willett (2007) Trans fatty acids and cardiovascular risk: a unique cardiometabolic imprint? Curr Atheroscler Rep 9, 486493.

106 D Mozaffarian & R Clarke (2009) Quantitative effects on cardiovascular risk factors and coronary heart disease risk of replacing partially hydrogenated vegetable oils with other fats and oils. Eur J Clin Nutr 63, 522533.

108RH Eckel (2007) Understanding the Complexity of Trans Fatty Acid Reduction in the American Diet: American Heart Association Trans Fat Conference 2006: Report of the Trans Fat Conference Planning Group. Circulation 115, 22312246.

109W Marcanson (2006) How Many Grams of Trans-Fat Are Recommended per Day? J Am Diet Assoc 106, 1507.

110ML Fernandez & M Calle (2010) Revisiting Dietary Cholesterol Recommendations: Does the Evidence Support a Limit of 300 mg/d? Curr Atheroscler Rep 12, 377383.

111 WCRF/AICR. Expert report: Continous update project. Available at URL ( (Accessed May 2011).

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *