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The association between dietary saturated fatty acids and ischemic heart disease depends on the type and source of fatty acid in the European Prospective Investigation into Cancer and Nutrition-Netherlands cohort.
Am J Clin Nutr 2016; 103(2):356-65AJ

Abstract

BACKGROUND

The association between saturated fatty acid (SFA) intake and ischemic heart disease (IHD) risk is debated.

OBJECTIVE

We sought to investigate whether dietary SFAs were associated with IHD risk and whether associations depended on 1) the substituting macronutrient, 2) the carbon chain length of SFAs, and 3) the SFA food source.

DESIGN

Baseline (1993-1997) SFA intake was measured with a food-frequency questionnaire among 35,597 participants from the European Prospective Investigation into Cancer and Nutrition-Netherlands cohort. IHD risks were estimated with multivariable Cox regression for the substitution of SFAs with other macronutrients and for higher intakes of total SFAs, individual SFAs, and SFAs from different food sources.

RESULTS

During 12 y of follow-up, 1807 IHD events occurred. Total SFA intake was associated with a lower IHD risk (HR per 5% of energy: 0.83; 95% CI: 0.74, 0.93). Substituting SFAs with animal protein, cis monounsaturated fatty acids, polyunsaturated fatty acids (PUFAs), or carbohydrates was significantly associated with higher IHD risks (HR per 5% of energy: 1.27-1.37). Slightly lower IHD risks were observed for higher intakes of the sum of butyric (4:0) through capric (10:0) acid (HRSD: 0.93; 95% CI: 0.89, 0.99), myristic acid (14:0) (HRSD: 0.90; 95% CI: 0.83, 0.97), the sum of pentadecylic (15:0) and margaric (17:0) acid (HRSD: 0.91: 95% CI: 0.83, 0.99), and for SFAs from dairy sources, including butter (HRSD: 0.94; 95% CI: 0.90, 0.99), cheese (HRSD: 0.91; 95% CI: 0.86, 0.97), and milk and milk products (HRSD: 0.92; 95% CI: 0.86, 0.97).

CONCLUSIONS

In this Dutch population, higher SFA intake was not associated with higher IHD risks. The lower IHD risk observed did not depend on the substituting macronutrient but appeared to be driven mainly by the sums of butyric through capric acid, the sum of pentadecylic and margaric acid, myristic acid, and SFAs from dairy sources. Residual confounding by cholesterol-lowering therapy and trans fat or limited variation in SFA and PUFA intake may explain our findings. Analyses need to be repeated in populations with larger differences in SFA intake and different SFA food sources.

Authors+Show Affiliations

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands;Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands; Department of Epidemiology and Biostatistics.EMGO+ Institute for Health and Care Research, Vrije University Medical Center, Amsterdam, Netherlands; and Unilever Research and Development, Vlaardingen, Netherlands.Unilever Research and Development, Vlaardingen, Netherlands.Unilever Research and Development, Vlaardingen, Netherlands.Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands;Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands; y.t.vanderschouw@umcutrecht.nl.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26791181

Citation

Praagman, Jaike, et al. "The Association Between Dietary Saturated Fatty Acids and Ischemic Heart Disease Depends On the Type and Source of Fatty Acid in the European Prospective Investigation Into Cancer and Nutrition-Netherlands Cohort." The American Journal of Clinical Nutrition, vol. 103, no. 2, 2016, pp. 356-65.
Praagman J, Beulens JW, Alssema M, et al. The association between dietary saturated fatty acids and ischemic heart disease depends on the type and source of fatty acid in the European Prospective Investigation into Cancer and Nutrition-Netherlands cohort. Am J Clin Nutr. 2016;103(2):356-65.
Praagman, J., Beulens, J. W., Alssema, M., Zock, P. L., Wanders, A. J., Sluijs, I., & van der Schouw, Y. T. (2016). The association between dietary saturated fatty acids and ischemic heart disease depends on the type and source of fatty acid in the European Prospective Investigation into Cancer and Nutrition-Netherlands cohort. The American Journal of Clinical Nutrition, 103(2), pp. 356-65. doi:10.3945/ajcn.115.122671.
Praagman J, et al. The Association Between Dietary Saturated Fatty Acids and Ischemic Heart Disease Depends On the Type and Source of Fatty Acid in the European Prospective Investigation Into Cancer and Nutrition-Netherlands Cohort. Am J Clin Nutr. 2016;103(2):356-65. PubMed PMID: 26791181.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association between dietary saturated fatty acids and ischemic heart disease depends on the type and source of fatty acid in the European Prospective Investigation into Cancer and Nutrition-Netherlands cohort. AU - Praagman,Jaike, AU - Beulens,Joline Wj, AU - Alssema,Marjan, AU - Zock,Peter L, AU - Wanders,Anne J, AU - Sluijs,Ivonne, AU - van der Schouw,Yvonne T, Y1 - 2016/01/20/ PY - 2015/09/02/received PY - 2015/12/02/accepted PY - 2016/1/22/entrez PY - 2016/1/23/pubmed PY - 2016/6/14/medline KW - epidemiology KW - follow-up studies KW - ischemic heart disease KW - nutrition KW - saturated fatty acids SP - 356 EP - 65 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 103 IS - 2 N2 - BACKGROUND: The association between saturated fatty acid (SFA) intake and ischemic heart disease (IHD) risk is debated. OBJECTIVE: We sought to investigate whether dietary SFAs were associated with IHD risk and whether associations depended on 1) the substituting macronutrient, 2) the carbon chain length of SFAs, and 3) the SFA food source. DESIGN: Baseline (1993-1997) SFA intake was measured with a food-frequency questionnaire among 35,597 participants from the European Prospective Investigation into Cancer and Nutrition-Netherlands cohort. IHD risks were estimated with multivariable Cox regression for the substitution of SFAs with other macronutrients and for higher intakes of total SFAs, individual SFAs, and SFAs from different food sources. RESULTS: During 12 y of follow-up, 1807 IHD events occurred. Total SFA intake was associated with a lower IHD risk (HR per 5% of energy: 0.83; 95% CI: 0.74, 0.93). Substituting SFAs with animal protein, cis monounsaturated fatty acids, polyunsaturated fatty acids (PUFAs), or carbohydrates was significantly associated with higher IHD risks (HR per 5% of energy: 1.27-1.37). Slightly lower IHD risks were observed for higher intakes of the sum of butyric (4:0) through capric (10:0) acid (HRSD: 0.93; 95% CI: 0.89, 0.99), myristic acid (14:0) (HRSD: 0.90; 95% CI: 0.83, 0.97), the sum of pentadecylic (15:0) and margaric (17:0) acid (HRSD: 0.91: 95% CI: 0.83, 0.99), and for SFAs from dairy sources, including butter (HRSD: 0.94; 95% CI: 0.90, 0.99), cheese (HRSD: 0.91; 95% CI: 0.86, 0.97), and milk and milk products (HRSD: 0.92; 95% CI: 0.86, 0.97). CONCLUSIONS: In this Dutch population, higher SFA intake was not associated with higher IHD risks. The lower IHD risk observed did not depend on the substituting macronutrient but appeared to be driven mainly by the sums of butyric through capric acid, the sum of pentadecylic and margaric acid, myristic acid, and SFAs from dairy sources. Residual confounding by cholesterol-lowering therapy and trans fat or limited variation in SFA and PUFA intake may explain our findings. Analyses need to be repeated in populations with larger differences in SFA intake and different SFA food sources. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/26791181/The_association_between_dietary_saturated_fatty_acids_and_ischemic_heart_disease_depends_on_the_type_and_source_of_fatty_acid_in_the_European_Prospective_Investigation_into_Cancer_and_Nutrition_Netherlands_cohort_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.115.122671 DB - PRIME DP - Unbound Medicine ER -