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Associations of Monounsaturated Fatty Acids From Plant and Animal Sources With Total and Cause-Specific Mortality in Two US Prospective Cohort Studies.
Circ Res. 2019 04 12; 124(8):1266-1275.CircR

Abstract

RATIONALE

Dietary monounsaturated fatty acids (MUFAs) can come from both plant and animal sources with divergent nutrient profiles that may potentially obscure the associations of total MUFAs with chronic diseases.

OBJECTIVE

To investigate the associations of cis-MUFA intake from plant (MUFA-P) and animal (MUFA-A) sources with total and cause-specific mortality.

METHODS AND RESULTS

We followed 63 412 women from the NHS (Nurses' Health Study; 1990-2012) and 29 966 men from the HPFS (Health Professionals Follow-Up Study; 1990-2012). MUFA-Ps and MUFA-As were calculated based on data collected through validated food frequency questionnaires administered every 4 years and updated food composition databases. During 1 896 864 person-years of follow-up, 20 672 deaths occurred. Total MUFAs and MUFA-Ps were inversely associated with total mortality after adjusting for potential confounders, whereas MUFA-As were associated with higher mortality. When MUFA-Ps were modeled to isocalorically replace other macronutrients, hazard ratios (HRs, 95% CIs) of total mortality were 0.84 (0.77-0.92; P<0.001) for replacing saturated fatty acids, 5% of energy); 0.86 (0.82-0.91; P<0.001) for replacing refined carbohydrates (5% energy); 0.91 (0.85-0.97; P<0.001) for replacing trans fats (2% energy), and 0.77 (0.71-0.82; P<0.001) for replacing MUFA-As (5% energy). For isocalorically replacing MUFA-As with MUFA-Ps, HRs (95% CIs) were 0.74 (0.64-0.86; P<0.001) for cardiovascular mortality; 0.73 (0.65-0.82; P<0.001) for cancer mortality, and 0.82 (0.73-0.91; P<0.001) for mortality because of other causes.

CONCLUSIONS

Higher intake of MUFA-Ps was associated with lower total mortality, and MUFA-As intake was associated with higher mortality. Significantly lower mortality risk was observed when saturated fatty acids, refined carbohydrates, or trans fats were replaced by MUFA-Ps, but not MUFA-As. These data suggest that other constituents in animal foods, such as saturated fatty acids, may confound the associations for MUFAs when they are primarily derived from animal products. More evidence is needed to elucidate the differential associations of MUFA-Ps and MUFA-As with mortality.

Authors+Show Affiliations

From the Department of Nutrition (M.G.-F., G.Z., W.C.W., F.B.H., Q.S.), Harvard T.H. Chan School of Public Health, Boston, MA. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.G.-F., W.C.W., F.B.H., Q.S.).From the Department of Nutrition (M.G.-F., G.Z., W.C.W., F.B.H., Q.S.), Harvard T.H. Chan School of Public Health, Boston, MA. CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, University of Chinese Academy of Sciences (G.Z.).From the Department of Nutrition (M.G.-F., G.Z., W.C.W., F.B.H., Q.S.), Harvard T.H. Chan School of Public Health, Boston, MA. Department of Epidemiology (W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.G.-F., W.C.W., F.B.H., Q.S.).Unilever Research and Development, Vlaardingen, The Netherlands (P.L.Z., A.J.W.).Unilever Research and Development, Vlaardingen, The Netherlands (P.L.Z., A.J.W.).From the Department of Nutrition (M.G.-F., G.Z., W.C.W., F.B.H., Q.S.), Harvard T.H. Chan School of Public Health, Boston, MA. Department of Epidemiology (W.C.W., F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.G.-F., W.C.W., F.B.H., Q.S.).From the Department of Nutrition (M.G.-F., G.Z., W.C.W., F.B.H., Q.S.), Harvard T.H. Chan School of Public Health, Boston, MA. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.G.-F., W.C.W., F.B.H., Q.S.).

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30689516

Citation

Guasch-Ferré, Marta, et al. "Associations of Monounsaturated Fatty Acids From Plant and Animal Sources With Total and Cause-Specific Mortality in Two US Prospective Cohort Studies." Circulation Research, vol. 124, no. 8, 2019, pp. 1266-1275.
Guasch-Ferré M, Zong G, Willett WC, et al. Associations of Monounsaturated Fatty Acids From Plant and Animal Sources With Total and Cause-Specific Mortality in Two US Prospective Cohort Studies. Circ Res. 2019;124(8):1266-1275.
Guasch-Ferré, M., Zong, G., Willett, W. C., Zock, P. L., Wanders, A. J., Hu, F. B., & Sun, Q. (2019). Associations of Monounsaturated Fatty Acids From Plant and Animal Sources With Total and Cause-Specific Mortality in Two US Prospective Cohort Studies. Circulation Research, 124(8), 1266-1275. https://doi.org/10.1161/CIRCRESAHA.118.313996
Guasch-Ferré M, et al. Associations of Monounsaturated Fatty Acids From Plant and Animal Sources With Total and Cause-Specific Mortality in Two US Prospective Cohort Studies. Circ Res. 2019 04 12;124(8):1266-1275. PubMed PMID: 30689516.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of Monounsaturated Fatty Acids From Plant and Animal Sources With Total and Cause-Specific Mortality in Two US Prospective Cohort Studies. AU - Guasch-Ferré,Marta, AU - Zong,Geng, AU - Willett,Walter C, AU - Zock,Peter L, AU - Wanders,Anne J, AU - Hu,Frank B, AU - Sun,Qi, PY - 2020/04/12/pmc-release PY - 2019/1/29/pubmed PY - 2020/1/24/medline PY - 2019/1/29/entrez KW - carbohydrates KW - cardiovascular disease KW - chronic disease KW - diet KW - fatty acids SP - 1266 EP - 1275 JF - Circulation research JO - Circ. Res. VL - 124 IS - 8 N2 - RATIONALE: Dietary monounsaturated fatty acids (MUFAs) can come from both plant and animal sources with divergent nutrient profiles that may potentially obscure the associations of total MUFAs with chronic diseases. OBJECTIVE: To investigate the associations of cis-MUFA intake from plant (MUFA-P) and animal (MUFA-A) sources with total and cause-specific mortality. METHODS AND RESULTS: We followed 63 412 women from the NHS (Nurses' Health Study; 1990-2012) and 29 966 men from the HPFS (Health Professionals Follow-Up Study; 1990-2012). MUFA-Ps and MUFA-As were calculated based on data collected through validated food frequency questionnaires administered every 4 years and updated food composition databases. During 1 896 864 person-years of follow-up, 20 672 deaths occurred. Total MUFAs and MUFA-Ps were inversely associated with total mortality after adjusting for potential confounders, whereas MUFA-As were associated with higher mortality. When MUFA-Ps were modeled to isocalorically replace other macronutrients, hazard ratios (HRs, 95% CIs) of total mortality were 0.84 (0.77-0.92; P<0.001) for replacing saturated fatty acids, 5% of energy); 0.86 (0.82-0.91; P<0.001) for replacing refined carbohydrates (5% energy); 0.91 (0.85-0.97; P<0.001) for replacing trans fats (2% energy), and 0.77 (0.71-0.82; P<0.001) for replacing MUFA-As (5% energy). For isocalorically replacing MUFA-As with MUFA-Ps, HRs (95% CIs) were 0.74 (0.64-0.86; P<0.001) for cardiovascular mortality; 0.73 (0.65-0.82; P<0.001) for cancer mortality, and 0.82 (0.73-0.91; P<0.001) for mortality because of other causes. CONCLUSIONS: Higher intake of MUFA-Ps was associated with lower total mortality, and MUFA-As intake was associated with higher mortality. Significantly lower mortality risk was observed when saturated fatty acids, refined carbohydrates, or trans fats were replaced by MUFA-Ps, but not MUFA-As. These data suggest that other constituents in animal foods, such as saturated fatty acids, may confound the associations for MUFAs when they are primarily derived from animal products. More evidence is needed to elucidate the differential associations of MUFA-Ps and MUFA-As with mortality. SN - 1524-4571 UR - https://www.unboundmedicine.com/medline/citation/30689516/Associations_of_Monounsaturated_Fatty_Acids_From_Plant_and_Animal_Sources_With_Total_and_Cause_Specific_Mortality_in_Two_US_Prospective_Cohort_Studies_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.118.313996?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -