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Title: | Dietary Fatty Acids, Macronutrient Substitutions, Food Sources and Incidence of Coronary Heart Disease: Findings From the EPIC‐CVD Case‐Cohort Study Across Nine European Countries |
Author: | Steur, Marinka Johnson, Laura Sharp, Stephen J. Imamura, Fumiaki Sluijs, Ivonne Key, Timothy J. Wood, Angela Chowdhury, Rajiv Guevara, Marcela Jakobsen, Marianne U. Johansson, Ingegerd Koulman, Albert Overvad, Kim Sánchez, Maria José Schouw, Yvonne T. van der Trichopoulou, Antonia Weiderpass, Elisabete Wennberg, Maria Zheng, Ju Sheng Boeing, Heiner Boer, Jolanda M. A. Boutron-Ruault, Marie-Christine Ericson, Ulrika Heath, Alicia K. Huybrechts, Inge Imaz, Liher Kaaks, Rudolf Krogh, Vittorio Kühn, Tilman Kyrø, Cecilie Masala, Giovanna Melander, Olle Moreno Iribas, Conchi Panico, Salvatore Quirós, José Ramón Rodríguez Barranco, Miguel Sacerdote, Carlotta Santiuste, Carmen Skeie, Guri Tjønneland, Anne Tumino, Rosario Verschuren, W. M. Monique Zamora-Ros, Raul Dahm, Christina C. Pérez Cornago, Aurora Schulze, Matthias B. Tong, Tammy Y. N. Riboli, Elio Wareham, Nicholas J. Danesh, John Butterworth, Adam S. Forouhi, Nita G. |
Keywords: | Malalties coronàries Àcids grassos en la nutrició Coronary heart disease Fatty acids in human nutrition |
Issue Date: | 19-Nov-2021 |
Publisher: | Ovid Technologies (Wolters Kluwer Health) |
Abstract: | Background There is controversy about associations between total dietary fatty acids, their classes (saturated fatty acids [SFAs], monounsaturated fatty acids, and polyunsaturated fatty acids), and risk of coronary heart disease (CHD). Specifically, the relevance of food sources of SFAs to CHD associations is uncertain. Methods and Results We conducted a case-cohort study involving 10 529 incident CHD cases and a random subcohort of 16 730 adults selected from a cohort of 385 747 participants in 9 countries of the EPIC (European Prospective Investigation into Cancer and Nutrition) study. We estimated multivariable adjusted country-specific hazard ratios (HRs) and 95% CIs per 5% of energy intake from dietary fatty acids, with and without isocaloric macronutrient substitutions, using Prentice-weighted Cox regression models and pooled results using random-effects meta-analysis. We found no evidence for associations of the consumption of total or fatty acid classes with CHD, regardless of macronutrient substitutions. In analyses considering food sources, CHD incidence was lower per 1% higher energy intake of SFAs from yogurt (HR, 0.93 [95% CI, 0.88-0.99]), cheese (HR, 0.98 [95% CI, 0.96-1.00]), and fish (HR, 0.87 [95% CI, 0.75-1.00]), but higher for SFAs from red meat (HR, 1.07 [95% CI, 1.02-1.12]) and butter (HR, 1.02 [95% CI, 1.00-1.04]). Conclusions This observational study found no strong associations of total fatty acids, SFAs, monounsaturated fatty acids, and polyunsaturated fatty acids, with incident CHD. By contrast, we found associations of SFAs with CHD in opposite directions dependent on the food source. These findings should be further confirmed, but support public health recommendations to consider food sources alongside the macronutrients they contain, and suggest the importance of the overall food matrix. |
Note: | Reproducció del document publicat a: https://doi.org/10.1161/JAHA.120.019814 |
It is part of: | Journal of the American Heart Association, 2021, vol 10, num 23 |
URI: | https://hdl.handle.net/2445/182837 |
Related resource: | https://doi.org/10.1161/JAHA.120.019814 |
ISSN: | 2047-9980 |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) Publicacions de projectes de recerca finançats per la UE |
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