RT Journal Article
T1 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
A1 Steur, Marinka
A1 Johnson, Laura
A1 Sharp, Stephen J.
A1 Imamura, Fumiaki
A1 Sluijs, Ivonne
A1 Key, Timothy J.
A1 Wood, Angela
A1 Chowdhury, Rajiv
A1 Guevara, Marcela
A1 Jakobsen, Marianne U.
A1 Johansson, Ingegerd
A1 Koulman, Albert
A1 Overvad, Kim
A1 Sanchez, Maria-Jose
A1 van der Schouw, Yvonne T.
A1 Trichopoulou, Antonia
A1 Weiderpass, Elisabete
A1 Wennberg, Maria
A1 Zheng, Ju-Sheng
A1 Boeing, Heiner
A1 Boer, Jolanda M. A.
A1 Boutron-Ruault, Marie-Christine
A1 Ericson, Ulrika
A1 Heath, Alicia K.
A1 Huybrechts, Inge
A1 Imaz, Liher
A1 Kaaks, Rudolf
A1 Krogh, Vittorio
A1 Kuhn, Tilman
A1 Kyro, Cecilie
A1 Masala, Giovanna
A1 Melander, Olle
A1 Moreno-Iribas, Conchi
A1 Panico, Salvatore
A1 Quiros, Jose R.
A1 Rodriguez-Barranco, Miguel
A1 Sacerdote, Carlotta
A1 Santiuste, Carmen
A1 Skeie, Guri
A1 Tjonneland, Anne
A1 Tumino, Rosario
A1 Verschuren, W. M. Monique
A1 Zamora-Ros, Raul
A1 Dahm, Christina C.
A1 Perez-Cornago, Aurora
A1 Schulze, Matthias B.
A1 Tong, Tammy Y. N.
A1 Riboli, Elio
A1 Wareham, Nicholas J.
A1 Danesh, John
A1 Butterworth, Adam S.
A1 Forouhi, Nita G.
K1 coronary heart disease
K1 dietary guidelines
K1 nutritional epidemiology
K1 primary prevention
K1 saturated fat
K1 Cardiovascular-disease
K1 Glycemic index
K1 Carbohydrate intake
K1 Life-style
K1 Risk
K1 Cancer
K1 Consumption
K1 Project
K1 Participants
K1 Metaanalysis
AB 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.
PB Wiley
YR 2021
FD 2021-12-07
LK https://hdl.handle.net/10668/24671
UL https://hdl.handle.net/10668/24671
LA en
DS RISalud
RD Apr 4, 2025