scholarly journals Use and misuse of dietary fatty acids for the prevention and treatment of coronary heart disease

2004 ◽  
Vol 44 (3) ◽  
pp. 283-288 ◽  
Author(s):  
Michel de Lorgeril ◽  
Patricia Salen
Keyword(s):  
Fatty Acids ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Dietary Fatty Acids ◽  
Prevention And Treatment

Abstract 50: Associations of Dietary Saturated Fatty Acids With Incident Coronary Heart Disease Depend on the Food Sources: EPIC-CVD Prospective Case-cohort Study in Nine European Countries

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Marinka Steur ◽  
Keyword(s):  
Fatty Acids ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Energy Intake ◽  
Saturated Fatty Acids ◽  
Red Meat ◽  
Dietary Fatty Acids ◽  
Food Sources ◽  
Total Fatty Acids ◽  
Country Specific

Introduction: The associations of dietary total fatty acids and the classes saturated, monounsaturated, and polyunsaturated fatty acids (SFAs, MUFAs, and PUFAs) with coronary heart disease (CHD) remain contentious. Moreover, the role of isocaloric macronutrient substitutions and specific food sources of SFAs, particularly in European context, is unclear. Hypothesis: We evaluated the hypothesis that associations of dietary fatty acids vary depending on specific macronutrient substitutions and food sources of SFAs. Methods: We conducted case-cohort analyses including 10,529 incident CHD cases and a random subcohort of 16,730 men and women selected from 385,747 eligible participants in nine countries of the European Prospective Investigation into Cancer and Nutrition Study. Habitual diet was assessed using country-specific dietary questionnaires, and macronutrient intakes were estimated using standardised nutrient databases. Country-specific HRs (95% CIs) per 5% energy intake from dietary total fatty acids, SFAs, MUFAs, and PUFAs were estimated using Prentice-weighted Cox regression models and pooled using random-effects meta-analyses, with and without considering isocaloric macronutrient substitutions. The associations of dietary SFAs from different food sources, including specific macronutrient substitutions, with CHD were also investigated. Results: There was no evidence of associations of dietary total fatty acids, SFAs, MUFAs, or PUFAs with incident CHD, regardless of the substitution macronutrient. Each 1% higher energy intake of SFAs from yoghurt, cheese, and fish were associated with a 7% (95% CI 1-12%), 2% (0-4%) and 13% (0-25%) lower CHD incidence, while SFAs from red meat and butter were associated with a 7% (2-12%) and 2% (0-4%) higher CHD incidence, respectively. Conclusions: There was no evidence of associations of dietary total fatty acids, SFAs, MUFAs, and PUFAs, with CHD incidence, regardless of the substitution nutrients, within the range of intakes in this European population. The opposite direction of associations of SFAs from different food sources such as red meat versus fermented dairy products suggests that public health recommendations should consider foods and overall diets, alongside the macronutrients they contain.

Abstract MP068: Dietary Fatty Acids and Coronary Heart Disease in Mortality in the Alpha Omega Cohort

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Famke J Mölenberg ◽  
Janette de Goede ◽  
Anne J Wanders ◽  
Peter L Zock ◽  
Daan Kromhout ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Lower Risk ◽  
Unsaturated Fatty Acids ◽  
Saturated Fatty Acids ◽  
Dietary Cholesterol ◽  
Dietary Factors ◽  
Dietary Fatty Acids ◽  
Alpha Omega

Background: Replacement of saturated fatty acids (SFA) with polyunsaturated fatty acids (PUFA) is associated with a lower risk of coronary heart disease (CHD) in the general population. Whether this is also the case for CHD patients is not yet clear. In this observational study of Dutch CHD patients, we examined the risk of CHD mortality for the exchange of SFA with total unsaturated fatty acids (UFA), PUFA and cis -monounsaturated fatty acids (MUFA). Methods: We included 4146 post-myocardial infarction patients aged 60-80 (78% male; Alpha Omega Cohort) in whom diet was assessed at baseline (2002-2006) by a validated 203-item food-frequency questionnaire. Cause-specific mortality was monitored until January 2013. Iso-caloric replacement of SFA with (subgroups of) UFA in relation to CHD mortality was studied in quintiles and continuously per 5 energy percent (en%), using Cox regression models. Hazard ratios (HR, 95%-CI) were obtained after adjustment for age, sex, BMI, smoking, education, physical activity, cardiovascular drugs (anticoagulants, antihypertensives, statins), diabetes, and dietary factors, i.e. total energy, protein (en%), carbohydrates (en%), trans fatty acids (en%), dietary fiber (g/d) and dietary cholesterol (mg/d). The model for PUFA also included MUFA as a covariate, and vice versa . Results: During a median follow-up of 7.3 years, there were 888 deaths including 249 CHD deaths. SFA replacement was inversely associated with CHD mortality when comparing extreme quintiles of intake, which was statistically significant for total UFA (HR: 0.44; 95% CI: 0.21-0.92; P = 0.03) and non-significant for PUFA (0.58, 0.31-1.09) and MUFA (0.81, 0.45-1.49). When expressed per 5 en% (Figure), replacing SFA with either UFA, PUFA or MUFA was associated with a more than 30% lower risk of CHD mortality. Findings were similar when confined to statin users. Conclusion: In well-treated CHD patients, replacement of SFA by UFA is associated with a lower CHD mortality risk.

scholarly journals 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

2021 ◽  
Author(s):  
Marinka Steur ◽  
Laura Johnson ◽  
Stephen J. Sharp ◽  
Fumiaki Imamura ◽  
Ivonne Sluijs ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Coronary Heart Disease ◽  
Cohort Study ◽  
Heart Disease ◽  
Polyunsaturated Fatty Acids ◽  
Energy Intake ◽  
Saturated Fatty Acids ◽  
Monounsaturated Fatty Acids ◽  
Dietary Fatty Acids ◽  
Food Sources

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.

scholarly journals Conclusions and recommendations from the symposium, Beyond Cholesterol: Prevention and Treatment of Coronary Heart Disease with n−3 Fatty Acids

2008 ◽  
Vol 87 (6) ◽  
pp. 2010S-2012S ◽  
Author(s):  
Richard J Deckelbaum ◽  
Alexander Leaf ◽  
Dariush Mozaffarian ◽  
Terry A Jacobson ◽  
William S Harris ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Prevention And Treatment
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