Abstract 036: Dietary Fatty Acids and the Risk of Fatal and Non-Fatal Coronary Heart Disease in Middle-Aged or Older Men: The Kuopio Ischaemic Heart Disease Risk Factor Study
Background: The epidemiological evidence of the role of dietary saturated fatty acids (SFA) in the etiology of coronary heart disease (CHD) is inconsistent. In general, however, replacement of SFA with polyunsaturated fatty acids (PUFA) rather than monounsaturated fatty acids (MUFA) or carbohydrates has been associated with lower risk of CHD. However, few studies have investigated populations with a high average intake of SFA. We investigated the associations of dietary fatty acids with the risk of CHD in men in a population with a high intake of SFA and high rates of CHD.
Methods: A total of 1981 men from the population-based Kuopio Ischaemic Heart Disease Risk Factor Study, aged 42-60 years and free of CHD at baseline, were included. The consumption of foods was assessed with instructed 4-day food recording by household measures. Multivariate nutrient-density models were used to analyze isocaloric replacement of nutrients. Multivariate analyses included age, examination year, body mass index, diabetes, family history of CHD, pack-years of smoking, education years, maximal oxygen uptake, systolic and diastolic blood pressure, and intakes of alcohol, fiber, total energy, and percentage of energy (E%) from protein. CHD events were ascertained from national registries.
Results: The mean dietary intake of SFA was 18.0 E%, of MUFA 11.8 E% and of PUFA 4.6 E%. During the mean follow-up of 19.1 years, 371 non-fatal and 167 fatal CHD events occurred. In the multivariate models, SFA intake was not associated with the risk of CHD when compared with equivalent energy from carbohydrates (Figure). In contrast, MUFA intake was associated with increased risk and PUFA intake with decreased risk, whether replacing carbohydrates or SFA.
Conclusions: Our results suggest that SFA intake is not a major risk factor for CHD when replacing carbohydrates in diet, even in populations with higher ranges of SFA intake. However, replacing SFA with PUFA is associated with lower risk of CHD. Further investigation on the impact of MUFA on the risk of CHD is warranted.
- © 2013 by American Heart Association, Inc.