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Intake of individual saturated fatty acids and risk of coronary heart disease in US men and women: two prospective longitudinal cohort studies

View Article: PubMed Central - PubMed

ABSTRACT

Objectives:  To investigate the association between long term intake of individual saturated fatty acids (SFAs) and the risk of coronary heart disease, in two large cohort studies.

Design:  Prospective, longitudinal cohort study.

Setting:  Health professionals in the United States.

Participants:  73 147 women in the Nurses’ Health Study (1984-2012) and 42 635 men in the Health Professionals Follow-up Study (1986-2010), who were free of major chronic diseases at baseline.

Main outcome measure:  Incidence of coronary heart disease (n=7035) was self-reported, and related deaths were identified by searching National Death Index or through report of next of kin or postal authority. Cases were confirmed by medical records review.

Results:  Mean intake of SFAs accounted for 9.0-11.3% energy intake over time, and was mainly composed of lauric acid (12:0), myristic acid (14:0), palmitic acid (16:0), and stearic acid (18:0; 8.8-10.7% energy). Intake of 12:0, 14:0, 16:0 and 18:0 were highly correlated, with Spearman correlation coefficients between 0.38 and 0.93 (all P<0.001). Comparing the highest to the lowest groups of individual SFA intakes, hazard ratios of coronary heart disease were 1.07 (95% confidence interval 0.99 to 1.15; Ptrend=0.05) for 12:0, 1.13 (1.05 to 1.22; Ptrend<0.001) for 14:0, 1.18 (1.09 to 1.27; Ptrend<0.001) for 16:0, 1.18 (1.09 to 1.28; Ptrend<0.001) for 18:0, and 1.18 (1.09 to 1.28; Ptrend<0.001) for all four SFAs combined (12:0-18:0), after multivariate adjustment of lifestyle factors and total energy intake. Hazard ratios of coronary heart disease for isocaloric replacement of 1% energy from 12:0-18:0 were 0.92 (95% confidence interval 0.89 to 0.96; P<0.001) for polyunsaturated fat, 0.95 (0.90 to 1.01; P=0.08) for monounsaturated fat, 0.94 (0.91 to 0.97; P<0.001) for whole grain carbohydrates, and 0.93 (0.89 to 0.97; P=0.001) for plant proteins. For individual SFAs, the lowest risk of coronary heart disease was observed when the most abundant SFA, 16:0, was replaced. Hazard ratios of coronary heart disease for replacing 1% energy from 16:0 were 0.88 (95% confidence interval 0.81 to 0.96; P=0.002) for polyunsaturated fat, 0.92 (0.83 to 1.02; P=0.10) for monounsaturated fat, 0.90 (0.83 to 0.97; P=0.01) for whole grain carbohydrates, and 0.89 (0.82 to 0.97; P=0.01) for plant proteins.

Conclusions:  Higher dietary intakes of major SFAs are associated with an increased risk of coronary heart disease. Owing to similar associations and high correlations among individual SFAs, dietary recommendations for the prevention of coronary heart disease should continue to focus on replacing total saturated fat with more healthy sources of energy.

No MeSH data available.


Fig 1 Aged adjusted intake (energy (%)) of individual saturated fatty acids over time in the Nurses’ Health Study (1984-2010) and Health Professionals Follow-up Study (1986-2010). 4:0=butyric acid; 6:0=caproic acid; 8:0=caprylic acid; 10:0=capric acid; 12:0=lauric acid; 14:0=myristic acid; 16:0=palmitic acid; 18:0=stearic acid
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f1: Fig 1 Aged adjusted intake (energy (%)) of individual saturated fatty acids over time in the Nurses’ Health Study (1984-2010) and Health Professionals Follow-up Study (1986-2010). 4:0=butyric acid; 6:0=caproic acid; 8:0=caprylic acid; 10:0=capric acid; 12:0=lauric acid; 14:0=myristic acid; 16:0=palmitic acid; 18:0=stearic acid

Mentions: Proportions of energy intake from SFAs decreased from 11.3% in the Nurses’ Health Study and 10.4% in the Health Professionals Follow-up Study at baseline to 9.1% and 9.0% in 1998, respectively, and slightly increased again to 9.9% and 9.8% in 2010, respectively (fig 1). Overall, 12:0, 14:0, 16:0, and 18:0 are the main SFAs in diet and account for 8.8-10.7% energy on average. Throughout follow-up, mean proportion of energy from 16:0 was 5.7% for both women and men, followed by 18:0 (2.6% for both sexes) and 14:0 (0.9% for women and 0.8% for men). Lauric acid (12:0) and 4:0-10:0 contributed to 0.2% and 0.5% energy in men and women. Individual SFAs in the diet were highly correlated; Spearman correlation coefficients ranged from 0.38 between 4:0-10:0 and 18:0, to 0.93 between 16:0 and 18:0 (all P<0.001; supplementary table 1).


Intake of individual saturated fatty acids and risk of coronary heart disease in US men and women: two prospective longitudinal cohort studies
Fig 1 Aged adjusted intake (energy (%)) of individual saturated fatty acids over time in the Nurses’ Health Study (1984-2010) and Health Professionals Follow-up Study (1986-2010). 4:0=butyric acid; 6:0=caproic acid; 8:0=caprylic acid; 10:0=capric acid; 12:0=lauric acid; 14:0=myristic acid; 16:0=palmitic acid; 18:0=stearic acid
© Copyright Policy - open-access
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC5121105&req=5

f1: Fig 1 Aged adjusted intake (energy (%)) of individual saturated fatty acids over time in the Nurses’ Health Study (1984-2010) and Health Professionals Follow-up Study (1986-2010). 4:0=butyric acid; 6:0=caproic acid; 8:0=caprylic acid; 10:0=capric acid; 12:0=lauric acid; 14:0=myristic acid; 16:0=palmitic acid; 18:0=stearic acid
Mentions: Proportions of energy intake from SFAs decreased from 11.3% in the Nurses’ Health Study and 10.4% in the Health Professionals Follow-up Study at baseline to 9.1% and 9.0% in 1998, respectively, and slightly increased again to 9.9% and 9.8% in 2010, respectively (fig 1). Overall, 12:0, 14:0, 16:0, and 18:0 are the main SFAs in diet and account for 8.8-10.7% energy on average. Throughout follow-up, mean proportion of energy from 16:0 was 5.7% for both women and men, followed by 18:0 (2.6% for both sexes) and 14:0 (0.9% for women and 0.8% for men). Lauric acid (12:0) and 4:0-10:0 contributed to 0.2% and 0.5% energy in men and women. Individual SFAs in the diet were highly correlated; Spearman correlation coefficients ranged from 0.38 between 4:0-10:0 and 18:0, to 0.93 between 16:0 and 18:0 (all P<0.001; supplementary table 1).

View Article: PubMed Central - PubMed

ABSTRACT

Objectives: &nbsp;To investigate the association between long term intake of individual saturated fatty acids (SFAs) and the risk of coronary heart disease, in two large cohort studies.

Design: &nbsp;Prospective, longitudinal cohort study.

Setting: &nbsp;Health professionals in the United States.

Participants: &nbsp;73&thinsp;147 women in the Nurses&rsquo; Health Study (1984-2012) and 42&thinsp;635 men in the Health Professionals Follow-up Study (1986-2010), who were free of major chronic diseases at baseline.

Main outcome measure: &nbsp;Incidence of coronary heart disease (n=7035) was self-reported, and related deaths were identified by searching National Death Index or through report of next of kin or postal authority. Cases were confirmed by medical records review.

Results: &nbsp;Mean intake of SFAs accounted for 9.0-11.3% energy intake over time, and was mainly composed of lauric acid (12:0), myristic acid (14:0), palmitic acid (16:0), and stearic acid (18:0; 8.8-10.7% energy). Intake of 12:0, 14:0, 16:0 and 18:0 were highly correlated, with Spearman correlation coefficients between 0.38 and 0.93 (all P&lt;0.001). Comparing the highest to the lowest groups of individual SFA intakes, hazard ratios of coronary heart disease were 1.07 (95% confidence interval 0.99 to 1.15; Ptrend=0.05) for 12:0, 1.13 (1.05 to 1.22; Ptrend&lt;0.001) for 14:0, 1.18 (1.09 to 1.27; Ptrend&lt;0.001) for 16:0, 1.18 (1.09 to 1.28; Ptrend&lt;0.001) for 18:0, and 1.18 (1.09 to 1.28; Ptrend&lt;0.001) for all four SFAs combined (12:0-18:0), after multivariate adjustment of lifestyle factors and total energy intake. Hazard ratios of coronary heart disease for isocaloric replacement of 1% energy from 12:0-18:0 were 0.92 (95% confidence interval 0.89 to 0.96; P&lt;0.001) for polyunsaturated fat, 0.95 (0.90 to 1.01; P=0.08) for monounsaturated fat, 0.94 (0.91 to 0.97; P&lt;0.001) for whole grain carbohydrates, and 0.93 (0.89 to 0.97; P=0.001) for plant proteins. For individual SFAs, the lowest risk of coronary heart disease was observed when the most abundant SFA, 16:0, was replaced. Hazard ratios of coronary heart disease for replacing 1% energy from 16:0 were 0.88 (95% confidence interval 0.81 to 0.96; P=0.002) for polyunsaturated fat, 0.92 (0.83 to 1.02; P=0.10) for monounsaturated fat, 0.90 (0.83 to 0.97; P=0.01) for whole grain carbohydrates, and 0.89 (0.82 to 0.97; P=0.01) for plant proteins.

Conclusions: &nbsp;Higher dietary intakes of major SFAs are associated with an increased risk of coronary heart disease. Owing to similar associations and high correlations among individual SFAs, dietary recommendations for the prevention of coronary heart disease should continue to focus on replacing total saturated fat with more healthy sources of energy.

No MeSH data available.