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Saturated Fats Compared With Unsaturated Fats and Sources of Carbohydrates in Relation to Risk of Coronary Heart Disease: A Prospective Cohort Study

Published on Oct 1, 2015in Journal of the American College of Cardiology 16.83
· DOI :10.1016/j.jacc.2015.07.055
Yanping Li43
Estimated H-index: 43
(Harvard University),
Adela Hruby18
Estimated H-index: 18
(Harvard University)
+ 8 AuthorsFrank B. Hu202
Estimated H-index: 202
(Harvard University)
Abstract
Abstract Background The associations between dietary saturated fats and the risk of coronary heart disease (CHD) remain controversial, but few studies have compared saturated with unsaturated fats and sources of carbohydrates in relation to CHD risk. Objectives This study sought to investigate associations of saturated fats compared with unsaturated fats and different sources of carbohydrates in relation to CHD risk. Methods We followed 84,628 women (Nurses’ Health Study, 1980 to 2010), and 42,908 men (Health Professionals Follow-up Study, 1986 to 2010) who were free of diabetes, cardiovascular disease, and cancer at baseline. Diet was assessed by a semiquantitative food frequency questionnaire every 4 years. Results During 24 to 30 years of follow-up, we documented 7,667 incident cases of CHD. Higher intakes of polyunsaturated fatty acids (PUFAs) and carbohydrates from whole grains were significantly associated with a lower risk of CHD comparing the highest with lowest quintile for PUFAs (hazard ratio [HR]: 0.80, 95% confidence interval [CI]: 0.73 to 0.88; p trend  0.10). Conclusions Our findings indicate that unsaturated fats, especially PUFAs, and/or high-quality carbohydrates can be used to replace saturated fats to reduce CHD risk.
  • References (22)
  • Citations (138)
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References22
Newest
Published on Oct 1, 2014in JAMA Internal Medicine 19.99
Dong D. Wang19
Estimated H-index: 19
(Harvard University),
Cindy W. Leung17
Estimated H-index: 17
(University of California, San Francisco)
+ 4 AuthorsBarry M. Popkin319
Estimated H-index: 319
(Harvard University)
Importance Many changes in the economy, policies related to nutrition, and food processing have occurred within the United States since 2000, and the net effect on dietary quality is not clear. These changes may have affected various socioeconomic groups differentially. Objective To investigate trends in dietary quality from 1999 to 2010 in the US adult population and within socioeconomic subgroups. Design, Setting, and Participants Nationally representative sample of 29 124 adults aged 20 to 85...
148 Citations Source Cite
Published on Jul 1, 2014in The American Journal of Clinical Nutrition 6.55
Shilpa N Bhupathiraju22
Estimated H-index: 22
,
Deirdre K. Tobias22
Estimated H-index: 22
+ 5 AuthorsFrank B. Hu202
Estimated H-index: 202
Background: Epidemiologic evidence for the relation between carbohydrate quality and risk of type 2 diabetes (T2D) has been mixed. Objective: We prospectively examined the association of dietary glycemic index (GI) and glycemic load (GL) with T2D risk. Design: We prospectively followed 74,248 women from the Nurses’ Health Study (1984–2008), 90,411 women from the Nurses’ Health Study II (1991–2009), and 40,498 men from the Health Professionals FollowUp Study (1986–2008) who were free of diabetes,...
150 Citations Source Cite
Published on Mar 18, 2014in Annals of Internal Medicine 19.38
Rajiv Chowdhury47
Estimated H-index: 47
,
Samantha Warnakula9
Estimated H-index: 9
+ 11 AuthorsSimon G. Thompson95
Estimated H-index: 95
Primary Funding Source: British Heart Foundation, Medical Research Council, Cambridge National Institute for Health Research Biomedical Research Centre, and Gates Cambridge.
606 Citations Source Cite
Published on Dec 1, 2013in The American Journal of Clinical Nutrition 6.55
Shilpa N Bhupathiraju22
Estimated H-index: 22
,
Nicole M. Wedick19
Estimated H-index: 19
+ 5 AuthorsFrank B. Hu202
Estimated H-index: 202
Background: Dietary guidelines recommend increasing fruit and vegetable intake and, most recently, have also suggested increasing variety. Objective: We prospectively examined the independent roles of quantity and variety in fruit and vegetable intake in relation to incident coronary heart disease (CHD). Design: We prospectively followed 71,141 women from the Nurses’ Health Study (1984–2008) and 42,135 men from the Health Professionals Follow-Up Study (1986–2008) who were free of diabetes, cardi...
83 Citations Source Cite
Published on Nov 1, 2013in British Journal of Nutrition 3.66
Minna E. Similä9
Estimated H-index: 9
(National Institute for Health and Welfare),
Jukka Kontto19
Estimated H-index: 19
(National Institute for Health and Welfare)
+ 2 AuthorsJarmo Virtamo90
Estimated H-index: 90
(National Institute for Health and Welfare)
14 Citations Source Cite
Published on Apr 4, 2013in The New England Journal of Medicine 79.26
Ramón Estruch73
Estimated H-index: 73
,
Emilio Ros72
Estimated H-index: 72
+ 15 AuthorsJosé Lapetra36
Estimated H-index: 36
cording to self-reported intake and biomarker analyses. A primary end-point event occurred in 288 participants. The multivariable-adjusted hazard ratios were 0.70 (95% confidence interval (CI), 0.54 to 0.92) and 0.72 (95% CI, 0.54 to 0.96) for the group assigned to a Mediterranean diet with extra-virgin olive oil (96 events) and the group assigned to a Mediterranean diet with nuts (83 events), respectively, ver -
2,588 Citations Source Cite
Published on May 1, 2011in American Journal of Preventive Medicine 4.13
Stephanie E. Chiuve44
Estimated H-index: 44
(Harvard University),
Laura Sampson34
Estimated H-index: 34
(Harvard University),
Barry M. Popkin319
Estimated H-index: 319
(Harvard University)
Background The Overall Nutritional Quality Index (ONQI) algorithm is a nutrient profiling scheme that incorporates more than 30 dietary components, and it aims to rank foods by relative healthfulness. Purpose To assess whether diets with a higher ONQI score predict lower risk of major chronic disease risk. Methods A total of 62,284 healthy women from the Nurses' Health Study and 42,382 healthy men from Health Professionals Follow-Up Study were followed from 1986 to 2006. Dietary data were collec...
102 Citations Source Cite
Published on Jun 1, 2010in The American Journal of Clinical Nutrition 6.55
Marianne Uhre Jakobsen32
Estimated H-index: 32
,
Claus Dethlefsen24
Estimated H-index: 24
+ 4 AuthorsKim Overvad111
Estimated H-index: 111
Background: Studies have suggested that replacing saturated fatty acids (SFAs) with carbohydrates is modestly associated with a higher risk of ischemic heart disease, whereas replacing SFAs with polyunsaturated fatty acids is associated with a lower risk of ischemic heart disease. The effect of carbohydrates, however, may depend on the type consumed. Objectives: By using substitution models, we aimed to investigate the risk of myocardial infarction (MI) associated with a higher energy intake fro...
147 Citations Source Cite
Published on Mar 23, 2010in PLOS Medicine 11.68
Dariush Mozaffarian113
Estimated H-index: 113
(Harvard University),
Renata Micha37
Estimated H-index: 37
(Harvard University),
Sarah K. Wallace3
Estimated H-index: 3
(Harvard University)
Background: Reduced saturated fat (SFA) consumption is recommended to reduce coronary heart disease (CHD), but there is an absence of strong supporting evidence from randomized controlled trials (RCTs) of clinical CHD events and few guidelines focus on any specific replacement nutrient. Additionally, some public health groups recommend lowering or limiting polyunsaturated fat (PUFA) consumption, a major potential replacement for SFA. Methods and Findings: We systematically investigated and quant...
651 Citations Source Cite
Published on May 1, 2009in The American Journal of Clinical Nutrition 6.55
Marianne Uhre Jakobsen32
Estimated H-index: 32
,
Éilis J. O'Reilly32
Estimated H-index: 32
(Harvard University)
+ 13 AuthorsSimin Liu102
Estimated H-index: 102
(Harvard University)
Background: Saturated fatty acid (SFA) intake increases plasma LDL-cholesterol concentrations; therefore, intake should be reduced to prevent coronary heart disease (CHD). Lower habitual intakes of SFAs, however, require substitution of other macronutrients to maintain energy balance. Objective: We investigated associations between energy intake from monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), and carbohydrates and risk of CHD while assessing the potential effect-mo...
661 Citations Source Cite
Cited By138
Newest
Published on Apr 6, 2019in Lipids in Health and Disease 2.66
Yongjian Zhu (Zhengzhou University), Yacong Bo (Zhengzhou University), Yanhua Liu (Zhengzhou University)
Background Several epidemiological studies have investigated the association between dietary fat intake and cardiovascular disease. However, dietary recommendations based on systematic review and meta-analysis might be more credible.
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Published on Jun 1, 2019in Public Health Nutrition 2.48
SuJin Song9
Estimated H-index: 9
,
Jae Eun Shim4
Estimated H-index: 4
,
Won O. Song35
Estimated H-index: 35
Source Cite
Published on May 16, 2019in Nature Reviews Cardiology 15.16
Jason H.Y. Wu33
Estimated H-index: 33
(The George Institute for Global Health),
Renata Micha37
Estimated H-index: 37
(Tufts University),
Dariush Mozaffarian113
Estimated H-index: 113
(Tufts University)
The effect of dietary fats on cardiometabolic diseases, including cardiovascular diseases and type 2 diabetes mellitus, has generated tremendous interest. Many earlier investigations focused on total fat and conventional fat classes (such as saturated and unsaturated fats) and their influence on a limited number of risk factors. However, dietary fats comprise heterogeneous molecules with diverse structures, and growing research in the past two decades supports correspondingly complex health effe...
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Published on May 16, 2019in European Heart Journal 23.43
Russell J. de Souza35
Estimated H-index: 35
(McMaster University),
Mahshid Dehghan22
Estimated H-index: 22
(Population Health Research Institute),
Sonia S. Anand74
Estimated H-index: 74
(McMaster University)
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Published on May 1, 2019in Current Atherosclerosis Reports 2.56
Elena Hemler1
Estimated H-index: 1
(Harvard University),
Frank B. Hu202
Estimated H-index: 202
(Harvard University)
Purpose of Review Plant-based diets have been widely promoted for cardiovascular disease (CVD) risk reduction. This review discusses the various definitions of plant-based diets and summarizes their associations with CVD risk, specifically distinguishing between healthy and unhealthy plant-based diets.
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Published on Apr 25, 2019in European Journal of Clinical Nutrition 2.95
Stephen J. Roy1
Estimated H-index: 1
(University of Texas at Austin),
Brandon G. Fico2
Estimated H-index: 2
(University of Texas at Austin)
+ 5 AuthorsHirofumi Tanaka60
Estimated H-index: 60
(University of Texas at Austin)
High consumption of low- and non-fat dairy products improves vascular dysfunction associated with elevated arterial blood pressure (BP). Currently, it is unknown if conventional full-fat dairy products improve vascular functions. To determine if adding whole milk and full-fat dairy products to the normal routine diet improves vascular function in adults with elevated BP. Sixty adults (age ± SEM; 58 ± 2 years) with elevated BP (systolic/diastolic; 120–159/ < 99 mmHg) were randomized into a contro...
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Published on Apr 9, 2019in Circulation 18.88
Marta Guasch-Ferré20
Estimated H-index: 20
(Harvard University),
Ambika Satija14
Estimated H-index: 14
(Harvard University)
+ 7 AuthorsMeir J. Stampfer247
Estimated H-index: 247
(Harvard University)
Background: Findings among randomized controlled trials evaluating the effect of red meat on cardiovascular disease risk factors are inconsistent. We provide an updated meta-analysis of randomized controlled trials on red meat and cardiovascular risk factors and determine whether the relationship depends on the composition of the comparison diet, hypothesizing that plant sources would be relatively beneficial. Methods: We conducted a systematic PubMed search of randomized controlled trials publi...
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Chen Cheng (Southeast University), Di Wang (Southeast University)+ 11 AuthorsGuofang Shu3
Estimated H-index: 3
(Southeast University)
AbstractThe aim of this study is to investigate the effects of palm olein (POL), cocoa butter (CB) and extra virgin olive oil (EVOO) on the lipid profile and low-density lipoprotein subfractions in a young, healthy Chinese population. After screening, 72 subjects were randomly assigned to three groups, and an 18-week randomized crossover trial was conducted. The first phase was a 2-week run-in period, followed by three phases of the 4-week experimental periods with a 2-week washout period betwee...
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