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Dietary fat and risk of coronary heart disease in men: cohort follow up study in the United States

Published on Jul 13, 1996in BMJ 23.56
· DOI :10.1136/bmj.313.7049.84
Alberto Ascherio116
Estimated H-index: 116
(Harvard University),
Eric B. Rimm166
Estimated H-index: 166
(Harvard University)
+ 3 AuthorsBarry M. Popkin319
Estimated H-index: 319
(Harvard University)
Abstract
Abstract Objective : To examine the association between fat intake and the incidence of coronary heart disease in men of middle age and older. Design : Cohort questionnaire study of men followed up for six years from 1986. Setting : The health professionals follow up study in the United States. Subjects : 43 757 health professionals aged 40 to 75 years free of diagnosed cardiovascular disease or diabetes in 1986. Main outcome measure : Incidence of acute myocardial infarction or coronary death. Results : During follow up 734 coronary events were documented, including 505 non-fatal myocardial infarctions and 229 deaths. After age and several coronary risk factors were controlled for significant positive associations were observed between intake of saturated fat and risk of coronary disease. For men in the top versus the lowest fifth of saturated fat intake (median = 14.8% v 5.7% of energy) the multivariate relative risk for myocardial infarction was 1.22 (95% confidence interval 0.96 to 1.56) and for fatal coronary heart disease was 2.21 (1.38 to 3.54). After ajustment for intake of fibre the risks were 0.96 (0.73 to 1.27) and 1.72 (1.01 to 2.90), respectively. Positive associations between intake of cholesterol and risk of coronary heart disease were similarly attenuated after adjustment for fibre intake. Intake of linolenic acid was inversely associated with risk of myocardial infarction; this association became significant only after adjustment for non-dietary risk factors and was strengthened after adjustment for total fat intake (relative risk 0.41 for a 1% increase in energy, P for trend Conclusions : These data do not support the strong association between intake of saturated fat and risk of coronary heart disease suggested by international comparisons. They are compatible, however, with the hypotheses that saturated fat and cholesterol intakes affect the risk of coronary heart disease as predicted by their effects on blood cholesterol concentration. They also support a specific preventive effect of linolenic acid intake. Key messages Diets high in saturated fat and cholesterol are associated with an increased risk of coronary disease, but these adverse effects are at least in part explained by their low fibre content and associations with other risk factors Diets high in linolenic acid (N-3 fatty acid from plants) are associated with a reduced risk of coronary heart disease, independently of other dietary and non-dietary risk factors Uncertainty remains on the optimal amount of polyunsaturated fat in the diet for prevention of coronary heart disease Benefits of reducing intakes of saturated fat and cholesterol are likely to be modest unless accompanied by an increased consumption of foods rich in fibre
  • References (57)
  • Citations (616)
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References57
Newest
Published on Feb 14, 1996in JAMA 47.66
Eric B. Rimm166
Estimated H-index: 166
,
Alberto Ascherio116
Estimated H-index: 116
+ 3 AuthorsBarry M. Popkin319
Estimated H-index: 319
Objective. —To examine prospectively the relationship between dietary fiber and risk of coronary heart disease. Design. —Cohort study. Setting. —In 1986, a total of 43 757 US male health professionals 40 to 75 years of age and free from diagnosed cardiovascular disease and diabetes completed a detailed 131 -item dietary questionnaire used to measure usual intake of total dietary fiber and specific food sources of fiber. Main Outcome Measure. —Fatal and nonfatal myocardial infarction (Ml). Result...
713 Citations Source Cite
Published on Jan 1, 1996in Epidemiology 4.99
Scott Chasan-Taber1
Estimated H-index: 1
,
Eric B. Rimm166
Estimated H-index: 166
+ 5 AuthorsBarry M. Popkin319
Estimated H-index: 319
347 Citations Source Cite
Published on Apr 13, 1995in The New England Journal of Medicine 79.26
Alberto Ascherio116
Estimated H-index: 116
,
Eric B. Rimm166
Estimated H-index: 166
+ 2 AuthorsBarry M. Popkin319
Estimated H-index: 319
Background It has been hypothesized that a diet containing n-3 fatty acids from fish reduces the risk of coronary heart disease, but few large epidemiologic studies have examined this question. Methods In 1986, 44,895 male health professionals, 40 to 75 years of age, who were free of known cardiovascular disease completed detailed and validated dietary questionnaires as part of the Health Professionals Follow-up Study. During six years of follow-up, we documented 1543 coronary events in this gro...
479 Citations Source Cite
Published on Feb 1, 1995in The Lancet 53.25
Tl Roberts2
Estimated H-index: 2
(National Institutes of Health),
D. Wood100
Estimated H-index: 100
(National Institutes of Health)
+ 2 AuthorsFc Lampe3
Estimated H-index: 3
(Southampton General Hospital)
Abstract Trans isomers of unsaturated fatty acids are formed by biological or industrial hydrogenation. A population case-control study of sudden cardiac death in men was done to test the hypothesis that trans isomers of oleic acid and linoleic acid increase the risk of sudden cardiac death due to coronary artery disease. In adipose tissue obtained at necropsy from 66 cases of sudden cardiac death and taken from 286 healthy age and sex matched controls, the proportions of trans isomers of oleic ...
135 Citations Source Cite
Published on Feb 1, 1995in The Lancet 53.25
Antti Aro51
Estimated H-index: 51
,
Irma Salminen24
Estimated H-index: 24
+ 13 AuthorsLenore Kohlmeier28
Estimated H-index: 28
Abstract Dietary isomeric trans fatty acids—mainly produced by hydrogenation of oils—are suspected of increasing the risk of coronary heart disease. Dietary trans fatty acid intake is reflected in the fatty acid composition of adipose tissue. In an international multicentre study in eight European countries and Israel (EURAMIC), adipose tissue aspiration samples were obtained from 671 men with acute myocardial infarction (AMI), aged 70 years or less, and 717 men without a history of AMI (control...
186 Citations Source Cite
Published on Jun 1, 1994in The Lancet 53.25
M. De Lorgeril14
Estimated H-index: 14
(French Institute of Health and Medical Research),
Serge Renaud28
Estimated H-index: 28
(French Institute of Health and Medical Research)
+ 6 AuthorsJ. Delaye14
Estimated H-index: 14
In a prospective, randomised single-blinded secondary prevention trial we compared the effect of a Mediterranean alpha-linolenic acid-rich diet to the usual post-infarct prudent diet. After a first myocardial infarction, patients were randomly assigned to the experimental (n = 302) or control group (n = 303). Patients were seen again 8 weeks after randomisation, and each year for 5 years. The experimental group consumed significantly less lipids, saturated fat, cholesterol, and linoleic acid but...
1,622 Citations Source Cite
Published on May 1, 1994in American Journal of Public Health 4.38
Barry M. Popkin319
Estimated H-index: 319
,
Alberto Ascherio116
Estimated H-index: 116
In the process of converting vegetable oils into solid fats, a process known as partial hydrogenation, some unsaturated bonds are converted to an unnatural trans position. In humans, trans fatty acids increase low-density lipoprotein cholesterol and decrease high-density lipoprotein cholesterol. In addition, positive associations between intake of trans fatty acids and coronary heart disease have been observed in epidemiological studies. The combined results of metabolic and epidemiological stud...
157 Citations Source Cite
Published on Dec 1, 1993in Circulation 18.88
Alan Chait3
Estimated H-index: 3
(American Heart Association),
John D Brunzell3
Estimated H-index: 3
(American Heart Association)
+ 7 AuthorsRebecca Mullis9
Estimated H-index: 9
(American Heart Association)
210 Citations Source Cite
Published on Jun 1, 1993in The American Journal of Clinical Nutrition 6.55
D. M. Hegsted25
Estimated H-index: 25
,
Lynne M. Ausman37
Estimated H-index: 37
+ 1 AuthorsGerard E. Dallal76
Estimated H-index: 76
Regression analysis of the combined published data on the effects of dietary fatty acids and cholesterol on serum cholesterol and lipoprotein cholesterol evaluated with groups of human subjects shows that 1) saturated fatty acids increase and are the primary determinants of serum cholesterol, 2) polyunsaturated fatty acids actively lower serum cholesterol, 3) mono-unsaturated fatty acids have no independent effect on serum cholesterol and, 4) dietary cholesterol increases serum cholesterol and m...
403 Citations Source Cite
Cited By616
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 Jul 1, 2019in Food Research International 3.52
Léa Guinot1
Estimated H-index: 1
(Laval University),
Laurie-Eve Rioux14
Estimated H-index: 14
(Laval University)
+ 2 AuthorsSylvie L. Turgeon34
Estimated H-index: 34
(Laval University)
Abstract Cheese characteristics, such as composition or textural properties, can impact the matrix degradation rate which could modulate the bioaccessibility of fatty acids during digestion. The aim of this study was to identify texture parameters influencing cheese degradation in a gastrointestinal environment. A static in vitro digestion model has been used on nine commercial cheeses: young and aged cheddar, regular and light cream cheese, parmesan, feta, camembert, mozzarella, and sliced proc...
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Published on Apr 15, 2019
Christian Sørensen Bork , Stine K. Venø1
Estimated H-index: 1
+ 2 AuthorsErik Berg Schmidt41
Estimated H-index: 41
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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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Published on Feb 1, 2019in Canadian Journal of Physiology and Pharmacology 2.21
Mihir Parikh2
Estimated H-index: 2
(University of Manitoba),
Grant N. Pierce44
Estimated H-index: 44
(University of Manitoba)
Flaxseed (Linum usitatissimum) is composed of a unique combination of bioactive components that appear to generate, through either an isolated or a synergistic action, a significant beneficial effect on the cardiovascular system. With a significant increase in the generation of data on the dietary impact of flaxseed on the cardiovascular system, a review of where we stand — what we know and what we still need to understand about these effects on the heart and the vasculature — was thought to be ...
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Published on Jan 29, 2019in Nutrients 4.20
Chen Du , Amy Smith + 6 AuthorsShanil Juma15
Estimated H-index: 15
Osteoarthritis (OA) is the most common joint disorder in the world and is the most frequent cause of walking related disability among older adults in the US, which brings a significant economic burden and reduces quality of life. The initiation and development of OA typically involves degeneration or progressive loss of the structure and function of articular cartilage. Inflammation is one of the major drives of the progression of OA. Dietary polyphenols have been studied for their anti-inflamma...
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Published on Jan 1, 2019in Indian heart journal
Prakash Chand Negi8
Estimated H-index: 8
,
Sachin Sondhi1
Estimated H-index: 1
+ 1 AuthorsSanjeev Asotra5
Estimated H-index: 5
Abstract Objective We report prevalence and risk factors of metabolic syndrome (MS) in the obese workforce of organized sector in hill city of Himachal Pradesh (HP), India. Methods The cross-sectional survey study of employees of organized sectors in Shimla city of HP, India, was conducted to collect data of demographics, health behavior, psychosocial factors, anthropometry, blood pressure, and blood chemistry to measure blood glucose and lipid profile in fasting state in 3004 employees using va...
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Published on Dec 4, 2018in Nutrients 4.20
Emmanouil Korakas1
Estimated H-index: 1
,
George Dimitriadis27
Estimated H-index: 27
+ 1 AuthorsVaia Lambadiari16
Estimated H-index: 16
The role of nutrition in the pathogenesis of cardiovascular disease has long been debated. The established notion of the deleterious effects of fat is recently under question, with numerous studies demonstrating the benefits of low-carbohydrate, high-fat diets in terms of obesity, diabetes, dyslipidemia, and metabolic derangement. Monounsaturated and polyunsaturated fatty acids, especially n-3 PUFAs (polyunsaturated fatty acids), are the types of fat that favor metabolic markers and are key comp...
2 Citations Source Cite
Elena Fattore22
Estimated H-index: 22
,
Elena Massa1
Estimated H-index: 1
AbstractThis narrative review summarises the main studies of the role of the different fatty acids in coronary heart disease (CHD) and cardiovascular disease (CVD) risk and the current scientific debate on dietary recommendations. Reduction and substitution of the saturated fatty acids (SFAs) with the polyunsaturated fatty acids (PUFAs) are still the main dietary recommendation to prevent CHD and CVD. In the last few years, however, the strength of the scientific evidence underlying this dietary...
2 Citations Source Cite