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 Ascherio115
Estimated H-index: 115
(Harvard University),
Eric B. Rimm165
Estimated H-index: 165
(Harvard University)
+ 3 AuthorsBarry M. Popkin317
Estimated H-index: 317
(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
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References57
Published on May 1, 1982in Circulation 18.88
JayN. Cohn106
Estimated H-index: 106
103 Citations Source Cite
Published on Jan 31, 1980
Ancel Keys67
Estimated H-index: 67
1,425 Citations Source Cite
Published on Sep 4, 1982in The Lancet 53.25
Daan Kromhout98
Estimated H-index: 98
(Leiden University),
E.B. Bosschieter3
Estimated H-index: 3
(Leiden University),
C. de Lezenne Coulander4
Estimated H-index: 4
(Leiden University)
Abstract In 1960, 871 middle-aged men in the town of Zutphen, The Netherlands, participated in a survey of risk indicators (including diet) for coronary heart disease (CHD). Information was collected about the usual food intake for the 6-12 months before the interview by the cross-check dietary history method. During 10 years of follow-up, 107 men died from all causes, 37 from CHD, and 44 from cancer. Mortality from CHD was about four times higher for men in the lowest quintile of dietary-fibre ...
154 Citations Source Cite
Published on Jul 1, 1965in Metabolism-clinical and Experimental 5.96
Ancel Keys67
Estimated H-index: 67
(University of Minnesota),
Joseph T. Anderson36
Estimated H-index: 36
(University of Minnesota),
Francisco Grande32
Estimated H-index: 32
(University of Minnesota)
Abstract For many dietary changes satisfactory prediction of the average change in the serum cholesterol level of man in mg./100 ml., is given by Δ Chol. = 1.35(2ΔS − ΔP) + 1.5ΔZ where S and P are percentages of total calories provided by glycerides of saturated and polyunsaturated fatty acids in the diet and Z 2 = mg. of dietary cholesterol/1000 Cal. This formula fails, however, when the dietary change involves large amounts of cocoa butter and discrepancies also appear with beef tallow or hydr...
786 Citations Source Cite
Geoffrey Rose43
Estimated H-index: 43
(University of London),
Henry Blackburn66
Estimated H-index: 66
(University of London)
2,433 Citations
Published on Oct 1, 1990in American Journal of Epidemiology 4.32
Bernard Rosner168
Estimated H-index: 168
(Brigham and Women's Hospital),
Donna Spiegelman126
Estimated H-index: 126
(Tufts University),
Barry M. Popkin317
Estimated H-index: 317
(Harvard University)
362 Citations Source Cite
Published on Jul 1, 1965in Metabolism-clinical and Experimental 5.96
Ancel Keys67
Estimated H-index: 67
(University of Minnesota),
Joseph T. Anderson36
Estimated H-index: 36
(University of Minnesota),
Francisco Grande32
Estimated H-index: 32
(University of Minnesota)
The series of metabolic ward experiments, with 22 physically healthy men in each, covered dietary cholesterol intakes from 50 to 1450 mg. daily, with all other variables controlled. The serum-cholesterol data, plus the data from comparable experiments reported from 4 other institutions, were analyzed in regard to average serum cholesterol response (Δ Chol., mg./100 ml.) to changed cholesterol intake. Leastsquares solution, using serum cholesterol responses in 19 sets of dietary cholesterol compa...
546 Citations Source Cite
Published on Dec 1, 1993in Circulation 18.88
Alan Chait1
Estimated H-index: 1
(American Heart Association),
John D Brunzell1
Estimated H-index: 1
(American Heart Association)
+ 7 AuthorsRebecca Mullis8
Estimated H-index: 8
(American Heart Association)
209 Citations Source Cite
Published on Dec 12, 1981in The Lancet 53.25
I Hjermann1
Estimated H-index: 1
,
I Holme1
Estimated H-index: 1
+ 1 AuthorsP Leren1
Estimated H-index: 1
Abstract 16 202 men, aged 40-49 years, were screened for coronary risk factors. Of these, 1232 healthy, normotensive men at high risk of coronary heart disease (CHD) were selected for a 5-year randomised trial to show whether lowering of serum lipids and cessation of smoking could reduce the incidence of CHD. Men were admitted to the trial if they had serum cholesterol levels of 7.5—9.8 mmol/l (290-380 mg/dl), coronary risk scores (based on cholesterol levels, smoking habits, and blood pressure)...
733 Citations Source Cite
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Published on Jul 1, 2001in Investigative Ophthalmology & Visual Science 3.39
John M. Ong34
Estimated H-index: 34
(Cedars-Sinai Medical Center),
Nadia C. Zorapapel1
Estimated H-index: 1
(Cedars-Sinai Medical Center)
+ 7 AuthorsM. C. Kenney39
Estimated H-index: 39
(Cedars-Sinai Medical Center)
PURPOSE. To examine the pathologic changes in the retina of apolipoprotein E (apoE)-deficient mice fed a high-cholesterol diet. METHODS. ApoE-deficient mice (ApoE) were maintained on either regular mouse chow (ApoE-R) or a high-cholesterol diet (ApoE-C) for 25 weeks. Age-matched control C57BL/6J mice (C57) were also maintained on either regular mouse chow (C57-R) or a cholesterol-containing diet (C57-C). Retinal function was assessed by dark-adapted electroretinography (ERG). The eyes were embed...
69 Citations
Published on Jan 1, 2011in Biochemistry 3.00
Background Despite a large amount of research in the past decades, the role of polyunsaturated fatty acids (PUFA) in the prevention of coronary heart disease (CHD) and stroke is still debated. Inconsistent findings in epidemiological studies may be due to methodological limitations of dietary assessment, which could be overcome by using PUFA levels in blood as a biomarker of intake. This thesis investigates dietary intake and plasma levels of various n-6 and n-3 PUFA in relation to CHD and strok...
Published on Jan 1, 2002in New Comprehensive Biochemistry
Joseph R. Hibbeln47
Estimated H-index: 47
(National Institutes of Health),
Kevin K. Makino2
Estimated H-index: 2
(National Institutes of Health)
1 Citations Source Cite
Published on Nov 16, 1996in BMJ 23.56
Tim Hardman1
Estimated H-index: 1
EDITOR,—Alberto Ascherio and colleagues studied over 40 000 health professionals to examine the association between fat intake and the incidence of coronary heart disease in men of middle age and older.1 Investigation into the influence of dietary fats on risk of heart disease has long been a contentious field, and the literature shows a quick response to the publication of new work. For example, after the publication of the paper by Law et al on cholesterol reduction …
1 Citations Source Cite
Korapat Mayurasakorn5
Estimated H-index: 5
,
Wilailuk Srisura1
Estimated H-index: 1
+ 1 AuthorsPun-orn Hongto2
Estimated H-index: 2
Objective: To determine the relationship between continuous egg consumption with Thai life-style dietary and serum lipids of healthy young people. Material and Method: Fifty-six participants with an average age of 35 were enrolled. In an experimental method of cholesterol intake, all participants were fed an additional egg per day to their basic diet. This project ran for 12 weeks. Results: The 12-week egg consumption significantly increased serum total cholesterol by 0.27 + 0.15 mmol/L (10.43 +...
17 Citations
Published on Jan 1, 2005in Handbook of experimental pharmacology
M. Kratz1
Estimated H-index: 1
(University of Washington)
As early as at the beginning of the last century, animal studies have pointed to a causal role of dietary cholesterol in atherogenesis. In humans, however, most observational studies have not provided convincing evidence for an impact of cholesterol intake on coronary heart disease (CHD). Rather, these studies have consistently established a close association between a certain eating pattern and the risk of CHD. This eating pattern has usually been characterized by a high intake of total fat, sa...
59 Citations Source Cite
Published on Jul 1, 2006in Southern Medical Journal 0.85
Stephen M. Adams6
Estimated H-index: 6
,
John B. Standridge5
Estimated H-index: 5
Observational studies provide a wealth of important correlations between diet and disease. There is a clear pattern of dietary habits that is associated with reduced rates of a multitude of common illnesses, including heart attack, cancer, stroke, diabetes, and hypertension. In some cases, interventional studies have proven the benefits of dietary change; in others, there is insufficient evidence to prove causation. Based on the existing evidence, the optimal diet should emphasize fruits and veg...
32 Citations Source Cite
Published on Nov 16, 1996in BMJ 23.56
G. Munby (RMIT University), D. F. Weetman (RMIT University)
EDITOR,—According to Alberto Ascherio and colleagues, saturated fat may not be as dangerous with respect to coronary heart disease as commonly supposed, some of the risk being counteracted by consumption of fibre.1 As might have been expected from the data in their table 1, consumption of saturated fat was positively correlated with cigarette smoking (r = …
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Published on Jan 1, 2004in Principles of Gender-Specific Medicine
José María Ordovás Muñoz104
Estimated H-index: 104
(Tufts University),
Li-Ming Loh (Singapore General Hospital)
Cardiovascular disease (CVD) is a multifactorial disease that is associated with nonmodifiable risk factors, such as age, gender, and genetic background, and with modifiable risk factors, including elevated total and low-density lipoprotein cholesterol (LDL-C) levels, as well as reduced high-density lipoprotein cholesterol (HDL) levels. The fact that these diseases were extremely rare just 100 years ago suggests that changes in the environment have been the major trigger for the current epidemic...
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