Dietary Fats in Relation to Total and Cause-Specific Mortality in a Prospective Cohort of 521 120 Individuals With 16 Years of Follow-Up

• Published in: Circulation research 2019-03, Vol.124 (5), p.757-768
• Main Authors: Zhuang, Pan, Zhang, Yu, He, Wei, Chen, Xiaoqian, Chen, Jingnan, He, Lilin, Mao, Lei, Wu, Fei, Jiao, Jingjing
• Format: Article
• Language: English
• Subjects: Aged; alpha-Linolenic Acid - administration & dosage; alpha-Linolenic Acid - adverse effects; Arachidonic Acid - administration & dosage; Arachidonic Acid - adverse effects; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - mortality; Cardiovascular Diseases - prevention & control; Cause of Death; Dietary Fats - administration & dosage; Dietary Fats - adverse effects; Fatty Acids - administration & dosage; Fatty Acids - adverse effects; Fatty Acids, Monounsaturated - administration & dosage; Fatty Acids, Monounsaturated - adverse effects; Fatty Acids, Omega-3 - administration & dosage; Female; Follow-Up Studies; Humans; Male; Medicin och hälsovetenskap; Middle Aged; Prognosis; Prospective Studies; Protective Factors; Risk Assessment; Risk Factors; Time Factors; Trans Fatty Acids - administration & dosage; Trans Fatty Acids - adverse effects; United States - epidemiology
• ISSN: 0009-7330; 1524-4571; 1524-4571
• DOI: 10.1161/CIRCRESAHA.118.314038

RATIONALE:Evidence linking saturated fat intake with cardiovascular health is controversial. The associations of unsaturated fats with total and cardiovascular disease (CVD) mortality remain inconsistent, and data about non-CVD mortality are limited. OBJECTIVE:To assess dietary fat intake in relation to total and cause-specific mortality. METHODS AND RESULTS:We analyzed data of 521 120 participants aged 50 to 71 years from the National Institutes of Health-American Association of Retired Persons Diet and Health Study with 16 years of follow-up. Intakes of saturated fatty acids (SFAs), trans-fatty acids, monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) were assessed via food frequency questionnaires. Hazard ratios and 95%CIs were estimated using the Cox proportional hazards model. Overall, 129 328 deaths were documented during 7.3 million person-years of follow-up. In the replacement of carbohydrates, multivariable-adjusted hazard ratios of total mortality comparing extreme quintiles were 1.29 (95% CI, 1.25–1.33) for SFAs, 1.03 (1.00–1.05) for trans-fatty acids, 0.98 (0.94–1.02) for MUFAs, 1.09 (1.06–1.13) for animal MUFAs, 0.94 (0.91–0.97) for plant MUFAs, 0.93 (0.91–0.95) for PUFAs, 0.92 (0.90–0.94) for marine omega-3 PUFAs, 1.06 (1.03–1.09) for α-linolenic acid, 0.88 (0.86–0.91) for linoleic acid, and 1.10 (1.08–1.13) for arachidonic acid. CVD mortality was inversely associated with marine omega-3 PUFA intake (P trend