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Association of types of dietary fats and all-cause and cause-specific mortality: a prospective cohort study and meta-analysis of prospective studies with 1,148,117 participants.

Session Controversies in dietary fat

Speaker Maciej Banach

Event : ESC Congress 2019

  • Topic : preventive cardiology
  • Sub-topic : Nutrition, Malnutrition and Heart Disease
  • Session type : Advances in Science

Authors : M Mazidi (Gothenburg,SE), DP Mikhailidis (London,GB), N Sattar (Glasgow,GB), PP Toth (Baltimore,US), S Judd (Birmingham,US), MJ Blaha (Baltimore,US), AV Hernandez (Storrs,US), M Banach (Lodz,PL)

Authors:
M. Mazidi1 , D.P. Mikhailidis2 , N. Sattar3 , P.P. Toth4 , S. Judd5 , M.J. Blaha4 , A.V. Hernandez6 , M. Banach7 , 1University of Gothenburg - Gothenburg - Sweden , 2University College London, Department of Biochemistry - London - United Kingdom , 3University of Glasgow, Institute of Cardiovascular and Medical Sciences - Glasgow - United Kingdom , 4Johns Hopkins University of Baltimore - Baltimore - United States of America , 5University of Alabama Birmingham, Department of Biostatistics - Birmingham - United States of America , 6University of Connecticut, Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group - Storrs - United States of America , 7Medical University of Lodz, Department of Hypertension - Lodz - Poland ,

On behalf: the International Lipid Expert Panel (ILEP) & Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group.

Topic(s):
Nutrition, Malnutrition and Heart Disease

Citation:
European Heart Journal ( 2019 ) 40 ( Supplement ), 7

Background: The associations between dietary fats with mortality are poorly delineated.

Purpose: Using a large prospective cohort we evaluated the link between total fat, mono-unsaturated (MUFA), polyunsaturated (PUFA) and saturated fatty acid (SFA) consumption and all-cause, coronary heart disease (CHD), stroke, and diabetes (T2D)-associated mortality in a representative sample of US adults. We then added our results to a systematic review and meta-analysis.

Methods: We evaluated 35,080 participants from the National Health and Nutrition Examination Surveys (NHANES) 1988–1999 (19.2 years follow-up) and 1999–2010 (12 years follow-up), with vital status available through December 31, 2011. Cox proportional hazard regression models were used to evaluate the association between baseline quartiles of fat consumption (g/day, 24h recall) and all-cause or cause-specific mortality. For the systematic review, selected databases were searched up to November 2018 and 29 prospective cohorts (n=1,148,117) met inclusion criteria. The DerSimonian-Laird method and generic inverse variance methods were used for random effects meta-analyses.

Results: In fully adjusted models from our prospective study, there was a negative association between total fat (hazard ratio [HR]:0.90, 95% confidence interval [CI]: 0.82, 0.99, Q4 vs. Q1) and PUFA (0.81,95% CI: 0.78–0.84) consumption and all-cause mortality (Figure), whereas SFA were positively associated with mortality (1.08, 95% CI: 1.04–1.11). In the meta-analysis we found a significant negative association between total fat (HR: 0.89, 95% CI: 0.82–0.97, I2:27%), MUFA (0.93, 95% CI: 0.87–0.99, I2:56%) and PUFA (0.86, 95% CI: 0.80–0.93, I2:63%) consumption and all-cause mortality. No significant association was observed between total fat and both CVD and CHD mortality (0.92, 95% CI: 0.79–1.08, I2:46%, and 1.03, 95% CI: 0.99–1.09, I2:42%, respectively), while a positive association between SFA intake and CHD mortality (1.10, 95% CI: 1.01–1.20, I2:52.6%) was observed. Neither MUFA nor PUFA were associated with CVD and CHD mortality. Inverse associations were observed between MUFA (0.80, 95% CI: 0.67–0.96, I2:0%) and PUFA (0.84, 95% CI: 0.80–0.90, I2:0%) intakes and stroke mortality.

Conclusions: Our results highlight differential associations of total fat, MUFA and PUFA intake with all-cause mortality, but no association of them with CVD and CHD mortalities. SFA intake was significantly associated with higher all-cause mortality inNHANES and with CHD mortality in our meta-analysis. The type of fat intake appears to be associated with important health outcomes.

All-cause death and total fat intake.

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