| 31) Leosdottir M (2007) | The Malmö Diet and Cancer Study | 28,098 middle-aged men and women without CVD.
(Sweden) | 8.4
(1991-96 to 2002) | 1,556?
(583 women, and
973 men) | Cardiovascular events | Monounsaturated fat (not defined, but including trans fatty acids) |
| Women | Men |
HR = 1.05 (0.74-1.48; P = 0.8) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
10.6: HR = 1.
12.6: HR = 1.04 (0.80-1.35).
14.0: HR = 1.00 (0.74-1.36).
16.0: HR = 1.05 (0.74-1.48).
|
HR = 0.94 (0.72-1.22; P = 0.7) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
11.1: HR = 1.
13.3: HR = 0.99 (0.81-1.22).
14.7: HR = 1.05 (0.84-1.33).
16.9: HR = 0.94 (0.72-1.22).
|
Age, smoking habits, alcohol consumption, socioeconomic status, marital status, physical activity, BMI, fibre intake, and blood pressure. |
| 31) Leosdottir M (2005) | The Malmö Diet and Cancer Study | 28,098 Swedish middle-aged individuals (11,063 men, and 17,035 women). | 6.6
(1991-96 to 2000) | See variables | Cardiovascular mortality | Monounsaturated fat (not defined, but including trans fatty acids) |
Women
(97? cases) | Men
(242? cases) |
RR = 1.53 (0.65-3.64; P = 0.34) for the highest vs lowest quartile of consumption.
Amount specific data (% of daily energy):
10.6: RR = 1.
12.6: RR = 1.66 (0.88-3.15).
14.0: RR = 1.91 (0.92-3.94).
16.0: RR = 1.53 (0.65-3.64).
|
RR = 0.61 (0.36-1.03; P = 0.11) for the highest vs lowest quartile of consumption.
Amount specific data (% of daily energy):
11.0: RR = 1.
13.3: RR = 0.63 (0.42-0.95; P = 0.027).
14.7: RR = 0.72 (0.47-1.12).
16.9: RR = 0.61 (0.36-1.03).
|
Age, alcohol consumption, smoking, social class, marital status, physical activity, BMI and fibre, saturated fat, and polyunsaturated fat intake. |
| 13) Tanasescu M (2004) | The Nurses' Health Study | 5,672 women with type 2 diabetes, but without CVD or cancer. | 1980 to 1994-98 | 619? | CVD events (nonfatal myocardial infarction, fatal coronary heart disease, and stroke) | Monounsaturated fat (not defined) |
RR = 0.84 (0.53-1.34; P = 0.56) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
11.1: RR = 1.
13.4: RR = 0.88 (0.65-1.19).
15: RR = 0.96 (0.68-1.36).
16.8: RR = 1.01 (0.68-1.49).
19.9: RR = 0.84 (0.53-1.34). | Age, smoking, postmenopausal hormone use, parental history of MI before age 60, alcohol intake, moderate vigorous activities, BMI, total caloric intake, protein intake, fiber intake, multivitamin use, vitamin E supplement use, medication use, saturated, polyunsaturated, and trans unsaturated fats and cholesterol. |
Prospective studies of monounsaturated fat and coronary heart disease:
| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments |
| 44) Corella D (2010) | The Spanish Cohort of EPIC-Heart
(The Spanish cardiovascular part of The EPIC Study) | 41,440 healthy subjects (15,632 men, and 25,806 women) aged 30-69, and without CHD.
(Nested case-control) | 10
(1992-96 to 2004) | 534 | CHD incidence (fatal or nonfatal myocardial infarction or angina requiring a revascularization procedure) | Monounsaturated fat (not defined) | Cases consumed less monounsaturated fat (15.1% energy) than controls (15.7% energy; P = 0.002). | Unadjusted.
Controls were matched to cases by center, sex, age, and time of enrollment. |
| 38) Nettleton JA (2008) | The Atherosclerosis Risk In Communities (ARIC) Study. | 14,153 African-American and white adults age 45-64.
(USA) | 13.3
(1987-89 to 2003) | 1,140? (639 men, 501 women) | Incident heart failure | Monounsaturated fat (not defined) | Cases did not consume significantly more monounsaturated fat (12.8% of energy) than controls (12.6% of energy; P = 0.12). | Total energy. |
| 35) Xu J (2006) | The Strong Heart Study | 2,938 American Indians aged 47-79, and free of CHD, dialysis treatment, liver cirrhosis, or having had a kidney transplant.
(USA) | 7.2
(1993-95 to 2002) | See variables | First CHD event (nonfatal CHD [definite MI, definite CHD, and electrocardiogram-evident definite MI], and fatal CHD [death from definite MI, definite sudden death due to CHD, definite fatal CHD, and possible fatal CHD]) | Monounsaturated fatty acids (not defined, but including meat, poultry, and fish) |
CHD event
(403 cases) | Nonfatal CHD
(298 cases) |
HR = 1.09 (0.80-1.48; P = 0.64) for the highest vs lowest quartile of consumption.
Amount specific data (% of energy):
8.5: HR = 1.
12.0: HR = 1.12 (0.82-1.51).
14.7: HR = 1.01 (0.81-1.49).
18.2: HR = 1.09 (0.80-1.48).
|
HR = 1.23 (0.86-1.76; P = 0.32) for the highest vs lowest quartile of consumption.
Amount specific data (% of energy):
8.5: HR = 1.
12.0: HR = 1.18 (0.83-1.69).
14.7: HR = 1.11 (0.77-1.59).
18.2: HR = 1.23 (0.86-1.76).
|
CHD death.
Stratified by age:
47-59
(46 cases) | 60-79
(92 cases) |
HR = 3.43 (1.17-10.04; P = 0.01) for the highest vs lowest quartile of consumption.
Amount specific data (% of energy):
8.7: HR = 1.
12.3: HR = 1.13 (0.34-3.74).
15.1: HR = 2.55 (0.88-7.43).
18.6: HR = 3.43 (1.17-10.04).
Omitting HDL cholesterol and LDL cholesterol from the model did not change the results (data not shown).
Additional adjustment for all fat components, gave the following HR's: 1.00, 0.94 (0.24-3.67), 2.52 (0.60-10.64), and 2.88 (0.59-14.21; P = 0.13).
|
HR = 0.54 (0.27-1.06; P = 0.07) for the highest vs lowest quartile of consumption.
Amount specific data (% of energy):
8.2: HR = 1.
11.7: HR = 1.05 (0.58-1.91).
14.3: HR = 0.89 (0.49-1.65).
17.7: HR = 0.54 (0.27-1.06).
|
Variable of interest as a % of energy, sex, age, study center, diabetes status, BMI, HDL, LDL, triaglycerol, smoking, alcohol, hypertension, protein, and total energy. |
| 31) Leosdottir M (2007) | The Malmö Diet and Cancer Study | 28,098 middle-aged men and women without CVD.
(Sweden) | 8.4
(1991-96 to 2002) | 908?
(no data about men vs women) | Acute coronary events | Monounsaturated fat (not defined, but including trans fatty acids) |
| Women | Men |
HR = 1.06 (0.65-1.71; P = 1.0) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
10.6: HR = 1.
12.6: HR = 1.20 (0.84-1.71).
14.0: HR = 0.99 (0.65-1.52).
16.0: HR = 1.06 (0.65-1.71).
|
HR = 0.87 (0.63-1.21; P = 0.4) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
11.1: HR = 1.
13.3: HR = 1.05 (0.82-1.35).
14.7: HR = 1.06 (0.80-1.04).
16.9: HR = 0.87 (0.63-1.21).
|
Age, smoking habits, alcohol consumption, socioeconomic status, marital status, physical activity, BMI, fibre intake, and blood pressure. |
| 29) Jakobsen MU (2004) | 4 different cohorts
(The 1914 cohort; The 1936 cohort, The MONICA I, and the MONICA III) | 3,686 subjects (1,837 men and 1,849 women) aged 30-71, and free of diabetes or CHD.
(Denmark) | 16
(1964-93 to 1998) | 228? men, and
98? women | CHD events (fatal and nonfatal heart disease) | Monounsaturated fatty acids (not defined) |
Stratified by gender:
| Women | Men |
HR = 1.25 (0.85-1.84) for an intake of a 5% higher level of energy.
HR = 1.01 (0.56-1.83) for an intake of a 5% higher level of energy instead of carbohydrates.
|
HR = 1.05 (0.83-1.33) for an intake of a 5% higher level of energy.
HR = 0.95 (0.65-1.40) for an intake of a 5% higher level of energy instead of carbohydrates.
|
Stratified by gender and age:
| Women < 60 years | Women ≥ 60 years | Men < 60 years | Men ≥ 60 years |
HR = 2.98 (1.38-6.44) for an intake of a 5% higher level of energy.
HR = 2.56 (1.15-5.73) for an intake of a 5% higher level of energy instead of carbohydrates.
|
HR = 1.03 (0.68-1.57) for an intake of a 5% higher level of energy.
HR = 0.75 (0.40-1.41) for an intake of a 5% higher level of energy instead of carbohydrates.
|
HR = 1.47 (0.91-2.37) for an intake of a 5% higher level of energy.
HR = 1.37 (0.78-2.40) for an intake of a 5% higher level of energy instead of carbohydrates.
|
HR = 0.95 (0.73-1.24) for an intake of a 5% higher level of energy.
HR = 0.85 (0.57-1.28) for an intake of a 5% higher level of energy instead of carbohydrates.
|
Variable of interest, total energy intake, and cohort identification.
Fat for carbohydrates was also adjusted for % energy from protein, % of energy from the other major types of fatty acids, familial history of MI, smoking, leisure time physical activity, educational attainment, alcohol, dietary fiber, and dietary cholesterol. |
| 19) Pietinen P (1997) | The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study | 21,930 male smokers (≥ 5 cigarettes/day) aged 50-69, and free of CVD, diabetes or cancer.
(Finland) | 6.1
(1985-88 to 1993) | See variables | Major coronary events (first nonfatal myocardial infarction, or coronary heart disease death) | Cis-monounsaturated fatty acids (not defined) |
Major coronary events
(1,399 cases) | Coronary death
(635 cases) |
RR = 0.82 (0.69-0.99; P = 0.186) for the highest vs lowest quintile of consumption.
Amount specific data (intake in g):
26.0: RR = 1.
29.5: RR = 0.88 (0.75-1.04).
31.8: RR = 0.89 (0.75-1.06).
34.1: RR = 0.95 (0.80-1.13).
37.8: RR = 0.82 (0.69-0.99).
|
RR = 0.79 (0.56-1.10; P = 0.429) for the highest vs lowest quintile of consumption.
Amount specific data (intake in g):
26.0: RR = 1.
29.5: RR = 0.71 (0.55-0.92).
31.8: RR = 0.76 (0.58-1.00).
34.1: RR = 0.76 (0.57-1.03).
37.8: RR = 0.79 (0.56-1.10).
After additional adjustment for vitamin E, vitamin C, and beta carotene, the RR became: 0.73 (0.56-0.95; P = 0.06).
|
Age, treatment group, smoking, BMI, blood pressure, intakes of energy, alcohol, and fiber, education, and physical activity.
The model for coronary death is also adjusted for trans-saturated and lineleic acid. |
| 18) Esrey KL (1996) | The Lipid Research Clinics Prevalence Follow-Up Study | 4,546 men and women aged 30-79 and free of CVD.
(USA) | 12.4
(1972-76 to 1987) | See variables | CHD mortality | Monounsaturated fat (not defined) |
Stratified by age
30-59
(52? cases) | 60-79
(40? cases) |
| RR = 1.08 (1.01-1.16; P = < 0.05) for monounsaturated fat as 1% of total energy.
|
RR = 1.00 (0.91-1.08) for monounsaturated fat as 1% of total energy.
|
Age, sex, energy intake, serum lipids, systolic blood pressure, cigarette smoking status, BMI, and glucose intolerance. |
| 16) Kromhout D (1995) | Cohort name not defined | 272 subjects (137 men and 135 women) aged 64-87 from a general practice in Rotterdam.
(The Netherlands) | 17
(1971-1987) | 58? | Primary & secondary CHD mortality | Mono-unsaturated fat (not defined) | No association was found with CHD mortality (no data shown). | Age, gender, and prevalence of myocardial infarction and angina pectoris. |
| 15) Knekt P (1994) | The Finnish Mobile Clinic Health Cohort | 5,133 men and women aged 30-69, and free of heart disease. | 14
(1968-72 to 1984) | 186? men, and 58? women. | CHD mortality | Monounsaturated fat (not defined) |
| Men: | Women: |
| Cases did not consume significantly more (44 g) than controls (42 g; P = 0.13).
|
Cases did not consume significantly more (29 g) than controls (28 g; P = 0.61).
|
Effect modification: No significant interaction was found with smoking, hypertension, and serum cholesterol (data not shown).Age. |
| 13) Oh K (2005) | The Nurses' Health Study | 78,778 women free of CVD, diabetes, hypercholesterolemia, or cancer. | 20
(1980-2000) | 1,766? | CHD incidence (nonfatal myocardial infarction and CHD death) | Monounsaturated fat (not defined) |
RR = 0.82 (0.62-1.10; P = 0.19) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
10.6: RR = 1.
12.5: RR = 0.94 (0.79-1.11).
13.8: RR = 0.95 (0.78-1.17).
15.3: RR = 0.91 (0.72-1.16).
18.0: RR = 0.82 (0.62-1.10).
No effect modification was found by age or BMI. | Age, BMI, smoking, alcohol intake, parental history of MI, history of hypertension, menopausal status and hormone use, aspirin use, multivitamin use, vitamin E supplement use, physical activity, and energy, protein, cholesterol, saturated, polyunsaturated, trans fat, alpha-linolenic acid, marine N-3 fatty acids, cereal fiber, and fruits and vegetables intake. |
| 13) Hu FB (1999) | The Nurses' Health Study | 80,082 women aged 34-59, and without CHD, stroke, cancer, hypercholesterolemia, or diabetes. | 14
(1980-1994) | 939? | Coronary heart disease (nonfatal myocardial infarction and fatal CHD) | Monounsaturated fat (not defined) |
RR's are from the standard multivariate model:
RR = 0.85 (0.49-1.50; P = 0.73) for the highest vs lowest quintile of consumption.
Amount specific data (Quintiles not defined):
Q1: RR = 1.
Q2: RR = 0.85 (0.63-1.14).
Q3: RR = 0.80 (0.54-1.17).
Q4: RR = 0.82 (0.51-1.31).
Q5: RR = 0.85 (0.49-1.50). | Age, time period, BMI, cigarette smoking, menopausal status, parental history of myocardial infarction, multiple vitamin use, vitamin E supplement use, alcohol consumption, history of hypertension, aspirin use, vigorous exercise, cholesterol intake, and total energy intake. |
| 13) Hu FB (1997) | The Nurses' Health Study | 80,082 women aged 34-59 and without CVD, diabetes, hypercholesterolemia, or cancer. | 14
(1980-1994) | 939? | Coronary heart disease incidence (nonfatal myocardial infarction or fatal coronary disease) | Monounsaturated fat (not defined) |
RR = 0.95 (0.64-1.39; P = 0.57) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
11.0: RR = 1.
13.1: RR = 1.11 (0.86-1.43).
14.6: RR = 1.05 (0.79-1.41).
16.3: RR = 1.03 (0.74-1.43).
19.3: RR = 0.95 (0.64-1.39). | Age, time period, BMI, cigarette smoking, menopausal status, parental history of MI before age 65, multivitamin use, vitamin E supplement use, alcohol consumption, history of hypertension, aspirin use, vigorous exercise, % energy from protein, dietary cholesterol, saturated fat, polyunsaturated fat, and trans unsaturated fats. |
| 7) Kromhout D (1984) | The Zutphen Study
(The Dutch part of The Seven Countries Study) | 857 CHD-free men aged 40-59. | 10
(1960-1970) | 30 | CHD death | Monounsaturated fat (not defined) |
| Consumption in g: | Consumption in % of energy intake: |
| Cases consumed less monounsaturated fat (56.7 g) than noncases (62.0 g; P = 0.094).
|
No significant difference in % of energy was found between cases (18.2) and controls (18.2; P = 0.985).
|
Unadjusted. |
| 5) Gillman MW (1997) | The Framingham Heart Study | 832 men aged 45-65, and free of cardiovascular disease.
(USA) | 18-22
(1966-69 to ?) | 83? | Coronary heart disease death | Monounsaturated fat (not defined) | RR = 1.01 (0.95-1.08) for each increment of 1% of total energy. | Systolic blood pressure, cigarette smoking, glucose intolerance, BMI, physical activity, left ventricular hypertrophy, and intake of energy, alcohol, and fruits and vegetables. |
| 5) Posner BM (1991) | The Framingham Study | 793 men aged 45-65 without preexisting CVD or cancer. | 16
(1966-69 to ?) | See variables | CHD incidence (angina pectoris, coronary insufficiency, MI, sudden death, or nonsudden death from CHD) | Monounsaturated fatty acids (not defined) |
Consumption in g:
Men aged 45-55
(99? cases) | Men aged 56-65
(114? cases) |
| RR = 0.64 (0.47-0.88) for consumption 30 g (NCEP recommendation) vs 48.5 g.
|
RR = 0.99 (0.77-1.27) for consumption 30 g (NCEP recommendation) vs 44.3 g.
|
Consumption in % of energy intake:
Men aged 45-55
(99? cases) | Men aged 56-65
(114? cases) |
| RR = 0.64 (0.48-0.87) for intake 10% (NCEP recommendation) vs 16.2%.
|
RR = 1.02 (0.78-1.34) for intake 10% (NCEP recommendation) vs 15.5%.
|
Energy intake, physical activity, serum cholesterol level, systolic blood pressure, left ventricular hypertrophy, cigarette smoking, glucose intolerance, and Metropolitan relative weight. |
| 5) Gordon T (1981) | The Framingham Study | 859 men aged 45-64 and free of CHD. | 4
(1966-69 to ?) | 14? | CHD death | Monounsaturated fatty acids (not defined) | Cases consumed the same amount (43 g) as noncases (47 g). | Age. |
| 5) Gordon T (1981) | The Framingham Study | 859 men aged 45-64 and free of CHD. | 4
(1966-69 to ?) | See variables | CHD incidence | Monounsaturated fatty acids (not defined) |
Total CHD
(MI, CHD death and angina pectoris)
(79? cases) | MI or CHD death
(51? cases) | Other CHD
(angina pectoris)
(28? cases) |
| Cases consumed the same amount (45 g) as noncases (46 g).
|
Cases consumed the same amount (43 g) as noncases (46 g).
|
Cases consumed the same amount (48 g) as noncases (46 g).
|
Consumption in % of calories:
Total CHD
(MI, CHD death and angina pectoris)
(79? cases) | MI or CHD death
(51? cases) | Other CHD
(angina pectoris)
(28? cases) |
| Cases consumed monounsaturated fatty acids in the same % of calories (16.2) as noncases (15.8).
|
Cases consumed monounsaturated fatty acids in the same % of calories (16.3) as noncases (15.8).
|
Cases consumed monounsaturated fatty acids in the same % of calories (15.9) as noncases (15.8).
|
Age. |
| 5) Gordon T (1981) | The Puerto Rico Heart Health Program | 8,218 men aged 45-64 and free of CHD. | 6
(1965-68 to ?) | 71? | CHD death | Monounsaturated fatty acids (not defined) | Cases consumed the same amount (37 g) as noncases (37 g). | Age. |
| 5) Gordon T (1981) | The Puerto Rico Heart Health Program | 8,218 men aged 45-64 and free of CHD. | 6
(1965-68 to ?) | See variables | CHD incidence | Monounsaturated fatty acids (not defined) |
Total CHD
(MI, CHD death and angina pectoris)
(286? cases) | MI or CHD death
(163? cases) | Other CHD
(angina pectoris)
(123? cases) |
| Cases consumed the same amount (36 g) as noncases (37 g).
|
Cases consumed the same amount (36 g) as noncases (37 g).
|
Cases consumed the same amount (37 g) as noncases (37 g).
|
Consumption in % of calories:
Total CHD
(MI, CHD death and angina pectoris)
(286? cases) | MI or CHD death
(163? cases) | Other CHD
(angina pectoris)
(123? cases) |
| Cases consumed monounsaturated fatty acids in the same % of calories (14.1) as noncases (13.8).
|
Cases consumed monounsaturated fatty acids in the same % of calories (14.2) as noncases (13.8).
|
Cases consumed monounsaturated fatty acids in the same % of calories (14.0) as noncases (13.8).
|
Age. |
| 4) Garcia-Palmieri MR (1980) | The Puerto Rico Heart Health Program | 8,218 men aged 45-64 who were free of CHD at entry. | 6
(1965-?) | See variables | CHD incidence | Monounsaturated fatty acids (not defined) |
Total CHD (MI, CHD death, coronary insufficiency, and angina pectoris):
Urban men
(213 cases) | Rural men
(73 cases) |
| Consumption in g: No significant difference was found between cases (38 g), and noncases (39 g).
|
Consumption in g: No significant difference was found between cases (33 g), and noncases (34 g).
|
MI and CHD death:
Urban men
(129 cases) | Rural men
(34 cases) |
| Consumption in g: No significant difference was found between cases (36 g), and noncases (39 g).
|
Consumption in g: No significant difference was found between cases (33 g), and noncases (34 g).
|
CHD death:
Urban men
(57 cases) | Rural men
(14 cases) |
| Consumption in g: No significant difference was found between cases (39 g), and noncases (39 g).
|
Consumption in g: No significant difference was found between cases (30 g), and noncases (34 g).
|
Coronary insufficiency:
Urban men
(31 cases) | Rural men
(14 cases) |
| Consumption in g: No significant difference was found between cases (36 g), and noncases (39 g).
|
Consumption in g: No significant difference was found between cases (36 g), and noncases (34 g).
|
Angina pectoris:
Urban men
(53 cases) | Rural men
(25 cases) |
| Consumption in g: No significant difference was found between cases (41 g), and noncases (39 g).
|
Consumption in g: No significant difference was found between cases (30 g), and noncases (34 g).
|
Age. |
| 3) McGee DL (1984) | The Honolulu Heart Program | 7,088 men of Japanese ancestry aged 45-68, and without coronary heart disease, stroke, or cancer.
(Oahu island) | 10
(1965-68 to ?) | See variables | Coronary heart disease incidence (myocardial infarction, CHD death, angina pectoris, or coronary insufficiency) | Monounsaturated fatty acids (not defined) |
Total CHD
(456? cases) | MI or CHD death
(309? cases) | Angina pectoris or coronary insufficiency
(147? cases) |
| Cases did not consume significantly more (33.0 g) than controls (32.9 g).
|
Cases did not consume significantly more (33.4 g) than controls (32.9 g).
|
Cases did not consume significantly less (32.0 g) than controls (32.9 g).
|
Age. |
| 5) Gordon T (1981) | The Honolulu Heart Study | 7,272 men aged 45-64 of Japanese ancestry and free of CHD. | 6
(1965-68 to ?) | 78? | CHD death | Monounsaturated fatty acids (not defined) | Cases consumed the same amount (33 g) as noncases (33 g). | Age. |
| 5) Gordon T (1981) | The Honolulu Heart Study | 7,272 men aged 45-64 of Japanese ancestry and free of CHD. | 6
(1965-68 to ?) | See variables | CHD incidence | Monounsaturated fatty acids (not defined) |
Total CHD
(MI, CHD death and angina pectoris)
(264? cases) | MI or CHD death
(164? cases) | Other CHD
(angina pectoris)
(100? cases) |
| Cases consumed the same amount (33 g) as noncases (33 g).
|
Cases consumed the same amount (32 g) as noncases (33 g).
|
Cases consumed the same amount (32 g) as noncases (33 g).
|
Consumption in % of calories:
Total CHD
(MI, CHD death and angina pectoris)
(264? cases) | MI or CHD death
(164? cases) | Other CHD
(angina pectoris)
(100? cases) |
| Cases consumed monounsaturated fatty acids in the same % of calories (13.2) as noncases (12.8).
|
Cases consumed monounsaturated fatty acids in a higher % of calories (13.6) than noncases (12.8; P = < 0.01).
|
Cases consumed monounsaturated fatty acids in the same % of calories (12.6) as noncases (12.8).
|
Age. |
| 3) Yano K (1978) | The Honolulu Heart Study | 7,705 men aged 45-68 of Japanese ancestry and living in Hawaii. | 6
(1965-68 to ) | See variables | CHD incidence (death attributable to CHD including sudden death; nonfatal myocardial infarction (MI); acute coronary insufficiency (CI) ascertained by severe chest pain lasting more than 30 minutes, with documented transient ST-T wave changes on ECG and without elevation of enzyme levels; angina pectoris (AP) ascertained by episodic substernal pain brought on by exertion and relieved by rest.) | Monounsaturated fatty acids (not defined) |
Consumption in amounts:
CHD death + MI
(179? cases) | Acute CI
(27? cases) | Angina
(88? cases) |
| Cases consumed the same amount of monounsaturated fatty acids (32 g/d) as noncases (33 g/d; P = not significant).
|
Cases consumed the same amount of monounsaturated fatty acids (30 g/d) as noncases (33 g/d; P = not significant).
|
Cases consumed the same amount of monounsaturated fatty acids (32 g/d) as noncases (33 g/d; P = not significant).
|
Age. |
Prospective studies of monounsaturated fat and stroke:
| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments |
| 41) Boden-Albala B (2009) | The Northern Manhattan Study (NOMAS) | 3,183 Hispanic, non-Hispanic white, and non-Hispanic black men and women aged > 40, and without stroke.
(USA) | 5.5
(1993-2001 to ?) | 142? | Ischemic stroke risk | Monounsaturated fat (not defined) | No increased risk was found for the highest vs lowest quintile of consumption (data not shown). | Age, race/ethnicity, sex, education, hypertension, diabetes, coronary artery disease, moderate alcohol, current and previous smoking, BMI, leisure time physical activity, sodium, potassium, fruit/vegetable, calcium, fiber, vitamin E, and calories. |
| 31) Leosdottir M (2007) | The Malmö Diet and Cancer Study | 28,098 middle-aged men and women without CVD.
(Sweden) | 8.4
(1991-96 to 2002) | 648?
(no data about men vs women) | Ischemic stroke | Monounsaturated fat (not defined, but including trans fatty acids) |
| Women | Men |
HR = 0.96 (0.59-1.56; P = 0.9) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
10.6: HR = 1.
12.6: HR = 0.90 (0.62-1.32).
14.0: HR = 0.99 (0.65-1.51).
16.0: HR = 0.96 (0.59-1.56).
|
HR = 0.82 (0.53-1.26; P = 0.6) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
11.1: HR = 1.
13.3: HR = 0.85 (0.60-1.19).
14.7: HR = 0.93 (0.64-1.34).
16.9: HR = 0.82 (0.53-1.26).
|
Age, smoking habits, alcohol consumption, socioeconomic status, marital status, physical activity, BMI, fibre intake, and blood pressure. |
| 30) Sauvaget C (2004) | The Adult Health Study
(A subcohort of the Hiroshima/Nagasaki Life Span Study) | 3,731 male and female atomic bomb survivors aged 35-89.
(Japan) | Median 14
(1983-2001) | 60 | Cerebral infarction death | Monounsaturated fatty acids (not defined) |
RH = 0.90 (0.45-1.82; P = 0.7790) for the highest vs lowest tertile of consumption.
Amount specific data (g/day):
8: RH = 1.
16: RH = 0.96 (0.51-1.80).
27: RH = 0.90 (0.45-1.82). | Stratified by sex and age.
Adjusted for radiation dose, city, BMI, smoking status, alcohol habits, and medical history of hypertension and diabetes. |
| 25) Iso H (2003) | No cohort name defined | 4,775 individuals (2,269 men and 2,506 women) aged 40-69, and without stroke.
(Japan) | 14.3
(1973-88 to 1997) | 68 | Intraparenchymal hemorrhage incidence (lasting ≥ 24 hours or until death) | Monounsaturated fat (not defined) |
RR = 0.53 (0.24-1.16; P = 0.10) for the highest vs lowest quartile of consumption.
Amount specific data (g/day):
8.0: RR = 1.
13.1: RR = 1.01 (0.55-1.87).
18.1: RR = 0.79 (0.40-1.55).
25.3: RR = 0.53 (0.24-1.16).
Other strokes: No correlations were found with risk of other stroke subtypes (subarachnoid hemmorhage [41 cases], and ischemic stroke [166 cases]; Data not shown). | Age, sex, total energy, BMI, hypertension, diabetes, serum total cholesterol, smoking status, ethanol intake, and menopausal status. |
| 20) Ross RK (1997) | No cohort name defined | 18,244 men aged 45-64 from Shanghai, and without cancer.
(China) | 1986-89 to 1994 | 245 | Stroke/cerebrovascular accident death | Monounsaturated fat (not defined) |
RR = 1.2 (0.8-1.7) for the highest vs lowest tertile of consumption.
Amount specific data (Tertiles not defined):
T1: RR = 1.
T2: RR = 1.2 (0.9-1.8).
T3: RR = 1.2 (0.8-1.7). | Education, marital status, BMI, lifetime cigarette smoking, lifetime ethanol intake, and history of hypertension. |
| 13) He K (2003) | The Health Professionals Follow Up Study | 43,732 men aged 40-75, and without a history of CVD or diabetes mellitus.
(USA) | 14
(1986-2000) | See variables | Stroke risk | Monounsaturated fat (not defined) |
Ischaemic stroke
(embolism or thrombosis)
(455 cases) | Haemorrhagic stroke
(subarachnoid and intracerebral)
(125 cases) |
RR = 1.00 (0.58-1.70; P = 0.85) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
20: RR = 1.
24: RR = 0.85 (0.59-1.22).
27: RR = 1.01 (0.67-1.53).
30: RR = 1.06 (0.67-1.68).
34: RR = 1.00 (0.58-1.70).
|
RR = 0.68 (0.24-1.96; P = 0.40) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
20: RR = 1.
24: RR = 0.96 (0.48-1.93).
27: RR = 0.69 (0.30-1.56).
30: RR = 0.61 (0.24-1.55).
34: RR = 0.68 (0.24-1.96).
|
Age, smoking, BMI, physical activity, history of hypertension, smoking status, aspirin use, multivitamin use, and consumption of alcohol, potassium, fibre, vitamin E, total servings of fruit and vegetables, total energy, hypercholesterolaemia, poyunsaturated fat, saturated fat, and trans fat. |
| 13) Iso H (2001) | The Nurses' Health Study | 85,764 women aged 34-59, and without cancer, angina, MI, coronary revascularization, stroke, or other CVD.
(USA) | 14
(1980-1994) | 74 | Intraparenchymal hemmorhage risk | Monounsaturated fat (not defined) |
RR = 0.53 (0.25-1.12; P = 0.13) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
20: RR = 1.
25: RR = 0.64 (0.32-1.27).
29: RR = 0.38 (0.17-0.81).
32: RR = 0.73 (0.37-1.44).
38: RR = 0.53 (0.25-1.12). | Age, smoking status, time interval, BMI, alcohol intake, menopausal status and postmenopausal hormone use, vigorous exercise, usual aspirin use, multivitamin use, vitamin E use, n3 fatty acid intake, calcium intake, and histories of hypertension, diabetes, and high cholesterol levels, and total energy. |
| 12) Simon JA (1995) | The Multiple Risk Factor Intervention Trial | 12,866 US men, aged 35-57.
(Nested case-control) | 6.9
(1973-76 to ?) | 96 | Stroke incidence (fatal or nonfatal) | Monounsaturated fat (not defined) | Cases consumed significantly more (15.9% kcal) than controls (14.4% kcal; P = < 0.05). | Unadjusted.
Cases matched to controls by age, clinical center, treatment group, and date of randomization. |
| 9) Seino F (1997) | The Shibata Study | 954 men and 1,329 women, age ≥ 40, and free of stroke.
(Japan) | 15.5
(1977-1992) | 141? | Stroke incidence (cerebral hemorrhage, cerebral infarction and subarachnoid hemorrhage. Excluding transient cerebral ischemic attack) | Monounsaturated fat (mainly from eggs, pork, mayonnaise, vegetable oil for flavoring, and tempura) |
RR = 0.28 (0.05-1.54; P = 0.64) for the highest vs lowest quartile of consumption.
Amount specific data (g/day):
10.2: RR = 1.
13.2: RR = 0.76 (0.36-1.61).
15.7: RR = 0.51 (0.17-1.55).
19.2: RR = 0.28 (0.05-1.54). | Sex, age, diastolic blood pressure, atrial fibrillation, energy, and total fat. |
| 7) Keli SO (1994) | The Zutphen Study
(The Dutch contribution to The Seven Countries Study) | 552 men aged 50-69.
(The Netherlands) | 1970-1985 | 42 | First stroke incidence (a sudden onset of neurological paralysis of > 24-hour duration or leading to death) | Monounsaturated fatty acids (not defined) | Stroke cases consumed the same amount (18.4% of energy) as noncases (17.6% of energy). | Unadjusted. |
| 5) Gillman MW (1997) | The Framingham Heart Study | 832 men aged 45-65, and free of cardiovascular disease.
(USA) | 18-22
(1966-69 to ?) | 61? | Ischemic stroke incidence (atherothrombotic brain infarction and embolus) | Monounsaturated fat (not defined) |
RR = 0.87 (0.81-0.94) for each increment of 1% of total energy.
Further adjustment for the total serum and HDL cholesterol levels and the physical activity index produced comparable results (no data shown).
Stratified by occurence of CHD during the follow-up period:
(age, and energy adjusted)
No CHD
(43? cases) | CHD
(18? cases) |
| RR = 0.87 (0.80-0.94) for each increment of 1% of total energy.
|
RR = 1.06 (0.93-1.21) for each increment of 1% of total energy.
|
Systolic blood pressure, cigarette smoking, glucose intolerance, BMI, physical activity, left ventricular hypertrophy, and intake of energy, alcohol, and fruits and vegetables. |
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