| 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 | Polyunsaturated fat (not defined, but including trans fatty acids) |
| Women | Men |
HR = 1.20 (0.91-1.60; P = 0.3) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
4.3: HR = 1.
5.4: HR = 1.09 (0.85-1.40).
6.3: HR = 1.12 (0.86-1.46).
8.1: HR = 1.20 (0.91-1.60).
|
HR = 1.12 (0.90-1.39; P = 0.3) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
4.5: HR = 1.
5.7: HR = 1.00 (0.82-1.20).
6.7: HR = 1.02 (0.83-1.24).
8.6: HR = 1.12 (0.90-1.39).
|
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 | Polyunsaturated fat (not defined, but including trans fatty acids) |
Women
(97? cases) | Men
(242? cases) |
RR = 0.63 (0.33-1.22; P = 0.10) for the highest vs lowest quartile of consumption.
Amount specific data (% of daily energy):
4.3: RR = 1.
5.4: RR = 0.82 (0.47-1.42).
6.3: RR = 0.46 (0.24-0.89; P = 0.021).
8.1: RR = 0.63 (0.33-1.22).
|
RR = 0.99 (0.65-1.53; P = 0.64) for the highest vs lowest quartile of consumption.
Amount specific data (% of daily energy):
4.5: RR = 1.
5.7: RR = 0.81 (0.56-1.19).
6.7: RR = 1.08 (0.74-1.58).
8.6: RR = 0.99 (0.65-1.53).
|
Age, alcohol consumption, smoking, social class, marital status, physical activity, BMI and fibre, saturated fat, and monounsaturated fat intake. |
| 28) Erkkilä AT (2003) | The Finnish cohort of the EUROASPIRE Study | 415 subjects (285 men and 130 women) aged 33-74 with CAD admitted to Kuopio University Hospital. | 5 | 44 | CVD risk (CVD death, AMI, or stroke | Polyunsaturated fat (not defined) | RR = 1.08 (0.82-1.42; P = 0.571) per 1-SD increment in intake. | Age, sex, diagnostic category, energy intake, serum cholesterol, serum triaglycerol, diabetes, BMI, and education. |
| 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) | Polyunsaturated fat (not defined) |
RR = 0.96 (0.70-1.31; P = 0.92) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
2.8: RR = 1.
3.8: RR = 1.02 (0.79-1.32).
4.5: RR = 1.09 (0.83-1.43).
5.3: RR = 1.10 (0.83-1.46).
6.5: RR = 0.96 (0.70-1.31). | 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, monounsaturated, and trans fats and cholesterol. |
Prospective studies of polyunsaturated 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) | Polyunsaturated fat (not defined) | Cases consumed nonsignificantly more polyunsaturated fat (6.3% energy) than controls (6.0% energy; P = 6.0; P = 0.09). | 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 | Polyunsaturated fat (not defined) | Cases consumed the same amount of polyunsaturated fat (5% of energy) as controls (5.0% of energy; P = 0.64). | 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]) | Polyunsaturated fatty acids (not defined) |
CHD event
(403 cases) | Nonfatal CHD
(298 cases) |
HR = 1.12 (0.82-1.54; P = 0.69) for the highest vs lowest quartile of consumption.
Amount specific data (% of energy):
3.5: HR = 1.
5.1: HR = 1.31 (0.98-1.76).
6.9: HR = 1.30 (0.96-1.76).
9.9: HR = 1.12 (0.82-1.54).
|
HR = 1.18 (0.81-1.71; P = 0.55) for the highest vs lowest quartile of consumption.
Amount specific data (% of energy):
3.5: HR = 1.
5.1: HR = 1.34 (0.94-1.89).
6.9: HR = 1.40 (0.98-1.99).
9.9: HR = 1.18 (0.81-1.71).
|
CHD death.
Stratified by age:
47-59
(46 cases) | 60-79
(92 cases) |
HR = 1.47 (0.55-3.96; P = 0.78) for the highest vs lowest quartile of consumption.
Amount specific data (% of energy):
3.5: HR = 1.
5.3: HR = 1.78 (0.71-4.47).
7.2: HR = 1.02 (0.36-2.84).
10.4: HR = 1.47 (0.55-3.96).
|
HR = 0.69 (0.35-1.36; P = 0.30) for the highest vs lowest quartile of consumption.
Amount specific data (% of energy):
3.4: HR = 1.
4.8: HR = 1.03 (0.57-1.86).
6.6: HR = 1.11 (0.61-2.01).
9.5: HR = 0.69 (0.35-1.36).
|
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 | Polyunsaturated fat (not defined, but including trans fatty acids) |
| Women | Men |
HR = 1.16 (0.79-1.71; P = 0.7) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
4.3: HR = 1.
5.4: HR = 1.09 (0.78-1.53).
6.3: HR = 0.98 (0.68-1.42).
8.1: HR = 1.16 (0.79-1.71).
|
HR = 1.20 (0.92-1.55; P = 0.1) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
4.5: HR = 1.
5.7: HR = 0.92 (0.73-1.67).
6.7: HR = 1.03 (0.81-1.31).
8.6: HR = 1.20 (0.92-1.55).
|
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) | Polyunsaturated fatty acids (not defined) |
Stratified by gender:
| Women | Men |
HR = 0.83 (0.47-1.45) for an intake of a 5% higher level of energy.
HR = 0.89 (0.50-1.57) for an intake of a 5% higher level of energy instead of carbohydrates.
|
HR = 0.86 (0.62-1.20) for an intake of a 5% higher level of energy.
HR = 0.80 (0.55-1.15) 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 = 0.68 (0.20-2.34) for an intake of a 5% higher level of energy.
HR = 0.66 (0.19-2.35) for an intake of a 5% higher level of energy instead of carbohydrates.
|
HR = 0.86 (0.51-1.44) for an intake of a 5% higher level of energy.
HR = 0.94 (0.51-1.74) for an intake of a 5% higher level of energy instead of carbohydrates.
|
HR = 1.12 (0.60-2.09) for an intake of a 5% higher level of energy.
HR = 1.06 (0.56-1.99) for an intake of a 5% higher level of energy instead of carbohydrates.
|
HR = 0.79 (0.53-1.16) for an intake of a 5% higher level of energy.
HR = 0.72 (0.47-1.10) 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. |
| 28) Erkkilä AT (2003) | The Finnish cohort of the EUROASPIRE Study | 415 subjects (285 men and 130 women) aged 33-74 with CAD admitted to Kuopio University Hospital. | 5 | See variables | CAD | Polyunsaturated fat (not defined) |
CAD death
(16 cases) | CAD death or AMI
(34 cases) |
| RR = 0.92 (0.55-1.54; P = 0.758) per 1-SD increment in intake.
|
RR = 1.08 (0.78-1.51; P = 0.642) per 1-SD increment in intake.
|
Age, sex, diagnostic category, energy intake, serum cholesterol, serum triaglycerol, diabetes, BMI, and education. |
| 28) Erkkilä AT (2003) | The Finnish cohort of the EUROASPIRE Study | 415 subjects (285 men and 130 women) aged 33-74 with CAD admitted to Kuopio University Hospital. | 5 | 38 | Revascularization | Polyunsaturated fat (not defined) | RR = 1.10 (0.83-1.44; P = 0.516) per 1-SD increment in intake. | Age, sex, diagnostic category, energy intake, serum cholesterol, serum triaglycerol, diabetes, BMI, and education. |
| 26) Soinio M (2003) | No cohort name defined | 366 men and 295 women with diabetes type 2, but free from CHD, aged 45-64 from Kuopio.
(Finland) | 7
(1982-84 to 1989) | See variables | CHD (nonfatal MI or CHD death) | Polyunsaturated fat (not defined) |
CHD death:
Men
(41 cases) | Women
(24 cases) |
| Cases consumed a smaller % of energy from polyunsaturated fat (4.3) than controls (5.0; P = 0.071).
|
No significant difference in consumption in % of energy was found between cases (4.3) and controls (4.6; P = 0.178).
|
CHD: The reported intake of PUFA tended to be low in those men who died from CHD or had a nonfatal MI (74 cases. No data shown).Unadjusted. |
| 24) Boniface DR (2002) | The Health and Lifestyle Survey | 1,225 men and 1,451 women aged 40-75, and without heart disease, diabetes, anti-hypertensive treatment, or being on a special diet.
(Great Britain) | 16
(1984-85 to 2000) | See variables | CHD death | Polyunsaturated fat (not defined) |
Men
(98 cases) | Women
(57 cases) |
16 y death rate = 9.0% (5.7-13.3; P = 0.66) for the highest vs lowest quintile of consumption.
Amount specific data (Quintiles not defined):
Q1: DR = 7.4% (4.5-11.5).
Q2: DR = 11.0% (7.4-15.6).
Q3: DR = 7.0% (4.1-11.0).
Q4: DR = 5.6% (3.1-9.2).
Q5: DR = 9.0% (5.7-13.3).
|
16 y death rate = 4.4% (2.4-7.4; P = 0.46) for the highest vs lowest quintile of consumption.
Amount specific data (Quintiles not defined):
Q1: DR = 2.4% (1.0-4.9).
Q2: DR = 5.2% (2.9-8.4).
Q3: DR = 3.8% (1.9-6.6).
Q4: DR = 3.8% (1.9-6.8).
Q5: DR = 4.4% (2.4-7.4).
|
Unadjusted. |
| 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) | Polyunsaturated fatty acids (not defined) |
Major coronary events
(1,399 cases) | Coronary death
(635 cases) |
RR = 1.11 (0.94-1.31; P = 0.470) for the highest vs lowest quintile of consumption.
Amount specific data (intake in g):
6.6: RR = 1.
8.0: RR = 1.01 (0.85-1.19).
9.6: RR = 1.09 (0.92-1.29).
12.5: RR = 0.97 (0.81-1.15).
20.6: RR = 1.11 (0.94-1.31).
|
RR = 1.27 (1.00-1.61; P = 0.034) for the highest vs lowest quintile of consumption.
Amount specific data (intake in g):
6.6: RR = 1.
8.0: RR = 0.92 (0.72-1.18).
9.6: RR = 1.06 (0.83-1.36).
12.5: RR = 0.90 (0.69-1.17).
20.6: RR = 1.27 (1.00-1.61).
|
Age, treatment group, smoking, BMI, blood pressure, intakes of energy, alcohol, and fiber, education, and physical activity. |
| 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 | Polyunsaturated fat (not defined) |
Stratified by age
30-59
(52? cases) | 60-79
(40? cases) |
| RR = 0.99 (0.90-1.08) for polyunsaturated fat as 1% of total energy.
|
RR = 1.00 (0.90-1.10) for polyunsaturated 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 | Polyunsaturated 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 | Polyunsaturated fat (not defined) |
| Men: | Women: |
| Cases did not consume significantly less (8.5 g) than controls (9.0 g; P = 0.16).
|
Cases did not consume significantly less (5.8 g) than controls (6.3 g; P = 0.25).
|
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) | Polyunsaturated fat (not defined) |
RR = 0.75 (0.60-0.92; P = 0.004) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
4.1: RR = 1.
5.0: RR = 0.98 (0.84-1.14).
5.6: RR = 0.83 (0.70-0.99).
6.3: RR = 0.84 (0.70-1.02).
7.4: RR = 0.75 (0.60-0.92).
Stratified by age:
< 65 years
(1,111 cases) | ≥ 65 years
(655 cases) |
RR = 0.66 (0.50-0.85; P = 0.002) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
4.1: RR = 1.
5.0: RR = 0.87 (0.72-1.05).
5.6: RR = 0.68 (0.55-0.85).
6.3: RR = 0.74 (0.59-0.93).
7.4: RR = 0.66 (0.50-0.85).
|
RR = 0.96 (0.66-1.39; P = 0.60) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
4.1: RR = 1.
5.0: RR = 1.22 (0.94-1.59).
5.6: RR = 1.18 (0.89-1.57).
6.3: RR = 1.08 (0.78-1.49).
7.4: RR = 0.96 (0.66-1.39).
|
Stratified by BMI:
< 25
(752 cases) | ≥ 25
(1,014 cases) |
RR = 0.91 (0.67-1.26; P = 0.43) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
4.1: RR = 1.
5.0: RR = 1.08 (0.86-1.36).
5.6: RR = 0.84 (0.65-1.10).
6.3: RR = 0.92 (0.69-1.23).
7.4: RR = 0.91 (0.67-1.26).
|
RR = 0.63 (0.47-0.84; P = 0.002) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
4.1: RR = 1.
5.0: RR = 0.90 (0.73-1.11).
5.6: RR = 0.81 (0.65-1.02).
6.3: RR = 0.78 (0.60-1.00).
7.4: RR = 0.63 (0.47-0.84).
|
No effect modification was found by menopausal status and hormone use.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, monounsaturated, 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) | Polyunsaturated fat (not defined) |
RR's are from the standard multivariate model:
RR = 0.83 (0.65-1.05; P = 0.14) for the highest vs lowest quintile of consumption.
Amount specific data (Quintiles not defined):
Q1: RR = 1.
Q2: RR = 0.97 (0.80-1.18).
Q3: RR = 0.93 (0.75-1.15).
Q4: RR = 0.96 (0.77-1.20).
Q5: RR = 0.83 (0.65-1.05). | 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) | Polyunsaturated fat (not defined) |
RR = 0.68 (0.53-0.88; P = 0.003) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
2.9: RR = 1.
3.9: RR = 0.94 (0.77-1.14).
4.6: RR = 0.88 (0.71-1.14).
5.3: RR = 0.81 (0.65-1.03).
6.4: RR = 0.68 (0.53-0.88). | 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, monounsaturated fat, and trans unsaturated fats. |
| 8) Kushi LH (1985) | The Ireland-Boston Diet-Heart Study | 1,001 middle-aged men of Irish descent. | 20
(1959-65 to 1982) | 110? | CHD mortality (death from coronary or ischemic disease) | Polyunsaturated fatty acids (not defined) | Cases did not consume a significantly lower % of calories from polyunsaturated fatty acids than noncases (P = 0.45). | Age, systolic blood pressure, total serum cholesterol, cigarette smoking, alcohol intake, and cohort. |
| 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 | Polyunsaturated fat (not defined) |
| Consumption in g: | Consumption in % of energy intake: |
| No significant difference in consumption was found between cases (18.3 g) and noncases (20.1 g; P = 0.132).
|
No significant difference in % of energy was found between cases (5.9) and controls (5.9; P = 0.979).
|
Unadjusted. |
| 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) | Polyunsaturated fatty acids (not defined) |
Consumption in g:
Men aged 45-55
(99? cases) | Men aged 56-65
(114? cases) |
| RR = 1.34 (0.93-1.93) for consumption 30 g (NCEP recommendation) vs 16.5 g.
|
RR = 1.26 (0.82-1.93) for consumption 30 g (NCEP recommendation) vs 15.0 g.
|
Consumption in % of energy intake:
Men aged 45-55
(99? cases) | Men aged 56-65
(114? cases) |
| RR = 1.34 (0.95-1.90) for intake 10% (NCEP recommendation) vs 5.5%.
|
RR = 1.27 (0.89-1.81) for intake 10% (NCEP recommendation) vs 5.4%.
|
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 | Polyunsaturated fatty acids (not defined) | Cases consumed the same amount (15 g) as noncases (16 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 | Polyunsaturated 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 (16 g) as noncases (16 g).
|
Cases consumed the same amount (16 g) as noncases (16 g).
|
Cases consumed the same amount (16 g) as noncases (16 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 polyunsaturated fatty acids in the same % of calories (5.8) as noncases (5.4).
|
Cases consumed polyunsaturated fatty acids in the same % of calories (6.0) as noncases (5.4).
|
Cases consumed polyunsaturated fatty acids in the same % of calories (5.4) as noncases (5.4).
|
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 | Polyunsaturated fatty acids (not defined) | Cases consumed the same amount (15 g) as noncases (14 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 | Polyunsaturated 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 (15 g) as noncases (14 g).
|
Cases consumed the same amount (15 g) as noncases (14 g).
|
Cases consumed the same amount (14 g) as noncases (14 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 polyunsaturated fatty acids in a higher % of calories (6.0) as noncases (5.3; P = < 0.01).
|
Cases consumed polyunsaturated fatty acids in a higer % of calories (6.2) as noncases (5.3; P = < 0.01).
|
Cases consumed polyunsaturated fatty acids in the same % of calories (5.7) as noncases (5.3).
|
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 | Polyunsaturated 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 (17 g), and noncases (16 g).
Consumption in % of calories: Cases consumed a higher % of calories from polyunsaturated fatty acids (6.7%), than noncases (5.9%; P = < 0.01).
|
Consumption in g: No significant difference was found between cases (10 g), and noncases (11 g).
Consumption in % of calories: No significant difference was found between cases (3.9%), and noncases (3.9%).
|
MI and CHD death:
Urban men
(129 cases) | Rural men
(34 cases) |
Consumption in g: No significant difference was found between cases (17 g), and noncases (16 g).
Consumption in % of calories: Cases consumed a higher % of calories from polyunsaturated fatty acids (6.9%), than noncases (5.9%; P = < 0.01).
|
Consumption in g: No significant difference was found between cases (7 g), and noncases (11 g).
Consumption in % of calories: No significant difference was found between cases (3.4%), and noncases (3.9%).
|
CHD death:
Urban men
(57 cases) | Rural men
(14 cases) |
| Consumption in g: No significant difference was found between cases (16 g), and noncases (16 g).
|
Consumption in g: No significant difference was found between cases (7 g), and noncases (11 g).
|
Coronary insufficiency:
Urban men
(31 cases) | Rural men
(14 cases) |
| Consumption in g: No significant difference was found between cases (16 g), and noncases (16 g).
|
Consumption in g: No significant difference was found between cases (11 g), and noncases (11 g).
|
Angina pectoris:
Urban men
(53 cases) | Rural men
(25 cases) |
| Consumption in g: No significant difference was found between cases (16 g), and noncases (16 g).
|
Consumption in g: No significant difference was found between cases (11 g), and noncases (11 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) | Polyunsaturated fat (not defined) |
Grams.
Age adjusted:
Total CHD
(456? cases) | MI or CHD death
(309? cases) | Angina pectoris or coronary insufficiency
(147? cases) |
| Cases did not consume significantly more (15.7 g) than controls (15.4 g).
|
Cases did not consume significantly less (15.2 g) than controls (15.4 g).
|
Cases did not consume significantly more (16.7 g) than controls (15.4 g).
|
% of calories:
Total CHD
(456? cases) | MI or CHD death
(309? cases) | Angina pectoris or coronary insufficiency
(147? cases) |
| Cases did not consume significantly more than controls (SLC = 0.09).
|
Cases did not consume significantly more than controls (SLC = 0.04).
|
Cases consumed significantly more than controls (SLC = 0.17; P = < 0.05).
|
SLC = Standardized logistic coefficient.Age, systolic blood pressure, serum cholesterol, cigarettes, body weight, physical activity, and intakes of calories, carbohydrates, starch, other carbohydrates, alcohol, vegetable protein, protein, saturated fat, and cholesterol. |
| 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 | Polyunsaturated fatty acids (not defined) | Cases consumed the same amount (16 g) as noncases (16 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 | Polyunsaturated 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 (16 g) as noncases (16 g).
|
Cases consumed the same amount (16 g) as noncases (16 g).
|
Cases consumed the same amount (17 g) as noncases (16 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 polyunsaturated fatty acids in a higher % of calories (6.7) than noncases (6.0; P = < 0.01).
|
Cases consumed polyunsaturated fatty acids in a higher % of calories (6.7) than noncases (6.0; P = < 0.01).
|
Cases consumed polyunsaturated fatty acids in the same % of calories (6.6) as noncases (6.0).
|
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.) | Polyunsaturated 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 polyunsaturated fatty acids (16 g/d) as noncases (15 g/d; P = not significant).
|
Cases consumed the same amount of polyunsaturated fatty acids (14 g/d) as noncases (15 g/d; P = not significant).
|
Cases consumed the same amount of polyunsaturated fatty acids (17 g/d) as noncases (15 g/d; P = not significant).
|
Consumption as proportion of calories:
CHD death + MI
(179? cases) | Acute CI
(27? cases) | Angina
(88? cases) |
| Cases consumed a larger proportion of calories of polyunsaturated fatty acids (7 %) than noncases (6 %; P = < 0.05).
|
Cases consumed the same proportion of calories of polyunsaturated fatty acids (6 %) as noncases (6 %; P = not significant).
|
Cases consumed a larger proportion of calories of polyunsaturated fatty acids (7 %) than noncases (6 %; P = < 0.05).
|
Age. |
| 1) Shekelle RB (1981) | The Western Electric Study | 1,900 men aged 40-55 who were free of CHD | 19
(1957-?) | ? | CHD death | Polyunsaturated fatty acids (linoleic acid, linolenic acid, and arachidonic acid) |
An inverse relation was found for the highest vs lowest tertile of consumption in % of cal. (P = 0.010).
Amount specific data (Tertiles not defined):
T1: 13.5
T2: 10.4
T3: 10.1 | Age, systolic blood pressure, number of cigarettes/day, serum cholesterol, alcoholic drinks/month, BMI, and ethnicity. |
Prospective studies of polyunsaturated 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 | Polyunsaturated 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 | Polyunsaturated fat (not defined, but including trans fatty acids) |
| Women | Men |
HR = 1.06 (0.71-1.59; P = 0.8) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
4.3: HR = 1.
5.4: HR = 1.00 (0.70-1.43).
6.3: HR = 1.03 (0.72-1.49).
8.1: HR = 1.06 (0.71-1.59).
|
HR = 1.06 (0.74-1.51; P = 0.9) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
4.5: HR = 1.
5.7: HR = 1.22 (0.90-1.65).
6.7: HR = 1.06 (0.76-1.47).
8.6: HR = 1.06 (0.74-1.51).
|
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 | Polyunsaturated fatty acids (not defined) |
RH = 0.68 (0.34-1.36; P = 0.2814) for the highest vs lowest tertile of consumption.
Amount specific data (g/day):
7: RH = 1.
13: RH = 0.88 (0.48-1.63).
22: RH = 0.68 (0.34-1.36).
This association changed after additional adjustment for cholesterol intake: RH = 0.99 (0.48-2.02; P = 0.9969). | 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) | Polyunsaturated fat (not defined) |
RR = 0.86 (0.42-1.75; P = 0.44) for the highest vs lowest quartile of consumption.
Amount specific data (g/day):
7.1: RR = 1.
10.6: RR = 1.20 (0.64-2.24).
13.8: RR = 0.70 (0.33-1.45).
18.9: RR = 0.86 (0.42-1.75).
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 | Polyunsaturated fat (not defined) |
RR = 1.3 (0.9-1.8) for the highest vs lowest tertile of consumption.
Amount specific data (Tertiles not defined):
T1: RR = 1.
T2: RR = 1.1 (0.7-1.5).
T3: RR = 1.3 (0.9-1.8). | 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 | Polyunsaturated fat (not defined) |
Ischaemic stroke
(embolism or thrombosis)
(455 cases) | Haemorrhagic stroke
(subarachnoid and intracerebral)
(125 cases) |
RR = 0.86 (0.59-1.25; P = 0.26) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
10: RR = 1.
11: RR = 1.15 (0.85-1.55).
13: RR = 1.11 (0.81-1.53).
14: RR = 0.98 (0.70-1.37).
17: RR = 0.86 (0.59-1.25).
|
RR = 0.95 (0.46-1.98; P = 0.99) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
10: RR = 1.
11: RR = 0.89 (0.49-1.64).
13: RR = 1.20 (0.66-2.19).
14: RR = 1.09 (0.57-2.09).
17: RR = 0.95 (0.46-1.98).
|
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, monounsaturated 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 | Polyunsaturated fat (not defined) |
RR = 0.69 (0.33-1.48; P = 0.59) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
4.5: RR = 1.
6.0: RR = 0.69 (0.33-1.42).
7.2: RR = 0.96 (0.48-1.90).
8.6: RR = 0.99 (0.51-1.93).
11.1: RR = 0.69 (0.33-1.48). | 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) | Polyunsaturated fat (not defined) | Cases did not consume significantly more (6.2% kcal) than controls (6.0% kcal). | Unadjusted.
Cases matched to controls by age, clinical center, treatment group, and date of randomization. |
| 10) Khaw KT (1987) | The Rancho Bernardo Cohort | 859 men and women aged 50-79 without CVD, of which 50% had hyperlipidemia.
(Southern California) | 12 | 24
(9 men, and 15 women) | Stroke-associated mortality | Polyunsaturated fat (not defined) |
| Men: | Women: |
| Cases consumed the same amount (32.0 g) as noncases (31.5 g; P = 0.86).
|
Cases consumed the same amount (25.3 g) as noncases (24.2 g; P = 0.59).
|
Age and calories. |
| 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) | Polyunsaturated fat (not defined) |
RR = 1.57 (0.50-4.94; P = 0.46) for the highest vs lowest quartile of consumption.
Amount specific data (g/day):
9.9: RR = 1.
12.6: RR = 1.07 (0.54-2.14).
14.7: RR = 1.52 (0.66-3.51).
17.8: RR = 1.57 (0.50-4.94). | 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) | Polyunsaturated fat (not defined) | Stroke cases consumed the same amount (7.0% of energy) as noncases (6.8% 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) | Polyunsaturated fat (not defined) | No association (No data shown; P = 0.33). | Age. |
| | | | | | | | | | | | | | | | | | | | | | |