| 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 | Saturated fat (not defined) |
| Women | Men |
HR = 0.98 (0.71-1.33; P = 0.5) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
12.2: HR = 1.
15.2: HR = 0.99 (0.77-1.27).
17.5: HR = 0.77 (0.58-1.03).
21.8: HR = 0.98 (0.71-1.33).
|
HR = 1.05 (0.83-1.34; P = 0.7) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
12.3: HR = 1.
15.3: HR = 1.02 (0.84-1.25).
17.7: HR = 1.01 (0.81-1.25).
22.3: HR = 1.05 (0.83-1.34).
|
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 | Saturated fat (not defined) |
Women
(97? cases) | Men
(242? cases) |
RR = 0.55 (0.26-1.17; P = 0.16) for the highest vs lowest quartile of consumption.
Amount specific data (% of daily energy):
12.2: RR = 1.
15.2: RR = 0.89 (0.49-1.62).
17.5: RR = 0.76 (0.39-1.45).
21.8: RR = 0.55 (0.26-1.17).
|
RR = 0.94 (0.58-1.53; P = 0.98) for the highest vs lowest quartile of consumption.
Amount specific data (% of daily energy):
12.3: RR = 1.
15.3: RR = 1.03 (0.69-1.53).
17.6: RR = 1.24 (0.82-1.89).
22.3: RR = 0.94 (0.58-1.53).
|
Age, alcohol consumption, smoking, social class, marital status, physical activity, BMI and fibre, monounsaturated fat, and polyunsaturated 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 | Saturated fat (not defined) | RR = 1.23 (0.89-1.68; P = 0.211) 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) | Saturated fat (not defined) |
RR = 1.29 (0.85-1.98; P = 0.16) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
10.8: RR = 1.
13: RR = 0.83 (0.62-1.12).
14.6: RR = 1.10 (0.80-1.52).
16.2: RR = 0.98 (0.68-1.41).
19.1: RR = 1.29 (0.85-1.98). | 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, monounsaturated, polyunsaturated, and trans unsaturated fats and cholesterol. |
| 13) McCullough ML (2000) | The Health Professionals Follow-up Study. | 38,622 men aged 40-75.
(USA) | 8
(1986-1994) | 1,092? | Cardiovascular disease risk (fatal and nonfatal myocardial infarction and stroke) | Saturated fat | An increased risk: RR for a 5-point increase (representing less saturated fat) = 0.91 (0.83-1.00; No P-value).
Highest (10 points) vs lowest tertile (0 points) = < 10 vs > or = 15% of total energy respectively. | Each component of the healthy food index was added individually into the multivariate model, adjusting for age, smoking, body mass index, alcohol intake, physical activity, diagnosis of hypertension or hypercholesterolemia at baseline, total energy intake, multivitamin use, vitamin E use, and time period. |
Prospective studies of saturated fat and coronary heart disease:
| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments |
| 48) Jakobsen MU (2009) | The Pooling Project of Cohort Studies on Diet and Coronary Disease
(Pooled analysis of 11 cohort studies) | 344,696 subjects (71% women) from 11 American and European cohort studies, and without a history of cardiovascular disease, diabetes, or cancer. | 4-10 | 5,249 events, and
2,155 deaths | Coronary heart disease incidence (fatal CHD [including sudden death], and nonfatal myocardial infarction) | Carbohydrates for saturated fatty acids (not defined) |
Inclusion criteria:
- Published follow-up study with ≥ 150 incident coronary events.
- Availability of usual dietary intake.
- Validation or repeatability study of the diet-assessment method used.
Included studies (Follow-up years/No. of CHD cases):
- The Adventist Health Study (6.3y/Events: 148 men/75 women. Deaths: 49 men/41 women.).
Fraser GE. A possible protective effect of nut consumption on risk of coronary heart disease. The Adventist Health Study. Arch Intern Med. 1992 Jul;152(7):1416-24. Abstract
- The ARIC Study (9.2y/Events: 269 men/123 women. Deaths: 51 men/- women.).
Folsom AR. Physical activity and incidence of coronary heart disease in middle-aged women and men. Med Sci Sports Exerc. 1997 Jul;29(7):901-9. Abstract
- The ATBC Study (6.0y/Events: 1,339. Deaths: 534.).
Pietinen P. Intake of fatty acids and risk of coronary heart disease in a cohort of Finnish men. The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Am J Epidemiol. 1997 May 15;145(10):876-87. Full text
- The Finnish Mobile Clinic Health Study (10.0y/Events: 322 men/162 women. Deaths: 147 men/48 women.).
Knekt P. Antioxidant vitamin intake and coronary mortality in a longitudinal population study. Am J Epidemiol. 1994 Jun 15;139(12):1180-9. Abstract
- The Glostrup Population Study (10y/Events: 102 men/34 women. Deaths: 38 men/14 women.).
Jakobsen MU. Dietary fat and risk of coronary heart disease: possible effect modification by gender and age. Am J Epidemiol. 2004 Jul 15;160(2):141-9. Full text
- The Health Professionals Follow-Up Study (9.7y/Events: 1,273. Deaths: 421.).
Ascherio A. Dietary fat and risk of coronary heart disease in men: cohort follow up study in the United States. BMJ. 1996 Jul 13;313(7049):84-90. Full text
- The Israeli Ischemic Heart Disease Study (-y/Events: -. Deaths: 165.).
Goldbourt U. Factors predictive of long-term coronary heart disease mortality among 10,059 male Israeli civil servants and municipal employees. A 23-year mortality follow-up in the Israeli Ischemic Heart Disease Study. Cardiology. 1993;82(2-3):100-21. Abstract
- The Iowa Women's Health Study (10.0y/Events: -. Deaths: 294.).
Kushi LH. Dietary antioxidant vitamins and death from coronary heart disease in postmenopausal women. N Engl J Med. 1996 May 2;334(18):1156-62. Abstract
- The Nurses' Health Study A (6.5y/Events: 397. Deaths: 97.).
Hu FB. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med. 1997 Nov 20;337(21):1491-9. Abstract
- The Nurses' Health Study B (10.0y/Events: 696. Deaths: 208.).
Hu FB. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med. 1997 Nov 20;337(21):1491-9. Abstract
- The Västerbotten Intervention Program (4.1y/Events: 134 men/23 women. Deaths: 38 men/- women.).
Hallmans G. Cardiovascular disease and diabetes in the Northern Sweden Health and Disease Study Cohort - evaluation of risk factors and their interactions. Scand J Public Health. Suppl. 2003;61:18-24. Abstract
- The Women's Health Study (5.3y/Events: 152. Deaths: 10.).
Liu S. A prospective study of dietary fiber intake and risk of cardiovascular disease among women. J Am Coll Cardiol. 2002 Jan 2;39(1):49-56. Abstract
HR's are per 5% increment in energy from carbohydrates instead of saturated fatty acids:
| Coronary events | Coronary deaths |
| An overall significant direct association between substitution of carbohydrates and risk of coronary events: HR = 1.07 (1.01-1.14). P for between-studies heterogeneity = 0.51
|
HR = 0.96 (0.82-1.12). P for between-studies heterogeneity = 0.05
|
Coronary events. Stratified by sex and age:
| Women | Men |
All women: HR = 1.00 (0.89-1.12). P for between-studies heterogeneity = 0.72
Women aged < 60 y: HR = 0.98 (0.86-1.12). P for between-studies heterogeneity = 0.42
Women aged ≥ 60 y: HR = 1.09 (0.88-1.36). P for between-studies heterogeneity = 0.50
|
All men: HR = 1.11 (1.02-1.20). P for between-studies heterogeneity = 0.37
Men aged < 60 y: HR = 1.12 (1.00-1.24). P for between-studies heterogeneity = 0.34
Men aged ≥ 60 y: HR = 1.14 (1.00-1.29). P for between-studies heterogeneity = 0.85
|
Coronary death. Stratified by sex and age:
| Women | Men |
All women: HR = 0.86 (0.65-1.13). P for between-studies heterogeneity = 0.16
Women aged < 60 y: HR = 0.91 (0.62-1.34). P for between-studies heterogeneity = 0.17
Women aged ≥ 60 y: HR = 0.80 (0.61-1.06). P for between-studies heterogeneity = 0.73
|
All men: HR = 1.03 (0.86-1.24). P for between-studies heterogeneity = 0.14
Men aged < 60 y: HR = 1.08 (0.82-1.43). P for between-studies heterogeneity = 0.09
Men aged ≥ 60 y: HR = 1.03 (0.80-1.33). P for between-studies heterogeneity = 0.29
|
Intake of MUFA's, PUFA's, trans fatty acids, and protein, total energy, age, calendar year of baseline questionnaire, time in study, smoking, BMI, physical activity, alcohol intake, history of hypertension, fiber intake, and cholesterol intake.
Additional adjustment for suggested dietary CHD risk factors (vitamin E, vitamin C, and folic acid) did not change the HRs, but the CIs became slightly wider. |
| 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) | Saturated fat (not defined) |
| g/day: | % energy: | consumption > 10% energy: |
| Cases consumed less saturated fat (29.0 g/day) than controls (30.6 g/day; P = 0.028).
|
Cases consumed less saturated fat (10.5% energy) than controls (10.9% energy; P = 0.029).
|
The same amount of cases consumed > 10% energy from saturated fat (55.2%) as controls (57.1%; P = 0.48).
|
Unadjusted.
Controls were matched to cases by center, sex, age, and time of enrollment. |
| 44) Jakobsen MU (2010) | The Danish Prospective Cohort Study "Diet, Cancer, and Health" | 53,644 subjects (25,149 men and 28,495 women) aged 50-64, and free of myocardial infarction, cardiac arrest, diabetes mellitus and cancer. | 12
(1993-97 to 2006-08) | See variables | Myocardial infarction incidence (nonfatal and fatal) | Carbohydrates/Saturated fatty acids |
Total carbohydrates:
All participants
(1,943 cases) | Women
(537 cases) | Men
(1,406 cases) |
| HR = 1.04 (0.92-1.17) per 5% increment of energy from carbohydrates and a concomitant lower energy intake from saturated fatty acids.
|
HR = 1.02 (0.82-1.28) per 5% increment of energy from carbohydrates and a concomitant lower energy intake from saturated fatty acids.
|
HR = 1.05 (0.92-1.21) per 5% increment of energy from carbohydrates and a concomitant lower energy intake from saturated fatty acids.
|
Carbohydrates with low-GI (first tertile):
| All participants | Women | Men |
| HR = 0.88 (0.72-1.07) per 5% increment of energy from carbohydrates (median dietary GI = 82) and a concomitant lower energy intake from saturated fatty acids.
|
HR = 1.17 (0.80-1.71) per 5% increment of energy from carbohydrates (median dietary GI = 80) and a concomitant lower energy intake from saturated fatty acids.
|
HR = 0.83 (0.65-1.04) per 5% increment of energy from carbohydrates (median dietary GI = 84) and a concomitant lower energy intake from saturated fatty acids.
|
Carbohydrates with medium-GI (second tertile):
| All participants | Women | Men |
| HR = 0.98 (0.80-1.21) per 5% increment of energy from carbohydrates (median dietary GI = 88) and a concomitant lower energy intake from saturated fatty acids.
|
HR = 0.80 (0.54-1.18) per 5% increment of energy from carbohydrates (median dietary GI = 85) and a concomitant lower energy intake from saturated fatty acids.
|
HR = 1.08 (0.84-1.38) per 5% increment of energy from carbohydrates (median dietary GI = 89) and a concomitant lower energy intake from saturated fatty acids.
|
Carbohydrates with high-GI (third tertile):
| All participants | Women | Men |
| HR = 1.33 (1.08-1.64) per 5% increment of energy from carbohydrates (median dietary GI = 93) and a concomitant lower energy intake from saturated fatty acids.
|
HR = 1.10 (0.75-1.63) per 5% increment of energy from carbohydrates (median dietary GI = 91) and a concomitant lower energy intake from saturated fatty acids.
|
HR = 1.34 (1.04-1.71) per 5% increment of energy from carbohydrates (median dietary GI = 94) and a concomitant lower energy intake from saturated fatty acids.
|
Age as time metric. Sex, glycemic carbohydrates, proteins, monounsaturated fatty acids, polyunsaturated fatty acids, total energy, alcohol consumption, BMI, education, smoking status, physical activity, and history of hypertension. |
| 39) Yamagishi K (2010) | The JACC Study (Japan Collaborative Cohort Study for Evaluation of Cancer Risk) | 58,453 subjects (23,024 men and 35,429 women) aged 40-79, and without heart disease, stroke, or cancer. | 14.1
(1988-90 to 1999-2003) | See variables | CHD mortality | Saturated fatty acids (not defined) |
Ischemic heart disease
(420 cases) | Myocardial infarction
(330 cases) |
HR = 0.93 (0.65-1.35; P = 0.86) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
2.5-< 11.0: HR = 1.
11.0-< 13.4: HR = 0.83 (0.61-1.13).
13.4-< 15.4: HR = 0.93 (0.68-1.28).
15.4-< 17.9: HR = 0.89 (0.63-1.24).
17.9-40.0: HR = 0.93 (0.65-1.35).
|
HR = 0.85 (0.56-1.29; P = 0.40) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
2.5-< 11.0: HR = 1.
11.0-< 13.4: HR = 0.82 (0.58-1.14).
13.4-< 15.4: HR = 0.92 (0.65-1.31).
15.4-< 17.9: HR = 0.74 (0.50-1.10).
17.9-40.0: HR = 0.85 (0.56-1.29).
|
Cardiac arrest
(107 cases) | Heart failure
(309 cases) |
HR = 0.50 (0.23-1.10; P = 0.11) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
2.5-< 11.0: HR = 1.
11.0-< 13.4: HR = 0.73 (0.41-1.31).
13.4-< 15.4: HR = 0.64 (0.34-1.21).
15.4-< 17.9: HR = 0.69 (0.36-1.34).
17.9-40.0: HR = 0.50 (0.23-1.10).
|
HR = 0.99 (0.64-1.52; P = 0.83) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
2.5-< 11.0: HR = 1.
11.0-< 13.4: HR = 0.88 (0.62-1.25).
13.4-< 15.4: HR = 0.75 (0.50-1.11).
15.4-< 17.9: HR = 1.01 (0.69-1.48).
17.9-40.0: HR = 0.99 (0.64-1.52).
|
No interaction was found with sex for any mortality end point.Age, sex, history of hypertension and diabetes, smoking status, alcohol consumption, BMI, mental stress, walking, sport, educational level, dietary intakes of total energy, cholesterol, omega-3 and omega-6 polyunsaturated fatty acids, vegetables, and fruit. |
| 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 | Saturated fat (not defined) | Cases consumed more saturated fat (12.2% of energy) than controls (12.0% of energy; P = 0.065). | Total energy. |
| 36) Umesawa M (2008) | The JPHC Study Cohort I | 41,526 men and women age 40-59 without a history of CVD or cancer.
(Japan) | 13
(1990-92 to 2003) | 322? | CHD incidence (MI and sudden cardiac death) | Saturated fat (not defined) | HR = 1.51 (0.98-2.35; P = 0.06, and P for trend = 0.12) for the highest vs lowest quintile of consumption (not defined). | Age, sex, BMI, history of diabetes, medication for hypercholesterolemia, menopause, smoking status, ethanol intake, sodium intake, potassium intake, n-3 fatty acid intake, and public health center. |
| 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]) | Saturated fatty acids (not defined, but including meat, poultry, and fish) |
CHD event
(403 cases) | Nonfatal CHD
(298 cases) |
HR = 1.11 (0.82-1.51; P = 0.45) for the highest vs lowest quartile of consumption.
Amount specific data (% of energy):
7.5: HR = 1.
10.6: HR = 1.05 (0.78-1.43).
12.9: HR = 1.12 (0.83-1.51).
16.5: HR = 1.11 (0.82-1.51).
|
HR = 1.15 (0.81-1.63; P = 0.24) for the highest vs lowest quartile of consumption.
Amount specific data (% of energy):
7.5: HR = 1.
10.6: HR = 0.90 (0.62-1.30).
12.9: HR = 1.21 (0.85-1.71).
16.5: HR = 1.15 (0.81-1.63).
|
CHD death.
Stratified by age:
47-59
(46 cases) | 60-79
(92 cases) |
HR = 5.17 (1.64-16.36; P = 0.01) for the highest vs lowest quartile of consumption.
Amount specific data (% of energy):
7.8: HR = 1.
10.8: HR = 3.23 (1.03-10.14).
13.1: HR = 1.58 (0.42-6.04).
16.7: HR = 5.17 (1.64-16.36).
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, 2.52 (0.66-9.65), 0.98 (0.20-4.87), and 2.98 (0.66-13.58; P = 0.19).
|
HR = 0.80 (0.41-1.54; P = 0.22) for the highest vs lowest quartile of consumption.
Amount specific data (% of energy):
7.2: HR = 1.
10.2: HR = 1.59 (0.89-2.83).
12.7: HR = 0.81 (0.41-1.63).
16.1: HR = 0.80 (0.41-1.54).
|
Variable of interest as a % of energy, sex, age, study center, diabetes status, BMI, HDL, LDL, triaglycerol, smoking, alcohol, hypertension, protein, and total energy. |
| 34) Ness AR (2005) | The Boyd Orr Cohort | 4,028 people (1,995 men, and 2,033 women) from England and Scotland. | average 37
(1948 to 2000) | 298 | CHD mortality | Saturated fat (not defined) |
RR = 0.70 (0.39-1.26; P = 0.2) for the highest vs lowest quartile of consumption.
Amount specific data (g):
8.8-24.0: RR = 1.
24.0-31.4: RR = 0.81 (0.54-1.21).
31.4-40.4: RR = 0.68 (0.43-1.08).
40.6-108.9: RR = 0.70 (0.39-1.26). | Age, energy, sex, childhood family food expenditure, father's social class, district of residence as a child, period of birth, season when studied as a child, and Townsend score for current address or place of death. |
| 33) Tucker KL (2005) | The Baltimore Longitudinal Study of Aging | 501 men age 34-80. | 18 | 71? | CHD mortality | Saturated fat (not defined) | RR = 1.04 (0.99-1.08).
Also, no significant association was found with CHD incidence (no data shown; P = > 0.05).
***RR = 1.22 (0.31-4.77) for the highest vs lowest tertile of consumption. Among men < 60 y: RR = 0.57 (0.14-2.30), and among men ≥ 60 y: RR = 2.31 (0.73-7.27). | Age, total energy, BMI, smoking, alcohol, physical activity, supplement use, fruit and vegetables, and secular trend. |
| 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 | Saturated fat (not defined) |
***RR = 0.95 (0.74-1.21) for the highest vs lowest quartile of consumption (n = 908).
| Women | Men |
HR = 0.81 (0.53-1.24; P = 0.2) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
12.2: HR = 1.
15.2: HR = 0.89 (0.63-1.24).
17.5: HR = 0.67 (0.45-0.99; P = < 0.05).
21.8: HR = 0.81 (0.53-1.24).
|
HR = 1.02 (0.76-1.37; P = 0.9) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
12.3: HR = 1.
15.3: HR = 1.02 (0.80-1.30).
17.7: HR = 0.96 (0.74-1.26).
22.3: HR = 1.02 (0.76-1.37).
|
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) | Saturated fatty acids (not defined) |
*** RR = 1.03 (0.66-1.60) for the highest vs lowest tertile of consumption (n = 326 cases).
Stratified by gender:
| Women | Men |
HR = 1.24 (0.98-1.57) for an intake of a 5% higher level of energy.
Borderline significantly positively associated: HR = 1.36 (0.98-1.88) for an intake of a 5% higher level of energy instead of carbohydrates.
|
HR = 1.04 (0.88-1.23) for an intake of a 5% higher level of energy.
HR = 1.03 (0.78-1.37) 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 = 2.48 (1.33-4.65) for an intake of a 5% higher level of energy.
HR = 2.68 (1.40-5.12) for an intake of a 5% higher level of energy instead of carbohydrates.
*** RR = 4.78 (0.95-24.10) for the highest vs lowest tertile of consumption.
|
HR = 1.12 (0.87-1.44) for an intake of a 5% higher level of energy.
HR = 1.22 (0.86-1.71) for an intake of a 5% higher level of energy instead of carbohydrates.
*** RR = 1.03 (0.53-2.00) for the highest vs lowest tertile of consumption.
|
HR = 1.29 (0.92-1.80) for an intake of a 5% higher level of energy.
HR = 1.29 (0.87-1.91) for an intake of a 5% higher level of energy instead of carbohydrates.
*** RR = 1.01 (0.48-2.14) for the highest vs lowest tertile of consumption.
|
HR = 0.96 (0.79-1.17) for an intake of a 5% higher level of energy.
HR = 0.94 (0.70-1.28) for an intake of a 5% higher level of energy instead of carbohydrates.
*** RR = 0.79 (0.48-1.29) for the highest vs lowest tertile of consumption.
|
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 | Saturated fat (not defined) |
CAD death
(16 cases) | CAD death or AMI
(34 cases) |
| RR = 1.01 (0.61-1.69; P = 0.966) per 1-SD increment in intake.
|
RR = 1.00 (0.68-1.46; P = 0.993) 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 | Saturated fat (not defined) | RR = 1.19 (0.85-1.66; P = 0.304) 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) | Saturated fat (not defined) |
CHD mortality:
Men
(41 cases) | Women
(24 cases) |
| No significant difference in consumption in % of energy was found between cases (19.7) and controls (19.8).
|
Cases consumed a smaller % of energy from saturated fat (18.6) than controls (20.1; P = 0.088).
|
CHD: The mean reported intake of saturated fatty acids was lower in women with CHD (P = 0.007; 43 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 | Saturated fat (not defined) |
Men
(98 cases) | Women
(57 cases) |
16 y death rate = 8.2% (5.1-12.4; P = 0.47) for the highest vs lowest quintile of consumption.
Amount specific data (Quintiles not defined):
Q1: DR = 7.4% (4.4-11.4).
Q2: DR = 7.8% (4.8-11.9).
Q3: DR = 6.5% (3.8-10.4).
Q4: DR = 10.1% (6.6-14.5).
Q5: DR = 8.2% (5.1-12.4).
RR = 1.00 (0.86-1.18; P = 0.96) for a 100 g/week increase, after adjustment for age, alcohol, smoking, exercise, and social class.
***RR = 1.51 (0.69-3.31) among men < 60 y, and RR = 1.01 (0.57-1.80) among men ≥ 60 y for the highest vs lowest tertile of consumption.
|
16 y death rate = 5.8% (3.4-9.2; P = 0.0018) for the highest vs lowest quintile of consumption.
Amount specific data (Quintiles not defined):
Q1: DR = 2.4% (1.0-4.9).
Q2: DR = 1.7% (0.6-4.0).
Q3: DR = 3.4% (1.7-6.2).
Q4: DR = 6.2% (3.7-9.6).
Q5: DR = 5.8% (3.4-9.2).
RR = 1.40 (1.09-1.79; P = 0.007) for a 100 g/week increase, after adjustment for age, alcohol, smoking, exercise, and social class (56 cases).
***RR = 1.32 (0.38-4.57) among women < 60 y, and RR = 2.34 (1.02-5.40) among women ≥ 60 y for the highest vs lowest tertile of consumption.
|
The cut-off points for the quintiles of saturated fat in grams per week were 220, 276, 337 and 427 for men and 159, 202, 252 and 319 for women.
***RR = 1.37 (1.17-1.65) for the highest vs lowest tertile of consumption among men and women combined (n = 155 cases).Unadjusted. |
| 21) Mann JI (1997) | The Oxford Vegetarian Study | 10,802 subjects (4102 men and 6700 women) aged 16-79, and without pre-existing disease.
(UK) | 13.3
(1980-84 to 1995) | 45 | Ischaemic heart disease death | Saturated fat (from meat, eggs, milk, cheese) |
Death rate ratio = 277 (125-613; P = < 0.01) for the highest vs lowest tertile of consumption.
Amount specific data (Tertiles not defined):
T1: DRR = 100.
T2: DRR = 211 (94-474).
T3: DRR = 277 (125-613). | Age, sex, smoking and social class.
DRR's did not appreciably change after additional adjustment for BMI. |
| 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) | Saturated fatty acids (not defined) |
Major coronary events
(1,399 cases) | Coronary death
(635 cases) |
RR = 0.87 (0.73-1.03; P = 0.189) for the highest vs lowest quintile of consumption.
Amount specific data (intake in g):
34.7: RR = 1.
43.3: RR = 0.87 (0.73-1.03).
50.3: RR = 0.82 (0.69-0.97).
57.4: RR = 0.95 (0.80-1.13).
67.5: RR = 0.87 (0.73-1.04).
|
RR = 0.93 (0.60-1.44; P = 0.909) for the highest vs lowest quintile of consumption.
Amount specific data (intake in g):
34.7: RR = 1.
43.3: RR = 0.90 (0.68-1.18).
50.3: RR = 0.92 (0.67-1.26).
57.4: RR = 1.04 (0.72-1.48).
67.5: RR = 0.93 (0.60-1.44).
|
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-, cis-mono and linoleic acid. |
| 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) | C12-C16 saturated fatty acids (not defined) |
Major coronary events
(1,399 cases) | Coronary death
(635 cases) |
RR = 0.88 (0.74-1.04; P = 0.184) for the highest vs lowest quintile of consumption.
Amount specific data (intake in g):
21.7: RR = 1.
27.1: RR = 0.88 (0.74-1.04).
31.5: RR = 0.83 (0.69-0.98).
35.8: RR = 0.91 (0.77-1.08).
42.2: RR = 0.88 (0.74-1.04).
|
RR = 0.74 (0.57-0.96; P = 0.045) for the highest vs lowest quintile of consumption.
Amount specific data (intake in g):
21.7: RR = 1.
27.1: RR = 0.79 (0.61-1.02).
31.5: RR = 0.76 (0.59-0.98).
35.8: RR = 0.84 (0.65-1.07).
42.2: RR = 0.74 (0.57-0.96).
|
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 | Saturated fat (not defined) |
Stratified by age
30-59
(52? cases) | 60-79
(40? cases) |
| RR = 1.11 (1.04-1.18; P = < 0.01) for saturated fat as 1% of total energy.
|
RR = 0.96 (0.88-1.05) for saturated 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 | Saturated 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 | Saturated fat (not defined) |
| Men: | Women: |
| Cases consumed significantly more (78 g) than controls (73 g; P = 0.01).
|
Cases did not consume significantly more (53 g) than controls (50 g; P = 0.21).
|
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) | Saturated fat (not defined) |
RR = 0.97 (0.73-1.27; P = 0.93) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
10.1: RR = 1.
11.9: RR = 0.94 (0.80-1.11).
13.3: RR = 0.96 (0.79-1.16).
14.8: RR = 1.01 (0.81-1.26).
17.6: RR = 0.97 (0.73-1.27).
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, monounsaturated, 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) | Saturated fat (not defined) |
RR's are from the standard multivariate model:
RR = 1.34 (0.81-2.21; P = 0.32) for the highest vs lowest quintile of consumption.
Amount specific data (Quintiles not defined):
Q1: RR = 1.
Q2: RR = 1.09 (0.82-1.44).
Q3: RR = 1.38 (0.97-1.95).
Q4: RR = 1.28 (0.84-1.95).
Q5: RR = 1.34 (0.81-2.21). | 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 (1999) | The Nurses' Health Study | 80,082 women aged 34-59, and without cancer, angina, myocardial anfarction, stroke, or other cardiovascular diseases.
(USA) | 14
(1980-1994) | 939? | Coronary heart disease incidence (nonfatal myocardial infarction or fatal coronary disease [including sudden death]) | Saturated fatty acids |
4:0-10:0
(top contributors hard cheese, butter, low-fat milk, whole milk, ice cream, and coffee whitener) | 12:0 (lauric acid) + 14:0 (myristic acid)
(top contributors hard cheese, coffee whitener, beef, low-fat milk, whole milk, and butter) | 16:0 (palmitic acid)
(top contributors beef as main dish, hard cheese, beef as sandwich, hamburger, and eggs) |
RR = 1.00 (0.82-1.21; P = 0.60) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
< 1.05: RR = 1.0.
1.05-1.29: RR = 0.95 (0.78-1.17).
1.30-1.50: RR = 0.86 (0.70-1.06).
1.51-1.77: RR = 0.77 (0.62-0.95).
> 1.77: RR = 1.00 (0.82-1.21).
|
RR = 1.05 (0.83-1.32; P = 0.46) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
< 1.13: RR = 1.0.
1.13-1.34: RR = 0.97 (0.78-1.21).
1.35-1.56: RR = 0.92 (0.73-1.15).
1.57-1.87: RR = 1.06 (0.85-1.33).
> 1.87: RR = 1.05 (0.83-1.32).
|
RR = 1.03 (0.71-1.50; P = 0.45) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
< 6.46: RR = 1.0.
6.46-7.34: RR = 0.70 (0.55-0.91).
7.35-8.19: RR = 0.83 (0.63-1.10).
8.20-9.33: RR = 1.02 (0.74-1.39).
9.34-20.45: RR = 1.03 (0.71-1.50).
|
18:0
(Stearic acid)
(top contributors beef as main dish, hard cheese, beef as sandwich, hamburger, and chocolate) | Sum of 12:0-18:0 |
RR = 1.16 (0.81-1.66; P = 0.30) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
< 2.93: RR = 1.0.
2.93-3.39: RR = 0.99 (0.77-1.28).
3.40-3.82: RR = 0.96 (0.72-1.28).
3.82-4.42: RR = 1.23 (0.90-1.68).
> 4.42: RR = 1.16 (0.81-1.66).
|
RR = 1.04 (0.72-1.48; P = 0.47) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
< 10.6: RR = 1.0.
10.7-12.1: RR = 0.82 (0.64-1.05).
12.2-13.6: RR = 0.87 (0.66-1.14).
13.7-15.5: RR = 1.05 (0.78-1.43).
> 15.5: RR = 1.04 (0.72-1.48).
|
Age, time period, BMI, cigarette smoking, menopausal status, parental history of myocardial infarction before age 60, vitamin E supplement use, alcohol consumption, history of hypertension, aspirin use, vigorous exercise, and intakes, of monounsaturated fat, polyunsaturated fat, trans fat, protein, dietary cholesterol, dietary fiber, and total energy. |
| 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) | Saturated fat (not defined) |
RR = 1.07 (0.77-1.48; P = 0.37) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
10.7: RR = 1.
12.8: RR = 0.87 (0.68-1.11).
14.3: RR = 0.85 (0.65-1.11).
16.0: RR = 1.05 (0.79-1.40).
18.8: RR = 1.07 (0.77-1.48). | 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, monounsaturated fat, polyunsaturated fat, and trans unsaturated fats. |
| 13) Ascherio A (1996) | The Health Professionals Follow Up Study | 43,757 men aged 40-75.
(USA) | 6
(1986-1992) | See variables | Coronary heart disease | Saturated fat (not defined) |
Total MI (including non-fatal MI and fatal cHD):
(734 cases) | Fatal CHD:
(229 cases) |
RR = 0.96 (0.73-1.27; P = 0.69) for the highest vs lowest quintile of consumption.
Amount specific data (g/day):
17: RR = 1.
21: RR = 1.01 (0.79-1.30).
24: RR = 0.84 (0.65-1.10).
27: RR = 0.90 (0.69-1.18).
33: RR = 0.96 (0.73-1.27).
RR for a proportion of energy of 5%:
RR = 0.96 (0.81-1.13).
After additional adjustment for total fat: RR = 0.86 (0.66-1.12).
***RR = 1.11 (0.87-1.42) for the highest vs lowest quintile of consumption (n = 1,702 cases). Among men < 60 y: RR = 1.24 (0.87-1.77), and among men ≥ 60 y: RR = 1.01 (0.73-1.41).
|
RR = 1.72 (1.01-2.90; P = 0.09) for the highest vs lowest quintile of consumption.
Amount specific data (g/day):
17: RR = 1.
21: RR = 1.41 (0.87-2.31).
24: RR = 1.38 (0.83-2.28).
27: RR = 1.32 (0.79-2.22).
33: RR = 1.72 (1.01-2.90).
RR for a proportion of energy of 5%:
RR = 1.28 (0.97-1.70).
After additional adjustment for total fat: RR = 1.34 (0.86-2.08).
|
Because of the possibility that the lowest fifth of saturated fat intake comprised men who had modified their diet recently to reduce their blood cholesterol concentration we repeated the analyses after excluding from that fifth those men who at baseline reported reducing their intake of butter, meat, whole milk, or eggs during the previous 10 years.Age, BMI, smoking habits, alcohol consumption, physical activity, history of hypertension or high blood cholesterol, family history of before age 60, profession, and fibre intake. |
| 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) | Saturated fatty acids (not defined) | Cases consumed a higher % of calories from saturated fatty acids than noncases (P = 0.05). | 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 | Saturated fat (not defined) |
| Consumption in g: | Consumption in % of energy intake: |
| Cases consumed less saturated fat (54.6 g) than noncases (59.8 g; P = 0.094).
|
No significant difference in % of energy was found between cases (17.7) and controls (17.6; P = 0.820).
|
Unadjusted. |
| 7) Kromhout D (1982) | The Zutphen Study
(The Dutch part of The Seven Countries Study) | 871 men aged 40-59. | 10
(1960-?) | 27 | CHD death | Saturated fat (not defined) | No difference in intake was found between cases and controls (no data shown). | 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 | Saturated fat (not defined) | RR = 1.03 (0.97-1.09) 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) | Saturated fatty acids (not defined) |
Consumption in g:
Men aged 45-55
(99? cases) | Men aged 56-65
(114? cases) |
| RR = 0.82 (0.64-1.04) for consumption 30 g (NCEP recommendation) vs 45.3 g.
|
RR = 1.04 (0.86-1.26) for consumption 30 g (NCEP recommendation) vs 42.3 g.
|
Consumption in % of energy intake:
Men aged 45-55
(99? cases) | Men aged 56-65
(114? cases) |
| RR = 0.78 (0.61-1.00) for intake 10% (NCEP recommendation) vs 15.2%.
|
RR = 1.06 (0.86-1.30) for intake 10% (NCEP recommendation) vs 14.8%.
|
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 | Saturated fatty acids (not defined) | Cases consumed the same amount (46 g) as noncases (44 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 | Saturated 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 (43 g) as noncases (44 g).
|
Cases consumed the same amount (39 g) as noncases (44 g).
|
Cases consumed the same amount (47 g) as noncases (44 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 saturated fatty acids in the same % of calories (15.3) as noncases (14.9).
|
Cases consumed saturated fatty acids in the same % of calories (14.8) as noncases (14.9).
|
Cases consumed saturated fatty acids in the same % of calories (15.9) as noncases (14.9).
|
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 | Saturated fatty acids (not defined) | Cases consumed the same amount (34 g) as noncases (36 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 | Saturated 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 (35 g) as noncases (36 g).
|
Cases consumed the same amount (33 g) as noncases (36 g).
|
Cases consumed the same amount (36 g) as noncases (36 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 saturated fatty acids in the same % of calories (13.5) as noncases (13.3).
|
Cases consumed saturated fatty acids in the same % of calories (13.4) as noncases (13.3).
|
Cases consumed saturated fatty acids in the same % of calories (13.6) as noncases (13.3).
|
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 | Saturated 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 (36 g), and noncases (37 g).
Consumption in % of calories: No significant difference was found between cases (13.6%), and noncases (13.5%).
|
Consumption in g: No significant difference was found between cases (33 g), and noncases (33 g).
Consumption in % of calories: No significant difference was found between cases (13.1%), and noncases (12.6%).
|
MI and CHD death:
Urban men
(129 cases) | Rural men
(34 cases) |
Consumption in g: No significant difference was found between cases (34 g), and noncases (37 g).
Consumption in % of calories: No significant difference was found between cases (13.3%), and noncases (13.5%).
|
Consumption in g: No significant difference was found between cases (33 g), and noncases (33 g).
Consumption in % of calories: Cases consumed a higher % of calories from saturated fatty acids (14.0%), than noncases (12.6%; P = < 0.05).
|
CHD death:
Urban men
(57 cases) | Rural men
(14 cases) |
| Consumption in g: No significant difference was found between cases (35 g), and noncases (37 g).
|
Consumption in g: No significant difference was found between cases (30 g), and noncases (33 g).
|
Coronary insufficiency:
Urban men
(31 cases) | Rural men
(14 cases) |
| Consumption in g: No significant difference was found between cases (34 g), and noncases (37 g).
|
Consumption in g: No significant difference was found between cases (35 g), and noncases (33 g).
|
Angina pectoris:
Urban men
(53 cases) | Rural men
(25 cases) |
| Consumption in g: No significant difference was found between cases (40 g), and noncases (37 g).
|
Consumption in g: No significant difference was found between cases (30 g), and noncases (33 g).
|
Age. |
| 3) McGee (1985) | The Honolulu Heart Program | 7,088 men of Japanese ancestry without CVD or cancer, and living on the island of Oahu. | 10
(1965-68 to ?) | 99? | CHD death | Saturated fatty acids (not defined) |
| Consumption in g: | Consumption in % of calories: |
| No significant association was found (risk was > 1; no data shown).
|
A positive association was found (No data shown; P = < 0.05).
|
Age, systolic blood pressure, BMI, physical activity index, and cigarettes smoked per day. |
| 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) | Saturated 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 less (31.7 g) than controls (31.9 g).
***RR = 0.86 (0.67-1.12) for the highest vs lowest quintile of consumption (n = 1,177 cases). Among men < 60 y: RR = 0.92 (0.68-1.23), and among men ≥ 60 y: RR = 0.70 (0.41-1.20).
|
Cases did not consume significantly more (32.4 g) than controls (31.9 g).
|
Cases did not consume significantly less (30.4 g) than controls (31.9 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 consumed significantly more than controls (SLC = 0.18; P = < 0.01).
|
Cases did not consume significantly less than controls (SLC = -0.12).
|
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, polyunsaturated 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 | Saturated fatty acids (not defined) | Cases consumed the same amount (32 g) as noncases (32 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 | Saturated 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 (32 g) as noncases (32 g).
|
Cases consumed the same amount (31 g) as noncases (32 g).
|
Cases consumed the same amount (31 g) as noncases (32 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 saturated fatty acids in the same % of calories (12.7) as noncases (12.3).
|
Cases consumed saturated fatty acids in a higher % of calories (12.9) than noncases (12.3; P = < 0.05).
|
Cases consumed saturated fatty acids in the same % of calories (12.2) as noncases (12.3).
|
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.) | Saturated 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 saturated fatty acids (31 g/d) as noncases (32 g/d; P = not significant).
|
Cases consumed the same amount of saturated fatty acids (30 g/d) as noncases (32 g/d; P = not significant).
|
Cases consumed the same amount of saturated fatty acids (31 g/d) as noncases (32 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 saturated fatty acids (13 %) than noncases (12 %; P = < 0.05).
|
Cases consumed the same proportion of calories of saturated fatty acids (12 %) as noncases (12 %; P = not significant).
|
Cases consumed the same proportion of calories of saturated fatty acids (12 %) as noncases (12 %; P = not significant).
|
Age. |
| 2) Goldbourt U (1993) | The Israeli Ischemic Heart Disease (IIHD) Study | 10,059 male civil servants and municipal employees aged ≥ 40, and born in Europe, mideastern Asian, and northern Africa. | 23
(1963-68 to 1986) | 1,098? | CHD mortality | Saturated fat (not defined) |
| Absolute intake: | Intake as percent of fat: |
An inverse relationship (no data shown).
Amount specific data (Rates/10,000 person-years of follow-up by quintiles of consumption. Quintiles in g/week):
< 131: 61
131-173: 56
173-213: 54
214-267: 50
≥ 267: 49
In multivariate analysis, the adjustment for serum cholesterol eliminated the significance, and the age- and cholesterol-adjusted RR approached 1 (data not tabulated).
***RR = 0.86 (0.56-1.35) for the highest vs lowest quartile of consumption after adjustment for age, blood pressure, serum cholesterol, ever-smoking, and diabetes prevalence in 1963 (n = 1,070 cases). Among men < 60 y: RR = 1.05 (0.87-1.27), and among men ≥ 60 y: RR = 0.66 (0.44-1.00).
|
Percent of fat derived from saturated fat was related to increased CHD mortality (P = significant).
Amount specific data (Rates/10,000 person-years of follow-up by quintiles of consumption. Quintiles as percent of total fat):
< 27.6: 48
27.6-30.6: 55
30.6-33.3: 53
33.3-36.4: 57
≥ 36.4: 58
In multivariate analysis, the adjustment for serum cholesterol eliminated the significance, and the age- and cholesterol-adjusted RR approached 1 (data not tabulated).
|
Age. |
| 2) Medalie JH (1973) | No cohort name defined | 9,764 Israeli male government and municipal employees aged ≥ 40. | 5
(1963-1968) | ? | First MI incidence | Saturated fat (not defined) |
| Consumption in g/week: | Consumption in % of calories: |
No significant association was found.
Infarction incidence rate/1000 (grams per week):
20-159: IRR = 35
160-219: IRR = 47
220-679: IRR = 38
Very high vs very low consumption:
Infarction incidence rate for the highest vs lowest decile of consumption (43, and 34 for 320-679 vs 20-99 grams/week, respectively).
|
No significant association was found.
Infarction incidence rate/1000 (% of calories from saturated fat/week):
1-9: IRR = 41
10-12: IRR = 42
13-49: IRR = 42
Very high vs very low consumption:
Infarction incidence rate for the highest vs lowest decile of consumption (47, and 42 for 15-49 vs 1-5% of calories, respectively).
|
Age-area adjusted. |
| 1) Shekelle RB (1981) | The Western Electric Study | 1,900 men aged 40-55 who were free of CHD | 19
(1957-?) | ? | CHD death | Saturated fatty acids (not defined) |
No significant association was found for the highest vs lowest tertile of consumption in % of cal. (P = 0.144).
Amount specific data (Tertiles not defined):
T1: 10.9
T2: 11.2
T3: 11.8.
***No significant association (P = 0.14; n = 215 cases). | Age, systolic blood pressure, number of cigarettes/day, serum cholesterol, alcoholic drinks/month, BMI, and ethnicity. |
1) Paul O/
Oglesby P (1963) | The Western Electric Study | 1,885 American men of Polish and Bohemian ancestry aged 40-55 without a history of MI or angina pectoris. | 4.5
(1957-?) | 88? | CHD risk (angina pectoris, MI, or CHD death. excluding sudden death) | Total saturated fatty acids (not defined) | No significant difference was apparent between cases (59 g/day), and controls (59 g/day; no data shown). | Unadjusted. |
Prospective studies of saturated 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 | Saturated fat (not defined) | HR = 1.7 (0.8-2.3) for the highest vs lowest quintile of consumption. | 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. |
| 39) Yamagishi K (2010) | The JACC Study (Japan Collaborative Cohort Study for Evaluation of Cancer Risk) | 58,453 subjects (23,024 men and 35,429 women) aged 40-79, and without heart disease, stroke, or cancer. | 14.1
(1988-90 to 1999-2003) | 976 | Total stroke mortality (intraparenchymal hemmorhage, subarachnoid hemmorhage, and ischemic stroke) | Saturated fatty acids (not defined) |
HR = 0.69 (0.53-0.89; P = 0.004) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
2.5-< 11.0: HR = 1.
11.0-< 13.4: HR = 0.90 (0.74-1.09).
13.4-< 15.4: HR = 0.89 (0.72-1.10).
15.4-< 17.9: HR = 0.80 (0.64-1.00).
17.9-40.0: HR = 0.69 (0.53-0.89).
This association remained after adjustment for animal protein: HR = 0.67 (0.49-0.92; P = 0.01), but became nonsignficant after additional adjustment for MUFA: HR = 0.75 (0.53-1.05; P = 0.10).
Intraparenchymal hemorrhage
(224 cases) | Subarachnoid hemorrhage
(153 cases) | Ischemic stroke
(321 cases) |
HR = 0.48 (0.27-0.85; P = 0.03) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
2.5-< 11.0: HR = 1.
11.0-< 13.4: HR = 0.87 (0.58-1.29).
13.4-< 15.4: HR = 0.89 (0.58-1.36).
15.4-< 17.9: HR = 0.90 (0.57-1.42).
17.9-40.0: HR = 0.48 (0.27-0.85).
This association remained after adjustment for animal protein: HR = 0.45 (0.22-0.89; P = 0.048).
|
HR = 0.91 (0.46-1.80; P = 0.47) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
2.5-< 11.0: HR = 1.
11.0-< 13.4: HR = 1.77 (1.08-2.89).
13.4-< 15.4: HR = 1.12 (0.64-1.98).
15.4-< 17.9: HR = 1.22 (0.68-2.20).
17.9-40.0: HR = 0.91 (0.46-1.80).
|
HR = 0.58 (0.37-0.90; P = 0.01) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
2.5-< 11.0: HR = 1.
11.0-< 13.4: HR = 0.74 (0.53-1.04).
13.4-< 15.4: HR = 0.79 (0.55-1.14).
15.4-< 17.9: HR = 0.63 (0.42-0.93).
17.9-40.0: HR = 0.58 (0.37-0.90).
This association remained after adjustment for animal protein: HR = 0.56 (0.32-0.97; P = 0.046).
|
No interaction was found with sex for any mortality end point.Age, sex, history of hypertension and diabetes, smoking status, alcohol consumption, BMI, mental stress, walking, sport, educational level, dietary intakes of total energy, cholesterol, omega-3 and omega-6 polyunsaturated fatty acids, vegetables, and fruit. |
| 34) Ness AR (2005) | The Boyd Orr Cohort | 4,028 people (1,995 men, and 2,033 women) from England and Scotland. | average 37
(1948 to 2000) | 83 | Stroke mortality | Saturated fat (not defined) |
RR = 1.31 (0.49-3.47; P = 0.9) for the highest vs lowest quartile of consumption.
Amount specific data (g):
8.8-24.0: RR = 1.
24.0-31.4: RR = 1.37 (0.74-2.51).
31.4-40.4: RR = 0.71 (0.32-1.58).
40.6-108.9: RR = 1.31 (0.49-3.47). | Age, energy, sex, childhood family food expenditure, father's social class, district of residence as a child, period of birth, season when studied as a child, and Townsend score for current address or place of death. |
| 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 | Saturated fat (not defined) |
***RR = 1.22 (0.91-1.64) for the highest vs lowest quartile of consumption (22.3 vs 12.3% of total energy).
| Women | Men |
HR = 1.26 (0.81-1.96; P = 0.6) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
12.2: HR = 1.
15.2: HR = 1.27 (0.88-1.83).
17.5: HR = 0.96 (0.64-1.45).
21.8: HR = 1.26 (0.81-1.96).
|
HR = 1.19 (0.80-1.77; P = 0.3) for the highest vs lowest quartile of consumption.
Amount specific data (% energy intake):
12.3: HR = 1.
15.3: HR = 0.96 (0.69-1.34).
17.7: HR = 1.15 (0.81-1.64).
22.3: HR = 1.19 (0.80-1.77).
|
Age, smoking habits, alcohol consumption, socioeconomic status, marital status, physical activity, BMI, fiber 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 | Saturated fatty acids (not defined) |
RH = 0.58 (0.28-1.20; P = 0.1449) for the highest vs lowest tertile of consumption.
Amount specific data (g/day):
7: RH = 1.
12: RH = 0.85 (0.46-1.54).
21: RH = 0.58 (0.28-1.20).
This association changed after additional adjustment for cholesterol intake: RH = 1.49 (0.70-3.17; P = 0.271). | 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) | 67 | Intraparenchymal hemorrhage incidence (lasting ≥ 24 hours or until death) | Saturated fat (not defined) |
RR = 0.30 (0.12-0.71; P = 0.005) for the highest vs lowest quartile of consumption.
Amount specific data (g/day):
5.2: RR = 1.
8.4: RR = 0.77 (0.42-1.42).
11.9: RR = 0.66 (0.34-1.25).
17.1: RR = 0.30 (0.12-0.71).
Effect modification:
RR = 0.72 (0.52-1.00) among hypertensives, and 0.36 (0.14-0.95) among nonhypertensives for 1 SD increase in intake (5.4 g/day).
RR = 3.91 (0.81-18.8; P = 0.04) among women, and 2.51 (0.85-7.43; P = 0.12) among men for the lowest vs highest quartile of consumption.
Associations did not vary according to BMI or serum glucose.
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 | Saturated fat (not defined) |
RR = 1.2 (0.9-1.8) for the highest vs lowest tertile of consumption.
Amount specific data (Tertiles not defined):
T1: RR = 1.
T2: RR = 1.3 (0.9-1.9).
T3: RR = 1.2 (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 | Saturated fat (not defined) |
***RR for total stroke = 0.79 (0.52-1.19) for the highest vs lowest quintile of consumption (31 vs 17 g/d. n = 598 cases). Among men < 60 y: RR = 0.72 (0.35-1.51), and among men ≥ 60 y: RR = 0.82 (0.49-1.36).
Ischaemic stroke
(embolism or thrombosis)
(455 cases) | Haemorrhagic stroke
(subarachnoid and intracerebral)
(125 cases) |
RR = 1.21 (0.75-1.97; P = 0.63) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
17: RR = 1.
21: RR = 1.24 (0.87-1.76).
24: RR = 1.26 (0.84-1.88).
26: RR = 1.13 (0.73-1.76).
31: RR = 1.21 (0.75-1.97).
|
RR = 1.17 (0.45-3.07; P = 0.83) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
17: RR = 1.
21: RR = 1.30 (0.64-2.64).
24: RR = 1.93 (0.91-4.08).
26: RR = 1.56 (0.67-3.67).
31: RR = 1.17 (0.45-3.07).
|
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, polyunsaturated fat, monounsaturated 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 | Saturated fat (not defined) |
RR = 1.05 (0.32-3.39; P = 0.83) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
20: RR = 1.
25: RR = 0.35 (0.14-0.86).
28: RR = 0.54 (0.20-1.41).
31: RR = 0.63 (0.22-1.83).
36: RR = 1.05 (0.32-3.39).
RR for primary hemmorhages = 3.08 (1.09-8.74) for the lowest decile compared with all higher levels of intake, and 2.72 (1.13-6.54) for the second lowest decile.
Stratified by history of hypertension:
With
(30 cases) | Without
(44 cases) |
RR = 0.22 (0.13-1.72; P = 0.10) for the highest vs lowest quintile of consumption.
Amount specific data (Quintiles):
Q1: RR = 1.
Q2: RR = 0.17 (0.04-0.85).
Q3: RR = 0.50 (0.11-2.21).
Q4: RR = 0.37 (0.06-2.19).
Q5: RR = 0.22 (0.13-1.72).
|
RR = 2.41 (0.54-10.7; P = 0.12) for the highest vs lowest quintile of consumption.
Amount specific data (Quintiles):
Q1: RR = 1.
Q2: RR = 0.54 (0.17-1.71).
Q3: RR = 0.63 (0.17-2.34).
Q4: RR = 0.89 (0.22-3.58).
Q5: RR = 2.41 (0.54-10.7).
|
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, total energy, dietary cholesterol, fat, and protein. |
| 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) | Saturated fat (not defined) | Cases did not consume significantly more (15.2% kcal) than controls (14.6% 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 | Saturated fat (not defined) |
| Men: | Women: |
| Cases consumed the same amount (14.9 g) as noncases (15.1 g; P = 0.62).
|
Cases consumed the same amount (11.4 g) as noncases (12.2 g; P = 0.61).
|
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) | Saturated fat (not defined) |
RR = 0.68 (0.21-2.26; P = 0.56) for the highest vs lowest quartile of consumption.
Amount specific data (g/day):
7.2: RR = 1.
9.8: RR = 0.90 (0.46-1.76).
12.1: RR = 1.10 (0.47-2.59).
15.4: RR = 0.68 (0.21-2.26). | 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) | Saturated fat (not defined) | Stroke cases consumed the same amount (17.3% of energy) as noncases (16.9% 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) | Saturated fat (not defined) |
RR = 0.90 (0.83-0.96) 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 = 0.90 (0.83-0.97) for each increment of 1% of total energy.
|
RR = 1.03 (0.93-1.14) 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. |
| 47) Siri-Tarino PW (2010) | The Honolulu Heart Study | 8,006 men aged 45-68. | Not defined. | 492 | Total stroke | Saturated fat (not defined) |
RR = 1.04 (0.72-1.50) for the highest vs lowest quintile of consumption (not defined).
Stratified by age:
| < 60 y: | ≥ 60 y: |
| RR = 0.95 (0.60-1.50).
|
RR = 1.23 (0.66-2.29).
|
Age, total energy, systolic blood pressure, BMI, smoking, family history of myocardial infarction, physical activity, intakes of PUFA's alcohol, protein, carbohydrate, vegetables, and cholesterol. |
| 3) McGee (1985) | The Honolulu Heart Program | 7,088 men of Japanese ancestry without CVD or cancer, and living on the island of Oahu. | 10
(1965-68 to ?) | 61? | Stroke death | Saturated fatty acids (not defined) |
| Consumption in g: | Consumption in % of calories: |
| No significant association was found (risk was < 1; no data shown).
|
An inverse association was found (No data shown; P = < 0.05).
|
Age, systolic blood pressure, BMI, physical activity index, and cigarettes smoked per day. |
| 3) Kagan A (1985) | The Honolulu Heart Program | 7,088 men aged 45-68 of Japanese ancestry on the island of Oahu. | 10
(1965-68 to ?) | 208?
(134 thrombo-embolic stroke, and 58 intracranial hemorrhage) | Stroke incidence | Saturated fat (not defined) | Fat intake was inversely related to the incidence of thrombo-embolic stroke as well as to the overall category of total stroke but there was no relation to the development of intracranial hemorrhage. However, the increasing risk of stroke was apparent only for the lowest quintile group of fat intake. A similar relation was found for the intake of saturated fatty acids as well.
The inverse relationship to fat intake became non-significant when blood pressure, left ventricular hypertrophy, serum glucose, cigarette smoking, and proteinuria were included in the model. | Age. |
| 3) Takeya Y (1984) | The Ni-Hon-San Study
(including The Honolulu Heart Study/Program) | I: 1,366 men aged 45-69 in Japan, and
II: 7,895 Japanese-American men aged 45-68 in Hawaii. | I: 4
(1972-74 to ?)
II: 6
(1965-68 to ?) | See variables | Stroke incidence (intracranial hemorrhage [intracerebral hemorrhage, and subarachnoid hemorrhage], and thrombo-embolic stroke) | Saturated fat (not defined) |
No significant association with total stroke incidence was found (in Japan, and in Hawaii) in an analysis including systolic blood pressure, serum cholesterol, relative body weight, hematocrit, proteinuria, LVH in ECG, alcohol, animal protein, cigarettes/day, calories/body weight, and age.
Japan:
Intracranial hemorrhage
(18? cases) | Thromboembolic stroke
(44? cases) |
| Cases did not consume significantly less (10.9 g) than controls (17.7 g).
|
Cases consumed significantly less (9.0 g) than controls (17.7 g; P = < 0.05).
|
Hawaii:
Intracranial hemorrhage
(34? cases) | Thromboembolic stroke
(74? cases) |
| Cases consumed significantly less (41.1 g) than controls (55.1 g; P = < 0.001).
|
Cases did not consume significantly less (53.3 g) than controls (55.1 g).
|
Age. |
| 47) Siri-Tarino PW (2010) | The Israeli Ischemic Heart Disease Study | 9,767 men aged ≥ 40. | Not defined. | 362 | Fatal stroke | Saturated fat (not defined) |
RR = 0.92 (0.56-1.51) for the highest vs lowest quartile of consumption.
Stratified by age:
| < 60 y: | ≥ 60 y: |
| RR = 0.75 (0.54-1.05).
|
RR = 1.26 (0.70-2.29).
|
Age, body height, blood pressure, smoking, and diabetes. |
Prospective studies of saturated fat and cardiovascular disease, other than CHD and stroke:
| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments |
| 37) Steffen LM (2007) | The LITE (Longitudinal Investigation of Thromboembolism Etiology)
(Using only data from the ARIC Cohort) | 14,962 black and white man and women aged 45-64 without a history of VTE.
(USA) | 12
(1987-89 to 2001) | 197 | Venous thromboembolism incidence | Saturated fatty acids (not defined) |
HR = 1.14 (0.43-3.00; P = 0.78) for the highest vs lowest quintile of consumption.
Amount specific data (g/d):
< 13.5: HR = 1.
13.5-17.7: HR = 1.29 (0.81-2.06).
17.7-22.0: HR = 0.84 (0.46-1.51).
22.0-28.1: HR = 1.40 (0.72-2.73).
> 28.1: HR = 1.14 (0.43-3.00).
The association did not change after additional adjustment for smoking, physical activity, alcohol intake, and HRT.
Results were similar among subjects with idiopathic VTE (111 cases; No data shown). | Age, race, gender, field center, energy vitamin supplement use, BMI, diabetes, folate, vitamin B6, and Omega-3 fatty acids. |
| 22) Lutsey PL (2009) | The Iowa Women's Health Study | 37,393 women aged 55-69. | 19
(1986-2004) | 1,950? | Venous thromboembolism incidence | Saturated fat (not defined) | No association was found (no data shown). | Age, kcal, education, smoking status, and physical activity. |
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
