Dietary fat intake and risk of cardiovascular disease and all-cause mortality in a population at high risk of cardiovascular disease
Dietary fat intake and risk of cardiovascular disease and all-cause mortality in a population at high risk of cardiovascular disease
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DOI：
10.3945/ajcn.115.116046
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发表时间：
2015-12-01
影响因子：
7.1
通讯作者：
Salas-Salvado, Jordi
中科院分区：
文献类型：
--
作者：
Guasch-Ferre, Marta;Babio, Nancy;Salas-Salvado, Jordi
背景资料：膳食脂肪的质量和脂肪替代更重要的心血管疾病（CVD）的预防比总膳食脂肪intake.Objective：目的是评估总脂肪摄入量和脂肪亚型与CVD（心肌梗死，中风，或心血管原因死亡）和心血管和全因死亡的风险之间的关联。我们还研究了一种常量营养素替代另一种常量营养素的等热量的假设效果。设计：我们前瞻性地研究了7038名参与者在高心血管疾病风险的PREvencion CON DIeta MEDIPEEA（PREDIMED）研究。该试验于2003年至2010年进行，但目前的分析是基于2012年之前的扩展随访。在基线和此后每年，总脂肪和特定脂肪亚型重复测量使用验证的食物频率问卷。时间依赖的考克斯比例风险models.Results：经过6年的随访，我们记录了336例CVD病例和414例死亡。总脂肪、单不饱和脂肪酸（MUFA）和多不饱和脂肪酸（PUFA）摄入量最高的五分位组与最低五分位组相比，CVD的HR（95% CI）分别为0.58（0.39，0.86）、0.50（0.31，0.81）和0.68（0.48，0.96）。在极端五分位数之间的比较中，较高的饱和脂肪酸（SFA）和反式脂肪摄入量与CVD风险增加81%（HR：1.81; 95% CI：1.05，3.13）和67%（HR：1.67; 95% CI：1.09，2.57）相关。PUFA和MUFA摄入量与全因死亡也呈负相关。用MUFA和PUFA等热量替代SFA或用MUFA替代反式脂肪与CVD风险降低相关。来自糕点和加工食品的SFA与较高的CVD风险相关。结论：摄入MUFAs和PUFAs与较低的CVD和死亡风险相关，而SFA和反式脂肪摄入与较高的CVD风险相关。用MUFAs和PUFAs替代SFA或用MUFAs替代反式脂肪与CVD呈负相关。
Background: Dietary fat quality and fat replacement are more important for cardiovascular disease (CVD) prevention than is total dietary fat intake.Objective: The aim was to evaluate the association between total fat intake and fat subtypes with the risk of CVD (myocardial infarction, stroke, or death from cardiovascular causes) and cardiovascular and all-cause death. We also examined the hypothetical effect of the isocaloric substitution of one macronutrient for another.Design: We prospectively studied 7038 participants at high CVD risk from the PREvencion con DIeta MEDiterranea (PREDIMED) study. The trial was conducted from 2003 to 2010, but the present analysis was based on an expanded follow-up until 2012. At baseline and yearly thereafter, total and specific fat subtypes were repeatedly measured by using validated food-frequency questionnaires. Time-dependent Cox proportional hazards models were used.Results: After 6 y of follow-up, we documented 336 CVD cases and 414 total deaths. HRs (95% CIs) for CVD for those in the highest quintile of total fat, monounsaturated fatty acid (MUFA), and polyunsaturated fatty acid (PUFA) intake compared with those in the lowest quintile were 0.58 (0.39, 0.86), 0.50 (0.31, 0.81), and 0.68 (0.48, 0.96), respectively. In the comparison between extreme quintiles, higher saturated fatty acid (SFA) and trans-fat intakes were associated with 81% (HR: 1.81; 95% CI: 1.05, 3.13) and 67% (HR: 1.67; 95% CI: 1.09, 2.57) higher risk of CVD. Inverse associations with all-cause death were also observed for PUFA and MUFA intakes. Isocaloric replacements of SFAs with MUFAs and PUFAs or trans fat with MUFAs were associated with a lower risk of CVD. SFAs from pastries and processed foods were associated with a higher risk of CVD.Conclusions: Intakes of MUFAs and PUFAs were associated with a lower risk of CVD and death, whereas SFA and trans-fat intakes were associated with a higher risk of CVD. The replacement of SFAs with MUFAs and PUFAs or of trans fat with MUFAs was inversely associated with CVD.