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dc.contributor.authorSteur, Marinka
dc.contributor.authorJohnson, Laura
dc.contributor.authorSharp, Stephen J.
dc.contributor.authorImamura, Fumiaki
dc.contributor.authorSluijs, Ivonne
dc.contributor.authorKey, Timothy J.
dc.contributor.authorWood, Angela M.
dc.contributor.authorChowdhury, Rajiv
dc.contributor.authorGuevara, Marcela
dc.contributor.authorJakobsen, Marianne Uhre
dc.contributor.authorJohansson, Ingegerd
dc.contributor.authorKoulman, Albert
dc.contributor.authorOvervad, Kim
dc.contributor.authorSánchez, Maria-José
dc.contributor.authorvan der Schouw, Yvonne T.
dc.contributor.authorTrichopoulou, Antonia
dc.contributor.authorWeiderpass, Elisabete
dc.contributor.authorWennberg, Maria
dc.contributor.authorZheng, Ju-Sheng
dc.contributor.authorBoeing, Heiner
dc.contributor.authorBoer, Jolanda M. A.
dc.contributor.authorBoutron-Ruault, Marie-Christine
dc.contributor.authorEricson, Ulrika
dc.contributor.authorHeath, Alicia K.
dc.contributor.authorHuybrechts, Inge
dc.contributor.authorImaz, Liher
dc.contributor.authorKaaks, Rudolf
dc.contributor.authorKrogh, Vittorio
dc.contributor.authorKühn, Tilman
dc.contributor.authorKyrø, Cecilie
dc.contributor.authorMasala, Giovanna
dc.contributor.authorMelander, Olle
dc.contributor.authorMoreno-Iribas, Conchi
dc.contributor.authorPanico, Salvatore
dc.contributor.authorQuirós, José R.
dc.contributor.authorRodríguez-Barranco, Miguel
dc.contributor.authorSacerdote, Carlotta
dc.contributor.authorSantiuste, Carmen
dc.contributor.authorSkeie, Guri
dc.contributor.authorTjønneland, Anne
dc.contributor.authorTumino, Rosario
dc.contributor.authorMonique Verschuren, Verschuren
dc.contributor.authorZamora-Ros, Raúl
dc.contributor.authorDahm, Christina C.
dc.contributor.authorPerez-Cornago, Aurora
dc.contributor.authorSchulze, Matthias B.
dc.contributor.authorTong, Tammy Y.N.
dc.contributor.authorRiboli, Elio
dc.contributor.authorWareham, Nick
dc.contributor.authorDanesh, John
dc.contributor.authorButterworth, Adam S.
dc.contributor.authorForouhi, Nita G.
dc.date.accessioned2022-03-08T08:57:15Z
dc.date.available2022-03-08T08:57:15Z
dc.date.issued2021-12-07
dc.description.abstractBACKGROUND: There is controversy about associations between total dietary fatty acids, their classes (saturated fatty acids [SFAs], monounsaturated fatty acids, and polyunsaturated fatty acids), and risk of coronary heart disease (CHD). Specifically, the relevance of food sources of SFAs to CHD associations is uncertain.<p> METHODS AND RESULTS: We conducted a case-cohort study involving 10 529 incident CHD cases and a random subcohort of 16 730 adults selected from a cohort of 385 747 participants in 9 countries of the EPIC (European Prospective Investigation into Cancer and Nutrition) study. We estimated multivariable adjusted country-specific hazard ratios (HRs) and 95% CIs per 5% of energy intake from dietary fatty acids, with and without isocaloric macronutrient substitutions, using Prentice-weighted Cox regression models and pooled results using random-effects meta-analysis. We found no evidence for associations of the consumption of total or fatty acid classes with CHD, regardless of macronutrient substitutions. In analyses considering food sources, CHD incidence was lower per 1% higher energy intake of SFAs from yogurt (HR, 0.93 [95% CI, 0.88–0.99]), cheese (HR, 0.98 [95% CI, 0.96–1.00]), and fish (HR, 0.87 [95% CI, 0.75–1.00]), but higher for SFAs from red meat (HR, 1.07 [95% CI, 1.02–1.12]) and butter (HR, 1.02 [95% CI, 1.00–1.04]).<p> CONCLUSIONS: This observational study found no strong associations of total fatty acids, SFAs, monounsaturated fatty acids, and polyunsaturated fatty acids, with incident CHD. By contrast, we found associations of SFAs with CHD in opposite directions dependent on the food source. These findings should be further confirmed, but support public health recommendations to consider food sources alongside the macronutrients they contain, and suggest the importance of the overall food matrix.en_US
dc.identifier.citationSteur, Johnson, Sharp, Imamura, Sluijs, Key, Wood, Chowdhury, Guevara, Jakobsen, Johansson, Koulman, Overvad, Sánchez, van der Schouw, Trichopoulou, Weiderpass, Wennberg, Zheng, Boeing, Boer, Boutron-Ruault, Ericson, Heath, Huybrechts, Imaz, Kaaks, Krogh, Kühn, Kyrø, Masala, Melander, Moreno-Iribas, Panico, Quirós, Rodríguez-Barranco, Sacerdote, Santiuste, Skeie, Tjønneland, Tumino, Monique Verschuren, Zamora-Ros, Dahm, Perez-Cornago, Schulze, Tong, Riboli, Wareham, Danesh, Butterworth, Forouhi. Dietary fatty acids, macronutrient substitutions, food sources and incidence of coronary heart disease: Findings from the EPIC-CVD case-cohort study across nine european countries. Journal of the American Heart Association (JAHA). 2021;10(23):1-37en_US
dc.identifier.cristinIDFRIDAID 2007110
dc.identifier.doi10.1161/JAHA.120.019814
dc.identifier.issn2047-9980
dc.identifier.urihttps://hdl.handle.net/10037/24318
dc.language.isoengen_US
dc.publisherAmerican Heart Associationen_US
dc.relation.journalJournal of the American Heart Association (JAHA)
dc.relation.projectIDinfo:eu-repo/grantAgreement/EC/FP7-HEALTH/279233/United Kingdom/Individualised CVD risk assessment: tailoring targeted and cost-effective approaches to Europe's diverse populations/EPIC-CVD/en_US
dc.relation.projectIDinfo:eu-repo/grantAgreement/EC/FP7-IDEAS-ERC/268834/United Kingdom/Interplay of genetic, nutrient and lifestyle factors on incidence of coronary disease/EPICHEART/en_US
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2021 The Author(s)en_US
dc.titleDietary fatty acids, macronutrient substitutions, food sources and incidence of coronary heart disease: Findings from the EPIC-CVD case-cohort study across nine european countriesen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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