Journal Name:
Arch Intern Med
Article Title:
Dietary Lipid Predictors of Coronary Heart Disease in Men
Date Written:
1991
Volume:
151
Number:
Page:
1181
Author(s):
Millen Posner, B.; Cobb, J.; Belanger, A.; Cupples, A.; D'Agostino, B.; Stokes, J.
Article:
Dietary intervention is an effective method for the prevention and treatment of cardiovascular disease (CVD). CVD remains a major cause of mortality in the US and places a significant economic burden on society in terms of treatment costs, disability, and death. More than a dozen national and international groups have established dietary recommendations as a form of prevention of CVD. All agree that a diet lower in total fat, particularly saturated fat, and reduced cholesterol intake will favorably impact incidence of CVD. Using data from the Framingham study, the objective of this study was to examine the association between the 16-year incidence of CHD and total dietary fat, saturated fat (SFA), monounsaturated fat (MUFA), polyunsaturated fat (PUFA), and cholesterol.
The Framingham study was initiated in 1948 and consisted of a cohort of 5209 men and women 30-62 years of age who were followed for a 16-year period to assess CVD risk, heart disease morbidity and mortality, and all-cause mortality. Follow up in this cohort was performed biennially over a 16-year period. Details of this study are reported elsewhere. For the purpose of the present study, data for all male subjects between the ages of 45 and 65 years in 1966-1969 (n=859), were included in an assessment of dietary intake. Due to age related differences in CHD risk, the sample was divided into two age groups: 45 - 50 years (n=420), and 56 - 65 years (n=393). At initiation of follow up (1966-1969), trained interviewers obtained information on the individual's previous 24-hour dietary intake, and nutrient intake estimates were calculated based on information available at the time. Subjects were considered to have developed CHD if upon review they had developed angina pectoris, coronary insufficiency, myocardial infarction, sudden death, or non sudden death from CHD.
Ninety-nine men in the younger cohort and 114 men in the older cohort developed CHD during the 16 year follow up. A significant positive association between incidence of CHD and both total fat and MUFA (as % energy) was observed in the younger cohort. In this same group, a marginally significant association between intake of SFA and CHD was also observed. A statistically significant association between PUFA or cholesterol intake and CHD in younger group of men was not found. In contrast, none of the dietary lipids were associated with CHD in the older cohort.
These data suggest that higher levels of SFA and MUFA are associated with higher CHD morbidity and mortality in men aged 45-50 years. These results are in conflict with a number of previous studies that observed a favorable effect of MUFAs on serum lipoproteins and CHD. These researchers note, however, that previous studies observing a beneficial effect of MUFAs on CHD involved MUFAs obtained largely from vegetable oil sources. In the present study, MUFAs were derived largely from animal food products concentrated in both MUFAs and SFAs, as demonstrated by the high degree of correlation between these variables. This, coupled with measurement of dietary intake, may have influenced these results., , , , ,
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