Impact of nonoptimal intakes of saturated, polyunsaturated, and trans fat on global burdens of coronary heart disease

Qianyi Wang, Ashkan Afshin, Mohammad Yawar Yakoob, Gitanjali M. Singh, Colin D. Rehm, Shahab Khatibzadeh, Renata Micha, Peilin Shi, Dariush Mozaffarian, Majid Ezzati, Saman Fahimi, Pattra Wirojratana, John Powles, Ibrahim Elmadfa, Mayuree Rao, Warren Alpert, Stephen S. Lim, Rebecca E. Engell, Kathryn G. Andrews, Pamela A. AbbottMorteza Abdollahi, Enrique O. Abeyá Gilardon, Habibul Ahsan, Mohannad Abed Alfattah Al Nsour, Suad N. Al-Hooti, Carukshi Arambepola, Dulitha N. Fernando, Hubert Barennes, Simon Barquera, Ana Baylin, Wulf Becker, Peter Bjerregaard, Lesley T. Bourne, Mario V. Capanzana, Katia Castetbon, Hsing Yi Chang, Yu Chen, Melanie J. Cowan, Leanne M. Riley, Stefaan De Henauw, Eric L. Ding, Charmaine A. Duante, Pablo Duran, Heléne Enghardt Barbieri, Farshad Farzadfar, Aida Filipovic Hadziomeragic, Regina M. Fisberg, Simon Forsyth, Didier Garriguet, Jean Michel Gaspoz, Dorothy Gauci, Neville Calleja, Brahmam N.V. Ginnela, Idris Guessous, Martin C. Gulliford, Wilbur Hadden, Christian Haerpfer, Daniel J. Hoffman, Anahita Houshiar-Rad, Inge Huybrechts, Nahla C. Hwalla, Hajah Masni Ibrahim, Manami Inoue, Maria D. Jackson, Lars Johansson, Lital Keinan-Boker, Cho il Kim, Eda Koksal, Hae Jeung Lee, Yanping Li, Nur Indrawaty Lipoeto, Guansheng Ma, Guadalupe L. Mangialavori, Yasuhiro Matsumura, Stephen T. McGarvey, Chan Mei Fen, Rafael A. Monge-Rojas, Abdulrahman Obaid Musaiger, Balakrishna Nagalla, Androniki Naska, Marga C. Ocke, Maciej Oltarzewski, Lucjan Szponar, Philippos Orfanos, Marja Leena Ovaskainen, Heli Tapanainen, Wen Harn Pan, Demosthenes B. Panagiotakos, Gulden Ayla Pekcan, Stefka Petrova, Noppawan Piaseu, Christos Pitsavos, Luz Gladys Posada, Luz Maria Sánchez-Romero, Rusidah B.T. Selamat, Sangita Sharma, Abla Mehio Sibai, Rosely Sichieri, Chansimaly Simmala, Laufey Steingrimsdottir, Gillian Swan, Elzbieta Halina Sygnowska, Robert Templeton, Anastasia Thanopoulou, Holmfridur Thorgeirsdóttir, Inga Thorsdottir, Antonia Trichopoulou, Shoichiro Tsugane, Aida Turrini, Sirje Vaask, Coline van Oosterhout, J. Lennert Veerman, Nowak Verena, Anna Waskiewicz, Sahar Zaghloul, Gábor Zajkás

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Saturated fat (SFA), x-6 (n-6) polyunsaturated fat (PUFA), and trans fat (TFA) influence risk of coronary heart disease (CHD), but attributable CHD mortalities by country, age, sex, and time are unclear. Methods and Results: National intakes of SFA, n-6 PUFA, and TFA were estimated using a Bayesian hierarchical model based on country-specific dietary surveys; food availability data; and, for TFA, industry reports on fats/oils and packaged foods. Etiologic effects of dietary fats on CHD mortality were derived from meta-analyses of prospective cohorts and CHD mortality rates from the 2010 Global Burden of Diseases study. Absolute and proportional attributable CHD mortality were computed using a comparative risk assessment framework. In 2010, nonoptimal intakes of n-6 PUFA, SFA, and TFA were estimated to result in 711 800 (95% uncertainty interval [UI] 680 700-745 000), 250 900 (95% UI 236 900-265 800), and 537 200 (95% UI 517 600-557 000) CHD deaths per year worldwide, accounting for 10.3% (95% UI 9.9%-10.6%), 3.6%, (95% UI 3.5%-3.6%) and 7.7% (95% UI 7.6%-7.9%) of global CHD mortality. Tropical oil-consuming countries were estimated to have the highest proportional n-6 PUFA- and SFAattributable CHD mortality, whereas Egypt, Pakistan, and Canada were estimated to have the highest proportional TFA-attributable CHD mortality. From 1990 to 2010 globally, the estimated proportional CHD mortality decreased by 9% for insufficient n-6 PUFA and by 21% for higher SFA, whereas it increased by 4% for higher TFA, with the latter driven by increases in low- and middle-income countries. Conclusions: Nonoptimal intakes of n-6 PUFA, TFA, and SFA each contribute to significant estimated CHD mortality, with important heterogeneity across countries that informs nation-specific clinical, public health, and policy priorities.

Original languageEnglish (US)
Article numbere002891
JournalJournal of the American Heart Association
Volume5
Issue number1
DOIs
StatePublished - Jan 1 2016

Keywords

  • Cardiovascular disease
  • Coronary heart disease
  • Dietary fat
  • Saturated fat
  • Trans fat
  • X-6 polyunsaturated fat

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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