Table 2.
Multivariable-adjusted hazard ratios (95% confidence intervals) for incident ischemic stroke by quintiles of dietary fat intake, WHI-OS,” 1993–2005†
| Dietary fat intake | Quintiles
|
P for trend | ||||
|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | ||
| Total fat, median intake, g/d | 40.8 | 41.9 | 43.8 | 51.3 | 75.2 | |
| Events, n | 188 | 186 | 203 | 218 | 254 | |
| Person-time, 104 yr | 13.5 | 13.5 | 13.3 | 13.1 | 12.9 | |
| Model 1§ | 1 (ref) | 0.96 (0.78, 1.18) | 1.04 (0.85, 1.27) | 1.11 (0.91, 1.35) | 1.38 (1.14, 1.66) | 0.0002 |
| Model 2|| | 1 (ref) | 0.88 (0.70, 1.10) | 0.91 (0.73, 1.14) | 0.97 (0.78, 1.22) | 1.16 (0.94, 1.44) | 0.07 |
| Model 3¶ | 1 (ref) | 0.90 (0.71, 1.13) | 0.93 (0.73, 1.19) | 1.00 (0.78, 1.28) | 1.20 (0.92, 1.57) | 0.09 |
| TFA, median intake, g/d | 2.2 | 2.3 | 2.6 | 3.4 | 6.1 | |
| Events, n | 154 | 197 | 224 | 223 | 251 | |
| Person-time, 104 yr | 13.4 | 13.4 | 13.3 | 13.2 | 13.1 | |
| Model 1 | 1 (ref) | 1.22 (0.99, 1.51) | 1.37 (1.11, 1.68) | 1.33 (1.09, 1.64) | 1.49 (1.22, 1.82) | 0.0002 |
| Model 2 | 1 (ref) | 1.23 (0.98, 1.56) | 1.30 (1.03, 1.65) | 1.16 (0.91, 1.48) | 1.38 (1.10, 1.74) | 0.02 |
| Model 3 | 1 (ref) | 1.26 (0.99, 1.61) | 1.33 (1.04, 1.71) | 1.17 (0.90, 1.51) | 1.39 (1.08, 1.79) | 0.048 |
| SFA, median intake, g/d | 12.9 | 13.4 | 14.5 | 17.0 | 26.1 | |
| Events, n | 185 | 194 | 211 | 219 | 240 | |
| Person-time, 104 yr | 13.5 | 13.4 | 13.3 | 13.1 | 12.9 | |
| Model 1 | 1 (ref) | 1.04 (0.85, 1.27) | 1.12 (0.92, 1.36) | 1.16 (0.95, 1.41) | 1.32 (1.09, 1.60) | 0.002 |
| Model 2 | 1 (ref) | 0.98 (0.78, 1.22) | 0.96 (0.77, 1.20) | 1.04 (0.84, 1.30) | 1.18 (0.95, 1.46) | 0.08 |
| Model 3 | 1 (ref) | 0.99 (0.78, 1.25) | 0.96 (0.75, 1.23) | 1.04 (0.81, 1.34) | 1.16 (0.90, 1.51) | 0.18 |
| PFA, median intake, g/d | 8.4 | 8.4 | 9.0 | 10.6 | 16.0 | |
| Events, n | 197 | 173 | 200 | 240 | 139 | |
| Person-time, 104 yr | 13.5 | 13.4 | 13.3 | 13.2 | 13.0 | |
| Model 1 | 1 (ref) | 0.85 (0.69, 1.04) | 0.98 (0.80, 1.19) | 1.15 (0.95, 1.39) | 1.18 (0.98, 1.43) | 0.005 |
| Model 2 | 1 (ref) | 0.80 (0.64, 1.00) | 0.92 (0.74, 1.15) | 1.03 (0.83, 1.27) | 1.02 (0.82, 1.26) | 0.27 |
| Model 3 | 1 (ref) | 0.81 (0.65, 1.02) | 0.94 (0.75, 1.18) | 1.04 (0.83, 1.31) | 1.05 (0.83, 1.33) | 0.22 |
| MFA, median intake, g/d | 14.9 | 15.6 | 16.7 | 19.8 | 28.9 | |
| Events, n | 191 | 192 | 195 | 228 | 243 | |
| Person-time, 104 yr | 13.6 | 13.4 | 13.3 | 13.1 | 12.9 | |
| Model 1 | 1 (ref) | 0.98 (0.80, 1.20) | 0.98 (0.80, 1.20) | 1.15 (0.95, 1.39) | 1.31 (1.08, 1.58) | 0.001 |
| Model 2 | 1 (ref) | 0.89 (0.71, 1.11) | 0.88 (0.70, 1.09) | 1.05 (0.84, 1.30) | 1.11 (0.89, 1.37) | 0.13 |
| Model 3 | 1 (ref) | 0.91 (0.72, 1.14) | 0.88 (0.69, 1.12) | 1.06 (0.83, 1.35) | 1.13 (0.87, 1.47) | 0.17 |
| Cholesterol, median intake, mg/d | 133.2 | 143.9 | 162.8 | 203.1 | 311.1 | |
| Events, n | 175 | 244 | 216 | 198 | 216 | |
| Person-time, 104 yr | 13.5 | 13.4 | 13.3 | 13.2 | 13.0 | |
| Model 1 | 1 (ref) | 1.39 (1.14, 1.69) | 1.25 (1.02, 1.52) | 1.17 (0.95, 1.43) | 1.35 (1.11, 1.65) | 0.05 |
| Model 2 | 1 (ref) | 1.33 (1.07, 1.64) | 1.18 (0.94, 1.48) | 1.09 (0.87, 1.36) | 1.16 (0.93, 1.46) | 0.72 |
| Model 3 | 1 (ref) | 1.32 (1.06, 1.65) | 1.17 (0.93, 1.47) | 1.07 (0.84, 1.35) | 1.14 (0.90, 1.44) | 0.95 |
| Keys score,‡ median score | 23.5 | 29.5 | 33.9 | 38.5 | 46.1 | |
| Events, n | 201 | 194 | 200 | 229 | 225 | |
| Person-time, 104 yr | 13.5 | 13.4 | 13.3 | 13.2 | 12.9 | |
| Model 1 | 1 (ref) | 0.99 (0.82, 1.21) | 1.02 (0.84, 1.24) | 1.19 (0.98, 1.44) | 1.19 (0.98, 1.44) | 0.02 |
| Model 2 | 1 (ref) | 0.91 (0.73, 1.13) | 0.93 (0.75, 1.16) | 1.13 (0.92, 1.39) | 1.08 (0.87, 1.34) | 0.14 |
| Model 3 | 1 (ref) | 0.91 (0.73, 1.13) | 0.92 (0.74, 1.16) | 1.11 (0.89, 1.39) | 1.04 (0.81, 1.33) | 0.35 |
Abbreviations: WHI-OS, Women’s Health Initiative Observational Study; BMI, body mass index; MFA, monounsaturated fatty acids; PFA, polyunsaturated fatty acids; SFA, saturated fatty acids; TFA, trans fatty acids.
All models were constructed using Cox proportional hazards regression analysis. Tests for tend were performed using the median value of each quintile entering this variable into the model as a continuous variable.
Keys Score=1.26 (2S-P)+1.5(square root(C)); S=percent of total energy from saturated fat; P=percent of total energy from polyunsaturated fat; C=daily cholesterol intake in mg/1000 kcal
Model 1: adjusted for age and race (white, black, Hispanic, other)
Model 2: adjusted for Model 1 covariates plus education (<high school, high school diploma or GED, vocational/training school or some college or associate degree, college graduate), family income (<$20K, $20K to <$35K, $35K to <$50K, $50K to <$75K, ≥$75K), years as a regular smoker (never, <10, 10 to <20, 20 to <30, ≥30), hormone replacement therapy use (never, past, current), total MET-hours per wk, alcohol intake, history of coronary heart disease, history of atrial fibrillation, history of diabetes, aspirin use, use of antihypertensive medication, use of cholesterol-lowering medication, BMI, systolic blood pressure, and total energy intake (quntiles)
Model 3: adjusted for Model 2 covariates plus dietary vitamin E (quintiles), fruits and vegetable intake (quintiles), fiber (quintiles)