Table 2.
Hazard Ratios of Coronary Heart Disease by Intake Of Fatty Acids as Percentages of Total Energy Intake
|
Quintile Categories of Fat Intake as a percentage of Total Energy Intake
|
p Trend | ||||||
|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | |||
| Total fatty acids | |||||||
| NHS | Median (%E) | 27.6 | 31.7 | 34.5 | 37.6 | 42.7 | |
| Cases | 808 | 735 | 676 | 698 | 575 | ||
| Age-adjusted | 1 (ref.) | 1.02 (0.92-1.13) | 1.05 (0.94-1.16) | 1.21 (1.10-1.35) | 1.31 (1.17-1.46) | <0.0001 | |
| Multivariate* | 1 (ref.) | 0.94 (0.85-1.04) | 0.89 (0.80-0.99) | 0.94 (0.84-1.05) | 0.87 (0.76-0.99) | 0.06 | |
| HPFS | Median (%E) | 24.1 | 28.5 | 31.4 | 34.2 | 38.3 | |
| Cases | 833 | 800 | 819 | 878 | 845 | ||
| Age-adjusted | 1 (ref.) | 1.00 (0.91-1.10) | 1.06 (0.96-1.17) | 1.19 (1.08-1.31) | 1.20 (1.09-1.32) | <0.0001 | |
| Multivariate* | 1 (ref.) | 0.94 (0.85-1.04) | 0.94 (0.84-1.04) | 0.99 (0.89-1.10) | 0.89 (0.79-1.00) | 0.16 | |
| Pooled | Multivariate* | 1 (ref.) | 0.94 (0.87-1.01) | 0.91 (0.85-0.99) | 0.97 (0.89-1.04) | 0.88 (0.81-0.96) | 0.02 |
| SFA | |||||||
| NHS | Median (%E) | 9.6 | 11.3 | 12.6 | 14.1 | 16.9 | |
| Cases | 791 | 754 | 711 | 649 | 587 | ||
| Age-adjusted | 1 (ref.) | 1.10 (1.00-1.22) | 1.18 (1.07-1.31) | 1.28 (1.15-1.42) | 1.54 (1.38-1.73) | <0.0001 | |
| Multivariate* | 1 (ref.) | 0.96 (0.86-1.08) | 0.95 (0.83-1.09) | 0.94 (0.81-1.09) | 1.01 (0.84-1.22) | 0.73 | |
| HPFS | Median (%E) | 7.4 | 9.2 | 10.4 | 11.6 | 13.6 | |
| Cases | 808 | 815 | 835 | 870 | 847 | ||
| Age-adjusted | 1 (ref.) | 1.07 (0.97-1.18) | 1.16 (1.05-1.28) | 1.26 (1.15-1.39) | 1.32 (1.19-1.45) | <0.0001 | |
| Multivariate* | 1 (ref.) | 0.95 (0.86-1.08) | 0.96 (0.85-1.10) | 0.95 (0.82-1.10) | 0.87 (0.74-1.02) | 0.16 | |
| Pooled | Multivariate* | 1 (ref.) | 0.96 (0.89-1.04) | 0.96 (0.87-1.05) | 0.95 (0.85-1.05) | 0.93 (0.82-1.05) | 0.46 |
| Trans fat | |||||||
| NHS | Median (%E) | 1.1 | 1.5 | 1.7 | 2.0 | 2.6 | |
| Cases | 726 | 771 | 748 | 683 | 564 | ||
| Age-adjusted | 1 (ref.) | 1.17 (1.06-1.30) | 1.26 (1.14-1.40) | 1.31 (1.17-1.45) | 1.38 (1.23-1.56) | <0.0001 | |
| Multivariate* | 1 (ref.) | 1.08 (0.97-1.21) | 1.13 (1.00-1.28) | 1.15 (1.00-1.31) | 1.20 (1.02-1.40) | 0.04 | |
| HPFS | Median (%E) | 0.7 | 1.0 | 1.3 | 1.5 | 1.9 | |
| Cases | 705 | 823 | 877 | 874 | 896 | ||
| Age-adjusted | 1 (ref.) | 1.20 (1.08-1.32) | 1.26 (1.14-1.39) | 1.31 (1.18-1.44) | 1.39 (1.25-1.53) | <0.0001 | |
| Multivariate* | 1 (ref.) | 1.18 (1.06-1.32) | 1.21 (1.07-1.36) | 1.22 (1.07-1.38) | 1.21 (1.06-1.38) | 0.03 | |
| Pooled | Multivariate* | 1 (ref.) | 1.13 (1.05-1.22) | 1.17 (1.08-1.27) | 1.18 (1.08-1.30) | 1.20 (1.09-1.32) | 0.002 |
| PUFA | |||||||
| NHS | Median (%E) | 3.9 | 4.9 | 5.6 | 6.3 | 7.4 | |
| Cases | 763 | 749 | 650 | 726 | 604 | ||
| Age-adjusted | 1 (ref.) | 0.91 (0.82-1.01) | 0.80 (0.72-0.89) | 0.92 (0.83-1.03) | 0.83 (0.75-0.93) | 0.003 | |
| Multivariate* | 1 (ref.) | 0.91 (0.82-1.01) | 0.78 (0.70-0.88) | 0.88 (0.78-0.99) | 0.76 (0.67-0.87) | 0.0003 | |
| HPFS | Median (%E) | 4.4 | 5.2 | 5.8 | 6.4 | 7.5 | |
| Cases | 886 | 893 | 799 | 831 | 766 | ||
| Age-adjusted | 1 (ref.) | 1.02 (0.93-1.12) | 0.93 (0.84-1.02) | 0.98 (0.89-1.08) | 0.92 (0.84-1.02) | 0.07 | |
| Multivariate* | 1 (ref.) | 1.00 (0.91-1.10) | 0.90 (0.81-1.00) | 0.92 (0.83-1.03) | 0.83 (0.74-0.94) | 0.001 | |
| Pooled | Multivariate* | 1 (ref.) | 0.96 (0.89-1.03) | 0.85 (0.78-0.92) | 0.90 (0.84-0.98) | 0.80 (0.73-0.88) | <0.0001 |
| MUFA | |||||||
| NHS | Median (%E) | 10.4 | 12.1 | 13.4 | 14.8 | 17.3 | |
| Cases | 788 | 747 | 744 | 669 | 544 | ||
| Age-adjusted | 1 (ref.) | 1.06 (0.96-1.18) | 1.17 (1.06-1.29) | 1.18 (1.06-1.31) | 1.27 (1.13-1.42) | <0.0001 | |
| Multivariate* | 1 (ref.) | 1.01 (0.90-1.14) | 1.05 (0.91-1.21) | 0.97 (0.83-1.15) | 0.90 (0.74-1.09) | 0.22 | |
| HPFS | Median (%E) | 9.0 | 10.9 | 12.1 | 13.3 | 15.1 | |
| Cases | 810 | 811 | 832 | 833 | 889 | ||
| Age-adjusted | 1 (ref.) | 1.02 (0.93-1.13) | 1.09 (0.99-1.20) | 1.12 (1.02-1.23) | 1.24 (1.13-1.36) | <0.0001 | |
| Multivariate* | 1 (ref.) | 0.97 (0.86-1.09) | 1.01 (0.88-1.15) | 1.00 (0.86-1.17) | 1.08 (0.91-1.29) | 0.33 | |
| Pooled | Multivariate* | 1 (ref.) | 0.99 (0.91-1.08) | 1.03 (0.93-1.13) | 0.99 (0.89-1.11) | 1.00 (0.87-1.13) | 0.86 |
Ref. = reference group. Abbreviations as in Table 1.
The multivariate model was adjusted for total energy intake, the energy contribution from protein, cholesterol intake, alcohol intake, smoking status, body mass index, physical activity, use of vitamins and aspirin, family history of MI and diabetes, and presence of baseline hypercholesterolemia and hypertension. The model was also adjusted for dietary intake of fruits and vegetables. The specific fat models were adjusted for the percentage of energy from all fat types simultaneously. Multivariate models thus represent the effect of substituting a percentage of energy from total fat or the specific fat type for an equivalent percentage of energy from total carbohydrates.