TABLE 2.
HRs for CVD mortality and IHD mortality in quintiles of total UFA, PUFA, and cis MUFA intake for theoretical, isocaloric replacement of SFAs plus TFAs in 4146 patients from the Alpha Omega Cohort1
| Quintiles of dietary FA intake2 |
||||||||
| 1 (n = 829) | 2 (n = 829) | 3 (n = 830) | 4 (n = 829) | 5 (n = 829) | P-trend3 | Per 5% of energy intake | P | |
| CVD mortality | ||||||||
| Total UFAs | ||||||||
| Median, en% | 12.9 | 15.3 | 17.2 | 19.3 | 22.7 | |||
| Cases, n | 96 | 69 | 66 | 65 | 76 | |||
| Model 14 | 1.00 | 0.59 (0.42, 0.83) | 0.47 (0.32, 0.69) | 0.38 (0.25, 0.59) | 0.37 (0.23, 0.58) | <0.001 | 0.65 (0.53, 0.82) | <0.001 |
| Model 25 | 1.00 | 0.63 (0.45, 0.89) | 0.50 (0.34, 0.75) | 0.43 (0.28, 0.66) | 0.42 (0.26, 0.67) | 0.001 | 0.69 (0.55, 0.86) | 0.001 |
| Model 36 | 1.00 | 0.64 (0.46, 0.91) | 0.51 (0.35, 0.76) | 0.45 (0.29, 0.69) | 0.45 (0.28, 0.72) | 0.003 | 0.71 (0.57, 0.89) | 0.003 |
| PUFAs | ||||||||
| Median, en% | 4.9 | 6.2 | 7.3 | 8.5 | 10.8 | |||
| Cases, n | 89 | 87 | 64 | 62 | 70 | |||
| Model 14 | 1.00 | 0.93 (0.68, 1.25) | 0.63 (0.45, 0.89) | 0.54 (0.38, 0.77) | 0.52 (0.36, 0.76) | <0.001 | 0.62 (0.47, 0.82) | 0.001 |
| Model 25 | 1.00 | 1.00 (0.74, 1.35) | 0.67 (0.48, 0.93) | 0.61 (0.43, 0.88) | 0.62 (0.42, 0.90) | 0.003 | 0.70 (0.53, 0.93) | 0.014 |
| Model 36 | 1.00 | 1.01 (0.75, 1.38) | 0.68 (0.48, 0.96) | 0.64 (0.44, 0.92) | 0.66 (0.44, 0.98) | 0.011 | 0.68 (0.51, 0.90) | 0.007 |
| cis MUFAs | ||||||||
| Median, en% | 7.2 | 8.6 | 9.8 | 11.0 | 12.8 | |||
| Cases, n | 80 | 75 | 61 | 81 | 75 | |||
| Model 14 | 1.00 | 0.93 (0.66, 1.30) | 0.70 (0.48, 1.03) | 0.86 (0.58, 1.28) | 0.69 (0.45, 1.07) | 0.11 | 0.71 (0.52, 0.96) | 0.027 |
| Model 25 | 1.00 | 1.10 (0.78, 1.55) | 0.85 (0.58, 1.25) | 1.00 (0.67, 1.50) | 0.75 (0.48, 1.16) | 0.15 | 0.68 (0.50, 0.93) | 0.015 |
| Model 36 | 1.00 | 1.10 (0.78, 1.55) | 0.84 (0.57, 1.24) | 0.98 (0.65, 1.47) | 0.74 (0.48, 1.15) | 0.13 | 0.75 (0.57, 1.00) | 0.048 |
| IHD mortality | ||||||||
| Total UFAs | ||||||||
| Median, en% | 12.9 | 15.3 | 17.2 | 19.3 | 22.7 | |||
| Cases, n | 61 | 44 | 50 | 47 | 47 | |||
| Model 14 | 1.00 | 0.55 (0.36, 0.84) | 0.50 (0.32, 0.80) | 0.38 (0.23, 0.64) | 0.30 (0.17, 0.54) | <0.001 | 0.57 (0.44, 0.75) | <0.001 |
| Model 25 | 1.00 | 0.59 (0.38, 0.90) | 0.54 (0.34, 0.87) | 0.44 (0.26, 0.73) | 0.35 (0.20, 0.63) | 0.001 | 0.61 (0.46, 0.80) | <0.001 |
| Model 36 | 1.00 | 0.60 (0.39, 0.92) | 0.56 (0.35, 0.89) | 0.45 (0.27, 0.76) | 0.37 (0.21, 0.67) | 0.002 | 0.62 (0.47, 0.82) | 0.001 |
| PUFAs | ||||||||
| Median, en% | 4.9 | 6.2 | 7.3 | 8.5 | 10.8 | |||
| Cases, n | 58 | 60 | 49 | 38 | 44 | |||
| Model 14 | 1.00 | 0.94 (0.65, 1.35) | 0.69 (0.46, 1.03) | 0.46 (0.29, 0.72) | 0.44 (0.28, 0.71) | <0.001 | 0.53 (0.38, 0.74) | <0.001 |
| Model 25 | 1.00 | 1.00 (0.69, 1.44) | 0.72 (0.48, 1.08) | 0.51 (0.33, 0.81) | 0.52 (0.33, 0.84) | 0.001 | 0.60 (0.42, 0.85) | 0.004 |
| Model 36 | 1.00 | 0.99 (0.68, 1.44) | 0.72 (0.48, 1.08) | 0.52 (0.33, 0.83) | 0.53 (0.33, 0.88) | 0.002 | 0.55 (0.39, 0.78) | 0.001 |
| cis MUFAs | ||||||||
| Median, en% | 7.2 | 8.6 | 9.8 | 11.0 | 12.8 | |||
| Cases, n | 50 | 48 | 44 | 57 | 50 | |||
| Model 14 | 1.00 | 0.89 (0.58, 1.36) | 0.73 (0.46, 1.17) | 0.86 (0.53, 1.41) | 0.65 (0.38, 1.11) | 0.14 | 0.65 (0.44, 0.94) | 0.024 |
| Model 25 | 1.00 | 1.04 (0.68, 1.60) | 0.89 (0.55, 1.43) | 1.02 (0.62, 1.68) | 0.73 (0.42, 1.25) | 0.21 | 0.64 (0.44, 0.93) | 0.020 |
| Model 36 | 1.00 | 1.06 (0.69, 1.64) | 0.89 (0.56, 1.44) | 1.03 (0.62, 1.69) | 0.74 (0.43, 1.27) | 0.23 | 0.70 (0.49, 0.99) | 0.045 |
CVD, cardiovascular disease; en%, percentage of total energy intake; FA, fatty acid; IHD, ischemic heart disease; TFA, trans fatty acid; UFA, unsaturated fatty acid.
HRs are presented with 95% CIs in quintiles of the replacing fatty acid intake, with the use of the lowest quintile as the reference.
The linear trend across HRs was tested by entering the median intakes in quintiles as a continuous variable in the Cox regression model.
Model includes total energy intake (kilocalories per day) and intake (en%; quintiles) of protein, carbohydrates, and MUFAs (in PUFA analysis) or PUFAs (in MUFA analysis).
Includes in model 1, with the addition of age, sex, Alpha Omega Trial treatment code (4 categories), BMI, prevalent diabetes (yes or no), antithrombotic drugs (yes or no), antihypertensive drugs (yes or no), lipid-lowering drugs (yes or no), level of education (3 categories), smoking status (3 categories), alcohol intake (4 categories), and physical activity (3 categories).
Includes in model 2, with the addition of dietary cholesterol (milligrams per day; quintiles) and dietary fiber (grams per day; quintiles).