TABLE 3.
Associations between MUFA intake and CHD risk1
| Quintile of MUFA intake, % of energy | ||||||
|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | P-trend | |
| Total MUFAs | ||||||
| NHS | ||||||
| Median (range), % | 8.7 (0.5–9.9) | 10.5 (9.6–11.4) | 11.7 (11.0–12.7) | 13.0 (12.2–14.2) | 14.9 (13.6–45.3) | |
| Cases/person-years | 393/254,654 | 380/255,118 | 422/255,036 | 367/254,931 | 410/254,721 | |
| Model 1 | 1 | 1.06 (0.92, 1.23) | 1.26 (1.10, 1.45) | 1.14 (0.99, 1.32) | 1.34 (1.17, 1.55) | <0.001 |
| Model 2 | 1 | 1.04 (0.90, 1.19) | 1.18 (1.02, 1.36) | 1.02 (0.88, 1.18) | 1.11 (0.96, 1.30) | 0.24 |
| Model 3 | 1 | 0.99 (0.85, 1.15) | 1.10 (0.94, 1.29) | 0.93 (0.78, 1.10) | 0.98 (0.81, 1.19) | 0.67 |
| HPFS | ||||||
| Median (range), % | 8.8 (1.3–10.1) | 10.8 (9.9–11.5) | 12.1 (11.3–12.8) | 13.3 (12.6–14.4) | 15.3 (14.0–35.1) | |
| Cases/person-years | 483/117,823 | 433/118,019 | 497/117,920 | 472/117,798 | 562/117,667 | |
| Model 1 | 1 | 0.88 (0.77, 1.00) | 1.08 (0.95, 1.22) | 1.04 (0.92, 1.18) | 1.22 (1.08, 1.38) | <0.001 |
| Model 2 | 1 | 0.88 (0.77, 1.00) | 1.06 (0.93, 1.21) | 1.00 (0.87, 1.14) | 1.10 (0.96, 1.26) | 0.06 |
| Model 3 | 1 | 0.82 (0.71, 0.94) | 0.95 (0.83, 1.10) | 0.86 (0.74, 1.01) | 0.90 (0.76, 1.07) | 0.46 |
| Pooled2 | ||||||
| Model 1 | 1 | 0.96 (0.87, 1.05) | 1.16 (1.05, 1.27) | 1.08 (0.99, 1.19) | 1.27 (1.16, 1.39) | <0.001 |
| Model 2 | 1 | 0.95 (0.86, 1.05) | 1.12 (1.02, 1.24) | 1.02 (0.92, 1.13) | 1.12 (1.01, 1.24) | 0.01 |
| Model 3 | 1 | 0.90 (0.81, 0.99) | 1.02 (0.92, 1.14) | 0.90 (0.80, 1.01) | 0.95 (0.83, 1.08) | 0.47 |
| MUFA-Ps | ||||||
| NHS | ||||||
| Median (range), % | 3.7 (0.4–4.8) | 4.9 (4.2–5.7) | 5.8 (5.1–6.7) | 6.8 (6.0–8.0) | 8.6 (7.2–43.9) | |
| Cases/person-years | 437/253,782 | 422/254,769 | 388/255,040 | 371/255,201 | 354/255,667 | |
| Model 1 | 1 | 1.01 (0.89, 1.16) | 0.97 (0.84, 1.11) | 0.94 (0.82, 1.08) | 0.90 (0.78, 1.04) | 0.08 |
| Model 2 | 1 | 1.02 (0.89, 1.17) | 0.97 (0.84, 1.11) | 0.93 (0.80, 1.07) | 0.91 (0.79, 1.05) | 0.09 |
| Model 3 | 1 | 1.01 (0.89, 1.16) | 0.95 (0.83, 1.09) | 0.91 (0.79, 1.05) | 0.89 (0.77, 1.03) | 0.04 |
| HPFS | ||||||
| Median (range), % | 4.0 (0.3–5.0) | 5.2 (4.5–6.0) | 6.1 (5.5–6.9) | 7.1 (6.4–8.0) | 8.8 (7.6–32.4) | |
| Cases/person-years | 560/117,331 | 507/117,821 | 467/118,035 | 429/117,983 | 484/118,057 | |
| Model 1 | 1 | 0.98 (0.86, 1.10) | 0.94 (0.83, 1.07) | 0.87 (0.77, 0.99) | 0.94 (0.83, 1.07) | 0.15 |
| Model 2 | 1 | 1.02 (0.90, 1.15) | 0.98 (0.86, 1.11) | 0.91 (0.80, 1.03) | 0.97 (0.86, 1.10) | 0.32 |
| Model 3 | 1 | 1.00 (0.88, 1.13) | 0.96 (0.85, 1.09) | 0.89 (0.78, 1.01) | 0.95 (0.84, 1.08) | 0.22 |
| Pooled2 | ||||||
| Model 1 | 1 | 0.99 (0.91, 1.09) | 0.95 (0.87, 1.05) | 0.90 (0.82, 0.99) | 0.92 (0.84, 1.01) | 0.03 |
| Model 2 | 1 | 1.03 (0.94, 1.12) | 0.98 (0.89, 1.08) | 0.93 (0.84, 1.02) | 0.95 (0.87, 1.05) | 0.10 |
| Model 3 | 1 | 1.01 (0.92, 1.11) | 0.96 (0.88, 1.06) | 0.91 (0.82, 1.00) | 0.93 (0.85, 1.03) | 0.04 |
| MUFA-As | ||||||
| NHS | ||||||
| Median (range), % | 3.4 (0.02–4.2) | 4.5 (3.8–5.1) | 5.3 (4.6–5.9) | 6.1 (5.3–7.0) | 7.5 (6.2–22.6) | |
| Cases/person-years | 348/255,276 | 369/255,152 | 421/255,195 | 400/254,908 | 434/253,928 | |
| Model 1 | 1 | 1.17 (1.01, 1.35) | 1.41 (1.22, 1.63) | 1.40 (1.21, 1.62) | 1.60 (1.39, 1.85) | <0.001 |
| Model 2 | 1 | 1.12 (0.97, 1.30) | 1.31 (1.13, 1.52) | 1.23 (1.06, 1.43) | 1.26 (1.08, 1.47) | 0.004 |
| Model 3 | 1 | 1.11 (0.95, 1.29) | 1.29 (1.09, 1.51) | 1.20 (1.00, 1.43) | 1.21 (0.97, 1.49) | 0.11 |
| HPFS | ||||||
| Median (range), % | 3.2 (0.01–4.0) | 4.5 (3.9–5.1) | 5.4 (4.8–6.0) | 6.4 (5.7–7.2) | 8.0 (6.7–20.8) | |
| Cases/person-years | 436/118,120 | 425/118,116 | 476/117,944 | 508/117,679 | 602/117,368 | |
| Model 1 | 1 | 1.02 (0.89, 1.17) | 1.19 (1.04, 1.35) | 1.33 (1.17, 1.51) | 1.49 (1.32, 1.69) | <0.001 |
| Model 2 | 1 | 1.00 (0.87, 1.15) | 1.15 (1.00, 1.31) | 1.25 (1.10, 1.44) | 1.31 (1.15, 1.51) | <0.001 |
| Model 3 | 1 | 0.99 (0.86, 1.14) | 1.12 (0.97, 1.31) | 1.22 (1.04, 1.44) | 1.26 (1.04, 1.54) | 0.004 |
| Pooled2 | ||||||
| Model 1 | 1 | 1.08 (0.98, 1.20) | 1.28 (1.16, 1.41) | 1.36 (1.24, 1.50) | 1.54 (1.40, 1.69) | <0.001 |
| Model 2 | 1 | 1.06 (0.96, 1.17) | 1.23 (1.11, 1.35) | 1.25 (1.13, 1.38) | 1.30 (1.17, 1.44) | <0.001 |
| Model 3 | 1 | 1.04 (0.94, 1.16) | 1.19 (1.07, 1.33) | 1.21 (1.07, 1.36) | 1.23 (1.06, 1.42) | 0.002 |
1HRs (95% CIs) were calculated by using a Cox proportional hazards model. Model 1 adjusted for age; model 2 further adjusted for ethnicity (white or other ethnicity), smoking status [never, former, current (1–14, 15–24, or ≥25 cigarettes/d), or missing], alcohol intake (0, 0.1–4.9, 5.0–14.9, and ≥15.0 g/d in women; 0, 0.1–4.9, 5.0–29.9, and ≥30.0 in men; or missing), family history of myocardial infarction (yes or no), family history of diabetes (yes or no), menopausal status and postmenopausal hormone use [premenopause, postmenopause (never, former, or current hormone use), or missing for women], physical activity (<3, 3.0–8.9, 9.0–17.9, 18.0–26.9, or ≥27.0 metabolic equivalent tasks/wk or missing), current aspirin use (yes or no), multivitamin use (yes or no), baseline hypertension, baseline hypercholesterolemia, BMI (kg/m2; <23, 23–24.9, 25–29.9, 30–34.9, or ≥35 or missing), total energy intake (kilocalories per day), and intake of fruit and vegetables (in quintiles) based on model 1; model 3 further adjusted for energy from SFAs based on model 2. CHD, coronary heart disease; HPFS, Health Professionals Follow-Up Study; MUFA-A, MUFA from animal sources; MUFA-P, MUFA from plant sources; NHS, Nurses’ Health Study.
2Study estimates from 2 cohorts were pooled by using a fixed-effects model.