Table 2.
Hazard Ratios (95% CIs) of total and cause-specific mortality according to MUFA intake in NHS and HPFS pooled
| Quintiles of MUFA intake (% energy) | ||||||||
|---|---|---|---|---|---|---|---|---|
| Q1 | Q2 | Q3 | Q4 | Q5 | P for trend | |||
| Total mortality | ||||||||
| Cases/person-years | 4574/379071 | 4037/379760 | 3939/379654 | 4030/379389 | 4092/378630 | |||
| Total MUFAs | Model 1 | 1 | 0.99 (0.95, 1.03) | 1.06 (1.01, 1.10) | 1.13 (1.08, 1.18) | 1.21 (1.16, 1.27) | <0.001 | |
| Model 2 | 1 | 0.99 (0.95, 1.04) | 1.01 (0.97, 1.06) | 1.04 (0.99, 1.09) | 1.00 (0.95, 1.06) | 0.50 | ||
| Model 3 | 1 | 0.93 (0.89, 0.98) | 0.92 (0.88, 0.97) | 0.91 (0.87, 0.96) | 0.84 (0.79, 0.89) | <0.001 | ||
| Cases/person-years | 5327/377503 | 4334/379286 | 3808/379871 | 3752/379897 | 3451/380306 | |||
| MUFA-Ps | Model 1 | 1 | 0.89 (0.85, 0.92) | 0.83 (0.79, 0.86) | 0.83 (0.79, 0.86) | 0.77 (0.73, 0.80) | <0.001 | |
| Model 2 | 1 | 0.94 (0.90, 0.98) | 0.88 (0.84, 0.92) | 0.86 (0.82, 0.90) | 0.79 (0.76, 0.83) | <0.001 | ||
| Model 3 | 1 | 0.95 (0.91, 1.00) | 0.90 (0.86, 0.95) | 0.90 (0.86, 0.94) | 0.84 (0.80, 0.89) | <0.001 | ||
| Cases/person-years | 3873/379974 | 3812/379939 | 3940/379823 | 4139/379262 | 4908/377885 | |||
| MUFA-As | Model 1 | 1 | 1.10 (1.05, 1.15) | 1.20 (1.15, 1.26) | 1.35 (1.29, 1.41) | 1.67 (1.60, 1.75) | <0.001 | |
| Model 2 | 1 | 1.10 (1.05, 1.15) | 1.15 (1.10, 1.21) | 1.21 (1.16, 1.27) | 1.32 (1.26, 1.39) | <0.001 | ||
| Model 3 | 1 | 1.05 (1.00, 1.11) | 1.08 (1.03, 1.14) | 1.11 (1.05, 1.18) | 1.16 (1.08, 1.24) | <0.001 | ||
| Cardiovascular mortality | ||||||||
| Cases/person-years | 1033/379071 | 885/379760 | 887/379654 | 889/379389 | 894/378630 | |||
| Total MUFAs | Model 1 | 1 | 0.97 (0.88, 1.06) | 1.09 (0.99, 1.19) | 1.10 (1.01, 1.21) | 1.22 (1.12, 1.34) | <0.001 | |
| Model 2 | 1 | 1.01 (0.92, 1.11) | 1.12 (1.01, 1.24) | 1.15 (1.04, 1.28) | 1.16 (1.04, 1.30) | <0.01 | ||
| Model 3 | 1 | 0.94 (0.85, 1.04) | 1.01 (0.91, 1.12) | 1.00 (0.89, 1.13) | 0.96 (0.84, 1.09) | 0.79 | ||
| Cases/person-years | 1129/377503 | 955/379286 | 831/379823 | 780/379897 | 793/380306 | |||
| MUFA-Ps | Model 1 | 1 | 0.87 (0.79, 0.94) | 0.82 (0.75, 0.90) | 0.77 (0.70, 0.84) | 0.79 (0.72, 0.87) | <0.001 | |
| Model 2 | 1 | 0.94 (0.86, 1.02) | 0.91 (0.83, 1.00) | 0.85 (0.77, 0.94) | 0.89 (0.80, 0.99) | <0.01 | ||
| Model 3 | 1 | 0.96 (0.88, 1.05) | 0.94 (0.85, 1.04) | 0.89 (0.81, 0.99) | 0.96 (0.86, 1.07) | 0.31 | ||
| Cases/person-years | 886/379974 | 831/379286 | 877/379823 | 930/379262 | 1064/377885 | |||
| MUFA-As | Model 1 | 1 | 1.07 (0.97, 1.18) | 1.19 (1.08, 1.31) | 1.37 (1.24, 1.50) | 1.62 (1.48, 1.78) | <0.001 | |
| Model 2 | 1 | 1.04 (0.94, 1.16) | 1.11 (0.99, 1.24) | 1.18 (1.05, 1.33) | 1.20 (1.04, 1.38) | <0.01 | ||
| Model 3 | 1 | 1.03 (0.93, 1.14) | 1.09 (0.97, 1.22) | 1.15 (1.01, 1.30) | 1.16 (1.00, 1.35) | 0.03 | ||
| Cancer mortality | ||||||||
| Cases/person-years | 1471/380877 | 1410/381180 | 1376/381046 | 1499/380710 | 1547/380248 | |||
| Total MUFAs | Model 1 | 1 | 1.04 (0.96, 1.12) | 1.08 (1.00, 1.16) | 1.21 (1.13, 1.31) | 1.29 (1.20, 1.39) | <0.001 | |
| Model 2 | 1 | 1.06 (0.98, 1.14) | 1.06 (0.98, 1.15) | 1.16 (1.07, 1.26) | 1.13 (1.04, 1.23) | <0.01 | ||
| Model 3 | 1 | 1.01 (0.94, 1.10) | 0.99 (0.91, 1.08) | 1.05 (0.96, 1.15) | 0.99 (0.90, 1.10) | 0.91 | ||
| Cases/person-years | 1735/3379452 | 1465/380886 | 1392/381219 | 1370/381159 | 1370/381342 | |||
| MUFA-Ps | Model 1 | 1 | 0.90 (0.84, 0.97) | 0.89 (0.83, 0.95) | 0.89 (0.82, 0.95) | 0.86 (0.80, 0.92) | <0.001 | |
| Model 2 | 1 | 0.95 (0.88, 1.02) | 0.94 (0.87, 1.02) | 0.93 (0.86, 1.00) | 0.89 (0.82, 0.96) | <0.01 | ||
| Model 3 | 1 | 0.97 (0.90, 1.04) | 0.98 (0.91, 1.06) | 0.98 (0.90, 1.06) | 0.96 (0.88, 1.05) | 0.43 | ||
| Cases/person-years | 1326/381444 | 1340/381296 | 1358/381176 | 1490/380643 | 1784/379500 | |||
| MUFA-As | Model 1 | 1 | 1.09 (1.01, 1.17) | 1.15 (1.07, 1.24) | 1.32 (1.23, 1.43) | 1.63 (1.51, 1.75) | <0.001 | |
| Model 2 | 1 | 1.09 (1.00, 1.18) | 1.11 (1.02, 1.21) | 1.21 (1.10, 1.33) | 1.32 (1.18, 1.47) | <0.001 | ||
| Model 3 | 1 | 1.08 (0.99, 1.17) | 1.10 (1.00, 1.20) | 1.20 (1.09, 1.32) | 1.29 (1.15, 1.45) | <0.001 | ||
| Non-cardiovascular and non-cancer mortality | ||||||||
| Cases/person-years | 2073/381379 | 1741/381855 | 1673/381802 | 1640/381578 | 1647/381297 | |||
| Total MUFAs | Model 1 | 1 | 0.97 (0.91, 1.03) | 1.03 (0.96, 1.10) | 1.06 (0.99, 1.13) | 1.14 (1.07, 1.22) | <0.001 | |
| Model 2 | 1 | 0.95 (0.89, 1.02) | 0.94 (0.88, 1.01) | 0.91 (0.85, 0.98) | 0.86 (0.79, 0.93) | <0.001 | ||
| Model 3 | 1 | 0.88 (0.83, 0.95) | 0.84 (0.78, 0.90) | 0.78 (0.72, 0.85) | 0.70 (0.63, 0.77) | <0.001 | ||
| Case/person-years | 2360/380294 | 1913/381513 | 1583/381840 | 1599/381930 | 1319/382254 | |||
| MUFA-Ps | Model 1 | 1 | 0.89 (0.84, 0.95) | 0.80 (0.75, 0.85) | 0.82 (0.77, 0.88) | 0.69 (0.65, 0.74) | <0.001 | |
| Model 2 | 1 | 0.95 (0.89, 1.01) | 0.84 (0.79, 0.90) | 0.84 (0.79, 0.91) | 0.71 (0.66, 0.76) | <0.001 | ||
| Model 3 | 1 | 0.95 (0.89, 1.01) | 0.84 (0.78, 0.90) | 0.84 (0.78, 0.91) | 0.71 (0.65, 0.77) | <0.001 | ||
| Case/person-years | 1660/381966 | 1640/381940 | 1404/381887 | 1713/381561 | 2057/380556 | |||
| MUFA-As | Model 1 | 1 | 1.12 (1.04, 1.20) | 1.25 (1.16, 1.33) | 1.34 (1.25, 1.43) | 1.70 (1.59, 1.81) | <0.001 | |
| Model 2 | 1 | 1.09 (1.01, 1.17) | 1.14 (1.06, 1.24) | 1.13 (1.04, 1.23) | 1.24 (1.12, 1.37) | <0.001 | ||
| Model 3 | 1 | 1.05 (1.02, 1.07) | 1.03 (0.96, 1.11) | 1.05 (0.97, 1.14) | 1.01 (0.92, 1.10) | 0.05 | ||
Hazard ratios and 95% confidence intervals were calculated in Cox proportional hazards models; NHS, Nurses’ Health Study; HPFS, Health Professional’s Follow-up Study; MUFA, monounsaturated fat; MUFA-P, MUFAs from plant sources; MUFA-A, MUFAs from animal sources.
Model 1, adjusted for age; Model 2, further adjusted for ethnicity (Caucasian, and other ethnicity), smoking status (never, former, current (1–14, 15–24, or ≥25 cigarettes/day), alcohol intake (gram/day: 0, 0.1–4.9, 5.0–14.9, and >15.0 in women, 0, 0.1–4.9, 5.0–29.9, and >30.0 in men), family history of myocardial infarction (yes/no), family history of diabetes (yes/no), family history of cancer (yes/no), menopausal status and post-menopausal hormone use (pre-menopause, post-menopause (never, former, or current hormone use), for women), physical activity (<3, 3.0–8.9, 9.0–17.9, 18.0–26.9, ≥27.0 METs/week), current aspirin use (yes/no), multivitamin use (yes/no), baseline hypertension, baseline hypercholesterolemia, BMI (<23, 23–24.9, 25–29.9, 30–34.9, >35kg/m2), intakes of total energy, energy from trans fats, fruits and vegetables, and coffee intake (in quintiles). Model 3, further adjusted for percentage of energy from SFAs. MUFA-P models were further adjusted for MUFA-A, and vice versa. Study estimates from two cohorts were pooled using a fixed effects model.