Abstract P157: Specific Dietary Fats in Relation to Total and Cause-specific Mortality

Abstract

Introduction: Previous studies have shown distinct associations between specific types of dietary fat and cardiovascular disease. However, studies of specific types of fat in relation to total and cause-specific mortality remain limited and inconsistent. Hypothesis: We hypothesized that specific types of dietary fat were differentially associated with total and cause-specific mortality. Methods: We investigated 83,349 women from the Nurses’ Health Study (1980-2012) and 42,884 men from the Health Professionals Follow-up Study (1986-2012) who were free from cardiovascular disease, cancer and diabetes at baseline. Dietary fat intake was assessed at baseline and updated every 2 to 4 years. Results: We documented 33,304 deaths during 3,439,954 person-years of follow-up. After adjustment for known and suspected risk factors, the hazard ratios (HRs) of total mortality comparing extreme quintiles of intake was 1.08, (95% confidence interval (CI), 1.03-1.14) for saturated fat, 0.81 (95% CI, 0.78-0.84) for polyunsaturated fat, 0.89 (95% CI, 0.84-0.94) for monounsaturated fat and 1.13 (95% CI, 1.07-1.18) for trans fat (P for trend <0.01 for all). Saturated fat intake was associated with a non-significant higher cardiovascular disease mortality across quintiles, while trans fat intake was associated a 20% higher cardiovascular disease mortality across quintiles. Dietary polyunsaturated and monounsaturated fats were each inversely associated with the risk of cardiovascular disease mortality. Replacing 5% of energy from saturated fats with equivalent energy from polyunsaturated fats and monounsaturated fats was associated with 26% (HR =0.74, 95% CI, 0.70-0.77) and 13% (HR =0.87, 95% CI, 0.82-0.92) lower total mortality, respectively. Replacing saturated fats with equivalent energy from polyunsaturated fats and monounsaturated fats was associated with lower risk of mortality due to cardiovascular disease, cancer and neurodegenerative disease. Intake of n-6 polyunsaturated fat, especially linoleic acid, was inversely associated with mortality due to most major causes, while marine n-3 polyunsaturated fat intake was associated with a modestly lower total mortality. Conclusions: Higher saturated fat intake was associated with higher mortality, whereas dietary polyunsaturated fat and monounsaturated fat intakes were inversely associated with mortality. These findings support current dietary recommendations to replace saturated fat with unsaturated fats.