Abstract
BackgroundCardiovascular diseases represent an increasing share of the global disease burden. There is concern that increased consumption of palm oil could exacerbate mortality from ischemic heart disease (IHD) and stroke, particularly in developing countries where it represents a major nutritional source of saturated fat.MethodsThe study analyzed country-level data from 1980-1997 derived from the World Health Organization's Mortality Database, U.S. Department of Agriculture international estimates, and the World Bank (234 annual observations; 23 countries). Outcomes included mortality from IHD and stroke for adults aged 50 and older. Predictors included per-capita consumption of palm oil and cigarettes and per-capita Gross Domestic Product as well as time trends and an interaction between palm oil consumption and country economic development level. Analyses examined changes in country-level outcomes over time employing linear panel regressions with country-level fixed effects, population weighting, and robust standard errors clustered by country. Sensitivity analyses included further adjustment for other major dietary sources of saturated fat.ResultsIn developing countries, for every additional kilogram of palm oil consumed per-capita annually, IHD mortality rates increased by 68 deaths per 100,000 (95% CI [21-115]), whereas, in similar settings, stroke mortality rates increased by 19 deaths per 100,000 (95% CI [-12-49]) but were not significant. For historically high-income countries, changes in IHD and stroke mortality rates from palm oil consumption were smaller (IHD: 17 deaths per 100,000 (95% CI [5.3-29]); stroke: 5.1 deaths per 100,000 (95% CI [-1.2-11.0])). Inclusion of other major saturated fat sources including beef, pork, chicken, coconut oil, milk cheese, and butter did not substantially change the differentially higher relationship between palm oil and IHD mortality in developing countries.ConclusionsIncreased palm oil consumption is related to higher IHD mortality rates in developing countries. Palm oil consumption represents a saturated fat source relevant for policies aimed at reducing cardiovascular disease burdens.
Highlights
Cardiovascular diseases represent an increasing share of the global disease burden
Palm oil consumption in developing countries has a significant link to increases in mortality rates for individuals age 50 and above due to ischemic heart disease but not due to stroke, with impacts on health above and beyond those observed in historically high-income countries
For every additional kilogram of palm oil consumed annually per capita, the ischemic heart disease (IHD) mortality rate increased by 68 deaths per 100,000; and the mortality rate for stroke increased by 19 deaths per 100,000, but the increase in stroke deaths was not statistically significant (Table 3)
Summary
There is concern that increased consumption of palm oil could exacerbate mortality from ischemic heart disease (IHD) and stroke, in developing countries where it represents a major nutritional source of saturated fat. The production and human consumption of palm oil, a tropical vegetable oil rich in saturated fats, have risen substantially in recent years, increasing by 40% from 1990 to 2007 in the world’s least developed countries [1]. Experimental evidence confirms that consumption of palm oil increases plasma concentrations of total cholesterol and low-density lipoproteins (LDLs) compared to other more unsaturated vegetable oils [5,6,7]. We believe that potential reductions in cardiovascular mortality are likely related to reductions in palm oil consumption, increasing use of healthier, culturally-acceptable, affordable and available substitute oils, and other changes in the epidemiologic environment (e.g., reductions in smoking)
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