The association between dietary fats and the incidence risk of cardiovascular outcomes: Tehran Lipid and Glucose Study

Zahra Gaeini,Parvin Mirmiran,Maryam Aghayan,Fereidoun Azizi,Zahra Bahadoran

doi:10.1186/s12986-021-00624-6

Abstract

BackgroundThe association between dietary fats and the risk of cardiovascular disease (CVD) is under debate. We aimed to determine the potential effects of dietary saturated fats (SFA), mono-unsaturated (MUFA) and poly-unsaturated (PUFA) fatty acids on the occurrence of CVD in an adult Asian population.MethodsThis study was conducted within the framework of the Tehran Lipid and Glucose Study on 2809 CVD-free adults, aged ≥ 19 years. Dietary intakes of fats were estimated using a validated 168-items semi-quantitative food frequency questionnaire, at baseline. Adjusted hazard ratios and 95% confidence intervals of CVD were calculated in tertile categories of dietary fats. The risk of CVD was estimated with multivariable Cox regression for the substitution of total fat or SFA with other macronutrients.ResultsDuring 10.6 years of follow up, the incidence rate of CVD events was 7.1%. Mean (± SD) age of the participants was 39 (± 14) years and 43.9% were men. Total fat, animal and plant sources of fats were not associated with risk of CVD events. No significant associations were found between total SFA, lauric acid, myristic acid, stearic acid, palmitic acid as well as MUFA and PUFA and CVD incidence. Substitutions of total fats or SFA with other macronutrients were not associated with CVD risk.ConclusionsIn this study, no significant associations were found between dietary fats and CVD risk. Considering the emerging body of literature that suggests no association between fats and CVD risk, reconsideration of dietary recommendations regarding low fat diets to prevent CVD, seems to be essential.

Highlights

IntroductionTraditional dietary guidelines generally recommended a low-fat diet (less than 30% of energy) and limiting saturated fatty acid (SFA) intake (less than 10% of energy) to prevent cardio-vascular disease (CVD) [1]
Traditional dietary guidelines generally recommended a low-fat diet and limiting saturated fatty acid (SFA) intake to prevent cardio-vascular disease (CVD) [1]
The isocaloric substitutions of total fat or saturated fats (SFA) with other macronutrients were not associated with cardiovascular disease (CVD) risk

Summary

Introduction

Traditional dietary guidelines generally recommended a low-fat diet (less than 30% of energy) and limiting saturated fatty acid (SFA) intake (less than 10% of energy) to prevent cardio-vascular disease (CVD) [1]. A large prospective cohort study in 18 countries reported that total fat and SFA intakes were not significantly associated with CVD [3]. A recent metaanalysis that included 43 cohort studies showed no significant association between total fat, SFA, monounsaturated (MUFA) and poly-unsaturated (PUFA) fatty acids with the risk of CVD events [4]. Prospective studies regarding the substituting macronutrients generally showed conflicting results, some of them reported a beneficial effect on CVD risk when SFA were replaced by PUFAs [8,9,10], whereas replacement of SFA with carbohydrates, mostly low quality carbohydrates, had clear adverse effect on cardio-metabolic risk factors [9, 11]. We aimed to determine the potential effects of dietary saturated fats (SFA), mono-unsaturated (MUFA) and poly-unsaturated (PUFA) fatty acids on the occurrence of CVD in an adult Asian population

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