Impact of Nonoptimal Intakes of Saturated, Polyunsaturated, and Trans Fat on Global Burdens of Coronary Heart Disease Academic Article uri icon

abstract

  • BACKGROUND:Saturated fat (SFA), ω-6 (n-6) polyunsaturated fat (PUFA), and trans fat (TFA) influence risk of coronary heart disease (CHD), but attributable CHD mortalities by country, age, sex, and time are unclear. METHODS AND RESULTS:National intakes of SFA, n-6 PUFA, and TFA were estimated using a Bayesian hierarchical model based on country-specific dietary surveys; food availability data; and, for TFA, industry reports on fats/oils and packaged foods. Etiologic effects of dietary fats on CHD mortality were derived from meta-analyses of prospective cohorts and CHD mortality rates from the 2010 Global Burden of Diseases study. Absolute and proportional attributable CHD mortality were computed using a comparative risk assessment framework. In 2010, nonoptimal intakes of n-6 PUFA, SFA, and TFA were estimated to result in 711 800 (95% uncertainty interval [UI] 680 700-745 000), 250 900 (95% UI 236 900-265 800), and 537 200 (95% UI 517 600-557 000) CHD deaths per year worldwide, accounting for 10.3% (95% UI 9.9%-10.6%), 3.6%, (95% UI 3.5%-3.6%) and 7.7% (95% UI 7.6%-7.9%) of global CHD mortality. Tropical oil-consuming countries were estimated to have the highest proportional n-6 PUFA- and SFA-attributable CHD mortality, whereas Egypt, Pakistan, and Canada were estimated to have the highest proportional TFA-attributable CHD mortality. From 1990 to 2010 globally, the estimated proportional CHD mortality decreased by 9% for insufficient n-6 PUFA and by 21% for higher SFA, whereas it increased by 4% for higher TFA, with the latter driven by increases in low- and middle-income countries. CONCLUSIONS:Nonoptimal intakes of n-6 PUFA, TFA, and SFA each contribute to significant estimated CHD mortality, with important heterogeneity across countries that informs nation-specific clinical, public health, and policy priorities.

authors

  • Wang, Qianyi
  • Afshin, Ashkan
  • Yakoob, Mohammad Yawar
  • Singh, Gitanjali M
  • Rehm, Colin D
  • Khatibzadeh, Shahab
  • Micha, Renata
  • Shi, Peilin
  • Mozaffarian, Dariush
  • Mozaffarian, Dariush
  • Micha, Renata
  • Shi, Peilin
  • Ezzati, Majid
  • Fahimi, Saman
  • Khatibzadeh, Shahab
  • Powles, John
  • Elmadfa, Ibrahim
  • Rao, Mayuree
  • Wirojratana, Pattra
  • Lim, Stephen S
  • Engell, Rebecca E
  • Andrews, Kathryn G
  • Abbott, Pamela A
  • Abdollahi, Morteza
  • Abeyá Gilardon, Enrique O
  • Ahsan, Habibul
  • Al Nsour, Mohannad Abed Alfattah
  • Al‐Hooti, Suad N
  • Arambepola, Carukshi
  • Barennes, Hubert
  • Barquera, Simon
  • Baylin, Ana
  • Becker, Wulf
  • Bjerregaard, Peter
  • Bourne, Lesley T
  • Calleja, Neville
  • Castetbon, Katia
  • Chang, Hsing‐Yi
  • Cowan, Melanie J
  • De Henauw, Stefaan
  • Ding, Eric L
  • Duante, Charmaine A
  • Duran, Pablo
  • Elmadfa, Ibrahim
  • Barbieri, Heléne Enghardt
  • Farzadfar, Farshad
  • Fernando, Dulitha N
  • Hadziomeragic, Aida Filipovic
  • Fisberg, Regina M
  • Forsyth, Simon
  • Garriguet, Didier
  • Gaspoz, Jean‐Michel
  • Gauci, Dorothy
  • Ginnela, Brahmam NV
  • Guessous, Idris
  • Hadden, Wilbur
  • Hoffman, Daniel J
  • Houshiar‐Rad, Anahita
  • Huybrechts, Inge
  • Hwalla, Nahla C
  • Ibrahim, Hajah Masni
  • Inoue, Manami
  • Jackson, Maria D
  • Johansson, Lars
  • Keinan‐Boker, Lital
  • Kim, Cho‐il
  • Koksal, Eda
  • Lee, Hae‐Jeung
  • Li, Yanping
  • Lipoeto, Nur Indrawaty
  • Ma, Guansheng
  • Mangialavori, Guadalupe L
  • Matsumura, Yasuhiro
  • McGarvey, Stephen T
  • Fen, Chan Mei
  • Monge‐Rojas, Rafael A
  • Musaiger, Abdulrahman Obaid
  • Nagalla, Balakrishna
  • Naska, Androniki
  • Ocke, Marga C
  • Oltarzewski, Maciej
  • Orfanos, Philippos
  • Ovaskainen, Marja‐Leena
  • Pan, Wen‐Harn
  • Panagiotakos, Demosthenes B
  • Pekcan, Gulden Ayla
  • Petrova, Stefka
  • Piaseu, Noppawan
  • Pitsavos, Christos
  • Posada, Luz Gladys
  • Riley, Leanne M
  • Sánchez‐Romero, Luz Maria
  • Selamat, Rusidah BT
  • Sharma, Sangita
  • Sibai, Abla Mehio
  • Sichieri, Rosely
  • Simmala, Chansimaly
  • Steingrimsdottir, Laufey
  • Swan, Gillian
  • Sygnowska, Elżbieta Halina
  • Szponar, Lucjan
  • Tapanainen, Heli
  • Templeton, Robert
  • Thanopoulou, Anastasia
  • Thorgeirsdóttir, Holmfridur
  • Thorsdottir, Inga
  • Trichopoulou, Antonia
  • Tsugane, Shoichiro
  • Turrini, Aida
  • Vaask, Sirje
  • van Oosterhout, Coline
  • Veerman, J Lennert
  • Verena, Nowak
  • Waskiewicz, Anna
  • Zaghloul, Sahar
  • Zajkás, Gábor

publication date

  • January 26, 2016