Impact of nonoptimal intakes of saturated, polyunsaturated, and trans fat on global burdens of coronary heart disease

Qianyi Wang, Ashkan Afshin, Mohammad Yawar Yakoob, Gitanjali M. Singh, Colin D. Rehm, Shahab Khatibzadeh, Renata Micha, Peilin Shi, Dariush Mozaffarian, Majid Ezzati, Saman Fahimi, Pattra Wirojratana, John Powles, Ibrahim Elmadfa, Mayuree Rao, Warren Alpert, Stephen S. Lim, Rebecca E. Engell, Kathryn G. Andrews, Pamela A. Abbott & 96 others Morteza Abdollahi, Enrique O. Abeyá Gilardon, Habibul Ahsan, Mohannad Abed Alfattah Al Nsour, Suad N. Al-Hooti, Carukshi Arambepola, Dulitha N. Fernando, Hubert Barennes, Simon Barquera, Ana Baylin, Wulf Becker, Peter Bjerregaard, Lesley T. Bourne, Mario V. Capanzana, Katia Castetbon, Hsing Yi Chang, Yu Chen, Melanie J. Cowan, Leanne M. Riley, Stefaan De Henauw, Eric L. Ding, Charmaine A. Duante, Pablo Duran, Heléne Enghardt Barbieri, Farshad Farzadfar, Aida Filipovic Hadziomeragic, Regina M. Fisberg, Simon Forsyth, Didier Garriguet, Jean Michel Gaspoz, Dorothy Gauci, Neville Calleja, Brahmam N.V. Ginnela, Idris Guessous, Martin C. Gulliford, Wilbur Hadden, Christian Haerpfer, Daniel J. Hoffman, Anahita Houshiar-Rad, Inge Huybrechts, Nahla C. Hwalla, Hajah Masni Ibrahim, Manami Inoue, Maria D. Jackson, Lars Johansson, Lital Keinan-Boker, Cho il Kim, Eda Koksal, Hae Jeung Lee, Yanping Li, Nur Indrawaty Lipoeto, Guansheng Ma, Guadalupe L. Mangialavori, Yasuhiro Matsumura, Stephen T. McGarvey, Chan Mei Fen, Rafael A. Monge-Rojas, Abdulrahman Obaid Musaiger, Balakrishna Nagalla, Androniki Naska, Marga C. Ocke, Maciej Oltarzewski, Lucjan Szponar, Philippos Orfanos, Marja Leena Ovaskainen, Heli Tapanainen, Wen Harn Pan, Demosthenes B. Panagiotakos, Gulden Ayla Pekcan, Stefka Petrova, Noppawan Piaseu, Christos Pitsavos, Luz Gladys Posada, Luz Maria Sánchez-Romero, Rusidah B.T. Selamat, Sangita Sharma, Abla Mehio Sibai, Rosely Sichieri, Chansimaly Simmala, Laufey Steingrimsdottir, Gillian Swan, Elzbieta Halina Sygnowska, Robert Templeton, Anastasia Thanopoulou, Holmfridur Thorgeirsdóttir, Inga Thorsdottir, Antonia Trichopoulou, Shoichiro Tsugane, Aida Turrini, Sirje Vaask, Coline van Oosterhout, J. Lennert Veerman, Nowak Verena, Anna Waskiewicz, Sahar Zaghloul, Gábor Zajkás

Research output: Contribution to journalArticle

Abstract

Background: Saturated fat (SFA), x-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 SFAattributable 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.

Original languageEnglish (US)
Article numbere002891
JournalJournal of the American Heart Association
Volume5
Issue number1
DOIs
StatePublished - 2016

Fingerprint

Coronary Disease
Fats
Uncertainty
Mortality
Oils
Health Priorities
Food
Egypt
Dietary Fats
Pakistan
Public Policy
Health Policy
Canada
Meta-Analysis

Keywords

  • Cardiovascular disease
  • Coronary heart disease
  • Dietary fat
  • Saturated fat
  • Trans fat
  • X-6 polyunsaturated fat

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Impact of nonoptimal intakes of saturated, polyunsaturated, and trans fat on global burdens of coronary heart disease. / Wang, Qianyi; Afshin, Ashkan; Yakoob, Mohammad Yawar; Singh, Gitanjali M.; Rehm, Colin D.; Khatibzadeh, Shahab; Micha, Renata; Shi, Peilin; Mozaffarian, Dariush; Ezzati, Majid; Fahimi, Saman; Wirojratana, Pattra; Powles, John; Elmadfa, Ibrahim; Rao, Mayuree; Alpert, Warren; 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; Fernando, Dulitha N.; Barennes, Hubert; Barquera, Simon; Baylin, Ana; Becker, Wulf; Bjerregaard, Peter; Bourne, Lesley T.; Capanzana, Mario V.; Castetbon, Katia; Chang, Hsing Yi; Chen, Yu; Cowan, Melanie J.; Riley, Leanne M.; De Henauw, Stefaan; Ding, Eric L.; Duante, Charmaine A.; Duran, Pablo; Barbieri, Heléne Enghardt; Farzadfar, Farshad; Hadziomeragic, Aida Filipovic; Fisberg, Regina M.; Forsyth, Simon; Garriguet, Didier; Gaspoz, Jean Michel; Gauci, Dorothy; Calleja, Neville; Ginnela, Brahmam N.V.; Guessous, Idris; Gulliford, Martin C.; Hadden, Wilbur; Haerpfer, Christian; 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; Szponar, Lucjan; Orfanos, Philippos; Ovaskainen, Marja Leena; Tapanainen, Heli; Pan, Wen Harn; Panagiotakos, Demosthenes B.; Pekcan, Gulden Ayla; Petrova, Stefka; Piaseu, Noppawan; Pitsavos, Christos; Posada, Luz Gladys; Sánchez-Romero, Luz Maria; Selamat, Rusidah B.T.; Sharma, Sangita; Sibai, Abla Mehio; Sichieri, Rosely; Simmala, Chansimaly; Steingrimsdottir, Laufey; Swan, Gillian; Sygnowska, Elzbieta Halina; 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.

In: Journal of the American Heart Association, Vol. 5, No. 1, e002891, 2016.

Research output: Contribution to journalArticle

Wang, Q, Afshin, A, Yakoob, MY, Singh, GM, Rehm, CD, Khatibzadeh, S, Micha, R, Shi, P, Mozaffarian, D, Ezzati, M, Fahimi, S, Wirojratana, P, Powles, J, Elmadfa, I, Rao, M, Alpert, W, Lim, SS, Engell, RE, Andrews, KG, Abbott, PA, Abdollahi, M, Abeyá Gilardon, EO, Ahsan, H, Al Nsour, MAA, Al-Hooti, SN, Arambepola, C, Fernando, DN, Barennes, H, Barquera, S, Baylin, A, Becker, W, Bjerregaard, P, Bourne, LT, Capanzana, MV, Castetbon, K, Chang, HY, Chen, Y, Cowan, MJ, Riley, LM, De Henauw, S, Ding, EL, Duante, CA, Duran, P, Barbieri, HE, Farzadfar, F, Hadziomeragic, AF, Fisberg, RM, Forsyth, S, Garriguet, D, Gaspoz, JM, Gauci, D, Calleja, N, Ginnela, BNV, Guessous, I, Gulliford, MC, Hadden, W, Haerpfer, C, Hoffman, DJ, Houshiar-Rad, A, Huybrechts, I, Hwalla, NC, Ibrahim, HM, Inoue, M, Jackson, MD, Johansson, L, Keinan-Boker, L, Kim, CI, Koksal, E, Lee, HJ, Li, Y, Lipoeto, NI, Ma, G, Mangialavori, GL, Matsumura, Y, McGarvey, ST, Fen, CM, Monge-Rojas, RA, Musaiger, AO, Nagalla, B, Naska, A, Ocke, MC, Oltarzewski, M, Szponar, L, Orfanos, P, Ovaskainen, ML, Tapanainen, H, Pan, WH, Panagiotakos, DB, Pekcan, GA, Petrova, S, Piaseu, N, Pitsavos, C, Posada, LG, Sánchez-Romero, LM, Selamat, RBT, Sharma, S, Sibai, AM, Sichieri, R, Simmala, C, Steingrimsdottir, L, Swan, G, Sygnowska, EH, Templeton, R, Thanopoulou, A, Thorgeirsdóttir, H, Thorsdottir, I, Trichopoulou, A, Tsugane, S, Turrini, A, Vaask, S, van Oosterhout, C, Veerman, JL, Verena, N, Waskiewicz, A, Zaghloul, S & Zajkás, G 2016, 'Impact of nonoptimal intakes of saturated, polyunsaturated, and trans fat on global burdens of coronary heart disease', Journal of the American Heart Association, vol. 5, no. 1, e002891. https://doi.org/10.1161/JAHA.115.002891
Wang, Qianyi ; Afshin, Ashkan ; Yakoob, Mohammad Yawar ; Singh, Gitanjali M. ; Rehm, Colin D. ; Khatibzadeh, Shahab ; Micha, Renata ; Shi, Peilin ; Mozaffarian, Dariush ; Ezzati, Majid ; Fahimi, Saman ; Wirojratana, Pattra ; Powles, John ; Elmadfa, Ibrahim ; Rao, Mayuree ; Alpert, Warren ; 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 ; Fernando, Dulitha N. ; Barennes, Hubert ; Barquera, Simon ; Baylin, Ana ; Becker, Wulf ; Bjerregaard, Peter ; Bourne, Lesley T. ; Capanzana, Mario V. ; Castetbon, Katia ; Chang, Hsing Yi ; Chen, Yu ; Cowan, Melanie J. ; Riley, Leanne M. ; De Henauw, Stefaan ; Ding, Eric L. ; Duante, Charmaine A. ; Duran, Pablo ; Barbieri, Heléne Enghardt ; Farzadfar, Farshad ; Hadziomeragic, Aida Filipovic ; Fisberg, Regina M. ; Forsyth, Simon ; Garriguet, Didier ; Gaspoz, Jean Michel ; Gauci, Dorothy ; Calleja, Neville ; Ginnela, Brahmam N.V. ; Guessous, Idris ; Gulliford, Martin C. ; Hadden, Wilbur ; Haerpfer, Christian ; 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 ; Szponar, Lucjan ; Orfanos, Philippos ; Ovaskainen, Marja Leena ; Tapanainen, Heli ; Pan, Wen Harn ; Panagiotakos, Demosthenes B. ; Pekcan, Gulden Ayla ; Petrova, Stefka ; Piaseu, Noppawan ; Pitsavos, Christos ; Posada, Luz Gladys ; Sánchez-Romero, Luz Maria ; Selamat, Rusidah B.T. ; Sharma, Sangita ; Sibai, Abla Mehio ; Sichieri, Rosely ; Simmala, Chansimaly ; Steingrimsdottir, Laufey ; Swan, Gillian ; Sygnowska, Elzbieta Halina ; 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. / Impact of nonoptimal intakes of saturated, polyunsaturated, and trans fat on global burdens of coronary heart disease. In: Journal of the American Heart Association. 2016 ; Vol. 5, No. 1.
@article{7879fb1555f541948c9343eb876bd724,
title = "Impact of nonoptimal intakes of saturated, polyunsaturated, and trans fat on global burdens of coronary heart disease",
abstract = "Background: Saturated fat (SFA), x-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 SFAattributable 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.",
keywords = "Cardiovascular disease, Coronary heart disease, Dietary fat, Saturated fat, Trans fat, X-6 polyunsaturated fat",
author = "Qianyi Wang and Ashkan Afshin and Yakoob, {Mohammad Yawar} and Singh, {Gitanjali M.} and Rehm, {Colin D.} and Shahab Khatibzadeh and Renata Micha and Peilin Shi and Dariush Mozaffarian and Majid Ezzati and Saman Fahimi and Pattra Wirojratana and John Powles and Ibrahim Elmadfa and Mayuree Rao and Warren Alpert and Lim, {Stephen S.} and Engell, {Rebecca E.} and Andrews, {Kathryn G.} and Abbott, {Pamela A.} and Morteza Abdollahi and {Abey{\'a} Gilardon}, {Enrique O.} and Habibul Ahsan and {Al Nsour}, {Mohannad Abed Alfattah} and Al-Hooti, {Suad N.} and Carukshi Arambepola and Fernando, {Dulitha N.} and Hubert Barennes and Simon Barquera and Ana Baylin and Wulf Becker and Peter Bjerregaard and Bourne, {Lesley T.} and Capanzana, {Mario V.} and Katia Castetbon and Chang, {Hsing Yi} and Yu Chen and Cowan, {Melanie J.} and Riley, {Leanne M.} and {De Henauw}, Stefaan and Ding, {Eric L.} and Duante, {Charmaine A.} and Pablo Duran and Barbieri, {Hel{\'e}ne Enghardt} and Farshad Farzadfar and Hadziomeragic, {Aida Filipovic} and Fisberg, {Regina M.} and Simon Forsyth and Didier Garriguet and Gaspoz, {Jean Michel} and Dorothy Gauci and Neville Calleja and Ginnela, {Brahmam N.V.} and Idris Guessous and Gulliford, {Martin C.} and Wilbur Hadden and Christian Haerpfer and Hoffman, {Daniel J.} and Anahita Houshiar-Rad and Inge Huybrechts and Hwalla, {Nahla C.} and Ibrahim, {Hajah Masni} and Manami Inoue and Jackson, {Maria D.} and Lars Johansson and Lital Keinan-Boker and Kim, {Cho il} and Eda Koksal and Lee, {Hae Jeung} and Yanping Li and Lipoeto, {Nur Indrawaty} and Guansheng Ma and Mangialavori, {Guadalupe L.} and Yasuhiro Matsumura and McGarvey, {Stephen T.} and Fen, {Chan Mei} and Monge-Rojas, {Rafael A.} and Musaiger, {Abdulrahman Obaid} and Balakrishna Nagalla and Androniki Naska and Ocke, {Marga C.} and Maciej Oltarzewski and Lucjan Szponar and Philippos Orfanos and Ovaskainen, {Marja Leena} and Heli Tapanainen and Pan, {Wen Harn} and Panagiotakos, {Demosthenes B.} and Pekcan, {Gulden Ayla} and Stefka Petrova and Noppawan Piaseu and Christos Pitsavos and Posada, {Luz Gladys} and S{\'a}nchez-Romero, {Luz Maria} and Selamat, {Rusidah B.T.} and Sangita Sharma and Sibai, {Abla Mehio} and Rosely Sichieri and Chansimaly Simmala and Laufey Steingrimsdottir and Gillian Swan and Sygnowska, {Elzbieta Halina} and Robert Templeton and Anastasia Thanopoulou and Holmfridur Thorgeirsd{\'o}ttir and Inga Thorsdottir and Antonia Trichopoulou and Shoichiro Tsugane and Aida Turrini and Sirje Vaask and {van Oosterhout}, Coline and Veerman, {J. Lennert} and Nowak Verena and Anna Waskiewicz and Sahar Zaghloul and G{\'a}bor Zajk{\'a}s",
year = "2016",
doi = "10.1161/JAHA.115.002891",
language = "English (US)",
volume = "5",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Impact of nonoptimal intakes of saturated, polyunsaturated, and trans fat on global burdens of coronary heart disease

AU - Wang, Qianyi

AU - Afshin, Ashkan

AU - Yakoob, Mohammad Yawar

AU - Singh, Gitanjali M.

AU - Rehm, Colin D.

AU - Khatibzadeh, Shahab

AU - Micha, Renata

AU - Shi, Peilin

AU - Mozaffarian, Dariush

AU - Ezzati, Majid

AU - Fahimi, Saman

AU - Wirojratana, Pattra

AU - Powles, John

AU - Elmadfa, Ibrahim

AU - Rao, Mayuree

AU - Alpert, Warren

AU - Lim, Stephen S.

AU - Engell, Rebecca E.

AU - Andrews, Kathryn G.

AU - Abbott, Pamela A.

AU - Abdollahi, Morteza

AU - Abeyá Gilardon, Enrique O.

AU - Ahsan, Habibul

AU - Al Nsour, Mohannad Abed Alfattah

AU - Al-Hooti, Suad N.

AU - Arambepola, Carukshi

AU - Fernando, Dulitha N.

AU - Barennes, Hubert

AU - Barquera, Simon

AU - Baylin, Ana

AU - Becker, Wulf

AU - Bjerregaard, Peter

AU - Bourne, Lesley T.

AU - Capanzana, Mario V.

AU - Castetbon, Katia

AU - Chang, Hsing Yi

AU - Chen, Yu

AU - Cowan, Melanie J.

AU - Riley, Leanne M.

AU - De Henauw, Stefaan

AU - Ding, Eric L.

AU - Duante, Charmaine A.

AU - Duran, Pablo

AU - Barbieri, Heléne Enghardt

AU - Farzadfar, Farshad

AU - Hadziomeragic, Aida Filipovic

AU - Fisberg, Regina M.

AU - Forsyth, Simon

AU - Garriguet, Didier

AU - Gaspoz, Jean Michel

AU - Gauci, Dorothy

AU - Calleja, Neville

AU - Ginnela, Brahmam N.V.

AU - Guessous, Idris

AU - Gulliford, Martin C.

AU - Hadden, Wilbur

AU - Haerpfer, Christian

AU - Hoffman, Daniel J.

AU - Houshiar-Rad, Anahita

AU - Huybrechts, Inge

AU - Hwalla, Nahla C.

AU - Ibrahim, Hajah Masni

AU - Inoue, Manami

AU - Jackson, Maria D.

AU - Johansson, Lars

AU - Keinan-Boker, Lital

AU - Kim, Cho il

AU - Koksal, Eda

AU - Lee, Hae Jeung

AU - Li, Yanping

AU - Lipoeto, Nur Indrawaty

AU - Ma, Guansheng

AU - Mangialavori, Guadalupe L.

AU - Matsumura, Yasuhiro

AU - McGarvey, Stephen T.

AU - Fen, Chan Mei

AU - Monge-Rojas, Rafael A.

AU - Musaiger, Abdulrahman Obaid

AU - Nagalla, Balakrishna

AU - Naska, Androniki

AU - Ocke, Marga C.

AU - Oltarzewski, Maciej

AU - Szponar, Lucjan

AU - Orfanos, Philippos

AU - Ovaskainen, Marja Leena

AU - Tapanainen, Heli

AU - Pan, Wen Harn

AU - Panagiotakos, Demosthenes B.

AU - Pekcan, Gulden Ayla

AU - Petrova, Stefka

AU - Piaseu, Noppawan

AU - Pitsavos, Christos

AU - Posada, Luz Gladys

AU - Sánchez-Romero, Luz Maria

AU - Selamat, Rusidah B.T.

AU - Sharma, Sangita

AU - Sibai, Abla Mehio

AU - Sichieri, Rosely

AU - Simmala, Chansimaly

AU - Steingrimsdottir, Laufey

AU - Swan, Gillian

AU - Sygnowska, Elzbieta Halina

AU - Templeton, Robert

AU - Thanopoulou, Anastasia

AU - Thorgeirsdóttir, Holmfridur

AU - Thorsdottir, Inga

AU - Trichopoulou, Antonia

AU - Tsugane, Shoichiro

AU - Turrini, Aida

AU - Vaask, Sirje

AU - van Oosterhout, Coline

AU - Veerman, J. Lennert

AU - Verena, Nowak

AU - Waskiewicz, Anna

AU - Zaghloul, Sahar

AU - Zajkás, Gábor

PY - 2016

Y1 - 2016

N2 - Background: Saturated fat (SFA), x-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 SFAattributable 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.

AB - Background: Saturated fat (SFA), x-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 SFAattributable 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.

KW - Cardiovascular disease

KW - Coronary heart disease

KW - Dietary fat

KW - Saturated fat

KW - Trans fat

KW - X-6 polyunsaturated fat

UR - http://www.scopus.com/inward/record.url?scp=84998636455&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84998636455&partnerID=8YFLogxK

U2 - 10.1161/JAHA.115.002891

DO - 10.1161/JAHA.115.002891

M3 - Article

VL - 5

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 1

M1 - e002891

ER -