title: Dietary fat intake and risk of coronary heart disease: the Strong Heart Study.
abstract: BACKGROUND
  The results of previous studies on the association between dietary fat intake and coronary heart disease (CHD) incidence are inconsistent.
  
  
  OBJECTIVE
  The aim of this study was to examine the association between dietary fat intake and CHD incidence in American Indians in the Strong Heart Study.
  
  
  METHODS
  A total of 2938 participants aged 47-79 y and free of CHD at the second examination (1993-1995) were examined and followed for CHD, nonfatal CHD, and fatal CHD events to 31 December 2002. Dietary intake was assessed by using a 24-h diet recall and was calculated as percentages of energy.
  
  
  RESULTS
  Participants were followed for a mean (+/-SD) of 7.2 +/- 2.3 y. During follow-up, 436 incident CHD cases (298 nonfatal CHD and 138 fatal CHD events) were ascertained. Participants aged 47-59 y in the highest quartile of intake of total fat, saturated fatty acids, or monounsaturated fatty acids had higher CHD mortality than did those in the lowest quartile [hazard ratio (95% CI): 3.57 (1.21, 10.49), 5.17 (1.64, 16.36), and 3.43 (1.17, 10.04), respectively] after confounders were controlled for. These associations were not observed for those aged 60-79 y.
  
  
  CONCLUSIONS
  Total fat, saturated fatty acid, and monounsaturated fatty acid intake were strong predictors of CHD mortality in American Indians aged 47-59 y, independent of other established CHD risk factors. It may be prudent for American Indians to reduce their fat intake early in life to reduce the risk of dying from CHD.
authors.affiliation: Center for American Indian Health Research, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73190, USA. susan-xu@ouhsc.edu
authors.forename: Jiaqiong
authors.initials: J
authors.lastname: Xu
authors.forename: Sigal
authors.initials: S
authors.lastname: Eilat-Adar
authors.forename: Catherine
authors.initials: C
authors.lastname: Loria
authors.forename: Uri
authors.initials: U
authors.lastname: Goldbourt
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Howard
authors.forename: Richard R
authors.initials: RR
authors.lastname: Fabsitz
authors.forename: Ellie M
authors.initials: EM
authors.lastname: Zephier
authors.forename: Claudia
authors.initials: C
authors.lastname: Mattil
authors.forename: Elisa T
authors.initials: ET
authors.lastname: Lee
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000453:epidemiology* / Q000209:etiology*; D004041:Dietary Fats / Q000008:administration & dosage* / Q000009:adverse effects*; D005227:Fatty Acids / Q000008:administration & dosage / Q000009:adverse effects; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D004041:Dietary Fats; D005227:Fatty Acids; D005229:Fatty Acids, Monounsaturated