title: Dietary fat quality and risk of sudden cardiac death in women.
abstract: BACKGROUND
  Dietary n-3 PUFAs are inversely associated with risk of sudden cardiac death (SCD); however, little is known about other fats and SCD. Furthermore, concerns have been raised that high n-6 PUFA intake may attenuate the benefits of n-3 PUFAs.
  
  
  OBJECTIVE
  We examined associations and selected interactions between dietary fatty acids, expressed as a proportion of total fat and SCD.
  
  
  METHODS
  We conducted a prospective cohort study among 91,981 women aged 34-59 y from the Nurses' Health Study in 1980. Over 30 y, we documented 385 SCDs.
  
  
  RESULTS
  In multivariable models, women in the highest compared with the lowest quintile of SFA intake had an RR of SCD of 1.44 (95% CI: 1.04, 1.98). Conversely, women in the highest compared with the lowest quintile of PUFA intake had an RR of SCD of 0.57 (95% CI: 0.41, 0.78). Intakes of n-6 and n-3 PUFAs were both significantly associated with a lower risk of SCD, and n-6 PUFAs did not modify the association between n-3 PUFAs and SCD. MUFAs and trans fats were not associated with SCD risk. After further adjustment for coronary heart disease (CHD) and CHD risk factors potentially in the causal pathway, the association between PUFAs and SCD remained significant, whereas the association for SFAs was no longer significant.
  
  
  CONCLUSIONS
  Intake of PUFAs as a proportion of fat was inversely associated with SCD risk, independent of traditional CHD risk factors. These results support dietary guidelines to improve dietary fat quality by replacing intake of SFAs with n-6 and n-3 PUFAs.
authors.affiliation: Center for Arrhythmia Prevention, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. schiuve@hsph.harvard.edu
authors.forename: Stephanie E
authors.initials: SE
authors.lastname: Chiuve
authors.forename: Eric B
authors.initials: EB
authors.lastname: Rimm
authors.forename: Roopinder K
authors.initials: RK
authors.lastname: Sandhu
authors.forename: Adam M
authors.initials: AM
authors.lastname: Bernstein
authors.forename: Kathy M
authors.initials: KM
authors.lastname: Rexrode
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.forename: Christine M
authors.initials: CM
authors.lastname: Albert
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D004041:Dietary Fats / Q000009:adverse effects* / Q000627:therapeutic use; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use; D043371:Fatty Acids, Omega-6 / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D008954:Models, Biological; D015233:Models, Statistical; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D004041:Dietary Fats; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6