title: Intake of trans fat and all-cause mortality in the Reasons for Geographical and Racial Differences in Stroke (REGARDS) cohort.
abstract: BACKGROUND
  A high intake of trans fatty acids decreases HDL cholesterol and is associated with increased LDL cholesterol, inflammation, diabetes, cancer, and mortality from cardiovascular disease. The relation between trans fat intake and all-cause mortality has not been established.
  
  
  OBJECTIVE
  The aim of this study was to determine the relation between trans fat intake and all-cause mortality.
  
  
  METHODS
  We used data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study-a prospective cohort study of white and black men and women residing in the continental United States. Energy-adjusted trans fat intake was categorized into quintiles, and Cox-regression was used to evaluate the association between trans fat intake and all-cause mortality.
  
  
  RESULTS
  During 7 y of follow-up, there were 1572 deaths in 18,513 participants included in REGARDS. From the first to the fifth quintile of trans fat intake, the mortality rates per 1000 person-years of follow-up (95% CIs) were 12.8 (11.3, 14.5), 14.3 (12.7, 16.2), 14.6 (13.0, 16.5), 19.0 (17.1, 21.1), and 23.6 (21.5, 25.9), respectively. After adjustment for demographic factors, education, and risk factors for mortality, the HRs (95% CIs) for all-cause mortality were 1.00, 1.03 (0.86, 1.23), 0.98 (0.82, 1.17), 1.25 (1.05, 1.48), and 1.24 (1.05, 1.48), respectively (P-trend = 0.004). The population attributable risk due to trans fat intake was 7% (95% CI: 5%, 8%).
  
  
  CONCLUSIONS
  Higher trans fat intake is associated with an increased risk of all-cause mortality.
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: James N
authors.initials: JN
authors.lastname: Kiage
authors.forename: Peter D
authors.initials: PD
authors.lastname: Merrill
authors.forename: Cody J
authors.initials: CJ
authors.lastname: Robinson
authors.forename: Yue
authors.initials: Y
authors.lastname: Cao
authors.forename: Talha A
authors.initials: TA
authors.lastname: Malik
authors.forename: Barrett C
authors.initials: BC
authors.lastname: Hundley
authors.forename: Ping
authors.initials: P
authors.lastname: Lao
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Judd
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
authors.forename: Virginia J
authors.initials: VJ
authors.lastname: Howard
authors.forename: Edmond K
authors.initials: EK
authors.lastname: Kabagambe
mesh_terms: D001741:Black or African American; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D015144:Southeastern United States / Q000453:epidemiology; D020521:Stroke / Q000209:etiology / Q000401:mortality*; D011795:Surveys and Questionnaires; D044242:Trans Fatty Acids / Q000008:administration & dosage* / Q000009:adverse effects* / Q000097:blood; D044465:White People
chemical_list: D008076:Cholesterol, HDL; D044242:Trans Fatty Acids
references.citation: Atherosclerosis. 1994 Mar;106(1):99-107
references.pmid: 8018112
references.citation: J Nutr. 2005 Mar;135(3):562-6
references.pmid: 15735094
references.citation: BMC Nephrol. 2011 Jun 29;12:30
references.pmid: 21714897
references.citation: Am J Epidemiol. 2008 Jun 1;167(11):1312-20
references.pmid: 18390841
references.citation: PLoS One. 2012;7(10):e47430
references.pmid: 23077615
references.citation: N Engl J Med. 2006 Apr 13;354(15):1601-13
references.pmid: 16611951
references.citation: Am J Clin Nutr. 2001 Jun;73(6):1019-26
references.pmid: 11382654
references.citation: Stroke. 2011 Feb;42(2):517-84
references.pmid: 21127304
references.citation: J AOAC Int. 2009 Sep-Oct;92(5):1258-76
references.pmid: 19916364
references.citation: Ann Neurol. 2012 Nov;72(5):704-15
references.pmid: 22383309
references.citation: Neuroepidemiology. 2005;25(3):135-43
references.pmid: 15990444
references.citation: Circulation. 1998 Aug 25;98(8):731-3
references.pmid: 9727541
references.citation: Am J Public Health. 1994 May;84(5):722-4
references.pmid: 8179036
references.citation: PLoS Med. 2009 Apr 28;6(4):e1000058
references.pmid: 19399161
references.citation: Cancer Causes Control. 2007 Jun;18(5):571-9
references.pmid: 17387622
references.citation: J Atheroscler Thromb. 2011;18(12):1071-9
references.pmid: 21921415
references.citation: PLoS One. 2010 Mar 02;5(3):e9434
references.pmid: 20209147
references.citation: Am J Clin Nutr. 2003 Sep;78(3):370-5
references.pmid: 12936917
references.citation: Prev Med. 1995 May;24(3):308-15
references.pmid: 7644455
references.citation: Oncology (Williston Park). 2002 Feb;16(2):217-26, 229; discussion 230-2
references.pmid: 11866137
references.citation: Arterioscler Thromb Vasc Biol. 2001 Jul;21(7):1233-7
references.pmid: 11451757
references.citation: Annu Rev Med. 2000;51:511-23
references.pmid: 10774479
references.citation: N Engl J Med. 1999 Jun 24;340(25):1994-8
references.pmid: 10379026
references.citation: N Engl J Med. 1999 Jan 14;340(2):115-26
references.pmid: 9887164
references.citation: Epidemiology. 2001 Jan;12(1):88-93
references.pmid: 11138826
references.citation: Stroke. 2009 Dec;40(12):3706-10
references.pmid: 19834015
references.citation: Annu Rev Microbiol. 2000;54:615-40
references.pmid: 11018139
references.citation: Am J Clin Nutr. 2004 Dec;80(6):1521-5
references.pmid: 15585763
references.citation: Public Health Nutr. 2006 Feb;9(1):84-93
references.pmid: 16480538
references.citation: Bull Cancer. 2005 Jul;92(7):670-84
references.pmid: 16123006
references.citation: J Nutr. 2011 Sep;141(9):1673-8
references.pmid: 21753062
references.citation: Am J Epidemiol. 2007 Mar 15;165(6):684-95
references.pmid: 17215383
references.citation: Stroke. 2012 Apr;43(4):974-9
references.pmid: 22328552
references.citation: Clin Chem. 2009 Sep;55(9):1627-36
references.pmid: 19643839
references.citation: J Nutr. 1993 Mar;123(3):489-501
references.pmid: 8463852
references.citation: Am J Clin Nutr. 2004 Jun;79(6):969-73
references.pmid: 15159225
references.citation: Nature. 2002 Dec 19-26;420(6917):860-7
references.pmid: 12490959
references.citation: Am J Epidemiol. 2001 Dec 15;154(12):1089-99
references.pmid: 11744511
references.citation: Diabetol Metab Syndr. 2011 Sep 22;3:24
references.pmid: 21939559
references.citation: Lipids. 2012 Oct;47(10):931-40
references.pmid: 22903556
references.citation: Am J Epidemiol. 2011 Aug 1;174(3):284-92
references.pmid: 21685411
references.citation: Am J Clin Nutr. 2003 May;77(5):1146-55
references.pmid: 12716665
references.citation: Am J Clin Nutr. 1997 Apr;65(4 Suppl):1220S-1228S; discussion 1229S-1231S
references.pmid: 9094926
references.citation: Am J Clin Nutr. 2004 Apr;79(4):606-12
references.pmid: 15051604
references.citation: N Engl J Med. 2000 Mar 23;342(12):836-43
references.pmid: 10733371
references.citation: Metabolism. 2002 Dec;51(12):1534-7
references.pmid: 12489064
references.citation: Fed Regist. 2003 Jul 11;68(133):41433-1506
references.pmid: 12856667
references.citation: Nutr Cancer. 2010;62(6):710-8
references.pmid: 20661818
references.citation: J Clin Epidemiol. 1990;43(12):1327-35
references.pmid: 2254769