title: Dietary intakes of fat and total mortality among Japanese populations with a low fat intake: the Japan Collaborative Cohort (JACC) Study.
abstract: BACKGROUND
  It may be useful to examine associations of fat intakes with total mortality as a basis for dietary recommendations. We aimed to elucidate associations between dietary fat and total mortality among Japanese populations with low fat intake.
  
  
  METHODS
  We conducted a prospective study consisting of 58,672 men and women aged 40 to 79 years. Fat intakes were estimated using a food frequency questionnaire. Multivariate-adjusted hazard ratios (HRs) for mortality by sex were computed according to quintiles of energy-adjusted fat intakes.
  
  
  RESULTS
  During the follow-up period (median duration, 19.3 years), 11,656 deaths were recorded. In men, we found no clear association between total fat and total mortality. HRs across quintiles of total fat intake were 1.00, 1.03 (95% confidence interval [CI], 0.95-1.12), 1.02 (0.94-1.10), 0.98 (0.90-1.07), and 1.07 (0.98-1.17). No significant association was detected in regard to types of fat. In women, HR was lowest in the fourth quintile of total fat intake followed by the top quintile; HRs across quintiles were 1.00, 1.03 (0.94-1.11), 1.00 (0.92-1.09), 0.88 (0.81-0.96), and 0.94 (0.86-1.03). Regarding types of fat in women, total mortality was inversely associated with intakes of saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), and polyunsaturated fatty acids (PUFA); the lowest HR was in the top quintile of intake for SFA, MUFA, and PUFA: 0.91 (95% CI, 0.83-1.00), 0.91 (0.83-0.99) and 0.88 (0.80 - 0.97), respectively (trend P across quintiles, 0.020, 0.012, and 0.029, respectively). Causes of death other than cancer and cardiovascular disease contributed most to decreases in HRs for total and types of fat. In women, analysis with finer categories revealed that the lowest risk for total mortality appeared at total fat intake of 28% of energy.
  
  
  CONCLUSIONS
  Our findings from a large cohort study among populations with relatively low fat intake provide evidence regarding optimal levels of fat intakes.
authors.affiliation: Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan. wakai@med.nagoya-u.ac.jp.
authors.forename: Kenji
authors.initials: K
authors.lastname: Wakai
authors.forename: Mariko
authors.initials: M
authors.lastname: Naito
authors.forename: Chigusa
authors.initials: C
authors.lastname: Date
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iso
authors.forename: Akiko
authors.initials: A
authors.lastname: Tamakoshi