title: Dietary fatty acids and risk of coronary heart disease in men: the Kuopio Ischemic Heart Disease Risk Factor Study.
abstract: OBJECTIVE
  The epidemiological evidence of the role of dietary saturated fatty acids (SFA) in the development of coronary heart disease (CHD) is inconsistent. We investigated the associations of dietary fatty acids with the risk of CHD and carotid atherosclerosis in men with high SFA intake and high rates of CHD.
  
  
  RESULTS
  In total, 1981 men from the population-based Kuopio Ischemic Heart Disease Risk Factor Study (KIHD), aged 42 to 60 years and free of CHD at baseline in 1984 to 1989, were investigated. Food consumption was assessed with 4-day food recording. Multivariate nutrient-density models were used to analyze isocaloric replacement of nutrients. CHD events were ascertained from national registries. Carotid atherosclerosis was assessed by ultrasonography of the common carotid artery intima-media thickness in 1015 men. During the average follow-up of 21.4 years, 183 fatal and 382 nonfatal CHD events occurred. SFA or trans fat intakes were not associated with CHD risk. In contrast, monounsaturated fat intake was associated with increased risk and polyunsaturated fat intake with decreased risk of fatal CHD, whether replacing SFA, trans fat, or carbohydrates. The associations with carotid atherosclerosis were broadly similar, whereas the associations with nonfatal CHD were weaker.
  
  
  CONCLUSIONS
  Our results suggest that SFA intake is not an independent risk factor for CHD, even in a population with higher ranges of SFA intake. In contrast, polyunsaturated fat intake was associated with lower risk of fatal CHD, whether replacing SFA, trans fat, or carbohydrates. Further investigation on the effect of monounsaturated fat on the CHD risk is warranted.
authors.affiliation: From the Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. jyrki.virtanen@uef.fi.
authors.forename: Jyrki K
authors.initials: JK
authors.lastname: Virtanen
authors.affiliation: From the Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
authors.forename: Jaakko
authors.initials: J
authors.lastname: Mursu
authors.affiliation: From the Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
authors.forename: Tomi-Pekka
authors.initials: TP
authors.lastname: Tuomainen
authors.affiliation: From the Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
authors.forename: Sari
authors.initials: S
authors.lastname: Voutilainen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002340:Carotid Artery Diseases / Q000453:epidemiology / Q000209:etiology; D059168:Carotid Intima-Media Thickness; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology*; D015930:Diet Records; D004041:Dietary Fats / Q000008:administration & dosage* / Q000009:adverse effects*; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage / Q000009:adverse effects; D004435:Eating; D005227:Fatty Acids / Q000008:administration & dosage* / Q000009:adverse effects*; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage / Q000009:adverse effects; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage / Q000009:adverse effects; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D015999:Multivariate Analysis; D012307:Risk Factors; D044242:Trans Fatty Acids / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D004041:Dietary Fats; D004042:Dietary Fats, Unsaturated; D005227:Fatty Acids; D005229:Fatty Acids, Monounsaturated; D005231:Fatty Acids, Unsaturated; D044242:Trans Fatty Acids
keywords: atherosclerosis; coronary disease; fatty acids