title: Dietary Saturated Fatty Acids and Coronary Heart Disease Risk in a Dutch Middle-Aged and Elderly Population.
abstract: We assessed whether the association between dietary saturated fatty acids (SFA) and incident coronary heart disease (CHD) depends on the food source, the carbon chain length of SFA, and the substituting macronutrient.
  
  
  
  From the Rotterdam Study, 4722 men and women (≥55 years) were included. Baseline (1990-1993) SFA intake was assessed using a validated food frequency questionnaire. CHD (nonfatal myocardial infarction and fatal CHD) was ascertained by medical records. Using multivariable Cox regression analysis, we calculated CHD risks for higher intakes of total SFA, SFA from specific food sources, SFA differing in carbon chain length, and substituting other macronutrients instead of SFA. During a median follow-up of 16.3 years, 659 CHD events occurred. Total SFA intake was not associated with CHD risk (hazard ratio [HR] per 5 en%, 1.13; 95% confidence interval, 0.94-1.22), and neither was SFA from specific food sources. A higher CHD risk was observed for palmitic acid (16:0) intake (HRSD, 1.26; 95% confidence interval, 1.05-1.15) but not for SFA with other chain lengths. Except for a higher CHD risk for substitution of SFA with animal protein (HR5en%, 1.24; 95% confidence interval, 1.01-1.51), substitution with other macronutrients was not associated with CHD.
  
  
  
  In this Dutch population, we observed that a higher intake of palmitic acid, which accounts for ≈50% of the total SFA intake, was associated with a higher CHD risk, as was substitution of total SFA with animal protein. Nevertheless, we found no association between total SFA intake and CHD risk, which did not differ by food source.
authors.affiliation: From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.).
authors.forename: Jaike
authors.initials: J
authors.lastname: Praagman
authors.affiliation: From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.).
authors.forename: Ester A L
authors.initials: EA
authors.lastname: de Jonge
authors.affiliation: From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.). j.c.kiefte-dejong@erasmusmc.nl.
authors.forename: Jessica C
authors.initials: JC
authors.lastname: Kiefte-de Jong
authors.affiliation: From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.).
authors.forename: Joline W J
authors.initials: JW
authors.lastname: Beulens
authors.affiliation: From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.).
authors.forename: Ivonne
authors.initials: I
authors.lastname: Sluijs
authors.affiliation: From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.).
authors.forename: Josje D
authors.initials: JD
authors.lastname: Schoufour
authors.affiliation: From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.).
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.).
authors.forename: Yvonne T
authors.initials: YT
authors.lastname: van der Schouw
authors.affiliation: From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.).
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
mesh_terms: D000367:Age Factors; D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology*; D004032:Diet / Q000009:adverse effects; D004044:Dietary Proteins / Q000009:adverse effects; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D019308:Palmitic Acid / Q000009:adverse effects*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D004044:Dietary Proteins; D019308:Palmitic Acid
keywords: atherosclerosis; cholesterol; cohort studies; coronary disease; fatty acids