title: Changes in Dietary Fat Intake and Projections for Coronary Heart Disease Mortality in Sweden: A Simulation Study.
abstract: OBJECTIVE
  In Sweden, previous favourable trends in blood cholesterol levels have recently levelled off or even increased in some age groups since 2003, potentially reflecting changing fashions and attitudes towards dietary saturated fatty acids (SFA). We aimed to examine the potential effect of different SFA intake on future coronary heart disease (CHD) mortality in 2025.
  
  
  METHODS
  We compared the effect on future CHD mortality of two different scenarios for fat intake a) daily SFA intake decreasing to 10 energy percent (E%), and b) daily SFA intake rising to 20 E%. We assumed that there would be moderate improvements in smoking (5%), salt intake (1g/day) and physical inactivity (5% decrease) to continue recent, positive trends.
  
  
  RESULTS
  In the baseline scenario which assumed that recent mortality declines continue, approximately 5,975 CHD deaths might occur in year 2025. Anticipated improvements in smoking, dietary salt intake and physical activity, would result in some 380 (-6.4%) fewer deaths (235 in men and 145 in women). In combination with a mean SFA daily intake of 10 E%, a total of 810 (-14%) fewer deaths would occur in 2025 (535 in men and 275 in women). If the overall consumption of SFA rose to 20 E%, the expected mortality decline would be wiped out and approximately 20 (0.3%) additional deaths might occur.
  
  
  CONCLUSIONS
  CHD mortality may increase as a result of unfavourable trends in diets rich in saturated fats resulting in increases in blood cholesterol levels. These could cancel out the favourable trends in salt intake, smoking and physical activity.
authors.affiliation: Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.|Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Björck
authors.affiliation: Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
authors.forename: Annika
authors.initials: A
authors.lastname: Rosengren
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Winkvist
authors.affiliation: Division of Public Health, University of Liverpool, Liverpool, United Kingdom.
authors.forename: Simon
authors.initials: S
authors.lastname: Capewell
authors.affiliation: Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.|Centre for Applied Biostatistics, Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Adiels
authors.affiliation: Division of Public Health, University of Liverpool, Liverpool, United Kingdom.
authors.forename: Piotr
authors.initials: P
authors.lastname: Bandosz
authors.affiliation: St George's, University of London, Population Health Research Institute, Cranmer Terrace, London, United Kingdom.
authors.forename: Julia
authors.initials: J
authors.lastname: Critchley
authors.affiliation: Research Unit, Medicine-Geriatric, Skellefteå, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Kurt
authors.initials: K
authors.lastname: Boman
authors.affiliation: Division of Public Health, University of Liverpool, Liverpool, United Kingdom.
authors.forename: Maria
authors.initials: M
authors.lastname: Guzman-Castillo
authors.affiliation: Division of Public Health, University of Liverpool, Liverpool, United Kingdom.
authors.forename: Martin
authors.initials: M
authors.lastname: O'Flaherty
authors.affiliation: Department of Odontology, Umeå University, Umeå, Sweden.
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Johansson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000453:epidemiology / Q000401:mortality* / Q000517:prevention & control; D004041:Dietary Fats / Q000378:metabolism*; D005227:Fatty Acids / Q000378:metabolism; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009026:Mortality / Q000639:trends; D012307:Risk Factors; D012907:Smoking; D017673:Sodium Chloride, Dietary / Q000378:metabolism; D013548:Sweden / Q000453:epidemiology
chemical_list: D004041:Dietary Fats; D005227:Fatty Acids; D017673:Sodium Chloride, Dietary; D002784:Cholesterol