title: Contribution of Trans-Fatty Acid Intake to Coronary Heart Disease Burden in Australia: A Modelling Study.
abstract: Trans-fatty acids (TFAs) intake has been consistently associated with a higher risk of coronary heart disease (CHD) mortality. We provided an updated assessment of TFA intake in Australian adults in 2010 and conducted modeling to estimate CHD mortality attributable to TFA intake. Data of the 2011-2012 National Nutrition and Physical Activity Survey was used to assess TFA intake. The CHD burden attributable to TFA was calculated by comparing the current level of TFA intake to a counterfactual setting where consumption was lowered to a theoretical minimum distribution of 0.5% energy. The average TFA intake among adults was 0.59% energy, and overall 10% of adults exceeded the World Health Organization (WHO) recommended limit of 1% energy. Education and income were moderately and inversely associated with TFA intake (p-value ≤ 0.001), with one in seven adults in the lowest income and education quintile having >1% energy from TFA. Australia had 487 CHD deaths (95% uncertainty interval, 367-615) due to TFA exposure, equivalent to 1.52% (95% uncertainty limits: 1.15%-1.92%) of all CHD mortality. The relative impact of TFA exposure on CHD mortality in Australia is limited, but, in absolute terms, still substantial. Policies aimed at reducing industrial TFA exposure can reduce socioeconomic inequalities in health and may therefore be desirable.
authors.affiliation: The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney 2042, Australia. jwu1@georgeinstitute.org.au.
authors.forename: Jason H Y
authors.initials: JH
authors.lastname: Wu
authors.affiliation: The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney 2042, Australia. miaobing.zheng@sydney.edu.au.
authors.forename: Miaobing
authors.initials: M
authors.lastname: Zheng
authors.affiliation: The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney 2042, Australia. eliseeleven@gmail.com.
authors.forename: Elise
authors.initials: E
authors.lastname: Catterall
authors.affiliation: Earth Institute and Institute of Human Nutrition, Columbia University, New York, NY 10025, USA. shauna.downs@sydney.edu.au.
authors.forename: Shauna
authors.initials: S
authors.lastname: Downs
authors.affiliation: National Heart Foundation of Australia, Heart Health & Research, Brisbane 4006, Australia. beth.meertens@heartfoundation.org.au.
authors.forename: Beth
authors.initials: B
authors.lastname: Thomas
authors.affiliation: School of Public Health, the University of Queensland, Brisbane 4006, Australia. l.veerman@sph.uq.edu.au.
authors.forename: Lennert
authors.initials: L
authors.lastname: Veerman
authors.affiliation: School of Public Health, the University of Queensland, Brisbane 4006, Australia. j.barendregt@sph.uq.edu.au.|Epigear International, Sunrise Beach 4567, Australia. j.barendregt@sph.uq.edu.au.
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Barendregt
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D003327:Coronary Disease / Q000401:mortality*; D004041:Dietary Fats / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015596:Nutrition Assessment; D018673:Nutrition Policy; D012307:Risk Factors; D044242:Trans Fatty Acids / Q000008:administration & dosage* / Q000009:adverse effects*; D014944:World Health Organization
chemical_list: D004041:Dietary Fats; D044242:Trans Fatty Acids
keywords: Australia; burden; coronary heart disease; mortality; trans-fatty acid