Dietary intake of saturated fat by food source and incident cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis

Abstract

Background: Although dietary recommendations have focused on restricting saturated fat (SF) consumption to reduce cardiovascular disease (CVD) risk, evidence from prospective studies has not supported a strong link between total SF intake and CVD events. An understanding of whether food sources of SF influence these relations may provide new insights.

Objective: We investigated the association of SF consumption from different food sources and the incidence of CVD events in a multiethnic population.

Design: Participants who were 45-84 y old at baseline (n = 5209) were followed from 2000 to 2010. Diet was assessed by using a 120-item food-frequency questionnaire. CVD incidence (316 cases) was assessed during follow-up visits.

Results: After adjustment for demographics, lifestyle, and dietary confounders, a higher intake of dairy SF was associated with lower CVD risk [HR (95% CI) for +5 g/d and +5% of energy from dairy SF: 0.79 (0.68, 0.92) and 0.62 (0.47, 0.82), respectively]. In contrast, a higher intake of meat SF was associated with greater CVD risk [HR (95% CI) for +5 g/d and a +5% of energy from meat SF: 1.26 (1.02, 1.54) and 1.48 (0.98, 2.23), respectively]. The substitution of 2% of energy from meat SF with energy from dairy SF was associated with a 25% lower CVD risk [HR (95% CI): 0.75 (0.63, 0.91)]. No associations were observed between plant or butter SF and CVD risk, but ranges of intakes were narrow.

Conclusion: Associations of SF with health may depend on food-specific fatty acids or other nutrient constituents in foods that contain SF, in addition to SF.

Figures

FIGURE 1.

HRs and 95%s of CVD risk according to quintiles of energy-adjusted SF from different sources (n = 5209). All values were derived from proportional hazards models with adjustment for age (y), sex, race-ethnicity (non-Hispanic white, African American, Hispanic, and Chinese American), study center, energy intake (kcal/d), education (<high school, high school, or >high school), alcohol intake (g/d), physical activity (active and sedentary leisure in metabolic equivalents-min/wk), BMI (in kg/m2), cigarette smoking (never, current, or former smoker and pack-years of cigarette smoking), dietary supplement use (>1/wk; yes or no), use of cholesterol-lowering medication (yes or no), intakes of fruit and vegetables (servings/d), and energy-adjusted intakes of dietary fiber (g/d), dietary vitamin E (IU/d), trans fat, and PUFA (g/d). P-trend values for dairy, meat, plant, and butter SF were 0.01, 0.12, 0.38, and 0.45, respectively. SF, saturated fat.

FIGURE 2.

Fatty acid profiles for dairy and meat products. The dairy profile corresponds to whole-fat American cheese; the meat profile corresponds to 15% fat ground beef. Data source: USDA National Nutrient Database for Standard Reference, Release 24 (http://ndb.nal.usda.gov/ndb/foods/list).