scholarly journals Coronary heart disease: dietary links and pathogenesis

2001 ◽  
Vol 4 (2b) ◽  
pp. 459-474 ◽  
Author(s):  
Serge Renaud ◽  
Dominique Lanzmann-Petithory
Keyword(s):  
Fatty Acids ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Saturated Fatty Acids ◽  
Epidemiologic Studies ◽  
Key Factors ◽  
Alpha Linolenic Acid ◽  
Intervention Trials ◽  
The Relationship

AbstractFor decades it has been postulated that the main environmental factor for coronary heart disease (CHD) was the intake of saturated fatty acids (SFA). Nevertheless, confirmation of the role of SFA in CHD through intervention trials has been disappointing. It was only when the diet was enriched in n-3 fatty acids that CHD was significantly prevented, especially cardiac death.In addition to n-3 fatty acids, many other foodstuffs or nutrients such as fibers, antioxidants, folic acid, calcium and even alcohol contribute to prevent CHD. Thus the relationship between diet and CHD morbidity and mortality appears to be much more complex than formerly suspected considering as key factors only SFA, linoleic acid, cholesterol and atherosclerosis. Some of the mechanisms are briefly described, but many additional nutrients (or non nutrients) may also play an important role in the pathogenesis of CHD.Finally, as a result of the most recent epidemiologic studies the ideal diet may comprise: 8% energy from SFA, 5% from polyunsaturated fatty acids with a ratio 5/1 of linoleic/alpha-linolenic acid+longer chains n-3, oleic acid as desired, large intake of cereals, vegetables, legumes and fruits, fish twice a week, cheese and yogurt as dairy products, rapeseed and olive oils as edible fat. Without side effects, such a diet can be highly palatable, easily enjoyed by many populations and may prevent effectively and rapidly (within a few weeks or months) CHD.

Abstract 50: Associations of Dietary Saturated Fatty Acids With Incident Coronary Heart Disease Depend on the Food Sources: EPIC-CVD Prospective Case-cohort Study in Nine European Countries

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Marinka Steur ◽  
Keyword(s):  
Fatty Acids ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Energy Intake ◽  
Saturated Fatty Acids ◽  
Red Meat ◽  
Dietary Fatty Acids ◽  
Food Sources ◽  
Total Fatty Acids ◽  
Country Specific

Introduction: The associations of dietary total fatty acids and the classes saturated, monounsaturated, and polyunsaturated fatty acids (SFAs, MUFAs, and PUFAs) with coronary heart disease (CHD) remain contentious. Moreover, the role of isocaloric macronutrient substitutions and specific food sources of SFAs, particularly in European context, is unclear. Hypothesis: We evaluated the hypothesis that associations of dietary fatty acids vary depending on specific macronutrient substitutions and food sources of SFAs. Methods: We conducted case-cohort analyses including 10,529 incident CHD cases and a random subcohort of 16,730 men and women selected from 385,747 eligible participants in nine countries of the European Prospective Investigation into Cancer and Nutrition Study. Habitual diet was assessed using country-specific dietary questionnaires, and macronutrient intakes were estimated using standardised nutrient databases. Country-specific HRs (95% CIs) per 5% energy intake from dietary total fatty acids, SFAs, MUFAs, and PUFAs were estimated using Prentice-weighted Cox regression models and pooled using random-effects meta-analyses, with and without considering isocaloric macronutrient substitutions. The associations of dietary SFAs from different food sources, including specific macronutrient substitutions, with CHD were also investigated. Results: There was no evidence of associations of dietary total fatty acids, SFAs, MUFAs, or PUFAs with incident CHD, regardless of the substitution macronutrient. Each 1% higher energy intake of SFAs from yoghurt, cheese, and fish were associated with a 7% (95% CI 1-12%), 2% (0-4%) and 13% (0-25%) lower CHD incidence, while SFAs from red meat and butter were associated with a 7% (2-12%) and 2% (0-4%) higher CHD incidence, respectively. Conclusions: There was no evidence of associations of dietary total fatty acids, SFAs, MUFAs, and PUFAs, with CHD incidence, regardless of the substitution nutrients, within the range of intakes in this European population. The opposite direction of associations of SFAs from different food sources such as red meat versus fermented dairy products suggests that public health recommendations should consider foods and overall diets, alongside the macronutrients they contain.

Abstract MP068: Dietary Fatty Acids and Coronary Heart Disease in Mortality in the Alpha Omega Cohort

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Famke J Mölenberg ◽  
Janette de Goede ◽  
Anne J Wanders ◽  
Peter L Zock ◽  
Daan Kromhout ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Lower Risk ◽  
Unsaturated Fatty Acids ◽  
Saturated Fatty Acids ◽  
Dietary Cholesterol ◽  
Dietary Factors ◽  
Dietary Fatty Acids ◽  
Alpha Omega

Background: Replacement of saturated fatty acids (SFA) with polyunsaturated fatty acids (PUFA) is associated with a lower risk of coronary heart disease (CHD) in the general population. Whether this is also the case for CHD patients is not yet clear. In this observational study of Dutch CHD patients, we examined the risk of CHD mortality for the exchange of SFA with total unsaturated fatty acids (UFA), PUFA and cis -monounsaturated fatty acids (MUFA). Methods: We included 4146 post-myocardial infarction patients aged 60-80 (78% male; Alpha Omega Cohort) in whom diet was assessed at baseline (2002-2006) by a validated 203-item food-frequency questionnaire. Cause-specific mortality was monitored until January 2013. Iso-caloric replacement of SFA with (subgroups of) UFA in relation to CHD mortality was studied in quintiles and continuously per 5 energy percent (en%), using Cox regression models. Hazard ratios (HR, 95%-CI) were obtained after adjustment for age, sex, BMI, smoking, education, physical activity, cardiovascular drugs (anticoagulants, antihypertensives, statins), diabetes, and dietary factors, i.e. total energy, protein (en%), carbohydrates (en%), trans fatty acids (en%), dietary fiber (g/d) and dietary cholesterol (mg/d). The model for PUFA also included MUFA as a covariate, and vice versa . Results: During a median follow-up of 7.3 years, there were 888 deaths including 249 CHD deaths. SFA replacement was inversely associated with CHD mortality when comparing extreme quintiles of intake, which was statistically significant for total UFA (HR: 0.44; 95% CI: 0.21-0.92; P = 0.03) and non-significant for PUFA (0.58, 0.31-1.09) and MUFA (0.81, 0.45-1.49). When expressed per 5 en% (Figure), replacing SFA with either UFA, PUFA or MUFA was associated with a more than 30% lower risk of CHD mortality. Findings were similar when confined to statin users. Conclusion: In well-treated CHD patients, replacement of SFA by UFA is associated with a lower CHD mortality risk.

Abstract MP001: Plasma Lipophilic Index and Risk of Coronary Heart Disease in US Men

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Hongyu Wu ◽  
Eric L Ding ◽  
Eric B Rimm ◽  
Frank B Hu ◽  
Qi Sun
Keyword(s):  
Fatty Acids ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Fatty Acid ◽  
Saturated Fatty Acids ◽  
Critical Role ◽  
Gas Liquid Chromatography ◽  
Multivariate Adjustment ◽  
Increased Risk ◽  
Chd Risk Factors

Background: Lipophilicity of fatty acids plays a critical role in modulating the fluidity and function of cellular and lipoprotein membranes that are involved in the etiology of coronary heart disease (CHD). However, no data are available on the relationship between overall fatty acid lipophilicity and risk of CHD. Objective: To examine a novel index of fatty acid lipophilicity in relation to risk of CHD in men. Methods: In a prospective CHD case-control study nested in the Health Professionals Follow-up Study (HPFS), fatty acids in total plasma and erythrocyte membrane were measured by gas-liquid chromatography in 459 CHD cases and 879 matched controls. Plasma lipophilic index (LI) was computed by summing the products between relative density (proportion of total fatty acids) of 21 major fatty acids and their melting points. Erythrocyte LI was derived from 14 fatty acids using the same method. Results: Both plasma and erythrocyte LI summarized a pattern that featured high saturated fatty acids and low polyunsaturated fatty acids. Plasma C24:0, C22:0, C20:0, C23:0, C18:0 (all P <0.0001) were positively and C20:5n–3, C22:6n–3, and C20:4n–6 (all P <0.0001) were inversely associated with plasma LI, and these fatty acids jointly explained ∼71% of plasma LI variation among control participants. Among controls, higher plasma LI was significantly correlated with adverse profiles of CHD risk factors, including elevated levels of triglycerides, C-reactive protein, interlukin-6, and tumor necrosis factor α receptor 1 and 2, and lower level of HDL-cholesterol and adiponectin (all P <0.005). After multivariate adjustment of covariates including age, smoking status, body mass index, and physical activity, plasma LI was significantly associated with increased risk of total CHD: odds ratio (95% confidence interval) was 1.82 (1.16, 2.86; P for trend = 0.016) comparing extreme quintiles. The association was more pronounced for non-fatal myocardial infarction (OR=2.06, 95% CI 1.24, 3.42; P for trend = 0.004) than for fatal CHD (OR=1.04, 95% CI 0.31, 3.55; P for trend = 0.63). The association between erythrocyte LI and risk of CHD was not significant after multivariate adjustment (OR=1.18, 95% CI 0.71, 1.79; P for trend = 0.66). Conclusions: Our data indicate that the novel plasma lipophilic index, which summarizes overall lipophilicity of major fatty acids in plasma, is associated with an increased risk of CHD in men.

Abstract P414: Biomarkers of Very Long-chain Saturated Fatty Acids and Incident Coronary Heart Disease: Prospective Evidence From 15 Cohorts in the Fatty Acids and Outcomes Research Consortium

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Andres V Ardisson Korat ◽  
Frank Qian ◽  
Fumiaki Imamura ◽  
Nathan Tintle ◽  
Jiaying Chen ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Outcomes Research ◽  
Arachidic Acid ◽  
Saturated Fatty Acids ◽  
Inverse Association ◽  
Total Plasma ◽  
Research Consortium ◽  
Long Chain

Background: Biomarker levels of very long-chain saturated fatty acids (VLCSFAs) have been found to be favorably associated with cardiovascular risk factors including lower risk of diabetes and reduced triglycerides. Few studies have examined the association between VLCSFAs and coronary heart disease (CHD). Aims: To assess the association of circulating arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0) with incident total, fatal, and nonfatal CHD. Methods: We used data from the Fatty Acids and Outcomes Research Consortium consisting of 15 prospective cohorts worldwide which included adults (age≥18 years) who were free of cardiovascular disease and had blood measurements of 20:0, 22:0, and 24:0 at baseline. A study protocol with standardized definitions of exposures, disease outcomes, and covariates was developed, for which each cohort conducted individual participant-level analysis. Cohort-specific associations were pooled using inverse variance-weighted meta-analysis to calculate the overall relative risk (RR) per interquintile range (difference between the 90 th and 10 th percentiles) and 95% confidence interval (CI). Results: Among 33,083 participants, 6,165 cases of total CHD were ascertained. The overall pooled RR and 95% CI were 0.96 (0.89, 1.02) for 20:0, 1.01 (0.92, 1.11) for 22:0, 0.94 (0.86, 1.02) for 24:0, and 0.96 (0.89, 1.04) for 20:0 + 22:0 + 24:0 ( Figure 1 ). However, we noted heterogeneity by lipid compartments, with significant inverse associations for higher 22:0 [0.77 (0.62, 0.96)], 24:0 [0.61 (0.49, 0.77)], and 20:0 + 22:0 + 24:0 [0.73 (0.60, 0.89)] in the total plasma/serum compartment but not in the phospholipid compartment. Similar associations were observed for fatal and nonfatal CHD and when using a random-effects model. Conclusion: Higher circulating VLCSFAs were not associated with total CHD in a global consortium of prospective studies. The finding of an inverse association with total CHD for VLCSFAs in the total plasma/serum compartment warrants further research.

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