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Am J Epidemiol 2004; 160:141-149.
Copyright © 2004 by the Johns Hopkins Bloomberg School of Public Health


ORIGINAL CONTRIBUTIONS

Dietary Fat and Risk of Coronary Heart Disease: Possible Effect Modification by Gender and Age

Marianne U. Jakobsen1,2 , Kim Overvad3,4,5, Jørn Dyerberg6, Marianne Schroll1,2 and Berit L. Heitmann1

1 Research Unit for Dietary Studies and Danish Epidemiology Science Centre, Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark.
2 Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark.
3 Department of Clinical Epidemiology, Aalborg Hospital, Aalborg, Denmark.
4 Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
5 Department of Epidemiology and Social Medicine, University of Aarhus, Aarhus, Denmark.
6 Department of Human Nutrition, Royal Veterinary and Agricultural University, Frederiksberg, Denmark.

In a 16-year follow-up study (ending in 1998) of 3,686 Danish men and women aged 30–71 years at recruitment, the association between energy intake from dietary fat and the risk of coronary heart disease was evaluated while assessing the possible modifying role of gender and age. In the models used, total energy and protein intake were fixed. Differences in intake of energy from fat thus reflected complementary differences in intake of energy from carbohydrates. A 5% higher level of energy from saturated fat intake was associated with a 36% greater risk of coronary heart disease among women (hazard ratio (HR) = 1.36, 95% confidence interval (CI): 0.98, 1.88). No overall association between saturated fat and coronary heart disease was found among men. However, age-dependent analyses showed that saturated fat was positively associated with coronary heart disease among the younger men (HR = 1.29, 95% CI: 0.87, 1.91) and the younger women (HR = 2.68, 95% CI: 1.40, 5.12) but not among the older men (HR = 0.94, 95% CI: 0.70, 1.28) and the older women (HR = 1.22, 95% CI: 0.86, 1.71). Polyunsaturated fat was inversely associated with coronary heart disease among women and men, although not significantly. In conclusion, the present study suggests that coronary heart disease risk relates to both the quantity and the quality of dietary fats.

carbohydrates; coronary disease; fatty acids

Abbreviations: Abbreviations: CI, confidence interval; HR, hazard ratio.


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