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Impact of Nonoptimal Intakes of Saturated, Polyunsaturated, and Trans Fat on Global Burdens of Coronary Heart Disease

2016; Wiley; Volume: 5; Issue: 1 Linguagem: Inglês

10.1161/jaha.115.002891

2047-9980

Qianyi Wang, Ashkan Afshin, Mohammad Yawar Yakoob, Gitanjali M Singh, Colin D. Rehm, Shahab Khatibzadeh, Renata Micha, Peilin Shi, Dariush Mozaffarian, Dariush Mozaffarian, Renata Micha, Peilin Shi, Majid Ezzati, Saman Fahimi, Shahab Khatibzadeh, John Powles, Ibrahim Elmadfa, Mayuree Rao, Pattra Wirojratana, Stephen S Lim, Rebecca E Engell, Kathryn Andrews, Pamela Abbott, Morteza Abdollahi, Enrique O. Abeyá Gilardon, Habibul Ahsan, Mohannad Abed Alfattah Al Nsour, Suad Al-Hooti, Carukshi Arambepola, B. Hubert, Sı́món Barquera, Ana Baylín, Wulf Becker, Peter Bjerregaard, Lesley T. Bourne, Neville Calleja, Katia Castetbon, Hsing‐Yi Chang, Melanie Cowan, Stefaan De Henauw, Eric L. Ding, Charmaine Duante, Pablo Durán, Ibrahim Elmadfa, Heléne Enghardt Barbieri, Farshad Farzadfar, Dulitha N. Fernando, Aida Filipović Hadžiomeragić, Regina Mara Fisberg, Simon Forsyth, Didier Garriguet, Jean‐Michel Gaspoz, Dorothy Gauci, Brahmam N. V. Ginnela, Idris Guessous, Wilbur Hadden, Daniël J. Hoffman, Anahita Houshiarrad, Inge Huybrechts, Nahla Hwalla, Hajah Masni Ibrahim, Manami Inoue, Maria Jackson, Lars Johansson, Lital Keinan‐Boker, Cho‐il Kim, Eda Köksal, Hae‐Jeung Lee, Yanping Li, Nur Indrawaty Lipoeto, Guansheng Ma, Guadalupe Mangialavori, Yasuhiro Matsumura, Gert Mensink, Stephen T. McGarvey, Chan Mei Fen, Rafael Monge‐Rojas, Abdulrahman O. Musaiger, Nagalla Balakrishna, Androniki Naska, Marga C. Ocké, Mariusz Ołtarzewski, Philippos Orfanos, Marja‐Leena Ovaskainen, Wen‐Harn Pan, Demosthenes B. Panagiotakos, Gülden Pekcan, Stefka Petrova, Noppawan Piaseu, Christos Pitsavos, Luz Gladys Posada, Leanne M Riley, Luz María Sánchez‐Romero, Rusidah B. T. Selamat, Sangita Sharma, Abla Mehio Sibai, Rosely Sichieri, Chansimaly Simmala, Laufey Steingrímsdóttir, Gillian Swan, Elzbieta Sygnowska, L Szponar, Heli Tapanainen, Robert Templeton, Anastasia Thanopoulou, Hólmfríður Þorgeirsdóttir, Inga Þórsdóttir, Antonia Trichopoulou, Shoichiro Tsugane, Aida Turrini, Sirje Vaask, Coline van Oosterhout, Lennert Veerman, Verena Nowak, Anna Waśkiewicz, Sahar Zaghloul, G Zajkás,

Obesity, Physical Activity, Diet

Background Saturated fat ( SFA ), ω‐6 (n‐6) polyunsaturated fat ( PUFA ), and trans fat ( TFA ) influence risk of coronary heart disease ( CHD ), but attributable CHD mortalities by country, age, sex, and time are unclear. Methods and Results National intakes of SFA , n‐6 PUFA , and TFA were estimated using a Bayesian hierarchical model based on country‐specific dietary surveys; food availability data; and, for TFA , industry reports on fats/oils and packaged foods. Etiologic effects of dietary fats on CHD mortality were derived from meta‐analyses of prospective cohorts and CHD mortality rates from the 2010 Global Burden of Diseases study. Absolute and proportional attributable CHD mortality were computed using a comparative risk assessment framework. In 2010, nonoptimal intakes of n‐6 PUFA , SFA , and TFA were estimated to result in 711 800 (95% uncertainty interval [UI] 680 700–745 000), 250 900 (95% UI 236 900–265 800), and 537 200 (95% UI 517 600–557 000) CHD deaths per year worldwide, accounting for 10.3% (95% UI 9.9%–10.6%), 3.6%, (95% UI 3.5%–3.6%) and 7.7% (95% UI 7.6%–7.9%) of global CHD mortality. Tropical oil–consuming countries were estimated to have the highest proportional n‐6 PUFA – and SFA ‐attributable CHD mortality, whereas Egypt, Pakistan, and Canada were estimated to have the highest proportional TFA ‐attributable CHD mortality. From 1990 to 2010 globally, the estimated proportional CHD mortality decreased by 9% for insufficient n‐6 PUFA and by 21% for higher SFA, whereas it increased by 4% for higher TFA , with the latter driven by increases in low‐ and middle‐income countries. Conclusions Nonoptimal intakes of n‐6 PUFA , TFA , and SFA each contribute to significant estimated CHD mortality, with important heterogeneity across countries that informs nation‐specific clinical, public health, and policy priorities.