Healthier Fats Could Reduce Heart Disease
Nonoptimal intakes of n-6 polyunsaturated fat (PUFA), trans fat (TFA), and saturated fat (SFA) each contribute to significant estimated coronary heart disease (CHD) mortality, with important heterogeneity across countries that informs nation-specific clinical, public health, and policy priorities, according to a new study.
“Considerable heterogeneity is evident in intakes of these dietary fats and in CHD mortality rates globally; however, differences in CHD mortality attributable to nonoptimal intakes of SFA, n-6 PUFA, and TFA by country, age, and sex are not well established,” the researchers explained. “Furthermore, whereas dietary intakes and CHD rates have changed substantially in recent decades, the regional and country-level trends in these burdens have not been evaluated in detail.”
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The investigators estimated national intakes of SFA, n-6 PUFA, and TFA 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. They derived etiologic effects of dietary fats on CHD mortality from meta-analyses of prospective cohorts and CHD mortality rates from the 2010 Global Burden of Diseases study. With a comparative risk assessment framework, they computed absolute and proportional attributable CHD mortality.
In 2010, nonoptimal intakes of n-6 PUFA, SFA, and TFA resulted in 711800 (95% uncertainty interval [UI] 680700-745000), 250900 (95% UI 236900-265800), and 537200 (95% UI 517600-557000) CHD deaths per year worldwide, respectively, 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, such as the Solomon Islands, the Philippines, and Malaysia, had the highest proportional n-6 PUFA- and SFA-attributable CHD mortality. Egypt, Pakistan, and Canada, on the other hand, had the highest proportional TFA-attributable CHD mortality.
Comparing 1990 to 2010 globally, the researchers estimated proportional CHD mortality dropped by 9% for insufficient n-6 PUFA and by 21% for higher SFA. In contrast, it jumped by 4% for higher TFA.
“Our analysis provides, for the first time, a rigorous comparison of global CHD burdens attributable to insufficient n-6 PUFA versus higher SFA,” they concluded in their study that included info from 186 countries. “In 80% of nations, n-6 PUFA-attributable CHD burdens were at least 2-fold higher than SFA-attributable burdens. This suggests that focus on increasing healthful n-6-rich vegetable oils may provide important public health benefits.”
-Mike Bederka
Reference:
Wang Q, Afshin A, Yakoob MY, et al.; for the Global Burden of Diseases Nutrition and Chronic Diseases Expert Group. Impact of nonoptimal intakes of saturated, polyunsaturated, and trans fat on global burdens of coronary heart disease. J Am Heart Assoc. 2016;5:e002891 doi:10.1161/JAHA.115.002891.