Dietary saturated fats and their food sources in relation to the risk of coronary heart disease in women

Background: Metabolic studies suggest that saturated fatty acids differ in their effects on blood lipids. Objective: The objective was to examine the associations between intakes of individual saturated fatty acids and their food sources in relation to the risk of coronary heart disease (CHD). Design: This was a prospective cohort study of 80082 women in the Nurses' H ealth Study aged 34-59 y, Subjects had no known cardiovascular disease, can cer, hypercholesterolemia, or diabetes, and completed validated food-freque ncy questionnaires in 1980. Results: During 14 y of follow-up, we documented 939 incident cases of majo r CHD events. in multivariate analyses in which age, smoking, and other cov ariates were controlled for, intakes of short- to medium-chain saturated fa tty acids (4:0-10:0) were not significantly associated with the risk of CHD . In contrast, intakes of longer-chain saturated fatty acids (12:0-18:0) we re each separately associated with a small increase in risk. The multivaria te RR for a 1% energy increase from stearic acid was 1.19 (95% CI: 1.02, 1. 37). The ratio of polyunsaturated to saturated fat was strongly and inverse ly associated with CHD risk (multivariate RR for a comparison of the highes t with the lowest deciles: 0.58; 95% CI: 0.41, 0.83; P for trend < 0.0001). Conversely, higher ratios of red meat to poultry and fish consumption and of high-fat to low-fat dairy consumption were associated with significantly greater risk. Conclusion: A distinction between stearic acid and other saturated fats doe s not appear to be important in dietary advice to reduce CHD risk, in part because of the high correlation between stearic acid and other saturated fa tty acids in typical diets.