Association between trans fatty acid intake and 10-year risk of coronary heart disease in the Zutphen Elderly Study: a prospective population-based study

Background Evidence on the relation between trans fatty acid intake and cor onary heart disease is limited. We investigated this relation in a Dutch po pulation with a fairly high trans fatty acid intake, including trans fatty acids from partly hydrogenated fish oils. Methods We prospectively studied 667 men of the Zutphen Elderly Study aged 64-84 years and free of coronary heart disease at baseline. We used dietary surveys to establish the participants' food consumption patterns. Informat ion on risk factors and diet was obtained in 1985, 1990, and 1995. After 10 years of follow-up from 1985-95, there were 98 cases of fatal or non-fatal coronary heart disease. Findings Between 1985 and 1995, average trans fatty acid intake decreased f rom 43% to 1.9% of energy. After adjustment for age, body mass index, smoki ng, and dietary covariates, trans fatty acid intake at baseline was positiv ely associated with the 10-year risk of coronary heart disease. The relativ e risk for a difference of 2% of energy in trans fatty acid intake at basel ine was 1.28 (95% CI 1.01-1.61). Interpretation A high intake of trans fatty acids tall types of isomers) co ntributes to the risk of coronary heart disease. The substantial decrease i n trans fatty acid intake, mainly due to industrial lowering of trans conte nts in Dutch edible fats, could therefore have had a large public-health im pact.