Cited by 661Fatty Acid Research and HealthNutritional Studies and DietCardiovascular Health and Risk Factors

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

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Hu, Frank B, Stampfer, Meir J, Manson, JoAnn E, Ascherio, Alberto, Colditz, Graham A, Speizer, Frank E, Hennekens, Charles H, Willett, Walter C·1999·The American Journal of Clinical Nutrition

DOI 10.1093/ajcn/70.6.1001

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Abstract

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' Health Study aged 34-59 y. Subjects had no known cardiovascular disease, cancer, hypercholesterolemia, or diabetes, and completed validated food-frequency questionnaires in 1980.Results During 14 y of follow-up, we documented 939 incident cases of major CHD events. In multivariate analyses in which age, smoking, and other covariates were controlled for, intakes of short- to medium-chain saturated fatty 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) were each separately associated with a small increase in risk. The multivariate 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 inversely associated with CHD risk (multivariate RR for a comparison of the highest 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 does 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 fatty acids in typical diets.

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BackgroundMethodInfluential
Relation of diet to cardiovascular disease risk factors in subjects with cardiovascular disease in Australia and New Zealand: analysis of the Long-Term Intervention with Pravastatin in Ischaemic Disease trial
Nestel, P. J., Baghurst, K. I., Colquhoun, D. M., Simes, R. J., Mehalski, K., White, H. D., Tonkin, A. M., Kirby, A. C., & Pollicino, C. A. (2005) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/81.6.1322 · Cited by 16
“Prospective trials among large cohort populations confirmed the importance of the dietary trans and saturated fatty acids in predicting future CVD events (6, 7).”
Background
Nutrition and metabolism
Nestel, P. J. (2011) · Current Opinion in Lipidology · doi:10.1097/mol.0b013e32834d5f3e · Cited by 14
The Relation between Erythrocyte Trans Fat and Triglyceride, VLDL- and HDL-Cholesterol Concentrations Depends on Polyunsaturated Fat
Kabagambe, E. K., Ordovás, J. M., Hopkins, P. N., Tsai, M. Y., & Arnett, D. K. (2012) · PLoS ONE · doi:10.1371/journal.pone.0047430 · Cited by 15
“Even among other non-trans fat subtypes, there are data to suggest differences in their effect on lipoproteins and CHD risk [1,10,11,12].”
Background
α‐Ketoisocaproate and β‐hydroxy‐β‐methyl butyrate regulate fatty acid composition and lipid metabolism in skeletal muscle of growing pigs
Zhong, Y., Song, B., Zheng, C., Li, F., Kong, X., Duan, Y., & Deng, J. (2019) · Journal of Animal Physiology and Animal Nutrition · doi:10.1111/jpn.13077 · Cited by 15
Dietary Fat Intake Is Differentially Associated with Risk of Paroxysmal Compared with Sustained Atrial Fibrillation in Women
Chiuve, S. E., Sandhu, R. K., Moorthy, M. V., Glynn, R. J., & Albert, C. M. (2015) · Journal of Nutrition · doi:10.3945/jn.115.212860 · Cited by 16
“Furthermore, we explored intake of individual SFAs based upon their differential associations with CVD risk (25, 26).”
Background
Efeito da temperatura da água sobre desempenho e perfil de ácidos graxos de tilápia do Nilo (Oreochromis niloticus)
Matsushita, M., Justi, K. C., Padre, R. D. G., Hayashi, C., Soares, C. M., Visentainer, J. V., & de Souza, N. E. (2005) · Acta Scientiarum Animal Sciences · doi:10.4025/actascianimsci.v27i4.1184 · Cited by 15
Calidad de grasa, arterioesclerosis y enfermedad coronaria: efectos de los ácidos grasos saturados y ácidos grasos trans
Torrejón, C., & Uauy, R. D. (2011) · Revista médica de Chile · doi:10.4067/s0034-98872011000700016 · Cited by 18
A genetic variant of PPARA modulates cardiovascular risk biomarkers after milk consumption
Loria‐Kohen, V., Espinosa‐Salinas, I., de Molina, A. R., Casas‐Agustench, P., Herránz, J., Molina, S., Fonollá, J., Olivares, M. M., Lara‐Villoslada, F., Reglero, G., et al. (2014) · Nutrition · doi:10.1016/j.nut.2014.02.012 · Cited by 15
Intensification of acid catalyzed synthesis of tricaprylin using ultrasound pretreatment
More, S. B., Gogate, P. R., & Waghmare, J. S. (2017) · Chemical Engineering and Processing - Process Intensification · doi:10.1016/j.cep.2017.07.027 · Cited by 15
The associations between dietary patterns and cardiovascular risk factors among adults: A cross-sectional study
Najafi, M., Mozaffari, H., Jalilpiran‬, Y., Mokhtari, P., Teymouri, M., & Faghih, S. (2020) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2020.09.001 · Cited by 16
Dietary fat saturation and gender/hormonal status modulate plasma lipids and lipoprotein composition11Abbreviations: HDL-C: high density lipoprotein cholesterol, LDL-C: low density lipoprotein cholesterol, PUFA: polyunsaturated fatty acids, SFA: saturated fatty acids, TAG: Triacylglycerol; VLDL-C: very low density lipoprotein cholesterol
Fernández, M. L., West, K. L., Roy, S., & Ramjiganesh, T. (2001) · The Journal of Nutritional Biochemistry · doi:10.1016/s0955-2863(01)00191-7 · Cited by 15
Unprocessed red meat and processed meat consumption and risk of stroke in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC)
Amiano, P., Chamosa, S., Etxezarreta, N., Arriola, L., Sánchez, M., Ardanáz, E., Molina‐Montes, E., Chirlaque, M., Moreno-Iribas, C., Huerta, J. M., et al. (2015) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2015.150 · Cited by 16
Dairy milk, regardless of fat content, protects against postprandial hyperglycemia-mediated impairments in vascular endothelial function in adults with prediabetes by limiting oxidative stress responses that reduce nitric oxide bioavailability
McDonald, J. D., Mah, E., Dey, P., Olmstead, B. D., Sasaki, G. Y., Villamena, F. A., & Bruno, R. S. (2018) · The Journal of Nutritional Biochemistry · doi:10.1016/j.jnutbio.2018.10.002 · Cited by 14
Intake of Fermented Dairy Products Induces a Less Pro‐Inflammatory Postprandial Peripheral Blood Mononuclear Cell Gene Expression Response than Non‐Fermented Dairy Products: A Randomized Controlled Cross‐Over Trial
Rundblad, A., Holven, K. B., Øyri, L. K. L., Hansson, P., Ivan, I. H., Gjevestad, G. O., Thoresen, M., & Ulven, S. M. (2020) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.202000319 · Cited by 14
Milk Fat and Health Consequences
Gibson, R. A. (2011) · Nestlé Nutrition Institute Workshop series · doi:10.1159/000325585 · Cited by 14
Association Between Meat Consumption and Carotid Intima-Media Thickness in Korean Adults with Metabolic Syndrome
Oh, S. M., Kim, H. C., Ahn, S. V., Jin, H. J., & Suh, I. (2010) · Journal of Preventive Medicine and Public Health · doi:10.3961/jpmph.2010.43.6.486 · Cited by 14
“In the past, studies to explore harmful effects of meat intake have focused on animal protein or saturated fat [29,30].”
Multilevel systems biology modeling characterized the atheroprotective efficiencies of modified dairy fats in a hamster model
Martin, J., Berton, A., Giniès, C., Bott, R., Scheercousse, P., Saddi, A., Gripois, D., Landrier, J., Dalemans, D., Alessi, M., et al. (2015) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00032.2015 · Cited by 14
“THE CONSUMPTION OF SATURATED fat has been frequently associated with an increase in LDL-cholesterol (67), which is a major cardiovascular risk factor, and with coronary heart diseases (19).”
Background
Setting the Lipid Component of the Diet: A Work in Process
Razo-Olvera, F. M. D., Melgarejo-Hernández, M. A., Mehta, R., & Aguilar-Salinas, C. A. (2017) · Advances in Nutrition · doi:10.3945/an.116.013672 · Cited by 15
“Results from short-term intervention studies on CVD biomarkers indicated that a diet higher in saturated fat from whole milk and butter increases LDL cholesterol when these are substituted for carbohydrates or unsaturated FAs; however, they may also increase HDL, and therefore might not affect or even lower the ratio…”
Background
Coronary Artery Disease
Simone, R. D. (1994) · Springer eBooks · doi:10.1007/978-3-642-78956-4_5 · Cited by 14
Effect of a Supplemented Diet with Canned Sardine on the Lipid Fraction of Human Plasma and Erythrocytes
Bandarra, N. M., Palma, P., Batista, I., Nunes, M. L., Morais, G., Bruges, M., Dickson, J., Barata, J. D., & Lima, B. S. (2002) · Journal of Aquatic Food Product Technology · doi:10.1300/j030v11n03_14 · Cited by 14
“These results were confirmed in animal experiments (Wong et al., 1984; Smit et al., 1991; Song, 1992; Escudero et al., 1999) and clinical investigations (Nestel et al., 1984; Sanders et al., 1985; Frank et al., 1999).”
Result
TRENDS IN THE INCIDENCE OF CORONARY HEART DISEASE AND CHANGES IN DIET AND LIFESTYLE IN WOMEN
Rank, F., Tampfer, M. E. J. S., Anson, E. M., Rodstein, F. R. G., Olditz, G. R. A. C., Peizer, F. R. E. S., & Illett, W. A. C. W. (2013) · Cited by 13
Extraction, Characterization and Fatty Acids Profiles of Nymphaea Lotus and Nymphaea Pubescens Seed Oils
Aliyu, M., Kano, M. A., Abdullahi, N., Kankara, I. A., Ibrahim, S. I., & Imam, A. A. (2017) · Biosciences Biotechnology Research Asia · doi:10.13005/bbra/2573 · Cited by 13
Acides gras saturés et risque cardio-métabolique
Lecerf, J. (2016) · Médecine des Maladies Métaboliques · doi:10.1016/s1957-2557(16)30141-9 · Cited by 13
CHARACTERIZATION OF A LAMB HAM: FATTY ACIDS AND VOLATILE COMPOUNDS COMPOSITION
Paleari, M. A., Moretti, V. M., Beretta, G., & Caprino, F. (2006) · Journal of Muscle Foods · doi:10.1111/j.1745-4573.2006.00059.x · Cited by 13
To what extent are the effects of diet on coronary heart disease lipid-mediated?
Serrano-Martínez, M., Martínez-Losa, E., Prado-Santamaría, M., Brugarolas‐Brufau, C., Fernandez‐Jarne, E., & Martínez‐González, M. Á. (2004) · International Journal of Cardiology · doi:10.1016/j.ijcard.2003.03.001 · Cited by 13
“Saturated and trans fats lead to higher plasma total and LDL cholesterol, and higher plasma lipids may lead to a higher coronary risk [1,17,18].”
Background
Measurement of Circulating Phospholipid Fatty Acids: Association between Relative Weight Percentage and Absolute Concentrations
Song, X., Schenk, J. M., Diep, P., Murphy, R. A., Harris, T. B., Eiríksdóttir, G., Gudnason, V. G., Casper, C., Lampe, J. W., & Neuhouser, M. L. (2016) · Journal of the American College of Nutrition · doi:10.1080/07315724.2015.1116417 · Cited by 13
What is the Place of Beef in a Healthful Sustainable Homo sapiens Diet?
Murimi, M. (2022) · American Journal of Health Promotion · doi:10.1177/08901171221088661c · Cited by 13
“Evidence shows that fats in beef are high in saturated fatty acids, including palmitic acid (16:0), stearic acid (18:0), and small amounts of myristic acid (14:0), all of which have been associated with the risk of developing cardiovascular diseases.(12) Beef fat has higher amounts of saturated fatty acids than white…”
Background
Milk Nutritive Role and Potential Benefits in Human Health
Pereira, P. M. D. C. C., & Vicente, F. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-809762-5.00013-9 · Cited by 12
The fatty acid composition of longissimus lumborum muscle of suckling and earlyweaned dual-purpose wool/meat lambs
Radzik-Rant, A., Rant, W., Rozbicka-Wieczorek, A., & KUŹNICKA, E. (2012) · Archives animal breeding/Archiv für Tierzucht · doi:10.5194/aab-55-285-2012 · Cited by 12
“An unbeneficial fatty acid composition of dietary lipids (saturated fatty acid, n-6 unsaturated fatty acid) was demonstrated to increase the risk to contract coronary heart disease (Kritchevsky 1998, Hu et al. 1999).”
Background
Nutritional characteristics and consumer acceptability of sausages with different combinations of goat and beef meats
Malekian, F., Khachaturyan, M., Gebrelul, S., & Henson, J. F. (2016) · Functional Foods in Health and Disease · doi:10.31989/ffhd.v6i1.224 · Cited by 12
An Exploratory Study of the Influence of Attitudes toward Animal Welfare on Meat Consumption in Ghana
Fuseini, A., & Sulemana, I. (2018) · Food Ethics · doi:10.1007/s41055-018-0028-6 · Cited by 13
Dairy-Based and Energy-Enriched Berry-Based Snacks Improve or Maintain Nutritional and Functional Status in Older People in Home Care
Nykänen, I., Törrönen, R., & Schwab, U. (2018) · The journal of nutrition health & aging · doi:10.1007/s12603-018-1076-7 · Cited by 12
Plasma and urine metabolomic analyses in aortic valve stenosis reveal shared and biofluid-specific changes in metabolite levels
Hageh, C. A., Rahy, R., Khazen, G., Brial, F., Khnayzer, R. S., Gauguier, D., & Zalloua, P. (2020) · PLoS ONE · doi:10.1371/journal.pone.0242019 · Cited by 12
“For instance, the intake of palmitic, stearic and elaidic acids was correlated to the progression of CHD [30] and was associated with a 9–24% increased risk of CHD [31].”
BackgroundInfluential
Relationship between Milk and Calcium Intake and Lipid Metabolism in Female Patients with Type 2 Diabetes
Kim, J., Hwang, J., Kim, K. N., Choi, Y., Chang, N., & Huh, K.-B. (2013) · Yonsei Medical Journal · doi:10.3349/ymj.2013.54.3.626 · Cited by 12
Dietary Fat and Risk of Cardiovascular Disease
Eshak, E. S., Yamagishi, K., & Iso, H. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-809657-4.99603-0 · Cited by 13
Evaluation of the New Individual Fatty Acid Dataset for UK Biobank: Analysis of Intakes and Sources in 207,997 Participants
Kelly, R. K., Pollard, Z., Young, H., Piernas, C., Lentjes, M. A. H., Mulligan, A. A., Huybrechts, I., Carter, J. L., Key, T. J., & Perez‐Cornago, A. (2022) · Nutrients · doi:10.3390/nu14173603 · Cited by 13
Integrating Metabolomics Domain Knowledge with Explainable Machine Learning in Atherosclerotic Cardiovascular Disease Classification
Santana, E. J., Ibrahimi, E., Ntalianis, E., Cauwenberghs, N., & Kuznetsova, T. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms252312905 · Cited by 14
Breeding for robust cows that produce healthier milk: RobustMilk
Veerkamp, R. F., Kaal, L. M. T. E., de Haas, Y., & Oldham, J. D. (2013) · Advances in Animal Biosciences · doi:10.1017/s2040470013000149 · Cited by 11
Cholesterol Intake Is Associated with Lecithin Intake in Japanese People
Ishinaga, M., Ueda, A., Mochizuki, T., Sugiyama, S., & Kobayashi, T. (2005) · Journal of Nutrition · doi:10.1093/jn/135.6.1451 · Cited by 11
“report that saturated fat intake is positively correlated with cholesterol intake (24), consistent with the present results (r 0.”
Result
Reproducibility and relative validity of a FFQ to estimate the intake of fatty acids
Praagman, J., Adolphs, A. P. J., van Rossum, C. T. M., Sluijs, I., van der Schouw, Y. T., & Beulens, J. W. J. (2016) · British Journal Of Nutrition · doi:10.1017/s000711451600132x · Cited by 11
“However, up to today, this FFQ has not been validated for classes of fatty acids and individual fatty acids, although over time it has become evident that effects of dietary fats on (cardiovascular) health may differ across classes((4)), and potentially even across individual fatty acids within these classes((5,6)).”
Background
Seafood Proteins and Human Health
Tahergorabi, R., & Jaczynski, J. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-802844-5.00029-4 · Cited by 11
The Role of Diet in the Prevention and Treatment of Cardiovascular Disease
Richter, C. K., Skulas‐Ray, A. C., & Kris‐Etherton, P. M. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-802928-2.00027-8 · Cited by 13

Authors: Hu, F. B., Stampfer, M. J., Manson, J. E., Ascherio, A., Colditz, G. A., Speizer, F. E., Hennekens, C. H., & Willett, W. C.
Affiliations: Brigham and Women's Hospital (US)
Corresponding author: Hu, Frank B
ORCID: Hu, Frank B
Stampfer, Meir J
Manson, JoAnn E
Ascherio, Alberto
Colditz, Graham A
Hennekens, Charles H
Willett, Walter C
Venue: The American Journal of Clinical Nutrition
Publisher: Elsevier BV
Published: 1999-12
Volume: 70
Issue: 6
Pages: 1001-1008
ISSN: 0002-9165 (ISSN-L)
DOI: 10.1093/ajcn/70.6.1001
OpenAlex: W2150396523
Cited by: 661
References: 25
Citations by year: 2026: 3 · 2025: 10 · 2024: 19 · 2023: 17 · 2022: 17 · 2021: 23 · 2020: 23 · 2019: 24 · 2018: 28 · 2017: 38 · 2016: 38 · 2015: 37 · 2014: 39 · 2013: 39 · 2012: 29
FWCI: 9.79
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 8478 d)
Locations: American Journal of Clinical Nutrition (publishedVersion)
PubMed (publishedVersion)
Funders: National Heart, Lung, and Blood Institute (HL24074, HL34594, R01HL034594)
National Cancer Institute (CA-40356)
Topics: Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Keywords: saturated fatty acids, coronary artery disease, women, stearic acid, long-chain saturated fatty acids, polyunsaturated to saturated fat ratio, dietary fat intake, food sources, red meat consumption, milk fat, Nurses' Health Study
MeSH terms: Adult, Coronary Disease, Dairy Products, Dietary Fats, Fatty Acids, Female, Follow-Up Studies, Humans, Meat, Middle Aged, Prospective Studies, Surveys and Questionnaires, Risk Factors, United States, Cohort Studies, Multivariate Analysis, Women's Health

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

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