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Plasma Phospholipid Fatty Acid Concentration and Incident Coronary Heart Disease in Men and Women: The EPIC-Norfolk Prospective Study
Open accessAbstract
BACKGROUND: The lack of association found in several cohort studies between dietary saturated fat and coronary heart disease (CHD) risk has renewed debate over the link between dietary fats and CHD. METHODS AND FINDINGS: We assessed the relationship between plasma phospholipid fatty acid (PFA) concentration and incident CHD using a nested case control design within a prospective study (EPIC-Norfolk) of 25,639 individuals aged 40-79 years examined in 1993-1997 and followed up to 2009. Plasma PFA concentrations were measured by gas chromatography in baseline samples retrieved from frozen storage. In 2,424 men and women with incident CHD compared with 4,930 controls alive and free of cardiovascular disease, mean follow-up 13 years, saturated PFA (14:0, 16:0,18:0) plasma concentrations were significantly associated with increased CHD risk (odds ratio [OR] 1.75, 95% CI 1.27-2.41, p<0.0001), in top compared to bottom quartiles (Q), and omega-6 polyunsaturated PFA concentrations were inversely related (OR 0.77, 0.60-0.99, p<0.05) after adjusting for age, sex, body mass index, blood pressure, smoking, alcohol intake, plasma vitamin C, social class, education, and other PFAs. Monounsaturated PFA, omega-3 PFA, and trans PFA concentrations were not significantly associated with CHD. Odd chain PFA (15:0, 17:0) concentrations were significantly inversely associated with CHD (OR 0.73, 0.59-0.91, p<0.001, Q4 versus Q1). Within families of saturated PFA or polyunsaturated PFA, significantly heterogeneous relationships with CHD were observed for individual fatty acids. CONCLUSIONS: In this study, plasma concentrations of even chain saturated PFA were found to be positively and omega-6 polyunsaturated PFA inversely related to subsequent coronary heart disease risk. These findings are consistent with accumulating evidence suggesting a protective role of omega-6 fats substituting for saturated fats for CHD prevention.
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“In cohorts utilizing objective blood biomarkers, greater dairy fat consumption is associated with lower incidence of diabetes59-61, 242, 243 and CHD,39, 244, 245 with mixed findings for stroke.246”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [244]
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Metadata
- Authors
- Khaw, K.-T., Friesen, M. D., Riboli, E., Luben, R., & Wareham, N.
- Affiliations
- University of Cambridge (GB)
- Johns Hopkins University (US)
- MRC Epidemiology Unit (GB)
- Corresponding author
- Khaw, Kay-Tee
- Venue
- PLoS Medicine
- Publisher
- Public Library of Science (PLoS)
- Published
- 2012-07-03
- Volume
- 9
- Issue
- 7
- Pages
- e1001255
- ISSN
- 1549-1277 (ISSN-L)
- 1549-1676
- PMC
- PMC3389034
- OpenAlex
- W2071137319
- Cited by
- 291
- References
- 41
- Citations by year
- 2026: 17 · 2025: 15 · 2024: 21 · 2023: 26 · 2022: 28 · 2021: 33 · 2020: 22 · 2019: 19 · 2018: 26 · 2017: 20 · 2016: 14 · 2015: 12 · 2014: 18 · 2013: 18 · 2012: 1
- FWCI
- 14.64
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- Cancer Research UK
- Medical Research Council
- Japan Society for the Promotion of Science (24249057)
- 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 › Lipoproteins and Cardiovascular Health
- Keywords
- plasma phospholipid fatty acids, coronary artery disease, saturated fatty acids, omega-6 fatty acids, odd-chain fatty acids, dietary fat, cardiovascular risk, EPIC-Norfolk study, omega-3 fatty acids, trans fatty acids, monounsaturated fatty acids
- MeSH terms
- Adult, Aged, Coronary Disease, Fatty Acids, Female, United Kingdom, Humans, Male, Middle Aged, Phospholipids, Prospective Studies, Incidence, Odds Ratio, Case-Control Studies
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