Περίληψη:
Background: Saturated fat (SFA), x-6 (n-6) polyunsaturated fat (PUFA), and trans fat (TFA) influence risk of coronary heart disease (CHD), but attributable CHD mortalities by country, age, sex, and time are unclear. Methods and Results: National intakes of SFA, n-6 PUFA, and TFA were estimated 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. Etiologic effects of dietary fats on CHD mortality were derived from meta-analyses of prospective cohorts and CHD mortality rates from the 2010 Global Burden of Diseases study. Absolute and proportional attributable CHD mortality were computed using a comparative risk assessment framework. In 2010, nonoptimal intakes of n-6 PUFA, SFA, and TFA were estimated to result in 711 800 (95% uncertainty interval [UI] 680 700-745 000), 250 900 (95% UI 236 900-265 800), and 537 200 (95% UI 517 600-557 000) CHD deaths per year worldwide, 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 were estimated to have the highest proportional n-6 PUFA- and SFAattributable CHD mortality, whereas Egypt, Pakistan, and Canada were estimated to have the highest proportional TFA-attributable CHD mortality. From 1990 to 2010 globally, the estimated proportional CHD mortality decreased by 9% for insufficient n-6 PUFA and by 21% for higher SFA, whereas it increased by 4% for higher TFA, with the latter driven by increases in low- and middle-income countries. Conclusions: Nonoptimal intakes of n-6 PUFA, TFA, and SFA each contribute to significant estimated CHD mortality, with important heterogeneity across countries that informs nation-specific clinical, public health, and policy priorities. © 2016 The Authors.
Συγγραφείς:
Wang, Q.
Afshin, A.
Yakoob, M.Y.
Singh, G.M.
Rehm, C.D.
Khatibzadeh, S.
Micha, R.
Shi, P.
Mozaffarian, D.
Ezzati, M.
Fahimi, S.
Wirojratana, P.
Powles, J.
Elmadfa, I.
Rao, M.
Alpert, W.
Lim, S.S.
Engell, R.E.
Andrews, K.G.
Abbott, P.A.
Abdollahi, M.
Abeyá Gilardon, E.O.
Ahsan, H.
Al Nsour, M.A.A.
Al-Hooti, S.N.
Arambepola, C.
Fernando, D.N.
Barennes, H.
Barquera, S.
Baylin, A.
Becker, W.
Bjerregaard, P.
Bourne, L.T.
Capanzana, M.V.
Castetbon, K.
Chang, H.-Y.
Chen, Y.
Cowan, M.J.
Riley, L.M.
De Henauw, S.
Ding, E.L.
Duante, C.A.
Duran, P.
Barbieri, H.E.
Farzadfar, F.
Hadziomeragic, A.F.
Fisberg, R.M.
Forsyth, S.
Garriguet, D.
Gaspoz, J.-M.
Gauci, D.
Calleja, N.
Ginnela, B.N.V.
Guessous, I.
Gulliford, M.C.
Hadden, W.
Haerpfer, C.
Hoffman, D.J.
Houshiar-Rad, A.
Huybrechts, I.
Hwalla, N.C.
Ibrahim, H.M.
Inoue, M.
Jackson, M.D.
Johansson, L.
Keinan-Boker, L.
Kim, C.-I.
Koksal, E.
Lee, H.-J.
Li, Y.
Lipoeto, N.I.
Ma, G.
Mangialavori, G.L.
Matsumura, Y.
McGarvey, S.T.
Fen, C.M.
Monge-Rojas, R.A.
Musaiger, A.O.
Nagalla, B.
Naska, A.
Ocke, M.C.
Oltarzewski, M.
Szponar, L.
Orfanos, P.
Ovaskainen, M.-L.
Tapanainen, H.
Pan, W.-H.
Panagiotakos, D.B.
Pekcan, G.A.
Petrova, S.
Piaseu, N.
Pitsavos, C.
Posada, L.G.
Sánchez-Romero, L.M.
Selamat, R.B.T.
Sharma, S.
Sibai, A.M.
Sichieri, R.
Simmala, C.
Steingrimsdottir, L.
Swan, G.
Sygnowska, E.H.
Templeton, R.
Thanopoulou, A.
Thorgeirsdóttir, H.
Thorsdottir, I.
Trichopoulou, A.
Tsugane, S.
Turrini, A.
Vaask, S.
van Oosterhout, C.
Veerman, J.L.
Verena, N.
Waskiewicz, A.
Zaghloul, S.
Zajkás, G.
