Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies - PubMed (original) (raw)

FIGURE 1

Study-specific and combined hazard ratios and 95% CIs for coronary events (A) (n = 306,244) and coronary deaths (B) (n = 327,660) in the Pooling Project of Cohort Studies on Diet and Coronary Disease. The model included intake of monounsaturated fatty acids, polyunsaturated fatty acids (PUFAs), trans fatty acids, carbohydrates (CHs), and protein expressed as percentages of total energy intake (E%; as continuous variables), total energy intake (kcal/d; as a continuous variable), smoking (never smokers, former smokers, or current smoker of 1–4, 5–14, 15–24, or ≥25 cigarettes/d), BMI (in kg/m2; <23, 23 to <25, 25 to <27.5, 27.5 to <30, or ≥30), physical activity (levels 1–5), highest attained educational level (<high school, high school, or >high school), alcohol intake (0, 0 to <5, 5 to <10, 10 to <15, 15 to <30, 30 to <50, or ≥50 g/d), history of hypertension (yes or no), and energy-adjusted quintiles of fiber intake (g/d) and cholesterol intake (mg/d). Age at baseline (y) and the calendar year in which the baseline questionnaire was returned (y) were entered into the model through the strata statement. Within each study, hazard ratios with 95% CIs for the incidence of a coronary event and of mortality from coronary heart disease were calculated by using Cox proportional hazards regression with time in study (y) as the time metric. The study-specific logs of hazard ratios were weighted by the inverse of their variances, and a combined estimate of the hazard ratios was computed by using a random-effects model. The estimated hazard ratios for PUFAs and CHs can be interpreted as the estimated differences in risk of a 5% lower energy intake from saturated fatty acids (SFAs) and a concomitant higher energy intake from PUFAs and CHs, respectively. The squares and horizontal lines represent the study-specific hazard ratios and 95% CIs, respectively. The area of the squares reflects the study-specific weight (inverse of the variance). The diamonds represent the combined hazard ratios and 95% CI. AHS, Adventis Health Study; ARIC, Atherosclerosis Risk in Communities Study; ATBC, Alpha-Tocopherol and Beta-Carotene Cancer Prevention Study; FMC, Finnish Mobile Clinic Health Study; GPS, Glostrup Population Study; HPFS, Health Professionals Follow-Up Study; IIHD, Israeli Ischemic Heart Disease Study; IWHS, Iowa Women's Health Study; NHSa, Nurses' Health Study 1980; NHSb, Nurses' Health Study 1986; VIP, Västerbotten Intervention Program; WHS, Women's Health Study.