Fat Quality Index and Risk of Cardiovascular Disease in the Sun Project
To examine the association between a dietary fat quality index (FQI), and the risk of incident cardiovascular events or deaths in the Seguimiento Universidad de Navarra (SUN) cohort.
Longitudinal analysis during 10.1 years of median follow-up. Cox models were used to estimate adjusted hazard ratios (HR) of incident cardiovascular diseases (CVD) according to tertiles of FQI and of different fat subtypes.
University of Navarra, Spain.
19,341 middle-aged adults.
Fat intake was measured with a validated food-frequency questionnaire. The FQI was calculated according to the ratio: (monounsaturated+polyunsaturated) / (saturated+trans fatty acids).
We observed 140 incident cases of CVD. No association was found for FQI (HR=0.94, 95 %CI 0.61–1.47 for the highest vs the lowest tertile, p for trend=0.884). No significant associations were found for different dietary fat subtypes on CVD risk. The results suggest no clear association between a higher FQI and a higher amount of energy from fat and incidence of CVD (p for interaction: 0.259 and p for trend only among participants with a percentage of energy from fat ≥35% of total energy: 0.272).
In this Mediterranean cohort, the FQI was not associated with cardiovascular events. A “heart-healthy diet” should focus its attention on dietary fat sources and should use an overall dietary pattern approach, rather than limiting the focus on fat subtypes. More research is needed to validate dietary advice on specific fatty acids intake or saturated fatty acids replacements for reducing CVD risk.
Key wordsFat quality index cardiovascular disease Mediterranean cohort SUN project
body mass index
food frequency questionnaire
fat quality index
metabolic equivalent index
monounsaturated fatty acids
polyunsaturated fatty acids
saturated fatty acids
Seguimiento Universidad de Navarra Follow-up University of Navarra
trans fatty acids
- 2.World Health Organization..Global status report on noncommunicable diseases; 2014.Google Scholar
- 9.Eckel RH, Jakicic JM, Ard JD, de Jesus JM, Houston Miller N, Hubbard VS, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014; 129:S76–99.CrossRefPubMedGoogle Scholar
- 11.Schwab U, Lauritzen L, Tholstrup T, Haldorssoni T, Riserus U, Uusitupa M, et al. Effect of the amount and type of dietary fat on cardiometabolic risk factors and risk of developing type 2 diabetes, cardiovascular diseases, and cancer: a systematic review. Food Nutr Res. 2014; 58.Google Scholar
- 13.Hooper L, Martin N, Abdelhamid A, Davey Smith G. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev. 2015:CD011737.Google Scholar
- 22.Mataix Verdú J. Tabla de composición de alimentos españoles. 4a edición ed. Granada. Granada; 2003.Google Scholar
- 23.Moreiras O, Carbajal A, Cabrera L. Tablas de composición de alimentos. 9a edición ed. Madrid: Pirámide; 2005.Google Scholar
- 24.Zazpe I, Sanchez-Tainta A, Santiago S, de la Fuente-Arrillaga C, Bes-Rastrollo M, Martinez JA, et al. Association between dietary carbohydrate intake quality and micronutrient intake adequacy in a Mediterranean cohort: the SUN (Seguimiento Universidad de Navarra) Project. Br J Nutr. 2014;111: 2000–2009.CrossRefPubMedGoogle Scholar
- 27.Bes-Rastrollo M. Validation of self-reported weight and body mass index in a cohort of university graduates in Spain. Rev Esp Obes 2005; 3:352–358.Google Scholar
- 30.U.S. Departments of Health and Human Services and Agriculture (USDA). Scientific Report of the 2015 Dietary Guidelines Advisory Committee Washington (DC); 2015.Google Scholar
- 31.Hooper L, Summerbell CD, Thompson R, Sills D, Roberts FG, Moore HJ, et al. Reduced or modified dietary fat for preventing cardiovascular disease. Cochrane Database Syst Rev. 2012; 5:CD002137.Google Scholar
- 38.Praagman J, Beulens JW, Alssema M, Zock PL, Wanders AJ, Sluijs I, et al. The association between dietary saturated fatty acids and ischemic heart disease depends on the type and source of fatty acid in the European Prospective Investigation into Cancer and Nutrition-Netherlands cohort. Am J Clin Nutr. 2016; 103:356–65.CrossRefPubMedGoogle Scholar
- 47.Andrade L, Zazpe I, Santiago S, Carlos S, Bes-Rastrollo M, Martínez-González MA. Ten-Year Changes in Healthy Eating Attitudes in the SUN Cohort. J Am Coll Nutr. 2017;16:1–11Google Scholar
- 48.The China Study: The Most Comprehensive Study of Nutrition Ever Conducted And the Startling Implications for Diet, Weight Loss, And Long-term Health. Benbella Book Paperback Edition. 2006. Dallas.Google Scholar