The journal of nutrition, health & aging

, Volume 22, Issue 4, pp 526–533 | Cite as

Fat Quality Index and Risk of Cardiovascular Disease in the Sun Project

  • S. Santiago
  • Itziar Zazpe
  • A. Gea
  • J. M. Nuñez-Córdoba
  • S. Carlos
  • M. Bes-Rastrollo
  • M. A. Martínez-González



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 words

Fat quality index cardiovascular disease Mediterranean cohort SUN project 



body mass index


confidence interval


cardiovascular disease


food frequency questionnaire


fat quality index


hazard ratio


metabolic equivalent index


monounsaturated fatty acids


polyunsaturated fatty acids


standard deviation


saturated fatty acids


Seguimiento Universidad de Navarra Follow-up University of Navarra


trans fatty acids


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Copyright information

© Serdi and Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • S. Santiago
    • 1
    • 2
  • Itziar Zazpe
    • 1
    • 2
    • 3
    • 4
  • A. Gea
    • 2
    • 3
    • 4
  • J. M. Nuñez-Córdoba
    • 2
    • 3
  • S. Carlos
    • 2
    • 3
  • M. Bes-Rastrollo
    • 2
    • 3
    • 4
  • M. A. Martínez-González
    • 2
    • 3
    • 4
    • 5
  1. 1.University of Navarra, Department of Nutrition and Food Sciences and PhysiologyPamplona, NavarraSpain
  2. 2.Instituto de Investigación Sanitaria de Navarra (IdiSNA)Pamplona, NavarraSpain
  3. 3.University of Navarra, Department of Preventive Medicine and Public HealthPamplonaSpain
  4. 4.Biomedical Research Centre Network on Obesity and Nutrition (CIBERobn) Physiopathology of Obesity and Nutrition, Institute of Health Carlos IIIMadridSpain
  5. 5.Department of NutritionHarvard TH Chan School of Public HealthBostonUSA

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