Association of types of dietary fats and all-cause and cause-specific mortality: A prospective cohort study and meta-analysis of prospective studies with 1,164,029 participants
Journal article, 2020

Background:Associations between dietary fats and mortality are unclear.

Methods: We evaluated the relationship between quartiles of total fat, mono-unsaturated (MUFA), polyunsaturated (PUFA) and saturated fatty acid (SFA) consumption, and all-cause, coronary heart disease (CHD), stroke, and type 2 diabetes (T2D)-associated mortality in 24,144 participants from the National Health and Nutrition Examination Surveys (NHANES) 1999-2010. We added our results to a meta-analysis based on searches until November 2018.

Results: In fully adjusted Cox-proportional hazard models in our prospective study, there was an inverse association between total fat (HR: 0.90, 95% confidence interval 0.82, 0.99, Q4 vs Q1) and PUFA (0.81, 0.78-0.84) consumption and all-cause mortality, whereas SFA were associated with the increased mortality (1.08, 1.04-1.11). In the meta-analysis of 29 prospective cohorts (n = 1,164,029) we found a significant inverse association between total fat (0.89, 0.82-0.97), MUFA (0.94, 0.89-0.99) and PUFA (0.89, 0.84-0.94) consumption and all-cause mortality. No association was observed between total fat and CVD (0.93, 0.80-1.08) or CHD mortality (1.03 0.99-1.09). A significant association between SFA intake and CHD mortality (1.10, 1.01-1.21) was observed. Neither MUFA nor PUFA were associated with CVD or CHD mortality. Inverse associations were observed between MUFA (0.80, 0.67-0.96) and PUFA (0.84, 0.80-0.90) intakes and stroke mortality.

Conclusions: We showed differential associations of total fat, MUFA and PUFA with all-cause mortality, but not CVD or CHD mortalities. SFA was associated with higher all-cause mortality in NHANES and with CHD mortality in our meta-analysis. The type of fat intake appears to be associated with important health outcomes. (C) 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.





Coronary heart disease

Dietary fats


Mohsen Mazidi

King's College London

Dimitri P. Mikhailidis

University College London (UCL)

Naveed Sattar

University of Glasgow

Peter P. Toth

Johns Hopkins University

CGH Medical Center

Suzanne Judd

University of Birmingham

Michael J. Blaha

Johns Hopkins University

Adrian V. Hernandez

University of Connecticut

UPC Univ Peruana Ciencias Aplicadas

Peter E. Penson

Liverpool John Moores University

Liverpool Ctr Cardiovasc Sci

Maciej Banach

Medical University of Lodz

Polish Mother's Memorial Hospital Research Institute

University of Zielona Góra

Clinical Nutrition

0261-5614 (ISSN)

Vol. 39 12 3677-3686

Subject Categories

Other Clinical Medicine

Cardiac and Cardiovascular Systems

Nutrition and Dietetics





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