Diet rich in unsaturated fatty acids lowers risk of CVD mortality in cardiac disease patients
Drug-treated patients with cardiac disease may reduce their risk of cardiovascular mortality by replacing saturated fatty acids (SFAs) with a higher proportion of unsaturated fatty acids (UFAs) in their diet, according to a recent study.
Researchers enrolled 4,146 patients (aged 60 to 80 years; 79 percent male) with a history of myocardial infarction and reliable dietary data at baseline to examine the risk of cardiovascular disease (CVD) and ischaemic heart disease (IHD) mortality when the sum of SFAs and trans fatty acids (TFAs) was theoretically replaced by total UFAs, polyunsaturated (P)UFAs or cis monounsaturated (MU)FAs.
They monitored cause-specific mortality until 1 January 2013. Cox regression models, adjusting for demographic factors, medication use, and lifestyle and dietary factors, were used to estimate hazard ratios (HRs) for CVD and IHD mortality for theoretical, isocaloric replacement of dietary FAs in quintiles (1 to 5) and continuously (per 5 percent of energy).
The average energy consumption of patients was 17.5 percent of total UFAs, 13.0 percent of SFAs and <1 percent of TFAs. A total of 372 CVD deaths and 249 IHD deaths occurred during approximately 7 years of follow-up.
Substitution modeling succeeded in lowering the risks of CVD mortality by replacing SFAs plus TFAs with total UFAs (HR in quintile 5 vs 1, 0.45; 95 percent CI, 0.28 to 0.72) or PUFAs (HR, 0.66; 0.44 to 0.98), whereas HRs in cis MUFA quintiles were not significant. HRs for IHD mortality were similar.
Continuous analyses revealed that substitution of SFAs plus TFAs with total UFAs, PUFAs or cis MUFAs (per 5 percent of energy) correlated with significantly reduced risks of CVD mortality (HR between 0.68 and 0.75) and IHD mortality (HRs between 0.55 and 0.70).