000177539 001__ 177539 000177539 005__ 20240229133742.0 000177539 0247_ $$2doi$$a10.1161/JAHA.120.019814 000177539 0247_ $$2pmid$$apmid:34796724 000177539 0247_ $$2altmetric$$aaltmetric:117224868 000177539 037__ $$aDKFZ-2021-02606 000177539 041__ $$aEnglish 000177539 082__ $$a610 000177539 1001_ $$00000-0002-9028-0290$$aSteur, Marinka$$b0 000177539 245__ $$aDietary Fatty Acids, Macronutrient Substitutions, Food Sources and Incidence of Coronary Heart Disease: Findings From the EPIC-CVD Case-Cohort Study Across Nine European Countries. 000177539 260__ $$aNew York, NY$$bAssociation$$c2021 000177539 3367_ $$2DRIVER$$aarticle 000177539 3367_ $$2DataCite$$aOutput Types/Journal article 000177539 3367_ $$0PUB:(DE-HGF)16$$2PUB:(DE-HGF)$$aJournal Article$$bjournal$$mjournal$$s1642512665_14848 000177539 3367_ $$2BibTeX$$aARTICLE 000177539 3367_ $$2ORCID$$aJOURNAL_ARTICLE 000177539 3367_ $$00$$2EndNote$$aJournal Article 000177539 500__ $$a2021 Dec 7;10(23):e019814 000177539 520__ $$aBackground There is controversy about associations between total dietary fatty acids, their classes (saturated fatty acids [SFAs], monounsaturated fatty acids, and polyunsaturated fatty acids), and risk of coronary heart disease (CHD). Specifically, the relevance of food sources of SFAs to CHD associations is uncertain. Methods and Results We conducted a case-cohort study involving 10 529 incident CHD cases and a random subcohort of 16 730 adults selected from a cohort of 385 747 participants in 9 countries of the EPIC (European Prospective Investigation into Cancer and Nutrition) study. We estimated multivariable adjusted country-specific hazard ratios (HRs) and 95% CIs per 5% of energy intake from dietary fatty acids, with and without isocaloric macronutrient substitutions, using Prentice-weighted Cox regression models and pooled results using random-effects meta-analysis. We found no evidence for associations of the consumption of total or fatty acid classes with CHD, regardless of macronutrient substitutions. In analyses considering food sources, CHD incidence was lower per 1% higher energy intake of SFAs from yogurt (HR, 0.93 [95% CI, 0.88-0.99]), cheese (HR, 0.98 [95% CI, 0.96-1.00]), and fish (HR, 0.87 [95% CI, 0.75-1.00]), but higher for SFAs from red meat (HR, 1.07 [95% CI, 1.02-1.12]) and butter (HR, 1.02 [95% CI, 1.00-1.04]). Conclusions This observational study found no strong associations of total fatty acids, SFAs, monounsaturated fatty acids, and polyunsaturated fatty acids, with incident CHD. By contrast, we found associations of SFAs with CHD in opposite directions dependent on the food source. These findings should be further confirmed, but support public health recommendations to consider food sources alongside the macronutrients they contain, and suggest the importance of the overall food matrix. 000177539 536__ $$0G:(DE-HGF)POF4-313$$a313 - Krebsrisikofaktoren und Prävention (POF4-313)$$cPOF4-313$$fPOF IV$$x0 000177539 588__ $$aDataset connected to CrossRef, PubMed, , Journals: inrepo01.inet.dkfz-heidelberg.de 000177539 650_7 $$2Other$$acoronary heart disease 000177539 650_7 $$2Other$$adietary guidelines 000177539 650_7 $$2Other$$anutritional epidemiology 000177539 650_7 $$2Other$$aprimary prevention 000177539 650_7 $$2Other$$asaturated fat 000177539 7001_ $$aJohnson, Laura$$b1 000177539 7001_ $$aSharp, Stephen J$$b2 000177539 7001_ $$00000-0002-6841-8396$$aImamura, Fumiaki$$b3 000177539 7001_ $$aSluijs, Ivonne$$b4 000177539 7001_ $$00000-0003-2294-307X$$aKey, Timothy J$$b5 000177539 7001_ $$aWood, Angela$$b6 000177539 7001_ $$00000-0003-4881-5690$$aChowdhury, Rajiv$$b7 000177539 7001_ $$00000-0001-9242-6364$$aGuevara, Marcela$$b8 000177539 7001_ $$00000-0001-6518-4136$$aJakobsen, Marianne U$$b9 000177539 7001_ $$00000-0002-9227-8434$$aJohansson, Ingegerd$$b10 000177539 7001_ $$aKoulman, Albert$$b11 000177539 7001_ $$aOvervad, Kim$$b12 000177539 7001_ $$aSánchez, Maria-José$$b13 000177539 7001_ $$avan der Schouw, Yvonne T$$b14 000177539 7001_ $$aTrichopoulou, Antonia$$b15 000177539 7001_ $$00000-0003-2237-0128$$aWeiderpass, Elisabete$$b16 000177539 7001_ $$aWennberg, Maria$$b17 000177539 7001_ $$aZheng, Ju-Sheng$$b18 000177539 7001_ $$aBoeing, Heiner$$b19 000177539 7001_ $$00000-0002-9714-4304$$aBoer, Jolanda M A$$b20 000177539 7001_ $$00000-0002-5956-5693$$aBoutron-Ruault, Marie-Christine$$b21 000177539 7001_ $$aEricson, Ulrika$$b22 000177539 7001_ $$00000-0001-6517-1300$$aHeath, Alicia K$$b23 000177539 7001_ $$00000-0003-3838-855X$$aHuybrechts, Inge$$b24 000177539 7001_ $$00000-0002-3777-4953$$aImaz, Liher$$b25 000177539 7001_ 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