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@ARTICLE{Steur:177539,
      author       = {M. Steur and L. Johnson and S. J. Sharp and F. Imamura and
                      I. Sluijs and T. J. Key and A. Wood and R. Chowdhury and M.
                      Guevara and M. U. Jakobsen and I. Johansson and A. Koulman
                      and K. Overvad and M.-J. Sánchez and Y. T. van der Schouw
                      and A. Trichopoulou and E. Weiderpass and M. Wennberg and
                      J.-S. Zheng and H. Boeing and J. M. A. Boer and M.-C.
                      Boutron-Ruault and U. Ericson and A. K. Heath and I.
                      Huybrechts and L. Imaz and R. Kaaks$^*$ and V. Krogh and T.
                      Kühn and C. Kyrø and G. Masala and O. Melander and C.
                      Moreno-Iribas and S. Panico and J. R. Quirós and M.
                      Rodríguez-Barranco and C. Sacerdote and C. Santiuste and G.
                      Skeie and A. Tjønneland and R. Tumino and W. M. M.
                      Verschuren and R. Zamora-Ros and C. C. Dahm and A.
                      Perez-Cornago and M. B. Schulze and T. Y. N. Tong and E.
                      Riboli and N. J. Wareham and J. Danesh and A. S. Butterworth
                      and N. G. Forouhi},
      title        = {{D}ietary {F}atty {A}cids, {M}acronutrient {S}ubstitutions,
                      {F}ood {S}ources and {I}ncidence of {C}oronary {H}eart
                      {D}isease: {F}indings {F}rom the {EPIC}-{CVD}
                      {C}ase-{C}ohort {S}tudy {A}cross {N}ine {E}uropean
                      {C}ountries.},
      journal      = {Journal of the American Heart Association},
      volume       = {10},
      number       = {23},
      issn         = {2047-9980},
      address      = {New York, NY},
      publisher    = {Association},
      reportid     = {DKFZ-2021-02606},
      pages        = {e019814},
      year         = {2021},
      note         = {2021 Dec 7;10(23):e019814},
      abstract     = {Background 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.},
      keywords     = {coronary heart disease (Other) / dietary guidelines (Other)
                      / nutritional epidemiology (Other) / primary prevention
                      (Other) / saturated fat (Other)},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34796724},
      doi          = {10.1161/JAHA.120.019814},
      url          = {https://inrepo02.dkfz.de/record/177539},
}