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Unformatted text preview: Dietary intake of saturated fatty acids and mortality from cardiovascular disease in Japanese: the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC) Study 13 Kazumasa Yamagishi, Hiroyasu Iso, Hiroshi Yatsuya, Naohito Tanabe, Chigusa Date, Shogo Kikuchi, Akio Yamamoto, Yutaka Inaba, and Akiko Tamakoshi for the JACC Study Group ABSTRACT Background: Prospective epidemiologic studies have generated mixed results regarding the association between saturated fatty acid (SFA) intake and risk of ischemic heart disease (IHD) and stroke. These associations have not been extensively studied in Asians. Objective: The aim of this study was to test the hypothesis that SFA intake is associated with the risk of cardiovascular disease mortality in Japanese whose average SFA intake is low. Design: The Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study) comprised 58,453 Japanese men and women who completed a food-frequency questionnaire. Participants were aged 4079 y at baseline (19881990) and were followed up for 14.1 y. Associations of energy-adjusted SFA intake with mor- tality from stroke (intraparenchymal and subarachnoid hemorrhages and ischemic stroke) and heart diseases (IHD, cardiac arrest, and heart failure) were examined after adjustment for age, sex, and cardiovascular disease risk and dietary factors. Results: We observed inverse associations of SFA intake with mor- tality from total stroke [ n = 976; multivariable hazard ratio (95% CI) for highest compared with lowest quintiles: 0.69 (0.53, 0.89); P for trend = 0.004], intraparenchymal hemorrhage [ n = 224; 0.48 (0.27, 0.85); P for trend = 0.03], and ischemic stroke [ n = 321; 0.58 (0.37, 0.90); P for trend = 0.01]. No multivariable-adjusted associations were observed between SFA and mortality from sub- arachnoid hemorrhage [ n = 153; 0.91 (0.46, 1.80); P for trend = 0.47] and heart disease [ n = 836; 0.89 (0.68, 1.15); P for trend = 0.59]. Conclusion: SFA intake was inversely associated with mortality from total stroke, including intraparenchymal hemorrhage and is- chemic stroke subtypes, in this Japanese cohort. Am J Clin Nutr 2010;92:75965. INTRODUCTION A few, but not all, studies have documented an increased risk of ischemic heart disease (IHD) with intake of saturated fatty acids (SFAs) since the Seven Countries Study showed an ecologic association several decades ago (1). SFA intake is strongly correlated with blood cholesterol concentrations (2), and high blood cholesterol is a strong risk factor for IHD (3). Nonetheless, the association between SFA intake and IHD has been contro- versial. SFA intake has been shown to be positively associated with the risk of IHD (4, 5), and replacing SFA intake with polyunsaturated fatty acid (PUFA) intake was associated with a lower risk of IHD (6). SFA intake, however, was inversely associated with the progression of coronary atherosclerosis (7). A recent meta-analyses of cohort studies did not support an adverse...
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- Fall '08