Thursday, March 1, 2012

Heart disease and stroke mortality are highest in countries with low saturated fat consumption

Background: In 1993, Artaud-Wild et al published an article linking per capita intakes of saturated fat to mortality rates from coronary heart disease (CHD) (1). A global analysis was done including data from 40 countries. Figure 1 shows that a strong positive correlation (R = 0.78) was found between a "cholesterol-saturated fat index" and CHD mortality among men. This correlation was similar for the % of energy from saturated fat intake (R = 0.77).

Figure 1:


Is more recent data available?
No articles about this correlation were published since. But in 2008, the British Heart Foundation published the European Cardiovascular Disease Statistics (2). The report included European mortality rates from both CHD and stroke for 1972 to 2005 for both men and women. In addition, it provided data about European per capita consumption of saturated fat for the year 1998. This data gives us the possibility to link saturated fat intake to mortality rates in 1998. A total of 41 countries had available data about both saturated fat intake and mortality rates for this year. I used a simple Pearson correlation to examine if a significant correlation could be found. The effect can be seen in figure 2.

Figure 2:


Results: unexpectedly, the highest mortality rates from CHD were found in the countries with the lowest intakes of saturated fats. The correlation was significant (2-tailed significant at < 0.01). The R2 for linearity = 0.34.

How can this difference in effect be explained?
  • Artaud-Wild et al used data from the year 1977, I used data from 1998.
  • Artaud-Wild et al used mortality rates that were not adjusted for age. I used age-standardized mortality rates.
  • Artaud-Wild et al used a global analysis including 40 countries. I used a European analysis including 41 countries. Sadly, I could not find data about more countries.
Were results similar looking at women or at stroke mortality?
Pearson correlations showed that higher mortality rates were consistently linked to lower intakes of saturated fat (two-tailed significance = < 0.01 for all). In addition to the correlation shown in figure 2, I also examined 3 other end points. Correlations were slightly stronger than the one seen in figure 2. Results are as follows:
  • Male stroke mortality: R2 = 0.38
  • Female CHD mortality: R2 = 0.43
  • Female stroke mortality: R2 = 0.43
Conclusion: a global analysis including 40 countries showed that higher intakes of saturated fat were linked to higher mortality rates from coronary heart disease among men in 1977. But a European analysis including 41 countries showed that lower intakes of saturated fat were linked to higher mortality rates from both coronary heart disease and stroke in both genders in 1998...............................


References:
1) Artaud-Wild SM et al. Differences in coronary mortality can be explained by differences in cholesterol and saturated fat intakes in 40 countries but not in France and Finland. A paradox. Circulation. 1993 Dec;88(6):2771-9. http://www.ncbi.nlm.nih.gov/pubmed/8252690
2) Allender S et al. European cardiovascular disease statistics 2008 edition. http://www.bhf.org.uk/idoc.ashx?docid=e4f82fee-58f0-4a51-8099-db9520123e24&version=-1  

Reacties:

3 reacties:

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