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dc.contributor.authorSteur, Marinka
dc.contributor.authorSánchez Pérez, María José 
dc.contributor.authorRodríguez Barranco, Miguel
dc.date.accessioned2022-01-07T11:22:41Z
dc.date.available2022-01-07T11:22:41Z
dc.date.issued2021-11-19
dc.identifier.citationSteur, M... [et al.] (2021). Dietary Fatty Acids, Macronutrient Substitutions, Food Sources and Incidence of Coronary Heart Disease: Findings From the EPIC‐CVD Case‐Cohort Study Across Nine European Countries. Journal of the American Heart Association, 10(23), e019814. DOI: [10.1161/JAHA.120.019814]es_ES
dc.identifier.urihttp://hdl.handle.net/10481/72234
dc.descriptionEPIC-CVD was supported by the European Commission Framework Programme 7 (HEALTH-F2-2012-279233), and the European Research Council (268834). The coordinating center was supported by core funding from the: United Kingdom MRC (G0800270; MR/L003120/1), British Heart Foundation (BHF) (SP/09/002; RG13/13/30194; RG/18/13/33946), and National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre (BRC) (BRC-1215-20014).* The establishment of the study subcohort was supported by the European Union Sixth Framework Programme (grant LSHM_CT_ 2006_037197 to the InterAct project) and the MRC Epidemiology Unit (grant MC_UU_00006/1). The coordination of EPIC is financially supported by International Agency for Research on Cancer and also by the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, which has additional infrastructure support provided by NIHR Imperial BRC. The national cohorts are supported by: Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Generale de l'Education Nationale, Institut National de la Sante et de la Recherche Medicale (France); German Cancer Aid, German Cancer Research Center, German Institute of Human Nutrition Potsdam-Rehbruecke, Federal Ministry of Education and Research (Germany); Associazione Italiana per la Ricerca sul Cancro--AIRC--Italy, Compagnia di SanPaolo and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports, Netherlands Cancer Registry, LK Research Funds, Dutch Prevention Funds, Zorg Onderzoek Nederland, World Cancer Research Fund, Statistics Netherlands (the Netherlands); Health Research Fund-Instituto de Salud Carlos III, Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skane and Vasterbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C8221/A29017 to EPIC-Oxford), MRC (1000143 to EPIC-Norfolk; MR/M012190/1 to EPIC-Oxford) (United Kingdom). EPIC-Greece was supported by the Hellenic Health Foundation (Greece). M.S., N.J.W., N.G.F., and F.I. acknowledge support from MRC Epidemiology Unit (MC_UU_ 00006/1 and MC_UU_00006/3). N.J.W. and N.G.F. acknowledge support from NIHR* Cambridge BRC: Nutrition, Diet, and Lifestyle Research Theme (IS-BRC-1215--20014) and NGF is a NIHR Senior Investigator Award holder. M.S. was also supported by BHF for part of this work while working in the BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. R. Z.-R. thanks the "Miguel Servet" program (CP15/00100) from the Institute of Health Carlos III (co-funded by the European Social Fund--European Social Fund Investing in Your Future). A.W. was supported by a BHF-Turing Cardiovascular Data Science Award and by the European Commission-Innovative Medicines Initiative (BigData@Heart).R.C.was funded by a MRC-Newton project grant to study genetic risk factors of cardiovascular disease among Southeast Asian people and the Academy of Sciences Malaysia (grant no. MR/P013880/1) and a United Kingdom Research and Innovation-Global Challenges Research Fund Project Grant to study risk factors of noncommunicable diseases in Bangladesh. J.D. holds a BHF Professorship and a NIHR Senior Investigator Award. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. Where authors are identified as personnel of the International Agency for Research on Cancer/World Health Organization, the authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions, policy, or views of the International Agency for Research on Cancer/World Health Organization. The funders of the study had no role in study design, data collection, analysis, data interpretation, or writing of the article, or in the decision to submit for publication. M.S. had full access to all the data in the study, and M.S. and N.G.F. had final responsibility for the decision to submit for publication.es_ES
dc.description.abstractBACKGROUND: 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.es_ES
dc.description.sponsorshipEuropean Commission Framework Programme 7 HEALTH-F2-2012-279233es_ES
dc.description.sponsorshipEuropean Research Council (ERC)es_ES
dc.description.sponsorshipEuropean Commission 268834es_ES
dc.description.sponsorshipUK Research & Innovation (UKRI)es_ES
dc.description.sponsorshipMedical Research Council UK (MRC) G0800270 MR/L003120/1es_ES
dc.description.sponsorshipBritish Heart Foundation SP/09/002 RG13/13/30194 RG/18/13/33946es_ES
dc.description.sponsorshipNational Institute for Health Research (NIHR) BRC-1215-20014es_ES
dc.description.sponsorshipEuropean Commission LSHM_CT_ 2006_037197es_ES
dc.description.sponsorshipUK Research & Innovation (UKRI)es_ES
dc.description.sponsorshipMedical Research Council UK (MRC) MC_UU_ 00006/1 MC_UU_00006/3es_ES
dc.description.sponsorshipInternational Agency for Research on Canceres_ES
dc.description.sponsorshipDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College Londones_ES
dc.description.sponsorshipDanish Cancer Societyes_ES
dc.description.sponsorshipLigue Contre le Cancer, Institut Gustave Roussy, Mutuelle Generale de l'Education Nationale, Institut National de la Sante et de la Recherche Medicale (France)es_ES
dc.description.sponsorshipGerman Cancer Aid, German Cancer Research Center, German Institute of Human Nutrition Potsdam-es_ES
dc.description.sponsorshipRehbruecke, Federal Ministry of Education and Research (Germany)es_ES
dc.description.sponsorshipFondazione AIRC per la ricerca sul cancroes_ES
dc.description.sponsorshipCompagnia di San Paoloes_ES
dc.description.sponsorshipDutch Ministry of Public Health, Welfare and Sportses_ES
dc.description.sponsorshipNetherlands Cancer Registryes_ES
dc.description.sponsorshipLK Research Fundses_ES
dc.description.sponsorshipDutch Prevention Fundses_ES
dc.description.sponsorshipZorg Onderzoek Nederlandes_ES
dc.description.sponsorshipWorld Cancer Research Fund International (WCRF)es_ES
dc.description.sponsorshipNetherlands Governmentes_ES
dc.description.sponsorshipInstituto de Salud Carlos IIIes_ES
dc.description.sponsorshipJunta de Andaluciaes_ES
dc.description.sponsorshipRegional Government of Asturiases_ES
dc.description.sponsorshipBasque Governmentes_ES
dc.description.sponsorshipRegional Government of Murciaes_ES
dc.description.sponsorshipRegional Government of Navarraes_ES
dc.description.sponsorshipCatalan Institute of Oncology (Spain)es_ES
dc.description.sponsorshipSwedish Cancer Societyes_ES
dc.description.sponsorshipCounty Council of Skane (Sweden)es_ES
dc.description.sponsorshipCounty Council of Vasterbotten (Sweden)es_ES
dc.description.sponsorshipCancer Research UK 14136 C8221/A29017es_ES
dc.description.sponsorshipUK Research & Innovation (UKRI)es_ES
dc.description.sponsorshipMedical Research Council UK (MRC) 1000143 MR/M012190/1es_ES
dc.description.sponsorshipHellenic Health Foundation (Greece)es_ES
dc.description.sponsorshipNIHR* Cambridge BRC: Nutrition, Diet, and Lifestyle Research Theme IS-BRC-1215-20014es_ES
dc.description.sponsorshipBritish Heart Foundationes_ES
dc.description.sponsorshipInstitute of Health Carlos III (European Social Fund-European Social Fund Investing in Your Future) CP15/00100es_ES
dc.description.sponsorshipBHF-Turing Cardiovascular Data Science Awardes_ES
dc.description.sponsorshipEuropean Commission-Innovative Medicines Initiative (BigData@Heart)es_ES
dc.description.sponsorshipMRC-Newton project grant MR/P013880/1es_ES
dc.description.sponsorshipUnited Kingdom Research and Innovation-Global Challenges Research Fundes_ES
dc.description.sponsorshipNIHR Senior Investigator Awardes_ES
dc.language.isoenges_ES
dc.publisherWiley-Blackwell Publishinges_ES
dc.rightsAtribución 3.0 España*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/es/*
dc.subjectCoronary heart disease es_ES
dc.subjectDietary guidelineses_ES
dc.subjectNutritional epidemiologyes_ES
dc.subjectPrimary preventiones_ES
dc.subjectSaturated fates_ES
dc.titleDietary Fatty Acids, Macronutrient Substitutions, Food Sources and Incidence of Coronary Heart Disease: Findings From the EPIC-CVD Case-Cohort Study Across Nine European Countrieses_ES
dc.typeinfo:eu-repo/semantics/articlees_ES
dc.relation.projectIDinfo:eu-repo/grantAgreement/EC/FP7/279233es_ES
dc.relation.projectIDinfo:eu-repo/grantAgreement/EC/FP7/268834es_ES
dc.rights.accessRightsinfo:eu-repo/semantics/openAccesses_ES
dc.identifier.doi10.1161/JAHA.120.019814
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersiones_ES


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