Moderate dietary fat consumption as a risk factor for ischemic heart disease in a population with a low fat intake: a case-control study in Korean men.
Moderate dietary fat consumption as a risk factor for ischemic heart disease in a population with a low fat intake: a case-control study in Korean men.
Year: 2001
Authors: I Suh, K Oh, K Lee, B Psaty, C Nam, S Kim, H Kang, et al.
Publication Name: Am J Clin Nutr.
Publication Details: Volume 73; Page 722
Abstract:
In Western countries, the results of numerous epidemiologic studies have shown that dietary factors such as total fat, saturated fatty acids (SFAs), polyunsaturated fatty acids (PUFAs), n-3 series fatty acids, and cholesterol are associated with the incidence of ischemic heart disease (IHD). What is important to note is that in these countries, total fat intakes are 35–40% of energy above that of recommended levels of <30% of energy. In Asia, current dietary intakes are much lower than those of the West as are dietary guidelines. For example, in Japan the new recommended dietary fat allowance is 20–25% of energy intake. In China dietary fat intake increased from 15.9% of energy in 1982 to 21.1% in 1990 and IHD incidence and mortality also increased. In such countries, in which both the average dietary fat consumption and the incidence of ischemic heart disease (IHD) are lower than in Western countries, a clear relationship between dietary fat intake and IHD incidence is unclear. The purpose of this study was to conduct a case-control study to examine the association of dietary fat with IHD incidence in Korean men. The case group consisted of 108 patients with confirmed myocardial infarction or IHD. The controls were 142 age-matched patients. Dietary fat intake was assessed using a semiquantitative food-frequency questionnaire. Body mass index (BMI), cigarette use, alcohol intake, exercise, and history of disease were determined. Mean percentages of energy from total fat, saturated fatty acids, and monounsaturated fatty acids were significantly higher in the cases than in the controls. BMI, smoking, and a history of hypertension were associated with the occurrence of IHD. Total fat intake was a significant risk factor after adjustment for BMI and smoking. Intake of PUFAs was similar to that in Western countries, but SFA intake was only 6–7% of energy intake, one-half of that reported in Western countries (13–18% of energy intake). However, intakes were higher than that of the cases was higher than that of the controls (6.8% compared with 5.9% of energy, respectively). PUFA intake was 4.4% of energy in the cases and 4.1% of energy in the controls. This data suggests that in a population with a relatively low fat intake (19% of energy intake), a moderate increase in total fat intake may be a risk factor for IHD. Even though the rate of IHD is low in Korea in comparison with that of Western countries, it increased 5- to 6-fold in the 1990’s. The average fat intake of Koreans increased during the same period from 14% of energy in 1986 to 19% of energy in 1997. From the data presented in this study, it appears that an increased dietary intake as well as SFA intake affects the incidence of IHD in such populations. The present study showed that a moderate dietary fat intake may be a significant risk factor for IHD incidence in a population with a low fat intake. The results suggest that current guidelines that recommend a total fat intake of 30% of energy may be too high for preventing IHD in Western countries. For developing countries, there is a need to find the safe fat intake level for the population to lower IHD risk.
