Prospective Study

The relationship between trans fatty acid intake and subsequent CHD events was investigated in approximately 85 000 US nurses (the Nurses Health Study). Trans fatty acid intake was calculated from food frequency questionnaires for women who had been diagnosed free from CHD, stroke, diabetes, and hypercholesterolemia. The subjects were followed up for 8 years and CHD events were recorded. The relative risk of CHD in the highest compared with the lowest quintile was 1.5 (95% confidence interval, 1.12-2.0), after adjustment for age, energy intake, social class, and smoking. However, there was no clear dose-response relationship between the highest and the lowest intake groups. The intake of trans fatty acids in the top quintile was 3.2% dietary energy compared with 1.3% in the lowest quintile.

It has been commented on that the benefit predicted by the authors, that individuals in the top quintile of intake could halve their risk of myocar-dial infarction by reducing their intake of trans fatty acids to that of the lowest quintile, seems a large effect in view of the small difference in intakes between these groups (3.3 g). The changes in plasma lipoprotein cholesterol concentrations that would be predicted to occur as a result of lowering trans fatty acid intake would not explain all of the observed increase in risk. Also, the study was carried out in a selected population of women and it is unclear that the findings are applicable to the whole population or to other population groups.

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