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Plant and Animal Fat Intake and Overall and CVD Mortality
Quick Takes
- Higher intake of fats from plants, including grains and vegetables, is associated with a lower risk of both overall and CVD-related mortality.
- Higher intake of fats from animals, including dairy, is associated with a higher risk for overall and CVD-related mortality.
- The replacement of 5% energy from animal fat with 5% energy from plant fat was associated with a lower risk of mortality, including a 4-24% reduction in overall mortality and a 5-30% reduction in CVD mortality.
Study Questions:
Is dietary plant or animal fat intake associated with overall and cardiovascular disease (CVD) mortality?
Methods:
The present analysis used data from the National Institutes of Health–American Association of Retired Persons (NIH-AARP) Diet and Health Study, a prospective cohort study that enrolled 617,119 participants, ages 50-71 years, from six US states and two metropolitan areas between 1995 and 1996. After exclusions, including participants with missing dietary data, 407,531 participants remained in the final analytic cohort, including 231,881 men and 175,650 women. Dietary data were collected at baseline using a validated food frequency questionnaire. The primary outcomes of interest were CV-related deaths and all-cause mortality collected through linkages with the Social Security Administration Death Master File from 1995 to 2019.
Results:
A total of 407,531 men and women (56.9% male) with a mean age of 61.2 (standard deviation 5.4) years were included in the analysis. The median daily dietary fat intake from plant and animal sources was 24.7 g and 29.3 g, respectively. During up to 24 years of observation and 8,107,711 person-years, 185,111 deaths were recorded, including 58,526 from CVD (45,634 for heart disease and 10,877 for stroke).
After multivariable adjustment, comparing the highest to the lowest quintiles, a greater intake of plant fat was associated with lower risk for overall and CVD mortality (hazard ratios [HRs], 0.91 and 0.86; adjusted absolute risk differences [ARDs], −1.10% and −0.73%, respectively; p for trend < 0.001). Fats from grains and vegetable oils were each associated with a lower risk for mortality (for grains, the risk of overall and CVD death was HRs, 0.92 and 0.86, respectively [adjusted ARDs, −0.98% and −0.71%]; p for trend < 0.001). For fats from vegetable oils, similar associations were observed (HRs, 0.88 and 0.85 for overall and CVD mortality, respectively [adjusted ARDs, −1.40% and −0.71%] p for trend < 0.001).
In contrast, a higher intake of total animal fat (HRs, 1.16 and 1.14; adjusted ARDs, 0.78% and 0.32%; p for trend < 0.001), dairy fat (HRs, 1.09 and 1.07; adjusted ARDs, 0.86% and 0.24%; p for trend < 0.001), or egg fat (HRs, 1.13 and 1.16; adjusted ARDs, 1.40% and 0.82%; p for trend < 0.001) was associated with an increased risk for mortality for overall and CVD mortality, respectively (comparing the highest to the lowest quintile).
Replacement of 5% energy from animal fat with 5% energy from plant fat was associated with a lower risk for mortality, including a 4-24% reduction in overall mortality and a 5-30% reduction in CVD mortality.
Conclusions:
The authors conclude that data from this prospective cohort study demonstrated consistent but small inverse associations between a higher intake of plant fat, particularly from grains and vegetable oils, and a lower risk for overall and CVD mortality. In contrast, a diet with a high intake of animal-based fat, including fat from dairy foods and eggs, was also shown to be associated with an elevated risk for both overall and CVD mortality.
Perspective:
These data add additional evidence to prior data supporting the intake of plant-based fats with a lower intake of fats from animal sources. Clinicians are recommended to discuss dietary patterns with patients, including the recommendations for sources of fats.
Clinical Topics: Diabetes and Cardiometabolic Disease, Prevention, Diet
Keywords: Diet, High-Fat, Heart Disease Risk Factors
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