Mahshid Dehghan, On behalf of the PURE investigators 1 Risk of - PowerPoint PPT Presentation

Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from 5 continents: The PURE study Mahshid Dehghan, On behalf of the PURE investigators 1

Risk of mortality and major CVD by % energy from macronutrients Mortality Major CVD Nutrients HR (95% CI) HR (95% CI) Nutrients HR (95% CI) HR (95% CI) %E total fat %E total fat Q1 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) Q1 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) Q1=11 Q2 vs Q1 0.90 (0.82, 0.98) 0.90 (0.82, 0.98) Q2 vs Q1 1.01 (0.92, 1.11) 1.01 (0.92, 1.11) Q2=18 Q3 vs Q1 0.81 (0.73, 0.90) 0.81 (0.73, 0.90) Q3 vs Q1 1.01 (0.90, 1.13) 1.01 (0.90, 1.13) Q3=24 Q4 vs Q1 0.80 (0.71, 0.90) 0.80 (0.71, 0.90) Q4 vs Q1 0.95 (0.84, 1.07) 0.95 (0.84, 1.07) Q4=29 Q5 vs Q1 0.77 (0.67, 0.87) 0.77 (0.67, 0.87) Q5 vs Q1 0.95 (0.83, 1.08) 0.95 (0.83, 1.08) Q5=35 %E carb %E carb Q1=46 Q1 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) Q1 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) Q2=55 Q2 vs Q1 1.07 (0.96, 1.20) 1.07 (0.96, 1.20) Q2 vs Q1 1.00 (0.90, 1.12) 1.00 (0.90, 1.12) Q3 vs Q1 1.06 (0.94, 1.19) 1.06 (0.94, 1.19) Q3 vs Q1 1.02 (0.91, 1.14) 1.02 (0.91, 1.14) Q3=61 Q4 vs Q1 1.17 (1.03, 1.32) 1.17 (1.03, 1.32) Q4 vs Q1 1.08 (0.96, 1.22) 1.08 (0.96, 1.22) Q4=68 Q5 vs Q1 1.28 (1.12, 1.46) 1.28 (1.12, 1.46) Q5 vs Q1 1.01 (0.88, 1.15) 1.01 (0.88, 1.15) Q5=77 2 .6 1 1 1.5 .6 1 1 1.5

Risk of mortality and major CVD by % energy from types of fat Mortality Major CVD Nutrients HR (95% CI) HR (95% CI) Nutrients HR (95% CI) HR (95% CI) Q1=3 %E SFA %E SFA Q1 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) Q1 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) Q2=6 Q2 vs Q1 0.96 (0.88, 1.05) 0.96 (0.88, 1.05) Q2 vs Q1 1.13 (1.02, 1.25) 1.13 (1.02, 1.25) Q3=8 Q3 vs Q1 0.92 (0.83, 1.02) 0.92 (0.83, 1.02) Q3 vs Q1 1.06 (0.95, 1.18) 1.06 (0.95, 1.18) SFA Q4 vs Q1 0.85 (0.75, 0.95) 0.85 (0.75, 0.95) Q4 vs Q1 1.03 (0.91, 1.17) 1.03 (0.91, 1.17) Q4=10 Q5 vs Q1 0.86 (0.76, 0.99) 0.86 (0.76, 0.99) Q5 vs Q1 0.95 (0.83, 1.10) 0.95 (0.83, 1.10) Q5=13 Q1=4 %E MUFA %E MUFA Q1 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) Q1 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) Q2=6 Q2 vs Q1 Q2 vs Q1 1.02 (0.93, 1.11) 1.02 (0.93, 1.11) 1.04 (0.94, 1.15) 1.04 (0.94, 1.15) Q3=8 Q3 vs Q1 0.91 (0.82, 1.00) 0.91 (0.82, 1.00) Q3 vs Q1 1.06 (0.95, 1.18) 1.06 (0.95, 1.18) MUFA Q4 vs Q1 0.81 (0.72, 0.91) 0.81 (0.72, 0.91) Q4 vs Q1 1.02 (0.90, 1.15) 1.02 (0.90, 1.15) Q4=10 Q5 vs Q1 0.81 (0.71, 0.92) 0.81 (0.71, 0.92) Q5 vs Q1 0.95 (0.84, 1.09) 0.95 (0.84, 1.09) Q5=13 %E PUFA %E PUFA Q1=2 Q1 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) Q1 1.00 (1.00, 1.00) 1.00 (1.00, 1.00) Q2 vs Q1 0.92 (0.84, 1.01) 0.92 (0.84, 1.01) Q2 vs Q1 1.01 (0.91, 1.11) 1.01 (0.91, 1.11) Q2=4 PUFA Q3 vs Q1 0.87 (0.79, 0.96) 0.87 (0.79, 0.96) Q3 vs Q1 0.99 (0.89, 1.10) 0.99 (0.89, 1.10) Q3=5 Q4 vs Q1 0.85 (0.77, 0.94) 0.85 (0.77, 0.94) Q4 vs Q1 0.97 (0.87, 1.09) 0.97 (0.87, 1.09) Q5 vs Q1 0.80 (0.71, 0.89) 0.80 (0.71, 0.89) Q5 vs Q1 1.01 (0.90, 1.14) 1.01 (0.90, 1.14) Q4=6 Q5=9 3 .6 1 1 1.5 .6 1 1 1.5

Conclusions and implications • A high carbohydrate diet (>60%E) is associated with higher risk of mortality • Higher intake of fats, including saturated and unsaturated fats, are associated with lower risk of mortality • No association between total fat, types of fat and CVD events 4

Conclusions and implications Current guidelines restricting total fat to <30%E and saturated fat to <10%E are not supported by this global study 5

de Souza et al, BMJ 2015 Hooper et al, Cochrane Rev 2015

Mahshid Dehghan, On behalf of the PURE investigators 1 Risk of - PowerPoint PPT Presentation

Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from 5 continents: The PURE study Mahshid Dehghan, On behalf of the PURE investigators 1 Risk of mortality and major CVD by % energy from

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