Issue 145 Item 11 Dietary Fat Predicts Coronary Heart Disease Events in Subjects

Men in the highest tertile of the polyunsaturated/saturated fat (P/S) ratio (>0.28) had a significantly lower risk for CHD death. The study investigated whether quantity or quality of dietary fat predicts coronary heart disease (CHD) events in middle-aged type 2 diabetic subjects.

The dietary habits of 366 type 2 diabetic men and 295 women, aged 45–64 years and free from CHD, were assessed with a 53-item food frequency questionnaire. They were followed up for 7 years.

The results showed that men in the highest tertile of the polyunsaturated/saturated fat (P/S) ratio (>0.28) had a significantly lower risk for CHD death than men in the two lowest tertiles (5.0 vs. 14.2%, P = 0.009). The risk for all CHD events was 14.2 vs. 23.2%, respectively (P = 0.044). polyunsaturated/saturated fat ratio did not predict CHD events in women. In Cox multiple regression analyses taking into account other cardiovascular risk factors, the highest P/S ratio tertile was associated with the lowest rate of CHD death in men (P = 0.048).

From the results it was concluded that low polyunsaturated/saturated fat ratio in men predicted future CHD events in type 2 diabetic subjects independently of conventional CHD risk factors. The association between a higher P/S ratio and reduced CHD death risk in men remained significant, even after adjustment for total cholesterol, HDL cholesterol, and triglycerides. This result suggests that the impact of the P/S ratio on CHD death cannot be explained by its effects on serum lipids alone. Other mechanisms behind the beneficial effect of a high polyunsaturated/saturated fat ratio might involve the effects on endothelial function and thrombogenesis. Diabetes Care 26:619-624, 2003