Leosdottir M, Nilsson P M, Nilsson J-A, Månsson H, Berglund G
Department of Medicine, Lund University, University Hospital (UMAS), Malmö, Sweden.
J Intern Med. 2005 Aug;258(2):153-65. doi: 10.1111/j.1365-2796.2005.01520.x.
Most current dietary guidelines encourage limiting relative fat intake to <30% of total daily energy, with saturated and trans fatty acids contributing no more than 10%. We examined whether total fat intake, saturated fat, monounsaturated, or polyunsaturated fat intake are independent risk factors for prospective all-cause, cardiovascular and cancer mortality.
Population-based, prospective cohort study.
The Malmö Diet and Cancer Study was set in the city of Malmö, southern Sweden. A total of 28,098 middle-aged individuals participated in the study 1991-1996.
Subjects were categorized by quartiles of relative fat intake, with the first quartile used as a reference point in estimating multivariate relative risks (RR; 95% CI, Cox's regression model). Adjustments were made for confounding by age and various lifestyle factors.
Women in the fourth quartile of total fat intake had a significantly higher RR of cancer mortality (RR 1.46; CI 1.04-2.04). A significant downwards trend was observed for cardiovascular mortality amongst men from the first to the fourth quartile (P=0.028). No deteriorating effects of high saturated fat intake were observed for either sex for any cause of death. Beneficial effects of a relatively high intake of unsaturated fats were not uniform.
With the exception of cancer mortality for women, individuals receiving more than 30% of their total daily energy from fat and more than 10% from saturated fat, did not have increased mortality. Current dietary guidelines concerning fat intake are thus generally not supported by our observational results.
当前大多数饮食指南鼓励将相对脂肪摄入量限制在每日总能量的<30%,其中饱和脂肪酸和反式脂肪酸的摄入量不超过10%。我们研究了总脂肪摄入量、饱和脂肪、单不饱和脂肪或多不饱和脂肪摄入量是否是全因、心血管疾病和癌症前瞻性死亡率的独立危险因素。
基于人群的前瞻性队列研究。
马尔默饮食与癌症研究在瑞典南部的马尔默市进行。1991年至1996年共有28098名中年个体参与了该研究。
根据相对脂肪摄入量的四分位数对研究对象进行分类,在估计多变量相对风险(RR;95%CI,Cox回归模型)时,将第一四分位数用作参考点。对年龄和各种生活方式因素的混杂作用进行了调整。
总脂肪摄入量处于第四四分位数的女性癌症死亡率的RR显著更高(RR 1.46;CI 1.04 - 2.04)。在男性中,从第一四分位数到第四四分位数观察到心血管死亡率有显著下降趋势(P = 0.028)。对于任何死因,未观察到高饱和脂肪摄入量对任何性别有不良影响。不饱和脂肪摄入量相对较高的有益影响并不一致。
除了女性的癌症死亡率外,每日总能量中超过30%来自脂肪且超过10%来自饱和脂肪的个体,死亡率并未增加。因此,我们的观察结果总体上不支持当前关于脂肪摄入量的饮食指南。