Chen Mu, Li Yanping, Sun Qi, Pan An, Manson JoAnn E, Rexrode Kathryn M, Willett Walter C, Rimm Eric B, Hu Frank B
Departments of Nutrition and.
Epidemiology, Harvard TH Chan School of Public Health, Boston, MA.
Am J Clin Nutr. 2016 Nov;104(5):1209-1217. doi: 10.3945/ajcn.116.134460. Epub 2016 Aug 24.
Few prospective studies have examined dairy fat in relation to cardiovascular disease (CVD).
We aimed to evaluate the association between dairy fat and incident CVD in US adults.
We followed 43,652 men in the Health Professionals Follow-Up Study (1986-2010), 87,907 women in the Nurses' Health Study (1980-2012), and 90,675 women in the Nurses' Health Study II (1991-2011). Dairy fat and other fat intakes were assessed every 4 y with the use of validated food-frequency questionnaires.
During 5,158,337 person-years of follow-up, we documented 14,815 incident CVD cases including 8974 coronary heart disease cases (nonfatal myocardial infarction or fatal coronary disease) and 5841 stroke cases. In multivariate analyses, compared with an equivalent amount of energy from carbohydrates (excluding fruit and vegetables), dairy fat intake was not significantly related to risk of total CVD (for a 5% increase in energy from dairy fat, the RR was 1.02; 95% CI: 0.98, 1.05), coronary heart disease (RR: 1.03; 95% CI: 0.98, 1.09), or stroke (RR: 0.99; 95% CI: 0.93, 1.05) (P > 0.05 for all). In models in which we estimated the effects of exchanging different fat sources, the replacement of 5% of energy intake from dairy fat with equivalent energy intake from polyunsaturated fatty acid (PUFA) or vegetable fat was associated with 24% (RR: 0.76; 95% CI: 0.71, 0.81) and 10% (RR: 0.90; 95% CI: 0.87, 0.93) lower risk of CVD, respectively, whereas the 5% energy intake substitution of other animal fat with dairy fat was associated with 6% increased CVD risk (RR: 1.06; 95% CI: 1.02, 1.09).
The replacement of animal fats, including dairy fat, with vegetable sources of fats and PUFAs may reduce risk of CVD. Whether the food matrix may modify the effect of dairy fat on health outcomes warrants further investigation.
很少有前瞻性研究探讨乳脂肪与心血管疾病（CVD）之间的关系。
我们旨在评估美国成年人中乳脂肪与新发CVD之间的关联。
我们在健康专业人员随访研究（1986 - 2010年）中跟踪了43652名男性，在护士健康研究（1980 - 2012年）中跟踪了87907名女性，以及在护士健康研究II（1991 - 2011年）中跟踪了90675名女性。使用经过验证的食物频率问卷每4年评估一次乳脂肪和其他脂肪摄入量。
在5158337人年的随访期间，我们记录了14815例新发CVD病例，包括8974例冠心病病例（非致命性心肌梗死或致命性冠心病）和5841例中风病例。在多变量分析中，与来自碳水化合物（不包括水果和蔬菜）的等量能量相比，乳脂肪摄入量与总CVD风险（乳脂肪能量增加5%，RR为1.02；95%CI：0.98，1.05）、冠心病（RR：1.03；95%CI：0.98，1.09）或中风（RR：0.99；95%CI：0.93，1.05）均无显著关联（所有P>0.05）。在我们估计交换不同脂肪来源影响的模型中，用来自多不饱和脂肪酸（PUFA）或植物脂肪的等量能量摄入替代5%的乳脂肪能量摄入分别与CVD风险降低24%（RR：0.76；95%CI：0.71，0.81）和10%（RR：0.90；95%CI：0.87，0.93）相关，而用乳脂肪替代5%的其他动物脂肪能量摄入与CVD风险增加6%相关（RR：1.06；95%CI：1.
