Impact of nonoptimal intakes of saturated,polyunsaturated,and trans fat on global burdens of coronary heart disease

Background: saturated fat (sfa),x-6 (n-6) polyunsaturated fat (pufa),and trans fat (tfa) influence risk of coronary heart disease (chd),but attributable chd mortalities by country,age,sex,and time are unclear. methods and results: national intakes of sfa,n-6 pufa,and tfa were estimated using a bayesian hierarchical model based on country-specific dietary surveys; food availability data; and,for tfa,industry reports on fats/oils and packaged foods. etiologic effects of dietary fats on chd mortality were derived from meta-analyses of prospective cohorts and chd mortality rates from the 2010 global burden of diseases study. absolute and proportional attributable chd mortality were computed using a comparative risk assessment framework. in 2010,nonoptimal intakes of n-6 pufa,sfa,and tfa were estimated to result in 711 800 (95% uncertainty interval [ui] 680 700-745 000),250 900 (95% ui 236 900-265 800),and 537 200 (95% ui 517 600-557 000) chd deaths per year worldwide,accounting for 10.3% (95% ui 9.9%-10.6%),3.6%,(95% ui 3.5%-3.6%) and 7.7% (95% ui 7.6%-7.9%) of global chd mortality. tropical oil-consuming countries were estimated to have the highest proportional n-6 pufa- and sfaattributable chd mortality,whereas egypt,pakistan,and canada were estimated to have the highest proportional tfa-attributable chd mortality. from 1990 to 2010 globally,the estimated proportional chd mortality decreased by 9% for insufficient n-6 pufa and by 21% for higher sfa,whereas it increased by 4% for higher tfa,with the latter driven by increases in low- and middle-income countries. conclusions: nonoptimal intakes of n-6 pufa,tfa,and sfa each contribute to significant estimated chd mortality,with important heterogeneity across countries that informs nation-specific clinical,public health,and policy priorities. © 2016 the authors.