Changes in Dietary Fat Intake and Projections for Coronary Heart Disease Mortality in Sweden: A Simulation Study

PLoS One. 2016 Aug 4;11(8):e0160474. doi: 10.1371/journal.pone.0160474. eCollection 2016.

Abstract

Objective: In Sweden, previous favourable trends in blood cholesterol levels have recently levelled off or even increased in some age groups since 2003, potentially reflecting changing fashions and attitudes towards dietary saturated fatty acids (SFA). We aimed to examine the potential effect of different SFA intake on future coronary heart disease (CHD) mortality in 2025.

Methods: We compared the effect on future CHD mortality of two different scenarios for fat intake a) daily SFA intake decreasing to 10 energy percent (E%), and b) daily SFA intake rising to 20 E%. We assumed that there would be moderate improvements in smoking (5%), salt intake (1g/day) and physical inactivity (5% decrease) to continue recent, positive trends.

Results: In the baseline scenario which assumed that recent mortality declines continue, approximately 5,975 CHD deaths might occur in year 2025. Anticipated improvements in smoking, dietary salt intake and physical activity, would result in some 380 (-6.4%) fewer deaths (235 in men and 145 in women). In combination with a mean SFA daily intake of 10 E%, a total of 810 (-14%) fewer deaths would occur in 2025 (535 in men and 275 in women). If the overall consumption of SFA rose to 20 E%, the expected mortality decline would be wiped out and approximately 20 (0.3%) additional deaths might occur.

Conclusion: CHD mortality may increase as a result of unfavourable trends in diets rich in saturated fats resulting in increases in blood cholesterol levels. These could cancel out the favourable trends in salt intake, smoking and physical activity.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cholesterol / blood
  • Coronary Disease / epidemiology
  • Coronary Disease / mortality*
  • Coronary Disease / prevention & control
  • Dietary Fats / metabolism*
  • Fatty Acids / metabolism
  • Feeding Behavior
  • Female
  • Humans
  • Life Style
  • Male
  • Middle Aged
  • Models, Theoretical*
  • Mortality / trends
  • Risk Factors
  • Smoking
  • Sodium Chloride, Dietary / metabolism
  • Sweden / epidemiology

Substances

  • Dietary Fats
  • Fatty Acids
  • Sodium Chloride, Dietary
  • Cholesterol

Grants and funding

The Swedish Research Council, www.vr.se, (SIMSAM; grants 2013-5187 and 2013-4236), the Swedish Council for Health, Working Life and welfare, www.forte.se, (EpiLife), and the Swedish Heart and Lung Foundation, www.hjart-lungfonden.se, supported this research. The Swedish state also provided funding under the agreement between the Swedish government and the county councils concerning economic support of research and education of doctors (ALF-agreement). The European Union Health Programme (Executive Agency for Health & Consumers), “EuroHeart II” (European Heart Health Strategy 2; ADONIS code A/100946) provided additional funding for the study methodology. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. MCG and PB also received support from the National Institute for Health Research’s School for Public Health Research (NIHR SPHR).