Key PointsQuestion听
What are the associations between dietary fats from plant and animal food sources and mortality in the US population?
Findings听
In this cohort study of 407鈥�531 participants with 24 years of follow-up and nearly 190鈥�000 deaths, greater plant fat intake was associated with lower overall and cardiovascular disease mortality, particularly fat from grains and vegetable oils, independent of other important mortality risk factors.
Meaning听
These findings provide detailed information about how increased intake of dietary fat from plant sources may help improve human health and related mortality outcomes.
Importance听
The impact of dietary fat intake on long-term human health has attracted substantial research interest, and the health effects of diverse dietary fats depend on available food sources. Yet there is a paucity of data elucidating the links between dietary fats from specific food sources and health.
Objective听
To study associations of dietary plant and animal fat intake with overall mortality and cardiovascular disease (CVD) mortality.
Design, Setting, and Participants听
This large prospective cohort study took place in the US from 1995 to 2019. The analysis of men and women was conducted in the National Institutes of Health鈥揂ARP Diet and Health Study. Data were analyzed from February 2021 to May 2024.
Exposures听
Specific food sources of dietary fats and other dietary information were collected at baseline, using a validated food frequency questionnaire.
Main Outcomes and Measures听
Hazard ratios (HRs) and 24-year adjusted absolute risk differences (ARDs) were estimated using multivariable-adjusted Cox proportional hazards regression.
Results听
The analysis included 407鈥�531 men and women (231鈥�881 [56.9%] male; the mean [SD] age of the cohort was 61.2 [5.4] years). During 8鈥�107鈥�711 person-years of follow-up, 185鈥�111 deaths were ascertained, including 58鈥�526 CVD deaths. After multivariable adjustment (including adjustment for the relevant food sources), a greater intake of plant fat (HRs, 0.91 and 0.86; adjusted ARDs, 鈭�1.10% and 鈭�0.73%; P for trend鈥�<鈥�.001), particularly fat from grains (HRs, 0.92 and 0.86; adjusted ARDs, 鈭�0.98% and 鈭�0.71%; P for trend鈥�<鈥�.001) and vegetable oils (HRs, 0.88 and 0.85; adjusted ARDs, 鈭�1.40% and 鈭�0.71%; P for trend鈥�<鈥�.001), was associated with a lower risk for overall and CVD mortality, respectively, comparing the highest to the lowest quintile. In contrast, a higher intake of total animal fat (HRs, 1.16 and 1.14; adjusted ARDs, 0.78% and 0.32%; P for trend鈥�<鈥�.001), dairy fat (HRs, 1.09 and 1.07; adjusted ARDs, 0.86% and 0.24%; P for trend鈥�<鈥�.001), or egg fat (HRs, 1.13 and 1.16; adjusted ARDs, 1.40% and 0.82%; P for trend鈥�<鈥�.001) was associated with an increased risk for mortality for overall and CVD mortality, respectively, comparing the highest to the lowest quintile. Replacement of 5% energy from animal fat with 5% energy from plant fat, particularly fat from grains or vegetable oils, was associated with a lower risk for mortality: 4% to 24% reduction in overall mortality, and 5% to 30% reduction in CVD mortality.
Conclusions and Relevance听
The findings from this prospective cohort study demonstrated consistent but small inverse associations between a higher intake of plant fat, particularly fat from grains and vegetable oils, and a lower risk for both overall and CVD mortality. A diet with a high intake of animal-based fat, including fat from dairy foods and eggs, was also shown to be associated with an elevated risk for both overall and CVD mortality.