Intake and adipose tissue composition of fatty acids and risk of myocardial infarction in a male Portuguese community sample

Objective To evaluate the relation between intake and adipose tissue composition of fatty acids and acute myocardial infarction in Portuguese men. Design Case-control study. Diet was assessed using a semiquantitative food frequency questionnaire. In 49 case and 49 control subjects, adipose tissue composition was assessed by gas-liquid chromatography. Subjects/setting Population-based; subjects were 297 consecutively admitted cases of first acute myocardial infarction in a tertiary care hospital who were aged 40 years. Three hundred ten community controls were selected by random-digit dialing. Main outcome measure Odds ratio (OR). Statistical analysis performed Logistic regression, adjusting for age, education, family, history of acute myocardial infarction, smoking, physical activity, body mass index, and energy intake. Results Total fat intake (OR 0.45, fourth quartile, P=0.02), lauric acid (OR 0.44, fourth quartile, P=0.02), palmitic acid (OR 0.58, fourth quartile, P=0.03), and oleic acid (OR 0.42, fourth quartile, P=0.03) were inversely associated with acute myocardial infarction. No significant effects were found for the remaining fatty acids. In the adipose tissue composition data, the adjusted risk estimates of acute myocardial infarction for the highest vs the lowest tertile were 0.16, 0.14, and 0.04 for lauric, oleic, and trans-fatty acids, respectively. A significant direct association was found for palmitic and linoleic acids (adjusted ORs for the highest tertile were 9.02 and 3.63, respectively). Conclusions Low intake of total fat and lauric acid from dairy products was associated with acute myocardial infarction. The association of polyunsaturated fatty acids with risk of acute myocardial infarction was nonsignificant after adjustment for energy intake and confounders. Recommendations on fatty acid intake should aim for both an upper and lower limit.