Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study

Dehghan, Mahshid; Mente, Andrew; Zhang, Xiaohe; Wentzel-Viljoen, Edelweiss; Rosengren, Annika; Amma, Leela Itty; Chifamba, Jephat; Lear, Scott A.; Liu, Xiaoyun; Mohammadifard, Noushin; Gao, Nan; Ramli, Anis Safura; Serón, Pamela; Szuba, Andrzej; Tsolekile, Lungiswa; Yusuf, Rita; Yusufali, Afzal Hussein; Rangarajan, Sumathy; Dagenais, Gilles R.; Bangdiwala, Shrikant I.; Islam, Shofiqul; Anand, Sonia S.; Yusuf, Salim; Dı́az, Rafael; Orlandini, Andrés; Linetsky, B; Toscanelli, S; Casaccia, Germana; Cuneo, JM Maini; Rahman, Omar; Azad, AK; Rabbani, Khondkar Ayaz; Cherry, HM; Mannan, Adnan; Hassan, I; Talukdar, AT; Tooheen, RB; Khan, MU; Sintaha, Mariz; Choudhury, Tarzia; Haque, Rabiul; Parvin, S; Avezum, Álvaro; Oliveira, GB; Marcílio, CS; Mattos, AC; Teo, Koon; DeJesus, Jane; Agapay, D; Tongana, T; Solano, Rubén; Kay, I. Patrick; Trottier, Sylvie; Rimac, Julija; Elsheikh, W; Heldman, L; Ramezani, E; Poirier, Paul; Turbide, Ginette; Auger, Dominique; Bluts, A LeBlanc De; Proulx, MC; Cayer, Marie-Pierre; Bonneville, Nadine; Gasevic, Danijela; Corber, E; Jong, Veronica de; Vukmirovich, I; Wielgosz, Andreas; Fodor, George; Pipe, Andrew; Shane, A; Lanas, Fernando; Martinez, S; Valdebenito, A; Oliveros, María José; Li, Wei; Liu, Lisheng; Chen, Chun‐Ming; Wang, Xingyu; Wang, Zhao; Zhang, Hongye; Xuan, Jianhua; Hu, Bo; Sun, Yi; Jiang, Bo; Xiuwen, Zhao; Xiaohong, Chang; Chen, Tao; Chen, Hui; Deng, Qi; Cheng, Xin; Xu, He; Li, Jian; Li, Juan; Li, Xu; Bing, Ren; Wang, Wei; Wang, Yang; Yang, Jun; Zhai, Yali; Zhu, Manlu; Lu, Fanghong; Wu, Jianfang; Li, Yindong; Hou, Yan; Zhang, Liangqing; Guo, Bin; Liao, Xiaoyang; Zhang, Shiying; Rongwen, Bian; Xiao-bing, Tian; Dong, Li; Chen, Di; Wu, Jianhui; Xiao, Yize; Liu, Tianlu; Zhang, Peng; Changlin, Dong; Li, Ning; Ma, Xiaolan; Yang, Yuqing; Rensheng, Lei; Fu, Minyue; He, Jing; Liu, Yu; Xing, Xin; Zhou, Qiang; López‐Jaramillo, Patricio; Camacho, Paul Anthony; Garcia, R; Jurado, Lja; Gómez-Arbeláez, Diego; Arguello, JF; Dueñas, R; Silva, S; Pradilla, LP; Ramírez, Francisco Buitrago; Molina, DI; Cure-Cure, Carlos; Pérez, Maritza; Hernandez, E; Arcos, Édgar; Fernandez, Sully; Narváez, Claudia; Paez, J; Sotomayor, A; García, Henry; Sánchez, G.; David, T; Rico, A.; Mony, Prem; Vaz, Mário; Bharathi, A V; Swaminathan, Sumathi; Kurpad, K Shankar Av; Jayachitra, KG; Kumar, Narinder; Mohan, Viswanathan; Deepa, Mohan; Parthiban, K; Anitha, M; Hemavathy, S; Rahulashankiruthiyayan, T; Anitha, D; Sridevi, K; Gupta, Rajeev; Panwar, RB; Mohan, Indu; Rastogi, Priyanka; Rastogi, Shweta; Bhargava, Rishi; Kumar, Rajesh; Thakur, JS; Patro, Binod Kumar; Lakshmi, P V M; Mahajan, Rama; Chaudary, P; Kutty, V. Raman; Vijayakumar, Krishnapillai; Ajayan, K V; Rajasree, G; Renjini, AR; Deepu, A; Sandhya, B.; Asha, Stephen Edward; Soumya, HS; Kelishadi, Roya; Bahonar, Ahmad; Heidari, Hadi; Yusoff, Khalid; Ng, KK; Devi, A; Nasir, NM; Yasin, M.al-muzzammil; Miskan, Maizatullifah; Rahman, E. Abdul; Arsad, Mkm; Ariffin, Farnaza; Razak, SA; Majid, FA; Bakar, NA; Yacob, MY; Zainon, N; Salleh, Ruhaya; Ramli, Mka; Halim, NA; Norlizan, SR; Ghazali, NM; Arshad, MN; Razali, Rosdinom; Ali, S; Othman, HR; Hafar, Cwjcw; Pit, A; Danuri, Norlaila; Basir, Fasia; Zahari, Sna; Abdullah, Hafez Mohammad Ammar; Arippin, MA; Zakaria, NA; Ismail, Noorhassim; Hasni, MJ; Azmi, MT; Mi, Zaleha; Hazdi, KY; Rizam, AR; Sazman, W; Azman, A; Khatib, Rasha; Khammash, Umaiyeh; Khatib, A; Giacaman, Rita; Iqbal, Romaina; Afridi, Asad Ali Khan; Khawaja, Rehman; Raza, Auriba; Kazmi, Khawar; Zatoński, Witold; Zatońska, Katarzyna; Ilow, Rafał; Ferus, M; Regulska−Ilow, Bożena; Różańska, Dorota; Wołyniec, Maria; Alkamel,; Ali, Mohammed K.; Kruger, Marlize; Voster, H H; Schutte, Aletta E.; Eloff, FC; Ridder, H de; Moss, H; Potgieter, J; Roux, A.V. Diez; Watson, Megan; Wet, G de; Olckers, Antonel; Jerling, Johann C.; Pieters, Marlien; Hoekstra, Trynke; Puoane, Thandi; Igumbor, Ehimario; Sanders, David; Naidoo, Pooveshni; Steyn, N; Peer, Nasheeta; Mayosi, Bongani M.; Rayner, B; Lambert, Vicki; Levitt, Naomi; Kolbe-Alexander, Tracy; Ntyintyane, Lucas; Hughes, G.; Swart, Rina; Fourie, Jean; Muzigaba, Moïse; Xapa, S; Gobile, N; Ndayi, K; Jwili, B; Ndibaza, K; Egbujie, Bonaventure Amandi; Boström, Kristina Bengtsson; Gustavsson, Annika; Andréasson, Mattias; Snällman, M; Wirdemann, L; Oğuz, Aytekin; İmeryüz, Neşe; Altuntaş, Yüksel; Güleç, Sadi; Temizhan, Ahmet; Karşıdağ, Kubilay; Calik, Kbt; Akalin, Aak; Caklili, OT; Keskinler, MV; Erbakan, AN; Yusufali, AM; Almahmeed, Wael; Swidan, H; Darwish, EA; Hashemi, Ara; Al-Khaja, Najib; Muscat-Baron, J.; Ahmed, Shadab; Mamdouh, TM; Darwish, WM; Abdelmotagali, Mhs; Awed, SA Omer; Movahedi, GA; Hussain, Fawaz Al; Shaibani, H Al; Gharabou, Rim; Youssef, DF; Nawati, Azs; Salah, Zar Abu; Abdalla, Rfe; Shuwaihi, SM Al; Omairi, MA Al; Cadigal, OD; Alejandrino, R.S.; Gwaunza, L; Terera, G; Mahachi, Carol; Murambiwa, Pretty; Machiweni, T; Mapanga, RF

doi:10.1016/s0140-6736(17)32252-3

Cited by 876 publications

(672 citation statements)

References 46 publications

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“…The role of SSBs in driving obesity and its associated complications has been supported in a recent review [70]. A lack of association between bread intake and BMI observed in this study is not congruent with other studies [47,71]. A previous study by Steyn (2001) [21] from Dikgale HDSS showed a high intake of carbohydrates such as, white bread, white sugar, maize porridge and white rice.…”

Section: Discussioncontrasting

confidence: 64%

Determinants of body mass index by gender in the Dikgale Health and Demographic Surveillance System site, South Africa

Mashinya

Alberts

Cook

et al. 2018

Global Health Action

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Background: The study was conducted in the Dikgale Health and Demographic Surveillance System (DHDSS) site where we have observed increasing obesity levels, particularly in women, despite evidence of high physical activity (PA) and a relatively low daily energy intake. Objective: This study aimed to assess the socio-demographic, behavioural and biological determinants of body mass index (BMI) in adult residents permanently residing in the DHDSS. Methods: A cross-sectional study was conducted in which socio-demographic, behavioural and biological characteristics from 1143 participants (aged 40–60 years) were collected using a paper questionnaire and standard anthropometric measures. Human immunodeficiency virus (HIV) testing was performed on all participants except those who indicated that they had tested positive. Chi-square and Mann-Whitney tests were used to analyze categorical and continuous variables, respectively, while hierarchical multivariate regression was used to analyze predictors of BMI. Results: The median age of women and men was 51 (46–56) and 50 (45–55) years, respectively. The prevalence of overweight-obesity was 76% in women and 21% in men. A significant negative association of BMI with HIV and smoking and a significant positive association with socio-economic status (SES) was observed in both sexes. In women, BMI was negatively associated with sleep duration (p = 0.015) and age (p = 0.012), but positively associated with sugar-sweetened beverages (SSBs) (p = 0.08). In men, BMI was negatively associated with alcohol use (p = 0.016) and positively associated with being married (p < 0.001). PA was not associated with BMI in either sexes. Full models explained 9.2% and 20% of the variance in BMI in women and men, respectively. Conclusion: BMI in DHDSS adults is not associated with physical inactivity but is associated wealth, marital status, sleep, smoking, alcohol use, and HIV status. Future studies should explore the contribution of nutrition, stunting, psycho-social and genetic factors to overweight and obesity in DHDSS.

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Section: Discussioncontrasting

confidence: 64%

Determinants of body mass index by gender in the Dikgale Health and Demographic Surveillance System site, South Africa

Mashinya

Alberts

Cook

et al. 2018

Global Health Action

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“…This resulted in a significant rise in total cholesterol to HDL ratio by trans-fat compared to saturated fat 16 . Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality 17 .…”

Section: Discussionmentioning

confidence: 80%

Correlation of Dietary Pattern and Risk Factors in Patients with Coronary Artery Disease in Rural Population of Tamil Nadu- Pilot Study

Narayanaswamy¹

2017

jmscr

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“…These are my reflections after reading article from Dehghan et al (1). It is increasing well documented that it is Industrial processing: fractionation, separation, condensation, drying, freezing, irradiation, burning, roasting, curing, microwaving, emulsifying, toasting, supplementing food additives but also plant breeding etc.…”

Section: Industrial Processes Destroys Health-promoting Foodsmentioning

confidence: 95%

Choose right carbohydrates and right fats (RCRF) - keys to optimal health

Bengmark

2017

Hepatobiliary Surg. Nutr.

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Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study

Cited by 876 publications

References 46 publications

Determinants of body mass index by gender in the Dikgale Health and Demographic Surveillance System site, South Africa

Determinants of body mass index by gender in the Dikgale Health and Demographic Surveillance System site, South Africa

Correlation of Dietary Pattern and Risk Factors in Patients with Coronary Artery Disease in Rural Population of Tamil Nadu- Pilot Study

Choose right carbohydrates and right fats (RCRF) - keys to optimal health

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