Dietary fat intake and early mortality patterns -: data from The Malmo Diet and Cancer Study

Objectives. Most current dietary guidelines encourage limiting relative fat intake to < 30% of total daily energy, with saturated and trans fatty acids contributing no more than 10%. We examined whether total fat intake, saturated fat, monounsaturated, or polyunsaturated fat intake are independent risk factors for prospective all-cause, cardiovascular and cancer mortality. Design. Population-based, prospective cohort study. Setting and subjects. The Malmo Diet and Cancer Study was set in the city of Malmo, southern Sweden. A total of 28 098 middle-aged individuals participated in the study 1991-1996. Main outcome measures. Subjects were categorized by quartiles of relative fat intake, with the first quartile used as a reference point in estimating multivariate relative risks (RR; 95% CI, Cox's regression model). Adjustments were made for confounding by age and various lifestyle factors. Results. Women in the fourth quartile of total fat intake had a significantly higher RR of cancer mortality (RR 1.46; CI 1.04-2.04). A significant downwards trend was observed for cardiovascular mortality amongst men from the first to the fourth quartile (P = 0.028). No deteriorating effects of high saturated fat intake were observed for either sex for any cause of death. Beneficial effects of a relatively high intake of unsaturated fats were not uniform. Conclusions. With the exception of cancer mortality for women, individuals receiving more than 30% of their total daily energy from fat and more than 10% from saturated fat, did not have increased mortality. Current dietary guidelines concerning fat intake are thus generally not supported by our observational results.