Individual saturated fatty acids and nonfatal acute myocardial infarction in Costa Rica

Background: Epidemiological studies on the effect of individual saturated fatty acids (SFAs) on cardiovascular disease, especially in developing countries with different dietary patterns, are scarce. Objective: To determine the risk of nonfatal acute myocardial infarction (MI) associated with consumption of individual SFAs and their food sources in Costa Rica. Design: The cases (n = 485) were survivors of a first acute MI and were matched by age, sex and area of residence to population controls (n = 508). Data on anthropometrical measurements, lifestyle and diet were collected using interviewer-administered questionnaires. Results: In analyses adjusted for confounders, consumption of total and individual SFAs was associated with an increased risk of MI. The odds ratio ( OR) (95% confidence intervals) for 1% increase in energy from total saturated fat was 1.12 (1.03 - 1.21) while it was 1.51 ( 1.03 - 2.22) for lauric acid+myristic acid, 1.14 (1.01 - 1.30) for palmitic acid and 2.00 ( 1.34 - 3.00) for stearic acid. Although lauric and myristic acids were associated with increased risk of MI, they were consumed in small amounts and most of the saturated fat (87%) came from palmitic and stearic acids, which derived mainly from red meat and fried foods. Consumption of cheese (1 - 2 vs 0 servings/day) was associated with increased risk of MI (OR = 3.07; 95% confidence interval: 1.74 - 5.39; P for trend <0.0001), while consumption of low-fat milk was not. Conclusion: Increased consumption of total and individual SFAs is associated with increased risk of MI. Lauric, myristic and stearic acids were more potent than palmitic acid. Sponsorship: National Institutes of Health Grant HL 49086 and HL 60692.