Saturated and Trans Fatty Acids Were Not Associated with All-Cause or Cause-Specific Mortality in a Japanese Population with Relatively Low Intakes: The Japan Public Health Center-Based Prospective Study

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BACKGROUND: World Health Organization (WHO) guidelines recommend that saturated fatty acids (SFAs) and trans fatty acids (TFAs) should comprise ≤10% and ≤1% of total energy intake, respectively. However, evidence of the mortality risk associated with increased TFA and SFA intake in populations with a relatively low fat intake is limited. OBJECTIVE: To examine the association between total fat, SFA, TFA, monounsaturated fatty acid (MUFA), and polyunsaturated fatty acid (PUFA) intake and all-cause and cause-specific mortality in a Japanese population. METHODS: We included 90,807 participants aged 45-74 years with no history of cancer or cardiovascular disease (CVD). Dietary assessment was performed using a validated food frequency questionnaire. Hazard ratios (HRs) and 95% confidence intervals (CIs) were assessed using Cox proportional hazards models for each quintile of dietary fat intake: total fat, SFA, MUFA, PUFA, TFA, industrially-derived TFA (i-TFAs), and ruminant-derived TFA (r-TFA). RESULTS: During a mean follow-up of 18.9 years, 22,618 deaths occurred. None of the analyses of fat intakes in quintiles showed a positive association with all-cause mortality for higher intakes of all fats, even for i-TF. In females, a nominally significant association was observed for all-cause mortality with PUFA (HR, Q5 vs. Q1 = 0.92 [0.84-0.997]) and cancer mortality with MUFA (HR, Q5 vs. Q1 = 0.84 [0.73-0.97]).In females, higher intakes of total fat and MUFA were nominally associated with higher respiratory disease mortality, whereas a higher SFA intake showed a suggestive association (P for trend <0.05). CONCLUSIONS: In this study, neither SFA nor TFA intake was positively associated with all-cause mortality, and higher PUFA intake was inversely associated with all-cause mortality in females.