Patterns of Dietary Fatty Acids and Fat Spreads in Relation to Blood Pressure, Lipids and Insulin Resistance in Young Adults: A Repeat Cross-Sectional Study

<b>Background/Objectives:</b> Determining whether dietary fatty acids and the use of fat spreads are associated with cardiovascular risk factors is difficult due to the multicollinearity of fatty acids and the consumption of multiple spread types. <b>Methods:</b> We applied clustering methodologies using data on 31 different fatty acids and 5 different types of fat spreads (high fat: butter, blended butters, and margarines; lower fat: polyunsaturated and monounsaturated) and investigated associations with blood pressure, serum lipid patterns and insulin resistance in the Raine Study Gen2 participants in Western Australia, at 20 and 22 years of age. <b>Results:</b> Amongst n = 785 participants, there were eight distinct clusters formed from the fatty acid data and ten distinct clusters formed from the fat spread data. Male participants had higher systolic blood pressure than females (122.2 ± 11.6 mmHg versus 111.7 ± 10.3, <i>p</i> < 0.001 at age 20 and 123.4 ± 10.6 versus 113.9 ± 9.8, <i>p</i> < 0.001 at age 22). Males consuming exclusively butter as a fat spread had significantly higher SBP (+4.3 mmHg) compared with males not using spreads. Males consuming a high intake of margarine had significantly higher SBP (+6.6 mmHg), higher DBP (+3.4 mmHg) and higher triglycerides (+30.5%). Amongst females, four patterns of fatty acid intake were associated with lower levels of HDL cholesterol compared with the low-saturated-fat/high <i>n</i>-3 reference group (<i>p</i> = 0.017 after adjustment for relevant confounders, range = -10.1% to -16.0%, <i>p</i> = 0.017). There were no associations between clusters and HOMA-IR or other serum lipids for males or females. <b>Conclusions:</b> Compared to using no fat spreads, amongst males, a high intake of margarine was characterised by higher systolic and diastolic blood pressure and higher serum triglycerides, whilst the use of butter also was associated with higher SBP. Diets low in <i>n</i>-3s or high in trans fats were associated with sub-optimal HDL levels amongst females.