The Contribution of Dietary Fatty Acids to Prediction of All-Cause Mortality in a Cohort of Middle-Aged Men Followed-Up for 61 Years Until Extinction

To describe the contribution of three classes of dietary fatty acids to all-cause mortality and age at death among middle-aged men followed up for 61 years until extinction. The cohort comprised 1712 men aged 40-59 years at entry examination in 1960, belonging to the Italian Rural Areas of the Seven Countries Study of Cardiovascular Diseases. A dietary survey allowed to estimate dietary fatty acids [saturated (SAFA), mono-unsaturated (MUFA), poly-unsaturated (PUFA) and their ratios (M/S, P/S)] that were fed as possible predictors in a series of Cox models and a multiple linear regression model (MLR) with all-cause mortality and age at death as end-points, respectively, together with 17 possible confounders. Cox multivariate coefficients of SAFA and MUFA were significantly predictive of the end-point (all-cause mortality) in a direct and inverse way, respectively, for the first 31 years and then for the final 61 years of follow-up while P/S and M/S ratios had a minor role. Prediction of the isolated events occurring between years 31 and 61 of follow-up did not show a significant association with the same fatty acids. In an MLR model with age at death as the endpoint, 1 standard deviation over SAFA was associated with the loss of 1 year. In comparison, 1 standard deviation over PUFA was associated with a gain of 0.61 years. Intake of butter, milk, cheese, meat, and pastry was significantly larger in high levels of SAFA and in low levels of P/S ratio. In a long-term follow-up, all-cause mortality and age at death are associated considerably with SAFA, MUFA, and partly PUFA using different predictive models, all adjusted for 17 possible confounding variables.