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Associations between saturated fat intake and other dietary macronutrients and incident hypertension in a prospective study of French women

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Abstract

Purpose

Saturated fat has long been associated with cardiovascular disease in multiple prospective studies, and randomized controlled trials. Few studies have assessed the relative associations between saturated fat and other macronutrients with hypertension, a major risk factor for cardiovascular disease. The aim of this study was to assess the relative associations between saturated fat, other macronutrients such as monounsaturated and polyunsaturated fat, proteins, and carbohydrates, and incident hypertension in a large prospective cohort of French women.

Methods

This study used data from the E3N cohort study, including participants free of hypertension at baseline. A food frequency questionnaire was used to determine dietary intakes of saturated fat (SFA), monounsaturated fat (MUFA), polyunsaturated fat (PUFA), animal protein (AP), vegetable protein (VP), carbohydrates (CH) and various foods. Cases of hypertension were based on self-report, validated by drug reimbursement data. Covariates were based on self-report. Cox proportional hazard models were used to estimate the relative associations between different macronutrients and hypertension risk, using the ‘substitution’ framework. Bootstrapping was used to generate 95% confidence intervals.

Results

This study included 45,854 women free of hypertension at baseline. During 708,887 person-years of follow-up, 12,338 incident cases of hypertension were identified. Compared to saturated fat, higher consumption of all other macronutrients was associated with a lower risk of hypertension (HRMUFA = 0.74 [0.67: 0.81], HRPUFA = 0.84 [0.77: 0.92], HRCH = 0.83 [0.77: 0.88], HRAP = 0.91 [0.85: 0.97], HRVP = 0.93 [0.83: 1.03]).

Conclusion

This study finds that relative to other macronutrients such as monounsaturated or polyunsaturated fat, higher intake of saturated fat is associated with a higher risk of hypertension among women.

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Data availability

Data described in the manuscript, code book, and analytic code can be made available upon request by qualified researchers.

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Acknowledgements

We gratefully acknowledge the contribution of all the participants in the E3N study for their diligence and their answers.

Funding

The E3N cohort is being carried out with the financial support of the “Mutuelle Générale de l’Education Nationale” (MGEN); European Community; French League against Cancer (LNCC); Gustave Roussy Institute (IGR); French Institute of Health and Medical Research (INSERM). This present study was also supported by the French Research Agency (Agence Nationale de la Recherche) via an “Investissement d’Avenir” grant (investment for the future grant, ANR-10-COHO-0006). CJM is supported by funding from the Federation Française de Cardiologie. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. University Paris-Saclay, UVSQ, Inserm U1018, Centre for Research in Epidemiology and Population Health (CESP), “Exposome and Heredity” Team, Gustave Roussy, 114 Rue Edouard Vaillant, 94805, Villejuif, France

    Conor James MacDonald, Anne-Laure Madkia, Gianluca Severi & Marie-Christine Boutron-Ruault

  2. Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

    Conor James MacDonald

  3. Université de Lille, CHU Lille, EA 2694-Santé Publique: Epidémiologie et Qualité des Soins, 59000, Lille, France

    Anne-Laure Madkia & Claire Mounier-Vehier

  4. CHU Lille, Institut Cœur-Poumon, Médecine Vasculaire et HTA, Lille, France

    Claire Mounier-Vehier

  5. Department of Statistics, Computer Science and Applications (DISIA), University of Florence, Firenze, Italy

    Gianluca Severi

Authors
  1. Conor James MacDonald
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  2. Anne-Laure Madkia
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  3. Claire Mounier-Vehier
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  4. Gianluca Severi
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  5. Marie-Christine Boutron-Ruault
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Contributions

ALM—designed research, conducted research, wrote paper. CMV—designed research, conducted research. GS—designed research, conducted research. MCBR—designed research, conducted research, wrote paper. CJM—designed research, conducted research, analyzed data, wrote paper, had primary responsibility for final content. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Marie-Christine Boutron-Ruault.

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Conflict of interest

The authors have no competing interests to declare.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Ethics approval

The E3N study was authorized by the French National Commission for Data Protection and Privacy (CNIL no 106.246). E3N data enrichment with the MGEN database was granted ethical approval (CCTIRS no 13.794) and was authorized by the CNIL (no. 327346V14).

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MacDonald, C.J., Madkia, AL., Mounier-Vehier, C. et al. Associations between saturated fat intake and other dietary macronutrients and incident hypertension in a prospective study of French women. Eur J Nutr 62, 1207–1215 (2023). https://doi.org/10.1007/s00394-022-03053-0

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