APOE and the Association of Fatty Acids With the Risk of Stroke, Coronary Heart Disease, and Mortality

[giftsplash]

What is everyone's take on this study?

Conclusions—

These exploratory results suggest that APOE-ε4 carriers may be more susceptible to the beneficial or adverse impact of fatty acids on cardiovascular disease and mortality. In this subgroup, higher linoleic acid was protective for stroke and mortality, whereas palmitic acid was a risk factor for stroke and coronary heart disease. The mechanisms underlying these novel findings warrant further investigation.

https://www.ahajournals.org/doi/10.1161 ... Im2jA7l1g4

[NF52]

What is everyone's take on this study?

Conclusions—

These exploratory results suggest that APOE-ε4 carriers may be more susceptible to the beneficial or adverse impact of fatty acids on cardiovascular disease and mortality. In this subgroup, higher linoleic acid was protective for stroke and mortality, whereas palmitic acid was a risk factor for stroke and coronary heart disease. The mechanisms underlying these novel findings warrant further investigation.

https://www.ahajournals.org/doi/10.1161 ... Im2jA7l1g4

Hi giftsplash,

This is a group of researchers in the US and France looking at population based studies (the Framingham Heart Study and a study of 3 cities in France) to see whether various oils in foods as measured at one baseline were associated with strokes, coronary artery disease or all-cause mortality 10 years later. The study itself was underwritten in part by governmental grants in the U.S. and France, which indicates that it went through a fairly rigorous process with the research strategy and methodology, personnel, proposed statistical outcomes and data-sharing all approved as of high quality. Their conclusions seem to be summarized as higher concentrations of linoleic acid might reduce the risk of stroke and heart disease over the next 10 years by about 54% compared to low levels, for someone with an average age of 74 and ApoE 4. Higher concentrations of palmitic acid in the same group might increase the risk of stroke or coronary artery disease by a similar percentage, compared to a lower dose. The key difference is that they ONLY found these results in the 481 or so people with ApoE 4. For others groups, and for other oils, the results were mixed.

Here's an excerpt of their Discussion. Good researchers almost always say "more study is needed." This is probably consistent with what lots of our community is eating.

Strengths of our study include the prospective evaluation of 2 independent community-based samples, with rigorous prospective surveillance for cardiovascular events and mortality, consistent diagnostic criteria over time, objective measurement of individual fatty acids, and control for potential confounders. We acknowledge several limitations. First, our samples are composed of European descent, which limits the generalization of our results to other ethnic groups. Second, we were limited to study stroke subtypes, such as intracerebral hemorrhage, subclassifications of ischemic stroke pathogenesis, or APOE-ε4 homozygotes separately, because of small numbers. Third, we used a single measure of fatty acids at baseline to represent long-term dietary and metabolic patterns. However, we tried to minimize exposure misclassification by establishing a follow-up of 10 years... Finally, we acknowledge the exploratory nature of these analyses and the need for replication in additional samples.