Estimated intake of milk fat is negatively associated with cardiovascular risk factors and does not increase the risk of a first acute myocardial infarction. A prospective case-control study

'Orujo' olive oil is obtained by chemical processes from the waste resulting from the mechanical extraction of virgin olive oil. The aim of the present study was to evaluate a new pharmacological property of two natural triterpenoids contained in olive oil, as vasodilatory agents, and to determine their mechanism of action. The two compounds studied were oleanolic acid and erythrodiol. The vasorelaxant effect induced by these pentacyclic triterpenoids was studied in isolated thoracic rat aorta. Oleanolic acid and erythrodiol, accumulatively added, showed vasorelaxant activities in aortic rings with endothelium pre-contracted by 10(-6) m-phenylephrine (maximum percentage of relaxation 86.38 (sem 2.89) and 73.53 (sem 6.01), respectively). They had almost no relaxant effect on depolarised or endothelium-denuded aortic segments. The relaxation was significantly attenuated by pre-treatment with the NO synthase inhibitor N(omega)-nitro-L-arginine-methylester (L-NAME; 3x10(-4) m). To characterise the involvement of endothelial factors, in addition to NO, arteries with endothelium were exposed to 10(-5) m-indomethacin (INDO), a cyclo-oxygenase inhibitor, or INDO plus L-NAME. INDO did not have any significant effect on the relaxant response of both compounds. The combination of L-NAME plus INDO only abolished the oleanolic acid-induced relaxation. The present results suggest that the mechanism of relaxation seems to be mainly mediated by the endothelial production of NO; however, other mechanisms cannot be excluded. It can be concluded that oleanolic acid and erythrodiol may have interesting therapeutic potential as new vasodilator drugs, thus protecting the cardiovascular system. Therefore, the intake of 'orujo' olive oil, as a source of these compounds, might be beneficial in this regard.     

Fiber intake and risk of nonfatal acute myocardial infarction

OBJECTIVE: To investigate the association between fiber intake and risk of acute myocardial infarction (AMI), also according to type and source of fiber, in a Mediterranean country. DESIGN: Hospital-based case-control study. SETTING: Northern Italy. SUBJECTS: A total of 507 cases of first nonfatal AMI and 478 controls in hospital for acute conditions. INTERVENTIONS: Subjects were interviewed with a questionnaire that included a validated food frequency section. Odds ratios (OR) were obtained using multiple logistic regression, and adjusted for several recognized risk factors for AMI. Fiber was measured as non-starch polysaccharides. RESULTS: Compared with the lowest one, the OR in the highest tertile was 0.72 for total fiber, 0.64 for soluble fiber, 0.77 for total insoluble fiber, 0.71 for cellulose, 0.81 for insoluble non-cellulosic polysaccharides, 0.82 for vegetable fiber, 0.64 for fruit fiber and 1.11 for cereal fiber, and the estimates were statistically significant for soluble and fruit fiber. When further adjusted for beta-carotene, vitamin C and vitamin E intake, the fruit fiber still showed the strongest inverse relation, although the association was no longer significant. The protective effect of fiber was more marked in, or restricted to, subjects with other AMI risk factors, such as smokers, diabetics and hypertensives. CONCLUSIONS: Though an inverse association between fiber intake and AMI risk appears established, the causality of this association is still open to debate. In this population, cereal fiber derives chiefly from refined grains, and this may explain the lack of protection by this type of fiber.     

Moderate alcohol intake and risk of myocardial infarction among non-smokers

We have conducted a hospital-based case-control study on 157patients with newly diagnosed myocardial infarction and 157hospital controls. All were men, 35–69 years old and non-smokersor ex-smokers of at least 6 months. A clearcut inverse dose-responserelationship was found between alcohol intake (chiefly red wine)and risk of Ml (odds ratios were 0.69, 0.43 and 0.42, for thosedrinking 1–30, 30–90 and >90 drinks per month,compared to <1). Adjustment by coronary risk factors in logistic-regressionmodels increased the strength of the association with alcohol.Protection was somewhat stronger than in studies conducted incountries where the consumption of beer or liquors is heavierthan that of wine. The protective effect might be due to theantioxidant properties of phenolic substances contained in redwine.     

Major habitual dietary patterns are associated with acute myocardial infarction and cardiovascular risk markers in a southern European population

Background

Most dietary pattern analyses in southern Europe have relied on a priori food approaches using Mediterranean-style diet indexes. These methods may not reflect the current population's food consumption.

Objective

To assess the association of a posteriori dietary patterns with acute myocardial infarction (AMI) and cardiovascular risk markers in the general adult population of Porto, Portugal.

Design

A population-based case-control study was conducted. Information was collected by trained interviewers. Diet was assessed with a validated 82-item food frequency questionnaire.

Participants/setting

Cases were patients consecutively hospitalized for an incident non-fatal AMI (n=820), and controls were individuals free of previous AMI selected from the hospitals' catchment area (n=2,196).

Statistical analyses

Dietary patterns, representing mutually exclusive clusters of individuals, were identified by multivariate finite mixture models among controls. Odds ratios (OR) and their 95% confidence intervals (CIs) were obtained from unconditional logistic regression, with adjustment for main confounders.

Results

In comparison to women with a “healthy” dietary pattern, those with a “low fruit and vegetables” pattern and a “red meat and alcohol” (also characterized by lower intake of dairy products and vegetables) pattern showed a higher risk of AMI (OR 1.85, 95% CI 1.01 to 3.39 and OR 1.91, 95% CI 1.17 to 3.12, respectively). Female controls with the “red meat and alcohol” pattern also had a higher total to high-density lipoprotein cholesterol ratio. In comparison to men with a “healthy” pattern, those with the “red meat and alcohol” pattern, similar to the counterpart found in women, were more likely to experience an AMI (OR 1.98, 95% CI 1.35 to 2.92); male controls with this pattern had higher diastolic and systolic blood pressure, C-reactive protein, and uric acid levels.

Conclusions

A dietary pattern with lower fruit and vegetable intakes in women, and a pattern characterized by higher consumption of red meat and alcohol (and lower of dairy products and vegetables) in both sexes, were associated with an increased risk of AMI and adverse cardiovascular risk profiles. These findings highlight the importance of sustained recommendations for fruit and vegetable intake and cautious guidance on consumption of alcoholic beverages, which clusters with less healthy dietary patterns of men and women.     

Allium vegetable intake and risk of acute myocardial infarction in Italy

Background  Interest in potential benefits of allium vegetables has its origin in antiquity, but the details of these benefits are still open to discussion. Only two epidemiological studies considered the relation between dietary intake of allium vegetables and cardiovascular diseases. Aim of the study  To provide further information we analysed the relationship between onion and garlic intake and acute myocardial infarction (AMI). Methods  We used data from a case–control study of 760 patients with a first episode of non-fatal AMI and 682 controls admitted to the same hospitals. Information was collected by trained interviewers using a validated and reproducible food-frequency questionnaire. Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) were obtained after allowance for recognized confounding factors. Results  Compared with non-users, the ORs of AMI for subsequent categories of onion intake were 0.90 (95% CI: 0.69–1.21) for <1 portion of onion per week and 0.78 (95% CI: 0.56–0.99) for ≥1 portion per week. For garlic, the ORs were 0.84 (95% CI: 0.66–1.09) for intermediate and 0.94 (95% CI: 0.68–1.32) for high use, compared with no or low use. Conclusion  The current study, the first from Mediterranean countries, suggests that a diet rich in onions may have a favourable effect on the risk of AMI.     

Beta-carotene intake and risk of nonfatal acute myocardial infarction in women

There are indications that beta-carotene, but not pre-formed vitamin A, is protective on the risk of acute myocardial infarction (AMI). The relationship between nonfatal AMI and the intake of beta-carotene and retinol was investigated in a case-control study conducted between 1983 and 1992 in northern Italy on 433 women with nonfatal AMI and 869 controls in hospital for acute, non-cardiovascular, non-neoplastic, non-digestive, non-hormone related conditions. Odds ratios (OR), with their 95% confidence intervals (CI), were computed by unconditional multiple logistic regression analysis, including terms for age, education, body mass index, smoking, alcohol and coffee drinking, menopausal status, hormone replacement therapy and history of diabetes, hypertension and hyperlipidemia. The risk of AMI was inversely related to beta-carotene intake, with an OR of 0.5 (95% CI: 0.3 to 0.8) for the highest quintile of intake compared to the lowest (² trend = 10.53, p < 0.01). Retinol intake was not associated with AMI, with an OR of 0.9 (95% CI: 0.6 to 1.3) for the highest quintile of intake compared to the lowest. Analysis in separate strata of covariates indicated that the inverse association of beta-carotene intake with risk of AMI was appreciably stronger in younger, lean women with no history of diabetes or hypertension, and in current smokers. The results of this study indicate that the risk of nonfatal AMI in women is inversely related to intake of beta-carotene containing foods, but not foods containing retinol.     

Prescription medications associated with a decreased risk of non-Hodgkin's lymphoma

Earlier epidemiologic studies have suggested an inverse association between non-Hodgkin's lymphoma and exposure to histamine(2) (H(2)) blockers, nonsteroidal anti-inflammatory drugs, cholesterol-lowering drugs, and antibiotics. Data from the PHARMO database were used to conduct a nested, population-based case-control study that included 1985-1998 drug-dispensing records for 300,000 residents of six Dutch cities. Included were those subjects without a previous history of cancer who were aged >/=20 years and were registered with an incident primary discharge diagnosis of non-Hodgkin's lymphoma between 1991 and 1998. This paper includes data on 211 cases and 800 controls individually matched on sex, age, community pharmacy, calendar time, and duration of follow-up. Conditional logistic regression analysis was used to evaluate the association between non-Hodgkin's lymphoma and categories of cumulative drug use in days. In multivariate analyses, nonsignificant risk reductions were found for all drugs tested, and the negative association tended to increase with increasing duration of use. For women, the odds ratio for H(2) blockers was 0.29 (95% confidence interval: 0.12, 0.69) and for analgesics was 0.40 (95% confidence interval: 0.22, 0.71). Results support an inverse association between occurrence of non-Hodgkin's lymphoma and use of H(2) blockers and analgesics among women, and they warrant confirmation in larger studies.     

Some dietary and adipose tissue carotenoids are associated with the risk of nonfatal acute myocardial infarction in Costa Rica

Antioxidants, particularly carotenoids and tocopherols, may protect against cardiovascular disease. The objective of this study was to determine whether dietary and adipose tissue carotenoids and tocopherols are associated with the risk of myocardial infarction (MI). Cases (n = 1456) of a first acute MI were identified and matched by age, sex, and residence to randomly selected population controls (n = 1456) living in Costa Rica. Carotenoids and tocopherols were measured in adipose tissue using HPLC. Dietary intake was assessed using a validated FFQ. Anthropometrical and lifestyle data were collected using an interviewer-administered questionnaire. Subjects were distributed into quintiles of intake or adipose tissue concentration of carotenoids or tocopherols. The lowest quintile was used as the referent in conditional logistic regression analyses. Adipose tissue beta-carotene showed a significant inverse relation with MI risk; the odds ratio (OR) comparing the highest to the lowest quintile was 0.70 (95% CI: 0.51-0.96, P for trend = 0.02). Intake of fruits and vegetables that are rich in beta-carotene was also inversely associated with the risk of MI (OR = 0.74; CI: 0.54-1.01, P for trend = 0.09). In contrast, lutein + zeaxanthin in adipose tissue (OR = 1.46; CI: 1.05-2.05, P for trend = 0.02) and diet (OR = 1.18; CI: 0.88-1.57, P for trend = 0.02) was positively associated with MI risk. MI risk was not associated with any of the other carotenoids or tocopherols in the diet or adipose tissue. Thus, the inverse association between beta-carotene and MI risk suggests that beta-carotene protects against MI or it is a marker of some protective factor in foods containing beta-carotene. The mechanism underlying the positive association between lutein + zeaxanthin and the risk of MI warrants investigation.     

Moderate alcohol intake is associated with decreased risk of insulin resistance among individuals with vitamin D insufficiency

ObjectiveTo determine whether moderate alcohol intake modifies the association between low vitamin D levels and insulin resistance (IR), we hypothesized that moderate alcohol intake would have a modifying effect on IR in people with low vitamin D levels.MethodsThis was a cross-sectional analysis of subjects ≥20 y old without a history of diabetes, coronary heart disease, or stroke in the National Health and Nutrition Examination Survey 2001–2004. Main outcome was IR status measured by homeostasis model assessment for IR (HOMA-IR; ≥ 2.6) and fasting insulin (>12.2 μU/mL) in moderate drinkers compared with non-drinkers by vitamin D levels (deficient ≤20 ng/mL, insufficient 21–32 ng/mL, normal >32 ng/mL).ResultsTwo thousand seven hundred twenty-one subjects met the inclusion criteria, representing a weighted total of >138 million people. Of these, 34% were vitamin D deficient and 47% insufficient. In adjusted analysis, compared with moderate drinkers with normal vitamin D levels, non-drinkers had no increased risk of IR by HOMA-IR levels (odds ratio [OR] 1.18, 95% confidence interval [CI] 0.61–2.30). Vitamin D–deficient individuals had a higher risk of IR regardless of alcohol consumption (moderate drinkers OR 2.12, 95% CI 1.41–3.19; non-drinkers OR 2.22, 95% CI 1.29–3.83). However, in those with insufficient vitamin D levels, moderate alcohol intake had a modifying effect on the odds of IR, with no difference seen in moderate drinkers (OR 1.29, 95% CI 0.92–1.80) and an increased risk found in non-drinkers (OR 1.82, 95% CI 1.07–3.11). Similar results were seen with fasting insulin.ConclusionModerate alcohol consumption appears to have a modifying effect on the risk of IR in individuals with insufficient levels of vitamin D.     

Plasma vitamin E and coenzyme Q10 are not associated with a lower risk of acute myocardial infarction in Singapore Chinese adults

Vitamin E and coenzyme Q10 (CoQ10) have antioxidant effects that may benefit cardiovascular health. Meta-analyses of randomized controlled trials have not shown a protective effect of supplementation with the vitamin E isomer α-tocopherol on the risk of acute myocardial infarction (AMI), but data on other isomers and CoQ10 are limited. Our objective was to examine the association of the plasma concentrations of vitamin E isomers (α-, γ-, and δ-tocopherol and α-, γ-, and δ-tocotrienol) and CoQ10 (ubiquinol and ubiquinone) with the incidence of AMI. We conducted a nested case-control study with 233 cases of incident AMI and 466 matched controls selected from the Singapore Chinese Health Study, aged 45-74 y at the time of recruitment and free of cardiovascular disease at the time of blood collection. We used conditional logistic regression to examine the association between vitamin E and CoQ10 and the risk of AMI adjusted for other risk factors. In the basic model, higher δ-tocopherol and ubiquinone concentrations were significantly associated with a higher risk of AMI, whereas there were no significant associations for the other vitamin E and CoQ10 isomers. After adjusting for lifestyle and other risk factors, only the association between δ-tocopherol and AMI risk remained significant [OR = 3.09 (95% CI: 1.53, 6.25) highest vs. lowest quintile; P-trend = 0.028]. We did not observe an inverse association between plasma concentrations of vitamin E isomers or CoQ10 and risk of AMI in Singapore Chinese. In contrast, plasma δ-tocopherol concentrations were associated with a higher risk of AMI. Our findings do not support a role of higher vitamin E or CoQ10 intakes in the prevention of AMI.     

Multivitamin supplements are inversely associated with risk of myocardial infarction in men and women--Stockholm Heart Epidemiology Program (SHEEP)

Epidemiologic data relating multivitamin supplement use to the risk of cardiovascular disease are sparse and inconsistent. We examined the association between self-selected use of low dose multivitamin supplements and the risk of myocardial infarction (MI). Our results are based on data from a large population-based, case-control study of subjects aged 45-70 y residing in Sweden, a country in which consumption of fruits and vegetables is relatively low and foods are not fortified with folic acid. The study included 1296 cases (910 men, 386 women) with a first nonfatal MI and 1685 controls (1143 men, 542 women) frequency-matched to the cases by sex, age and hospital catchment area. Odds ratios (OR) and 95% CI were calculated from unconditional logistic regression models. Among controls, 57% of the women and 35% of the men used dietary supplements; corresponding figures for the cases were 42 and 27%, respectively. Of those taking supplements, 80% used multivitamin preparations. After adjustment for major cardiovascular risk factors, the OR of MI comparing regular users of supplements with nonusers were 0.79 (95% CI 0.63-0.98) for men and 0.66 (95% CI 0.48-0.91) for women. This inverse association was not modified by such healthy lifestyle habits as consumption of fruits and vegetables, intake of dietary fiber, smoking habits and level of physical activity, although never smoking appeared to outweigh the association in women. Findings from this study indicate that use of low dose multivitamin supplements may aid in the primary prevention of MI.     

No evidence of decreased risk of colorectal adenomas with white meat,poultry, and fish intake: a meta-analysis of observational studies

PurposeObservational studies on the association between white meat (including fish and poultry) intake and the risk of colorectal adenoma (CRA), the precursor of colorectal cancer, have reported mixed results. To provide a quantitative assessment of this association, we summarized the evidence from observational studies.MethodsRelevant studies published on or before April 30, 2012 were identified from MEDLINE and EMBASE. Summary effect size estimates with 95% confidence intervals (CIs) were calculated with a random-effects model. Between-study heterogeneity was assessed using the Cochran Q and I² statistics.ResultsA total of 23 publications from 21 independent studies (16 case–control and 5 cohort studies) were included in this meta-analysis. Based on high versus low analysis, the summary effect size estimate of CRA was 0.96 (95% CI, 0.84–1.09) for white meat intake, 0.98 (95% CI, 0.80–1.19) for fish intake, and 0.98 (95% CI, 0.80–1.18) for poultry intake. Subgroup analyses revealed that the null associations of CRA with intake of white meat (fish/poultry) were independent of geographic locations, study design, type of food frequency questionnaire, number of cases, and adjustments for confounders, such as body mass index, use of nonsteroidal anti-inflammatory drugs, dietary energy intake, smoking, and physical activity.ConclusionsIntake of white meat (fish/poultry) is not associated with the risk of CRA.     

Risk of first non-fatal myocardial infarction negatively associated with olive oil consumption: a case-control study in Spain

BACKGROUND: Olive oil is the main source of dietary lipids in most Mediterranean countries where mortality and incidence rates for coronary heart disease (CHD) are the lowest in Europe. Although international comparisons and mechanistic reasons support the hypothesis that a high olive oil intake may prevent CHD, limited data from studies of individuals are available. METHODS: A hospital-based case-control study was conducted in Pamplona (Spain) recruiting 171 patients (81% males, age <80 years) who suffered their first acute myocardial infarction and 171 age-, gender- and hospital-matched controls (admitted to minor surgery, trauma or urology wards). A validated semi-quantitative food frequency questionnaire (136 items) was used to appraise previous long-term dietary exposures. The same physician conducted the face-to-face interview for each case patient and his/her matched control. Conditional logistic regression modelling was used to take into account potential dietary and non-dietary confounders. RESULTS: The exposure to the upper quintile of energy-adjusted olive oil (median intake: 54 g/day) was associated with a statistically significant 82% relative reduction in the risk of a first myocardial infarction (OR = 0.18; 95% CI : 0.06-0.63) after adjustment for dietary and non-dietary confounders. CONCLUSIONS: Our data suggest that olive oil may reduce the risk of coronary disease. These findings require confirmation in further observational studies and trials.     

Endemic goiter associated with high iodine intake

OBJECTIVES: This study assessed the relation of iodine content of household water to thyroid size and urinary iodine excretion in an area with high iodine concentration in the water. METHODS: The iodine content of household water and indicators of iodine status (thyroid size and urinary iodine level) were assessed in selected villages in Jiangsu Province, China. RESULTS: Water iodine levels were positively correlated with urinary iodine levels and indicators of thyroid size at the township level. CONCLUSIONS: Excess iodine in household water was the likely cause of endemic goiter and elevated urinary iodine levels in the study area. This finding affects public health policy on the institution of universal salt iodization for the elimination of iodine deficiency disorders.     

Social capital is associated with decreased risk of hunger

This article explores whether social capital-a measure of trust, reciprocity and social networks-is positively associated with household food security, independent of household-level socioeconomic factors. Interviews were conducted in 330 low-income households from Hartford, Connecticut. Social capital was measured using a 7-item Likert scale and was analyzed using household- and community-level scores. Household food security and hunger were measured using the US Household Food Security Module. chi2 tests were used to examine associations between social capital, food security and household demographic characteristics. Logistic regression was used to examine whether household- and community-level social capital decreases the odds of household hunger, and to estimate which household characteristics increase the likelihood of having social capital. Consistent with our hypotheses, social capital, at both the household and community levels, is significantly associated with household food security in these data. Community-level social capital is significantly associated with decreased odds of experiencing hunger (adjusted odds ratio (AOR)=0.47 [95% CI 0.28, 0.81], P<0.01), while controlling for household socioeconomic status. Results show that households with an elderly member are over two and a half times as likely to have high social capital (AOR=2.68 [1.22, 5.87], P<0.01) than are non-elderly households, after controlling for socioeconomic status. Having a household member who participates in a social or civic organization is also significantly associated with having higher levels of social capital. Social capital, particularly in terms of reciprocity among neighbors, contributes to household food security. Households may have similarly limited financial or food resources, but households with higher levels of social capital are less likely to experience hunger.     

Soy and isoflavone intake are associated with reduced risk of ovarian cancer in southeast china

To investigate whether intake of soy and isoflavones has an inverse association with ovarian cancer risk, a case-control study was conducted in Hangzhou, China. Cases were 254 patients with histologically confirmed epithelial ovarian cancer. The 652 controls comprised 340 hospital visitors, 261 non-neoplastic hospital outpatients, and 51 women recruited from the community. Habitual dietary intakes including 9 soy foods were measured by face-to-face interview using a validated and reliable food-frequency questionnaire. Unconditional logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) accounting for age, demographic characteristics, hormonal factors, and total energy intake. Intake of soy and isoflavones was inversely related to the risk of ovarian cancer. Compared with the highest versus the lowest quartile intake, the ORs were 0.50 (95% CI = 0.31-0.82) for total soy foods and 0.51 (95% CI = 0.31-0.85) for isoflavones. Among subgroups of soy foods and isoflavones, the ORs for soybeans, bean curd, daidzein, genistein, and glycitein were 0.35 (95% CI = 0.22-0.58), 0.49 (95% CI = 0.29-0.81), 0.52 (95% CI = 0.31-0.87), 0.50 (95% CI = 0.30-0.84), and 0.59 (95% CI = 0.35-0.97), respectively.     

Coffee use prior to myocardial infarction restudied: heavier intake may increase the risk

Because of conflicting evidence about the relation of coffee use to coronary artery disease, the authors conducted a new cohort study of hospitalizations among 101,774 white persons and black persons admitted to Kaiser Permanente hospitals in northern California in 1978-1986. In analyses controlled for eight covariates, use of coffee was associated with higher risk of myocardial infarction (p = 0.0002). Compared with nondrinkers of coffee, the following relative risks (RRs) were found: at 1-3 cups/day, RR = 1.14 (95% confidence interval (CI) 0.91-1.42); at 4-6 cups/day, RR = 1.42 (CI 1.10-1.84), p = 0.007; and at greater than 6 cups/day, RR = 1.41 (CI 1.00-1.99), p = 0.05. The relation remained significant when also controlled for blood cholesterol, blood glucose, blood pressure, and adiposity, singly or combined. Tea use was unrelated to myocardial infarction; neither coffee nor tea was related to other coronary diagnoses. Although causality remains unestablished and uncertainty remains, the authors conclude that 1) these data suggest a weak independent relation of coffee use to acute myocardial infarction, not mediated by an effect on blood cholesterol; and 2) persons at risk of myocardial infarction should consider limitation of coffee intake to less than 4 cups/day.     

Trans fatty acids in adipose tissue and the food supply are associated with myocardial infarction

Metabolic studies have clearly shown that trans fatty acids (TFAs) elevate LDL and lower HDL cholesterol. Epidemiologic studies showed a relation between TFA intake and the risk of myocardial infarction (MI), but studies examining adipose tissue TFAs have not uniformly confirmed this. We performed a case control study examining both adipose tissue levels and dietary intake of TFAs and first MI. Between 1995 and 1997, 209 cases of first MI completed a 300-item FFQ and 79 had an adipose tissue biopsy; 179 matched controls completed the FFQ and 167 had a biopsy. During the course of the study (mid-1996), TFAs were eliminated from margarines sold in Australia. Cases biopsied before mid-1996 had greater levels of trans 18:1(n-9) (32% P < 0.03) and trans 18:1(n-11) (23%, P < 0.001) than controls biopsied before mid-1996. After June 1996, there were no differences between cases and controls in any of the adipose tissue TFAs measured. Logistic regression showed that trans 18:1(n-11) (P = 0.03) was an independent predictor of a first MI. Cases consumed 0.5 g/d (P = 0.002) more TFAs than controls. Subjects in the highest quintile of TFA intake had an OR for first MI of 2.1 (95% CI, 1.1-4.3), which was not independent of saturated fat intake. Apparent TFA intake from margarine was related to adipose tissue 18:1t[(n-9) and (n-10)] in 1995 (r = 0.66, 0.66, respectively). We conclude that TFAs in adipose tissue are associated with an increased risk of coronary artery disease and rapidly disappear from adipose tissue when not included in margarines.