Abstract/Summary

Background: Evidence on the associations with cardiovascular diseases (CVD) for the substitution of saturated fatty acids (SFA) from meats with SFA from dairy and meats remains uncertain, especially for unprocessed and processed poultry. This study aims to model theoretical substitution of SFA from meats with SFA from dairy and meats with incident CVD. Methods: A total of 120,496 UK Biobank participants (57% female, mean age: 55.9 ±7.8 years) without prevalent CVD and with ≥two 24hr-dietary assessments were included. Multivariable adjusted Cox regressions were used to estimate CVD risk (9890 cases) for the substitution of equivalised SFA from meat with dairy (2.5% of energy), over a median follow-up of 10.5 years. Results: Substitution equivalised SFA from total meat with total dairy was associated with lower CVD risk (Hazard Ratio, 95% CI: 0.91, 0.86, 0.96). Strong inverse associations were found for the substitution of SFA from processed poultry with milk (0.67, 0.45, 0.99), yogurt (0.58, 0.38, 0.87) and cheese (0.64, 0.43, 0.94) and for the substitution of SFA from processed total or poultry with unprocessed total (0.87, 0.76, 0.98) or poultry meats (0.61, 0.40, 0.93), respectively. Analyses involving whole food groups, adjusted for total SFA intake, showed similar results. Conclusions: Associations between major SFA sources and CVD may not be solely driven by their SFA content, but also by other nutrients within these foods and their food matrices. Although our data do not prove causality, it could contribute to the evidence-base to inform more specific dietary guidance, particularly in relation to processed meat consumption.