Theoretical Effects of Substituting Butter with Margarine on Risk of Cardiovascular Disease.

BACKGROUND: Several recent articles have called into question the deleterious effects of high animal fat diets due to mixed results from epidemiologic studies and the lack of clinical trial evidence in meta-analyses of dietary intervention trials. We were interested in examining the theoretical effects of substituting plant-based fats from different types of margarine for animal-based fat from butter on the risk of atherosclerosis-related cardiovascular disease (CVD). METHODS: We prospectively studied 71,410 women, aged 50-79 years, and evaluated their risk for clinical myocardial infarction (MI), total coronary heart disease (CHD), ischemic stroke, and atherosclerosis-related CVD with an average of 13.2 years of follow-up. Butter and margarine intakes were obtained at baseline and year 3 by means of a validated food frequency questionnaire. Cox proportional hazards regression using a cumulative average diet method was used to estimate the theoretical effect of substituting 1 teaspoon/day of three types of margarine for the same amount of butter. RESULTS: Substituting butter or stick margarine with tub margarine was associated with lower risk of MI (HRs = 0.95 and 0.91). Subgroup analyses, which evaluated these substitutions among participants with a single source of spreadable fat, showed stronger associations for MI (HRs = 0.92 and 0.87). Outcomes of total CHD, ischemic stroke, and atherosclerosis-related CVD showed wide confidence intervals but the same trends as the MI results. CONCLUSIONS: This theoretical dietary substitution analysis suggests that substituting butter and stick margarine with tub margarine when spreadable fats are eaten may be associated with reduced risk of myocardial infarction.

Margarine consumption, asthma, and allergy in young adults: results of the German National Health Survey 1998.

PURPOSE: To examine whether frequent intake of margarine is associated with allergy prevalence in adults using data of a representative national health survey. METHODS: Data on 7124 subjects aged 18 to 79 years were obtained from the German National Health Survey 1998. Confounder-adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated by multiple logistic regression, using the frequency of intake of low-fat butter, regular and low-fat margarine as explanatory variable in relation to frequent intake of regular butter as reference group. RESULTS: Frequent intake of margarine of any kind was positively associated with current asthma during the past 12 months in young adults aged 18 to 29 years (aOR, 2.33; 95% CI, 1.03-5.26). In subgroup analysis, the positive association was confined to frequent intake of low-fat margarine (4.51; 1.78-11.43) or the combination of low-fat margarine and low-fat butter (4.79; 1.84-12.44). Consumption of margarine of any kind was not related to hay fever, atopic dermatitis, and atopic sensitization to inhalant allergens. CONCLUSIONS: Frequent intake of margarine rich in n-6 PUFA is not consistently associated with allergic diseases in adults. Other constituents of low-fat margarine or certain dietary habits and lifestyle factors, characterized by use of low-fat margarine, may be related to current asthma.

The combined use of cholesterol-lowering drugs and cholesterol-lowering bread spreads: health behavior data from Finland.

BACKGROUND: Cholesterol-lowering drugs may metabolically interact with cholesterol-lowering bread spreads. This study analyses the prevalence of use of drugs, bread spreads or the combination of both in people aware of their high/elevated cholesterol level, and compares users of the three therapies on health behavior and demographics. METHODS: Participants (9581, 25-74 years) from The National FINRISK 2002 Study filled out a questionnaire on demographics and health (related) issues. Blood samples, blood pressure, body weight and height were measured. RESULTS: Of those who reported to have a high cholesterol level (31% of the study population), 19% used cholesterol-lowering drugs, 11% used cholesterol-lowering bread spreads and 5% combined both therapies. On a population level, only 1% jointly used a drug and bread spread therapy. The combination was used by especially highly educated people and those having a healthy diet. CONCLUSION: Combining a cholesterol-lowering drug with a bread spread regimen is relatively rare, even among those being aware of their high cholesterol levels. The combined usage was most frequent among 'the better off'. Public health risks of a metabolic interaction between both therapies may not be of major importance yet, but future follow-up is recommended.

Food and fatty acid intake and atopic disease in adults.

The aim of the study was to assess the relationship between dietary intake of selected foods and fatty acids with atopic disease prevalence in adults. Data from the European Community Respiratory Health Survey in Erfurt, combined with a 3-day weighed records dietary survey, was used. Complete data was available from 469 males and 333 females aged 20-64 yrs. Multiple logistic regression was applied comparing the highest with the lowest quartile of dietary exposures and linear trends were tested stratified by sex. In males, margarine intake and a high ratio of omega-6 to omega-3 fatty acids were positively associated with hay fever. In females, a high intake of total fat, palmitoleic and oleic acids were positively associated with sensitisation. A high total fat, high monounsaturated fatty acid and high oleic acid consumption were positively associated with hay fever. Whilst an excessive intake of fat or imbalance in fat intake, particular of monounsaturated fatty acids, increased the risk for hay fever and allergic sensitisation in females, mostly no significant associations were found for males. Dietary factors were mostly not related with prevalence rates of bronchial hyperresponsiveness and atopic eczema either in males or in females.