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.

Predictors of usage and fatty acid composition of cooking fats in Bogotá, Colombia.

OBJECTIVE: To examine correlates of home usage of commercially available cooking fats in Bogotá, Colombia and to determine their fatty acid composition. DESIGN: Cross-sectional survey. SETTING: Bogotá, Colombia. SUBJECTS: A representative sample of low- and middle-income families (n 2408). RESULTS: The types of fat primarily used for cooking at home were mixed vegetable oils (66 %), sunflower oil (21 %) and other oils/fats including margarine (13 %). In multivariate analysis, usage of sunflower oil as the primary cooking fat was positively related to home ownership, age of the father and health as a reason for choosing the main cooking fat, and inversely associated with the number of people per room and an index of household food insecurity. The trans fat content of sunflower oil was unexpectedly higher (mean 4.2 %, range 2.2-8.6) than that of the vegetable mixture oils (mean 3.1 %, range 1.1-6.5). CONCLUSIONS: Vegetable oils are the primary home cooking fats in Bogotá, Colombia. Higher socio-economic status is associated with usage of sunflower oil. Paradoxically, oblivious to the higher trans content of sunflower oil and the negligible amount of n-3 fatty acids, families commonly reported 'health' as a reason to choose sunflower over other oils.