Associations of dietary fatty acids with the incidence of carotid atherosclerotic plaque components: A 6-year follow-up study with serial MRI.

BACKGROUND AND AIMS: The influence of dietary fatty acids (FAs) on carotid atherosclerotic plaque components remains unknown. We aimed to assess the association of dietary saturated (SFA), mono-unsaturated (MUFA), and poly-unsaturated FAs (PUFA) with the incidence of carotid plaque components.

METHODS

Within the population-based Rotterdam Study, 570 stroke-free participants (mean age: 68 years; 47 % women) with subclinical carotid atherosclerosis underwent two serial carotid MRI (mean scan interval: 5.9 years). Carotid calcification, lipid-rich necrotic core (LRNC) and intraplaque hemorrhage (IPH) were evaluated. Intake of dietary FAs was assessed by food-frequency questionnaires around the time of baseline MRI. We used generalized estimating equation to investigate the association between dietary FAs and new onset of carotid plaque components.

RESULTS

We found that a higher PUFA intake was associated with a lower incidence of IPH (adjusted odds ratio (OR) per 5 g/d increase: 0.80 (95 % confidence interval (CI): 0.65 to 0.98)). In the substitution models, a modelled higher PUFA intake at the expense of MUFA or SFA was also associated with a lower risk of incident IPH, with adjusted ORs per 5 g/day more PUFA of 0.81 (95 % CI: 0.58 to 1.14) for replacing SFA and 0.60 (95 % CI: 0.37 to 0.97) for replacing MUFA. No associations between SFA or MUFA and the carotid plaque components were found.

CONCLUSION

Among persons with subclinical carotid plaque, dietary FA intake is a modifiable risk factor for changes in carotid plaque vulnerability. Diet with more PUFA is associated with a lower risk of IPH in carotid plaque.