The association between oils and fats consumption and the risk of premature coronary artery disease in a multi-centric case-control study: Iran premature coronary artery (IPAD)

Abstract

Background and aims The impact of different dietary fats on premature coronary artery disease (PCAD) has not been well established. Given Iran's ethnic diversity, this study examined the association between fat intake and the risk and severity of PCAD in multiple Iranian ethnicities. Methods and results In this multicenter case-control study, men aged <55 and women aged <65 years who were candidates for coronary angiography were recruited from major Iranian ethnicities. Intake of hydrogenated vegetable oil (HVO), non-hydrogenated vegetable oil (non-HVO), animal fat, and a composite fat consumption index (FCI) was assessed using a validated food frequency questionnaire and dichotomized at the median. Logistic regression models were fitted in three steps: crude, age- and sex-adjusted, and multivariate-adjusted. A total of 2459 participants were included: 1395 with PCAD and 1064 controls. The mean age was 51.47 +/- 7.24. A higher non-HVO intake was associated with a lower risk of PCAD in the fully adjusted model (odds ratio OR: 0.37; 95 % confidence interval CI: 0.29, 0.46). This pattern was similar in the Fars (OR = 0.31), Kurdish (OR = 0.26), Bakhtiari (OR = 0.28), and Qashqaei (OR = 0.24) groups but not in the Azari group. Non-HVO intake was also associated with lower PCAD severity (OR: 0.31; 95 %CI 0.26, 0.37). No significant associations were observed between HVO, animal fat, or FCI. The interaction tests did not show any meaningful ethnic modifications. Conclusions Replacing solid and hydrogenated fats with liquid nonhydrogenated vegetable oils may reduce both the risk and severity of PCAD in Iranian adults and support dietary advice that prioritizes fat quality.