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Evan Allen @EAllen0417
, 7 tweets, 2 min read Read on Twitter
Today we look at the Health and Lifestyle Survey by Boniface and Tefft published in 2002. This study looked at ~2600 men and women. The methodology was a single interview with follow up. Patients with existing CVD were excluded.
The study showed a strong and significant effect on CHD mortality in women, but none in men. The pooled analysis was not mentioned in their results. The average SFA consumption was 414 calories per day in the non-excluded patients. This is 20% of a typical day's calories.
SFA consumption was generally higher in the men than in the women. CHD mortality as a whole in the unexcluded group was 8% in men, 4% in women. You can see that age was the most important determiner of risk from this chart. nature.com/articles/16015…
The authors point out that SFA was associated with multiple other health behaviors including, sedentary lifestyle, smoking, social disadvantage and teetotaling. They suggest that men also may have been systematically less accurate in describing their intake of food.
Sometimes an exposure shows an effect in one gender and not in the other. This is where an understanding of pathophysiology should allow a proper conclusion. E.g, in prostate cancer this is normal. It's uni-gendered. In CHD there are differences in rate, but the disease is same.
To accept that SFA causes disease in women is to accept that it causes it in men, and vice versa, unless and until someone shows that CAD happens differently in women than it does in men, not just at different rates. This is very unlikely.
Tomorrow we look at Jakobsen's Danish study from 2004. This one looks at very similar data in very similar populations to Boniface and Tefft. It's not surprising S-T & K used both in their analysis.
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