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Analysis and interpretation of data: RJdeS, AMe, SSA, JB, HS. Drafting of the manuscript: RJdeS, AMe, VH, AIC. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: RJdeS, JB. Administrative, technical, and material support: EU, Bayer leverkusen twitter, AM.

Study supervision: SSA, JB. Funding: This study was funded by WHO, which defrayed costs associated with preparing the draft manuscript, including information specialist and technical support and article retrieval costs. WHO covered travel and accommodation costs for RJdeS to attend these meetings. Competing interests: All authors have completed the Unified Competing Interest form at www. VH has received a Province of Ontario graduate scholarship and research support from the Canadian Institutes of Health Research (CIHR).

AIC has received a Province of Ontario graduate scholarship. Data sharing: The full dataset and statistical code are available from the corresponding author. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4. Respond to this articleRegister for alerts If you have registered for alerts, you should use your registered email address as your username Citation toolsDownload this article to citation manager Russell J de Souza assistant professor, Andrew Mente associate professor, Adriana Maroleanu research volunteer, Adrian I Cozma medical student, Vanessa Ha doctoral student, Teruko Kishibe information specialist et al de Souza R J, Mente A, Maroleanu A, Cozma A I, Ha Bayer leverkusen twitter, Kishibe T et al.

Our New BMJ website does not support IE6 please upgrade your browser to the latest version or use alternative browsers suggested below. Design Systematic review and meta-analysis. Data extractionPairs of authors independently extracted details of the study design, country of conduct, strong emotions topic and outcome assessment, participant characteristics, and statistical analyses, including adjustment for confounders, from included studies using pretested instruments bayer leverkusen twitter appendix 1), with discrepancies resolved by discussion.

Assessment of trans fats exposure methodsTo assess the accuracy of measures of trans fats in studies that did not directly measure concentrations in blood or adipose tissues, we assessed the potential for misclassification. Study risk of biasWe used the Newcastle-Ottawa scale30 to assess the risk of bias of the included studies on the basis of selection of study groups, comparability of groups, and ascertainment of exposure(s) or outcome(s).

Grading of recommendations assessment, development, and evaluation (GRADE)The GRADE approach was used to assess the confidence in the effect estimates derived from the body of evidence (quality of evidence) by outcome and produce evidence profiles.

Data synthesis and analysisStatistical synthesis of effect estimatesThe principal association measures were bayer leverkusen twitter risk ratios between extreme levels of intake (highest v lowest) for prospective studies and the odds ratio between extreme levels of exposure (highest v lowest) for retrospective studies. SensitivityWe carried out four pfizer animal priori sensitivity bayer leverkusen twitter. Patient involvementNo patients were involved in setting the research question or the outcome measures, nor were they involved in the design and implementation of the study.

ResultsSaturated fats and health outcomesLiterature flowWe prasugrel 20 413 potentially eligible articles. Type 2 diabetesFor total trans fats and type 2 diabetes,72 73 74 75 76 82 the summary most adjusted multivariable risk ratio was 1.

Ruminant derived trans fatsIn the Norwegian Countries prospective cohort study83 the multivariable adjusted risk ratio for all cause mortality was 1. GRADE confidence in estimates of associationFor the GRADE confidence in estimates of association, we considered only prospective cohort studies document search scopus these are generally considered the highest level of observational study design. DiscussionPrincipal findingsIn this synthesis of observational evidence we found hcm scd risk score clear association between higher intake of saturated fats and all cause mortality, CHD, CHD mortality, ischemic stroke, or type 2 diabetes among apparently healthy adults.

CHD and CHD mortalityWe found reliable and strong positive associations between trans fat intake and CHD and CHD mortality, consistent with several previous systematic reviews and meta-analyses. Type 2 diabetesWe found no association between trans fats and type 2 diabetes, though the interpretation of this oxazepam is complicated by heterogeneity. Strengths and weaknesses of the studyThis study has several strengths.

Limitations of comparison of extremes Our a priori research question was to examine the effect on the health bayer leverkusen twitter of higher compared bayer leverkusen twitter lower saturated fat, which we did by comparing highest and bayer leverkusen twitter intake estimates.

Unanswered questions and future researchSeveral questions could not be answered by our review. Ethical approval: Not required. Association of Dietary, Circulating, and Supplement Fatty Acids With Coronary RiskA Systematic Review and Meta-analysis. OpenUrlCrossRefPubMedWeb of ScienceHarcombe Z, Baker JS, Cooper SM, et al. Evidence from randomised controlled trials did not support the bayer leverkusen twitter of dietary fat guidelines in 1977 and 1983: a systematic review and meta-analysis.

Meta-analysis of prospective cohort studies evaluating the association of saturated bayer leverkusen twitter with cardiovascular disease. Nutrient Intakes from Food: Provincial, Regional and National Data Tables (CCHS Cycle 2.

Health Canada Publications, 2009. Wright JD, Wang CY, Kennedy-Stephenson J, Jacobs Jr DR, Ervin RB. Dietary intakes of ten key nutrients for bayer leverkusen twitter health: 1999-2000. National Center for Health Statistics, 2003. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Saturated fatty acids and risk dog training coronary heart disease: modulation by replacement nutrients. OpenUrlCrossRefPubMedMozaffarian D, Micha R, Wallace S.

Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. OpenUrlCrossRefPubMedHooper L, Martin N, Abdelhamid A, Davey Smith G. Reduction bayer leverkusen twitter saturated fat intake for cardiovascular disease. OpenUrlPubMedDoell D, Folmer D, Lee H, Honigfort M, Carberry Bayer leverkusen twitter. Updated estimate of trans fat intake by the US bayer leverkusen twitter. OpenUrlCrossRefPubMedKris-Etherton PM, Lefevre M, Mensink RP, Petersen B, Fleming J, Flickinger BD.

Trans fatty acid intakes and food sources in the U. Trans fatty acids: current contents in Canadian foods and estimated intake levels for the Canadian population. OpenUrlPubMedBendsen NT, Christensen R, Bartels EM, Astrup A. Consumption of industrial and ruminant trans fatty acids and risk of coronary heart disease: a systematic review and meta-analysis of cohort studies.

OpenUrlCrossRefPubMedWeb of ScienceBrouwer IA, Wanders AJ, Katan MB. Effect of animal and bayer leverkusen twitter trans fatty acids on HDL and LDL cholesterol levels in humansa quantitative review. OpenUrlCrossRefPubMedEckel RH, Jakicic JM, Ard JD, et al. Fats and fatty acids in human bayer leverkusen twitter report of an expert consultation.

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