British Journal of Nutrition

Full Papers

Dietary Survey and Nutritional Epidemiology

Plasma phospholipid fatty acids and CHD in older men: Whitehall study of London civil servants

Robert Clarkea1 c1, Martin Shipleya2, Jane Armitagea1, Rory Collinsa1 and William Harrisa3

a1 Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Richard Doll Building, Old Road Campus, Roosevelt Drive, Oxford OX3 7LF, UK

a2 Department of Epidemiology and Public Health, University College London Medical School, London WCIE 6BT, UK

a3 Sanford School of Medicine of the University of South Dakota, Sioux Falls, SD, USA


Dietary fatty acids (FA) are the major determinants of blood lipids, and measurements of plasma phospholipid FA (PL-FA) composition that reflect the dietary intake of FA may provide insights into the relationships between diet and CHD. We assessed CHD mortality associations with PL-FA (SFA, PUFA and MUFA) levels measured in a nested case–control study of 116 cases of CHD death and 239 controls that were frequency-matched for age and employment grade. The participants had plasma levels of total cholesterol, LDL-cholesterol (LDL-C), HDL-cholesterol, apo B and apo A1, C-reactive protein (CRP) and fibrinogen recorded. SFA levels were significantly positively correlated with total cholesterol, LDL-C, apo B, CRP protein and fibrinogen. By contrast, phospholipid-PUFA were inversely associated with CRP, but not with any of the lipids. A higher SFA content (top v. bottom quarter) was associated with a 2-fold higher risk of CHD (OR and 95 % CI: OR 2·12; 95 % CI: 1·13, 3·99), and an equivalent difference in PUFA was associated with a halving in CHD risk (OR 0·49; 95 % CI: 0·26, 0·94), but MUFA was unrelated to CHD risk. These associations were substantially attenuated, after additional adjustment for lipids and inflammatory markers. Higher levels of saturated fat and lower levels of polyunsaturated fats were each associated with a higher risk of CHD in elderly men, and these associations were partly explained by their effects on blood lipids and biomarkers of inflammation.

(Received June 24 2008)

(Revised October 09 2008)

(Accepted October 27 2008)

(Online publication December 24 2008)


c1 Corresponding author: Dr Robert Clarke, fax +44 1865 743985, email


Abbreviations: CRP, C-reactive protein; FA, fatty acid; HDL-C, HDL-cholesterol; ICD, International Classification of Disease; LDL-C, LDL-cholesterol; PL-FA, plasma phospholipid fatty acid; PL-PUFA, phospholipid-PUFA