Objective: To investigate the association between the intake of n-6 PUFA and subsequent change in body weight and waist circumference at different levels of the carbohydrate:protein ratio. Design: Follow-up study with anthropometric measurements at recruitment and on average 5·3 years later. Dietary intake was determined at recruitment by using an FFQ that was designed for the study and validated. We applied linear regression models with 5-year change in weight or waist circumference as outcome and including a two-way interaction term between n-6 PUFA and carbohydrate intakes, lower-order terms, protein intake, long-chain n-3 PUFA intake and other potential confounders. Due to adjustment for intake of protein, levels of carbohydrate indirectly reflect levels of the carbohydrate:protein ratio. Setting: Diet, Cancer and Health follow-up study, Denmark. Subjects: Women and men (n 29 152) aged 55 years. Results: For a high intake of n-6 PUFA (6·9 % of energy) v. a low intake of n-6 PUFA (3·4 % of energy), the difference in 5-year weight change was − 189·7 g (95 % CI − 636·8, 257·4 g) at a low carbohydrate:protein ratio and − 86·7 g (95 % CI − 502·9, 329·6 g) at a high carbohydrate:protein ratio; the differences in 5-year waist circumference change were 0·26 cm (95 % CI − 0·47, 0·98 cm) and − 0·52 cm (95 % CI − 1·19, 0·15 cm), respectively. Inclusion of the dietary glycaemic index did not change the results. Conclusions: No consistent associations between the intake of n-6 PUFA and change in body weight or waist circumference at different levels of the carbohydrate:protein ratio were observed.
Keywords
Dietary carbohydrates Dietary fats Dietary proteins ObesityBMI and waist circumference are proxy measures of overall body fat mass and abdominal fat mass, respectively, and strong predictors of obesity-related mortality (1) . Studies on the evolutionary aspects of diet indicate that major changes have taken place in the Western diet, particularly during the last 100 years; changes that correlate with the increasing prevalence of obesity (2) . Today, more than 85 % of the total intake of n-6 and n-3 PUFA is n-6 PUFA (3) . In the USA, the estimated per capita consumption of soyabean oil, the major source of the n-6 PUFA linoleic acid (18 : 2n-6), has increased more than 1000-fold from 1909 to 1999 (4) ; thus, the availability of 18 : 2n-6 increased from 2·8 % to 7·2 % of energy during the 20th century. Interesting, the increase in the availability of soyabean oil paralleled the increase in the prevalence of obesity (2) . Likewise, the availability of sugars was also positively correlated with obesity whereas energy was not (2) . Of note, in mice, increasing 18 : 2n-6 from 1 % to 8 % of energy in the feed, reflecting the 20th century increase in availability of 18 : 2n-6, promoted obesity (2) . Still, in man, the effect of n-6 PUFA on obesity development has not been investigated in detail. The findings from the mouse experiment by Alvheim et al. (2) are in line with other animal experiments which