The investigators propose to conduct a population-based case-control study in Costa Rica to test hypotheses relating dietary intake of specific fatty acids (FA), vitamin E and beta-carotene to risk of coronary heart disease (CHD). Specific associations to be addressed include the relationships between intakes of palm oil, palmitic acid, linoleic acid, trans-isomers of fatty acids, oleic acid, vitamin E, beta-carotene and incidence rate of CHD. Secondary hypotheses to be examined include the relation between intake of vitamin B-6, dietary fiber, body fat and fat distribution and risk of CHD. The Costa Rican population is especially suitable for this study because it is characterized by the following: 1) a range of intake of specific types of fat, especially palm oil, that are of worldwide interest but that cannot be studied in the U.S., 2) a centralized health infrastructure and available census information, and 3) research participation rates over 85%. Case subjects will be 480 residents of a defined geographic region who have been diagnosed as having a myocardial infarction for the first time. Control subjects will be randomly selected using census data from the National Statistics and Census Bureau and matched with the cases for age (+ 5 years), sex, and area of residence. The relationships between dietary FA intake and CHD will be evaluated using a semiquantitative food frequency questionnaire (SFFQ) and analysis of adipose tissue FA composition with capillary column gas-liquid chromatography. Vitamin E and beta-carotene intake will also be assessed by analyses of subcutaneous adipose tissue as well as by the SFFQ. The SFFQ used in this study has been previously used in this population and is predictive of relevant biochemical CHD risk factors. The validity of the SFFQ will be assessed further using seven 24-hour recalls, as well as by comparison with plasma determinations of carotenoid and alpha-tocopherol levels in a subset of 120 controls. Analysis of dietary data will be carried out using stratified and multivariate models, adjusting for significant confounders such as socioeconomic status (SES), cigarette smoking, and body habitus. The investigators state that the findings from this study will provide abundant information on associations between dietary factors and coronary heart disease, and in particular regarding the relation of palm oil and palmitic acid intake to the risk of myocardial infarction, a topic of great debate and economic consequence but for which data have been almost entirely lacking.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
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Epidemiology and Disease Control Subcommittee 2 (EDC)
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Harvard University
Schools of Public Health
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Luan, D; Wang, D; Campos, H et al. (2018) Adipose tissue palmitoleic acid is inversely associated with nonfatal acute myocardial infarction in Costa Rican adults. Nutr Metab Cardiovasc Dis 28:973-979
Cespedes, E; Baylin, A; Campos, H (2015) Adipose tissue n-3 fatty acids and metabolic syndrome. Eur J Clin Nutr 69:114-20
Gong, Jian; Campos, Hannia; Fiecas, Joseph Mark A et al. (2013) A case-control study of physical activity patterns and risk of non-fatal myocardial infarction. BMC Public Health 13:122
Mattei, Josiemer; Malik, Vasanti; Hu, Frank B et al. (2012) Substituting homemade fruit juice for sugar-sweetened beverages is associated with lower odds of metabolic syndrome among Hispanic adults. J Nutr 142:1081-7
Castro-Webb, Nelsy; Ruiz-Narvaez, Edward A; Campos, Hannia (2012) Cross-sectional study of conjugated linoleic acid in adipose tissue and risk of diabetes. Am J Clin Nutr 96:175-81
Rhee, Jinnie J; Mattei, Josiemer; Campos, Hannia (2012) Association between commercial and traditional sugar-sweetened beverages and measures of adiposity in Costa Rica. Public Health Nutr 15:1347-54
Mattei, Josiemer; Hu, Frank B; Campos, Hannia (2011) A higher ratio of beans to white rice is associated with lower cardiometabolic risk factors in Costa Rican adults. Am J Clin Nutr 94:869-76
Gong, Jian; Campos, Hannia; McGarvey, Stephen et al. (2011) Adipose tissue palmitoleic acid and obesity in humans: does it behave as a lipokine? Am J Clin Nutr 93:186-91
Gong, Jian; Campos, Hannia; McGarvey, Stephen et al. (2011) Genetic variation in stearoyl-CoA desaturase 1 is associated with metabolic syndrome prevalence in Costa Rican adults. J Nutr 141:2211-8
Ruiz-Narváez, Edward A; Bare, Lance; Arellano, Andre et al. (2010) West African and Amerindian ancestry and risk of myocardial infarction and metabolic syndrome in the Central Valley population of Costa Rica. Hum Genet 127:629-38

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