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P < 0.0001). Interpretation of such comparisons of populations with widely different lifestyles is hazardous, but at the very least these data leave room for a major effect of trans fat on CHD risk. Several case-control or cross-sectional studies have also been conducted. In a case-control study in the Boston area, we found a strong processed fatshydrogen and significant positive association between trans fat intake assessed using a FFQ and risk of acute myocardial infarction.25 The relative risk comparing the highest to the lowest quintile of trans fat intake was 2.4 (P for trend processed fatshydrogen <0.0001); this association was entirely explained by trans intake from hydrogenated vegetable oil. Previously, Bolton-Smith et al. examined cross-sectionally the association between trans intake and undiagnosed CHD among participants in the Scottish Heart Study.26 Subjects were considered to have CHD if they had angina or possible MI according to the Rose chest pain questionnaire, or an electrocardiogram recording indication of ischemia.26
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