Background: Epidemiological studies on the effect of individual saturated fatty acids (SFAs) on cardiovascular disease, especially in developing countries with different dietary patterns, are scarce.

Objective: To determine the risk of nonfatal acute myocardial infarction (MI) associated with consumption of individual SFAs and their food sources in Costa Rica.

Design: The cases (n=485) were survivors of a first acute MI and were matched by age, sex and area of residence to population controls (n=508). Data on anthropometrical measurements, lifestyle and diet were collected using interviewer-administered questionnaires.

Results: In analyses adjusted for confounders, consumption of total and individual SFAs was associated with an increased risk of MI. The odds ratio (OR) (95% confidence intervals) for 1% increase in energy from total saturated fat was 1.12 (1.03–1.21) while it was 1.51 (1.03–2.22) for lauric acid+myristic acid, 1.14 (1.01–1.30) for palmitic acid and 2.00 (1.34–3.00) for stearic acid. Although lauric and myristic acids were associated with increased risk of MI, they were consumed in small amounts and most of the saturated fat (87%) came from palmitic and stearic acids, which derived mainly from red meat and fried foods. Consumption of cheese (1–2 vs 0 servings/day) was associated with increased risk of MI (OR=3.07; 95% confidence interval: 1.74–5.39; P for trend <0.0001), while consumption of low-fat milk was not.

Conclusions: Increased consumption of total and individual SFAs is associated with increased risk of MI. Lauric, myristic and stearic acids were more potent than palmitic acid.