A diet consisting more than 60% of energy from carbohydrates (including refined) was related to higher mortality, although not with the risk of cardiovascular disease. The research on dietary fats found that they are not associated with major cardiovascular disease, but higher fat consumption was associated with lower mortality; this was seen for all major types of fats (saturated fats, polyunsaturated fats, and monounsaturated fats), with saturated fats being associated with lower stroke risk. The data are from the Prospective Urban Rural Epidemiology (PURE) study which followed more than 135,000 people from 18 low-income, middle-income, and high-income countries. The study asked people about their diet and followed them for an average of seven and half years. The data was adjusted for age, sex, energy intake, current smoking status, urban or rural location, physical activity, baseline diabetes, education, and other dietary variables (white meat, red meat, bread, and cereal intake). However, this is a prospective study which means causation cannot be established.