Background: The relation between dietary fat, blood lipids, plasma factor VII coagulant activity (FVIIc) and risk of coronary heart disease (CHD) according to the R353Q polymorphism in the factor VII gene was assessed. Methods: Cross-sectional study of 15 073 individuals participating in the European Prospective Investigation of Cancer (EPIC) Norfolk, 7433 of which had FVIIc available. Nested case–control study of 985 CHD cases and 2009 matched controls. Results: FVIIc was significantly associated with total fat intake in females, especially in the RR homozygotes (standardized β=0.24; 95% confidence interval (95% CI) 0.08–0.40; P