Dietary α-linolenic acid, marine ω-3 fatty acids, and mortality in a population with high fish consumption: Findings from the PREvención con DIeta MEDiterránea (PREDIMED) Study Academic Article uri icon

abstract

  • Epidemiological evidence suggests a cardioprotective role of α-linolenic acid (ALA), a plant-derived ω-3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω-3 fatty acids (long-chain n-3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all-cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long-chain n-3 polyunsaturated fatty acids (≥500 mg/day).We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable-adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption (r=0.94). During a 5.9-y follow-up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios for meeting ALA recommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56-0.92) for all-cause mortality and 0.95 (95% CI 0.58-1.57) for fatal cardiovascular disease. The hazard ratios for meeting the recommendation for long-chain n-3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67-1.05) for all-cause mortality, 0.61 (95% CI 0.39-0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29-0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22-1.01) for sudden cardiac death. The highest reduction in all-cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45-0.87]).In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all-cause mortality, whereas protection from cardiac mortality is limited to fish-derived long-chain n-3 polyunsaturated fatty acids.URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639.

authors

  • Sala-Vila, A
  • Guasch-Ferré, M
  • Hu, FB
  • Sánchez-Tainta, A
  • Bulló, M
  • Serra-Mir, M
  • López-Sabater, C
  • Sorlí, JV
  • Arós, F
  • Fiol, M
  • Muñoz, MA
  • Serra-Majem, L
  • Alfredo Martínez, J
  • Corella, D
  • Fitó, M
  • Salas-Salvadó, J
  • Martínez-González, MA
  • Estruch, R
  • Ros, E
  • Pérez-Heras, A
  • Viñas, C
  • Casas, R
  • De Santamaría, L
  • Romero, S
  • Sacanella, E
  • Chiva, G
  • Valderas, P
  • Arranz, S
  • Baena, JM
  • García, M
  • Oller, M
  • Amat, J
  • Duaso, I
  • García, Y
  • Iglesias, C
  • Simón, C
  • Quinzavos, L
  • Parra, L
  • Liroz, M
  • Benavent, J
  • Clos, J
  • Pla, I
  • Amorós, M
  • Bonet, MT
  • Martin, MT
  • Sánchez, MS
  • Altirriba, J
  • Manzano, E
  • Altés, A
  • Cofán, M
  • Valls-Pedret, C
  • Doménech, M
  • Gilabert, R
  • Bargalló, N
  • González, R
  • Molina, C
  • Márquez, F
  • Babio, N
  • Sorli, M
  • García Roselló, J
  • Diaz-López, A
  • Martin, F
  • Tort, R
  • Isach, A
  • Costa, B
  • Cabré, JJ
  • Fernández-Ballart, J
  • Ibarrola-Jurado, N
  • Alegret, C
  • Martínez, P
  • Millán, S
  • Piñol, JL
  • Basora, T
  • Hernández, JM
  • Toledo, E
  • Buil-Cosiales, P
  • Ruiz-Canela, M
  • Sanjulián, B
  • Díez-Espino, J
  • Extremera-Urabayen, V
  • García-Arellano, A
  • Zazpe, I
  • Basterra-Gortari, FJ
  • Goñi, E
  • Razquin, C
  • Serrano-Martínez, M
  • Bes-Rastrollo, M
  • Gea, A
  • Martínez-Lapiscina, EH
  • Nuñez-Córdoba, JM
  • Arroyo-Azpa, C
  • García-Pérez, L
  • Villanueva-Tellería, J
  • Cortés-Ugalde, F
  • Sagredo-Arce, T
  • De La Noceda-Montoy, MDG
  • Vigata-López, MD
  • Arceiz-Campo, MT
  • Urtasun-Samper, A

publication date

  • 2016

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