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Sala‐Vila, Aleix; Guasch‐Ferré, Marta; Hu, Frank B.; Sánchez‐Tainta, Ana; Bulló, Mònica; Serra‐Mir, Mercè; López‐Sabater, Carmen; Sorlí, Jose V.; Arós, Fernando; Fiol, Miquel; Muñoz, Miguel A.; Serra‐Majem, Luis; Martínez, J. Alfredo; Corella, Dolores; Fitó, Montserrat; Salas‐Salvadó, Jordi; Martínez‐González, Miguel A.; Estruch, Ramón; Ros, Emilio; Pérez‐Heras, A.; Viñas, C.; Casas, R.; de Santamaría, L.; Romero, S.; [...]

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

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  • Media type: E-Article
  • Title: 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
  • Contributor: Sala‐Vila, Aleix; Guasch‐Ferré, Marta; Hu, Frank B.; Sánchez‐Tainta, Ana; Bulló, Mònica; Serra‐Mir, Mercè; López‐Sabater, Carmen; Sorlí, Jose V.; Arós, Fernando; Fiol, Miquel; Muñoz, Miguel A.; Serra‐Majem, Luis; Martínez, J. Alfredo; Corella, Dolores; Fitó, Montserrat; Salas‐Salvadó, Jordi; Martínez‐González, Miguel A.; Estruch, Ramón; Ros, Emilio; Pérez‐Heras, A.; Viñas, C.; Casas, R.; de Santamaría, L.; Romero, S.; [...]
  • imprint: Ovid Technologies (Wolters Kluwer Health), 2016
  • Published in: Journal of the American Heart Association
  • Language: English
  • DOI: 10.1161/jaha.115.002543
  • ISSN: 2047-9980
  • Keywords: Cardiology and Cardiovascular Medicine
  • Origination:
  • Footnote:
  • Description: <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid ( <jats:styled-content style="fixed-case">ALA</jats:styled-content> ), a plant‐derived ω‐3 fatty acid. It is unclear whether <jats:styled-content style="fixed-case">ALA</jats:styled-content> 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 <jats:styled-content style="fixed-case">ALA</jats:styled-content> (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). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> We longitudinally evaluated 7202 participants in the <jats:styled-content style="fixed-case">PRE</jats:styled-content> vención con <jats:styled-content style="fixed-case">DI</jats:styled-content> eta <jats:styled-content style="fixed-case">MED</jats:styled-content> iterránea ( <jats:styled-content style="fixed-case">PREDIMED</jats:styled-content> ) trial. Multivariable‐adjusted Cox regression models were fitted to estimate hazard ratios. <jats:styled-content style="fixed-case">ALA</jats:styled-content> intake correlated to walnut consumption ( <jats:italic>r</jats:italic> =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 <jats:styled-content style="fixed-case">ALA</jats:styled-content> recommendation (n=1615, 22.4%) were 0.72 (95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 0.56–0.92) for all‐cause mortality and 0.95 (95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 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% <jats:styled-content style="fixed-case">CI</jats:styled-content> 0.67–1.05) for all‐cause mortality, 0.61 (95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 0.39–0.96) for fatal cardiovascular disease, 0.54 (95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 0.29–0.99) for fatal coronary heart disease, and 0.49 (95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 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% <jats:styled-content style="fixed-case">CI</jats:styled-content> 0.45–0.87]). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> In participants without prior cardiovascular disease and high fish consumption, dietary <jats:styled-content style="fixed-case">ALA</jats:styled-content> , 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. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Clinical Trial Registration</jats:title> <jats:p xml:lang="en"> <jats:styled-content style="fixed-case">URL</jats:styled-content> : <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.Controlled-trials.com/">http://www.Controlled-trials.com/</jats:ext-link> . Unique identifier: <jats:styled-content style="fixed-case">ISRCTN</jats:styled-content> 35739639. </jats:p> </jats:sec>
  • Access State: Open Access