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

Abstract

BackgroundEpidemiological 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).Methods and ResultsWe 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]).ConclusionsIn 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.Clinical Trial Registration URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639.

Red blood cell polyunsaturated fatty acids and mortality in the Women's Health Initiative Memory Study

“…in heart failure 27 ), our observations can be considered supportive of a beneficial association between DPAn-3 and total mortality. Our null findings for ALA agree with some previous studies 8, 14 , but ALA levels have been associated with CVD death 26 , and ALA intake was associated with reduced total mortality in a large RCT from Spain 28 .…”

Obesity and Cardiometabolic Defects in Heart Failure Pathology

“…The double blind and randomized GISSI-HF trial showed that long-term supplementation of fish oil (1g) to heart failure patients reduced endpoints of all-causes mortality and readmission for cardiovascular complications (108). The Recent PREDIMED study supports the GISSI-HF outcome that reveals prior cardiovascular disease, relatively higher fish intake, and dietary alpha linoleic acid (one of the omega-3 fatty acid) sourced from walnuts and olive oil limit all-causes mortality, but the protection from cardiac death comes only from fish-derived long-chain omega-3 fatty acids (101). Nineteen countries comprehensive studies of free-living populations suggest that concentrations of seafood and plant-derived ω-3 fatty acids biomarkers are associated with a modestly lower incidence of fatal CHD (33).…”

Модифікація Способу Життя Та Дієтичне Харчування Хворих На Артеріальну Гіпертензію У поєднанні З Цукровим Діабетом: Рекомендації Європейських Консенсусів Та Реалії Життя (Огляд Літератури)

“…Останнім десятиліттям проведе-но низку епідеміологічних досліджень щодо ролі здо-рового харчування й окремих нутрієнтів із первин-ної профілактики при АГ, АО, ЦД 2-го типу (OMNI HEART study, Mediterranean Diet, MUFA diet study, ATTICA registry, EPIC, SUN, PREvencion con DIeta MEDiterranea, PREDIMED study). Відомі також до-слідження щодо профілактики та сприятливих ефек-тів антигіпертензивних, антидіабетичних і анорекси-генних препаратів (KOPS, EPIC, STORM, XENDOS, RIO-EUROPA, RIO-DIABETES, [30][31][32][33][34][35][36][37][38][39][40][41].…”

“…Наприкінці минулого сторіччя отримано дані щодо впливу окремих нутрієнтів на рівні АТ та глі-кемії [30][31][32][33][34][35][36][37][38][39][40][41][42][68][69][70][71][72][73].Серед продуктів харчування, що містять речовини й компоненти, які поліпшують функцію ендотелію, слід назвати антоціаніни, фла-воноїдні полімери, флавоноли, ізофлавони, полі-феноли, станоли, фолієву кислоту, антиоксиданти, лютеїн, резвератрол. Метааналіз 36 досліджень із се-редньодобовим споживанням 3,7 г риб'ячого жиру демонструє вірогідне зниження АТ на 2,1/1,6 мм рт.ст.…”