The associations of circulating common and uncommon polyunsaturated fatty acids and modification effects on dietary quality with all-cause and disease-specific mortality in NHANES 2003–2004 and 2011–2012

Abstract

Background Associations of dietary or supplementary intake of several unsaturated fatty acids and mortality have been widely studied but the results were still hitherto inconsistent or limited. It is still need to explore the effects of these fatty acids by using the objective biomarkers. Objective We aimed to investigate the relevancy of several serum n-3 and n-6 fatty acids with all-cause and disease-specific mortality to confirm their health effects and effects on the associations between dietary quality and all-cause mortality. Methods A total of 4132 people from NHANES 2003–2004 and 2011–2012 and the mortality information was confirmed from the NDI. CPH models adjusted for known risk factors were conducted to explore the associations between circulating n-3 and n-6 fatty acids and all-cause or CVD or cancer mortality under complex sampling. We further evaluated their effects on association between dietary quality and all-cause mortality. Results A total of 437 deaths occurred during the mean follow-up of 83.34 months, including 157 CVD death and 100 cancer death. Serum LA, ALA, EPA and DHA were associated with all-cause mortality (HR in quintile5: LA:0.584, 95%CI: 0.387–0.882, P trend = 0.011; ALA:0.626, 95%CI: 0.432–0.907, P trend = 0.008; EPA:0.535, 95%CI: 0.375–0.764, P trend = 0.001; DHA:0.669, 95%CI: 0.468–0.955, P trend = 0.031). Additionally, serum EPA and ALA were respectively related to CVD and cancer mortality (Q5 HR: EPA:0.450, 95%CI: 0.23–0.854, P trend = 0.009; ALA:0.387, 95%CI: 0.167–0.900, P trend = 0.022). Serum AA, GLA, DGLA and SDA were not associated with any risk of mortality. The effect on all-cause mortality of the lower AHEI scores can be improved by adherence to a higher serum LA, EPA and DHA (in the lowest AHEI strata, LA in tertile3 compared to tertile1 HR:0.596, 95%CI: 0.366–0.970; EPA:0.660, 95%CI: 0.454–0.959; DHA:0.666, 95%CI; 0.444–1.000). Conclusions Our results support the recent dietary recommendations to increase the intake of plant-derived and marine-derived n-6 and n-3 to improve the ability of primary and secondary prevention.

Association of Circulating Very Long-Chain Saturated Fatty Acids With Cardiovascular Mortality in NHANES 2003-2004, 2011-2012

“…The following covariates were used in our study: age; sex was categorized as male and female; participants’ self-reported race was categorized as Mexican American, non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, and other races; height and weight were assessed by body mass index (BMI), and we calculated participants’ BMI using the following formula: based on weight (kg)/height 2 (m); smoking status was assessed by the question “Ever smoked at least 100 cigarettes in your lifetime?” and was categorized as yes, no, or don’t know; drinking status was assessed by the question “Have you had at least 12 alcoholic drinks in your lifetime?” and was categorized as yes, no, or don’t know; waist circumference was estimated in centimeters; physical activity was assessed by the question “Have you done any physical activity in the past 7 days?” and was categorized as yes, no, or don’t know; monthly household income was categorized as $0 to $4,999, $5000 to $9,999, $10 000 to $14,999, $15 000 to $19,999, $20 000 to $24 999, and don’t know; the Alternative Healthy Eating Index (AHEI) [ 23-25 ] is based on a comprehensive review of the original Healthy Eating Index and subsequent studies that included 11 food components (fruits, vegetables, whole grains, sugary drinks and juices, nuts and legumes, red and processed meats, trans fats, long-chain n-3 fats, polyunsaturated fatty acids, sodium, and alcohol), and showed associations with chronic disease risk and even with total and cause-specific mortality [ 26 ]. The scores for each item were calculated by dividing the actual intake by the maximum criterion and multiplying by the full score for that item, with each component of the food ranging from 0 (unhealthy) to 10 (healthiest) and the total score ranging from 0 to 110.…”

Neuroimmunological effects of omega-3 fatty acids on migraine: a review

“…These factors include age, sex, existing comorbidities, targeted symptoms, blood biomarkers, and specific treatment protocols, before fully endorsing the use of omega-3 PUFAs either as an independent treatment or in conjunction with other medications for migraine management ( 80 ). Furthermore, conducting risk–benefit evaluations of omega-3 PUFA administration is crucial, aimed at identifying patient groups for whom omega-3 PUFA therapy would present an optimal risk–benefit balance ( 97 ).…”