Intake of total omega-3 fatty acids, eicosapentaenoic acid and docosahexaenoic acid and risk of coronary heart disease in the Spanish EPIC cohort study

Association between fish intake and prevalence of frailty in community-dwelling older adults after 4-year follow-up: the Korean frailty and aging cohort study

Cross-sectional epidemiological studies suggested the intake of fish and seafood was negatively associated with the prevalence of frailty. This study aimed to investigate the hypothesis that the prevalence of frailty is negatively associated with the consumption of total seafood and fish at baseline and 4-year follow-up. Using a multicenter longitudinal study of community-dwelling Korean adults aged 70-84 years old, 953 participants at baseline and 623 participants at 4-year follow-up were included after excluding participants without data on frailty or dietary intake in the Korean Frailty and Aging Cohort Study. Frailty was defined using the Cardiovascular Health Study index, and participants with scores ≥3 were considered frail. The trained dietitians obtained two non-consecutive 24-h dietary recalls during spring and fall at baseline. The prevalence of frailty was 13.5%. The intake of fish (OR 0.47; 95% CI 0.24-0.91; p for trend = 0.028) and total seafood (OR 0.34; 95% CI 0.18-0.68; p for trend = 0.002) at baseline was associated with frailty at 4-year follow-up after adjusting for the confounding factors. The intake of fish and total seafood at the baseline was negatively associated with the prevalence of exhaustion, low handgrip strength, and slow gait speed at 4-year follow-up. However, shellfish intake was not associated with frailty. In addition, the intake of fish, shellfish, and total seafood did not differ among the frailty transition groups in terms of deterioration, persistence, and reversal. The total consumption of seafood, particularly fish, could be beneficial for preventing frailty in Korean community-dwelling older adults. In particular, the consumption of fish (total seafood) at baseline could be beneficial for preventing exhaustion, low handgrip strength, and slow gait speed at 4-year follow-up.

Dietary intake, biomarkers and supplementation of fatty acids and risk of coronary events: a systematic review and dose-response meta-analysis of randomized controlled trials and prospective observational studies

We aimed to review the association of dietary fats and risk of coronary events in adults. We searched PubMed, Embase, CENTRAL, Scopus, and Web of Sciences to April 2022 for prospective cohorts and randomized trials investigating the association of dietary intake and biomarkers of fats and fatty acid interventions and the risk of coronary events. We performed random-effects meta-analyses to estimate relative risk (RR) for the top versus bottom tertiles of exposures. One-hundered sixty-five prospective cohorts and randomized trials were included. Dietary intake and biomarkers of total fat and saturated, monounsaturated, and polyunsaturated fatty acids were not associated with the risk of coronary events. Dietary intake of trans fatty acids, palmitic acid, stearic acid, and saturated fatty acids from meat and unprocessed meat was modestly associated with a higher risk and, in contrast, intake of alpha-linolenic acid, long-chain omega-3 fatty acids, and linoleic acid was modestly associated with a lower risk. Supplementation with long-chain omega-3 fatty acids and increasing the consumption of alpha-linolenic and linoleic acids in place of saturated fats reduced the risk of coronary events. Existing evidence, in its totality, provides a modest support in favor of current recommendations suggesting replacement of saturated fats with polyunsaturated fats.

Relationship of Circulating Vegetable Omega-3 to Prognosis in Patients With Heart Failure

BACKGROUND

There is an urgent need for cost-effective strategies to promote quality of life in patients with heart failure (HF). Several studies reported benefits in HF prognosis for marine omega-3 fatty acids and plant-based dietary patterns.

OBJECTIVES

The aim of this study was to explore whether dietary alpha-linolenic acid (ALA), the main plant omega-3, relates to a better HF prognosis.

METHODS

ALA was determined in serum phospholipids (which reflect long-term dietary ALA intake and metabolism) by gas chromatography in 905 ambulatory patients with HF caused by different etiologies.

RESULTS

After a median follow-up of 2.4 years (range: 0.02-3 years), 140 all-cause deaths, 85 cardiovascular (CV) deaths, and 141 first HF hospitalizations (composite of all-cause death and first HF hospitalization, n = 238) were documented. Using Cox regression analyses, we observed that, compared with patients at the lowest quartile of ALA in serum phospholipids (Q1), those at the 3 upper quartiles (Q2-Q4) exhibited a reduction in the risk of composite of all-cause death and first HF hospitalization (HR: 0.61; 95% CI: 0.46-0.81). Statistically significant reductions were observed for all-cause death (HR: 0.58; 95% CI: 0.41-0.82), CV death (HR: 0.51; 95% CI: 0.32-0.80), first HF hospitalization (HR: 0.58; 95% CI: 0.40-0.84), and the composite of CV death and HF hospitalization (HR: 0.58; 95% CI: 0.42-0.79).

CONCLUSIONS

HF patients with bottom 25% ALA levels in serum phospholipids had a worse prognosis during a mid-term follow-up compared with those with the highest levels. This might be a target population in whom to test dietary ALA-rich interventions to promote quality of life.

Intake of fish and long-chain n-3 polyunsaturated fatty acids and risk of diseases in a Japanese population: a narrative review

Since the 1970s, the potential benefit of fish intake in terms of noncommunicable diseases has been one of the most important themes in disease prevention. Epidemiological studies have revealed the extent to which fish consumption affects the incidence of and mortality from diseases. Meta-analyses summarized the effect of fish and long-chain n-3 polyunsaturated fatty acid intake on noncommunicable diseases, especially cardiovascular diseases in Western countries. However, few reviews have spotlighted the effect of fish intake in East-Asian countries that have high population levels of fish intake such as Japan. We narratively reviewed the epidemiological studies concerned with the associations of fish and long-chain n-3 polyunsaturated fatty acid intake with risk of noncommunicable diseases, mainly of cardiovascular disease, among Japanese, whose fish intake has been twice or more than that of most Westerners. Overall, fish or long-chain n-3 polyunsaturated fatty acid intake may be beneficial for prevention of noncommunicable diseases, especially coronary heart disease and heart failure in Japanese as well as in Westerners. However, the beneficial effects of their intakes seemed to be nonlinear and varied according to disease severity and culture. Studies on other noncommunicable disease were also narratively reviewed.

Fine mapping of genome-wide association study signals to identify genetic markers of the plasma triglyceride response to an omega-3 fatty acid supplementation

Background

Using a genome-wide association study (GWAS) approach, our group previously computed a genetic risk score (GRS) from single nucleotide polymorphisms (SNPs) of 10 loci that affect the plasma triglyceride (TG) response to an omega-3 (n-3) fatty acid (FA) supplementation.

Objectives

The objective was to compute a novel and more refined GRS using fine mapping to include a large number of genetic variants.

Methods

A total of 208 participants of the Fatty Acid Sensor (FAS) Study received 5 g fish oil/d, containing 1.9-2.2 g eicosapentaenoic acid and 1.1 g docosahexanoic acid, for 6 wk. Plasma TG concentrations were measured before and after supplementation. Dense genotyping and genotype imputation were used to refine mapping around GWAS hits. A GRS was computed by summing the number of at-risk alleles of tagging SNPs. Analyses were replicated in samples of the FINGEN study.

Results

A total of 31 tagging SNPs associated with the TG response were used for GRS calculation in the FAS study. In a general linear model adjusted for age, sex, and body mass index, the GRS explained 49.73% of TG response variance (P < 0.0001). Nonresponders to the n-3 FA supplementation had a higher GRS than did responders. In the FINGEN replication study, the GRS explained 3.67% of TG response variance (P = 0.0006).

Conclusions

Fine mapping proved to be effective to refine the previous GRS. Carrying increasing numbers of at-risk alleles of 31 SNPs confers a higher risk of being nonresponsive to n-3 FAs. The genetic profile therefore appears to be an important determinant of the plasma TG response to an n-3 FA supplementation and could be used to target those most likely to gain clinical benefit. This trial was registered at http://www.clinicaltrials.gov as NCT01343342.

Vitamin B12 Deficiency Across Three Generations Adversely Influences Long-chain Polyunsaturated Fatty Acid Status and Cardiometabolic Markers in Rats

BACKGROUND AND AIMS

Vitamin B₁₂ and omega-3 fatty acid deficiency is prevalent in the vegetarian population and is associated with adverse pregnancy outcomes and cardiometabolic risk. The present study investigates the long-term effects of vitamin B₁₂ deficiency/supplementation in the presence of omega-3 fatty acids on cardiometabolic profile and long-chain polyunsaturated fatty acid levels (LCPUFA) in the F₃ generation offspring.

METHODS

Three generations of rats were fed the following diets: control; vitamin B₁₂ deficient; vitamin B₁₂ supplemented; vitamin B₁₂ deficient + omega-3 fatty acid supplemented; vitamin B₁₂ + omega-3 fatty acid supplemented. Animals were sacrificed at 3 months of age.

RESULTS

Vitamin B₁₂ deficiency lowered (p <0.01 for both) plasma eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), liver DHA (p <0.05), plasma/liver omega-3 fatty acids (p <0.05 for both), increased triglycerides (p <0.05) and systolic BP (p <0.01) and lowered cholesterol levels (p <0.05) as compared to control. Vitamin B₁₂ deficiency in the presence of omega-3 fatty acids improved plasma/liver EPA, DHA and omega-3 fatty acid profile and maintained cholesterol, triglyceride and BP levels. Vitamin B₁₂ supplementation lowered liver DHA (p <0.05) and cholesterol (p <0.01), whereas BP was similar to control. Combined supplementation of vitamin B₁₂ and omega-3 fatty acids improved omega-3 fatty acid profile, lowered cholesterol/triglyceride levels and maintained the BP similar to that of control.

CONCLUSION

Vitamin B₁₂ deficiency across three generations adversely affects LCPUFA and cardiometabolic profile in the adult offspring. This study provides clues for a combined supplementation of vitamin B₁₂ and omega-3 fatty acids to reduce the risk for noncommunicable diseases.

A Meta-Analysis of Randomized Controlled Trials and Prospective Cohort Studies of Eicosapentaenoic and Docosahexaenoic Long-Chain Omega-3 Fatty Acids and Coronary Heart Disease Risk

OBJECTIVE

To conduct meta-analyses of randomized controlled trials (RCTs) to estimate the effect of eicosapentaenoic and docosahexaenoic acid (EPA+DHA) on coronary heart disease (CHD), and to conduct meta-analyses of prospective cohort studies to estimate the association between EPA+DHA intake and CHD risk.

METHODS

A systematic literature search of Ovid/Medline, PubMed, Embase, and the Cochrane Library from January 1, 1947, to November 2, 2015, was conducted; 18 RCTs and 16 prospective cohort studies examining EPA+DHA from foods or supplements and CHD, including myocardial infarction, sudden cardiac death, coronary death, and angina, were identified. Random-effects meta-analysis models were used to generate summary relative risk estimates (SRREs) and 95% CIs. Heterogeneity was examined in subgroup and sensitivity analyses and by meta-regression. Dose-response was evaluated in stratified dose or intake analyses. Publication bias assessments were performed.

RESULTS

Among RCTs, there was a nonstatistically significant reduction in CHD risk with EPA+DHA provision (SRRE=0.94; 95% CI, 0.85-1.05). Subgroup analyses of data from RCTs indicated a statistically significant CHD risk reduction with EPA+DHA provision among higher-risk populations, including participants with elevated triglyceride levels (SRRE=0.84; 95% CI, 0.72-0.98) and elevated low-density lipoprotein cholesterol (SRRE=0.86; 95% CI, 0.76-0.98). Meta-analysis of data from prospective cohort studies resulted in a statistically significant SRRE of 0.82 (95% CI, 0.74-0.92) for higher intakes of EPA+DHA and risk of any CHD event.

CONCLUSION

Results indicate that EPA+DHA may be associated with reducing CHD risk, with a greater benefit observed among higher-risk populations in RCTs.

Nutritional factors and metabolic variables in relation to the risk of coronary heart disease: A case control study in Armenian adults

INTRODUCTION

Dietary factors can affect the coronary heart disease (CHD). Results of previous studies on the association between the diet and CHD are not consistent in different countries. There were no data on this association in Armenia.

OBJECTIVE

Aims of this case-control study were to evaluate the association between nutritional factors and CHD among Armenians in Yerevan.

METHODS

During 2010 and 2011, we randomly selected 320 CHD patients with a diagnosis of CHD less than 6 months and 320 subjects without CHD (≥30years old) from the hospitals and polyclinics in Yerevan. Dietary intakes with 135 food items over the previous 12 months were evaluated using a semi-quantitative food frequency questionnaire.

RESULTS

After adjusting for some CHD risk factors higher intakes of polyunsaturated fatty acids (PUFA) and monounsaturated fatty acids (MUFA) were associated with a reduced risk of CHD, while this association was not witnessed for saturated fatty acids (SFA). In addition, findings indicated an inverse relation between vitamins (E, B6 and B12, folic acid) and fiber with CHD. In this population, smoking, hypertension, and metabolic syndrome (MetS) were significantly more common among patients with CHD.

CONCLUSION

The intake of vitamins E, B6 and B12, folic acid, PUFA, MUFA and fiber appeared to be predictors of CHD, independently of other risk factors.

A Correlation Study of DHA Dietary Intake and Plasma, Erythrocyte and Breast Milk DHA Concentrations in Lactating Women from Coastland, Lakeland, and Inland Areas of China

We aimed to assess the correlation between docosahexaenoic acid (DHA) dietary intake and the plasma, erythrocyte and breast milk DHA concentrations in lactating women residing in the coastland, lakeland and inland areas of China. A total of 408 healthy lactating women (42 ± 7 days postpartum) were recruited from four hospitals located in Weihai (coastland), Yueyang (lakeland) and Baotou (inland) city. The categories of food containing DHA, the average amount consumed per time and the frequency of consumption in the past month were assessed by a tailored DHA food frequency questionnaire, the DHA Intake Evaluation Tool (DIET). DHA dietary intake (mg/day) was calculated according to the Chinese Food Composition Table (Version 2009). In addition, fasting venous blood (5 mL) and breast milk (10 mL) were collected from lactating women. DHA concentrations in plasma, erythrocyte and breast milk were measured using capillary gas chromatography, and were reported as absolute concentration (μg/mL) and relative concentration (weight percent of total fatty acids, wt. %). Spearman correlation coefficients were used to assess the correlation between intakes of DHA and its concentrations in biological specimens. The study showed that the breast milk, plasma and erythrocyte DHA concentrations were positively correlated with DHA dietary intake; corresponding correlation coefficients were 0.36, 0.36 and 0.24 for relative concentration and 0.33, 0.32, and 0.18 for absolute concentration (p < 0.05). The median DHA dietary intake varied significantly across areas (p < 0.05), which was highest in the coastland (24.32 mg/day), followed by lakeland (13.69 mg/day), and lowest in the inland (8.84 mg/day). The overall relative and absolute DHA concentrations in breast milk were 0.36% ± 0.23% and 141.49 ± 107.41 μg/mL; the concentrations were significantly lower in inland women than those from coastland and lakeland. We conclude that DHA dietary intake is positively correlated with DHA concentrations in blood and breast milk in Chinese lactating women, suggesting that the tailored DHA food frequency questionnaire, DIET, is a valid tool for the assessment of DHA dietary intake.

Association of fish consumption and dietary intake of marine n-3 PUFA with myocardial infarction in a prospective Danish cohort study

Several studies have investigated the potential benefits of marine n-3 PUFA in CVD, generally suggesting a lower risk of CHD. However, recent trials have questioned these results. This study investigated the association of fish consumption with dietary intake of marine n-3 PUFA with incident myocardial infarction (MI). In a Danish cohort study, 57 053 subjects between 50 and 64 years of age were enrolled from 1993 to 1997. From national registries, we identified all cases of incident MI. Dietary fish consumption was assessed using a semi-quantitative food questionnaire, including twenty-six questions regarding fish intake. In addition, we calculated the intake of total and individual marine n-3 PUFA. During a median follow-up of 17·0 years, we identified 3089 cases of incident MI. For both men and women, a high intake of fatty fish was inversely related to incident MI. Thus, when comparing the highest and the lowest quintile of fatty fish intake, we found a 12 % lower relative risk of MI in men (hazard ratio (HR) 0·88; 95 % CI 0·77, 1·00) and a 22 % lower relative risk in women (HR 0·78; 95 % CI 0·63, 0·96) after adjustments. For women, similar associations were observed for individual and total marine n-3 PUFA. In contrast, intake of lean fish was not associated with MI. In conclusion, incident MI was inversely related to a high intake of fatty fish, but not lean fish. However, test for trends across quintiles was not statistically significant. In general, this study supports the view that consumption of fatty fish may protect against MI.

Dietary α-Linolenic Acid and Total ω-3 Fatty Acids Are Inversely Associated with Abdominal Aortic Calcification in Older Women, but Not in Older Men

BACKGROUND

Associations of α-linolenic acid (ALA), eicosapentaenoic acid (EPA) plus decosahexaenoic acid (DHA), and total omega-3 (n-3) fatty acid (FA) intakes with abdominal aortic calcification (AAC) are not well understood.

OBJECTIVE

This study explored the associations between baseline and long-term changes in ω-3 FA consumption and AAC severity among community-dwelling older men and women.

METHODS

The present study used a subset of the Melbourne Collaborative Cohort Study in which participants were interviewed in 1990-1994 and again in 2010-2011. Dietary intake was evaluated at both baseline and follow-up with use of food-frequency questionnaires. AAC severity was assessed by both lateral thoraco-lumbar radiography and dual-energy X-ray absorptiometry (DXA) at follow-up.

RESULTS

A total of 312 participants aged 45-64 y old at baseline were followed for a duration of (mean ± SD) 18 ± 1 y. Baseline energy-adjusted ALA intake tended to be inversely associated with AAC severity by radiography [OR (95% CI) for tertile 3 vs. tertile 1: 0.49 (0.23, 1.02), P-trend: 0.06] and was inversely associated with AAC severity by DXA [OR (95% CI) for tertile 3 vs. tertile 1: 0.37 (0.16, 0.83)] in women, after adjustment for confounders. Women in the third tertile of total ω-3 FA intake had significantly lower AAC severity by radiography [OR (95% CI): 0.33 (0.16, 0.71)] and DXA [OR (95% CI): 0.27 (0.12, 0.62)] than those in the first tertile. Changes in tertile of ω-3 FA intake over 18 y were not found to be associated with AAC severity in either men or women.

CONCLUSION

The results of our study suggest that dietary ALA and total ω-3 FA intakes are both important predictors of the development of AAC in older women, but not in older men.

Omega-3 Fatty Acid Blood Levels Clinical Significance Update

The potential benefit of fish oil (omega-3 fatty acids) consumption to reduce cardiovascular disease (CVD) risk remains controversial. Some investigations report reduced CVD risk associated with fish or fish oil consumption while others report no benefit. This controversy is in part resolved when consideration is given to omega-3 blood levels in relation to CVD risk as well as blood levels achieved in clinical trials of omega-3 supplementation and CVD benefit. There is a wide variation in omega-3 blood levels achieved between individuals in response to a given dose of an omega-3 supplement. Many studies tested a daily dose of 1 gram omega-3 supplementation. The individual variation in blood omega-3 levels achieved in response to a fixed daily dose helps to explain why some individuals may obtain CVD protection benefit while others do not due to failure to achieve a therapeutic threshold. Recent development of a population range in a United States population helps to provide clinical guidance since population omega-3 blood level ranges may vary due to environmental and genetic reasons. Omega-3 supplementation may also be of benefit in reducing the adverse impact of air pollution on CVD risk.