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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
Author: Sala Vila, Aleix
Guasch-Ferré, Marta
Hu, Frank B.
Sánchez Tainta, Ana
Bulló, Mònica
Serra-Mir, Mercè
López Sabater, María del Carmen
Sorlí, José V.
Arós, Fernando
Fiol Sala, Miguel
Muñoz, Miguel Ángel
Serra Majem, Lluís
Martínez, J. Alfredo, 1957-
Corella Piquer, Dolores
Fitó Colomer, Montserrat
Salas Salvadó, Jordi
Martínez-González, Miguel Ángel, 1957-
Estruch Riba, Ramon
Ros Rahola, Emilio
Vinyoles, Ernest
PREDIMED Study Investigators
Keywords: Àcids grassos en la nutrició
Factors de risc en les malalties
Hàbits alimentaris
Sistema cardiovascular
Cuina mediterrània
Fatty acids in human nutrition
Risk factors in diseases
Food habits
Cardiovascular system
Mediterranean cooking
Issue Date: 26-Jan-2015
Abstract: Background 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). Methods and Results 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]). Conclusions 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.
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It is part of: Journal Of The American Heart Association, 2015, vol. 5, num. 2
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ISSN: 2047-9980
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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