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This study was funded in part by Instituto de Salud Carlos III (ISCIII) (Spanish Ministry of Economy) through grants RTIC G03/140, RTIC RD 06/0045, Centro Nacional de Investigaciones Cardiovasculares CNIC 06/2007, ISCIII FIS PS09/01292, the Spanish Ministry of Science and Innovation (MICINN) AGL2010-22319-C03-02 and AGL2009-13906-C02-02, and an unrestricted grant from the California Walnut Commission. Sala-Vila holds a Miguel Servet I fellowship from the Ministry of Economy and Competitiveness through the ISCIII.

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Dietary alpha-Linolenic Acid, Marine omega-3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvencion con DIeta MEDiterranea (PREDIMED) Study

Publicat a:Journal Of The American Heart Association. 5 (1): e002543- - 2016-01-01 5(1), DOI: 10.1161/JAHA.115.002543

Autors: Sala-Vila, Aleix; Guasch-Ferre, Marta; Hu, Frank B; Sanchez-Tainta, Ana; bullo, Monica; Serra-Mir, Merce; Lopez-Sabater, Carmen; Sorli, Jose V; Aros, Fernando; Fiol, Miquel; Munoz, Miguel A; Serra-Majem, Luis; Alfredo Martinez, J; Corella, Dolores; Fito, Montserrat; Salas-Salvado, Jordi; Martinez-Gonzalez, Miguel A; Estruch, Ramon; Ros, Emilio

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Epidemiological evidence suggests a cardioprotective role of ?-linolenic acid (ALA), a plant-derived ?-3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ?-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).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]).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.URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639.© 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

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