Published Online
on March 10, 2003

A more recent version of this article appeared on April 1, 2003

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Submitted on October 22, 2002
Revised on December 30, 2002
Accepted on January 2, 2003

Adipose Tissue -Linolenic Acid and Nonfatal Acute Myocardial Infarction in Costa Rica

Ana Baylin MD, DrPH, Edmond K. Kabagambe BVM, PhD, Alberto Ascherio MD, DrPH, Donna Spiegelman DSc, and Hannia Campos PhD^*

From the Departments of Nutrition (A.B., E.K.K., A.A., H.C.), Epidemiology (A.A., D.S.), and Biostatistics (D.S.), Harvard School of Public Health, Boston, Mass; and Centro Centroamericano de Población, Universidad de Costa Rica, San Pedro de Montes de Oca, Costa Rica (H.C.).

^* To whom correspondence should be addressed. E-mail: hcampos{at}hsph.harvard.edu.

Background---Linolenic acid may protect against cardiovascular disease. We examined the association between adipose tissue -linolenic acid and nonfatal acute myocardial infarction (MI) in a population-based case-control study in Costa Rica.

Methods and Results--The 482 case patients with a first nonfatal acute MI and 482 population control subjects were matched by age, sex, and area of residence. Fatty acids were assessed by gas-liquid chromatography in adipose tissue samples collected from all subjects. ORs and 95% CIs were calculated from multivariate conditional logistic regression models. Subjects in the top quintiles of adipose tissue -linolenic acid had a lower risk of MI than those in the lowest quintile: OR (95% CI), 1.00; 0.80 (0.52 to 1.24); 0.53 (0.34 to 0.82); 0.44 (0.28 to 0.67); and 0.37 (0.24 to 0.59); test for trend, P<0.0001. This association was strengthened after adjustment for established MI risk factors, including smoking, physical activity, income, and adipose tissue linoleic acid and trans fatty acids (OR for the top versus lowest quintile, 0.23; 95% CI, 0.10 to 0.50; test for trend, P<0.0001). Further adjustment for the intake of saturated fat, fiber, alcohol, and vitamin E did not change this association (OR for the top versus lowest quintile, 0.23; 95% CI, 0.10 to 0.55; test for trend, P<0.0001).

Conclusions--The inverse association observed between -linolenic acid and nonfatal acute MI suggests that consumption of vegetable oils rich in -linolenic acid confers important protection against cardiovascular disease.

Key words: coronary disease • diet • fatty acids • epidemiology • risk factors

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