Abstract 20129: Polyunsaturated Fat Intake Estimated by Circulating Biomarkers is Inversely Associated with Cardiovascular Disease and All-Cause Mortality in a Large Population-Based Cohort of Swedish Women and Men
Increased intake of certain polyunsaturated fatty acids (PUFA) in place of saturated fatty acids has shown beneficial effects on cardiovascular disease (CVD) risk, although results are inconsistent. This may partly be explained by sex differences and shortcomings with self-reported intake data.
The objective was to evaluate associations between markers of PUFA intake, from vegetable oils and fish, with CVD incidence and mortality (all-cause).
In a representative population-based prospective cohort study including 2193 women and 2039 men (all aged 60 y) in Stockholm County, Sweden, PUFA were measured in serum cholesteryl esters by gas chromatography at baseline (1997-1998). Using national registers, 484 first CVD events (male, n=294; female, n=190) and 456 deaths (n=265; n=191) were identified during follow-up (median 14.5y), in individuals without prior CVD events at baseline. Associations between PUFA intake (assessed by circulating PUFA [linoleic acid, LA; α-linolenic acid, ALA; eicosapentaenoic acid, EPA; docosahexaenoic acid, DHA]) and risk of CVD and mortality were evaluated in men and women separately and together, by Cox proportional hazard models. Hazard ratios (HR) with 95% confidence interval (95%CI) were estimated in crude models and after adjusting for BMI, sex, education, smoking, physical activity, alcohol intake, diabetes, hypertension, and hypercholesterolemia.
In the whole population, EPA and DHA were inversely associated with mortality risk in adjusted model; 1 SD increment in EPA and DHA decreased the risk of mortality by 21% (HR 0.79 [95%CI 0.65-0.96]) and 22% (0.78 [0.66, 0.93]), respectively. Among women, EPA and DHA were associated with reduced CVD risk (HR 0.79 [95% CI 0.64-0.97] and 0.74 [0.61-0.89], respectively), whereas women with high ALA levels had moderately increased risk of CVD (1.16 [1.02-1.32]). High LA levels were associated with reduced mortality in men (0.73 [0.64-0.83]).
In line with some previous studies, circulating PUFA reflecting dietary n-3 and n-6 PUFA intake were in general inversely linked with CVD and/or mortality. Sex specific relations between PUFA and CVD/mortality motivate further investigations and may partly explain previous inconsistencies regarding dietary PUFA in CVD prevention.
Author Disclosures: M. Marklund: None. F. Laguzzi: None. M. Vikström: None. Z. Alsharari: None. P. Sjögren: None. B. Gigante: None. T. Cederholm: None. K. Leander: None. M. Hellenius: None. U. De Faire: None. U. Risérus: None.
- © 2014 by American Heart Association, Inc.