Long-Chain Monounsaturated Fatty Acids and Incidence of Congestive Heart Failure in Two Prospective Cohorts
Background—Decades-old animal experiments suggested dietary long-chain monounsaturated fatty acids (LCMUFA) caused cardiotoxicity, leading, for example, Canada to develop Canadian-oil-low-in-erucic-acid (Canola) from rapeseed. However, potential cardiotoxicity in humans and contemporary dietary sources of LCMUFA are unknown.
Methods and Results—We prospectively investigated associations of plasma phospholipid LCMUFA (20:1, 22:1, and 24:1), objective biomarkers of exposure, with incidence congestive heart failure (CHF) in two independent cohorts: 3,694 older adults (mean age=75.2±5.2 years) in the Cardiovascular Health Study (CHS, 1992-2006), and 3,577 middle-aged adults (mean age=54.1±5.8 years) in the Atherosclerosis Risk in Communities Study Minnesota subcohort (ARIC, 1987-2008). We further examined dietary correlates of circulating LCMUFA in CHS and ARIC, and US dietary sources of LCMUFA in the 2003-2010 National Health and Nutrition Examination Survey (NHANES). In CHS, 997 CHF events occurred during 39,238 person-years; and in ARIC, 330 events during 64,438 person-years. After multivariable-adjustment, higher levels of 22:1 and 24:1 were positively associated with greater incident CHF in both CHS and ARIC: hazard ratios (95% confidence interval)=1.34 (1.02-1.76) and 1.57 (1.11-2.23) for highest vs. lowest quintiles of 22:1, respectively; and 1.75 (1.23-2.50) and 1.92 (1.22-3.03) for 24:1, respectively (P-trend≤0.03 each). A variety of foods related to circulating LCMUFA in CHS and ARIC, consistent with food sources of LCMUFA in NHANES, including fish, poultry, meats, whole grains, and mustard.
Conclusions—Higher circulating levels of 22:1 and 24:1, with apparently diverse dietary sources, were associated with incident CHF in two independent cohorts, suggesting possible cardiotoxicity of LCMUFA in humans.
- longitudinal study
- congestive heart failure
- fatty acid
- Received January 8, 2013.
- Revision received February 27, 2013.
- Accepted March 4, 2013.