Polyunsaturated Fat Intake Estimated by Circulating Biomarkers and Risk of Cardiovascular Disease and All-Cause Mortality in a Population-Based Cohort of 60-Year-Old Men and Women
Background—High intake of polyunsaturated fatty acids (PUFA) may reduce the risk of cardiovascular disease (CVD) and mortality. Large prospective studies including both sexes and circulating PUFA as dietary biomarkers are needed. We investigated sex-specific associations of major dietary PUFA; eicosapentaenoic acid (EPA), docohexaenoic acid (DHA), linoleic acid (LA), and α-linolenic acid (ALA), with incident CVD and all-cause mortality in a population-based cohort.
Methods and Results—PUFA in serum cholesterol esters were measured at baseline in 2193 Swedish 60-year old women and 2039 men. Using national registers, 484 incident CVD events (294 men and 190 women) and 456 all-cause deaths (265 men and 191 women) were identified during follow-up (median 14.5y), in individuals without prior CVD at baseline. Associations of PUFA with CVD and mortality were evaluated using Cox proportional hazard models. In multivariable adjusted models, 1-SD increments of EPA and DHA were associated with lower risk of incident CVD among women (hazard ratios 0.79 [95% CI 0.64-0.97] and 0.74 [0.61-0.89], respectively). ALA was associated with moderately increased CVD risk in women (1.16 [1.02-1.32]). Inverse associations with all-cause mortality was observed for EPA and DHA among all participants (0.81 [0.72-0.91] and 0.80 [0.72-0.89], respectively) and for LA in men (0.73 [0.64-0.83]).
Conclusions—Serum LA and very long-chain n-3 PUFA, partly reflecting vegetable oil and fish intake, respectively, were inversely associated with all-cause mortality. Inverse associations of EPA and DHA with incident CVD were only observed in women.
- Received January 22, 2015.
- Revision received June 9, 2015.
- Accepted June 11, 2015.