RT Journal Article
T1 Dietary α-Linolenic Acid, Marine ω-3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvención con DIeta MEDiterránea (PREDIMED) Study.
A1 Sala-Vila, Aleix
A1 Guasch-Ferré, Marta
A1 Hu, Frank B
A1 Sánchez-Tainta, Ana
A1 Bulló, Mònica
A1 Serra-Mir, Mercè
A1 López-Sabater, Carmen
A1 Sorlí, Jose V
A1 Arós, Fernando
A1 Fiol, Miquel
A1 Muñoz, Miguel A
A1 Serra-Majem, Luis
A1 Martínez, J Alfredo
A1 Corella, Dolores
A1 Fitó, Montserrat
A1 Salas-Salvadó, Jordi
A1 Martínez-González, Miguel A
A1 Estruch, Ramón
A1 Ros, Emilio
A1 PREDIMED Investigators, 
A1 B, 
K1 fatty acid
K1 nutrition
K1 sudden cardiac death
AB Epidemiological evidence suggests a cardioprotective role of α-linolenic acid (ALA), a plant-derived ω-3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω-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.
YR 2016
FD 2016-01-26
LK http://hdl.handle.net/10668/9778
UL http://hdl.handle.net/10668/9778
LA en
DS RISalud
RD Apr 20, 2025