1. 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
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Sala-Vila, A., Guasch-Ferré, Marta, Hu, F.B., Sánchez-Tainta, A., Bulló, M., Serra-Mir, M., López-Sabater, C., Sorlí, J.V., Arós, F., Fiol, M., Muñoz, M.A., Riera, C., Francés, F., Vinyoles, E., Guarner, A., Márquez, F., Guillén, M., Rovira, M.A., Piñol, J.L., Sacanella, E., Basora, T., García, Y., Rovira, A., Santamaría, M.I., Mata, M., de Juan, C., Ruiz-Gutiérrez, Valentina, Pages, M.A., Brau, A., Urtasun-Samper, A., Ruano, C., Tresserra-Rimbau, A., de Santamaría, L., Llopis-Osorio, E., Marti, A., Chiva, G., Moñino, M., Mitjavila, M.T., Valderas, P., Arranz, S., Carrasco, P., Alonso Gómez, A., Galera, A., Alonso, A., Baena, J.M., Basterra-Gortari, F. Javier, Carratalá-Calvo, A., Gil Zarzosa, J., García, M., Pérez-Heras, A., Frontera, G., Oller, M., Benavent, J., Gea, A., Ginard, M., Amat, J., Gueto Rubio, M.V., Diaz-López, A., Clos, J., Pla, I., Amorós, M., Bonet, M.T., Baby, P., de la Torre, Rafael, Martín, M.T., Lapetra, José, Lamuela-Raventós, Rosa M., García-Valdueza, M., Sánchez, M.S., Martin, F., Macías-Gutiérrez, B., Altirriba, J., Tort, R., Isach, A., Fitó, Montserrat, Sarmiendo De La Fe, F., Romero, S., Costa, B., Elosúa, R., García, L., Cabré, J.J., Babio, N., Santana-Santana, A.J., Fernández-Ballart, J., Hernández, J.M., García García, M., Ibarrola-Jurado, Nuria, San Vicente, J., Toledo, E., Buil-Cosiales, P., Ruiz-Canela, M., Vargas López, E., Simón, C., de Diego Salas, J., Sanjulián, B., Felipe, I., Falcón-Sanabria, I., Serra-Majem, L., Trias, F., Díez-Espino, Javier, Viñas, C., Martínez, E., Extremera-Urabayen, V., Núñez-Córdoba, J.M., Proenza, A., Santos, J.M., García-Arellano, A., Marrugat, J., González, J.I., Ferrer, M., Arroyo-Azpa, C., García-Pérez, L., Villanueva-Tellería, J., Cortés-Ugalde, F., Gilabert, R., de la Cruz, E., Sagredo-Arce, T., Ros, E., Duaso, I., Jurado-Ruíz, Enrique, Sarasa, I., De La Noceda-Montoy, M.D.G., Saiz, C., Mengual, L., Vigata-López, M.D., Portolés, O., Giménez, F.J., Montero Romero, Emilio, Verdú, J.M., Martínez, P., Coltell, O., Ortiz, A.P., Soler, Y., Cofán, M., Guillem-Saiz, P., Osma, R., Yuste, M.C., Quiles, L., Ruiz-Baixauli, J., Estruch, R., Pascual, V., Baca Osorio, A., Fiol, F., Bertolín-Muñoz, A., Salaverría, I., del Hierro, T., Corella, D., Razquin, C., Portillo, M.P., Algorta, J., Sánchez Luque, J.J., Ramos, A., Francisco, S., Jover, A., Parra, L., García, J., Covas, María Isabel, Medina-Remón, Alexander, Iglesias, C., Tello, S., Sáez, G., Zazpe, I., Salas-Salvadó, J., Prieto, R., Liroz, M., Vila, J., Álvarez-Pérez, J., Molina, C., Schröder, H., Díaz Benítez, E., Bautista-Castaño, Inmaculada, Martínez-González, M.A., Doménech, M., Godoy, D., Manzano, E., Maldonado-Díaz, I., Flores, G., Quinzavos, L., Churio-Beraza, B., Sánchez-Villegas, A., Barragán, R., Sorli, M., Castro, I., Gómez-Gracia, Enrique, Roura, P., García Roselló, J., Henríquez, P., Tur, J., Ortega-Calvo, M., Fernández-Crehuet, Joaquín, Benítez Pont, R., Bianchi Alba, M., Wärnberg, J., Loma-Osorio, A., Alegret, C., Gómez-Huelgas, R., Asensio, E.M., Alfredo Martínez, J., Bargalló, N., Martínez-González, J., Román, P., Bes-Rastrollo, M., Velasco García, V., García, F.José, Iglesias, P., González, R., Goñi, E., Muñoz-Aguayo, Daniel, Corchado, Y., Millán, S., Sanz, E., Mayoral, E., Leal, M., Martínez-Lapiscina, E.H., Lama, C., Padres, E., Ortega-Azorín, C., Pintó, Xavier, Altés, A., Figueras, R., Solanich, X., Pujol, R., Castellote-Bargalló, A. I., Simón-García, C., Arceiz Campo, M.T., Corbella, E., Valls-Pedret, C., Serrano-Martínez, M., Casas, R., Martín-Rillo, M.J., Cabezas, C., Universitat de Barcelona, Instituto de Salud Carlos III, Centro Nacional de Investigaciones Cardiovasculares (España), and Ministerio de Ciencia e Innovación (España)
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Male ,Gerontology ,Time Factors ,Epidemiology ,modelos de riesgos proporcionales ,humanos ,030204 cardiovascular system & hematology ,chemistry.chemical_compound ,0302 clinical medicine ,Risk Factors ,estudios prospectivos ,evaluación de riesgos ,Medicine ,Nuts ,Sudden cardian death ,030212 general & internal medicine ,Food science ,Longitudinal Studies ,Prospective Studies ,mediana edad ,Original Research ,Diet and Nutrition ,Aged, 80 and over ,chemistry.chemical_classification ,education.field_of_study ,anciano ,alpha-Linolenic acid ,dieta ,Factors de risc en les malalties ,Hàbits alimentaris ,Fatty Acids ,ω-3 fatty acids ,Fatty acids in human nutrition ,alpha-Linolenic Acid ,distribución de la ji al cuadrado ,Middle Aged ,Cardiovascular system ,nutrition ,Cardiovascular Diseases ,Female ,Dieta ,Cardiology and Cardiovascular Medicine ,Nutritive Value ,conducta de reducción del riesgo ,Risk factors in diseases ,Food habits ,Population ,enfermedades cardiovasculares ,030209 endocrinology & metabolism ,Juglans ,Risk Assessment ,sudden cardiac death ,03 medical and health sciences ,alimentos del mar ,factores de tiempo ,Mediterranean cooking ,Àcids grassos en la nutrició ,Fatty Acids, Omega-3 ,Cuina mediterrània ,Peix com a aliment ,Humans ,factores de riesgo ,análisis multifactorial ,education ,Olive Oil ,Dieta -- Mediterrània, Regió de la ,Dieta mediterranea ,ácidos grasos ,α-linolenic acid ,Aged ,Proportional Hazards Models ,Sistema cardiovascular ,Chi-Square Distribution ,business.industry ,Correction ,Fatty acid ,Hàbits alimentaris -- Mediterrània, Regió de la ,Protective Factors ,Fish consumption ,Predimed ,Diet ,nueces ,chemistry ,Seafood ,Spain ,Multivariate Analysis ,valor nutritivo ,estudios longitudinales ,fatty acid ,business ,Risk Reduction Behavior ,ácido alfa-linolénico - Abstract
12 Páginas.-- 6 Tablas.-- 1 Figura, Background-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). Methods and Results-We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable-adjusted Cox regressionmodels were fitted to estimate hazard ratios. ALA intake correlated towalnut 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 formeeting ALArecommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56-0.92) for all-causemortality and 0.95 (95% CI 0.58-1.57) for fatal cardiovascular disease. The hazard ratios formeeting 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-causemortality, 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]). Conclusions-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., This study was funded in part by Instituto de Salud Carlos III (ISCIII) (Spanish Ministry of Economy) through grants RTIC G03/140, RTIC RD 06/0045, Centro Nacional de Investigaciones Cardiovasculares CNIC 06/2007, ISCIII FIS PS09/01292, the Spanish Ministry of Science and Innovation (MICINN) AGL2010‐22319‐C03‐02 and AGL2009‐13906‐C02‐02, and an unrestricted grant from the California Walnut Commission. Sala‐Vila holds a Miguel Servet I fellowship from the Ministry of Economy and Competitiveness through the ISCIII.