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Title

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

AuthorsSala-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. CSIC; García, L.; Flores, G.; Verdú, J.M.; Baby, P.; Ramos, A.; Medina-Remón, A.; Mengual, L.; Roura, P.; De Santamaría, L.; Babio, N.; Sanz, E.; Yuste, M.C.; Guarner, A.; Rovira, A.; Santamaría, M.I.; Mata, M.; De Juan, C.; Brau, A.; Tresserra-Rimbau, A.; Marti, A.; Mitjavila, M.T.; Felipe, I.; Osma, R.; Portillo, M.P.; Romero, S.; Sáez, G.; Tur, J.; Sacanella, E.; Chiva, G.; Valderas, P.; Arranz, S.; Carrasco, P.; Alonso Gómez, A.; Baena, J.M.; Gil Zarzosa, J.; García, M. CSIC ORCID; Oller, M.; Amat, J.; Duaso, I.; García, Y.; Iglesias, C.; Simón, C.; Quinzavos, L.; Loma-Osorio, A.; Parra, L.; Ortega-Azorín, C.; Sorli, M.; Liroz, M.; Benavent, J.; Clos, J.; Pla, I.; Amorós, M.; Bonet, M.T.; Martin, M.T.; García-Valdueza, M.; Sánchez, M.S.; Altirriba, J.; Manzano, E.; García Roselló, J.; Asensio, E.M.; Altés, A.; Diaz-López, A.; Martin, F.; Tort, R.; Isach, A.; Fitó, Montserrat; Costa, B.; Cabré, J.J.; Fernández-Ballart, J.; Ibarrola-Jurado, N.; Sánchez Luque, J.J.; Barragán, R.; Alegret, C.; Martínez, P.; Millán, S.; Piñol, J.L.; Moñino, M.; Basora, T.; Hernández, J.M.; Toledo, E.; Buil-Cosiales, P.; Ruiz-Canela, M.; Vargas López, E.; Sanjulián, B.; Serra-Majem, L.; Diéz-Espino, Javier; Extremera-Urabayen, V.; Proenza, A.; García-Arellano, A.; Zazpe, I.; Basterra-Gortari, F.J.; Goñi, E.; Razquin, C.; Serrano-Martínez, M.; Ruiz-Gutiérrez, Valentina CSIC ; Bes-Rastrollo, M.; Gea, A.; Francés, F.; Prieto, R.; Martínez-Lapiscina, E.H.; Nuñez-Córdoba, J.M.; Arroyo-Azpa, C.; García-Pérez, L.; Villanueva-Tellería, J.; Cortés-Ugalde, F.; Sagredo-Arce, T.; Jurado Ruiz, E.; De La Noceda-Montoy, M.D.G.; Vigata-López, M.D.; Leal, M.; Arceiz-Campo, M.T.; Guillén, M.; Urtasun-Samper, A.; Gueto-Rubio, M.V.; González, J.I.; Saiz, C.; Portolés, O.; Giménez, F.J.; Montero Romero, E.; Coltell, O.; Cofán, M.; Guillem-Saiz, P.; Quiles, L.; Pascual, V.; Alfredo Martínez, J.; Riera, C.; Pages, M.A.; Godoy, D.; Carratalá-Calvo, A.; Martín-Rillo, M.J.; García García, M.; Frontera, G.; Llopis-Osorio, E.; Ruiz-Baixauli, J.; Bertolín-Muñoz, A.; Salaverría, I.; Del Hierro, T. ; Corella, D.; Algorta, J.; Francisco, S.; Alonso, A.; Alonso, A.; Ginard, M.; Lapetra, J.; San Vicente, J.; Fiol, F.; Jover, A.; García, J.; Covas, M.I.; Tello, S.; Salas-Salvadó, J.; Vila, J.; Schröder, H.; Valls-Pedret, C.; Pérez-Heras, A.; De La Torre, R.; Muñoz-Aguayo, D.; Elosúa, R.; Marrugat, J.; Ferrer, M.; Álvarez-Pérez, J.; Díaz Benítez, E.; Bautista-Castaño, Inmaculada; Martínez-González, M.A.; Doménech, M.; Maldonado-Díaz, I.; Churio-Beraza, B.; Sánchez-Villegas, A.; Castro, I.; Henríquez, P.; Ruano, C.; Ortiz, A.P.; Sarmiendo De La Fe, F.; Simón-García, C.; Falcón-Sanabria, I.; Gilabert, R.; Macías-Gutiérrez, B.; Estruch, R.; Martínez, E. CSIC ORCID; Santana-Santana, A.J.; Gómez-Gracia, Enrique; Fernández-Crehuet, J.; Benítez Pont, R.; Bianchi Alba, M.; Wärnberg, J.; Gómez-Huelgas, R.; Bargalló, N.; Martínez-González, J.; Velasco García, V.; De Diego Salas, J.; Santos, J.M.; Ros, E.; Baca Osorio, A.; Ortega-Calvo, M.; Román, P.; José García, F.; Iglesias, P.; González, R.; Corchado, Y.; Mayoral, E.; Lama, C.; Pintó, Xavier; Lamuela-Raventós, R.M.; Viñas, C.; De La Cruz, E.; Galera, A.; Soler, Y.; Trias, F.; Molina, C.; Sarasa, I.; Padres, E.; Figueras, R.; Solanich, X.; Pujol, R.; Castellote-Bargalló, A. I.; Corbella, E.; Casas, R.; Cabezas, C.; Vinyoles, E.; Márquez, F.; Rovira, M.A.
KeywordsFatty acid
Nutrition
Sudden cardian death
Issue Date2016
PublisherAmerican Heart Association
CitationJournal of the American Heart Association 5: e002543 (2016)
AbstractBackground-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.
Description12 Páginas.-- 6 Tablas.-- 1 Figura
Publisher version (URL)http://dx.doi.org/10.1161/JAHA.115.002543
URIhttp://hdl.handle.net/10261/207758
DOIhttp://dx.doi.org/10.1161/JAHA.115.002543
Identifiersdoi: 10.1161/JAHA.115.002543
issn: 2047-9980
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