Fish and Omega-3 Fatty Acid Intake and Risk of Coronary Heart Disease in Women

Hu, Frank B.; Bronner, Leslie; Willett, Walter C.; Stampfer, Meir J.; Rexrode, Kathryn M; Chen, Albert; Hunter, David J.; Manson, JoAnn E.

doi:10.1001/jama.287.14.1815

Cited by 854 publications

(344 citation statements)

References 39 publications

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“…Some studies on fish consumption and health report that fish consumers on average have a healthier lifestyle than nonconsumers (Hu et al, 2002;Oomen et al, 2000). However, in our study we find that there are a higher percentage of overweight and obese persons in the fish group, and the average BMI is higher than for the other groups.…”

Section: Discussioncontrasting

confidence: 81%

Dietary patterns and lifestyle factors in the Norwegian EPIC cohort: The Norwegian Women and Cancer (NOWAC) study

et al. 2005

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Objective: To identify different dietary patterns in Norway using a combination of cluster and factor analysis. Design: Cross-sectional study. Setting: Nation-wide, population-based study. Subjects: The Norwegian EPIC cohort is a subcohort of the Norwegian Women and Cancer study (NOWAC), and consist 37.226 women aged 41-56 y who answered a food frequency questionnaire (FFQ) in 1998. Interventions: The associations among 50 food variables were first investigated by using principal component analysis. Five important factors were found. The five principal components were then used as input in the cluster analysis. Different socioeconomic and lifestyle variables were examined. Results: Six clusters of dietary patterns were found, and were labelled accordingly: 'traditional fish eaters', 'healthy eaters', 'average, less fish, less healthy', 'Western', 'traditional bread eaters', and 'alcohol users'. The traditional fish eaters and the traditional bread eaters were both highly represented in the north and west of Norway and were more likely to be present among persons with lower income and lower education. The healthy and the alcohol drinkers were found mostly in the south and east and were more likely to have higher income. Persons in the alcohol group were more likely to be current smokers. The western group had the highest percentage of three or more persons in the household and the shortest time since last birth, indicating that families with children dominate this group. Conclusion: Our data indicate six different dietary patterns in Norway, each with different socio-demographic and lifestyle characteristics.

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Section: Discussioncontrasting

confidence: 81%

Dietary patterns and lifestyle factors in the Norwegian EPIC cohort: The Norwegian Women and Cancer (NOWAC) study

et al. 2005

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“…The association between EPA and DHA and the risk of non-fatal myocardial infarction (MI) is, however, unclear. Higher fish intake is significantly associated with reduced risk for non-fatal MI (5) , but the associations between EPA and DHA levels in erythrocytes and reduced risk for non-fatal MI were not significant in the Nurses' Health cohort study (6) . Two cohort studies of men also found non-significant relationships between fish intake and the risk of non-fatal MI (7,8) .…”

mentioning

confidence: 85%

Erythrocyte fatty acid profiles can predict acute non-fatal myocardial infarction

et al. 2009

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The risk of CHD has been linked to n-3 and trans-fatty acids. The purpose of the present study was to evaluate the hypothesis that lower n-3 fatty acids and higher trans-fatty acids in erythrocytes are associated with an increased risk of acute non-fatal myocardial infarction (MI), and that fatty acid profiles can discriminate MI cases from controls. Fifty cases with acute non-fatal MI and fifty age-and sex-matched controls without MI were recruited. The Omega-3 Index (the sum of EPA and DHA in erythrocytes) was significantly lower in cases than controls (9·57 (SEM 0·28) v. 11·81 (SEM 0·35) %; P,0·001), while total trans-fatty acids were significantly higher (1·01 (SEM 0·04) v. 0·56 (SEM 0·03) %; P,0·001). The Omega-3 Index was associated with decreased risk of MI (OR 0·08 (95 % CI 0·02, 0·38); P¼0·001), while total trans-fatty acids were associated with an increased risk of MI (OR 72·67 (95 % CI 6·68, 790·74); P,0·001). The area under the receiver operating characteristic curve of fatty acid profiles was larger than that for traditional risk factors, suggesting that fatty acid profiles make a higher contribution to the discrimination of MI cases from controls compared with modified Framingham risk factors. In conclusion, a higher Omega-3 Index and lower trans-fatty acids in erythrocytes are associated with a decreased risk of MI. Furthermore, fatty acid profiles improve discrimination of acute non-fatal MI compared with established risk factors.

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“…There are, however, few available clinical outcome data. Two prospective cohort studies among women with type 2 diabetes showed the risk of CHD to be much lower among those with high intakes of n-3 PUFA [3,4], but no randomised controlled clinical outcome trials have been reported and the evidence from secondary prevention trials in non-diabetic populations is conflicting [2,3] with a recent meta-analysis casting doubt on the strength of the evidence [5].…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of the effects of n-3 polyunsaturated fatty acids on haematological and thrombogenic factors in type 2 diabetes

et al. 2006

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Aim/hypothesis To determine whether marine-derived n-3 polyunsaturated fatty acids (n-3 PUFA) (also known as omega-3 fatty acids) have beneficial effects on haematological and thrombogenic risk markers in addition to dyslipidaemia, in patients with type 2 diabetes. Methods A systematic review and meta-analysis of randomised controlled trials comparing dietary or nondietary intake of n-3 PUFA with placebo in type 2 diabetes was conducted by systematically searching databases from 1966 to February 2006. Changes in C-reactive protein, IL-6, TNF-α, platelet function, fibrinogen, factor VII, von Willebrand factor, endothelial function, heart rate and blood pressure were recorded. Inclusion of studies, data extraction and quality were assessed independently in duplicate. Results Twelve trials involving 847 subjects with a mean treatment duration of 8.5 weeks included sufficient data to permit pooling. Compared with placebo, n-3 PUFA supplementation had a significant effect on two outcomes: reducing the level of diastolic blood pressure (five trials, 248 subjects) by a mean of 1.8 mm Hg (95% CI 0.0-3.6, p=0.05) and increasing factor VII (two trials, 116 subjects) by 24.9% (95% CI 7.2-42.6, p=0.006). There were no significant effects on systolic blood pressure, fibrinogen or heart rate. Conclusions/interpretation These results suggest that, in addition to the recognised effects on dyslipidaemia, n-3 PUFA decreases diastolic blood pressure, and appears to increase factor VII. Larger and more rigorously conducted clinical trials are required to establish conclusively the role of n-3 PUFA in cardiovascular risk markers and clinical outcomes in type 2 diabetes.

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Fish and Omega-3 Fatty Acid Intake and Risk of Coronary Heart Disease in Women

Abstract: Among women, higher consumption of fish and omega-3 fatty acids is associated with a lower risk of CHD, particularly CHD deaths.

Cited by 854 publications

References 39 publications

Dietary patterns and lifestyle factors in the Norwegian EPIC cohort: The Norwegian Women and Cancer (NOWAC) study

Dietary patterns and lifestyle factors in the Norwegian EPIC cohort: The Norwegian Women and Cancer (NOWAC) study

Erythrocyte fatty acid profiles can predict acute non-fatal myocardial infarction

Meta-analysis of the effects of n-3 polyunsaturated fatty acids on haematological and thrombogenic factors in type 2 diabetes

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