Serum fatty acid levels, dietary style and coronary heart disease in three neighbouring areas in Japan: the Kumihama study

Abstract

CHD mortality is extremely low in Japan, particularly in rural districts, when compared with that in Western countries. This has been partly attributed to the difference in dietary lifestyle. We investigated the factors influencing CHD mortality in a rural coastal district of Japan, comprising mercantile, farming, and fishing areas with distinct dietary habits. We prospectively examined the incidence of CHD from 1994 to 1998, as well as coronary risk factors and serum fatty acid concentrations. The incidence of angina pectoris was significantly (P=0.01) lower in the fishing area than in the mercantile and farming areas. Blood pressure, physical activity, prevalence of diabetes, serum levels of uric acid and HDL-cholesterol were similar between the three areas. Total- and LDL-cholesterol levels were significantly lower but the smoking rate was markedly higher in the fishing area than in the other two areas. Serum levels of saturated fatty acids and n-6 polyunsaturated fatty acids (PUFA) were lowest in the fishing area, but n-3 PUFA did not differ significantly. The n-6:n-3 PUFA ratio was lowest and eicosapentaenoic:arachidonic acid was highest in the fishing area. Although many previous studies have emphasized the beneficial effect of n-3 PUFA in preventing CHD, the present study indicated that a lower intake of n-6 PUFA and saturated fatty acids has an additional preventive effect on CHD even when the serum level of n-3 PUFA is high because of high dietary fish consumption.

Relationship between n-3 Polyunsaturated Fatty Acids and Extent of Vessel Disease in Patients with ST Elevation Myocardial Infarction

“…Serum levels of PUFAs are known to be differently distributed according to sex and age, reflecting dietary habits and age-related changes, and residential areas with different levels of fish consumption, [22][23][24][25][26] but their tendencies in STEMI patients remain unclear. In our study, the ratios of serum EPA/AA and DHA/AA in STEMI patients significantly varied in the male patients according to the age groups and were lower in younger men, as is the case for healthy people.…”

An Increase in the EPA/AA Ratio is Associated with Improved Arterial Stiffness in Obese Patients with Dyslipidemia

“…It has been reported that n-3 PUFAs, including EPA and docosahexaenoic acid (DHA), exert antiplatelet and anti-inflammatory actions, in part through antagonizing the activity of proinflammatory eicosanoids derived from arachidonic acid (AA), one of the n-6 PUFAs 5,11) . Previous epidemiological studies reported that high n-3/n-6 PUFA levels and the EPA/ AA ratio are associated with a low rate of ischemic heart disease 12,13) . In addition, a sub-analysis of the JELIS and other studies suggested that a high serum EPA/AA ratio is significantly associated with a low incidence of cardiac death or myocardial infarction, and a low coronary plaque score 14,15) .…”

Relationship between Arteriosclerosis Obliterans and the Ratio of Serum Eicosapentaenoic Acid to Arachidonic Acid

“…Recent reports have determined that unsaturated fatty acids can improve CAD. [3][4][5] Therefore, we hypothesized that fatty acids are associated with ASO.…”