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Title: Dietary alpha-linolenic acid, Marine omega-3 fatty acids, and mortality in a population with high fish consumption: findings from the PREvencion con Dleta MEDiterranea (PREDIMED) Study
Authors: Sala-Vila, Aleix
Guasch-Ferre, Marta
Hu, Frank B.
Sanchez-Tainta, Ana
bullo, Monica
Serra-Mir, Merce
Lopez-Sabater, Carmen
Sorli, Jose V.
Aros, Fernando
Fiol, Miquel
Munoz, Miguel A.
Serra-Majem, Luis 
Alfredo Martinez, J.
Corella, Dolores
Fito, Montserrat
Salas-Salvado, Jordi
Martinez-Gonzalez, Miguel A.
Estruch, Ramon
Ros, Emilio
UNESCO Clasification: 32 Ciencias médicas
Keywords: Cardiovascular Risk-Factors
N-3 Fatty-Acids
Nut Consumption
Fatty Acid
Sudden Cardiac Death
Issue Date: 2016
Journal: Journal of the American Heart Association 
Abstract: Epidemiological evidence suggests a cardioprotective role of a-linolenic acid (ALA), a plant-derived x-3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine x-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 PREvencion con DIeta MEDiterranea (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.
ISSN: 2047-9980
DOI: 10.1161/JAHA.115.002543
Source: Journal Of The American Heart Association [ISSN 2047-9980], v. 5 (1), (Enero 2016)
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