Long-chain n-3 fatty acids and classical cardiovascular disease risk factors among the Catalan population
Introduction
The protective cardiovascular effect of fish consumption has been firmly established by numerous scientific studies (Harris et al., 2008, Lee et al., 2008, Psota et al., 2006, Wang et al., 2006). High intakes of the long-chain n-3 fatty acids eicosapentaenoic acid (EPA, 20:5n-3) and docosahexaenoic acid (DHA, 22:6n-3) have been found to be associated with reduced coronary artery disease risk through several potential mechanisms. They include antithrombotic (Din et al., 2008, Robinson and Stone, 2006) and anti-arrhythmic effects (Chrysohoou et al., 2007, Leaf, 2007, London et al., 2007, Reiffel and McDonald, 2006), reduced inflammatory responses (Calder, 2006), decreased heart rate variability (Mozaffarian et al., 2008, Mozaffarian et al., 2005), reduced blood pressure (Geleijnse et al., 2002, Ueshima et al., 2007), decreased triglyceride (TG) concentrations (Harris, 1997), and increased insulin sensitivity.
International associations recommend a fish intake of at least twice a week for healthy adults. For patients with documented coronary heart disease (CHD), 1 g of EPA and DHA per day is desirable (Gebauer et al., 2006, Lichtenstein et al., 2006). However, if cardiac effects of fish consumption are primarily related to effects of n-3 LC-PUFA, then associations may vary, depending not only on the quantity but also on the type of fish consumed (Mozaffarian et al., 2003), as n-3 PUFA content can vary by an order of magnitude when comparing fatty fish with lean fish.
A recent review (Calder, 2004), in which 25 major studies investigating associations between fish or long-chain n-3 fatty acids and cardiovascular disease (CVD) were revised, concluded that long-chain n-3 fatty acid consumption should be promoted for all individuals, especially those at risk of developing CVD. It suggests that there is a wide gap between current intakes of long-chain n-3 PUFA and many of the recommendations given from international organisations.
Nowadays a shift away from traditional lifestyles and diets in several populations, especially among young people, is being associated with an increased prevalence of risk factors for CVD, such as high blood pressure, elevated blood lipids, diabetes, and obesity (Hibbeln et al., 2006, Moreno et al., 2002).
This fact must be also taken into account in populations with healthy dietary patterns, such as those followed in the Mediterranean area. There is therefore a need of verifying and promoting their main characteristic food components, such as fish and seafood.
The aim of this study was to examine the current marine-derived n-3 fatty acid status of a representative sample of the adult population in Catalonia, a Mediterranean region, and to evaluate the relationship of the current Catalan fish intake with plasma concentrations of EPA and DHA and some classical cardiovascular disease risk factors.
Section snippets
Study design
A cross-sectional nutritional survey among the Catalan adult population (n = 1600; 18–80 years) was carried out in 2002–2003 (Juncà et al., 2003). Its primary objective was to collect relevant information on the dietary habits of the Catalan population and assess their food consumption patterns. Dietary habits were assessed by means of a quantitative food-frequency questionnaire (FFQ). The sampling technique included stratification according to geographical area and municipality size, age and
Results
The study population was composed of 203 men (mean ± SD age: 49.3 ± 14.7) and 313 women (mean ± SD age: 45.5 ± 15.5) aged 18–77. EPA and DHA accounted for 78% of total plasma n-3 fatty acids (Table 1). The geometric concentration of total n-6 FA was 41.3% by weight and arachidonic acid (AA) accounted for 16.2% of n-6 FA. 97% of the sample had a ratio of plasma PUFA/SFA > 1.0 and the n-6 to n-3 ratio of total plasma FA was 12.5/1. Mean energy intake per kg body weight was 123.5 ± 42.6 kJ/kg (29.5 ± 10.2 kJ/kg).
Discussion
Fish is one of the characteristic food groups of healthy Mediterranean dietary patterns, which has traditionally been consumed in Catalonia (Cucó et al., 2002, Serra-Majem et al., 2003), possibly being one of the factors contributing to the mortality rates for CVD being relatively low in Spain, compared with those in other developed countries (Moreno et al., 2002).
The mean daily fish and shellfish intake in Catalonia (78.5 ± 51.4 g/day) was in the same range of data reported for the Spanish
Acknowledgements
The authors are grateful to the Public Health Division of the Department of Health of the Autonomous Government of Catalonia for providing the blood samples for the study. Special thanks to Mr. Robin Rycroft for the manuscript correction; and the CIBER (Centro de Investigación Biomédica en Red) for the research project CB06/02/0079.
Supported by Mercadona S.A. and the Centre Català de la Nutrició de l’Institut d’Estudis Catalans. The PhD-grant F.P.U. to Isabel Bondia-Pons has been given by the
References (52)
- et al.
Habitual fish consumption, plasma phospholipid fatty acids, and serum lipids: The Tromso study
American Journal of Clinical Nutrition
(1992) - et al.
Comparison of conventional and fast gas chromatography in human plasma fatty acid determination
Journal of Chromatography B
(2004) - et al.
An omega-3 polyunsaturated fatty acid concentrate increases plasma high-density lipoprotein 2 cholesterol and paraoxonase levels in patients with familial combined hyperlipidemia
Metabolism
(2004) - et al.
Factorial study of the effect of n-3 fatty acid supplementation and atorvastatin on the kinetics of HDL apoliproteins A-I and A-II in men with abdominal obesity
American Journal of Clinical Nutrition
(2006) - et al.
Long-term fish consumption is associated with protection against arrhythmia in healthy persons in Mediterranean region – The ATTICA study
American Journal of Clinical Nutrition
(2007) - et al.
N-3 fatty acids and cardiovascular disease risk factors among the Inuit of Nunavik
American Journal of Clinical Nutrition
(2001) - et al.
Dietary intervention with oil rich fish reduces platelet–monocyte aggregation in man
Atherosclerosis
(2008) - et al.
Highly purified eicosapentaenoic acid and docosahexaenoic acid in humans have similar triacylglycerol-lowering effect but divergent effects on serum fatty acids
American Journal of Clinical Nutrition
(1997) - et al.
Omega-3 fatty acids and coronary heart disease risk: Clinical and mechanistic perspectives
Atherosclerosis
(2008) - et al.
Changes in hemostasis during treatment of hypertriglyceridemia with a diet rich in monounsaturated and n-3 polyunsaturated fatty acids in comparison with a low-fat diet
Thrombosis Research
(2001)
Effects of supplementation with fish oil-derived n-3 fatty acids and gamma-linolenic acid on circulating plasma lipids and fatty acids profiles in women
American Journal of Clinical Nutrition
Omega-3 fatty acids for cardioprotection
Mayo Clinic Proceedings
Health benefits and potential risks related to consumption of fish or fish oil
Regulatory Toxicology and Pharmacology
N-3 fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: A systematic review
American Journal of Clinical Nutrition
Effects of purified eicosapentaenoic acid and docosahexaenoic acid on glycemic control, blood pressure, and serum lipids in type 2 diabetic patients with treated hypertension
American Journal of Clinical Nutrition
Determination of phospholipid fatty acids in biological samples by solid-phase extraction and fast gas chromatography
Journal of Chromatography A
N-3 fatty acids and cardiovascular disease: Evidence explained and mechanisms explored
Clinical Science (London)
N-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases
American Journal of Clinical Nutrition
Omega-3 fatty acids
American Family Physician
The contribution of foods to the dietary lipid profile of a Spanish population
Public Health Nutrition
Fish consumption is associated with lower heart rates
Circulation
N-3 fatty acid recommendations and food sources to achieve essentially and cardiovascular benefits
American Journal of Clinical Nutrition
Blood pressure response to fish oil supplementation: Metaregression analysis of randomized trials
Journal of Hypertension
Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording
European Journal of Clinical Nutrition
N3-fatty acids and serum lipoproteins: Human studies
American Journal of Clinical Nutrition
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