Elsevier

Food Chemistry

Volume 119, Issue 1, 1 March 2010, Pages 54-61
Food Chemistry

Long-chain n-3 fatty acids and classical cardiovascular disease risk factors among the Catalan population

https://doi.org/10.1016/j.foodchem.2009.05.073Get rights and content

Abstract

The protective cardiovascular effect of long-chain n-3 fatty acids has been firmly established in populations with high fish consumption, like those from Mediterranean countries. The current fish consumption in a representative sample from Catalonia, a Mediterranean region, and its relationship with plasma concentrations of eicosapentaenoic (EPA) and docosahexaenoic (DHA) and some classical cardiovascular disease risk factors was evaluated. Mean fish and seafood intake was 78.5 ± 51.4 g/day. Mean plasma concentrations of EPA and DHA were respectively 0.48% and 1.99% of total fatty acids. Consumption of marine foods among the Catalan population, the main source of n-3 fatty acids, appears to beneficially affect some cardiovascular disease risk factors. Our results show that both EPA and DHA are negatively associated with triacylglycerol (TG) concentrations and the ratio of total cholesterol (TC) to HDL-cholesterol. Furthermore, EPA but not DHA has a beneficial effect on plasma HDL-cholesterol among the Catalan population. There were no significant associations between long-chain n-3 fatty acids and LDL-cholesterol, TC, glucose, insulin or blood pressure. Oily fish intake, which is richest in EPA and DHA, is currently at an order of only 1 serving per week in the Catalan population and its increase should therefore be promoted.

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

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