By Lucy Piper
Regular consumption of seafood and plant-based omega-3 polyunsaturated fatty acids (PUFAs) could help lower the risk of fatal coronary heart disease (CHD), confirm findings from a pooled analysis of 19 studies.
The studies, which included 45,637 participants from 16 countries, including the USA, Australia, France, Germany, Singapore and Russia assessed adipose tissue biomarkers of omega-3 fats allowing separate investigation of seafood-derived eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA) and plant-derived α-linoleic acid (ALA).
During a median 10 years of follow-up, there were 7973 total CHD events, 2781 fatal CHD events and 7157 nonfatal myocardial infarction (MI) events.
For each of the long-chain omega-3 PUFAs - EPA, DPA and DHA - each standard deviation increase was associated with an approximately 9% lower risk of fatal CHD.
A similarly lower risk of fatal CHD was also seen for ALA, which the researchers observe is in line with previous evidence of its effects on thrombosis, inflammation, arrhythmia and endothelial function.
"Our findings, combined with relative affordability, global accessibility, and sustainability of ALA, support the potential importance of ALA for improving global cardiovascular health", they comment.
DHA was also found to be associated with a significant 6% lower risk of total CHD events, but otherwise there were no associations with EPA, DPA or ALA and none of the PUFAs were associated with nonfatal MI.
"Our findings are consistent with prior experimental evidence that long-chain omega-3 PUFAs may have membrane stabilizing actions in the setting of ischemia-induced ventricular fibrillation and observational evidence indicating that benefits of fish consumption are most related to arrhythmic events and fatal CHD", the researchers comment in JAMA Internal Medicine.
They also found that across the studies, the findings were consistent by age, gender, omega-6 PUFA LA and arachidonic acid levels, year of biomarker sampling, diabetes status and aspirin and statin use.
The study provided some novel insights regarding which lipid compartments most influence CHD, lead researcher Liana Del Gobbo (Stanford University School of Medicine, California, USA) and colleagues note.
Stronger inverse associations with CHD for EPA, DPA and DHA were found in phospholipids and total plasma, compared with adipose tissue and cholesterol esters, although the researchers acknowledge that there were fewer estimates and cases for the latter two compartments.
"Altogether, our findings suggest that seafood and plant-derived omega-3 PUFAs are beneficial for fatal CHD prevention across diverse population subgroups", they conclude.
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JAMA Intern Med 2016; Advance online publication