OBJECTIVE: To determine the longitudinal association between serial biomarker measures of circulating omega 3 polyunsaturated fatty acid (n3-PUFA) levels and healthy ageing. DESIGN: Prospective cohort study. SETTING: Four communities in the United States (Cardiovascular Health Study) from 1992 to 2015. PARTICIPANTS: 2622 adults with a mean (SD) age of 74.4 (4.8) and with successful healthy ageing at baseline in 1992-93. EXPOSURE: Cumulative levels of plasma phospholipid n3-PUFAs were measured using gas chromatography in 1992-93, 1998-99, and 2005-06, expressed as percentage of total fatty acids, including α-linolenic acid from plants and eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid from seafood. MAIN OUTCOME MEASURE: Healthy ageing defined as survival without chronic diseases (ie, cardiovascular disease, cancer, lung disease, and severe chronic kidney disease), the absence of cognitive and physical dysfunction, or death from other causes not part of the healthy ageing outcome after age 65. Events were centrally adjudicated or determined from medical records and diagnostic tests. RESULTS: Higher levels of long chain n3-PUFAs were associated with an 18% lower risk (95% confidence interval 7% to 28%) of unhealthy ageing per interquintile range after multivariable adjustments with time-varying exposure and covariates. Individually, higher eicosapentaenoic acid and docosapentaenoic acid (but not docosahexaenoic acid) levels were associated with a lower risk: 15% (6% to 23%) and 16% (6% to 25%), respectively. α-linolenic acid from plants was not noticeably associated with unhealthy ageing (hazard ratio 0.92, 95% confidence interval 0.83 to 1.02). CONCLUSIONS: In older adults, a higher cumulative level of serially measured circulating n3-PUFAs from seafood (eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid), eicosapentaenoic acid, and docosapentaenoic acid (but not docosahexaenoic acid from seafood or α-linolenic acid from plants) was associated with a higher likelihood of healthy ageing. These findings support guidelines for increased dietary consumption of n3-PUFAs in older adults.
Link to Full TextBMJ., 2018., Oct 17;363:k4067. doi: 10.1136/bmj.k4067.
Healthy ageing is generally defined as survival without chronic disease or cognitive and physical dysfunction Omega 3 polyunsaturated fatty acids (n3-PUFAs) from seafood and plants exert favorable physiologic effects that could benefit healthy ageing. In this study, higher self reported estimates of dietary n3-PUFA and baseline biomarker n3-PUFA levels are each inversely associated with the risk of cardiovascular disease. Higher levels of serially measured circulating n3-PUFAs from seafood were associated with a lower risk of unhealthy ageing after multivariable adjustments. In this prospective cohort study among community based older US adults, higher serial levels of eicosapentaenoic acid, docosapentaenoic acid, and summed long chain n3-PUFAs, but not α-linolenic acid biomarkers, were associated with a higher likelihood of healthy ageing. In general, about 18% to 24% difference in risk was observed across the five groups. Docosahexaenoic acid was not noticeably associated with healthy ageing, although the risk estimate tended toward benefit, and was statistically significant after adjusting for total fish intake. Associations were generally linear and were robust to various sensitivity analyses.
In exploratory analyses, an association was seen between α-linolenic acid and disease-free (as opposed to functional) healthy ageing, as well as an interaction with age. These findings require confirmation in further investigations. These findings encourage the need for further investigations into plausible biological mechanisms and interventions related to n3-PUFAs for the maintenance of healthy ageing, and to support guidelines for increased dietary consumption of fish in older adults.