Am J Clin Nutr., 2003, Volume 77; Issue 4: Pages 819 - 825.

Dietary linolenic acid and carotid atherosclerosis: the National Heart, Lung, and Blood Institute Family Heart Study.

Djousse, L. Folsom, AR. Province, MA. Hunt, SC. Ellison, RC. National Heart, Lung, and Blood Institute Family Heart Study.

Key Findings:

In this study, data was used from 1575 white participants of the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study to assess whether dietary consumption of total linolenic acid (α- and γ-linolenic acid) was associated with carotid artery plaques and intima-media thickness (IMT) of the carotid arteries. Dietary linolenic acid was associated with a lower prevalence odds ratio of carotid artery plaques. This association was independent of long-chain n−3 fatty acid intake. Dietary linoleic acid, fish consumption, and fish n−3 fatty acid intake were not related significantly to prevalent carotid plaques. When examined as a continuous variable, total linolenic acid intake was inversely associated with IMT at 2 of the 3 sites. Further, the findings suggest that a cardioprotective effect of linolenic acid may be observed at an early stage of the atherosclerotic process, reflected by plaque formation in the carotid arteries.

ABSTRACT:

BACKGROUND: Dietary intake of linolenic acid is associated with a lower risk of cardiovascular disease mortality. However, it is unknown whether linolenic acid is associated with a lower risk of carotid atherosclerosis. OBJECTIVE: The objective was to examine the association between dietary linolenic acid and the presence of atherosclerotic plaques and the intima-media thickness of the carotid arteries. DESIGN: In a cross-sectional design, we studied 1575 white participants of the National Heart, Lung, and Blood Institute Family Heart Study who were free of coronary artery disease, stroke, hypertension, and diabetes mellitus. High-resolution ultrasound was used to assess intima-media thickness and the presence of carotid plaques beginning 1 cm below to 1 cm above the carotid bulb. We used logistic regression and a generalized linear model for the analyses. RESULTS: From the lowest to the highest quartile of linolenic acid intake, the prevalence odds ratio (95% CI) of a carotid plaque was 1.0 (reference), 0.47 (0.30, 0.73), 0.38 (0.22, 0.66), and 0.49 (0.26, 0.94), respectively, in a model that adjusted for age, sex, energy intake, waist-to-hip ratio, education, field center, smoking, and the consumption of linoleic acid, saturated fat, fish, and vegetables. Linoleic acid, fish long-chain fatty acids, and fish consumption were not significantly related to carotid artery disease. Linolenic acid was inversely related to thickness of the internal and bifurcation segments of the carotid arteries but not to the common carotid artery. CONCLUSION: Higher consumption of total linolenic acid is associated with a lower prevalence odds of carotid plaques and with lesser thickness of segment-specific carotid intima-media thickness.

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