Eur J Epidemiol., 2008., Volume 23; Pages 3 - 10.

Rapid declines in coronary heart disease mortality in Eastern Europe are associated with increased consumption of oils rich in alpha-linolenic acid.

Zatonski, W. Campos, H. Willett, W.

Key Findings:

From the beginning of the 1960’s to about 1990, opposing time trends were observed in coronary heart disease (CHD) rates between Eastern and Western European countries.  In all former socialistic economic countries, CHD was uniformly increasing or stable. In contrast, in Western European countries a steady decline in CHD was observed over these years. The two major vegetable oils that are consumed are rapeseed and sunflower with the difference between these oils being content of ALA, which is relatively high in rapeseed (9.3/100 g).  The data presented here suggest that the ALA intake in Eastern Europe is generally low, and many countries were well below the recommendations for ALA in 2002. The 5 countries that achieved an ALA increase of more than 0.6 g/day between the peak mortality year and 2002 had substantial reductions in CHD risk. Partial replacement of oils that do not have ALA, such as sunflower oil, with oils that are rich in ALA, such as flaxseed oil and flaxseed, would lead to health benefits in Eastern Europe.

ABSTRACT:

During the 1980’s, opposing time trends were observed in coronary heart disease (CHD) rates between Eastern and Western European countries. In all former socialistic economic countries, CHD was uniformly increasing or stable, but a steady decline in CHD was observed in Western European countries. Surprisingly, during the 1990’s CHD mortality substantially decreased in some Eastern European countries but not in others. These changes were accompanied by major shifts in food consumption, including the type of vegetable oils used by the population. There are two major vegetable oils consumed in Eastern Europe (rapeseed and sunflower) that differ greatly in their content of n-3 fatty acids, specifically alpha-linolenic acid (ALA). Low ALA intake has been associated with risk of fatal CHD and sudden cardiac death. The purpose of this study was to examine trends in CHD in eleven Eastern European countries to identify whether national changes in vegetable oil consumption after 1990 were associated with changes in CHD mortality rates. Our data show that countries which experienced an increase in ALA consumption also experienced a substantial decline in CHD mortality. These results were consistent in men and women. We hypothesize that the decline in CHD mortality observed in Eastern Europe can be attributed, in part, to changes in ALA consumption.

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