Key Findings:
A high consumption of n3 fatty acids is associated with a lower risk of coronary artery disease (CAD) incidence and mortality. Alpha linolenic acid may also reduce the risk of CAD because of its antithrombotic effects. In this study, the relationship between reported intake of linolenic acid and prevalent CAD in 4584 male and female participants of the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study was assessed. In addition, whether these relationship were influenced by 1) fish consumption, 2) the P:S, and 3) the ratio of linoleic to linolenic acid, were examined. In a secondary analysis, the relationship between linoleic acid and CAD was assessed, adjusting for linolenic fatty acid and the interaction between the 2 fatty acids. An inverse relationship was noted between n3 fatty acid intake and CAD. A higher intake of either linolenic acid or linoleic acid was associated with a lower prevalence odds ratio of CAD in both men and women. The results also indicated that the combined intake of both fatty acids had synergistic effects.
ABSTRACT:
Background: Epidemiologic studies suggest that a higher consumption of eicosapentaenoic acid and docosahexaenoic acid is associated with a reduced risk of cardiovascular disease. Studies in humans and animals also reported an inverse association between alpha-linolenic acid and cardiovascular disease morbidity and mortality. Objective: We examined the relation between dietary linolenic acid and prevalent coronary artery disease (CAD). Design: We studied 4584 participants with a mean (+/- SD) age of 52.1 +/- 13.7 y in the National Heart, Lung, and Blood Institute Family Heart Study in a cross-sectional design. Participants’ diets were assessed with a semiquantitative food-frequency questionnaire. For each sex, we created age- and energy-adjusted quintiles of linolenic acid, and we used logistic regression to estimate prevalent odds ratios for CAD. Results: From the lowest to the highest quintile of linolenic acid, the prevalence odds ratios of CAD were 1.0, 0.77, 0.61, 0.58, and 0.60 for the men (P for trend = 0.012) and 1.0, 0.57, 0.52, 0.30, and 0.42 for the women (P for trend = 0.014) after adjustment for age, linoleic acid, and anthropometric, lifestyle, and metabolic factors. Linoleic acid was also inversely related to the prevalence odds ratios of CAD in the multivariate model (0.60 and 0.61 in the second and third tertiles, respectively) after adjustment for linolenic acid. The combined effect of linoleic and linolenic acids was stronger than the individual effects of either fatty acid. Conclusions: A higher intake of either linolenic or linoleic acid was inversely related to the prevalence odds ratio of CAD. The 2 fatty acids had synergistic effects on the prevalence odds ratio of CAD.