Key Findings
Data from the Singapore Chinese Health Study, a population based prospective cohort of approximately 63,000 men and women based sources showed intake of ALA, EPA and DHA to be related to a decreased risk of cardiovascular mortality, particularly CHD deaths. The findings were strongest in individuals without cardiovascular disease at baseline.
ABSTRACT
Although studies suggest that omega 3 fatty acids intake may reduce cardiovascular disease (CVD) mortality risk, few studies have differentiated dietary eicosapentaenoic and docosahexaenoic acid (EPA and DHA) from alpha linolenic acid (ALA), and epidemiological research in Asian populations is limited. Methods: The Singapore Chinese Health Study is a population-based cohort that recruited 63,257 Chinese adults aged 45 to 74 years from 1993 to 1998. Usual diet was measured at recruitment using a validated semi quantitative food frequency questionnaire, and mortality information was identified via registry linkage up to 31 December 2011. Cox proportional hazard models were used to calculate hazard ratios (HRs) with adjustment for potential confounders. Results: We documented 4780 cardiovascular deaths (including 2697 coronary heart disease (CHD) deaths and 1298 stroke deaths) during 890,473 person years of follow up. Omega 3 fatty acids intake was monotonically associated with reduced risk of cardiovascular mortality. Compared to the lowest quartile, the HR was 0.88 (95 per cent confidence interval, CI, 0.81 to 0.96), 0.88 (95 per cent CI 0.80 to 0.97), and 0.83 (95 per cent CI 0.74 to 0.92) for the second, third, and highest quartile, respectively. Both EPA DHA and ALA were independently associated with reduced risk of cardiovascular mortality: HR comparing extreme quartiles was 0.86 and 0.81, respectively. The associations were similar for deaths from CHD and stroke and persisted in participants who were free of CVD at baseline. Conclusions: Higher intakes of marine (EPA DHA) and plant (ALA) omega 3 fatty acids are both associated with reduced risk of cardiovascular mortality in a Chinese population. (Authors abstract)
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