The association between dietary omega-3 fatty acids and cardiovascular death: the Singapore Chinese Health Study
Background Although studies suggest that omega-3 fatty acids intake may reduce cardiovascular disease (CVD) mortality risk, few studies have differentiated dietary eicosapentaenoic/docosahexaenoic acid (EPA/DHA) from alpha-linolenic acid (ALA), and epidemiological research in Asian populations is li...
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| Veröffentlicht in: | European journal of preventive cardiology 2015-03, Vol.22 (3), p.364-372 |
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| creator | Koh, Angela S Pan, An Wang, Renwei Odegaard, Andrew O Pereira, Mark A Yuan, Jian-Min Koh, Woon-Puay |
| description | Background
Although studies suggest that omega-3 fatty acids intake may reduce cardiovascular disease (CVD) mortality risk, few studies have differentiated dietary eicosapentaenoic/docosahexaenoic acid (EPA/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 45–74 years from 1993 to 1998. Usual diet was measured at recruitment using a validated semiquantitative 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% confidence interval, CI, 0.81–0.96), 0.88 (95% CI 0.80–0.97), and 0.83 (95% CI 0.74–0.92) for the second, third, and highest quartile, respectively (p-trend = 0.003). Both EPA/DHA and ALA were independently associated with reduced risk of cardiovascular mortality: HR comparing extreme quartiles was 0.86 (95% CI 0.77–0.96, p-trend = 0.002) and 0.81 (95% CI 0.73–0.90, p-trend |
| doi_str_mv | 10.1177/2047487313517576 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4501020</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_2047487313517576</sage_id><sourcerecordid>1654700498</sourcerecordid><originalsourceid>FETCH-LOGICAL-c500t-fcb8f29c2195c5dfbf5833cc354d6fc388be71e8c2ca88e0b9391b153fdf8fe83</originalsourceid><addsrcrecordid>eNp1kdFvFCEQxjdGY5vad58Mj76swgIH64OJuWhr0sSH1mcyC8MtzR6cwLa5_969XHtRE-eFyfDNbwa-pnnL6AfGlPrYUaGEVpxxyZRUqxfN-aHUCq3Zy1Ou-FlzWco9XWJFu07r181ZJ7jgWojzZnc3IoFSkg1QQ4pkwPqIGIkLWCHvSdriBlpOPNS6J2CDKwSiIxayC-kBip0nyMQh1PETqQvtNsQN7FJGsh5DxILkGmGqI7mts9u_aV55mApePp0Xzc9vX-_W1-3Nj6vv6y83rZWU1tbbQfuutx3rpZXOD15qzq3lUriVt1zrARVDbTsLWiMdet6zgUnundceNb9oPh-5u3nYorMYa4bJ7HLYLs8yCYL5-yaG0WzSgxGSMtrRBfD-CZDTrxlLNdtQLE4TRExzMWwlhaJU9IdZ9Ci1OZWS0Z_GMGoOXpl_vVpa3v253qnh2ZlF0B4FBTZo7tOc4_Jd_wf-Btp8nmM</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1654700498</pqid></control><display><type>article</type><title>The association between dietary omega-3 fatty acids and cardiovascular death: the Singapore Chinese Health Study</title><source>SAGE Complete A-Z List</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Koh, Angela S ; Pan, An ; Wang, Renwei ; Odegaard, Andrew O ; Pereira, Mark A ; Yuan, Jian-Min ; Koh, Woon-Puay</creator><creatorcontrib>Koh, Angela S ; Pan, An ; Wang, Renwei ; Odegaard, Andrew O ; Pereira, Mark A ; Yuan, Jian-Min ; Koh, Woon-Puay</creatorcontrib><description>Background
Although studies suggest that omega-3 fatty acids intake may reduce cardiovascular disease (CVD) mortality risk, few studies have differentiated dietary eicosapentaenoic/docosahexaenoic acid (EPA/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 45–74 years from 1993 to 1998. Usual diet was measured at recruitment using a validated semiquantitative 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% confidence interval, CI, 0.81–0.96), 0.88 (95% CI 0.80–0.97), and 0.83 (95% CI 0.74–0.92) for the second, third, and highest quartile, respectively (p-trend = 0.003). Both EPA/DHA and ALA were independently associated with reduced risk of cardiovascular mortality: HR comparing extreme quartiles was 0.86 (95% CI 0.77–0.96, p-trend = 0.002) and 0.81 (95% CI 0.73–0.90, p-trend < 0.001), 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.</description><identifier>ISSN: 2047-4873</identifier><identifier>EISSN: 2047-4881</identifier><identifier>DOI: 10.1177/2047487313517576</identifier><identifier>PMID: 24343844</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aged ; alpha-Linolenic Acid - administration & dosage ; Asian Continental Ancestry Group ; Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - ethnology ; Cardiovascular Diseases - mortality ; Cardiovascular Diseases - prevention & control ; China - ethnology ; Diet - ethnology ; Docosahexaenoic Acids - administration & dosage ; Eicosapentaenoic Acid - administration & dosage ; Feeding Behavior - ethnology ; Female ; Humans ; Linear Models ; Male ; Middle Aged ; Multivariate Analysis ; Proportional Hazards Models ; Protective Factors ; Risk Assessment ; Risk Factors ; Singapore - epidemiology ; Surveys and Questionnaires ; Time Factors</subject><ispartof>European journal of preventive cardiology, 2015-03, Vol.22 (3), p.364-372</ispartof><rights>The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav</rights><rights>The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c500t-fcb8f29c2195c5dfbf5833cc354d6fc388be71e8c2ca88e0b9391b153fdf8fe83</citedby><cites>FETCH-LOGICAL-c500t-fcb8f29c2195c5dfbf5833cc354d6fc388be71e8c2ca88e0b9391b153fdf8fe83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/2047487313517576$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/2047487313517576$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>230,314,776,780,881,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24343844$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koh, Angela S</creatorcontrib><creatorcontrib>Pan, An</creatorcontrib><creatorcontrib>Wang, Renwei</creatorcontrib><creatorcontrib>Odegaard, Andrew O</creatorcontrib><creatorcontrib>Pereira, Mark A</creatorcontrib><creatorcontrib>Yuan, Jian-Min</creatorcontrib><creatorcontrib>Koh, Woon-Puay</creatorcontrib><title>The association between dietary omega-3 fatty acids and cardiovascular death: the Singapore Chinese Health Study</title><title>European journal of preventive cardiology</title><addtitle>Eur J Cardiovasc Prev Rehabil</addtitle><description>Background
Although studies suggest that omega-3 fatty acids intake may reduce cardiovascular disease (CVD) mortality risk, few studies have differentiated dietary eicosapentaenoic/docosahexaenoic acid (EPA/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 45–74 years from 1993 to 1998. Usual diet was measured at recruitment using a validated semiquantitative 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% confidence interval, CI, 0.81–0.96), 0.88 (95% CI 0.80–0.97), and 0.83 (95% CI 0.74–0.92) for the second, third, and highest quartile, respectively (p-trend = 0.003). Both EPA/DHA and ALA were independently associated with reduced risk of cardiovascular mortality: HR comparing extreme quartiles was 0.86 (95% CI 0.77–0.96, p-trend = 0.002) and 0.81 (95% CI 0.73–0.90, p-trend < 0.001), 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.</description><subject>Aged</subject><subject>alpha-Linolenic Acid - administration & dosage</subject><subject>Asian Continental Ancestry Group</subject><subject>Cardiovascular Diseases - diagnosis</subject><subject>Cardiovascular Diseases - ethnology</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>China - ethnology</subject><subject>Diet - ethnology</subject><subject>Docosahexaenoic Acids - administration & dosage</subject><subject>Eicosapentaenoic Acid - administration & dosage</subject><subject>Feeding Behavior - ethnology</subject><subject>Female</subject><subject>Humans</subject><subject>Linear Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Proportional Hazards Models</subject><subject>Protective Factors</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Singapore - epidemiology</subject><subject>Surveys and Questionnaires</subject><subject>Time Factors</subject><issn>2047-4873</issn><issn>2047-4881</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kdFvFCEQxjdGY5vad58Mj76swgIH64OJuWhr0sSH1mcyC8MtzR6cwLa5_969XHtRE-eFyfDNbwa-pnnL6AfGlPrYUaGEVpxxyZRUqxfN-aHUCq3Zy1Ou-FlzWco9XWJFu07r181ZJ7jgWojzZnc3IoFSkg1QQ4pkwPqIGIkLWCHvSdriBlpOPNS6J2CDKwSiIxayC-kBip0nyMQh1PETqQvtNsQN7FJGsh5DxILkGmGqI7mts9u_aV55mApePp0Xzc9vX-_W1-3Nj6vv6y83rZWU1tbbQfuutx3rpZXOD15qzq3lUriVt1zrARVDbTsLWiMdet6zgUnundceNb9oPh-5u3nYorMYa4bJ7HLYLs8yCYL5-yaG0WzSgxGSMtrRBfD-CZDTrxlLNdtQLE4TRExzMWwlhaJU9IdZ9Ci1OZWS0Z_GMGoOXpl_vVpa3v253qnh2ZlF0B4FBTZo7tOc4_Jd_wf-Btp8nmM</recordid><startdate>20150301</startdate><enddate>20150301</enddate><creator>Koh, Angela S</creator><creator>Pan, An</creator><creator>Wang, Renwei</creator><creator>Odegaard, Andrew O</creator><creator>Pereira, Mark A</creator><creator>Yuan, Jian-Min</creator><creator>Koh, Woon-Puay</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20150301</creationdate><title>The association between dietary omega-3 fatty acids and cardiovascular death: the Singapore Chinese Health Study</title><author>Koh, Angela S ; Pan, An ; Wang, Renwei ; Odegaard, Andrew O ; Pereira, Mark A ; Yuan, Jian-Min ; Koh, Woon-Puay</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c500t-fcb8f29c2195c5dfbf5833cc354d6fc388be71e8c2ca88e0b9391b153fdf8fe83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>alpha-Linolenic Acid - administration & dosage</topic><topic>Asian Continental Ancestry Group</topic><topic>Cardiovascular Diseases - diagnosis</topic><topic>Cardiovascular Diseases - ethnology</topic><topic>Cardiovascular Diseases - mortality</topic><topic>Cardiovascular Diseases - prevention & control</topic><topic>China - ethnology</topic><topic>Diet - ethnology</topic><topic>Docosahexaenoic Acids - administration & dosage</topic><topic>Eicosapentaenoic Acid - administration & dosage</topic><topic>Feeding Behavior - ethnology</topic><topic>Female</topic><topic>Humans</topic><topic>Linear Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Proportional Hazards Models</topic><topic>Protective Factors</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Singapore - epidemiology</topic><topic>Surveys and Questionnaires</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koh, Angela S</creatorcontrib><creatorcontrib>Pan, An</creatorcontrib><creatorcontrib>Wang, Renwei</creatorcontrib><creatorcontrib>Odegaard, Andrew O</creatorcontrib><creatorcontrib>Pereira, Mark A</creatorcontrib><creatorcontrib>Yuan, Jian-Min</creatorcontrib><creatorcontrib>Koh, Woon-Puay</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of preventive cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koh, Angela S</au><au>Pan, An</au><au>Wang, Renwei</au><au>Odegaard, Andrew O</au><au>Pereira, Mark A</au><au>Yuan, Jian-Min</au><au>Koh, Woon-Puay</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The association between dietary omega-3 fatty acids and cardiovascular death: the Singapore Chinese Health Study</atitle><jtitle>European journal of preventive cardiology</jtitle><addtitle>Eur J Cardiovasc Prev Rehabil</addtitle><date>2015-03-01</date><risdate>2015</risdate><volume>22</volume><issue>3</issue><spage>364</spage><epage>372</epage><pages>364-372</pages><issn>2047-4873</issn><eissn>2047-4881</eissn><abstract>Background
Although studies suggest that omega-3 fatty acids intake may reduce cardiovascular disease (CVD) mortality risk, few studies have differentiated dietary eicosapentaenoic/docosahexaenoic acid (EPA/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 45–74 years from 1993 to 1998. Usual diet was measured at recruitment using a validated semiquantitative 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% confidence interval, CI, 0.81–0.96), 0.88 (95% CI 0.80–0.97), and 0.83 (95% CI 0.74–0.92) for the second, third, and highest quartile, respectively (p-trend = 0.003). Both EPA/DHA and ALA were independently associated with reduced risk of cardiovascular mortality: HR comparing extreme quartiles was 0.86 (95% CI 0.77–0.96, p-trend = 0.002) and 0.81 (95% CI 0.73–0.90, p-trend < 0.001), 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.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>24343844</pmid><doi>10.1177/2047487313517576</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | SAGE Complete A-Z List; Oxford University Press Journals All Titles (1996-Current); MEDLINE; Alma/SFX Local Collection |
| subjects | Aged alpha-Linolenic Acid - administration & dosage Asian Continental Ancestry Group Cardiovascular Diseases - diagnosis Cardiovascular Diseases - ethnology Cardiovascular Diseases - mortality Cardiovascular Diseases - prevention & control China - ethnology Diet - ethnology Docosahexaenoic Acids - administration & dosage Eicosapentaenoic Acid - administration & dosage Feeding Behavior - ethnology Female Humans Linear Models Male Middle Aged Multivariate Analysis Proportional Hazards Models Protective Factors Risk Assessment Risk Factors Singapore - epidemiology Surveys and Questionnaires Time Factors |
| title | The association between dietary omega-3 fatty acids and cardiovascular death: the Singapore Chinese Health Study |
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