Dietary alpha linolenic acid and long chain n3 PUFA partners in prevention of all cause mortality in individuals at high cardiovascular risk.

Most evidence supporting the cardioprotective role of omega 3 fatty acids derives from studies of long chain n 3 polyunsatutared fatty acids (LCn3PUFA), mainly found in fatty fish. Walnuts, soy and olive oil to a much lesser extent contain alpha linolenic acid (ALA), the vegetable n3PUFA. Whether dietary ALA has cardioprotective effects on its own is a matter of dispute. We aimed to investigate the association between ALA intake and risk of both cardiovascular and all cause mortality in individuals at high cardiovascular risk from Spain, a country with customarily high intakes of both ALA and LCn3PUFA. Design  We evaluated 4139 women and 3063 men aged 55 80 y enrolled in the PREDIMED trial. Nutrient consumption was ascertained by a validated food frequency questionnaire and mortality by medical records and linkage to the National Death Index. Multivariable adjusted Cox regression models (including meeting the AHA recommendation to consume ≥500 mg per d of LCn3PUFA for primary prevention) were fitted to estimate hazard ratios (HR) for mortality for each 1 g per d increase in ALA intake at baseline. Results  During follow up >5 y, 431 deaths occurred (104 from cardiovascular disease; 32 from sudden cardiac death; 171 from cancer). For men, meeting the AHA recommendation (as occurred in 79.4 percent of the study population) was related to a borderline significantly reduced risk of total mortality (HR  0.78; 95 percent CI  0.58 1.05), fatal cardiovascular disease (HR  0.56; 0.31 1.01) and sudden cardiac death (HR  0.40; 0.16 1.04). For each additional daily gram of ALA, there was a 23 percent lower risk of total mortality (HR  0.77; 0.64 0.93) and a lower 29 percent risk of fatal cancer (HR  0.71; 0.52 to 0.97).  No significant associations were found in women. Conclusion  Our study suggests that ALA contributes to reduction of total mortality and fatal cancer in men even when the background diet is high in marine derived LCn3PUFA. (Authors abstract)