Omega-3 fatty acids and risk of cardiovascular disease in Inuit:First prospective cohort study

• Published in: Atherosclerosis
• Main Authors: Senftleber, Ninna Karsbæk, Albrechtsen, Anders, Lauritzen, Lotte, Larsen, Christina Lytken, Bjerregaard, Peter, Diaz, Lars J., Rønn, Pernille F, Jørgensen, Marit Eika
• Format: Article in Journal/Newspaper
• Language: English
• Published: 2020
• Subjects: /dk/atira/pure/core/keywords/TheFacultyOfScience; Faculty of Science; Cardiovascular disease; Ischemic heart disease; Stroke; n-3; Polyunsaturated fatty acid; Fish; Inuit; Greenland; Circumpolar; Arctic; Epidemiology; greenlander*; inuit
• Online Access: https://curis.ku.dk/portal/da/publications/omega3-fatty-acids-and-risk-of-cardiovascular-disease-in-inuit(b275df4b-6ee5-40d2-8ce3-5359ae4b510b).html; https://doi.org/10.1016/j.atherosclerosis.2020.08.032

Background and aims: No prospective study have ever assessed if marine n-3 polyunsaturated fatty acids protect Inuit against cardiovascular disease as claimed. It is highly relevant as cardiovascular disease (CVD) incidence rates are rising concurrent with a westernization of diet. We aimed to assess the association between blood cell membrane phospholipid content of eicosapentaenoic acid and docosahexaenoic acid (EPA + DHA) on CVD risk in Inuit. Methods: We used data from a cohort of adult Greenlanders with follow-up in national registers. The main outcome was fatal and non-fatal CVD incidence among participants without previous CVD. The continuous effect of EPA + DHA was calculated as incidence rate ratios (IRRs) using Poisson regression with age as time scale, adjusting for age, sex, genetic admixture, lifestyle and dietary risk factors. Results: Out of 3095 eligible participants, 2924 were included. During a median follow-up of 9.7 years, 216 had their first CVD event (8.3 events/1000 person years). No association between EPA + DHA and CVD risk was seen, with IRR = 0.99 per percentage point EPA + DHA increase (95% CI: 0.95-1.03, p = 0.59). No association was seen with risk of ischemic heart disease (IHD) (IRR = 1.03, 95% CI: 0.97-1.09) and stroke (IRR = 0.98, 95% CI: 0.93-1.03) as separate outcomes or for intake of EPA and DHA. Conclusions: We can exclude that the CVD risk reduction is larger than 21% for individuals at the 75% EPA + DHA percentile compared to the 25% percentile. We need a larger sample size and/or longer follow-up to detect smaller effects and associations with IHD and/or stroke.