Repository logo
 

Longitudinal associations between marine omega-3 supplement users and Coronary Heart Disease in a UK population-based cohort

Accepted version
Peer-reviewed

Change log

Authors

Lentjes, MAH 
Keogh, RH 
Welch, AA 
Mulligan, AA 
Luben, RN 

Abstract

Objectives: Assess the association between marine omega-3 polyunsaturated fatty acid (n 3 PUFA) intake from supplements, mainly cod liver oil, and coronary heart disease (CHD) mortality. Design: Prospective cohort study, with three exposure measurements over 22 y. Setting: Norfolk-based European Prospective Investigation into Cancer (EPIC-Norfolk, UK). Participants: 22,035 men and women from the general population, 39-79 y at recruitment. Exposure: Supplement use was assessed in three questionnaires (1993-1998; 2002-2004; 2004-2011). Participants were grouped into non-supplement users (NSU), n 3 PUFA supplement users (SU+n3) and non n 3 PUFA supplement users (SU n3). Cox regression adjusted for time-point specific variables: age, smoking, prevalent illnesses, BMI, alcohol consumption, physical activity and season and baseline assessments of sex, social class, education and dietary intake (7-day diet diary). Primary and secondary outcome measures: During a median of 19 y follow-up, 1562 CHD deaths were registered for 22,035 included participants. Results: Baseline supplement use was not associated with CHD mortality, but baseline food and supplement intake of n 3 PUFA was inversely associated with CHD mortality after adjustment for fish consumption. Using time-varying covariate analysis, significant associations were observed for SU+n3 (HR: 0.74, 95%CI: 0.66, 0.84), but not for SU n3 vs. NSU. In further analyses, the association for SU+n3 persisted in those who did not take other supplements (HR: 0.83, 95%CI: 0.71, 0.96) and those who did (HR: 0.74, 95%CI: 0.60, 0.91). Those who became SU+n3 over time or were consistent SU+n3 vs. consistent NSU had a lower hazard of CHD mortality; no association with CHD was observed in those who stopped using n 3 PUFA-containing supplements. Conclusions: Recent use of n 3 PUFA supplements was associated with a lower hazard of CHD mortality in this general population with low fish consumption. Residual confounding cannot be excluded, but the findings observed may be explained by postulated biological mechanisms and the results were specific to SU+n3.

Description

Keywords

cardiac epidemiology, epidemiology, nutrition & dietetics, Adult, Aged, Animals, Coronary Disease, Diet, Dietary Supplements, Fatty Acids, Omega-3, Female, Fishes, Humans, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, Risk Factors, Surveys and Questionnaires, United Kingdom

Journal Title

BMJ Open

Conference Name

Journal ISSN

2044-6055
2044-6055

Volume Title

7

Publisher

BMJ Journals
Sponsorship
Medical Research Council (G1000143)
Cancer Research Uk (None)
Research into Ageing (RiA) (262)
Medical Research Council (G0401527)
Cancer Research Uk (None)
Medical Research Council (MC_UU_12015/1)
Department of Health (via National Institute for Health Research (NIHR)) (NF-SI-0512-10135)
Medical Research Council (MR/N003284/1)
All authors report grants from Cancer Research UK programme grants (G0401527, G1000143) and grants from the Medical Research Council (MRC) programme grants (C864/A8257, C864/A14136) during the study. RHK is supported by a MRC Fellowship (MR/M014827/1).