Tags

Type your tag names separated by a space and hit enter

Longitudinal associations between marine omega-3 supplement users and coronary heart disease in a UK population-based cohort.
BMJ Open 2017; 7(10):e017471BO

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 years.

SETTING

Norfolk-based European Prospective Investigation into Cancer (EPIC-Norfolk, UK).

PARTICIPANTS

22 035 men and women from the general population, 39-79 years 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, body mass index, 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-year 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 to 0.84), but not for SU-n3 versus 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 to 0.97). Those who became SU+n3 over time or were consistent SU+n3 versus 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.

Authors+Show Affiliations

Department of Public Health and Primary Care, University of Cambridge, UK.Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.Department of Population Health and Primary Care, University of East Anglia, Norwich, UK.Department of Public Health and Primary Care, University of Cambridge, UK.Department of Public Health and Primary Care, University of Cambridge, UK.MRC Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Cambridge, UK.School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

29030414

Citation

Lentjes, Marleen A H., et al. "Longitudinal Associations Between Marine Omega-3 Supplement Users and Coronary Heart Disease in a UK Population-based Cohort." BMJ Open, vol. 7, no. 10, 2017, pp. e017471.
Lentjes MAH, Keogh RH, Welch AA, et al. Longitudinal associations between marine omega-3 supplement users and coronary heart disease in a UK population-based cohort. BMJ Open. 2017;7(10):e017471.
Lentjes, M. A. H., Keogh, R. H., Welch, A. A., Mulligan, A. A., Luben, R. N., Wareham, N. J., & Khaw, K. T. (2017). Longitudinal associations between marine omega-3 supplement users and coronary heart disease in a UK population-based cohort. BMJ Open, 7(10), pp. e017471. doi:10.1136/bmjopen-2017-017471.
Lentjes MAH, et al. Longitudinal Associations Between Marine Omega-3 Supplement Users and Coronary Heart Disease in a UK Population-based Cohort. BMJ Open. 2017 Oct 13;7(10):e017471. PubMed PMID: 29030414.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Longitudinal associations between marine omega-3 supplement users and coronary heart disease in a UK population-based cohort. AU - Lentjes,Marleen A H, AU - Keogh,Ruth H, AU - Welch,Ailsa A, AU - Mulligan,Angela A, AU - Luben,Robert N, AU - Wareham,Nicholas J, AU - Khaw,Kay-Tee, Y1 - 2017/10/13/ PY - 2017/10/15/entrez PY - 2017/10/17/pubmed PY - 2018/6/9/medline KW - cardiac epidemiology KW - epidemiology KW - nutrition & dietetics SP - e017471 EP - e017471 JF - BMJ open JO - BMJ Open VL - 7 IS - 10 N2 - 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 years. SETTING: Norfolk-based European Prospective Investigation into Cancer (EPIC-Norfolk, UK). PARTICIPANTS: 22 035 men and women from the general population, 39-79 years 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, body mass index, 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-year 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 to 0.84), but not for SU-n3 versus 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 to 0.97). Those who became SU+n3 over time or were consistent SU+n3 versus 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. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/29030414/Longitudinal_associations_between_marine_omega_3_supplement_users_and_coronary_heart_disease_in_a_UK_population_based_cohort_ L2 - http://bmjopen.bmj.com/cgi/pmidlookup?view=long&pmid=29030414 DB - PRIME DP - Unbound Medicine ER -