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Original Research Communication |
1 From the Epidemiology Unit, Department of Social Medicine, Hadassah University Hospital, Jerusalem (JDK and NG); the Department of Human Nutrition and Metabolism (NAK and EMB), Hebrew University-Hadassah School of Public Health, Jerusalem (JDK, NAK, and EMB); and the School of Public Health, University of Ghana, Legon, Accra, Ghana (FB).
Background: The Jewish population of Israel consumes a diet rich in n-6 polyunsaturated fatty acids (PUFAs), principally linoleic acid. The consequences of this diet for ischemic heart disease (IHD) remain unclear.
Objective: We assessed the association of adipose tissue n-6 fatty acids, which are derived entirely from the diet, with acute myocardial infarction (AMI).
Design: A total of 180 cases and 492 IHD-free controls aged 25–64 were included in a population-based case-control study of Jerusalem residents hospitalized with a first AMI. Diet was assessed by the use of a food-frequency questionnaire and adipose tissue fatty acids by gas chromatography of biopsy samples taken from subcutaneous gluteal tissue. The data were analyzed by multivariate logistic regression.
Results: Dietary PUFAs (
: 10.1% of energy) correlated (r = 0.43, P < 0.001) with adipose tissue linoleic acid, which constituted 25.6% of storage fatty acids. High intakes of linoleic acid were not associated with excess risk of AMI (age- and sex-adjusted odds ratio for the third versus the first tertile: 0.96; 95% CI: 0.62, 1.48; NS). In contrast, arachidonic acid, the long chain n-6 derivative of linoleic acid, was positively associated with AMI (age- and sex-adjusted odds ratio: 2.12; 95% CI: 1.33, 3.36; P = 0.004). With multivariate adjustment, there was no evidence for an adverse association of linoleic acid with AMI, whereas the risk associated with arachidonic acid persisted, albeit attenuated.
Conclusions: A very high linoleic acid intake does not appear to confer increased risk of nonfatal AMI. Nonetheless, the increased risk associated with arachidonic acid, a finding that requires confirmation, tempers an inference that diets rich in n-6 fatty acids are safe vis-à-vis coronary health.
Key Words: Polyunsaturated fatty acids • adipose tissue fatty acids • linoleic acid • arachidonic acid • myocardial infarction • ischemic heart disease • Jewish population • epidemiology
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