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Intake of n–6 and n–3 fatty acids and fish and risk of community-acquired pneumonia in US men^1,2,3

¹ From the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada (ATM); the Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA (ATM); the Departments of Epidemiology (GCC, EBR, WCW, and WWF) and Nutrition (EBR, WCW, and WWF), Harvard School of Public Health, Boston, MA; and The Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA (GCC, EBR, and WCW)

Background: Essential fatty acids modulate inflammation and glucose metabolism and may alter infection risk.

Objective: We examined the association between intakes of n–6 and n–3 fatty acids and fish and the risk of community-acquired pneumonia.

Design: We prospectively evaluated 38 378 male US health professionals aged 44–79 y at the outset. We updated medical and lifestyle information biennially through questionnaires and diet every 4 y with the use of a validated food-frequency questionnaire. We excluded men who reported pneumonia, myocardial infarction, stroke, other heart disease, arterial surgery, cancer, or asthma before 1990 or those with incomplete dietary data. Community-acquired pneumonia was determined by blinded medical record review of chest radiographs.

Results: During 10 y of follow-up, there were 441 new cases of nonfatal community-acquired pneumonia. Pneumonia risk was lower in men in the highest energy-adjusted quintiles of intake than in men in the lowest quintiles of intake of linoleic acid [multivariate relative risk (RR): 0.70; 95% CI: 0.51, 0.96; P for trend = 0.01] and -linolenic acid (multivariate RR: 0.68; 95% CI: 0.50, 0.93; P for trend = 0.01). Pneumonia risk decreased 4% for every 1-g/d increase in linoleic acid intake (multivariate RR: 0.96; 95% CI: 0.93, 0.99). Pneumonia risk was reduced by 31% for every 1-g/d increase in -linolenic acid intake (multivariate RR: 0.69; 95% CI: 0.51, 0.93). Intakes of eicosapentaenoic acid and docosahexaenoic acid were not significantly related to pneumonia risk.

Conclusion: Higher intakes of -linolenic and linoleic acids and possibly of fish may reduce the risk of pneumonia.

Key Words: n–6 Fatty acids • n–3 fatty acids • fish • prospective study • community-acquired pneumonia

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