Document Detail


n-6 fatty acid-specific and mixed polyunsaturate dietary interventions have different effects on CHD risk: a meta-analysis of randomised controlled trials.
MedLine Citation:
PMID:  21118617     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Randomised controlled trials (RCT) of mixed n-6 and n-3 PUFA diets, and meta-analyses of their CHD outcomes, have been considered decisive evidence in specifically advising consumption of 'at least 5-10 % of energy as n-6 PUFA'. Here we (1) performed an extensive literature search and extracted detailed dietary and outcome data enabling a critical examination of all RCT that increased PUFA and reported relevant CHD outcomes; (2) determined if dietary interventions increased n-6 PUFA with specificity, or increased both n-3 and n-6 PUFA (i.e. mixed n-3/n-6 PUFA diets); (3) compared mixed n-3/n-6 PUFA to n-6 specific PUFA diets on relevant CHD outcomes in meta-analyses; (4) evaluated the potential confounding role of trans-fatty acids (TFA). n-3 PUFA intakes were increased substantially in four of eight datasets, and the n-6 PUFA linoleic acid was raised with specificity in four datasets. n-3 and n-6 PUFA replaced a combination of TFA and SFA in all eight datasets. For non-fatal myocardial infarction (MI)+CHD death, the pooled risk reduction for mixed n-3/n-6 PUFA diets was 22 % (risk ratio (RR) 0.78; 95 % CI 0.65, 0.93) compared to an increased risk of 13 % for n-6 specific PUFA diets (RR 1.13; 95 % CI 0.84, 1.53). Risk of non-fatal MI+CHD death was significantly higher in n-6 specific PUFA diets compared to mixed n-3/n-6 PUFA diets (P = 0.02). RCT that substituted n-6 PUFA for TFA and SFA without simultaneously increasing n-3 PUFA produced an increase in risk of death that approached statistical significance (RR 1.16; 95 % CI 0.95, 1.42). Advice to specifically increase n-6 PUFA intake, based on mixed n-3/n-6 RCT data, is unlikely to provide the intended benefits, and may actually increase the risks of CHD and death.
Authors:
Christopher E Ramsden; Joseph R Hibbeln; Sharon F Majchrzak; John M Davis
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, N.I.H., Intramural    
Journal Detail:
Title:  The British journal of nutrition     Volume:  104     ISSN:  1475-2662     ISO Abbreviation:  Br. J. Nutr.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-01     Completed Date:  2011-01-04     Revised Date:  2011-10-20    
Medline Journal Info:
Nlm Unique ID:  0372547     Medline TA:  Br J Nutr     Country:  England    
Other Details:
Languages:  eng     Pagination:  1586-600     Citation Subset:  IM    
Affiliation:
Section on Nutritional Neurosciences, Laboratory of Membrane Biochemistry and Biophysics, NIAAA, NIH, Bethesda, MD, USA. chris.ramsden@nih.gov
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MeSH Terms
Descriptor/Qualifier:
Coronary Disease / etiology,  mortality,  prevention & control*
Dietary Fats / administration & dosage*
Fatty Acids, Omega-3 / therapeutic use*
Fatty Acids, Omega-6 / adverse effects,  therapeutic use*
Humans
Linoleic Acid / administration & dosage
Myocardial Infarction / etiology,  prevention & control*
Randomized Controlled Trials as Topic
Risk Factors
Chemical
Reg. No./Substance:
0/Dietary Fats; 0/Fatty Acids, Omega-3; 0/Fatty Acids, Omega-6; 2197-37-7/Linoleic Acid
Comments/Corrections
Comment In:
Br J Nutr. 2011 Sep;106(6):958; author reply 959-60   [PMID:  21914241 ]
Br J Nutr. 2011 Sep;106(6):951-2; author reply 953-7   [PMID:  21679479 ]
Br J Nutr. 2010 Dec;104(11):1575-6   [PMID:  21118616 ]

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