Alpha-linolenic acid intake (omega 3) and intake of a variety of fruit and vegetables were related with incidence of coronary heart disease and stroke in the general population.
Aim: to examine the relationship between the consumption of plant-derived bioactive compounds and the risk of coronary heart disease (CHD) and strokes in the general Dutch population. In addition, to understand whether plant-derived n-3 fatty acids (ALA) can provide the same benefits as demonstrated by marine-based n-3 fatty acids – eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
Methodology: Data was pooled from the large Dutch population-based cohort study Monitoring Project on Risk Factors for Chronic Disease (the MORGEN project). The cohort provided data for over 20,000 men and women who were followed up for 8-19 years. Habitual diet was assessed at baseline (1993-1997) using a validated food frequency questionnaire and CHD and stroke incidence were attained from mortality and morbidity registers. In addition, blood sample analysis from baseline of 279 individuals who experienced a fatal CHD incidence during follow up was compared to 279 matched controls for n-6 and n-3 fatty acid cholesteryl ester levels.
Results: Individuals consuming the greatest variety of fruit and vegetables were also more likely to consume the greatest quantity which was in turn associated with an improved nutritional intake, especially of vitamin C. Intakes of ALA ranged from 0.9g in the lowest quintile to 2g per day in the top quintile (Q5). The main source of ALA was mayonnaise, margarine, soy bean oil and bread. Fruit and vegetable consumption were not associated with CHD or stroke incidence. However, ALA consumption of 1.2-2g per day was associated with a 35-50% reduction in stroke incidents compared to intakes of 0.9g or less daily. After adjusting for confounding factors, plasma n-3 and n-6 cholesteryl esters were not significantly related to fatal CHD.
Conclusions: Recommending a variety of fruit and vegetables could be a practical route to increasing overall intakes. Dutch intakes of dietary ALA were not found to benefit heart health, however, they were found to be protective against strokes from 1.2g per day.
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- De Goede, Verschuren WMM, Boer JMA et al. Alpha-linolenic acid intake and 10-year incidence of coronary heart disease and stroke in 20,000 middle-aged men and women in the Netherlands. PLoS ONE 2011;6(3):e17967
- Oude Griep LM, Verschuren WMM, Kromhout D et al. Variety in fruit and vegetables consumption and 10-year incidence of CHD and stroke. Public Health Nutrition 2012;15(12):2280-86.
- De Goede, Verschuren WMM, Boer JMA et al. N-6 and n-3 fatty acid cholesteryl esters in relation to fatal CHD in a Dutch adult population: a nested case-control study and meta-analysis. PLoS ONE 2013;8(5):e59408