New Data Show Omega-3 Polyunsaturated Fatty Acids Lower CVD Risk in Persons with Family History of CVD

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Higher intake of omega-3 polyunsaturated fatty acids (PUFA) may reduce the risk for cardiovascular disease (CVD) in persons with a family history of CVD, according to a new study published in Circulation.

“Among the dietary factors, particular attention in CVD prevention has been given to the quantity and type of fat consumed,” wrote first author Federica Laguzzi, PhD, assistant professor in the unit of cardiovascular and nutritional epidemiology in the Institute of Environmental Medicine at Karolinska Institute in Stockholm, and colleagues. “High intake of omega-3 and omega-6 [PUFA], from oily fish and vegetable oils or nuts, has been consistently recommended for the prevention of CVD, while a balance between energy intake and expenditure is maintained.”

“CVD tends to aggregate in families, a phenomenon partly explained by a genetic component of CVD, as demonstrated in twin studies. ... To our knowledge, no study to date has examined biomarkers of polyunsaturated fatty acids in combination with data on family history to assess interactions,” added Laguzzi and colleagues.

Researchers conducted the harmonized pooled analysis of 15 observational studies, including 40 885 participants across 10 countries, to examine whether a diet low in PUFA modified CVD risk in individuals with and without a family history of CVD, according to the study.

For the purpose of the study, family history of CVD was defined as a participant having a parent or sibling with a fatal or nonfatal CVD, irrespective of their age at diagnosis. Researchers observed between-study heterogeneity to be low-moderate (I2 < 60%) for the pooled analyses of family history.

Biomarkers of PUFA intake were measured in phospholipids, red blood cells, total serum, plasma, cholesterol esters, and adipose tissue as percentages of total fatty acids. Levels of PUFA ≤25th percentile reflected low intake of linoleic acid (LA), alpha linolenic acid (ALA), or eicosapentaenoic/docosahexaenoic acids (EPA/DHA), according to the study.

FINDINGS

After multivariable adjustments, investigators observed a significant interaction between low EPA/DHA and family history of CVD (product term pooled relative risk [RR] 1.09, 95% CI 1.02-1.16; P=.01).

Investigators found that the pooled RR of CVD associated with the combined exposure to low EPA/DHA and family history was 1.41 (95% CI 1.30-1.54), while it was 1.25 (95% CI 1.16–1.33) for family history alone and 1.06 (95% CI 0.98–1.14) for EPA/DHA alone, compared with persons with neither exposure.

“Although these results should be interpreted with caution, it seems reasonable to conclude that our results support the current cardiovascular prevention guidelines regarding the consumption of foods rich in n-3 EPA/DHA (ie, oily fish), especially for people with a family history of CVD,” concluded Laguzzi et al. “Our side findings support the current recommendations stating that foods rich in n-6 LA and n-3 ALA such as vegetable oils and nuts should be a part of the diet.”

Source: Laguzzi F, Åkesson A, Marklund M, et al. Role of polyunsaturated fat in modifying cardiovascular risk associated with family history of cardiovascular disease: Pooled de novo results from 15 observational studies. Circulation. Published online December 4, 2023. doi:10.1161/CIRCULATIONAHA.123.065530