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ω-3 Fatty Acids and the Risk of Coronary Heart Disease

A European Union Clinical and Financial Impact Evaluation of the Columbus Concept

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Wild-Type Food in Health Promotion and Disease Prevention

Abstract

Populations whose diet is low in ω-6 polyunsaturated fatty acids (PUFA) and relatively high in ω-3 PUFA are known to have a reduced risk of cardiovascular disease. Several clinical trials have examined dietary change as a therapeutic intervention and confirmed the benefit of this approach. This chapter presents the results of a meta-analysis that demonstrates that, in patients with established coronary heart disease, the risk of a recurrent event is reduced by 29% (95% confidence interval 6–47%) by the introduction of a diet with a low ω-6:ω-3 ratio. By appropriate crop and animal feed selection, it is possible to yield both plant and animal-derived fats that fulfil these dietary requirements, and which can be applied simply, and cheaply on a population-wide basis: the Columbus Concept. Given current approx annual management costs for myocardial infarction of €2.5 billion across the European Union, we estimate potential savings of around €570 million if such dietary change was universally instituted in high risk cardiovascular populations.

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References

  1. British Heart Foundation Health Promotion Research Group. European Cardiovascular Disease Statistics. 2000 edition. Oxford, UK, 2000, pp. 14–19.

    Google Scholar 

  2. Dawber TR, Kannel WB, Revotskie N, et al. Some factors associated with the development of coronary heart disease; six years’ follow-up experience in the Framingham Study. Am J Public Health 1959;49:1349–1356.

    CAS  Google Scholar 

  3. Mann GV, Pearson G, Gordon T, Dawber TR. Diet and cardiovascular disease in the Framingham Study. I. Measurement of dietary intake. Clin Nutr 1962;11:200–225.

    CAS  Google Scholar 

  4. Dyerberg J, Bang HO. Lipid metabolism, atherogenesis, and haemostasis in Eskimos: the role of the prostaglandin-3 family. Haemostasis 1979;8:227–233.

    CAS  Google Scholar 

  5. Taylor TG, Gibney MJ, Morgan JB. Haemostatic function and polyunsaturated fatty acids. Lancet 1979;2:1378.

    Article  CAS  Google Scholar 

  6. Culp BR, Lands WE, Lucches BR, Pitt B, Romson J. The effect of dietary supplementation of fish oil on experimental myocardial infarction. Prostaglandins 1980;20:1021–1031.

    Article  CAS  Google Scholar 

  7. Feskens EJ, Kromhout D. Epidemiologic studies on Eskimos and fish intake. Ann NY Acad Sci 1993;683:9–15.

    Article  CAS  Google Scholar 

  8. Oomen CM, Feskens EJ, Rasanen L, Fidanza F, Nissinen AM, Menotti A, et al. Fish consumption and coronary heart disease mortality in Finland, Italy, and The Netherlands. Am J Epidemiol 2000;151:999–1006.

    CAS  Google Scholar 

  9. Daviglus ML, Stamler J, Orencia AJ, et al. Fish consumption and the 30 year risk of fatal myocardial infarction. N Engl J Med 1997;336:1046–1053.

    Article  CAS  Google Scholar 

  10. Menotti A, Kromhout D, Blackburn H, Fidanza F, Buzina R, Nissinen A. Food intake patterns and 25-year mortality from coronary heart disease: cross-cultural correlations in the Seven Countries Study. The Seven Countries Study Research Group. Eur J Epidemiol 1999;15:507–515.

    Article  CAS  Google Scholar 

  11. Steffen LM, Jacobs DR, Jr., Stevens J, Shahar E, Carithers T, Folsom AR. Associations of wholegrain, refined-grain, and fruit and vegetable consumption with risks of all-cause mortality and incident coronary artery disease and ischemic stroke: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Clin Nutr 2003;78:383–390.

    CAS  Google Scholar 

  12. Panagiotakos DB, Pitsavos C, Kokkinos P, Chrysohoou C, Vavuranakis M, Stefanadis C, et al. Consumption of fruits and vegetables in relation to the risk of developing acute coronary syndromes; the CARDIO2000 case-control study. Nutr J 2003;2:2.

    Article  Google Scholar 

  13. Kris-Etherton PM, Taylor DS, Yu-Poth S, et al. Polyunsaturated fatty acids in the food chain in the United States. Am J Clin Nutr 2000 Jan;71(1 Suppl):179S–188S.

    CAS  Google Scholar 

  14. Din JN, Newby DE, Flapan AD. ω 3 fatty acids and cardiovascular disease — fishing for a natural treatment. BMJ 2004;2004:30–35.

    Article  Google Scholar 

  15. Sanders TA. Polyunsaturated fatty acids in the food chain in Europe. Am J Clin Nutr 2000;71:176S–178S.

    CAS  Google Scholar 

  16. Simopoulos AP. The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomed Pharmacother 2002;56:365–379.

    Article  CAS  Google Scholar 

  17. Staessen L, De Bacquer D, De Henauw S, et al. Fatty acid composition of the Belgian diet: estimates derived from the Belgian Interuniversity Research on Nutrition and Health. Ann Nutr Metab 1998;42(3):151–159.

    Article  CAS  Google Scholar 

  18. Workshop on the Essentiality of and Dietary Reference Intakes for ω-6 and ω 3 Fatty Acids, NIH Washington DC April 7–9, 1999. http://www.issfal.org.uk/adequateintakes.htm.

  19. Hu FB, Bronner L, Willett WC, et al. Fish and omega-3 fatty acid intake and risk of coronary heart disease in women. JAMA 2002;287:1815–1821.

    Article  CAS  Google Scholar 

  20. Iso H, Rexrode KM, Stampfer MJ, et al. Intake of fish and omega-3 fatty acids and risk of stroke in women. JAMA 2001;285:304–312.

    Article  CAS  Google Scholar 

  21. Ascherio A, Rimm EB, Stampfer MJ, Giovannucci EL, Willett WC. Dietary intake of marine n-3 fatty acids, fish intake, and the risk of coronary disease among men. N Engl J Med 1995;332:977–982.

    Article  CAS  Google Scholar 

  22. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials 1996;17:1–12.

    Article  CAS  Google Scholar 

  23. Sans S, Kesteloot H, Kromhout D. The burden of cardiovascular diseases mortality in Europe. Task Force of the European Society of Cardiology on Cardiovascular Mortality and Morbidity Statistics in Europe. Eur Heart J 1997;18:1231–1248.

    Google Scholar 

  24. Tunstall-Pedoe H, Kuulasmaa K, Mahonen M, et al. Contribution of trends in survival and coronary-event rates to changes in coronary heart disease mortality: 10-year results from 37 WHO MONICA Project populations. Lancet 1999;353:1547–1557.

    Article  CAS  Google Scholar 

  25. Volmink JA, Newton JN, Hicks NR, et al. Coronary event and case fatality rates in an English population: results of the Oxford myocardial infarction incidence study. Heart 1998;80:40–44.

    CAS  Google Scholar 

  26. British Heart Foundation Health Promotion Research Group. European Cardiovascular Disease Statistics. 2000 edition. Oxford, UK, 2000, pp. 26–27.

    Google Scholar 

  27. Peeters A, Mamun AA, Willekens F, Bonneux L. A cardiovascular life history. A life course analysis of the original Framingham Heart Study cohort. Eur Heart J 2002;23:458–466.

    Article  CAS  Google Scholar 

  28. British Heart Foundation. Deaths by cause, sex and age: 2001, UK http://www.heartstats.org/temp/TABsp1.2spweb03.xls.

  29. Phillips C, Belsey JD, Shindler J. Flora pro.activ: A clinical and financial impact analysis. J Med Econ 2000;3:61–76.

    Google Scholar 

  30. Department of Health. Reference Costs 2002. London 2003.

    Google Scholar 

  31. Fox KAA, Cokkinos DV, Deckers J, et al. The ENACT study: A pan-European survey of acute coronary syndromes. Eur Heart J 2000;21:1440–1449.

    Article  CAS  Google Scholar 

  32. Gupta M, Chang W-C, van der Werf F, et al. International differences in in-hospital revascularization and outcomes following acute myocardial infarction. A multilevel analysis of patients in ASSENT-2. Eur Heart J 2003;24:1640–1650.

    Article  Google Scholar 

  33. Melville M, Brown N, Gray D et al. Outcome and use of health services four years after admission for acute myocardial infarction: case record follow up study. BMJ 1999;319:231–232.

    Google Scholar 

  34. Rotter M, Pfiffner D, Maier W, Zeiher AM, Meier B. Interventional cardiology in Europe 1999. Eur Heart J 2003;24:1164–1170.

    Article  Google Scholar 

  35. Burr ML, Fehily AM, Gilbert JF et al. Effects of changes in fat, fish and fibre intakes on death and myocardial reinfarction-diet and reinfaction trial (DART). Lancet 1989;756–761.

    Google Scholar 

  36. Singh RB, Dubnov G, Niaz MA et al. Effect of an Indo-Mediterranean diet on progression of coronary artery disease in high risk patients (Indo-Mediterranean Diet Heart Study): A randomised single-blind trial. Lancet 2002;360:1455–1461.

    Article  Google Scholar 

  37. de Lorgeril M, Salen P, Martin J-L, et al. Mediterranean diet, traditional risk factors and the rate of cardiovascular complications after myocardial infarction. Final report of the Lyon diet heart study. Circulation 1999;99:779–785.

    Google Scholar 

  38. Singh RB, Rastogi SS, Verma R, et al. Randomised controlled trial of cardioprotective diet in patients with recent acute myocardial infarction: Results of one year follow up. BMJ 1992;304:1015–1019.

    Article  CAS  Google Scholar 

  39. GISSI-Prevenzione Investigators. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 1999;354:447–455.

    Article  Google Scholar 

  40. Nilsen DWT, Grethe A, Landmark K, et al. Effects of a high dose concentrate of n-3 fatty acids or corn oil introduced early after an acute myocardial onfarction on serum triacylglycerol and HDL cholesterol. Am J Clin Nutr 2001;74:50–56.

    CAS  Google Scholar 

  41. LaRosa JC, He J, Vupputuri S. Effect of statins on risk of coronary disease a meta-analysis of randomized controlled trials. JAMA 1999;282:2340–2346.

    Article  CAS  Google Scholar 

  42. Antiplatelet Trialists’ Collaboration. Collaborative overview of randomised trials of antiplatelet therapy-I: Prevention of death, myocardial infarction and stroke by prolonged antiplatelet therapy in various categories of patients. BMJ 1994;308:81–106.

    Google Scholar 

  43. Office for National Statistics and Food Standards Agency. The National Diet and Nutrition Survey The Stationery Office London 2002.

    Google Scholar 

  44. Iribarren C, Crow RS, Hannan PJ, Jacobs DR, Jr., Luepker RV. Validation of death certificate diagnosis of out-of-hospital sudden cardiac death. AmJCardiol 1998;82:50–53.

    CAS  Google Scholar 

  45. Ebrahim S, Smith GD. Systematic review of randomised controlled trials of multiple risk factor interventions for preventing coronary heart disease. BMJ 1997;314:1666–1674.

    CAS  Google Scholar 

  46. De Meester F, Stannard J, Remacle C, D’Hollander F, Goeminne X, Erpicum Th. Columbus®, the Natural Original Egg-A Model for Healthy Animal-derived Food. Leatherhead Food RA Ind J 1998;1:289–300.

    Google Scholar 

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Belsey, J.D. (2008). ω-3 Fatty Acids and the Risk of Coronary Heart Disease. In: De Meester, F., Watson, R.R. (eds) Wild-Type Food in Health Promotion and Disease Prevention. Humana Press. https://doi.org/10.1007/978-1-59745-330-1_6

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