Intake of fish and long-chain omega-3 polyunsaturated fatty acids and incidence of metabolic syndrome among American young adults: a 25-year follow-up study
Studies suggest that long-chain ω-3 polyunsaturated fatty acid (LCω3PUFA) intake and its primary food source—fish—may have beneficial effects on the individual components of metabolic syndrome (MetS). We examined the longitudinal association between fish or LCω3PUFA intake and MetS incidence.
We prospectively followed 4356 American young adults, free from MetS and diabetes at baseline, for incident MetS and its components in relation to fish and LCω3PUFA intake. MetS was defined by the National Cholesterol Education Program/Adult Treatment Panel III criteria. Cox proportional hazards model was used for analyses, controlling for socio-demographic, behavioral, and dietary factors.
During the 25-year follow-up, a total of 1069 incident cases of MetS were identified. LCω3PUFA intake was inversely associated with the incidence of MetS in a dose–response manner. The multivariable adjusted hazards ratio (HR) [95 % confidence interval (CI)] of incident MetS was 0.54 (95 % CI 0.44, 0.67; P for linear trend < 0.01) as compared the highest to the lowest quintile of LCω3PUFA intake. A threshold inverse association was found between non-fried fish consumption and the incidence of MetS. The multivariable adjusted HRs (95 % CIs) from the lowest to the highest quintile were 1.00, 0.70 (0.51, 0.95), 0.68 (0.52, 0.91), 0.67 (0.53, 0.86), and 0.71 (0.56, 0.89) (P for linear trend = 0.49). The observed inverse associations were independent of the status of baseline individual components of MetS.
Our findings suggest that intakes of LCω3PUFAs and non-fried fish in young adulthood are inversely associated with the incidence of MetS later in life.
KeywordsLongitudinal studies Omega-3 fatty acids Fish consumption Metabolic syndrome
This study was partially supported by Grants from the NIH (R01HL081572 and R01ES021735). The Coronary Artery Risk Development in Young Adults Study (CARDIA) is supported by contracts HHSN268201300025C, HHSN268201300026C, HHSN268201300027C, HSN268201300028C, HHSN268201300029C, and HHSN268200900041C from the National Heart, Lung, and Blood Institute (NHLBI), the Intramural Research Program of the National Institute on Aging (NIA) and an intra-agency agreement between NIA and NHLBI (AG0005). Dr. Kim Yong-Seok was supported by the Dongguk University Research Fund. The authors thank Dr. Janne Boone-Heinonen for her helpful comments. The authors also thank the other investigators and the staff of the CARDIA Study for valuable contributions.
Compliance with Ethical Standards
Conflict of interest
None of the authors had a conflict of interest.
- 2.Carpentier YA, Portois L, Malaisse WJ (2006) n-3 fatty acids and the metabolic syndrome. Am J Clin Nutr 83:1499S–1504SGoogle Scholar
- 4.Ruidavets JB, Bongard V, Dallongeville J, Arveiler D, Ducimetière P, Perret B, Simon C, Amouyel P, Ferrières J (2007) High consumptions of grain, fish, dairy products and combinations of these are associated with a low prevalence of metabolic syndrome. J Epidemiol Community Health 61:810–817. doi: 10.1136/jech.2006.052126 CrossRefGoogle Scholar
- 9.Lai YH, Petrone AB, Pankow JS, Arnett DK, North KE, Ellison RC, Hunt SC, Djoussé L (2013) Association of dietary omega-3 fatty acids with prevalence of metabolic syndrome: the National Heart, Lung, and Blood Institute Family Heart Study. Clin Nutr 32:966–969. doi: 10.1016/j.clnu.2013.05.002 CrossRefGoogle Scholar
- 13.McDonald A, Van Horn L, Slattery M et al (1991) The CARDIA dietary history: development, implementation, and evaluation. J Am Diet Assoc 91:1104–1112Google Scholar
- 14.Liu K, Slattery M, Jacobs D Jr et al (1994) A study of the reliability and comparative validity of the cardia dietary history. Ethn Dis 4:15–27Google Scholar
- 15.Nutrition Coordinating Center, University of Minnesota. Nutrition Data System for Research (NDSR), Food and Nutrient Database. http://www.ncc.umn.edu/products/ndsr.html. Accessed 10 Nov 2014
- 20.Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the third report of The National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 285:2486–2497CrossRefGoogle Scholar
- 21.Fang J, Austin P, Tu J (2009) Test for linearity between continuous confounder and binary outcome first, run a multivariate regression analysis second. http://support.sas.com/resources/papers/proceedings09/252-2009.pdf. Accessed 10 Nov 2014
- 25.Harris WS (1997) n-3 fatty acids and serum lipoproteins: human studies. Am J Clin Nutr 65:1645S–1654SGoogle Scholar
- 30.Garaulet M, Pérez-Llamas F, Pérez-Ayala M, Martínez P, de Medina FS, Tebar FJ, Zamora S (2001) Site-specific differences in the fatty acid composition of abdominal adipose tissue in an obese population from a Mediterranean area: relation with dietary fatty acids, plasma lipid profile, serum insulin, and central obesity. Am J Clin Nutr 74:585–591Google Scholar
- 32.Ramel A, Martinéz A, Kiely M, Morais G, Bandarra NM, Thorsdottir I (2008) Beneficial effects of long-chain n-3 fatty acids included in an energy-restricted diet on insulin resistance in overweight and obese European young adults. Diabetologia 51:1261–1268. doi: 10.1007/s00125-008-1035-7 CrossRefGoogle Scholar
- 33.Krebs JD, Browning LM, McLean NK, Rothwell JL, Mishra GD, Moore CS, Jebb SA (2006) Additive benefits of long-chain n-3 polyunsaturated fatty acids and weight-loss in the management of cardiovascular disease risk in overweight hyperinsulinaemic women. Int J Obes 30:1535–1544. doi: 10.1038/sj.ijo.0803309 CrossRefGoogle Scholar
- 34.Giacco R, Cuomo V, Vessby B, Uusitupa M, Hermansen K, Meyer BJ, Riccardi G, Rivellese AA (2007) Fish oil, insulin sensitivity, insulin secretion and glucose tolerance in healthy people: is there any effect of fish oil supplementation in relation to the type of background diet and habitual dietary intake of n-6 and n-3 fatty acids? Nutr Metab Cardiovasc Dis 17:572–580CrossRefGoogle Scholar
- 37.Conquer JA, Holub BJ (1996) Supplementation with an algae source of docosahexaenoic acid increases (n-3) fatty acid status and alters selected risk factors for heart disease in vegetarian subjects. J Nutr 126:3032–3039Google Scholar
- 38.Grimsgaard S, Bonaa KH, Hansen JB, Nordøy A (1997) Highly purified eicosapentaenoic acid and docosahexaenoic acid in humans have similar triacylglycerol-lowering effects but divergent effects on serum fatty acids. Am J Clin Nutr 66:649–659Google Scholar
- 40.Kunesová M, Braunerová R, Hlavatý P et al (2006) The influence of n-3 polyunsaturated fatty acids and very low calorie diet during a short-term weight reducing regimen on weight loss and serum fatty acid composition in severely obese women. Physiol Res 55:63–72Google Scholar