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Rapid declines in coronary heart disease mortality in Eastern Europe are associated with increased consumption of oils rich in alpha-linolenic acid

  • CARDIOVASCULAR DISEASE
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Abstract

During the 1980’s, opposing time trends were observed in coronary heart disease (CHD) rates between Eastern and Western European countries. In all former socialistic economic countries, CHD was uniformly increasing or stable, but a steady decline in CHD was observed in Western European countries. Surprisingly, during the 1990’s CHD mortality substantially decreased in some Eastern European countries but not in others. These changes were accompanied by major shifts in food consumption, including the type of vegetable oils used by the population. There are two major vegetable oils consumed in Eastern Europe (rapeseed and sunflower) that differ greatly in their content of n-3 fatty acids, specifically alpha-linolenic acid (ALA). Low ALA intake has been associated with risk of fatal CHD and sudden cardiac death. The purpose of this study was to examine trends in CHD in eleven Eastern European countries to identify whether national changes in vegetable oil consumption after 1990 were associated with changes in CHD mortality rates. Our data show that countries which experienced an increase in ALA consumption also experienced a substantial decline in CHD mortality. These results were consistent in men and women. We hypothesize that the decline in CHD mortality observed in Eastern Europe can be attributed, in part, to changes in ALA consumption.

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References

  1. Mathers CD, Fat DM, Inoue M, Rao C, Lopez AD. Counting the dead and what they died from: an assessment of the global status of cause of death data. Bull World Health Organ 2005;83:171–7.

    PubMed  Google Scholar 

  2. Zatonski WA, Boyle P. Health transformations in Poland after 1988. J Epidemiol Biostat 1996;1:183–97.

    Google Scholar 

  3. Kesteloot H, Sans S, Kromhout D. Dynamics of cardiovascular and all cause mortality in Western and Eastern Europe. Eur Heart J 2006;27:101–113.

    Google Scholar 

  4. Zatonski WA, McMichael AJ, Powles JW. Ecological study of reasons for sharp decline in mortality from ischaemic heart disease in Poland since 1991. BMJ 1998;316:1047–51.

    PubMed  CAS  Google Scholar 

  5. Zatonski WA, Willett WC. Changes in dietary fat and declining coronary heart disease in Poland: population based study. BMJ 2005;23:187–8.

    Article  Google Scholar 

  6. Hibbeln JR, Nieminen LR, Blasbalg TL, Riggs JA, Lands WE. Healthy intakes of n-3 and n-6 fatty acids: estimations considering worldwide diversity. Am J Clin Nutr 2006;83:1483S–93S.

    PubMed  CAS  Google Scholar 

  7. Hu FB, Stampfer MJ, Manson JE, Rimm EB, Wolk A, Colditz GA, Hennekens CH, Willett WC. Dietary intake of alpha-linolenic acid and risk of fatal ischemic heart disease among women. Am J Clin Nutr 1999;69:890–7.

    PubMed  CAS  Google Scholar 

  8. Albert CM, Oh K, Whang W, Manson JE, Chae CU, Stampfer MJ, Willett WC, Hu FB. Dietary alpha-linolenic acid intake and risk of sudden cardiac death and coronary heart disease. Circulation 2005;112:3232–8.

    Article  PubMed  CAS  Google Scholar 

  9. Djousse L, Arnett DK, Carr JJ, Eckfeldt JH, Hopkins PN, Province MA, Ellison RC. Dietary linolenic acid is inversely associated with calcified atherosclerotic plaque in the coronary arteries: the National Heart, Lung, and Blood Institute Family Heart Study. Circulation 2005;111:2921–6.

    Article  PubMed  CAS  Google Scholar 

  10. Baylin A, Kabagambe EK, Ascherio A, Spiegelman D, Campos H. Adipose tissue alpha-linolenic acid and nonfatal acute myocardial infarction in Costa Rica. Circulation 2003;107:1586–91.

    Article  PubMed  CAS  Google Scholar 

  11. Djousse L, Rautaharju PM, Hopkins PN, Whitsel EA, Arnett DK, Eckfeldt JH, Province MA, Ellison RC. Dietary linolenic acid and adjusted QT and JT intervals in The national heart, lung, and blood institute family heart study. J Am Coll Cardiol 2005;45:1716–22.

    Article  PubMed  CAS  Google Scholar 

  12. Mozaffarian D, Ascherio A, Hu FB, Stampfer MJ, Willett WC, Siscovick DS, Rimm EB. Interplay between different polyunsaturated fatty acids and risk of coronary heart disease in men. Circulation 2005;111:157–64.

    Article  PubMed  CAS  Google Scholar 

  13. Sekula W, Figurska K, Jutrowska I, Barysz A. Changes in the food consumption pattern during the political and economic transition in Poland and their nutritional health implications. Pol Popul Rev 2005;27:141–58.

    Google Scholar 

  14. Joshipura KJ, Hu FB, Manson JE, Stampfer MJ, Rimm EB, Speizer FE, Colditz G, Ascherio A, Rosner B, Spiegelman D, Willett WC. The effect of fruit and vegetable intake on risk for coronary heart disease. Ann Intern Med 2001;134:1106–14.

    PubMed  CAS  Google Scholar 

  15. Oomen CM, Ocke MC, Feskens EJ, Kok FJ, Kromhout D. alpha-Linolenic acid intake is not beneficially associated with 10-y risk of coronary artery disease incidence: the Zutphen Elderly Study. Am J Clin Nutr 2001;74:457–63.

    PubMed  CAS  Google Scholar 

  16. de Lorgeril M, Renaud S, Mamelle N, Salen P, Martin JL, Monjaud I, Guidollet J, Touboul P, Delaye J. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 1994;343:1454–9.

    Article  PubMed  Google Scholar 

  17. Natvig H, Borchgrevink CF, Dedichen J, Owren PA, Schiotz EH, Westlund K. A controlled trial of the effect of linolenic acid on incidence of coronary heart disease. The Norwegian vegetable oil experiment of 1965–66. Scand J Clin Lab Invest Suppl 1968;105:1–20.

    Article  PubMed  CAS  Google Scholar 

  18. Leaf A, Xiao YF, Kang JX, Billman GE. Prevention of sudden cardiac death by n-3 polyunsaturated fatty acids. Pharmacol Ther 2003;98:355–77.

    Article  PubMed  CAS  Google Scholar 

  19. Leaf A, Kang JX, Xiao YF, Billman GE. Clinical prevention of sudden cardiac death by n-3 polyunsaturated fatty acids and mechanism of prevention of arrhythmias by n-3 fish oils. Circulation 2003;107:2646–52.

    Article  PubMed  Google Scholar 

  20. Burdge GC, Finnegan YE, Minihane AM, Williams CM, Wootton SA. Effect of altered dietary n-3 fatty acid intake upon plasma lipid fatty acid composition, conversion of [13C]alpha-linolenic acid to longer-chain fatty acids and partitioning towards beta-oxidation in older men. Br J Nutr 2003;90:311–21.

    Article  PubMed  CAS  Google Scholar 

  21. IOM. Dietary reference intakes: energy, carbohydrates, fiber, fat, fatty acids, cholesterol, protein, amino acids. Washington DC: National Academies Press, 2002.

    Google Scholar 

  22. Mozaffarian D, Katan MB, Ascherio A, Stampfer MJ, Willett WC. Trans fatty acids and cardiovascular disease. N Engl J Med 2006;354:1601–13.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The work on this manuscript was conducted within the European Commission Public Health Project: HEM—Closing the Gap—Reducing Premature Mortality. Baseline for Monitoring Health Evolution Following Enlargement (grant agreement no 2003121) to the Cancer Centre and Institute of Oncology, Cancer Epidemiology and Prevention Division, Warsaw (Principal Investigator: Witold Zatonski).

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Correspondence to Witold Zatonski.

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Zatonski, W., Campos, H. & Willett, W. Rapid declines in coronary heart disease mortality in Eastern Europe are associated with increased consumption of oils rich in alpha-linolenic acid. Eur J Epidemiol 23, 3–10 (2008). https://doi.org/10.1007/s10654-007-9195-1

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  • DOI: https://doi.org/10.1007/s10654-007-9195-1

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