Positive Health Online

Abstract

PIETINEN and colleagues, Department of Nutrition, National Public Health Institute, Helsinki, Finland studied the relation between the intake of specific fatty acids and risk of coronary heart disease. @m:METHODS: The cohort examined recruited to the Finnish Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, were 21,930 smoking men, aged 50-69 who were free of diagnosed cardiovascular disease. All the men completed a dietary questionnaire at outset. @r: After 6 years of follow-up from 1985-88, 1,399 major coronary events and 635 coronary deaths were recorded. There was a significant positive association between consumption of trans-fatty acids and risk of coronary death, after controlling for age, supplement group, various coronary risk factors, total energy and intake of fibre. Compared with men in the lowest quintile of intake of trans-fatty acid intake, (multivariate relative risk of coronary death = 1.0), the risk of men in the top quintile of trans-fatty acid consumption was 1.39. There was also a direct association between intake of omega-3 fatty acids from fish and risk of coronary death; relative risk = 1.30 for men in the highest compared to the lowest quintile of consumption. There was no association between intakes of saturated or cis-monounsaturated fatty acids, linoleic or linolenic acid, dietary cholesterol and risk of coronary death. @c: In this cohort of smoking men, there was a direct association between fatty acid consumption and risk of coronary death.

Background

Methodology

Results

Conclusion

References

Pietinen P et al. Intake of fatty acids and risk of coronary heart disease in a cohort of Finnish men. The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Am J Epidemiol 145(10): 876-87. May 15 1997.

Comment

Once again, this is the by now infamous study of the Finnish smokers, in which those who were supplemented with beta-carotene, showed a higher risk of death from cancer than those who didnt take beta-carotene. Since the publication of these results, there has been an avalanche of critical comment and attempts to explain the bizarre and counter-intuitive results. One would expect that eating more trans-fatty acids would increase risk coronary death, but there is a large body of clinical research evidence demonstrating that increased omega-3 fatty acid consumption is associated with a lower risk of coronary death. So the results in this study with smokers, with respect to omega-3 fatty acids, again appear to be the reverse of what one would predict. My own personal explanation behind some of the unexpected results lies in the men themselves, who were aged 50-69, had smoked heavily for several decades and many of whom had worked in jobs with exposure to carcinogens including asbestos. Of this group of 21,930 men, 1,399 or 6.3% suffered major coronary events in the 6 years of follow-up. I feel that undoing a lifetime of nutritional, lifestyle and environmental abuse is difficult if not impossible, and that epidemiological studies such as this one are unlikely to be able to answer refined questions relating to diet and risk of death from coronary heart disease and cancer.