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Search Plan and Results Question
What is the relationship between consumption of plant n-3 fatty acids and risk of cardiovascular disease? (DGAC 2010)
What is the relationship between consumption of seafood n-3 fatty acids and risk of cardiovascular disease? (DGAC 2010)
Date Searched
8/21/09
Inclusion Criteria
Subjects/Population
Age: Adults (19 years +)
Setting: Any, except ICU, Burn Unit or Emergency Care, US and International
Health Status:
- Healthy
- Dyslipidemia, Hyperlipidemia* or Hypercholesterolemia, CHD, CVD
*According to ATP III (2004), hyperlipidemia is defined as a TC greater than 200 and/or LDL-C greater than 130 without CVD; LDL-C greater than 100 with CVD; and LDL-C greater than 70 for patients with a CHD event, stroke, TIA, peripheral vascular disease AND ONE OF THE FOLLOWING:1) acute coronary syndrome, 2) type 2 diabetes mellitus, 3) metabolic syndrome, 4) a SINGLE POORLY CONTROLLED risk factor, 5) 3 risk factors irrespective of how well controlled.
Note: in ATP III, diabetes is regarded as a CHD risk equivalent.
Nutrition Related Problem/Condition:
Cardiac Events: MI, arythmia, angioplasty, stent, death
Study design preferences:
- Meta-analysis and Systematic reviews
- RCT or Clinical Controlled Studies
- Large nonrandomized observational studies
- Prospective Cohort, large case-control studies
- Cross Sectional Studies (last resort)
Feeding period must be greater than 4 weeks.
Size of study groups:
- Sample size must equal 10 subjects for each study group. For example, this would include 10 subjects in the intervention group and 10 subjects in the control or comparison group.
Study dropout rate: Less than 20%; preference for smaller dropout rates
Year Range: March 2004 –Dec 2007 (covered by ADA) July 2007 to Aug 2009 (covered by USDA)
Authorship:
- If an author is included on more than one Review Article or primary research article that is similar in content, the most recent review or article will be accepted and earlier versions will be rejected.
- If an author is included on more than one Review Article or primary research article and the content is different, then both reviews may be accepted.
Languages: Limited to articles in English
Other: Article must be published in peer-reviewed journal
Exclusion Criteria
Subjects/Population
Age: Infants, Children and adolescents <19 years
Setting: ICU, Burn Unit, Emergency Care
Health Status:
- Presence of diabetes
- TC less than or equal to 200 and/or LDL-C less than or equal to 130. Also, see inclusion criteria
Nutrition Related Problem/Condition: (i.e., eating disorders)
Cardiac Events: stroke, triglyceride, lipids, inflammatory markers
Size of study groups: Sample sizes < 10
Study Designs:
- Small case studies
- Cross sectional Studies
- Feeding periods <4 weeks.
- Experimental fat must be from natural sources
Study Dropout rate: Dropout rate in a study is 20% or greater
Year Range: Prior to July 2007 included in ADA analysis
Authorship: Studies by same author similar in content
Languages: Articles not in English
Other: Animal studies; Abstracts or presentations
Search Terms: Search Vocabulary
(arrhythmia* OR "Arrhythmias, Cardiac"[Mesh] OR "Arrhythmia, Sinus"[Mesh]) AND ("Fatty Acids, Omega-3"[Mesh] OR “Docosahexaenoic Acids”[mh] OR "alpha-Linolenic Acid"[Mesh] OR "SR 3 linolenic acid "[Substance Name] OR "8, 11, 14-Eicosatrienoic Acid"[Mesh] OR "Fish Oils"[Mesh] OR “Plant Oils”)
("Fatty Acids, Omega-3"[Mesh] OR "Fish Oils"[Mesh] OR "alpha-Linolenic Acid"[Mesh] OR "SR 3 linolenic acid "[Substance Name] OR "8, 11, 14-Eicosatrienoic Acid"[Mesh]) AND ("Death, Sudden, Cardiac"[Mesh OR "Biological Markers"[Mesh] OR "Coronary Disease"[Mesh] OR "Myocardial Infarction"[Mesh] OR "Cardiovascular Diseases"[Mesh])
("Fatty Acids, Omega-3"[Mesh] OR “Docosahexaenoic Acids” "alpha-Linolenic Acid"[Mesh] OR "SR 3 linolenic acid "[Substance Name] OR "8, 11, 14-Eicosatrienoic Acid"[Mesh]) AND ("Fish Oils"[Mesh] OR “Plant Oils”) AND ("Biological Markers"[Mesh] OR "Coronary Disease"[Mesh] OR "Myocardial Infarction"[Mesh] OR "Cardiovascular Diseases"[Mesh:NoExp] OR “blood pressure”[mh] OR hypertension[mh])
Total hits from all electronic database searches: 371
Total articles identified to review from electronic databases: 60
Number of Primary Articles Identified: 21
Number of Review Articles Identified: 4
Total Number of Articles Identified: 22
Number of Articles Reviewed but Excluded: 32
Seafood n-3 fatty acid question:
What is the relationship between consumption of Seafood n-3 fatty acids and risk of cardiovascular disease?
He K, Song Y, Daviglus ML, Liu K, Van Horn L, Dyer AR, Greenland P. Accumulated evidence on fish consumption and coronary heart disease mortality: a meta-analysis of cohort studies.Circulation. 2004 Jun 8;109(22):2705-11. PubMed PMID: 15184295.
Yamagishi K, Iso H, Date C, Fukui M, Wakai K, Kikuchi S, Inaba Y, Tanabe N, Tamakoshi A; Japan Collaborative Cohort Study for Evaluation of Cancer Risk Study Group. Fish, omega-3 polyunsaturated fatty acids, and mortality from cardiovascular diseases in a nationwide community-based cohort of Japanese men and women the JACC (Japan Collaborative Cohort Study for Evaluation of Cancer Risk) Study. J Am Coll Cardiol. 2008 Sep 16;52(12):988-96. PMID: 18786479.
Plant n-3 fatty acids question:
What is the relationship between consumption of Plant n-3 fatty acids and risk of cardiovascular disease?
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 Nov 22;112(21):3232-8. PMID: 16301356 (ADA).
Lemaitre RN, King IB, Sotoodehnia N, Rea TD, Raghunathan TE, Rice KM, Lumley TS, Knopp RH, Cobb LA, Copass MK, Siscovick DS. Red blood cell membrane alpha-linolenic acid and the risk of sudden cardiac arrest. Metabolism. 2009 Apr;58(4):534-40. PMID: 19303975.
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Articles
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Reasons for Exclusion
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Measures omega-3 index of admitted ACS patients No intervention. Cross sectional Study.
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Cross Sectional Study. Uses plasma fatty acid concentrations as marker to dietary n-3 fatty acids determined by FFQ.
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Intervention provided as capsules
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No dietary intervention.
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Outcomes measured involved inhibition of cognitive decline in hypertension
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Intervention provided as capsules
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Cazzola R, Russo-Volpe S, Miles EA, Rees D, Banerjee T, Roynette CE, Wells SJ, Goua M, Wahle KW, Calder PC, Cestaro B.Age- and dose-dependent effects of an eicosapentaenoic acid-rich oil on cardiovascular risk factors in healthy male subjects.Atherosclerosis. 2007 Jul;193(1):159-67. Epub 2006 Aug 1. PMID: 16879829
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Intervention provided as capsules
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Narrative review
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Studies frequency, processing and type of fish consumption on plasma fatty acids.
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Intermediate outcome, not CVD event s
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Intermediate outcomes, not CVD event
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Reported outcomes limited to FA composition of mononuclear cells
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Intervention provided as capsules
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Delgado-Lista J, Lopez-Miranda J, Cortés B, Perez-Martinez P, Lozano A, Gomez-Luna R, Gomez P, Gomez MJ, Criado J, Fuentes F, Perez-Jimenez F.Chronic dietary fat intake modifies the postprandial response of hemostatic markers to a single fatty test meal. Am J Clin Nutr. 2008 Feb;87(2):317-22. PMID: 18258620
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Intervention does not meet criteria. Single test meal.
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De Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. 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. PubMed ID:9989963.
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Intervention provided as dietary advice
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Intermediate outcome not CVD event s
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Intermediate outcome Qtrr measurments, not CVD events
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Dodin S, Cunnane SC, Mâsse B, Lemay A, Jacques H, Asselin G, Tremblay-Mercier J, Marc I, Lamarche B, Légaré F, Forest JC.Flaxseed on cardiovascular disease markers in healthy menopausal women: a randomized, double-blind, placebo-controlled trial. Nutrition. 2008 Jan;24(1):23-30. Epub 2007 Nov 5. PMID: 17981439.
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Intermediate outcomes, not CVD event
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Ebbesson SO, Roman MJ, Devereux RB, Kaufman D, Fabsitz RR, Maccluer JW, Dyke B, Laston S, Wenger CR, Comuzzie AG, Romenesko T, Ebbesson LO, Nobmann ED, Howard BV.Consumption of omega-3 fatty acids is not associated with a reduction in carotid atherosclerosis: the Genetics of Coronary Artery Disease in Alaska Natives study.Atherosclerosis. 2008 Aug;199(2):346-53. Epub 2007 Dec 4. PMID: 18054937.
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Intermediate outcome not CVD event s
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Intermediate outcome Qtrr measurments, not CVD events
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Study involves Markers ofn–3 LCPUFA. Does not address question
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Freund-Levi Y, Hjorth E, Lindberg C, Cederholm T, Faxen-Irving G, Vedin I, Palmblad J, Wahlund LO, Schultzberg M, Basun H, Eriksdotter Jönhagen M.Effects of omega-3 fatty acids on inflammatory markers in cerebrospinal fluid and plasma in Alzheimer's disease: the OmegAD study.Dement Geriatr Cogn Disord. 2009;27(5):481-90. Epub 2009 May 12. PMID: 19439966..
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Intervention provided as capsules
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Intermediate outcomes, not CVD event
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Narrative Review
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Gissi-HF Investigators, Tavazzi L, Maggioni AP, Marchioli R, Barlera S, Franzosi MG, Latini R, Lucci D, Nicolosi GL, Porcu M, Tognoni G.Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial.Lancet. 2008 Oct 4;372(9645):1223-30. Epub 2008 Aug 29. PMID: 18757090..
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Subjects had chronic heart failure.
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Goyens PL, Mensink RP. Effects of alpha-linolenic acid versus those of EPA/DHA on cardiovascular risk markers in healthy elderly subjects. Eur J Clin Nutr. 2006 Aug;60(8):978-84. Epub 2006 Feb 15. PMID: 16482073
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Intermediate outcome Qtrr measurments, not CVD events
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Study involves n-3/n-6 ratio. Not variables that address the question.
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Narrative review
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Reviewed outcomes did not distinguish supplements from dietary
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Intermediate outcome not CVD events
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He K, Liu K, Daviglus ML, Mayer-Davis E, Jenny NS, Jiang R, Ouyang P, Steffen LM, Siscovick D, Wu C, Barr RG, Tsai M, Burke GL.Intakes of long-chain n-3 polyunsaturated fatty acids and fish in relation to measurements of subclinical atherosclerosis.Am J Clin Nutr. 2008 Oct;88(4):1111-8. PMID: 18842801.
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Intermediate outcome not CVD events
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Reported outcomes limited to FA composition of plasma based on diet
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