Dietary linoleic acid and risk of coronary heart disease: a systematic review and meta-analysis of prospective cohort studies - PubMed (original) (raw)
Review
Dietary linoleic acid and risk of coronary heart disease: a systematic review and meta-analysis of prospective cohort studies
Maryam S Farvid et al. Circulation. 2014.
Abstract
Background: Previous studies on intake of linoleic acid (LA), the predominant n-6 fatty acid, and coronary heart disease (CHD) risk have generated inconsistent results. We performed a systematic review and meta-analysis of prospective cohort studies to summarize the evidence regarding the relation of dietary LA intake and CHD risk.
Methods and results: We searched MEDLINE and EMBASE databases through June 2013 for prospective cohort studies that reported the association between dietary LA and CHD events. In addition, we used unpublished data from cohort studies in a previous pooling project. We pooled the multivariate-adjusted relative risk (RR) to compare the highest with the lowest categories of LA intake using fixed-effect meta-analysis. We identified 13 published and unpublished cohort studies with a total of 310 602 individuals and 12 479 total CHD events, including 5882 CHD deaths. When the highest category was compared with the lowest category, dietary LA was associated with a 15% lower risk of CHD events (pooled RR, 0.85; 95% confidence intervals, 0.78-0.92; I(2)=35.5%) and a 21% lower risk of CHD deaths (pooled RR, 0.79; 95% confidence intervals, 0.71-0.89; I(2)=0.0%). A 5% of energy increment in LA intake replacing energy from saturated fat intake was associated with a 9% lower risk of CHD events (RR, 0.91; 95% confidence intervals, 0.87-0.96) and a 13% lower risk of CHD deaths (RR, 0.87; 95% confidence intervals, 0.82-0.94).
Conclusions: In prospective observational studies, dietary LA intake is inversely associated with CHD risk in a dose-response manner. These data provide support for current recommendations to replace saturated fat with polyunsaturated fat for primary prevention of CHD.
Keywords: cardiovascular disease; coronary disease; diet; linoleic acid; meta-analysis; polyunsaturated fatty acids; saturated fatty acids.
© 2014 American Heart Association, Inc.
Conflict of interest statement
Conflict of Interest Disclosures: None of the other authors had a conflict of interest to declare.
Figures
Figure 1
Search, screening and selection process of prospective cohort studies of dietary linoleic acid and risk of coronary heart disease.
Figure 2
Dietary intake of linoleic acid and relative risk of total coronary heart disease events (highest category versus lowest category). The relative risk was pooled by using fixed effects meta-analysis.
Figure 3
Dietary intake of linoleic acid and relative risk of coronary heart disease deaths (highest category versus lowest category). The relative risk was pooled by using fixed effects meta-analysis.
Figure 4
Dose-response analysis for curvilinear association between dietary intake of linoleic acid and total coronary heart disease events. P=0.91 for non-linearity relationship, indicating a linear relationship.
Figure 5
Dose-response analysis for curvilinear association between dietary intake of linoleic acid and coronary heart disease deaths. P=0.72 for non-linearity relationship, indicating a linear relationship.
Figure 6
Two-stage dose-response meta-analysis of each 5% energy increment of dietary intake of linoleic acid and relative risk of total coronary heart disease events. The relative risk was pooled by using fixed effects meta-analysis.
Figure 7
Two-stage dose-response meta-analysis of each 5% energy increment of dietary intake of linoleic acid and relative risk of coronary heart disease deaths. The relative risk was pooled by using fixed effects meta-analysis.
Comment in
- Omega-6 fatty acids and cardiovascular disease: friend, not foe?
Harris WS, Shearer GC. Harris WS, et al. Circulation. 2014 Oct 28;130(18):1562-4. doi: 10.1161/CIRCULATIONAHA.114.012534. Epub 2014 Aug 26. Circulation. 2014. PMID: 25161044 No abstract available.
Similar articles
- Dietary intake and biomarkers of linoleic acid and mortality: systematic review and meta-analysis of prospective cohort studies.
Li J, Guasch-Ferré M, Li Y, Hu FB. Li J, et al. Am J Clin Nutr. 2020 Jul 1;112(1):150-167. doi: 10.1093/ajcn/nqz349. Am J Clin Nutr. 2020. PMID: 32020162 Free PMC article. - Linoleic acid and coronary heart disease.
Harris WS. Harris WS. Prostaglandins Leukot Essent Fatty Acids. 2008 Sep-Nov;79(3-5):169-71. doi: 10.1016/j.plefa.2008.09.005. Epub 2008 Oct 31. Prostaglandins Leukot Essent Fatty Acids. 2008. PMID: 18951772 Review. - Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis.
Ramsden CE, Zamora D, Leelarthaepin B, Majchrzak-Hong SF, Faurot KR, Suchindran CM, Ringel A, Davis JM, Hibbeln JR. Ramsden CE, et al. BMJ. 2013 Feb 4;346:e8707. doi: 10.1136/bmj.e8707. BMJ. 2013. PMID: 23386268 Free PMC article. Clinical Trial. - Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies.
de Souza RJ, Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T, Uleryk E, Budylowski P, Schünemann H, Beyene J, Anand SS. de Souza RJ, et al. BMJ. 2015 Aug 11;351:h3978. doi: 10.1136/bmj.h3978. BMJ. 2015. PMID: 26268692 Free PMC article. Review.
Cited by
- Beneficial effects of linoleic acid on cardiometabolic health: an update.
Jackson KH, Harris WS, Belury MA, Kris-Etherton PM, Calder PC. Jackson KH, et al. Lipids Health Dis. 2024 Sep 12;23(1):296. doi: 10.1186/s12944-024-02246-2. Lipids Health Dis. 2024. PMID: 39267068 Free PMC article. Review. - Enteropathway: the metabolic pathway database for the human gut microbiota.
Shiroma H, Darzi Y, Terajima E, Nakagawa Z, Tsuchikura H, Tsukuda N, Moriya Y, Okuda S, Goto S, Yamada T. Shiroma H, et al. Brief Bioinform. 2024 Jul 25;25(5):bbae419. doi: 10.1093/bib/bbae419. Brief Bioinform. 2024. PMID: 39222063 Free PMC article. - Eight-year diet and physical activity intervention affects serum metabolites during childhood and adolescence: A nonrandomized controlled trial.
Zarei I, Eloranta AM, Klåvus A, Väistö J, Lehtonen M, Mikkonen S, Koistinen VM, Sallinen T, Haapala EA, Lintu N, Soininen S, Haikonen R, Atalay M, Schwab U, Auriola S, Kolehmainen M, Hanhineva K, Lakka TA. Zarei I, et al. iScience. 2024 Jun 17;27(7):110295. doi: 10.1016/j.isci.2024.110295. eCollection 2024 Jul 19. iScience. 2024. PMID: 39055945 Free PMC article. - Hydroxytyrosol Linoleoyl Ether Ameliorates Metabolic-Associated Fatty Liver Disease Symptoms in Obese Zucker Rats.
Tovar R, de Ceglia M, Rodríguez-Pozo M, Vargas A, Gavito A, Suárez J, Boronat A, de la Torre R, de Fonseca FR, Baixeras E, Decara J. Tovar R, et al. ACS Pharmacol Transl Sci. 2024 Apr 4;7(5):1571-1583. doi: 10.1021/acsptsci.4c00105. eCollection 2024 May 10. ACS Pharmacol Transl Sci. 2024. PMID: 38751648 - Plasma Metabolic Profiling and Multiclass Diagnostic Model Development for Stable Angina Pectoris and Acute Myocardial Infarction.
Lu R, Lin W, Jin Q, Wang D, Zhang C, Wang H, Chen T, Gao J, Wang X. Lu R, et al. ACS Omega. 2024 Mar 26;9(14):16322-16333. doi: 10.1021/acsomega.3c10474. eCollection 2024 Apr 9. ACS Omega. 2024. PMID: 38617635 Free PMC article.
References
- Harris WS, Mozaffarian D, Rimm E, Kris-Etherton P, Rudel LL, Appel LJ, Engler MM, Engler MB, Sacks F. Omega-6 fatty acids and risk for cardiovascular disease: a science advisory from the American Heart Association Nutrition Subcommittee of the Council on Nutrition, Physical Activity, and Metabolism; Council on Cardiovascular Nursing Council on Epidemiology and Prevention. Circulation. 2009;119:902–907. - PubMed
- Hu FB, Stampfer MJ, Manson JE, Rimm E, Colditz GA, Rosner BA, Hennekens CH, Willett WC. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med. 1997;337:1491–1499. - PubMed
- Jakobsen MU, O’Reilly EJ, Heitmann BL, Pereira MA, Bälter K, Fraser GE, Goldbourt U, Hallmans G, Knekt P, Liu S, Pietinen P, Spiegelman D, Stevens J, Virtamo J, Willett WC, Ascherio A. Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies. Am J Clin Nutr. 2009;89:1425–1432. - PMC - PubMed
- Mozaffarian D, Wu JH. Omega-3 fatty acids and cardiovascular disease: effects on risk factors, molecular pathways, and clinical events. J Am Coll Cardiol. 2011;58:2047–2067. - PubMed
Publication types
MeSH terms
Substances
Grants and funding
- R01 DK058845/DK/NIDDK NIH HHS/United States
- U01 CA167552/CA/NCI NIH HHS/United States
- UM1 CA167552/CA/NCI NIH HHS/United States
- R01 HL060712/HL/NHLBI NIH HHS/United States
- P01 CA055075/CA/NCI NIH HHS/United States
- HL60712/HL/NHLBI NIH HHS/United States
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical