Dietary n-6 polyunsaturated fatty acids and cardiovascular disease: Epidemiologic evidence

• Published in: Prostaglandins, leukotrienes and essential fatty acids leukotrienes and essential fatty acids, 2018-08, Vol.135, p.5-9
• Main Author: Wang, Dong D.
• Format: Article
• Language: English
• Subjects: Cardiovascular disease; Cardiovascular Diseases - chemically induced; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Coronary heart disease; Dietary Fats, Unsaturated - adverse effects; Fatty Acids - administration & dosage; Fatty Acids, Omega-3 - administration & dosage; Fatty Acids, Omega-6 - administration & dosage; Fatty Acids, Unsaturated - adverse effects; Humans; Linoleic acid; n-6 polyunsaturated fatty acid; Nutrition Policy; Randomized Controlled Trials as Topic; Risk Factors; Stroke
• ISSN: 0952-3278; 1532-2823
• DOI: 10.1016/j.plefa.2018.05.003

•Prospective cohort studies support that a higher intake of n-6 polyunsaturated fat is associated with a lower risk of cardiovascular disease.•High-quality randomized controlled trials support the cardioprotective effect of replacing saturated fats by polyunsaturated fats in the diet.•Epidemiologic studies provide key evidence to the dietary guidelines that recommend replacing saturated fats by polyunsaturated fats in the diet. Epidemiologists have been studying the effect of n-6 polyunsaturated fatty acids (PUFAs) intake on the risk of cardiovascular disease (CVD) for many decades. Abundant evidence from prospective studies on the clinical endpoints of CVD, including cohort studies measuring n-6 PUFA intake by food frequency questionnaires and nested case-control studies using biomarkers of intake level, strongly support that higher intakes of n-6 PUFAs are associated with a lower risk of CVD. Furthermore, a significant reduction in CVD risk can be achieved when saturated fatty acids (SFAs) is replaced by n-6 PUFAs. Evidence from appropriately designed and vigorously executed randomized controlled trials support that high-PUFA (predominantly linoleic acid) and low-SFA diets, compared to high-SFA diets, reduced the risk of coronary heart disease. Overall, epidemiologic studies provide a solid evidence base of the current dietary guidelines that recommend replacing SFA by PUFA, both n-6 and n-3 PUFA, for CVD prevention.