title: Omega 3:6 ratio intake and incidence of glaucoma: the SUN cohort.
abstract: OBJECTIVE
  Omega 3 and omega 6 polyunsaturated fatty acids have been related to many diseases, especially to cardiovascular diseases. We aimed to assess the association between the intake of omega 3, omega 6 fatty acids and their ratio and the incidence of glaucoma in this prospective cohort study.
  
  
  METHODS
  We followed-up 17,128 participants initially free of glaucoma for a median time of 8.2 years. Validated data of diet were collected at baseline with a 136-item semi-quantitative food-frequency questionnaire and information of new diagnosis of glaucoma in biennial follow-up questionnaires. Multivariable Cox regression models were fit to assess the relationship between omega 3, omega 6 and their ratio and the incidence of glaucoma in the total sample and in participants aged ≥40 years at baseline.
  
  
  RESULTS
  During a median follow-up time of 8.2 years, 156 new cases of glaucoma were identified. No significant association was observed for the omega 3 or the omega 6 intake and the risk of glaucoma. Participants in the highest quintile of omega 3:6 ratio intake had a significantly higher risk of glaucoma than participants in the lowest quintile (hazard ratio (HR): 1.91 [95%CI: 1.05-3.46], p for trend 0.03). The association became stronger (HR for the comparison of the 5th versus the 1st quintile: 2.43 [95%CI: 1.17-5.03], p for trend 0.02) when we considered only those participants who were ≥40 years old.
  
  
  CONCLUSIONS
  Our data suggest an association between omega 3:6 ratio intake and incident glaucoma in our cohort, especially among older participants.
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine-Clinic, University of Navarra, Pamplona, Navarra, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: Pérez de Arcelus
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine-Clinic, University of Navarra, Pamplona, Navarra, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Spain. Electronic address: etoledo@unav.es.
authors.forename: Estefanía
authors.initials: E
authors.lastname: Toledo
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine-Clinic, University of Navarra, Pamplona, Navarra, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Instituto de Salud Carlos III (ISCIII), Spanish Government, Spain.
authors.forename: Miguel Á
authors.initials: MÁ
authors.lastname: Martínez-González
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine-Clinic, University of Navarra, Pamplona, Navarra, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Sayón-Orea
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine-Clinic, University of Navarra, Pamplona, Navarra, Spain.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Gea
authors.affiliation: Department of Ophthalmology, School of Medicine-Clinic, University of Navarra, Pamplona, Navarra, Spain; RETICS Prevención, detección precoz y tratamiento de la patología ocular prevalente, degenerativa y crónica (RD12/0034), Instituto de Salud Carlos III (ISCIII), Spanish Government, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Moreno-Montañés
mesh_terms: D000328:Adult; D004032:Diet; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D043371:Fatty Acids, Omega-6 / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6
keywords: Cohort study; Glaucoma; Omega 3:6 ratio; SUN