title: Polyunsaturated fatty acid intake and risk of cardiovascular mortality in a low fish-consuming population: a prospective cohort analysis.
abstract: OBJECTIVE
  The aim of this study was to examine the relationship between polyunsaturated fatty acids (PUFA) intake (n-6 and n-3) and mortality in a population-based sample with a low fish intake.
  
  
  METHODS
  Cox regression was used to examine the relationships between dietary PUFA intake and all-cause or CVD mortality in the Australian Diabetes, Obesity and Lifestyle Study (AusDiab) cohort, a population of 11,247 Australians aged ≥25 years recruited in 1999/2000 and followed until 2012. Demographic, lifestyle and behavioural information were collected by questionnaire and fasting blood tests undertaken. Dietary intake was collected by a 121-item food frequency questionnaire. Vital status and causes of death were collected by death registry linkage.
  
  
  RESULTS
  Those in the highest quintile of n-6 PUFA intake had lower risk of CVD mortality (HR 0.57, 95 % CI 0.38-0.86) after age and sex adjustment, but this failed to retain significance after further risk factor adjustment. Consumption of ≥1 serves/week of non-fried fish was associated with reduced risk of CVD mortality (HR 0.64, 95 % CI 0.45-0.91, p = 0.013) compared to those eating less than 1 serve/month, after sex and age adjustment, but did not retain significance after further adjustment. However, long-chain n-3 intake was not associated with CVD mortality, and those in the highest quintile of n-3 intake had a higher risk of all-cause mortality.
  
  
  CONCLUSIONS
  These findings do not support previous suggestions that n-6 PUFA have adverse effects on CVD risk. Greater intake of non-fried fish was associated with lower risk of CVD mortality, but those with the highest total n-3 intake were at slightly increased risk of all-cause mortality.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, 6th Floor, The Alfred Centre, 99 Commercial Rd, Melbourne, 3004, Australia. alice.owen@monash.edu.
authors.forename: Alice J
authors.initials: AJ
authors.lastname: Owen
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, 6th Floor, The Alfred Centre, 99 Commercial Rd, Melbourne, 3004, Australia.|Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
authors.forename: Dianna J
authors.initials: DJ
authors.lastname: Magliano
authors.affiliation: Sansom Institute for Health Research, University of South Australia, Adelaide, Australia.
authors.forename: Kerin
authors.initials: K
authors.lastname: O'Dea
authors.affiliation: Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
authors.forename: Elizabeth L M
authors.initials: EL
authors.lastname: Barr
authors.affiliation: Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Shaw
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001315:Australia; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000401:mortality; D004032:Diet; D002149:Energy Intake; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000097:blood; D043371:Fatty Acids, Omega-6 / Q000008:administration & dosage* / Q000097:blood; D005260:Female; D005399:Fishes; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D017747:Seafood; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6
keywords: Cardiovascular disease; Diet; Fatty acids; Mortality