title: Fish Consumption, Omega-3 Fatty Acids, and Risk of Cardiovascular Disease.
abstract: BACKGROUND
  Data on omega-3 polyunsaturated fatty acids in relation to cardiovascular disease are limited in women. The aim of this study was to examine longitudinal relations of tuna and dark fish, α-linolenic acid, and marine omega-3 fatty acid intake with incident major cardiovascular disease in women.
  
  
  METHODS
  This was a prospective cohort study of U.S. women participating in the Women's Health Study from 1993 to 2014, during which the data were collected and analyzed. A total of 39,876 women who were aged ≥45 years and free of cardiovascular disease at baseline provided dietary data on food frequency questionnaires. Analyses used Cox proportional hazards models to evaluate the association between fish and energy-adjusted omega-3 polyunsaturated fatty acid intake and the risk of major cardiovascular disease, defined as a composite outcome of myocardial infarction, stroke, and cardiovascular death, in 38,392 women in the final analytic sample (96%).
  
  
  RESULTS
  During 713,559 person years of follow-up, 1,941 cases of incident major cardiovascular disease were confirmed. Tuna and dark fish intake was not associated with the risk of incident major cardiovascular disease (p-trend >0.05). Neither α-linolenic acid nor marine omega-3 fatty acid intake was associated with major cardiovascular disease or with individual cardiovascular outcomes (all p-trend >0.05). There was no effect modification by age, BMI, or baseline history of hypertension.
  
  
  CONCLUSIONS
  In this cohort of women without history of cardiovascular disease, intakes of tuna and dark fish, α-linolenic acid, and marine omega-3 fatty acids were not associated with risk of major cardiovascular disease.
authors.affiliation: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Division of Aging, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Palo Alto, California. Electronic address: rheej@stanford.edu.
authors.forename: Jinnie J
authors.initials: JJ
authors.lastname: Rhee
authors.affiliation: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Eunjung
authors.initials: E
authors.lastname: Kim
authors.affiliation: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Julie E
authors.initials: JE
authors.lastname: Buring
authors.affiliation: Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Kurth
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D017747:Seafood / Q000706:statistics & numerical data*; D014413:Tuna; D014481:United States / Q000453:epidemiology
chemical_list: D015525:Fatty Acids, Omega-3