Ph.D. - Biomedical Sciences (Epidemiology)
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ItemEthnic differences in fish and other sources of omega-3 fatty acids and mortality from coronary heart disease, stroke, and hypertension in a multiethnic cohort([Honolulu] : [University of Hawaii at Manoa], [December 2010], 2010-12)Background: Fish and other sources for omega-3 fatty acids (ω3) were found to be protective against cardiovascular diseases (CVD). However, little is known regarding whether the levels of benefit differ by food sources or by ethnicity. This research studied how sources of ω3 contribute to its effects on coronary heart disease (CHD), stroke, and hypertension mortality among African-Americans, Caucasians, Japanese, Native Hawaiians, and Latinos in the Multiethnic Cohort. These groups have varying sources of ω3 and CVD mortality rates. Methods: Using data from over 180,000 adults aged 45-75, residing in Hawaii and Los Angeles County, relative risks (RR) of mortality due to CHD and stroke overall by sex and ethnicity were computed by Cox regression for ω3 sources, adjusting for known risk factors. Results: Fish, vegetable oils, and soy products were major ω3 sources. There were 4,516 CHD deaths and 1,789 stroke deaths during an average of 11.9 years of follow-up through the end of 2005. ω3 was inversely associated with CHD mortality (5th vs. 1st quintile: RR=0.77, 95% Confidence Intervals=0.60-0.98) in men, but the trend was unclear in women. Whereas fried fish was positively related to CHD risk, baked, boiled or raw fish had an inverse relation in men. Salted and dried fish intake was positively related to CHD risk, while oils, shoyu and tofu had inverse relations in both sexes. Canned tuna was inversely associated with stroke mortality, as were ω3 and oils. Fried fish was positively related to stroke risk in men, while total fish had an inverse relation in women. Baked, boiled and raw fish was inversely related to stroke risk, except among Japanese men (p=0.0014 for interaction). Salted and dried fish was positively related to hemorrhagic but not ischemic stroke mortality. Conclusions: The findings suggest a cardiovascular protective effect of ω3 that varied by source and preparation method. Fresh fish, soy products, and vegetable oils may be protective, while fried, salted, or dried fish may be detrimental, especially leading to the high hemorrhagic stroke mortality in Japanese men, presumably due to their respective high level of trans fat or sodium.