
Individuals with prediabetes or diabetes may benefit from increased dietary intake of n-3 polyunsaturated fatty acids (PUFAs), particularly alpha-linolenic acid (ALA) and docosapentaenoic acid (DPA), which help lower the risk of all-cause and cardiovascular mortality, suggests a US study.
Overall, 16,539 eligible individuals from the National Health and Nutrition Examination Survey (NHANES) 2003 to 2008 were enrolled and categorized into T1, T2, and T3 based on the tertiles of n-3 PUFA. The investigators evaluated the association between n-3 PUFA and mortality via Cox proportional risk regression models, Kaplan-Meier curve, and subgroup analyses.
Restricted cubic spline (RCS) curves were used to graphically show the dose-response relationship. In addition, the mixed and individual effects of n-3 PUFA on mortality were assessed by using weighted quantile sum (WQS) models.
A total of 3,010 individuals died during a median follow-up of 8.42 years, with 989 deaths due to cardiovascular (CV) disease.
After adjusting for multiple variables, higher intake of n-3 PUFAs resulted in a significantly reduced risk of all-cause (T2: 0.81, 95 percent confidence interval [CI], 0.71‒0.92; T3: 0.77, 95 percent CI, 0.64‒0.94) and CV mortality (T2: 0.75, 95 percent CI, 0.61‒0.93) compared with the reference (T1).
In RCS curves, a negative nonlinear association was noted between n-3 PUFA and mortality. In subgroup analyses, none of the interactions reached statistical significance, except for BMI (p=0.049 for interaction). Notably, WQS analysis revealed that ALA and DPA were the main contributors to the benefits of n-3 PUFAs against mortality.