The evidence regarding fatty acids and breast cancer risk is inconclusive. Adipose tissue fatty acids can be used as biomarkers of fatty acid intake and of endogenous fatty acid exposure. Fatty acids in adipose tissue are correlated owing to common dietary sources and shared metabolic pathways, which group fatty acids into naturally occurring patterns. We aimed to prospectively investigate associations between adipose tissue fatty acid patterns and long-term risk of total breast cancer and breast cancer subtypes characterised by oestrogen and progesterone receptor status (ER and PR).
This case-cohort study was based on data from the Danish cohort Diet, Cancer and Health. At baseline, a fat biopsy and information on lifestyle and reproductive factors were collected. From the 31 original fatty acids measured, patterns of fatty acids were identified using the treelet transform. During a median follow-up of 5.3 years, 474 breast cancer cases were identified. Hazard ratios and 95% confidence intervals of risk of total breast cancer and of subtypes according to quintiles of factor score were determined by weighted Cox proportional hazards regression.
After adjustment for potential confounders, factor scores for the seven patterns identified by the treelet transform were not associated with risk of total breast cancer, nor with risk of ER+, ER-, PR+ or PR- tumours.
No clear associations between the patterns of fatty acids at baseline and long-term risk of total breast cancer or ER+, ER-, PR+ or PR- tumours were observed.
Obesity is a modifiable risk factor for acute myocardial infarction (MI), but lean body mass (LBM) may also be an important factor. Low LBM may increase the risk of MI and LBM may modify the effect of obesity on MI. Thus, the inability of the classical anthropometric measures to evaluate LBM may lead to misclassification of MI risk in both lean and obese persons. We investigated the associations between incident MI and bioelectrical impedance analyses (BIA) derived measures of body composition in combination with body mass index (BMI) and anthropometric measures of body fat distribution.
From 1993 to 1997, 27?148 men and 29?863 women, aged 50 to 64 year, were recruited into the Danish prospective study Diet, Cancer and Health. During 11.9 years of follow-up we identified 2028 cases of incident MI (1487 men and 541 women). BMI, waist circumference (WC), hip circumference and BIA of body composition including body fat mass (BFM), body fat percentage and LBM were measured at baseline. We used Cox proportional hazard models with age as time axis and performed extensive control for confounding. Weight, BMI, classical estimates of abdominal obesity and BIA estimates of obesity showed significant positive associations with incident MI. However, BFM adjusted for WC showed no association. Low LBM was associated with a higher risk of incident MI in both genders, and high LBM was associated with a higher risk in men.
Obesity was positively associated with MI. Estimates of obesity achieved by BIA seemed not to add additional information to classical anthropometric measures regarding MI risk. Both high and low LBM may be positively associated with MI.
All serum protein electrophoresis performed in the period 1 May 1979-30 April 1982 in the county of Northern Jutland, Denmark, were studied to find the annual detection rate and the clinical significance of a monoclonal gammopathy (MG) in different age groups. A monoclonal gammopathy was found in 325 persons (185 males and 140 females). The average annual detection rate of MG per 100,000 individuals increased with age in both sexes (p less than 0.01, Kolmogorov test). The lowest and highest detection rate for males/females were 2.8/3.3 (age group less than 50 years) and 236.8/100.3 (age group greater than or equal to 80 years) per 100,000 individuals, respectively. Monoclonal gammopathy was associated with a B-cell malignancy in 28 percent (95% confidence limits 23.9-32.4%) of the persons irrespective of sex and age.
The low incidence of myocardial infarction in Greenland Eskimos may be due to their intake of marine food with a high content of n-3 polyunsaturated fatty acids (PUFAs). In Eskimos the platelet count is lowered, the platelet aggregation is inhibited, the bleeding time is prolonged and the ratio between proaggregatory thromboxanes and anti-aggregatory prostacyclins is decreased, when compared to age- and sex-matched Danes. In this review, studies evaluating the effect of a fish diet or fish-oil supplementation on human platelet function are summarized. Most studies have demonstrated that supplementation with n-3 PUFAs can cause inhibition of platelet behaviour. The optimal dose of n-3 PUFAs and the patient groups most likely to profit from supplementation need to be defined. The safety and the clinical effect of the supplementation should be investigated in long-term studies.
Previous studies in Greenland suggest that death rates from ischemic heart disease [IHD] are lower in Eskimos than in Danes and other Caucasian populations. This has been explained by a high intake of n-3 polyunsaturated fatty acids with beneficial effects on blood lipids and hemostasis. In other populations, lipoprotein(a) [Lp(a)] is associated with IHD, plasma concentrations of Lp(a) being genetically determined to a major extent. We have compared Lp(a) concentrations and apo(a) phenotypes in 120 Greenlandic Eskimos with those in 466 Danish men. The median Lp(a) concentration in Eskimos (8.7 mg/dl;[95% CI 6.5-10.7]) was not significantly different from that in Danes (6.3 mg/dl; [95% CI 5.2-7.0]), whereas the 90th percentile was significantly higher among Danes: 46.36 mg/dl; [95% CI 43.0-54.3] vs. 27.6 mg/dl [95% CI 20.7-36.9]. In 20% of the Danes, but in only 8% of the Eskimos (P = 0.009), the concentration of Lp(a) exceeded 30 mg/dl. The difference is probably explained by a low frequency of the low molecular weight apo(a) phenotypes among Eskimos, since the apo(a) isoforms F and B were absent, and the S1 and S2 types were present in only 3.3% of Eskimos. In contrast, these apo(a) isoforms were present in 26.6% of the Danes in either single-band or double-band phenotypes. The pattern of apo(a) polymorphism found in this study could provide part of a genetic explanation for the putative low rates of IHD in Eskimo populations.
BACKGROUND: Studies of long-term intake of industrially produced trans fatty acids (TFA) and n-3 polyunsaturated fatty acids (PUFA) suggest opposite effects on cardiovascular disease risk. Common mechanisms of action are probable. OBJECTIVE: To examine the effects on cardiovascular risk markers of dietary enrichment with TFA or n-3 PUFA. DESIGN: Randomized, double-blind, parallel intervention trial. SETTING: Department of Human Nutrition, The Royal Veterinary and Agricultural University. SUBJECTS: In all, 87 healthy males included, 79 completed. INTERVENTION: Subjects were randomly assigned to 8 weeks of a daily intake of 33 g of experimental fats from either partially hydrogenated soy oil containing 20 g of TFA, 12 g of fish oil with approximately 4 g of n-3 PUFA and 21 g of control fat, or 33 g of control fat. The experimental fats were incorporated into bakery products. Plasma lipids, blood pressure, heart rate variability (HRV), arterial dilatory capacity, compliance, and distensibility were recorded before and after intervention and at follow-up 12 weeks after the intervention. RESULTS: High-density lipoprotein cholesterol (HDL-C) decreased in the TFA group and triglycerides and mean arterial blood pressure decreased in the n-3 PUFA group compared to the control group. HRV, arterial dilatory capacity, compliance, and distensibility were unchanged. CONCLUSION: The results indicate that the association between coronary heart disease risk and intake of TFA and n-3 PUFA relates only modestly to changes in traditional risk markers. SPONSORSHIP: Danish Medical Research Council (Grant no. 22-01-0390), Center of Advanced Food Research (Copenhagen, Denmark) (Grant no. KVL-R-2001-107), the Danish Heart Association (Grant no. 99-2-3-45-22748), Novozymes (Bagsvaerd, Denmark), Aarhus Olie (Aarhus, Denmark), and from private sources. The experimental fats were provided by Pronova Biocare (Aalesund, Norway) and Aarhus Olie (Aarhus, Denmark).
OBJECTIVES: Dietary n-3 polyunsaturated fatty acids (PUFA) derived from fish may reduce the incidence of sudden cardiac death (SCD). The aim of the present study was to examine associations between n-3 PUFA and 24-h heart rate variability in patients with type 1 and type 2 diabetes mellitus (DM). DESIGN: Observational study. SETTING: The out-patient's diabetic clinic at Hjørring Hospital, Hjørring, Denmark. SUBJECTS: Forty-three patients with type 1 DM and 38 patients with type 2 DM. MAIN OUTCOME MEASURES: The patients fulfilled a food-questionnaire regarding fish consumption, whilst the content of n-3 PUFA in platelets was measured and 24-h heart rate variability (HRV) was obtained. RESULTS: The patients fish consumption was strongly related to their content of n-3 PUFA in platelets. Furthermore, in patients with type 1 DM a close positive association was found between the content of n-3 PUFA in platelets and 24-h HRV. This association was not significant in patients with type 2 DM. CONCLUSIONS: The positive association between n-3 PUFA in platelets and HRV may indicate a beneficial effect of n-3 PUFA on HRV in patients with type 1 DM. Further studies are warranted to clarify whether supplementation with n-3 PUFA reduce the risk of SCD amongst patients with DM.
Patients with homozygous homocystinuria are at greatly increased risk for development of atherosclerosis and thrombosis (1). Elevated plasma levels of homocysteine (HCY) are caused by reduced enzymatic catabolism or reduced enzymatic remethylation of HCY, due to either hereditary enzyme defects or to nutritional deficiencies of vitamins functioning as cofactors. However, several recent studies have suggested that persons with mildly elevated plasma levels of HCY also are at increased risk for coronary heart disease. (2-4). There are some indications that dietary n-3 polyunsaturated fatty acids (PUFAs) may offer protection against coronary heart disease (5-6). Several mechanisms may be involved, including beneficial effects of n-3 PUFAs on plasma lipids, platelet and leukocyte reactivity, blood pressure and vasoreactivity (7). Interestingly, Olszewski el al. recently found HCY-levels to be lowered 36% in 15 type IIa or IIb hyperlipemic men by n-3 PUFA supplementation. A possible beneficial effect of n-3 PUFA on the incidence of coronary heart disease was initially suggested from studies in Greenland Inuits by our group (8). We therefore investigated plasma levels of homocysteine in a group of traditionally living Greenland Inuits with a diet consisting mainly of marine food and with a very high content of n-3 PUFAs.
The electrocardiogram (ECG) is the only means of diagnosing atrial infarction antemortem. Certain ECG changes (PR-segment displacements) have been taken earlier as signs of atrial infarction. The purpose of this study was to assess the interobserver variation on suggested ECG signs of atrial infarction in patients admitted with acute myocardial infarction. The ECGs from 290 patients were evaluated by three physicians with respect to the occurrence of each of the following seven criteria suggestive of atrial infarction: (1) PR-segment elevation > 0.5 mm in lead I; (2) PR-segment depressions > 0.5 mm in leads II and III; (3) PR-segment depressions > 1.2 mm in leads I, II, and III; (4) PR-segment depressions > 0.5 mm in leads V1 and V2; (5) PR-segment elevations > 0.5 mm in leads V5 and V6; (6) PR-segment depressions > 1.5 mm in precordial leads; and (7) abnormal P waves. Kappa values ranged from 0.00-0.86. Of the seven criteria tested only criteria 2, 4, and 7 could be detected in a reasonable number of patients. The interobserver variations of these criteria were considerable, although the strength of agreement could be designated as fair to moderate.
In order to evaluate the effect of marine n-3 polyunsaturated fatty acids (n-3 PUFA) on systolic left ventricular function, we investigated the effect of daily supplementation with 5.2 g n-3 PUFA for 12 weeks in 55 patients with a recent myocardial infarction in a double blind placebo-controlled design. Left ventricular function was assessed by transthoracal echo-cardiography and plasma concentration of proANP and N-terminal proANP. No effect of n-3 PUFA could be demonstrated on these indices of left ventricular function.