British Journal of Nutrition

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British Journal of Nutrition (2010), 103:602-607 Cambridge University Press
Copyright © The Authors 2009

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Dietary Surveys and Nutritional Epidemiology

Dietary intake of total marine n-3 polyunsaturated fatty acids, eicosapentaenoic acid, docosahexaenoic acid and docosapentaenoic acid and the risk of acute coronary syndrome – a cohort study

Albert M. Joensena1a2 c1, Erik B. Schmidta1a2, Claus Dethlefsena2, Søren P. Johnsena3, Anne Tjønnelanda4, Lars H. Rasmussena1 and Kim Overvada1

a1 Department of Cardiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark
a2 Centre for Cardiovascular Research Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark
a3 Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark
a4 Danish Cancer Society, Institute of Cancer Epidemiology, Copenhagen, Denmark
Article author query
joensen am [PubMed]  [Google Scholar]
schmidt eb [PubMed]  [Google Scholar]
dethlefsen c [PubMed]  [Google Scholar]
johnsen sp [PubMed]  [Google Scholar]
tjønneland a [PubMed]  [Google Scholar]
rasmussen lh [PubMed]  [Google Scholar]
overvad k [PubMed]  [Google Scholar]


Dietary intake of marine n-3 PUFA has been negatively associated with the risk of CHD among subjects with known CHD, whereas an effect in healthy subjects is less documented. We assessed the hypothesis that dietary intake of marine n-3 PUFA is negatively associated with the risk of acute coronary syndrome (ACS) in healthy subjects. In the Danish Diet, Cancer and Health cohort study, 57 053 participants were enrolled. Dietary intake of total n-3 PUFA, including EPA, docosapentaenoic acid (DPA) and DHA, was assessed. During a mean follow-up period of 7·6 years, we identified all cases (n 1150) from this cohort with an incident ACS diagnosis in the Danish National Patient Registry or the Cause of Death Registry. Diagnoses were verified through medical record review. In Cox proportional hazard models, we adjusted for established risk factors for CHD. Men in the four highest quintiles of n-3 PUFA intake (>0·39 g n-3 PUFA per d) had a lower incidence of ACS compared with men in the lowest quintile. The hazard ratio was 0·83 (95 % CI 0·67, 1·03) when we compared men in the second lowest and lowest quintile of n-3 PUFA intake. Higher intake of n-3 PUFA did not strengthen this association. Associations for EPA, DPA and DHA were all negative, but less consistent. No convincing associations were found among women. In conclusion, we found borderline significant negative associations between the intake of marine n-3 PUFA and ACS among healthy men.

(Received May 21 2009)

(Revised July 14 2009)

(Accepted August 26 2009)

(Online publication October 14 2009)

Key Words:n-3 Fatty acids; Acute coronary syndrome; Cohort studies


c1 Corresponding author: Dr A. M. Joensen, fax +45 99326861, email


Abbreviations: ACS, acute coronary syndrome; DPA, docosapentaenoic acid; MI, myocardial infarction