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Serum fatty acid levels, dietary style and coronary heart disease in three neighbouring areas in Japan: the Kumihama study

Published online by Cambridge University Press:  09 March 2007

Tomoki Nakamura*
Affiliation:
Department of Medicine, Kumihama Municipal Hospital, Kyoto, Japan Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
Akihiro Azuma
Affiliation:
Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
Toshiro Kuribayashi
Affiliation:
Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
Hiroki Sugihara
Affiliation:
Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
Seisuke Okuda
Affiliation:
Department of Medicine, Kumihama Municipal Hospital, Kyoto, Japan
Masao Nakagawa
Affiliation:
Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
*
*Corresponding author: Dr Tomoki Nakamura, fax +81 75 251 5514, email tomnak@koto.kpu-m.ac.jp
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Abstract

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CHD mortality is extremely low in Japan, particularly in rural districts, when compared with that in Western countries. This has been partly attributed to the difference in dietary lifestyle. We investigated the factors influencing CHD mortality in a rural coastal district of Japan, comprising mercantile, farming, and fishing areas with distinct dietary habits. We prospectively examined the incidence of CHD from 1994 to 1998, as well as coronary risk factors and serum fatty acid concentrations. The incidence of angina pectoris was significantly (P=0·01) lower in the fishing area than in the mercantile and farming areas. Blood pressure, physical activity, prevalence of diabetes, serum levels of uric acid and HDL-cholesterol were similar between the three areas. Total- and LDL-cholesterol levels were significantly lower but the smoking rate was markedly higher in the fishing area than in the other two areas. Serum levels of saturated fatty acids and n−6 polyunsaturated fatty acids (PUFA) were lowest in the fishing area, but n−3 PUFA did not differ significantly. The n−6:n−3 PUFA ratio was lowest and eicosapentaenoic:arachidonic acid was highest in the fishing area. Although many previous studies have emphasized the beneficial effect of n−3 PUFA in preventing CHD, the present study indicated that a lower intake of n−6 PUFA and saturated fatty acids has an additional preventive effect on CHD even when the serum level of n−3 PUFA is high because of high dietary fish consumption.

Type
Research Article
Copyright
Copyright © The Nutrition Society 2003

References

American Heart Association Committee (1975) AHA Committee Report: A reporting system on patient evaluated for coronary artery disease. News from the American Heart Association. Circulation 51, 5.CrossRefGoogle Scholar
Andersen, RE, Wadden, TA, Bartlett, SJ, Zemel, B, Verde, TJ & Franckowiak, AC (1999) Effects of lifestyle activity vs structured aerobic exercise in obese women: a randomized trial. Journal of the American Medical Association 281, 335340.CrossRefGoogle ScholarPubMed
Bjerregaard, P, Mulvad, G & Pedersen, HS (1997) Cardiovascular risk factors in Inuit of Greenland. International Journal of Epidemiology 26, 11821190.CrossRefGoogle ScholarPubMed
Criqui, MH & Ringel, BL (1994) Does diet or alcohol explain the French paradox? Lancet 344, 17191723.CrossRefGoogle ScholarPubMed
Crombie, IK, McLoone, P, Smith, WCS, Thomson, M & Pedoe, HT (1987) International differences in coronary heart disease mortality and consumption of fish and other foodstuffs. European Heart Journal 8, 560563.CrossRefGoogle Scholar
de Lorgeril, M, Salen, P, Martin, JL, Monjaud, I, Delaye, J & Mamelle, N (1999) Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction. Final report of the Lyon diet heart study. Circulation 99, 779785.CrossRefGoogle ScholarPubMed
Dolecek, TA & Grandits, G (1991) Dietary polyunsaturated fatty acids and mortality in the multiple risk factor intervention trial (MRFIT). World Review of Nutrition and Diet 66, 205216.CrossRefGoogle ScholarPubMed
Duell, PB & Malinow, MR (1997) Homocyst(e)ine: an important risk factor for atherosclerotic vascular disease. Current Opinion in Lipidology 8, 2834.CrossRefGoogle ScholarPubMed
Dunn, AL, Marcus, BH, Kampert, JB, Garcia, ME, Kohl, HW III & Blair, SN (1999) Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness: a randomized trial. Journal of the American Medical Association 281, 327334.CrossRefGoogle ScholarPubMed
Dyerberg, J & Bang, HO (1979) Haemostatic function and platelet polyunsaturated fatty acids in Eskimos. Lancet ii, 433435.CrossRefGoogle Scholar
Dyerberg, J, Bang, HO & Hjorne, N (1975) Fatty acid composition of the plasma lipids in Greenland Eskimos. American Journal of Clinical Nutrition 28, 958966.CrossRefGoogle ScholarPubMed
Friedewald, WT, Levy, RI & Fredrickson, DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clinical Chemistry 18, 499502.CrossRefGoogle ScholarPubMed
Fukiyama, K, Kimura, Y & Muratani, H (2000) Incidence and long-term prognosis of initial stroke and acute myocardial infarction in Okinawa, Japan. Hypertension Research 23, 127135.CrossRefGoogle ScholarPubMed
Gordon, T, Castelli, WP, Hjortland, MC, Kannel, WB & Dawber, TR (1977) High density lipoprotein as a protective factor against coronary heart disease. The Framingham study. American Journal of Medicine 62, 707714.CrossRefGoogle ScholarPubMed
Grundt, H, Nilsen, DW, Hetland, O, Mansoor, MA, Aarsland, T & Woie, L (1999) Atherothrombogenic risk modulation by n-3 fatty acids was not associated with changes in homocysteine in subjects with combined hyperlipidemia. Thrombosis and Haemostasis 81, 561565.Google ScholarPubMed
Hambrecht, R, Wolf, A, Gielen, S, Linke, A, Hofer, J, Erbs, S, Schoene, N & Schuler, G (2000) Effect of exercise on coronary endothelial function in patients with coronary artery disease. New England Journal of Medicine 342, 454460.CrossRefGoogle ScholarPubMed
Hirai, A (1985) An epidemiological study on the dietary ingestion of eicosapentaenoic acid (EPA) and platelet function in Japanese. Journal of the Japanese Society of Internal Medicine 74, 1320 (in Japanese).Google Scholar
Hirai, A, Hamazaki, T, Tateno, T, Nishikawa, T, Tamura, Y & Kumagai, A (1980) Eicosapentaenoic acid and platelet function in Japanese. Lancet ii, 11321133.CrossRefGoogle Scholar
Iso, H, Sato, S, Falsom, AR, Shimamoto, T, Terao, A, Munger, RG, Kitamura, A, Konishi, M, Iida, M & Komachi, Y (1989) Serum fatty acids and fish intake in rural Japanese, urban Japanese, Japanese American and Caucasian American men. International Journal of Epidemiology 18, 374381.CrossRefGoogle ScholarPubMed
Ito, Y (1987) Epidemiology of coronary artery disease in Japan. In Coronary Artery Disease, vol. 45, pp. 10961102. Osaka, Japan: Nihon Rinsyo Inc. (in Japanese)Google Scholar
Kamada, I, Tsutsui, T, Chatani, Y, Hifumi, J, Ohfuji, M, Adachi, T & Ohta, H (1991) Studies on fatty acid composition of human serum lipids (II). Serum fatty acid composition of inhabitants in a fishing area, Kyoto. Japanese Journal of Hygiene 36, 4350.Google Scholar
Kannel, WB & Sorlie, P (1979) Some health benefits of physical activity. Archives of Internal Medicine 139, 857861.CrossRefGoogle ScholarPubMed
Keys, A (1970) Coronary heart disease in seven countries. Circulation 41, Suppl. 1, 162183.Google Scholar
Keys, A, Menotti, A, Karvonen, MJ, Aravanis, C, Blackburn, H, Buzina, R, Djordjevic, BS, Dontas, AS, Fidanza, F, Keys, MH, Kromhout, D, Nedeljkovic, S, Punsar, S, Seccareccia, F & Toshima, H (1986) The diet and 15-year death rate in the Seven Countries Study. American Journal of Epidemiology 124, 903915.CrossRefGoogle ScholarPubMed
Kondo, T, Ogawa, K, Satake, T, Kitazawa, M, Taki, K & Sugiyama, S (1986) Plasma-free eicosapentaenoic acid/arachidonic acid ratio: a possible new coronary risk factor. Clinical Cardiology 9, 413416.CrossRefGoogle ScholarPubMed
Konishi, M, Iida, M, Naito, Y, Terao, A, Takayama, Y, Ito, H, Yutani, C, Ito, M, Kojima, S, Shimamoto, T, Inada, H, Doi, M, Iso, H, Sato, S, Kitamura, A & Komachi, Y (1987) The trend of coronary heart disease and its risk factors based on epidemiological investigations. Japanese Circulation Journal 51, 319324.CrossRefGoogle ScholarPubMed
Kuriki, K, Nagatani, T, Fujiwara, N, Sato, T, Tokutome, Y, Imaeda, N, Maki, S & Tokutome, N (2000) Relationship between the amount of fat intake for 7 days and serum fatty acid levels. Journal of Epidemiology 10, Suppl. 1, 106 (in Japanese).Google Scholar
Malinow, MR, Duell, PB, Hess, DL, Anderson, PH, Kruger, WD, Phillipson, BE, Gluckman, RA, Block, PC & Upson, BM (1998) Reduction of plasma homocyst(e)ine levels by breakfast cereal fortified with folic acid in patients with coronary heart disease. New England Journal of Medicine 338, 10091015.CrossRefGoogle Scholar
Morris, JN, Marr, JW & Clayton, DG (1977) Diet and heart; A post-script. British Medical Journal 2, 13071314.CrossRefGoogle Scholar
Okuyama, H (2001) High n-6 to n-3 ratio of dietary fatty acids rather than serum cholesterol as a major risk factor for coronary heart disease. European Journal of Lipid Science and Technology 103, 418422.3.0.CO;2-#>CrossRefGoogle Scholar
Renaud, S & de Lorgeril, M (1992) Wine, alcohol, platelets, and the French paradox for coronary heart disease. Lancet 339, 15231526.CrossRefGoogle ScholarPubMed
Rimm, EB, Willett, WC, Hu, FB, Sampson, L, Colditz, GA, Manson, JE, Hennekens, C & Stampfer, MJ (1998) Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. Journal of the American Medical Association 279, 359364.CrossRefGoogle ScholarPubMed
Shiba, T, Urita, Y, Takatsuka, J, Takeuchi, S, Igarashi, M, Asada, T, Asano, T, Kanai, A & Omoto, M (1980) Effect of dietary habits on eicosapentaenoic acid and arachidonic acid contents in human plasma. Journal of the Medical Society of Toho University 27, 404407.Google Scholar
Taylor, TG, Gibney, MJ & Morgan, TB (1979) Haemostatic function and polyunsaturated fatty acid. Lancet ii, 1378.CrossRefGoogle Scholar
Umemura, U, Koike, K, Iso, H, Sankai, T, Shimamoto, T, Sato, S, Iida, M, Handa, K & Komachi, Y (1993) Population-based comparative study on dietary habits and serum fatty acid compositions. Japanese Journal of Hygiene 48, 939954 (in Japanese).Google ScholarPubMed
Zuijdgeest-Van Leeuwen, SD, Dagnelie, PC, Rietveld, T, van den Berg, JWO & Wilson, JHP (1999) Incorporation and washout of orally administered n-3 fatty acid ethyl esters in different plasma lipid fractions. British Journal of Nutrition 82, 481488.CrossRefGoogle ScholarPubMed