Dietary Intake and Biomarkers of α-Linolenic Acid and Mortality: A Meta-Analysis of Prospective Cohort Studies

Background: The association between α-linolenic acid (ALA) and mortality is inconsistent and has not been summarized systematically.Objective: The purpose was to conduct a meta-analysis that synthesized the results of prospective cohort studies to investigate associations between ALA intake and mortality.Methods: We conducted a comprehensive search on PubMed, Embase, and Web of Science databases on May 1, 2021, for relevant prospective cohort studies which reported associations of ALA (assessed by dietary surveys and/or ALA concentrations in body tissues) with mortality from all-cause, cardiovascular disease (CVD), and other diseases. Multivariable-adjusted relative risks (RRs) were pooled by a random or fixed-effects model.Results: A total of 34 prospective cohort studies, of which 17 reported dietary ALA intake, 14 for ALA biomarkers, and the remaining 3 reported both of intake and biomarkers. The studies included 6,58,634 participants, and deaths were classified into all-cause mortality (56,898), CVD mortality (19,123), and other diseases mortality (19,061). Pooled RRs of ALA intake were 0.93 (95% CI: 0.86, 1.01, I2 = 71.2%) for all-cause mortality, 0.90 (95% CI: 0.83, 0.98, I2 = 22.1%) for CVD mortality, and 0.94 (95% CI: 0.83, 1.06, I2 = 73.3%) for other diseases mortality. The two-stage random-effects dose-response analysis showed a linear relationship between dietary ALA intake and CVD-mortality and each 0.5% energy increment of ALA intake was associated with a 5% lower risk of CVD-mortality (RR: 0.95; 95% CI: 0.90, 1.00). Pooled RRs per SD increment of ALA biomarkers were 0.99 (95% CI: 0.96, 1.01, I2 = 27%) for all-cause mortality, 1.00 (95% CI: 0.98, 1.03, I2 = 0%) for CVD mortality and 0.98 (95% CI: 0.95, 1.01, I2 = 0%) for other diseases mortality.Conclusions: This meta-analysis summarizing the available prospective cohort studies indicated that ALA intake was associated with reduced risk of mortality, especially CVD mortality. Our findings suggest that ALA consumption may be beneficial for death prevention. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO; identifier: CRD42021264532.

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Abstract MP48: Whole Grain Intake is Inversely Associated with Mortality From All Causes, Cardiovascular Disease, and Cancer in a Dose-response Manner, a Meta-analysis of Prospective Cohort Studies

Circulation ◽

10.1161/circ.133.suppl_1.mp48 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Geng Zong ◽

Alisa Gao ◽

Frank Hu ◽

Qi Sun

Keyword(s):

Cohort Studies ◽

Dose Response ◽

Cancer Mortality ◽

Prospective Cohort ◽

Meta Analysis ◽

Multiple Chronic Conditions ◽

Whole Grain ◽

Prospective Cohort Studies ◽

All Cause Mortality ◽

Cvd Mortality

Introduction: Whole grain intake has been associated with lower risks of multiple chronic conditions, but its association with mortality warrants further evaluation. Hypothesis: We performed a meta-analysis of prospective cohort studies on the association of whole grain intake with all-cause and cause-specific mortality, and tested the hypothesis that they followed inverse dose-response pattern. Methods: Published studies reporting relative risks (RRs) between whole grain consumption and mortality from Medline and Embase through August, 2015. Original results from National Health and Nutrition Examination Survey (NHANES) III and NHANES 1999-2004 were included. Whole grain ingredients (gram/day) were estimated among studies reporting RRs for ≥3 categories of whole grain intake. Results: Fourteen unique analyses were included, which consisted of 786,076 participants, 97,867 all-cause deaths, 23,957 CVD deaths, and 37,492 cancer deaths. Pooled RRs (95% confidence intervals) comparing high with low whole grain categories were 0.84 (0.80, 0.88; P <0.001, I2=74%, P heterogeneity<0.001) for all-cause mortality, 0.82 (0.79, 0.85; P <0.001, I2=0%, P heterogeneity=0.53) for CVD mortality, and 0.88(0.83, 0.94; P <0.001, I2=54%, P heterogeneity=0.02) for cancer mortality. Whole grain consumption was <50 grams/day among most studies. Dose-response meta-analysis showed strong monotonic associations between whole grain and mortality (All P nonlinearity > 0.05): RRs (95%CIs) for each 16 grams/day increase (approximately 1 serving/day) in whole grain were 0.93(0.92, 0.94) for all-cause mortality, 0.91(0.90, 0.93) for CVD mortality, and 0.95(0.94, 0.96) for cancer mortality. These findings were robust in several stratified analyses and/or sensitivity analyses. Egger’s test did not suggest significant publication bias. Conclusions: Our findings supported health benefit of increasing current whole grain intake of <1 serving/day to ≥3 servings/day as recommended by current Dietary Guidelines for Americans.

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Abstract P225: The Associations of Dietary and Biomarkers of Linoleic Acid Intake and All-cause and Cardiovascular Mortality: A Systematic Review and Meta-analysis

Circulation ◽

10.1161/circ.137.suppl_1.p225 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Jun Li ◽

Marta Guasch-Ferré ◽

Yanping Li ◽

Frank Hu

Keyword(s):

Systematic Review ◽

Linoleic Acid ◽

Cohort Studies ◽

Prospective Cohort ◽

Lower Risk ◽

Meta Analysis ◽

Dietary Survey ◽

Prospective Cohort Studies ◽

All Cause Mortality ◽

Cvd Mortality

Background: Previous studies on intake of linoleic acid (LA), a predominant n-6 fatty acid, and risk of mortality from all-cause and cardiovascular disease (CVD) have generated inconsistent results. We performed a systematic review and meta-analysis of prospective cohort studies to summarize the evidence regarding the relation of LA and all-cause and CVD mortality. Methods: We searched MEDLINE and EMBASE databases through June 2017 for prospective cohort studies reporting association of LA (assessed by dietary survey or biomarker in blood or adipose tissue) with all-cause and CVD mortality. In addition, unpublished data from pooling projects were included. We pooled the multivariate-adjusted Hazards ratios (HRs) using random-effect meta-analysis, which allowed for between-study heterogeneity. Results: 27 studies covering 37 prospective cohorts were identified; these included 274,565 individuals with dietary assessment (34,597 all-cause and 10,636 CVD deaths) and 54,794 individuals with biomarker measurements (6,767 all-cause and 5,311 CVD deaths). Comparing the highest category with the lowest, dietary LA intake was associated with a 14% lower risk of all-cause mortality (95% confidence interval [CI], 2%-25%, I 2 =71%) and a 20% lower risk of CVD mortality (95% CI, 13%-26%, I 2 =0). Baseline health status (i.e. general population, CVD/high risk for CVD, or cancer) might be a main source of heterogeneity for the association of dietary LA intake with all-cause mortality. As for biomarkers, 1 SD increment in LA was associated with a 9% lower risk of all-cause mortality (95% CI, 4%-14%, I 2 =61%) and a 10% lower risk of CVD mortality (95% CI, 5%-14%, I 2 =13%). Heterogeneity was presented across tissue types and between genders. Conclusions: In prospective cohort studies, LA intake, assessed by either dietary survey or biomarkers, was inversely associated with all-cause and CVD mortality in a dose-response manner. These data support the current recommendations on polyunsaturated fat intake for prevention of CVD and early death.

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Dietary glycemic index, glycemic load, and risk of mortality from all causes and cardiovascular diseases: a systematic review and dose-response meta-analysis of prospective cohort studies

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqz061 ◽

2019 ◽

Vol 110 (4) ◽

pp. 921-937 ◽

Cited By ~ 4

Author(s):

Farnaz Shahdadian ◽

Parvane Saneei ◽

Alireza Milajerdi ◽

Ahmad Esmaillzadeh

Keyword(s):

Cohort Studies ◽

Glycemic Index ◽

Prospective Cohort ◽

Meta Analysis ◽

Glycemic Load ◽

Positive Association ◽

Prospective Cohort Studies ◽

All Cause Mortality ◽

Dietary Glycemic Index ◽

Cvd Mortality

ABSTRACT Background Previous findings on the association of dietary glycemic index (GI) and glycemic load (GL) with mortality are conflicting. Objectives The aim of this study was to summarize earlier findings on the association between dietary GI and GL and the risk of cardiovascular disease (CVD) and all-cause mortality. Methods A comprehensive literature search was performed of electronic databases, including MEDLINE (PubMed), Scopus, ISI Web of Science, EMBASE, and Google scholar, up to September 2018. Prospective cohort studies that reported GI and GL as the exposure and all-cause or CVD mortality as the outcome were included in the analysis. The random-effects model was used to estimate pooled RR and 95% CIs of all-cause and CVD mortality. Results Eighteen cohort studies with a total of 251,497 participants, reporting 14,774 cases of all-cause mortality and 3658 cases of CVD mortality, were included in the present analysis. No significant association was found between dietary GI and all-cause mortality (RR: 1.07; 95% CI: 0.96, 1.19) and CVD mortality (RR: 1.02; 95% CI: 0.87, 1.20). In addition, dietary GL was not associated with all-cause mortality (RR: 1.08; 95% CI: 0.93, 1.27) or CVD mortality (RR: 1.07; 95% CI: 0.92, 1.25). However, the highest dietary GI, in comparison to the lowest one, significantly increased the risk of all-cause mortality in women (RR: 1.17; 95% CI: 1.02, 1.35). No evidence for a nonlinear association between dietary GI or GL and all-cause and CVD mortality was found (P > 0.05). Conclusions This meta-analysis of prospective cohort studies showed no significant association between either dietary GI or GL and all-cause and CVD mortality in men, but a positive association of GI with all-cause mortality in women.

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The association between napping and the risk of cardiovascular disease and all-cause mortality: a systematic review and dose-response meta-analysis

European Heart Journal ◽

10.1093/ehjci/ehaa946.2818 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

Z Pan ◽

M Huang ◽

J Huang ◽

Z Yao

Keyword(s):

Cardiovascular Disease ◽

Cohort Studies ◽

Dose Response ◽

Prospective Cohort ◽

Meta Analysis ◽

Random Effect ◽

Response Analysis ◽

Night Sleep ◽

Prospective Cohort Studies ◽

All Cause Mortality

Abstract Background Napping is a habit prevalent worldwide and occurs from an early age. Some sleep specialists have suggested it as a potential public health tool due to the prevalence of sleep disorder. However, the association between napping and the risk of cardiovascular disease (CVD) and all-cause mortality remains unclear. Purpose To assess the association between napping and the risk of CVD and all-cause mortality. Methods We conducted a systematic search of Medline, Embase and Cochrane databases from inception through December 2019 for prospective cohort studies investigating the association between napping and the risk of CVD and/or all-cause mortality. Overall estimates were calculated using random effect models with inverse variance weighting. Dose-response meta-analysis was performed using restricted cubic spline models. The results were reported as hazard ratio (HR) and 95% confidence interval (CI). Results A total of 313651 participants (57.8% female, 38.9% took naps) from 20 cohort studies were included in the analysis. Overall, pooled analysis detected no association between daytime nap and CVD (HR 1.13, 95% CI 0.99–1.28). However, in subgroup analysis including only participants who were female (HR 1.31, 95% CI 1.09–1.58), older (age>65 years) (HR 1.36, 95% CI 1.07–1.72), or took a longer nap (nap time>60 minutes) (HR 1.34, 95% CI 1.05–1.63), napping was significantly associated with a higher risk of CVD comparing to not napping. All-cause mortality was associated with napping overall (HR 1.19, 95% CI 1.12–1.26), and effect sizes were even more pronounced in females (HR 1.22, 95% CI 1.13–1.31), older participants (HR 1.27, 95% CI 1.11–1.45) and those who took a long nap (HR 1.30, 95% CI 1.12–1.47). Furthermore, after stratifying participants by night sleep time (<6 and >6h/day), no significant association was detected except those who slept >6h/day at night and took a long nap (HR 1.13, 95% CI 1.03–1.24). Dose-response analysis showed a J-curve relation between nap time and CVD (Figure 1). The HR decreased from 0 to 25 min/day, followed by a sharp increase in the risk at longer times. A positive linear relationship between nap time and all-cause mortality was also observed. Conclusion Long napping over 60 minutes per day is associated with increased risks of CVD and all-cause mortality. Night sleep duration may play a role in the relation between napping and all-cause mortality. Further, large-scale prospective cohort studies need to confirm our conclusion and investigate the underlying mechanisms driving these associations. Funding Acknowledgement Type of funding source: None

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Tea consumption and mortality of all cancers, CVD and all causes: a meta-analysis of eighteen prospective cohort studies

British Journal Of Nutrition ◽

10.1017/s0007114515002329 ◽

2015 ◽

Vol 114 (5) ◽

pp. 673-683 ◽

Cited By ~ 58

Author(s):

Jun Tang ◽

Ju-Sheng Zheng ◽

Ling Fang ◽

Yongxin Jin ◽

Wenwen Cai ◽

...

Keyword(s):

Cohort Studies ◽

Green Tea ◽

Prospective Cohort ◽

Lower Risk ◽

Meta Analysis ◽

Black Tea ◽

Tea Consumption ◽

Prospective Cohort Studies ◽

All Cause Mortality ◽

Cvd Mortality

AbstractEpidemiological studies have demonstrated inconsistent associations between tea consumption and mortality of all cancers, CVD and all causes. To obtain quantitative overall estimates, we conducted a dose–response meta-analysis of prospective cohort studies. A literature search in PubMed and Embase up to April 2015 was conducted for all relevant papers published. Random-effects models were used to calculate pooled relative risks (RR) with 95 % CI. In eighteen prospective studies, there were 12 221, 11 306 and 55 528 deaths from all cancers, CVD and all causes, respectively. For all cancer mortality, the summary RR for the highest v. lowest category of green tea and black tea consumption were 1·06 (95 % CI 0·98, 1·15) and 0·79 (95 % CI 0·65, 0·97), respectively. For CVD mortality, the summary RR for the highest v. lowest category of green tea and black tea consumption were 0·67 (95 % CI 0·46, 0·96) and 0·88 (95 % CI 0·77, 1·01), respectively. For all-cause mortality, the summary RR for the highest v. lowest category of green tea and black tea consumption were 0·80 (95 % CI 0·68, 0·93) and 0·90 (95 % CI 0·83, 0·98), respectively. The dose–response analysis indicated that one cup per d increment of green tea consumption was associated with 5 % lower risk of CVD mortality and with 4 % lower risk of all-cause mortality. Green tea consumption was significantly inversely associated with CVD and all-cause mortality, whereas black tea consumption was significantly inversely associated with all cancer and all-cause mortality.

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Association between Intake of Sweetened Beverages with All-Cause Mortality: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

SSRN Electronic Journal ◽

10.2139/ssrn.3521426 ◽

2020 ◽

Author(s):

Hongyi Li ◽

Huoyan Liang ◽

Han Yang ◽

Xiaojuan Zhang ◽

Xianfei Ding ◽

...

Keyword(s):

Systematic Review ◽

Cohort Studies ◽

Prospective Cohort ◽

Meta Analysis ◽

Prospective Cohort Studies ◽

Sweetened Beverages ◽

All Cause Mortality

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Dose–Response Relation between Tea Consumption and Risk of Cardiovascular Disease and All-Cause Mortality: A Systematic Review and Meta-Analysis of Population-Based Studies

Advances in Nutrition ◽

10.1093/advances/nmaa010 ◽

2020 ◽

Vol 11 (4) ◽

pp. 790-814 ◽

Cited By ~ 4

Author(s):

Mei Chung ◽

Naisi Zhao ◽

Deena Wang ◽

Marissa Shams-White ◽

Micaela Karlsen ◽

...

Keyword(s):

Cardiovascular Disease ◽

Cohort Studies ◽

Prospective Cohort ◽

Lower Risk ◽

Meta Analysis ◽

Risk Of Bias ◽

Tea Consumption ◽

All Cause Mortality ◽

Specific Mortality ◽

Cvd Mortality

ABSTRACT Tea flavonoids have been suggested to offer potential benefits to cardiovascular health. This review synthesized the evidence on the relation between tea consumption and risks of cardiovascular disease (CVD) and all-cause mortality among generally healthy adults. PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, Food Science and Technology Abstracts, and Ovid CAB Abstract databases were searched to identify English-language publications through 1 November 2019, including randomized trials, prospective cohort studies, and nested case-control (or case-cohort) studies with data on tea consumption and risk of incident cardiovascular events (cardiac or peripheral vascular events), stroke events (including mortality), CVD-specific mortality, or all-cause mortality. Data from 39 prospective cohort publications were synthesized. Linear meta-regression showed that each cup (236.6 mL) increase in daily tea consumption (estimated 280 mg and 338 mg total flavonoids/d for black and green tea, respectively) was associated with an average 4% lower risk of CVD mortality, a 2% lower risk of CVD events, a 4% lower risk of stroke, and a 1.5% lower risk of all-cause mortality. Subgroup meta-analysis results showed that the magnitude of association was larger in elderly individuals for both CVD mortality (n = 4; pooled adjusted RR: 0.89; 95% CI: 0.83, 0.96; P = 0.001), with large heterogeneity (I2 = 72.4%), and all-cause mortality (n = 3; pooled adjusted RR: 0.92; 95% CI: 0.90, 0.94; P < 0.0001; I2 = 0.3%). Generally, studies with higher risk of bias appeared to show larger magnitudes of associations than studies with lower risk of bias. Strength of evidence was rated as low and moderate (depending on study population age group) for CVD-specific mortality outcome and was rated as low for CVD events, stroke, and all-cause mortality outcomes. Daily tea intake as part of a healthy habitual dietary pattern may be associated with lower risks of CVD and all-cause mortality among adults.

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Lipid profile and prognosis in patients with coronary heart disease: a meta-analysis of prospective cohort studies

BMC Cardiovascular Disorders ◽

10.1186/s12872-020-01835-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xiangmei Zhao ◽

Dongying Wang ◽

Lijie Qin

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Cohort Studies ◽

Lipid Profile ◽

Prospective Cohort ◽

Cardiac Death ◽

Meta Analysis ◽

Prospective Cohort Studies ◽

All Cause Mortality ◽

Reduced Risk

Abstract Background This meta-analysis based on prospective cohort studies aimed to evaluate the associations of lipid profiles with the risk of major adverse cardiovascular outcomes in patients with coronary heart disease (CHD). Methods The PubMed, Embase, and Cochrane Library electronic databases were systematically searched for prospective cohort study published through December 2019, and the pooled results were calculated using the random-effects model. Results Twenty-one studies with a total of 76,221 patients with CHD met the inclusion criteria. The per standard deviation (SD) increase in triglyceride was associated with a reduced risk of major adverse cardiovascular events (MACE). Furthermore, the per SD increase in high-density lipoprotein cholesterol (HDL-C) was associated with a reduced risk of cardiac death, whereas patients with lower HDL-C were associated with an increased risk of MACE, all-cause mortality, and cardiac death. Finally, the risk of MACE was significantly increased in patients with CHD with high lipoprotein(a) levels. Conclusions The results of this study suggested that lipid profile variables could predict major cardiovascular outcomes and all-cause mortality in patients with CHD.

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Intake of Fish and Marine n-3 Polyunsaturated Fatty Acids and Risk of Cardiovascular Disease Mortality: A Meta-Analysis of Prospective Cohort Studies

Nutrients ◽

10.3390/nu13072342 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2342

Author(s):

Lan Jiang ◽

Jinyu Wang ◽

Ke Xiong ◽

Lei Xu ◽

Bo Zhang ◽

...

Keyword(s):

Cardiovascular Disease ◽

Fatty Acids ◽

Polyunsaturated Fatty Acids ◽

Cohort Studies ◽

Mortality Risk ◽

Prospective Cohort ◽

Meta Analysis ◽

Pufa Intake ◽

Prospective Cohort Studies ◽

Cvd Mortality

Previous epidemiological studies have investigated the association of fish and marine n-3 polyunsaturated fatty acids (n-3 PUFA) consumption with cardiovascular disease (CVD) mortality risk. However, the results were inconsistent. The purpose of this meta-analysis is to quantitatively evaluate the association between marine n-3 PUFA, fish and CVD mortality risk with prospective cohort studies. A systematic search was performed on PubMed, Web of Science, Embase and MEDLINE databases from the establishment of the database to May 2021. A total of 25 cohort studies were included with 2,027,512 participants and 103,734 CVD deaths. The results indicated that the fish consumption was inversely associated with the CVD mortality risk [relevant risk (RR) = 0.91; 95% confidence intervals (CI) 0.85−0.98]. The higher marine n-3 PUFA intake was associated with the reduced risk of CVD mortality (RR = 0.87; 95% CI: 0.85–0.89). Dose-response analysis suggested that the risk of CVD mortality was decreased by 4% with an increase of 20 g of fish intake (RR = 0.96; 95% CI: 0.94–0.99) or 80 milligrams of marine n-3 PUFA intake (RR = 0.96; 95% CI: 0.94–0.98) per day. The current work provides evidence that the intake of fish and marine n-3 PUFA are inversely associated with the risk of CVD mortality.

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Abstract MP017: Television Viewing and Life Expectancy in the United States

Circulation ◽

10.1161/circ.125.suppl_10.amp017 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Peter T Katzmarzyk ◽

I-Min Lee

Keyword(s):

United States ◽

Life Expectancy ◽

Cohort Studies ◽

Prospective Cohort ◽

Television Viewing ◽

Meta Analysis ◽

The United States ◽

Sedentary Behaviors ◽

Prospective Cohort Studies ◽

All Cause Mortality

Introduction: Sedentary behaviors such as television viewing are ubiquitous in modern society. Several prospective studies have demonstrated an association between television viewing and incident obesity and type 2 diabetes as well as cardiovascular disease and all-cause mortality. Hypothesis: We tested the null hypothesis that television viewing has no impact on life expectancy in the United States. Methods: A prevalence-based cause-deleted methodology was used to estimate the gains in life expectancy in the population that would be expected under current mortality patterns if television viewing was eliminated as a potential risk factor in the United States. The population attributable fraction (PAF, calculated using adjusted relative risk (RR) = ∑P(RR-1/RR)) was computed from the RR of all-cause mortality associated with television viewing (2–3.9 h and ≥4 h versus < 2 h) obtained from a meta-analysis of available prospective cohort studies, and the estimated case prevalence (P) of television viewing obtained from the U.S. National Health and Nutrition Examination Survey (2005–06) and the prospective cohort studies. The resulting PAF was applied to mortality rates among 18+ year olds living in the United States and an abridged life table analysis was used to estimate the potential gains in life expectancy. Results: Three prospective cohort studies contributed data to the meta-analysis, yielding summary RR estimates for all-cause mortality of 1.17 (95% CI: 1.04 – 1.32) and 1.49 (95% CI: 1.22–1.82) for 2–3.9 h and ≥4 h of television viewing versus <2 h, respectively. The estimated case prevalences of television viewing in the U.S. population were 23.8%, 45.7% and 37.2% for <2 h, 2–3.9 h and ≥4 h of television viewing, respectively. The estimated gain in life expectancy in the US population associated with television viewing was 1.38 years. The lower and upper limits from a sensitivity analysis which involved simultaneously varying the estimates of RR (using the upper and lower bounds of the 95% CI) and the prevalence of television viewing (± 20%) were 0.48 years and 2.50 years. Conclusions: Reducing sedentary behaviors such as television viewing has the potential to increase life expectancy in the United States.

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