Abstract

Population-based data suggest that high intake of omega-3 (n-3) polyunsaturated fatty acids (PUFA) may be beneficial in a variety of health conditions. It is likely that mainly those patients with preexisting n-3 deficiency are those that benefit most from n-3 fatty acid supplementation. Therefore, for targeted interventions, a fast and reliable screening tool for n-3 PUFA intake is necessary. Thus, the aim of this project was to adapt and validate a food frequency questionnaire (FFQ) for n-3 PUFA intake in Switzerland while using as references the following: (1) 7-day food records (FR), and (2) n-3 fatty acid composition of red blood cells (RBC). We recruited 46 healthy adults for the first part of the study and 152 for the second. We used the dietary software EBISpro for the analysis of n-3 PUFA intake. RBC fatty acid composition was determined by gas chromatography mass spectrometry (GC-MS). Using correlation analysis, we found a moderate significant association between FFQ and FR for α-linolenic acid (ALA), eicosapentanoic acid (EPA), docosahexanoic acid (DHA), and total n-3 fatty acids (all r between 0.523 and 0.586, all p < 0.001). Bland Altman analysis further showed good agreement between the two methods and no proportional bias. Correlations between FFQ and RBC fatty acid composition were also moderate for EPA and DHA (r = 0.430 and r = 0.605, p < 0.001), but weaker for ALA and total n-3 (r = 0.314 and r = 0.211, p < 0.01). The efficacy of the FFQ to classify individuals into the same or adjacent quartile of RBC PUFA content ranged between 70% and 87% for the different fatty acids. In conclusion, we showed that the Swiss n-3 PUFA FFQ is a valid tool to assess dietary n-3 PUFA intake, especially DHA and EPA, to determine population groups at risk for low intake.

Highlights

  • The first evidence of a beneficial effect of omega-3 (n-3) polyunsaturated fatty acids (PUFA) on human health was described based on population data from Greenland Eskimos between 1950 and 1974.Eskimos traditionally consume a diet very high in seafood and were found to have a low prevalence of several chronic diseases, including coronary heart disease, asthma, diabetes mellitus and multiple sclerosis [1]

  • We have developed an adapted Swiss n-3 PUFA food frequency questionnaire (FFQ) to approximate the intake of n-3 PUFA intake in Swiss populations based on an existing, validated questionnaire developed in the US [14]

  • As FFQs are sensitive to different dietary practices, it is important to validate a new questionnaire in the target population

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Summary

Introduction

Eskimos traditionally consume a diet very high in seafood and were found to have a low prevalence of several chronic diseases, including coronary heart disease, asthma, diabetes mellitus and multiple sclerosis [1]. Since those early observations, sufficient PUFA intake has been widely recognized as an important determinant of a variety of health conditions, including inflammatory conditions, mental health, cardiovascular disease, and cancer [2,3,4,5,6,7]. Nutrients 2019, 11, 1863 revolution, the western diet has moved from a balanced omega-6 (n-6) to n-3 ratio towards a major excess in n-6 fatty acids. Numerous researchers propose that the increase in civilization diseases such as diabetes, metabolic syndrome, and mental disorders such as depression and attention deficit and hyperactivity disorders may be related to this shift towards a more “proinflammatory diet” [9]

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