Alpha-linolenic Acid Consumption Research Articles

Insight into the binding of alpha-linolenic acid (ALA) on human serum albumin using spectroscopic and molecular dynamics (MD) studies

Alpha-linolenic acid (ALA) is one of the necessary fatty acids for the human body. It is a precursor for synthesizing eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The consumption of ALA as an anti-inflammatory factor plays a significant role in preventing cardiovascular diseases. The current study was investigated to evaluate the binding affinity and molecular interactions between human serum albumin (HSA) with ALA through spectroscopic and computational studies. In the existence of ALA, the absorbance of HSA is reduced, confirming the development of the HSA-ALA complex. The fluorescence spectroscopic data implied that the quenching mechanism for HSA-ALA interaction was static mode. The negative values of ΔH° and ΔS° indicated that hydrogen bonding and van der Waals are the predominant intermolecular forces in the complex between HSA and ALA. The binding of ALA induces changes in the structure of HSA, which were revealed by far-UV circular dichroism (CD). The reduction of root mean square deviation (RMSD) after binding to ALA proved the stability of the structure of HSA in the presence of ALA. The results of the esterase activity of HSA presented that ALA competitively binds with HSA. This study demonstrated the importance of ALA in medicine and emphasized its main pharmacological significance.

The Consumption of Omega-3 Fatty Acids in American Adults

ObjectivesRecent intakes of omega-3 fatty acids in American adults are unknown. Therefore, the objective of this study is to determine the consumption of omega-3 fatty acids in American adults by analyzing the National Health and Nutrition Examination Survey (NHANES) 2017–2018. The hypothesis is that American adults will meet the adequate intake (AI) values for alpha-linolenic acid (ALA), whereas the consumption of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) will fall below the recommendations set forth by the American Heart Association and the World Health Organization.MethodsNHANES 2017–2018 was analyzed to determine the consumption of ALA, EPA, and DHA from food sources in American adults. Gender, age, and “race/Hispanic origin” were used to analyze the average consumption of omega-3 fatty acids in these groups. Male and female adults (19 to 80 years) were included in the analyses. Exclusion criteria were children and adolescents (18 years and younger) and adults who indicated that they consumed less than 1,000 kilocalories or more than 6,000 kilocalories per day.ResultsThe main results demonstrated that American adults consumed approximately 1.98 grams/day of ALA. Therefore, American adults achieved the AI values for ALA, which are 1.1 grams/day for females and 1.6 grams/day for males. In contrast, American adults consumed approximately 35 milligrams/day of EPA and 76 milligrams/day of DHA. The American Heart Association recommends consuming oily fish at least twice per week, which equals approximately 500 mg of EPA plus DHA. In addition, individuals with documented cardiovascular disease should consume approximately 1 gram/day of EPA plus DHA. The World Health Organization recommends consuming 0.25 to 2 grams/day of EPA plus DHA. As such, American adults did not meet the recommendations for EPA and DHA.ConclusionsNHANES 2017–2018 analyses revealed that American adults are meeting the AI values for ALA, whereas they are not achieving the recommendations for EPA and DHA. These outcomes suggest that the low intakes of EPA and DHA may increase the risk for cardiovascular disease.Funding SourcesNo funding was used for this project.

Omega-3 fatty acid levels and sensory quality of eggs following consumption of alpha-linolenic acid enriched diets

The aim of the study was to increase the levels of omega-3 fatty acids in eggs, mainly in the form of eicosapentaenoic acid (EPA, 20:5n-3) and docosahexaenoic acid (DHA, 22:6n -3) as EPA and DHA have beneficial health effects. This study tested whether the inclusion of a vegetable source of omega-3 (n-3) fat in the form of alpha-linolenic acid (ALA, 18:3n-3) in the diets of laying hens (Hy-Line brown) would improve n-3 fat accumulation, without altering the product performance or the sensory characteristics of eggs. In this study, the ALA levels of the diets were varied from 0.3 to 6% energy (%en). In order to optimize the conversion of ALA into n-3 long chain polyunsaturated fatty acids (LCPUFA), grain-based diets containing a low linoleic acid (LA, 18:2n-6) level were chosen as a basal diet, and the level of competing substrate, LA, in the dietary treatments was also kept constant. Results showed that increasing the levels of dietary ALA increased all n-3 LCPUFA (EPA, DPA, and DHA) in the eggs. Importantly, diets enriched with ALA did not impair the sensory quality of the eggs. In conclusion, brown laying hens fed ALA enriched diets produced eggs higher in n-3 fatty acids, and met the requirement needed for labelling as n-3 PUFA sources, which provides an alternative n-3 rich food for consumers.

Role of a Maternal Diet High in Linoleic Acid on the Plasma Fatty Acid Composition in Rat Offspring

Linoleic acid (LA) is a major omega‐6 polyunsaturated fatty acid (PUFA) which is essential in our diet. LA is an important fatty acid for fetal growth and development and is transported from mother to fetus through the placenta. Dietary intake of LA has increased significantly in western societies primarily due to increased consumption of vegetable oils. Conversely, the consumption of alpha‐linolenic acid (ALA), an omega‐3 PUFA, has remained similar or decreased due to limited consumption of fish. Metabolites of omega‐3 PUFAs such as docosahexaenoic (DHA) and eicosapentaenoic (EPA) have critical roles in fetal neural development and may influence brain function in later in life. The aim of this study is to investigate the effect of a maternal diet high in LA on offspring fatty acid composition at 40 days of age (adolescence). Female rats were fed with either low LA diet (LLA; 1.44% of energy from LA) or high LA (HLA; 6.21% of energy from LA) with matched ALA (0.3% of energy) for 10 weeks before pregnancy and during gestation. The pups were weaned at postnatal day 25 (PN25) and fed with either LLA or HLA diet (Four groups ‐ LL, LH, HL, HH; first letter denotes maternal diet and second letter denotes post‐weaning diet). The offspring were sacrificed at postnatal day 40 and biological samples were collected and stored at −80°C. The concentration of fatty acids in plasma was quantified using gas chromatography. Total omega‐6 fatty acid (FA) and LA levels in plasma were significantly elevated in the offspring fed with HLA diet at weaning and offspring from dams fed with HLA (LH, HL, HH) compared to offspring from LLA dams fed with LLA at weaning (LL) both in male and female offspring. Total omega‐3 FA was significantly decreased in offspring from HLA dams fed with HLA diet (HH) at weaning in comparison to offspring from LLA dams fed with LLA at weaning (LL). The concentration of ALA was significantly decreased in male offspring from HLA dams fed with HLA diet (HH) compared to HL offspring; however, there was no difference in female offspring. In addition, the plasma level of EPA was significantly decreased in male offspring fed with HLA diet at weaning (LH and HH) compared with LL offspring; however, there was no difference in female offspring. Moreover, DHA, an important omega‐3 FA for brain development, was significantly decreased in HH offspring compared to LL offspring. Hence, the findings from the current study suggest that elevated LA in both maternal diet and weaning diet influence the plasma fatty acid composition in adolescent offspring in a rat model.Support or Funding InformationThis work was supported by the Allen Foundation (D.H.H., A.J.M.), and through the Australian Government's Collaborative Research Networks (CRN) programme (A.J.M.). Scholarship funding is provided by Griffith University International Postgraduate Research Scholarship (GUIPRS; N.S.), Griffith University Postgraduate Research Scholarship (GUPRS, N.S.) and Griffith Health Top Up Scholarship (N.S.). B.S.M. is supported by a National Health and Medical Research Council of Australia Career Development Award (Level 2) (APP1083009).

Omega-3 Consumption Assessment in Vegetarian Diets

Abstract Understanding feeding consumption and nutrient ingestion in vegetarian diet is essential to foster nutritional adequacy. The goal was assessing Omega-3 consumption in such diets. It is a transversal study, performed with 09 vegetarian adults. The ingestion was achieved by means of 24-Hour Reminder and the nutrients were defined by nutritional software. The results disclosed that the diet is rich in ALA (Alpha-Linolenic Acid), however the functions are performed by EPA (Eicosapentaenoic Acid) and DHA (Docosahexaenoic Acid). ALA is capable of converting inefficiently in the other ones. In the present study, ALA consumption is above DRI’s (2.55g± 2.14), but when it is converted to EPA (326mg) and DHA (65.5mg) is below EFSA guidance and North American cardiovascular disease prevention and treatment guidelines. It was possible to conclude that this nutrient is essential to health, and in vegetarian diet, it is not achieved, a special care is required in diet planning. Keywords Consumption; Nutrients; Omega-3; Vegetarian diet Abbreviations ALA: Alpha-Linolenic Acid; EPA: Eicosapentaenoic Acid; DHA: Docosahexaenoic Acid

Flaxseed oil supplementation manipulates correlations between serum individual mol % free fatty acid levels and insulin resistance in type 2 diabetics. Insulin resistance and percent remaining pancreatic β-cell function are unaffected.

Elevated total serum free fatty acids (FFAs) concentrations have been suggested, controversially, to enhance insulin resistance and decrease percent remaining β-cell function. However, concentrations of individual serum FFAs have never been published in terms of their relationship (correlation) to homeostatic model assessment-insulin resistance (HOMA-IR) and percent remaining β-cell function (HOMA-%β) in the type 2 diabetics (T2Ds). Alpha-linolenic acid consumption has a negative correlation with the insulin resistance, which in turn is negatively correlated with the remaining β-cell function. The primary objective was to test the hypothesis that there would be different relationship (correlation) between the blood serum individual free FFA mol % levels and HOMA-IR and/or HOMA-%β in T2D. The secondary objective was to test the hypothesis that flaxseed oil, previously being shown to be ineffective in the glycemic control in T2Ds, may alter these correlations in a statistically significant manner as well as HOMA-IR and/or HOMA-%β. Patients were recruited via a newspaper advertisement and two physicians have been employed. All the patients came to visit one and three months later for a second visit. At the second visit, the subjects were randomly assigned (double blind) to flaxseed or safflower oil treatment for three months, until the third visit. Different statistically significant correlations or trends towards among some serum individual free FFA mol % levels and HOMA-IR and HOMA-%β, pre- and post-flaxseed and safflower oil supplementation were found. However, flaxseed oil had no impact on HOMA-IR or HOMA-%β despite statistically significant alterations in correlations compared to baseline HOMA-IR. The obtained data indicate that high doses of flaxseed oil have no statistically significant effect on HOMA-IR or HOMA-%β in T2Ds, probably due to the additive effects of negative and positive correlations.

Benefits on body fat composition of isocalorically controlled diets including functionally optimized meat products: Role of alpha-linolenic acid

The effects on body composition and cardiovascular risk of functional meat products, within a balanced diet, were investigated in a randomized, double-blind, 10-week nutritional intervention. Fifty-four adults were distributed in three groups, consuming 600 g/week of a reference meat product (RP), optimized nutritional product-1 (ONP-1), lower in fat, or ONP-2, n-3 PUFA enriched. Measures were performed at baseline and the endpoint. All groups lost fat mass, being subjects on the ONP-2 group those with more fat loss (p = 0.042) compared to the other groups. Correlation analyses evidenced significant associations between alpha-linolenic acid (ALA) intake and plasma levels (p = 0.001), as well as between plasma levels and fat mass changes (p = 0.03). The inclusion of optimized meat products, with n-3 PUFA (Polyunsaturated fatty acids) and an improved nutritional profile may be a healthy strategy, as a functional food, within an isocalorically controlled diet. ALA consumption may play a role in body composition changes.

Dietary omega-3 PUFA and health: Stearidonic acid-containing seed oils as effective and sustainable alternatives to traditional marine oils

The daily consumption of dietary omega-3 PUFA is recommended by governmental agencies in several countries and by a number of health organizations. The molecular mechanisms by which these dietary PUFA affect health involve the enrichment of cellular membranes with long-chain 20- and 22-carbon omega-3 PUFA that impacts tissues by altering membrane protein functions, cell signaling, and gene expression profiles. These changes are recognized to have health benefits in humans, especially relating to cardiovascular outcomes. Cellular membrane enrichment and health benefits are associated with the consumption of long-chain omega-3 PUFA found in marine oils, but are not generally linked with the consumption of alpha-linolenic acid, the 18-carbon omega-3 PUFA found in plant seed oils. However, the supply of omega-3 PUFA from marine sources is limited and may not be sustainable. New plant-derived sources of omega-3 PUFA like stearidonic acid-soy oil from genetically modified soybeans and Ahiflower oil from Buglossoides arvensis seeds that are enriched in the 18-carbon omega-3 PUFA stearidonic acid are being developed and show promise to become effective as well as sustainable sources of omega-3 PUFA. An example of changes in tissue lipid profiles associated with the consumption of Ahiflower oil is presented in a mouse feeding study.

Abstract MP003: Alpha-linolenic Acid Intake and Biomarker in Relation to Risk of Cardiovascular Disease: A Meta-analysis and Systematic Review

Introduction: Several studies have investigated the association between the plant-based omega-3 alpha-linolenic acid (ALA) and risk of cardiovascular disease (CVD); however, results remain largely inconsistent. We have conducted a meta-analysis of all available epidemiological studies reporting on association between ALA consumption or its biomarker composition and risk of CVD. Methods: A search of MEDLINE, EMBASE, Web of Science, Cochrane Library and clinical trial registry databases (to February 2011) was supplemented by manual searches of bibliographies of retrieved articles and relevant reviews. Prospective cohort or case-control studies were included if they reported the association between ALA (assessed in dietary intake, and as circulating blood or adipose tissue biomarker) and CVD (including myocardial infarction [MI], sudden cardiac arrest, acute coronary syndrome, and stroke). Multivariate-adjusted risk estimate in each study was converted to relative risk (RR) comparing the top vs. bottom thirds of ALA, and were combined using fixed-effect models given that heterogeneity was not detected in most situations. A fixed-effect dose-response meta-analysis was conducted if data were available. Results: Fifteen prospective cohort and 12 case-control studies were identified with aggregate data on 188,896 individuals and 12,233 total CVD events. Comparing the top to bottom thirds, a higher ALA intake was associated with a lower risk of CVD death (RR=0.80; 95% CI 0.67–0.96; 6 cohort studies), but not non-fatal MI (RR=0.95; 95% CI 0.85–1.06; 1 cohort and 2 case-control studies), or total CVD (RR=0.93; 95% CI 0.85–1.02; 1 case-control and 6 cohort studies). Higher ALA biomarker levels in adipose tissues, plasma or serum (top vs. bottom thirds) were inversely associated with non-fatal MI (RR=0.75; 95% CI 0.62–0.92; 7 case-control studies), but not CVD death (RR=1.20; 95% CI 0.98–1.46; 1 case-control and 2 cohort studies) or total CVD (RR=0.89; 95% CI 0.75–1.04; 4 cohort and 3 case-control studies). In the dose-response meta-analyses, each 1 g/d increment of ALA intake was associated with a 10% lower risk of CVD death (RR=0.90; 95% CI 0.83–0.99; 5 cohort studies), and each 0.5% increment of adipose tissue ALA concentration was associated with a 21% (RR=0.79; 95% CI 0.70–0.89; 5 case-control studies) lower risk of non-fatal MI. Conclusion: Higher dietary ALA intakes are associated with a lower risk of CVD death, while higher ALA biomarker levels are associated with a lower risk of non-fatal MI. These findings highlight the need for additional well-designed observational studies as well as large randomized clinical trials to evaluate effects of ALA on CVD.

Understanding Omega-3 Polyunsaturated Fatty Acids

Current intakes of very long-chain omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are low in most individuals living in Western countries. A good natural source of these fatty acids is seafood, especially oily fish. Fish oil capsules contain these fatty acids also. Very long-chain omega-3 fatty acids are readily incorporated from capsules into transport (blood lipids), functional (cell and tissue), and storage (adipose) pools. This incorporation is dose-dependent and follows a kinetic pattern that is characteristic for each pool. At sufficient levels of incorporation, EPA and DHA influence the physical nature of cell membranes and membrane protein-mediated responses, lipid-mediator generation, cell signaling, and gene expression in many different cell types. Through these mechanisms, EPA and DHA influence cell and tissue physiology and the way cells and tissues respond to external signals. In most cases the effects seen are compatible with improvements in disease biomarker profiles or health-related outcomes. As a result, very long-chain omega-3 fatty acids play a role in achieving optimal health and in protection against disease. Long-chain omega-3 fatty acids not only protect against cardiovascular morbidity but also against mortality. In some conditions, for example rheumatoid arthritis, they may be beneficial as therapeutic agents. On the basis of the recognized health improvements brought about by long-chain omega-3 fatty acids, recommendations have been made to increase their intake. The plant omega-3 fatty acid, alpha-linolenic acid (ALA), can be converted to EPA, but conversion to DHA appears to be poor in humans. Effects of ALA on human health-related outcomes appear to be due to conversion to EPA, and since this is limited, moderately increased consumption of ALA may be of little benefit in improving health outcomes compared with increased intake of preformed EPA + DHA.

Rapid declines in coronary heart disease mortality in Eastern Europe are associated with increased consumption of oils rich in alpha-linolenic acid

During the 1980's, opposing time trends were observed in coronary heart disease (CHD) rates between Eastern and Western European countries. In all former socialistic economic countries, CHD was uniformly increasing or stable, but a steady decline in CHD was observed in Western European countries. Surprisingly, during the 1990's CHD mortality substantially decreased in some Eastern European countries but not in others. These changes were accompanied by major shifts in food consumption, including the type of vegetable oils used by the population. There are two major vegetable oils consumed in Eastern Europe (rapeseed and sunflower) that differ greatly in their content of n-3 fatty acids, specifically alpha-linolenic acid (ALA). Low ALA intake has been associated with risk of fatal CHD and sudden cardiac death. The purpose of this study was to examine trends in CHD in eleven Eastern European countries to identify whether national changes in vegetable oil consumption after 1990 were associated with changes in CHD mortality rates. Our data show that countries which experienced an increase in ALA consumption also experienced a substantial decline in CHD mortality. These results were consistent in men and women. We hypothesize that the decline in CHD mortality observed in Eastern Europe can be attributed, in part, to changes in ALA consumption.

Dose effect of alpha-linolenic acid on lipid metabolism in the hamster

In order to meet dietary requirements, the consumption of alpha-linolenic acid (ALA, 18:3 n-3) must be promoted. However, its effects on triglyceride (TG) and cholesterol metabolism are still controversial, and may be dose-dependent. The effects of increasing dietary ALA intakes (1%, 10%, 20% and 40% of total FA) were investigated in male hamsters. ALA replaced oleic acid while linoleic and saturated FA were kept constant. Triglyceridemia decreased by 45% in response to 10% dietary ALA and was not affected by higher intakes. It was associated with lower hepatic total activities of acetyl-CoA-carboxylase (up to -29%) and malic enzyme (up to -42%), which were negatively correlated to ALA intake (r(2) = 0.33 and r(2) = 0.38, respectively). Adipose tissue lipogenesis was 2-6 fold lower than in the liver and was not affected by dietary treatment. Substitution of 10% ALA for oleic acid increased cholesterolemia by 15% but, as in TG, higher ALA intakes did not amplify the response. The highest ALA intake (40%) dramatically modified the hepatobiliary metabolism of sterols: cholesterol content fell by 45% in the liver and increased by 28% in the faeces. Besides, faecal bile acids decreased by 61%, and contained more hydrophobic and less secondary bile acids. Thus, replacing 10% oleic acid by ALA is sufficient to exert a beneficial hypotriglyceridemic effect, which may be counteracted by the slight increase in cholesterolemia. Higher intakes did not modify these parameters, but a very high dose resulted in adverse effects on sterol metabolism.

Dose effect of alpha-linolenic acid on PUFA conversion, bioavailability, and storage in the hamster.

If an increased consumption of alpha-linolenic acid (ALA) is to be promoted in parallel with that of n-3 long-chain-rich food, it is necessary to consider to what extent dietary ALA can be absorbed, transported, stored, and converted into long-chain derivatives. We investigated these processes in male hamsters, over a broad range of supply as linseed oil (0.37, 3.5, 6.9, and 14.6% energy). Linoleic acid (LA) was kept constant (8.5% energy), and the LA/ALA ratio was varied from 22.5 to 0.6. The apparent absorption of individual FA was very high (>96%), and that of ALA remained almost maximum even at the largest supply (99.5%). The capacity for ALA transport and storage had no limitation over the chosen range of dietary intake. Indeed, ALA intake was significantly correlated with ALA level not only in cholesteryl esters (from 0.3 to 9.7% of total FA) but also in plasma phospholipids and red blood cells (RBC), which makes blood components extremely reliable as biomarkers of ALA consumption. Similarly, ALA storage in adipose tissue increased from 0.85 to 14% of total FA and was highly correlated with ALA intake. As for bioconversion, dietary ALA failed to increase 22:6n-3, decreased 20:4n-6, and efficiently increased 20:5n-3 (EPA) in RBC and cardiomyocytes. EPA accumulation did not tend to plateau, in accordance with identical activities of delta5- and delta6-desaturases in all groups. Dietary supply of ALA was therefore a very efficient means of improving the 20:4n-6 to 20:5n-3 balance.

Prevention of coronary disease and sudden death by nutrition

Nutrition influences sudden cardiac death (SCD) not only by determining the development of atherosclerotic coronary disease but possibly also by more specific rhythm stabilizing abilities of some nutrients. QUANTITATIVE ASPECTS: A body mass index >30 is associated with a 2.6-fold risk of SCD, probably via the risk factors diabetes and hypertension. QUALITATIVE ASPECTS: alpha-linolenic acid (ALA) is a substrate for the production of the N-3-fatty acids eicosapentaenoic acid (EPA) und docosahexaenoic acid (DHA). The consumption of ALA correlates with decreased MI risk. Fish consumption is (in case control studies) associated with reduced MI-risk and (in prospective controlled studies) with decreased risk of SCD. Two or more fish meals/week and the estimated N-3-fatty acids (n-3-FA) ingestion of > 1.2 g/week correlate with a reduced SCD-risk. The blood level of the N-3-FA EPA and DHA correlate highly with a reduced risk for SCD. It is likely that the marine production of N-3-FA will not suffice to supply the amount needed for large scale prevention. Industrial farming of algae and genetic modification of mammal muscle cells resulting in improved ability to transform N-6-FA to corresponding N-3-FA could contribute to better availability of N-3-FA for prevention. Nutrition influences sudden cardiac death (SCD) not only by determining the development of atherosclerotic coronary disease but possibly also by more specific rhythm stabilizing abilities of some nutrients.

Omega-3 fatty acids and antioxidants in edible wild plants.

Human beings evolved on a diet that was balanced in the omega-6 and omega-3 polyunsaturated fatty acids (PUFA), and was high in antioxidants. Edible wild plants provide alpha-linolenic acid (ALA) and higher amounts of vitamin E and vitamin C than cultivated plants. In addition to the antioxidant vitamins, edible wild plants are rich in phenols and other compounds that increase their antioxidant capacity. It is therefore important to systematically analyze the total antioxidant capacity of wild plants and promote their commercialization in both developed and developing countries. The diets of Western countries have contained increasingly larger amounts of linoleic acid (LA), which has been promoted for its cholesterol-lowering effect. It is now recognized that dietary LA favors oxidative modification of low density lipoprotein (LDL) cholesterol and increases platelet response to aggregation. In contrast, ALA intake is associated with inhibitory effects on the clotting activity of platelets, on their response to thrombin, and on the regulation of arachidonic acid (AA) metabolism. In clinical studies, ALA contributed to lowering of blood pressure, and a prospective epidemiological study showed that ALA is inversely related to the risk of coronary heart disease in men. Dietary amounts of LA as well as the ratio of LA to ALA appear to be important for the metabolism of ALA to longer-chain omega-3 PUFAs. Relatively large reserves of LA in body fat. as are found in vegans or in the diet of omnivores in Western societies, would tend to slow down the formation of long-chain omega-3 fatty acids from ALA. Therefore, the role of ALA in human nutrition becomes important in terms of long-term dietary intake. One advantage of the consumption of ALA over omega-3 fatty acids from fish is that the problem of insufficient vitamin E intake does not exist with high intake of ALA from plant sources.

Relation between Dietary Linolenic Fatty Acid and Coronary Heart Disease in the NHLBI Family Heart Study

0014 Epidemiologic studies suggest that higher consumption of alpha linolenic acid, eicosapentaenoic acid, and docosahexanoic acid is associated with lower risk of coronary heart disease (CHD). Little is known about the influence of the linoleic-to-linolenic ratio on the relation of linolenic acid to CHD. We used data collected on 4,406 participants of the NHLBI Family Heart Study (mean age of 52 years)to examine the relation between dietary linolenic acid and prevalent coronary heart disease and to determine if such a relation was influenced by fish consumption and linoleic-to-linolenic ratio. Dietary linolenic acid was assessed by semiquantitative food frequency questionnaire. We used generalized estimating equations to estimate the odds ratios of coronary heart disease across age- and energy-adjusted quintiles of linolenic acid. From the lowest to the highest quintile of linolenic acid, the prevalence odds ratios (95 % CI) of coronary heart disease were 1.00 (referent), 0.77 (0.49-1.21), 0.51 (0.32-0.81), 0.52 (0.33-0.84), and 0.48 (0.30-0.76), respectively, for men (p for trend 0.0009) and 1.00, 0.55 (0.29-1.04), 0.75 (0.41-1.38), 0.43 (0.21-0.88), and 0.40 (0.20-0.82), respectively, for women (p for trend 0.015), controlling for age, energy intake, anthropometric, lifestyle, and metabolic factors. This association was observed across all categories of fish consumption frequency. When stratified by tertiles of linoleic-to-linolenic ratio (ranges of 2.3-8.4, 8.5-11.1, and 11.2-64.0), a statistically significant inverse relation between linolenic acid and CHD was observed only in the lowest tertile of linoleic-to-linolenic ratio (p for trend 0.0001, 0.39, and 0.13, respectively, for the first, second, and third tertile of linoleic-to-linolenic ratio). In conclusion, these data suggest an inverse relation between dietary linolenic acid intake and prevalent coronary heart disease in both sexes, independent of fish consumption. A lower ratio of linoleic-to-linolenic fatty acid might be necessary to observe the benefits of linolenic acid on coronary heart disease.