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Intake of alpha-linolenic acid is not consistently associated with a lower risk of peripheral artery disease: results from a Danish cohort study

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Abstract

Intake of the plant-derived omega-3 fatty acid alpha-linolenic acid (ALA) has been associated with anti-atherosclerotic properties. However, information on the association between ALA intake and development of peripheral artery disease (PAD) is lacking. In this follow-up study, we investigated the association between dietary intake of ALA and the rate of PAD among middle-aged Danish men and women enrolled into the Danish Diet, Cancer and Health cohort between 1993 and 1997. Incident PAD cases were identified through the Danish National Patient Register. Intake of ALA was assessed using a validated food frequency questionnaire. Statistical analyses were performed using Cox proportional hazard regression allowing for separate baseline hazards among sexes and adjusted for established risk factors for PAD. During a median of 13.6 years of follow-up, we identified 950 valid cases of PAD with complete information on covariates. The median energy-adjusted ALA intake within the cohort was 1.76 g/d (95% central range: 0.94-3.28). In multivariable analyses, we found no statistically significant association between intake of ALA and the rate of PAD (P = 0.339). Also, no statistically significant associations were observed in analyses including additional adjustment for co-morbidities and in sex-specific analyses. In supplemental analyses with additional adjustment for potential dietary risk factors, we found a weak inverse association to PAD with ALA intake above the median, but the association was not statistically significant (P = 0.314). In conclusion, dietary intake of ALA was not consistently associated with decreased risk of PAD.