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

• Published in: British journal of nutrition Vol. 89; no. 2; pp. 267 - 272
• Main Authors: Nakamura, Tomoki, Azuma, Akihiro, Kuribayashi, Toshiro, Sugihara, Hiroki, Okuda, Seisuke, Nakagawa, Masao
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.02.2003; CABI Pub
• Subjects: Adult; Aged; Agriculture; Analysis of Variance; Animals; Biological and medical sciences; Blood pressure; blood serum; Cardiology. Vascular system; Cardiovascular diseases; Cholesterol; Cholesterol - blood; Cholesterol, LDL - blood; Coastal zone; coronary disease; Coronary Disease - blood; Coronary Disease - mortality; Coronary heart disease; Coronary risk factors; Cross-Sectional Studies; diabetes; Diet; Dietary style; eating habits; farming systems; fatty acid composition; Fatty acids; Fatty Acids - blood; Fatty Acids, Unsaturated - blood; Female; fish consumption; Fishes; Fishing; Heart; high density lipoprotein cholesterol; Humans; Incidence; Japan - epidemiology; lifestyle; low density lipoprotein cholesterol; Male; Medical sciences; Middle Aged; Mortality; omega-3 fatty acids; omega-6 fatty acids; physical activity; Polyunsaturated fatty acids; Prospective Studies; Risk Factors; Rural Population; saturated fatty acids; Smoking; uric acid; Asia; Japan; Coronary risk factors; Coronary heart disease; Dietary style; Fatty acids; Human; Feeding behavior; Rural environment; Cardiovascular disease; Environmental factor; Lipids; n-3 fatty acid; Feeding; Prospective; n-6 fatty acid; Diet; Cross sectional study; Risk factor; Coronary heart disease: Dietary style: Fatty acids: Coronary risk factors; Unsaturated fatty acid; Macronutrient; Nutritional status; Life style
• ISSN: 0007-1145; 1475-2662
• DOI: 10.1079/BJN2002747

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.