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Blood n-3 fatty acid levels and total and cause-specific mortality from 17 prospective studies
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The health effects of omega-3 fatty acids have been controversial. Here we report the results of a de novo pooled analysis conducted with data from 17 prospective cohort studies examining the associations between blood omega-3 fatty acid levels and risk for all-cause mortality. Over a median of 16 years of follow-up, 15,720 deaths occurred among 42,466 individuals. We found that, after multivariable adjustment for relevant risk factors, risk for death from all causes was significantly lower (by 15–18%, at least p < 0.003) in the highest vs the lowest quintile for circulating long chain (20–22 carbon) omega-3 fatty acids (eicosapentaenoic, docosapentaenoic, and docosahexaenoic acids). Similar relationships were seen for death from cardiovascular disease, cancer and other causes. No associations were seen with the 18-carbon omega-3, alpha-linolenic acid. These findings suggest that higher circulating levels of marine n-3 PUFA are associated with a lower risk of premature death.
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“Observational studies consistently show that an O3I of ≥8% is ideal for reducing risk of major adverse cardiovascular events116 (MACE), stroke20 and all-cause mortality117.”
From Effects of Omega-3 Fatty Acid Treatment on Risk for Atrial Fibrillation: An Updated Meta-Analysis of 35 Trials including 114 592 Individuals (2026) · cites this paper as [117]
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Metadata
- Authors
- Harris, W. S., Tintle, N. L., Imamura, F., Qian, F., Korat, A. V. A., Marklund, M., Djoussé, L., Bassett, J. K., Carmichael, P.-H., Chen, Y.-Y., Hirakawa, Y., Küpers, L. K., Laguzzi, F., Lankinen, M., Murphy, R. A., Samieri, C., Senn, M. K., Shi, P., Virtanen, J. K., Brouwer, I. A., Chien, K.-L., Eiriksdottir, G., Forouhi, N. G., Geleijnse, J. M., Giles, G. G., Gudnason, V., Helmer, C., Hodge, A., Jackson, R., Khaw, K.-T., Laakso, M., Lai, H., Laurin, D., Leander, K., Lindsay, J., Micha, R., Mursu, J., Ninomiya, T., Post, W., Psaty, B. M., Risérus, U., Robinson, J. G., Shadyab, A. H., Snetselaar, L., Sala-Vila, A., Sun, Y., Steffen, L. M., Tsai, M. Y., Wareham, N. J., Wood, A. C., Wu, J. H. Y., Hu, F., Sun, Q., Siscovick, D. S., Lemaitre, R. N., Mozaffarian, D., & The Fatty Acids and Outcomes Research Consortium (FORCE)
- Affiliations
- University of South Dakota (US)
- Dordt University (US)
- University of Cambridge (GB)
- Brigham and Women's Hospital (US)
- Johns Hopkins University (US)
- Cancer Council Victoria (AU)
- National Taiwan University (TW)
- Kyushu University (JP)
- Wageningen University & Research (NL)
- Karolinska Institutet (SE)
- University of Eastern Finland (FI)
- BC Cancer Agency (CA)
- Université de Bordeaux (FR)
- Baylor College of Medicine (US)
- Tufts University (US)
- Amsterdam Public Health (NL)
- The University of Melbourne (AU)
- University of Iceland (IS)
- The Ohio State University (US)
- Université Laval (CA)
- University of Ottawa (CA)
- University of Washington (US)
- Uppsala University (SE)
- University of Iowa (US)
- University of California San Diego (US)
- University of Minnesota (US)
- UNSW Sydney (AU)
- New York Academy of Medicine (US)
- Corresponding author
- Harris, William S.
- ORCID
- Harris, William S.
- Tintle, Nathan L.
- Imamura, Fumiaki
- Qian, Frank
- Korat, Andres V. Ardisson
- Marklund, Matti
- Djoussé, Luc
- Bassett, Julie K.
- Carmichael, Pierre-Hugues
- Chen, Yun-Yu
- Hirakawa, Yoichiro
- Küpers, Leanne K.
- Laguzzi, Federica
- Lankinen, Maria
- Murphy, Rachel A.
- Samieri, Cécilia
- Senn, Mackenzie K.
- Virtanen, Jyrki K.
- Brouwer, Ingeborg A.
- Chien, Kuo-Liong
- Forouhi, Nita G.
- Geleijnse, Johanna M.
- Giles, Graham G.
- Gudnason, Vilmundur
- Helmer, Catherine
- Hodge, Allison
- Khaw, Kay-Tee
- Laakso, Markku
- Lai, Heidi
- Laurin, Danielle
- Leander, Karin
- Micha, Renata
- Ninomiya, Toshiharu
- Post, Wendy
- Psaty, Bruce M.
- Risérus, Ulf
- Robinson, Jennifer G.
- Shadyab, Aladdin H.
- Snetselaar, Linda
- Sun, Yangbo
- Steffen, Lyn M.
- Tsai, Michael Y.
- Wareham, Nicholas J.
- Wood, Alexis C.
- Wu, Jason H. Y.
- Hu, Frank
- Sun, Qi
- Siscovick, David S.
- Lemaitre, Rozenn N.
- Mozaffarian, Dariush
- Venue
- Nature Communications
- Published
- 2021-04-22
- Volume
- 12
- Issue
- 1
- Pages
- 2329-2329
- ISSN
- 2041-1723 (ISSN-L)
- PMC
- PMC8062567
- OpenAlex
- W3155934512
- Cited by
- 244
- References
- 67
- Citations by year
- 2026: 33 · 2025: 45 · 2024: 45 · 2023: 46 · 2022: 53 · 2021: 21
- FWCI
- 26.29
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Nature Communications (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- HAL (submittedVersion, cc-by)
- Socio-Environmental Systems Modeling (submittedVersion, cc-by)
- Opin vísindi (Opin vísindi) (submittedVersion, cc-by-nc-sa)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Digital Commons-TMC (Texas Medical Center) (submittedVersion)
- Uppsala University Publications (Uppsala University) (submittedVersion, other-oa)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Opin vísindi (Opin vísindi) (submittedVersion, other-oa)
- Oskar-Bordeaux (Universite de Bordeaux) (submittedVersion, cc-by)
- Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
- Apollo
- Apollo (cc-by)
- Funders
- Bill and Melinda Gates Foundation
- Rockefeller Foundation
- Amgen
- Eli Lilly and Company
- Sanofi
- Yale University
- Pharmavite
- Cleveland Clinic
- Cleveland Clinic Foundation
- Danone
- Regeneron Pharmaceuticals
- Amarin Corporation
- California Walnut Commission
- National Institute for Health and Care Research (NIHR202397)
- Cambridge University Hospitals (146281)
- Esperion Therapeutics
- National Institutes of Health
- Medical Research Council (MC_UU_12015/5, MC_UU_12015/1)
- National Cancer Institute (T32CA009001)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Life Sciences › Agricultural and Biological Sciences › Aquatic Science › Aquaculture Nutrition and Growth
- Keywords
- omega-3 fatty acids, blood fatty acid levels, all-cause mortality, cardiovascular mortality, cancer mortality, eicosapentaenoic acid, docosahexaenoic acid, docosapentaenoic acid, alpha-linolenic acid, marine omega-3 fatty acids, cause-specific mortality
- MeSH terms
- Aged, Aged, 80 and over, Cause of Death, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Fatty Acids, Omega-3, Mortality, Premature, Protective Factors
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