Evidence map›Paper›PMID 27357102›Full record

ArticleJAMA internal medicine2016

ω-3 Polyunsaturated Fatty Acid Biomarkers and Coronary Heart Disease: Pooling Project of 19 Cohort Studies.

Liana C Del Gobbo, Fumiaki Imamura, Stella Aslibekyan, Matti Marklund, Jyrki K Virtanen, Maria Wennberg, Mohammad Y Yakoob, Stephanie E Chiuve, Luicito Dela Cruz, Alexis C Frazier-Wood and 40 more

Erratum issuedOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JAMA internal medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 192 papers, 22 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
192citing papers in PubMed, 22 pooled it
38.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

192 citing papers in PubMed, 22 syntheses or guidelines pooled it, 391 citations in OpenAlex.

  1. Dried Blood Spots to Assess Cardiovascular-Kidney-Metabolic Health.Journal of the American Heart Association · 2025
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132 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

50 authors at 20 institutions in 9 countries.

Liana C Del GobboDepartment of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California.
Fumiaki ImamuraMedical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge University, Cambridge, United Kingdom.
Stella AslibekyanDepartment of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham.
Matti MarklundDepartment of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Jyrki K VirtanenInstitute of Public Health and Clinical Nutrition, University of Eastern Finland, Joensuu, Finland.
Maria WennbergDepartment of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Mohammad Y YakoobDepartment of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California.
Stephanie E ChiuveDivision of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts8Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
Luicito Dela CruzCancer Epidemiology Centre, Cancer Council Victoria, Victoria, Australia.
Alexis C Frazier-WoodUSDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas.
Amanda M FrettsDepartment of Epidemiology, University of Washington, Seattle.
Eliseo GuallarDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Chisa MatsumotoDivision of Cardiology, Tokyo Medical University, Tokyo, Japan14Division of Aging, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Kiesha PremSaw Swee Hock School of Public Health, National University of Singapore, Singapore.
Tosh TanakaTranslational Gerontology Branch, National Institute on Aging, Bethesda, Maryland.
Jason H Y WuThe George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia.
Xia ZhouDivision of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis.
Catherine HelmerInstitut National de la Santé et de la Recherche Médicale, Institut de Santé Publique, d'Épidémiologie et de Développement, Centre IInstitut National de la Santé et de la Recherche Médicale U897-Epidemiologie-Biostatistique, Bordeaux, France20University B.
Erik IngelssonDepartment of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California21Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Jian-Min YuanDivision of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania23Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
Pascale Barberger-GateauInstitut National de la Santé et de la Recherche Médicale, Institut de Santé Publique, d'Épidémiologie et de Développement, Centre IInstitut National de la Santé et de la Recherche Médicale U897-Epidemiologie-Biostatistique, Bordeaux, France20University B.
Hannia CamposDepartment of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
Paulo H M ChavesBenjamin Leon Center for Geriatric Research and Education, Florida International University, Miami.
Luc DjousséDivision of Aging, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Graham G GilesCancer Epidemiology Centre, Cancer Council Victoria, Victoria, Australia.
Jose Gómez-AracenaDepartment of Preventive Medicine, Universidad de Malaga, Malaga, Spain.
Allison M HodgeCancer Epidemiology Centre, Cancer Council Victoria, Victoria, Australia.
Frank B HuDepartment of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts24Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts27Channing Division of Network Medicine, Department of Medicine, Brigh.
Jan-Håkan JanssonDepartment of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Ingegerd JohanssonDepartment of Odontology, Umeå University, Umeå, Sweden.
Kay-Tee KhawDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
Woon-Puay KohSaw Swee Hock School of Public Health, National University of Singapore, Singapore30Duke-NUS Graduate Medical School Singapore, Singapore.
Rozenn N LemaitreCardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle.
Lars LindDepartment of Medical Sciences, Uppsala University, Uppsala, Sweden.
Robert N LubenDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
Eric B RimmDepartment of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts24Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts27Channing Division of Network Medicine, Department of Medicine, Brigh.
Ulf RisérusDepartment of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Cecilia SamieriInstitut National de la Santé et de la Recherche Médicale, Institut de Santé Publique, d'Épidémiologie et de Développement, Centre IInstitut National de la Santé et de la Recherche Médicale U897-Epidemiologie-Biostatistique, Bordeaux, France20University B.
Paul W FranksDepartment of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden24Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts32Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund Un.
David S SiscovickThe New York Academy of Medicine, New York.
Meir StampferDepartment of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts24Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts27Channing Division of Network Medicine, Department of Medicine, Brigh.
Lyn M SteffenDivision of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis.
Brian T SteffenDivision of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis.
Michael Y TsaiDepartment of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis.
Rob M van DamSaw Swee Hock School of Public Health, National University of Singapore, Singapore24Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts35Department of Medicine, Yong Loo Lin School of Medicine, National University of.
Sari VoutilainenInstitute of Public Health and Clinical Nutrition, University of Eastern Finland, Joensuu, Finland.
Walter C WillettDepartment of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts24Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts27Channing Division of Network Medicine, Department of Medicine, Brigh.
Mark WoodwardDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland17The George Institute for Global Health, Sydney Medical School, University of Sydney, Sydney, Australia36The George Institute for Global Health, Nuffield Depa.
Dariush MozaffarianFriedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.
Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Fatty Acids and Outcomes Research Consortium (FORCe)
Harvard University · USUppsala University · SECancer Council Victoria · AUInserm · FRUmeå University · SEUniversity of Cambridge · GBUniversity of Minnesota · USNational University Health System · SGUniversity of Eastern Finland · FIUniversity of Washington · USBrigham and Women's Hospital · USChildren's Nutrition Research Center at Baylor College of Medicine · USFlorida International University · USJohns Hopkins University · USLund University · SEMinnesota Department of Health · USNational Institute on Aging · USNational University of Singapore · SGNew York Academy of Medicine · USStanford University · US

Funding

Statistical MethodsP01CA087969 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI TWOROGER, SHELLEY S · 2000 to 2019
$77.8M
Institute for Clinical and Translational Research (UL1)UL1RR025005 · NCRR · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2007 to 2011
$75.8M
Institute for Clinical and Translational ResearchUL1TR001079 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$60.1M
Validity of Diet and Activity Measures in WomenP01CA055075 · NCI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI SPIEGELMAN, DONNA L · 1991 to 2009
$41.8M
Clinical and Translational Science AwardUL1TR000040 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GINSBERG, HENRY N · 2012 to 2015
$26.2M
Transgenic CoreP30DK046200 · NIDDK · TUFTS MEDICAL CENTER · PI GREENBERG, ANDREW S, PERISSI, VALENTINA · 1992 to 2021
$25.0M
Long Term Multidisciplinary Study of Cancer in Women: The Nurses Health StudyUM1CA186107 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI ELIASSEN, A. HEATHER, STAMPFER, MEIR · 2014 to 2023
$22.3M
Genome-Wide Association Analysis in Essential Hypertension (FEHGAS study)R01HL086694 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI ARAVINDA CHAKRAVARTI · 2007 to 2026
$21.2M
Cancer Epidemiology Cohort in Male Health ProfessionalsU01CA167552 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Lorelei Mucci, Walter C. Willett · 2017 to 2026
$17.0M
Physicians' Health Study II: Prevention Trial of VitaminsR01CA097193 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI GAZIANO, J. MICHAEL · 2002 to 2011
$15.7M
RISK FACTORS FOR CVD IN WOMENR01HL034594 · NHLBI · TULANE UNIVERSITY OF LOUISIANA · PI JoAnn Elisabeth Manson, Lu Qi · 1985 to 2026
$13.8M
Dietary Etiology of Heart DiseaseR01HL035464 · NHLBI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI ERIC B RIMM, Qi Sun · 1986 to 2026
$13.6M
British Heart FoundationChief Scientist OfficeIntramural NIH HHS Z99 AG999999Medical Research Council G0401527Medical Research Council G1000143Medical Research Council MR/N003284/1NCATS NIH HHS UL1 TR001079NCI NIH HHS P01 CA055075NCI NIH HHS P01 CA087969NCI NIH HHS R01 CA034944NCI NIH HHS R01 CA040360NCI NIH HHS R01 CA049449NCI NIH HHS R01 CA080205NCI NIH HHS R01 CA097193NCI NIH HHS R01 CA144034NCI NIH HHS U01 CA167552NCI NIH HHS U01 CA182876NCI NIH HHS UM1 CA167552NCI NIH HHS UM1 CA182876NCI NIH HHS UM1 CA186107NCRR NIH HHS UL1 RR025005NHGRI NIH HHS U01 HG004402NHLBI NIH HHS N01 HC055222NHLBI NIH HHS N01 HC085079NHLBI NIH HHS N01 HC085080NHLBI NIH HHS N01 HC085081NHLBI NIH HHS N01 HC085082NHLBI NIH HHS N01 HC085083NHLBI NIH HHS N01 HC085086NHLBI NIH HHS N01 HC095159NHLBI NIH HHS N01 HC095160NHLBI NIH HHS N01 HC095161NHLBI NIH HHS N01 HC095162NHLBI NIH HHS N01 HC095163NHLBI NIH HHS N01 HC095164NHLBI NIH HHS N01 HC095165NHLBI NIH HHS N01 HC095166NHLBI NIH HHS N01 HC095167NHLBI NIH HHS N01 HC095168NHLBI NIH HHS N01 HC095169NHLBI NIH HHS N02 HL064278NHLBI NIH HHS R01 HL026490NHLBI NIH HHS R01 HL034594NHLBI NIH HHS R01 HL034595NHLBI NIH HHS R01 HL035464NHLBI NIH HHS R01 HL059367NHLBI NIH HHS R01 HL060712NHLBI NIH HHS R01 HL081549NHLBI NIH HHS R01 HL085710NHLBI NIH HHS R01 HL086694NHLBI NIH HHS R01 HL087641NHLBI NIH HHS R01 HL088521NHLBI NIH HHS R21 HL088081NHLBI NIH HHS U01 HL080295NIAAA NIH HHS R01 AA011181NIA NIH HHS R01 AG023629NIDDK NIH HHS P30 DK046200NIMHD NIH HHS R01 MD009164
6 · The paper itself

Abstract

importanceThe role of ω-3 polyunsaturated fatty acids for primary prevention of coronary heart disease (CHD) remains controversial. Most prior longitudinal studies evaluated self-reported consumption rather than biomarkers.

objectiveTo evaluate biomarkers of seafood-derived eicosapentaenoic acid (EPA; 20:5ω-3), docosapentaenoic acid (DPA; 22:5ω-3), and docosahexaenoic acid (DHA; 22:6ω-3) and plant-derived α-linolenic acid (ALA; 18:3ω-3) for incident CHD. DATA SOURCES: A global consortium of 19 studies identified by November 2014. STUDY SELECTION: Available prospective (cohort, nested case-control) or retrospective studies with circulating or tissue ω-3 biomarkers and ascertained CHD. DATA EXTRACTION AND SYNTHESIS: Each study conducted standardized, individual-level analysis using harmonized models, exposures, outcomes, and covariates. Findings were centrally pooled using random-effects meta-analysis. Heterogeneity was examined by age, sex, race, diabetes, statins, aspirin, ω-6 levels, and FADS desaturase genes. MAIN OUTCOMES AND MEASURES: Incident total CHD, fatal CHD, and nonfatal myocardial infarction (MI).

resultsThe 19 studies comprised 16 countries, 45 637 unique individuals, and 7973 total CHD, 2781 fatal CHD, and 7157 nonfatal MI events, with ω-3 measures in total plasma, phospholipids, cholesterol esters, and adipose tissue. Median age at baseline was 59 years (range, 18-97 years), and 28 660 (62.8%) were male. In continuous (per 1-SD increase) multivariable-adjusted analyses, the ω-3 biomarkers ALA, DPA, and DHA were associated with a lower risk of fatal CHD, with relative risks (RRs) of 0.91 (95% CI, 0.84-0.98) for ALA, 0.90 (95% CI, 0.85-0.96) for DPA, and 0.90 (95% CI, 0.84-0.96) for DHA. Although DPA was associated with a lower risk of total CHD (RR, 0.94; 95% CI, 0.90-0.99), ALA (RR, 1.00; 95% CI, 0.95-1.05), EPA (RR, 0.94; 95% CI, 0.87-1.02), and DHA (RR, 0.95; 95% CI, 0.91-1.00) were not. Significant associations with nonfatal MI were not evident. Associations appeared generally stronger in phospholipids and total plasma. Restricted cubic splines did not identify evidence of nonlinearity in dose responses. CONCLUSIONS AND RELEVANCE: On the basis of available studies of free-living populations globally, biomarker concentrations of seafood and plant-derived ω-3 fatty acids are associated with a modestly lower incidence of fatal CHD.

Indexed as

alpha-Linolenic AcidBiomarkersCohort StudiesCoronary DiseaseDocosahexaenoic AcidsFatty Acids, Omega-3Fatty Acids, UnsaturatedFemaleHumansIncidenceMaleOdds Ratioalpha-Linolenic AcidBiomarkersDocosahexaenoic Acidsdocosapentaenoic acidFatty Acids, Omega-3Fatty Acids, Unsaturated

Identifiers

PMID27357102
PMCPMC5183535
OpenAlexW2469860611

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.