ERF of omega-3 fatty acids

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Question

What is the exposure-response function (ERF) of omega-3 fatty acids on several health end points?

Answer

+ Show code- Hide code library(OpasnetUtils) objects.latest("Op_en5830", code_name = "initiate") # [[ERF of omega-3 fatty acids]] ovariables ERF, threshold. oprint(summary(EvalOutput(ERF)))

Rationale

Data

ERF of omega-3 fatty acids(-)

Obs	Exposure agent	Trait	Response metric	Exposure route	Exposure metric	Exposure unit	ERF parameter	Threshold	ERF	Description
1	DHA	Child's intelligence	Change in IQ points	Placenta	Maternal intake	mg/kg bw/day	ERS bw	0	0.07 +- 0.01	Cohen et al. 2005; Gradowska 2013; Standard deviation
2	DHA	Child's IQ	Change in IQ points	Placenta	Maternal intake	g/day	ERS	0	0.8-1.8	Cohen et al. 2005 according to Zeilmaker 2013
3	Omega3	Coronary heart disease	Mortality	Ingestion	Intake from fish	mg/day EPA+DHA	RR	0	0.9980 +- 0.000396	Mozaffarian and Rimm 2006; Gradowska 2013 slope = -0.002, SD = exp(-0.002)-exp(-0.002+3.97E-4)
4	Omega3	CHD	Arrythmia mortality	Ingestion	Intake from fish	mg/day EPA+DHA	Relative Hill	200	-0.3	Mozaffarian and Rimm 2006
5	Fish	Subclinical brain infarct (one or more)	Prevalence	Ingestion	Intake of tuna/other fish	≥3 times/week vs. <1/month	RR	0	0.74 (0.54 - 1.01)	Virtanen et al. 2008; 95% CI
6	Fish	Any prevalent subclinical brain infarct	Prevalence	Ingestion	Intake of tuna/other fish	Each one serving per week	RR	0	0.93 (0.88 - 0.994)	Virtanen et al. 2008; 95% CI
7	Fish	Subclinical brain infarct (one or more)	Incidence	Ingestion	Intake of tuna/other fish	≥3 times/week vs. <1/month	RR	0	0.56 (0.30 - 1.07)	Virtanen et al. 2008; 95% CI
8	Fish	Any incident subclinical brain infarct	Incidence	Ingestion	Intake of tuna/other fish	Each one serving per week	RR	0	0.89 (0.78 - 0.993)	Virtanen et al. 2008; 95% CI
9	Fish	Status of cerebral white matter	Grade score	Ingestion	Intake of tuna/other fish	Each one serving per week	ERS	0	0.038	Virtanen et al. 2008; 95% CI

ERF publications

ERF data as described in original articles

Exposure agent	Trait	Response metric	Exposure route	Exposure metric	Exposure unit	ERF parameter	Threshold	ERF	Description
DHA	Child´s IQ	Change in IQ points	Placenta	Maternal intake	mg/kg bw/day	ERS	0	0.07(±0.01)	Cohen et al. 2005; Gradowska 2013
Omega3	CHD	Δlog(CHD mortality rate)	Ingestion	Intake from fish	mg/day EPA+DHA	ERS	0	-0.002 (±3.97E-4)	Mozaffarian and Rimm 2006; Gradowska 2013
Fish	Subclinical brain infarct (one or more)	Prevalence	Ingestion	Intake of tuna/other fish	=3 times/week vs. <1/month	RR	0	0.74(0.54-1.01)	Virtanen et al. 2008
Fish	Any prevalent subclinical brain infarct	Prevalence	Ingestion	Intake of tuna/other fish	Each one serving per week	Decrease in RR %	0	7(0.6-12)	Virtanen et al. 2008
Fish	Subclinical brain infarct (one or more)	Incidence	Ingestion	Intake of tuna/other fish	=3 times/week vs. <1/month	RR	0	0.56(0.30-1.07)	Virtanen et al. 2008
Fish	Any incident subclinical brain infarct	Incidence	Ingestion	Intake of tuna/other fish	Each one serving per week	Decrease in RR %	0	11(0.7-22)	Virtanen et al. 2008
Fish	Status of cerebral white matter	Grade score	Ingestion	Intake of tuna/other fish	Each one serving per week	Increase in grade score %	0	3.8	Virtanen et al. 2008

Exposure-response of fish oil intake for MI risk in adults is indexed by variable age. It applies to age categories > 18 years.

The study by Cohen et al. 2005 estimates that increasing maternal docosahexaenoic acid (DHA) intake by 100 mg/day increases child's IQ by 0.13 points D↷. This value represents central estimate while the upper and lower bound for this ERF is 0.08 and 0.18. Triangular distribution is used.

In a recent study, 3660 over 65-year-old individuals were monitored for five years, and the change in small brain infarctions was observed by magnetic resonance imageing. The infaction risk was 25 % lower in those who ate at least three portions of omega-3-rich fish meals per week, and 13 % lower in those who ate one meal per week.

Fernandez-Jarne et al. examined the relationship between intake of fish and n-3 PUFA and the risk of first acute myocardial infarction (AMI) in a low risk population from Navarre (Spain). They found that the n-3 PUFA intake has a protective effect on AMI. The adjusted odds ratio (OR) for the second and third tertile of n-3 PUFA intake were 0.44 (95% Cl, 0.21-0.91) and 0.47 (95% Cl, 0.22-1.00), respectively. The trend test was not statistically significant. D↷

Mozaffarian and Rimm estimated that at intakes between 0 and 250 mg/d, the relative risk of coronary heart disease (CHD) death is lower by 14.6% (95% CI: 8% to 21%) per each 100 mg/d of EPA and DHA intake and that at higher intakes ( > 250 mg/d) the risk reduction is 0.0% (95% CI: -0.9% to 0.8%) per each 100 mg/d.

The ERF of omega-3 fatty acids (DHA+EPA) intake from fish (in unit of mg/kg bw-day) on the CHD mortality is estimated based on information provided in . First, the central estimate and the 95% CI for the change (in this case decrease) in natural logarithm of relative risk (RR) of CHD mortality per unit change in omega-3 fatty acids intake (in unit of mg/day) in both intake intervals were derived. In general, the relationship between the percent change in RR (%RR) associated with c-unit increase in omega-3 fatty acids intake and the incremental change in lnRR (beta) per unit change in omega-3 fatty acids intake is beta = (1/c)*ln((%RR/100)+1). Normal distribution was chosen to describe the uncertainty in the parameter of the log-linear model for RR in each intake interval. For intake of EPA+DHA between 0 and 250 mg/day the mean and the standard deviation of parameter distribution are -0.0016 and 0.0004, for higher intakes 0 and 0.0005. Then, the distribution of ERF of omega-3 fatty acids intake from fish in units of mg/kg bw-day was obtained by multiplying ERFs of omega-3 fatty acids intake measured in mg/day by the body weight of adult.

Unit

lnRR/ 1 (mg/kg bw-day) change in EPA+DHA intake from fish

Beneris distributions

For intakes of EPA+DHA from fish between 0 and 250 mg/day: N(-0.0016,0.0004)*BW

For intakes of EPA+DHA from fish higher than 250 mg/day: N(0,0.0005)*BW

Calculations

+ Show code- Hide code library(OpasnetUtils) d <- opbase.data("Op_en5830") d$Obs <- NULL colnames(d) <- gsub(" ", "_", colnames(d)) d$Result <- ifelse(d$Result == "", "0", as.character(d$Result)) ERF <- Ovariable("ERF", data = d[d$Observation == "ERF", colnames(d) != "Observation"]) threshold <- Ovariable("Threshold", data = d[d$Observation == "Threshold", colnames(d) != "Observation"]) objects.store(ERF, threshold) cat("Ovariables ERF, threshold stored.\n")

See also

• ERF of methyl mercury
• A press release from the University of Kuopio (in Finnish)
• Reviews by Henna Karvonen in Beneris:
  • Impact of fish consumption on nutrient intakes
  • ‎‎Cardiovascular dose-responses of fish consumption
  • Mental health dose-responses of fish consumption
  • Immunological disease dose-responses of fish consumption
  • Diabetes and glucose dose-responses of fish consumption‎
  • Developmental dose-responses of fish consumption
  • Cancer dose-responses of fish consumption
  • Bone dose-responses of fish consumption
  • All-cause mortality dose-response of fish consumption‎