Difference between revisions of "ERF of omega-3 fatty acids"
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=== Data === | === Data === | ||
| − | <t2b index="Exposure agent,Response,Exposure,Exposure unit,ER function,Scaling,Observation" locations="Threshold,ERF" desc="Description" unit="-"> | + | <t2b index="Exposure agent,Response,Age,Exposure,Exposure unit,ER function,Scaling,Observation" locations="Threshold,ERF" desc="Description" unit="-"> |
| − | DHA|Change in child's IQ points|Maternal intake through placenta|mg /kg bw /day|ERS|BW|0|0.07 +- 0.01|Cohen et al. 2005; Gradowska 2013; Standard deviation | + | DHA|Change in child's IQ points||Maternal intake through placenta|mg /kg bw /day|ERS|BW|0|0.07 +- 0.01|Cohen et al. 2005; Gradowska 2013; Standard deviation |
| − | DHA|Change in child's IQ points|Maternal intake through placenta|mg /day|ERS|None|0|0.0013 (0.0008 - 0.0018)|Cohen et al. 2005; also according to Zeilmaker 2013 | + | DHA|Change in child's IQ points||Maternal intake through placenta|mg /day|ERS|None|0|0.0013 (0.0008 - 0.0018)|Cohen et al. 2005; also according to Zeilmaker 2013 |
| − | Omega3|Coronary heart disease mortality|Ingested intake of EPA+DHA from fish|mg /day|RR|None|0|0.9980 +- 0.000396|Mozaffarian and Rimm 2006; Gradowska 2013 slope = -0.002, SD = exp(-0.002)-exp(-0.002+3.97E-4) | + | Omega3|Coronary heart disease mortality||Ingested intake of EPA+DHA from fish|mg /day|RR|None|0|0.9980 +- 0.000396|Mozaffarian and Rimm 2006; Gradowska 2013 slope = -0.002, SD = exp(-0.002)-exp(-0.002+3.97E-4) |
| − | Omega3|CHD arrythmia mortality|Ingested intake of EPA+DHA from fish|mg /day|Relative Hill|None|200|-0.3|Mozaffarian and Rimm 2006 | + | Omega3|CHD arrythmia mortality||Ingested intake of EPA+DHA from fish|mg /day|Relative Hill|None|200|-0.3|Mozaffarian and Rimm 2006 |
| − | Omega3|CHD2 mortality|Ingested intake of EPA+DHA from fish|mg /day|Relative Hill|None|47|-0.17 (-0.25 - -0.088)|Cohen et al 2005. "antiarrhythmic effect". No-exposure is <1 serving/mo, therefore ED50 = two servings per month = 1400 mg/mo = 47 mg/d | + | Omega3|CHD2 mortality||Ingested intake of EPA+DHA from fish|mg /day|Relative Hill|None|47|-0.17 (-0.25 - -0.088)|Cohen et al 2005. "antiarrhythmic effect". No-exposure is <1 serving/mo, therefore ED50 = two servings per month = 1400 mg/mo = 47 mg/d |
| − | Omega3|CHD2 mortality|Ingested intake of EPA+DHA from fish|mg /day|RR|None|0|0.99951 (0.99934 - 0.99989)|Cohen et al 2005 "antiatherosclerotic effect". 1-0.039*0.01 | + | Omega3|CHD2 mortality||Ingested intake of EPA+DHA from fish|mg /day|RR|None|0|0.99951 (0.99934 - 0.99989)|Cohen et al 2005 "antiatherosclerotic effect". 1-0.039*0.01 |
| − | Omega3|Stroke mortality|Ingested intake of EPA+DHA from fish|mg /day|Relative Hill|None|47|-0.12 (-0.25 - 0.01)|Cohen et al. 2005 | + | Omega3|Stroke mortality||Ingested intake of EPA+DHA from fish|mg /day|Relative Hill|None|47|-0.12 (-0.25 - 0.01)|Cohen et al. 2005 |
| − | Omega3|Stroke mortality|Ingested intake of EPA+DHA from fish|mg /day|RR|None|0|0.9998 (0.99934 - 1.00027)|1-0.02*0.01, Cohen et al 2005: −2.0% 95% CI: +2.7% to −6.6% | + | Omega3|Stroke mortality||Ingested intake of EPA+DHA from fish|mg /day|RR|None|0|0.9998 (0.99934 - 1.00027)|1-0.02*0.01, Cohen et al 2005: −2.0% 95% CI: +2.7% to −6.6% |
| − | Fish|Subclinical brain infarct (one or more) prevalence|Ingested intake of tuna/other fish|≥3 times/week vs. <1/month|RR|None|0|0.74 (0.54 - 1.01)|Virtanen et al. 2008; 95% CI | + | Fish|Subclinical brain infarct (one or more) prevalence||Ingested intake of tuna/other fish|≥3 times/week vs. <1/month|RR|None|0|0.74 (0.54 - 1.01)|Virtanen et al. 2008; 95% CI |
| − | Fish|Any prevalent subclinical brain infarct prevalence|Ingested intake of tuna/other fish|Each one serving per week|RR|None|0|0.93 (0.88 - 0.994)|Virtanen et al. 2008; 95% CI | + | Fish|Any prevalent subclinical brain infarct prevalence||Ingested intake of tuna/other fish|Each one serving per week|RR|None|0|0.93 (0.88 - 0.994)|Virtanen et al. 2008; 95% CI |
| − | Fish|Subclinical brain infarct (one or more)incidence|Ingested intake of tuna/other fish|≥3 times/week vs. <1/month|RR|None|0|0.56 (0.30 - 1.07)|Virtanen et al. 2008; 95% CI | + | Fish|Subclinical brain infarct (one or more)incidence||Ingested intake of tuna/other fish|≥3 times/week vs. <1/month|RR|None|0|0.56 (0.30 - 1.07)|Virtanen et al. 2008; 95% CI |
| − | Fish|Any incident subclinical brain infarct incidence|Ingested intake of tuna/other fish|Each one serving per week|RR|None|0|0.89 (0.78 - 0.993)|Virtanen et al. 2008; 95% CI | + | Fish|Any incident subclinical brain infarct incidence||Ingested intake of tuna/other fish|Each one serving per week|RR|None|0|0.89 (0.78 - 0.993)|Virtanen et al. 2008; 95% CI |
| − | Fish|Status of cerebral white matter grade score|Ingested intake of tuna/other fish|Each one serving per week|ERS|None|0|0.038|Virtanen et al. 2008; 95% CI | + | Fish|Status of cerebral white matter grade score||Ingested intake of tuna/other fish|Each one serving per week|ERS|None|0|0.038|Virtanen et al. 2008; 95% CI |
</t2b> | </t2b> | ||
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Question
What is the exposure-response function (ERF) of omega-3 fatty acids on several health end points?
Answer
⇤# : Note: This article has NOT been implemented in the result: Engeset et al. 2014: Fish consumption and mortality in the European Prospective Investigation into Cancer and Nutrition cohort --Jouni (talk) 12:51, 8 March 2015 (UTC)
Rationale
Data
| Obs | Exposure agent | Response | Age | Exposure | Exposure unit | ER function | Scaling | Threshold | ERF | Description |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | DHA | Change in child's IQ points | Maternal intake through placenta | mg /kg bw /day | ERS | BW | 0 | 0.07 +- 0.01 | Cohen et al. 2005; Gradowska 2013; Standard deviation | |
| 2 | DHA | Change in child's IQ points | Maternal intake through placenta | mg /day | ERS | None | 0 | 0.0013 (0.0008 - 0.0018) | Cohen et al. 2005; also according to Zeilmaker 2013 | |
| 3 | Omega3 | Coronary heart disease mortality | Ingested intake of EPA+DHA from fish | mg /day | RR | None | 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 | Ingested intake of EPA+DHA from fish | mg /day | Relative Hill | None | 200 | -0.3 | Mozaffarian and Rimm 2006 | |
| 5 | Omega3 | CHD2 mortality | Ingested intake of EPA+DHA from fish | mg /day | Relative Hill | None | 47 | -0.17 (-0.25 - -0.088) | Cohen et al 2005. "antiarrhythmic effect". No-exposure is <1 serving/mo, therefore ED50 = two servings per month = 1400 mg/mo = 47 mg/d | |
| 6 | Omega3 | CHD2 mortality | Ingested intake of EPA+DHA from fish | mg /day | RR | None | 0 | 0.99951 (0.99934 - 0.99989) | Cohen et al 2005 "antiatherosclerotic effect". 1-0.039*0.01 | |
| 7 | Omega3 | Stroke mortality | Ingested intake of EPA+DHA from fish | mg /day | Relative Hill | None | 47 | -0.12 (-0.25 - 0.01) | Cohen et al. 2005 | |
| 8 | Omega3 | Stroke mortality | Ingested intake of EPA+DHA from fish | mg /day | RR | None | 0 | 0.9998 (0.99934 - 1.00027) | 1-0.02*0.01, Cohen et al 2005: −2.0% 95% CI: +2.7% to −6.6% | |
| 9 | Fish | Subclinical brain infarct (one or more) prevalence | Ingested intake of tuna/other fish | ≥3 times/week vs. <1/month | RR | None | 0 | 0.74 (0.54 - 1.01) | Virtanen et al. 2008; 95% CI | |
| 10 | Fish | Any prevalent subclinical brain infarct prevalence | Ingested intake of tuna/other fish | Each one serving per week | RR | None | 0 | 0.93 (0.88 - 0.994) | Virtanen et al. 2008; 95% CI | |
| 11 | Fish | Subclinical brain infarct (one or more)incidence | Ingested intake of tuna/other fish | ≥3 times/week vs. <1/month | RR | None | 0 | 0.56 (0.30 - 1.07) | Virtanen et al. 2008; 95% CI | |
| 12 | Fish | Any incident subclinical brain infarct incidence | Ingested intake of tuna/other fish | Each one serving per week | RR | None | 0 | 0.89 (0.78 - 0.993) | Virtanen et al. 2008; 95% CI | |
| 13 | Fish | Status of cerebral white matter grade score | Ingested intake of tuna/other fish | Each one serving per week | ERS | None | 0 | 0.038 | Virtanen et al. 2008; 95% CI |
- ERF publications
| 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 [1] 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. [2]
Fernandez-Jarne et al. [3] 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 [4] 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 [4]. 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
| Health effect | Relationship | Central estimate | Uncertainty |
|---|---|---|---|
| Fish consumption and CHD mortality | ΔRR for some fish consumption vs no fish consumption (<1 serving/month) | −17% | 95% CI a: −8.8% to −25% |
| ΔRR per additional serving/week | −3.9% | 95% CI a: −1.1% to −6.6% | |
| Fish consumption and stroke incidence | ΔRR for some fish consumption vs no fish consumption (<1 serving/month) | −12% | 95% CI a: +1.0% to −25% |
| ΔRR per additional serving/week | −2.0% | 95% CI a: +2.7% to −6.6% | |
| MeHg exposure and cognitive development | ΔIQ per μg/g total Hg in maternal hair | −0.7 pts | Bounds: 0 to 1.5 pts |
| DHA intake and cognitive development | ΔIQ per g/day maternal intake of DHA | 1.3 pts | Bounds: 0.8 to 1.8 pts |
a 95% CI is based on the distribution for this coefficient calculated from the regression analysis used to develop the dose–response relationship for CHD or stroke. CHD, coronary heart disease; CI, confidence interval; DHA, docosahexaenoic acid; MeHg, methyl mercury; pts, points; RR, relative risk. Serving size was 100 g.
Here we need to convert the serving size to omega-3 intake. It depends on the average omega-3 content in the diets of the patients in the studies, and it is not known to us. Therefore, we may assume that it is higher than in lean fish (0 - 0.5 %) and lower than in fatty fish (1-2 %), i.e. say 0.7 % or 700 mg per serving. Therefore, the published RR changes (per servings/week) must be multiplied by 1 per (servings * 700 mg/serving / (week * 7 d/week) = 0.01 * RR changes per mg/d. CHD2 is used as the trait to prevent double counting with the other ERFs based on Mozaffarian and Rimm.
In addition, Cohen[5] concluded that the ERFs for CHD and stroke are non-linear with a larger reduction in risk between non-consumers and some-consumers (the limit defined as 1 serving per month). In addition, a linear incremental benefit was estimated for intakes more than 1 serving per week. This results in two independent ERFs where the low-dose "antiarrhythmic" effect follows Relative Hill function and the high-dose "antiatherosclerotic" effect follows RR function. Cohen assumed a negative correlation between these, but this is not easy to implement with the current HIA ovariables and therefore we ignore the correlation; this results in an increase of the estimated uncertainty in the model.
Calculations
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
References
- ↑ Cohen, J.T., PhD, Bellinger, D.C, PhD, W.E., MD, Bennett A., and Shaywitz B.A. 2005b. A Quantitative Analysis of Prenatal Intake of n-3 Polyunsaturated Fatty Acids and Cognitive Development. American Journal of Preventive Medicine 2005;29(4):366–374).
- ↑ Fish consumption and risk of subclinical brain abnormalities on MRI in older adults Jyrki K. Virtanen, David S. Siscovick, Will T. Longstreth, Lewis H. Kuller, Dariush Mozaffarian Neurology 2008;71:439–446.
- ↑ Fernandez-Jarne E, Garrido FA, Gutierrez AA, Arrillaga CDF, Martinez-Gonzales MA. Dietary intake of n-3 fatty acids and the risk of acute myocardial infarction: a case-control study. (In Spanish) 2002;118:121–5.
- ↑ 4.0 4.1 Mozaffarian D., Rimm E.B., Fish intake, contaminants, and human health. Evaluating the risks and the benefits. (Reprinted) JAMA, 2006. Vol 296, No. 15
- ↑ 5.0 5.1 Cohen JT, Bellinger DC, Shaywitz BA. A quantitative analysis of prenatal methyl mercury exposure and cognitive development. Am J Prev Med. 2005 Nov;29(4):353-65. [1]
