The association between whole-blood levels of long-chain omega-3 fatty acids and changes in leukocyte telomere length was examined in a prospective cohort study of 608 patients with stable coronary artery disease. During an average follow-up period of 5 years, individuals in the lowest quartile of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) had the fastest rate of telomere shortening, whereas those in the highest quartile experienced the slowest rate of telomere shortening (p for trend < 0.001 across quartiles). This association persisted after adjustment for age, gender, race, smoking, income, diabetes, blood pressure, lipids, and markers of inflammation.
Comment by Alan Gaby MD
Increased dietary intake of long-chain omega-3 fatty acids is associated with prolonged survival in patients with coronary heart disease. These fatty acids have a number of beneficial effects, including reducing triglyceride levels and blood pressure, inhibiting platelet aggregation, and decreasing inflammation.
The results of the present study suggest that omega-3 fatty acids may prolong life by another mechanism: slowing the rate of telomere shortening. Telomeres are regions of repetitive DNA at the end of chromosomes that protect the chromosomes from damage. As people age, telomeres become progressively shorter, and telomere length is considered to be a marker of aging. The results of the present study suggest that the fatty acids in fish oil may slow the aging process in heart patients. The mechanism of this effect has not been identified.
CONTEXT: Increased dietary intake of marine omega-3 fatty acids is associated with prolonged survival in patients with coronary heart disease. However, the mechanisms underlying this protective effect are poorly understood.
OBJECTIVE: To investigate the association of omega-3 fatty acid blood levels with temporal changes in telomere length, an emerging marker of biological age.
DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study of 608 ambulatory outpatients in California with stable coronary artery disease recruited from the Heart and Soul Study between September 2000 and December 2002 and followed up to January 2009 (median, 6.0 years; range, 5.0-8.1 years).
MAIN OUTCOME MEASURES: We measured leukocyte telomere length at baseline and again after 5 years of follow-up. Multivariable linear and logistic regression models were used to investigate the association of baseline levels of omega-3 fatty acids (docosahexaenoic acid [DHA] and eicosapentaenoic acid [EPA]) with subsequent change in telomere length.
RESULTS: Individuals in the lowest quartile of DHA+EPA experienced the fastest rate of telomere shortening (0.13 telomere-to-single-copy gene ratio [T/S] units over 5 years; 95% confidence interval [CI], 0.09-0.17), whereas those in the highest quartile experienced the slowest rate of telomere shortening (0.05 T/S units over 5 years; 95% CI, 0.02-0.08; P < .001 for linear trend across quartiles). Levels of DHA+EPA were associated with less telomere shortening before (unadjusted beta coefficient x 10(-3) = 0.06; 95% CI, 0.02-0.10) and after (adjusted beta coefficient x 10(-3) = 0.05; 95% CI, 0.01-0.08) sequential adjustment for established risk factors and potential confounders. Each 1-SD increase in DHA+EPA levels was associated with a 32% reduction in the odds of telomere shortening (adjusted odds ratio, 0.68; 95% CI, 0.47-0.98).
CONCLUSION: Among this cohort of patients with coronary artery disease, there was an inverse relationship between baseline blood levels of marine omega-3 fatty acids and the rate of telomere shortening over 5 years.
Farzaneh-Far R, Lin J, Epel ES, Harris WS, Blackburn EH, Whooley MA. Association of marine omega-3 fatty acid levels with telomeric aging in patients with coronary heart disease. JAMA. 2010 Jan 20;303(3):250-7. PMID: 20085953
Reprinted with exclusive permission of Townsend Letter May 2010