Jehi, TonySabaté, JoanBitok, EdwardSala Vila, AleixRos, EmilioCofán, MontserratOda, KeijiRajaram, Sujatha2022-10-132022Jehi T, Sabaté J, Bitok E, Sala-Vila A, Ros E, Cofan M, Oda K, Rajaram S. n-3 index is associated with cardiometabolic risk factors but is not improved by walnut intake in free-living elderly: a single-blind, randomised controlled trial. Br J Nutr. 2022 Jun 10: 1-8. DOI: 10.1017/S00071145220017510007-1145http://hdl.handle.net/10230/54366n-3 index, the erythrocyte proportion of the EPA + DHA fatty acids is a clinical marker of age-related disease risk. It is unclear whether regular intake of α-linolenic acid (ALA), a plant-derived n-3 polyunsaturated fatty acid, raises n-3 index in older adults. Of the 356 participants at the Loma Linda, CA centre from the original study, a randomly selected subset (n 192) was included for this secondary analysis (mostly Caucasian women, mean age 69 years). Participants were assigned to either the walnut (15 % of daily energy from walnuts) or the control group (usual diet, no walnuts) for 2 years. Erythrocyte fatty acids were determined at baseline and 1-year following intervention. No differences were observed for erythrocyte EPA, but erythrocyte DHA decreased albeit modestly in the walnut group (-0·125 %) and slightly improved in the control group (0·17 %). The change in n-3 index between the walnut and control groups was significantly different only among fish consumers (those who ate fish ≥ once/month). Longitudinal analyses combining both groups showed significant inverse association between the 1-year changes of the n-3 index and fasting plasma TAG (ß = -10), total cholesterol (ß = -5·59) and plasma glucose (ß = -0·27). Consuming ALA-rich walnuts failed to improve n-3 index in elders. A direct source of EPA/DHA may be needed to achieve desirable n-3 index, as it is inversely associated with cardiometabolic risk. Nevertheless, incorporating walnuts as part of heart healthy diets is still encouraged.application/pdfeng© Cambridge University Press. The published version of the article: Jehi T, Sabaté J, Bitok E, Sala-Vila A, Ros E, Cofan M, Oda K, Rajaram S. n-3 index is associated with cardiometabolic risk factors but is not improved by walnut intake in free-living elderly: a single-blind, randomised controlled trial. Br J Nutr. 2022 Jun 10: 1-8. is available at https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/abs/n3-index-is-associated-with-cardiometabolic-risk-factors-but-is-not-improved-by-walnut-intake-in-freeliving-elderly-a-singleblind-randomised-controlled-trial/9210C08BB1372E15AC607CB0BFB12C5B.info:eu-repo/semantics/articlehttp://dx.doi.org/10.1017/S0007114522001751Cardiometabolic diseaseWalnutsn-3 Indexα-Linolenic acidinfo:eu-repo/semantics/openAccess