Applied nutritional investigation -3 fatty acids and selenium as coronary heart disease risk modifying factors in Asian Indian and Chinese males Manav, M.B.B.S., Jin Su, BS.c, Kenneth Hughes, D.M., Hin Peng Lee, MS.c., and Choon Nam Ong, Ph.D.* Department of Community, Occupational, and Family Medicine, National University of Singapore, Singapore, Singapore Manuscript received March 10, 2004; accepted June 18, 2004. Abstract Objective: Asian Indian men are reported to have a higher incidence of coronary heart disease than men of other ethnic groups worldwide. Among the many hypotheses, one possible risk factor may be related to their dietary habits. This study estimated the plasma concentrations of fatty acids, antioxidant vitamins, and selenium in Indians and Chinese of Singapore. Methods: The study population consisted of 145 Indian men and 147 Chinese men ages 26 to 79 y from a cross-sectional survey, the National University of Singapore Heart Study. Results: Our findings indicated that Indians had lower plasma concentrations of docosahexanoic acid (3.07% versus 3.54%, P  0.001), -linolenic acid (0.48% versus 0.57%, P  0.001), and total -3 fatty acids (4.71% versus 5.27%, P  0.001) than did the Chinese. Arachidonic acid was higher in Indians (4.83%) than in the Chinese (4.51%, P = 0.007). The ratio of -3 acid to -6 fatty acid was also lower in Indians (0.15) than in the Chinese (0.16, P = 0.007). There were no significant differences in the concentrations of monounsaturated fatty acids, but saturated fatty acids were higher in Indians (39.17%) than in the Chinese (38.28%, P  0.001). Analysis of vitamins A, C, and E showed no significant differences between Indians (0.67, 5.72, and 13.04 mg/L, respectively) and Chinese (0.68, 6.48, and 12.71 mg/L, respectively); however, serum concentration of selenium in Indians (117.49 g/L) was significantly lower than in the Chinese (126.72 g/L, P  0.001). Conclusion: The results suggest that lower plasma concentrations of -3 fatty acids and selenium and higher concentrations of arachidonic acid and saturated fatty acids in Indians may reflect lower intakes of marine foods and, as a consequence, higher susceptibility to coronary heart disease. © 2004 Elsevier Inc. All rights reserved. Keywords: Coronary heart disease; Fatty acids; Docosahexanoic acid; Selenium; Fish intake; Asian Indians; Chinese Introduction Coronary heart disease (CHD) is a leading cause of morbidity and mortality worldwide and there is increasing evidence that the rates of CHD differ among ethnic groups. Singapore is a multiracial country consisting of approxi- mately 4 million people comprising 76.8% Chinese, 13.9% Malays, 7.9% Asian Indians, and 1.4% other ethnic groups [1]. Asian Indians have been found in a number of countries to be more susceptible to CHD than other ethnic groups [2–5] and this has been seen in Singapore [6]. However the greater susceptibility of Indians to CHD is not explained by certain conventional risk factors such as cigarette smoking, hypertension, and hypercholesterolemia [7,8], and it is be- lieved that other factors may play a role in the different ethnic risks of CHD. Evidence of lower incidences of thrombotic diseases in Greenland Eskimos compared with mainland Danish popu- lation [9] aroused interest in the potentially beneficial ef- fects of sea foods because the diet of Eskimos is rich in marine lipids [10]. Thereafter, several epidemiologic studies have reported inverse relations between fish consumption and decreased risk of CHD [11]. Fish and marine oils are rich in eicosapentaenoic acid (EPA; 20:5 -3) and docosa- hexanoic acid (DHA; 22:6 -3), which are long-chain poly- unsaturated fatty acids of the -3 series to which are attrib- * Corresponding author. Tel.: +65-6874-4982; fax: +65-6779-1489. E-mail address: cofongcn@nus.edu.sg (C.N. Ong). Nutrition 20 (2004) 967–973 www.elsevier.com/locate/nut 0899-9007/04/$ – see front matter © 2004 Elsevier Inc. All rights reserved. doi:10.1016/j.nut.2004.08.003