Highlights
- •Inuit had a low occurrence of ischemic heart disease and a high intake of n-3 fatty acids.
- •n-3 fatty acid consumption has been linked to inflammation that predicts vascular risk.
- •The inflammatory biomarkers YKL-40 and hsCRP were higher in Inuit compared to non-Inuit.
- •YKL-40 and hsCRP increased with higher intakes of traditional Inuit diet.
- •Markers of inflammation may reflect the disease rather than the cause of the disease.
Abstract
Background
Chronic low-grade inflammation is involved in the initiation and progression of atherosclerosis
and ischemic heart disease. This was rare in pre-western Inuit who lived on a diet
that consisted mainly of marine mammals rich in n-3 fatty acids.
Objectives
To assess the association between biomarkers of inflammation and the intake of traditional
Inuit diet in addition to Inuit ethnicity.
Methods
YKL-40 and hsCRP were measured in serum from 535 Inuit and non-Inuit living in the
capital city Nuuk in West Greenland or in the main town or a settlement in rural East
Greenland. Dietary habits were assessed by an interview-based food frequency questionnaire.
Results
The participation rate was 95%. YKL-40 was higher in Inuit than in non-Inuit (p < 0.001), in Inuit with a higher intake of traditional Inuit diet (p < 0.001), and in Inuit from rural compared to urban areas (p < 0.001). It also rose with age (p < 0.001), alcohol intake (0.019) and smoking (p < 0.001). Inuit had higher hsCRP compared to non-Inuit (p = 0.003) and hsCRP increased in parallel with intake of traditional Inuit foods (p < 0.001). Alcohol associated with a decrease in hsCRP in Inuit (p = 0.004). YKL-40 and hsCRP increased with higher intakes of traditional Inuit diet
after adjusting for ethnicity, gender, age, smoking, alcohol intake and BMI.
Conclusions
Biomarkers of inflammation vary in parallel with the intake of traditional Inuit diet.
A diet based on marine mammals from the Arctic does not reduce inflammatory activity
and it may be speculated that markers of inflammation reflect the disease rather than
the cause of the disease.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to AtherosclerosisAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Atherosclerosis – an inflammatory disease.N Engl J Med. 1999; 340: 115-126
- Increased levels of the calcification marker matrix gla protein and the inflammatory markers YKL-40 and CRP in patients with type 2 diabetes and ischemic heart disease.Cardiovasc Diabetol. 2010; 9: 1-7
- Omega-3 fatty acids and HDL. How do they work in the prevention of cardiovascular disease?.Curr Vasc Pharmacol. 2012; 10: 432-441
- Short-time infusion of fish oil-based lipid emulsions, approved for parenteral nutrition, reduces monocyte proinflammatory cytokine generation and adhesive interaction with endothelium in humans.J Immunol. 2003; 171: 4837-4843
- Fatty acids and inflammation: the cutting edge between food and pharma.Eur J Pharmacol. 2011; 668: S50-S58
- Marine n-3 fatty acids for cardiovascular risk reduction and disease control in rheumatoid arthritis: “Kill two Birds with one Stone”?.Curr Pharm Des. 2012; 18: 1531-1542
- Low occurrence of ischemic heart disease among Inuit around 1963 suggested from ECG among 1851 East Greenland Inuit.Atherosclerosis. 2009; 203: 599-603
- Frequent left ventricular hypertrophy independent of blood pressure in 1851 pre-western Inuit.Atherosclerosis. 2011; 216: 484-488
- Changes in iodine excretion in 50-69-y-old denizens of an Arctic society in transition and iodine excretion as a biomarker of the frequency of consumption of traditional Inuit foods.Am J Clin Nutr. 2005; 81: 656-663
- Vitamin D status in Greenland is influenced by diet and ethnicity: a population-based survey in an Arctic hunter society in transition.Br J Nutr. 2013; 109: 928-935
- The composition of the Eskimo food in north western Greenland.Am J Clin Nutr. 1980; 33: 2657-2661
- YKL-40 – an emerging biomarker in cardiovascular disease and diabetes.Cardiovasc Diabetol. 2009; 8: 61
- Serum YKL-40 levels in patients with coronary artery disease.Coron Artery Dis. 2007; 18: 391-396
- High serum YKL-40 concentrations is associated with cardiovascular and all-cause mortality in patients with stable coronary artery disease.Eur Heart J. 2009; 30: 1066-1072
- Plasma concentration of C-reactive protein and the calculated Framingham coronary heart disease risk score.Circulation. 2003; 108: 161-165
- Prognostic markers in young patients with premature coronary heart disease.Atherosclerosis. 2012; 224: 213-217
- Low incidence of cardiovascular disease among the Inuit – what is the evidence?.Atherosclerosis. 2003; 166: 351-357
- n-3 fatty acids and cardiovascular outcomes in patients with dysglycemia.N Engl J Med. 2012; 367: 309-318
- High prevalence of markers of coronary heart disease among Greenland Inuit.Atherosclerosis. 2008; 196: 772-778
- Inflammatory biomarkers, race/ethnicity and cardiovascular disease.Nutr Rev. 2007; 65: S234-S238
- Review on persistent organic pollutants in the environment of Greenland and Faroe Islands.Chemosphere. 1999; 38: 3075-3093
- Modification of environmental toxicity by nutrients: implications in atherosclerosis.Cardiovasc Toxicol. 2005; 5: 153-160
- Studies on serum YKL-40 as a biomarker in diseases with inflammation, tissue remodeling, fibroses and cancer.Dan Med Bull. 2006; 53: 172-209
- YKL-40, a new inflammatory marker with relation to insulin resistance and with a role in endothelial dysfunction and atherosclerosis.Inflamm Res. 2006; 55: 221-227
- Iodine deficiency influences thyroid autoimmunity in old age – a comparative population-based study.Maturitas. 2012; 71: 39-43
- Gender diversity in developing overweight over 35 years of Westernization in an Inuit hunter cohort and ethno-specific body mass index for evaluation of body-weight abnormalities.Eur J Endocrinol. 2004; 151: 735-740
- Obesity and central fat pattern among Greenland Inuit and a general population of Denmark (Inter99): relationship to metabolic risk factors.Int J Obes. 2003; 27: 1507-1515
- Expression levels of YKL-40 in obesity-associated type 2 diabetes are related to inflammation: impact of conventional weight loss and gastric bypass.J Clin Endocrinol Metab. 2011; 96: 200-209
- Ethnicity influences BMI as evaluated from reported serum lipid values in Inuit and non-Inuit: raised upper limit of BMI in Inuit?.Ethn Dis. 2013; 23: 77-82
- The causal relationship between passive smoking and inflammation on the development of cardiovascular disease: a review of the evidence.Inflamm Allergy Drug Targets. 2009; 8: 328-333
- YKL-40 is elevated in patients with chronic obstructive pulmonary disease and activates alveolar macrophages.J Immunol. 2008; 181: 5167-5173
- Serum levels of YKL-40 and PIIINP as prognostic markers in patients with alcoholic liver disease.J Hepatol. 2003; 39: 179-186
- Benign course of long-standing hepatitis B virus infection among Greenland Inuit?.Scand J Gastroenterol. 2008; 43: 334-343
- Population-based comparative epidemiological survey of hepatitis B, D and C among Inuit migrated to Denmark and in high endemic Greenland.Scand J Gastroenterol. 2012; 47: 692-701
Article info
Publication history
Published online: April 15, 2013
Accepted:
March 19,
2013
Received in revised form:
March 16,
2013
Received:
December 11,
2012
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.