Dietary Fatty Acids, Cardiovascular Disease, and Life Expectancy Among Adults With Adverse Mental Health‐Related Characteristics: A Cohort‐Based Target Trial Emulation Study

Abstract

ABSTRACT Adverse mental health‐related characteristics contribute to decreased life expectancy, largely driven by an elevated risk of cardiovascular disease (CVD). Dietary fatty acids influence disease occurrence and progression, yet the associations of polyunsaturated fatty acids (PUFAs) with CVD risk and life expectancy in individuals with adverse mental health‐related characteristics remain unclear. This study focused on individuals with loneliness, anxiety/depression, and neuroticism. In prospective cohort analysis, we found that higher intakes of alpha‐linolenic acid (ALA), stearidonic acid (SDA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) were negatively associated with total CVD risk in individuals with loneliness and anxiety/depression. Target trial emulation analyses further showed that higher EPA and DHA intakes were associated with lower early‐onset CVD risk among participants with loneliness, higher ALA and EPA intakes with lower total CVD risk among those with anxiety/depression, and higher EPA intake with lower early‐onset CVD risk among those with neuroticism. Moreover, higher intakes of n‐3 PUFAs were associated with a gain in life expectancy, ranging from 0.42 to 1.81 years. These findings highlight n‐3 PUFA intake, particularly ALA and EPA, as a dietary factor associated with cardiovascular health and longevity in psychologically vulnerable populations.