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Simopoulos AP. Importance of the ratio of omega-6/omega-3 essential fatty acids: evolutionary aspects. World Rev Nutr Diet 2003; 92:1-22. [PMID: 14579680 DOI: 10.1159/000073788] [Citation(s) in RCA: 197] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Zeghichi S, Kallithraka S, Simopoulos AP. Nutritional composition of molokhia (Corchorus olitorius) and stamnagathi (Cichorium spinosum). World Rev Nutr Diet 2003; 91:1-21. [PMID: 12747085 DOI: 10.1159/000069924] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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Zeghichi S, Kallithraka S, Simopoulos AP, Kypriotakis Z. Nutritional composition of selected wild plants in the diet of Crete. World Rev Nutr Diet 2003; 91:22-40. [PMID: 12747086 DOI: 10.1159/000069928] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Simopoulos AP. Essential fatty acids in health and chronic diseases. FORUM OF NUTRITION 2003; 56:67-70. [PMID: 15806801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Simopoulos AP. Genetics. Implications for nutrition. FORUM OF NUTRITION 2003; 56:226-9. [PMID: 15806875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Abstract
Among the fatty acids, it is the omega-3 polyunsaturated fatty acids (PUFA) which possess the most potent immunomodulatory activities, and among the omega-3 PUFA, those from fish oil-eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)--are more biologically potent than alpha-linolenic acid (ALA). Some of the effects of omega-3 PUFA are brought about by modulation of the amount and types of eicosanoids made, and other effects are elicited by eicosanoid-independent mechanisms, including actions upon intracellular signaling pathways, transcription factor activity and gene expression. Animal experiments and clinical intervention studies indicate that omega-3 fatty acids have anti-inflammatory properties and, therefore, might be useful in the management of inflammatory and autoimmune diseases. Coronary heart disease, major depression, aging and cancer are characterized by an increased level of interleukin 1 (IL-1), a proinflammatory cytokine. Similarly, arthritis, Crohn's disease, ulcerative colitis and lupus erythematosis are autoimmune diseases characterized by a high level of IL-1 and the proinflammatory leukotriene LTB(4) produced by omega-6 fatty acids. There have been a number of clinical trials assessing the benefits of dietary supplementation with fish oils in several inflammatory and autoimmune diseases in humans, including rheumatoid arthritis, Crohn's disease, ulcerative colitis, psoriasis, lupus erythematosus, multiple sclerosis and migraine headaches. Many of the placebo-controlled trials of fish oil in chronic inflammatory diseases reveal significant benefit, including decreased disease activity and a lowered use of anti-inflammatory drugs.
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MESH Headings
- Animals
- Anti-Inflammatory Agents/administration & dosage
- Arthritis, Rheumatoid/diet therapy
- Arthritis, Rheumatoid/immunology
- Arthritis, Rheumatoid/metabolism
- Asthma/diet therapy
- Asthma/immunology
- Asthma/metabolism
- Autoimmune Diseases/diet therapy
- Autoimmune Diseases/metabolism
- Cardiovascular Diseases/immunology
- Cardiovascular Diseases/metabolism
- Cytokines/biosynthesis
- Depressive Disorder, Major/diet therapy
- Depressive Disorder, Major/immunology
- Depressive Disorder, Major/metabolism
- Docosahexaenoic Acids/metabolism
- Eicosapentaenoic Acid/metabolism
- Fatty Acids, Omega-3/administration & dosage
- Fatty Acids, Omega-3/metabolism
- Fatty Acids, Omega-3/physiology
- Fatty Acids, Omega-6
- Fatty Acids, Unsaturated/metabolism
- Fish Oils/administration & dosage
- Fish Oils/chemistry
- Humans
- Inflammation/diet therapy
- Inflammation/metabolism
- Inflammatory Bowel Diseases/diet therapy
- Inflammatory Bowel Diseases/immunology
- Inflammatory Bowel Diseases/metabolism
- Prostaglandins/metabolism
- Psoriasis/immunology
- Psoriasis/metabolism
- Psoriasis/therapy
- alpha-Linolenic Acid/metabolism
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Abstract
Several sources of information suggest that human beings evolved on a diet with a ratio of omega-6 to omega-3 essential fatty acids (EFA) of approximately 1 whereas in Western diets the ratio is 15/1-16.7/1. Western diets are deficient in omega-3 fatty acids, and have excessive amounts of omega-6 fatty acids compared with the diet on which human beings evolved and their genetic patterns were established. Excessive amounts of omega-6 polyunsaturated fatty acids (PUFA) and a very high omega-6/omega-3 ratio, as is found in today's Western diets, promote the pathogenesis of many diseases, including cardiovascular disease, cancer, and inflammatory and autoimmune diseases, whereas increased levels of omega-3 PUFA (a low omega-6/omega-3 ratio) exert suppressive effects. In the secondary prevention of cardiovascular disease, a ratio of 4/1 was associated with a 70% decrease in total mortality. A ratio of 2.5/1 reduced rectal cell proliferation in patients with colorectal cancer, whereas a ratio of 4/1 with the same amount of omega-3 PUFA had no effect. The lower omega-6/omega-3 ratio in women with breast cancer was associated with decreased risk. A ratio of 2-3/1 suppressed inflammation in patients with rheumatoid arthritis, and a ratio of 5/1 had a beneficial effect on patients with asthma, whereas a ratio of 10/1 had adverse consequences. These studies indicate that the optimal ratio may vary with the disease under consideration. This is consistent with the fact that chronic diseases are multigenic and multifactorial. Therefore, it is quite possible that the therapeutic dose of omega-3 fatty acids will depend on the degree of severity of disease resulting from the genetic predisposition. A lower ratio of omega-6/omega-3 fatty acids is more desirable in reducing the risk of many of the chronic diseases of high prevalence in Western societies, as well as in the developing countries, that are being exported to the rest of the world.
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Abstract
The last quarter of the 20th century was characterized by an increase in the consumer's interest in the nutritional aspects of health. As a result, governments began to develop dietary guidelines in addition to the traditional recommended dietary allowances, which have been superseded now by dietary reference intakes. In addition to governments, various scientific societies and nongovernmental organizations have issued their dietary advice to combat chronic diseases and obesity. Human beings evolved on a diet that was balanced in n-6 and n-3 essential fatty acid intake, whereas Western diets have a ratio of n-6/n-3 of 16.74. The scientific evidence is strong for decreasing the n-6 and increasing the n-3 intake to improve health throughout the life cycle. This paper discusses the reasons for this change and recommends the establishment of a Nutrition and Food Policy, instead of a Food and Nutrition Policy, because the latter subordinates the nutritional aspects to the food policy aspects. Nutrition and food planning comprise a tool of nutrition and food policy, whose objectives are the achievement of the adequate nutrition of the population as defined by nutritional science. The scientific basis for the development of a public policy to develop dietary recommendations for essential fatty acids, including a balanced n-6/n-3 ratio is robust. What is needed is a scientific consensus, education of professionals and the public, the establishment of an agency on nutrition and food policy at the national level, and willingness of governments to institute changes. Education of the public is essential to demand changes in the food supply.
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Simopoulos AP. ¿Qué son las dietas mediterráneas? Medwave 2002. [DOI: 10.5867/medwave.2002.03.3580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Simopoulos AP. The Hippocratic concept of positive health in the 5th century BC and in the new millennium. World Rev Nutr Diet 2002; 89:1-4. [PMID: 11530728 DOI: 10.1159/000059782] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Simopoulos AP. Omega-3 fatty acids and cardiovascular disease: The epidemiological evidence. Environ Health Prev Med 2002; 6:203-9. [PMID: 21432336 PMCID: PMC2723470 DOI: 10.1007/bf02897971] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2001] [Accepted: 07/17/2001] [Indexed: 01/07/2023] Open
Abstract
Epidemiological studies in the last 40 years suggest that omega-3 fatty acids derived from fish and fish oil decrease the risk of coronary heart disease, hypertension and stroke, and their complications. The beneficial effects of omega-3 fatty acids include effects on lipids, blood pressure, cardiac and vascular function, eicosanoids, coagulation, and immunological responses. However, not all population studies have shown that omega-3 fatty acids are associated with reduced rates of coronary mortality. Such studies suffer either from small numbers of subjects or the population already had a high intake of fish. When comparing the highest intake of fish to that of the lowest fish intake, the beneficial effects of omega-3 fatty acids have been shown. In population-based case-control studies, the patients consuming modest amounts of fish, the equivalent of one fatty fish meal per week, had a significant lower risk of primary cardiac arrest compared with those who did not eat fish at all. In case-control studies, the intake of eicosapentaenoic acid and docosahexaenoic acid as reflected in adipose tissue content is inversely associated with risk of myocardial infarction.
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Simopoulos AP. The Mediterranean diets: What is so special about the diet of Greece? The scientific evidence. J Nutr 2001; 131:3065S-73S. [PMID: 11694649 DOI: 10.1093/jn/131.11.3065s] [Citation(s) in RCA: 245] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The term "Mediterranean diet," implying that all Mediterranean people have the same diet, is a misnomer. The countries around the Mediterranean basin have different diets, religions and cultures. Their diets differ in the amount of total fat, olive oil, type of meat and wine intake; milk vs. cheese; fruits and vegetables; and the rates of coronary heart disease and cancer, with the lower death rates and longer life expectancy occurring in Greece. Extensive studies on the traditional diet of Greece (the diet before 1960) indicate that the dietary pattern of Greeks consists of a high intake of fruits, vegetables (particularly wild plants), nuts and cereals mostly in the form of sourdough bread rather than pasta; more olive oil and olives; less milk but more cheese; more fish; less meat; and moderate amounts of wine, more so than other Mediterranean countries. Analyses of the dietary pattern of the diet of Crete shows a number of protective substances, such as selenium, glutathione, a balanced ratio of (n-6):(n-3) essential fatty acids (EFA), high amounts of fiber, antioxidants (especially resveratrol from wine and polyphenols from olive oil), vitamins E and C, some of which have been shown to be associated with lower risk of cancer, including cancer of the breast. These findings should serve as a strong incentive for the initiation of intervention trials that will test the effect of specific dietary patterns in the prevention and management of patients with cancer.
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Crawford M, Galli C, Visioli F, Renaud S, Simopoulos AP, Spector AA. Role of plant-derived omega-3 fatty acids in human nutrition. ANNALS OF NUTRITION & METABOLISM 2001; 44:263-5. [PMID: 11146334 DOI: 10.1159/000046694] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
An international workshop on the role of plant-derived omega-3 fatty acids in human nutrition took place in Milan on February 9, 2000. The meeting was sponsored by the Nutrition Foundation of Italy and was organized by its Scientific Director, Dr. Andrea Poli. It was attended by experts in polyunsaturated fatty acids and human lipid nutrition. This is the first meeting devoted to the health aspects of alpha-linolenic acid, the omega-3 fatty acid contained in plant-derived edible products, as distinct from the more widely studied long-chain omega-3 products typically present in fish and fish-derived products. This report, which is based on updated scientific evidence presented and discussed at the workshop, was prepared by the international expert panel.
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Simopoulos AP, Leaf A, Salem N. Essentiality of and recommended dietary intakes for omega-6 and omega-3 fatty acids. ANNALS OF NUTRITION & METABOLISM 2001; 43:127-30. [PMID: 10436312 DOI: 10.1159/000012777] [Citation(s) in RCA: 202] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Simopoulos AP. Genetic variants, diet, and physical activity. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 2001; 101:302-4. [PMID: 11269607 DOI: 10.1016/s0002-8223(01)00079-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Simopoulos AP, Leaf A, Salem N. Workshop statement on the essentiality of and recommended dietary intakes for Omega-6 and Omega-3 fatty acids. Prostaglandins Leukot Essent Fatty Acids 2000; 63:119-21. [PMID: 10991764 DOI: 10.1054/plef.2000.0176] [Citation(s) in RCA: 150] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Simopoulos AP. Commentary on the workshop statement. Essentiality of and recommended dietary intakes for Omega-6 and Omega-3 fatty acids. Prostaglandins Leukot Essent Fatty Acids 2000; 63:123-4. [PMID: 10991765 DOI: 10.1054/plef.2000.0177] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Simopoulos AP, Sidossis LS. What is so special about the traditional diet of Greece. The scientific evidence. World Rev Nutr Diet 2000; 87:24-42. [PMID: 10929525 DOI: 10.1159/000059727] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Abstract
The diet of our ancestors was less dense in calories, being higher in fiber, rich in fruits, vegetables, lean meat, and fish. As a result, the diet was lower in total fat and saturated fat, but contained equal amounts of n-6 and n-3 essential fatty acids. Linoleic acid (LA) is the major n-6 fatty acid, and alpha-linolenic acid (ALA) is the major n-3 fatty acid. In the body, LA is metabolized to arachidonic acid (AA), and ALA is metabolized to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The ratio of n-6 to n-3 essential fatty acids was 1 to 2:1 with higher levels of the longer-chain polyunsaturated fatty acids (PUFA), such as EPA, DHA, and AA, than today's diet. Today this ratio is about 10 to 1:20 to 25 to 1, indicating that Western diets are deficient in n-3 fatty acids compared with the diet on which humans evolved and their genetic patterns were established. The n-3 and n-6 EPA are not interconvertible in the human body and are important components of practically all cell membranes. The N-6 and n-3 fatty acids influence eicosanoid metabolism, gene expression, and intercellular cell-to-cell communication. The PUFA composition of cell membranes is, to a great extent, dependent on dietary intake. Therefore, appropriate amounts of dietary n-6 and n-3 fatty acids need to be considered in making dietary recommendations. These two classes of PUFA should be distinguished because they are metabolically and functionally distinct and have opposing physiological functions; their balance is important for homeostasis and normal development. Studies with nonhuman primates and human newborns indicate that DHA is essential for the normal functional development of the retina and brain, particularly in premature infants. A balanced n-6/n-3 ratio in the diet is essential for normal growth and development and should lead to decreases in cardiovascular disease and other chronic diseases and improve mental health. Although a recommended dietary allowance for essential fatty acids does not exist, an adequate intake (AI) has been estimated for n-6 and n-3 essential fatty acids by an international scientific working group. For Western societies, it will be necessary to decrease the intake of n-6 fatty acids and increase the intake of n-3 fatty acids. The food industry is already taking steps to return n-3 essential fatty acids to the food supply by enriching various foods with n-3 fatty acids. To obtain the recommended AI, it will be necessary to consider the issues involved in enriching the food supply with n-3 PUFA in terms of dosage, safety, and sources of n-3 fatty acids.
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Simopoulos AP, Leaf A, Salem N. Workshop on the Essentiality of and Recommended Dietary Intakes for Omega-6 and Omega-3 Fatty Acids. J Am Coll Nutr 1999; 18:487-9. [PMID: 10511332 DOI: 10.1080/07315724.1999.10718888] [Citation(s) in RCA: 188] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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