101
|
Medina I, Lois S, Lizárraga D, Pazos M, Touriño S, Cascante M, Torres JL. Functional fatty fish supplemented with grape procyanidins. Antioxidant and proapoptotic properties on colon cell lines. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2006; 54:3598-3603. [PMID: 19127731 DOI: 10.1021/jf0527145] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This work shows the properties of grape procyanidins with additional anticarcinogenic properties for increasing the shelf life of functional seafood preparations. Galloylated procyanidins (100 ppm, 2.7 mean degree of polymerization, 25% galloylation) extended the shelf life of minced horse mackerel muscle stored at 4 degrees C more than 8 days compared to controls without addition of polyphenols. The levels of endogenous alpha-tocopherol, EPA, and DHA of fish muscle were also preserved after 10 days at 4 degrees C. Therefore, the presence of procyanidins increased the stability of a product based on minced fish muscle during cold storage and maintained its functionality associated with the presence of polyunsaturated fatty acids and alpha-tocopherol. In addition, grape procyanidins showed a significant capacity to induce apoptosis in colon cancer cells (HT29 cell line) while being inactive in noncancer control cells (IEC-6). Thus, the product based on fatty fish muscle supplemented with grape procyanidins appears to be a stable functional food offering the combined action of omega-3 fatty acids and natural polyphenols.
Collapse
Affiliation(s)
- I Medina
- Instituto de Investigaciones Marinas del CSIC, Eduardo Cabello 6, E-36208 Vigo, Spain.
| | | | | | | | | | | | | |
Collapse
|
102
|
Harper CR, Jacobson TA. Usefulness of omega-3 fatty acids and the prevention of coronary heart disease. Am J Cardiol 2005; 96:1521-9. [PMID: 16310434 DOI: 10.1016/j.amjcard.2005.07.071] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2005] [Revised: 07/07/2005] [Accepted: 07/07/2005] [Indexed: 11/18/2022]
Abstract
Clinical trial evidence exists that supports a role for the omega-3 polyunsaturated fatty acids in coronary heart disease prevention. However, the results from these clinical trials have varied and were conducted in diverse population groups using several different types of omega-3 polyunsaturated fatty acids, including eicosapentaenoic acid, docosahexaenoic acid, and alpha-linolenic acid (ALA). Thus, we systematically reviewed previously published reports assessing the different types of omega-3 polyunsaturated fatty acid interventions and cardiovascular outcomes. Fourteen randomized clinical trials were included in the review. Six trials were included with fish oil, with 1 large trial (10,000 patients) dominating the analysis. In aggregate, the fish oil trials demonstrated a reduction in total mortality and sudden death without a clinically significant reduction in nonfatal myocardial infarction. The 6 trials with ALA supplements or an ALA-enriched diet were of poorer design than the fish oil trials and had limited power. Many of the trials with ALA involved other changes in dietary components. In aggregate, the ALA trials demonstrated possible benefits in reducing sudden death and nonfatal myocardial infarction, but with wider confidence intervals than in the fish oil trials. In conclusion, the evidence suggests a role for fish oil (eicosapentaenoic acid, docosahexaenoic acid) or fish in secondary prevention because recent clinical trial data have demonstrated a significant reduction in total mortality, coronary heart disease death, and sudden death. The data on ALA have been limited by studies of smaller sample size and limited quality.
Collapse
Affiliation(s)
- Charles R Harper
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | | |
Collapse
|
103
|
Abstract
The cardiovascular benefits of omega (n)-3 fatty acids (FA) become clearer with each passing year. Although useful in large doses for lowering serum triglyceride levels, the primary benefits are likely to arise from smaller, nutritional intakes of eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA). Doses of less than 1 g/d appear to reduce risk for fatal coronary heart disease events, perhaps by stabilizing the myocardium and reducing risk for fatal arrhythmias. New evidence points to a possible benefit on atrial fibrillation, particularly in the immediate post-cardiac surgery setting. Studies in women with coronary heart disease now suggest that plaque progression may be slowed by increased intakes of oily fish, even in women with diabetes. The relative importance of the n-6 FA linoleic acid (LA), the short-chain n-3 FA alpha linolenic acid (ALA), and the long-chain n-3 FAs EPA and DHA is becoming clearer. If intakes of the latter are adequate (perhaps over 250 mg/d), then there appears to be little need to consume more ALA or less LA.
Collapse
Affiliation(s)
- William S Harris
- Lipid and Diabetes Research Center, Mid America Heart Institute, Saint Luke's Health System, Kansas City, MO 64111, USA.
| |
Collapse
|
104
|
Opinion of the Scientific Panel on contaminants in the food chain [CONTAM] related to the safety assessment of wild and farmed fish. EFSA J 2005. [DOI: 10.2903/j.efsa.2005.236] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
|
105
|
Castro IA, Barroso LP, Sinnecker P. Functional foods for coronary heart disease risk reduction: a meta-analysis using a multivariate approach. Am J Clin Nutr 2005. [DOI: 10.1093/ajcn/82.1.32] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Inar A Castro
- From the Department of Food and Experimental Nutrition (IAC and PS), Pharmaceutical Science Faculty, and the Statistics Department, Institute of Mathematics and Statistics (LPB), University of São Paulo, São Paulo, Brazil
| | - Lúcia P Barroso
- From the Department of Food and Experimental Nutrition (IAC and PS), Pharmaceutical Science Faculty, and the Statistics Department, Institute of Mathematics and Statistics (LPB), University of São Paulo, São Paulo, Brazil
| | - Patricia Sinnecker
- From the Department of Food and Experimental Nutrition (IAC and PS), Pharmaceutical Science Faculty, and the Statistics Department, Institute of Mathematics and Statistics (LPB), University of São Paulo, São Paulo, Brazil
| |
Collapse
|
106
|
Marchioli R, Levantesi G, Macchia A, Maggioni AP, Marfisi RM, Silletta MG, Tavazzi L, Tognoni G, Valagussa F. Antiarrhythmic Mechanisms of n-3 PUFA and the Results of the GISSI-Prevenzione Trial. J Membr Biol 2005; 206:117-28. [PMID: 16456722 DOI: 10.1007/s00232-005-0788-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2005] [Indexed: 11/26/2022]
Abstract
The purpose of this paper is twofold: on the one hand, to confirm the positive results on n-3 PUFA from the overall results Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GlSSI)-Prevenzione trial; on the other, to summarize and describe how the results of an important trial can help generate hypotheses either on mechanisms of action or on differential results in particular subgroups of patients, as well as test the pathophysiological hypotheses that have accompanied in the years the story of the hypothesized mechanisms of action of a drug. GISSI-Prevenzione was conceived as a pragmatic population trial on patients with recent myocardial infarction and it was conducted in the framework of the Italian public health system. In GISSI-Prevenzione, 11,323 patients were enrolled in a clinical trial aimed at testing the effectiveness of n-3 polyunsaturated fatty acids (PUFA) and vitamin E. Patients were invited to follow Mediterranean dietary habits, and were treated with up-to-date preventive pharmacological interventions. Long-term n-3 PUFA at 1 g daily, but not vitamin E at 300 mg daily, was beneficial for death and for combined death, non-fatal myocardial infarction, and stroke. All the benefit, however, was attributable to the decrease in risk for overall (-20%), cardiovascular (-30%), and sudden death (-45%). At variance from the orientation of a scientific scenario largely dominated by the "cholesterol-heart hypothesis", GISSI-Prevenzione results indicate n-3 PUFA (virtually devoid of any cholesterol-lowering effect) as a relevant pharmacological treatment for secondary prevention after myocardial infarction.
Collapse
Affiliation(s)
- R Marchioli
- Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
107
|
Abstract
Cardiac disease continues to be a major cause of death in the Western world. Several preventive measures can be implemented to reduce the risk of a cardiac event. One of these measures is diet. A diet that is rich in fatty fish provides a considerable quantity of omega-3-fatty acids. These fatty acids have been shown to reduce the risk of cardiac events such as arrhythmias, stroke and thrombosis. The nurse has a key health education role to play in the promotion of healthy eating in order to reduce the incidence of cardiac events in patients with existing cardiac disease.
Collapse
MESH Headings
- Arachidonic Acids/metabolism
- Arrhythmias, Cardiac/etiology
- Arrhythmias, Cardiac/prevention & control
- Cause of Death
- Cholesterol/chemistry
- Cholesterol/metabolism
- Death, Sudden, Cardiac/etiology
- Death, Sudden, Cardiac/prevention & control
- Diet, Fat-Restricted
- Dietary Supplements
- Fatty Acids, Omega-3/chemistry
- Fatty Acids, Omega-3/metabolism
- Fatty Acids, Omega-3/therapeutic use
- Heart Diseases/epidemiology
- Heart Diseases/etiology
- Heart Diseases/prevention & control
- Humans
- Hypercholesterolemia/complications
- Hypercholesterolemia/metabolism
- Hypercholesterolemia/prevention & control
- Hypertension/complications
- Hypertension/prevention & control
- Hypertriglyceridemia/complications
- Hypertriglyceridemia/prevention & control
- Incidence
- Interleukins/metabolism
- Nurse's Role
- Patient Education as Topic
- Risk Factors
- Thrombosis/complications
- Thrombosis/prevention & control
- Tumor Necrosis Factors/metabolism
- United Kingdom/epidemiology
Collapse
Affiliation(s)
- Maggi Banning
- The School of Health and Social Sciences, Middlesex University, Archway Campus, London
| |
Collapse
|
108
|
Abstract
OBJECTIVE Cardiovascular disease (CVD) is the leading cause of death for women in the United States and is largely preventable. The American Heart Association has recently released evidence-based guidelines for the prevention of CVD in women; these include gender-specific recommendations for the management of dyslipidemia. This article reviews these recommendations and the evidence supporting them. DESIGN This was a qualitative review of a systematic literature search related to lipid guidelines for women and discussion of rationale and evidence for new clinical recommendations. MAIN RESULTS Lifestyle modifications are the cornerstone of lipid management. Substantial evidence from randomized clinical trials supports the use of low-density lipoprotein cholesterol-lowering therapy (primarily statins) in all high-risk women and the use of niacin or fibrates when high-density lipoprotein cholesterol is low or non-high-density lipoprotein cholesterol is elevated. Fewer data are available for women at lower or intermediate risk. CONCLUSIONS Encouragement of lifestyle modification and appropriate use of lipid-altering therapy will have a substantial impact on reducing the burden of cardiovascular disease in women.
Collapse
|
109
|
Schmidt EB, Arnesen H, Christensen JH, Rasmussen LH, Kristensen SD, De Caterina R. Marine n−3 polyunsaturated fatty acids and coronary heart disease. Thromb Res 2005; 115:257-62. [PMID: 15668184 DOI: 10.1016/j.thromres.2004.09.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2004] [Accepted: 09/13/2004] [Indexed: 10/26/2022]
Affiliation(s)
- E B Schmidt
- Department of Preventive Cardiology, Aalborg Sygehus, Arhus University Hospitals, Denmark.
| | | | | | | | | | | |
Collapse
|
110
|
Hooper L, Thompson RL, Harrison RA, Summerbell CD, Moore H, Worthington HV, Durrington PN, Ness AR, Capps NE, Davey Smith G, Riemersma RA, Ebrahim SBJ. Omega 3 fatty acids for prevention and treatment of cardiovascular disease. Cochrane Database Syst Rev 2004:CD003177. [PMID: 15495044 PMCID: PMC4170890 DOI: 10.1002/14651858.cd003177.pub2] [Citation(s) in RCA: 108] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND It has been suggested that omega 3 (W3, n-3 or omega-3) fats from oily fish and plants are beneficial to health. OBJECTIVES To assess whether dietary or supplemental omega 3 fatty acids alter total mortality, cardiovascular events or cancers using both RCT and cohort studies. SEARCH STRATEGY Five databases including CENTRAL, MEDLINE and EMBASE were searched to February 2002. No language restrictions were applied. Bibliographies were checked and authors contacted. SELECTION CRITERIA RCTs were included where omega 3 intake or advice was randomly allocated and unconfounded, and study duration was at least six months. Cohorts were included where a cohort was followed up for at least six months and omega 3 intake estimated. DATA COLLECTION AND ANALYSIS Studies were assessed for inclusion, data extracted and quality assessed independently in duplicate. Random effects meta-analysis was performed separately for RCT and cohort data. MAIN RESULTS Forty eight randomised controlled trials (36,913 participants) and 41 cohort analyses were included. Pooled trial results did not show a reduction in the risk of total mortality or combined cardiovascular events in those taking additional omega 3 fats (with significant statistical heterogeneity). Sensitivity analysis, retaining only studies at low risk of bias, reduced heterogeneity and again suggested no significant effect of omega 3 fats. Restricting analysis to trials increasing fish-based omega 3 fats, or those increasing short chain omega 3s, did not suggest significant effects on mortality or cardiovascular events in either group. Subgroup analysis by dietary advice or supplementation, baseline risk of CVD or omega 3 dose suggested no clear effects of these factors on primary outcomes. Neither RCTs nor cohorts suggested increased relative risk of cancers with higher omega 3 intake but estimates were imprecise so a clinically important effect could not be excluded. REVIEWERS' CONCLUSIONS It is not clear that dietary or supplemental omega 3 fats alter total mortality, combined cardiovascular events or cancers in people with, or at high risk of, cardiovascular disease or in the general population. There is no evidence we should advise people to stop taking rich sources of omega 3 fats, but further high quality trials are needed to confirm suggestions of a protective effect of omega 3 fats on cardiovascular health. There is no clear evidence that omega 3 fats differ in effectiveness according to fish or plant sources, dietary or supplemental sources, dose or presence of placebo.
Collapse
Affiliation(s)
- L Hooper
- MANDEC, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester, UK, M15 6FH.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
111
|
Grundt H, Nilsen DWT, Hetland Ø, Mansoor MA. Clinical outcome and atherothrombogenic risk profile after prolonged wash-out following long-term treatment with high doses of n-3 PUFAs in patients with an acute myocardial infarction. Clin Nutr 2004; 23:491-500. [PMID: 15297084 DOI: 10.1016/j.clnu.2003.09.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2003] [Accepted: 09/05/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND Sustained effects following withdrawal of n-3 PUFAs are unknown. METHODS Clinical outcome [cardiac death, resuscitation, recurrent myocardial infarction (MI) or unstable angina pectoris] was assessed after prolonged wash-out following randomised treatment with high-dosed n-3 PUFAs or corn oil for 12-24 months in 300 acute MI patients. Atherothrombogenic risk markers, serum glucose and markers of lipid peroxidation and inflammation were evaluated in 89 out of the 100 last included patients. RESULTS After a total median observation period of 45 (range 0-53) months no intergroup difference in prognosis was observed for any of the cardiac events. Favourable effects on serum triglycerides and HDL-cholesterol by n-3 PUFAs were lost after washout, but triglycerides decreased in the corn oil as compared to the n-3 group, P < 0.001. The decline in total cholesterol after withdrawal was similar in both groups. No intergroup difference in the change in thiobarbituric acid-malondialdehyde, a marker of lipid peroxidation, ultrasensitive C-reactive protein, homocysteine, glucose or blood platelets was noted at sustained follow-up. CONCLUSION Clinical outcome was similar in both patient groups, and the atherothrombogenic risk improvement by n-3 PUFAs was lost after prolonged wash-out. Withdrawal did not affect homocysteine, glucose or markers of lipid peroxidation or inflammation.
Collapse
Affiliation(s)
- Heidi Grundt
- Department of Medicine, Rogaland Central Hospital, P.O. Box 8100, Stavanger 4068, and University of Bergen, Norway.
| | | | | | | |
Collapse
|
112
|
Dangour AD, Sibson VL, Fletcher AE. Hormones and Supplements: Do They Work?: Micronutrient Supplementation in Later Life: Limited Evidence for Benefit. J Gerontol A Biol Sci Med Sci 2004; 59:659-73. [PMID: 15304530 DOI: 10.1093/gerona/59.7.b659] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The importance of attaining adequate macronutrient and micronutrient intake throughout the life course is essential for the maintenance of health. Claims have been made for the benefits of micronutrient supplementation in later life, and this review considers the strength of the evidence behind these claims focusing on studies with cardiovascular, cancer, eye health, immune, and cognitive end points. While observational data suggest the presence of a link between dietary micronutrient intake and health outcomes, evidence from large randomized controlled trials does not support the use of antioxidant vitamin or mineral supplements among well-nourished older populations. Moreover, there is evidence of possible adverse affects of micronutrient supplementation. In conclusion, the considerable enthusiasm for the use of micronutrient, especially antioxidant, supplements as anti-aging treatments or as treatments for specific diseases of later life is not supported by the currently available scientific literature.
Collapse
Affiliation(s)
- Alan D Dangour
- Nutrition and Public Health Intervention Research Unit, Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, U.K.
| | | | | |
Collapse
|
113
|
de Bree A, Mennen LI, Hercberg S, Galan P. Evidence for a protective (synergistic?) effect of B-vitamins and omega-3 fatty acids on cardiovascular diseases. Eur J Clin Nutr 2004; 58:732-44. [PMID: 15116076 DOI: 10.1038/sj.ejcn.1601871] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The results of dietary intervention trials favor the hypothesis that higher intakes of B-vitamins (folate, vitamin B(6) and B(12)), and subsequently lower total homocysteine (tHcy) concentrations, are causally associated with a decreased risk of vascular disease in patients with cardiovascular diseases (CVD). The same is true for a higher intake of omega-3 fish fatty acids. Yet, the lack of hard end points and/or appropriate study designs precludes a definitive conclusion about causality. In the future, intervention trials with hard end points and randomized double-blind placebo-controlled designs should be able to elucidate the causality problem. There are several pathways by which B-vitamins and omega-3 fatty acids may exert their protective effect on CVD, a common pathway is a beneficial effect on the endothelial function and hemostasis. With respect to synergy between B-vitamins and omega-3 fatty acids, there is no evidence that fish oils have a tHcy-lowering effect beyond the effect of the B-vitamins. Nevertheless, animal studies clearly illustrate that vitamin B(6)- as well as folate-metabolism are linked with those of long-chain omega-3 fatty acids. Furthermore, a human study indicated synergistic effects of folic acid (synthetic form of folate) and vitamin B(6) together with omega-3 fatty acids on the atherogenic index and the fibrinogen concentration. Although these results are promising, they were produced in very small selective study populations. Thus, confirmation in large well-designed intervention trials is warranted.
Collapse
Affiliation(s)
- A de Bree
- Scientific and Technical Institute of Nutrition and Food (ISTNA-CNAM), INSERM U557, INRA U1125, Paris, France.
| | | | | | | |
Collapse
|
114
|
Di Stasi D, Bernasconi R, Marchioli R, Marfisi RM, Rossi G, Tognoni G, Tacconi MT. Early modifications of fatty acid composition in plasma phospholipids, platelets and mononucleates of healthy volunteers after low doses of n-3 polyunsaturated fatty acids. Eur J Clin Pharmacol 2004; 60:183-90. [PMID: 15069592 DOI: 10.1007/s00228-004-0758-8] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2003] [Accepted: 03/03/2004] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Although previous data suggested that only doses of 4 g/day or higher of n-3 polyunsaturated fatty acids (PUFA) have had a beneficial effect in the prevention of atherosclerosis and cardiovascular diseases, the GISSI-Prevenzione Study in a 3-year trial showed that 1 g/day reduced total and cardiovascular mortality in over 11,000 post-infarction patients. The aim of this study was to investigate the time course and the extent of incorporation of n-3 fatty acids in plasma and blood cells after 1 g/day of n-3 PUFA, the dose effective in the GISSI-Prevenzione in comparison with higher doses. METHODS Thirty-six healthy volunteers were given 1, 2 and 4 g/day of n-3 PUFA ethyl esters for 12 weeks, followed by a 4-week washout. Blood was collected at weeks 0, 1, 2, 4, 8, 12 and 16 and used for lipid profile analysis and measurement of fatty acid composition in plasma phospholipids, platelets and mononucleates. RESULTS Total n-3 PUFA increased by 2.0-, 2.2- and 2.9-fold versus baseline after 12-week treatment with 1, 2 and 4 g respectively. A statistically significant raise of total n-3 PUFA was seen in platelets and mononucleates. Among individual n-3 PUFA, 22:5 n-3 was enriched early and dose dependently in plasma phospholipids, platelets and mononucleates; the raise of 22:6 n-3 was less marked especially in platelets and mononucleates. CONCLUSIONS One gram per day of n-3 PUFA induces fast (within 1 week) and striking changes in blood composition of PUFA that may well explain their beneficial effects against cardiovascular diseases.
Collapse
Affiliation(s)
- Delia Di Stasi
- Department of Molecular Biochemistry and Pharmacology, Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea 62, 20157 Milan, Italy
| | | | | | | | | | | | | |
Collapse
|
115
|
Abstract
PURPOSE OF REVIEW Omega-3 fatty acids are gaining acceptance in the cardiovascular field. The present review describes the most recent studies and developments in the field. RECENT FINDINGS Marine omega-3 fatty acids, that is eicosapentaenoic and docosahexaenoic acids, prevent fatal myocardial infarction and sudden cardiac death by their antiarrhythmic effects and presumably also by their effect on infarct size, the latter mediated by plaque stabilization, improvements in endothelial function and other mechanisms. In contrast, a cardioprotective effect of alpha-linolenic acid, a plant-derived omega-3 fatty acid, remains to be clearly demonstrated in adequate intervention trials. Other forms of applications, like parenteral use or other indications, like in the psychiatric field, are currently being actively investigated. SUMMARY Eicosapentaenoic and docosahexaenoic acids, but not alpha-linolenic acid, prevent sudden death and other cardiovascular catastrophies, and have therefore been recently incorporated into the pertinent guidelines of European and American cardiologic societies.
Collapse
MESH Headings
- Anti-Arrhythmia Agents/pharmacology
- Anti-Arrhythmia Agents/therapeutic use
- Cardiovascular Diseases/epidemiology
- Cardiovascular Diseases/prevention & control
- Coronary Disease/epidemiology
- Coronary Disease/prevention & control
- Death, Sudden, Cardiac/epidemiology
- Death, Sudden, Cardiac/prevention & control
- Dietary Fats, Unsaturated/metabolism
- Dietary Fats, Unsaturated/pharmacology
- Dietary Fats, Unsaturated/therapeutic use
- Fatty Acids, Omega-3/metabolism
- Fatty Acids, Omega-3/pharmacology
- Fatty Acids, Omega-3/therapeutic use
- Humans
Collapse
Affiliation(s)
- Clemens von Schacky
- Medical Clinic and Policlinic Innenstadt, University of Munich, Ziemssenstrasse 1, D-80336 Munich, Germany.
| |
Collapse
|
116
|
Grundt H, Nilsen DWT, Hetland Ø, Valente E, Fagertun HE. Activated factor 12 (FXIIa) predicts recurrent coronary events after an acute myocardial infarction. Am Heart J 2004; 147:260-6. [PMID: 14760323 DOI: 10.1016/j.ahj.2003.07.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Activated factor XII (FXIIa) is involved in vascular injury and repair, participating in inflammation, thrombosis, and fibrinolysis. We wanted to test the hypothesis that FXIIa may predict an acute coronary syndrome (ACS) after a myocardial infarction (MI) and to evaluate whether FXIIa is related to global markers of end-stage coagulation and inflammation, including fibrin monomer (FM) and ultrasensitive C-reactive protein (microCRP). METHODS In a prospective study of 300 patients with acute MI, we evaluated the predictive value of FXIIa in blood samples drawn 4 to 6 days after admission. Cardiac death, re-MI, and troponin-T-positive unstable angina pectoris were registered during a median follow-up period of 1.5 years. RESULTS In the upper quartile of FXIIa (Q4) (> or =2.23 ng/mL) 32.0% of patients had an ACS as compared with 16.9% of patients with FXIIa in the three lower quartiles (Q1-3, P =.008). Relative risk of recurrent ACS for patients with FXIIa in the Q4 as compared with Q1-3 was 1.89 (95% CI, 1.22 to 2.93). A secondary ACS occurred earlier in patients with FXIIa in the Q4 as compared with those with FXIIa in the Q1-3 (P =.0039). Conventional risk factors as potential confounders were not associated with time to event. FXIIa did not correlate with FM or microCRP, and the FM and microCRP levels were of a similar magnitude in the Q4 as compared with the Q1 and the Q1-3 of FXIIa. CONCLUSIONS FXIIa predicts recurrent coronary events after MI. The prognostic ability of FXIIa was not reflected by markers of hypercoagulability or inflammation.
Collapse
Affiliation(s)
- Heidi Grundt
- Department of Clinical Chemistry, Rogaland Central Hospital, Stavanger, Norway.
| | | | | | | | | |
Collapse
|
117
|
Abstract
Omega 3 fatty acids from fish and fish oils can protect against coronary heart disease. This article reviews the evidence regarding fish oils and coronary disease and outlines the mechanisms through which fish oils might confer cardiac benefits
Collapse
Affiliation(s)
- Jehangir N Din
- Cardiovascular Research, University of Edinburgh, Edinburgh EH16 4SB.
| | | | | |
Collapse
|
118
|
|
119
|
Davis BC, Kris-Etherton PM. Achieving optimal essential fatty acid status in vegetarians: current knowledge and practical implications. Am J Clin Nutr 2003; 78:640S-646S. [PMID: 12936959 DOI: 10.1093/ajcn/78.3.640s] [Citation(s) in RCA: 163] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Although vegetarian diets are generally lower in total fat, saturated fat, and cholesterol than are nonvegetarian diets, they provide comparable levels of essential fatty acids. Vegetarian, especially vegan, diets are relatively low in alpha-linolenic acid (ALA) compared with linoleic acid (LA) and provide little, if any, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Clinical studies suggest that tissue levels of long-chain n-3 fatty acids are depressed in vegetarians, particularly in vegans. n-3 Fatty acids have numerous physiologic benefits, including potent cardioprotective effects. These effects have been demonstrated for ALA as well as EPA and DHA, although the response is generally less for ALA than for EPA and DHA. Conversion of ALA by the body to the more active longer-chain metabolites is inefficient: < 5-10% for EPA and 2-5% for DHA. Thus, total n-3 requirements may be higher for vegetarians than for nonvegetarians, as vegetarians must rely on conversion of ALA to EPA and DHA. Because of the beneficial effects of n-3 fatty acids, it is recommended that vegetarians make dietary changes to optimize n-3 fatty acid status.
Collapse
Affiliation(s)
- Brenda C Davis
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA 16802, USA.
| | | |
Collapse
|
120
|
Grundt H, Nilsen DWT, Mansoor MA, Nordøy A. Increased lipid peroxidation during long-term intervention with high doses of n-3 fatty acids (PUFAs) following an acute myocardial infarction. Eur J Clin Nutr 2003; 57:793-800. [PMID: 12792664 DOI: 10.1038/sj.ejcn.1601730] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess the oxidative burden of a highly concentrated compound of n-3 PUFAs as compared to corn oil by measuring thiobarbituric acid-malondialdehyde complex (TBA-MDA) by HPLC. We also studied the influence on TBA-MDA of statins combined with n-3 PUFAs or corn oil. DESIGN A prospective, randomised, double-blind, controlled study. SETTING One hospital centre in Stavanger, Norway. SUBJECTS A total of 300 subjects with an acute myocardial infarction (MI). INTERVENTIONS Gelatine capsules, containing 850-882 mg EPA and DHA as concentrated ethylesters, or 1 g of corn oil, were ingested in a dose of two capsules twice a day for at least 1 y. Alpha-tocopherol (4 mg) was added to all capsules to protect the PUFAs against oxidation. RESULTS After 1 y TBA-MDA increased modestly in the n-3 PUFA group (n=125), as compared to the corn oil group (n=130), P=0.027. Multiple linear regression analyses of fatty acids in serum total phospholipids (n=56) on TBA-MDA measured after 12 months intervention, showed no dependency. Performing best subsets regression, serum phospholipid concentration of arachidonic acid (20:4 n-6 PUFA) was identified as a predictor of TBA-MDA at 12 months follow-up, P=0.004. We found no impact of statins on TBA-MDA. CONCLUSION TBA-MDA increased modestly after long-term intervention with n-3 PUFAs compared to corn oil post-MI, suggesting biological changes induced by n-3 PUFAs, rather than simply reflecting their concentration differences. The peroxidative potential of n-3 PUFAs was not modified by statin treatment. SPONSORSHIP : Pharmacia A/S and Pronova A/S, Norway.
Collapse
Affiliation(s)
- H Grundt
- Department of Clinical Chemistry, Central Hospital in Rogaland, POB 8100, 4068 Stavanger, Norway.
| | | | | | | |
Collapse
|
121
|
Kris-Etherton PM, Harris WS, Appel LJ. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Arterioscler Thromb Vasc Biol 2003; 23:e20-30. [PMID: 12588785 DOI: 10.1161/01.atv.0000038493.65177.94] [Citation(s) in RCA: 250] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
122
|
Abstract
PURPOSE OF REVIEW Of all known dietary factors, long-chain omega-3 fatty acids may be the most protective against death from coronary heart disease. New evidence has confirmed and refined the cardioprotective role of these fatty acids. RECENT FINDINGS Omega-3 fatty acid supplementation reduces the risk of sudden cardiac death and death from any cause within 4 months in post-myocardial infarction patients. Evidence continues to accrue for benefits in the primary prevention of coronary heart disease and stroke, and an anti-arrhythmogenic mechanism is emerging as the most likely explanation. SUMMARY Current evidence suggests that individuals with coronary artery disease may reduce their risk of sudden cardiac death by increasing their intake of long-chain omega-3 fatty acids by approximately 1 g per day.
Collapse
Affiliation(s)
- William S Harris
- Lipid and Diabetes Research Center, Saint Luke's Hospital, University of Missouri - Kansas City School of Medicine, 64111, USA.
| | | | | |
Collapse
|
123
|
|