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Marcus MD, Link MS. Omega-3 Fatty Acids and Arrhythmias. Circulation 2024; 150:488-503. [PMID: 39102482 DOI: 10.1161/circulationaha.123.065769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
The pro- and antiarrhythmic effects of omega-3 polyunsaturated fatty acids (n-3 PUFAs) have been extensively studied in preclinical and human trials. Despite early evidence of an antiarrhythmic role of n-3 PUFA in the prevention of sudden cardiac death and postoperative and persistent atrial fibrillation (AF), subsequent well-designed randomized trials have largely not shown an antiarrhythmic benefit. Two trials that tested moderate and high-dose n-3 PUFA demonstrated a reduction in sudden cardiac death, but these findings have not been widely replicated, and the potential of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) to reduce arrhythmic death in combination, or as monotherapy, remains uncertain. The accumulated clinical evidence does not support supplementation of n-3 PUFA for postoperative AF or secondary prevention of AF. Several large, contemporary, randomized controlled trials of high-dose n-3 PUFA for primary or secondary cardiovascular prevention have demonstrated a small, significant, dose-dependent increased risk of incident AF compared with mineral oil or corn oil comparator. These findings were reproduced with both icosapent ethyl monotherapy and a mixed EPA+DHA formulation. The proarrhythmic mechanism of increased AF in contemporary cohorts exposed to high-dose n-3 PUFA is unknown. EPA and DHA and their metabolites have pleiotropic cardiometabolic and pro- and antiarrhythmic effects, including modification of the lipid raft microenvironment; alteration of cell membrane structure and fluidity; modulation of sodium, potassium, and calcium currents; and regulation of gene transcription, cell proliferation, and inflammation. Further characterization of the complex association between EPA, EPA+DHA, and DHA and AF is needed. Which formulations, dose ranges, and patient subgroups are at highest risk, remain unclear.
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Affiliation(s)
- Mason D Marcus
- Department of Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX
| | - Mark S Link
- Department of Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, TX
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2
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Anthony R, Macartney MJ, Heileson JL, McLennan PL, Peoples GE. A review and evaluation of study design considerations for omega-3 fatty acid supplementation trials in physically trained participants. Nutr Res Rev 2024; 37:1-13. [PMID: 36620998 DOI: 10.1017/s095442242300001x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Long-chain omega-3 polyunsaturated fatty acid (LC n-3 PUFA) supplements, rich in eicosapentaenoic acid and/or docosahexaenoic acid, are increasingly being recommended within athletic institutions. However, the wide range of doses, durations and study designs implemented across trials makes it difficult to provide clear recommendations. The importance of study design characteristics in LC n-3 PUFA trials has been detailed in cardiovascular disease research, and these considerations may guide LC n-3 PUFA study design in healthy cohorts. This systematic review examined the quality of studies and study design considerations used in evaluating the evidence for LC n-3 PUFA improving performance in physically trained adults. SCOPUS, PubMed and Web of Science electronic databases were searched to identify studies that supplemented LC n-3 PUFA in physically trained participants. Forty-six (n = 46) studies met inclusion. Most studies used a randomised control design. Risk of bias, assessed using the design-appropriate Cochrane Collaboration tool, revealed that studies had a predominant judgment of 'some concerns', 'high risk' or 'moderate risk' in randomised controlled, randomised crossover or non-randomised studies, respectively. A custom five-point quality assessment scale demonstrated that no study satisfied all recommendations for LC n-3 PUFA study design. This review has highlighted that the disparate range of study designs is likely contributing to the inconclusive state of outcomes pertaining to LC n-3 PUFA as a potential ergogenic aid. Further research must adequately account for the specific LC n-3 PUFA study design considerations, underpinned by a clear hypothesis, to achieve evidence-based dose, duration and composition recommendations for physically trained individuals.
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Affiliation(s)
- Ryan Anthony
- Graduate School of Medicine, University of Wollongong, Wollongong, Australia
- Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Michael J Macartney
- Graduate School of Medicine, University of Wollongong, Wollongong, Australia
- Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Jeffery L Heileson
- Department of Health, Human Performance and Recreation, Robbins College of Health and Human Sciences, Baylor University, Texas, USA
| | - Peter L McLennan
- Graduate School of Medicine, University of Wollongong, Wollongong, Australia
- Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Gregory E Peoples
- Graduate School of Medicine, University of Wollongong, Wollongong, Australia
- Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
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3
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García-Maldonado E, Alcorta A, Zapatera B, Vaquero MP. Changes in fatty acid levels after consumption of a novel docosahexaenoic supplement from algae: a crossover randomized controlled trial in omnivorous, lacto-ovo vegetarians and vegans. Eur J Nutr 2022; 62:1691-1705. [DOI: 10.1007/s00394-022-03050-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022]
Abstract
Abstract
Purpose
To determine serum fatty acids of lacto-ovo vegetarian (LOV), vegan (VEG) and omnivorous (OMN) adults, and to analyse the effects of consuming a docosahexaenoic acid (DHA) supplement of vegetable origin on fatty acid profile.
Methods
A randomized, double-blind, placebo-controlled crossover design was conducted in healthy adults. Volunteers (n = 116) were randomly assigned to a DHA-supplement (dose 250 mg/day), made from the microalgae Schizochytrium sp., or a placebo during 5-week periods separated by a 5-week washout interim period. Compliance and dietary intake were estimated and serum fatty acids were determined by gas chromatography. Results were analysed by mixed linear models.
Results
Percentage of linoleic acid (C18:2n6) in serum was the highest among the fatty acids in the three diet groups, followed by oleic (C18:1n9) and palmitic (C16:0) acids. Linoleic (C18:2n6) and alpha-linolenic (C18:3n3) acids were higher in VEG compared to OMN (p < 0.001), while in LOV, their levels were intermediate between the other groups. Women presented higher DHA (C22:6n3) than men (p < 0.001). The DHA-supplement increased serum DHA compared to placebo in the three diet groups (p < 0.001), and a higher increase was observed in VEG followed by LOV (p < 0.001). The ratio serum n-6/n-3 improved by the supplementation but remained higher in LOV and VEG than in OMN. In contrast, the DHA-supplement decreased docosapentaenoic (C22:5n3) and docosatetraenoic (C22:4n6) acids in all diet groups (p < 0.001) and increased the eicosapentaenoic to alpha-linolenic fatty acids ratio (p = 0.016).
Conclusion
The DHA-supplement at dose of 250 mg/day was effective in increasing serum DHA either in omnivorous, lacto-ovo vegetarian and vegan adults.
Clinical trial registration
Registered at Clinicaltrials.gov (www.clinicaltrials.gov), NCT04278482.
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The Effects of a Meldonium Pre-Treatment on the Course of the LPS-Induced Sepsis in Rats. Int J Mol Sci 2022; 23:ijms23042395. [PMID: 35216510 PMCID: PMC8924897 DOI: 10.3390/ijms23042395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/09/2022] [Accepted: 02/14/2022] [Indexed: 02/01/2023] Open
Abstract
A dysregulated and overwhelming response to an infection accompanied by the exaggerated pro-inflammatory state and metabolism disturbance leads to the fatal outcome in sepsis. Previously we showed that meldonium, an anti-ischemic drug clinically used to treat myocardial and cerebral ischemia, strongly increases mortality in faecal-induced peritonitis (FIP) in rats. We postulated that the same mechanism that is responsible for the otherwise strong anti-inflammatory effects of meldonium could be the culprit of the increased mortality. In the present study, we applied the LPS-induced model of sepsis to explore the presence of any differences from and/or similarities to the FIP model. When it comes to energy production, despite some shared similarities, it is evident that LPS and FIP models of sepsis differ greatly. A different profile of sympathoadrenal activation may account for this observation, as it was lacking in the FIP model, whereas in the LPS model it was strong enough to overcome the effects of meldonium. Therefore, choosing the appropriate model of sepsis induction is of great importance, especially if energy homeostasis is the main focus of the study. Even when differences in the experimental design of the two models are acknowledged, the role of different patterns of energy production cannot be excluded. On that account, our results draw attention to the importance of uninterrupted energy production in sepsis but also call for much-needed revisions of the current recommendations for its treatment.
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Andelova K, Bacova BS, Sykora M, Hlivak P, Barancik M, Tribulova N. Mechanisms Underlying Antiarrhythmic Properties of Cardioprotective Agents Impacting Inflammation and Oxidative Stress. Int J Mol Sci 2022; 23:1416. [PMID: 35163340 PMCID: PMC8835881 DOI: 10.3390/ijms23031416] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 01/27/2023] Open
Abstract
The prevention of cardiac life-threatening ventricular fibrillation and stroke-provoking atrial fibrillation remains a serious global clinical issue, with ongoing need for novel approaches. Numerous experimental and clinical studies suggest that oxidative stress and inflammation are deleterious to cardiovascular health, and can increase heart susceptibility to arrhythmias. It is quite interesting, however, that various cardio-protective compounds with antiarrhythmic properties are potent anti-oxidative and anti-inflammatory agents. These most likely target the pro-arrhythmia primary mechanisms. This review and literature-based analysis presents a realistic view of antiarrhythmic efficacy and the molecular mechanisms of current pharmaceuticals in clinical use. These include the sodium-glucose cotransporter-2 inhibitors used in diabetes treatment, statins in dyslipidemia and naturally protective omega-3 fatty acids. This approach supports the hypothesis that prevention or attenuation of oxidative and inflammatory stress can abolish pro-arrhythmic factors and the development of an arrhythmia substrate. This could prove a powerful tool of reducing cardiac arrhythmia burden.
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Affiliation(s)
- Katarina Andelova
- Centre of Experimental Medicine, Slovak Academy of Sciences, Institute for Heart Research, Dúbravská Cesta 9, 84104 Bratislava, Slovakia; (K.A.); (M.S.); (M.B.)
| | - Barbara Szeiffova Bacova
- Centre of Experimental Medicine, Slovak Academy of Sciences, Institute for Heart Research, Dúbravská Cesta 9, 84104 Bratislava, Slovakia; (K.A.); (M.S.); (M.B.)
| | - Matus Sykora
- Centre of Experimental Medicine, Slovak Academy of Sciences, Institute for Heart Research, Dúbravská Cesta 9, 84104 Bratislava, Slovakia; (K.A.); (M.S.); (M.B.)
| | - Peter Hlivak
- Department of Arrhythmias and Pacing, National Institute of Cardiovascular Diseases, Pod Krásnou Hôrkou 1, 83348 Bratislava, Slovakia;
| | - Miroslav Barancik
- Centre of Experimental Medicine, Slovak Academy of Sciences, Institute for Heart Research, Dúbravská Cesta 9, 84104 Bratislava, Slovakia; (K.A.); (M.S.); (M.B.)
| | - Narcis Tribulova
- Centre of Experimental Medicine, Slovak Academy of Sciences, Institute for Heart Research, Dúbravská Cesta 9, 84104 Bratislava, Slovakia; (K.A.); (M.S.); (M.B.)
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Macartney MJ, Ghodsian MM, Noel-Gough B, McLennan PL, Peoples GE. DHA-Rich Fish Oil Increases the Omega-3 Index in Healthy Adults and Slows Resting Heart Rate without Altering Cardiac Autonomic Reflex Modulation. J Am Coll Nutr 2021; 41:637-645. [PMID: 34379997 DOI: 10.1080/07315724.2021.1953417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Regular fish consumption, a rich source of long-chain omega-3 (ω-3) docosahexaenoic acid (DHA), modifies cardiac electrophysiology. However, human studies investigating fish oil and cardiac electrophysiology have predominantly supplemented therapeutic (high) doses of fish oil (often ω-3 eicosapentaenoic acid (EPA) rich sources). This study examined whether non-therapeutic doses of DHA-rich fish oil modulate cardiac electrophysiology at rest and during cardiovascular reflex challenges to the same extent, if at all, in young healthy adults. Participants (N = 20) were supplemented (double-blinded) with (2x1g.day-1) soy oil (Control n = 9) or DHA-rich tuna fish oil (FO n = 11) providing DHA: 560 mg and EPA: 140 mg. The Omega-3 Index (O3I; erythrocyte membrane % EPA + DHA), heart rate (HR) and HR variability (HRV) were analyzed during rest, maximal isometric handgrip and cold diving reflex challenges at baseline and following 8 weeks. The baseline O3I (Control: 5.1 ± 1.0; FO: 5.4 ± 0.9; P > 0.05), resting HR (Control: 65 ± 12bpm; FO: 66 ± 8bpm; P > 0.05) and HRV metrics did not significantly differ between the groups prior to supplementation. Relative to the control group, the O3I was increased (Control: 5.0 ± 1.1; FO: 7.8 ± 1.2; P < 0.001), and resting HR was slowed in the FO group following supplementation (Control: 66 ± 9bpm; FO: 61 ± 6bpm; P = 0.046). However, no significant (P > 0.05) between-group differences were observed in HR responsiveness or any indices of HRV during reflex challenges. In young healthy adults, dietary achievable doses of ω-3 DHA-rich fish oil exerted a direct slowing effect on resting HR, without compromising the HR response to either dominant sympathetic or parasympathetic modulation.
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Affiliation(s)
- Michael J Macartney
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia.,Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Mathew M Ghodsian
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia
| | - Bransen Noel-Gough
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia
| | - Peter L McLennan
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia.,Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Gregory E Peoples
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia.,Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
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7
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Macartney MJ, Peoples GE, McLennan PL. Cardiac contractile dysfunction, during and following ischaemia, is attenuated by low-dose dietary fish oil in rats. Eur J Nutr 2021; 60:4495-4503. [PMID: 34120245 DOI: 10.1007/s00394-021-02608-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/02/2021] [Indexed: 12/31/2022]
Abstract
AIMS Supplementing animal diets with high-dose fish oil, rich in long chain omega-3 (ω-3) docosahexaenoic acid (DHA), enhances cardiac contractile efficiency and attenuates dysfunction, attributable to ischaemia. However, it remains unclear whether smaller doses, equivalent to what is achievable via regular fish consumption in the human diet, offer similar protection. METHODS Male Sprague-Dawley (12-15w) rats were fed isoenergetic diets (ad libitum) containing 10% fat by weight (22% energy) for 4-5w. Control diet (CON) contained 5.5% beef tallow; 2.5% ω-6 sunflower seed oil; 2% olive oil. Fish oil diets included high-DHA tuna oil exchanged for olive oil to provide 0.32% (FO1; human equivalent EPA + DHA 570 mg/d) or 1.25% (FO2; equivalent EPA + DHA 2.3 g/d) wt/wt dose of fish oil. Anaesthetised rats (pentobarbital: 60 mg/kg i.p.) were subjected to 45 min coronary artery occlusion then reperfusion in vivo as a whole animal model of regional myocardial ischaemia, with left ventricular haemodynamic function measured by conductance catheter. RESULTS Ischaemia-induced reductions in rate pressure product recovered faster in the FO2 group and post-ischaemic left ventricular pressure-volume loop integrity (shifted downwards and right in CON) was partially protected in both fish oil groups. CONCLUSION Ischaemia-induced contractile dysfunction in rats is limited from fish oil doses equivalent to regular consumption of fish in the human diet. These observations highlight plausible and clinically relevant physiological changes that rationalise nutritional conditioning of the heart with DHA for on-going cardioprotection.
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Affiliation(s)
- Michael J Macartney
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia. .,Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia.
| | - Gregory E Peoples
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia.,Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Peter L McLennan
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia.,Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia
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8
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Anthony R, Brown MA, Walton KL, McLennan PL, Peoples GE. A daily dose of fish oil increased the omega‐3 index in older adults and reduced their heart rate during a walking activity: A pilot study. NUTR BULL 2021. [DOI: 10.1111/nbu.12497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ryan Anthony
- Centre for Medical and Exercise Physiology School of Medicine University of Wollongong Wollongong NSW Australia
| | - Marc A. Brown
- Centre for Medical and Exercise Physiology School of Medicine University of Wollongong Wollongong NSW Australia
| | - Karen L. Walton
- Discipline of Nutrition and Dietetics School of Medicine University of Wollongong Wollongong NSW Australia
- Illawarra Health and Medical Research Institute University of Wollongong Wollongong NSW Australia
| | - Peter L. McLennan
- Centre for Medical and Exercise Physiology School of Medicine University of Wollongong Wollongong NSW Australia
| | - Gregory E. Peoples
- Centre for Medical and Exercise Physiology School of Medicine University of Wollongong Wollongong NSW Australia
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Filipovic MG, Reiner MF, Rittirsch S, Irincheeva I, Aeschbacher S, Grossmann K, Risch M, Risch L, Limacher A, Conen D, Beer JH. Blood Omega-3 Fatty Acids Are Inversely Associated With Albumin-Creatinine Ratio in Young and Healthy Adults (The Omega-Kid Study). Front Cardiovasc Med 2021; 8:622619. [PMID: 33987209 PMCID: PMC8110728 DOI: 10.3389/fcvm.2021.622619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 03/31/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Omega-3 fatty acids are associated with a lower risk of cardiovascular disease (CVD) and with beneficial effects on CV risk factors. The albumin-creatinine ratio (ACR) is a risk factor for CVD, all-cause mortality and accelerated glomerular filtration rate (GFR) decline in the general population. We aimed to investigate the association between n-3 PUFAS and ACR in heathy individuals with preserved GFR. Design and Methods: The present cross-sectional analysis is part of the GAPP study, a population-based cohort of healthy adults aged 25-41 years. Individuals with known CVD, diabetes, or a BMI >35 kg/m2 were excluded. eGFR was calculated according to the combined Creatinine/Cystatin C CKD-EPI formula. ACR was obtained from a fasting morning urine sample. The Omega-3 Index (relative amount of EPA and DHA of total fatty acids in %) was obtained from whole blood aliquots. Results: Overall, 2001 participants (median age 37 years IQR 31; 40, 53% female) were included in this analysis. Median Omega-3 Index was 4.59 (IQR 4.06; 5.25) and median eGFR 111 ml/min/1.73 m2 (IQR 103; 118). Median ACR was 0.14 mg/mmol (IQR 0; 0.43). We found a significant inverse association of the Omega-3 Index with ACR (ratio 0.84, 95%CI 0.73-0.96; p = 0.011) which remained after comprehensive adjustment (ratio 0.86, 95%CI 0.74-1.00; p = 0.048). No association of the Omega-3 Index with eGFR was found. The adjusted difference in eGFR per 1-unit increase in Omega3-Index was -0.21 (95%CI -0.76; 0.35; p = 0.47). Conclusions: A higher Omega-3 Index was significantly associated with lower ACR in this young and healthy population with preserved eGFR. Omega-3 fatty acids may exhibit cardio- and nephroprotective effects in healthy individuals through modulation of ACR.
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Affiliation(s)
- Mark G Filipovic
- Institute of Anesthesiology, Cantonal Hospital of Winterthur, Winterthur, Switzerland
| | - Martin F Reiner
- Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland.,Center for Molecular Cardiology University of Zurich, Zurich, Switzerland
| | - Saskia Rittirsch
- Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland
| | - Irina Irincheeva
- Clinical Trials Unit (CTU) Bern, University of Bern, Bern, Switzerland
| | - Stefanie Aeschbacher
- Cardiovascular Research Institute Basel and Division of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Martin Risch
- Labormedizinisches Zentrum Dr Risch, Vaduz, Liechtenstein.,Division of Laboratory Medicine, Cantonal Hospital Graubünden, Chur, Switzerland
| | - Lorenz Risch
- Labormedizinisches Zentrum Dr Risch, Vaduz, Liechtenstein.,Department of Laboratory Medicine, Institute of Clinical Chemistry, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland.,Private University Triesen, Triesen, Liechtenstein
| | - Andreas Limacher
- Clinical Trials Unit (CTU) Bern, University of Bern, Bern, Switzerland
| | - David Conen
- Population Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Juerg H Beer
- Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland.,Center for Molecular Cardiology University of Zurich, Zurich, Switzerland
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Racey M, MacFarlane A, Carlson SE, Stark KD, Plourde M, Field CJ, Yates AA, Wells G, Grantham A, Bazinet RP, Ma DWL. Dietary Reference Intakes based on chronic disease endpoints: outcomes from a case study workshop for omega 3's EPA and DHA. Appl Physiol Nutr Metab 2021; 46:530-539. [PMID: 33583256 DOI: 10.1139/apnm-2020-0994] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Given the focus on developing Dietary Reference Intakes (DRIs) based on chronic disease risk reduction and recent research for omega-3 long chain PUFA since the last DRI review, the Canadian Nutrition Society convened a panel of stakeholders for a 1-day workshop in late 2019. Attendees discussed the new NASEM guidelines for establishing DRI values based on chronic disease risk endpoints and the strength of current evidence for EPA and DHA as it relates to the new guidelines. Novelty: Summarizes evidence and expert opinions regarding the potential for reviewing DRI values for EPA and DHA and cardiovascular disease risk and early development.
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Affiliation(s)
- Megan Racey
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Amanda MacFarlane
- Bureau of Nutritional Sciences, Health Canada, Ottawa, ON K1A 0K9, Canada
| | - Susan E Carlson
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Ken D Stark
- Department of Kinesiology, Faculty of Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Mélanie Plourde
- Faculté de Médecine et des Sciences de la Santé, Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada.,Centre de Recherche sur le Vieillissement, Centre Intégré Universitaire de Santé et Services Sociaux de l'Estrie-Centre Hospitalier Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Catherine J Field
- Faculty of Agricultural, Life and Environmental Sciences, Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AB T6G 2H5, Canada
| | - Allison A Yates
- Food and Nutrition Board, Institute of Medicine, and USDA/ARS Beltsville (retired), Johnson City, TN 37615, USA
| | - George Wells
- Department of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada.,Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
| | - Andrea Grantham
- Canadian Nutrition Society, 867 La Chapelle Street, Ottawa, ON K1C 6A8, Canada
| | - Richard P Bazinet
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - David W L Ma
- Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada
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Bayés-Genís A, Revuelta-López E, Sala-Vila A. Reply: Effects of Omega-3 Fatty Acids on Ventricular Remodeling and Systemic Inflammation After Acute Myocardial Infarction. J Am Coll Cardiol 2021; 77:1026-1028. [PMID: 33602462 DOI: 10.1016/j.jacc.2020.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/14/2020] [Indexed: 11/17/2022]
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12
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Macartney MJ, Peoples GE, McLennan PL. Cardiac Arrhythmia Prevention in Ischemia and Reperfusion by Low-Dose Dietary Fish Oil Supplementation in Rats. J Nutr 2020; 150:3086-3093. [PMID: 32886112 DOI: 10.1093/jn/nxaa256] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/20/2020] [Accepted: 08/04/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Supplementing animal diets with fish oil increases myocardial omega-3 polyunsaturated fatty acids [ω-3 (n-3) PUFA], lowers heart rate, and prevents malignant cardiac arrhythmias. In contrast to epidemiological reports, results of some human clinical trials and of unphysiologically high doses employed in animal studies call into question the application of dietary ω-3 PUFA for cardioprotection. OBJECTIVE This study tested the hypothesis that low ω-3 PUFA dietary thresholds for myocardial incorporation in rats, equivalent in dose to what humans derive from eating fish, can reduce heart rate and arrhythmia vulnerability. METHODS Male Sprague-Dawley rats (12-15 wk old) were fed isoenergetic diets containing 10% fat for 4-5 wk. The control diet (CON) contained 5.5% beef tallow, 2.5% sunflower seed oil, and 2% olive oil. Fish oil diets contained high-DHA tuna oil, exchanged for olive oil: 0.31% [fish oil group 1 (FO1)] (human equivalent EPA + DHA 570 mg/d); 1.25% [fish oil group 2 (FO2)] (equivalent EPA + DHA 2.3 g/d). Anaesthetized rats (pentobarbital, 60 mg/kg intraperitoneally) were subjected in vivo to 15-min cardiac ischemia by left coronary artery occlusion and then reperfusion, with arrhythmias detected by electrocardiogram. RESULTS Fish oil dose dependently modulated myocardial membrane fatty acids (DHA mean ± SEM: CON, 5.0 ± 0.2%; FO1, 13.1 ± 0.9%; FO2, 18.3 ± 0.4%; n = 4-5; P-trend < 0.001 ANOVA); resting heart rate (CON, 453 ± 6; FO1, 432 ± 4; FO2, 422 ± 5 bpm; n = 15-18; P-trend < 0.001); reduced ventricular fibrillation (VF) (CON, 89%; FO1, 60%; P = 0.052; FO2, 50%; n = 15-18; P = 0.013 chi square); and total arrhythmia severity (arrhythmia score: CON, 6.1 ± 0.4; FO1, 4.6 ± 0.5; FO2, 3.1 ± 0.7; n = 15-18; P-trend < 0.01) during ischemia and reperfusion (VF: Con, 86%; FO1, 22% P = 0.011; FO2, 8% P = 0.001; n = 7-12); (arrhythmia score: CON, 4.6 ± 0.3; FO1, 3.1 ± 0.3; FO2, 1.3 ± 0.3; n = 7-12; P-trend < 0.001). CONCLUSIONS Ventricular arrhythmias were prevented and heart rate was slowed by lower ω-3 PUFA intake in rats than previously reported, equivalent to human fish consumption and associated with increased myocardial DHA. The efficacy of low-dose fish oil demonstrates biological plausibility for nutritional ω-3 fatty acid-mediated cardioprotection and suggests that effectiveness in human clinical trials may be obscured by failure to exclude fish eaters.
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Affiliation(s)
- Michael J Macartney
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia.,Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Gregory E Peoples
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia.,Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Peter L McLennan
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia.,Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
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13
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Schmidt EB, Calder PC. Marine n-3 Fatty Acids, Sudden Cardiac Death, and Ischemic Heart Disease: Fish or Supplements? J Nutr 2020; 150:3055-3057. [PMID: 33188414 DOI: 10.1093/jn/nxaa319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/10/2020] [Accepted: 09/22/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Erik B Schmidt
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Philip C Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
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14
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Circulating Omega-3 Fatty Acids and Incident Adverse Events in Patients With Acute Myocardial Infarction. J Am Coll Cardiol 2020; 76:2089-2097. [DOI: 10.1016/j.jacc.2020.08.073] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/28/2020] [Accepted: 08/28/2020] [Indexed: 11/17/2022]
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15
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Russell JS, Griffith TA, Naghipour S, Vider J, Du Toit EF, Patel HH, Peart JN, Headrick JP. Dietary α-Linolenic Acid Counters Cardioprotective Dysfunction in Diabetic Mice: Unconventional PUFA Protection. Nutrients 2020; 12:nu12092679. [PMID: 32887376 PMCID: PMC7551050 DOI: 10.3390/nu12092679] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/12/2020] [Accepted: 08/26/2020] [Indexed: 12/15/2022] Open
Abstract
Whether dietary omega-3 (n-3) polyunsaturated fatty acid (PUFA) confers cardiac benefit in cardiometabolic disorders is unclear. We test whether dietary -linolenic acid (ALA) enhances myocardial resistance to ischemia-reperfusion (I-R) and responses to ischemic preconditioning (IPC) in type 2 diabetes (T2D); and involvement of conventional PUFA-dependent mechanisms (caveolins/cavins, kinase signaling, mitochondrial function, and inflammation). Eight-week male C57Bl/6 mice received streptozotocin (75 mg/kg) and 21 weeks high-fat/high-carbohydrate feeding. Half received ALA over six weeks. Responses to I-R/IPC were assessed in perfused hearts. Localization and expression of caveolins/cavins, protein kinase B (AKT), and glycogen synthase kinase-3 β (GSK3β); mitochondrial function; and inflammatory mediators were assessed. ALA reduced circulating leptin, without affecting body weight, glycemic dysfunction, or cholesterol. While I-R tolerance was unaltered, paradoxical injury with IPC was reversed to cardioprotection with ALA. However, post-ischemic apoptosis (nucleosome content) appeared unchanged. Benefit was not associated with shifts in localization or expression of caveolins/cavins, p-AKT, p-GSK3β, or mitochondrial function. Despite mixed inflammatory mediator changes, tumor necrosis factor-a (TNF-a) was markedly reduced. Data collectively reveal a novel impact of ALA on cardioprotective dysfunction in T2D mice, unrelated to caveolins/cavins, mitochondrial, or stress kinase modulation. Although evidence suggests inflammatory involvement, the basis of this "un-conventional" protection remains to be identified.
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Affiliation(s)
- Jake S. Russell
- School of Medical Science, Griffith University Gold Coast, Southport QLD 4217, Australia; (J.S.R.); (T.A.G.); (S.N.); (J.V.); (E.F.D.T.); (J.N.P.)
| | - Tia A. Griffith
- School of Medical Science, Griffith University Gold Coast, Southport QLD 4217, Australia; (J.S.R.); (T.A.G.); (S.N.); (J.V.); (E.F.D.T.); (J.N.P.)
| | - Saba Naghipour
- School of Medical Science, Griffith University Gold Coast, Southport QLD 4217, Australia; (J.S.R.); (T.A.G.); (S.N.); (J.V.); (E.F.D.T.); (J.N.P.)
| | - Jelena Vider
- School of Medical Science, Griffith University Gold Coast, Southport QLD 4217, Australia; (J.S.R.); (T.A.G.); (S.N.); (J.V.); (E.F.D.T.); (J.N.P.)
| | - Eugene F. Du Toit
- School of Medical Science, Griffith University Gold Coast, Southport QLD 4217, Australia; (J.S.R.); (T.A.G.); (S.N.); (J.V.); (E.F.D.T.); (J.N.P.)
| | - Hemal H. Patel
- VA San Diego Healthcare System and Department of Anesthesiology, University of California, San Diego, CA 92093, USA;
| | - Jason N. Peart
- School of Medical Science, Griffith University Gold Coast, Southport QLD 4217, Australia; (J.S.R.); (T.A.G.); (S.N.); (J.V.); (E.F.D.T.); (J.N.P.)
| | - John P. Headrick
- School of Medical Science, Griffith University Gold Coast, Southport QLD 4217, Australia; (J.S.R.); (T.A.G.); (S.N.); (J.V.); (E.F.D.T.); (J.N.P.)
- Correspondence: ; Tel.: +61-7-5552-8292
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Oliveira C, Silveira EA, Rosa L, Santos A, Rodrigues AP, Mendonça C, Silva L, Gentil P, Rebelo AC. Risk Factors Associated with Cardiac Autonomic Modulation in Obese Individuals. J Obes 2020; 2020:7185249. [PMID: 32318288 PMCID: PMC7152942 DOI: 10.1155/2020/7185249] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 03/07/2020] [Indexed: 12/18/2022] Open
Abstract
Obesity leads to an imbalance in the autonomic nervous system, especially in increased sympathetic modulation and decreased vagal tone, and some anthropometric, metabolic, and lifestyle variables may increase the risk of developing cardiovascular disease. Objective. To analyze the association between cardiovascular autonomic modulation and biochemical and anthropometric markers, food intake, and physical activity level in severely obese individuals. Methodology. The present study is a cutout of a randomized clinical trial "Effect of nutritional intervention and olive oil in severe obesity" (DieTBra Trial), where the baseline data were analyzed. Anthropometric data, biochemical exams, heart rate variability (HRV), accelerometry, and 24 h recall (R24H) of obese patients (body mass index BMI ≥35 kg/m2) were collected. Results. 64 obese patients were analyzed, with a mean age of 39.10 ± 7.74 years (27 to 58 years). By HRV analysis, in the frequency domain, the obese had a higher predominance of sympathetic autonomic modulation (low frequency (LF) 56.44 ± 20.31 nu) and lower parasympathetic modulation (high frequency (HF) 42.52 ± 19.18 nu). A negative association was observed between the variables Homeostasis Evaluation Model (HOMA-IR) and HF (p = 0.049). In the physical activity analysis, there was a negative association between moderate to vigorous physical activity and the sympathetic component (p = 0.043), and for sedentary time (ST), there was a negative association with HF (p = 0.049) and LF/HF (p = 0.036) and a positive association with LF (p = 0.014). For multiple linear regression, waist circumference (WC) and HOMA-IR values were negatively associated with HF (β = -0.685, p = 0.010; β = -14.989, p = 0.010; respectively). HOMA-IR (β = 0.141, p = 0.003) and the percentage of lipids ingested (β = -0.030, p = 0.043) were negatively associated with LF/HF. Conclusion. Among the cardiovascular risk variables studied, insulin resistance and central adiposity showed the greatest influence on cardiac autonomic modulation of obese, increasing the risk for cardiovascular disease.
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Affiliation(s)
- Camila Oliveira
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Erika Aparecida Silveira
- Medicine Faculty, Coordinator of the Severe Obesity Study Group, Federal University of Goiás, Goiânia, Brazil
| | - Lorena Rosa
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Annelisa Santos
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Ana Paula Rodrigues
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Carolina Mendonça
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Lucas Silva
- Medicine Faculty, Health Science Post-Graduation Program, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Paulo Gentil
- College of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | - Ana Cristina Rebelo
- Department of Morphology, Biological Sciences Institute, Federal University of Goiás, Goiânia, Goiás, Brazil
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17
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Macartney MJ, Peoples GE, Treweek TM, McLennan PL. Docosahexaenoic acid varies in rat skeletal muscle membranes according to fibre type and provision of dietary fish oil. Prostaglandins Leukot Essent Fatty Acids 2019; 151:37-44. [PMID: 31756643 DOI: 10.1016/j.plefa.2019.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 08/28/2019] [Accepted: 08/28/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND Dietary fish oil provides polyunsaturated fatty acid (PUFA) docosahexaenoic acid (DHA) and is associated with modified oxygen consumption, contractile fatigue and physiological responses to ischaemia or hypoxia in striated muscle. This study systematically investigated the membrane incorporation of fatty acids, with a focus on DHA, into skeletal muscle in relation to functional/metabolic differences and their responsiveness to fish oil doses. METHODS Male Sprague-Dawley rats were randomised to isoenergetic diets (10% fat by weight). Human Western-style diets were simulated with 5.5% tallow, 2.5% n-6 PUFA sunflower seed oil and 2% olive oil (Control). High-DHA tuna oil exchanged for olive oil provided a Low (0.32%) or moderate (Mod) (1.25%) fish oil diet. Membrane phospholipid fatty acid composition was analysed in samples of five skeletal muscles selected for maximum variation in muscle fibre-type. RESULTS Concentrations of DHA varied according to muscle fibre type, very strongly associated with fast oxidative glycolytic fibre population (r2 = 0.93; P < 0.01). No relationship was evident between DHA and fast glycolytic or slow oxidative fibre populations. Fish oil diets increased membrane incorporation of DHA in all muscles, mainly at the expense of n-6 PUFA linoleic and arachidonic acid. CONCLUSION The exquisite responsiveness of all skeletal muscles to as little fish oil as the equivalent of 1-2 fish meals per week in a human diet and the selective relationship to fatigable muscle fibre-types supports an integral role for DHA in muscle physiology, and particularly in fatigue resistance of fast-twitch muscles. SUMMARY Skeletal muscle fibres vary according to structural, metabolic and neurological characteristics and ultimately influences contractile function. This study sort to determine if the composition of phospholipid polyunsaturated fatty acids (PUFA), incorporated in their membranes, might also differ according to fibre type and when omega-3 PUFA are made available in the diet. We systematically demonstrated that the omega-3 PUFA, docosahexaenoic acid (DHA), incorporated into skeletal muscle membranes well above its provision in the diet and without competitive influence of high omega-6 PUFA concentrations, typical to the Western-style human diet. Notably, incorporation preferentially occurred according to metabolic characteristics of each muscle, supporting the notion that DHA plays an integral role in fast oxidative glycolytic muscle fibres.
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Affiliation(s)
- M J Macartney
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Hobart, Australia; Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia.
| | - G E Peoples
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia
| | - T M Treweek
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia
| | - P L McLennan
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia
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18
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Papandreou C, Sala-Vila A, Galié S, Muralidharan J, Estruch R, Fitó M, Razquin C, Corella D, Ros E, Timiraos J, Lapetra J, Serra-Majem L, Carlos S, Castañer O, Asensio EM, Salas-Salvadó J, Bulló M. Association Between Fatty Acids of Blood Cell Membranes and Incidence of Coronary Heart Disease. Arterioscler Thromb Vasc Biol 2019; 39:819-825. [PMID: 30727755 DOI: 10.1161/atvbaha.118.312073] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
To examine the associations between baseline levels of fatty acids in blood cell membranes and their 1-year changes with the incidence of coronary heart disease (CHD) in older adults at high cardiovascular disease risk.
Approach and Results—
This is a case-control study nested in the PREDIMED trial (Prevención con Dieta Mediterránea), with 136 CHD cases and 272 controls (matched on age, sex, body mass index, intervention group, and time of permanence in the study to the time event). We used gas chromatography to measure the proportion of 22 fatty acids in blood cell membranes at baseline and after 1 year. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% CIs. After adjustment for classical CHD risk factors and multiple testing, 1 SD increase in baseline levels of C22:0, C24:0 and the sum of individual very long chain saturated fatty acids was associated with 56% (OR, 0.44 [95% CI, 0.28–0.69]), 59% (OR, 0.41 [95% CI, 0.25–0.65]), and 55% (OR, 0.45 [95% CI, 0.29–0.70]) a decreased odds of developing CHD, respectively. Baseline C20:1n9 was associated with higher odds of CHD (OR, 1.58 [95% CI, 1.25–2.00]).
Conclusions—
Higher levels of C22:0 and C24:0 were associated with a lower CHD incidence, whereas higher levels of C20:1n9 were associated with a higher risk. This study adds to the growing body of evidence suggesting potential differences in the cardiovascular disease effects of different types of circulating saturated fatty acids.
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Affiliation(s)
- Christopher Papandreou
- From the Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Rovira i Virgili University, Reus, Spain (C.P., S.G., J.M., J.S.-S., M.B.)
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (C.P., A.S.-V., S.G., J.M., R.E., M.F., C.R., D.C., E.R., J.T., J.L., L.S.-M., O.C., E.M.A., J.S.-S., M.B.)
| | - Aleix Sala-Vila
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (C.P., A.S.-V., S.G., J.M., R.E., M.F., C.R., D.C., E.R., J.T., J.L., L.S.-M., O.C., E.M.A., J.S.-S., M.B.)
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic (A.S.-V., E.R.), University of Barcelona, Spain
| | - Serena Galié
- From the Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Rovira i Virgili University, Reus, Spain (C.P., S.G., J.M., J.S.-S., M.B.)
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (C.P., A.S.-V., S.G., J.M., R.E., M.F., C.R., D.C., E.R., J.T., J.L., L.S.-M., O.C., E.M.A., J.S.-S., M.B.)
| | - Jananee Muralidharan
- From the Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Rovira i Virgili University, Reus, Spain (C.P., S.G., J.M., J.S.-S., M.B.)
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (C.P., A.S.-V., S.G., J.M., R.E., M.F., C.R., D.C., E.R., J.T., J.L., L.S.-M., O.C., E.M.A., J.S.-S., M.B.)
| | - Ramón Estruch
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (C.P., A.S.-V., S.G., J.M., R.E., M.F., C.R., D.C., E.R., J.T., J.L., L.S.-M., O.C., E.M.A., J.S.-S., M.B.)
- Department of Internal Medicine, Hospital Clínic, IDIBAPS August Pi i Sunyer Biomedical Research Institute (R.E.), University of Barcelona, Spain
| | - Montserrat Fitó
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (C.P., A.S.-V., S.G., J.M., R.E., M.F., C.R., D.C., E.R., J.T., J.L., L.S.-M., O.C., E.M.A., J.S.-S., M.B.)
- Cardiovascular Risk and Nutrition (Regicor Study Group), Hospital del Mar Research Institute (IMIM), Barcelona, Spain (M.F., O.C.)
| | - Cristina Razquin
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (C.P., A.S.-V., S.G., J.M., R.E., M.F., C.R., D.C., E.R., J.T., J.L., L.S.-M., O.C., E.M.A., J.S.-S., M.B.)
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (C.R., S.C.)
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain (C.R., S.C.)
| | - Dolores Corella
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (C.P., A.S.-V., S.G., J.M., R.E., M.F., C.R., D.C., E.R., J.T., J.L., L.S.-M., O.C., E.M.A., J.S.-S., M.B.)
- Department of Preventive Medicine, University of Valencia, Spain (D.C., E.M.A.)
| | - Emilio Ros
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (C.P., A.S.-V., S.G., J.M., R.E., M.F., C.R., D.C., E.R., J.T., J.L., L.S.-M., O.C., E.M.A., J.S.-S., M.B.)
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomediques August Pi Sunyer (IDIBAPS), Hospital Clinic (A.S.-V., E.R.), University of Barcelona, Spain
| | - Juan Timiraos
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (C.P., A.S.-V., S.G., J.M., R.E., M.F., C.R., D.C., E.R., J.T., J.L., L.S.-M., O.C., E.M.A., J.S.-S., M.B.)
- Department of Neurology, University Hospital Araba, Vitoria, Spain (J.T.)
| | - Jose Lapetra
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (C.P., A.S.-V., S.G., J.M., R.E., M.F., C.R., D.C., E.R., J.T., J.L., L.S.-M., O.C., E.M.A., J.S.-S., M.B.)
- Department of Family Medicine, Unit Research, Distrito Sanitario Atención Primaria Sevilla, Spain (J.L.)
| | - Lluis Serra-Majem
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (C.P., A.S.-V., S.G., J.M., R.E., M.F., C.R., D.C., E.R., J.T., J.L., L.S.-M., O.C., E.M.A., J.S.-S., M.B.)
- Department of Clinical Sciences, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.)
| | - Silvia Carlos
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (C.R., S.C.)
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain (C.R., S.C.)
| | - Olga Castañer
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (C.P., A.S.-V., S.G., J.M., R.E., M.F., C.R., D.C., E.R., J.T., J.L., L.S.-M., O.C., E.M.A., J.S.-S., M.B.)
- Cardiovascular Risk and Nutrition (Regicor Study Group), Hospital del Mar Research Institute (IMIM), Barcelona, Spain (M.F., O.C.)
| | - Eva M Asensio
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (C.P., A.S.-V., S.G., J.M., R.E., M.F., C.R., D.C., E.R., J.T., J.L., L.S.-M., O.C., E.M.A., J.S.-S., M.B.)
- Department of Clinical Sciences, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Spain (L.S.-M.)
| | - Jordi Salas-Salvadó
- From the Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Rovira i Virgili University, Reus, Spain (C.P., S.G., J.M., J.S.-S., M.B.)
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (C.P., A.S.-V., S.G., J.M., R.E., M.F., C.R., D.C., E.R., J.T., J.L., L.S.-M., O.C., E.M.A., J.S.-S., M.B.)
| | - Mònica Bulló
- From the Department of Biochemistry and Biotechnology, Human Nutrition Unit, IISPV, Hospital Universitari Sant Joan de Reus, Rovira i Virgili University, Reus, Spain (C.P., S.G., J.M., J.S.-S., M.B.)
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain (C.P., A.S.-V., S.G., J.M., R.E., M.F., C.R., D.C., E.R., J.T., J.L., L.S.-M., O.C., E.M.A., J.S.-S., M.B.)
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Senevirathne A, Neale E, Peoples G, Tapsell L. Relationship between long-chain omega-3 polyunsaturated fatty acid intake and ankle brachial index, pulse wave velocity and resting heart rate in a sample of overweight adults: A secondary analysis of baseline data in the HealthTrack study. Nutr Diet 2018; 76:95-103. [DOI: 10.1111/1747-0080.12479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 08/10/2018] [Accepted: 08/19/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Anjana Senevirathne
- School of Medicine, Faculty of Science Medicine and Health; University of Wollongong; Wollongong New South Wales Australia
| | - Elizabeth Neale
- School of Medicine, Faculty of Science Medicine and Health; University of Wollongong; Wollongong New South Wales Australia
| | - Gregory Peoples
- School of Medicine, Faculty of Science Medicine and Health; University of Wollongong; Wollongong New South Wales Australia
| | - Linda Tapsell
- School of Medicine, Faculty of Science Medicine and Health; University of Wollongong; Wollongong New South Wales Australia
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20
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Filipovic MG, Aeschbacher S, Reiner MF, Stivala S, Gobbato S, Bonetti N, Risch M, Risch L, Camici GG, Luescher TF, von Schacky C, Conen D, Beer JH. Whole blood omega-3 fatty acid concentrations are inversely associated with blood pressure in young, healthy adults. J Hypertens 2018; 36:1548-1554. [PMID: 29570511 PMCID: PMC6085127 DOI: 10.1097/hjh.0000000000001728] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 01/26/2018] [Accepted: 02/23/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND Omega-3 fatty acids (n - 3 FA) may have blood pressure (BP)-lowering effects in untreated hypertensive and elderly patients. The effect of n - 3 FA on BP in young, healthy adults remains unknown. The Omega-3 Index reliably reflects an individuals' omega-3 status. We hypothesized that the Omega-3 Index is inversely associated with BP levels in young healthy adults. METHODS The current study (n = 2036) is a cross-sectional study investigating the baseline characteristics of a cohort, which includes healthy adults, age 25-41 years. Individuals with cardiovascular disease, known diabetes or a BMI higher than 35 kg/m were excluded. The Omega-3 Index was determined in whole blood using gas chromatography. Association with office and 24-h BP was assessed using multivariable linear regression models adjusted for potential confounders. RESULTS Median Omega-3 Index was 4.58% (interquartile range 4.08; 5.25). Compared with individuals in the lowest Omega-3 Index quartile, individuals in the highest had a SBP and DBP that was 4 and 2 mmHg lower, respectively (P < 0.01). A significant linear inverse relationship of the Omega-3 Index with 24-h and office BP was observed. Per 1-U increase in log-transformed Omega-3 Index the lowering in BP (given as multivariable adjusted β coefficients; 95% confidence interval) was -2.67 mmHg (-4.83; -0.51; P = 0.02) and -2.30 mmHg (-3.92; -0.68; P = 0.005) for 24-h SBP and DBP, respectively. CONCLUSION A higher Omega-3 Index is associated with statistically significant, clinically relevant lower SBP and DBP levels in normotensive young and healthy individuals. Diets rich in n - 3 FA may be a strategy for primary prevention of hypertension.
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Affiliation(s)
- Mark G. Filipovic
- Department of Internal Medicine, Cantonal Hospital of Baden, Baden
- Center for Molecular Cardiology, University of Zurich, Zurich
| | - Stefanie Aeschbacher
- Division of Cardiology, Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Martin F. Reiner
- Department of Internal Medicine, Cantonal Hospital of Baden, Baden
- Center for Molecular Cardiology, University of Zurich, Zurich
| | - Simona Stivala
- Center for Molecular Cardiology, University of Zurich, Zurich
| | - Sara Gobbato
- Center for Molecular Cardiology, University of Zurich, Zurich
| | - Nicole Bonetti
- Center for Molecular Cardiology, University of Zurich, Zurich
| | - Martin Risch
- Labormedizinisches Zentrum Dr Risch, Vaduz, Liechtenstein
- Division of Laboratory Medicine, Cantonal Hospital Graubünden, Chur
| | - Lorenz Risch
- Labormedizinisches Zentrum Dr Risch, Vaduz, Liechtenstein
- Department of Laboratory Medicine, Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Berne, Berne, Switzerland
- Department of Preventative Cardiology, Private University Triesen, Triesen, Liechtenstein
| | | | - Thomas F. Luescher
- Department of Cardiology, Royal Brompton & Harefield Hospitals, Imperial College, London, UK
| | - Clemens von Schacky
- Department of Preventive Cardiology, Ludwig-Maximilians University, Munich, Germany
| | - David Conen
- Division of Cardiology, Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Juerg H. Beer
- Department of Internal Medicine, Cantonal Hospital of Baden, Baden
- Center for Molecular Cardiology, University of Zurich, Zurich
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21
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Ghasemi Fard S, Wang F, Sinclair AJ, Elliott G, Turchini GM. How does high DHA fish oil affect health? A systematic review of evidence. Crit Rev Food Sci Nutr 2018; 59:1684-1727. [PMID: 29494205 DOI: 10.1080/10408398.2018.1425978] [Citation(s) in RCA: 125] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The health benefits of fish oil, and its omega-3 long chain polyunsaturated fatty acid content, have attracted much scientific attention in the last four decades. Fish oils that contain higher amounts of eicosapentaenoic acid (EPA; 20:5n-3) than docosahexaenoic acid (DHA; 22:6n-3), in a distinctive ratio of 18/12, are typically the most abundantly available and are commonly studied. Although the two fatty acids have traditionally been considered together, as though they were one entity, different physiological effects of EPA and DHA have recently been reported. New oils containing a higher quantity of DHA compared with EPA, such as fractionated and concentrated fish oil, tuna oil, calamari oil and microalgae oil, are increasingly becoming available on the market, and other oils, including those extracted from genetically modified oilseed crops, soon to come. This systematic review focuses on the effects of high DHA fish oils on various human health conditions, such as the heart and cardiovascular system, the brain and visual function, inflammation and immune function and growth/Body Mass Index. Although inconclusive results were reported in several instances, and inconsistent outcomes observed in others, current data provides substantiated evidence in support of DHA being a beneficial bioactive compound for heart, cardiovascular and brain function, with different, and at times complementary, effects compared with EPA. DHA has also been reported to be effective in slowing the rate of cognitive decline, while its possible effects on depression disorders are still unclear. Interestingly, gender- and age- specific divergent roles for DHA have also been reported. This review provides a comprehensive collection of evidence and a critical summary of the documented physiological effects of high DHA fish oils for human health.
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Affiliation(s)
- Samaneh Ghasemi Fard
- a School of Medicine, Deakin University , Geelong , Australia.,b Nu-Mega Ingredients Pty Ltd , Altona North , Melbourne , Australia
| | - Fenglei Wang
- c Department of Food Science and Nutrition , Zhejiang University , Hangzhou , China
| | - Andrew J Sinclair
- a School of Medicine, Deakin University , Geelong , Australia.,e Department of Nutrition , Dietetics and Food, Monash University , Clayton , Australia
| | - Glenn Elliott
- b Nu-Mega Ingredients Pty Ltd , Altona North , Melbourne , Australia
| | - Giovanni M Turchini
- d School of Life and Environmental Sciences , Deakin University , Geelong , Australia
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22
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Colussi G, Catena C, Fagotto V, Darsiè D, Brosolo G, Bertin N, Sechi LA. Atrial fibrillation and its complications in arterial hypertension: The potential preventive role of ω-3 polyunsaturated fatty acids. Crit Rev Food Sci Nutr 2018; 59:1937-1948. [PMID: 29381383 DOI: 10.1080/10408398.2018.1434126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Atrial fibrillation (AF) is the most common type of arrhythmia in the general population with a prevalence that reaches one third of patients with arterial hypertension. Several risk factors frequently associated with hypertension predispose the myocardium to AF by inducing atrial inflammation and fibrosis and altering atrial electrical and mechanical characteristics. AF influences the quality of life of hypertensive patients since it increases incidence of stroke and other thromboembolic events, and mortality. Polyunsaturated fatty acids of the ω-3 family (ω-3 PUFA) have been demonstrated to be beneficial in cardiovascular disease prevention by reducing plasma lipids and blood pressure levels and decreasing the risk of sudden death. These fatty acids can act as potent anti-inflammatory and anti-arrhythmic agents. Many studies have investigated a possible preventive effect of ω-3 PUFA on incident AF reporting contradictory results. This article overviews the evidence currently available on this important topic and provides some conclusive remarks on the possibility that these fatty acids could be beneficial in hypertensive patients.
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Affiliation(s)
- GianLuca Colussi
- a Division of Internal Medicine, Department of Medicine , University of Udine , Udine , Italy
| | - Cristiana Catena
- a Division of Internal Medicine, Department of Medicine , University of Udine , Udine , Italy
| | - Valentina Fagotto
- a Division of Internal Medicine, Department of Medicine , University of Udine , Udine , Italy
| | - Daniele Darsiè
- a Division of Internal Medicine, Department of Medicine , University of Udine , Udine , Italy
| | - Gabriele Brosolo
- a Division of Internal Medicine, Department of Medicine , University of Udine , Udine , Italy
| | - Nicole Bertin
- a Division of Internal Medicine, Department of Medicine , University of Udine , Udine , Italy
| | - Leonardo A Sechi
- a Division of Internal Medicine, Department of Medicine , University of Udine , Udine , Italy
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23
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Innes JK, Calder PC. The Differential Effects of Eicosapentaenoic Acid and Docosahexaenoic Acid on Cardiometabolic Risk Factors: A Systematic Review. Int J Mol Sci 2018; 19:ijms19020532. [PMID: 29425187 PMCID: PMC5855754 DOI: 10.3390/ijms19020532] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 02/06/2018] [Accepted: 02/06/2018] [Indexed: 01/01/2023] Open
Abstract
A large body of evidence supports the cardioprotective effects of the long-chain omega-3 polyunsaturated fatty acids (PUFAs), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). There is increasing interest in the independent effects of EPA and DHA in the modulation of cardiometabolic risk factors. This systematic review aims to appraise the latest available evidence of the differential effects of EPA and DHA on such risk factors. A systematic literature review was conducted up to May 2017. Randomised controlled trials were included if they met strict eligibility criteria, including EPA or DHA > 2 g/day and purity ≥ 90%. Eighteen identified articles were included, corresponding to six unique studies involving 527 participants. Both EPA and DHA lowered triglyceride concentration, with DHA having a greater triglyceride-lowering effect. Whilst total cholesterol levels were largely unchanged by EPA and DHA, DHA increased high-density lipoprotein (HDL) cholesterol concentration, particularly HDL2, and increased low-density lipoprotein (LDL) cholesterol concentration and LDL particle size. Both EPA and DHA inhibited platelet activity, whilst DHA improved vascular function and lowered heart rate and blood pressure to a greater extent than EPA. The effects of EPA and DHA on inflammatory markers and glycaemic control were inconclusive; however both lowered oxidative stress. Thus, EPA and DHA appear to have differential effects on cardiometabolic risk factors, but these need to be confirmed by larger clinical studies.
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Affiliation(s)
- Jacqueline K Innes
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK.
| | - Philip C Calder
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK.
- National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, UK.
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24
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Meyer BJ, Groot RHMD. Effects of Omega-3 Long Chain Polyunsaturated Fatty Acid Supplementation on Cardiovascular Mortality: The Importance of the Dose of DHA. Nutrients 2017; 9:nu9121305. [PMID: 29189735 PMCID: PMC5748755 DOI: 10.3390/nu9121305] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 11/16/2017] [Accepted: 11/24/2017] [Indexed: 12/11/2022] Open
Abstract
Recent evidence on the relationship between omega-3 long chain polyunsaturated fatty acid (n-3 LCPUFA) supplementation and cardiovascular health suggests that n-3 LCPUFA may no longer be efficacious. This review summarises the randomised controlled trials (RCTs) that assess the effect of n-3 LCPUFA supplementation on cardiovascular mortality. It appears that in the RCTs that showed no effect of n-3 LCPUFA on cardiovascular mortality, the dose of n-3 LCPUFA (in particular docosahexaenoic acid (DHA)) and hence the n-3 LCPUFA status, may not have been sufficiently high to demonstrate the efficacy, and/or the baseline n-3 LCPUFA status was already too high. The intention-to-treat analysis (ITT) is the gold standard for analysing RCTs and ITT is used for drug intervention trials where exposure to the drug versus no drug exposure provides two clearly distinct groups to determine the efficacy of the drug being studied. This differs in nutrition trials as often the nutrient of interest being studied is already being consumed by both groups (placebo and active) and therefore a true placebo group with absolutely no intake of the nutrient being studied is highly unlikely. Therefore, in n-3 LCPUFA supplementation trials, as there is no clear distinction between the two groups (placebo and n-3 LCPUFA), a per-protocol analysis (comparison of groups that includes only those participants that fully completed the original intervention allocation) should be conducted in addition to ITT analysis. Furthermore, blood analysis pre- and post-supplementation should be conducted to ensure that: (1) that the baseline n-3 status is not too high, in order to alleviate a potential ceiling effect; and (2) that the dose is high enough and hence the increase in omega-3 status will be high enough in order to assess the efficacy of n-3 LCPUFA supplementation.
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Affiliation(s)
- Barbara J Meyer
- School of Medicine, Lipid Research Centre, Illawarra Health & Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Renate H M de Groot
- Welten Institute-Research Centre for Learning, Teaching, and Technology, Open University of The Netherlands, 6419 AT Heerlen, The Netherlands.
- Department of Complex Genetics, School for Nutrition, Toxicology and Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands.
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25
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Omega-3 Index and Anti-Arrhythmic Potential of Omega-3 PUFAs. Nutrients 2017; 9:nu9111191. [PMID: 29084142 PMCID: PMC5707663 DOI: 10.3390/nu9111191] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 10/18/2017] [Accepted: 10/23/2017] [Indexed: 01/22/2023] Open
Abstract
Omega-3 polyunsaturated fatty acids (PUFAs), namely eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are permanent subjects of interest in relation to the protection of cardiovascular health and the prevention of the incidence of both ventricular and atrial arrhythmias. The purpose of this updated review is to focus on the novel cellular and molecular effects of omega-3 PUFAs, in the context of the mechanisms and factors involved in the development of cardiac arrhythmias; to provide results of the most recent studies on the omega-3 PUFA anti-arrhythmic efficacy and to discuss the lack of the benefit in relation to omega-3 PUFA status. The evidence is in the favor of omega-3 PUFA acute and long-term treatment, perhaps with mitochondria-targeted antioxidants. However, for a more objective evaluation of the anti-arrhythmic potential of omega-3 PUFAs in clinical trials, it is necessary to monitor the basal pre-interventional omega-3 status of individuals, i.e., red blood cell content, omega-3 index and free plasma levels. In the view of evidence-based medicine, it seems to be crucial to aim to establish new approaches in the prevention of cardiac arrhythmias and associated morbidity and mortality that comes with these conditions.
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26
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Tang X, Qian LL, Wang RX, Yao Y, Dang SP, Wu Y, Wang W, Ji Y, Sun MQ, Xia DY, Liu XY, Zhang DM, Chai Q, Lu T. Regulation of Coronary Arterial Large Conductance Ca2+-Activated K+ Channel Protein Expression and Function by n-3 Polyunsaturated Fatty Acids in Diabetic Rats. J Vasc Res 2017; 54:329-343. [PMID: 29040972 DOI: 10.1159/000479870] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 07/28/2017] [Indexed: 12/22/2022] Open
Abstract
AIM The objective of this study was to examine the effects of n-3 polyunsaturated fatty acids (n-3 PUFAs) on coronary arterial large conductance Ca2+-activated K+ (BK) channel function in coronary smooth muscle cells (SMCs) of streptozotocin-induced diabetic rats. METHODS The effects of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) on coronary BK channel open probabilities were determined using the patch clamp technique. The mRNA and protein expressions of BK channel subunits were measured using qRT-PCR and Western blots. The coronary artery tension and coronary SMC Ca2+ concentrations were measured using a myograph system and fluorescence Ca2+ indicator. RESULTS Compared to nondiabetic control rats, the BK channel function was impaired with a reduced response to EPA and DHA in freshly isolated SMCs of diabetic rats. Oral administration of n-3 PUFAs had no effects on protein expressions of BK channel subunits in nondiabetic rats, but significantly enhanced those of BK-β1 in diabetic rats without altering BK-α protein levels. Moreover, coronary ring tension induced by iberiotoxin (a specific BK channel blocker) was increased and cytosolic Ca2+ concentrations in coronary SMCs were decreased in diabetic rats, but no changes were found in nondiabetic rats. CONCLUSIONS n-3 PUFAs protect the coronary BK channel function and coronary vasoreactivity in diabetic rats as a result of not only increasing BK-β1 protein expressions, but also decreasing coronary artery tension and coronary smooth muscle cytosolic Ca2+ concentrations.
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Affiliation(s)
- Xu Tang
- Department of Cardiology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
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27
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In vitro effect of flaxseed oil and α-linolenic acid against the toxicity of lipopolysaccharide (LPS) to human umbilical vein endothelial cells. Inflammopharmacology 2017; 26:645-654. [DOI: 10.1007/s10787-017-0400-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 09/15/2017] [Indexed: 12/23/2022]
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28
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Hishikawa D, Valentine WJ, Iizuka-Hishikawa Y, Shindou H, Shimizu T. Metabolism and functions of docosahexaenoic acid-containing membrane glycerophospholipids. FEBS Lett 2017; 591:2730-2744. [PMID: 28833063 PMCID: PMC5639365 DOI: 10.1002/1873-3468.12825] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 08/13/2017] [Accepted: 08/17/2017] [Indexed: 12/12/2022]
Abstract
Omega‐3 (ω‐3) fatty acids (FAs) such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are known to have important roles in human health and disease. Besides being utilized as fuel, ω‐3 FAs have specific functions based on their structural characteristics. These functions include serving as ligands for several receptors, precursors of lipid mediators, and components of membrane glycerophospholipids (GPLs). Since ω‐3 FAs (especially DHA) are highly flexible, the levels of DHA in GPLs may affect membrane biophysical properties such as fluidity, flexibility, and thickness. Here, we summarize some of the cellular mechanisms for incorporating DHA into membrane GPLs and propose biological effects and functions of DHA‐containing membranes of several cell and tissue types.
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Affiliation(s)
- Daisuke Hishikawa
- Department of Lipid Signaling, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - William J Valentine
- Department of Lipid Signaling, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yoshiko Iizuka-Hishikawa
- Department of Lipid Signaling, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Hideo Shindou
- Department of Lipid Signaling, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.,Department of Lipid Science, The University of Tokyo, Bunkyo-ku, Japan.,AMED, Chiyoda-ku, Tokyo, Japan
| | - Takao Shimizu
- Department of Lipid Signaling, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan.,Department of Lipidomics Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
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29
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McLennan PL, Pepe S. Prescribing More Stringent Design of Randomized Clinical Trials of Omega-3 Polyunsaturated Fatty Acids. Mayo Clin Proc 2017; 92:1005-1006. [PMID: 28578776 DOI: 10.1016/j.mayocp.2017.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 03/30/2017] [Indexed: 12/15/2022]
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30
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Craddock JC, Neale EP, Probst YC, Peoples GE. Algal supplementation of vegetarian eating patterns improves plasma and serum docosahexaenoic acid concentrations and omega-3 indices: a systematic literature review. J Hum Nutr Diet 2017; 30:693-699. [PMID: 28417511 DOI: 10.1111/jhn.12474] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Vegetarians are likely to have lower intakes of preformed docosahexaenoic acid (DHA) than omnivorous populations who consume fish and animal products. As such, vegetarian populations have omega-3 indices up to 60% lower than those who consume marine products. Algae, the primary producer of DHA in the marine food chain, offer an alternative source of DHA for those who do not consume marine or animal products. This systematic review aims to examine the evidence for the relationship between supplementation with algal forms of DHA and increased DHA concentrations in vegetarian populations. METHODS The SCOPUS, Science Direct and Web of Science scientific databases were searched to identify relevant studies assessing the effect of algal DHA consumption by vegetarian (including vegan) populations. RESULTS Four randomised controlled trials and two prospective cohort studies met the inclusion criteria. All included studies reported algal sources of DHA significantly improve DHA concentrations (including plasma, serum, platelet and red blood cell fractions), as well as omega-3 indices, in vegetarian populations. An evident time or dose response was not apparent given the small number of studies to date. CONCLUSIONS Future studies should address long chain n-3 polyunsaturated fatty acid deficiencies in vegetarian populations using algal DHA and explore the potential physiological and health improvements in these individuals.
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Affiliation(s)
- J C Craddock
- Faculty of Science Medicine and Health, School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - E P Neale
- Faculty of Science Medicine and Health, School of Medicine, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Y C Probst
- Faculty of Science Medicine and Health, School of Medicine, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - G E Peoples
- Faculty of Science Medicine and Health, Graduate School of Medicine, School of Medicine, University of Wollongong, Wollongong, NSW, Australia
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31
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Sala-Vila A, Fernández-Jiménez R, Pizarro G, Calvo C, García-Ruiz JM, Fernández-Friera L, Rodriguez MD, Escalera N, Palazuelos J, Macías A, Pérez-Asenjo B, Fernández-Ortiz A, Ros E, Fuster V, Ibáñez B. Nutritional preconditioning by marine omega-3 fatty acids in patients with ST-segment elevation myocardial infarction: A METOCARD-CNIC trial substudy. Int J Cardiol 2017; 228:828-833. [DOI: 10.1016/j.ijcard.2016.11.214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 11/06/2016] [Indexed: 02/02/2023]
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32
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Peoples GE, McLennan PL. Dietary fish oil delays hypoxic skeletal muscle fatigue and enhances caffeine-stimulated contractile recovery in the rat in vivo hindlimb. Appl Physiol Nutr Metab 2017; 42:613-620. [PMID: 28177707 DOI: 10.1139/apnm-2016-0501] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Oxygen efficiency influences skeletal muscle contractile function during physiological hypoxia. Dietary fish oil, providing docosahexaenoic acid (DHA), reduces the oxygen cost of muscle contraction. This study used an autologous perfused rat hindlimb model to examine the effects of a fish oil diet on skeletal muscle fatigue during an acute hypoxic challenge. Male Wistar rats were fed a diet rich in saturated fat (SF), long-chain (LC) n-6 polyunsaturated fatty acids (n-6 PUFA), or LC n-3 PUFA DHA from fish oil (FO) (8 weeks). During anaesthetised and ventilated conditions (normoxia 21% O2 (SaO2-98%) and hypoxia 14% O2 (SaO2-89%)) the hindlimb was perfused at a constant flow and the gastrocnemius-plantaris-soleus muscle bundle was stimulated via sciatic nerve (2 Hz, 6-12V, 0.05 ms) to established fatigue. Caffeine (2.5, 5, 10 mM) was supplied to the contracting muscle bundle via the arterial cannula to assess force recovery. Hypoxia, independent of diet, attenuated maximal twitch tension (normoxia: 82 ± 8; hypoxia: 41 ± 2 g·g-1 tissue w.w.). However, rats fed FO sustained higher peak twitch tension compared with the SF and n-6 PUFA groups (P < 0.05), and the time to decline to 50% of maximum twitch tension was extended (SF: 546 ± 58; n-6 PUFA: 522 ± 58; FO: 792 ± 96 s; P < 0.05). In addition, caffeine-stimulated skeletal muscle contractile recovery was enhanced in the FO-fed animals (SF: 41 ± 3; n-6 PUFA: 40 ± 4; FO: 52 ± 7% recovery; P < 0.05). These results support a physiological role of DHA in skeletal muscle membranes when exposed to low-oxygen stress that is consistent with the attenuation of muscle fatigue under physiologically normoxic conditions.
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Affiliation(s)
- Gregory E Peoples
- School of Medicine, University of Wollongong, Wollongong, 2522, NSW, Australia.,School of Medicine, University of Wollongong, Wollongong, 2522, NSW, Australia
| | - Peter L McLennan
- School of Medicine, University of Wollongong, Wollongong, 2522, NSW, Australia.,School of Medicine, University of Wollongong, Wollongong, 2522, NSW, Australia
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33
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Bürgin-Maunder CS, Nataatmadja M, Vella RK, Fenning AS, Brooks PR, Russell FD. Investigation of long chain omega-3 PUFAs on arterial blood pressure, vascular reactivity and survival in angiotensin II-infused Apolipoprotein E-knockout mice. Clin Exp Pharmacol Physiol 2016; 43:174-81. [PMID: 26638987 DOI: 10.1111/1440-1681.12520] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 11/16/2015] [Accepted: 11/25/2015] [Indexed: 02/02/2023]
Abstract
Abdominal aortic aneurysm (AAA) is an inflammatory vascular disease. Long chain omega-3 polyunsaturated fatty acids (LC n-3 PUFAs) decrease inflammation and oxidative stress in an angiotensin II-infused apolipoprotein E-knockout (ApoE(-/-)) mouse model of AAA. This study investigated the effects of LC n-3 PUFAs on blood pressure and vascular reactivity in fourteen angiotensin II-infused ApoE(-/-) male mice. Blood pressure was obtained using a non-invasive tail cuff method and whole blood was collected by cardiac puncture. Vascular reactivity of the thoracic aorta was assessed using wire myography and activation of endothelial nitric oxide synthase (eNOS) was determined by immunohistochemistry. A high LC n-3 PUFA diet increased the omega-3 index and reduced the n-6 to n-3 PUFA ratio. At day 10 post-infusion with angiotensin II, there was no difference in systolic blood pressure or diastolic blood pressure in mice fed the high or low n-3 PUFA diets. The high LC n-3 PUFA diet resulted in a non-significant trend for delay in time to death from abdominal aortic rupture. Vascular reactivity and eNOS activation remained unchanged in mice fed the high compared to the low LC n-3 PUFA diet. This study argues against direct improvement in vascular reactivity in ApoE(-/-) mice that were supplemented with n-3 PUFA for 8 weeks prior to infusion with angiotensin II.
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Affiliation(s)
- Corinna S Bürgin-Maunder
- Inflammation and Healing Research Cluster, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Maria Nataatmadja
- The Prince Charles Hospital, University of Queensland, Brisbane, Queensland, Australia
| | - Rebecca K Vella
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Andrew S Fenning
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Peter R Brooks
- Inflammation and Healing Research Cluster, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Fraser D Russell
- Inflammation and Healing Research Cluster, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
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Glück T, Alter P. Marine omega-3 highly unsaturated fatty acids: From mechanisms to clinical implications in heart failure and arrhythmias. Vascul Pharmacol 2016; 82:11-9. [PMID: 27080538 DOI: 10.1016/j.vph.2016.03.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 03/12/2016] [Accepted: 03/29/2016] [Indexed: 12/17/2022]
Abstract
Therapeutic implications of marine omega-3 highly unsaturated fatty acids (HUFA) in cardiovascular disease are still discussed controversially. Several clinical trials report divergent findings and thus leave ambiguity on the meaning of oral omega-3 therapy. Potential prognostic indications of HUFA treatment have been predominantly studied in coronary artery disease, sudden cardiac death, ventricular arrhythmias, atrial fibrillation and heart failure of various origin. It is suspected that increased ventricular wall stress is crucially involved in the prognosis of heart failure. Increased wall stress and an unfavorable myocardial remodeling is associated with an increased risk of arrhythmias by stretch-activated membrane ion channels. Integration of HUFA into the microenvironment of cardiomyocyte ion channels lead to allosteric changes and increase the electrical stability. Increased ventricular wall stress appears to be involved in the local myocardial as well as in the hepatic fatty acid metabolism, i.e. a cardio-hepatic syndrome. Influences of an altered endogenous HUFA metabolism and an inverse shift of the fatty acid profile was underrated in the past. A better understanding of these interacting endogenous mechanisms appears to be required for interpreting the findings of recent experimental and clinical studies. The present article critically reviews major studies on basic pathophysiological mechanisms and treatment effects in clinical trials.
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Affiliation(s)
- Tobias Glück
- Department of Medicine, Pulmonary and Critical Care Medicine, Philipps University, Marburg, Germany; Department of Medicine, Cardiology and Angiology, AGAPLESION Evangelisches Krankenhaus Mittelhessen, Gießen, Germany.
| | - Peter Alter
- Department of Medicine, Pulmonary and Critical Care Medicine, Philipps University, Marburg, Germany.
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Abdukeyum GG, Owen AJ, Larkin TA, McLennan PL. Up-Regulation of Mitochondrial Antioxidant Superoxide Dismutase Underpins Persistent Cardiac Nutritional-Preconditioning by Long Chain n-3 Polyunsaturated Fatty Acids in the Rat. J Clin Med 2016; 5:jcm5030032. [PMID: 26959067 PMCID: PMC4810103 DOI: 10.3390/jcm5030032] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 02/26/2016] [Accepted: 02/29/2016] [Indexed: 02/05/2023] Open
Abstract
Reactive oxygen species paradoxically underpin both ischaemia/reperfusion (I/R) damage and ischaemic preconditioning (IPC) cardioprotection. Long-chain omega-3 polyunsaturated fatty acids (LCn-3 PUFA) are highly susceptible to peroxidation, but are paradoxically cardioprotective. This study tested the hypothesis that LCn-3 PUFA cardioprotection is underpinned by peroxidation, upregulating antioxidant activity to reduce I/R-induced lipid oxidation, and the mechanisms of this nutritional preconditioning contrast to mechanisms of IPC. Rats were fed: fish oil (LCn-3 PUFA); sunflower seed oil (n-6 PUFA); or beef tallow (saturated fat, SF) enriched diets for six weeks. Isolated hearts were subject to: 180 min normoxic perfusion; a 30 min coronary occlusion ischaemia protocol then 120 min normoxic reperfusion; or a 3 × 5 min global IPC protocol, 30 min ischaemia, then reperfusion. Dietary LCn-3 PUFA raised basal: membrane docosahexaenoic acid (22:6n-3 DHA); fatty acid peroxidisability index; concentrations of lipid oxidation products; and superoxide dismutase (MnSOD) activity (but not CuZnSOD or glutathione peroxidase). Infarct size correlated inversely with basal MnSOD activity (r2 = 0.85) in the ischaemia protocol and positively with I/R-induced lipid oxidation (lipid hydroperoxides (LPO), r2 = 0.475; malondialdehyde (MDA), r2 = 0.583) across ischaemia and IPC protocols. While both dietary fish oil and IPC infarct-reduction were associated with reduced I/R-induced lipid oxidation, fish oil produced nutritional preconditioning by prior LCn-3 PUFA incorporation and increased peroxidisability leading to up-regulated mitochondrial SOD antioxidant activity.
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Affiliation(s)
- Grace G Abdukeyum
- Division of Medical and Exercise Science, School of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong NSW 2522, Australia.
| | - Alice J Owen
- Centre of Cardiovascular Research & Education in Therapeutics, School of Public Health & Preventive Medicine, Monash University, Melbourne VIC 3004, Australia.
| | - Theresa A Larkin
- Centre for Human and Applied Physiology, Graduate School of Medicine, School of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong NSW 2522, Australia.
| | - Peter L McLennan
- Centre for Human and Applied Physiology, Graduate School of Medicine, School of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong NSW 2522, Australia.
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Sala‐Vila A, Guasch‐Ferré M, Hu FB, Sánchez‐Tainta A, Bulló M, Serra‐Mir M, López‐Sabater C, Sorlí JV, Arós F, Fiol M, Muñoz MA, Serra‐Majem L, Martínez JA, Corella D, Fitó M, Salas‐Salvadó J, Martínez‐González MA, Estruch R, Ros E. Dietary α-Linolenic Acid, Marine ω-3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvención con DIeta MEDiterránea (PREDIMED) Study. J Am Heart Assoc 2016; 5:e002543. [PMID: 26813890 PMCID: PMC4859371 DOI: 10.1161/jaha.115.002543] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 11/10/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND Epidemiological evidence suggests a cardioprotective role of α-linolenic acid (ALA), a plant-derived ω-3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω-3 fatty acids (long-chain n-3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all-cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long-chain n-3 polyunsaturated fatty acids (≥500 mg/day). METHODS AND RESULTS We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable-adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption (r=0.94). During a 5.9-y follow-up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios for meeting ALA recommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56-0.92) for all-cause mortality and 0.95 (95% CI 0.58-1.57) for fatal cardiovascular disease. The hazard ratios for meeting the recommendation for long-chain n-3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67-1.05) for all-cause mortality, 0.61 (95% CI 0.39-0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29-0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22-1.01) for sudden cardiac death. The highest reduction in all-cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45-0.87]). CONCLUSIONS In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all-cause mortality, whereas protection from cardiac mortality is limited to fish-derived long-chain n-3 polyunsaturated fatty acids. CLINICAL TRIAL REGISTRATION URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639.
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Affiliation(s)
- Aleix Sala‐Vila
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBERobn)Instituto de Salud Carlos III (ISCIII)MadridSpain
- Lipid ClinicDepartment of Endocrinology and NutritionInstitut d'Investigacions Biomèdiques August Pi i SunyerHospital ClinicBarcelonaSpain
| | - Marta Guasch‐Ferré
- Human Nutrition UnitBiochemistry Biotechnology DepartmentFaculty of Medicine and Health SciencesUniversitat Rovira i Virgili, and Hospital Universitari de Sant Joan de Reus, IISPVReusSpain
| | - Frank B. Hu
- Departments of Nutrition and EpidemiologyHarvard School of Public HealthBostonMA
| | - Ana Sánchez‐Tainta
- Department of Preventive Medicine and Public HealthUniversity of NavarraPamplonaSpain
| | - Mònica Bulló
- Human Nutrition UnitBiochemistry Biotechnology DepartmentFaculty of Medicine and Health SciencesUniversitat Rovira i Virgili, and Hospital Universitari de Sant Joan de Reus, IISPVReusSpain
| | - Mercè Serra‐Mir
- Lipid ClinicDepartment of Endocrinology and NutritionInstitut d'Investigacions Biomèdiques August Pi i SunyerHospital ClinicBarcelonaSpain
| | - Carmen López‐Sabater
- Department of Nutrition and Food ScienceSchool of PharmacyXaRTA, INSAUniversity of BarcelonaSpain
| | - Jose V. Sorlí
- Department of Preventive MedicineUniversity of ValenciaSpain
| | - Fernando Arós
- Department of CardiologyUniversity Hospital of AlavaVitoriaSpain
| | - Miquel Fiol
- Institute of Health SciencesInstituto de Investigación Sanitaria de PalmaPalma de MallorcaSpain
| | - Miguel A. Muñoz
- Cardiovascular Risk and Nutrition Research GroupInstitut Hospital del Mar d'Investigacions Mèdiques (IMIM)Barcelona Biomedical Research ParkBarcelonaSpain
| | - Luis Serra‐Majem
- Research Institute of Biomedical and Health SciencesUniversity of Las Palmas de Gran CanariaLas PalmasSpain
| | - J. Alfredo Martínez
- Department of Nutrition and Food Sciences, Physiology and ToxicologyUniversity of NavarraPamplonaSpain
| | - Dolores Corella
- Department of Preventive MedicineUniversity of ValenciaSpain
| | - Montserrat Fitó
- Cardiovascular Risk and Nutrition Research GroupInstitut Hospital del Mar d'Investigacions Mèdiques (IMIM)Barcelona Biomedical Research ParkBarcelonaSpain
| | - Jordi Salas‐Salvadó
- Human Nutrition UnitBiochemistry Biotechnology DepartmentFaculty of Medicine and Health SciencesUniversitat Rovira i Virgili, and Hospital Universitari de Sant Joan de Reus, IISPVReusSpain
| | | | - Ramón Estruch
- Department of Internal MedicineInstitut d'Investigacions Biomèdiques August Pi i SunyerHospital ClinicBarcelonaSpain
| | - Emilio Ros
- Lipid ClinicDepartment of Endocrinology and NutritionInstitut d'Investigacions Biomèdiques August Pi i SunyerHospital ClinicBarcelonaSpain
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Abstract
Nutrition plays an increasingly significant role in lifestyle strategies for cardiovascular prevention. Foods and dietary patterns that encompass specific foods and beverages and their combinations, with synergies among their components, are the subject of much epidemiologic and clinical research in relation to health issues, including cardiovascular disease. Foods with the highest evidence for beneficial effects on cardiovascular outcomes (mainly fatal and nonfatal coronary artery disease and stroke) and intermediate risk markers (principally cholesterol and blood pressure) are fruits and vegetables, legumes, nuts, whole grains, dairy products, fish, and alcohol consumed in moderation. Epidemiologic and clinical trial evidence on cardiovascular health issues is reviewed for these foods and for the dietary pattern with the highest probability of a causal link with cardiovascular protection, namely the Mediterranean diet. When pertinent, mechanisms of protection derived from specific nutrients in foods are also examined. The explosion of knowledge in cardioprotective foods and diets needs to be translated to the public, as dietary quality is still far from optimal in large segments of the population.
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Abeywardena MY, Adams M, Dallimore J, Kitessa SM. Rise in DPA Following SDA-Rich Dietary Echium Oil Less Effective in Affording Anti-Arrhythmic Actions Compared to High DHA Levels Achieved with Fish Oil in Sprague-Dawley Rats. Nutrients 2016; 8:nu8010014. [PMID: 26742064 PMCID: PMC4728628 DOI: 10.3390/nu8010014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 12/17/2015] [Accepted: 12/18/2015] [Indexed: 11/16/2022] Open
Abstract
Stearidonic acid (SDA; C18:4n-3) has been suggested as an alternative to fish oil (FO) for delivering health benefits of C ≥ 20 long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFA). Echium oil (EO) represents a non-genetically-modified source of SDA available commercially. This study compared EO and FO in relation to alterations in plasma and tissue fatty acids, and for their ability to afford protection against ischemia-induced cardiac arrhythmia and ventricular fibrillation (VF). Rats were fed (12 weeks) diets supplemented with either EO or FO at three dose levels (1, 3 and 5% w/w; n = 18 per group). EO failed to influence C22:6n-3 (DHA) but increased C22:5n-3 (DPA) in tissues dose-dependently, especially in heart tissue. Conversely, DHA in hearts of FO rats showed dose-related elevation; 14.8%-24.1% of total fatty acids. Kidney showed resistance for incorporation of LC n-3 PUFA. Overall, FO provided greater cardioprotection than EO. At the highest dose level, FO rats displayed lower (p < 0.05) episodes of VF% (29% vs. 73%) and duration (22.7 ± 12.0 vs. 75.8 ± 17.1 s) than the EO group but at 3% EO was comparable to FO. We conclude that there is no endogenous conversion of SDA to DHA, and that DPA may be associated with limited cardiac benefit.
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Affiliation(s)
- Mahinda Y Abeywardena
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Food & Nutrition, Kintore Ave, Adelaide SA 5000, Australia.
| | - Michael Adams
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Food & Nutrition, Kintore Ave, Adelaide SA 5000, Australia.
| | - Julie Dallimore
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Food & Nutrition, Kintore Ave, Adelaide SA 5000, Australia.
| | - Soressa M Kitessa
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Food & Nutrition, Kintore Ave, Adelaide SA 5000, Australia.
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40
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Bernard M, Maixent JM, Gerbi A, Lan C, Cozzone PJ, Pieroni G, Armand M, Coste TC. Dietary docosahexaenoic acid-enriched glycerophospholipids exert cardioprotective effects in ouabain-treated rats via physiological and metabolic changes. Food Funct 2015; 7:798-804. [PMID: 26662260 DOI: 10.1039/c5fo01300c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Docosahexaenoic acid (DHA) might prevent heart failure or optimise drug treatments by improving cardiac contraction. We investigated whether DHA-enriched avian glycerophospholipids (GPL-DHA) exert cardioprotection in ouabain-treated rats after 4 weeks of dietary supplementation with 10, 35 or 60 mg DHA per kg body weight versus none (DHA10, DHA35, DHA60 and control groups, respectively). The contractile responsiveness to different doses of ouabain (10(-7) to 10(-4) M), ouabain intoxication (at 3 × 10(-4) M), and relative variations in cardiac energy metabolism were determined using (31)P NMR in isolated perfused rat hearts. The fatty acid composition of cardiac membranes was analysed by gas chromatography. DHA accretion in the heart was dose-dependent (+8%, +30% and +45% for DHA10, DHA35 and DHA60, respectively). The cardiac phosphocreatine content significantly increased at the baseline in DHA35 (+45%) and DHA60 groups (+85%), and at the different doses of ouabain in the DHA60 group (+73% to 98%). The maximum positive inotropy achieved at 10(-4) M ouabain was significantly increased in all DHA groups versus control (+150%, +122.5% and +135% for DHA10, DHA35 and DHA60, respectively), and ouabain intoxication was delayed. The increase in myocardial phosphocreatine content and the improved efficacy of ouabain on myocardial contraction without toxicity suggest the potential of GPL-DHA as a dietary supplement or ingredient for functional food, and possibly as a co-treatment with digitalis drugs in humans.
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Affiliation(s)
- Monique Bernard
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, F-13385 Marseille, France.
| | | | - Alain Gerbi
- RDVC Produits Santé, F-76600 Le Havre, France
| | - Carole Lan
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, F-13385 Marseille, France.
| | | | - Gérard Pieroni
- Application Santé des Lipides, ASL, Bioparc de Vichy, F-03270 Hauterive, France
| | - Martine Armand
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, F-13385 Marseille, France.
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Moderate Dietary Supplementation with Omega-3 Fatty Acids Does Not Impact Plasma Von Willebrand Factor Profile in Mildly Hypertensive Subjects. BIOMED RESEARCH INTERNATIONAL 2015; 2015:394871. [PMID: 26290867 PMCID: PMC4531153 DOI: 10.1155/2015/394871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 09/28/2014] [Accepted: 10/28/2014] [Indexed: 01/01/2023]
Abstract
Long chain omega-3 polyunsaturated fatty acids (LC n-3 PUFAs) have blood pressure lowering and antithrombotic effects, which may benefit hypertensive patients. Increased plasma concentration of von Willebrand factor (vWF), a procoagulant glycoprotein, has been identified in patients with severe hypertension, with some, but not all studies showing an increase with mild hypertension. In this study, we determined the plasma concentration, multimer distribution, and collagen binding activity of vWF in subjects with mild hypertension and determined whether these parameters might improve after dietary supplementation with moderate amounts of LC n-3 PUFAs. Hypertensive and normotensive subjects were randomized to 12-week treatment with LC n-3 PUFAs (2.52 g/day) or placebo (canola oil). Home blood pressure measurements were recorded daily, and blood samples were collected every 3 weeks. LC n-3 PUFAs increased the n-3 index to cardioprotective levels (>8%). Plasma concentration, multimer distribution, and collagen binding activity of vWF were not reduced by LC n-3 PUFA treatment. We conclude that, at the concentration and duration used in this study, benefits of LC n-3 PUFAs in subjects with mild hypertension are not associated with a direct effect on vWF concentration or function. This trial is registered with the Australian New Zealand Clinical Trials Registry ACTRN12610000713099.
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Muscle fatigue resistance in the rat hindlimbin vivofrom low dietary intakes of tuna fish oil that selectively increase phospholipidn-3 docosahexaenoic acid according to muscle fibre type. Br J Nutr 2015; 114:873-84. [DOI: 10.1017/s0007114515002512] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AbstractDietary fish oil (FO) modulates muscle O2consumption and contractile function, predictive of effects on muscle fatigue. High doses unattainable through human diet and muscle stimulation parameters used engender uncertainty in their physiological relevance. We tested the hypothesis that nutritionally relevant FO doses can modulate membrane fatty acid composition and muscle fatigue. Male Sprague–Dawley rats were randomised to control (10 % olive oil (OO) by weight) or low or moderate FO diet (LowFO and ModFO) (HiDHA tuna fish oil) for 15 weeks (LowFO: 0·3 % FO, 9·7 % OO, 0·25 % energy as EPA+DHA; ModFO: 1·25 % FO, 8·75 % OO, 1·0 % energy as EPA+DHA). Hindlimb muscle function was assessed under anaesthesiain vivousing repetitive 5 s burst sciatic nerve stimulation (0·05 ms, 7–12 V, 5 Hz, 10 s duty cycle, 300 s). There were no dietary differences in maximum developed muscle force. Repetitive peak developed force fell to 50 % within 62 (sem10) s in controls and took longer to decline in FO-fed rats (LowFO 110 (sem15) s; ModFO 117 (sem14) s) (P<0·05). Force within bursts was better sustained with FO and maximum rates of force development and relaxation declined more slowly. The FO-fed rats incorporated higher muscle phospholipid DHA-relative percentages than controls (P<0·001). Incorporation of DHA was greater in the fast-twitch gastrocnemius (Control 9·3 (sem0·8) %, LowFO 19·9 (sem0·4), ModFO 24·3 (sem1·0)) than in the slow-twitch soleus muscle (Control 5·1 (sem0·2), LowFO 14·3 (sem0·7), ModFO 18·0 (sem1·4)) (P<0·001), which was comparable with the myocardium, in line with muscle fibre characteristics. The LowFO and ModFO diets, emulating human dietary and therapeutic supplement intake, respectively, both elicited muscle membrane DHA enrichment and fatigue resistance, providing a foundation for translating these physiological effects to humans.
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McLennan PL, Pepe S. Weighing Up Fish and Omega-3 PUFA Advice with Accurate, Balanced Scales: Stringent Controls and Measures Required for Clinical Trials. Heart Lung Circ 2015; 24:740-3. [DOI: 10.1016/j.hlc.2015.06.825] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 06/15/2015] [Indexed: 02/06/2023]
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Abstract
Hypoxia induces several responses at cardiovascular, pulmonary and reproductive levels, which may lead to chronic diseases. This is relevant in human populations exposed to high altitude (HA), in either chronic continuous (permanent inhabitants) or intermittent fashion (HA workers, tourists and mountaineers). In Chile, it is estimated that 1.000.000 people live at highlands and more than 55.000 work in HA shifts. Initial responses to hypoxia are compensatory and induce activation of cardioprotective mechanisms, such as those seen under intermittent hypobaric (IH) hypoxia, events that could mediate preconditioning. However, whenever hypoxia is prolonged, the chronic activation of cellular responses induces long-lasting modifications that may result in acclimatization or produce maladaptive changes with increase in cardiovascular risk. HA exposure during pregnancy induces hypoxia and oxidative stress, which in turn may promote cellular responses and epigenetic modifications resulting in severe impairment in growth and development. Sadly, this condition is accompanied with an increased fetal and neonatal morbi-mortality. Further, developmental hypoxia may program cardio-pulmonary circulations later in postnatal life, ending in vascular structural and functional alterations with augmented risk on pulmonary and cardiovascular failure. Additionally, permanent HA inhabitants have augmented risk and prevalence of chronic hypoxic pulmonary hypertension, right ventricular hypertrophy and cardiopulmonary remodeling. Similar responses are seen in adults that are intermittently exposed to chronic hypoxia (CH) such as shift workers in HA areas. The mechanisms involved determining the immediate, short and long-lasting effects are still unclear. For several years, the study of the responses to hypoxic insults and pharmacological targets has been the motivation of our group. This review describes some of the mechanisms underlying hypoxic responses and potential therapeutic approaches with antioxidants such as melatonin, ascorbate, omega 3 (Ω3) or compounds that increase the nitric oxide (NO) bioavailability.
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Alter P, Glück T, Figiel JH, Koczulla AR, Vogelmeier CF, Rupp H. From Heart Failure to Highly Unsaturated Fatty Acid Deficiency and Vice Versa: Bidirectional Heart and Liver Interactions. Can J Cardiol 2015; 32:217-25. [PMID: 26277086 DOI: 10.1016/j.cjca.2015.05.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 05/15/2015] [Accepted: 05/15/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In several trials, beneficial prognostic effects of highly unsaturated fatty acids (HUFAs) in heart failure were shown. Because other studies showed no incremental benefit in nearly preserved cardiac function, the question arises, whether the degree of cardiac dysfunction is involved. It is hypothesized that increased left ventricular (LV) wall stress affects the endogenous hepatic HUFA metabolism, which in turn exhibits adverse cardiac consequences. METHODS Cardiac magnetic resonance imaging was performed in 30 patients with suspected cardiomyopathy. The serum fatty acid profile was assessed using gas chromatography/mass spectrometry. RESULTS Docosahexaenoic acid (DHA; P = 0.002) and eicosapentaenoic acid (EPA; by trend) levels were decreased in patients with reduced LV ejection fraction (≤ 50%) or LV dilatation (≥ 90 mL/m(2)). Decreased DHA (P = 0.003) and EPA (P = 0.022) levels were associated with a reduced LV ejection fraction. Decreased DHA level was correlated with increased end-diastolic (P = 0.047) and end-systolic LV wall stress (P = 0.001). Pseudocholinesterase activity was inversely correlated with end-diastolic (P = 0.020) and end-systolic LV wall stress (P = 0.025). CONCLUSIONS DHA level was significantly reduced in heart failure. Similar, but less pronounced effects were found for EPA and arachidonic acid by trend. Increased LV wall stress was correlated with a reduced DHA level. Increased LV wall stress exhibits various adverse consequences (eg, increased oxygen consumption, favouring of arrhythmias, and an unfavourable remodelling). The increase of wall stress was paralleled by reduced HUFA level. Increased LV wall stress was correlated with reduced pseudocholinesterase, which is suggestive of hepatic congestion (ie, a cardiohepatic syndrome, involved in the altered fatty acid profile in heart failure) and has major consequences regarding the dose-efficacy of HUFA treatment.
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Affiliation(s)
- Peter Alter
- Department of Medicine, Pulmonary and Critical Care Medicine, University of Marburg, Marburg, Germany.
| | - Tobias Glück
- Department of Medicine, Pulmonary and Critical Care Medicine, University of Marburg, Marburg, Germany
| | - Jens H Figiel
- Department of Radiology, University of Marburg, Marburg, Germany
| | - A Rembert Koczulla
- Department of Medicine, Pulmonary and Critical Care Medicine, University of Marburg, Marburg, Germany
| | - Claus F Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University of Marburg, Marburg, Germany
| | - Heinz Rupp
- Department of Medicine, Pulmonary and Critical Care Medicine, University of Marburg, Marburg, Germany
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Hong MY, Lumibao J, Mistry P, Saleh R, Hoh E. Fish Oil Contaminated with Persistent Organic Pollutants Reduces Antioxidant Capacity and Induces Oxidative Stress without Affecting Its Capacity to Lower Lipid Concentrations and Systemic Inflammation in Rats. J Nutr 2015; 145:939-44. [PMID: 25788582 PMCID: PMC4408738 DOI: 10.3945/jn.114.206607] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 03/02/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Numerous studies have investigated the benefits of fish, fish oil, and ω-3 (n-3) polyunsaturated fatty acids against cardiovascular diseases. However, concern surrounding contamination with persistent organic pollutants (POPs) prompts caution in the recommendation to consume fish and fish oil. OBJECTIVE The present study compared the effects of fish oil contaminated with polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCs) on serum lipid profiles, inflammation, and oxidative stress. METHODS Twenty eight-day-old male Sprague-Dawley rats (n = 30) consumed diets of unmodified fish oil (FO) consisting of 15% fat by weight, persistent organic pollutant-contaminated fish oil (POP FO) (PCBs at 2.40 μg/g; OCs at 3.80 μg/g FO), or corn oil (control; CO) for 9 wk. Lipid profiles and C-reactive protein concentrations were assessed. Hepatic gene expression related to lipid metabolism was determined by real time quantitative polymerase chain reaction analysis. RESULTS After 9 wk of feeding, accumulation of PCBs and OCs in the fat tissue of the POP FO group compared with the other 2 groups was confirmed (P < 0.01). Both fish oil groups showed greater HDL cholesterol (FO 53 ± 5.3 and POP FO 55 ± 7.7 vs. CO 34 ± 2.3 mg/dL), but lower triglycerides (24 ± 2.8 and 22 ± 3.0 vs. 43 ± 5.6 mg/dL), LDL cholesterol (38 ± 14 and 34 ± 9.2 vs. 67 ± 4.4 mg/dL), and C-reactive protein (113 ± 20 and 120 ± 26 vs. 189 ± 22 μg/dL) compared with the CO group (P < 0.05). Gene expression of fatty acid synthase in both fish oil groups was also less than in the CO group (P < 0.05). However, the POP FO group showed greater lipid peroxidation (5.1 ± 0.7 vs. 2.9 ± 0.9 and 2.6 ± 0.6 μM) and less antioxidant capacity (0.08 ± 0.06 vs. 0.5 ± 0.1 and 0.4 ± 0.1 mM) than the CO and FO groups (P < 0.05). CONCLUSIONS These findings indicate that, despite exhibiting benefits on serum lipid concentrations and inflammation, contamination with PCBs and OCs showed significant negative effects on oxidative stress and antioxidant capacity in rats. Future studies should investigate the effects of different contaminant doses and the possibility of a dose-dependent response, a lengthened feeding time, and interactions between contaminant mixtures and oils of varying composition to advise on dietary consumption of fish and fish oil.
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Affiliation(s)
| | - Jan Lumibao
- School of Exercise and Nutritional Sciences, and
| | | | - Rhonda Saleh
- Graduate School of Public Health, San Diego State University, San Diego, CA
| | - Eunha Hoh
- Graduate School of Public Health, San Diego State University, San Diego, CA
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Intrinsic heart rate recovery after dynamic exercise is improved with an increased omega-3 index in healthy males. Br J Nutr 2014; 112:1984-92. [DOI: 10.1017/s0007114514003146] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Dietary fish consumption contributes to a reduced risk of cardiac mortality. In the present study, the effect of low-dose fish oil (FO) supplementation on heart rate (HR) response to intense exercise and recovery was investigated in physically fit males. The subjects (n 26) were supplemented (double-blind, parallel design) with (2 × 1 g/d) soya bean oil (control) or tuna FO providing the long-chain n-3 PUFA DHA (560 mg) and EPA (140 mg). Erythrocyte omega-3 index (%EPA+DHA), HR, HR variability and HR recovery were analysed during rest, intense exercise and recovery at baseline and after 8 weeks of supplementation. The mean erythrocyte omega-3 index, which did not differ between the groups at baseline (control 4·2 (sem 0·2), n 13; FO 4·7 (sem 0·2), n 13), remained unchanged in the control group (3·9 (sem 0·2)), but increased in the FO group (6·3 (sem 0·3); P< 0·01). The mean HR during supine resting conditions (control 56 (sem 10); FO 59 (sem 9)) was not affected by FO supplementation. Poincaré analysis of HR variability at rest exhibited a decreasing trend in parasympathetic activity in the FO group (SD1 (standard deviation of points perpendicular to the axis of line of identity)/SD2 (standard deviation of points along the axis of line of identity): control 0·02 (sem 0·01); FO − 0·05 (sem 0·02); P= 0·18). Peak HR was not affected by supplementation. However, during submaximal exercise over 5 min, fewer total heart beats were recorded in the FO group ( − 22 (sem 6) ( = − 4·5 beats/min)), but not in the control group (+1 (sem 4)) (P< 0·05). Supine HR recovery (half-time) after cycling was significantly faster after FO supplementation (control − 0·4 (sem 1·2) s; FO − 8·0 (sem 1·7) s; P< 0·05). A low intake of FO increased the omega-3 index and reduced the mean exercise HR and improved HR recovery without compromising the peak HR. A direct influence of DHA via reductions in the cardiac intrinsic beat rate was balanced by a reciprocal decrease in vagal tone.
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