Anti-inflammatory and cardioprotective effects of n-3 polyunsaturated fatty acids and plant sterols in hyperlipidemic individuals

Comparison of fish oil supplements and corn oil effects on serum lipid profile: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

The present study aimed to investigate the effects of fish oil supplements compared to corn oil on serum lipid profiles by performing a meta-analysis of randomized controlled trials (RCTs).

METHODS

Online databases including PubMed, Web of Science, and Scopus were searched until 30 December 2022. Pooled effect sizes were reported as the weighted mean difference (WMD) with 95% confidence intervals (CI). The Cochrane Collaboration's risk-of-bias tool was utilized to evaluate the quality of the studies. Lipid parameters, including triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL), and high-density lipoprotein cholesterol (HDL), were assessed in the meta-analysis.

RESULTS

Overall, 16 eligible trials were included in this systematic review and meta-analysis. The results revealed that the fish oil supplements significantly reduced TG (WMD: - 25.50 mg/dl, 95% CI: - 42.44, - 8.57, P = 0.000) levels compared to corn oil. Also, in this study, fish oil supplements had a positive and significant effect on HDL (WMD: 2.54 mg/dl, 95% CI: 0.55, 4.52). There were no significant changes in TC and LDL.

CONCLUSIONS

Our findings showed the effects of fish oil supplements on reducing TG and increasing HDL-c compared to corn oil. Further larger and well-designed RCTs are required to confirm these data.

Phytosterol intake and risk of coronary artery disease: Results from 3 prospective cohort studies

BACKGROUND

Phytosterols are structurally similar to cholesterol and partially inhibit intestinal absorption of cholesterol, although their impact on coronary artery disease (CAD) risk remains to be elucidated.

OBJECTIVES

This study aimed to prospectively assess the associations between total and individual phytosterol intake and CAD risk in United States health professionals.

METHODS

The analysis included 213,992 participants from 3 prospective cohorts-the Nurses' Health Study (NHS), NHSII, and Health Professionals Follow-Up Study-without cardiovascular disease or cancer at baseline. Diet was assessed using a validated food frequency questionnaire every 2-4 y since baseline. Associations between phytosterol intake and the risk of CAD, such as nonfatal myocardial infarction and fatal CAD, were evaluated using Cox proportional hazards regression models.

RESULTS

More than 5,517,993 person-years, 8725 cases with CAD were documented. Comparing extreme quintiles, pooled hazard ratios (95% CIs) of CAD were 0.93 (0.86, 1.01; P-trend = 0.16) for total phytosterols, 0.89 (0.82, 0.96; P-trend = 0.05) for campesterol, 0.95 (0.88, 1.02; P-trend = 0.10) for stigmasterol, and 0.92 (0.85, 1.00; P-trend = 0.09) for β-sitosterol. Nonlinear associations were observed for total phytosterols, campesterol, and β-sitosterol: the risk reduction plateaued at intakes above ∼180, 30, and 130 mg/d, respectively (P-nonlinearity < 0.001). In a subset of participants (N range between 11,983 and 22,039), phytosterol intake was inversely associated with plasma concentrations of total cholesterol, triglycerides, high-density lipoprotein cholesterol, and IL-6 and positively associated with adiponectin, whereas no significant associations were observed for low-density lipoprotein cholesterol or C-reactive protein concentrations.

CONCLUSIONS

Higher long-term intake of total and major subtypes of phytosterols may be associated with a modest reduction in CAD risk, displaying a nonlinear relationship that plateau at moderate intake levels. The role of phytosterols in preventing CAD warrants further investigation.

Implication of Oxysterols and Phytosterols in Aging and Human Diseases

Cholesterol is easily oxidized and can be transformed into numerous oxidation products, among which oxysterols. Phytosterols are plant sterols related to cholesterol. Both oxysterols and phytosterols can have an impact on human health and diseases.Cholesterol is a member of the sterol family that plays essential roles in biological processes, including cell membrane stability and myelin formation. Cholesterol can be metabolized into several molecules including bile acids, hormones, and oxysterols. On the other hand, phytosterols are plant-derived compounds structurally related to cholesterol, which can also have an impact on human health. Here, we review the current knowledge about the role of oxysterols and phytosterols on human health and focus on the impact of their pathways on diseases of the central nervous system (CNS), autoimmune diseases, including inflammatory bowel diseases (IBD), vascular diseases, and cancer in both experimental models and human studies. We will first discuss the implications of oxysterols and then of phytosterols in different human diseases.

Omega-3 long-chain polyunsaturated fatty acids: Metabolism and health implications

Recently, omega-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFAs) have gained substantial interest due to their specific structure and biological functions. Humans cannot naturally produce these fatty acids (FAs), making it crucial to obtain them from our diet. This comprehensive review details n-3 LC-PUFAs and their role in promoting and maintaining optimal health. The article thoroughly analyses several sources of n-3 LC-PUFAs and their respective bioavailability, covering marine, microbial and plant-based sources. Furthermore, we provide an in-depth analysis of the biological impacts of n-3 LC-PUFAs on health conditions, with particular emphasis on cardiovascular disease (CVD), gastrointestinal (GI) cancer, diabetes, depression, arthritis, and cognition. In addition, we highlight the significance of fortification and supplementation of n-3 LC-PUFAs in both functional foods and dietary supplements. Additionally, we conducted a detailed analysis of the several kinds of n-3 LC-PUFAs supplements currently available in the market, including an assessment of their recommended intake, safety, and effectiveness. The dietary guidelines associated with n-3 LC-PUFAs are also highlighted, focusing on the significance of maintaining a well-balanced intake of n-3 PUFAs to enhance health benefits. Lastly, we highlight future directions for further research in this area and their potential implications for public health.

Plant-Based Dietary Patterns and Cardiovascular Disease Risk in Australians: Protocol for a Cross-Sectional Study

Plant-based diets (PBDs) emphasise higher intakes of plant foods and lower intakes of animal foods, and they have been associated with reduced cardiovascular morbidity/mortality and lower cardiovascular disease (CVD) risk factors. Evidence is limited regarding the dietary profile, diet quality, and nutritional adequacy of PBDs, including their impact on CVD risk compared with traditional meat-eating diets in Australians. The PBD Study (PBDS) is a cross-sectional study that will recruit 240 adults from the Hunter region (NSW) without known CVD who are habitually consuming vegan (no animal flesh/animal products), lacto-ovo vegetarian (dairy and/or eggs only), pesco-vegetarian (fish/seafood only), or semi-vegetarian (minimal animal flesh) diets or are a regular meat-eater. To investigate dietary profile, diet quality, nutritional adequacy, and CVD risk, questionnaires (medical history, demographics, and physical activity), blood samples (biomarkers), physical measures (anthropometry, blood pressure, body composition, and bone density), and dietary intake (food frequency questionnaire and diet history) will be collected. One-way ANOVA and Kruskal-Wallis tests will compare the CVD risk and other quantitative measures, and Chi-square or Fisher's Exact tests will be used for qualitative data. Directed acyclic graphs will determine the confounding variables, and linear regression and mediation analyses will account for the confounders and estimate the effect of dietary patterns on CVD risk. p-values will be adjusted using the Benjamini-Hochberg method to control the False Discovery Rate to 5%.

Plasma free amino acid profiles are associated with serum high molecular weight adiponectin levels in Japanese medical check-up population without type 2 diabetes mellitus

To prevent the progression of type 2 diabetes mellitus (T2DM), early detection and intervention are important. Several studies have already shown that the serum adiponectin level could be useful for evaluating the future risk of T2DM. Recently, plasma free amino acid (PFAA) concentrations have also emerged as potential biomarkers that predict the future onset of T2DM. In this study, we aimed to further characterise PFAA profiles by elucidating the association with the serum high molecular weight (HMW) adiponectin level in this cross-sectional study. A total of 1000 Japanese subjects who underwent medical check-ups were enrolled, and their plasma concentrations of 21 amino acids and clinical parameters were measured. The subjects without T2DM were divided into quartiles (Q1-4) by serum HMW adiponectin level, and the association with between PFAA concentrations was analysed. Concentrations of glutamate, alanine, proline, tyrosine, histidine, methionine, lysine, branched-chain amino acids (BCAAs) and tryptophan varied significantly according to the adiponectin quartile. Furthermore, serum adiponectin levels showed significant inverse correlations with these amino acids. The change in the PFAA profile in the group with the lowest adiponectin concentrations (Q1) was similar to that of T2DM patients. Although both adiponectin levels and PFAA concentrations are known to be altered by the accumulation of visceral fat and insulin resistance, the levels of glutamate, BCAA, lysine and tryptophan remain significantly associated with adiponectin level after adjustment for age, body mass index and homeostasis model assessment of insulin resistance, showing the direct association between PFAA concentrations and the serum HMW adiponectin level. Registration number: University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) UMIN000029920, registered on Nov 13th 2017 (prospectively registered).

Dietary omega-3 fatty acids and endometrial cancer risk in the Epidemiology of Endometrial Cancer Consortium: An individual-participant meta-analysis

BACKGROUND

Limited data from prospective studies suggest that higher dietary intake of long-chain omega-3 polyunsaturated fatty acids (LCn3PUFA), which hold anti-inflammatory properties, may reduce endometrial cancer risk; particularly among certain subgroups characterized by body mass and tumor pathology.

MATERIALS AND METHODS

Data from 12 prospective cohort studies participating in the Epidemiology of Endometrial Cancer Consortium were harmonized as nested case-control studies, including 7268 endometrial cancer cases and 26,133 controls. Habitual diet was assessed by food frequency questionnaire, from which fatty acid intakes were estimated. Two-stage individual-participant data mixed effects meta-analysis estimated adjusted odds ratios (OR) and 95% confidence intervals (CI) through logistic regression for associations between study-specific energy-adjusted quartiles of LCn3PUFA and endometrial cancer risk.

RESULTS

Women with the highest versus lowest estimated dietary intakes of docosahexaenoic acid, the most abundant LCn3PUFA in diet, had a 9% increased endometrial cancer risk (Quartile 4 vs. Quartile 1: OR 1.09, 95% CI: 1.01-1.19; P trend = 0.04). Similar elevated risks were observed for the summary measure of total LCn3PUFA (OR 1.07, 95% CI: 0.99-1.16; P trend = 0.06). Stratified by body mass index, higher intakes of LCn3PUFA were associated with 12-19% increased endometrial cancer risk among overweight/obese women and no increased risk among normal-weight women. Higher associations appeared restricted to White women. The results did not differ by cancer grade.

CONCLUSION

Higher dietary intakes of LCn3PUFA are unlikely to reduce endometrial cancer incidence; rather, they may be associated with small to moderate increases in risk in some subgroups of women, particularly overweight/obese women.

Inflammasomes: Cause or consequence of obesity-associated comorbidities in humans

Inflammasomes are multiprotein intracellular complexes composed of innate immune system receptors and sensors; they activate the inflammatory cascade in response to infectious microbes and/or molecules derived from host proteins. Because of cytokine secretion, inflammasomes can induce amplified systemic responses, its dysregulation can exacerbate symptoms in infectious diseases, and it has been related to the development of autoimmune diseases, inflammatory disorders, and even cancer. Obesity is associated with a chronic low-grade inflammation, in which circulating proinflammatory cytokines are elevated. Some publications describe changes in inflammation markers as a consequence of obesity, but others suggest that chronic inflammation might cause obesity (e.g., C-reactive protein): these assumptions reflect the difficulty of identifying the appropriate role of inflammation as cause or consequence of obesity and its related complications. Obesity is recognized as a clinical risk factor for developing cardiovascular diseases including atherosclerosis, metabolic syndrome, insulin resistance, and diabetes mellitus. Changes in the expression of inflammasomes are described in some of these obesity-related complications, and moreover, its modulation might exert a beneficial effect in some cases. Despite some contradictory results, most publications suggest a promising clinical effect based on in vitro and in vivo experiments. In this review, we summarized recent publications about inflammasome dysregulation in humans and its relationship with obesity-related comorbidities.

In vitro α-glucosidase inhibitory activity of Tamarix nilotica shoot extracts and fractions

α-glucosidase inhibitors represent an important class of type 2 antidiabetic drugs and they act by lowering postprandial hyperglycemia. Today, only three synthetic inhibitors exist on the market, and there is a need for novel, natural and more efficient molecules exhibiting this activity. In this study, we investigated the ability of Tamarix nilotica ethanolic and aqueous shoot extracts, as well as methanolic fractions prepared from aqueous crude extracts to inhibit α-glucosidase. Both, 50% ethanol and aqueous extracts inhibited α-glucosidase in a concentration-dependent manner, with IC₅₀ values of 12.5 μg/mL and 24.8 μg/mL, respectively. Importantly, α-glucosidase inhibitory activity observed in the T. nilotica crude extracts was considerably higher than pure acarbose (IC₅₀ = 151.1 μg/mL), the most highly prescribed α-glucosidase inhibitor on the market. When T. nilotica crude extracts were fractionated using methanol, enhanced α-glucosidase inhibitory activity was observed in general, with the highest observed α-glucosidase inhibitory activity in the 30% methanol fraction (IC₅₀ = 5.21 μg/mL). Kinetic studies further revealed a competitive reversible mechanism of inhibition by the plant extract. The phytochemical profiles of 50% ethanol extracts, aqueous extracts, and the methanolic fractions were investigated and compared using a metabolomics approach. Statistical analysis revealed significant differences in the contents of the crude extracts and fractions and potentially identified the molecules that were most responsible for these observed variations. Higher α-glucosidase inhibitory activity was associated with an enrichment of terpenoids, fatty acids, and flavonoids. Among the identified molecules, active compounds with known α-glucosidase inhibitory activity were detected, including unsaturated fatty acids, triterpenoids, and flavonoid glycosides. These results put forward T. nilotica as a therapeutic plant for type 2 diabetes and a source of α-glucosidase inhibitors.

Biological and pharmacological effects and nutritional impact of phytosterols: A comprehensive review

Phytosterols (PSs), classified into plant sterols and stanols, are bioactive compounds found in foods of plant origin. PSs have been proposed to exert a wide number of pharmacological properties, including the potential to reduce total and low-density lipoprotein (LDL) cholesterol levels and thereby decreasing the risk of cardiovascular diseases. Other health-promoting effects of PSs include anti-obesity, anti-diabetic, anti-microbial, anti-inflammatory, and immunomodulatory effects. Also, anticancer effects have been strongly suggested, as phytosterol-rich diets may reduce the risk of cancer by 20%. The aim of this review is to provide a general overview of the available evidence regarding the beneficial physiological and pharmacological activities of PSs, with special emphasis on their therapeutic potential for human health and safety. Also, we will explore the factors that influence the physiologic response to PSs.

The Effect of a Persian Herbal Medicine Compound on the Lipid Profiles of Patients with Dyslipidemia: A Randomized Double-Blind Placebo-Controlled Clinical Trial

INTRODUCTION

It has been well established in the world that lipid disorders promote the development of atherosclerosis and its clinical consequences. This study aimed to assess the impacts of a Persian medicinal (PM) compound on lipid profile.

MATERIALS AND METHODS

From June 21 to October 21, 2020, a randomized double-blind controlled clinical trial was conducted with 74 dyslipidemic patients, who were randomly divided into two equally populated groups: one prescribed with a Persian medicinal herbal compound (n = 37) and a placebo group (n = 37). A Persian herbal medicine including fenugreek, sumac, and purslane is introduced. Biochemical parameters including 12-hour fasting serum levels of total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), very-low-density lipoprotein (VLDL), and triglyceride (TG) were measured before the initiation and after the completion of study protocol.

RESULTS

Percent changes of biochemical parameters include the following: intervention group = cholesterol: 35.22, Tg: 45.91, LDL: 24.81, HDL: 2.05, VLDL: 8.94 and placebo group = cholesterol: 6.94, Tg: -7.3, LDL: 7.37, HDL: 2.88, VLDL: -0.14. The serum levels of total cholesterol (p=0.01) and LDL (p=0.01) significantly decreased and no increase was recorded in HDL (p=0.03) levels over time in the intervention group. Furthermore, between-group analysis showed a statistically significant difference between the intervention and placebo groups in this regard. VLDL (p=0.2) and TG (p=0.2) levels also decreased, however not significantly.

CONCLUSION

This study showed that a Persian medicinal herbal compound could be safe and beneficial to decrease the levels of serum cholesterol and LDL in dyslipidemic patients. However, larger long-term studies are recommended to clarify this effect.

Bioactive Sugarcane Lipids in a Circular Economy Context

Most of the global sugar and ethanol supply trade comes from the harvesting of Saccharum officinarum (i.e., sugarcane). Its industrial processing results in numerous by-products and waste streams, such as tops, straw, filter cake, molasses and bagasse. The recovery of lipids (i.e., octacosanol, phytosterols, long-chain aldehydes and triterpenoids) from these residues is an excellent starting point for the development of new products for various application fields, such as health and well-being, representing an important feature of the circular economy. By selecting green scalable extraction procedures, industry can reduce its environmental impact. Refluxed ethanol extraction methods have been demonstrated to meet these characteristics. On the other hand, effective non-solvent methodologies such as molecular distillation and supercritical CO₂ extraction can fractionate lipids based on high temperature and pressure application with similar yields. Sugarcane lipophilic extracts are usually analyzed through gas chromatography (GC) and liquid chromatography (LC) techniques. In many cases, the identification of such compounds involves the development of high-temperature GC–MS/FID techniques. On the other hand, for the identification and quantification of thermolabile lipids, LC–MS techniques are suitable for the separation and identification of major lipid classes. Generically, its composition includes terpenes, phytosterols, tocopherol, free fatty acids, fatty alcohols, wax esters, triglycerides, diglycerides and monoglycerides. These compounds are already known for their interesting application in various fields such as pharma and cosmetics due to their anti-hypercholesterolemic, anti-hyperglycemic, antioxidant and anti-inflammatory properties.

Synergistic potential of nutraceuticals: mechanisms and prospects for futuristic medicine

Nutraceuticals are valued for their therapeutic effects and numerous health benefits. In recent years, several studies have demonstrated their superior performances when co-delivered; the concept of synergism has been established for various bioactives. Apart from improvements in the bioavailability of partnering compounds, this approach can protect the radical scavenging potential and biological effects of individual compounds. In this review, the intricate mechanisms that promote synergistic effects when bioactive compounds are co-delivered are detailed. Importantly, a range of potential medical applications that have been established through such synergistic effects is presented, emphasizing recent developments in this field. Also, a section has been devoted to highlighting perspectives on co-encapsulation at the nanoscale for improved synergistic benefits. While prospects for the treatment of chronic diseases are well-demonstrated, several challenges and safety concerns remain, and these have been discussed, providing recommendations for future research.

Phytosterols: Targeting Neuroinflammation in Neurodegeneration

Plant-derived sterols, phytosterols, are well known for their cholesterol-lowering activity in serum and their anti-inflammatory activities. Recently, phytosterols have received considerable attention due to their beneficial effects on various non-communicable diseases, and recommended use as daily dietary components. The signaling pathways mediated in the brain by phytosterols have been evaluated, but little is known about their effects on neuroinflammation, and no clinical studies have been undertaken on phytosterols of interest. In this review, we discuss the beneficial roles of phytosterols, including their attenuating effects on inflammation, blood cholesterol levels, and hallmarks of the disease, and their regulatory effects on neuroinflammatory disease pathways. Despite recent advancements made in phytosterol pharmacology, some critical questions remain unanswered. Therefore, we have tried to highlight the potential of phytosterols as viable therapeutics against neuroinflammation and to direct future research with respect to clinical applications.

Dietary Fat Intake and Risk of Uterine Leiomyomata: A Prospective Ultrasound Study

Uterine leiomyomata (UL) are associated with severe reproductive morbidity and are the primary indication for hysterectomy in the United States. A recent prospective cohort study of Black women reported positive associations between intakes of marine-sourced ω-3 fatty acids and UL risk. We examined whether intakes of dietary fat were associated with UL incidence in a 5-year prospective study of premenopausal Black women living in Detroit who underwent serial ultrasound. At baseline (2010-2012) and 20, 40, and 60 months of follow-up, participants underwent transvaginal ultrasound. Among 1,171 UL-free women at baseline, incident UL were detected in 277 women. Cox regression was used to estimate hazard ratios and 95% confidence intervals for the association of dietary fat and UL incidence. Intakes of total fat and saturated, monounsaturated, polyunsaturated, and trans-fat were not appreciably associated with UL incidence. Intake of the marine ω-3 polyunsaturated fatty acid, docosahexaenoic acid, was associated with 49% higher UL incidence (quartile 4 vs. 1: hazard ratio = 1.49, 95% confidence interval: 1.04, 2.14; P for trend = 0.01). Intakes of total marine ω-3 polyunsaturated fatty acids were similarly associated with elevated UL incidence (hazard ratio = 1.35, 95% confidence interval: 0.94, 1.93; P for trend = 0.03). It remains unclear whether the fatty acids or persistent environmental pollutants drive the association.

Systematic review of marine-derived omega-3 fatty acid supplementation effects on leptin, adiponectin, and the leptin-to-adiponectin ratio

Increasing evidence suggests that adipokines, leptin and adiponectin, produced and secreted by adipocytes, are involved in regulating systemic inflammation and may be important targets for interventions to reduce the chronic systemic inflammation linked to some conditions common in aging (e.g., atherosclerosis). Lower leptin levels and higher adiponectin levels in peripheral circulation have been associated with less systemic inflammation. While some studies have shown that marine-derived omega-3 fatty acids (eicosapentaenoic acid [EPA] and/or docosahexaenoic acid [DHA]) have effects on leptin and adiponectin in the context of inflammation, the extent of their effects remain unclear. The purpose of this systematic review was to summarize findings from randomized, controlled trials that measured effects of EPA+DHA supplementation on circulating levels of leptin and adiponectin to determine the state of the science. PubMed, CINAHL, Web of Science, Scopus, and Cochrane Trials were searched up to June 2018 for studies meeting inclusion criteria. Thirty-one studies included in this review were conducted in 16 countries. Eighteen studies reported lower leptin and/or higher adiponectin levels with EPA+DHA supplementation versus placebo at study end point (9 reported statistically significant differences), but doses, supplementation duration, and population characteristics varied across studies. In 9 studies reporting significantly lower leptin and/or higher adiponectin levels the EPA+DHA dose was 0.52 to 4.2 g/day for 4 to 24 weeks. Additional studies are warranted which assess dose parameters and patient populations similar to studies reporting significant effects of EPA+DHA on leptin or adiponectin in order to evaluate the extent of reproducibility before recommending EPA+DHA as a therapy to target these adipokines.

Crosstalk Between Dietary Pattern, Anthropometric Parameters, and Adiponectin Concentration Among Patients with Metabolic Syndrome

Background: Adiponectin is known to mediate antidiabetic and cardioprotective metabolic effects. Current evidence suggests that diet, both its quantity and quality, affects adiponectin concentration. Methods: The purpose of this study was to evaluate the association of adiponectin with cardiometabolic risk factors, anthropometric features, and diet characteristics in obese patients with multiple cardiometabolic risk factors. The group of 113 nondiabetic patients (90 males, mean age: 48 ± 9 years) fulfilling the criteria of metabolic syndrome (IDF, 2005) was divided into 2 subgroups according to median adiponectin concentration calculated for that cohort (6.83 μg/mL)-low-adiponectin (LA) and high-adiponectin (HA) subgroup. Biochemical and anthropometric measurements were recorded and nutrients intake was assessed using 24-hr dietary recall method and diet history questionnaire. Results: No significant differences between LA and HA were noted regarding the anthropometric parameters. However, there were significant differences in biochemical indices, and HA was characterized by a more favorable insulin level, homeostasis model assessment of insulin resistance (HOMA-IR) value, and plasma lipid profile than LA. Both LA and HA subgroups were comparable in terms of energy, protein, carbohydrate, and total fat intake, but there were significant differences between the level of polyunsaturated fatty acids (PUFA) consumption (6.06 ± 1.0 and 6.37 ± 1.1, respectively) and omega-3/omega-6 ratio (as follows: 0.09 ± 0.01 and 0.16 ± 0.04). Conclusions: These results highlight interactions between diet, adiponectin concentration, and biochemical profile. Nondiabetic patients with metabolic syndrome with higher PUFA consumption, including higher omega-3/omega-6 ratio, were characterized by higher circulating adiponectin level and more favorable biochemical profile. Thus, it might be assumed that the protective role of omega-3 fatty acids might be mediated by adiponectin in patients with metabolic syndrome.

Lowering effects of fish oil supplementation on proinflammatory markers in hypertension: results from a randomized controlled trial

Reduced inflammation is one of the potential mechanisms underlying the cardioprotective efficacy of fish oil enriched with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Supplementation with fish oil has favorable effects on cardiometabolic profiles in Inner Mongolia patients with hypertension, but whether the cardiovascular benefits can be ascribed to reduced subclinical inflammation is unclear among this population. Seventy-seven middle-aged/elderly hypertensive volunteers were randomly assigned to receive either fish oil (FO, n = 38, 2 g day-1 EPA + DHA) or control corn oil (CO, n = 39) for 90 days. FA compositions in erythrocytes and C-reactive protein (CRP, mg L-1), interleukin-6 (IL-6, pg mL-1) and tumor necrosis factor-α (TNF-α, pg mL-1) concentrations in the plasma were measured before and after the 90-day supplementation, and the cardiometabolic risk was expressed as continuously distributed z-scores calculated by standardizing and then summing the individual cardiovascular risk factors. Significant reductions in the TNF-α (-1.87 ± 2.71 vs. -0.64 ± 2.62, p = 0.02) and CRP levels (-0.85 ± 2.49 vs. 0.56 ± 2.14, p = 0.01) were found in the FO group compared with the CO group, but not in the IL-6 levels (-0.66 ± 1.05 vs. -0.25 ± 0.94, p = 0.10). The decreases in the changes of TNF-α levels were positively correlated with the reductions in the cardiometabolic risk scores in the subjects supplemented with FO (r = 0.35, p = 0.02), but not in the control subjects supplemented with CO (r = 0.09, p = 0.54). FO supplementation increased the levels of EPA (p = 0.013), DHA (p = 0.040) and total n-3 FA (p = 0.035), and decreased the levels of 20:4n-6 (p = 0.041) and total n-6 FA (p = 0.011) and the ratio of n-6 to n-3 FA (p = 0.001), compared with the changes related to the CO group. The increases in the changes of erythrocyte total n-3 FA levels were inversely correlated with the concentrations of TNF-α (r = -0.34, p = 0.001) and CRP (r = -0.29, p = 0.020). The present findings suggest that fish oil supplementation may attenuate the proinflammatory reactions in hypertension, which might help promote the cardiometabolic benefits in this Inner Mongolia population.

Fish Oil Dilemma: Does It Increase the Risk of Ventricular Arrhythmias and Death? Can Fish Oil Kill You?

Omega-3-fatty-acids are now increasingly being used for potential beneficial anti-inflammatory effect in the treatment and management of cardiovascular disease. Eicosapentaenoic acid and Docosahexaenoic acid are 2 essential omega-3 fatty acids found predominately in fish and fish oil supplements. Despite the increased use of fish oil products for both primary and secondary prevention of cardiovascular morbidity and mortality, the available literature evidence are controversial. We searched through PubMed for studies that have investigated the impact of omega-3 fatty acids on coronary heart disease and mortality. Our systemic review suggests that most studies, which are mostly observational, have found there to be a potential benefit of omega-3 fatty acids on coronary heart disease whereas some other studies have found conflicting results. More randomized controlled studies are warranted with adequate sample size to clearly establish the risk and benefits of omega-3 fatty acids on cardiovascular disease.

Effect of trans-Octadecenoic Acid Positional Isomers on Tumor Necrosis Factor-α Secretion in RAW264.7 Cells

We compared the cytotoxic effects and tumor necrosis factor-α (TNF-α) production induced by 13 trans-octadecenoic acid positional isomers (trans-4-C18:1 to trans-16-C18:1) in RAW264.7 cells using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay and enzyme-linked immunosorbent assay, respectively. No significant differences were observed in the cytotoxic effects among the 13 trans-C18:1 positional isomers and control on RAW264.7 cells. TNF-α production significantly decreased by treatment of trans-4-C18:1 as compared to control, but no significant differences in TNF-α production were observed among other trans-C18:1 positional isomers and control. These results suggest that the double bond position in trans-C18:1 may affect TNF-α production in cells.

Phytosterols and Inflammation

Besides the well-characterized effect of foods and supplements enriched with plant sterols/stanols on serum LDL-C concentrations, evidence is now emerging that phytosterols exert beneficial effects on non-lipid variables such as inflammatory and oxidative stress markers, coagulation parameters and endothelial function. This makes sterols and stanols an attractive alternative for dietary interventions in cardiovascular disease prevention, particularly in populations at low or medium risk. This review aims to summarize the current knowledge derived from experimental studies and human data on the anti-inflammatory effects of phytosterols/stanols and their relevance in promoting atheroprotection and preventing cardiovascular disease. The anti-inflammatory effects induced by plant sterols/stanols have been demonstrated in in vitro studies and in experimental animal models. However, not all the beneficial effects seen at an experimental level have translated into clinical benefit. Indeed, clinical studies that evaluate the association between phytosterols consumption and inflammatory variables (CRP and cytokines) are inconsistent and have not yet provided a solid answer. Plant sterols have been proposed as useful adjuncts to statin therapy to further reduce the risk of cardiovascular disease. However, there is limited available data and more research needs to be done.

Effects of Flaxseed Interventions on Circulating Inflammatory Biomarkers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

There have been various clinical studies on the effect of flaxseed-derived products on circulating inflammatory biomarkers, but the findings from these are contradictory. The aim of the present study was to clarify any association. A comprehensive literature search was conducted from inception to May 2018. From the eligible trials, 32 articles describing studies conducted on adults aged 18-70 y were selected for the meta-analysis. Meta-analyses using the random-effects model were performed to investigate the data and results showed significant effects of flaxseed intake on circulating high-sensitivity CRP (hs-CRP) [weighted mean difference (WMD) = -0.75; 95% CI: -1.19, -0.30; P < 0.001] and TNFα (WMD = -0.38; 95% CI: -0.75,-0.01; P = 0.04). However, no significant changes were found in IL6 concentration (WMD = -0.24; 95% CI: -0.70, 0.21; P = 0.28) and C-reactive protein (CRP) (WMD = -0.34; 95% CI:-0.89, 0.20; P = 0.22). Moreover, by eliminating 1 of the studies from the sensitivity analysis, changes in IL6 concentration were significant (WMD = -0.44; 95% CI: -0.81, -0.08). The changes in inflammatory biomarkers were dependent on study design (parallel or crossover), supplement type (flaxseed, flaxseed oil, or lignan), study quality (high or low), and participants' age and BMI. According to this meta-analysis, flaxseed significantly reduced circulating concentrations of hs-CRP and TNFα, but did not affect IL6 and CRP. Further research is needed to examine the effect of different doses and long-term benefits of flaxseed and its derivatives on inflammatory factors.

Fatty Acids and Herbal Medicine

Background:

Fatty acid is a type of carboxylic acid with carbon chain that can be short (4 carbons, such as butyric acid) or long (14 carbons and more, like DHA). Generally, fatty acids are divided into two groups of unsaturated fatty acids and saturated fatty acids. They have important and valuable medicinal properties especially against microbial pathogens.

Objective:

Studies have shown that the epidemic of the twentieth century's heart disease is due to the abuse of trans fatty acids. The consumption of various fatty acids has various therapeutic effects on various diseases.

Method:

Relevant articles were searched from Google Scholar, Pub Med, Scopus, Science direct, and Cochrane library.

Results:

Getting omega-3 fatty acids through diet and supplements affects both acute and chronic inflammation. Consumption of omega-3 fatty acids can slow down the growth of cancer, increase the effect of chemotherapy and reduce the side effects of chemotherapy or cancer. This can be done by reducing angiogenesis in the tumor, creating the differentiation of cancer cells, reducing the risk of heart attack from cancer, etc.

Conclusion:

In general, fatty acids are valuable and affordable, and available with numerous medicinal properties, including anti-fungal and anti-bacterial properties that can be extracted from and used by many sources, especially many medicinal plants. Since antimicrobial chemicals generally have many side effects and have resistance to many microbial species, various studies and experiments to identify and extract fatty acids and their application to the title of the pharmaceutical formulation are essential.

Dietary Long-Chain n-3 Fatty Acid Intake and Arthritis Risk in the Women's Health Initiative

BACKGROUND

The prevalence of arthritis in the United States is substantial and on the rise. Long-chain n-3 polyunsaturated fatty acids, which have anti-inflammatory properties, have been shown to provide therapeutic benefit to arthritis patients; however, to date few have examined these associations with arthritis risk.

OBJECTIVE

The study objective was to examine the associations of long-chain n-3 polyunsaturated fatty acids intake with osteoarthritis (OA) and rheumatoid arthritis (RA) risk among postmenopausal women.

DESIGN

This was a prospective cohort study.

PARTICIPANTS

The sample for this analysis consisted of 80,551 postmenopausal women, aged 55 to 79 years and with no history of arthritis, recruited into the Women's Health Initiative Observational Study and Clinical Trials cohort between 1993 and 1998. Women completed a 120-item food frequency questionnaire at baseline.

MAIN OUTCOME MEASURES

After a median follow-up of 8 years, 22,306 incident OA and 3,348 RA cases were identified.

STATISTICAL ANALYSES PERFORMED

Adjusted Cox regression models were used to estimate hazard ratios and 95% CI for the associations between dietary LCn-3PUFA intake and OA and RA risk.

RESULTS

Individual and total long-chain n-3 polyunsaturated fatty acids (Quintile 5 vs Quintile 1: hazard ratio 1.04, 95% CI 0.99 to 1.09 for OA; hazard ratio 1.01, 95% CI 0.90 to 1.13 for RA) were not associated with OA and RA risk. Further, no associations were observed between n-6 polyunsaturated fatty acids intake and either arthritis outcome.

CONCLUSIONS

This study is the first to examine associations of long-chain n-3 polyunsaturated fatty acids intake with OA risk and the largest to examine associations with RA risk. Despite their therapeutic potential, the study provides no evidence of benefit of these nutrients in relation to arthritis risk.

Dietary Intake of Omega-3 fatty acids and Endocrine-related Gynecological Cancer: A Meta-Analysis of Observational Studies

Purpose

Previous observational epidemiological studies have reported inconsistent findings on the association between dietary intake of omega-3 fatty acids and endocrine-related gynecological cancer such as ovarian cancer and endometrial cancer. This study aimed to investigate this association using a meta-analysis of observational studies.

Materials and Methods

We searched PubMed, EMBASE, and Cochrane library by using key words related with the topic in April 2017. The pooled odd ratios (pORs), relative risks (pRRs), or hazard ratios (pHRs) with 95% confidence intervals (CIs) were calculated based on the random-effects model. Also, we performed subgroup meta-analysis by methodological quality, types of cancer, study design, and omega-3 fatty acids.

Results

A total of ten observational studies with six case-control and four cohort studies were included in the final meta-analysis. In the meta-analysis of all the studies, dietary intake of total omega-3 fatty acids was not significantly associated with the risk of endometrial and ovarian cancers (pOR/HR, 0.87; 95% CI, 0.73-1.04; I²=67.2%) (highest versus lowest intake). In the subgroup meta-analysis by type of study, there was no significant association between them in cohort studies (pHR, 1.03; 95% CI, 0.63-1.67, I²=81.9%), whereas its reduced risk was observed in case-control studies (pOR, 0.81; 95% CI, 0.67 to 0.98, I²=55.7%).

Conclusion

The current meta-analysis of observational studies suggests that there is no higher level of evidence to support the protective effect of dietary omega-3 fatty acids on endocrine-related gynecological cancer. Further prospective studies should be conducted to confirm the association.

Effects of Phytosterol Supplementation on Serum Levels of Lipid Profiles, Liver Enzymes, Inflammatory Markers, Adiponectin, and Leptin in Patients Affected by Nonalcoholic Fatty Liver Disease: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial

OBJECTIVE

Considering the high prevalence of nonalcoholic fatty liver disease and based on the evidence about the role of dietary cholesterol in liver inflammation, and also with regard to the effect of phytosterols on the metabolism of cholesterol, we aimed at exploring the therapeutic potential of phytosterol supplementation against nonalcoholic fatty liver disease.

METHOD

Thirty-eight patients with nonalcoholic fatty liver disease were randomly divided into two groups: The phytosterol group (n = 19) received a 1.6-g phytosterol supplement daily and the control group (n = 19) received 1.6 g starch daily as placebo for an 8-week period. Blood samples of all patients were taken at baseline (week 0) and at the end of the study (week 8) for measurement of lipid profiles, liver enzymes, inflammatory markers, adiponectin, and leptin.

RESULTS

Phytosterol supplementation significantly improved the levels of low-density lipoprotein cholesterol, aspartate aminotransferase, alanine aminotransferase, and tumor necrosis factor alpha compared to the placebo group. On the other hand, there were no significant differences between the two groups in total cholesterol, triglycerides, high-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, ratios of low-density lipoprotein cholesterol/high-density lipoprotein cholesterol and total cholesterol/high-density lipoprotein cholesterol, gamma-glutamyl transferase, interleukin 6, high-sensitivity C-reactive protein, adiponectin, and leptin.

CONCLUSIONS

The present study suggested that daily consumption of 1.6 g phytosterols efficiently lowers low-density lipoprotein cholesterol, aspartate aminotransferase, alanine aminotransferase, and tumor necrosis factor alpha in patients with nonalcoholic fatty liver disease.

How does high DHA fish oil affect health? A systematic review of evidence

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.

In vitro lipolytic, antioxidant and anti-inflammatory activities of roasted pistachio kernel and skin constituents

A comprehensive phytochemical analysis was conducted on pistachios to identify the differential contributions of skin and kernel phytochemicals to in vitro bioactivity. Qualitative and quantitative analyses of skin and kernel non-polar extracts (SNP and KNP, respectively) indicated that the major components are fatty acids (696.36 and 879.70 mg g^-1), phytosterols (16.08 and 4.28 mg g^-1), and γ-tocopherol (304.17 and 397.10 μg g^-1). Analysis of the skin and kernel polar extracts (SP and KP, respectively) showed that skin accumulated higher levels of phenolic compounds, especially flavan-3-ols, compared to the kernel. An (epi)catechin hexoside was the major component in SP and KP (9.8 mg g^-1 and 3.3 mg g^-1, respectively). Flavan-3-ols with different degrees of polymerization were detected in SP, but only the monomers were identified in the KP. Quercetin glycosides were the major flavonols present in both SP and KP. Bioassays with 3T3L1 mouse adipocytes demonstrated that all extracts decreased lipid accumulation, with SNP demonstrating the highest activity (17% inhibition). Bioassay guided fractionation of SNP indicated that the lipolytic activity was highest in the fraction consisting of linoleic acid (20%), linolenic acid (10%), and β-sitosterol (50%). Radical scavenging assays indicated that all pistachio extracts significantly inhibited ROS, while SP was the most inhibiting to NO production in LPS-stimulated RAW 264.7 macrophages. Gene expression profiles associated with inflammation (IL6, iNOS, and COX2) were characterized in the LPS-stimulated RAW264.7 macrophages after treatment with pistachio extracts. SP and KP were the most potent to inhibit the expression of COX2. The SNP had the strongest effect in decreasing non-mitochondrial oxidative burst associated with inflammatory response in macrophages.

Modulation of the gut microbiota by the mixture of fish oil and krill oil in high-fat diet-induced obesity mice

Previous studies confirmed that dietary supplements of fish oil and krill oil can alleviate obesity in mice, but the underlying mechanism remains unclear. This study aims to discern whether oil treatment change the structure of the gut microbiota during the obesity alleviation. The ICR mice received high-fat diet (HFD) continuously for 12 weeks after two weeks of acclimatization with a standard chow diet, and the mice fed with a standard chow diet were used as the control. In the groups that received HFD with oil supplementation, the weight gains were attenuated and the liver index, total cholesterol, triglyceride and low-density lipoprotein cholesterol were reduced stepwise compared with the HFD group, and the overall structure of the gut microbiota, which was modulated in the HFD group, was shifted toward the structure found in the control group. Moreover, eighty-two altered operational taxonomic units responsive to oil treatment were identified and nineteen of them differing in one or more parameters associated with obesity. In conclusion, this study confirmed the effect of oil treatment on obesity alleviation, as well as on the microbiota structure alterations. We proposed that further researches are needed to elucidate the causal relationship between obesity alleviation and gut microbiota modulation.

Nutritional modulation of metabolic inflammation

Metabolic inflammation is a very topical area of research, wherein aberrations in metabolic and inflammatory pathways probably contribute to atherosclerosis, insulin resistance (IR) and type 2 diabetes. Metabolic insults arising from obesity promote inflammation, which in turn impedes insulin signalling and reverse cholesterol transport (RCT). Key cells in the process are metabolically activated macrophages, which up-regulate both pro- and anti-inflammatory pathways in response to lipid spillover from adipocytes. Peroxisome proliferator-activated receptors and AMP-activated protein kinase (AMPK) are regulators of cellular homeostasis that influence both inflammatory and metabolic pathways. Dietary fats, such as saturated fatty acids (SFAs), can differentially modulate metabolic inflammation. Palmitic acid, in particular, is a well-characterized nutrient that promotes metabolic inflammation via the NLRP3 (the nod-like receptor containing a pyrin domain) inflammasome, which is partly attributable to AMPK inhibition. Conversely, some unsaturated fatty acids are less potent agonists of metabolic inflammation. For example, monounsaturated fatty acid does not reduce AMPK as potently as SFA and n-3 polyunsaturated fatty acids actively resolve inflammation via resolvins and protectins. Nevertheless, the full extent to which nutritional state modulates metabolic inflammation requires greater clarification.

Bioactive compounds as an alternative for drug co-therapy: Overcoming challenges in cardiovascular disease prevention

Different pharmacological interventions have been applied with success to reduce the progression of atherosclerosis. However, many patients are not good responders or must interrupt treatment due to adverse effects. Bioactive compounds such as omega-3 fatty acids (n-3 FA), plant sterol esters (PSE) and phenolic compounds (PHC) are natural molecules with great potential to reduce the atherosclerosis burden by reducing inflammation, LDL cholesterol (LDL-C) and oxidative stress, respectively. Although their physiological effects on biomarkers are much lower than those expected by drugs used for the same purpose, bioactive compounds can easily be incorporated into the daily diet and present no adverse effects. However, little is known about the combination of n-3 FA, PSE, PHC, and drugs in atherosclerosis progression. This review article summarizes potential effects of co-therapies involving n-3 FA, PSE, and PHC combined with major hypolipidemic drugs on atherosclerosis biomarkers and clinical outcomes. Evidence of additive and/or complementary effects regarding drugs action reveals possible roles for bioactive compounds in disease management. Pharmaceutical companies, physicians, and food scientists should be prepared to better understand this type of interaction and its consequences in terms of efficacy and life quality.

High fat diet and associated changes in the expression of micro-RNAs in tissue: Lessons learned from animal studies

Environment and genetic factors play an important role in the development of obesity, and diet is one of the main contributing factors to this disease. High fat intake is associated with body weight gain, leading to obesity and other metabolic diseases. MicroRNAs (miRNAs) are a group of small, noncoding RNAs that are important regulators of gene expression at posttranscriptional level. Studies have shown that high fat intake, independent of body weight status, can significantly impact both negatively and positively the expression of miRNAs and thus the biological function of tissues such as adipose, skeletal, and cardiac muscle, liver, neuronal, and endothelial. This review will summarize the effects of high calorie diet in the form of high fat intake on miRNA expression in various tissues of animal models and of high fat fed offspring. We will also briefly review the impact of different dietary lipids on miRNA expression. Given changes in miRNA expression have been associated with the development of many diseases including obesity, understanding their biological role could have important clinical implications and offer tangible therapeutic targets for the prevention, management, and/or treatment of obesity and other lifestyle-related disorders.

trans-Fatty acids promote proinflammatory signaling and cell death by stimulating the apoptosis signal-regulating kinase 1 (ASK1)-p38 pathway

Food-borne trans-fatty acids (TFAs) are mainly produced as byproducts during food manufacture. Recent epidemiological studies have revealed that TFA consumption is a major risk factor for various disorders, including atherosclerosis. However, the underlying mechanisms in this disease etiology are largely unknown. Here we have shown that TFAs potentiate activation of apoptosis signal-regulating kinase 1 (ASK1) induced by extracellular ATP, a damage-associated molecular pattern leaked from injured cells. Major food-associated TFAs such as elaidic acid (EA), linoelaidic acid, and trans-vaccenic acid, but not their corresponding cis isomers, dramatically enhanced extracellular ATP-induced apoptosis, accompanied by elevated activation of the ASK1-p38 pathway in a macrophage-like cell line, RAW264.7. Moreover, knocking out the ASK1-encoding gene abolished EA-mediated enhancement of apoptosis. We have reported previously that extracellular ATP induces apoptosis through the ASK1-p38 pathway activated by reactive oxygen species generated downstream of the P2X purinoceptor 7 (P2X₇). However, here we show that EA did not increase ATP-induced reactive oxygen species generation but, rather, augmented the effects of calcium/calmodulin-dependent kinase II-dependent ASK1 activation. These results demonstrate that TFAs promote extracellular ATP-induced apoptosis by targeting ASK1 and indicate novel TFA-associated pathways leading to inflammatory signal transduction and cell death that underlie the pathogenesis and progression of TFA-induced atherosclerosis. Our study thus provides insight into the pathogenic mechanisms of and proposes potential therapeutic targets for these TFA-related disorders.

Effects of Pomegranate Seed Oil on Metabolic State of Patients with Type 2 Diabetes Mellitus

BACKGROUND

Rapid increasing prevalence of diabetes mellitus is a serious health concern in the world. New data determined that the pathogenesis of diabetes mellitus is chronic low-grade inflammation, resulting insulin resistance. Pomegranate seed oil (PSO) has anti-inflammatory effects; though it may reduce insulin resistance and improve glycemia in diabetes mellitus. The present study has been designed to investigate the effects of PSO as a natural dietary component on metabolic state of patients with Type 2 diabetes mellitus.

METHODS

In a randomized double-blind clinical trial study, 80 patients (28 men) with Type 2 diabetes were randomly allocated to the intervention and control groups. The intervention group consumed PSO capsules, containing 1000 mg PSO twice daily (2000 mg PSO), whereas controls take placebo for 8 weeks. The participants followed their previous dietary patterns and medication use. Dietary factors and metabolic factors including lipid profile, fasting plasma sugar, and insulin and were assayed at the baseline and after 8 weeks.

RESULTS

Participants in two intervention and control group were similar regarding anthropometric and the dietary factors at baseline and after trial (P > 0.05). Mean level of total cholesterol, triglyceride, low-density lipoprotein-cholesterol, and high-density lipoprotein was not different significantly between groups after trial (P > 0.05). Consumption of PSO did not significantly affect the levels of parameters such as fasting blood sugar (FBS), insulin, HbA1c, alanine transferase, and homeostasis model assessment-insulin resistance.

CONCLUSIONS

Consumption of 2000mg PSO per day for 8 weeks had no effect on FBS, insulin resistance and lipid profile in diabetic patients.

Plant sterol-enriched soy milk consumption modulates 5-lipoxygenase, 12-lipoxygenase, and myeloperoxidase activities in healthy adults - a randomized-controlled trial

A randomized, double blind, placebo-controlled and crossover study was conducted to simultaneously measure the effects, after 3-h and 4-week daily exposure to plant sterols-enriched food product, on inflammation, oxidative status, 5-lipoxygenase, 12-lipoxygenase, and myeloperoxidase activities in healthy adults. Eighteen healthy participants (67% female, 35.3 (mean) ± 9.5 (SD) years, mean body mass index 22.8 kg m^-2) received two soy milk (20g) treatments daily: placebo and one containing 2.0 g free plant sterols equivalent of their palmitates (β-sitosterol, 55%; campesterol, 29%; stigmasterol, 23%). F₂-isoprostanes, leukotriene B₄, sitosterol, campesterol, and stigmasterol concentrations were measured in the blood plasma and urine, using stable isotope-labeled gas chromatography-mass spectrometry. High-sensitivity c-reactive protein, tumor necrosis factor-_α, and lipoxin A₄ concentrations in blood serum were measured using commercially available enzyme immunoassays. Myeloperoxidase activity, serum lipid hydroperoxides, plasma and urinary F₂-isoprostanes, plasma and urinary leukotriene B₄, and plasma high-sensitivity c-reactive protein concentrations were significantly reduced, while circulating lipoxin A₄ concentrations were significantly elevated after 4-week plant sterols treatment. Plant sterols treatment decreased plasma leukotriene B₄ and increased plasma lipoxin A₄ concentrations acutely. Total plant sterols, β-sitosterol, campesterol, and stigmasterol concentrations were significantly elevated after 4-week treatments compared with the pre-treatment concentrations. Our results suggest that dietary plant sterols, in the combination used, can alleviate lipid peroxidation and inflammatory events in vivo. These effects are possibly exerted via the modulation of myeloperoxidase, 5-lipoxygenase, and 12-lipoxygenase activities.

Impacto da suplementação com ácidos graxos ômega-3 nas subfrações da lipoproteína de alta densidade de indivíduos tabagistas

RESUMO Objetivo Avaliar o efeito da suplementação com ômega-3 nas subfrações das lipoproteínas de alta densidade em indivíduos tabagistas. Métodos Ensaio clínico, randomizado, duplo-cego. Foi selecionada uma amostra com 33 tabagistas, de ambos os sexos, com idade entre 30 e 60 anos, suplementados com ômega-3 (n=17) ou placebo (ácidos graxos ômega-6, n=16) por dois meses. As subfrações das lipoproteínas de alta densidade foram analisadas pelo sistema Lipoprint. Os testes estatísticos foram realizados com o auxílio do programa Statistical Package for the Social Sciences, versão 20.0. Resultados A média de idade foi 49 anos, com predominância da raça branca. Após a intervenção, o grupo ômega-3 modificou positivamente o perfil lipídico e as subfrações das lipoproteínas de alta densidade dos tabagistas. Nos modelos de regressão linear testados, o percentual de ácido docosahexaenoico plasmático apresentou associações negativas com o percentual das lipoproteínas de alta densidade-pequena. Conclusão A suplementação com ômega-3 está associada a uma alteração favorável na distribuição das subfrações das lipoproteínas de alta densidade, aumentando as lipoproteínas de alta densidade-grande e diminuindo as lipoproteínas de alta densidade-pequena. Isso reforça a importância do ômega-3 na saúde cardiovascular de indivíduos tabagistas.

Prevention of age-induced N(ε)-(carboxymethyl)lysine accumulation in the microvasculature

OBJECTIVE

N(ε)-(carboxymethyl)lysine (CML) is one of the major advanced glycation end products in both diabetics and nondiabetics. CML depositions in the microvasculature have recently been linked to the aetiology of acute myocardial infarction and cognitive impairment in Alzheimer's disease, possibly related to local enhancement of inflammation and oxidative processes. We hypothesized that CML deposition in the microvasculature of the heart and brain is age-induced and that it could be inhibited by a diet intervention with docosahexaenoic acid (DHA), an omega-3 fatty acid known for its anti-inflammatory and antioxidative actions.

MATERIALS AND METHODS

ApoE(-/-) mice (n = 50) were fed a Western diet and were sacrificed after 40, 70 and 90 weeks. Part of these mice (n = 20) were fed a Western diet enriched with DHA from 40 weeks on. CML in cardiac and cerebral microvessels was quantified using immunohistochemistry.

RESULTS

Cardiac microvascular depositions of CML significantly increased with an immunohistochemical score of 11·85 [5·92-14·60] at 40 weeks, to 33·17 [17·60-47·15] at 70 weeks (P = 0·005). At the same time points, cerebral microvascular CML increased from 6·45; [4·78-7·30] to 12·99; [9·85-20·122] (P = 0·003). DHA decreased CML in the intramyocardial vasculature at both 70 and 90 weeks, significant at 70 weeks [33·17; (17·60-47·15) vs. 14·73; (4·44-28·16) P = 0·037]. No such effects were found in the brain.

CONCLUSIONS

Accumulation of N(ε)-(carboxymethyl)lysine in the cerebral and cardiac microvasculature is age-induced and is prevented by DHA in the intramyocardial vessels of ApoE(-/-) mice.

Associations of Dietary Long-Chain ω-3 Polyunsaturated Fatty Acids and Fish Consumption With Endometrial Cancer Risk in the Black Women's Health Study

Dietary long-chain (LC) ω-3 polyunsaturated fatty acids (PUFAs), which derive primarily from intakes of fatty fish, are thought to inhibit inflammation and de novo estrogen synthesis. This study prospectively examined the associations of dietary LC ω-3 PUFAs and fish with endometrial cancer risk in 47,602 African-American women living in the United States, aged 21-69 years at baseline in 1995, and followed them until 2013 (n = 282 cases). Multivariable-adjusted Cox regression models estimated hazard ratios and 95% confidence intervals for associations of LC ω-3 PUFA (quintiled) and fish (quartiled) intake with endometrial cancer risk, overall and by body mass index (BMI; weight (kg)/height (m)(2)). The hazard ratio for quintile 5 of total dietary LC ω-3 PUFAs versus quintile 1 was 0.79 (95% confidence interval (CI): 0.51, 1.24); there was no linear trend. Hazard ratios for the association were smaller among normal-weight women (BMI <25: hazard ratio (HR) = 0.53, 95% CI: 0.18, 1.58) than among overweight/obese women (BMI ≥ 25: HR = 0.88, 95% CI: 0.54, 1.43), but these differences were not statistically significant. Fish intake was also not associated with risk (quartile 4 vs. quartile 1: HR = 0.86, 95% CI: 0.56, 1.31). Again hazard ratios were smaller among normal-weight women (HR = 0.65) than among overweight/obese women (HR = 0.94). While compatible with no association, the hazard ratios observed among leaner African-American women are similar to those from recent prospective studies conducted in predominantly white populations.

The metabolic change of serum lysophosphatidylcholines involved in the lipid lowering effect of triterpenes from Alismatis rhizoma on high-fat diet induced hyperlipidemia mice

ETHNOPHARMACOLOGICAL RELEVANCE

Alismatis rhizoma (AR), a Traditional Chinese Medicine with lipid-regulating properties, is usually used to treat hyperlipidemia. Lysophosphatidylcholines (Lyso PCs) play a crucial role in lipid metabolism disorders. In this study, the triterpene fraction purified from boiling water extract of AR was evaluated for its lipid lowering activity using mice with high-fat diet (HFD) induced hyperlipidemia. The metabolic changes of individual Lyso PCs treated with the triterpene fraction were detected by ultra-high performance liquid chromatography-triple quadrupole-linear ion trap mass spectrometer (UHPLC-QTRAP-MS/MS).

MATERIALS AND METHODS

HFD induced hyperlipidemia mice were administrated with triterpene and non-triterpene fractions at doses of 180, 360 and 720 mg/kg body weight/day for 4 weeks, respectively. Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and atherogenic Index (AI) in mice serum were measured. The chemical components in the lipid-lowering fraction were characterized by ultra-high performance liquid chromatography-quadrupole time of flight tandem mass spectrometry (UHPLC-QTOF-MS/MS). The changes of Lyso PC in the serum of mice treated with the lipid-lowering fraction were quantified by UHPLC-QTRAP-MS/MS.

RESULTS

A total of 18 alisol derivatives were identified in the triterpene fraction. The hyperlipidemia mice treated with the triterpene fraction showed a significant decrease in serum TC, LDL-C and AI after continuous consumption of HFD for 4 weeks. The results also showed that 27 serum Lyso PCs in mice fed with HFD were down-regulated, and 19 were up-regulated. The abnormal serum level of Lyso PCs associated with hyperlipidemia was intervened by the alisol derivatives, with increase of unsaturated Lyso PCs and decrease of saturated ones.

CONCLUSIONS

The study demonstrated for the first time that triterpenes from the AR extract can lower serum lipid level in HFD induced hyperlipidemia mice. These metabolism changes of Lyso PCs could further improve our understanding of the potential mechanism of lipid lowering effect of AR.

Exploration of the preventive effect of S. lessoniana liver oil on cardiac markers, hematological patterns and lysosomal hydrolases in isoproterenol-induced myocardial infarction in wistar rats: a novel report

The purpose of this study was to explore thein vivocardioprotective potency of liver (digestive gland) oil fromS. lessonianaon isoproterenol induced myocardial infracted wistar rats.

Associations of erythrocyte ω-3 fatty acids with biomarkers of ω-3 fatty acids and inflammation in breast tissue

There is increasing evidence that chronic inflammation is associated with increased breast cancer risk. Long-chain omega-3 polyunsaturated fatty acids (LCω-3PUFA) may reduce circulating biomarkers of inflammation; however associations of blood LCω-3PUFA with breast tissue LCω-3PUFA and breast tissue biomarkers of inflammation are not well understood. We conducted a cross-sectional analysis of breast tissue and blood samples from n = 85 women with no history of breast cancer, who underwent breast reduction surgery. Fatty acids of erythrocytes and undissected breast tissues were analyzed by gas chromatography; C-reactive protein (CRP), interleukin (IL)-6 and IL-8 in plasma and tissue were measured by ELISA. Multivariable-adjusted regression models were used to estimate associations between erythrocyte LCω-3PUFA and breast tissue biomarkers. Women in the highest erythrocyte LCω-3PUFA tertile had LCω-3PUFA concentrations in the breast 73% (95% CI: 31-128%; p trend < 0.0001) higher than women in the lowest tertile. Associations for each individual LCω-3PUFA were similar in magnitude. No significant association was found for the shorter ω-3 PUFA, α-linolenic acid. Although compatible with no association, women in the highest tertile of erythrocyte eicosapentaenoic acid had a nonsignificant 32% (95% CI: -23 to 62%) reduced breast tissue CRP. No correlation was observed between erythrocyte ω-3 PUFA and tissue IL-6 or IL-8 concentrations. Our findings provide evidence that erythrocyte ω-3 fatty acids are valid measures of breast tissue concentrations, and limited evidence that inverse associations from prospective epidemiologic studies of blood LCω-3PUFA and breast cancer risk may be partly explained by reductions in breast tissue inflammation; however, these findings require replication.

Long-chain ω-3 fatty acid intake and endometrial cancer risk in the Women's Health Initiative

BACKGROUND

Inflammation may be important in endometrial cancer development. Long-chain ω-3 (n-3) polyunsaturated fatty acids (LCω-3PUFAs) may reduce inflammation and, therefore, reduce cancer risk. Because body mass is associated with both inflammation and endometrial cancer risk, it may modify the association of fat intake on risk.

OBJECTIVE

We examined whether intakes of LCω-3PUFAs were associated with endometrial cancer risk overall and stratified by body size and histologic subtype.

DESIGN

Women were n = 87,360 participants of the Women's Health Initiative Observational Study and Clinical Trials who were aged 50-79 y, had an intact uterus, and completed a baseline food-frequency questionnaire. After 13 y of follow-up, n = 1253 incident invasive endometrial cancers were identified. Cox regression models were used to estimate HRs and 95% CIs for the association of intakes of individual ω-3 fatty acids and fish with endometrial cancer risk.

RESULTS

Intakes of individual LCω-3PUFAs were associated with 15-23% linear reductions in endometrial cancer risk. In women with body mass index (BMI; in kg/m(2)) <25, those in the upper compared with lowest quintiles of total LCω-3PUFA intake (sum of eicosapentaenoic, docosapentaenoic, and docosahexaenoic acids) had significantly reduced endometrial cancer risk (HR: 0.59; 95% CI: 0.40, 0.82; P-trend = 0.001), whereas there was little evidence of an association in overweight or obese women. The reduction in risk observed in normal-weight women was further specific to type I cancers.

CONCLUSIONS

Long-chain ω-3 intake was associated with reduced endometrial cancer risk only in normal-weight women. Additional studies that use biomarkers of ω-3 intake are needed to more accurately estimate their effects on endometrial cancer risk. This trial was registered at clinicaltrials.gov as NCT00000611.

Omega-3 fatty acids and inflammation: a perspective on the challenges of evaluating efficacy in clinical research

Chronic inflammation is a common underpinning of many diseases. There is a strong pre-clinical evidence base demonstrating the efficacy of omega-3 fatty acids for ameliorating inflammation and thereby reducing disease burden. Clinically, C-reactive protein (CRP) serves as both a reliable marker for monitoring inflammation and a modifiable endpoint for studies of anti-inflammatory pharmaceuticals. However, clinical omega-3 fatty acid supplementation trials have not replicated pre-clinical findings in terms of consistent CRP reductions. Methodological differences present numerous challenges in translating pre-clinical evidence to clinical results. It is crucial that future clinical nutrition research clearly distinguish between the reversal of established inflammation and preventing the development of inflammation. Future clinical studies evaluating the ability of omega-3 fatty acids to attenuate an excessive inflammatory response, may be advanced by employing new statistical approaches and utilizing models of induced inflammation, such as low-dose human endotoxemia.