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Bernhard B, Heydari B, Abdullah S, Francis SA, Lumish H, Wang W, Jerosch-Herold M, Harris WS, Kwong RY. Effect of six month's treatment with omega-3 acid ethyl esters on long-term outcomes after acute myocardial infarction: The OMEGA-REMODEL randomized clinical trial. Int J Cardiol 2024; 399:131698. [PMID: 38184150 DOI: 10.1016/j.ijcard.2023.131698] [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] [Received: 09/29/2023] [Revised: 12/15/2023] [Accepted: 12/29/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Omega-3 polyunsaturated fatty acids (O3-FA) have been shown to reduce inflammation and adverse cardiac remodeling after acute myocardial infarction (AMI). However, the impact of O3-FA on long-term clinical outcomes remains uncertain. AIMS To investigate the impact of O3-FA on adverse cardiac events in long-term follow up post AMI in a pilot-study. METHODS Consecutive patients with AMI were randomized 1:1 to receive 6 months of O3-FA (4 g/daily) or placebo in the prospective, multicenter OMEGA-REMODEL trial. Primary endpoint was a composite of major adverse cardiovascular events (MACE) encompassing all-cause death, heart failure hospitalizations, recurrent acute coronary syndrome, and late coronary artery bypass graft (CABG). RESULTS A total of 358 patients (62.8% male; 48.1 ± 16.1 years) were followed for a median of 6.6 (IQR: 5.0-9.1) years. Among those receiving O3-FA (n = 180), MACE occurred in 65 (36.1%) compared to 62 (34.8%) of 178 assigned to placebo. By intention-to-treat analysis, O3-FA treatment assignment did not reduce MACE (HR = 1.014; 95%CI = 0.716-1.436; p = 0.938), or its individual components. However, patients with a positive response to O3-FA treatment (n = 43), defined as an increase in the red blood cell omega-3 index (O3I) ≥5% after 6 months of treatment, had lower annualized MACE rates compared to those without (2.9% (95%CI = 1.2-5.1) vs 7.1% (95%CI = 5.7-8.9); p = 0.001). This treatment benefit persisted after adjustment for baseline characteristics (HRadjusted = 0.460; 95%CI = 0.218-0.970; p = 0.041). CONCLUSION In long-term follow-up of the OMEGA-REMODEL randomized trial, O3-FA did not reduce MACE after AMI by intention to treat principle, however, patients who achieved a ≥ 5% increase of O3I subsequent to treatment had favorable outcomes.
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Affiliation(s)
- Benedikt Bernhard
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Bobak Heydari
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Stephenson Cardiac Imaging Center, University of Calgary, Calgary, Alberta, Canada
| | - Shuaib Abdullah
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; VA North Texas Medical Center and University of Texas-Southwestern Medical School, Dallas, TX, USA
| | - Sanjeev A Francis
- Department of Cardiovascular Medicine, Maine Medical Center, Portland, USA
| | - Heidi Lumish
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Wei Wang
- Division of Sleep Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Michael Jerosch-Herold
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - William S Harris
- Fatty Acid Research Institute, Sioux Falls, SD 57106, USA; Sanford School of Medicine, University of South Dakota, Sioux Falls, SD 57105, USA
| | - Raymond Y Kwong
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
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Reiner MF, Bertschi DA, Werlen L, Wiencierz A, Aeschbacher S, Lee P, Rodondi N, Moutzouri E, Bonati L, Reichlin T, Moschovitis G, Rutishauser J, Kühne M, Osswald S, Conen D, Beer JH. Omega-3 Fatty Acids and Markers of Thrombosis in Patients with Atrial Fibrillation. Nutrients 2024; 16:178. [PMID: 38257071 PMCID: PMC10821080 DOI: 10.3390/nu16020178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/25/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024] Open
Abstract
Omega-3 fatty acids (n-3 FAs) are associated with a lower risk of ischemic stroke in patients with atrial fibrillation (AF). Antithrombotic mechanisms may in part explain this observation. Therefore, we examined the association of n-3 FAs with D-dimer and beta-thromboglobulin (BTG), markers for activated coagulation and platelets, respectively. The n-3 FAs eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), docosapentaenoic acid (DPA) and alpha-linolenic acid (ALA) were determined via gas chromatography in the whole blood of 2373 patients with AF from the Swiss Atrial Fibrillation cohort study (ClinicalTrials.gov Identifier: NCT02105844). In a cross-sectional analysis, we examined the association of total n-3 FAs (EPA + DHA + DPA + ALA) and the association of individual fatty acids with D-dimer in patients with detectable D-dimer values (n = 1096) as well as with BTG (n = 2371) using multiple linear regression models adjusted for confounders. Median D-dimer and BTG levels were 0.340 ug/mL and 448 ng/mL, respectively. Higher total n-3 FAs correlated with lower D-dimer levels (coefficient 0.94, 95% confidence interval (Cl) 0.90-0.98, p = 0.004) and lower BTG levels (coefficient 0.97, Cl 0.95-0.99, p = 0.003). Likewise, the individual n-3 FAs EPA, DHA, DPA and ALA showed an inverse association with D-dimer. Higher levels of DHA, DPA and ALA correlated with lower BTG levels, whereas EPA showed a positive association with BTG. In patients with AF, higher levels of n-3 FAs were associated with lower levels of D-dimer and BTG, markers for activated coagulation and platelets, respectively. These findings suggest that n-3 FAs may exert antithrombotic properties in patients with AF.
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Affiliation(s)
- Martin F. Reiner
- Department of Cardiology, University Heart Center Zurich, 8091 Zurich, Switzerland;
| | - Daniela A. Bertschi
- Department of Internal Medicine, Cantonal Hospital of Baden, 5404 Baden, Switzerland
| | - Laura Werlen
- Department of Clinical Research, University of Basel, University Hospital Basel, 3010 Basel, Switzerland
| | - Andrea Wiencierz
- Department of Clinical Research, University of Basel, University Hospital Basel, 3010 Basel, Switzerland
| | - Stefanie Aeschbacher
- Department of Cardiology, University Hospital Basel, 4056 Basel, Switzerland
- Cardiovascular Research Institute Basel, University Hospital Basel, 4056 Basel, Switzerland
| | - Pratintip Lee
- Center for Molecular Cardiology, Laboratory for Platelet Research, University of Zurich, 8952 Zurich, Switzerland
| | - Nicolas Rodondi
- Department of General Internal Medicine, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, 3010 Bern, Switzerland
| | - Elisavet Moutzouri
- Institute of Primary Health Care (BIHAM), University of Bern, 3010 Bern, Switzerland
| | - Leo Bonati
- Department of Neurology and Stroke Center, University Hospital Basel, 4031 Basel, Switzerland
| | - Tobias Reichlin
- Department of Cardiology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
| | - Giorgio Moschovitis
- Division of Cardiology, Ospedale Regionale di Lugano, 6900 Ticino, Switzerland
| | - Jonas Rutishauser
- Department of Internal Medicine, Cantonal Hospital of Baden, 5404 Baden, Switzerland
- Center for Molecular Cardiology, Laboratory for Platelet Research, University of Zurich, 8952 Zurich, Switzerland
| | - Michael Kühne
- Department of Cardiology, University Hospital Basel, 4056 Basel, Switzerland
- Cardiovascular Research Institute Basel, University Hospital Basel, 4056 Basel, Switzerland
| | - Stefan Osswald
- Department of Cardiology, University Hospital Basel, 4056 Basel, Switzerland
- Cardiovascular Research Institute Basel, University Hospital Basel, 4056 Basel, Switzerland
| | - David Conen
- Population Health Research Institute, McMaster University, Hamilton, ON L8L 2X2, Canada
| | - Jürg H. Beer
- Department of Internal Medicine, Cantonal Hospital of Baden, 5404 Baden, Switzerland
- Center for Molecular Cardiology, Laboratory for Platelet Research, University of Zurich, 8952 Zurich, Switzerland
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3
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Hooks MP, Madigan SM, Woodside JV, Nugent AP. Dietary Intake, Biological Status, and Barriers towards Omega-3 Intake in Elite Level (Tier 4), Female Athletes: Pilot Study. Nutrients 2023; 15:2821. [PMID: 37447148 DOI: 10.3390/nu15132821] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 07/15/2023] Open
Abstract
Omega-3 polyunsaturated fatty acids (n-3 PUFA) have unique properties which benefit athlete populations. The literature investigating NCAA collegiate, rugby sevens and German endurance athletes indicates suboptimal n-3 PUFA dietary intake and biological status. The aims of this study were: (i) to explore the dietary intakes and FA profiles of elite level, team-based, female athletes and (ii) to understand perceived barriers towards achieving n-3 dietary guidelines. A total of 35 athletes (24.8 ± 4.5 years) completed both a questionnaire and a finger prick test. All the participants reported consuming fish and seafood over the previous six months however only nine athletes consumed ≥ 2 servings of fish per week. Four participants reported using an n-3 supplement. The mean omega-3 index (O3I; including supplementers) was below target levels of >8% (5.19 ± 0.86%). O3I was significantly higher (p < 0.001) in those consuming ≥ 2 servings of fish per week and/or supplements (5.91 ± 0.81%) compared with those who did not (4.82 ± 0.63%). The main barriers reported by those not consuming two servings of fish per week were sensory (n = 11; 42%), cooking skills (n = 10; 38%) and knowledge of n-3 benefits (n = 7; 27%). The current study shows that elite level female athletes present with suboptimal n-3 dietary intake and O3I due to their food preferences, cooking skills and n-3 knowledge.
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Affiliation(s)
- Matthew P Hooks
- School of Biological Sciences, Institute for Global Food Security, Queen's University Belfast, Belfast BT9 5DL, Northern Ireland, UK
| | - Sharon M Madigan
- Sport Ireland Institute of Sport, D15 Y52H Dublin, Ireland
- Sport and Human Performance Research Centre, University of Limerick, V94 T9PX Limerick, Ireland
- Department of Physical Education and Sport Sciences, University of Limerick, V94 T9PX Limerick, Ireland
| | - Jayne V Woodside
- Centre for Public Health, Institute for Global Food Security, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT9 7BL, Northern Ireland, UK
| | - Anne P Nugent
- School of Biological Sciences, Institute for Global Food Security, Queen's University Belfast, Belfast BT9 5DL, Northern Ireland, UK
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, D04 V1W8 Dublin, Ireland
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4
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Damaiyanti DW, Tsai ZY, Masbuchin AN, Huang CY, Liu PY. Interplay between fish oil, obesity and cardiometabolic diabetes. J Formos Med Assoc 2023:S0929-6646(23)00098-0. [DOI: 10.1016/j.jfma.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 02/24/2023] [Accepted: 03/14/2023] [Indexed: 03/31/2023] Open
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Grundler F, Viallon M, Mesnage R, Ruscica M, von Schacky C, Madeo F, Hofer SJ, Mitchell SJ, Croisille P, Wilhelmi de Toledo F. Long-term fasting: Multi-system adaptations in humans (GENESIS) study-A single-arm interventional trial. Front Nutr 2022; 9:951000. [PMID: 36466423 PMCID: PMC9713250 DOI: 10.3389/fnut.2022.951000] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 10/31/2022] [Indexed: 09/10/2024] Open
Abstract
Fasting provokes fundamental changes in the activation of metabolic and signaling pathways leading to longer and healthier lifespans in animal models. Although the involvement of different metabolites in fueling human fasting metabolism is well known, the contribution of tissues and organs to their supply remains partly unclear. Also, changes in organ volume and composition remain relatively unexplored. Thus, processes involved in remodeling tissues during fasting and food reintroduction need to be better understood. Therefore, this study will apply state-of-the-art techniques to investigate the effects of long-term fasting (LF) and food reintroduction in humans by a multi-systemic approach focusing on changes in body composition, organ and tissue volume, lipid transport and storage, sources of protein utilization, blood metabolites, and gut microbiome profiles in a single cohort. This is a prospective, single-arm, monocentric trial. One hundred subjects will be recruited and undergo 9 ± 3 day-long fasting periods (250 kcal/day). We will assess changes in the composition of organs, bones and blood lipid profiles before and after fasting, as well as high-density lipoprotein (HDL) transport and storage, untargeted metabolomics of peripheral blood mononuclear cells (PBMCs), protein persulfidation and shotgun metagenomics of the gut microbiome. The first 32 subjects, fasting for 12 days, will be examined in more detail by magnetic resonance imaging (MRI) and spectroscopy to provide quantitative information on changes in organ volume and function, followed by an additional follow-up examination after 1 and 4 months. The study protocol was approved by the ethics board of the State Medical Chamber of Baden-Württemberg on 26.07.2021 and registered at ClinicalTrials.gov (NCT05031598). The results will be disseminated through peer-reviewed publications, international conferences and social media. Clinical trial registration [ClinicalTrials.gov], identifier [NCT05031598].
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Affiliation(s)
| | - Magalie Viallon
- UJM-Saint-Etienne, INSA, CNRS UMR 5520, INSERM U1206, CREATIS, F-42023, Université de Lyon, Saint-Étienne, France
- Department of Radiology, University Hospital Saint-Étienne, Saint-Étienne, France
| | - Robin Mesnage
- Buchinger Wilhelmi Clinic, Überlingen, Germany
- Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
| | - Massimiliano Ruscica
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Frank Madeo
- Institute of Molecular Biosciences, NAWI Graz, University of Graz, Graz, Austria
- BioHealth Graz, Graz, Austria
- BioTechMed Graz, Graz, Austria
| | - Sebastian J. Hofer
- Institute of Molecular Biosciences, NAWI Graz, University of Graz, Graz, Austria
- BioHealth Graz, Graz, Austria
- BioTechMed Graz, Graz, Austria
| | - Sarah J. Mitchell
- Department of Health Sciences and Technology, ETH Zürich, Schwerzenbach, Switzerland
| | - Pierre Croisille
- UJM-Saint-Etienne, INSA, CNRS UMR 5520, INSERM U1206, CREATIS, F-42023, Université de Lyon, Saint-Étienne, France
- Department of Radiology, University Hospital Saint-Étienne, Saint-Étienne, France
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6
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Heffernan M, Doherty LC, Hack Mendes R, Clarke M, Hodge S, Clements M, McAnena L, Rivelsrud M, Ward M, Strain JJ, McNulty H, Brennan L. Effectiveness of a fortified drink in improving B vitamin biomarkers in older adults: a controlled intervention trial. Nutr Metab (Lond) 2021; 18:104. [PMID: 34876175 PMCID: PMC8650259 DOI: 10.1186/s12986-021-00630-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/25/2021] [Indexed: 11/10/2022] Open
Abstract
Background Older adults are reported to have sub-optimal B vitamin status; targeted food-based solutions may help to address this. The objectives of the OptiAge food intervention study were to develop and investigate the effectiveness of a B vitamin-fortified drink in improving B vitamin biomarkers in older Irish adults with a primary outcome of change in the B vitamin biomarker status. Methods A double-blinded randomised controlled trial was performed in parallel at University College Dublin and Ulster University. Participants aged > 50 years were recruited following screening for exclusion criteria (i.e. taking medications known to interfere with B vitamin metabolism, supplements containing B vitamins, consuming > 4 portions of B vitamin-fortified foods per week or diagnosed with gastrointestinal, liver or pulmonary disease). Recruited participants meeting the inclusion criteria were randomised (by sex and study centre) to receive daily for 16 weeks either B vitamin-fortified or placebo drinks as developed by Smartfish, Norway. Each B vitamin-fortified drink (200 ml) contained 200 µg folic acid, 10 µg vitamin B12, 10 mg vitamin B6 and 5 mg riboflavin, while the placebo was an identical, isocaloric formulation without added B vitamins. Fasting blood samples were collected pre- and post-intervention which were used to measure the primary outcome of change in B vitamin biomarker levels. Results A total of 95 participants were randomised, of which 81 commenced the trial. Of these, 70 completed (37 in the active and 33 in the placebo groups). Intention to treat (ITT) analysis of the B vitamins demonstrated a significant improvement in all B vitamin biomarkers in the active compared to placebo groups: p < 0.01 for each of serum folate, serum vitamin B12 and plasma pyridoxal 5′-phosphate (vitamin B6) and the functional riboflavin biomarker, erythrocyte glutathione reductase activation coefficient (EGRac). Correspondingly, a significant lowering of serum homocysteine from 11.9 (10.3–15.1) µmol/L to 10.6 (9.4–13.0) µmol/L was observed in response to the active treatment (P < 0.001). Similar results were seen in a per-protocol analysis. Conclusions The results demonstrate that a B vitamin-fortified drink was effective in optimising B vitamin status, making this a useful intervention option to improve B vitamin status in older adults. Trial registration ISRCTN, ISRCTN61709781—Retrospectively registered, https://www.isrctn.com/ISRCTN61709781 Supplementary Information The online version contains supplementary material available at 10.1186/s12986-021-00630-8.
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Affiliation(s)
- Maria Heffernan
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Leanne C Doherty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Roberta Hack Mendes
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Michelle Clarke
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Stephanie Hodge
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Michelle Clements
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Liadhan McAnena
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | | | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Lorraine Brennan
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland.
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O'Mahoney LL, Churm R, Stavropoulos-Kalinoglou A, Ajjan RA, Orsi NM, Mappa G, Price OJ, Campbell MD. Associations Between Erythrocyte Membrane Fatty Acid Compositions and Biomarkers of Vascular Health in Adults With Type 1 Diabetes With and Without Insulin Resistance: A Cross-Sectional Analysis. Can J Diabetes 2021; 46:111-117. [PMID: 34353737 DOI: 10.1016/j.jcjd.2021.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/06/2021] [Accepted: 06/18/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to assess the relationship between specific erythrocyte fatty acid levels and vascular health in type 1 diabetes (T1D) with and without insulin resistance (IR). METHODS We analyzed baseline pretreatment data in a subset of 23 patients with T1D from a previously published randomized controlled trial consisting of comprehensive erythrocyte-derived fatty acid profiles and a panel of inflammation-associated endothelial markers. Estimated glucose disposal rate was used to identify and categorize patients with IR. We utilized principal component analysis (PCA) to cluster vascular biomarkers to compute a single "vascular signal" and utilized univariate linear regression models to investigate the association with IR and fatty acid profiles. RESULTS Subjects with IR displayed significantly higher levels of linoleic acid (p=0.001), lower levels of eicosapentaenoic acid (EPA) (p<0.001), lower levels of omega-3 polyunsaturated fatty acid (n-3PUFA) (p<0.006) and an increased omega-6 (n-6)PUFA:n-3PUFA ratio (p=0.001). IR was associated with significantly higher linoleic acid levels, total n-6PUFA and an increased ratio of n-6PUFA:n-3PUFA, and negatively associated with arachidonic acid and EPA levels, total saturated fatty acid and total n-3PUFA. The PCA-derived vascular biomarker cluster was positively associated with linoleic acid and n-6PUFA:n-3PUFA ratio, and inversely associated with EPA. CONCLUSIONS Specific erythrocyte membrane fatty acid compositions are associated with impaired vascular health and IR in adults with T1D. These findings suggest that IR and risk of associated complications may be influenced by specific fatty acid profiles, and thus potentially modified by the selective targeting of dietary fatty acids.
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Affiliation(s)
- Lauren L O'Mahoney
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, United Kingdom; Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom.
| | - Rachel Churm
- Applied Sports, Technology, Exercise and Medicine Research Centre, Swansea University, Swansea, United Kingdom
| | | | - Ramzi A Ajjan
- Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Nicolas M Orsi
- Leeds Institute of Medical Research at St James's, St James's University Hospital, Leeds, United Kingdom
| | - Georgia Mappa
- Leeds Institute of Medical Research at St James's, St James's University Hospital, Leeds, United Kingdom
| | - Oliver J Price
- Leeds Institute of Medical Research at St James's, St James's University Hospital, Leeds, United Kingdom; School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, UK
| | - Matthew D Campbell
- Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom; School of Food Science and Biotechnology, Zhejiang Gongshang University, Hangzhou, China; Institute of Health Sciences and Wellbeing, University of Sunderland, Sunderland, United Kingdom
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8
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Reiner MF, Baumgartner P, Wiencierz A, Coslovsky M, Bonetti NR, Filipovic MG, Montrasio G, Aeschbacher S, Rodondi N, Baretella O, Kühne M, Moschovitis G, Meyre P, Bonati LH, Lüscher TF, Camici GG, Osswald S, Conen D, Beer JH. The Omega-3 Fatty Acid Eicosapentaenoic Acid (EPA) Correlates Inversely with Ischemic Brain Infarcts in Patients with Atrial Fibrillation. Nutrients 2021; 13:651. [PMID: 33671288 PMCID: PMC7922349 DOI: 10.3390/nu13020651] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/06/2021] [Accepted: 02/09/2021] [Indexed: 02/04/2023] Open
Abstract
The omega-3 fatty acid (n-3 FA) eicosapentaenoic acid (EPA) reduces stroke in patients with atherosclerotic cardiovascular disease. Whether EPA affects stroke or cerebral small vessel dis-ease in patients with atrial fibrillation (AF) remains uncertain. EPA, docosahexaenoic acid (DHA), docosapentaenoic acid (DPA), and alpha-linolenic acid (ALA) were determined by gas chromatography in 1657 AF patients from the Swiss Atrial Fibrillation study. All patients underwent brain MRI to detect ischemic brain infarcts, classified as large noncortical or cortical infarcts (LNCCIs); markers of small vessel disease, classified as small noncortical infarcts (SNCIs), number of microbleeds, and white matter lesion (WML) volumes. Individual and total n-3 FAs (EPA + DHA + DPA + ALA) were correlated with LNCCIs and SNCIs using logistic regression, with numbers of microbleeds using a hurdle model, and WML volumes using linear regression. LNCCIs were detected in 372 patients (22.5%). EPA correlated inversely with the prevalence of LNCCIs (odds ratio [OR] 0.51 per increase of 1 percentage point EPA, 95% confidence interval [CI] 0.29-0.90). DPA correlated with a higher LNCCI prevalence (OR 2.48, 95%CI 1.49-4.13). No associations with LNCCIs were found for DHA, ALA, and total n-3 FAs. Neither individual nor total n-3 FAs correlated with markers of small vessel disease. In conclusion, EPA correlates inversely with the prevalence of ischemic brain infarcts, but not with markers of small vessel disease in patients with AF.
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Affiliation(s)
- Martin F. Reiner
- Department of Internal Medicine, Cantonal Hospital of Baden, 5404 Baden, Switzerland; (M.F.R.); (N.R.B.); (G.M.)
| | - Philipp Baumgartner
- Department of Neurology, University Hospital of Zurich, 8091 Zurich, Switzerland;
| | - Andrea Wiencierz
- Clinical Trial Unit University Hospital of Basel, 4031 Basel, Switzerland; (A.W.); (M.C.)
| | - Michael Coslovsky
- Clinical Trial Unit University Hospital of Basel, 4031 Basel, Switzerland; (A.W.); (M.C.)
| | - Nicole R. Bonetti
- Department of Internal Medicine, Cantonal Hospital of Baden, 5404 Baden, Switzerland; (M.F.R.); (N.R.B.); (G.M.)
- Center for Molecular Cardiology, Laboratory for Platelet Research, University of Zurich, 8952 Schlieren, Switzerland; (T.F.L.); (G.G.C.)
| | - Mark G. Filipovic
- Institute of Anesthesiology, Cantonal Hospital Winterthur, 8400 Winterthur, Switzerland;
| | - Giulia Montrasio
- Department of Internal Medicine, Cantonal Hospital of Baden, 5404 Baden, Switzerland; (M.F.R.); (N.R.B.); (G.M.)
| | - Stefanie Aeschbacher
- Department of Cardiology, University Hospital of Basel, 4031 Basel, Switzerland; (S.A.); (M.K.); (P.M.); (S.O.)
- Cardiovascular Research Institute Basel, University Hospital of Basel, 4031 Basel, Switzerland;
| | - Nicolas Rodondi
- Department of General Internal Medicine, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (N.R.); (O.B.)
- Institute of Primary Health Care (BIHAM), University of Bern, 3010 Bern, Switzerland
| | - Oliver Baretella
- Department of General Internal Medicine, Bern University Hospital, University of Bern, 3010 Bern, Switzerland; (N.R.); (O.B.)
- Institute of Primary Health Care (BIHAM), University of Bern, 3010 Bern, Switzerland
| | - Michael Kühne
- Department of Cardiology, University Hospital of Basel, 4031 Basel, Switzerland; (S.A.); (M.K.); (P.M.); (S.O.)
- Cardiovascular Research Institute Basel, University Hospital of Basel, 4031 Basel, Switzerland;
| | - Giorgio Moschovitis
- Division of Cardiology, Ospedale Regionale di Lugano, 6900 Ticino, Switzerland;
| | - Pascal Meyre
- Department of Cardiology, University Hospital of Basel, 4031 Basel, Switzerland; (S.A.); (M.K.); (P.M.); (S.O.)
- Cardiovascular Research Institute Basel, University Hospital of Basel, 4031 Basel, Switzerland;
| | - Leo H. Bonati
- Department of Neurology and Stroke Center, University Hospital Basel, University of Basel, 4031 Basel, Switzerland;
| | - Thomas F. Lüscher
- Center for Molecular Cardiology, Laboratory for Platelet Research, University of Zurich, 8952 Schlieren, Switzerland; (T.F.L.); (G.G.C.)
- Royal Brompton and Harefield Hospitals, London SW3 6NP, UK
- Imperial College, London SW7 2BU, UK
| | - Giovanni G. Camici
- Center for Molecular Cardiology, Laboratory for Platelet Research, University of Zurich, 8952 Schlieren, Switzerland; (T.F.L.); (G.G.C.)
| | - Stefan Osswald
- Department of Cardiology, University Hospital of Basel, 4031 Basel, Switzerland; (S.A.); (M.K.); (P.M.); (S.O.)
- Cardiovascular Research Institute Basel, University Hospital of Basel, 4031 Basel, Switzerland;
| | - David Conen
- Cardiovascular Research Institute Basel, University Hospital of Basel, 4031 Basel, Switzerland;
- Population Health Research Institute, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Jürg H. Beer
- Department of Internal Medicine, Cantonal Hospital of Baden, 5404 Baden, Switzerland; (M.F.R.); (N.R.B.); (G.M.)
- Center for Molecular Cardiology, Laboratory for Platelet Research, University of Zurich, 8952 Schlieren, Switzerland; (T.F.L.); (G.G.C.)
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9
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Mareev VY, Mareev YV. Influence of Omega-3 PUFA on Non-invasive factors determining the risk of arrhYthmias eXcess and sudden cardiac death in patients with HFpEF with ischemic etiology (ONYX). ACTA ACUST UNITED AC 2020; 60:86-98. [DOI: 10.18087/cardio.2020.10.n1327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/30/2020] [Indexed: 11/18/2022]
Abstract
Aim Patients with heart failure with reduced left ventricular (LV) ejection fraction (HFrEF) who have had acute myocardial infarction have an unfavorable prognosis, largely due to ventricular arrhythmias (VA) and risk of sudden cardiac death (SCD). The optimal treatment (triple neurohormonal blockade plus implantable cardioverter defibrillator and cardiac resynchronization therapy) reduced the risk of SCD primarily due to reverse cardiac remodeling, but has not solved this problem completely. Efficacy of purified ω-3 polyunsaturated fatty acid esters (PUFA) in low doses (1 g/day) in reducing VA and risk of SCD in HFrEF patients was demonstrated in two large randomized clinical trials. The PUFA effects was suggested to be related also with increased heart rhythm variability (HRV) and chronotropic action, which might depend on the drug dose. The present open, prospective, randomized, comparative study in parallel groups evaluated the effect of Omacor in different doses on noninvasive markers of SCD risk in patients with ischemic HFrEF receiving the optimal drug therapy.Methods Patients (n=40) were randomized at a 1:1:2 ratio to the control group (n=10), the Omacor 1 g/day treatment group (n=10), and the Omacor 2 g/day treatment group (n=20) and were followed up for 12 months. Clinical evaluation included changes in the CHF functional class (FC) and Clinical Condition Scale (CCS) score; concentration of N-terminal pro-hormone brain natriuretic peptide (NT-proBNP); and peak oxygen consumption during exercise (peak VO2). The LV function was evaluated by LVEF. Holter ECG monitoring was used for evaluation of HRV (SDNN), average 24-h heart rate (HR), number of ventricular extrasystoles (VE) per hour and severity of VA, and presence of paired VE and VT runs.Results Improvement of CHF FC became significant only with the high-dose Omacor treatment (2 g/day). The CCS score showed a tendency towards decrease also with a lower dose (1 g/day) whereas the level of NT-proBNP significantly decreased with both Omacor doses. The increase in LV EF was significant only with the use of Omacor 2 g/day (+3 %, р=0.002). A negative chronotropic effect of ω-3 PUFA was observed. Average 24-h HR decreased by 8 bpm (р=0.05) and 11 bpm (р<0.001) with Omacor 1 g/day and 2 g/day, respectively. Either dose of ω-3 PUFA significantly improved VO2, which directly correlated with LV EF and inversely correlated with HR. The decrease in number of VE was associated not only with improved HRV (SDNN) but also with the decrease in 24-h HR, and thus Omacor 2 g/day significantly decreased the number of VE (by 16 per hour) and dangerous VA (paired VE and VT runs ceased to be detected in 40 % of patients).Conclusion Since HR, HRV, and VA are closely interrelated, the effect of ω-3 PUFA specifically on these noninvasive markers apparently determines its ability to decrease the risk of SCD in patients with ischemic HFrEF. The antiarrhythmic effect of Omacor was greater with higher doses of this drug.
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Affiliation(s)
- V. Yu. Mareev
- Medical Research and Educational Center of the M. V. Lomonosov Moscow State University, Moscow, Russia
Faculty of Fundamental Medicine, Lomonosov Moscow State University, Russia
| | - Yu. V. Mareev
- National Medical Research Centre for Therapy and Preventive Medicine, Moscow, Russia
Robertson Centre for Biostatistics, Glasgow, Great Britain
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10
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High levels of eicosapentaenoic acid are associated with lower pericoronary adipose tissue attenuation as measured by coronary CTA. Atherosclerosis 2020; 316:73-78. [PMID: 33129586 DOI: 10.1016/j.atherosclerosis.2020.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 09/28/2020] [Accepted: 10/06/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND AIMS Higher pericoronary adipose tissue (PCAT) attenuation, a novel marker of inflammation in coronary CT angiography (CTA), has been shown to indicate increased cardiac mortality. Supplementation of eicosapentaenoic acid (EPA) has been shown to decrease cardiovascular death. Whether blood levels of n-3 fatty acids are associated with differences in PCAT attenuation is unknown. METHODS This is a cross-sectional analysis including 64 symptomatic patients who underwent coronary CTA. PCAT attenuation was measured in Hounsfield Units (HU) around the proximal 40 mm of the right coronary artery using semi-automated software. Erythrocyte membrane fatty acid composition was analyzed using gas chromatography. Individual fatty acids were expressed as a percentage of total identified fatty acids. RESULTS The patient cohort was divided into two groups using the median PCAT attenuation of -78.1 HU (each n = 32). No differences were seen in age, sex, BMI or traditional cardiovascular risk factors (CVRF) between groups (all p > 0.05). In univariable analysis, significantly higher values of EPA (1.00% [0.78; 1.26] vs. 0.78% [0.63; 0.99]; p = 0.02) were seen in patients with lower PCAT attenuation. All other fatty acids showed no differences (all p > 0.05). Moreover, a significant negative correlation was seen between PCAT attenuation and EPA (CC: 0.38; p = 0.002). In multivariable analysis, an inverse association of EPA with PCAT attenuation existed (ß = -0.31, p = 0.017), independent of age, gender, BMI and number of CVRF (all p > 0.1). CONCLUSIONS High levels of EPA are associated with lower PCAT attenuation on coronary CTA. This may indicate a different composition of pericoronary adipose tissue, potentially caused by a lower degree of coronary inflammation.
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11
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Investigation of gene-gene interactions in cardiac traits and serum fatty acid levels in the LURIC Health Study. PLoS One 2020; 15:e0238304. [PMID: 32915819 PMCID: PMC7485803 DOI: 10.1371/journal.pone.0238304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 08/13/2020] [Indexed: 01/25/2023] Open
Abstract
Epistasis analysis elucidates the effects of gene-gene interactions (G×G) between multiple loci for complex traits. However, the large computational demands and the high multiple testing burden impede their discoveries. Here, we illustrate the utilization of two methods, main effect filtering based on individual GWAS results and biological knowledge-based modeling through Biofilter software, to reduce the number of interactions tested among single nucleotide polymorphisms (SNPs) for 15 cardiac-related traits and 14 fatty acids. We performed interaction analyses using the two filtering methods, adjusting for age, sex, body mass index (BMI), waist-hip ratio, and the first three principal components from genetic data, among 2,824 samples from the Ludwigshafen Risk and Cardiovascular (LURIC) Health Study. Using Biofilter, one interaction nearly met Bonferroni significance: an interaction between rs7735781 in XRCC4 and rs10804247 in XRCC5 was identified for venous thrombosis with a Bonferroni-adjusted likelihood ratio test (LRT) p: 0.0627. A total of 57 interactions were identified from main effect filtering for the cardiac traits G×G (10) and fatty acids G×G (47) at Bonferroni-adjusted LRT p < 0.05. For cardiac traits, the top interaction involved SNPs rs1383819 in SNTG1 and rs1493939 (138kb from 5’ of SAMD12) with Bonferroni-adjusted LRT p: 0.0228 which was significantly associated with history of arterial hypertension. For fatty acids, the top interaction between rs4839193 in KCND3 and rs10829717 in LOC107984002 with Bonferroni-adjusted LRT p: 2.28×10−5 was associated with 9-trans 12-trans octadecanoic acid, an omega-6 trans fatty acid. The model inflation factor for the interactions under different filtering methods was evaluated from the standard median and the linear regression approach. Here, we applied filtering approaches to identify numerous genetic interactions related to cardiac-related outcomes as potential targets for therapy. The approaches described offer ways to detect epistasis in the complex traits and to improve precision medicine capability.
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12
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O'Mahoney LL, Dunseath G, Churm R, Holmes M, Boesch C, Stavropoulos-Kalinoglou A, Ajjan RA, Birch KM, Orsi NM, Mappa G, Price OJ, Campbell MD. Omega-3 polyunsaturated fatty acid supplementation versus placebo on vascular health, glycaemic control, and metabolic parameters in people with type 1 diabetes: a randomised controlled preliminary trial. Cardiovasc Diabetol 2020; 19:127. [PMID: 32787879 PMCID: PMC7425064 DOI: 10.1186/s12933-020-01094-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/25/2020] [Indexed: 12/11/2022] Open
Abstract
Background The role of omega-3 polyunsaturated fatty acids (n-3PUFA), and the potential impact of n-3PUFA supplementation, in the treatment and management of type 1 diabetes (T1D) remains unclear and controversial. Therefore, this study aimed to examine the efficacy of daily high-dose-bolus n-3PUFA supplementation on vascular health, glycaemic control, and metabolic parameters in subjects with T1D. Methods Twenty-seven adults with T1D were recruited to a 6-month randomised, double-blind, placebo-controlled trial. Subjects received either 3.3 g/day of encapsulated n-3PUFA or encapsulated 3.0 g/day corn oil placebo (PLA) for 6-months, with follow-up at 9-months after 3-month washout. Erythrocyte fatty acid composition was determined via gas chromatography. Endpoints included inflammation-associated endothelial biomarkers (vascular cell adhesion molecule-1 [VCAM-1], intercellular adhesion molecule-1 [ICAM-1], E-selectin, P-selectin, pentraxin-3, vascular endothelial growth factor [VEGF]), and their mediator tumor necrosis factor alpha [TNFα] analysed via immunoassay, vascular structure (carotid intima-media thickness [CIMT]) and function (brachial artery flow mediated dilation [FMD]) determined via ultrasound technique, blood pressure, glycosylated haemoglobin (HbA1c), fasting plasma glucose (FPG), and postprandial metabolism. Results Twenty subjects completed the trial in full. In the n-3PUFA group, the mean ± SD baseline n-3PUFA index of 4.93 ± 0.94% increased to 7.67 ± 1.86% (P < 0.001) after 3-months, and 8.29 ± 1.45% (P < 0.001) after 6-months. Total exposure to n-3PUFA over the 6-months (area under the curve) was 14.27 ± 3.05% per month under n-3PUFA, and 9.11 ± 2.74% per month under PLA (P < 0.001). VCAM-1, ICAM-1, E-selectin, P-selectin, pentraxin-3, VEGF, TNFα, CIMT, FMD, blood pressure, HbA1c, FPG, and postprandial metabolism did not differ between or within groups after treatment (P > 0.05). Conclusions This study indicates that daily high-dose-bolus of n-3PUFA supplementation for 6-months does not improve vascular health, glucose homeostasis, or metabolic parameters in subjects with T1D. The findings from this preliminary RCT do not support the use of therapeutic n-3PUFA supplementation in the treatment and management of T1D and its associated complications. Trial Registration ISRCTN, ISRCTN40811115. Registered 27 June 2017, http://www.isrctn.com/ISRCTN40811115.
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Affiliation(s)
| | - Gareth Dunseath
- Diabetes Research Group, Swansea University Medical School, Swansea University, Swansea, UK
| | - Rachel Churm
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, UK
| | - Mel Holmes
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK
| | - Christine Boesch
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK
| | | | - Ramzi A Ajjan
- Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Karen M Birch
- School of Biomedical Sciences, University of Leeds, Leeds, UK
| | - Nicolas M Orsi
- Leeds Institute of Medical Research at St James's, St James's University Hospital, Leeds, UK
| | - Georgia Mappa
- Leeds Institute of Medical Research at St James's, St James's University Hospital, Leeds, UK
| | - Oliver J Price
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Matthew D Campbell
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, UK.
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Abstract
The omega-3 index, the percentage of EPA plus DHA in erythrocytes (measured by standardised analysis), represents a human body's status in EPA and DHA. An omega-3 index is measured in many laboratories around the world; however, even small differences in analytical methods entail large differences in results. Nevertheless, results are frequently related to the target range of 8-11 %, defined for the original and scientifically validated method (HS-Omega-3 Index®), raising ethical issues, and calling for standardisation. No human subject has an omega-3 index <2 %, indicating a vital minimum. Thus, the absence of EPA and DHA cannot be tested against presence. Moreover, clinical events correlate with levels, less with the dose of EPA and DHA, and the bioavailability of EPA and DHA varies inter-individually. Therefore, the effects of EPA and DHA are difficult to demonstrate using typical drug trial methods. Recent epidemiologic data further support the relevance of the omega-3 index in the cardiovascular field, since total mortality, cardiovascular mortality, cardiovascular events such as myocardial infarction or stroke, or blood pressure all correlate inversely with the omega-3 index. The omega-3 index directly correlates with complex brain functions. Compiling recent data supports the target range for the omega-3 index of 8-11 % in pregnancy. Many other potential applications have emerged. Some, but not all health issues mentioned have already been demonstrated to be improved by increasing intake of EPA and DHA. Increasing the omega-3 index into the target range of 8-11 % with individualised doses of toxin-free sources for EPA and DHA is tolerable and safe.
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Affiliation(s)
- Clemens von Schacky
- Omegametrix, Martinsried, Germany and Preventive Cardiology, University of Munich, Germany
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14
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High Variability in Erythrocyte, Plasma and Whole Blood EPA and DHA Levels in Response to Supplementation. Nutrients 2020; 12:nu12041017. [PMID: 32276315 PMCID: PMC7231102 DOI: 10.3390/nu12041017] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/31/2020] [Accepted: 04/02/2020] [Indexed: 12/15/2022] Open
Abstract
(1) Aim: the aim of this secondary analysis was to report the variability in response to n-3 long chain polyunsaturated fatty acids (LCPUFA) supplementation in erythrocytes, plasma and whole blood of a previously published dose response study. (2) Methods: a randomized, double-blind, placebo-controlled trial of parallel design was conducted, whereby pre-menopausal women were randomly assigned to consume 0, 0.35, 0.7 or 1 g/day of supplemental eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA). Fasted blood samples were taken at baseline and after eight weeks intervention. Erythrocyte, plasma and whole blood fatty acids were extracted using the method of Lepage and Roy and analysed using gas chromatography. (3) Results: There were significant increases in EPA plus DHA levels in the 0.7 g and 1 g dose groups, with the highest increase with the 1 g dose notably: in erythrocytes (from 5.69% to 7.59%), plasma (from 2.94% to 5.48%) and in whole blood (from 3.81% to 6.03%). There was high variability in response to the supplement in erythrocytes, plasma and whole blood across the different doses. (4) Conclusion: there is high individual variability in n-3 LCPUFA levels in response to n-3 LCPUFA supplementation, which should be taken into account in clinical trials using n-3 LCPUFA supplements.
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15
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Omega-3 Fatty Acids in Pregnancy-The Case for a Target Omega-3 Index. Nutrients 2020; 12:nu12040898. [PMID: 32224878 PMCID: PMC7230742 DOI: 10.3390/nu12040898] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/17/2020] [Accepted: 03/24/2020] [Indexed: 12/18/2022] Open
Abstract
Scientific societies recommend increasing intake of docosahexaenoic acid (DHA) by 200 mg/day during pregnancy. However, individually, clinical events correlate quite strongly with levels of eicosapentaenoic acid (EPA) and DHA in blood, but these levels poorly correlate with amounts ingested. EPA and DHA in erythrocytes (Omega-3 Index) have a low biologic variability. If analyzed with a standardized analytical procedure (HS-Omega-3 Index®), analytical variability is low. Thus, the largest database of any fatty acid analytical method was provided. Pregnant women in Germany had a mean Omega-3 Index below the target range suggested for cardiovascular disease of 8–11%, with large interindividual variation, and quite independent of supplementation with EPA and DHA. In Germany, premature birth is a major health issue. Premature birth and other health issues of pregnant women and their offspring correlate with levels of EPA and DHA in blood and can be reduced by increasing intake of EPA and DHA, according to individual trials and pertinent meta-analyses. Very high intake or levels of EPA and DHA may also produce health issues, like bleeding, prolonged gestation, or even premature birth. While direct evidence remains to be generated, evidence from various scientific approaches supports that the target range for the Omega-3 Index of 8–11% might also pertain to pregnancy and lactation.
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16
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Bilinski K, Chang D, Fahey P, Bensoussan A. Effect of omega-3 supplementation on the omega-3 blood index and fatty acid biomarkers in healthy individuals. ADVANCES IN INTEGRATIVE MEDICINE 2020. [DOI: 10.1016/j.aimed.2019.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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17
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Bittner DO, Goeller M, Zopf Y, Achenbach S, Marwan M. Early-onset coronary atherosclerosis in patients with low levels of omega-3 fatty acids. Eur J Clin Nutr 2020; 74:651-656. [DOI: 10.1038/s41430-019-0551-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 12/04/2019] [Accepted: 12/18/2019] [Indexed: 01/07/2023]
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18
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Hudek R, von Schacky C, Passow A, Abdelkawi AF, Werner B, Gohlke F. Degenerative rotator cuff tears are associated with a low Omega-3 Index. Prostaglandins Leukot Essent Fatty Acids 2019; 148:35-40. [PMID: 31492432 DOI: 10.1016/j.plefa.2019.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 06/30/2019] [Accepted: 07/02/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The etiology of degenerative rotator cuff tears is multifactorial but chronic inflammation plays an important role in the pathogenesis. Some polyunsaturated fatty acids (PUFA) can modulate inflammation and marine n-3 (Omega-3) PUFA have anti-inflammatory effects. We hypothesized that the Omega-3 Index is lower in patients with degenerative rotator cuff tears when compared to controls without rotator cuff tendinopathy. METHODS From 684 consecutive patients with full thickness rotator cuff tears 655 were excluded because of possible bias. In the remaining 29 patients (22 m, 7 f; 53,9 y) with degenerative full thickness rotator-cuff tears, erythrocyte fatty acids were analyzed using the HS-Omega-3 Index® methodology. 15 healthy volunteers (10 m, 5 f; 52.5y) served as a control. RESULTS The Omega-3 Index (% EPA + DHA) was 5.01% (95% CI: 3.81-4.66) in patients and 6.01% (95% CI: 4.48-5.72) in controls (p = 0.028) CONCLUSIONS: Patients with full thickness degenerative rotator cuff tears had a significantly lower Omega-3 Index than controls without rotator cuff tendinopathy. Whether a lower Omega-3 Index represents an independent risk factor for degenerative rotator cuff tears should be further investigated, e.g. in a longitudinal study.
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Affiliation(s)
- Robert Hudek
- RHÖN Klinikum AG, Klinik für Schulterchirurgie, Salzburger Leite 1, 97616 Bad Neustadt, Germany.
| | | | - Adrian Passow
- Omegametrix GmbH, Am Klopferspitz 19, 82152 Martinsried, Germany.
| | - Ayman F Abdelkawi
- RHÖN Klinikum AG, Klinik für Schulterchirurgie, Salzburger Leite 1, 97616 Bad Neustadt, Germany
| | - Birgit Werner
- RHÖN Klinikum AG, Klinik für Schulterchirurgie, Salzburger Leite 1, 97616 Bad Neustadt, Germany
| | - Frank Gohlke
- RHÖN Klinikum AG, Klinik für Schulterchirurgie, Salzburger Leite 1, 97616 Bad Neustadt, Germany.
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Watson H, Mitra S, Croden FC, Taylor M, Wood HM, Perry SL, Spencer JA, Quirke P, Toogood GJ, Lawton CL, Dye L, Loadman PM, Hull MA. A randomised trial of the effect of omega-3 polyunsaturated fatty acid supplements on the human intestinal microbiota. Gut 2018; 67:1974-1983. [PMID: 28951525 DOI: 10.1136/gutjnl-2017-314968] [Citation(s) in RCA: 281] [Impact Index Per Article: 46.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 08/22/2017] [Accepted: 08/23/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Omega-3 polyunsaturated fatty acids (PUFAs) have anticolorectal cancer (CRC) activity. The intestinal microbiota has been implicated in colorectal carcinogenesis. Dietary omega-3 PUFAs alter the mouse intestinal microbiome compatible with antineoplastic activity. Therefore, we investigated the effect of omega-3 PUFA supplements on the faecal microbiome in middle-aged, healthy volunteers (n=22). DESIGN A randomised, open-label, cross-over trial of 8 weeks' treatment with 4 g mixed eicosapentaenoic acid/docosahexaenoic acid in two formulations (soft-gel capsules and Smartfish drinks), separated by a 12-week 'washout' period. Faecal samples were collected at five time-points for microbiome analysis by 16S ribosomal RNA PCR and Illumina MiSeq sequencing. Red blood cell (RBC) fatty acid analysis was performed by liquid chromatography tandem mass spectrometry. RESULTS Both omega-3 PUFA formulations induced similar changes in RBC fatty acid content, except that drinks were associated with a larger, and more prolonged, decrease in omega-6 PUFA arachidonic acid than the capsule intervention (p=0.02). There were no significant changes in α or β diversity, or phyla composition, associated with omega-3 PUFA supplementation. However, a reversible increased abundance of several genera, including Bifidobacterium, Roseburia and Lactobacillus was observed with one or both omega-3 PUFA interventions. Microbiome changes did not correlate with RBC omega-3 PUFA incorporation or development of omega-3 PUFA-induced diarrhoea. There were no treatment order effects. CONCLUSION Omega-3 PUFA supplementation induces a reversible increase in several short-chain fatty acid-producing bacteria, independently of the method of administration. There is no simple relationship between the intestinal microbiome and systemic omega-3 PUFA exposure. TRIAL REGISTRATION NUMBER ISRCTN18662143.
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Affiliation(s)
- Henry Watson
- Institute of Biomedical and Clinical Sciences, St James's University Hospital, University of Leeds, Leeds, UK
| | - Suparna Mitra
- Institute of Biomedical and Clinical Sciences, Leeds General Infirmary, University of Leeds, Leeds, UK
| | - Fiona C Croden
- Human Appetite Research Unit (Nutrition and Behaviour Research Group), School of Psychology, University of Leeds, Leeds, UK
| | - Morag Taylor
- Institute of Cancer and Pathology, St James's University Hospital, University of Leeds, Leeds, UK
| | - Henry M Wood
- Institute of Cancer and Pathology, St James's University Hospital, University of Leeds, Leeds, UK
| | - Sarah L Perry
- Institute of Biomedical and Clinical Sciences, St James's University Hospital, University of Leeds, Leeds, UK
| | - Jade A Spencer
- Institute of Cancer Therapeutics, University of Bradford, Bradford, UK
| | - Phil Quirke
- Institute of Cancer and Pathology, St James's University Hospital, University of Leeds, Leeds, UK
| | - Giles J Toogood
- Department of Hepatobiliary Surgery, St James's University Hospital, Leeds, UK
| | - Clare L Lawton
- Human Appetite Research Unit (Nutrition and Behaviour Research Group), School of Psychology, University of Leeds, Leeds, UK
| | - Louise Dye
- Human Appetite Research Unit (Nutrition and Behaviour Research Group), School of Psychology, University of Leeds, Leeds, UK
| | - Paul M Loadman
- Institute of Cancer Therapeutics, University of Bradford, Bradford, UK
| | - Mark A Hull
- Institute of Biomedical and Clinical Sciences, St James's University Hospital, University of Leeds, Leeds, UK
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Péter S, Navis G, de Borst MH, von Schacky C, van Orten-Luiten ACB, Zhernakova A, Witkamp RF, Janse A, Weber P, Bakker SJL, Eggersdorfer M. Public health relevance of drug-nutrition interactions. Eur J Nutr 2018; 56:23-36. [PMID: 28748481 PMCID: PMC5559559 DOI: 10.1007/s00394-017-1510-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The public health relevance of drug–nutrition interactions is currently highly undervalued and overlooked. This is particularly the case for elderly persons where multi-morbidity and consequently polypharmacy is very common. Vitamins and other micronutrients have central functions in metabolism, and their interactions with drugs may result in clinically relevant physiological impairments but possibly also in positive effects. On 12 April 2016, the University Medical Center Groningen (The Netherlands), as part of its Healthy Ageing program, organized a workshop on the public health relevance of drug–nutrient interactions. In this meeting, experts in the field presented results from recent studies on interactions between pharmaceuticals and nutrients, and discussed the role of nutrition for elderly, focusing on those persons receiving pharmaceutical treatment. This paper summarizes the proceedings of the symposium and provides an outlook for future research needs and public health measures. Since food, pharma and health are closely interconnected domains, awareness is needed in the medical community about the potential relevance of drug–nutrition interactions. Experts and stakeholders should advocate for the integration of drug–nutrition evaluations in the drug development process. Strategies for the individual patients should be developed, by installing drug review protocols, screening for malnutrition and integrating this topic into the general medical advice.
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Affiliation(s)
- Szabolcs Péter
- DSM Nutritional Products Ltd., Wurmisweg 576, 4303, Kaiseraugst, Switzerland.
| | - Gerjan Navis
- University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Martin H de Borst
- University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Clemens von Schacky
- Preventive Cardiology, Medizinische Klinik und Poliklinik I, Ludwig Maximilians-Universität München, Ziemssenstr. 15, 80336, Munich, Germany.,Omegametrix GmbH, Am Klopferspitz 19, 82152, Martinsried, Germany
| | - Anne Claire B van Orten-Luiten
- Division of Human Nutrition, Wageningen University, Stippeneng 4, 6708 WE, Wageningen, The Netherlands.,Department of Geriatric Medicine, Hospital Gelderse Vallei, Willy Brandtlaan 10, 6716 RP, Ede, The Netherlands
| | - Alexandra Zhernakova
- University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Renger F Witkamp
- Division of Human Nutrition, Wageningen University, Stippeneng 4, 6708 WE, Wageningen, The Netherlands
| | - André Janse
- Department of Geriatric Medicine, Hospital Gelderse Vallei, Willy Brandtlaan 10, 6716 RP, Ede, The Netherlands
| | - Peter Weber
- DSM Nutritional Products Ltd., Wurmisweg 576, 4303, Kaiseraugst, Switzerland.,University of Hohenheim, Schloß Hohenheim 1, 70599, Stuttgart, Germany
| | - Stephan J L Bakker
- University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Manfred Eggersdorfer
- DSM Nutritional Products Ltd., Wurmisweg 576, 4303, Kaiseraugst, Switzerland.,University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
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Saturated fatty acids and mortality in patients referred for coronary angiography—The Ludwigshafen Risk and Cardiovascular Health study. J Clin Lipidol 2018; 12:455-463.e3. [DOI: 10.1016/j.jacl.2018.01.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 01/11/2018] [Accepted: 01/12/2018] [Indexed: 01/15/2023]
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Lukaschek K, von Schacky C, Kruse J, Ladwig KH. Cognitive Impairment Is Associated with a Low Omega-3 Index in the Elderly: Results from the KORA-Age Study. Dement Geriatr Cogn Disord 2018; 42:236-245. [PMID: 27701160 DOI: 10.1159/000448805] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/31/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Omega-3 polyunsaturated fatty acids (PUFA) may affect the risk of cognitive decline in older adults. METHODS Cross-sectional analysis was conducted among 720 (50.4% women) participants aged 68-92 years (mean age: 77.6, SD ±6.2) of the population-based KORA-Age study. Eicosapentaenoic acid and docosahexaenoic acid (omega-3 index) were measured in erythrocytes as a percentage of total fatty acids. The categories low (<5.7), intermediate (5.7-6.8), and high (>6.8) levels of the omega-3 index were built using tertiles. The association between cognitive status and omega-3 levels was assessed by logistic regression analyses with adjustments for important concurrent risk factors of cognitive decline. RESULTS In the sex- and age-adjusted model (model 1), subjects with a low omega-3 index were at a significantly higher risk for cognitive impairment (OR: 1.77, 95% CI: 1.15-2.73, p = 0.009). This association remained stable after further adjusting for educational level (model 2; OR: 1.75, 95% CI: 1.13-2.71, p = 0.01) and metabolic risk factors (model 3; OR: 1.77, 95% CI: 1.14-2.75, p = 0.01). After further controlling for affective disorders (model 4), the association did not attenuate (OR: 1.77, 95% CI: 1.14-2.76, p = 0.01). CONCLUSION A robust association was found between low omega-3 levels and cognitive impairment in an elderly population. Further research is needed to understand the link between omega-3 PUFA and cognitive functioning.
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Affiliation(s)
- Karoline Lukaschek
- Department of Psychosomatic Medicine and Psychotherapy, University of Gießen, Gießen, Germany
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Iwen KA, Backhaus J, Cassens M, Waltl M, Hedesan OC, Merkel M, Heeren J, Sina C, Rademacher L, Windjäger A, Haug AR, Kiefer FW, Lehnert H, Schmid SM. Cold-Induced Brown Adipose Tissue Activity Alters Plasma Fatty Acids and Improves Glucose Metabolism in Men. J Clin Endocrinol Metab 2017; 102:4226-4234. [PMID: 28945846 DOI: 10.1210/jc.2017-01250] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 09/05/2017] [Indexed: 12/12/2022]
Abstract
CONTEXT Mounting evidence suggests beneficial effects of brown adipose tissue (BAT) activation on glucose and lipid metabolism in humans. It is unclear whether cold-induced BAT activation affects not only insulin sensitivity but also insulin secretion. Likewise, the role in clearing circulating fatty acids (FAs) has not been fully explored. OBJECTIVE Exploring the effects of cold-induced BAT activation on insulin sensitivity and secretion, as well as on plasma FA profiles. DESIGN Fifteen healthy men participated in a cross-balanced repeated within-subject study with two experimental conditions. Subjects were exposed to thermoneutrality (22°C) and to moderate cold (18.06°C, shivering excluded) by use of a water-perfused whole body suit. Cold-induced BAT activation was quantified by [18F]-fluorodeoxyglucose positron emission tomography-computed tomography in a subset of volunteers. A Botnia clamp procedure was applied to determine pancreatic first phase insulin response (FPIR) and insulin sensitivity. Hormones and metabolites, including 26 specific plasma FAs, were sampled throughout the experiment. RESULTS Cold exposure induced BAT activity. Plasma noradrenaline and dopamine concentrations increased in response to cold. Peripheral glucose uptake and insulin sensitivity significantly improved by ∼20%, whereas FPIR remained stable. Lignoceric acid (C24:0) concentrations increased, whereas levels of eicosanoic acid (C20:1n9), nervonic acid (C24:1n9), and behenic acid (C22:0) decreased. CONCLUSIONS Cold-exposure induces sympathetic nervous system activity and BAT metabolism in humans, resulting in improved glucose metabolism without affecting pancreatic insulin secretion. In addition, BAT activation is associated with altered circulating concentrations of distinct FAs. These data support the concept that human BAT metabolism significantly contributes to whole body glucose and lipid utilization in a coordinated manner.
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Affiliation(s)
- K Alexander Iwen
- Department of Internal Medicine I, Section of Endocrinology & Diabetes, University Hospital Schleswig-Holstein, 23538 Lübeck, Germany
| | - Jenny Backhaus
- Department of Internal Medicine I, Section of Endocrinology & Diabetes, University Hospital Schleswig-Holstein, 23538 Lübeck, Germany
| | - Melanie Cassens
- Department of Internal Medicine I, Section of Endocrinology & Diabetes, University Hospital Schleswig-Holstein, 23538 Lübeck, Germany
| | - Maren Waltl
- Department of Internal Medicine I, Section of Endocrinology & Diabetes, University Hospital Schleswig-Holstein, 23538 Lübeck, Germany
| | - Oana C Hedesan
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, 1090 Vienna, Austria
| | | | - Joerg Heeren
- Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Christian Sina
- Department of Internal Medicine I, Section of Nutritional Medicine and Institute of Nutritional Medicine, University Hospital Schleswig-Holstein, 23538 Lübeck, Germany
| | - Leonie Rademacher
- Department of Internal Medicine I, Section of Endocrinology & Diabetes, University Hospital Schleswig-Holstein, 23538 Lübeck, Germany
| | - Anne Windjäger
- Department of Internal Medicine I, Section of Endocrinology & Diabetes, University Hospital Schleswig-Holstein, 23538 Lübeck, Germany
| | - Alexander R Haug
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - Florian W Kiefer
- Clinical Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, 1090 Vienna, Austria
| | - Hendrik Lehnert
- Department of Internal Medicine I, Section of Endocrinology & Diabetes, University Hospital Schleswig-Holstein, 23538 Lübeck, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Sebastian M Schmid
- Department of Internal Medicine I, Section of Endocrinology & Diabetes, University Hospital Schleswig-Holstein, 23538 Lübeck, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
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Nettleton JA, von Schacky C, Brouwer IA, Koletzko B. International Society for the Study of Fatty Acids and Lipids 2016 Debate: For Science-Based Dietary Guidelines on Fats, Meta-Analysis and Systematic Reviews Are Decisive. ANNALS OF NUTRITION AND METABOLISM 2017; 71:26-30. [PMID: 28675886 DOI: 10.1159/000478794] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 06/15/2017] [Indexed: 11/19/2022]
Abstract
This paper summarizes a debate on whether meta-analyses and systematic reviews are decisive in formulating guidelines for dietary fat. Held during the 12th congress of the International Society for the Study of Fatty Acids and Lipids in Stellenbosch, South Africa, September 7, 2016, the debate was hosted by the International Union of Nutritional Sciences and the International Expert Movement to Improve Dietary Fat Quality (IEM, www.theiem.org). Clemens von Schacky, Ludwig Maximilians-University, Munich, Germany, supported the statement, describing the types of weaknesses in individual studies and clinical trials. With examples of how to overcome such limitations, he concluded that nutritional guidelines on fat need a proper scientific basis in which randomized controlled trials (RCTs) with clinical endpoints and their meta-analyses are essential and decisive. In contention, Ingeborg Brouwer, Vrije Universiteit, Amsterdam, declared that recommendations on dietary fat intake should always be based on the totality of the evidence, including physiologic and biochemical knowledge and associations from observational epidemiology. RCTs and meta-analyses have their shortcomings, but well-conducted systematic reviews and meta-analyses support a transparent process for developing dietary fat guidelines. Participants agreed that evidence-based decision-making for dietary guidance should consider all the best available evidence using a transparent, systematic review.
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Omega-6 fatty acids: Opposing associations with risk—The Ludwigshafen Risk and Cardiovascular Health Study. J Clin Lipidol 2017. [DOI: 10.1016/j.jacl.2017.05.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Sánchez-Borrego R, von Schacky C, Osorio MJA, Llaneza P, Pinto X, Losa F, Navarro MC, Lubián D, Mendoza N. Recommendations of the Spanish Menopause Society on the consumption of omega-3 polyunsaturated fatty acids by postmenopausal women. Maturitas 2017; 103:71-77. [PMID: 28778336 DOI: 10.1016/j.maturitas.2017.06.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 06/17/2017] [Accepted: 06/22/2017] [Indexed: 01/19/2023]
Abstract
The consumption of long-chain omega-3 polyunsaturated fatty acids (LCO3-PUFAs) has shown a great variety of beneficial effects, including cardiovascular, metabolic and inflammatory effects, which make them interesting for the postmenopausal woman. Because LCO3-PUFAs could be effective and safe during this period, a panel of experts from the Spanish Menopause Society met to establish a set of recommendations for their use in postmenopausal women based on the best available evidence. The decrease in triglycerides is the most consistent effect observed with LCO3-PUFAs (at doses greater than 3g/day). In addition, LCO3-PUFAs have antiarrhythmic effects, reduce blood pressure, improve depressive and psychotic symptoms, and do not increase the risk of cancer. However, further studies are needed to confirm the benefit of LCO3-PUFAs in the relief of menopause symptoms and osteoporosis.
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Affiliation(s)
| | - Clemens von Schacky
- Preventive Cardiology, Medizinische Klinik I, Ludwig Maximilians-University of Munich, Germany
| | | | - Plácido Llaneza
- Department of Obstetrics and Gynecology, University of Asturias, Spain
| | | | | | | | - Daniel Lubián
- Department of Obstetrics and Gynecology, University of Cadiz, Spain
| | - Nicolás Mendoza
- Departamento de Obstetricia y Ginecología, Universidad de Granada, Spain.
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Abstract
A low Omega-3 Index (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in erythrocytes) is associated with cardiac, cerebral, and other health issues. Intake of EPA and DHA, but not of alpha-linolenic acid (ALA), increases the Omega-3 Index. We investigated bioavailability, safety, palatability and tolerability of EPA and DHA in a novel source: a variety of sausages. We screened 96 healthy volunteers, and recruited 44 with an Omega-3 Index <5%. Participants were randomly assigned to receive a variety of sausages enriched with approximately 250 mg EPA and DHA per 80 g (n = 22) daily for 8 weeks, or matching placebo sausages (n = 22). All sausages contained approximately 250 mg ALA/80 g. In the verum group, the mean Omega-3 Index increased from 4.18 ± 0.54 to 5.72 ± 0.66% (p < 0.001), while it remained unchanged in the placebo group. While ALA levels increased only in the placebo group, DPA levels increased in both groups. Inter-individual variability in the response was large. The mean increase of the Omega-3 Index per intake of EPA and DHA we observed was higher than for other sources previously studied, indicating superior bioavailability. As increasing production of EPA and DHA is difficult, improvements of bioavailability can facilitate reaching the target range for the Omega-3 Index (8-11%).
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Gellert S, Schuchardt JP, Hahn A. Low long chain omega-3 fatty acid status in middle-aged women. Prostaglandins Leukot Essent Fatty Acids 2017; 117:54-59. [PMID: 28237088 DOI: 10.1016/j.plefa.2017.01.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 12/16/2016] [Accepted: 01/24/2017] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Long-chain (LC) omega-3 fatty acids (n-3 PUFAs) have beneficial effects on cardiovascular health and cognitive decline. Several studies have shown that the LC n-3 PUFA status in women in western countries is low. The aim of this study was to assess the LC n-3 PUFA status in middle-aged German women and to identify variables that might affect the status. MATERIAL AND METHODS From the nationwide and cross-sectional German VitaMinFemin study, fatty acid levels in the erythrocyte membrane (% of total erythrocyte fatty acids) were ascertained for 446 women (40-60 years). RESULTS The average omega-3 index (% of eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) of the total study population was 5.49±1.17%. A total of 62.8% of women had a low omega-3 index (>4-6%). The omega-3 index was affected by age and smoking, with slightly higher values in women ≥50 years (p=0.032) and non-smokers (p=0.002). Women taking hormonal contraceptives showed a lower EPA level (p<0.001), a lower ratio of EPA/alpha-linoleic acid (p<0.001) and a higher ratio of DHA/EPA (p<0.001) than women without hormonal contraception. CONCLUSION The low LC n-3 PUFA status in middle-aged German women (40-60 years) is related to an increased risk of cardiovascular diseases and possibly other diseases and should therefore be improved. Further studies are needed to determine the influence of estrogen on the effect on LC n-3 PUFA status.
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Affiliation(s)
- Sandra Gellert
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Germany.
| | | | - Andreas Hahn
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Germany
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Individual omega-9 monounsaturated fatty acids and mortality—The Ludwigshafen Risk and Cardiovascular Health Study. J Clin Lipidol 2017; 11:126-135.e5. [DOI: 10.1016/j.jacl.2016.10.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 10/26/2016] [Accepted: 10/31/2016] [Indexed: 11/23/2022]
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Reiner MF, Stivala S, Limacher A, Bonetti NR, Méan M, Egloff M, Rodondi N, Aujesky D, von Schacky C, Lüscher TF, Camici GG, Beer JH. Omega-3 fatty acids predict recurrent venous thromboembolism or total mortality in elderly patients with acute venous thromboembolism. J Thromb Haemost 2017; 15:47-56. [PMID: 27790827 DOI: 10.1111/jth.13553] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Indexed: 01/02/2023]
Abstract
Essentials The role of omega-3 fatty acids (n-3 FAs) in recurrent venous thromboembolism (VTE) is unknown. Association of n-3 FAs with recurrent VTE or total mortality was investigated in 826 patients. Whole blood n-3 FAs were inversely correlated with recurrent VTE or total mortality. Major and non-major bleeding was not increased in patients with higher levels of n-3 FAs. SUMMARY Background The role of omega-3 fatty acids (n-3 FAs) in recurrent venous thromboembolism (VTE) remains unknown. Objectives To investigate the association of n-3 FAs with recurrent VTE or total mortality at 6 months and 3 years. Methods N-3 FAs were assessed in 826 patients aged ≥ 65 years, categorized into low, medium and high based on the 25th and 75th percentile. Mean follow-up was 29 months. Results At 6 months, subjects with medium (adjusted hazard ratio [HR], 0.37; 95% confidence interval [CI], 0.22-0.62) and high n-3 FA levels (adjusted HR, 0.36; 95% CI, 0.20-0.67) were less likely to develop recurrent VTE or total mortality, compared with those with low n-3 FAs. At 3 years, medium levels (adjusted HR, 0.67; 95% CI, 0.47-0.96) were associated with lower risk of recurrent VTE or total mortality. As compared with low n-3 FAs, the adjusted sub-hazard ratio [SHR] of recurrent VTE was 0.39 (95% CI, 0.15-0.99) in patients with medium and 0.17 (95% CI, 0.03-0.82) in patients with high n-3 FAs. The cumulative incidence of recurrent VTE was lower in the medium and high n-3 FA groups as compared with the low n-3 FA groups, but seems to have worn off after 3 years. The incidence of major and non-major bleeding was not greater in the high n-3 FA group. Conclusion Higher levels of n-3 FAs were associated with a lower risk of recurrent VTE or total mortality in elderly patients with VTE, but not with greater bleeding risk.
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Affiliation(s)
- M F Reiner
- Center for Molecular Cardiology, Laboratory for Platelet Research, University of Zurich, Schlieren, Switzerland
- Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland
| | - S Stivala
- Center for Molecular Cardiology, Laboratory for Platelet Research, University of Zurich, Schlieren, Switzerland
- Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland
| | - A Limacher
- Clinical Trials Unit Bern, Department of Clinical Research, and Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - N R Bonetti
- Center for Molecular Cardiology, Laboratory for Platelet Research, University of Zurich, Schlieren, Switzerland
- Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland
| | - M Méan
- Division of General Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - M Egloff
- Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland
| | - N Rodondi
- Department of General Internal Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - D Aujesky
- Department of General Internal Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
| | - C von Schacky
- Department of Preventive Cardiology, Ludwig-Maximilian University Munich, Munich, Germany
| | - T F Lüscher
- Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland
- Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland
| | - G G Camici
- Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland
| | - J H Beer
- Center for Molecular Cardiology, Laboratory for Platelet Research, University of Zurich, Schlieren, Switzerland
- Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland
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Watson H, Cockbain AJ, Spencer J, Race A, Volpato M, Loadman PM, Toogood GJ, Hull MA. Measurement of red blood cell eicosapentaenoic acid (EPA) levels in a randomised trial of EPA in patients with colorectal cancer liver metastases. Prostaglandins Leukot Essent Fatty Acids 2016; 115:60-66. [PMID: 27914515 DOI: 10.1016/j.plefa.2016.10.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 10/05/2016] [Accepted: 10/06/2016] [Indexed: 12/12/2022]
Abstract
We investigated red blood cell (RBC) PUFA profiles, and the predictive value of RBC EPA content for tumour EPA exposure and clinical outcomes, in the EMT study, a randomised trial of EPA in patients awaiting colorectal cancer (CRC) liver metastasis surgery (Cockbain et al., 2014) [8]. There was a significant increase in RBC EPA in the EPA group (n=43; median intervention 30 days; mean absolute 1.26[±0.14]% increase; P<0.001), but not in the placebo arm (n=45). EPA incorporation varied widely in EPA users and was not explained by treatment duration or compliance. There was little evidence of 'contamination' in the placebo group. The EPA level predicted tumour EPA content (r=0.36; P=0.03). Participants with post-treatment EPA≥1.22% (n=49) had improved OS compared with EPA <1.22% (n=29; HR 0.42[95%CI 0.16-0.95]). RBC EPA content should be evaluated as a biomarker of tumour exposure and clinical outcomes in future EPA trials in CRC patients.
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Affiliation(s)
- Henry Watson
- Leeds Institute of Biomedical & Clinical Sciences, University of Leeds, St James's University Hospital, Leeds LS9 7TF, United Kingdom; Department of Hepatobiliary Surgery, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds LS9 7TF, United Kingdom
| | - Andrew J Cockbain
- Leeds Institute of Biomedical & Clinical Sciences, University of Leeds, St James's University Hospital, Leeds LS9 7TF, United Kingdom; Department of Hepatobiliary Surgery, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds LS9 7TF, United Kingdom
| | - Jade Spencer
- Institute of Cancer Therapeutics, University of Bradford, Bradford BD7 1DP, United Kingdom
| | - Amanda Race
- Institute of Cancer Therapeutics, University of Bradford, Bradford BD7 1DP, United Kingdom
| | - Milene Volpato
- Leeds Institute of Biomedical & Clinical Sciences, University of Leeds, St James's University Hospital, Leeds LS9 7TF, United Kingdom
| | - Paul M Loadman
- Institute of Cancer Therapeutics, University of Bradford, Bradford BD7 1DP, United Kingdom
| | - Giles J Toogood
- Department of Hepatobiliary Surgery, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds LS9 7TF, United Kingdom
| | - Mark A Hull
- Leeds Institute of Biomedical & Clinical Sciences, University of Leeds, St James's University Hospital, Leeds LS9 7TF, United Kingdom.
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Kleber ME, Delgado GE, Lorkowski S, März W, von Schacky C. Omega-3 fatty acids and mortality in patients referred for coronary angiography. The Ludwigshafen Risk and Cardiovascular Health Study. Atherosclerosis 2016; 252:175-181. [DOI: 10.1016/j.atherosclerosis.2016.06.049] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 06/24/2016] [Accepted: 06/29/2016] [Indexed: 01/24/2023]
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Comparison of fatty acid intakes assessed by a cardiovascular-specific food frequency questionnaire with red blood cell membrane fatty acids in hyperlipidaemic Australian adults: a validation study. Eur J Clin Nutr 2016; 70:1433-1438. [PMID: 27507074 DOI: 10.1038/ejcn.2016.144] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 06/14/2016] [Accepted: 07/04/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND/OBJECTIVES Limited dietary intake tools have been validated specifically for hyperlipidaemic adults. The Australian Eating Survey (AES) Food Frequency Questionnaire (FFQ) was adapted to include foods with cardio-protective properties (CVD-AES). The aims were to estimate dietary fatty acid (FA) intakes derived from the CVD-AES and AES and compare them with red blood cell (RBC) membrane FA content. SUBJECTS/METHODS Dietary intake was measured using the semi-quantitative 120-item AES and 177-item CVD-AES. Nutrient intakes were calculated using AUSNUT 2011-2013. Fasting RBC membrane FAs were assessed using gas chromatography. Extent of agreement between intakes estimated by AES or CVD-AES and RBC membrane composition (% of total FAs) for linoleic acid (LA), alpha-linolenic acid (ALA), eicosapentanoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA) were assessed using Spearman's correlation coefficients, adjusted linear regressions and Kappa statistics. RESULTS Data from 39 participants (72% female, 59.3±11.1 years) indicate stronger positive correlations between RBC membrane FAs and CVD-AES dietary estimates compared with the AES. Significant (P<0.05) moderate-strong correlations were found between CVD-AES FAs and FA proportions in RBC membranes for EPA (r=0.62), DHA (r=0.53) and DPA (r=0.42), with a moderate correlation for LA (r=0.39) and no correlation with ALA. Significant moderate correlations were found with the AES for DHA (r=0.39), but not for LA, ALA, EPA or DPA. CONCLUSIONS The CVD-AES provides a more accurate estimate of long chain FA intakes in hyperlipidaemic adults, compared with AES estimates. This indicates that a CVD-specific FFQ should be used when evaluating FA intakes in this population.
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Data on gender and subgroup specific analyses of omega-3 fatty acids in the Ludwigshafen Risk and Cardiovascular Health Study. Data Brief 2016; 8:1311-21. [PMID: 27570810 PMCID: PMC4990639 DOI: 10.1016/j.dib.2016.07.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 07/20/2016] [Accepted: 07/26/2016] [Indexed: 11/22/2022] Open
Abstract
This paper contains additional data related to the research article “Omega-3 fatty acids and mortality in patients referred for coronary angiography – The Ludwigshafen Risk and Cardiovascular Health Study” (Kleber et al., in press) [1]. The data shows characteristics of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study according to tertiles of omega-3 fatty acids as well as stratified by gender. The association of proportions of omega-3 fatty acids measured in erythrocyte membranes with different causes of death is investigated with a special focus on modeling the association of EPA with mortality in a nonlinear way. Further, the association of omega-3 fatty acids with all-cause mortality adjusted for high-sensitive C-reactive protein as a marker of systemic inflammation is examined as well as the association of EPA with cause-specific death.
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Hanson JA, Lin YH, Dretsch MN, Strandjord SE, Haub MD, Hibbeln JR. Whole food, functional food, and supplement sources of omega-3 fatty acids and omega-3 HUFA scores among U.S. soldiers. J Funct Foods 2016. [DOI: 10.1016/j.jff.2016.02.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
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Rice HB, Bernasconi A, Maki KC, Harris WS, von Schacky C, Calder PC. Conducting omega-3 clinical trials with cardiovascular outcomes: Proceedings of a workshop held at ISSFAL 2014. Prostaglandins Leukot Essent Fatty Acids 2016; 107:30-42. [PMID: 26858145 DOI: 10.1016/j.plefa.2016.01.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 01/04/2016] [Accepted: 01/04/2016] [Indexed: 12/19/2022]
Abstract
In contrast to earlier long-chain (LC) omega-3 (i.e. EPA and DHA) investigations, some recent studies have not demonstrated significant effects of EPA and DHA on cardiovascular disease (CVD) outcomes. The neutral findings may have been due to experimental design issues, such as: maintenance on aggressive cardiovascular drug treatment overshadowing the benefits of LC omega-3s, high background LC omega-3 intake, too few subjects in the study, treatment duration too short, insufficient LC omega-3 dosage, increase in omega-6 fatty acid intake during the study, failure to assess the LC omega-3 status of the subjects prior to and during treatment and lack of clarity concerning which mechanisms were expected to produce benefits. At the 11th ISSFAL Congress, a workshop was held on conducting LC omega-3 clinical trials with cardiovascular outcomes, with the goal of gaining a better understanding concerning aspects of experimental design that should be considered when planning clinical studies related to EPA and DHA and potential cardiovascular benefits.
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Affiliation(s)
- Harry B Rice
- Global Organization for EPA and DHA Omega-3s (GOED), Salt Lake City, UT, USA.
| | - Aldo Bernasconi
- Global Organization for EPA and DHA Omega-3s (GOED), Salt Lake City, UT, USA
| | - Kevin C Maki
- Midwest Center for Metabolic and Cardiovascular Research, Glen Ellyn, IL, USA
| | - William S Harris
- Health Diagnostic Laboratory, Inc., Richmond, VA, USA; University of South Dakota School of Medicine, Sioux Falls, SD, USA; OmegaQuant Analytics, LLC, Sioux Falls, SD, USA
| | | | - Philip C Calder
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
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Lupton JR, Blumberg JB, L'Abbe M, LeDoux M, Rice HB, von Schacky C, Yaktine A, Griffiths JC. Nutrient reference value: non-communicable disease endpoints--a conference report. Eur J Nutr 2016; 55 Suppl 1:S1-10. [PMID: 26983608 PMCID: PMC4819601 DOI: 10.1007/s00394-016-1195-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Nutrition is complex-and seemingly getting more complicated. Most consumers are familiar with "essential nutrients," e.g., vitamins and minerals, and more recently protein and important amino acids. These essential nutrients have nutrient reference values, referred to as dietary reference intakes (DRIs) developed by consensus committees of scientific experts convened by the Institute of Medicine of the National Academy of Sciences, Engineering, and Medicine and carried out by the Food and Nutrition Board. The DRIs comprise a set of four nutrient-based reverence values, the estimated average requirements, the recommended dietary allowances (RDAs), the adequate intakes and the tolerable upper intake levels for micronutrient intakes and an acceptable macronutrient distribution range for macronutrient intakes. From the RDA, the US Food and Drug Administration (FDA) derives a labeling value called the daily value (DV), which appears on the nutrition label of all foods for sale in the US. The DRI reports do not make recommendations about whether the DV labeling values can be set only for what have been defined to date as "essential nutrients." For example, the FDA set a labeling value for "dietary fiber" without having the DV. Nutrient reference values-requirements are set by Codex Alimentarius for essential nutrients, and regulatory bodies in many countries use these Codex values in setting national policy for recommended dietary intakes. However, the focus of this conference is not on essential nutrients, but on the "nonessential nutrients," also termed dietary bioactive components. They can be defined as "Constituents in foods or dietary supplements, other than those needed to meet basic human nutritional needs, which are responsible for changes in health status (Office of Disease Prevention and Health Promotion, Office of Public Health and Science, Department of Health and Human Services in Fed Regist 69:55821-55822, 2004)." Substantial and often persuasive scientific evidence does exist to confirm a relationship between the intake of a specific bioactive constituent and enhanced health conditions or reduced risk of a chronic disease. Further, research on the putative mechanisms of action of various classes of bioactives is supported by national and pan-national government agencies, and academic institutions, as well as functional food and dietary supplement manufacturers. Consumers are becoming educated and are seeking to purchase products containing bioactives, yet there is no evaluative process in place to let the public know how strong the science is behind the benefits or the quantitative amounts needed to achieve these beneficial health effects or to avoid exceeding the upper level (UL). When one lacks an essential nutrient, overt deficiency with concomitant physiological determents and eventually death are expected. The absence of bioactive substances from the diet results in suboptimal health, e.g., poor cellular and/or physiological function, which is relative and not absolute. Regrettably at this time, there is no DRI process to evaluate bioactives, although a recent workshop convened by the National Institutes of Health (Options for Consideration of Chronic Disease Endpoints for Dietary Reference Intakes (DRIs); March 10-11, 2015; http://health.gov/dietaryguidelines/dri/ ) did explore the process to develop DVs for nutrients, the lack of which result in increased risk of chronic disease (non-communicable disease) endpoints. A final report is expected soon. This conference (CRN-International Scientific Symposium; "Nutrient Reference Value-Non-Communicable Disease (NRV-NCD) Endpoints," 20 November in Kronberg, Germany; http://www.crn-i.ch/2015symposium/ ) explores concepts related to the Codex NRV process, the public health opportunities in setting NRVs for bioactive constituents, and further research and details on the specific class of bioactives, n-3 long-chain polyunsaturated fatty acids (also termed omega-3 fatty acids) and their constituents, specifically docosahexaenoic acid and eicosapentaenoic acid.
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Affiliation(s)
- J R Lupton
- Emeritus, Texas A&M University, College Station, TX, USA
| | | | - M L'Abbe
- University of Toronto, Toronto, ON, Canada
| | - M LeDoux
- Natural Alternatives International, Inc., San Marcos, CA, USA
| | - H B Rice
- Global Organization for EPA and DHA Omega-3s, Salt Lake City, UT, USA
| | | | - A Yaktine
- The National Academies of Sciences, Engineering, and Medicine, Washington, DC, USA
| | - J C Griffiths
- Council for Responsible Nutrition, Washington, DC, USA.
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Association between Blood Omega-3 Index and Cognition in Typically Developing Dutch Adolescents. Nutrients 2016; 8:nu8010013. [PMID: 26729157 PMCID: PMC4728627 DOI: 10.3390/nu8010013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 12/10/2015] [Accepted: 12/15/2015] [Indexed: 01/30/2023] Open
Abstract
The impact of omega-3 long-chain polyunsaturated fatty acids (LCPUFAs) on cognition is heavily debated. In the current study, the possible association between omega-3 LCPUFAs in blood and cognitive performance of 266 typically developing adolescents aged 13–15 years is investigated. Baseline data from Food2Learn, a double-blind and randomized placebo controlled krill oil supplementation trial in typically developing adolescents, were used for the current study. The Omega-3 Index was determined with blood from a finger prick. At baseline, participants finished a neuropsychological test battery consisting of the Letter Digit Substitution Test (LDST), D2 test of attention, Digit Span Forward and Backward, Concept Shifting Test and Stroop test. Data were analyzed with multiple regression analyses with correction for covariates. The average Omega-3 Index was 3.83% (SD 0.60). Regression analyses between the Omega-3 Index and the outcome parameters revealed significant associations with scores on two of the nine parameters. The association between the Omega-3 Index and both scores on the LDST (β = 0.136 and p = 0.039), and the number of errors of omission on the D2 (β = −0.053 and p = 0.007). This is a possible indication for a higher information processing speed and less impulsivity in those with a higher Omega-3 Index.
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Perretti M, Leroy X, Bland EJ, Montero-Melendez T. Resolution Pharmacology: Opportunities for Therapeutic Innovation in Inflammation. Trends Pharmacol Sci 2015; 36:737-755. [PMID: 26478210 DOI: 10.1016/j.tips.2015.07.007] [Citation(s) in RCA: 160] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 07/22/2015] [Accepted: 07/27/2015] [Indexed: 12/31/2022]
Abstract
Current medicines for the clinical management of inflammatory diseases act by inhibiting specific enzymes or antagonising specific receptors or blocking their ligands. In the past decade, a new paradigm in our understanding of the inflammatory process has emerged with the appreciation of genetic, molecular, and cellular mechanisms that are engaged to actively resolve inflammation. The 'resolution of acute inflammation' is enabled by counter-regulatory checkpoints to terminate the inflammatory reaction, promoting healing and repair. It may be possible to harness this knowledge for innovative approaches to the treatment of inflammatory pathologies. Here we discuss current translational attempts to develop agonists at proresolving targets as a strategy to rectify chronic inflammatory status. We reason this new approach will lead to the identification of better drugs that will establish a new branch of pharmacology, 'resolution pharmacology'.
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Affiliation(s)
- Mauro Perretti
- William Harvey Research Institute, Queen Mary University of London, London, UK.
| | - Xavier Leroy
- Drug Discovery Biology, Actelion Pharmaceuticals Ltd, Allschwil, Switzerland
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Kleber ME, Delgado GE, Lorkowski S, März W, von Schacky C. Trans-fatty acids and mortality in patients referred for coronary angiography: the Ludwigshafen Risk and Cardiovascular Health Study. Eur Heart J 2015; 37:1072-8. [DOI: 10.1093/eurheartj/ehv446] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 08/17/2015] [Indexed: 11/12/2022] Open
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Ghasemifard S, Sinclair AJ, Kaur G, Lewandowski P, Turchini GM. What Is the Most Effective Way of Increasing the Bioavailability of Dietary Long Chain Omega-3 Fatty Acids--Daily vs. Weekly Administration of Fish Oil? Nutrients 2015; 7:5628-45. [PMID: 26184297 PMCID: PMC4517018 DOI: 10.3390/nu7075241] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 06/24/2015] [Accepted: 07/01/2015] [Indexed: 12/28/2022] Open
Abstract
The recommendations on the intake of long chain omega-3 polyunsaturated fatty acids (n-3 LC-PUFA) vary from eating oily fish ("once to twice per week") to consuming specified daily amounts of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) ("250-500 mg per day"). It is not known if there is a difference in the uptake/bioavailability between regular daily consumption of supplementsvs. consuming fish once or twice per week. In this study, the bioavailability of a daily dose of n-3 LC-PUFA (Constant treatment), representing supplements, vs. a large weekly dose of n-3 LC-PUFA (Spike treatment), representing consuming once or twice per week, was assessed. Six-week old healthy male Sprague-Dawley rats were fed either a Constant treatment, a Spike treatment or Control treatment (no n-3 LC-PUFA), for six weeks. The whole body, tissues and faeces were analysed for fatty acid content. The results showed that the major metabolic fate of the n-3 LC-PUFA (EPA+docosapentaenoic acid (DPA) + DHA) was towards catabolism (β-oxidation) accounting for over 70% of total dietary intake, whereas deposition accounted less than 25% of total dietary intake. It was found that significantly more n-3 LC-PUFA were β-oxidised when originating from the Constant treatment (84% of dose), compared with the Spike treatment (75% of dose). Conversely, it was found that significantly more n-3 LC-PUFA were deposited when originating from the Spike treatment (23% of dose), than from the Constant treatment (15% of dose). These unexpected findings show that a large dose of n-3 LC-PUFA once per week is more effective in increasing whole body n-3 LC-PUFA content in rats compared with a smaller dose delivered daily.
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Affiliation(s)
| | | | - Gunveen Kaur
- Centre for Physical Activity and Nutrition Research (CPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood 3125, Australia.
| | | | - Giovanni M Turchini
- School of Life and Environmental Sciences, Deakin University, Warrnambool 3280, Australia.
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Köhler A, Sarkkinen E, Tapola N, Niskanen T, Bruheim I. Bioavailability of fatty acids from krill oil, krill meal and fish oil in healthy subjects--a randomized, single-dose, cross-over trial. Lipids Health Dis 2015; 14:19. [PMID: 25884846 PMCID: PMC4374210 DOI: 10.1186/s12944-015-0015-4] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 02/23/2015] [Indexed: 12/13/2022] Open
Abstract
Background Krill contains two marine omega-3 polyunsaturated fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), mainly bound in phospholipids. Typical products from krill are krill oil and krill meal. Fish oils contain EPA and DHA predominantly bound in triglycerides. The difference in the chemical binding of EPA and DHA has been suggested to affect their bioavailability, but little is known on bioavailability of EPA and DHA in krill meal. This study was undertaken to compare the acute bioavailability of two krill products, krill oil and krill meal, with fish oil in healthy subjects. Methods A randomized, single-dose, single-blind, cross-over, active-reference trial was conducted in 15 subjects, who ingested krill oil, krill meal and fish oil, each containing approx. 1 700 mg EPA and DHA. Fatty acid compositions of plasma triglycerides and phospholipids were measured repeatedly for 72 hours. The primary efficacy analysis was based on the 72 hour incremental area under the curve (iAUC) of EPA and DHA in plasma phospholipid fatty acids. Results A larger iAUC for EPA and DHA in plasma phospholipid fatty acids was detected after krill oil (mean 89.08 ± 33.36% × h) than after krill meal (mean 44.97 ± 18.07% x h, p < 0.001) or after fish oil (mean 59.15 ± 22.22% × h, p=0.003). Mean iAUC’s after krill meal and after fish oil were not different. A large inter-individual variability in response was observed. Conclusion EPA and DHA in krill oil had a higher 72-hour bioavailability than in krill meal or fish oil. Our finding that bioavailabilities of EPA and DHA in krill meal and fish oil were not different argues against the interpretation that phospholipids are better absorbed than triglycerides. Longer-term studies using a parameter reflecting tissue fatty acid composition, like erythrocyte EPA plus DHA are needed. Trial registration NCT02089165
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Affiliation(s)
- Anton Köhler
- Preventive Cardiology, Medizinische Klinik I, University of Munich, Ziemssenstr. 1, Munich, D-80336, Germany.
| | - Essi Sarkkinen
- Oy Foodfiles Ltd, Kuopio, Finland. .,University of Eastern Finland, Kuopio, Finland.
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von Schacky C. Omega-3 fatty acids in cardiovascular disease--an uphill battle. Prostaglandins Leukot Essent Fatty Acids 2015; 92:41-7. [PMID: 24935800 DOI: 10.1016/j.plefa.2014.05.004] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 02/13/2014] [Accepted: 05/06/2014] [Indexed: 12/12/2022]
Abstract
In cardiology, results of recent large intervention trials with eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) supplements were neutral. In contrast, in epidemiologic studies, an inverse relation between clinical events and intake of EPA+DHA was found which was steeper for higher levels of EPA+DHA. A standardized way of determining levels is the Omega-3 Index, which is the percentage of EPA+DHA of a total of 26 fatty acids measured in erythrocytes. According to current criteria, a low Omega-3 Index is a cardiovascular risk factor. What can explain this contradiction? Trial participants were recruited irrespective of their baseline status in EPA+DHA - an important predictor of events. Levels of EPA+DHA have a statistically normal distribution; together with the large inter-individual variability of levels' responding to increased intake, this created a large overlap of EPA+DHA levels between intervention and control groups. Moreover, trial participants were advised to take EPA+DHA supplements with breakfast, frequently a low fat meal, resulting in poor bioavailability. As a result, there is an urgent need for new intervention trials in cardiology, for which participants with a low baseline omega-3 index are recruited, and then treated with individually tailored doses of EPA+DHA to a prespecified target range.
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Affiliation(s)
- Clemens von Schacky
- Medizinische Klinik I, Department Preventive Cardiology, Ludwig-Maximilians-University, Ziemssenstrasse 1, D-80336 Munich, Germany; Omegametrix, Am Klopferspitz 19, 82152 Martinsried, Germany(1).
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Schuchardt JP, Neubronner J, Block RC, von Schacky C, Hahn A. Associations between Omega-3 Index increase and triacylglyceride decrease in subjects with hypertriglyceridemia in response to six month of EPA and DHA supplementation. Prostaglandins Leukot Essent Fatty Acids 2014; 91:129-34. [PMID: 25108576 DOI: 10.1016/j.plefa.2014.07.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 07/14/2014] [Accepted: 07/15/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Ingestion of long-chain n-3 PUFA effectively decreases serum triacylglycerol (TAG) levels and increases the Omega-3 Index, defined as the % of EPA and DHA in erythrocyte fatty acids. However, it remains unclear whether there is a relationship between the Omega-3 Index increase (ΔO3I increase) and the TAG level decrease (ΔTAG). We hypothesized that TAG reduction is strongly depended on Omega-3 Index increase. SUBJECTS AND METHODS Secondary analyses of data from a former double-blind placebo-controlled trial in which 150 dyslipidemic statin-treated subjects were randomized to four capsules of fish oil daily either as re-esterified TAG or ethyl esters in identical doses (1.01 g EPA+0.67 g DHA) or corn oil as a placebo for a period of six month. RESULTS 108 subjects fulfilled the criteria of the current study protocol and were included in the analyses. A weak but significant negative correlation between ΔO3I and ΔTAG was observed (r=-0.211, p<0.05). However, the relation between ΔO3I and serum ΔTAG was not linear (coefficients of determination R(2): 0.044). After sub-grouping the study population into Omega-3 Index response groups, the group with a mean ΔO3I of>4% after six months of n-3 PUFA treatment demonstrated the greatest TAG reduction. DISCUSSION AND CONCLUSIONS A weak association between Omega-3 Index increase and TAG level decrease was found. This may be explained by highly fluctuating TAG levels, a large inter-individual difference in response of the Omega-3 Index, a cohort of subjects with only slightly elevated TAG levels and high Omega-3 Index values at baseline, and possibly to insufficient statistical power. Since there was no strong association between Omega-3 Index increase and the TAG level decrease, we conclude that changes in serum TAG levels are not a viable substitute for the Omega-3 Index to monitor treatment with EPA and DHA.
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Affiliation(s)
| | - Juliane Neubronner
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Germany
| | - Robert C Block
- Department of Public Health Sciences and the Cardiology Division, Department of Medicine, the University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Clemens von Schacky
- PreventiveCardiology, Medizinische Klinik und Poliklinik Innenstadt, Ludwig Maximilians University Munich, Germany
| | - Andreas Hahn
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Germany
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von Schacky C. Omega-3 index and cardiovascular health. Nutrients 2014; 6:799-814. [PMID: 24566438 PMCID: PMC3942733 DOI: 10.3390/nu6020799] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 02/12/2014] [Accepted: 02/13/2014] [Indexed: 12/14/2022] Open
Abstract
Recent large trials with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the cardiovascular field did not demonstrate a beneficial effect in terms of reductions of clinical endpoints like total mortality, sudden cardiac arrest or other major adverse cardiac events. Pertinent guidelines do not uniformly recommend EPA + DHA for cardiac patients. In contrast, in epidemiologic findings, higher blood levels of EPA + DHA were consistently associated with a lower risk for the endpoints mentioned. Because of low biological and analytical variability, a standardized analytical procedure, a large database and for other reasons, blood levels of EPA + DHA are frequently assessed in erythrocytes, using the HS-Omega-3 Index® methodology. A low Omega-3 Index fulfills the current criteria for a novel cardiovascular risk factor. Neutral results of intervention trials can be explained by issues of bioavailability and trial design that surfaced after the trials were initiated. In the future, incorporating the Omega-3 Index into trial designs by recruiting participants with a low Omega-3 Index and treating them within a pre-specified target range (e.g., 8%-11%), will make more efficient trials possible and provide clearer answers to the questions asked than previously possible.
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Affiliation(s)
- Clemens von Schacky
- Preventive Cardiology, Medical Clinic and Poli-Clinic I, Ludwig Maximilians-University Munich, Ziemssenstr. 1, Munich 80336, Germany.
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O’Sullivan A, Armstrong P, Schuster GU, Pedersen TL, Allayee H, Stephensen CB, Newman JW. Habitual diets rich in dark-green vegetables are associated with an increased response to ω-3 fatty acid supplementation in Americans of African ancestry. J Nutr 2014; 144:123-31. [PMID: 24259553 PMCID: PMC3901419 DOI: 10.3945/jn.113.181875] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Although substantial variation exists in individual responses to omega-3 (ω-3) (n-3) fatty acid supplementation, the causes for differences in response are largely unknown. Here we investigated the associations between the efficacy of ω-3 fatty acid supplementation and a broad range of nutritional and clinical factors collected during a double-blind, placebo-controlled trial in participants of African ancestry, randomly assigned to receive either 2 g eicosapentaenoic acid (EPA) + 1 g docosahexaenoic acid (n = 41) or corn/soybean oil placebo (n = 42) supplements for 6 wk. Food-frequency questionnaires were administered, and changes in erythrocyte lipids, lipoproteins, and monocyte 5-lipoxygenase-dependent metabolism were measured before and after supplementation. Mixed-mode linear regression modeling identified high (n = 28) and low (n = 13) ω-3 fatty acid response groups on the basis of changes in erythrocyte EPA abundance (P < 0.001). Compliance was equivalent (∼88%), whereas decreases in plasma triglycerides and VLDL particle sizes and reductions in stimulated monocyte leukotriene B4 production were larger in the high-response group. Although total diet quality scores were similar, the low-response group showed lower estimated 2005 Healthy Eating Index subscores for dark-green and orange vegetables and legumes (P = 0.01) and a lower intake of vegetables (P = 0.02), particularly dark-green vegetables (P = 0.002). Because the findings reported here are associative in nature, prospective studies are needed to determine if dietary dark-green vegetables or nutrients contained in these foods can enhance the efficacy of ω-3 fatty acid supplements. This trial was registered at clinicaltrials.gov as NCT00536185.
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Affiliation(s)
| | | | | | | | - Hooman Allayee
- Institute for Genetic Medicine and Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Charles B. Stephensen
- Nutrition, University of California, Davis, Davis, CA,Immunity and Disease Prevention Research Unit, Western Human Nutrition Research Center, Agricultural Research Service, USDA, Davis, CA
| | - John W. Newman
- Nutrition, University of California, Davis, Davis, CA,Obesity and Metabolism Research Unit, and,To whom correspondence should be addressed. E-mail:
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Wu JHY, Marchioli R, Silletta MG, Macchia A, Song X, Siscovick DS, Harris WS, Masson S, Latini R, Albert C, Brown NJ, Lamarra M, Favaloro RR, Mozaffarian D. Plasma phospholipid omega-3 fatty acids and incidence of postoperative atrial fibrillation in the OPERA trial. J Am Heart Assoc 2013; 2:e000397. [PMID: 24145742 PMCID: PMC3835252 DOI: 10.1161/jaha.113.000397] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Long‐chain polyunsaturated omega‐3 fatty acids (n‐3 PUFA) demonstrated antiarrhythmic potential in experimental studies. In a large multinational randomized trial (OPERA), perioperative fish oil supplementation did not reduce the risk of postoperative atrial fibrillation (PoAF) in cardiac surgery patients. However, whether presupplementation habitual plasma phospholipid n‐3 PUFA, or achieved or change in n‐3 PUFA level postsupplementation are associated with lower risk of PoAF is unknown. Methods and Results In 564 subjects undergoing cardiac surgery between August 2010 and June 2012 in 28 centers across 3 countries, plasma phospholipid levels of eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) were measured at enrollment and again on the morning of cardiac surgery following fish oil or placebo supplementation (10 g over 3 to 5 days, or 8 g over 2 days). The primary endpoint was incident PoAF lasting ≥30 seconds, centrally adjudicated, and confirmed by rhythm strip or ECG. Secondary endpoints included sustained (≥1 hour), symptomatic, or treated PoAF; the time to first PoAF; and the number of PoAF episodes per patient. PoAF outcomes were assessed until hospital discharge or postoperative day 10, whichever occurred first. Relative to the baseline, fish oil supplementation increased phospholipid concentrations of EPA (+142%), DPA (+13%), and DHA (+22%) (P<0.001 each). Substantial interindividual variability was observed for change in total n‐3 PUFA (range=−0.7% to 7.5% after 5 days of supplementation). Neither individual nor total circulating n‐3 PUFA levels at enrollment, morning of surgery, or change between these time points were associated with risk of PoAF. The multivariable‐adjusted OR (95% CI) across increasing quartiles of total n‐3 PUFA at enrollment were 1.0, 1.06 (0.60 to 1.90), 1.35 (0.76 to 2.38), and 1.19 (0.64 to 2.20); and for changes in n‐3 PUFA between enrollment and the morning of surgery were 1.0, 0.78 (0.44 to 1.39), 0.89 (0.51 to 1.55), and 1.01 (0.58 to 1.75). In stratified analysis, demographic, medication, and cardiac parameters did not significantly modify these associations. Findings were similar for secondary PoAF endpoints. Conclusions Among patients undergoing cardiac surgery, neither higher habitual circulating n‐3 PUFA levels, nor achieved levels or changes following short‐term fish oil supplementation are associated with risk of PoAF. Clinical Trial Registration URL: Clinicaltrials.gov Unique identifier: NCT00970489
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Affiliation(s)
- Jason H Y Wu
- Department of Epidemiology, Harvard School of Public Health, Boston, MA
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Singhal A, Lanigan J, Storry C, Low S, Birbara T, Lucas A, Deanfield J. Docosahexaenoic acid supplementation, vascular function and risk factors for cardiovascular disease: a randomized controlled trial in young adults. J Am Heart Assoc 2013; 2:e000283. [PMID: 23817470 PMCID: PMC3828816 DOI: 10.1161/jaha.113.000283] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background A high consumption of omega‐3 long‐chain polyunsaturated fatty acids, and particularly docosahexaenoic acid (DHA), has been suggested to reduce the risk of cardiovascular disease (CVD). However, while DHA supplementation may have benefits for secondary prevention, few studies have investigated the role of DHA in the primary prevention of CVD. Here, we tested the hypothesis that DHA supplementation improves endothelial function and risk factors for CVD. Methods and Results Healthy volunteers (n=328), aged 18 to 37 years, were randomly assigned to 1.6 g DHA/day (from a microalgae source) together with 2.4 g/day carrier oil (index group) or to 4.0 g/day olive oil (control) (both given in eight 500‐mg capsules/day for 16 weeks). Flow‐mediated endothelium‐dependent vasodilation (FMD) of the brachial artery (primary outcome) was measured before and after the intervention (n=268) using high‐resolution vascular ultrasound. FMD was the same in both groups at randomization (mean, SD; 0.27, 0.1 mm), but postintervention was higher in the control group (0.29, 0.1 mm) compared with the DHA‐supplemented group (0.26, 0.1 mm; mean difference −0.03 mm; 95% CI −0.005 to −0.06 mm; P=0.02). Of other outcomes, only triglyceride (mean difference −28%, 95% CI −40% to −15%; P<0.0001) and very low‐density lipoprotein concentrations were significant lower in DHA‐supplemented individuals compared with controls. Conclusions DHA supplementation did not improve endothelial function in healthy, young adults. Nevertheless, lower triglyceride concentrations with DHA supplementation was consistent with previous reports and could have benefits for the prevention of CVD. Clinical Trial Registration Information URL: http://www.controlled-trials.com/ Unique identifier: ISRCTN no: 19987575.
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Affiliation(s)
- Atul Singhal
- The Childhood Nutrition Research Center, UCL Institute of Child Health, London, UK
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Schuchardt JP, Hahn A. Bioavailability of long-chain omega-3 fatty acids. Prostaglandins Leukot Essent Fatty Acids 2013; 89:1-8. [PMID: 23676322 DOI: 10.1016/j.plefa.2013.03.010] [Citation(s) in RCA: 226] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 03/26/2013] [Indexed: 11/18/2022]
Abstract
Supplements have reached a prominent role in improving the supply of long-chain omega-3 fatty acids, such as Eicosapentaenoic acid (EPA 20:5n-3) and Docosahexaenoic acid (DHA 22:6n-3). Similar to other nutrients, the availability of omega-3 fatty acids is highly variable and determined by numerous factors. However, the question of omega-3 fatty acids bioavailability has long been disregarded, which may have contributed to the neutral or negative results concerning their effects in several studies. This review provides an overview of the influence of chemical binding form (free fatty acids bound in ethylesters, triacylglycerides or phospholipids), matrix effects (capsule ingestion with concomitant intake of food, fat content in food) or galenic form (i.e. microencapsulation, emulsification) on the bioavailability of omega-3 fatty acids. There is a need to systematically investigate the bioavailability of omega-3 fatty acids formulations, which might be a key to designing more effective studies in the future.
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von Schacky C. Meta-analysing randomised controlled trials with omega-3 fatty acids in cardiovascular disease. ACTA ACUST UNITED AC 2012; 18:e33. [PMID: 23161504 DOI: 10.1136/eb-2012-100960] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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