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Cao M, Yang F, McClements DJ, Guo Y, Liu R, Chang M, Wei W, Jin J, Wang X. Impact of dietary n-6/n-3 fatty acid ratio of atherosclerosis risk: A review. Prog Lipid Res 2024; 95:101289. [PMID: 38986846 DOI: 10.1016/j.plipres.2024.101289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 07/04/2024] [Accepted: 07/07/2024] [Indexed: 07/12/2024]
Abstract
Atherosclerosis is a causative factor associated with cardiovascular disease (CVD). Over the past few decades, extensive research has been carried out on the relationship between the n-6/n-3 fatty acid ratio of ingested lipids and the progression of atherosclerosis. However, there are still many uncertainties regarding the precise nature of this relationship, which has led to challenges in providing sound dietary advice to the general public. There is therefore a pressing need to review our current understanding of the relationship between the dietary n-6/n-3 fatty acid ratio and atherosclerosis, and to summarize the underlying factors contributing to the current uncertainties. Initially, this article reviews the association between the n-6/n-3 fatty acid ratio and CVDs in different countries. A summary of the current understanding of the molecular mechanisms of n-6/n-3 fatty acid ratio on atherosclerosis is then given, including inflammatory responses, lipid metabolism, low-density lipoprotein cholesterol oxidation, and vascular function. Possible reasons behind the current controversies on the relationship between the n-6/n-3 fatty acid ratio and atherosclerosis are then provided, including the precise molecular structures of the fatty acids, diet-gene interactions, the role of fat-soluble phytochemicals, and the impact of other nutritional factors. An important objective of this article is to highlight areas where further research is needed to clarify the role of n-6/n-3 fatty acid ratio on atherosclerosis.
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Affiliation(s)
- Minjie Cao
- State Key Laboratory of Food Science and Resources, School of Food Science and Technology, Jiangnan University, Wuxi, China; Department of Food Science, University of Massachusetts Amherst, Amherst, MA 01003, USA
| | - Fangwei Yang
- College of Light Industry and Food Engineering, Nanjing Forestry University, No.159 Longpan Road, Xuanwu District, Nanjing, China
| | | | - Yiwen Guo
- State Key Laboratory of Food Science and Resources, School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Ruijie Liu
- State Key Laboratory of Food Science and Resources, School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Ming Chang
- State Key Laboratory of Food Science and Resources, School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Wei Wei
- State Key Laboratory of Food Science and Resources, School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Jun Jin
- State Key Laboratory of Food Science and Resources, School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Xingguo Wang
- State Key Laboratory of Food Science and Resources, School of Food Science and Technology, Jiangnan University, Wuxi, China.
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Zhang Y, Sun Y, Yu Q, Song S, Brenna JT, Shen Y, Ye K. Higher ratio of plasma omega-6/omega-3 fatty acids is associated with greater risk of all-cause, cancer, and cardiovascular mortality: A population-based cohort study in UK Biobank. eLife 2024; 12:RP90132. [PMID: 38578269 PMCID: PMC10997328 DOI: 10.7554/elife.90132] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Abstract
Background Circulating omega-3 and omega-6 polyunsaturated fatty acids (PUFAs) have been associated with various chronic diseases and mortality, but results are conflicting. Few studies examined the role of omega-6/omega-3 ratio in mortality. Methods We investigated plasma omega-3 and omega-6 PUFAs and their ratio in relation to all-cause and cause-specific mortality in a large prospective cohort, the UK Biobank. Of 85,425 participants who had complete information on circulating PUFAs, 6461 died during follow-up, including 2794 from cancer and 1668 from cardiovascular disease (CVD). Associations were estimated by multivariable Cox proportional hazards regression with adjustment for relevant risk factors. Results Risk for all three mortality outcomes increased as the ratio of omega-6/omega-3 PUFAs increased (all Ptrend <0.05). Comparing the highest to the lowest quintiles, individuals had 26% (95% CI, 15-38%) higher total mortality, 14% (95% CI, 0-31%) higher cancer mortality, and 31% (95% CI, 10-55%) higher CVD mortality. Moreover, omega-3 and omega-6 PUFAs in plasma were all inversely associated with all-cause, cancer, and CVD mortality, with omega-3 showing stronger effects. Conclusions Using a population-based cohort in UK Biobank, our study revealed a strong association between the ratio of circulating omega-6/omega-3 PUFAs and the risk of all-cause, cancer, and CVD mortality. Funding Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institute of Health under the award number R35GM143060 (KY). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Affiliation(s)
- Yuchen Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, University of GeorgiaAthens, GeorgiaUnited States
| | - Yitang Sun
- Department of Genetics, University of GeorgiaAthens, GeorgiaUnited States
| | - Qi Yu
- Department of Biostatistics and Bioinformatics, Emory UniversityAtlanta, GeorgiaUnited States
| | - Suhang Song
- Department of Health Policy and Management, College of Public Health, University of GeorgiaAthens, GeorgiaUnited States
| | - J Thomas Brenna
- Division of Nutritional Sciences, Cornell UniversityIthaca, New YorkUnited States
- Dell Pediatric Research Institute and the Depts of Pediatrics, of Nutrition, and of Chemistry, University of Texas at AustinAustin, TexasUnited States
| | - Ye Shen
- Department of Epidemiology and Biostatistics, College of Public Health, University of GeorgiaAthens, GeorgiaUnited States
| | - Kaixiong Ye
- Department of Genetics, University of GeorgiaAthens, GeorgiaUnited States
- Institute of Bioinformatics, University of GeorgiaAthens, GeorgiaUnited States
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Zhang Y, Sun Y, Yu Q, Song S, Brenna JT, Shen Y, Ye K. Higher ratio of plasma omega-6/omega-3 fatty acids is associated with greater risk of all-cause, cancer, and cardiovascular mortality: a population-based cohort study in UK Biobank. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.01.16.23284631. [PMID: 36711941 PMCID: PMC9882493 DOI: 10.1101/2023.01.16.23284631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background Circulating omega-3 and omega-6 polyunsaturated fatty acids (PUFAs) have been associated with various chronic diseases and mortality, but results are conflicting. Few studies examined the role of omega-6/omega-3 ratio in mortality. Methods We investigated plasma omega-3 and omega-6 PUFAs and their ratio in relation to all-cause and cause-specific mortality in a large prospective cohort, the UK Biobank. Of 85,425 participants who had complete information on circulating PUFAs, 6,461 died during follow-up, including 2,794 from cancer and 1,668 from cardiovascular disease (CVD). Associations were estimated by multivariable Cox proportional hazards regression with adjustment for relevant risk factors. Results Risk for all three mortality outcomes increased as the ratio of omega-6/omega-3 PUFAs increased (all Ptrend < 0.05). Comparing the highest to the lowest quintiles, individuals had 26% (95% CI, 15-38%) higher total mortality, 14% (95% CI, 0-31%) higher cancer mortality, and 31% (95% CI, 10-55%) higher CVD mortality. Moreover, omega-3 and omega-6 PUFAs in plasma were all inversely associated with all-cause, cancer, and CVD mortality, with omega-3 showing stronger effects. Conclusions Using a population-based cohort in UK Biobank, our study revealed a strong association between the ratio of circulating omega-6/omega-3 PUFAs and the risk of all-cause, cancer, and CVD mortality.
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Affiliation(s)
- Yuchen Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia, US
| | - Yitang Sun
- Department of Genetics, University of Georgia, Athens, Georgia, US
| | - Qi Yu
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, US
| | - Suhang Song
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia, US
| | - J. Thomas Brenna
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, US
- Dell Pediatric Research Institute and the Depts of Pediatrics, of Nutrition, and of Chemistry, University of Texas at Austin, Austin, TX, US
| | - Ye Shen
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia, US
| | - Kaixiong Ye
- Department of Genetics, University of Georgia, Athens, Georgia, US
- Institute of Bioinformatics, University of Georgia, Athens, Georgia, US
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Guo C, Lin Y, Wu S, Li H, Wu M, Wang F. Association of the dietary inflammation index (DII) with the prevalence of chronic kidney disease in patients with type-2 diabetes mellitus. Ren Fail 2023; 45:2277828. [PMID: 37994461 PMCID: PMC11011236 DOI: 10.1080/0886022x.2023.2277828] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/26/2023] [Indexed: 11/24/2023] Open
Abstract
Chronic kidney disease (CKD) is a major complication of diabetes mellitus (DM). Inflammation is an essential component in the process of CKD progression in patients with DM. Diet is a significant determinant of systemic inflammation levels. However, the association between the dietary inflammatory index (DII) and CKD in individuals with DM remains largely unknown; therefore, the aim of this study was to explore whether the DII is linked to the prevalence of CKD in patients with DM. The research method was as follows: first, data from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018 were obtained. There were 7,974 participants in our study. These individuals were then classified into three groups according to DII tertiles (T1-T3), with each group consisting of 2,658 participants. Logistic regression analysis was employed to examine whether there was a connection between the DII and CKD. We observed a significant association between the DII and the prevalence of CKD in individuals with DM. After full adjustment for age, sex, ethnicity, smoking, drinking, body mass index (BMI), triglyceride (TG), total cholesterol (TC), metabolic equivalents (METs), energy intake, hypoglycemic medications, hypertension, and cardiovascular disease (CVD), the group with a higher DII had a greater frequency of CKD (T2 group: OR: 1.40; 95% CI: 1.10-1.76; p = 0.006; T3 group: OR: 1.67; 95% CI: 1.29-2.17; p < 0.001). The implementation of an anti-inflammatory diet could serve as an intervention strategy for patients with DM to prevent the onset of CKD.
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Affiliation(s)
- Chunhua Guo
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Yong Lin
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Senchao Wu
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Huaqing Li
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Meng Wu
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Fuzhen Wang
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
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Hara A, Tsujiguchi H, Suzuki K, Nakamura M, Okada M, Zhao J, Takazawa C, Suzuki F, Kasahara T, Shimizu Y, Tsuboi H, Kannon T, Tajima A, Takamura T, Nakamura H. Distinct associations between dietary omega-3 and omega-6 fatty acids intake with chronic kidney disease in adults with and without diabetes: A cross-sectional study. Nutrition 2023; 115:112156. [PMID: 37536024 DOI: 10.1016/j.nut.2023.112156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/27/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE We explored the relationship of dietary intake of fatty acids with chronic kidney disease (CKD) according to glycemic status in Japanese people. METHODS A total of 1031 participants aged ≥40 y were included in this population-based, cross-sectional study. A validated self-administered diet history questionnaire was used to measure the dietary intakes of fat and fatty acids, including omega-3 and omega-6 polyunsaturated fatty acids. CKD was defined as estimated glomerular filtration rate < 60 mL/min/1.73 m2 and diabetes as the use of antidiabetic medication, fasting plasma glucose ≥ 126 mg/dL, or hemoglobin A1c of ≥6.5%. Urine biomarkers of kidney injury (liver-type fatty acid-binding protein, β2-microglobulin, and albumin) were also examined. RESULTS The mean age of the participants was 62.5 ± 11.2 y, and 482 (46.8%) of them were men. Overall, 177 (17.2%) participants had CKD. In the multivariable model, low omega-3 intake (odds ratio = 0.109; 95% CI, 0.019-0.645) and high omega-6-to-omega-3 ratio (odds ratio = 2.112; 95% CI, 1.167-3.822) were associated with CKD in participants with diabetes but not in those without. In selected participants with diabetes, a substantial trend of urinary liver-type fatty acid-binding protein and β2-microglobulin level elevation along with an increase in the dietary ratio of omega-6 to omega-3 was observed. CONCLUSIONS Low dietary omega-3 intake and high omega-6-to-omega-3 ratio were associated with CKD in middle-aged and older Japanese people with diabetes but not in those without diabetes. These results may provide insight into the more tailored approaches for dietary polyunsaturated fatty acids to prevent CKD.
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Affiliation(s)
- Akinori Hara
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan.
| | - Hiromasa Tsujiguchi
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Keita Suzuki
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Masaharu Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Masaru Okada
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Jiaye Zhao
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Chie Takazawa
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Fumihiko Suzuki
- Department of Geriatric Dentistry, Ohu University School of Dentistry, Fukushima, Japan
| | - Tomoko Kasahara
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Yukari Shimizu
- Department of Nursing, Faculty of Health Sciences, Komatsu University, Ishikawa, Japan
| | - Hirohito Tsuboi
- Department of Human Nursing, The University of Shiga Prefecture, Hikone, Japan
| | - Takayuki Kannon
- Department of Biomedical Data Science, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Atsushi Tajima
- Department of Bioinformatics and Genomics, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Toshinari Takamura
- Department of Comprehensive Metabology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Hiroyuki Nakamura
- Department of Hygiene and Public Health, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
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Zhang Y, Jing L, Xu X, Ma T, Dong J. Dietary fatty acids intake and all-cause and cardiovascular mortality in patients on peritoneal dialysis. Clin Nutr 2023; 42:2188-2197. [PMID: 37797355 DOI: 10.1016/j.clnu.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 08/18/2023] [Accepted: 09/04/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND & AIMS The relationship between dietary fatty acids (FA) and clinical outcomes are relatively lacking in non-dialyzed and dialyzed chronic kidney disease (CKD) population, resulting in insufficient guide about the dietary FA intake in this population. In this study, we aimed to observe the association between the intake of total or different types of FA and all-cause and cardiovascular (CV) mortality in patients undergoing peritoneal dialysis (PD). METHODS This is a prospective cohort study with data retrospectively analyzed in 881 patients undergoing PD. Dietary FA intake measured by 3-day dietary records. The outcomes were defined as all-cause and CV death. Baseline FA intake and time-averaged FA intake were categorized by tertiles based on the distribution among the study population. We used univariate and multivariate Cox proportional regression models to determine the association between amounts and types of FA and all-cause and CV mortality. RESULTS During a median follow up of 45 months, 93 patients were still being maintained on PD, 467 had died, including 189 (40.5%) attributable to CV death. Compared to patients in the low tertile of total FA (TFA) intake at baseline group, the middle or/and high tertile groups were more likely to be male, younger, well-educated and better nutritional status (P < 0.05). At the baseline, no association was found between all-cause and CV death in either total or different types of FA after adjusting for nutritional variables. As for time-averaged analyses, the associations of TFA, saturated FA (SFA), monounsaturated FA (MUFA), ω-3 and ω-6 polyunsaturated FA (PUFA) and all-cause mortality were weakened after adjustment for laboratory and nutrients variables. However, PUFA independently reduced 5% of mortality even after adjustment for laboratory and nutrients variables [HR 0.95 (0.91, 0.99), P = 0.023], and the ratio of MUFA/PUFA was positively associated with the risk for all-cause mortality [HR 1.05 (1.01, 1.09), P = 0.008]. Furthermore, each 10% increase of the ratio of ω-6/ω-3 was only weakly associated with the risk for all-cause mortality [HR 1.02 (1.00, 1.04), P = 0.034]. As for CVD mortality, the impacts of total and each type of FA disappeared after adjustment for laboratory or nutrients variables. CONCLUSIONS Time-averaged PUFA intake was independently associated with a lower risk for all-cause mortality in our PD cohort, while the higher ratio of MUFA/PUFA and ω-6/ω-3 increased all-cause mortality. More observational and interventional researches are needed to determine these associations.
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Affiliation(s)
- Yaling Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health, Ministry of Education, Beijing, China; Department of Nephrology, Taiyuan Central Hospital, Taiyuan, China
| | - Lulu Jing
- Department of Clinical Nutrition, Peking University First Hospital, Beijing, China
| | - Xiao Xu
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health, Ministry of Education, Beijing, China
| | - Tiantian Ma
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health, Ministry of Education, Beijing, China
| | - Jie Dong
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health, Ministry of Education, Beijing, China.
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Huang G, Ren G. Interaction between ω-6 fatty acids intake and blood cadmium on the risk of low cognitive performance in older adults from National Health and Nutrition Examination Survey (NHANES) 2011-2014. BMC Geriatr 2022; 22:292. [PMID: 35392817 PMCID: PMC8988388 DOI: 10.1186/s12877-022-02988-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background Identifying preventable diets and environmental exposure is essential to ensuring the health of the aging population. This study evaluated the interaction effect between blood cadmium and ω-6 fatty acids intake on low cognitive performance in Americans. Method The data of this cross-sectional study were obtained from the 2011–2012 and 2013–2014 National Health and Nutritional Examination Survey (NHANES). Cognitive performance was measured by the Consortium to Establish a Registry for Alzheimer’s Disease test, Animal Fluency Test, and Digit Symbol Substitution Test. Multivariate logistic regression models were used. Results A total of 1,918 individuals were included, with 467 (24.35%) low cognitive performance. Compared with participants with normal-level blood cadmium, those with high-level blood cadmium had a higher risk of low cognitive performance [odds ratio (OR) was 1.558 with 95% confidence interval (CI): 1.144–2.123]. Low-level ω-6 fatty acids intake was positively associated with low cognitive performance [OR = 1.633 (95%CI: 1.094–2.436)] compared with normal-level intake. Moreover, there was a significant interaction between low-level ω-6 fatty acids intake and high-level blood cadmium on the risk of low cognitive performance (relative excess risk due to interaction: 0.570, 95%CI: 0.208-0.932; the attributable proportion of interaction: 0.219, 95%CI: 0.102‐0.336; synergy index: 1.552, 95%CI: 1.189‐2.027). Conclusions There was a synergistic interaction between low-level ω-6 fatty acids intake and high-level blood cadmium on low cognitive performance. Low-level ω-6 fatty acids intake may amplify the adverse effects of long-term exposure to cadmium on cognitive performance. This may have a certain significance for the prevention of cognitive decline in the elderly. Supplementary information The online version contains supplementary material available at 10.1186/s12877-022-02988-7.
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Affiliation(s)
- Guangxiang Huang
- Department of Neurology, The First People's Hospital of Xiaoshan District, Xiaoshan First Affiliated Hospital of Wenzhou Medical University, 311200, Hangzhou, Zhejiang, P. R. China
| | - Gang Ren
- Department of Neurology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, No.99 Longcheng Street, Shanxi, 030032, Taiyuan, P. R. China.
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Li WL, Zhang NH, Ge SW, Xu G. Dietary Omega-3 Fatty Acid Intake and Mortality in CKD Population: A 1999-2014 NHANES Analysis. Am J Nephrol 2021; 52:909-918. [PMID: 34839290 DOI: 10.1159/000520027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/21/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION High risk of early death, especially contributed to cardiovascular disease, exists in patients who have chronic kidney disease (CKD). And the burden of cardiovascular disease is able to be lightened by an increase in omega-3 polyunsaturated fatty acid (omega-3 PUFA). A diet high in omega-3 PUFA in the general population is protective, although it is inconclusive about its beneficial role in the CKD population. METHODS From the 1999 to 2014 National Health and Nutrition Examination Surveys (NHANES), we can collect 2,990 participants who suffered from CKD, who were classified into 4 groups: <0.86, 0.87-1.30, 1.31-1.92, and 1.93-9.65 g/day based on NHANES 24-h dietary recall questionnaire dietary omega-3 PUFA. Moreover, their mortality details were available to be obtained by linking NHANES to the National Death Index. The associations between dietary omega-3 PUFA and mortality were evaluated by constructing multivariable Cox proportional hazards models. RESULTS Over 8 years of a median follow-up, 864 deaths were recorded. The adjusted hazard ratios (95% confidence interval) for all-cause mortality of the diseased people with CKD in the 2nd (0.87-1.30 g/day), 3rd (0.87-1.30 g/day), and 4th (1.93-9.65 g/day) quartiles of dietary omega-3 PUFA were 0.94 (0.72, 1.23), 0.74 (0.54, 1.02), and 0.67 (0.48, 0.93), respectively, versus those with the lowest quartile of dietary omega-3 PUFA intake (<0.86 g/day) (p for trend = 0.011). CONCLUSION There may be a inverse relation of dietary omega-3 PUFA intake and all-cause mortality in patients with CKD. Therefore, an increase of dietary omega-3 PUFA may be encouraged to be used clinically in patients with CKD.
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Affiliation(s)
- Wei-Lan Li
- Division of Internal Medicine, Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,
| | - Nan-Hui Zhang
- Department of Nephrology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Shu-Wang Ge
- Division of Internal Medicine, Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Xu
- Division of Internal Medicine, Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Vahid F, Rahmani D. Can an anti-inflammatory diet be effective in preventing or treating viral respiratory diseases? A systematic narrative review. Clin Nutr ESPEN 2021; 43:9-15. [PMID: 34024569 PMCID: PMC9587761 DOI: 10.1016/j.clnesp.2021.04.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 01/09/2023]
Abstract
Respiratory Viruses infections (RVI) such as rhinovirus, coronavirus, influenza virus, and adenovirus affect the respiratory and the immune systems. The role of nutrition in the respiratory and immune systems has been studied in some studies, and its importance is undeniable. In addition, one of the key findings in this disease is high inflammation that affects almost all patients. This systematic narrative review aims to answer the question, "Can an anti-inflammatory diet be effective in preventing or treating viral respiratory diseases?" A systematic review search was used for the articles extraction. All studies published in English from 1999 to 2020 investigating dietary inflammatory conditions and RVI were included. Food items with anti-inflammatory properties were selected based on the definition of the dietary inflammatory index (DII). We used Google Scholar, Pub Med, Scopus, Web of Science, Springer, Science Direct, Directory of Open Access Journals, Elsevier, Taylor and Francis, ProQuest, EBSCO, MEDLINE, and SciELO databases for extracting articles. Keywords were restricted by DII. Based on DII, food items/nutrients are involved in inflammation, some of which have anti-inflammatory and some inflammatory properties. Some foods/nutrients, in addition to their anti-inflammatory properties, have antioxidant, antiviral, and immune-enhancing properties. Considering the immune system's involvement, increased inflammation, and involvement of the pulmonary system in RVI and the remarkable role of the anti-inflammatory foods for counteracting them, it is recommended to use a predominantly anti-inflammatory diet along with prevention/control and treatment protocols. An anti-inflammatory diet (based on DII) includes turmeric, ginger, garlic, onions, saffron, dietary vitamin C, vitamin D, zinc, and omega-3 are recommended to reduce infection symptoms and duration.
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Affiliation(s)
- Farhad Vahid
- Population Health Department, Public Health Research, Luxembourg Institute of Health, Luxembourg,Corresponding author
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Pangestuti R, Shin KH, Kim SK. Anti-Photoaging and Potential Skin Health Benefits of Seaweeds. Mar Drugs 2021; 19:172. [PMID: 33809936 PMCID: PMC8004118 DOI: 10.3390/md19030172] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/16/2021] [Accepted: 03/20/2021] [Indexed: 12/17/2022] Open
Abstract
The skin health benefits of seaweeds have been known since time immemorial. They are known as potential renewable sources of bioactive metabolites that have unique structural and functional features compared to their terrestrial counterparts. In addition, to the consciousness of green, eco-friendly, and natural skincare and cosmetics products, their extracts and bioactive compounds such as fucoidan, laminarin, carrageenan, fucoxanthin, and mycosporine like amino acids (MAAs) have proven useful in the skincare and cosmetic industries. These bioactive compounds have shown potential anti-photoaging properties. Furthermore, some of these bioactive compounds have been clinically tested and currently available in the market. In this contribution, the recent studies on anti-photoaging properties of extracts and bioactive compounds derived from seaweeds were described and discussed.
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Affiliation(s)
- Ratih Pangestuti
- Director of Research and Development Division for Marine Bio Industry, Indonesian Institute of Sciences (LIPI), West Nusa Tenggara 83352, Indonesia;
| | - Kyung-Hoon Shin
- Department. of Marine Science and Convergence Engineering, College of Science and Technology, Hanyang University, Gyeonggi-do 11558, Korea;
| | - Se-Kwon Kim
- Department. of Marine Science and Convergence Engineering, College of Science and Technology, Hanyang University, Gyeonggi-do 11558, Korea;
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11
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Circulating fatty acid profiles are associated with protein energy wasting in maintenance hemodialysis patients: a cross-sectional study. Sci Rep 2021; 11:1416. [PMID: 33446880 PMCID: PMC7809126 DOI: 10.1038/s41598-020-80812-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/28/2020] [Indexed: 12/02/2022] Open
Abstract
The metabolic impact of circulating fatty acids (FAs) in patients requiring hemodialysis (HD) is unknown. We investigated the associations between plasma triglyceride (TG) FAs and markers of inflammation, insulin resistance, nutritional status and body composition. Plasma TG-FAs were measured using gas chromatography in 341 patients on HD (age = 55.2 ± 14.0 years and 54.3% males). Cross-sectional associations of TG-FAs with 13 markers were examined using multivariate linear regression adjusted for potential confounders. Higher levels of TG saturated fatty acids were associated with greater body mass index (BMI, r = 0.230), waist circumference (r = 0.203), triceps skinfold (r = 0.197), fat tissue index (r = 0.150), serum insulin (r = 0.280), and homeostatic model assessment of insulin resistance (r = 0.276), but lower malnutrition inflammation score (MIS, r = − 0.160). Greater TG monounsaturated fatty acid levels were associated with lower lean tissue index (r = − 0.197) and serum albumin (r = − 0.188), but higher MIS (r = 0.176). Higher levels of TG n-3 polyunsaturated fatty acids (PUFAs) were associated with lower MIS (r = − 0.168) and interleukin-6 concentrations (r = − 0.115). Higher levels of TG n-6 PUFAs were associated with lower BMI (r = − 0.149) but greater serum albumin (r = 0.112). In conclusion, TG monounsaturated fatty acids were associated with poor nutritional status, while TG n-3 PUFAs were associated with good nutritional status. On the other hand, TG saturated fatty acids and TG n-6 PUFAs had both favorable and unfavorable associations with nutritional parameters.
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12
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Yue H, Qiu B, Jia M, Liu J, Wang J, Huang F, Xu T. Development and optimization of spray-dried functional oil microcapsules: Oxidation stability and release kinetics. Food Sci Nutr 2020; 8:4730-4738. [PMID: 32994934 PMCID: PMC7500757 DOI: 10.1002/fsn3.1684] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 11/10/2022] Open
Abstract
This study aimed to optimize the microencapsulation method for a functional oil using high amylose corn starch (HACS) and assessed its structure and antioxidant capacity. The results showed that the optimal microencapsulation condition is achieved by using 28.5% of functional oil, 15.75% of HACS, and 57.86% of proportion of monoglyceride in emulsifier with 94.86% microencapsulation efficiency. Scanning electron microscopy and particle size measurement showed that the functional oil microcapsules were uniform size, smooth surface, spherical shape, and without cracks in the wall of the capsules. In vitro oil release of microencapsulates results showed that microencapsulated functional oil containing HACS has a better sustained release effect. The microcapsules containing HACS exhibited a lower lipid oxidation rate during storage. In conclusion, microencapsulation of HACS as wall material improved the stability of functional oil and this formulation of microcapsules was satisfactorily applied in powdered food for diabetic patients.
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Affiliation(s)
- Hao Yue
- Institute of Agro-Food Science and Technology Shandong Academy of Agricultural Sciences/Shandong Provincial Food for Special Medical Purpose Engineering Technology Research Center/Key Laboratory of Agro-Products Processing Technology of Shandong Province/Key Laboratory of Novel Food Resources Processing Ministry of Agriculture Jinan China
| | - Bin Qiu
- Institute of Agro-Food Science and Technology Shandong Academy of Agricultural Sciences/Shandong Provincial Food for Special Medical Purpose Engineering Technology Research Center/Key Laboratory of Agro-Products Processing Technology of Shandong Province/Key Laboratory of Novel Food Resources Processing Ministry of Agriculture Jinan China
| | - Min Jia
- Institute of Agro-Food Science and Technology Shandong Academy of Agricultural Sciences/Shandong Provincial Food for Special Medical Purpose Engineering Technology Research Center/Key Laboratory of Agro-Products Processing Technology of Shandong Province/Key Laboratory of Novel Food Resources Processing Ministry of Agriculture Jinan China
| | - Jie Liu
- China-Canada Joint Lab of Food Nutrition and Health (Beijing) Beijing Technology & Business University (BTBU) Beijing China
| | - Jing Wang
- China-Canada Joint Lab of Food Nutrition and Health (Beijing) Beijing Technology & Business University (BTBU) Beijing China
| | - Fenghong Huang
- Institute of Agro-Food Science and Technology Shandong Academy of Agricultural Sciences/Shandong Provincial Food for Special Medical Purpose Engineering Technology Research Center/Key Laboratory of Agro-Products Processing Technology of Shandong Province/Key Laboratory of Novel Food Resources Processing Ministry of Agriculture Jinan China
| | - Tongcheng Xu
- Institute of Agro-Food Science and Technology Shandong Academy of Agricultural Sciences/Shandong Provincial Food for Special Medical Purpose Engineering Technology Research Center/Key Laboratory of Agro-Products Processing Technology of Shandong Province/Key Laboratory of Novel Food Resources Processing Ministry of Agriculture Jinan China
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13
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Farajzadeh Alan D, Naeli MH, Naderi M, Jafari SM, Tavakoli HR. Production of Trans-free fats by chemical interesterified blends of palm stearin and sunflower oil. Food Sci Nutr 2019; 7:3722-3730. [PMID: 31763021 PMCID: PMC6848835 DOI: 10.1002/fsn3.1231] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/29/2019] [Accepted: 08/31/2019] [Indexed: 11/28/2022] Open
Abstract
In this study, production of trans-free fats through chemical interesterification of binary blends of palm stearin (PS) and sunflower oil (SFO) and their physicochemical changes after the process was investigated. Analyzed responses included fatty acid and triacylglycerol composition, iodine value, free fatty acid (FFA), soap content, peroxide value (PV), plastic range, slip melting point (SMP), solid fat content (SFC), and oxidative stability along with potential applications of the interesterified fats. Transfatty acid content of PS/SFO blends was lower than 0.36%. Chemical interesterification increased the FFA and soap content and also decreased PV and oxidative stability index (at 110°C). After the process, SMP and SFC were reduced, also the plastic range transferred to the lower temperatures. All the interesterified blends melted completely at the body temperature, and their SFC was <32%. The melting characteristics of the PS/SFO-interesterified blends were suitable for many fat-based products.
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Affiliation(s)
- Davood Farajzadeh Alan
- Medicine, Quran and Hadith Research CenterBaqiyatallah University of Medical SciencesTehranIran
| | - Mohammad Hossein Naeli
- Department of Food Science and TechnologyFaculty of Agricultural EngineeringSari Agricultural Sciences and Natural Resources UniversitySariIran
| | - Mehdi Naderi
- Department of Food Materials and Process Design EngineeringFaculty of Food Science and TechnologyGorgan University of Agricultural Sciences and Natural ResourcesGorganIran
| | - Seid Mahdi Jafari
- Department of Food Materials and Process Design EngineeringFaculty of Food Science and TechnologyGorgan University of Agricultural Sciences and Natural ResourcesGorganIran
| | - Hamid Reza Tavakoli
- Health Research CenterLife Style InstituteBaqiyatallah University of medical SciencesTehranIran
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14
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Ketogenic Diet and Microbiota: Friends or Enemies? Genes (Basel) 2019; 10:genes10070534. [PMID: 31311141 PMCID: PMC6678592 DOI: 10.3390/genes10070534] [Citation(s) in RCA: 155] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 07/06/2019] [Accepted: 07/10/2019] [Indexed: 12/12/2022] Open
Abstract
Over the last years, a growing body of evidence suggests that gut microbial communities play a fundamental role in many aspects of human health and diseases. The gut microbiota is a very dynamic entity influenced by environment and nutritional behaviors. Considering the influence of such a microbial community on human health and its multiple mechanisms of action as the production of bioactive compounds, pathogens protection, energy homeostasis, nutrients metabolism and regulation of immunity, establishing the influences of different nutritional approach is of pivotal importance. The very low carbohydrate ketogenic diet is a very popular dietary approach used for different aims: from weight loss to neurological diseases. The aim of this review is to dissect the complex interactions between ketogenic diet and gut microbiota and how this large network may influence human health.
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15
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Campos-Staffico AM, Costa APR, Carvalho LSF, Moura FA, Santos SN, Coelho-Filho OR, Nadruz W, Quinaglia E Silva JC, Sposito AC. Omega-3 intake is associated with attenuated inflammatory response and cardiac remodeling after myocardial infarction. Nutr J 2019; 18:29. [PMID: 31060562 PMCID: PMC6503367 DOI: 10.1186/s12937-019-0455-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 04/29/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Myocardial infarction (MI) elicits an intense acute inflammatory response that is essential for cardiac repair. However, an excessive inflammatory response also favors myocardial apoptosis, cardiac remodeling, and cardiovascular mortality. Omega-3 polyunsaturated fatty acids (ω-3) bear anti-inflammatory effects, which may mitigate the inflammatory response during MI. This study investigated whether ω-3 intake is associated with attenuation of the MI-related inflammatory response and cardiac remodeling. METHODS ST-elevation MI (STEMI) patients (n = 421) underwent clinical, biochemical, nutritional, 3D echocardiogram, Cardiac Magnetic Resonance imaging (CMRi) at 30 days and 3D echocardiogram imaging at six months after the MI. Blood tests were performed at day one (D1) and day five (D5) of hospitalization. Changes in inflammatory markers (ΔD5-D1) were calculated. A validated food frequency questionnaire estimated the nutritional consumption and ω-3 intake in the last 3 months before admission. RESULTS The intake of ω-3 below the median (< 1.7 g/day) was associated with a short-term increase in hs-C-reactive protein [OR:1.96(1.24-3.10); p = 0.004], Interleukin-2 [OR:2.46(1.20-5.04); p = 0.014], brain-type natriuretic peptide [OR:2.66(1.30-5.44); p = 0.007], left-ventricle end-diastolic volume [OR:5.12(1.11-23.52)]; p = 0.036] and decreases in left-ventricle ejection fraction [OR:2.86(1.47-6.88); p = 0.017] after adjustment for covariates. No differences were observed in the extension of infarcted mass obtained by CMRi. CONCLUSION These findings suggest that a reduced daily intake of ω-3 may intensify outcome-determining mechanisms after STEMI, such as acute inflammatory response and late left ventricular remodeling. TRIAL REGISTRATION Clinical Trial Registry number and website: NCT02062554 .
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Affiliation(s)
| | | | | | - Filipe A Moura
- Cardiology Department, State University of Campinas (Unicamp), Campinas, SP, Brazil
- Department of Medicine, Weill-Cornell Medical College, New York, United States
| | - Simone N Santos
- Cardiology Department, State University of Campinas (Unicamp), Campinas, SP, Brazil
| | | | - Wilson Nadruz
- Cardiology Department, State University of Campinas (Unicamp), Campinas, SP, Brazil
| | | | - Andrei C Sposito
- Cardiology Department, State University of Campinas (Unicamp), Campinas, SP, Brazil.
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16
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Khor BH, Sahathevan S, Sualeheen A, Ali MSM, Narayanan SS, Chinna K, Gafor AHA, Goh BL, Ahmad G, Morad Z, Daud ZAM, Khosla P, Sundram K, Karupaiah T. Dietary fatty acid intake in hemodialysis patients and associations with circulating fatty acid profiles: A cross-sectional study. Nutrition 2019; 63-64:14-21. [PMID: 30927642 DOI: 10.1016/j.nut.2019.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 12/05/2018] [Accepted: 01/09/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVES The aims of this study were threefold: first, to assess the dietary fatty acid (FA) intake and blood FA status in Malaysian patients on hemodialysis (HD); second, to examine the association between dietary FA intakes and blood FA profiles in patients on HD; and third, to determine whether blood FAs could serve as a biomarker of dietary fat intake quality in these patients. METHODS Using 3 d of dietary records, FA intakes of 333 recruited patients were calculated using a food database built from laboratory analyses of commonly consumed Malaysian foods. Plasma triacylglycerol (TG) and erythrocyte FAs were determined by gas chromatography. RESULTS High dietary saturated fatty acid (SFA) and monounsaturated fatty acid (MUFA) consumption trends were observed. Patients on HD also reported low dietary ω-3 and ω-6 polyunsaturated fatty acid (PUFA) consumptions and low levels of TG and erythrocyte FAs. TG and dietary FAs were significantly associated respective to total PUFA, total ω-6 PUFA, 18:2 ω-6, total ω-3 PUFA, 18:3 ω-3, 22:6 ω-3, and trans 18:2 isomers (P < 0.05). Contrarily, only dietary total ω-3 PUFA and 22:6 ω-3 were significantly associated with erythrocyte FAs (P < 0.01). The highest tertile of fish and shellfish consumption reflected a significantly higher proportion of TG 22:6 ω-3. Dietary SFAs were directly associated with TG and erythrocyte MUFA, whereas dietary PUFAs were not. CONCLUSION TG and erythrocyte FAs serve as biomarkers of dietary PUFA intake in patients on HD. Elevation of circulating MUFA may be attributed to inadequate intake of PUFAs.
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Affiliation(s)
- Ban-Hock Khor
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sharmela Sahathevan
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ayesha Sualeheen
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohammad Syafiq Md Ali
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | | | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Abdul Halim Abdul Gafor
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Bak-Leong Goh
- Department of Nephrology, Serdang Hospital, Selangor, Malaysia
| | - Ghazali Ahmad
- Department of Nephrology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Zaki Morad
- National Kidney Foundation of Malaysia, Petaling Jaya, Selangor, Malaysia
| | - Zulfitri Azuan Mat Daud
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Pramod Khosla
- Department of Nutrition and Food Sciences, Wayne State University, Detroit, Michigan, USA
| | | | - Tilakavati Karupaiah
- Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; School of BioSciences, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia.
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17
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Cardoso C, Martinho JP, Lopes PA, Martins S, Correia J, Afonso C, Alarcón FJ, González-Fernández MJ, Pinto RM, Prates JA, Bandarra NM, Guil-Guerrero JL. Stearidonic acid combined with alpha-linolenic acid improves lipemic and neurological markers in a rat model subject to a hypercaloric diet. Prostaglandins Leukot Essent Fatty Acids 2018; 135:137-146. [PMID: 30103925 DOI: 10.1016/j.plefa.2018.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 05/18/2018] [Accepted: 07/16/2018] [Indexed: 12/31/2022]
Abstract
In this study, we hypothesized that terrestrial plant oils, rich in alpha linolenic acid (ALA) and stearidonic acid (SDA) relative to fish oil, rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), prevent negative effects on cardiovascular and neurological function using a rat model fed a hypercaloric diet. Results showed effects on the FA profile, namely, eicosapentaenoic, EPA, and docosahexaenoic, DHA, levels. There were also effects on neural aspects (cAMP response element-binding protein, CREB, gene expression, at least, doubled) and the pro-inflammatory/anti-inflammatory balance (TNF-α, tumor necrosis factor alpha reduced by 30-50%). The most positive impact of ALA and SDA was the beneficial reduction of total lipids (from 395 ± 3 to 352-361 mg/dL), VLDL-cholesterol (from 21.8 ± 0.2 to 14.1-17.8 mg/dL), and triacylglycerols (from 109 ± 1 to 71-89 mg/dL) in both LIN (diet enriched in linseed oil) and BUG (diet enriched in Buglossoides oil) groups. Overall, data indicate that ALA- and SDA-rich lipid sources may counteract the undesirable cardiovascular effects of a hypercaloric diet based on milk fat.
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Affiliation(s)
- Carlos Cardoso
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Rua Alfredo Magalhães Ramalho, 6, 1495-006, Lisbon, Portugal; CIIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas 289, 4050-123, Porto, Portugal.
| | - Joana Paiva Martinho
- CIISA, Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, 1300-477, Lisboa, Portugal
| | - Paula A Lopes
- CIISA, Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, 1300-477, Lisboa, Portugal
| | - Susana Martins
- CIISA, Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, 1300-477, Lisboa, Portugal
| | - Jorge Correia
- CIISA, Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, 1300-477, Lisboa, Portugal
| | - Cláudia Afonso
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Rua Alfredo Magalhães Ramalho, 6, 1495-006, Lisbon, Portugal; CIIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas 289, 4050-123, Porto, Portugal.
| | - Francisco J Alarcón
- Food Technology Division, University of Almería, Crta, Sacramento s/n, 04120, Almería, Spain
| | | | - Rui M Pinto
- iMed.UL, Faculdade de Farmácia, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003, Lisboa, Portugal
| | - José A Prates
- CIISA, Faculdade de Medicina Veterinária, Universidade de Lisboa, Avenida da Universidade Técnica, 1300-477, Lisboa, Portugal
| | - Narcisa M Bandarra
- Division of Aquaculture and Upgrading (DivAV), Portuguese Institute for the Sea and Atmosphere (IPMA, IP), Rua Alfredo Magalhães Ramalho, 6, 1495-006, Lisbon, Portugal; CIIMAR, Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas 289, 4050-123, Porto, Portugal
| | - José L Guil-Guerrero
- Food Technology Division, University of Almería, Crta, Sacramento s/n, 04120, Almería, Spain
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18
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Saglimbene VM, Wong G, Ruospo M, Palmer SC, Campbell K, Larsen VG, Natale P, Teixeira-Pinto A, Carrero JJ, Stenvinkel P, Gargano L, Murgo AM, Johnson DW, Tonelli M, Gelfman R, Celia E, Ecder T, Bernat AG, Del Castillo D, Timofte D, Török M, Bednarek-Skublewska A, Duława J, Stroumza P, Hoischen S, Hansis M, Fabricius E, Wollheim C, Hegbrant J, Craig JC, Strippoli GFM. Dietary n-3 polyunsaturated fatty acid intake and all-cause and cardiovascular mortality in adults on hemodialysis: The DIET-HD multinational cohort study. Clin Nutr 2017; 38:429-437. [PMID: 29248251 DOI: 10.1016/j.clnu.2017.11.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 11/27/2017] [Accepted: 11/28/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Patients on hemodialysis suffer from high risk of premature death, which is largely attributed to cardiovascular disease, but interventions targeting traditional cardiovascular risk factors have made little or no difference. Long chain n-3 polyunsaturated fatty acids (n-3 PUFA) are putative candidates to reduce cardiovascular disease. Diets rich in n-3 PUFA are recommended in the general population, although their role in the hemodialysis setting is uncertain. We evaluated the association between the dietary intake of n-3 PUFA and mortality for hemodialysis patients. METHODS The DIET-HD study is a prospective cohort study (January 2014-June 2017) in 9757 adults treated with hemodialysis in Europe and South America. Dietary n-3 PUFA intake was measured at baseline using the GA2LEN Food Frequency Questionnaire. Adjusted Cox regression analyses clustered by country were conducted to evaluate the association of dietary n-3 PUFA intake with cardiovascular and all-cause mortality. RESULTS During a median follow up of 2.7 years (18,666 person-years), 2087 deaths were recorded, including 829 attributable to cardiovascular causes. One third of the study participants consumed sufficient (at least 1.75 g/week) n-3 PUFA recommended for primary cardiovascular prevention, and less than 10% recommended for secondary prevention (7-14 g/week). Compared to patients with the lowest tertile of dietary n-3 PUFA intake (<0.37 g/week), the adjusted hazard ratios (95% confidence interval) for cardiovascular mortality for patients in the middle (0.37 to <1.8 g/week) and highest (≥1.8 g/week) tertiles of n-3 PUFA were 0.82 (0.69-0.98) and 1.03 (0.84-1.26), respectively. Corresponding adjusted hazard ratios for all-cause mortality were 0.96 (0.86-1.08) and 1.00 (0.88-1.13), respectively. CONCLUSIONS Dietary n-3 PUFA intake was not associated with cardiovascular or all-cause mortality in patients on hemodialysis. As dietary n-3 PUFA intake was low, the possibility that n-3 PUFA supplementation might mitigate cardiovascular risk has not been excluded.
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Affiliation(s)
- Valeria M Saglimbene
- Sydney School of Public Health, The University of Sydney, Edward Ford Building A27, NSW 2006, Australia; Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden.
| | - Germaine Wong
- Sydney School of Public Health, The University of Sydney, Edward Ford Building A27, NSW 2006, Australia; Centre for Kidney Research, Children's Hospital at Westmead, 170 Hawkesbury Road, Westmead, NSW 2145, Australia; Department of Renal Medicine, Westmead Hospital, Hawkesbury Rd & Darcy Road, Westmead, NSW 2145, Australia.
| | - Marinella Ruospo
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden; Division of Nephrology and Transplantation, Amedeo Avogadro University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy.
| | - Suetonia C Palmer
- Department of Medicine, University of Otago Christchurch, PO Box 4345, 8140, New Zealand.
| | - Katrina Campbell
- Department of Nutrition and Dietetics, University of Queensland at Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, QLD 4102, Australia.
| | - Vanessa Garcia Larsen
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Patrizia Natale
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden; Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, 70124 Bari, Italy.
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, The University of Sydney, Edward Ford Building A27, NSW 2006, Australia.
| | - Juan-Jesus Carrero
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
| | - Peter Stenvinkel
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
| | - Letizia Gargano
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden.
| | - Angelo M Murgo
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden.
| | - David W Johnson
- Department of Nephrology, Division of Medicine, University of Queensland at the Princess Alexandra Hospital, ARTS Building, Ipswich Road, Woolloongabba, Brisbane, QLD 4102, Australia; Translational Research Institute, University of Queensland, 37 Kent Street, Woolloongabba, QLD 4102, Australia.
| | - Marcello Tonelli
- Cumming School of Medicine, Health Sciences Centre, University of Calgary, 2500 University Dr NW, Calgary AB T2N 1N4, Canada.
| | - Rubén Gelfman
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden.
| | - Eduardo Celia
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden.
| | - Tevfik Ecder
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden.
| | - Amparo G Bernat
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden.
| | | | - Delia Timofte
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden.
| | - Marietta Török
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden.
| | - Anna Bednarek-Skublewska
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden; Medical University of Lublin, Aleje Racławickie 1, Lublin, Poland.
| | - Jan Duława
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden; Medical University of Silesia, Medyków 18, Katowice, Poland.
| | - Paul Stroumza
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden.
| | - Susanne Hoischen
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden.
| | - Martin Hansis
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden.
| | - Elisabeth Fabricius
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden.
| | - Charlotta Wollheim
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden.
| | - Jörgen Hegbrant
- Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden.
| | - Jonathan C Craig
- Sydney School of Public Health, The University of Sydney, Edward Ford Building A27, NSW 2006, Australia; Centre for Kidney Research, Children's Hospital at Westmead, 170 Hawkesbury Road, Westmead, NSW 2145, Australia.
| | - Giovanni F M Strippoli
- Sydney School of Public Health, The University of Sydney, Edward Ford Building A27, NSW 2006, Australia; Diaverum Medical-Scientific Office, Trollebergsvagen 2-4, 222 29 Lund, Sweden; Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare, 70124 Bari, Italy; Diaverum Academy, Via Solarino 1, Bari 70124, Italy.
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Roach LA, Lambert K, Holt JL, Meyer BJ. Diet quality in patients with end-stage kidney disease undergoing dialysis. J Ren Care 2017; 43:226-234. [PMID: 28944596 DOI: 10.1111/jorc.12215] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND People on haemodialysis (HD) are at risk of consuming a poor quality diet. This includes inadequate intake of omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA). OBJECTIVE This study aims to investigate diet quality, with a particular focus on n-3 LCPUFA intake, in a population of incentre HD patients. DESIGN Dietary intake was measured using three 24 hour recalls; the Polyunsaturated food frequency questionnaire (PUFA FFQ) and the Total Diet Score (TDS). Dietary intake was also compared to evidence based practice guidelines (EBPG). Nutritional status was assessed using the Patient Generated Subjective Global Assessment (PG SGA). SUBJECTS A total of 32 dialysis patients were recruited, from two regional HD centres in New South Wales, Australia. MAIN OUTCOME MEASURE Diet quality was the main outcome measure. RESULTS Diet quality of study participants was poor, with the majority not meeting the EBPG for energy, protein and potassium. All participants exceeded the recommended amount of saturated fat. The mean TDS of the dialysis cohort was 10.2, which was significantly higher than the TDS of 9.3 of a healthy disease free cohort (p < 0.05). Positive correlations were found between TDS and LC omega-3 intake (r = 0.392) and TDS and total omega-6 intake (r = 0.363). Only 22% of participants met the suggested dietary target for n-3 LCPUFA intake. CONCLUSION Dialysis patients in this study had suboptimal diet quality. Improvements are required for better adherence to the EBPG. Increased consumption of n-3 LCPUFA fatty acids may also be of benefit.
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Affiliation(s)
- Lauren A Roach
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Kelly Lambert
- Illawarra Shoalhaven Local Health District, Department of Clinical Nutrition, Wollongong, New South Wales, Australia
| | - Jane L Holt
- Illawarra Shoalhaven Local Health District, Renal Service, Wollongong, New South Wales, Australia
| | - Barbara J Meyer
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Sabatino A, Regolisti G, Gandolfini I, Delsante M, Fani F, Gregorini MC, Fiaccadori E. Diet and enteral nutrition in patients with chronic kidney disease not on dialysis: a review focusing on fat, fiber and protein intake. J Nephrol 2017; 30:743-754. [PMID: 28884267 DOI: 10.1007/s40620-017-0435-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 08/24/2017] [Indexed: 02/07/2023]
Abstract
The clinical data available on dietary requirements of patients with chronic kidney disease (CKD) not on dialysis are limited and largely inconclusive in terms of the renal, cardiovascular and nutritional outcomes achievable through dietary modifications. Restriction of protein intake during the early stages of CKD may in fact slow its progression, but at the same time this approach may also lead to protein-energy wasting, if energy intake is not adequate and properly monitored. Unfortunately, compliance to dietary recommendations is traditionally low in this patient population. A switch from saturated to mono- and polyunsaturated fats is generally recognized as advantageous for cardiac health; however, the benefits in term of renal function are largely unknown. Similarly, the association between dietary fiber intake and kidney disease is largely unknown. In fact, while there is evidence on the positive health effects of dietary fibers in the general population, nutritional guidelines for CKD lack formal recommendations concerning fiber intake. This paper reviews data and evidence from clinical trials and meta-analyses on renal and cardiovascular outcomes related to modifications in protein, fat and fiber intake. Suggestions for maintaining nutritional status through patient-oriented dietary patterns and enteral supplementation in CKD patients on conservative therapy are also presented.
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Affiliation(s)
- Alice Sabatino
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43100, Parma, Italy
| | - Giuseppe Regolisti
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43100, Parma, Italy
| | - Ilaria Gandolfini
- Postgraduate School of Nephrology, University of Parma, Parma, Italy
| | - Marco Delsante
- Postgraduate School of Nephrology, University of Parma, Parma, Italy
| | - Filippo Fani
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43100, Parma, Italy
| | | | - Enrico Fiaccadori
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43100, Parma, Italy. .,Postgraduate School of Nephrology, University of Parma, Parma, Italy.
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Dietary Metabolites and Chronic Kidney Disease. Nutrients 2017; 9:nu9040358. [PMID: 28375181 PMCID: PMC5409697 DOI: 10.3390/nu9040358] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 03/30/2017] [Accepted: 03/31/2017] [Indexed: 01/04/2023] Open
Abstract
Dietary contents and their metabolites are closely related to chronic kidney disease (CKD) progression. Advanced glycated end products (AGEs) are a type of uremic toxin produced by glycation. AGE accumulation is not only the result of elevated glucose levels or reduced renal clearance capacity, but it also promotes CKD progression. Indoxyl sulfate, another uremic toxin derived from amino acid metabolism, accumulates as CKD progresses and induces tubulointerstitial fibrosis and glomerular sclerosis. Specific types of amino acids (d-serine) or fatty acids (palmitate) are reported to be closely associated with CKD progression. Promising therapeutic targets associated with nutrition include uremic toxin absorbents and inhibitors of AGEs or the receptor for AGEs (RAGE). Probiotics and prebiotics maintain gut flora balance and also prevent CKD progression by enhancing gut barriers and reducing uremic toxin formation. Nrf2 signaling not only ameliorates oxidative stress but also reduces elevated AGE levels. Bardoxolone methyl, an Nrf2 activator and NF-κB suppressor, has been tested as a therapeutic agent, but the phase 3 clinical trial was terminated owing to the high rate of cardiovascular events. However, a phase 2 trial has been initiated in Japan, and the preliminary analysis reveals promising results without an increase in cardiovascular events.
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Snelson M, Clarke RE, Coughlan MT. Stirring the Pot: Can Dietary Modification Alleviate the Burden of CKD? Nutrients 2017; 9:nu9030265. [PMID: 28287463 PMCID: PMC5372928 DOI: 10.3390/nu9030265] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 02/27/2017] [Accepted: 03/06/2017] [Indexed: 02/06/2023] Open
Abstract
Diet is one of the largest modifiable risk factors for chronic kidney disease (CKD)-related death and disability. CKD is largely a progressive disease; however, it is increasingly appreciated that hallmarks of chronic kidney disease such as albuminuria can regress over time. The factors driving albuminuria resolution remain elusive. Since albuminuria is a strong risk factor for GFR loss, modifiable lifestyle factors that lead to an improvement in albuminuria would likely reduce the burden of CKD in high-risk individuals, such as patients with diabetes. Dietary therapy such as protein and sodium restriction has historically been used in the management of CKD. Evidence is emerging to indicate that other nutrients may influence kidney health, either through metabolic or haemodynamic pathways or via the modification of gut homeostasis. This review focuses on the role of diet in the pathogenesis and progression of CKD and discusses the latest findings related to the mechanisms of diet-induced kidney disease. It is possible that optimizing diet quality or restricting dietary intake could be harnessed as an adjunct therapy for CKD prevention or progression in susceptible individuals, thereby reducing the burden of CKD.
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Affiliation(s)
- Matthew Snelson
- Glycation, Nutrition and Metabolism Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne 3004, Australia.
| | - Rachel E Clarke
- Glycation, Nutrition and Metabolism Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne 3004, Australia.
- Department of Physiology, Monash University, Clayton 3800, Australia.
| | - Melinda T Coughlan
- Glycation, Nutrition and Metabolism Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne 3004, Australia.
- Department of Diabetes, Central Clinical School, Monash University, Alfred Medical Research and Education Precinct, Melbourne 3004, Australia.
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Affiliation(s)
- Giacomo Garibotto
- Division of Nephrology, Dialysis and Transplantation, Department of Internal Medicine, University of Genoa and IRCCS Azienda Ospedaliera Universitaria San Martino-IST, Genoa, Italy
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Ou SH, Chen MY, Huang CW, Chen NC, Wu CH, Hsu CY, Chou KJ, Lee PT, Fang HC, Chen CL. Potential Role of Vegetarianism on Nutritional and Cardiovascular Status in Taiwanese Dialysis Patients: A Case-Control Study. PLoS One 2016; 11:e0156297. [PMID: 27295214 PMCID: PMC4905649 DOI: 10.1371/journal.pone.0156297] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 05/12/2016] [Indexed: 02/03/2023] Open
Abstract
Background & Objectives Cardiovascular disease remains the most common cause of death for patients on chronic dialysis. End stage renal disease patients undergoing dialysis imposed to reduce phosphorus intake, which likely contributes to development of vegetarian diet behaviors. Vegetarian diets are often lower in protein content, in contradiction to the recommendation that a high protein diet is followed by patients undergoing dialysis. The purpose of the study was to investigate the effects of a vegetarian diet on the nutritional and cardiovascular status of dialysis patients. Design, Setting, Participants, Measurements A study of 21 vegetarian dialysis patients and 42 age- and sex-matched non-vegetarian dialysis patients selected as controls was conducted in the Kaohsiung Veterans General Hospital. Brachial-ankle pulse wave velocity and biochemistry data including total homocysteine levels, serum lipid profiles, high-sensitivity C-reactive protein, vitamin D levels, albumin, and normalized protein catabolic rate were measured. Results Compared with the non-vegetarian control group, vegetarian subjects had lower body weight, body mass index, serum phosphate, blood urea nitrogen, serum creatinine, vitamin D, uric acid, albumin, and normalized protein catabolic rate (p < 0.05). The vegetarian group showed higher brachial-ankle pulse wave velocity than the non-vegetarian group (1926.95 ± 456.45 and 1684.82 ± 309.55 cm/sec, respectively, p < 0.05). After adjustment for age, albumin, pre-dialysis systolic blood pressure, and duration of dialysis, vegetarian diet remained an independent risk factor for brachial-ankle pulse wave velocity. Conclusions The present study revealed that patients on dialysis who follow vegetarian diets may experience subclinical protein malnutrition and vitamin D deficiency that could offset the beneficial cardiovascular effects of vegetarianism.
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Affiliation(s)
- Shih-Hsiang Ou
- Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Mei-Yin Chen
- Division of Nutrition, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chien-Wei Huang
- Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Nai-Ching Chen
- Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Kaohsiung, Taiwan
| | - Chien-Hsing Wu
- Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Kaohsiung, Taiwan
| | - Chih-Yang Hsu
- Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Kang-Ju Chou
- Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Po-Tsang Lee
- Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Hua-Chang Fang
- Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Chien-Liang Chen
- Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
- * E-mail: ;
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25
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Naeli MH, Farmani J, Zargaraan A. Rheological and Physicochemical Modification oftrans-Free Blends of Palm Stearin and Soybean Oil by Chemical Interesterification. J FOOD PROCESS ENG 2016. [DOI: 10.1111/jfpe.12409] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Mohammad Hossein Naeli
- Department of Food Science and Technology, Faculty of Agricultural Engineering; Sari Agricultural Sciences and Natural Resources University; PO Box: 578 Sari Iran
| | - Jamshid Farmani
- Department of Food Science and Technology, Faculty of Agricultural Engineering; Sari Agricultural Sciences and Natural Resources University; PO Box: 578 Sari Iran
| | - Azizollaah Zargaraan
- Office of the Vice President for Research; National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences; P.O. Box 19395-4741 Tehran Iran
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Wong TC, Chen YT, Wu PY, Chen TW, Chen HH, Chen TH, Hsu YH, Yang SH. Ratio of dietary ω-3 and ω-6 fatty acids-independent determinants of muscle mass-in hemodialysis patients with diabetes. Nutrition 2016; 32:989-94. [PMID: 27157471 DOI: 10.1016/j.nut.2016.02.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 01/18/2016] [Accepted: 02/18/2016] [Indexed: 12/15/2022]
Abstract
OBJECTIVE ω-3 and ω-6 polyunsaturated fatty acids (PUFAs) are essential nutrients in the human diet and possibly affect muscle mass. We evaluated the association between the dietary ratios of ω-3 and ω-6 PUFAs and muscle mass, indicated as skeletal muscle mass (SMM) and appendicular skeletal muscle mass (ASM), in patients with diabetes undergoing hemodialysis (HD). METHODS In this cross-sectional study, data on 69 patients with diabetes who underwent standard HD therapy were analyzed. For estimating muscle mass, anthropometric and bioelectrical impedance analyses were conducted following dialysis. In addition, routine laboratory and 3-d dietary data were obtained. The adequate intake (AI) cut-off for ω-3 PUFAs was 1.6 g/d and 1.1 g/d for male and female patients, respectively. RESULTS The average age of the participants was 63.0 ± 10.4 y. The mean ratios of ω-3/ω-6 PUFA intake, ω-6/ω-3 PUFA intake, SMM, and ASM of the patients were 0.13 ± 0.07, 9.4 ± 6.4, 24.6 ± 5.4 kg, and 18.3 ± 4.6 kg, respectively. Patients who had AI of ω-3 PUFAs had significantly higher SMM and ASM than did their counterparts. Linear and stepwise multivariable adjustment analyses revealed that insulin resistance and the ω-6/ω-3 PUFA ratio were the independent deleterious determinants of ASM normalized to height in HD patients. CONCLUSIONS Patients with AI of ω-3 PUFAs had total-body SMM and ASM that were more appropriate. A higher dietary ratio of ω-6/ω-3 PUFAs was associated with reduced muscle mass in HD patients.
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Affiliation(s)
- Te-Chih Wong
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan, Republic of China
| | - Yu-Tong Chen
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan, Republic of China
| | - Pei-Yu Wu
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan, Republic of China
| | - Tzen-Wen Chen
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan, Republic of China
| | - Hsi-Hsien Chen
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan, Republic of China
| | - Tso-Hsiao Chen
- Division of Nephrology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China
| | - Yung-Ho Hsu
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China
| | - Shwu-Huey Yang
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan, Republic of China; Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan, Republic of China.
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Rafikova O, Meadows ML, Kinchen JM, Mohney RP, Maltepe E, Desai AA, Yuan JXJ, Garcia JGN, Fineman JR, Rafikov R, Black SM. Metabolic Changes Precede the Development of Pulmonary Hypertension in the Monocrotaline Exposed Rat Lung. PLoS One 2016; 11:e0150480. [PMID: 26937637 PMCID: PMC4777490 DOI: 10.1371/journal.pone.0150480] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 02/14/2016] [Indexed: 12/13/2022] Open
Abstract
There is increasing interest in the potential for metabolic profiling to evaluate the progression of pulmonary hypertension (PH). However, a detailed analysis of the metabolic changes in lungs at the early stage of PH, characterized by increased pulmonary artery pressure but prior to the development of right ventricle hypertrophy and failure, is lacking in a preclinical animal model of PH. Thus, we undertook a study using rats 14 days after exposure to monocrotaline (MCT), to determine whether we could identify early stage metabolic changes prior to the manifestation of developed PH. We observed changes in multiple pathways associated with the development of PH, including activated glycolysis, increased markers of proliferation, disruptions in carnitine homeostasis, increased inflammatory and fibrosis biomarkers, and a reduction in glutathione biosynthesis. Further, our global metabolic profile data compare favorably with prior work carried out in humans with PH. We conclude that despite the MCT-model not recapitulating all the structural changes associated with humans with advanced PH, including endothelial cell proliferation and the formation of plexiform lesions, it is very similar at a metabolic level. Thus, we suggest that despite its limitations it can still serve as a useful preclinical model for the study of PH.
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Affiliation(s)
- Olga Rafikova
- Division of Translational and Regenerative Medicine, The University of Arizona, Tucson, Arizona, United States of America
- Department of Medicine, The University of Arizona, Tucson, Arizona, United States of America
| | - Mary L. Meadows
- Vascular Biology Center, Georgia Regents University, Augusta, Georgia, United States of America
| | | | | | - Emin Maltepe
- Division of Neonatology, University of California San Francisco, San Francisco, California, United States of America
| | - Ankit A. Desai
- Department of Medicine, The University of Arizona, Tucson, Arizona, United States of America
| | - Jason X.-J. Yuan
- Division of Translational and Regenerative Medicine, The University of Arizona, Tucson, Arizona, United States of America
- Department of Medicine, The University of Arizona, Tucson, Arizona, United States of America
| | - Joe G. N. Garcia
- Department of Medicine, The University of Arizona, Tucson, Arizona, United States of America
| | - Jeffrey R. Fineman
- Department of Pediatrics, University of California San Francisco, San Francisco, California, United States of America
- Cardiovascular Research Institute, University of California San Francisco, San Francisco, California, United States of America
| | - Ruslan Rafikov
- Division of Translational and Regenerative Medicine, The University of Arizona, Tucson, Arizona, United States of America
- Department of Medicine, The University of Arizona, Tucson, Arizona, United States of America
- * E-mail:
| | - Stephen M. Black
- Division of Translational and Regenerative Medicine, The University of Arizona, Tucson, Arizona, United States of America
- Department of Medicine, The University of Arizona, Tucson, Arizona, United States of America
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Asemi Z, Soleimani A, Bahmani F, Shakeri H, Mazroii N, Abedi F, Fallah M, Mohammadi AA, Esmaillzadeh A. Effect of the omega-3 fatty acid plus vitamin E supplementation on subjective global assessment score, glucose metabolism, and lipid concentrations in chronic hemodialysis patients. Mol Nutr Food Res 2016; 60:390-8. [PMID: 26518514 DOI: 10.1002/mnfr.201500584] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 08/25/2015] [Accepted: 10/08/2015] [Indexed: 11/07/2022]
Abstract
SCOPE This study was conducted to determine the effects of omega-3 fatty acid plus vitamin E supplementation on subjective global assessment (SGA) score and metabolic profiles in chronic hemodialysis (HD) patients. METHODS AND RESULTS This randomized double-blind placebo-controlled clinical trial was conducted among 120 chronic HD patients. Participants were randomly divided into four groups to receive: (i) 1250 mg/day omega-3 fatty acid containing 600 mg eicosapentaenoic acid and 300 mg docosahexaenoic acid + vitamin E placebo (n = 30), (ii) 400 IU/day vitamin E + omega-3 fatty acids placebo (n = 30), (iii) 1250 mg omega-3 fatty acids/day + 400 IU/day vitamin E (n = 30), and (iv) omega-3 fatty acids placebo + vitamin E placebo (n = 30) for 12 wk. Fasting blood samples were taken at baseline and after 12-wk intervention to measure metabolic profiles. Patients who received combined omega-3 fatty acids and vitamin E supplements compared with vitamin E, omega-3 fatty acids, and placebo had significantly decreased SGA score (p < 0.001), fasting plasma glucose (p = 0.01), serum insulin levels (p = 0.001), homeostasis model of assessment insulin resistance (p = 0.002), and improved quantitative insulin sensitivity check index (p = 0.006). CONCLUSION Omega-3 fatty acids plus vitamin E supplementation for 12 wk among HD patients had beneficial effects on SGA score and metabolic profiles.
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Affiliation(s)
- Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Soleimani
- Department of Internal Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Fereshteh Bahmani
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Hossein Shakeri
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Navid Mazroii
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Fatemeh Abedi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Melika Fallah
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Ali Akbar Mohammadi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Ahmad Esmaillzadeh
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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He L, Li MS, Lin M, Zhao TY, Gao P. Effect of fish oil supplement in maintenance hemodialysis patients: a systematic review and meta-analysis of published randomized controlled trials. Eur J Clin Pharmacol 2015; 72:129-39. [DOI: 10.1007/s00228-015-1976-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 11/01/2015] [Indexed: 01/09/2023]
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Low n-6/n-3 PUFA Ratio Improves Lipid Metabolism, Inflammation, Oxidative Stress and Endothelial Function in Rats Using Plant Oils as n-3 Fatty Acid Source. Lipids 2015; 51:49-59. [DOI: 10.1007/s11745-015-4091-z] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 10/19/2015] [Indexed: 01/10/2023]
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Marventano S, Kolacz P, Castellano S, Galvano F, Buscemi S, Mistretta A, Grosso G. A review of recent evidence in human studies of n-3 and n-6 PUFA intake on cardiovascular disease, cancer, and depressive disorders: does the ratio really matter? Int J Food Sci Nutr 2015; 66:611-22. [PMID: 26307560 DOI: 10.3109/09637486.2015.1077790] [Citation(s) in RCA: 156] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Polyunsaturated fatty acids (PUFAs) have been considered of great interest for human health due to their potential anti-inflammatory action that may protect from a number of chronic-degenerative diseases with an inflammatory pathogenesis. This review aimed to report the most updated evidence of both n-3 and n-6 PUFAs effect on cardiovascular disease, cancer, and depression in humans. Attention has been also paid to those studies exploring the effects of the ratio intake. Results from pooled analyses of human studies reported a general positive effect of n-3 PUFAs intake on all outcomes considered. In contrast, the role of n-6 PUFAs on human health needs to be better assessed in order to clearly identify which compound exerts beneficial/harmful effects. Only a limited number of clinical studies considered the n-3:n-6 PUFAs ratio, rather reporting contrasting results. A number of limitations when considering the ratio between these two families of PUFAs have risen.
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Affiliation(s)
- Stefano Marventano
- a Department of Medical, Surgical Sciences, and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Public Health , University of Catania , Catania , Italy
| | - Paulina Kolacz
- b Department of Human Nutrition , Jagiellonian University Medical College in Krakow , Krakow , Poland
| | - Sabrina Castellano
- c Department of Biomedical and Biotechnological Sciences, Section of Pharmacology and Biochemistry , University of Catania , Catania , Italy , and
| | - Fabio Galvano
- c Department of Biomedical and Biotechnological Sciences, Section of Pharmacology and Biochemistry , University of Catania , Catania , Italy , and
| | - Silvio Buscemi
- d Department of Internal Medicine , University of Palermo , Palermo , Italy
| | - Antonio Mistretta
- a Department of Medical, Surgical Sciences, and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Public Health , University of Catania , Catania , Italy
| | - Giuseppe Grosso
- a Department of Medical, Surgical Sciences, and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Public Health , University of Catania , Catania , Italy
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Bessell E, Jose MD, McKercher C. Associations of fish oil and vitamin B and E supplementation with cardiovascular outcomes and mortality in people receiving haemodialysis: a review. BMC Nephrol 2015; 16:143. [PMID: 26283325 PMCID: PMC4539726 DOI: 10.1186/s12882-015-0142-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 08/06/2015] [Indexed: 11/10/2022] Open
Abstract
Background Cardiovascular complications are the leading cause of mortality in patients with end-stage kidney disease. Research indicates that the Mediterranean diet is protective of cardiovascular disease in the general population. Components of this diet have been trialled in haemodialysis patients with the aim of reducing the risk of cardiovascular disease and improving associated risk factors. Components include fish, fruit and vegetables in the form of fish oil supplements and vitamin and antioxidant supplements. This narrative review provides an overview of observational studies, and interventional and randomised controlled trials examining the association of these supplements with cardiovascular outcomes in haemodialysis patients. Methods We reviewed the relevant literature by searching English-language publications in Web of Science and references from relevant articles published since 1992. Eight-seven abstracts were reviewed and 38 relevant articles were included. Results The extant literature suggests that risk of mortality is reduced in patients with a higher fish intake and those with higher serum omega-3 fatty acid levels. However, the pathways by which risk of mortality is reduced have not been fully extrapolated. While only a few studies have examined the effect of vitamin B supplementation in haemodialysis patients, these studies suggest that supplementation alone does not reduce the risk of mortality. Finally, studies examining vitamin E supplementation have drawn inconsistent conclusions regarding its pro-oxidant or antioxidant effects. Differences between studies are likely due to methodological variations in regards to dose, route of administration and treatment duration. Conclusions Nutritional and dietary supplementation in haemodialysis patients is an area which requires larger, more methodologically robust randomised controlled trials to determine if risk of cardiovascular outcomes can be improved.
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Affiliation(s)
- Erica Bessell
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, 7000, Australia.
| | - Matthew D Jose
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, 7000, Australia. .,School of Medicine, University of Tasmania, Hobart, Tasmania, 7000, Australia.
| | - Charlotte McKercher
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, 7000, Australia.
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Kalantar-Zadeh K, Brown A, Chen JLT, Kamgar M, Lau WL, Moradi H, Rhee CM, Streja E, Kovesdy CP. Dietary restrictions in dialysis patients: is there anything left to eat? Semin Dial 2015; 28:159-68. [PMID: 25649719 PMCID: PMC4385746 DOI: 10.1111/sdi.12348] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A significant number of dietary restrictions are imposed traditionally and uniformly on maintenance dialysis patients, whereas there is very little data to support their benefits. Recent studies indicate that dietary restrictions of phosphorus may lead to worse survival and poorer nutritional status. Restricting dietary potassium may deprive dialysis patients of heart-healthy diets and lead to intake of more atherogenic diets. There is little data about the survival benefits of dietary sodium restriction, and limiting fluid intake may inherently lead to lower protein and calorie consumption, when in fact dialysis patients often need higher protein intake to prevent and correct protein-energy wasting. Restricting dietary carbohydrates in diabetic dialysis patients may not be beneficial in those with burnt-out diabetes. Dietary fat including omega-3 fatty acids may be important caloric sources and should not be restricted. Data to justify other dietary restrictions related to calcium, vitamins, and trace elements are scarce and often contradictory. The restriction of eating during hemodialysis treatment is likely another incorrect practice that may worsen hemodialysis induced hypoglycemia and nutritional derangements. We suggest careful relaxation of most dietary restrictions and adoption of a more balanced and individualized approach, thereby easing some of these overzealous restrictions that have not been proven to offer major advantages to patients and their outcomes and which may in fact worsen patients' quality of life and satisfaction. This manuscript critically reviews the current paradigms and practices of recommended dietary regimens in dialysis patients including those related to dietary protein, carbohydrate, fat, phosphorus, potassium, sodium, and calcium, and discusses the feasibility and implications of adherence to ardent dietary restrictions and future research.
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Affiliation(s)
- Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, California
- Long Beach Veterans Affairs Healthcare System, Long Beach, California
- Dept. Epidemiology, UCLA Fielding School of Public Health, University of California Los Angeles, Los Angeles, California
| | - Amanda Brown
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, California
- Long Beach Veterans Affairs Healthcare System, Long Beach, California
| | - Joline L. T. Chen
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, California
- Long Beach Veterans Affairs Healthcare System, Long Beach, California
| | | | - Wei-Ling Lau
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, California
| | - Hamid Moradi
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, California
- Long Beach Veterans Affairs Healthcare System, Long Beach, California
| | - Connie M. Rhee
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, California
| | - Elani Streja
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, California
- Long Beach Veterans Affairs Healthcare System, Long Beach, California
| | - Csaba P. Kovesdy
- Univ. of Tennessee Health Science Center, Memphis, Tennessee
- Memphis Veterans Affairs Healthcare System, Memphis, Tennessee
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Sim JJ, Shi J, Al-Moomen R, Behayaa H, Kalantar-Zadeh K, Jacobsen SJ. Plasma renin activity and its association with ischemic heart disease, congestive heart failure, and cerebrovascular disease in a large hypertensive cohort. J Clin Hypertens (Greenwich) 2014; 16:805-13. [PMID: 25255792 DOI: 10.1111/jch.12419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 08/21/2014] [Accepted: 08/24/2014] [Indexed: 12/24/2022]
Abstract
Plasma renin activity (PRA) may be a surrogate for vascular damage. The authors hypothesize that PRA is associated with cardiovascular and cerebrovascular disease (CED). A cross-sectional study (January 1, 1998, to December 31, 2009) was performed on hypertensive individuals 18 years and older using multivariable logistic regression models to estimate odds ratios (ORs) for ischemic heart disease (IHD), congestive heart failure (CHF), and CED based on PRA quartiles controlling for age, sex, race, diabetes mellitus (DM), and medication use. Among 7887 individuals (60% women; 34% whites, 23% blacks, and 19% Hispanics; and 29% with DM), the adjusted ORs (95% CI) for IHD were 0.94 (0.80-1.10), 1.09 (0.92-1.29), and 1.18 (1.00-1.39); for CHF were 1.23 (0.99-1.53), 1.27 (1.01-1.61), and 1.41 (1.13-1.77); and for CED were 0.95 (0.78-1.17), 0.77 (0.61-0.97), and 0.97 (0.78-1.20) for the second, third, and fourth quartiles compared with the first quartile. Higher PRA was associated with greater likelihood for prevalent IHD and CHF but not CED in this large ethnically diverse population of hypertensive individuals.
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Affiliation(s)
- John J Sim
- Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA
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Hung AM, Booker C, Ellis CD, Siew ED, Graves AJ, Shintani A, Abumrad NN, Himmelfarb J, Ikizler TA. Omega-3 fatty acids inhibit the up-regulation of endothelial chemokines in maintenance hemodialysis patients. Nephrol Dial Transplant 2014; 30:266-74. [PMID: 25204316 DOI: 10.1093/ndt/gfu283] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Chronic systemic inflammation is common in patients with chronic kidney disease on dialysis (CKD5D) and has been considered a key mediator of the increased cardiovascular risk in this patient population. In this study, we tested the hypothesis that supplementation of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) will attenuate the systemic inflammatory process in CKD5D patients. METHODS The design was a randomized, double-blinded, placebo controlled pilot trial (NCT00655525). Thirty-eight patients were randomly assigned in a 1 : 1 fashion to receive 2.9 g of eicosapentaenoic acid (C20:5, n-3) plus docosahexaenoic acid (C22:6, n-3) versus placebo for 12 weeks. The primary outcome was change in pro-inflammatory chemokines measured by lipopolysaccharide (LPS)-stimulated peripheral blood mononuclear cells (PBMCs). Secondary outcomes were changes in systemic inflammatory markers. Analysis of covariance was used to compare percent change from baseline to 12 weeks. RESULTS Thirty-one patients completed 12 weeks and three patients completed 6 weeks of the study. Median age was 52 (interquartile range 45, 60) years, 74% were African-American and 79% were male. Supplementation of ω-3 PUFAs effectively decreased the LPS-induced PBMC expression of RANTES (Regulated upon Activation, Normal T cell Expressed and Secreted) and MCP-1 (Monocyte Chemotactic Protein-1; unadjusted P = 0.04 and 0.06; adjusted for demographics P = 0.02 and 0.05, respectively). There was no significant effect of the intervention on serum inflammatory markers (C-reactive protein, interleukin-6 and procalcitonin). CONCLUSIONS The results of this pilot study suggest that supplementation of ω-3 PUFAs is beneficial in decreasing the levels of endothelial chemokines, RANTES and MCP-1. Studies of larger sample size and longer duration are required to further evaluate effects of ω-3 PUFAs on systemic markers of inflammation, other metabolic parameters and clinical outcomes, particularly cardiovascular outcomes in CKD5D patients.
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Affiliation(s)
- Adriana M Hung
- CSR&D, Veterans Administration Tennessee Valley Healthcare System, Nashville, TN, USA Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Cindy Booker
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Charles D Ellis
- Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Edward D Siew
- CSR&D, Veterans Administration Tennessee Valley Healthcare System, Nashville, TN, USA Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amy J Graves
- Division of Biostatistics, Vanderbilt University, Nashville, TN, USA
| | - Ayumi Shintani
- Division of Biostatistics, Vanderbilt University, Nashville, TN, USA
| | - Naji N Abumrad
- Department of Surgery, Vanderbilt University, Nashville, TN, USA
| | | | - Talat Alp Ikizler
- CSR&D, Veterans Administration Tennessee Valley Healthcare System, Nashville, TN, USA Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN, USA
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Heo S, Moser DK, Pressler SJ, Dunbar SB, Dekker RL, Lennie TA. Depressive symptoms and the relationship of inflammation to physical signs and symptoms in heart failure patients. Am J Crit Care 2014; 23:404-13. [PMID: 25179036 DOI: 10.4037/ajcc2014614] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Depressive symptoms in patients with heart failure can affect the relationship between physical signs and symptoms and inflammation. OBJECTIVE To examine the relationship between soluble tumor necrosis factor receptor I and physical signs and symptoms and the effects of depressive symptoms on this relationship in patients with heart failure. METHODS Data on physical signs and symptoms (Symptom Status Questionnaire-Heart Failure), depressive symptoms (Beck Depression Inventory-II), and levels of the receptor (blood samples) were collected from 145 patients with heart failure. Data on the receptor were square root transformed to achieve normality. Patients were divided into 2 groups according to their scores for depressive symptoms (nondepressed <14 and depressed ≥14). Hierarchical multiple regression was used to analyze the data. RESULTS In the total sample, with controls for covariates, higher levels of the receptor were significantly related to more severe physical signs and symptoms (F = 7.915; P < .001). In subgroup analyses, with controls for covariates, levels of the receptor were significantly related to physical signs and symptoms only in the patients without depression (F = 3.174; P = .005). CONCLUSION Both depressive symptoms and inflammation should be considered along with physical signs and symptoms in patients with heart failure. Further studies are needed to determine the effects of improvement in inflammation on improvement in physical signs and symptoms, with consideration given to the effects of depressive symptoms.
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Affiliation(s)
- Seongkum Heo
- Seongkum Heo is an assistant professor, University of Arkansas for Medical Sciences, College of Nursing, Little Rock, Arkansas. Debra K. Moser is a professor and Gill Chair of Nursing, Rebecca L. Dekker is an assistant professor, and Terry A. Lennie is a professor, University of Kentucky, College of Nursing, Lexington, Kentucky. Susan J. Pressler is a professor, University of Michigan, School of Nursing, Ann Arbor, Michigan, and Sandra B. Dunbar is a professor, Emory University, School of Nursing, Atlanta, Georgia.
| | - Debra K Moser
- Seongkum Heo is an assistant professor, University of Arkansas for Medical Sciences, College of Nursing, Little Rock, Arkansas. Debra K. Moser is a professor and Gill Chair of Nursing, Rebecca L. Dekker is an assistant professor, and Terry A. Lennie is a professor, University of Kentucky, College of Nursing, Lexington, Kentucky. Susan J. Pressler is a professor, University of Michigan, School of Nursing, Ann Arbor, Michigan, and Sandra B. Dunbar is a professor, Emory University, School of Nursing, Atlanta, Georgia
| | - Susan J Pressler
- Seongkum Heo is an assistant professor, University of Arkansas for Medical Sciences, College of Nursing, Little Rock, Arkansas. Debra K. Moser is a professor and Gill Chair of Nursing, Rebecca L. Dekker is an assistant professor, and Terry A. Lennie is a professor, University of Kentucky, College of Nursing, Lexington, Kentucky. Susan J. Pressler is a professor, University of Michigan, School of Nursing, Ann Arbor, Michigan, and Sandra B. Dunbar is a professor, Emory University, School of Nursing, Atlanta, Georgia
| | - Sandra B Dunbar
- Seongkum Heo is an assistant professor, University of Arkansas for Medical Sciences, College of Nursing, Little Rock, Arkansas. Debra K. Moser is a professor and Gill Chair of Nursing, Rebecca L. Dekker is an assistant professor, and Terry A. Lennie is a professor, University of Kentucky, College of Nursing, Lexington, Kentucky. Susan J. Pressler is a professor, University of Michigan, School of Nursing, Ann Arbor, Michigan, and Sandra B. Dunbar is a professor, Emory University, School of Nursing, Atlanta, Georgia
| | - Rebecca L Dekker
- Seongkum Heo is an assistant professor, University of Arkansas for Medical Sciences, College of Nursing, Little Rock, Arkansas. Debra K. Moser is a professor and Gill Chair of Nursing, Rebecca L. Dekker is an assistant professor, and Terry A. Lennie is a professor, University of Kentucky, College of Nursing, Lexington, Kentucky. Susan J. Pressler is a professor, University of Michigan, School of Nursing, Ann Arbor, Michigan, and Sandra B. Dunbar is a professor, Emory University, School of Nursing, Atlanta, Georgia
| | - Terry A Lennie
- Seongkum Heo is an assistant professor, University of Arkansas for Medical Sciences, College of Nursing, Little Rock, Arkansas. Debra K. Moser is a professor and Gill Chair of Nursing, Rebecca L. Dekker is an assistant professor, and Terry A. Lennie is a professor, University of Kentucky, College of Nursing, Lexington, Kentucky. Susan J. Pressler is a professor, University of Michigan, School of Nursing, Ann Arbor, Michigan, and Sandra B. Dunbar is a professor, Emory University, School of Nursing, Atlanta, Georgia
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Caligiuri SPB, Blydt-Hansen T, Love K, Grégoire M, Taylor CG, Zahradka P, Aukema HM. Evidence for the use of glomerulomegaly as a surrogate marker of glomerular damage and for alpha-linolenic acid-rich oils in the treatment of early obesity-related glomerulopathy in a diet-induced rodent model of obesity. Appl Physiol Nutr Metab 2014; 39:951-959. [PMID: 24927777 DOI: 10.1139/apnm-2013-0476] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2023]
Abstract
Obesity-related glomerulopathy (ORG) is a unique and emerging condition that can lead to renal failure. Early detection, aided by an earlier diagnostic marker, would improve patient outcomes; this could be facilitated by an accurate model. Such a model would be useful to examine interventions like dietary fatty acids, which are known to influence renal diseases in later stages. In this study, obese-prone rats were provided high-fat (55% of energy) diets for 12 weeks to generate a model of diet-induced obesity. The rats were subsequently provided dietary oils with various levels of alpha-linolenic acid (ALA) and linoleic acid (LA) for 8 weeks, as follows: (g ALA:LA per 100 g oil): canola/flax (20:18), canola (8:18), soy (9:53), high-oleic canola/canola (5:16), high-oleic canola (2:15), lard/soy (1:8), and safflower (0.2:73). The model developed obesity, glomerulomegaly, proteinuria, and scarce glomerular damage with an indolent course. Morphometry and histology revealed glomerulomegaly as the first renal structural alteration. The utility of this marker as a predictor for the presence of ORG and renal injury was evidenced by its correlation to visceral adiposity (p < 0.0001, r = 0.44), proteinuria (p < 0.0001, ρ = 0.55), change in proteinuria (p = 0.0092, ρ = 0.42), and glomerular damage (p < 0.0001, ρ = 0.48). Renal triglyceride ALA:LA was strongly correlated with dietary ALA:LA (p < 0.0005, ρ = 0.96), and inversely associated with mean glomerular volume (p = 0.02, ρ = -0.82). The diet-induced obese model accurately represents early ORG, and implicates glomerulomegaly as an early surrogate diagnostic marker. Early intervention with ALA-rich dietary oils slowed glomerular enlargement; these findings warrant further clinical investigation to promote optimal patient outcomes.
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Affiliation(s)
- Stephanie P B Caligiuri
- a Department of Human Nutritional Sciences, University of Manitoba, W383 Duff Roblin Building, Winnipeg, MB R3T 2N2, Canada
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Gharekhani A, Khatami MR, Dashti-Khavidaki S, Razeghi E, Abdollahi A, Hashemi-Nazari SS, Mansournia MA. Effects of Oral Supplementation With Omega-3 Fatty Acids on Nutritional State and Inflammatory Markers in Maintenance Hemodialysis Patients. J Ren Nutr 2014; 24:177-85. [DOI: 10.1053/j.jrn.2014.01.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 12/02/2013] [Accepted: 01/19/2014] [Indexed: 11/11/2022] Open
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The effect of omega-3 fatty acids on depressive symptoms and inflammatory markers in maintenance hemodialysis patients: a randomized, placebo-controlled clinical trial. Eur J Clin Pharmacol 2014; 70:655-65. [PMID: 24643636 DOI: 10.1007/s00228-014-1666-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 02/28/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE This study was designed to investigate the effects of omega-3 fatty acids on depression and chronic inflammation in hemodialysis patients. METHOD Fifty-four maintenance hemodialysis patients were randomized to ingest two omega-3 (each containing 180 mg eicosapentaenoic acid and 120 mg docosahexaenoic acid) or placebo capsules, three times daily for 4 months. MAIN OUTCOME MEASURES Beck Depression Inventory (BDI) score and serum levels of C-reactive protein (CRP), interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-α, ferritin, intact parathyroid hormone (iPTH), and ratios of IL-10 to IL-6 and IL-10 to TNF-α were measured at baseline and at the end of the study. RESULTS Omega-3 supplement lowered BDI score significantly after 4 months of intervention. Among pro- and anti-inflammatory mediators, only serum ferritin level and IL-10 to IL-6 ratio showed significant changes in favor of omega-3 supplement during the study. In linear regression model adjusted for baseline values, omega-3 treatment was a significant predictor of reduced serum CRP, ferritin, and iPTH levels, and increased IL-10 to IL-6 ratio. No significant association was found between the anti-inflammatory and anti-depressant effects of omega-3 supplement. CONCLUSIONS Supplemental use of omega-3 fatty acids decreases depressive symptoms in hemodialysis patients apart from their anti-inflammatory effects.
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Steiber AL. Chronic kidney disease: considerations for nutrition interventions. JPEN J Parenter Enteral Nutr 2014; 38:418-26. [PMID: 24637245 DOI: 10.1177/0148607114527315] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Chronic kidney disease (CKD) is highly prevalent and has major health consequences for patients. Caring for patients with CKD requires knowledge of the food supply, renal pathophysiology, and nutrition-related medications used to work synergistically with diet to control the signs and symptoms of the disease. The nutrition care process and International Dietetic and Nutrition Terminology allow for systematic, holistic, quality care of patients with this complex, progressive disease. Nutrition interventions must be designed with the individual patients needs in mind while prioritizing factors with the largest negative impact on health outcomes and mortality risk. New areas of nutrition treatment are emerging that involve a greater focus on micronutrient needs, the microbiome, and vegetarian-style diets. These interventions may improve outcomes by decreasing inflammation, improving energy and protein delivery, and lowering phosphorus, electrolytes, and fluid retention.
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Sertoglu E, Kurt I, Tapan S, Uyanik M, Serdar MA, Kayadibi H, El-Fawaeir S. Comparison of plasma and erythrocyte membrane fatty acid compositions in patients with end-stage renal disease and type 2 diabetes mellitus. Chem Phys Lipids 2014; 178:11-7. [PMID: 24384240 DOI: 10.1016/j.chemphyslip.2013.12.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 12/22/2013] [Accepted: 12/23/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND In this study, we aimed to compare the serum lipid profile and fatty acid (FA) compositions of erythrocyte membrane (EM) and plasma in three different patient groups (group 1: type 2 diabetes mellitus (T2DM)+end-stage renal disease (ESRD), group 2: ESRD, group 4: T2DM) and healthy controls (group 3) simultaneously. METHODS 40 ESRD patients treated with hemodialysis (HD) in Gulhane School of Medicine (20 with T2DM) and 32 controls (17 with T2DM, 15 healthy controls) were included in the study. Plasma and EM FA concentrations were measured by gas chromatography-flame ionization detector (GC-FID). RESULTS Plasma and EM palmitic acid (PA) and stearic acid (SA) levels were significantly higher in T2DM patients compared to controls (p=0.040 and p=0.002 for plasma, p=0.001 and p=0.010 for EM, respectively). EM docosahexaenoic acid (DHA) levels were also significantly lower in patients with ESRD+T2DM and ESRD compared to controls (p=0.004 and p=0.037, respectively). CONCLUSIONS Patients with insulin resistance display a pattern of high long chain saturated FAs (PA, SA and arachidic acids). However, while there are no recognized standards for normal EM DHA content, decreased levels of EM DHA in ESRD patient groups (groups 1 and 2) suggest that there may be reduced endogenous synthesis of DHA in HD subjects, due to the decreased functionality of desaturase and elongase enzymes. Because membrane PUFA content affects membrane fluidity and cell signaling, these findings are worthy of further investigation.
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Affiliation(s)
- Erdim Sertoglu
- Ankara Mevki Military Hospital, Anittepe Dispensary, Ankara, Turkey.
| | - Ismail Kurt
- Gulhane School of Medicine, Department of Medical Biochemistry, Ankara, Turkey
| | - Serkan Tapan
- Gulhane School of Medicine, Department of Medical Biochemistry, Ankara, Turkey
| | - Metin Uyanik
- Gulhane School of Medicine, Department of Medical Biochemistry, Ankara, Turkey
| | - Muhittin A Serdar
- Acıbadem University School of Medicine, Department of Medical Biochemistry, Istanbul, Turkey
| | - Huseyin Kayadibi
- Adana Military Hospital, Department of Medical Biochemistry, Adana, Turkey
| | - Saad El-Fawaeir
- Gulhane School of Medicine, Department of Medical Biochemistry, Ankara, Turkey
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Ristic-Medic D, Perunicic-Pekovic G, Rasic-Milutinovic Z, Takic M, Popovic T, Arsic A, Glibetic M. Effects of dietary milled seed mixture on fatty acid status and inflammatory markers in patients on hemodialysis. ScientificWorldJournal 2014; 2014:563576. [PMID: 24578648 PMCID: PMC3919090 DOI: 10.1155/2014/563576] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Accepted: 10/27/2013] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Plant seeds have gained interest for their health benefits due to their fatty acid content. The objective of this study was to determine the effects of dietary consumption of milled sesame/pumpkin/flax seed mixture on glycemic control, serum lipids, phospholipid fatty acid status, and inflammatory factors in patients on hemodialysis. METHODS Thirty patients with well nutrition status (18 male, 12 female) were enrolled in the study. Participants consumed 30 g of milled sesame/pumpkin/flax (6 g/6 g/18 g, resp.) seeds mixture added to their habitual diet. RESULTS Total n-6 and n-3 polyunsaturated fatty acids and levels of linoleic, dihomo-gamma-linolenic (DGLA), arachidonic, alpha-linolenic (ALA), eicosapentaenoic, docosapentaenoic, and docosahexaenoic (DHA) acid were increased after 12 weeks of supplementation. A significant decrease of the serum triglyceride level (P < 0.001), glucose, insulin, calculated IR HOMA (P < 0.05), and inflammatory markers (TNF-alpha, IL-6, and hs-CRP, P < 0.001) was observed after seed mixture treatment. The serum levels of CRP and TNF-alpha negative correlate with ALA, DHA, and DGLA. CONCLUSION Results of this study indicated that dietary milled sesame/pumpkin/flax seed mixture added to a habitual diet lowered triglyceride and CRP, TNF-alpha, IL-6 levels, affect glycemic control and improved fatty acid profile and pruritus symptoms in hemodialysis patients.
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Affiliation(s)
- Danijela Ristic-Medic
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, P.O. Box 102, 11000 Belgrade, Serbia
| | - Gordana Perunicic-Pekovic
- Department of Nephrology and Dialysis, Clinical Hospital Zemun, University of Belgrade, Belgrade, Serbia
| | - Zorica Rasic-Milutinovic
- Department of Endocrinology, Diabetes and Metabolism, Clinical Hospital Zemun, University of Belgrade, Belgrade, Serbia
| | - Marija Takic
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, P.O. Box 102, 11000 Belgrade, Serbia
| | - Tamara Popovic
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, P.O. Box 102, 11000 Belgrade, Serbia
| | - Aleksandra Arsic
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, P.O. Box 102, 11000 Belgrade, Serbia
| | - Marija Glibetic
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, P.O. Box 102, 11000 Belgrade, Serbia
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Sabbatini M, Apicella L, Cataldi M, Maresca I, Nastasi A, Vitale S, Memoli B, Postiglione L, Riccio E, Gallo R, Federico S, Guida B. Effects of a Diet Rich in N-3 Polyunsaturated Fatty Acids on Systemic Inflammation in Renal Transplant Recipients. J Am Coll Nutr 2013; 32:375-83. [DOI: 10.1080/07315724.2013.826482] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Kelton D, Lysecki C, Aukema H, Anderson B, Kang JX, Ma DWL. Endogenous synthesis of n-3 PUFA modifies fatty acid composition of kidney phospholipids and eicosanoid levels in the fat-1 mouse. Prostaglandins Leukot Essent Fatty Acids 2013; 89:169-77. [PMID: 23994161 DOI: 10.1016/j.plefa.2013.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Revised: 07/29/2013] [Accepted: 08/02/2013] [Indexed: 11/16/2022]
Abstract
The goal of the present study was to determine whether endogenous synthesis of n-3 polyunsaturated fatty acids (PUFA) in the fat-1 mouse is comparable to fish oil feeding with respect to kidney n-3 PUFA composition and eicosanoid levels. Wild-type and heterozygous fat-1 mice, capable of synthesizing n-3 PUFA endogenously, were given diets enriched in either n-3 or n-6 PUFA in a 2×2 factorial design and terminated after 12 weeks. Kidney phospholipid fatty acids were analysed by gas chromatography. Kidney eicosanoids were analysed by liquid chromatography tandem mass spectrometry. Relative to control mice fed n-6 PUFA, n-3 PUFA fed and fat-1 mice had higher levels of kidney phospholipid n-3 PUFA, and lower levels of n-6 PUFA and eicosanoids. However, mice fed n-3 PUFA mice had higher levels of n-3 PUFA and lower levels of eicosanoids as compared to fat-1 mice. In conclusion, diet feeding had a greater impact on kidney fatty acid composition and eicosanoid levels than the genetic effect of the fat-1 gene. However, the fat-1 mouse remains a close approximation that can be used as a complementary model to study the role of n-3 PUFA in the kidney.
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Affiliation(s)
- D Kelton
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
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Kalantar-Zadeh K, Ikizler TA. Let them eat during dialysis: an overlooked opportunity to improve outcomes in maintenance hemodialysis patients. J Ren Nutr 2013; 23:157-63. [PMID: 23313434 PMCID: PMC3632653 DOI: 10.1053/j.jrn.2012.11.001] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Revised: 11/13/2012] [Accepted: 11/13/2012] [Indexed: 12/16/2022] Open
Abstract
In individuals with chronic kidney disease, surrogates of protein-energy wasting, including a relatively low serum albumin and fat or muscle wasting, are by far the strongest death risk factor compared with any other condition. There are data to indicate that hypoalbuminemia responds to nutritional interventions, which may save lives in the long run. Monitored, in-center provision of high-protein meals and/or oral nutritional supplements during hemodialysis is a feasible, inexpensive, and patient-friendly strategy despite concerns such as postprandial hypotension, aspiration risk, infection control and hygiene, dialysis staff burden, diabetes and phosphorus control, and financial constraints. Adjunct pharmacologic therapies can be added, including appetite stimulators (megesterol, ghrelin, and mirtazapine), anabolic hormones (testosterone and growth factors), antimyostatin agents, and antioxidative and anti-inflammatory agents (pentoxiphylline and cytokine modulators), to increase efficiency of intradialytic food and oral supplementation, although adequate evidence is still lacking. If more severe hypoalbuminemia (<3.0 g/dL) not amenable to oral interventions prevails, or if a patient is not capable of enteral interventions (e.g., because of swallowing problems), then parenteral interventions such as intradialytic parenteral nutrition can be considered. Given the fact that meals and supplements during hemodialysis would require only a small fraction of the funds currently used for dialysis patients this is also an economically feasible strategy.
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Affiliation(s)
- Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Medical Center, Orange, California 92868, USA.
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Jiao J, Zhang Y. Transgenic Biosynthesis of Polyunsaturated Fatty Acids: A Sustainable Biochemical Engineering Approach for Making Essential Fatty Acids in Plants and Animals. Chem Rev 2013; 113:3799-814. [DOI: 10.1021/cr300007p] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Jingjing Jiao
- Chronic Disease Research Institute,
Department of Nutrition and Food Hygiene, School of Public Health,
Zhejiang University, Hangzhou 310058, China
| | - Yu Zhang
- Department of Food Science and
Nutrition, School of Biosystems Engineering and Food Science, Zhejiang
University, Hangzhou 310058, China
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Inverse relationship between long-chain n-3 fatty acids and risk of sudden cardiac death in patients starting hemodialysis. Kidney Int 2013; 83:1130-5. [PMID: 23389417 PMCID: PMC3655118 DOI: 10.1038/ki.2013.4] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Experimental and clinical evidence suggests that long chain n-3 fatty acids may protect against sudden cardiac death, the leading cause of mortality in hemodialysis patients. Here we investigated whether long chain n-3 fatty acids have a protective relationship with sudden cardiac death in 100 patients who died of sudden cardiac death during the first year of starting hemodialysis and 300 patients who survived. Individuals were selected from a nationally representative cohort of over 1000 U.S. hemodialysis units in 2004–2005. The odds of sudden cardiac death were calculated by quartile of long chain n-3 fatty acids levels over the first year. There was a significant inverse relationship between long chain n-3 fatty acids and the risk of sudden cardiac death even after adjusting for relevant co-morbid conditions, biochemical values, and dietary fats. The odds of sudden cardiac death at 1 year for the second, third, and fourth quartile groups of long chain n-3 fatty acids were 0.37, 0.22, and 0.20, respectively, compared to the lowest quartile. This significant inverse relationship was maintained even during the highest-risk first few months on hemodialysis. Thus, long chain n-3 fatty acids are strongly and independently associated with a lower risk of sudden cardiac death in hemodialysis patients throughout the first year of hemodialysis.
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Huang X, Sjögren P, Cederholm T, Ärnlöv J, Lindholm B, Risérus U, Carrero JJ. Serum and adipose tissue fatty acid composition as biomarkers of habitual dietary fat intake in elderly men with chronic kidney disease. Nephrol Dial Transplant 2012; 29:128-36. [PMID: 23229929 DOI: 10.1093/ndt/gfs478] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Fatty acid (FA) composition in serum cholesterol esters (CE) and adipose tissue (AT) reflect the long-term FA intake in the general population. Because both dietary intake and FA biomarkers associate with renal function, our aim was to identify which CE and AT FAs are useful biomarkers of habitual FA intake in individuals with chronic kidney disease (CKD). METHODS Cross-sectional analysis was performed in 506 men (aged 70 years) with a glomerular filtration rate (GFR) of <60 mL/min per 1.73 m(2) from the Uppsala Longitudinal Study of Adult Men cohort. Dietary habits were evaluated with a 7-day dietary record. FA compositions in CE and AT were analyzed by gas-liquid chromatography in two random subsamples of 248 and 318 individuals, respectively. RESULTS Both CE and AT linoleic acid and docosahexaenoic acid (DHA) were strongly associated with their corresponding intake, after adjustments for non-dietary factors. The proportions of eicosapentaenoic acid (EPA) and palmitic acid in CE and AT moderately correlated with dietary intake, whereas correlations of other FAs were weaker or absent. Proportions of EPA and DHA in CE and AT were positively associated with the total energy-adjusted fish intake. Results were confirmed in adequate reporters as identified by the Goldberg cutoff method. These relationships held constant, regardless of a GFR above or below 45 mL/min per 1.73 m(2) or the prevalence of microalbuminuria. CONCLUSIONS Proportions of EPA, DHA, palmitic and linoleic acid in serum CE and AT are good indicators of their dietary intake in men with CKD. They can be considered valid biomarkers for epidemiological studies and assessment of compliance.
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Affiliation(s)
- Xiaoyan Huang
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden
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Friedman AN, Yu Z, Tabbey R, Denski C, Tamez H, Wenger J, Thadhani R, Li Y, Watkins BA. Low blood levels of long-chain n-3 polyunsaturated fatty acids in US hemodialysis patients: clinical implications. Am J Nephrol 2012; 36:451-8. [PMID: 23128302 DOI: 10.1159/000343741] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 09/21/2012] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cardioprotective and other clinical benefits of long-chain n-3 polyunsaturated fatty acids (PUFA) are inversely related to dietary intake and hence blood content. We therefore investigated, in the first study of its kind, the blood content and distribution of these fatty acids in a large representative population of US hemodialysis patients. METHODS Frozen sera were obtained from 400 individuals who were part of a large, contemporary, representative cohort of US incident hemodialysis patients. Long-chain n-3 PUFA were measured in total serum lipids and in the neutral and polar serum fractions using gas chromatography and solid phase extraction techniques. Mean long-chain n-3 PUFA levels were compared to levels in other dialysis and nondialysis populations from published reports. RESULTS The study population was qualitatively similar to the overall US hemodialysis population in terms of major clinical characteristics. Long-chain n-3 PUFA were present in the serum polar fraction, with essentially none being detected in the neutral fraction (p < 0.0001 for polar vs. neutral fractions for all three long-chain n-3 PUFA). Mean serum long-chain n-3 PUFA levels (weight percent (±SD): total 1.55 ± 0.95, polar 3.99 ± 1.45) were low compared to nondialysis and most other non-US hemodialysis cohorts. CONCLUSIONS While US hemodialysis patients have a blood distribution of long-chain n-3 PUFA that is similar to that in the general population, blood content is among the lowest recorded in the medical literature. This has implications for renal dietary recommendations and makes US patients an ideal group for testing the clinical effects of long-chain n-3 PUFA supplementation.
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Affiliation(s)
- Allon N Friedman
- Department of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, USA.
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Huang X, Stenvinkel P, Qureshi AR, Risérus U, Cederholm T, Bárány P, Heimbürger O, Lindholm B, Carrero JJ. Essential polyunsaturated fatty acids, inflammation and mortality in dialysis patients. Nephrol Dial Transplant 2012; 27:3615-20. [PMID: 22565059 DOI: 10.1093/ndt/gfs132] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Polyunsaturated fatty acids (PUFA) are essential nutrients with anti-inflammatory and cardioprotective properties. We investigated the association of essential dietary PUFA intake, reflected by plasma fatty acid composition, with inflammation and mortality in dialysis patients. METHODS We recruited 222 Swedish dialysis subjects (39% women) with median age of 57 years and average 12 months of dialysis vintage. Plasma phospholipid PUFA were assessed by gas-liquid chromatography. Overall mortality was assessed after 18.4 (10th-90th percentiles: 2.3-60) months of follow-up. RESULTS Linoleic acid (LA), Mead acid (MA), α-linolenic acid (ALA) and long-chain n-3 PUFA (LC n-3; the sum of eicosapentaenoic, docosapentaenoic and docosahexaenoic acids) represented 19.7, 0.26, 0.26 and 7.64% of all fatty acids in plasma, respectively. This may reflect an adequate n-3 PUFA intake. LA was negatively (β = - 0.21, P = 0.004) but MA positively (β = 0.25, P < 0.001) associated with interleukin (IL)-6 in multivariate analyses. Neither ALA nor LC n-3 were independently associated with IL-6. During follow-up, 61 deaths and 115 kidney transplants occurred. Fully adjusted competing risk models showed that every percent increase in the proportion of plasma LA was associated with 12% reduction in mortality risk before transplantation (hazard ratio 0.88, 95% confidence interval 0.79-0.99). MA was directly associated with mortality. Neither ALA nor LC n-3 predicted outcome. CONCLUSIONS The proportion of plasma phospholipid LA is inversely associated with IL-6 and all-cause mortality in Swedish dialysis patients. We raise the hypothesis that dialysis patients could benefit from increased intake of vegetable oils, the primary source of LA in the Western-type diet.
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Affiliation(s)
- Xiaoyan Huang
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden
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