Are the health benefits of fish oils limited by products of oxidation?

Protein hydrolysate and oil from fish waste reveal potential as dog food ingredients

The increased fish consumption by the growing human population in the world translates into an increase in fish waste. The reintroduction of these fish by-products into food and feed chains presents economic benefits and contributes to counteracting their negative environmental impact. Under this context, the present study aimed to evaluate the effects of the dietary inclusion of fish hydrolysate and oil obtained from fish waste (experimental diet) in substitution of shrimp hydrolysate and salmon oil (control diet) mainly imported from third countries on palatability, apparent total tract digestibility, fecal characteristics and metabolites, blood fatty acid profile, flatulence, and coat quality of adult dogs. A two-bowl test was performed to evaluate palatability by the pairwise comparison between the two diets. A feeding trial was conducted according to a crossover design with two diets (control and experimental diets), six adult Beagle dogs per diet, and two periods of 6 weeks each. The replacement of shrimp hydrolysate and salmon oil with fish hydrolysate and oil did not affect the first diet approach and taste, as well as the intake ratio. Generally, the digestibility of dry matter, nutrients, and energy was not affected by diet, but the intake of digestible crude protein (CP) and ether extract was higher, respectively, with the control and the experimental diet. The higher intake of eicosapentaenoic acid and docosahexaenoic acid with the experimental diet was reflected in a higher content of these long-chain polyunsaturated fatty acids and the omega-3 index of red blood cells, but it did not affect coat quality. The significantly higher intake of digestible CP with the control diet might have contributed to the higher fecal ammonia-N and valerate concentrations. Daily fecal output and characteristics were similar between diets. Overall, results suggest that fish hydrolysate and oil from the agrifood industry might constitute sustainable functional ingredients for dog feeding while adding value for wild fisheries, aquaculture, and fish farming under a circular economy approach and reducing dependence on imports from third countries with a high carbon footprint.

Do patients benefit from omega-3 fatty acids?

Omega-3 fatty acids (O3FAs) possess beneficial properties for cardiovascular (CV) health and elevated O3FA levels are associated with lower incident risk for CV disease (CVD.) Yet, treatment of at-risk patients with various O3FA formulations has produced disparate results in large, well-controlled and well-conducted clinical trials. Prescription formulations and fish oil supplements containing low-dose mixtures of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have routinely failed to prevent CV events in primary and secondary prevention settings when added to contemporary care, as shown most recently in the STRENGTH and OMEMI trials. However, as observed in JELIS, REDUCE-IT, and RESPECT-EPA, EPA-only formulations significantly reduce CVD events in high-risk patients. The CV mechanism of action of EPA, while certainly multifaceted, does not depend solely on reductions of circulating lipids, including triglycerides (TG) and LDL, and event reduction appears related to achieved EPA levels suggesting that the particular chemical and biological properties of EPA, as compared to DHA and other O3FAs, may contribute to its distinct clinical efficacy. In vitro and in vivo studies have shown different effects of EPA compared with DHA alone or EPA/DHA combination treatments, on atherosclerotic plaque morphology, LDL and membrane oxidation, cholesterol distribution, membrane lipid dynamics, glucose homeostasis, endothelial function, and downstream lipid metabolite function. These findings indicate that prescription-grade, EPA-only formulations provide greater benefit than other O3FAs formulations tested. This review summarizes the clinical findings associated with various O3FA formulations, their efficacy in treating CV disease, and their underlying mechanisms of action.

Nutrient footprint versus EPA + DHA security in land-locked regions-more of local pond farmed, imported marine fish or fish oil capsules?

EPA + DHA intake in land-locked central Europe (CE) is barely fulfilled. Imported marine fish/farmed salmonids are likely the backbone of an ailing EPA + DHA security. Supplementing with captured marine fish oil capsules (~0.5 g up to 1.6 g CO2-eq. mg EPA + DHA-1) could be comparable in GHG emissions with fish consumption itself (~1 g to as low as 0.6 g CO2-eq. mg EPA + DHA-1). But synergistic benefits of EPA + DHA intake by consuming fish protein need consideration too. Taking semi-intensive pond carp and intensively farmed salmon as models, we analyzed footprint, eco-services, and resource use efficiency perspectives of achieving EPA + DHA security in a CE region. Despite a lower production footprint, pond-farmed fish greatly lag in EPA + DHA supply (carp 101-181 mg 100 g-1 < salmon 750-1300 mg 100 g-1). It doubles-to-quadruples footprint 'per mg' of EPA + DHA: nitrogen (carp 18.3 > salmon 8.7 mg N), phosphorus (carp 6.8 > salmon 1.6 mg P), and climate change (carp 1.84 > salmon 0.8 g CO2-eq.). With enhancements in pond carp (>300 mg EPA + DHA 100 g-1), these differences may cease to exist. Harnessing EPA + DHA bioaccumulation pathways active in ponds, finishing feeding strategies, and polyculture, the EPA + DHA content in pond fish may be increased. Ecosystem services with EPA + DHA mining from pond food web or high EPA + DHA output-to-input ratio (pond carp 1-200 > RAS salmon 0.75) make ponds an eco-efficient system. As fish consumption in CE must improve, pond-farmed fish would be needed to complement (but not substitute) salmonid/marine fish/oil capsules consumption. Achieving EPA + DHA security with minimum pressure on the environment or global resources.

Dietary effect of grape (Vitis vinifera) seed extract mitigates hepatic disorders caused by oxidized fish oil in rainbow trout (Oncorhynchus mykiss)

The major goal of this study was to determine the effect of grape seed extract (GSE) on liver damage in rainbow trout (Oncorhynchus mykiss) that was caused by the consumption of dietary oxidized fish oil (OFO). Rainbow trout were fed six different experimental diets coded OX-GSE 0 (OFO diet), OX-GSE 1 (OFO and 0.1% GSE), OX-GSE 3 (OFO and 0.3% GSE), GSE 0 (fresh fish oil and 0.0% GSE), GSE 1 (fresh fish oil and 0.1% GSE), and GSE 3 (fresh fish oil and 0.3% GSE) for 30 days. The lowest % hepatosomatic index (HSI) result was calculated in fish fed with OX-GSE 0 and the highest HSI was determined in fish fed with GSE 1 diets (p < 0.05). Histopathologically, hydropic degeneration in hepatocytes significantly increased OX-GSE 0 and GSE 3 compared to GSE 1 diets (p < 0.05). Deposition of lipid droplets in hepatocytes was significantly increased in OX-GSE 0 and OX-GSE 3 groups than others (p < 0.05). Liver biochemistry parameters such as superoxide dismutase (SOD), glutathione (GSH), and malondialdehyde (MDA) were significantly affected by OX and GSE treatments (p < 0.05). There were significant differences in alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) among the liver enzymes analyzed in serum in OX and GSE (p < 0.05), meanwhile no difference was observed in lactate dehydrogenase (LDH) values between groups (p > 0.05). In conclusion, liver biochemistry and histopathology of rainbow trout consuming diets containing oxidized fish oil were negatively affected. However, it was determined that the supplementation of 0.1% GSE to the diet had a significant ameliorative role in these adverse effects.

Role of Omega-3 Fatty Acids in Cardiovascular Disease: the Debate Continues

PURPOSE OF REVIEW

The omega-3 fatty acids (n3-FAs), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have recently undergone testing for their ability to reduce residual cardiovascular (CV) risk among statin-treated subjects. The outcome trials have yielded highly inconsistent results, perhaps attributable to variations in dosage, formulation, and composition. In particular, CV trials using icosapent ethyl (IPE), a highly purified ethyl ester of EPA, reproducibly reduced CV events and progression of atherosclerosis compared with mixed EPA/DHA treatments. This review summarizes the mechanistic evidence for differences among n3-FAs on the development and manifestations of atherothrombotic disease.

RECENT FINDINGS

Large randomized clinical trials with n3-FAs have produced discordant outcomes despite similar patient profiles, doses, and triglyceride (TG)-lowering effects. A large, randomized trial with IPE, a prescription EPA only formulation, showed robust reduction in CV events in statin treated patients in a manner proportional to achieved blood EPA concentrations. Multiple trials using mixed EPA/DHA formulations have not shown such benefits, despite similar TG lowering. These inconsistencies have inspired investigations into mechanistic differences among n3-FAs, as EPA and DHA have distinct membrane interactions, metabolic products, effects on cholesterol efflux, antioxidant properties, and tissue distribution. EPA maintains normal membrane cholesterol distribution, enhances endothelial function, and in combination with statins improves features implicated in plaque stability and reduces lipid content of plaques. Insights into reductions in residual CV risk have emerged from clinical trials using different formulations of n3-FAs. Among high-risk patients on contemporary care, mixed n3-FA formulations showed no reduction in CV events. The distinct benefits of IPE in multiple trials may arise from pleiotropic actions that correlate with on-treatment EPA levels beyond TG-lowering. These effects include altered platelet function, inflammation, cholesterol distribution, and endothelial dysfunction. Elucidating such mechanisms of vascular protection for EPA may lead to new interventions for atherosclerosis, a disease that continues to expand worldwide.

Omega-3-fatty acids: Do they prevent cardiovascular disease?

Despite cardiovascular disease (CVD) reductions with high-intensity statins, there remains residual risk among patients with metabolic disorders. Alongside low-density lipoproteins (LDL-C), elevated triglycerides (TG) are associated with incident CVD events. Omega-3 fatty acids (n3-FAs), specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), lower TG levels, but their ability to reduce CV risk has been highly inconsistent. Trials using icosapent ethyl (IPE), a purified EPA ethyl ester, produced reductions in CVD events and atherosclerotic plaque regression compared with mixed EPA/DHA formulations despite similar TG-reductions. The separate effects of EPA and DHA on tissue distribution, oxidative stress, inflammation, membrane structure and endothelial function may contribute to these discordant outcomes. Additional mechanistic trials will provide further insights into the role of n3-FAs in reducing CVD risk beyond TG lowering.

Assessment of the safety of dietary fish oil supplements in terms of content and quality

The fatty acid composition of top-selling fish oil dietary supplements in the markets was compared with the content stated on product label, and their oxidative qualities and heavy metal contents were evaluated in this study. While all the capsule groups (C) confirmed the label information, it was observed that one-third of the syrup groups (S) had less than the specified content. Capsule groups generally had richer EPA and DHA contents than syrup groups in the samples examined. The peroxide values (PV) of all fish oil capsules and syrups were found in the range of 1.97-2.89 mEq/kg and 2.22-18.30 mEq/kg, respectively. As for free fatty acids (FFA) values, the C4, S6, S9, and S10 groups were above the 3% oleic acid limit recommended for high-quality oils. However, thiobarbituric acid reactive substances (TBARs) values were found below 1 mg MA/kg in all groups. All fish oil supplements were within the limits specified in terms of As (0.50-4.19 µg/g), Cd (0.14 µg/g detected for one group, C5), Cu (not detected), Fe (0.32-15.7 µg/g), and Hg (≤ 0.1 µg/g). On the other hand, two fish oil supplements from the capsule group (0.17 for C6 and 1.01 µg/g for C8) and one group from the syrup group (0.29 µg/g for S10) exceeded the recommended limit in terms of Pb (0.1 mg/kg). As a result of the research, it can be concluded that the chemical quality of fish oils in syrup form needs to be improved and their reliability in terms of fatty acid content should be increased. Considering the heavy metals, it seems significant to follow up the fish oil products more strictly.

Sustainability in Skin Care: Incorporation of Avocado Peel Extracts in Topical Formulations

The avocado peel is an agro-industrial by-product that has exhibited a massive increase in its production in the last few years. The reuse and valorisation of this by-product are essential since its disposal raises environmental concerns. In the present study, ethanolic extracts of avocado peels of the Hass variety were obtained, for three extraction times (1.5 h, 3 h and 4 h) and analysed for their antioxidant and antibacterial properties. Antioxidant evaluations of the extracts revealed that the extraction time of 1.5 h exhibited the best results amongst the three, with a DPPH inhibition percentage of 93.92 ± 1.29 and an IC₅₀ percentage, the necessary concentration of the extract to inhibit 50% of DPPH, of 37.30 ± 1.00. The antibacterial capacity of the extracts was evaluated and it was revealed that they were able to inhibit the growth and development of bacteria of the Staphylococcus family. The obtained extract was incorporated in two types of cosmetic formulations (oil-in-water and water-in-oil) and their stability was evaluated and compared with formulations containing synthetic preservatives (BHT and phenoxyethanol). The results of the stability evaluation suggest that the avocado peel extract has the potential to be incorporated in both types of emulsions, acting as an antioxidant and antibacterial agent, proving it to be a viable option to reduce/replace the use of synthetic preservatives. Furthermore, the avocado peel extract proved to be more effective and stable in oil-in-water emulsions. These results highlight the possibility of obtaining sustainable cosmetics, significantly reducing the negative impacts on the environment by the incorporation of extracts sourced from the avocado peel, an interesting source of phenolic compounds, an abundant and low-cost by-product.

Addition of Olive Leaf Extract to a Mixture of Algae and Extra Virgin Olive Oils Decreases Fatty Acid Oxidation and Synergically Attenuates Age-Induced Hypertension, Sarcopenia and Insulin Resistance in Rats

Olive-derived products, such as virgin olive oil (EVOO) and/or olive leaf extracts (OLE), exert anti-inflammatory, insulin-sensitizing and antihypertensive properties and may be useful for stabilizing omega 3 fatty acids (n-3 PUFA) due to their high content in antioxidant compounds. In this study, the addition of OLE 4:0.15 (w/w) to a mixture of algae oil (AO) rich in n-3 PUFA and EVOO (25:75, w/w) prevents peroxides formation after 12 months of storage at 30 °C. Furthermore, the treatment with the oil mixture (2.5 mL/Kg) and OLE (100 mg/Kg) to 24 month old Wistar rats for 21 days improved the lipid profile, increased the HOMA-IR and decreased the serum levels of miRNAs 21 and 146a. Treatment with this new nutraceutical also prevented age-induced insulin resistance in the liver, gastrocnemius and visceral adipose tissue by decreasing the mRNA levels of inflammatory and oxidative stress markers. Oil mixture + OLE also attenuated the age-induced alterations in vascular function and prevented muscle loss by decreasing the expression of sarcopenia-related markers. In conclusion, treatment with a new nutraceutical based on a mixture of EVOO, AO and OLE is a useful strategy for improving the stability of n-3 PUFA in the final product and to attenuate the cardiometabolic and muscular disorders associated with aging.

Kinetic modeling of malondialdehyde reactivity in oil to simulate actual malondialdehyde formation upon lipid oxidation

The reactivity of malondialdehyde in saturated glycerol triheptanoate oil was studied over a wide temperature range (298.15-453.15 K). With respect to the non-ideal character of a lipid medium, a kinetic model was proposed that described the experimental malondialdehyde data by a reversible hydrolytic cleavage and an irreversible aldol self-condensation reaction. Significant parameter estimates were obtained by using a global one-step non-linear regression procedure. The aldol self-condensation of malondialdehyde showed to be the main degradation route of malondialdehyde in oils. Simulation of the malondialdehyde formation during lipid oxidation of sunflower oil demonstrated that, depending on the heating time, the experimentally obtained malondialdehyde concentrations can substantially underestimate the ongoing lipid oxidation.

Effect of Temperature and Humidity on Oil Quality of Harvested Torreya grandis cv. Merrillii Nuts During the After-Ripening Stage

Temperature and relative humidity (RH) influence post-harvest ripening, a crucial stage for quality promotion in some oil plants or fruits. Torreya grandis cv. Merrillii nuts, which are rich in unsaturated fatty acids (UFA), are easily affected by temperature and humidity, and they oxidize quickly during the post-harvest ripening stage, leading to the deterioration of nut quality. In this study, the main nutraceutical components, fatty acid composition, and related metabolic parameters of lipid rancidity under four treatments (20°C and 70% RH, T20-LH; 30°C and 70% RH, T30-LH; 20°C and 90% RH, T20-HH; 30°C and 90% RH, T30-HH) were measured. The post-harvest ripening process was advanced under HH treatments (T20-HH and T30-HH) compared to LH treatments (T20-LH and T30-LH) and was associated with a shorter time for the seed coat to turn dark black and a faster reduction in starch content. The amount of unsaturated fatty acids significantly increased under the T20-HH treatment, but significantly decreased under the T30-HH treatment from 12 to 16 d of ripening time. The acid value (AV) and lipase activity under the T30-HH treatment remained virtually constant from 12 to 16 d of ripening time, and this was accompanied by a dramatic increase in peroxide value (POV), lipoxygenase (LOX) activity, and relative expression of the LOX2 gene. Meanwhile, a significant positive correlation between LOX activity and POV, malondialdehyde (MDA) content, and O2⋅- content was observed. The results imply that the lower amount of oxidative rancidity induced by the T20-HH treatment is related to the LOX activity induced by down-regulation of the LOX2 gene during the late after-ripening stage. Therefore, the T20-HH treatment not only promoted the post-harvest process of T. grandis 'Merrillii' nuts but also delayed lipid oxidation, which was ultimately associated with better oil quality at the late after-ripening stage.

The dietary peroxidized lipid, 13-HPODE, promotes intestinal inflammation by mediating granzyme B secretion from natural killer cells

The dietary peroxidized lipid, 13-HPODE, stimulates natural killer cell granzyme B production and secretion, with potential implications for intestinal inflammation.

Analysis of Oxidative Carbonyl Compounds by UPLC-High-Resolution Mass Spectrometry in Milk Powder

Long-chain polyunsaturated fatty acids are highly susceptible to lipid oxidation which causes undesirable odors and flavors in food. We present the development, validation, and application of a semiquantitative screening method to monitor volatile and nonvolatile carbonyl compounds generated from lipids oxidation after 7-(diethylamino)-2-oxochromene-3-carbohydrazide (CHH) derivatization using liquid chromatography high-resolution mass spectrometry. An inclusion list containing eligible compounds was used in full scan mode to identify potential oxidative markers. In an antioxidants study using lecithin and tocopherols, the proposed method was successfully used to monitor the docosahexaenoic acid (DHA)-specific oxidative markers in a model milk powder system enriched with fish oils. The results showed that lecithin inhibits oxidation by reducing the peroxidation rate, while δ-tocopherol delays the oxidation with distinct induction periods. Here, we explore the optimum concentration of soy lecithin and δ-tocopherol needed to limit lipid oxidation in a complex food matrix such as milk powder.

Knowledge, Perceptions, and Patterns of Fish Oil Use in Cardiac Patients

BACKGROUND

Fish oils are the most widely used nonvitamin, nonmineral dietary supplements in the United States. They are not over-the-counter medications and are neither approved nor indicated for treating disease. Patient knowledge and patterns of fish oil use are not well defined.

OBJECTIVE

To determine cardiac patients' knowledge and patterns of fish oil use.

METHODS

One thousand consecutive patients admitted to an in-patient cardiology service (2015-2017) taking fish oil dietary supplements or prescription omega-3 fatty acids were asked to complete an anonymous questionnaire concerning product knowledge and use.

RESULTS

A total of 711 (71%) patients completed the questionnaire. Primary reasons for use included general health (34%), heart health (28%), arthritis (9%), and lipid disorders (8%). Few patients (14%) were advised to take fish oil products by a health-care provider. Only 2.5% were taking prescription omega-3 fatty acids. Only 26% knew the active ingredient in their fish oil product. Supplements were purchased through a nonpharmacy retail seller by 81% of respondents.

CONCLUSIONS

Most cardiac patients consuming fish oil dietary supplements do so without medical supervision and without knowledge of the active ingredients. As most patients obtain supplements outside of a pharmacy, opportunities to monitor and educate patients remain a major challenge.

New Insights into Mechanisms of Action for Omega-3 Fatty Acids in Atherothrombotic Cardiovascular Disease

PURPOSE OF REVIEW

Treatment of hypercholesterolemia with statins results in significant reductions in cardiovascular risk; however, individuals with well-controlled low-density lipoprotein cholesterol (LDL-C) levels, but persistent high triglycerides (TG), remain at increased risk. Genetic and epidemiologic studies have shown that elevated fasting TG levels are associated with incident cardiovascular events. At effective doses, omega-3 fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), lower TG levels but may have additional atheroprotective properties compared to other TG-lowering therapies such as niacin and fibrates. The purpose of this review is to evaluate mechanisms related to the potential benefits of omega-3 fatty acids in atherothrombotic disease.

RECENT FINDINGS

Large randomized clinical trials are currently under way to test the cardiovascular benefits of omega-3 fatty acids at a pharmacologic dosage (4 g/day). A large randomized trial with a prescription EPA-only formulation was shown to reduce a composite of cardiovascular events by 25% in statin-treated patients with established cardiovascular disease or diabetes and other CV risk factors. EPA and DHA have distinct tissue distributions as well as disparate effects on membrane structure and lipid dynamics, rates of lipid oxidation, and signal transduction pathways. Compared to other TG-lowering therapies, EPA has been found to inhibit cholesterol crystal formation, inflammation, and oxidative modification of atherogenic lipoprotein particles. The anti-inflammatory and endothelial benefits of EPA are enhanced in combination with a statin. Omega-3 fatty acids like EPA only at a pharmacologic dose reduce fasting TG and interfere with mechanisms of atherosclerosis that results in reduced cardiovascular events. Additional mechanistic trials will provide further insights into their role in reducing cardiovascular risk in subjects with well-managed LDL-C but elevated TG levels.

Lowering Effects of n-3 Fatty Acid Supplements on Blood Pressure by Reducing Plasma Angiotensin II in Inner Mongolia Hypertensive Patients: A Double-Blind Randomized Controlled Trial

Whether n-3 fatty acid (FA) has hypotensive actions among Chinese adults remains inconclusive. Hypertensive patients from Inner Mongolia, China ( n = 126) were recruited to a double-blind, randomized controlled trial. We investigated the effects of n-3 FA supplements on blood pressure (BP, mm Hg), plasma concentrations of angiotensin II (Ang II, pg/mL), and nitric oxygen (NO, μmol/L), using fish oil ( n = 41, 4 capsules/day, equivalent to 2 g of eicosapentaenoic acid plus docosahexaenoic acid) and flaxseed oil ( n = 42, 4 capsules/day, equivalent to 2.5 g of α-linolenic acid). Comparing to the control group (corn oil, n = 43), the mean systolic BP (-4.52 ± 9.28 vs -1.51 ± 9.23, P = 0.040) and the plasma Ang II levels (-12.68 ± 10.87 vs -4.93 ± 9.08, P = 0.023) were significantly lowered in the fish oil group, whereas diastolic BP ( P = 0.285) and plasma NO levels ( P = 0.220) were not. Such findings suggest that marine-based n-3 FA has a hypotensive efficacy in Chinese hypertensive patients possibly through inhibiting Ang II-dependent vasoconstrictions.

Aldehydes identified in commercially available ω-3 supplements via 1 H NMR spectroscopy

OBJECTIVES

Cardiovascular disease (CVD) is the leading cause of mortality globally. Studies have suggested that supplementary ω-3 oils may provide cardiovascular protection, although the literature is equivocal. Recently, it has been established that many commercially available ω-3 supplements are unacceptably oxidized, leading to myriad potential health risks. One oxidation product of concern is aldehydes, which have been shown to have mutagenic, cytotoxic, and inflammatory properties that may contribute to many different disease processes, including CVD. The aim of this study was to assess the prevalence of aldehyde contamination in commercially available ω-3 supplements.

METHODS

We tested 12 different ω-3 oils (6 fish, 4 krill, 2 algae), using 1 H-nuclear magnetic resonance scanning. This work is of a pilot nature, as such we randomly selected and purchased 12 different oils over the counter from various local retailers according to the sales representatives' recommendations.

RESULTS

The four krill products contained aldehydes at concentrations between 5.652 (±0.496) and 6.779 (±1.817) mMol/L. Both algae samples contained aldehydes: 1.235 (±0.111) and 1.565 (±0.618) mMol/L. Two of the six fish oils contained aldehydes 1.568 (±0.291) and 4.319 (±2.361) mMol/L. There is currently no standard for aldehyde content nor for labeling of ω-3 supplements. Two-thirds (8 of 12) of the ω-3 supplements tested in this study contained aldehydes. Aldehydes have the potential to precipitate serious health problems even at very low absolute intake volumes. These findings may provide reason for sober reflection.

Effects of Marine Oils, Digested with Human Fluids, on Cellular Viability and Stress Protein Expression in Human Intestinal Caco-2 Cells

In vitro digestion of marine oils has been reported to promote lipid oxidation, including the formation of reactive aldehydes (e.g., malondialdehyde (MDA) and 4-hydroxy-2-hexenal (HHE)). We aimed to investigate if human in vitro digestion of supplemental levels of oils from algae, cod liver, and krill, in addition to pure MDA and HHE, affect intestinal Caco-2 cell survival and oxidative stress. Cell viability was not significantly affected by the digests of marine oils or by pure MDA and HHE (0-90 μM). Cellular levels of HSP-70, a chaperone involved in the prevention of stress-induced protein unfolding was significantly decreased (14%, 28%, and 14% of control for algae, cod and krill oil, respectively; p ≤ 0.05). The oxidoreductase thioredoxin-1 (Trx-1) involved in reducing oxidative stress was also lower after incubation with the digested oils (26%, 53%, and 22% of control for algae, cod, and krill oil, respectively; p ≤ 0.001). The aldehydes MDA and HHE did not affect HSP-70 or Trx-1 at low levels (8.3 and 1.4 μM, respectively), whilst a mixture of MDA and HHE lowered Trx-1 at high levels (45 μM), indicating less exposure to oxidative stress. We conclude that human digests of the investigated marine oils and their content of MDA and HHE did not cause a stress response in human intestinal Caco-2 cells.

High-quality fish oil has a more favourable effect than oxidised fish oil on intermediate-density lipoprotein and LDL subclasses: a randomised controlled trial

Fish oil (FO) supplementation reduces the risk of CVD. However, it is not known if FO of different qualities have different effects on lipoprotein subclasses in humans. We aimed at investigating the effects of oxidised FO and high-quality FO supplementation on lipoprotein subclasses and their lipid concentrations in healthy humans. In all, fifty-four subjects completed a double-blind randomised controlled intervention study. The subjects were randomly assigned to receive high-quality FO (n 17), oxidised FO (n 18) or high-oleic sunflower oil capsules (HOSO, n 19) for 7 weeks. The concentration of marine n-3 fatty acids was equal in high-quality FO and oxidised FO (1·6 g EPA+DHA/d). The peroxide value (PV) and anisidine value (AV) were 4 mEq/kg and 3 in high-quality FO and HOSO, whereas the PV and AV in the oxidised FO were 18 mEq/kg and 9. Blood samples were collected at baseline and end of study. NMR spectroscopy was applied for the analysis of lipoprotein subclasses and their lipid concentrations. High-quality FO reduced the concentration of intermediate-density lipoprotein (IDL) particles and large, medium and small LDL particles, as well as the concentrations of total lipids, phospholipids, total cholesterol, cholesteryl esters and free cholesterol in IDL and LDL subclasses compared with oxidised FO and HOSO. Hence, high-quality FO and oxidised FO differently affect lipid composition in lipoprotein subclasses, with a more favourable effect mediated by high-quality FO. In future trials, reporting the oxidation levels of FO would be useful.

Omega-3 Long-Chain Polyunsaturated Fatty Acid Content and Oxidation State of Fish Oil Supplements in New Zealand

Forty-seven fish oil products available on the New Zealand market were analyzed for eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) content, as well as for oxidative status in a collaborative effort by several analytical laboratories. Of the tested products, 72%, 86% and 77% complied with voluntary industry-set maximum limits on Peroxide Value (PV), para-Anisidine Value (p-AV), and TOTOX, respectively. 91% of the products complied with EPA/DHA content claims. All fish oils complied with a p-AV limit of 30, 98% with a PV limit of 10 meq O2/kg, and 96% with a calculated TOTOX value of 50, which are less stringent limits used by the European and British Pharmacopeia and the Australian authorities. The results are in stark contrast to the very low percentage of fish oil products reported to be in compliance with primary oxidation limits and EPA/DHA content by a recently published assessment of fish oil supplements in New Zealand. Possible reasons for this discrepancy are evaluated and discussed.

Polyunsaturated lipids and vitamin A oxidation during cod liver oil in vitro gastrointestinal digestion. Antioxidant effect of added BHT

The extent of cod liver oil hydrolysis and oxidation during in vitro gastrointestinal digestion was investigated by Proton Nuclear Magnetic Resonance (¹H NMR) and Solid Phase Microextraction-Gas Chromatography/Mass Spectrometry (SPME-GC/MS). These techniques evidenced the degradation of polyunsaturated ω-3 and ω-6 lipids and, for the first time, that of vitamin A, naturally present in cod liver oil. Cis,trans-conjugated dienes associated with hydroperoxides, as well as monoepoxides, cis,trans-2,4-alkadienals, 4-hydroperoxy- and 4-hydroxy-2-alkenals, and several vitamin A derived metabolites were generated. Moreover, the effect of the addition of the synthetic antioxidant 2,6-di-tert-butyl-hydroxytoluene (BHT) at 20 and 800ppm was tackled. Both techniques showed BHT to be efficient in limiting oxidation reactions during digestion, almost inhibiting them at 800ppm. Therefore, the simultaneous intake of antioxidants with cod liver oil should be considered, in order to increase polyunsaturated lipid and vitamin A bioaccessibility and avoid formation of toxic oxidation compounds like oxygenated alpha,beta-unsaturated aldehydes.

The impact of essential fatty acid, B vitamins, vitamin C, magnesium and zinc supplementation on stress levels in women: a systematic review

BACKGROUND

Women juggling multiple roles in our complex society are increasingly experiencing psychological stress. Dietary supplementation to manage stress is widespread despite limited supporting evidence. A systematic review of the available literature was undertaken to investigate the efficacy of specific dietary supplements in managing female stress and anxiety.

OBJECTIVES

To identify the impact of essential fatty acids (EFAs), B vitamins, vitamin C, magnesium and/or zinc, consumed as dietary supplements to the daily diet, on female stress and anxiety levels.

INCLUSION CRITERIA TYPES OF PARTICIPANTS

Women aged 18 years and over, who had participated in a study where stress and/or anxiety were assessed.

TYPES OF INTERVENTION(S)

Dietary supplementation with EFAs, B vitamins, vitamin C, magnesium and/or zinc.

TYPES OF COMPARATORS

Supplements, either alone or combined, were compared with either no intervention or placebo.

TYPES OF STUDIES

Randomized controlled and pseudo-randomized trials were included.

OUTCOMES

Stress and anxiety were assessed using self-report or physiological outcome measures.

SEARCH STRATEGY

Published and unpublished studies were sought via MEDLINE (via PubMed), Embase, Scopus, CINAHL, PsycINFO, PsycARTICLES, MedNar, National Institute of Mental Health and the International Association for Women's Mental Health.

METHODOLOGICAL QUALITY

Methodological quality was evaluated using standardized critical appraisal instruments from the Joanna Briggs Institute.

DATA EXTRACTION

Data were extracted using the standardized data extraction instruments from the Joanna Briggs Institute.

DATA SYNTHESIS

Due to heterogeneity of the included studies, narrative synthesis was performed.

RESULTS

Fourteen studies were included in this review. Essential fatty acids were effective in reducing perceived stress and salivary cortisol levels during pregnancy and anxiety in premenstrual women, and anxiety during menopause in the absence of depression, but were ineffective when depression was disregarded. Disregarding the hormonal phase, EFAs were ineffective in reducing stress or anxiety in four groups of women. Combined magnesium and vitamin B6 supplementation reduced premenstrual anxiety but had no effect when used in isolation and did not affect stress in women suffering from dysmenorrhea when combined or used in isolation. Older women experienced anxiety reduction using vitamin B6, but not folate or vitamin B12. High-dose sustained-release vitamin C was effective in reducing anxiety and blood pressure in response to stress.

CONCLUSION

The current review suggests that EFAs may be effective in reducing prenatal stress and salivary cortisol and may reduce anxiety during premenstrual syndrome and during menopause in the absence of depression. Magnesium and vitamin B6 may be effective in combination in reducing premenstrual stress, and vitamin B6 alone may reduce anxiety effectively in older women. High-dose sustained-release vitamin C may reduce anxiety and mitigate increased blood pressure in response to stress.

IMPLICATIONS FOR PRACTICE

Essential fatty acids may be effective in reducing prenatal stress and salivary cortisol levels, and premenstrual or menopausal anxiety in the absence of depression. Combining magnesium and vitamin B6 may reduce premenstrual anxiety and vitamin B6 may reduce anxiety in older women. High-dose sustained-release vitamin C may reduce anxiety and mitigate increased blood pressure in response to stress.

IMPLICATIONS FOR RESEARCH

Investigating supplementation in longer term studies is warranted and should include compliance testing, the use of inert substances as controls and reliable outcome measures.

A new genotype of flax (Linum usitatissimum L.) with decreased susceptibility to fat oxidation: consequences to hematological and biochemical profiles of blood indices

BACKGROUND

Flaxseed is an alternative to marine products that provide the traditional dietary sources of ω-fatty acids. A new genotype of flax, W92, is rich in natural antioxidants as well as having a reduced content of α-linolenic acid and therefore shows decreased susceptibility to fat oxidation. The objective of this study was to evaluate the effect of a diet supplemented with W92 flaxseed on hematological and biochemical blood indices.

RESULTS

A positive impact of diet with the addition of flaxseed was observed on erythrocyte indices, including red blood cell (RBC), hematocrit (HCT), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) values. There were no significant differences for white blood cell (WBC), total protein and glucose values. Aspartate aminotransferase and alanine aminotransferase estimations in serum were also carried out and no obvious toxicity to the liver was shown. Moreover, a lipid profile was performed in serum samples and a decrease in total cholesterol and low-density lipoprotein cholesterol (LDL-C), accompanied by an increase in high-density lipoprotein cholesterol (HDL-C), was observed in rabbits fed flaxseed diets.

CONCLUSION

Based on the results obtained, it appeared that the inclusion of a new genetically modified type of flaxseed in the diet altered cholesterol metabolism and could reduce the possibility of cardiovascular diseases. Diet enrichment with W92 flaxseed may be a solution to the health issues that are a result of improper diet in humans and animals. © 2016 Society of Chemical Industry.

Formation of reactive aldehydes (MDA, HHE, HNE) during the digestion of cod liver oil: comparison of human and porcine in vitro digestion models

In this work, we investigated lipid oxidation of cod liver oil during gastrointestinal (GI) digestion using two types of in vitro digestion models. In the first type of model, we used human GI juices, while we used digestive enzymes and bile from porcine origin in the second type of model. Human and porcine models were matched with respect to factors important for lipolysis, using a standardized digestion protocol. The digests were analysed for reactive oxidation products: malondialdehyde (MDA), 4-hydroxy-trans-2-nonenal (HNE), and 4-hydroxy-trans-2-hexenal (HHE) by liquid chromatography/atmospheric pressure chemical ionization-mass spectrometry (LC/APCI-MS), and for free fatty acids (FFA) obtained during the digestion by gas chromatography-mass spectrometry (GC-MS). The formation of the oxidation products MDA, HHE, and HNE was low during the gastric digestion, however, it increased during the duodenal digestion. The formation of the oxidation products reached higher levels when digestive juices of human origin were used (60 μM of MDA, 9.8 μM of HHE, and 0.36 μM of HNE) [corrected] compared to when using enzymes and bile of porcine origin (0.96, and 1.6 μM of MDA; 0.16, and 0.23 μM of HHE; 0.026, [corrected] and 0.005 μM of HNE, respectively, in porcine models I and II). In all models, FFA release was only detected during the intestinal step, and reached up to 31% of total fatty acids (FA). The findings in this work may be of importance when designing oxidation oriented lipid digestion studies.

Omega-3 Fatty Acid Formulations in Cardiovascular Disease: Dietary Supplements are Not Substitutes for Prescription Products

Omega-3 fatty acid products are available as prescription formulations (icosapent ethyl, omega-3-acid ethyl esters, omega-3-acid ethyl esters A, omega-3-carboxylic acids) and dietary supplements (predominantly fish oils). Most dietary supplements and all but one prescription formulation contain mixtures of the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Products containing both EPA and DHA may raise low-density lipoprotein cholesterol (LDL-C). In clinical trials, the EPA-only prescription product, icosapent ethyl, did not raise LDL-C compared with placebo. To correct a common misconception, it is important to note that omega-3 fatty acid dietary supplements are not US FDA-approved over-the-counter drugs and are not required to demonstrate safety and efficacy prior to marketing. Conversely, prescription products are supported by extensive clinical safety and efficacy investigations required for FDA approval and have active and ongoing safety monitoring programs. While omega-3 fatty acid dietary supplements may have a place in the supplementation of diet, they generally contain lower levels of EPA and DHA than prescription products and are not approved or intended to treat disease. Perhaps due to the lack of regulation of dietary supplements, EPA and DHA levels may vary widely within and between brands, and products may also contain unwanted cholesterol or fats or potentially harmful components, including toxins and oxidized fatty acids. Accordingly, omega-3 fatty acid dietary supplements should not be substituted for prescription products. Similarly, prescription products containing DHA and EPA should not be substituted for the EPA-only prescription product, as DHA may raise LDL-C and thereby complicate the management of patients with dyslipidemia.

Alcoholic Liver Disease: Update on the Role of Dietary Fat

Alcoholic liver disease (ALD) spans a spectrum of liver pathology, including fatty liver, alcoholic steatohepatitis, and cirrhosis. Accumulating evidence suggests that dietary factors, including dietary fat, as well as alcohol, play critical roles in the pathogenesis of ALD. The protective effects of dietary saturated fat (SF) and deleterious effects of dietary unsaturated fat (USF) on alcohol-induced liver pathology are well recognized and documented in experimental animal models of ALD. Moreover, it has been demonstrated in an epidemiological study of alcoholic cirrhosis that dietary intake of SF was associated with a lower mortality rates, whereas dietary intake of USF was associated with a higher mortality. In addition, oxidized lipids (dietary and in vivo generated) may play a role in liver pathology. The understanding of how dietary fat contributes to the ALD pathogenesis will enhance our knowledge regarding the molecular mechanisms of ALD development and progression, and may result in the development of novel diet-based therapeutic strategies for ALD management. This review explores the relevant scientific literature and provides a current understanding of recent advances regarding the role of dietary lipids in ALD pathogenesis.

Fish oil supplements in New Zealand are highly oxidised and do not meet label content of n-3 PUFA

We evaluated the quality and content of fish oil supplements in New Zealand. All encapsulated fish oil supplements marketed in New Zealand were eligible for inclusion. Fatty acid content was measured by gas chromatography. Peroxide values (PV) and anisidine values (AV) were measured, and total oxidation values (Totox) calculated. Only 3 of 32 fish oil supplements contained quantities of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) that were equal or higher than labelled content, with most products tested (69%) containing <67%. The vast majority of supplements exceeded recommended levels of oxidation markers. 83% products exceeded the recommended PV levels, 25% exceeded AV thresholds, and 50% exceeded recommended Totox levels. Only 8% met the international recommendations, not exceeding any of these indices. Almost all fish oil supplements available in the New Zealand market contain concentrations of EPA and DHA considerably lower than claimed by labels. Importantly, the majority of supplements tested exceeded the recommended indices of oxidative markers. Surprisingly, best-before date, cost, country of origin, and exclusivity were all poor markers of supplement quality.

Analysis of the omega-3 fatty acid content of South African fish oil supplements: a follow-up study

INTRODUCTION

Globally the omega-3 (n-3) fatty acid supplement industry is expanding rapidly while consumers are becoming more aware of the health benefits of n-3 fatty acids. Our group conducted a survey in 2009 on 45 commercially available fish oil supplements on the South African market. The aim of the study was to determine the fatty acid composition and content of supplements for comparison with the claimed contents on the product label. The survey was repeated in 2012 on 63 supplements.

METHODS

Sixty-three commercially available n-3 fatty acid supplements were analysed using gas-liquid chromatography to determine their fatty acid composition and content.

RESULTS

This analysis has shown an improvement in the accuracy of EPA content (44% in 2009) declared on supplement labels compared to the 2012 (52%) survey. It was also evident that a higher percentage of supplements (13% in 2009 vs 35% in 2012) contained DHA levels higher than declared. In 2009, 64% of supplements cost R2.01 to R5.00 or more to achieve a daily intake of 500 mg EPA + DHA, compared to 81% in 2012. Forty-four per cent of supplements were found to be in the early stages of rancidity [conjugated diene (CD) levels] compared to 73% in 2009. More than 80% of supplements had peroxide levels higher than the recommended content as specified by the Global Organisation for EPA and DHA Omega-3 (GOED). The majority (81%; n = 51) of the supplements under study in 2012 had a 1.1-1.5:1 EPA-to-DHA ratio or less, compared to 56% in 2009. Almost a third (32%) of the supplements in the 2012 survey contained ethyl esters (EE) or a combination of ethyl esters and triglycerides.

CONCLUSION

Although the results of the 2012 versus the 2009 analysis were encouraging in terms of the accuracy of EPA declared on the supplement labels, the high peroxide levels found in the supplement oils are of concern. High peroxide levels are associated with potential health implications. EE were present in some of the supplements, even though the safety of EE has not been confirmed in vulnerable groups such as pregnant women and children.

Failure of a dietary model to affect markers of inflammation in domestic cats

Background

Oxidative stress and inflammation can be altered by dietary factors in various species. However, little data are available in true carnivorous species such as domestic cats. As numerous anti-inflammatory and anti-oxidative additives become available and might be of use in cats with chronic low-grade inflammatory diseases, the current study aimed to develop a model of diet-induced inflammation by use of two opposite diets. It was hypothesized that a high fat diet enhanced in n-6 PUFA and with lower concentrations of antioxidants would evoke inflammation and oxidative stress in domestic cats.

Results

Sixteen healthy adult cats were allocated to two groups. One group received a moderate fat diet, containing pork lard and salmon oil (AA:(EPA + DHA) ratio 0.19) (MFn-3), while the other group was fed a high fat diet, containing pork lard and chicken fat (AA:(EPA + DHA) ratio 2.06) (HFn-6) for 12 weeks. Prior to and 2, 4, 6, 8, 10 and 12 weeks after starting the testing period, blood samples were collected. Erythrocytic fatty acid profile showed clear alterations in accordance to the dietary fatty acid profile. Serum thiobarbituric acid reactive substances was higher when fed MFn-3 compared to the HFn-6, suggesting augmented oxidative stress. This was associated with a reduced serum vitamin E status, as serum α-tocopherol concentrations were lower with MFn-3, even with higher dietary levels of vitamin E. Serum cytokine and serum amyloid A concentrations were not influenced by diet.

Conclusion

These results point towards a resistance of cats to develop dietary fat-induced inflammation, but also suggest a high susceptibility to oxidative stress when fed a fish oil-supplemented diet even with moderate fat level and additional vitamin E.

Dietary vegetable oils do not alter the intestine transcriptome of gilthead sea bream (Sparus aurata), but modulate the transcriptomic response to infection with Enteromyxum leei

Background

Studies conducted with gilthead sea bream (Sparus aurata L.) have determined the maximum dietary replacement of fish meal and oil without compromising growth or product quality. The present study aimed to analyze the effect of the nutritional background on fish health and fish fed plant protein-based diets with fish oil (FO diet) or a blend of vegetable oils (66VO diet) were exposed for 102 days to the intestinal myxosporean parasite Enteromyxum leei, and the intestine transcriptome was analyzed with a customized oligo-microarray of 7,500 annotated genes.

Results

Infection prevalence was high and similar in the two diet groups, but the outcome of the disease was more pronounced in fish fed the 66VO diet. No differences were found in the transcriptome of both diet control groups, whereas the number of differentially expressed genes in infected groups was considerable. K-means clustering of these differentially expressed genes identified four expression patterns that reflected the progression of the disease with the magnitude of the fold-change being higher in infected 66VO fish. A positive correlation was found between the time of infection and the magnitude of the transcriptional change within the 66VO group, being higher in early infected animals. Within this diet group, a strong up-regulation of many components of the immune specific response was evidenced, whereas other genes related to complement response and xenobiotic metabolism were down-regulated.

Conclusions

The high replacement of fish oil by vegetable oils in practical fish feeds did not modify the intestine transcriptome of gilthead sea bream, but important changes were apparent when fish were exposed to the myxosporean E. leei. The detected changes were mostly a consequence rather than a cause of the different disease progression in the two diet groups. Hence, the developed microarray constitutes an excellent diagnostic tool to address changes associated with the action of intestinal pathogens, but lacks a prognostic value to predict in advance the different susceptibility of growing fish to the current pathogen.

Margarines fortified with α-linolenic acid, eicosapentaenoic acid, or docosahexaenoic acid alter the fatty acid composition of erythrocytes but do not affect the antioxidant status of healthy adults

We aimed to investigate the effects of increased intake of α-linolenic acid (ALA), EPA, or DHA incorporated into a food matrix on the fatty acid composition of erythrocytes and on biomarkers of oxidant/antioxidant status. To this end, a controlled dietary study was conducted in 74 healthy men and women. The participants were randomly assigned to 1 of 3 interventions in which margarines fortified with either 10 weight percent ALA, EPA, or DHA ethyl esters replaced their normal spread for 6 wk. The total intakes of ALA, EPA, and DHA were 4.4, 2.2, and 2.3 g/d, respectively. Consuming EPA increased the erythrocyte proportion of EPA (394%) and the omega-3 index (sum of EPA and DHA, 38%). Consumption of DHA increased erythrocyte DHA (91%), the omega-3 index (98%), and EPA (137%). The omega-3 index increased to a significantly greater extent in the DHA group than in the EPA group. ALA did not increase erythrocyte EPA or the omega-3 index. We found no change in plasma uric acid or antioxidant capacity in any of the groups. Plasma malondialdehyde (MDA) increased with the EPA and DHA interventions. All 3 interventions decreased erythrocyte linoleic acid hydroperoxides but did not affect their MDA concentrations. In conclusion, the intake of both isolated EPA and DHA incorporated into margarine resulted in an enhanced incorporation of EPA and DHA into erythrocytes. Our findings indicate that DHA is quantitatively superior to EPA in view of the EPA+DHA tissue incorporation and also that 4 g/d ALA is not sufficient to increase the omega-3 index over a 6-wk period.

Oxidation of cod liver oil during gastrointestinal in vitro digestion

Oxidation of cod liver oil rich in long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFA) was investigated during a gastrointestinal (GI) in vitro digestion. The digestion stimulated TBA-reactive substances (TBARS) formation in both the gastric and intestinal steps, whereas levels of lipid hydroperoxides remained nearly constant. The presence of digestive compounds was decisive for the TBARS development because TBARS did not change when the cod liver oil was subjected only to the temperature and pH gradient of the GI model. Preformed oxidation products in the cod liver oil resulted in further elevated TBARS levels during the digestion. Addition of hemoglobin (11.5 μM) to emulsified cod liver oil dramatically increased TBARS and lipid hydroperoxide levels during GI digestion, whereas 1 mg α-tocopherol/g oil did not show any protection against oxidation. Specific concern thus needs to be taken in the design of foods containing LC n-3 PUFA to preserve these lipids and avoid harmful oxidation, both before and after consumption.