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Suh SW, Lim E, Burm SY, Lee H, Bae JB, Han JW, Kim KW. The influence of n-3 polyunsaturated fatty acids on cognitive function in individuals without dementia: a systematic review and dose-response meta-analysis. BMC Med 2024; 22:109. [PMID: 38468309 DOI: 10.1186/s12916-024-03296-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 02/12/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Omega-3 polyunsaturated fatty acids (n-3 PUFA) have been suggested as a cognitive enhancing agent, though their effect is doubtful. We aimed to examine the effect of n-3 PUFA on the cognitive function of middle-aged or older adults without dementia. METHODS We reviewed randomized controlled trials of individuals aged 40 years or older. We systematically searched PubMed/MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Library databases. We used the restricted cubic splines model for non-linear dose-response meta-analysis in terms of the standardized mean difference with 95% confidence intervals. RESULTS The current meta-analysis on 24 studies (n 9660; follow-up 3 to 36 months) found that the beneficial effect on executive function demonstrates an upward trend within the initial 12 months of intervention. This effect is prominently observed with a daily intake surpassing 500 mg of n-3 PUFA and up to 420 mg of eicosapentaenoic acid (EPA). Furthermore, these trends exhibit heightened significance in regions where the levels of blood docosahexaenoic acid (DHA) + EPA are not very low. CONCLUSIONS Supplementation of n-3 PUFA may confer potential benefits to executive function among the middle-aged and elderly demographic, particularly in individuals whose dietary DHA + EPA level is not substantially diminished.
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Affiliation(s)
| | - Eunji Lim
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Suh-Yuhn Burm
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Hyungji Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea.
- Department of Brain and Cognitive Sciences, Seoul National University, College of Natural Sciences, Seoul, South Korea.
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Tremblay AJ, Lamarche B, Hogue JC, Couture P. n-3 Polyunsaturated Fatty Acid Supplementation Has No Effect on Postprandial Triglyceride-Rich Lipoprotein Kinetics in Men with Type 2 Diabetes. J Diabetes Res 2016; 2016:2909210. [PMID: 27034958 PMCID: PMC4789436 DOI: 10.1155/2016/2909210] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 02/14/2016] [Indexed: 11/18/2022] Open
Abstract
Dietary n-3 polyunsaturated fatty acids (PUFAs) have been proposed to modulate plasma lipids, lipoprotein metabolism, and inflammatory state and to reduce triglyceride (TG) concentrations. The present double-blind, randomized, placebo-controlled, crossover study investigated the effects of n-3 PUFA supplementation at 3 g/d for 8 weeks on the intravascular kinetics of intestinally derived apolipoprotein (apo) B-48-containing lipoproteins in 10 men with type 2 diabetes. In vivo kinetics of the TG-rich lipoprotein (TRL) apoB-48 and VLDL apoB-100 were assessed using a primed-constant infusion of L-[5,5,5-D3] leucine for 12 hours in a fed state. Compared with the placebo, n-3 PUFA supplementation significantly reduced fasting TG concentrations by -9.7% (P = 0.05) but also significantly increased plasma levels of cholesterol (C) (+6.0%, P = 0.05), LDL-C (+12.2%, P = 0.04), and HDL-C (+8.4, P = 0.007). n-3 PUFA supplementation had no significant impact on postprandial TRL apoB-48 and VLDL apoB-100 levels or on the production or catabolic rates of these lipoproteins. These data indicate that 8-week supplementation with n-3 PUFAs in men with type 2 diabetes has no beneficial effect on TRL apoB-48 and VLDL apoB-100 levels or kinetics.
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Affiliation(s)
- André J. Tremblay
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC, Canada G1V 0A6
| | - Benoît Lamarche
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC, Canada G1V 0A6
| | - Jean-Charles Hogue
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC, Canada G1V 0A6
| | - Patrick Couture
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC, Canada G1V 0A6
- CHUQ Research Center, Laval University, Quebec City, QC, Canada G1V 4G2
- *Patrick Couture:
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Phang M, Lincz LF, Garg ML. Eicosapentaenoic and docosahexaenoic acid supplementations reduce platelet aggregation and hemostatic markers differentially in men and women. J Nutr 2013; 143:457-63. [PMID: 23390192 DOI: 10.3945/jn.112.171249] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Although long-chain n3 polyunsaturated fatty acids [n3 PUFAs; eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] have been reported to reduce platelet aggregation, the available evidence on this is equivocal. We previously demonstrated that the acute effects of n3 PUFA supplementation on platelet aggregation are sex specific. We aimed to determine if this gender bias is maintained during long-term n3 PUFA supplementation and whether this translates to other hemostatic markers. A double-blinded, randomized, placebo controlled trial was conducted in 94 healthy men and women. Platelet aggregation, thromboxane (TX) B2, P-selectin (P-sel), von Willebrand factor (vWF), and plasminogen activator inhibitor-1 were measured at baseline and 4 wk postsupplementation with EPA-rich (1000 mg EPA:200 mg DHA) or DHA-rich (200 mg EPA:1000 mg DHA) oil capsules daily. The effects of n3 PUFA on platelet activity were compared between men and women. In men and women combined, EPA and DHA reduced platelet aggregation following 4 wk of supplementation relative to placebo (-11.8%, P = 0.016; and -14.8%, P = 0.001, respectively). In subgroup analyses, in men, only the EPA treatment reduced platelet aggregation by -18.4% compared with placebo (P = 0.005) and women (P = 0.011). In contrast, in women, only the DHA treatment reduced platelet aggregation (-18.9%) compared with placebo (P = 0.001) and men (P = 0.017). Significant sex × treatment interactions were also observed on hemostatic markers and uptake of n3 PUFAs. The significant interactions between sex and specific, supplemental, long-chain n3 PUFAs result in platelet aggregation being differentially affected in men and women. With respect to thrombotic disease risk, men are more likely to benefit from supplementation with EPA, whereas women are more responsive to DHA.
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Affiliation(s)
- Melinda Phang
- Nutraceuticals Research Group, School of Biomedical Sciences and Pharmacy, University of Newcastle, NSW, Australia
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Ash MM, Wolford KA, Carden TJ, Hwang KT, Carr TP. Unrefined and refined black raspberry seed oils significantly lower triglycerides and moderately affect cholesterol metabolism in male Syrian hamsters. J Med Food 2011; 14:1032-8. [PMID: 21548801 DOI: 10.1089/jmf.2010.0181] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Unrefined and refined black raspberry seed oils (RSOs) were examined for their lipid-modulating effects in male Syrian hamsters fed high-cholesterol (0.12% g/g), high-fat (9% g/g) diets. Hamsters fed the refined and the unrefined RSO diets had equivalently lower plasma total cholesterol and high-density lipoprotein (HDL) cholesterol in comparison with the atherogenic coconut oil diet. The unrefined RSO treatment group did not differ in liver total and esterified cholesterol from the coconut oil-fed control animals, but the refined RSO resulted in significantly elevated liver total and esterified cholesterol concentrations. The unrefined RSO diets significantly lowered plasma triglycerides (46%; P=.0126) in comparison with the coconut oil diet, whereas the refined RSO only tended to lower plasma triglyceride (29%; P=.1630). Liver triglyceride concentrations were lower in the unrefined (46%; P=.0002) and refined (36%; P=.0005) RSO-fed animals than the coconut oil group, with the unrefined RSO diet eliciting a lower concentration than the soybean oil diet. Both RSOs demonstrated a null or moderate effect on cholesterol metabolism despite enrichment in linoleic acid, significantly lowering HDL cholesterol but not non-HDL cholesterol. Dramatically, both RSOs significantly reduced hypertriglyceridemia, most likely due to enrichment in α-linolenic acid. As a terrestrial source of α-linolenic acid, black RSOs, both refined and unrefined, provide a promising alternative to fish oil supplementation in management of hypertriglyceridemia, as demonstrated in hamsters fed high levels of dietary triglyceride and cholesterol.
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Affiliation(s)
- Mark M Ash
- Department of Nutrition and Health Sciences, University of Nebraska, Lincoln, Nebraska 68583-0806, USA
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5
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Montegaard C, Tulk HMF, Lauritzen L, Tholstrup T, Robinson LE. Acute ingestion of long-chain (n-3) polyunsaturated fatty acids decreases fibrinolysis in men with metabolic syndrome. J Nutr 2010; 140:38-43. [PMID: 19889809 DOI: 10.3945/jn.109.111427] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Individuals with metabolic syndrome (MetS) often have elevated plasma plasminogen activator inhibitor-1 (PAI-1) and tissue plasminogen activator (t-PA), contributing to an increased risk of cardiovascular disease. PAI-1 and t-PA may be affected by chronic (n-3) long-chain PUFA [(n-3)LCPUFA] supplementation; however, the acute impact of fat ingestion on these risk factors has not been established. Our objective was to investigate the acute effect of (n-3)LCPUFA on plasma PAI-1, t-PA, and platelet aggregation. We conducted a randomized crossover study in which men (n = 8, > or =45 y) with MetS consumed water or a high-saturated fat beverage (1 g fat/kg body weight) with either a high or low content of (n-3)LCPUFA. Blood samples were collected over 8 h to measure triacylglycerol (TAG), PAI-1, t-PA, and platelet aggregation. Both fat loads resulted in a significant increase in whole blood TAG concentration, plasma PAI-1 and t-PA concentrations, and PAI-1 activity, as well as a significant decrease in t-PA activity during the postprandial period. Interestingly, PAI-1 concentration and activity increased more following the high (n-3)LCPUFA compared with the low (n-3)LCPUFA beverage (P < 0.05). Furthermore, the high (n-3)LCPUFA beverage resulted in a lower t-PA activity (P < 0.05), whereas the effects of the 2 fat loads on the plasma t-PA concentration and platelet aggregation did not differ. Overall, acute intake of a high (n-3)LCPUFA beverage shifted the balance between plasma PAI-1 and t-PA, which might indicate a lower capacity for fibrinolysis.
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Affiliation(s)
- Camilla Montegaard
- Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Frederiksberg C 1870, Denmark; 4Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada, N1G 2W1
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6
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He K, Liu K, Daviglus ML, Mayer-Davis E, Jenny NS, Jiang R, Ouyang P, Steffen LM, Siscovick D, Wu C, Barr RG, Tsai M, Burke GL. Intakes of long-chain n-3 polyunsaturated fatty acids and fish in relation to measurements of subclinical atherosclerosis. Am J Clin Nutr 2008; 88:1111-8. [PMID: 18842801 PMCID: PMC4151325 DOI: 10.1093/ajcn/88.4.1111] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Data on the relations of different types of fish meals and long-chain n-3 polyunsaturated fatty acids (PUFAs) to measures of atherosclerosis are sparse. OBJECTIVE We examined intakes of long-chain n-3 PUFAs and fish in relation to clinical measures of subclinical atherosclerosis. DESIGN A cross-sectional study was conducted in a multiethnic group of 5,488 adults aged 45-84 y and free of clinical cardiovascular disease. Diet was assessed by using self-administered food-frequency questionnaires. Subclinical atherosclerosis was determined by measurements of common carotid intima-media thickness (cCIMT, >80th percentile), internal CIMT (iCIMT, >80th percentile), coronary artery calcium score (CAC score, >0), or ankle-brachial index (ABI, <0.90). RESULTS After adjustment for potential confounders, intakes of long-chain n-3 PUFAs and nonfried (broiled, steamed, baked, or raw) fish were inversely related to subclinical atherosclerosis determined by cCIMT but not by iCIMT, CAC score, or ABI. The multivariate odds ratio comparing the highest to the lowest quartile of dietary exposures in relation to subclinical atherosclerosis determined by cCIMT was 0.69 (95% CI: 0.55, 0.86; P for trend < 0.01) for n-3 PUFA intake; 0.80 (95% CI: 0.64, 1.01; P = 0.054) for nonfried fish consumption; and 0.90 (95% CI: 0.73, 1.11; P = 0.38) for fried fish consumption. CONCLUSIONS This study indicates that the dietary intake of long-chain n-3 PUFAs or nonfried fish is associated with a lower prevalence of subclinical atherosclerosis classified by cCIMT, although significant changes in iCIMT, CAC score, and ABI were not observed. Our findings also suggest that the association of fish and atherosclerosis may vary depending on the type of fish meal consumed and the measures of atherosclerosis.
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Affiliation(s)
- Ka He
- Department of Nutrition, School of Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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7
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Castro IA, Barroso LP, Sinnecker P. Functional foods for coronary heart disease risk reduction: a meta-analysis using a multivariate approach. Am J Clin Nutr 2005. [DOI: 10.1093/ajcn/82.1.32] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Inar A Castro
- From the Department of Food and Experimental Nutrition (IAC and PS), Pharmaceutical Science Faculty, and the Statistics Department, Institute of Mathematics and Statistics (LPB), University of São Paulo, São Paulo, Brazil
| | - Lúcia P Barroso
- From the Department of Food and Experimental Nutrition (IAC and PS), Pharmaceutical Science Faculty, and the Statistics Department, Institute of Mathematics and Statistics (LPB), University of São Paulo, São Paulo, Brazil
| | - Patricia Sinnecker
- From the Department of Food and Experimental Nutrition (IAC and PS), Pharmaceutical Science Faculty, and the Statistics Department, Institute of Mathematics and Statistics (LPB), University of São Paulo, São Paulo, Brazil
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Yzebe D, Lievre M. Fish oils in the care of coronary heart disease patients: a meta-analysis of randomized controlled trials. Fundam Clin Pharmacol 2005; 18:581-92. [PMID: 15482380 DOI: 10.1111/j.1472-8206.2004.00268.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
What is the place of fish oils in the care of coronary heart disease (CHD) patients? As several clinical trials have already addressed this question without giving definitive answers, we did a meta-analysis of trials regarding the efficacy of omega-3 fatty acids in preventing cardiovascular mortality and morbidity. We searched the MEDLINE (1966-2003), EMBASE databases, proceedings abstracts and references of reviewed articles. Randomized controlled trials (RCTs) of the efficacy of omega-3 fatty acids among adults with recent or acute myocardial infarction (MI), or angina were selected. Two reviewers abstracted data independently. Five relevant outcomes, mortality from all causes, fatal and non-fatal MI, non-fatal stroke and angina, were measured. Data were synthesized using a fixed effect model. Ten RCTs with 14,727 patients were included. No significant heterogeneity was detected. Daily intake of omega-3 fatty acids for a mean duration of 37 months decreased all causes of mortality by 16% (relative risk 0.84, 95% confidence interval [0.76; 0.94]) and the incidence of death due to MI by 24% (0.76, [0.66; 0.88]). No significant effect was found for the other outcomes. Because of the suboptimal quality of the studies included into the meta-analysis and the absence of data in patients receiving statins, these results do not justify adding fish oils systematically to the heavy pharmaceutical assortment already recommended in CHD patients.
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Affiliation(s)
- Delphine Yzebe
- Lyon Hospitals, Service de Pharmacologie clinique, EA643, Faculté RTH Laënnec, rue Guillaume Paradin, 69008 Lyon, France.
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9
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Calabresi L, Villa B, Canavesi M, Sirtori CR, James RW, Bernini F, Franceschini G. An omega-3 polyunsaturated fatty acid concentrate increases plasma high-density lipoprotein 2 cholesterol and paraoxonase levels in patients with familial combined hyperlipidemia. Metabolism 2004; 53:153-8. [PMID: 14767865 DOI: 10.1016/j.metabol.2003.09.007] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A remarkable reduction of plasma concentrations of high-density lipoproteins (HDL), especially of the HDL(2) subfraction, is one of the typical lipoprotein alterations found in patients with familial combined hyperlipidemia (FCHL). Fourteen FCHL patients received 4 capsules daily of Omacor (an omega-3 polyunsaturated fatty acid [omega3 FA] concentrate providing 1.88 g of eicosapentaenoic acid [EPA] and 1.48 g of docosahexaenoic acid [DHA] per day; Pronova Biocare, Oslo, Norway) or placebo for 8 weeks in a randomized, double-blind, crossover study. Plasma triglycerides were 44% lower, and LDL cholesterol and apoliporpotein (apo)B were 25% and 7% higher after Omacor than placebo. HDL cholesterol was higher (+8%) after Omacor than placebo, but this difference did not achieve statistical significance. Omacor caused a selective increase of the more buoyant HDL(2) subfraction; plasma HDL(2) cholesterol and total mass increased by 40% and 26%, respectively, whereas HDL(3) cholesterol and total mass decreased by 4% and 6%. Both HDL(2) and HDL(3) were enriched in cholesteryl esters and depleted of triglycerides after Omacor. No changes were observed in the plasma concentration of major HDL apolipoproteins, LpA-I and LpA-I:A-II particles, lecithin:cholesterol acyltransferase (LCAT), and cholesteryl ester transfer protein (CETP). The plasma concentration of the HDL-bound antioxidant enzyme paraoxonase increased by 10% after Omacor. Omacor may be helpful in correcting multiple lipoprotein abnormalities and reducing cardiovascular risk in FCHL patients.
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Affiliation(s)
- Laura Calabresi
- Center E. Grossi Paoletti, Department of Pharmacological Sciences, University of Milano, Milan, Italy
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Pérez-Jiménez F, López-Miranda J, Mata P. Protective effect of dietary monounsaturated fat on arteriosclerosis: beyond cholesterol. Atherosclerosis 2002; 163:385-98. [PMID: 12052487 DOI: 10.1016/s0021-9150(02)00033-3] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The consumption of diets enriched in monounsaturated fat has been related to a lower rate of coronary heart disease. It is well known that this dietary model decreases LDL-cholesterol plasma levels when replacing a saturated fat enriched diet. For this reason, a high monounsaturated fat diet is now being advocated to prevent cardiovascular disease, especially in Mediterranean countries. However, some expert panels-the Joint Task Force of European and other Societies on Coronary Prevention and the International Task Force for Prevention of Coronary Heart Disease-recommend replacing dietary saturated fat by complex carbohydrates, limiting the intake of total fat to <30% of the energy and monounsaturated fat to no more than 10-15% of total calories, reaching a similar effect on LDL-cholesterol plasma levels to a high monounsaturated fat diet. The most appropriate nutritional model to prevent arteriosclerosis should be supported by research into other biological effects of both diets. Therefore, it is interesting to review the non-lipid effect of monounsaturated fat, starting with its influence on other cardiovascular risk factors, such as carbohydrate metabolism and blood pressure. Moreover, substantial evidence of the effect of dietary monounsaturated fat on a wide range of healthy benefits beyond cholesterol, which have been investigated in recent years, such as lipoprotein oxidation, coagulation, fibrinolysis and endothelium, will be discussed. Furthermore, many observational epidemiological studies suggest that a high intake of monounsaturated fat is associated with reduced coronary risk and this will be analyzed in accordance with the clinical evidence to discuss the best dietary model to prevent coronary artery disease.
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Affiliation(s)
- Francisco Pérez-Jiménez
- Unidad de Lípidos y Arteriosclerosis, Hospital Universitario Reina Sofia, Avenida Menéndez Pidal s/n, 14004 Cordoba, Spain.
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Montoya MT, Porres A, Serrano S, Fruchart JC, Mata P, Gerique JAG, Castro GR. Fatty acid saturation of the diet and plasma lipid concentrations, lipoprotein particle concentrations, and cholesterol efflux capacity. Am J Clin Nutr 2002; 75:484-91. [PMID: 11864853 DOI: 10.1093/ajcn/75.3.484] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The fatty acid content and saturation degree of the diet can modulate HDL composition and cholesterol efflux. OBJECTIVE We studied the modifications in plasma lipoprotein particles and serum capacity to stimulate cholesterol efflux induced by different fatty acids. DESIGN Seventeen women and 24 men followed in the same sequence 4 diets containing 35% of total energy as fat. The saturated fat diet contained 17% palm oil; the monounsaturated fat diet, 20.9% olive oil; the n-6 polyunsaturated fat diet, 12.5% sunflower oil; and the n-3 polyunsaturated fat diet, sunflower oil supplemented with 4-4.5 g fish oil/d. Each phase lasted 4-5 wk. RESULTS In both sexes, apolipoprotein (apo) A-I concentrations were significantly lower with unsaturated fat diets than with the saturated fat diet, but concentrations of lipoproteins containing only apo A-I (Lp A-I) were lower only in the men. Concentrations of lipoproteins containing both apo A-I and apo A-II (Lp A-I:A-II) were lower with both polyunsaturated fat diets in the women but significantly higher in the men. Lp E concentrations were significantly higher with the 2 polyunsaturated fat diets. Lp E non-B particle concentrations were not modified in the men but were significantly higher in the women in both polyunsaturated fat phases. Lp C-III concentrations were higher with the saturated fat diet only in the men. The serum samples taken after the n-3 polyunsaturated fat phase were the most efficient for extracting cellular cholesterol in both sexes. CONCLUSIONS The monounsaturated and polyunsaturated fat diets were healthier, producing a better lipid profile. The n-3 polyunsaturated fat diet increased the capacity of serum to promote the efflux of cholesterol from cells in culture.
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Abstract
The n-6 and n-3 polyunsaturated fatty acids (PUFAs) are essential nutrients; intake of relatively small amounts of these fatty acids prevents nutritional deficiencies. Replacing dietary saturated fat with PUFAs may confer health gains. Experimental data support the notion that high intake of n-6 PUFAs may increase in vivo lipid peroxidation. This effect may be counteracted by dietary antioxidant supplementation. The influence of a high n-3 PUFA intake on measures of lipid peroxidation has been equivocal. In clinical trials, subjects who consumed diets rich in n-6 or n-3 PUFAs had fewer atherothrombotic endpoints than did control groups. In this report, data regarding the influence of PUFAs on lipid peroxidation as well as on cholesterol and glucose metabolism, hemostasis, and other aspects of interest are reviewed and discussed. Currently, daily intake of PUFAs as >10% of total energy is not recommended. Below this ceiling there is little evidence that high dietary intake of n-6 or n-3 PUFAs implies health risks.
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Affiliation(s)
- J Eritsland
- Department of Cardiology, Ullevâl University Hospital, Oslo, Norway
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Sanders TA, Oakley FR, Miller GJ, Mitropoulos KA, Crook D, Oliver MF. Influence of n-6 versus n-3 polyunsaturated fatty acids in diets low in saturated fatty acids on plasma lipoproteins and hemostatic factors. Arterioscler Thromb Vasc Biol 1997; 17:3449-60. [PMID: 9437192 DOI: 10.1161/01.atv.17.12.3449] [Citation(s) in RCA: 88] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Modification of dietary fat composition may influence hemostatic variables, which are associated with increased risk of coronary heart disease (CHD). To address this question, we performed a controlled feeding study on 26 healthy male nonsmoking subjects with diets of differing fat composition. For the first 3 weeks, the subjects were given a diet calculated to supply 30% energy as total fat: 8% as monounsaturated, 4% as polyunsaturated, and 16% energy as saturated fatty acids, respectively (saturated diet). This was followed immediately by two diets taken in random order, each of 3-week duration and separated by an 8-week washout period on the subject's usual diet. Both diets were calculated to supply 30% of energy as fat: 14% monounsaturated, 6% as polyunsaturated, and 8% energy as saturated fatty acids. They both provided 5 g (approximately 1.7% energy) more of polyunsaturated fatty acids than the saturated fat diet; in one diet as long-chain n-3 fatty acids (n-3 diet) and in the other as linoleic acid (n-6 diet). Fasting plasma lipids, lipoproteins, and hemostatic factors were measured on the final 3 days of each dietary period. In a subset of 9 subjects the postprandial responses to a test meal were studied on the penultimate day of each period, each meal having the fat composition of its parent diet. On the n-3 diet compared with the n-6 diet, plasma triglyceride, HDL3 cholesterol, apoprotein AII, and fibrinogen concentrations were lower and HDL2 cholesterol concentration was higher (P = .0001, P = .003, P = .0001, P = .004, and P = .001, respectively). On both the n-3 and n-6 diets compared with the saturated diet, fasting plasma total and LDL cholesterol, apoprotein B, beta-thromboglobulin concentrations, and platelet counts were lower (P < .0001, P < .0001, P < .001, P < .01, and P < .05 respectively) and plasma Lp(a) and von Willebrand factor concentrations were higher (P = .02 and P < .01, respectively). Fasting factor VII coagulant activity (VIIc) was increased and apoprotein AI concentration reduced following the n-3 diet (P = .004 and P = .01, respectively) compared with the saturated diet. Plasma fibrinogen concentration was significantly greater following the n-6 diet than on the saturated diet (P = .02). Postprandially, plasma triglyceridemia was greater on the n-6 diet and lowest on the n-3 diet (P < .001) with the saturated diet being intermediate. Plasma VIIc was increased at 4 hours following the standardized test meals on the n-3 and n-6 diets (both P < .05) but not on the saturated diet. An increased intake of long chain n-3 fatty acids decreases fasting plasma triglyceride and apoprotein AII concentrations and increases HDL2 cholesterol concentrations and results in less postprandial lipemia but leads to an increase in VIIc. An increased intake of linoleic acid may raise plasma fibrinogen concentration. Decreasing the intake of saturated fatty acids reduces plasma LDL cholesterol and apoprotein B without affecting HDL cholesterol concentration independent of the type of polyunsaturated fatty acids in the diet. When advice is given to reduce saturated fat intake, it is important to ensure an appropriate ratio of n-3/n-6 fatty acids in the diet.
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Affiliation(s)
- T A Sanders
- Nutrition, Food & Health Research Centre, Kings College London
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14
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Vorster HH, Cummings JH, Veldman FJ. Diet and haemostasis: time for nutrition science to get more involved. Br J Nutr 1997; 77:671-84. [PMID: 9175989 DOI: 10.1079/bjn19970067] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Abnormal haemostasis, and specifically a pre-thrombotic state characterized by hypercoagulability, increased platelet aggregation and impaired fibrinolysis, is associated with increased atheroma and thrombosis. The recent literature clearly indicates that diet may prevent or be used to treat some abnormal haemostatic states. There are reports on effects of energy intake and expenditure, alcohol consumption, intakes of total fat, different fatty acids, fish oil, NSP and vitamins on markers of coagulation, platelet function and fibrinolysis. Some of the confusion and controversy in this field has arisen because the wrong markers of haemostasis have been measured in dietary trials. Moreover, many of the studies have lacked good dietary control. It is suggested that more sensitive, functional markers of the balance between the different facets of the haemostatic system should be measured. It is also important to test hypotheses developed from known observations and to propose mechanisms of action of the various dietary factors, based on our improved understanding of the haemostatic system.
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Affiliation(s)
- H H Vorster
- Department of Nutrition, Potchefstroom University for Christian Higher Education, South Africa
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15
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Toft I, Bønaa KH, Ingebretsen OC, Nordøy A, Jenssen T. Fibrinolytic function after dietary supplementation with omega3 polyunsaturated fatty acids. Arterioscler Thromb Vasc Biol 1997; 17:814-9. [PMID: 9157942 DOI: 10.1161/01.atv.17.5.814] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Hypertension is associated with derangements in glucose and lipid metabolism. Increased levels of plasminogen activator inhibitor type 1 (PAI-1) are thought to potentiate the development of coronary events in this condition. Fish oil (omega3 polyunsaturated fatty acids [PUFAs]) have lipid-lowering effects, but the cardioprotective potential has been questioned because fish oil has been found to increase PAI-1 activity. This study was performed to determine the effects of omega3 PUFAs on the fibrinolytic function in hypertension. Seventy-eight persons with untreated hypertension were included in a 16-week, double-blind, randomized, controlled intervention study with 4 g/d of eicosapentaenoic and docosahexaenoic acids or corn oil placebo. Plasma PAI-1 activity, tissue plasminogen activator (tPA) activity, levels of fibrinogen and factor VII(c), and platelet count were measured before and after intervention (mean+/-SE). PAI-1 activity changed similarly in the fish oil and corn oil groups (1.8+/-1.0 U/mL versus 3.5+/-1.2 U/mL, P=.25), as did tPA (-0.02+/-0.02 IU/mL versus -0.13+/-0.03 IU/mL, P=.28), levels of factor VII(c) (6+/-5% versus 5+/-4%, P>.3), and platelet count (2+/-7x10(9)/L versus 3+/-5x10(9)/L, P>.3). None of these variables changed from pretreatment levels during fish oil intake. Fibrinogen levels increased significantly both during fish oil (0.6+/-0.1 g/L, P=.0001) and corn oil (0.4+/-0.1 g/L, P=.002) intake. There was no between-group difference (P>.3). In conclusion, a daily intake of 4 g omega3 PUFAs does not affect PAI-1 and tPA activity in persons with hypertension. A modest increase in fibrinogen levels was observed after both fish oil and corn oil intake.
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Affiliation(s)
- I Toft
- Institute of Clinical Medicine, University of Tromso, Norway.
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16
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Emeis J, Verheijen J, Ronday H, de Maat M, Brakman P. Progress in clinical fibrinolysis. ACTA ACUST UNITED AC 1997. [DOI: 10.1016/s0268-9499(97)80098-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Rambjør GS, Wålen AI, Windsor SL, Harris WS. Eicosapentaenoic acid is primarily responsible for hypotriglyceridemic effect of fish oil in humans. Lipids 1996; 31 Suppl:S45-9. [PMID: 8729093 DOI: 10.1007/bf02637050] [Citation(s) in RCA: 107] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The aim of this study was to determine whether eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA), or both, were responsible for the triglyceride (TG)-lowering effects of fish oil. EPA (91% pure) and DHA (83% pure), a fish oil concentrate (FOC; 41% EPA and 23% DHA) and an olive oil (OO) placebo (all ethyl esters) were tested. A total of 49 normolipidemic subjects participated. Each subject was given placebo for 2-3 wk and one of the n-3 supplements for 3 wk in randomized, blinded trials. The target n-3 fatty acid (FA) intake was 3 g/day in all studies. Blood samples were drawn twice at the end of each supplementation phase and analyzed for lipids, lipoproteins, and phospholipid FA composition. In all groups, the phospholipid FA composition changed to reflect the n-3 FA given. On DHA supplementation, EPA levels increased to a small but significant extent, suggesting that some retroconversion may have occurred. EPA supplementation did not raise DHA levels, however. FOC and EPA produced significant decreases in both TG and very low density lipoprotein (VLDL) cholesterol (C) levels (P < 0.01) and increases in low density lipoprotein (LDL) cholesterol levels (P < 0.05). DHA supplementation did not affect cholesterol, triglyceride, VLDL, LDL, or high density lipoprotein (HDL) levels, but it did cause a significant increase in the HDL2/HDL3 cholesterol ratio. We conclude that EPA appears to be primarily responsible for TG-lowering (and LDL-C raising) effects of fish oil.
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Affiliation(s)
- G S Rambjør
- Department of Pharmacology, University of Oslo, Norway
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18
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Lopez-Segura F, Velasco F, Lopez-Miranda J, Castro P, Lopez-Pedrera R, Blanco A, Jimenez-Pereperez J, Torres A, Trujillo J, Ordovas JM, Pérez-Jiménez F. Monounsaturated fatty acid-enriched diet decreases plasma plasminogen activator inhibitor type 1. Arterioscler Thromb Vasc Biol 1996; 16:82-8. [PMID: 8548431 DOI: 10.1161/01.atv.16.1.82] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
An increase in levels of plasma plasminogen activator inhibitor type 1 (PAI-1) is one of the main hemostatic alterations in patients with coronary heart disease. Despite growing interest in the fibrinolytic system, few studies have been undertaken to determine the effect exerted on it by the different dietary fatty acids. We investigated the effect of a monounsaturated fat (MUFA)-rich diet in comparison with a low-fat diet (National Cholesterol Education Program step 1 diet) (NCEP-1) on factors involved in blood coagulation and fibrinolysis. We also determined the effect of dietary cholesterol on these blood parameters. Twenty-one young, male, healthy volunteers followed two low-fat/high-carbohydrate diets (< 30% fat, < 10% saturated fat, 14% MUFA) for 24 days each, with 115 or 280 mg of cholesterol per 1000 kcal per day, and two oleic acid-enriched diets (38% fat, 24% MUFA) with the same dietary cholesterol as the low-fat/high-carbohydrate diets. Plasma levels of fibrinogen, thrombin-antithrombin complexes, prothrombin fragments 1+2, plasminogen, alpha 2 antiplasmin, and tissue plasminogen activator were not significantly different among the experimental diets used in this study. Consumption of the diet rich in MUFA resulted in a significant decrease in both PAI-1 plasma activity (P < .005) and antigenic PAI-1 (P < .04) compared with the carbohydrate-rich diet (NCEP-1). The addition of dietary cholesterol to each of these diets did not result in any significant additional effect. Changes in insulin levels and PAI-1 activity were positively correlated (r = .425; P < .02). In conclusion, consumption of diets rich in MUFAs decreases PAI-1 plasma activity, which is accompanied by a parallel decrease in plasma insulin levels.
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Affiliation(s)
- F Lopez-Segura
- Unidad de Lípidos y Arteriosclerosis, Hospital Universitario Reina Sofia, Córdoba, Spain
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19
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Koyama H, Watanabe C, Satoh H, Hosokai H, Tamura S. Consistent relationship between selenium and apolipoprotein A-II concentrations in the sera of fasting middle-aged male abstainers and regular consumers of alcohol. Biol Trace Elem Res 1995; 50:33-42. [PMID: 8546882 DOI: 10.1007/bf02789147] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Several studies have suggested that selenium serum levels may be associated with serum lipids and apolipoproteins. In the present study, 99 clerical workers aged 40-49 yr were selected based on their drinking and smoking habits. The serum concentration of selenium was not affected by these lifestyle factors. The regular drinkers had raised serum high-density lipoprotein cholesterol, apo A-I, and apo A-II concentrations. Correlation analysis showed that serum selenium was positively and consistently associated with apo A-II regardless of alcohol consumption. Factor analysis revealed that serum selenium had no association with factors that represented each lipoprotein fraction (LDL, HDL, and VLDL). The present study indicates that serum selenium is positively correlated only with apo A-II levels.
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Affiliation(s)
- H Koyama
- Department of Environmental Health Sciences, Tohoku University School of Medicine, Sendai, Japan
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20
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Sacks FM, Stone PH, Gibson CM, Silverman DI, Rosner B, Pasternak RC. Controlled trial of fish oil for regression of human coronary atherosclerosis. HARP Research Group. J Am Coll Cardiol 1995; 25:1492-8. [PMID: 7759696 DOI: 10.1016/0735-1097(95)00095-l] [Citation(s) in RCA: 160] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES This randomized clinical trial tested whether fish oil supplements can improve human coronary atherosclerosis. BACKGROUND Epidemiologic studies of populations whose intake of oily fish is high, as well as laboratory studies of the effects of the polyunsaturated fatty acids in fish oil, support the hypothesis that fish oil is antiatherogenic. METHODS Patients with angiographically documented coronary heart disease and normal plasma lipid levels were randomized to receive either fish oil capsules (n = 31), containing 6 g of n-3 fatty acids, or olive oil capsules (n = 28) for an average duration of 28 months. Coronary atherosclerosis on angiography was quantified by computer-assisted image analysis. RESULTS Mean (+/- SD) baseline characteristics were age 62 +/- 7 years, plasma total cholesterol concentration 187 +/- 31 mg/dl (4.83 +/- 0.80 mmol/liter) and triglyceride levels 132 +/- 70 mg/dl (1.51 +/- 0.80 mmol/liter). Fish oil lowered triglyceride levels by 30% (p = 0.007) but had no significant effects on other plasma lipoprotein levels. At the end of the trial, eicosapentaenoic acid in adipose tissue samples was 0.91% in the fish oil group compared with 0.20% in the control group (p < 0.0001). At baseline, the minimal lumen diameter of coronary artery lesions (n = 305) was 1.64 +/- 0.76 mm, and percent narrowing was 48 +/- 14%. Mean minimal diameter of atherosclerotic coronary arteries decreased by 0.104 and 0.138 mm in the fish oil and control groups, respectively (p = 0.6 between groups), and percent stenosis increased by 2.4% and 2.6%, respectively (p = 0.8). Confidence intervals exclude improvement by fish oil treatment of > 0.17 mm, or > 2.6%. CONCLUSIONS Fish oil treatment for 2 years does not promote major favorable changes in the diameter of atherosclerotic coronary arteries.
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Affiliation(s)
- F M Sacks
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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21
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Surette ME, Whelan J, Lu G, Hardard'ottir I, Kinsella JE. Dietary n - 3 polyunsaturated fatty acids modify Syrian hamster platelet and macrophage phospholipid fatty acyl composition and eicosanoid synthesis: a controlled study. BIOCHIMICA ET BIOPHYSICA ACTA 1995; 1255:185-91. [PMID: 7696333 DOI: 10.1016/0005-2760(94)00206-e] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The aim of this study was to determine the effects of varying intakes of dietary n - 3 polyunsaturated fatty acids (PUFA) on the fatty acyl composition and arachidonic acid metabolite synthesis of platelets and macrophages in Syrian hamsters consuming diets that were strictly controlled for n - 6 PUFA content. Animals consumed highly controlled diets which were not supplemented with n - 3 PUFA (control) or supplemented with 0.4%, 0.8% or 2% (w/w) n - 3 fatty acids. The content of n - 3 PUFA in cellular phospholipids increased progressively with the intake of n - 3 PUFA, while n - 6 PUFA, including arachidonic acid, decreased despite the constant intake of 18:2(n - 6); this latter effect was more substantial in macrophages than in platelets. The synthesis by stimulated macrophages of prostaglandin E2, 6-keto-prostaglandin F1 alpha, thromboxane B2 and 11- and 15-hydroxyeicosatetraenoic acids decreased with the intake of 0.8% n - 3 PUFA to 30-50% of the control values. Little effect of diets on platelet aggregation and eicosanoid synthesis was observed reflecting the limited effect on platelet arachidonic acid content. The synthesis of 12-hydroxyeicosapentaenoic acid by stimulated platelets increased with n - 3 PUFA consumption in a dose-dependent fashion. Circulating triacylglycerols and HDL-cholesterol were decreased only in animals consuming 2% n - 3 PUFA. The strict control of n - 6 PUFA intake allows the determination of the effects of n - 3 PUFA intake on the measured parameters without confounding effects of other dietary lipids.
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Affiliation(s)
- M E Surette
- Lipids Research Laboratory, Cornell University, Ithaca, NY 14853, USA
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22
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Prisco D, Paniccia R, Filippini M, Francalanci I, Bandinelli B, Comeglio P, Rostagno C, Abbate R, Neri Serneri GG. No changes in PAI-1 levels after four-month n-3 PUFA ethyl ester supplementation in healthy subjects. Thromb Res 1994; 76:237-44. [PMID: 7863474 DOI: 10.1016/0049-3848(94)90195-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Recent studies have indicated that diets rich in fish or supplemented with fish oils may increase PAI-1 plasma levels. However, this finding has not been consistent and could be related, at least in part, to the type of supplementation. Aim of this study was to investigate the effects of medium-term treatment with n-3 polyunsaturated fatty acid (PUFA) ethyl esters on fibrinolysis. Twenty normolipemic healthy male subjects (age 27 to 41 yrs) were randomly assigned to receive either 4 x 1 g capsules of n-3 PUFA ethyl esters (ESAPENT, Farmitalia-Carlo Erba, Milan, Italy) or 4 x 1 g capsules of olive oil (as placebo) for 4 months in a double blind study. Blood samples for lipid and hemostatic studies were obtained at 0, 2, and 4 months of treatment and 1, 2 and 3 months of wash-out. Plasma lipids, fibrinolytic system, lipoprotein (a)-Lp(a)-, fibrinogen (Fbg) and prothrombin activation fragment 1+2 (F1+2) were assayed. No changes in these parameters were observed in the group of ten subjects treated with olive oil. After n-3 PUFA supplementation no significant alterations were found in plasma lipids, even if a trend to lower triglyceride and Lp(a) levels was detectable. No changes in either PAI-1 activity or PAI-1 antigen levels or F1+2 plasma levels were observed. A trend to lower Fbg levels was found after n-3 PUFA, but changes were not statistically significant. The results of this study indicate that a 4-month treatment with 4 g daily n-3 PUFA ethyl esters does not affect PAI-1 plasma levels.
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Affiliation(s)
- D Prisco
- Clinica Medica I, University of Florence, Italy
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23
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Malyszko J, Urano T, Knofler R, Ihara H, Shimoyama I, Uemura K, Takada Y, Takada A. Correlations between platelet aggregation, fibrinolysis, peripheral and central serotonergic measures in subhuman primates. Atherosclerosis 1994; 110:63-8. [PMID: 7857371 DOI: 10.1016/0021-9150(94)90068-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We have studied the relationships between whole blood and plasma serotonin (5-hydroxytryptamine, 5-HT), its major metabolite 5-hydroxyindoleacetic acid (5-HIAA) and serum lipids, platelet aggregation in the whole blood and in the platelet-rich plasma (PRP), and some fibrinolytic parameters in monkeys. Plasma 5-HT was found to be positively related to 5-HT- and ADP-induced platelet aggregation, tissue plasminogen activator (tPA) activity, serum cholesterol and LDL-cholesterol, whereas 5-HT in cerebrospinal fluid correlated inversely with serum cholesterol. Plasminogen activator inhibitor (PAI) activity was positively related to LDL. Euglobulin clot lysis time was related to both tPA and PAI activities. The significance of these findings and the possible role of 5-HT in atherogenesis and hemostasis are discussed.
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Affiliation(s)
- J Malyszko
- Department of Physiology, Hamamatsu University School of Medicine, Shizuoka, Japan
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24
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Haglund O, Mehta JL, Saldeen T. Effects of fish oil on some parameters of fibrinolysis and lipoprotein(a) in healthy subjects. Am J Cardiol 1994; 74:189-92. [PMID: 8023790 DOI: 10.1016/0002-9149(94)90100-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- O Haglund
- Department of Forensic Medicine, University of Uppsala, Sweden
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25
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Eritsland J, Seljeflot I, Abdelnoor M, Arnesen H, Torjesen PA. Long-term effects of n-3 fatty acids on serum lipids and glycaemic control. Scand J Clin Lab Invest 1994; 54:273-80. [PMID: 7939369 DOI: 10.3109/00365519409087522] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The long-term influence of n-3 polyunsaturated fatty acids (n-3 PUFAs) on serum lipids and glucose homeostasis was studied in a group of non-diabetic, moderately hypertriglyceridaemic patients undergoing coronary artery bypass grafting. They were investigated according to the same procedure before and 6 months after the operation. Following randomization postoperatively, 28 patients received 3.4 g eicosapentaenoic and docosahexaenoic acid per day, whereas 29 patients comprised the control group. The decline in serum triglycerides after 6 months was significantly greater in the n-3 PUFA group than in the control group (median decline, -33.2% vs. -11.1%, p = 0.002), while no group difference was noted in serum total, HDL, or LDL cholesterol levels. Fasting plasma glucose levels decreased less in the n-3 PUFA group compared with the control group (median change, -0.2 mmol l-1 vs. -0.5 mmol l-1, p = 0.054). The corresponding changes in fasting insulin levels were -2 mIU ml-1 in the n-3 PUFA group and no change in the control group (p = 0.039). In both groups combined, the recorded changes in serum triglyceride and serum insulin levels were negatively correlated with the change in serum phospholipid n-3 fatty acids (r = -0.35, p = 0.008 and r = -0.32, p = 0.016, respectively). An oral glucose tolerance test revealed no significant group differences after 6 months, neither in the peak levels, nor in the areas under the curves between 0 and 3h after the glucose load for glucose, insulin, and C-peptide.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J Eritsland
- Department of Cardiology, Ullevål Hospital, Oslo, Norway
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26
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Saba P, Galeone F, Giuntoli F, Natali A, Del Corso C, Brunelleschi G. A pilot study of the effects of omega-3 polyunsaturated fatty acids on blood lipids in hyperlipidemic patients. Curr Ther Res Clin Exp 1994. [DOI: 10.1016/s0011-393x(05)80526-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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27
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Eritsland J, Seljeflot I, Abdelnoor M, Arnesen H. Long-term influence of omega-3 fatty acids on fibrinolysis, fibrinogen, and serum lipids. ACTA ACUST UNITED AC 1994. [DOI: 10.1016/s0268-9499(05)80029-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Reverse cholesterol transport identifies a series of metabolic events resulting in the transport of excess cholesterol from peripheral tissues to the liver. High-density lipoproteins (HDL) are the vehicle of cholesterol in this reverse transport, a function believed to explain the inverse correlation between plasma HDL levels and atherosclerosis. An attempt to stimulate, by the use of drugs, this transport process may hold promise in the prevention and treatment of arterial disease. Among the agents affecting lipoprotein metabolism, only probucol exerts significant effects on reverse cholesterol transport, by stimulating the activity of the cholesteryl ester transfer protein and, consequently, altering HDL subfraction composition/distribution. Another approach to the stimulation of reverse cholesterol transport consists of raising plasma HDL levels; studies in animals, either by exogenous supplementation or by endogenous overexpression, have shown a consistent benefit in terms of atherosclerosis regression and/or non-progression. Thus, it is time to consider different future treatments of atherosclerosis, combining the classical lipid-lowering treatments with innovative methods to promote cholesterol removal from the arterial wall.
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Abstract
Drugs affecting lipid metabolism may influence, to a variable extent, the hemostatic system, that is, platelet activation, fibrinogen, and fibrinolysis. These effects may or may not be linked to the activity of these compounds on the lipid/lipoprotein profile. For this reason it may be important to consider the effects of hypolipidemic drugs on the different aspects of hemostasis, because this may allow a better understanding of their clinical use, as well as, eventually, a more proper selection in individual patients. Among the major lipid-lowering agents, fibric acids belong to a multifaceted series of abnormal fatty acids known to interact with a liver nuclear receptor, in turn activating fatty acid catabolism. A similar activity may be exerted by n-3 fatty acids from fish, as well as by other chemically related or unrelated compounds. Among fibric acids all but gemfibrozil can reduce fibrinogen levels; this last drug can, however, apparently activate fibrinolysis. Among the selective cholesterol-lowering medications, both resins and HMG CoA reductase inhibitors may reduce, in some patients, over prolonged periods of treatment, platelet sensitivity to major aggregants. This effect may be seen best with non-liver-selective agents (e.g., simvastatin), although recent data cast doubt on its constancy. A direct comparative evaluation of different HMG CoA reductase inhibitors on platelet aggregability has never been carried out. These last drugs may also reduce the circulating levels of the tissue factor pathway inhibitor (TFPI), transported by LDL in plasma, which is a potentially negative effect. A lipid-lowering molecule with antioxidant activity, for example, probucol, may also possibly play a role in controlling platelet activation.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- C R Sirtori
- Center E. Grossi Paoletti, University of Milano, Italy
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30
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Affiliation(s)
- T A Sanders
- Department of Nutrition and Dietetics, King's College London, University of London
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31
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Malle E, Kostner GM. Effects of fish oils on lipid variables and platelet function indices. Prostaglandins Leukot Essent Fatty Acids 1993; 49:645-63. [PMID: 8248270 DOI: 10.1016/0952-3278(93)90074-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- E Malle
- Karl-Franzens University, Institute of Medical Biochemistry, Graz, Austria
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32
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Collier GR, Sinclair AJ. Role of N-6 and N-3 fatty acids in the dietary treatment of metabolic disorders. Ann N Y Acad Sci 1993; 683:322-30. [PMID: 8352454 DOI: 10.1111/j.1749-6632.1993.tb35723.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The impetus to examine the effects on n-3 PUFA was generated from epidemiologic studies of a traditional population largely dependent on the marine environment. These studies and clinical interventions support a recommendation to increase the consumption of n-3 fatty acids, particularly in communities that currently have a low n-3 fatty acid intake. If we are to be guided by the diet of other traditional hunter-gatherer populations, dependent on both terrestrial and marine sources of food, it is clear that we may need to reappraise the importance of long chain PUFA of the n-6 series such as arachidonic acid. Recent studies on such populations indicate that elevated arachidonic acid levels, when associated with elevated n-3 PUFA, are likely not to be harmful to health.
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Affiliation(s)
- G R Collier
- Department of Human Nutrition, Deakin University, Geelong, Australia
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Glueck CJ, Glueck HI, Tracy T, Speirs J, McCray C, Stroop D. Relationships between lipoprotein(a), lipids, apolipoproteins, basal and stimulated fibrinolytic regulators, and D-dimer. Metabolism 1993; 42:236-46. [PMID: 8474322 DOI: 10.1016/0026-0495(93)90042-m] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In 191 newly referred hyperlipidemic patients, our specific aim was to assess relationships between levels of lipoprotein(a) [Lp(a)], lipids, apolipoproteins, regulators of basal and stimulated fibrinolytic activity, and D-dimer, a measure of in vivo fibrinolysis. Lp(a) levels correlated with none of the measures of basal fibrinolytic regulators or D-dimer. In 25 patients, levels of stimulated regulators of fibrinolytic activity and D-dimer were measured after 10-minute cuff venous occlusion. Lp(a) levels again correlated with none of the stimulated regulators of fibrinolytic activity or D-dimer. However, both basal and stimulated levels of fibrinolytic regulators and D-dimer were closely related to other major risk factors for coronary heart disease (CHD) including triglyceride, apolipoprotein (apo) A1, apo B, Quetelet index (QI), and sex. By stepwise regression in 191 patients, the following standardized partial regression coefficients were significant (P < or = .05), and model R2 and P values were as follows: basal tissue plasminogen activator (tPA) with apo B-.18, with time .17, with QI -.28, R2 = 17%, P < or = .0001; basal plasminogen activator inhibitor (PAI) with apo B..25, with time -.15, with QI .17, R2 = 14%, P < or = .0001; basal alpha 2-antiplasmin with apo A1.14, with apo B.24, with QI.17, with sex .30, R2 = 25%, P < .0001; basal plasminogen with A1.15, with apo B.21, with QI.17, with sex.17, R2 = 15%, P < or = .0001; basal fibrinogen with Lp(a).17, with QI.21, with sex.26, R2 = 14%, P < or = .0001; D-dimer with sex.15, R2 = 21%, P < or = .048. Given the absence of any relationship between Lp(a) levels and inhibition or stimulation of fibrinolysis regulators or D-dimer either in the basal or stimulated state, we postulate that Lp(a)'s major atherogenic effects are mediated by mechanisms other than reduction of fibrinolysis stimulation or in vivo fibrinolysis.
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Affiliation(s)
- C J Glueck
- Cholesterol Center, Jewish Hospital, Cincinnati, OH 45229
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Haglund O. Effects of fish oil on risk factors for cardiovascular disease. Minireview based on a doctoral thesis. Ups J Med Sci 1993; 98:89-148. [PMID: 8184521 DOI: 10.3109/03009739309179307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- O Haglund
- Department of Forensic Medicine, University of Uppsala, Sweden
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Goodnight SH, Cairns JA, Fisher M, FitzGerald GA. Assessment of the therapeutic use of n-3 fatty acids in vascular disease and thrombosis. Chest 1992; 102:374S-384S. [PMID: 1395822 DOI: 10.1378/chest.102.4_supplement.374s] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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McNamara DJ. Dietary fatty acids, lipoproteins, and cardiovascular disease. ADVANCES IN FOOD AND NUTRITION RESEARCH 1992; 36:253-351. [PMID: 1497850 DOI: 10.1016/s1043-4526(08)60107-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Dietary fat quality and quantity significantly affect the metabolism of all the plasma lipoproteins and probably constitute the most significant dietary determinants of plasma lipoprotein levels. Since the major role of the plasma lipoproteins is the transport of exogenous and endogenous fat, this would be expected of a highly regulated, metabolically homeostatic system. The data clearly show that dietary fat saturation affects all aspects of lipoprotein metabolism, from synthesis to intravascular remodeling and exchanges to receptor-mediated and nonspecific catabolism. The experimental data regarding dietary fatty acid effects on lipoprotein metabolism are complicated and at times contradictory due to the large degree of metabolic heterogeneity in the population, which, when coupled with the known abnormalities of lipoprotein metabolism associated with certain types of hyperlipoproteinemia, can present responses from A to Z. It is clear that the same dietary pattern has different effects in different individuals and that complicating factors of individuality raise some concerns regarding generalized dietary recommendations. As new knowledge of the role of dietary factors and CVD risk develops, and our abilities to characterize the individual patient's response to dietary interventions become more refined, it may be possible to specify dietary fat intervention from a patient-oriented concept rather than a single all-purpose diet approach. Thus it would be possible to design dietary interventions to match patient needs and gain both efficacy and compliance. With the spectrum of approaches possible--low fat, moderate fat with MUFA, n-3 PUFA, etc.--we should be able to approach dietary interventions to reduce CVD risk at both a population-based level and a patient-specific level. There remains much to learn regarding the effects of dietary fatty acids on the synthesis, intravascular modifications, and eventual catabolism of the plasma lipoproteins. The area of lipoprotein metabolism in health and disease, of its modifications by diets and drugs, and of the contributions of genetic heterogeneity to these processes is one of notable advances over the past two decades and continues to be an area of intense investigation.
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Affiliation(s)
- D J McNamara
- Department of Nutrition and Food Science, University of Arizona, Tucson 85721
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