Dietary linolenic acid is inversely associated with plasma triacylglycerol: the National Heart, Lung, and Blood Institute Family Heart Study

Acute and subchronic oral toxicity study of Camelina sativa oil in Wistar rats

Objective

The aim of these studies was to ascertain if Camelina sativa oil is harmful in both the acute and subchronic states.

Methods

Wistar rats of both sexes were used in an acute toxicity test, and the fatal dosage (LD50) of oral Camelina sativa oil was greater than 27.6 g/kg bw. Rats were gavaged with Camelina sativa oil at dosages of 0.00, 0.92, 1.84, and 3.68 g/kg bw per day for 90 days. In addition, satellite groups were established in the control and high-dose groups for a 28-day recovery period. The following factors were assessed: mortality, clinical anomalies, body weight, food intake, hematological, serum biochemistry, urine, gross necropsy, and histology.

Results

There were no observable toxicity-related changes in any of the three dosage groups. There is no toxicological relevance to the change in the high-dose hematological indicator PLT at the conclusion of the recovery period because it was within the usual range for this strain in our laboratory. The test material did not result in any pathological alterations, according to a pathological examination.

Conclusion

Since the results of the current study, the no-observed-adverse-effect-level (NOAEL) for Camelina sativa oil in rats has been determined to be greater than 3.68 g/kg bw.

Beneficial Effects of Dietary Flaxseed Oil through Inflammation Pathways and Gut Microbiota in Streptozotocin-Induced Diabetic Mice

Flaxseed oil (FO) has displayed potential anti-diabetes properties by providing a high content of α-linolenic acid. However, the effects and mechanisms of FO on type 1 diabetes are still unclear. The present study aims to explore the effects of different doses of FO feeding on hepatic inflammation and gut microbiota in streptozotocin-induced diabetic mice. Forty-eight six-week-old C57BL/6J male mice were divided into a control group (CON), a diabetic group (MOD), a diabetes with 7.0% w/w FO feeding group (FO-L), and a diabetes with 10.5% w/w FO feeding group (FO-H) for six weeks. The 7.0% w/w and 10.5% w/w FO feeding groups exhibited potential recovery of the number and size of pancreas tissues. The fasting blood glucose level was significantly decreased only after 4 weeks of feeding with 10.5% w/w FO in diabetic mice. The 10.5% w/w FO feeding group significantly decreased the postprandial blood glucose level of mice in the OGTT test. Hepatic glycogen levels were dramatically upregulated in the mice fed with both 7.0% w/w and 10.5% w/w FO. FO feeding significantly attenuated hepatic LPS, TNF-α, and IL-1β levels. In addition, we observed that 7.0% w/w and 10.5% w/w FO feedings notably downregulated hepatic gene and protein expressions of TLR4, MyD88, and P65. Furthermore, only 10.5% FO regulated fecal microbiota by increasing the relative abundance of the Bacteroidetes phylum, Lactococcus family, and Muribaculaceae and Streptococcaceae family and genus in streptozotocin-induced diabetic mice. Therefore, we conclude that FO feeding plays a role in anti-inflammation via the regulation of hepatic LPS/TLR4/MyD88 pathways and gut microbiota. In addition, different doses of FO supplementation may exhibit varying mechanisms in streptozotocin-induced mice.

The review of alpha-linolenic acid: Sources, metabolism, and pharmacology

α-linolenic acid (ALA, 18:3n-3) is a carboxylic acid composed of 18 carbon atoms and three cis double bonds, and is an essential fatty acid indispensable to the human body. This study aims to systematically review related studies on the dietary sources, metabolism, and pharmacological effects of ALA. Information on ALA was collected from the internet database PubMed, Elsevier, ResearchGate, Web of Science, Wiley Online Library, and Europe PMC using a combination of keywords including "pharmacology," "metabolism," "sources." The following findings are mainly contained. (a) ALA can only be ingested from food and then converted into eicosapentaenoic acid and docosahexaenoic acid in the body. (b) This conversion process is relatively limited and affected by many factors such as dose, gender, and disease. (c) Pharmacological research shows that ALA has the anti-metabolic syndrome, anticancer, antiinflammatory, anti-oxidant, anti-obesity, neuroprotection, and regulation of the intestinal flora properties. (d) There are the most studies that prove ALA has anti-metabolic syndrome effects, including experimental studies and clinical trials. (e) The therapeutic effect of ALA will be affected by the dosage. In short, ALA is expected to treat many diseases, but further high quality studies are needed to firmly establish the clinical efficacy of ALA.

Effects of flaxseed on blood pressure, body mass index, and total cholesterol in hypertensive patients: A randomized clinical trial

OBJECTIVES

Given the antioxidant properties of flaxseed and its biologically active ingredients, this study was conducted to determine the effects of flaxseed supplementation on body mass index (BMI), blood pressure, and total cholesterol levels in patients with hypertension.

METHODS

In this triple-blind clinical trial, 112 patients, with an age range of 35 to 70 years, were randomized to 2 groups receiving 10 g (n = 45) and 30 g (n = 45) of flaxseed supplementation and 1 group receiving placebo (n = 45) for 12 weeks by stratified block randomization. They were evaluated in terms of systolic (SBP) and diastolic blood pressure (DBP), BMI, and total serum cholesterol. Physical activity was measured using the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and food intake was assessed using the Food Frequency Questionnaire (FFQ). The data were analyzed with SPSS, version 22, using the chi-square, Kruskal-Wallis, repeated measures analysis, ANOVA, and ANCOVA tests.

RESULTS

The interaction effects among the study groups and time on the mean SBP (p = 0.001), DBP (p = 0.001), total cholesterol level (p = 0.032), and BMI (p < 0.001) were significant. During the study, the 30-g group achieved the best results, so that a 13.38-unit decrease in SBP was observed compared to a 1.72 unit increase in the placebo group and a 5.6-unit decrease in DBP was measured compared to a 2.39 unit increase in the placebo group. BMI decreased by 0.86 units compared to 0.06 units in the placebo group. Total cholesterol also decreased by 20.4 units compared to 11.86 units in the placebo group.

CONCLUSION

The results of this study showed that flaxseed can be effective in reducing blood pressure, total cholesterol, and body mass index in hypertensive patients in a twelve-week period.

Integrating metabolomics and network pharmacology to explore the protective effect of gross saponins of Tribulus terrestris L. fruit against ischemic stroke in rat

ETHNOPHARMACOLOGICAL RELEVANCE

Tribulus terrestris L. belongs to the family Zygophyllaceae and has been widely used as a folk medicine for a long history in Asian countries. Gross saponins of Tribulus terrestris L. fruit (GSTTF) has an obvious neuroprotective effect on the treatment of ischemic stroke, but its potential therapeutic mechanisms have not been thoroughly studied.

AIM OF THE STUDY

To investigate the protective effect of GSTTF against ischemic stroke in rat.

MATERIALS AND METHODS

The combination of metabolomics and network pharmacology analysis was applied to investigate the protective effects of GSTTF on ischemic stroke and its putative mechanism. The related pathway of the biomarkers highlighted from metabolomics analysis was explored, then the possible targets of GSTTF were further revealed by network pharmacology analysis. Molecular docking was conducted to investigate the interaction between the active compound and target protein.

RESULTS

Metabolomics analysis showed that metabolic disturbances were observed in serum for the rats in middle cerebral artery occlusion (MCAO). These MCAO-induced deviations in serum metabolism can be reversely changed by GSTTF via metabolic pathways regulation. Twenty-four proteins with the connectivity degree larger than 15 were selected by the network pharmacology analysis, which are considered as the possible therapeutic targets of the GSTTF against ischemic stroke. The results of molecular docking showed that the active compounds were capable of binding to the representative potential targets HSD11B1 and AR, respectively. And the docking mode of two compounds with the lowest binding energy to their target protein was illustrated by the ribbon binding map.

CONCLUSION

The present study combines metabolomics and network pharmacology analysis to investigate the mechanism of MCAO-induced ischemic stroke and reveal the efficiency and possible mechanisms of GSTTF for ischemic stroke. Further studies on the bioactive saponin as well as their synergistic action on ischemic stroke will be conducted to better reveal the underlying mechanisms.

Intake of Alpha-Linolenic Acid-Rich Perilla frutescens Leaf Powder Decreases Home Blood Pressure and Serum Oxidized Low-Density Lipoprotein in Japanese Adults

Oxidized low-density lipoprotein (Ox-LDL) is known to be highly atherogenic. Thus, decreasing the blood levels of Ox-LDL through dietary means is an important approach to reduce cardiovascular events in high-risk individuals. In this randomized placebo-controlled human interventional trial, we aimed to evaluate whether Perilla frutescens leaf powder (PLP) ameliorates Ox-LDL and home blood pressure, along with its biological antioxidant potential. Healthy Japanese volunteers aged 30-60 years (n = 60) were randomized to PLP and placebo groups. The PLP group consumed PLP dried using a microwave under reduced pressure, and the placebo group consumed pectin fiber daily for 6 months. Home blood pressure, serum biochemical parameters, and fatty acid profiles of erythrocyte plasma membranes were analyzed. Plasma Ox-LDL levels significantly decreased in the PLP group but not in the placebo group. Mean changes in the biological antioxidant potential and alpha-linolenic acid levels in the erythrocyte plasma membrane were significantly increased in the PLP group than in the placebo group. In subjects with prehypertension (systolic blood pressure [SBP] ³ 120 mmHg), the mean reduction in morning or nocturnal SBP was significantly greater in the PLP group than in the placebo group. Thus, PLP intake may be an effective intervention to prevent cardiovascular diseases.

Effect of Flaxseed Powder on Cardiovascular Risk Factor in Dyslipidemic and Hypertensive Patients

Background:

Hyperlipidemia and hypertension are the most important causes of ischemic heart disease. There is evidence that flaxseed powder can improve lipid profile and blood pressure. In this study, we want to investigate the effects of flaxseed powder consumption on patients with hyperlipidemia and hypertension.

Methods:

This randomized double-blind placebo-controlled clinical trial was performed on 80 hyperlipidemic and hypertensive patients (men and women between 20 and 60 years old). In this study, participants were recruited from Imam Khomeini hospital clinics of Shiraz University of Medical Sciences in 2017 randomly allocated to flaxseed powder group and placebo group. The intervention group received 36 g of flaxseed sachet (n = 40), and control group received 12 g placebo sachet (n = 40) for 8 weeks. Serum lipid profiles, blood pressure, fasting blood sugar, and anthropometric indices were measured. Data were analyzed by using SPSS.

Results:

We found significant reduction (P < 0.001) in anthropometric indices (waist circumference and waist-to-hip ratio) and lipid profiles (triglycerides [P = 0.015], total cholesterol [P = 0.018], and low-density lipoprotein [P < 0.001]) within flaxseed group in comparison with placebo group.

Conclusions:

Based on beneficial effects of flaxseed on cardiovascular risk factors, it seems that flaxseed consumption can be considered as a useful therapeutic approach for reducing lipid profile and anthropometric indices.

Can modulators of apolipoproteinB biogenesis serve as an alternate target for cholesterol-lowering drugs?

Understanding the molecular defects underlying cardiovascular disease is necessary for the development of therapeutics. The most common method to lower circulating lipids, which reduces the incidence of cardiovascular disease, is statins, but other drugs are now entering the clinic, some of which have been approved. Nevertheless, patients cannot tolerate some of these therapeutics, the drugs are costly, and/or the treatments are approved for only rare forms of disease. Efforts to find alternative treatments have focused on other factors, such as apolipoproteinB (apoB), which transports cholesterol in the blood stream. The levels of apoB are regulated by endoplasmic reticulum (ER) associated degradation as well as by a post ER degradation pathway in model systems, and we suggest that these events provide novel therapeutic targets. We discuss first how cardiovascular disease arises and how cholesterol is regulated, and then summarize the mechanisms of action of existing treatments for cardiovascular disease. We then review the apoB biosynthetic pathway, focusing on steps that might be amenable to therapeutic interventions.

The nutraceutical potential of omega-3 alpha-linolenic acid in reducing the consequences of stroke

Stroke is a worldwide major cause of mortality and morbidity. Preclinical studies have identified over 1000 molecules with brain-protective properties. More than 200 clinical trials have evaluated neuroprotective candidates for ischemic stroke yet, to date almost all failed, leading to a re-analysis of treatment strategies against stroke. An emerging view is to seek combinatory therapy, or discovering molecules able to stimulate multiple protective and regenerative mechanisms. A pertinent experimental approach to identify such candidates is the study of brain preconditioning, which refers to how the brain protects itself against ischemia and others stress-inducing stimuli. The recent discovery that nutrients like alpha-linolenic acid (ALA is an essential omega-3 polyunsaturated fatty acid required as part of our daily diet), may be an efficient brain preconditionner against stroke fosters the novel concept of brain preconditioning by nutraceuticals. This review stresses the underestimated role of nutrition in preventing and combating stroke. Although there is a consensus that increased consumption of salt, fatty foods and alcoholic beverages may promote pathologies like hypertension, obesity and alcoholism - all of which are well known risk factors of stroke - few risk factors are attributed to a deficiency in an essential nutrient in the diet. The ALA deficiency observed in the Western modern diets may itself constitute a risk factor. This review outlines how ALA supplementation by modification of the daily diet prevented mortality and cerebral damage in a rodent model of ischemic stroke. It also describes the pleiotropic ability of ALA to trigger responses that are multicellular, mechanistically diverse, resulting in neuronal protection, stimulation of neuroplasticity, and brain artery vasodilation. Overall, this review proposes a promising therapeutic opportunity by integrating a nutritional-based approach focusing on enriching the daily diet in ALA to prevent the devastating damage caused by stroke.

Plasma Fatty Acids in Zambian Adults with HIV/AIDS: Relation to Dietary Intake and Cardiovascular Risk Factors

Objective. To determine whether 24 hr dietary recalls (DR) are a good measure of polyunsaturated fatty acid (PUFA) intake when compared to plasma levels, and whether plasma PUFA is associated with markers of HIV/AIDS progression and cardiovascular disease (CVD) risk. Methods. In a cross-sectional study among 210 antiretroviral therapy-naïve HIV-infected adults from Lusaka, Zambia, we collected data on medical history and dietary intake using 24 hr DR. We measured fatty acids and markers of AIDS progression and CVD risk in fasting plasma collected at baseline. Results. PUFA intakes showed modest correlations with corresponding plasma levels; Spearman correlations were 0.36 (p < 0.01) for eicosapentaenoic acid and 0.21 (p = 0.005) for docosahexaenoic acid. While there were no significant associations (p > 0.05) between total plasma PUFA and C-reactive protein (CRP) or lipid levels, plasma arachidonic acid was inversely associated with CRP and triglycerides and positively associated with HDL-C, CD4+ T-cell count, and plasma albumin (p < 0.05). Plasma saturated fatty acids (SFA) were positively associated with CRP (β = 0.24; 95% CI: 0.08 to 0.40, p = 0.003) and triglycerides (β = 0.08; 95% CI: 0.03 to 0.12, p < 0.01). Conclusions. Our data suggest that a single DR is inadequate for assessing PUFA intake and that plasma arachidonic acid levels may modulate HIV/AIDS progression and CVD risk.

Alpha-linolenic acid: an omega-3 fatty acid with neuroprotective properties-ready for use in the stroke clinic?

Alpha-linolenic acid (ALA) is plant-based essential omega-3 polyunsaturated fatty acids that must be obtained through the diet. This could explain in part why the severe deficiency in omega-3 intake pointed by numerous epidemiologic studies may increase the brain's vulnerability representing an important risk factor in the development and/or deterioration of certain cardio- and neuropathologies. The roles of ALA in neurological disorders remain unclear, especially in stroke that is a leading cause of death. We and others have identified ALA as a potential nutraceutical to protect the brain from stroke, characterized by its pleiotropic effects in neuroprotection, vasodilation of brain arteries, and neuroplasticity. This review highlights how chronic administration of ALA protects against rodent models of hypoxic-ischemic injury and exerts an anti-depressant-like activity, effects that likely involve multiple mechanisms in brain, and may be applied in stroke prevention. One major effect may be through an increase in mature brain-derived neurotrophic factor (BDNF), a widely expressed protein in brain that plays critical roles in neuronal maintenance, and learning and memory. Understanding the precise roles of ALA in neurological disorders will provide the underpinnings for the development of new therapies for patients and families who could be devastated by these disorders.

Fatty acid profile and meat quality of young bulls fed ground soybean or ground cottonseed and vitamin E

The objective of this study was to evaluate the fatty acid profile and qualitative characteristics of meat from feedlot young bulls fed ground soybean or ground cottonseed, with or without supplementation of vitamin E. A total of 40 Red Norte young bulls, with an initial average age of 20 months, and an initial average BW of 339±15 kg, were allotted in a completely randomized design using a 2×2 factorial arrangement, with two oilseeds, and daily supplementation or not of 2500 IU of vitamin E. The experimental period was for 84 days, which was preceded by an adaptation period of 28 days. The treatments were ground soybean (SB), ground soybean plus vitamin E (SBE), ground cottonseed (CS) and ground cottonseed plus vitamin E (CSE). The percentage of cottonseed and soybean in the diets (dry matter basis) was 24% and 20%, respectively. Diets were isonitrogenous (13% CP) and presented similar amount of ether extract (6.5%). The animals were slaughtered at average live weight of 464±15 kg, and samples were taken from the longissimus dorsi muscle for the measurement of fatty acid concentration and the evaluation of lipid oxidation and color of the beef. Before fatty acid extraction, muscle tissue and subcutaneous fat of the longissimus dorsi were separated to analyze fatty acid profile in both tissues. Supplementation of vitamin E did not affect fatty acid concentration, lipid oxidation and color (P>0.05). Subcutaneous fat from animals fed CS diet had greater C12:0, C16:0 and C18:0 contents (P<0.03). In addition, CS diets reduced the C18:1 and C18:2 cis-9, trans-11 contents in subcutaneous fat (P<0.05). The muscle from animals fed CS tended to higher C16:0 and C18:0 contents (P<0.11), and decreased C18:1, C18:2 cis-9, trans-11 and C18:3 contents (P<0.05) compared with SB. The Δ9-desaturase index was greater in muscle from animals fed SB (P<0.01). At 42 days of age, meat from cattle fed SB had a greater lipid oxidation rate (P<0.05). Meat from animals fed SB diets had less lightness and redness indices than meat from animals fed CS diets after 14 days of age. In conclusion, the addition of ground cottonseed in the finishing diets did increase the saturated fatty acid content of the longissimus dorsi. However, animals fed cottonseed exhibited greater lightness and redness of beef. In this study, the addition of vitamin E did not affect qualitative characteristics of meat.

Association of serum aryl hydrocarbon receptor activity and RBC omega-3 polyunsaturated fatty acids with flow-mediated dilation in healthy, young Hispanic cigarette smokers

Impaired flow-mediated dilation (FMD) occurs prior to clinical disease in young cigarette smokers. We investigated two potential biomarkers of FMD: serum aryl hydrocarbon receptor (AHR) activity and RBC omega-3 polyunsaturated fatty acids in healthy young Hispanic cigarette smokers. We recruited never (n=16) and current (n=16) Hispanic smokers (32 ± 7 years old), excluding individuals with clinical cardiovascular disease. We measured FMD with duplex ultrasound, RBC fatty acids and serum AHR activity using a luciferase reporter assay. FMD was significantly impaired in smokers (5.8 ± 4%) versus never smokers (12.3 ± 7.4%, p=0.001). Serum AHR activity was significantly increased in smokers (1467 ± 358 relative light units (RLU)) versus never smokers (689 ± 251 RLU, p<0.001), and correlated positively with FMD only in smokers (r=0.691, p<0.004). RBC percentage of α-linolenic acid (ALA%) was significantly increased in smokers (0.14 ± 0.03%) versus never smokers (0.11 ± 0.03%, p=0.018), and correlated inversely with FMD only in smokers (r=-0.538, p=0.03). The combination of serum AHR activity, ALA%, and systolic blood pressure significantly correlated with FMD in a multivariable regression model (r=0.802, p<0.008). These results suggest that serum AHR activity and RBC ALA% could serve as biomarkers of FMD in healthy, young Hispanic cigarette smokers.

α-Linolenic acid: nutraceutical, pharmacological and toxicological evaluation

α-Linolenic acid (ALA), a carboxylic acid with 18 carbons and three cis double bonds, is an essential fatty acid needed for human health and can be acquired via regular dietary intake of foods that contain ALA or dietary supplementation of foods high in ALA, for example flaxseed. ALA has been reported to have cardiovascular-protective, anti-cancer, neuro-protective, anti-osteoporotic, anti-inflammatory, and antioxidative effects. ALA is the precursor of longer chain omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), but its beneficial effects on risk factors for cardiovascular diseases are still inconclusive. The recommended intake of ALA for cardiovascular health is reported to be 1.1-2.2g/day. Although there are limited toxicological data for ALA, no serious adverse effects have been reported. The evidence on an increased prostate cancer risk in association with dietary ALA is not conclusive. Based on the limited data currently available, it may be concluded that ALA may be beneficial as a nutraceutical/pharmaceutical candidate and is safe for use as a food ingredient.

A randomised controlled trial on hypolipidemic effects of Nigella Sativa seeds powder in menopausal women

BACKGROUND

The risk of cardiovascular diseases (CVD) is increased tremendously among menopausal women, and there is an increasing demand for alternative therapies for managing factors like dyslipidemia that contribute to CVD development.

METHODS

In this study, Nigella sativa was evaluated for its hypolipidemic effects among menopausal women. In a randomised trial, hyperlipidemic menopausal women were assigned to treatment (n=19) or placebo groups (n=18), and given N. sativa or placebo for two months after their informed consents were sought. At baseline, blood samples were taken and at one month intervals thereafter until one month after the end of the study.

RESULTS

The results showed that N. sativa significantly improved lipid profiles of menopausal women (decreased total cholesterol, low density lipoprotein cholesterol and triglyceride, and increased high density lipoprotein cholesterol) more than the placebo treatment over 2 months of intervention. One month after cessation of treatment, the lipid profiles in the N. sativa-treated group tended to change towards the pretreatment levels.

CONCLUSIONS

N. sativa is thought to have multiple mechanisms of action and is cost-effective. Therefore, it could be used by menopausal women to remedy hypercholesterolemia, with likely more benefits than with single pharmacological agents that may cause side effects. The use of N. sativa as an alternative therapy for hypercholesterolemia could have profound impact on the management of CVD among menopausal women especially in countries where it is readily available.

α-Linolenic acid suppresses cholesterol and triacylglycerol biosynthesis pathway by suppressing SREBP-2, SREBP-1a and -1c expression

α-Linolenic acid (ALA), a major fatty acid in flaxseed oil, has multiple functionalities such as anti-cardiovascular and anti-hypertensive activities. In this study, we investigated the effects of ALA on lipid metabolism and studied the possible mechanisms of its action in differentiated 3T3-L1 adipocytes using DNA microarray analysis. From a total of 34,325 genes in the DNA chip, 87 genes were down-regulated and 185 genes were up-regulated at least twofold in differentiated 3T3-L1 adipocyte cells treated with 300 μM ALA for a week, 5-12 days after induction of cell differentiation, compared to ALA-untreated 3T3-L1 adipocytes (control). From the Reactome analysis results, eight lipid metabolism-related genes involved in cholesterol and triacylglycerol biosynthesis pathway and lipid transport were significantly down-regulated by ALA treatment. Furthermore, ALA significantly decreased the mRNA expressions of sterol regulatory element binding protein (SREBP)-2, SREBP-1a, SREBP-1c and fatty acid synthase (FAS) in 3T3-L1 adipocyte cells. On the other hand, the average levels of the gene expressions of carnitine palmitoyltransferase 1a (CPT-1a) and leptin in 300 μM ALA treatment were increased by 1.7- and 2.9-fold, respectively, followed by an increase in the intracellular ATP content. These results show that ALA is likely to inhibit cholesterol and fatty acid biosynthesis pathway by suppressing the expression of transcriptional factor SREBPs. Furthermore, ALA promotes fatty acid oxidation in 3T3-L1 adipocytes, thereby increasing its health benefits.

Circulating and dietary α-linolenic acid and incidence of congestive heart failure in older adults: the Cardiovascular Health Study

BACKGROUND

Few studies have evaluated the association between the n-3 fatty acid α-linolenic acid (ALA) and the incidence of congestive heart failure (CHF).

OBJECTIVE

We investigated whether plasma phospholipid concentrations and estimated dietary consumption of ALA are associated with incident CHF.

DESIGN

We used data from the Cardiovascular Health Study, a prospective cohort study of cardiovascular diseases among adults aged ≥65 y, from 4 US communities. A total of 2957 participants free of prevalent heart disease and with available fatty acid measurements were included in biomarker analyses (30,722 person-years and 686 incident CHF events). A total of 4432 participants free of prevalent heart disease were included in dietary analyses (52,609 person-years and 1072 events). We investigated the association of ALA with incident CHF by using Cox regression.

RESULTS

After adjustment for age, sex, race, education, smoking status, BMI, waist circumference, and alcohol consumption, plasma phospholipid ALA was not associated with incident CHF (HR for the highest compared with the lowest quartile: 0.97; 95% CI: 0.79, 1.21; P-trend = 0.85). Likewise, dietary ALA was not associated with incident CHF (adjusted HR for the highest compared with the lowest quartile: 0.96; 95% CI: 0.82, 1.20; P-trend = 0.97). We observed no association of biomarker or dietary ALA with nonvalvular CHF subtype. We also found little evidence of an association between ALA and CHF in subgroups based on age, sex, diabetes, fish consumption, BMI, or FADS2 genotype (rs1535).

CONCLUSION

ALA intake is not associated with incident CHF in older adults. This trial was registered at clinicaltrials.gov as NCT00005133.

Essential fatty acid intake and coronary heart disease risk factors among college students of 3 ethnic groups

OBJECTIVES

Few studies address gender and ethnic variations in essential fatty acid (EFA) intake and risk factors for coronary heart disease (CHD). The purpose of this study was to estimate EFA intake among college students of 3 ethnic groups and compare the relationship between EFA intake and CHD risk factors.

METHODS

Using a cross-sectional design, 300 subjects from 3 ethnic groups--one-third (n = 100) non-Hispanic white, one-third Hispanic, and one-third non-Hispanic black-completed the Cardiovascular Risk Assessment Instruments and a Food Frequency Questionnaire to determine fatty acid intake. Measured CHD risk factors were quantified as CHD Risk Point Standards (CHDRPS).

RESULTS

Results showed that Hispanic females had a significantly higher mean percent intake of arachidonic acid and ratio of linoleic acid to alpha-linolenic acid than non-Hispanic white females, and Hispanic males had significantly higher mean percent intake of EPA and [EPA plus docosahexaenoic acid (DHA)] than non-Hispanic white males. An inverse correlation was found between CHDRPS and DHA among non-Hispanic blacks. A significant positive correlation was found between CHDRPS and linoleic acid among non-Hispanic white females, as well as serum homocysteine (tHcy) concentrations and the ratio of linoleic acid to alpha-linolenic acid intake among non-Hispanic black females.

CONCLUSION

Gender and ethnic differences play a role in adherence to dietary guidelines, demonstrating relevance for future research in this area.

The cardiovascular effects of flaxseed and its omega-3 fatty acid, alpha-linolenic acid

Preventing the occurrence of cardiovascular disease (CVD) with nutritional interventions is a therapeutic strategy that may warrant greater research attention. The increased use of omega (&omega;)-3 fatty acids is a powerful example of one such nutritional strategy that may produce significant cardiovascular benefits. Marine food products have provided the traditional dietary sources of &omega;-3 fatty acids. Flaxseed is an alternative to marine products. It is one of the richest sources of the plant-based &omega;-3 fatty acid, alpha-linolenic acid (ALA). Based on the results of clinical trials, epidemiological investigations and experimental studies, ingestion of ALA has been suggested to have a positive impact on CVD. Because of its high ALA content, the use of flaxseed has been advocated to combat CVD. The purpose of the present review was to identify the known cardiovascular effects of flaxseed and ALA and, just as importantly, what is presently unknown.

Are all n-3 polyunsaturated fatty acids created equal?

N-3 Polyunsaturated fatty acids have been shown to have potential beneficial effects for chronic diseases including cancer, insulin resistance and cardiovascular disease. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in particular have been studied extensively, whereas substantive evidence for a biological role for the precursor, alpha-linolenic acid (ALA), is lacking. It is not enough to assume that ALA exerts effects through conversion to EPA and DHA, as the process is highly inefficient in humans. Thus, clarification of ALA's involvement in health and disease is essential, as it is the principle n-3 polyunsaturated fatty acid consumed in the North American diet and intakes of EPA and DHA are typically very low. There is evidence suggesting that ALA, EPA and DHA have specific and potentially independent effects on chronic disease. Therefore, this review will assess our current understanding of the differential effects of ALA, EPA and DHA on cancer, insulin resistance, and cardiovascular disease. Potential mechanisms of action will also be reviewed. Overall, a better understanding of the individual role for ALA, EPA and DHA is needed in order to make appropriate dietary recommendations regarding n-3 polyunsaturated fatty acid consumption.

Bioavailability of alpha-linolenic acid from flaxseed diets as a function of the age of the subject

BACKGROUND

Dietary flaxseed may have beneficial cardiovascular effects. An aged population has a higher incidence of cardiovascular disease, but they may react differently to flaxseed in the diet.

OBJECTIVE

To investigate the response, over a period of 4 weeks, of subjects aged 18-29 or 45-69 years to a diet containing the same amount of alpha-linolenic acid (ALA) (6 g) introduced in the form of ground flaxseed (30 g) or flaxseed oil.

RESULTS

All subjects who received flaxseed oil showed a significant increase in plasma ALA and eicosapentaenoic acid (EPA) concentrations over the course of this study. Subjects who received ground flaxseed in the 18-29-year-old group showed a statistically significant increase in their plasma ALA levels, and although there was a trend in the same direction for the 45-69-year-old subjects, this did not achieve statistical significance. The diets induced no major changes in platelet aggregation, plasma total cholesterol, low-density lipoprotein or high-density lipoprotein cholesterol levels in any of the groups. Younger subjects showed a decrease in triglyceride (TG) values compared with older subjects. There were no significant side effects that caused compliancy issues.

CONCLUSION

Subject age does not seem to be a major determining factor in influencing ALA absorption from a flaxseed-supplemented diet nor in the metabolism of ALA to EPA in the groups fed flaxseed oil. Concerns about side effects in older subjects administered a higher fiber load in a flaxseed-supplemented diet are not justified. However, younger but not older subjects showed a beneficial decrease in circulating TGs due to flaxseed supplementation.

omega-3 polyunsaturated fatty acid supplementation for the treatment of heart failure: mechanisms and clinical potential

Heart failure (HF) is a complex clinical syndrome with multiple aetiologies. Current treatment options can slow the progression to HF, but overall the prognosis remains poor. Clinical studies suggest that high dietary intake of the omega-3 polyunsaturated fatty acids (omega-3PUFA) found in fish oils (eicosapentaenoic and docosahexaenoic acids) may lower the incidence of HF, and that supplementation with pharmacological doses prolongs event-free survival in patients with established HF. The mechanisms for these potential benefits are complex and not well defined. It is well established that fish oil supplementation lowers plasma triglyceride levels, and more recent work demonstrates anti-inflammatory effects, including reduced circulating levels of inflammatory cytokines and arachidonic acid-derived eicosanoids, and elevated plasma adiponectin. In animal studies, fish oil favourably alters cardiac mitochondrial function. All of these effects may work to prevent the development and progression of HF. The omega-3PUFA found in plant sources, alpha-linolenic acid, may also be protective in HF; however, the evidence is not as compelling as for fish oil. This review summarizes the evidence related to use of omega-3PUFA supplementation as a potential treatment for HF and discusses possible mechanisms of action. In general, there is growing evidence that supplementation with omega-3PUFA positively impacts established pathophysiological targets in HF and has potential therapeutic utility for HF patients.

Modification of blood antioxidant status and lipid profile in response to high-intensity endurance exercise after low doses of omega-3 polyunsaturated fatty acids supplementation in healthy volunteers

We investigated whether endurance exercise might modify the blood antioxidant status and lipid profile after omega-3 fatty acid supplementation. Two groups of healthy, fit males performed 1 h of exercise with a constant work load corresponding to 60% of their individual VO(2 max) and various pedaling rates (45 min-60 rev/min followed by a maximal rate), before and after receiving, over 6 weeks, omega-3 fatty acids in a daily dose of 1.3 g or placebo. The resting concentration of triglycerides decreased after omega-3 fatty acid consumption. In response to endurance exercise, the superoxide dismutase activity markedly decreased in sedentary control subjects. This effect was partially protected by omega-3 fatty acid consumption. Supplementation tended to increase atalase activity in response to exercise, and this activity was significantly higher after 1 h of recovery. We conclude that the beneficial effect of omega-3 fatty acid supplementation during endurance exercise may be due to the activation of the superoxide dismutase and catalase pathways.

Bioavailability of alpha-linolenic acid in subjects after ingestion of three different forms of flaxseed

BACKGROUND

Dietary flaxseed may have significant health-related benefits due to its high content of the omega-3 fatty acid, alpha-linolenic acid (ALA). However, before extensive work can be undertaken in clinical populations to determine its efficacy, basic information on ALA bioavailability from flaxseed and the physiological effects of its ingestion need to be examined.

OBJECTIVE

The purpose of this study, therefore, was to determine the bioavailability of ALA when the flaxseed was ingested in the form of whole seed, milled seed or as flaxseed oil.

DESIGN

The flaxseed components (30 g of seed or 6 g of ALA in the oil) were baked into muffins for delivery over a 3 month test period in healthy male and female subjects.

RESULTS

Flaxseed ingestion over a 1 month period resulted in significant (P = 0.005) increases in plasma ALA levels in the flaxseed oil and the milled flaxseed supplemented groups. The former group had significantly (P = 0.004) higher ALA levels than the milled flaxseed group. The subjects supplemented with whole flaxseed did not achieve a significant (P > 0.05) increase in plasma ALA levels. An additional two months of flaxseed ingestion did not achieve significantly higher levels of plasma ALA in any of the groups. However, no significant increase was detected in plasma eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA) levels in any of the flax-fed groups. There were no changes in plasma cholesterol or triglycerides or in platelet aggregation at any time point in any of the groups. Subjects in all of the groups exhibited some symptoms of gastro-intestinal discomfort during the early stages of the study but these disappeared in the oil and milled seed groups. However, compliance was a problem in the whole flaxseed group.

CONCLUSION

In summary, ingestion of flax oil and milled flaxseed delivered significant levels of ALA to the plasma whereas whole flaxseed did not. Whole seed and oil preparations induced adverse gastrointestinal effects within 4 weeks and these were severe enough to induce the withdrawal of some subjects from these two groups. No one withdrew from the group that ingested milled flaxseed and, therefore, may represent a good form of flaxseed to avoid serious side-effects and still provide significant increases in ALA to the body.

Alpha-linolenic acid and risk of nonfatal acute myocardial infarction

BACKGROUND

Intake of long-chain n-3 fatty acids found in fish is low in many countries worldwide. alpha-Linolenic acid could be a viable cardioprotective alternative to these fatty acids in these countries.

METHODS AND RESULTS

Cases (n=1819) with a first nonfatal acute myocardial infarction and population-based controls (n=1819) living in Costa Rica matched for age, sex, and area of residence were studied. Fatty acids were assessed by gas chromatography in adipose tissue samples and by a validated food frequency questionnaire specifically designed for this population. Odds ratios and 95% confidence intervals were calculated from multivariate conditional logistic regression models. alpha-Linolenic acid in adipose tissue ranged from 0.36% in the lowest decile to 1.04% in the highest decile. The corresponding median levels of intake were 0.42% and 0.86% energy. Greater alpha-linolenic acid (assessed either in adipose or by questionnaire) was associated with lower risk of myocardial infarction. The odds ratios for nonfatal myocardial infarction for the highest compared with the lowest deciles were 0.41 (95% confidence interval, 0.25 to 0.67) for alpha-linolenic acid in adipose tissue and 0.61 (95% confidence interval, 0.42 to 0.88) for dietary alpha-linolenic acid. The relationship between alpha-linolenic acid and myocardial infarction was nonlinear; risk did not decrease with intakes > approximately 0.65% energy (1.79 g/d). Fish or eicosapentaenoic acid and docosahexaenoic acid intake at the levels found in this population did not modify the observed association.

CONCLUSIONS

Consumption of vegetable oils rich in alpha-linolenic acid could confer important cardiovascular protection. The apparent protective effect of alpha-linolenic acid is most evident among subjects with low intakes.

Presecretory oxidation, aggregation, and autophagic destruction of apoprotein-B: a pathway for late-stage quality control

Hepatic secretion of apolipoprotein-B (apoB), the major protein of atherogenic lipoproteins, is regulated through posttranslational degradation. We reported a degradation pathway, post-ER pre secretory proteolysis (PERPP), that is increased by reactive oxygen species (ROS) generated within hepatocytes from dietary polyunsaturated fatty acids (PUFA). We now report the molecular processes by which PUFA-derived ROS regulate PERPP of apoB. ApoB exits the ER; undergoes limited oxidant-dependent aggregation; and then, upon exit from the Golgi, becomes extensively oxidized and converted into large aggregates. The aggregates slowly degrade by an autophagic process. None of the oxidized, aggregated material leaves cells, thereby preventing export of apoB-lipoproteins containing potentially toxic lipid peroxides. In summary, apoB secretory control via PERPP/autophagosomes is likely a key component of normal and pathologic regulation of plasma apoB levels, as well as a means for remarkably late-stage quality control of a secreted protein.

Effects of flaxseed oil supplementation on plasma adiponectin levels in dyslipidemic men

BACKGROUND

Dietary alpha-linolenic acid (ALA) has been associated with reduced risk of development of atherosclerosis. Adiponectin is a hormone specifically secreted by adipocytes and considered to have anti-atherogenic properties.

AIM OF THE STUDY

We examined the effect of increased dietary intake of ALA on plasma concentration of adiponectin.

METHODS

Thirty-five non-diabetic, dyslipidemic men, 38-71 years old, were randomly allocated to take either 15 ml of flaxseed oil rich in ALA (8.1 g/day; n = 18), or 15 ml of safflower oil per day, containing the equivalent n-6 fatty acid (11.2 g/day linoleic acid, LA; n = 17) (control group). The intervention period lasted for 12 weeks.

RESULTS

Plasma levels of adiponectin did not change after the increase in dietary intake of ALA in the flaxseed oil supplementation group, compared to the control group. No changes in body mass index, serum lipid concentrations, LDL density, or plasma TNF-alpha were found in the flaxseed oil versus the control group.

CONCLUSIONS

Dietary ALA has no effect on plasma adiponectin concentration in dyslipidemic men.

Fatty acid composition of nuts--implications for cardiovascular health

It is well established that, due to their high content of saturated fatty acids (SFA), the intake of meat and meat products is strongly associated with elevated blood cholesterol concentrations and an increased risk of hypertension, diabetes and cardiovascular diseases. Conversely, the intake of foods rich in unsaturated fatty acids, such as those contained in most vegetable fats and oils and oily fish, is associated with improved lipid profiles, a lower potency of intermediate biomarkers of atherosclerosis and lesser incidence of cardiovascular diseases. There are persuasive evidences that dietary substitution of monounsaturated fatty acids (MUFA) or n-6 polyunsaturated fatty acids (PUFA) for SFA lowers blood cholesterol and may have beneficial effects on inflammation, thrombosis, and vascular reactivity. MUFA may have an advantage over PUFA because enrichment of lipoprotein lipids with MUFA increases their resistance to oxidation. Marine n-3 PUFA have a number of anti-atherosclerotic effects, including anti-arrhythmic properties and, at relatively high doses, reduce serum triglycerides. These effects appear to be shared in part by vegetable n-3 PUFA. Nuts are natural foods rich in unsaturated fatty acids; most nuts contain substantial amounts of MUFA, while walnuts are especially rich in both n-6 and n-3 PUFA. Healthy fats in nuts contribute to the beneficial effects of frequent nut intake observed in epidemiological studies (prevention of coronary heart disease, diabetes, and sudden death) and in short-term feeding trials (cholesterol lowering, LDL resistance to oxidation, and improved endothelial function).

Gender-related response of lipid metabolism to dietary fatty acids in the hamster

Gender and dietary fatty acids are involved in the regulation of lipid metabolism, disturbances of which can lead to pathologies such as metabolic syndrome or CVD. Possible interactions between these factors were investigated in male and female hamsters fed diets rich in either saturated fatty acids (‘butter’ diet) or in α-linolenic acid (‘linseed oil’ diet). Gender effect predominated over the diet effect on cholesterol (CH) metabolism; compared to males, females exhibited lower concentrations of plasma total CH (−20%,P<0·001), LDL-CH (−40%,P<0·001) and HDL-CH (−16%,P<0·001), together with higher LDL receptor (+40%) and lower HDL receptor (−60%) hepatic content. Triacylglycerol (TG) metabolism was affected by diet above all: compared to animals fed the ‘butter’ diet, those fed the ‘linseed oil’ diet exhibited lower plasma (−23%,P=0·046) and liver TG (−20%,P=0·026) concentration which may result from both an increased β-oxidation (P<0·001), without any change in PPARα mRNA, and a decreased hepatic lipogenesis (P=0·023), without increased sterol response element binding protein 1c (SREBP1c) mRNA. The response to diet was much more pronounced in males than in females, without gender effect on the transcription level of PPARα and SREBP1c. Finally, the ‘linseed oil’ diet decreased the insulin resistance index (−80%,P<0·001) with a more marked effect in males, in relation to their higher hepatic PPARγ expression (+90%,P=0·012). In conclusion, in our model, the response of either TG or CH to dietary fatty acids is modulated differently by gender. The possible relevance of these interactions to dietary practice should be taken into account in man.

Effects of altering the ratio of dietary n-6 to n-3 fatty acids on insulin sensitivity, lipoprotein size, and postprandial lipemia in men and postmenopausal women aged 45-70 y: the OPTILIP Study

BACKGROUND

Insulin resistance is associated with elevated plasma triacylglycerol, low HDL concentrations, elevated postprandial lipemia, and a predominance of small, dense LDLs (sdLDLs). It has been hypothesized that the dietary ratio of n-6 to n-3 (n-6:n-3) polyunsaturated fatty acids (PUFAs) may have favorable effects on these risk factors by increasing insulin sensitivity.

OBJECTIVE

The objective was to measure changes in insulin sensitivity, lipoprotein size, and postprandial lipemia after a 6-mo alteration in n-6:n-3.

DESIGN

In a randomized, parallel design in 258 subjects aged 45-70 y, we compared 4 diets providing 6% of energy as PUFAs with an n-6:n-3 between 5:1 and 3:1 with a control diet that had an n-6:n-3 of 10:1. The diets were enriched in alpha-linolenic acid, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), or both. Insulin sensitivity was assessed with the homeostatic model assessment of insulin resistance and the revised quantitative insulin sensitivity test.

RESULTS

Dietary intervention did not influence insulin sensitivity or postprandial lipase activities. Fasting and postprandial triacylglycerol concentrations were lower, and the proportion of sdLDLs decreased (by 12.7%; 95% CI: -22.9%, 2.4%), with an n-6:n-3 of approximately 3:1, which was achieved by the addition of long-chain n-3 PUFAs (EPA and DHA).

CONCLUSIONS

Decreasing the n-6:n-3 does not influence insulin sensitivity or lipase activities in older subjects. The reduction in plasma triacylglycerol after an increased intake of n-3 long-chain PUFAs results in favorable changes in LDL size.

Maternal erythrocyte omega-3 and omega-6 fatty acids, and plasma lipid concentrations, are associated with habitual dietary fish consumption in early pregnancy

OBJECTIVES

We investigated the relationship between selected maternal erythrocyte omega-3 and omega-6 polyunsaturated fatty acids (PUFA) and plasma lipids in early pregnancy and reported habitual fish consumption during the periconceptional period.

DESIGN AND METHODS

This cohort study included 923 pregnant women who reported periconceptional dietary habits and provided a blood sample before 20 weeks of gestation. PUFA was determined by gas chromatography and plasma lipids by standard enzymatic methods. Differences in erythrocyte PUFA and plasma lipid concentrations were estimated using linear regression.

RESULTS

Mean erythrocyte eicosapentanoic acid and other PUFA content (%/total) were positively associated with frequency of self-reported fish consumption. Arachidonic acid was inversely related with frequent fish consumption (p trend <0.001). Women who consumed fish >twice/week had lower plasma triglyceride (-11.5 mg/dl) and higher HDL-cholesterol (+2.8 mg/dl) concentrations than women consuming fish <once/week.

CONCLUSIONS

These results support findings of inverse relation between fish consumption and preeclampsia risk.

Lipid profile of rats fed high-fat diets based on flaxseed, peanut, trout, or chicken skin

OBJECTIVE

Dietary saturated fatty acids are associated with coronary disease. Conversely, dietary monounsaturated polyunsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) seem to exert a protective effect. This study evaluated the lipid profile of rats fed high-fat (HF) diets, with fat added as different sources of PUFA (flaxseed and trout), MUFA (peanut), and saturated fatty acid (chicken skin).

METHODS

Adult male Wistar rats were placed into six dietary groups (n = 10): control (normal); high fat, with 1% cholesterol, 10% soy oil, and 5% lard; and four groups fed similar HF diets, with 10% lipid as trout, flaxseed, peanut, or chicken skin. After 28 d the animals were killed. Blood, livers, and adipose tissue samples were collected.

RESULTS

A higher level (P < 0.05) of total serum cholesterol was observed in rats fed the normal diet (93.57 +/- 14.95 mg/dL) compared with those fed the HF diet (67.57 +/- 12.54 mg/dL). Total cholesterol levels in rats fed the flaxseed diet were lower (P < 0.05) than in rats fed the other fats. No difference was observed in cholesterol levels between groups fed the peanut and chicken skin diets (P > 0.05). Animals fed the peanut diet showed decreased body weight gain than did animals in the other treatment groups. There were large lipid and cholesterol depositions in livers of rats fed the HF diet. Lipid deposition in adipose tissue followed the same dietary fatty acid profile, i.e., high levels of omega-3 PUFA in the flaxseed group, high levels of MUFA in the peanut and chicken skin groups and high levels of omega-6 PUFA in the trout group.

CONCLUSIONS

These data indicate that flaxseed is promising for dietary manipulation of hyperlipidemia.

Relationships between serum unsaturated fatty acids and coronary risk factors: negative relations between nervonic acid and obesity-related risk factors

Relative increases in unsaturated fatty acids (USFA) in the diet are considered to exert beneficial effects on coronary risk factors (CRF). However, detailed analysis of the relationships between serum USFA and CRF are scanty and there is no report of the relationship between nervonic acid (NA) and CRF. The objective of the present study was to analyze the relationships between serum USFA and CRF. Body height and weight, blood pressure, fasting serum total cholesterol (TC), triacyl-glycerol (TG), HDL cholesterol (HDLc), fasting blood sugar (FBS), total fatty acid composition, leptin, and high-sensitivity C-reactive protein (CRP) were measured in 31 men (age, 41-78 years) and 11 women (age, 54-77 years). The relationships between serum USFA, and body mass index (BMI), leptin, systolic blood pressure (SBP), diastolic blood pressure (DBP), TC, TG, HDLc, FBS, and CRP were analyzed using multiple regression analysis. The final results were summarized using coronary risk factor scores (CRFS) in order to assess the correlations between USFA with CRF. Oleic acid (OA), linoleic acid (LA), and eicosapentaenoic acid (EPA) were positively related to coronary risk factors (total CRFS = 2, 3, and 4, respectively), while nervonic acid (NA) exerted negative effects on these risk factors (total CRFS = -6 ). It is concluded NA may have preventive effects on obesity-related metabolic disorders.

Influence of alpha-linolenic acid and fish-oil on markers of cardiovascular risk in subjects with an atherogenic lipoprotein phenotype

We tested the hypothesis that dietary alpha-linolenic acid (ALA) can exert effects on markers of cardiovascular risk similar to that produced by its longer chain counterparts in fish-oil. A dietary intervention study was undertaken to examine the effects of an ALA-enriched diet in 57 men expressing an atherogenic lipoprotein phenotype (ALP). Subjects were randomly assigned to one of three diets enriched either with flaxseed oil (FXO: high ALA, n = 21), sunflower oil (SO: high linoleic acid, n = 17), or SO with fish-oil (SOF n = 19) for 12 weeks, resulting in dietary intake ratios of n-6:n-3 PUFA of 0.5, 27.9 and 5.2, respectively. The relative abundance of ALA and EPA in erythrocyte membranes increased on the FXO diet (p < 0.001), whereas both EPA and DHA increased after fish-oil (p < 0.001). There were significant decreases in total plasma cholesterol within (FXO -12.3%, p = 0.001; SOF -7.6%, p = 0.014; SO -7.3%, p = 0.033) and between diets (p = 0.019), and decreases within diets after 12 weeks for HDL cholesterol on flaxseed oil (FXO -10%, p=0.009), plasma TG (-23%, p < 0.001) and small, dense LDL (-22% p = 0.003) in fish-oil. Membrane DHA levels were inversely associated with the changes in plasma TG ( p= 0.001) and small, dense LDL (p<0.05) after fish-oil. In conclusion, fish-oil produced predictable changes in plasma lipids and small, dense LDL (sdLDL) that were not reproduced by the ALA-enriched diet. Membrane DHA levels appeared to be an important determinant of these fish-oil-induced effects.

Dose effect of alpha-linolenic acid on lipid metabolism in the hamster

In order to meet dietary requirements, the consumption of alpha-linolenic acid (ALA, 18:3 n-3) must be promoted. However, its effects on triglyceride (TG) and cholesterol metabolism are still controversial, and may be dose-dependent. The effects of increasing dietary ALA intakes (1%, 10%, 20% and 40% of total FA) were investigated in male hamsters. ALA replaced oleic acid while linoleic and saturated FA were kept constant. Triglyceridemia decreased by 45% in response to 10% dietary ALA and was not affected by higher intakes. It was associated with lower hepatic total activities of acetyl-CoA-carboxylase (up to -29%) and malic enzyme (up to -42%), which were negatively correlated to ALA intake (r(2) = 0.33 and r(2) = 0.38, respectively). Adipose tissue lipogenesis was 2-6 fold lower than in the liver and was not affected by dietary treatment. Substitution of 10% ALA for oleic acid increased cholesterolemia by 15% but, as in TG, higher ALA intakes did not amplify the response. The highest ALA intake (40%) dramatically modified the hepatobiliary metabolism of sterols: cholesterol content fell by 45% in the liver and increased by 28% in the faeces. Besides, faecal bile acids decreased by 61%, and contained more hydrophobic and less secondary bile acids. Thus, replacing 10% oleic acid by ALA is sufficient to exert a beneficial hypotriglyceridemic effect, which may be counteracted by the slight increase in cholesterolemia. Higher intakes did not modify these parameters, but a very high dose resulted in adverse effects on sterol metabolism.

Dietary linolenic acid is inversely associated with calcified atherosclerotic plaque in the coronary arteries: the National Heart, Lung, and Blood Institute Family Heart Study

BACKGROUND

High dietary intake of linolenic acid is associated with a lower risk of cardiovascular disease mortality. However, little is known about the association between linolenic acid and subclinical atherosclerosis.

METHODS AND RESULTS

To examine the association between dietary linolenic acid measured by food frequency questionnaire and calcified atherosclerotic plaque in the coronary arteries (CAC) measured by cardiac CT, we studied 2004 white participants of the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study aged 32 to 93 years. The presence of CAC was defined on the basis of total CAC score of > or =100. We used generalized estimating equations to estimate odds ratios for the presence of CAC across quintiles of linolenic acid. The average consumption of dietary linolenic acid was 0.82+/-0.36 g/d for men and 0.69+/-0.29 g/d for women. From the lowest to the highest quintile of linolenic acid, adjusted odds ratios (95% CI) for the presence of CAC were 1.0 (reference), 0.61 (0.42 to 0.88), 0.55 (0.35 to 0.84), 0.57 (0.37 to 0.88), and 0.35 (0.22 to 0.55), respectively (P for trend <0.0001), after we controlled for age, gender, education, family risk group, smoking, fruit and vegetable intake, history of coronary artery disease, hypertension, diabetes mellitus, and statin use. When linolenic acid was used as a continuous variable, the multivariate adjusted odds ratio was 0.38 (95% CI, 0.24 to 0.46) per gram of linolenic acid intake. Use of different cut points for CAC score yielded similar results.

CONCLUSIONS

Consumption of dietary linolenic acid is associated with a lower prevalence of CAC in a dose-response fashion in white men and women.

Dietary Linolenic Acid and Adjusted QT and JT Intervals in the National Heart, Lung, and Blood Institute Family Heart Study

OBJECTIVES

The goal of this study was to examine whether higher consumption of total linolenic acid was associated with rate-adjusted QT and JT intervals (QTrr and JTrr, respectively).

BACKGROUND

Higher intake of fish omega-3 fatty acids and plant omega-3 such as alpha-linolenic acid is associated with lower risk of myocardial infarction. While long-chain omega-3 can inhibit ventricular arrhythmia, it is not known whether alpha-linolenic acid influences ventricular repolarization.

METHODS

We studied 3,642 subjects from the National Heart, Lung, and Blood Institute Family Heart study who were free of myocardial infarction, left ventricular hypertrophy, pacemaker, and with QRS <120 ms. We used the 95th percentile of the gender-specific distribution of QTrr and JTrr to define abnormally prolonged repolarization. Within each gender, we created age- and energy-adjusted tertiles of linolenic acid and used regression models for analyses.

RESULTS

Mean age was 50 years, and average intake of total linolenic acid was 0.74 g/day. There was an inverse association between consumption of linolenic acid and QTrr and JTrr (p for trend 0.001 and 0.0005, respectively). From the lowest (reference) to the highest gender-, age-, and energy-adjusted tertile of linolenic acid, multivariable adjusted odds ratios for prolonged QTrr were 1.0, 0.74 (95% confidence interval [CI] 0.57 to 0.96), and 0.59 (95% CI 0.44 to 0.77), respectively (p for trend 0.0003). Corresponding values for JTrr were 1.0, 0.73 (95% CI 0.52 to 1.03), and 0.59 (95% CI 0.40 to 0.87), respectively (p for trend 0.009). Exclusion of subjects taking drugs known to influence QT did not influence this association.

CONCLUSIONS

Higher intake of dietary linolenic acid might be associated with a reduced risk of abnormally prolonged repolarization in men and women.

Essential fatty acids and their derivatives

PURPOSE OF REVIEW

This review will address recent research in metabolism of essential fatty acids and their long chain derivatives. Our main focus will be the association between essential fatty acid status and various disease states, as well as the effects of supplementation with essential fatty acids or their derivatives on a number of clinical outcomes.

RECENT FINDINGS

There have been several papers over the last few years that show links between supplementation with fish oil (n-3 polyunsaturated fatty acids) and cardiovascular disease. Recent data suggest that the use of fish oil (containing n-3 fatty acids) in a variety of disorders such as cystic fibrosis, coronary disease and in the prevention of sudden death is beneficial. Several papers show reductions in systemic markers of inflammation. More widespread use of essential fatty acid derivatives in infant formula can certainly be questioned on the basis of the recent data. Fewer benefits are seen with ingestion of the essential fatty acids themselves, likely related to limited conversion to their long chain derivatives in humans.

SUMMARY

Derivatives of essential fatty acids have the potential to modify a number of disease states, either ingested in greater quantities in the diet, or taken as supplements in the form of fish oil.

Dietary Linolenic Acid Is Associated With a Lower Prevalence of Hypertension in the NHLBI Family Heart Study

Dietary linolenic acid has been shown to be associated with coronary artery disease. However, limited data are available on its effects on blood pressure. We used data from 4594 white participants (aged 25 to 93 years) in the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study to evaluate whether dietary linolenic acid was associated with prevalent hypertension and resting blood pressure. We used generalized estimating equations to determine the prevalence odds ratios (ORs) of hypertension and adjusted means of systolic and diastolic blood pressure across quartiles of linolenic acid. Mean dietary linolenic acid intake was 0.81±0.35 g per day for men and 0.69±0.29 g per day for women. From the lowest to the highest quartile of linolenic acid, multivariable adjusted ORs (95% confidence interval [CI]) for hypertension were 1.0 (reference), 0.73 (0.56 to 0.95), 0.71 (0.53 to 0.95), and 0.67 (0.47 to 0.96), respectively ( P for trend 0.04), controlling for age, sex, energy intake, body mass index, risk group, study site, education, smoking, alcohol intake, exercise, and history of coronary artery disease and diabetes mellitus. Dietary linolenic acid was related inversely to resting systolic ( P for trend 0.03) but not diastolic blood pressure ( P for trend 0.43). Linoleic acid, an omega-6 fatty acid, was not associated with prevalent hypertension or blood pressure. These data suggest that dietary linolenic acid is associated with a lower prevalence of hypertension and lower systolic blood pressure in white subjects.

Aggressive diets and lipid responses

Poor diet and physical inactivity, the two major contributors to the development of overweight and obesity, have recently been identified as the second most common actual cause of death in the United States. With the increasing awareness of the strong link between obesity and chronic disease, in particular cardiovascular disease, a myriad of diets have surfaced and many of them claim weight loss depends more on the macronutrient composition of the diet than the number of calories consumed. Long-term outcome data, particularly cardiovascular outcome data, on these diets are sparse. This article summarizes previous and recent reports of popular and aggressive diets, such as low-carbohydrate diets, low-fat diets, and very low-calorie diets, addressing their effects on weight loss and focusing on their effects on lipids and lipoproteins.

Hold the antioxidants and improve plasma lipids?

Intrahepatic proteolysis is a major determinant of secretion of ApoB-containing lipoproteins into plasma. Stimulation of post-ER presecretory proteolysis (PERPP) of ApoB by n-3 polyunsaturated fatty acids has been found to result in reduced secretion of VLDL particles by hepatocytes. A new study has shown that this stimulation is promoted by pro-oxidant conditions that result in increased hepatic lipid hydroperoxide content. Conversely, PERPP is suppressed by antioxidants and by saturated fatty acids, which are not susceptible to lipid peroxidation. Hence reduction of oxidative stress may have the unexpected side effect of increasing plasma lipid levels.