Effects of omega-3 fatty acid supplementation on heart rate variability at rest and during acute stress in adults with moderate hypertriglyceridemia

Ambivalence towards pork belly: exploring its significance and contradictions from the perspectives of the food industry and nutritional science

Pork is the most consumed meat in South Korea, and pork belly is the preferred cut. However, pork production cannot meet the demand, leading to a heavy reliance on imports, particularly for pork bellies. In contrast, low-fat cuts face oversupply problems owing to low demand and export challenges. Pork belly fat content varies with breed, sex, growth rate, and fatty acid composition. Western countries favor higher fat saturation for processed products, whereas South Koreans prefer grilled or roasted bellies. Excessive consumption of high-fat pork cuts like pork belly, which is rich in saturated fatty acids, can increase the risk of severe diseases, highlighting the importance of reducing saturated fat intake and increasing the consumption of monounsaturated fatty acids and polyunsaturated fatty acids to mitigate these risks. The pork industry and public health sector should diversify production, promote leaner pork, and raise awareness about the implications of excessive pork consumption.

Indications for omega-3 fatty acid supplementation in prevention of cardiovascular disease: From fish to pharmaceuticals

OBJECTIVE

To explore the evidence for omega-3 fatty acid (O3FA) supplementation in primary and secondary prevention of cardiovascular disease (CVD).

SOURCES OF INFORMATION

PubMed, Cochrane reviews, and Google Scholar were searched for meta-analyses and reviews related to O3FAs and CVD. Salient, recent randomized controlled trials referenced in these reviews were retrieved. Current lipid guidelines were reviewed.

MAIN MESSAGE

Most O3FAs are derived from marine or aquatic microalgae, which are consumed by fish. The essential fatty acids eicosapentaenoic acid and docosahexaenoic acid are mainly sourced from fish, with a small fraction coming from plants. Omega-3 fatty acids modestly lower triglyceride levels, but the major impact on CVD is through a variety of other mechanisms related to cell membrane function, antioxidant properties, and reduction of atherogenic small low-density lipoprotein cholesterol particles. Guidelines continue to recommend eating 2 servings of fish per week. There is little evidence of benefit of O3FAs in primary prevention of CVD. Given that 40% of Canadians have insufficient levels and that these low levels may be associated with other chronic diseases over time, supplementation with O3FAs could be considered, particularly in those with hypertriglyceridemia, in those who eat no fish, or for vegetarians or vegans. Doses up to 1 g daily are considered safe. For secondary prevention after statin optimization, if triglyceride levels are between 1.5 and 5.6 mmol/L, guidelines recommend with level 1A evidence taking 2 g of icosapent ethyl twice a day. This is also recommended in primary prevention for patients with diabetes and hypertriglyceridemia and additional CVD risk factors. As fish stocks dwindle over time, preserving fisheries for developing countries and obtaining O3FA from microalgal or genetically modified plant sources may become important.

CONCLUSION

All guidelines recommend at least 2 servings of oily fish per week, although benefit from O3FAs is mostly seen in secondary prevention. Fish oil and combination preparations of eicosapentaenoic acid and docosahexaenoic acid have failed to show benefit at any dose at any level of prevention in patients who are appropriately prescribed statins. High-dose eicosapentaenoic acid shows substantial benefit in selected patients taking statins who have high triglyceride levels.

Indications relatives à un supplément d’acides gras oméga-3 pour prévenir les maladies cardiovasculaires

Objectif

Explorer les données probantes en faveur d’un supplément d’acides gras oméga-3 (AGO3) en prévention primaire et secondaire des maladies cardiovasculaires (MCV).

Sources de l’information

Une recherche documentaire a été effectuée dans PubMed, la bibliothèque Cochrane et Google Scholar pour trouver des méta-analyses et des revues portant sur les AGO3 et les MCV. Les études randomisées contrôlées récentes et pertinentes qui ont été citées dans ces revues ont été retenues. Les lignes directrices actuelles sur les lipides ont été examinées.

Message principal

La plupart des AGO3 dérivent des microalgues marines ou aquatiques qui sont consommées par le poisson. Les acides gras essentiels, notamment l’acide eicosapentaénoïque et l’acide docosahexaénoïque, sont principalement tirés du poisson, et une petite fraction vient des végétaux. Les acides gras oméga-3 abaissent modestement les taux de triglycérides, mais l’effet le plus important sur les MCV se produit par l’intermédiaire de divers autres mécanismes liés au fonctionnement des membranes cellulaires, aux propriétés antioxydantes et à la réduction des petites particules de cholestérol à lipoprotéines de basse densité athérogènes. Les lignes directrices continuent de recommander de consommer 2 portions de poisson par semaine. Il existe peu de données probantes sur les bienfaits des AGO3 en prévention primaire des MCV. Étant donné que 40 % des Canadiens en ont des taux insuffisants et que ces faibles taux peuvent être associés à d’autres maladies chroniques avec le temps, des suppléments d’AGO3 pourraient être envisagés, surtout pour ceux qui ont une hypertriglycéridémie ou qui ne mangent pas de poisson, ou pour les végétariens et les végans. Des doses allant jusqu’à 1 g par jour sont jugées sécuritaires. Pour la prévention secondaire après l’optimisation des statines, si les taux de triglycérides se situent entre 1,5 et 5,6 mmol/L, les lignes directrices recommandent, sur la base de données probantes de niveau 1A, de prendre 2 g d’icosapent éthyle 2 fois par jour. Cette même recommandation s’applique en prévention primaire pour les patients qui ont le diabète, une hypertriglycéridémie et un facteur de risque additionnel de MCV. À mesure que les stocks de poisson diminuent avec le temps, la préservation des pêches pour les pays en développement et l’obtention des AGO3 à partir des microalgues ou de sources végétales génétiquement modifiées pourraient prendre de l’importance.

Conclusion

Toutes les lignes directrices recommandent au moins 2 portions de poisson gras par semaine, même si les bienfaits des AGO3 sont principalement observés en prévention secondaire. Les huiles de poisson et les préparations composées d’acide eicosapentaénoïque et d’acide docosahexaénoïque n’ont pas démontré de bienfaits, quels que soient la dose et le niveau de prévention, chez les patients à qui on a prescrit des statines de manière appropriée. L’acide eicosapentaénoïque à forte dose procure des bienfaits considérables chez certains patients qui prennent des statines et ont des taux élevés de triglycérides.

Omega 3 fatty acids can reduce early doxorubicin-induced cardiotoxicity in children with acute lymphoblastic leukemia

OBJECTIVES

Omega 3 polyunsaturated fatty acids are dietary factors with several beneficial cardiovascular effects. This study aimed to assess the possible protective effect of omega 3 fatty acids on early doxorubicin-induced cardiac toxicity in children with acute lymphoblastic leukemia (ALL).

PATIENTS AND METHODS

Sixty children of newly diagnosed ALL were randomized into two groups: group I (n = 30) who received omega 3 fatty acids 1000 mg/day for 6 months in addition to their usual protocol of chemotherapy including doxorubicin; and group II (n = 30) who received their usual doxorubicin protocol during the period from February 2020 till August 2021. Echocardiographic examinations were performed before and after the treatment. Glutathione, malondialdehyde (MDA), superoxide dismutase (SOD), troponin I, creatine kinase MB (CK-MB), and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured also before and after omega 3 treatment.

RESULTS

After 6 months of omega 3 administration, group I had a significantly lower MDA level and a significantly higher glutathione and SOD levels than group II. Similarly, the levels of troponin I, CK-MB, and NT-proBNP were significantly high in group II, whereas they were unchanged in group I after treatment. Similarly, systolic function (presented with peak mitral annular systolic velocity and two-dimensional global longitudinal strain) of the heart was preserved in omega 3-treated patients, unlike the control group that showed significant impairment of left ventricular function after 6 months.

CONCLUSION

Omega 3 fatty acids may decrease early cardiac injury and doxorubicin-induced cardiotoxicity in children with ALL.

Exploring the effects of oily fish consumption on measures of acute and long-term stress in healthy 8-9-year-old children: the FiSK Junior randomised trial

Long-chain n-3 PUFA (n-3 LCPUFA) are known to reduce blood pressure (BP), heart rate and vagal tone, but potential stress-mitigating effects of n-3 LCPUFA are not well investigated. We explored the effects of oily fish consumption on long-term stress and the stress response in schoolchildren. Healthy 8-9-year-old children were randomised to receive about 300 g/week of oily fish or poultry for 12 weeks (199 randomised, 197 completing). At baseline and endpoint, we measured erythrocyte n-3 LCPUFA, hair cortisol and the response to a 1-min cold pressor test (CPT) on saliva cortisol, BP and continuous electrocardiogram recordings. Post-intervention hair cortisol did not differ between the groups, but sex-specificity was indicated (Psex × group = 0·074, boys: -0·9 (95 % CI -2·9, 1·0) ng/g, girls: 0·7 (95 % CI -0·2, 1·6) ng/g). Children in the fish group tended to be less prone to terminate CPT prematurely (OR 0·20 (95 % CI 0·02, 1·04)). Mean heart beat interval during CPT was 18·2 (95 % CI 0·3, 36·6) ms longer and high frequency power increased (159 (95 % CI 29, 289) ms2) in the fish v. poultry group. The cardiac autonomic response in the 10 min following CPT was characterised by a sympathetic peak followed by a parasympathetic peak, which was most pronounced in the fish group. This exploratory study does not support a strong effect of oily fish consumption on stress but indicates that oily fish consumption may increase vagal cardiac tone during the physiological response to CPT. These results warrant further investigation.

Obesity, Nutrition and Heart Rate Variability

Heart rate variability (HRV) represents the activity and balance of the autonomic nervous system and its capability to react to internal and external stimuli. As a measure of general body homeostasis, HRV is linked to lifestyle factors and it is associated with morbidity and mortality. It is easily accessible by heart rate monitoring and gains interest in the era of smart watches and self-monitoring. In this review, we summarize effects of weight loss, training, and nutrition on HRV with a special focus on obesity. Besides weight reduction, effects of physical activity and dietary intervention can be monitored by parameters of HRV, including its time and frequency domain components. In the future, monitoring of HRV should be included in any weight reduction program as it provides an additional tool to analyze the effect of body weight on general health and homeostasis. HRV parameters could, for example, be monitored easily by implementation of an electrocardiogram (ECG) every two to four weeks during weight reduction period. Indices presumibly showing beneficial changes could be a reduction in heart rate and the number of premature ventricular complexes as well as an increase in standard deviation of normal-to-normal beat intervals (SDNN), just to name some.

A unifying conceptual framework of factors associated to cardiac vagal control

Cardiac vagal control (CVC) reflects the activity of the vagus nerve regulating cardiac functioning. CVC can be inferred via heart rate variability measurement, and it has been positively associated to a broad range of cognitive, emotional, social, and health outcomes. It could then be considered as an indicator for effective self-regulation, and given this role, one should understand the factors increasing and decreasing CVC. The aim of this paper is to review the broad range of factors influencing CVC, and to provide a unifying conceptual framework to integrate comprehensively those factors. The structure of the unifying conceptual framework is based on the theory of ecological rationality, while its functional aspects are based on the neurovisceral integration model. The structure of this framework distinguishes two broad areas of associations: person and environment, as this reflects adequately the role played by CVC regarding adaptation. The added value of this framework lies at different levels: theoretically, it allows integrating findings from a variety of scientific disciplines and refining the predictions of the neurovisceral integration model; methodologically, it helps identifying factors that increase and decrease CVC; and lastly at the applied level, it can play an important role for society regarding health policies and for the individual to empower one's flourishing.

Enhancing cardiac vagal activity: Factors of interest for sport psychology

Self-regulation plays a critical role in sport performance. An objective, psychophysiological marker of self-regulation is cardiac vagal activity, the activity of the vagus nerve regulating cardiac functioning. The aim of this paper is to provide an overview of factors influencing cardiac vagal activity, which can be useful for athletes. Specifically, we organize this overview in two main domains: personal factors and environmental factors. Among the personal factors, we discuss the behavioral strategies that can be used by athletes: nutrition, non-ingestive oral habits, water immersion, body temperature reduction, sleeping habits, relaxation methods, cognitive techniques, praying, music, and exercise. Among environmental factors, we discuss those linked to the social (i.e., contact with humans and animals) and physical (i.e., aromas, lights, sounds, temperature, outdoor, altitude) environment. Future research directions are given, as well as practical implications for athletes and coaches.

Association of Use of Omega-3 Polyunsaturated Fatty Acids With Changes in Severity of Anxiety Symptoms: A Systematic Review and Meta-analysis

IMPORTANCE

No systematic review or meta-analysis has assessed the efficacy of omega-3 polyunsaturated fatty acids (PUFAs) for anxiety.

OBJECTIVE

To evaluate the association of anxiety symptoms with omega-3 PUFA treatment compared with controls in varied populations.

DATA SOURCES

PubMed, Embase, ProQuest, ScienceDirect, Cochrane Library, ClinicalKey, Web of Science, and ClinicalTrials.gov databases were searched up to March 4, 2018.

STUDY SELECTION

A search was performed of clinical trials assessing the anxiolytic effect of omega-3 PUFAs in humans, in either placebo-controlled or non-placebo-controlled designs. Of 104 selected articles, 19 entered the final data extraction stage.

DATA EXTRACTION AND MEASURES

Two authors independently extracted the data according to a predetermined list of interests. A random-effects model meta-analysis was performed and this study was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.

MAIN OUTCOMES AND MEASURES

Changes in the severity of anxiety symptoms after omega-3 PUFA treatment.

RESULTS

In total, 1203 participants with omega-3 PUFA treatment (mean age, 43.7 years; mean female proportion, 55.0%; mean omega-3 PUFA dosage, 1605.7 mg/d) and 1037 participants without omega-3 PUFA treatment (mean age, 40.6 years; mean female proportion, 55.0%) showed an association between clinical anxiety symptoms among participants with omega-3 PUFA treatment compared with control arms (Hedges g, 0.374; 95% CI, 0.081-0.666; P = .01). Subgroup analysis showed that the association of treatment with reduced anxiety symptoms was significantly greater in subgroups with specific clinical diagnoses than in subgroups without clinical conditions. The anxiolytic effect of omega-3 PUFAs was significantly better than that of controls only in subgroups with a higher dosage (at least 2000 mg/d) and not in subgroups with a lower dosage (<2000 mg/d).

CONCLUSIONS AND RELEVANCE

This review indicates that omega-3 PUFAs might help to reduce the symptoms of clinical anxiety. Further well-designed studies are needed in populations in whom anxiety is the main symptom.

Omega-3 Fatty Acid Supplementation Improves Heart Rate Variability in Obese Children

Obese children and adolescents are at high risk of developing cardiovascular diseases later in life. We hypothesized that cardiovascular prophylaxis with omega-3 fatty acids could benefit them. In our study, 20 children and adolescents (mean body mass index percentile: 99.1; mean age: 11.0 years) underwent two ambulatory 24 h Holter electrocardiography (ECG) recordings (before and after at least 3 months of omega-3 fatty acid supplementation). Time domain heart rate variability (HRV) and heart rate (HR) were examined for these patients. As a control, we used 24 h Holter ECG recordings of 94 nonobese children and adolescents. Time domain HRV parameters, which are indicators of vagal stimulation, were significantly lower in obese patients than in healthy controls, but HR was higher (standard deviation of the normal-to-normal [SDNN] interbeat intervals: −34.02%; root mean square of successive differences [RMSSD] between normal heartbeats: −40.66%; percentage of consecutive RR intervals [pNN50]: −60.24%; HR: +13.37%). After omega-3 fatty acid supplementation, time domain HRV parameters and HR of obese patients were similar to the values of healthy controls (SDNN interbeat intervals: −21.73%; RMSSD: −19.56%; pNN50: −25.59%; HR: +3.94%). Therefore, omega-3 fatty acid supplementation may be used for cardiovascular prophylaxis in obese children and adolescents.

Protective Effects of ω-3 PUFA in Anthracycline-Induced Cardiotoxicity: A Critical Review

It has been demonstrated that ω-3 polyunsaturated fatty acids (ω-3 PUFA) may exert a beneficial role as adjuvants in the prevention and treatment of many disorders, including cardiovascular diseases and cancer. Particularly, several in vitro and in vivo preclinical studies have shown the antitumor activity of ω-3 PUFA in different kinds of cancers, and several human studies have shown that ω-3 PUFA are able to decrease the risk of a series of cardiovascular diseases. Several mechanisms have been proposed to explain their pleiotropic beneficial effects. ω-3 PUFA have also been shown to prevent harmful side-effects (including cardiotoxicity and heart failure) induced by conventional and innovative anti-cancer drugs in both animals and patients. The available literature regarding the possible protective effects of ω-3 PUFA against anthracycline-induced cardiotoxicity, as well as the mechanisms involved, will be critically discussed herein. The study will analyze the critical role of different levels of ω-3 PUFA intake in determining the results of the combinatory studies with anthracyclines. Suggestions for future research will also be considered.

Characteristics of pork belly consumption in South Korea and their health implication

Fresh pork belly is a highly popular meat in South Korea, accounting for 59 % of the approximately 100 g of meat per capita that is consumed daily. Fresh pork belly offers not only high-quality protein from the lean cuts but also substantial micronutrients including fat-soluble vitamins and minerals. However, fresh pork belly generally consists of about 30 % fat, with saturated fatty acids representing half of this value. Excessive consumption of saturated fatty acids increases total cholesterol, low-density lipoprotein-cholesterol, and triglycerides while decreasing high-density lipoprotein-cholesterol, raising concerns about an increased risk of hyperlipidemia, followed by cardiovascular diseases. In this review, we discuss the consumption and production trends in South Korea, the general characteristics, and health issues related to fresh pork belly to delineate the features of pork production and consumer welfare.

The autonomic nervous system and cardiovascular disease: role of n-3 PUFAs

In the last decades, a large body of experimental and clinical evidence has been accumulated showing that cardiovascular diseases are often accompanied by an imbalance in the sympathetic-vagal outflow to the heart, resulting in a chronic adrenergic activation. The arterial baroreceptor system is a key component of mechanisms contributing to the neural regulation of the cardiovascular system. Several methods have been proposed to assess autonomic activity by analyzing heart rate and blood pressure changes either spontaneously occurring or following provocations. The autonomic nervous system has been regarded as one of the putative mechanisms involved into the beneficial effects of exposure to n-3 fatty acids observed in epidemiological studies. The aim of the present review is to provide an update on the clinical evidence proposed so far linking exposure to n-3 fatty acids to autonomic nervous system modulation.

The effect of intranasal oxytocin administration on acute cold pressor pain: a placebo-controlled, double-blind, within-participants crossover investigation

BACKGROUND

This study examined the effect of synthetic oxytocin delivered intranasally on acute pain sensitivity using a placebo-controlled, double-blind, within-participant crossover design.

METHODS

Thirty-seven (18 were male) pain-free young adults underwent two laboratory sessions separated by 1 week. Each session consisted of baseline, administration, second baseline, pain, and recovery phases, completed in a fixed order. Participants were given an intransal administration of 40 IU oxytocin or placebo. Blood pressure and heart rate (HR) were measured at 1-minute intervals throughout each phase. Pain was induced by submersing the nondominant hand in cold (2°C) water. Pain threshold, intensity, unpleasantness, and Short-Form McGill Pain Questionnaire-2 pain descriptors were rated immediately after pain testing. Mood was assessed using visual analog scales after baseline, second baseline, and pain phases. The second laboratory session was identical to the first, with the exception that a different nasal spray was administered.

RESULTS

Participants reported lower pain intensity (50.57 [20.94] versus 56.73 [20.12], p = .047), pain unpleasantness (47.00 [27.24] versus 55.78 [22.46], p = .033), and Short-Form McGill Pain Questionnaire-2 pain descriptors (53.38 [31.18] versus 60.92 [31.17], p = .031) and higher pain threshold (45.70 [59.55] versus 38.35 [59.12], p = .040) after oxytocin administration relative to placebo. There was a nasal spray by phase interaction on HR (p = .006). Pain-related increase in HR was attenuated by oxytocin nasal spray. Systolic and diastolic blood pressure increased during pain testing but were unaffected by nasal spray.

CONCLUSIONS

These results suggest that oxytocin can lead to decreased acute pain sensitivity.

Dietary supplementation with either saturated or unsaturated fatty acids does not affect the mechanoenergetics of the isolated rat heart

It is generally recognized that increased consumption of polyunsaturated fatty acids, fish oil (FO) in particular, is beneficial to cardiac and cardiovascular health, whereas equivalent consumption of saturated fats is deleterious. In this study, we explore this divergence, adopting a limited purview: The effect of dietary fatty acids on the mechanoenergetics of the isolated heart per se. Mechanical indices of interest include left‐ventricular (LV) developed pressure, stroke work, cardiac output, coronary perfusion, and LV power. The principal energetic index is whole‐heart oxygen consumption, which we subdivide into its active and basal moieties. The primary mechanoenergetic index of interest is cardiac efficiency, the ratio of work performance to metabolic energy expenditure. Wistar rats were divided into three Diet groups and fed, ad libitum, reference (REF), fish oil‐supplemented (FO), or saturated fatty acid‐supplemented (SFA) food for 6 weeks. At the end of the dietary period, hearts were excised, mounted in a working‐heart rig, and their mechanoenergetic performance quantified over a range of preloads and afterloads. Analyses of Variance revealed no difference in any of the individual mechanoenergetic indices among the three Diet groups. In particular, we found no effect of prior dietary supplementation with either saturated or unsaturated fatty acids on the global efficiency of the heart.

Literature reports have claimed profound effects of dietary supplementation with either saturated or polyunsaturated fatty acids on the contractile efficiency of the heart – diminishing and enhancing efficiency, respectively. We have mimicked the experimental protocols used in those reports and find no effect of diet on any index of cardiac mechanoenergetics, including efficiency.

Global metabolomic profiling reveals an association of metal fume exposure and plasma unsaturated fatty acids

Background

Welding-associated air pollutants negatively affect the health of exposed workers; however, their molecular mechanisms in causing disease remain largely unclear. Few studies have systematically investigated the systemic toxic effects of welding fumes on humans.

Objectives

To explore the effects of welding fumes on the plasma metabolome, and to identify biomarkers for risk assessment of welding fume exposure.

Methods

The two-stage, self-controlled exploratory study included 11 boilermakers from a 2011 discovery panel and 8 boilermakers from a 2012 validation panel. Plasma samples were collected pre- and post-welding fume exposure and analyzed by chromatography/mass spectrometry.

Results

Eicosapentaenoic or docosapentaenoic acid metabolic changes post-welding were significantly associated with particulate (PM_2.5) exposure (p<0.05). The combined analysis by linear mixed-effects model showed that exposure was associated with a statistically significant decline in metabolite change of eicosapentaenoic acid [(95% CI) = −0.013(−0.022∼−0.004); p = 0.005], docosapentaenoic acid n₃ [(95% CI) = −0.010(−0.018∼−0.002); p = 0.017], and docosapentaenoic acid n₆ [(95% CI) = −0.007(−0.013∼−0.001); p = 0.021]. Pathway analysis identified an association of the unsaturated fatty acid pathway with exposure (p_Study−₂₀₁₁ = 0.025; p_Study−₂₀₁₂ = 0.021; p_Combined = 0.009). The functional network built by these fatty acids and their interactive genes contained significant enrichment of genes associated with various diseases, including neoplasms, cardiovascular diseases, and lipid metabolism disorders.

Conclusions

High-dose exposure of metal welding fumes decreases unsaturated fatty acids with an exposure-response relationship. This alteration in fatty acids is a potential biological mediator and biomarker for exposure-related health disorders.