Omega-3: The good oil

Hyaluronic acid-poly(glyceryl)10-stearate nanoemulsion for co-delivery of fish oil and resveratrol: Enhancing bioaccessibility and antioxidant potency

Hyaluronic acid (HA), an endogenous polysaccharide comprising alternating D-glucuronic acid and N-acetylglucosamine units, is renowned for its high hydrophilicity, biocompatibility, and biodegradability. These attributes have rendered HA invaluable across medical and drug delivery fields. HA can be altered through physical, chemical, or enzymatic methods to improve the properties of the modified substances. In this work, we synthesized a derivative via the esterification of HA with poly(glyceryl)10-stearate (PG10-C18), designated as HA-PG10-C18. This novel derivative was employed to fabricate a nano co-delivery system (HA-PG10-C18@Res-NE) for fish oil and resveratrol (Res), aiming to enhance their stability and bioaccessibility. An exhaustive investigation of HA-PG10-C18@Res-NE revealed that the HA-modified system displayed superior physicochemical stability, notably in withstanding oxidation and neutralizing free radicals. Moreover, in vitro simulated digestion underscored the system's enhanced bioaccessibility of Res and more efficient release of free fatty acids. These outcomes underscore the strategic advantage of HA in modifying PG10-C18 for nanoemulsion formulation. Consequently, HA-PG10-C18 stands as a promising emulsifier for encapsulating lipophilic bioactives in functional foods, nutraceuticals, and pharmaceuticals.

Athletes Can Benefit from Increased Intake of EPA and DHA-Evaluating the Evidence

Fatty fish, which include mackerel, herring, salmon and sardines, and certain species of algae (e.g., Schizochytrium sp., Crytthecodiniumcohnii and Phaeodactylumtricornutum) are the only naturally rich sources of the omega-3 polyunsaturated fatty acids (n-3 PUFAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). EPA and DHA are the most biologically active members of the n-3 PUFA family. Limited dietary sources and fluctuating content of EPA and DHA in fish raise concerns about the status of EPA and DHA among athletes, as confirmed in a number of studies. The beneficial effects of EPA and DHA include controlling inflammation, supporting nervous system function, maintaining muscle mass after injury and improving training adaptation. Due to their inadequate intake and beneficial health-promoting effects, athletes might wish to consider using supplements that provide EPA and DHA. Here, we provide an overview of the effects of EPA and DHA that are relevant to athletes and discuss the pros and cons of supplements as a source of EPA and DHA for athletes.

Dietary trends among Polish women in 2011-2022-cross-sectional study of food consumption frequency among women aged 20-50 in Silesia region, Poland

Background

Women's nutrition should be different from that of men. Women have lower energy requirements than men. And the need for certain vitamins and minerals is higher in women, this applies to iron, calcium, magnesium, vitamin D and vitamin B9 (folic acid). This is related to hormonal changes including menstruation, pregnancy, breastfeeding and the onset of menopause. Through hormonal changes and the changing physiological state, women are at greater risk of anaemia, bone weakness and osteoporosis.The aim of the study was to assess changes in the dietary pattern among women from the Silesian Agglomeration in Poland between 2011 and 2022.

Material and method

The survey was conducted in 2011 (March-May 2011) and in 2022 (October-November 2022) among women living in the Silesian Agglomeration (Silesia region) in Poland aged 20-50. After consideration of the inclusion and exclusion criteria, 745 women were included in the final analysis, including 437 women screened in 2011 and 308 women screened in 2022.The research tool used in this publication was a survey questionnaire consisting of 2 parts. The first part of the questionnaire consisted of demographic data. The second part of the study focused on the dietary habits of the women surveyed and the frequency of consumption of individual foods (FFQ).

Results

More women in 2022 ate breakfast than in 2011 (77.6% vs. 63.8% p < 0.001), were more likely to eat breakfast I at home (73.1% vs. 62.5%; p < 0.001), were more likely to eat breakfast II (39.0% vs. 35.2%; p = 0.001), were more likely to eat breakfast II at home (28.6% vs. 19.2%; p = 0.002), and were more likely to eat lunch at work (16.6% vs. 3.4%; p < 0.001). Women in 2022 were more likely to consume fast-food (p = 0.001), salty snacks (chips, crisps) (p < 0.001) and sweets (p < 0.001). Women in 2022 were more likely to consume whole-grain bread (p < 0.001), wholemeal pasta (p < 0.001), brown rice (p < 0.001), oatmeal (p < 0.001), buckwheat groats (p = 0.06), and bran (p < 0.001) than women in 2011. They were less likely to consume white bread (p < 0.0001), light pasta (p = 0.004), white rice (p = 0.008) and cornflakes (p < 0.001) in 2022.Women in 2022 were significantly more likely to consume vegetables (p < 0.001) than women in 2011.

Conclusion

Eating habits in Silesia region women changed between 2011 and 2022. In 2022, women were more likely to choose cereal products considered health-promoting and rich in dietary fiber (including whole-grain bread, whole-grain pasta, oatmeal, bran) were more likely to consume vegetables, dry pulses and vegetarian dinners, and consumed less meat, cured meats, fish and dairy products. Consumption of fast-food, salty snacks (such as chips) and sweets increased.

Global Impacts of Western Diet and Its Effects on Metabolism and Health: A Narrative Review

The Western diet is a modern dietary pattern characterized by high intakes of pre-packaged foods, refined grains, red meat, processed meat, high-sugar drinks, candy, sweets, fried foods, conventionally raised animal products, high-fat dairy products, and high-fructose products. The present review aims to describe the effect of the Western pattern diet on the metabolism, inflammation, and antioxidant status; the impact on gut microbiota and mitochondrial fitness; the effect of on cardiovascular health, mental health, and cancer; and the sanitary cost of the Western diet. To achieve this goal, a consensus critical review was conducted using primary sources, such as scientific articles, and secondary sources, including bibliographic indexes, databases, and web pages. Scopus, Embase, Science Direct, Sports Discuss, ResearchGate, and the Web of Science were used to complete the assignment. MeSH-compliant keywords such "Western diet", "inflammation", "metabolic health", "metabolic fitness", "heart disease", "cancer", "oxidative stress", "mental health", and "metabolism" were used. The following exclusion criteria were applied: (i) studies with inappropriate or irrelevant topics, not germane to the review's primary focus; (ii) Ph.D. dissertations, proceedings of conferences, and unpublished studies. This information will allow for a better comprehension of this nutritional behavior and its effect on an individual's metabolism and health, as well as the impact on national sanitary systems. Finally, practical applications derived from this information are made.

Effect of fish oil and canola oil supplementation on immunological parameters, feed intake, and growth of Holstein calves

Supplemental n-3 fatty acids (FA) may support better immune responses than n-6 and n-9 FA in dairy calves. The objective was to evaluate the effect of n-3 FA, supplemented as a fish oil product (FO) in the milk replacer (MR), in comparison to n-6 and n-9 FA, supplemented as canola oil (CO), on body weight (BW), daily gain, and immunological parameters of preweaning Holstein calves. The study was conducted from September to December 2019. Calves were randomly allocated to a control group (n = 15; BW = 36.2 ± 1.5 kg; mean ± SEM) supplemented daily with 30 mL of CO and to an experimental group (n = 15; BW = 36.3 ± 1.5 kg) supplemented with 60 g of a product containing 30 g of FO. Both treatments were added to the MR during the morning feeding. All calves were fed 4 L of MR at 12.5% solids at 0700 and 1600 h for wk 1, 6 L from wk 2 to 7, and 3 L once daily (0700 h) during wk 8 until weaning (56 d). Blood samples were collected at 7, 14, 21, 28, 35, 42, 49, and 56 d of age for serum haptoglobin, TNF-α, IL-1β, and protectin. Dry matter intake was recorded in all experimental calves daily. Seroneutralization titers to vaccination against viral diseases (infectious bovine rhinotracheitis, parainfluenza 3, bovine viral diarrhea, and bovine respiratory syncytial virus) were determined. Mixed models for repeated measures were developed to analyze variables over time. Seroneutralization titers were analyzed by the Kruskal-Wallis test. The other variables were compared by a generalized linear model. Serum FA profile at 35 d of age showed that FO supported higher concentrations of n-3 FA than CO. Final BW [65.2 vs. 62.0 kg, standard error of the mean (SEM) = 2.1 kg] and average daily gain (0.52 vs. 0.46 kg/d, SEM = 0.1 kg/d) tended to be higher for the FO than the CO group. An interaction of treatment × day for dry matter intake was observed, especially during weaning (2.17 kg vs. 1.94 kg, SEM = 0.158 kg, for FO and CO group, respectively). Blood lactate (mmol/L) was higher in the CO than in the FO group at d 7. Haptoglobin and IL-1β were higher for the CO group on d 14 than the FO group. The TNF- α concentrations for the FO group were reduced over time, whereas the concentrations in the CO group remained constant. Protectin was higher in the FO group on d 14, but was lower on d 28, 35, and 49. Seroneutralization antibody titers postvaccination for the PI₃ virus were higher for the FO than the CO group. In conclusion, calves supplemented with FO had lower concentrations of blood lactate, haptoglobin, IL-1β and TNF-α than calves supplemented with CO during the study period. The FO supplementation had a higher DMI than CO supplementation. Results of this trial should be interpreted with caution due to the lack of a negative control group as well as the lower birth weight and growth rate observed under heat stress conditions.

Regulation of Neutrophil Function by Marine n-3 Fatty Acids-A Mini Review

While normal functioning neutrophils contribute in various, critical ways to the maintenance of a stable immune system, their hypo- or hyper-activation has been implicated in the onset or exacerbation of multiple inflammatory conditions often affecting the vulnerable, aging population. As such, many would benefit from interventions capable of targeting neutrophils in disease-specific ways without disrupting their primary role in maintaining immune function. After consumption, marine omega-3 fatty acids are rapidly incorporated into the phospholipid bilayer of neutrophils, changing the fatty acid composition and consequently modifying neutrophil function. In addition to eicosanoid synthesis, the mechanisms by which marine n-3 fatty acids and their metabolites alter neutrophil function involve blockage of transcription factors that subsequently reduce pro-inflammatory gene expression by neutrophils and through the disruption of lipid rafts. In the current mini-review, a brief explanation of marine n-3 fatty acid metabolism is provided and the subsequent impact on neutrophil function is discussed. In addition, current evidence of the effects of marine n-3 fatty acid supplementation on neutrophil function from clinical trials conducted in the past 15 years is summarized.

Effects of omega-3 supplementation on muscle damage after resistance exercise in young women: a randomized placebo-controlled trial

BACKGROUND

Omega-3 is a nutritional strategie that have been used to recover muscles from exercise-induced muscle damage in a preventive perspective.

AIM

To verify whether omega-3 (ω-3) supplementation after a session of resistance exercise facilitates muscle recovery in women undergoing a balanced diet.

METHODS

This clinical trial was registered under the number NCT02839525. Thirty healthy women (22.2 ± 3.3 years) participated in this double-blinded, placebo-controlled trial. They were randomly distributed into ω-3 (n=15) and placebo (n=15) groups. They ingested ω-3 fish oil (3200 mg/day) or placebo (olive oil) at the dinner after the exercise bout (10 sets of 10 unilateral eccentric contractions in a knee extension chair), as well as at lunch for the three subsequent days. In addition, both groups followed a balanced diet along the four days. Muscle soreness and maximal isometric and isokinetic voluntary contractions were assessed immediately before, and 24, 48, and 72 hours after the resistance exercise.

MAIN FINDINGS

There was no significant group-time interaction for any outcome. Participants presented increased levels of muscle soreness and reduced muscle strength capacity along the three days after exercise. There was no difference between placebo and ω-3 groups.

CONCLUSION

Supplementation of ω-3 fish oil for three days after resistance exercise provided no additional benefits compared to placebo supplementation on recovery of healthy young women following a balanced diet.

Effect of omega-3 on painful symptoms of patients with osteoarthritis of the synovial joints: systematic review and meta-analysis

OBJECTIVES

The aim of this study was to determine the effect of omega-3 on the painful symptomatology of osteoarthritis (OA) in synovial joints.

STUDY DESIGN

An electronic/manual search was conducted (2004-2019). Using pain as a primary outcome and stiffness/function and swelling as secondary outcomes, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, Consolidated Standards of Reporting Trials (CONSORT) reporting quality, and Cochrane/RoB-2 risk of bias assessment. Data were processed using RevMan v5.2 (Cochrane Collaboration).

RESULTS

Six randomized controlled trials were selected. The study population included 454 patients with OA. In 4 studies the pain in the intervention group presented significant pain reduction compared with the control group (mean difference = 22.89; 95% confidence interval, 3.37-42.42). Studies did not stablish the effective anti-inflammatory dose. The number of studies on stiffness/function and inflammation was low (n = 2). The evidence and degree of recommendation was 2B. The randomized controlled trials presented high clinical and methodological variability.

CONCLUSION

Omega-3 can significantly reduce painful symptoms in patients suffering from OA in synovial joints. However, the limited number of studies, range of doses, intervention periods, baseline characteristics of patients, and asymmetry in reporting bias, combined with the heterogeneity in the combined effect of the studies, offer low-quality evidence on which clinical guidance cannot be based.

Salmon oil supplementation in dogs affects the blood flow of testicular arteries

The administration of fish oils is known to cause changes in several reproductive parameters of domestic animals. The ingestion of polyunsaturated fatty acids (PUFAs) of the omega-3 family, such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), has been described and correlated with changes in the semen quality, testosterone levels and male fertility. Nevertheless, few studies monitored and registered effects after ceasing supplementation. In the present study, we monitored the Doppler velocimetric and ultrasonographic parameters of nine dogs' testis for 90 days (D90) checking the effect of salmon oil supplementation, and monitoring continued for 60 days more, after ceasing supplementation (D150). Ultrasonographic evaluations comprised determining the Doppler velocimetric parameters, testicular and epididymal volume, and testicular echotexture. Peak systolic velocity (PSV) as well as final diastolic velocity (EDV) in the supratesticular arteries (STA), and marginal artery (MA) increased during the period of treatment and kept that level up to D150. There was no difference between the fish-oil supplementation period and the unsupplemented one regarding the testicular and epididymal volume and echogenicity and heterogeneity characteristics. A negative correlation was found between heterogeneity of testis and sperm production (r = -.41, p = .008). Doppler velocimetry indices were affected by the supplementation, leading to an increase in testicular blood flow.

A High Dietary Incorporation Level of Chlorella vulgaris Improves the Nutritional Value of Pork Fat without Impairing the Performance of Finishing Pigs

Simple Summary

Pork is one of the most consumed meats worldwide but its production and quality are facing significant challenges, including feeding sustainability and the unhealthy image of fat. In fact, corn, and soybean, the two main conventional feedstuffs for pig production, are in unsustainable competition with the human food supply and biofuel industry. Moreover, the nutritional value of pork lipids is small due to their low contents of the beneficial n-3 polyunsaturated fatty acids and lipid-soluble antioxidants. The inclusion of microalgae in pig diets represents a promising approach for the development of sustainable pork production and the improvement of its quality. The current study aimed to investigate the impact of Chlorella vulgaris as ingredient (5% in the diet), alone and in combination with carbohydrases, on growth performance, carcass characteristics and pork quality traits in finishing pigs. Our data indicate that the use of 5% C. vulgaris in finishing pig diets does not impair animal growth and ameliorates the nutritional value of pork. Therefore, C. vulgaris could be used advantageously as an alternative sustainable ingredient in swine feeding.

Abstract

The influence of a high inclusion level of Chlorella vulgaris, individually and supplemented with two carbohydrase mixtures, in finishing pig diets was assessed on zootechnical performance, carcass characteristics, pork quality traits and nutritional value of pork fat. Forty crossbred entire male pigs, sons of Large White × Landrace sows crossed with Pietrain boars, with an initial live weight of 59.1 ± 5.69 kg were used in this trial. Swines were randomly assigned to one of four dietary treatments (n = 10): cereal and soybean meal-based diet (control), control diet with 5% C. vulgaris (CV), CV diet supplemented with 0.005% Rovabio^® Excel AP (CV + R) and CV diet supplemented with 0.01% of a four-CAZyme mixture (CV + M). Animals were slaughtered, after the finishing period, with a BW of 101 ± 1.9 kg. Growth performance, carcass characteristics and meat quality traits were not influenced (p > 0.05) by the incorporation of C. vulgaris in the diets. However, the inclusion of the microalga in finishing pig diets increased some lipid-soluble antioxidant pigments and n-3 PUFA, and decreased the n-6:n-3 ratio of fatty acids, thus ameliorating the nutritional value of pork fat. Moreover, the supplementation of diets with the carbohydrase mixtures did not change (p > 0.05) neither animal performance nor meat quality traits, indicating their inefficacy in the increase of digestive utilization of C. vulgaris by pigs under these experimental conditions. It is concluded that the use of C. vulgaris in finishing pig diets, at this high incorporation level, improves the nutritional value of pork fat without compromising pig performance.

DHA from microalgae Schizochytrium spp. (Thraustochytriaceae) modifies the inflammatory response and gonadal lipid profile in domestic cats

The present study aimed to evaluate the inflammatory response, oxidative status and fatty acid deposition in reproductive tissues of cats supplemented with the dried microalgae Schizochytrium spp. (Thraustochytriaceae) as a DHA source. Thirty-seven cats (males, n 21; females, n 16; 11·5 (sd 0·5) months of age) were divided by sex into five groups. Treatment diets contained algae biomass at 4·0, 8·0, 12·0 or 16·0 g/kg replacing poultry fat (n-6 source). Cats were fed the respective diet for 62 d and neutered on day 58. Blood samples were collected at the beginning of the experiment (day 1), before neutering (day 58) and 4 d after surgery (day 62) for analysis of inflammation and oxidative markers. Acute-phase protein levels were altered (P < 0·01) in the postoperative period, without any treatment effect (P > 0·05). PGE2 concentrations after surgery were reduced linearly (R2 0·8706; P = 0·002) with microalgal inclusion. Blood platelet count was reduced (P = 0·001) after the surgery regardless treatment, but it was higher in the DHA group compared with control (P < 0·001). The DHA deposition (testicles, R2 0·846; ovaries, R2 0·869) and the n-6:n-3 ratio (testicles, R2 0·859; ovaries, R2 0·955) in gonads had a pattern which fitted a quadratic model. DHA from Schizochytrium spp. modifies PGE2 response after the surgery in cats. The physiological roles of the DHA in the reproduction of cats were not investigated, but its gonadal deposition after supplementation was observed.

Defining a Healthy Diet: Evidence for The Role of Contemporary Dietary Patterns in Health and Disease

The definition of what constitutes a healthy diet is continually shifting to reflect the evolving understanding of the roles that different foods, essential nutrients, and other food components play in health and disease. A large and growing body of evidence supports that intake of certain types of nutrients, specific food groups, or overarching dietary patterns positively influences health and promotes the prevention of common non-communicable diseases (NCDs). Greater consumption of health-promoting foods and limited intake of unhealthier options are intrinsic to the eating habits of certain regional diets such as the Mediterranean diet or have been constructed as part of dietary patterns designed to reduce disease risk, such as the Dietary Approaches to Stop Hypertension (DASH) or Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets. In comparison with a more traditional Western diet, these healthier alternatives are higher in plant-based foods, including fresh fruits and vegetables, whole grains, legumes, seeds, and nuts and lower in animal-based foods, particularly fatty and processed meats. To better understand the current concept of a “healthy diet,” this review describes the features and supporting clinical and epidemiologic data for diets that have been shown to prevent disease and/or positively influence health. In total, evidence from epidemiological studies and clinical trials indicates that these types of dietary patterns reduce risks of NCDs including cardiovascular disease and cancer.

Effect of omega-3 fatty acids and fish oil supplementation on multiple sclerosis: a systematic review

Background: Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system, resulting in the degradation of the myelin sheath. Diet especially fish oils and omega-3 has been found to play an important role in MS. This work aimed to review the literature systematically for evidence on the effect of omega-3 fatty acids (EPA, DPA and DHA) on MS progression in adults.Methods: The literature search was conducted in PubMed, Oxford, Cochrane, Embase, International pharmaceutical abstract, PsychINFO, and clinical trials government. The inclusions were studies performed on humans both male and female, aged 18 years at minimum, diagnosed with MS according to McDonald 2010 criteria. Otherwise, all studies were excluded.Results: A total of 5554 studies were screened and seven were thoroughly focused on as they typically met the inclusion criteria. These studies showed the beneficial roles of fish oil supplementation and omega-3 fatty acids in improving the quality of life of MS patients. These roles were attributed to their beneficial effects on inflammatory markers, glutathione reductase, reducing the relapsing rate, and achieving balanced omega-6 to omega-3 ratios.Conclusion: Omega-3 and fish oils supplementations have beneficial effects on reducing the relapsing rate, inflammatory markers, and improving the quality of life for MS patients.

Oral administration of EPA-rich oil impairs collagen reorganization due to elevated production of IL-10 during skin wound healing in mice

Wound healing is an essential process for organism survival. Some fatty acids have been described as modulators of wound healing. However, the role of omega-3 fatty acids is unclear. In the present work, we investigate the effects of oral administration of eicosapentaenoic acid (EPA)-rich oil on wound healing in mice. After 4 weeks of EPA-rich oil supplementation (2 g/kg of body weight), mice had increased serum concentrations of EPA (20:5ω-3) (6-fold) and docosahexaenoic acid (DHA; 22:6ω-3) (33%) in relation to control mice. Omega-3 fatty acids were also incorporated into skin in the EPA fed mice. The wound healing process was delayed at the 3rd and 7th days after wounding in mice that received EPA-rich oil when compared to control mice but there was no effect on the total time required for wound closure. Collagen reorganization, that impacts the quality of the wound tissue, was impaired after EPA-rich oil supplementation. These effects were associated with an increase of M2 macrophages (twice in relation to control animals) and interleukin-10 (IL-10) concentrations in tissue in the initial stages of wound healing. In the absence of IL-10 (IL-10-/- mice), wound closure and organization of collagen were normalized even when EPA was fed, supporting that the deleterious effects of EPA-rich oil supplementation were due to the excessive production of IL-10. In conclusion, oral administration of EPA-rich oil impairs the quality of wound healing without affecting the wound closure time likely due to an elevation of the anti-inflammatory cytokine IL-10.

Intravenous Lipid Emulsions to Deliver Bioactive Omega-3 Fatty Acids for Improved Patient Outcomes

Lipids used in intravenous nutrition support (i.e., parenteral nutrition) provide energy, building blocks, and essential fatty acids. These lipids are included as emulsions since they need to be soluble in an aqueous environment. Fish oil is a source of bioactive omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid). Lipid emulsions, including fish oil, have been used for parenteral nutrition for adult patients post-surgery (mainly gastrointestinal). This has been associated with alterations in biomarkers of inflammation and immune defense, and in some studies, a reduction in length of intensive care unit and hospital stay. These benefits, along with a reduction in infections, are emphasized through recent meta-analyses. Perioperative administration of fish oil may be superior to postoperative administration, but this requires further exploration. Parenteral fish oil has been used in critically ill adult patients. Here, the influence on inflammatory processes, immune function, and clinical endpoints is less clear. However, some studies found reduced inflammation, improved gas exchange, and shorter length of hospital stay in critically ill patients if they received fish oil. Meta-analyses do not present a consistent picture but are limited by the small number and size of studies. More and better trials are needed in patient groups in which parenteral nutrition is used and where fish oil, as a source of bioactive omega-3 fatty acids, may offer benefits.

Current feeding strategies to improve pork intramuscular fat content and its nutritional quality

Pork, one of the most consumed meats worldwide, has been facing major challenges regarding its low sensory quality and unhealthy image of fat. This chapter addresses current feeding strategies to ameliorate pork sensory attributes and nutritional quality by increasing intramuscular fat deposition and improving fatty acid composition, respectively. Dietary protein reduction, alone or combined with some components, contributes to satisfy consumer requirements and enhances the competitiveness of the meat industry with higher pork quality and lower production costs. In addition, feeding sources of n-3 polyunsaturated fatty acids to pigs, mainly from marine origin (rich in eicosapentaenoic and docosahexaenoic acids), increases their content in pork, thus improving the health value of its fatty acid profile. In the near future, the inclusion of microalgae and seaweeds in feed represents a promising approach for the maintenance and development of the livestock sector, as an environmental friendly alternative to balance food and feed industries.

Dispelling myths about intravenous fish oil-based lipid emulsions: a clinical perspective

PURPOSE OF REVIEW

Intravenous lipid emulsions (IVLEs) are an essential component of parenteral nutrition. With the recent incorporation of new lipid emulsions into the Canadian and American market, the clinician responsible for prescribing these lipids should be educated regarding the different fatty acid (FA) profiles of these lipids, as well as their metabolic and functional effects.

RECENT FINDINGS

New IVLEs contain a mix of soybean oil and olive oil, or a mix of soybean oil, coconut oil, olive oil and fish oil. These new lipid emulsions provide less essential fatty acids (FAs) (linoleic and alpha linolenic acids) than in pure soybean oil, yet incorporation of fish oil into an IVLE may decrease the amount of essential FAs required. Fish oil is a treatment for hypertriglyceridemia, and therefore, IVLEs that include fish oil may decrease serum triglycerides. Historical perspective is that fish oil can be associated with increased bleeding time. Evidence suggests that there is no association between fish oil and increased bleeding in patients, even those who are using anticoagulants. New IVLEs provide less vitamin K than soybean oil alone. Patients, or the parenteral nutrition solutions that include these new IVLEs should be supplemented with vitamin K.

SUMMARY

Canadian and American Guidelines for IVLEs were based on soybean oil. Current practice should be tailored to which IVLE is being prescribed.

Very long-chain n-3 fatty acids and human health: fact, fiction and the future

EPA and DHA appear to be the most important n-3 fatty acids, but roles for n-3 docosapentaenoic acid are now also emerging. Intakes of EPA and DHA are usually low, typically below those recommended. Increased intakes result in higher concentrations of EPA and DHA in blood lipids, cells and tissues. Increased content of EPA and DHA modifies the structure of cell membranes and the function of membrane proteins. EPA and DHA modulate the production of lipid mediators and through effects on cell signalling can alter the patterns of gene expression. Through these mechanisms, EPA and DHA alter cell and tissue responsiveness in a way that often results in more optimal conditions for growth, development and maintenance of health. DHA has vital roles in brain and eye development and function. EPA and DHA have a wide range of physiological roles, which are linked to certain health or clinical benefits, particularly related to CVD, cancer, inflammation and neurocognitive function. The benefits of EPA and DHA are evident throughout the life course. Future research will include better identification of the determinants of variation of responses to increased intake of EPA and DHA; more in-depth dose-response studies of the effects of EPA and DHA; clearer identification of the specific roles of EPA, docosapentaenoic acid and DHA; testing strategies to enhance delivery of n-3 fatty acids to the bloodstream; and exploration of sustainable alternatives to fish-derived very long-chain n-3 fatty acids.

Omega-3 fatty acids and inflammatory processes: from molecules to man

Inappropriate, excessive or uncontrolled inflammation contributes to a range of human diseases. Inflammation involves a multitude of cell types, chemical mediators and interactions. The present article will describe nutritional and metabolic aspects of omega-6 (n-6) and omega-3 (n-3) fatty acids and explain the roles of bioactive members of those fatty acid families in inflammatory processes. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are n-3 fatty acids found in oily fish and fish oil supplements. These fatty acids are capable of partly inhibiting many aspects of inflammation including leucocyte chemotaxis, adhesion molecule expression and leucocyte–endothelial adhesive interactions, production of eicosanoids like prostaglandins and leukotrienes from the n-6 fatty acid arachidonic acid and production of pro-inflammatory cytokines. In addition, EPA gives rise to eicosanoids that often have lower biological potency than those produced from arachidonic acid, and EPA and DHA give rise to anti-inflammatory and inflammation resolving mediators called resolvins, protectins and maresins. Mechanisms underlying the anti-inflammatory actions of EPA and DHA include altered cell membrane phospholipid fatty acid composition, disruption of lipid rafts, inhibition of activation of the pro-inflammatory transcription factor nuclear factor κB so reducing expression of inflammatory genes and activation of the anti-inflammatory transcription factor peroxisome proliferator-activated receptor γ. Animal experiments demonstrate benefit from EPA and DHA in a range of models of inflammatory conditions. Human trials demonstrate benefit of oral n-3 fatty acids in rheumatoid arthritis and in stabilizing advanced atherosclerotic plaques. Intravenous n-3 fatty acids may have benefits in critically ill patients through reduced inflammation. The anti-inflammatory and inflammation resolving actions of EPA, DHA and their derivatives are of clinical relevance.