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Xiao Y, Chen Y, Pietzner A, Elbelt U, Fan Z, Weylandt KH. Circulating Omega-3 Polyunsaturated Fatty Acids Levels in Coronary Heart Disease: Pooled Analysis of 36 Observational Studies. Nutrients 2024; 16:1610. [PMID: 38892543 PMCID: PMC11174367 DOI: 10.3390/nu16111610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/19/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Long-chain n-3 polyunsaturated fatty acid (PUFA) supplementation has shown potential benefits in the prevention of coronary heart disease (CHD); however, the impact of omega-3 fatty acid levels on CHD risk remains a subject of debate. Here, we aimed to investigate the association between n-3 PUFA levels and the risk of CHD, with particular reference to the subtypes of n-3 PUFA. METHODS Prospective studies and retrospective case-control studies analyzing n-3 PUFA levels in CHD, published up to 30 July 2022, were selected. A random effects meta-analysis was used for pooled assessment, with relative risks (RRs) expressed as 95% confidence intervals (CIs) and standardized mean differences expressed as weight mean differences (WMDs). Subgroup and meta-regression analyses were conducted to assess the impact of n-3 PUFA exposure interval on the CHD subtype variables of the study. RESULTS We included 20 prospective studies (cohort and nested case-control) and 16 retrospective case-control studies, in which n-3 PUFAs were measured. Higher levels of n-3 PUFAs (ALA, EPA, DPA, DHA, EPA + DHA, total n-3 PUFAs) were associated with a reduced risk of CHD, with RRs (95% CI) of 0.89 (0.81, 0.98), 0.83 (0.72, 0.96); 0.80 (0.67,0.95), 0.75 (0.64, 0.87), 0.83 (0.73, 0.95), and 0.80 (0.70, 0.93), respectively, p < 0.05. CHD patients had significantly lower n-3 PUFA levels compared to healthy controls (p < 0.05). In the subgroup analysis, a significant inverse trend was found for both fatal CHD and non-fatal CHD with n-3 PUFA (EPA + DHA) levels. Also, the link between n-3 PUFA levels in erythrocytes with total CHD was generally stronger than other lipid pools. CONCLUSIONS n-3 PUFAs are significantly related to CHD risk, and these findings support the beneficial effects of n-3 PUFAs on CHD.
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Affiliation(s)
- Yanan Xiao
- Department of Medicine, Pingxiang People’s Hospital, Gannan Medical University, Pingxiang 337000, China;
- Division of Medicine, Department of Gastroenterology, Metabolism and Oncology, University Hospital Ruppin-Brandenburg, Brandenburg Medical School, 16816 Neuruppin, Germany
- Faculty of Health Sciences, Joint Faculty of the Brandenburg University of Technology, Brandenburg Medical School and University of Potsdam, 14467 Potsdam, Germany
| | - Yifang Chen
- Division of Medicine, Department of Gastroenterology, Metabolism and Oncology, University Hospital Ruppin-Brandenburg, Brandenburg Medical School, 16816 Neuruppin, Germany
- Faculty of Health Sciences, Joint Faculty of the Brandenburg University of Technology, Brandenburg Medical School and University of Potsdam, 14467 Potsdam, Germany
| | - Anne Pietzner
- Division of Medicine, Department of Gastroenterology, Metabolism and Oncology, University Hospital Ruppin-Brandenburg, Brandenburg Medical School, 16816 Neuruppin, Germany
- Faculty of Health Sciences, Joint Faculty of the Brandenburg University of Technology, Brandenburg Medical School and University of Potsdam, 14467 Potsdam, Germany
| | - Ulf Elbelt
- Division of Medicine, Department of Gastroenterology, Metabolism and Oncology, University Hospital Ruppin-Brandenburg, Brandenburg Medical School, 16816 Neuruppin, Germany
- Medical Department, Division of Psychosomatic Medicine, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Zhimin Fan
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing 100029, China
| | - Karsten H. Weylandt
- Division of Medicine, Department of Gastroenterology, Metabolism and Oncology, University Hospital Ruppin-Brandenburg, Brandenburg Medical School, 16816 Neuruppin, Germany
- Faculty of Health Sciences, Joint Faculty of the Brandenburg University of Technology, Brandenburg Medical School and University of Potsdam, 14467 Potsdam, Germany
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Jayedi A, Soltani S, Emadi A, Ghods K, Shab-Bidar S. Dietary intake, biomarkers and supplementation of fatty acids and risk of coronary events: a systematic review and dose-response meta-analysis of randomized controlled trials and prospective observational studies. Crit Rev Food Sci Nutr 2023:1-20. [PMID: 37632423 DOI: 10.1080/10408398.2023.2251583] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/28/2023]
Abstract
We aimed to review the association of dietary fats and risk of coronary events in adults. We searched PubMed, Embase, CENTRAL, Scopus, and Web of Sciences to April 2022 for prospective cohorts and randomized trials investigating the association of dietary intake and biomarkers of fats and fatty acid interventions and the risk of coronary events. We performed random-effects meta-analyses to estimate relative risk (RR) for the top versus bottom tertiles of exposures. One-hundered sixty-five prospective cohorts and randomized trials were included. Dietary intake and biomarkers of total fat and saturated, monounsaturated, and polyunsaturated fatty acids were not associated with the risk of coronary events. Dietary intake of trans fatty acids, palmitic acid, stearic acid, and saturated fatty acids from meat and unprocessed meat was modestly associated with a higher risk and, in contrast, intake of alpha-linolenic acid, long-chain omega-3 fatty acids, and linoleic acid was modestly associated with a lower risk. Supplementation with long-chain omega-3 fatty acids and increasing the consumption of alpha-linolenic and linoleic acids in place of saturated fats reduced the risk of coronary events. Existing evidence, in its totality, provides a modest support in favor of current recommendations suggesting replacement of saturated fats with polyunsaturated fats.
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Affiliation(s)
- Ahmad Jayedi
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepideh Soltani
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Alireza Emadi
- Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran
| | - Kamran Ghods
- School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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3
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Hierons SJ, Abbas K, Sobczak AIS, Cerone M, Smith TK, Ajjan RA, Stewart AJ. Changes in plasma free fatty acids in obese patients before and after bariatric surgery highlight alterations in lipid metabolism. Sci Rep 2022; 12:15337. [PMID: 36097032 PMCID: PMC9468139 DOI: 10.1038/s41598-022-19657-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022] Open
Abstract
Obesity is a complex disease that increases an individual’s risk of developing other diseases and health-related problems. A common feature is dyslipidemia characterized by increased levels of plasma lipids, which include non-esterified fatty acids (NEFAs). The role of NEFAs in obesity-related morbidity is interesting as NEFAs constitute a reservoir of metabolic energy, are principal components of cell membranes and are precursors for signalling molecules. Bariatric surgery promotes sustained weight loss in severely obese patients, reducing the incidence and severity of co-morbidities. In this study we measure changes in circulating NEFA species in plasma samples taken from 25 obese individuals before and 9 months after Roux-en-Y gastric bypass surgery. The mean weight of the cohort reduced by 29.2% from 149.0 ± 25.1 kg pre-surgery to 105.5 ± 19.8 kg post-surgery and the BMI by 28.2% from 51.8 ± 6.3 kg/m2 pre-surgery to 37.2 ± 5.4 kg/m2. Mean glycated haemoglobin (HbA1c) reduced from 6.5 ± 1.3 to 5.5 ± 0.5%, consistent with the intervention leading to improved glycaemic control, particularly in those who were dysglycemic prior to surgery. Total and LDL cholesterol concentrations were markedly reduced following surgery. Concentrations of seven NEFAs were found to decrease 9 months after surgery compared to pre-surgery levels: myristate, palmitoleate, palmitate, linoleate, oleate, stearate and arachidonate. Bariatric surgery led to increased lipogenesis and elongase activity and decreased stearoyl-CoA desaturase 1 activity. This study therefore highlights metabolic changes that take place following gastric bypass surgery in severely obese patients.
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Affiliation(s)
- Stephen J Hierons
- School of Medicine, University of St Andrews, St Andrews, KY16 9TF, UK
| | - Kazim Abbas
- Renal Transplant Unit, Manchester Royal Infirmary, Manchester, UK
| | | | - Michela Cerone
- Biomedical Sciences Research Complex, University of St Andrews, St Andrews, KY16 9ST, UK
| | - Terry K Smith
- Biomedical Sciences Research Complex, University of St Andrews, St Andrews, KY16 9ST, UK
| | - Ramzi A Ajjan
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Alan J Stewart
- School of Medicine, University of St Andrews, St Andrews, KY16 9TF, UK.
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Bhargava S, de la Puente-Secades S, Schurgers L, Jankowski J. Lipids and lipoproteins in cardiovascular diseases: a classification. Trends Endocrinol Metab 2022; 33:409-423. [PMID: 35370062 DOI: 10.1016/j.tem.2022.02.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/15/2022]
Abstract
Lipids and lipoproteins, their metabolism, and their transport are essential contributing factors of cardiovascular disease (CVD) as they regulate plasma cholesterol concentration, enhancing cholesterol uptake by macrophages, leading to foam cell formation and ultimately resulting in plaque formation and inflammation. However, lipids and lipoproteins have cardioprotective functions as well, such as preventing oxidation of proatherogenic molecules and downregulating inflammatory proteins.
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Affiliation(s)
- Shruti Bhargava
- Institute of Molecular Cardiovascular Research, Medical Faculty, RWTH Aachen University, Aachen, Germany; Experimental Vascular Pathology, Cardiovascular Research Institute Maastricht (CARIM), University of Maastricht, Maastricht, The Netherlands
| | - Sofia de la Puente-Secades
- Institute of Molecular Cardiovascular Research, Medical Faculty, RWTH Aachen University, Aachen, Germany; Experimental Vascular Pathology, Cardiovascular Research Institute Maastricht (CARIM), University of Maastricht, Maastricht, The Netherlands
| | - Leon Schurgers
- Experimental Vascular Pathology, Cardiovascular Research Institute Maastricht (CARIM), University of Maastricht, Maastricht, The Netherlands
| | - Joachim Jankowski
- Institute of Molecular Cardiovascular Research, Medical Faculty, RWTH Aachen University, Aachen, Germany; Experimental Vascular Pathology, Cardiovascular Research Institute Maastricht (CARIM), University of Maastricht, Maastricht, The Netherlands.
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5
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Ren XL, Liu Y, Chu WJ, Li ZW, Zhang SS, Zhou ZL, Tang J, Yang B. Blood levels of omega-6 fatty acids and coronary heart disease: a systematic review and metaanalysis of observational epidemiology. Crit Rev Food Sci Nutr 2022; 63:7983-7995. [PMID: 35380474 DOI: 10.1080/10408398.2022.2056867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Individual omega-6 polyunsaturated fatty acids (PUFAs), principally linoleic acid (LA) and arachidonic acid (AA), may have differential impacts on cardiovascular risk. We aimed to summarize the up-to-date epidemiology evidence on the relationship between blood levels of omega-6 PUFAs and the risk of coronary heart disease (CHD). Population-based studies determining PUFA levels in blood were identified until May 2021 in PubMed, Embase, Web of Science, and Cochrane Library. Random-effects meta-analyses of cohorts comparing the highest versus lowest category were conducted to combine study-specific risk ratios (RRs) with 95% confidence intervals (CIs). Blood levels of omega-6 PUFAs were compared between the CHD case and non-case, presented as a weight mean difference (WMD). Twenty-one cohorts and eleven case-control studies were included. The WMD was -0.71 (95% CI: -1.20, -0.21) for LA and 0.08 (95% CI: -0.28, 0.43) for AA. LA levels were inversely associated with total CHD risk (RR: 0.85, 95% CI: 0.71, 1.00), but not AA. Each one-SD increase in LA levels resulted in 10% reductions in the risk of fatal CHD (RR: 0.90, 95% CI: 0.86, 0.95), but not in non-fatal CHD. Such findings highlight that the current recommendation for optimal intakes of omega-6 PUFAs (most LA) may offer a coronary benefit in primary prevention.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2022.2056867 .
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Affiliation(s)
- Xiao-Li Ren
- The Laboratory Animal Center, Wenzhou Medical University, Wenzhou, China
- Institute of Lipids Medicine, Wenzhou Medical University, Wenzhou, China
| | - Yang Liu
- The 1st School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
- School of Basic Medical Sciences, Southwest Medical University, Luzhou, China
| | - Wei-Jie Chu
- The 1st School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
| | - Ze-Wang Li
- The 1st School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
| | - Shuang-Shuang Zhang
- The 1st School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
| | - Zhi-Liang Zhou
- Institute of Lipids Medicine, Wenzhou Medical University, Wenzhou, China
- The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jun Tang
- Institute of Lipids Medicine, Wenzhou Medical University, Wenzhou, China
- Department of Food Science & Nutrition, Zhejiang University, Hangzhou, China
| | - Bo Yang
- Institute of Lipids Medicine, Wenzhou Medical University, Wenzhou, China
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
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Middleton ALO, Byrne JP, Calder PC. The Influence of Bariatric (Metabolic) Surgery on Blood Polyunsaturated Fatty Acids: A Systematic Review. Clin Nutr ESPEN 2022; 48:121-140. [DOI: 10.1016/j.clnesp.2022.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 01/27/2022] [Accepted: 02/02/2022] [Indexed: 11/15/2022]
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Naghshi S, Aune D, Beyene J, Mobarak S, Asadi M, Sadeghi O. Dietary intake and biomarkers of alpha linolenic acid and risk of all cause, cardiovascular, and cancer mortality: systematic review and dose-response meta-analysis of cohort studies. BMJ 2021; 375:n2213. [PMID: 34645650 PMCID: PMC8513503 DOI: 10.1136/bmj.n2213] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To examine the associations between dietary intake and tissue biomarkers of alpha linolenic acid (ALA) and risk of mortality from all causes, cardiovascular disease (CVD), and cancer. DESIGN Systematic review and meta-analysis of prospective cohort studies. DATA SOURCES PubMed, Scopus, ISI Web of Science, and Google Scholar to 30 April 2021. STUDY SELECTION Prospective cohort studies that reported the risk estimates for death from all causes, CVD, and cancer. DATA SYNTHESIS Summary relative risks and 95% confidence intervals were calculated for the highest versus lowest categories of ALA intake using random effects and fixed effects models. Linear and non-linear dose-response analyses were conducted to assess the dose-response associations between ALA intake and mortality. RESULTS 41 articles from prospective cohort studies were included in this systematic review and meta-analysis, totalling 1 197 564 participants. During follow-up ranging from two to 32 years, 198 113 deaths from all causes, 62 773 from CVD, and 65 954 from cancer were recorded. High intake of ALA compared with low intake was significantly associated with a lower risk of deaths from all causes (pooled relative risk 0.90, 95% confidence interval 0.83 to 0.97, I2=77.8%, 15 studies), CVD (0.92, 0.86 to 0.99, I2=48.2%, n=16), and coronary heart disease (CHD) (0.89, 0.81 to 0.97, I2=5.6%, n=9), and a slightly higher risk of cancer mortality (1.06, 1.02 to 1.11, I2=3.8%, n=10). In the dose-response analysis, a 1 g/day increase in ALA intake (equivalent to one tablespoon of canola oil or 0.5 ounces of walnut) was associated with a 5% lower risk of all cause (0.95, 0.91 to 0.99, I2=76.2%, n=12) and CVD mortality (0.95, 0.91 to 0.98, I2=30.7%, n=14). The pooled relative risks for the highest compared with lowest tissue levels of ALA indicated a significant inverse association with all cause mortality (0.95, 0.90 to 0.99, I2=8.2%, n=26). Also, based on the dose-response analysis, each 1 standard deviation increment in blood concentrations of ALA was associated with a lower risk of CHD mortality (0.92, 0.86 to 0.98, I2=37.1%, n=14). CONCLUSIONS The findings show that dietary ALA intake is associated with a reduced risk of mortality from all causes, CVD, and CHD, and a slightly higher risk of cancer mortality, whereas higher blood levels of ALA are associated with a reduced risk of all cause and CHD mortality only. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021229487.
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Affiliation(s)
- Sina Naghshi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Dagfinn Aune
- Department of Nutrition, Bjørknes University College, Oslo, Norway
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Joseph Beyene
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Chanchlani Research Centre, McMaster University, Hamilton, ON, Canada
| | - Sara Mobarak
- Abadan University of Medical Sciences, Abadan, Iran
| | - Masoomeh Asadi
- Department of Operating Room Nursing, Abadan University of Medical Sciences, Abadan, Iran
| | - Omid Sadeghi
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Li J, Guasch-Ferré M, Li Y, Hu FB. Dietary intake and biomarkers of linoleic acid and mortality: systematic review and meta-analysis of prospective cohort studies. Am J Clin Nutr 2020; 112:150-167. [PMID: 32020162 PMCID: PMC7326588 DOI: 10.1093/ajcn/nqz349] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 12/31/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Current evidence on associations between intakes of linoleic acid (LA), the predominant n-6 (ω-6) fatty acid, and mortality is inconsistent and has not been summarized by a systematic review and meta-analysis. OBJECTIVE The aim was to perform a systematic review and meta-analysis of prospective cohort studies to examine associations between LA intake and mortality. METHODS We conducted a comprehensive search of MEDLINE and EMBASE databases through 31 July 2019 for prospective cohort studies reporting associations of LA (assessed by dietary surveys and/or LA concentrations in adipose tissue or blood compartments) with mortality from all causes, cardiovascular disease (CVD), and cancer. Multivariable-adjusted RRs were pooled using random-effects meta-analysis. RESULTS Thirty-eight studies reporting 44 prospective cohorts were identified; these included 811,069 participants with dietary intake assessment (170,076 all-cause, 50,786 CVD, and 59,684 cancer deaths) and 65,411 participants with biomarker measurements (9758 all-cause, 6492 CVD, and 1719 cancer deaths). Pooled RRs comparing extreme categories of dietary LA intake (high vs low) were 0.87 (95% CI: 0.81, 0.94; I2 = 67.9%) for total mortality, 0.87 (95% CI: 0.82, 0.92; I2 = 3.7%) for CVD mortality, and 0.89 (95% CI: 0.85, 0.93; I2 = 0%) for cancer mortality. Pooled RRs for each SD increment in LA concentrations in adipose tissue/blood compartments were 0.91 (95% CI: 0.87, 0.95; I2 = 64.1%) for total mortality, 0.89 (95% CI: 0.85, 0.94; I2 = 28.9%) for CVD mortality, and 0.91 (95% CI: 0.84, 0.98; I2 = 26.3%) for cancer mortality. Meta-regressions suggested baseline age and dietary assessment methods as potential sources of heterogeneity for the association between LA and total mortality. CONCLUSIONS In prospective cohort studies, higher LA intake, assessed by dietary surveys or biomarkers, was associated with a modestly lower risk of mortality from all causes, CVD, and cancer. These data support the potential long-term benefits of PUFA intake in lowering the risk of CVD and premature death.
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Affiliation(s)
- Jun Li
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Marta Guasch-Ferré
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Yanping Li
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Frank B Hu
- Address correspondence to FBH (E-mail: )
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9
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Yamagishi SI, Matsui T. Effects of Dietary Intake and Supplementation of Fatty Acids on Cardiometabolic Disorders in Humans: a Lesson from a Large Number of Meta-Analyses. LETT DRUG DES DISCOV 2019. [DOI: 10.2174/1570180816666181107113148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Dietary fatty acids have exerted numerous pathophysiological effects in humans. Indeed,
monounsaturated fatty acids and ω-3 polyunsaturated fatty acids are generally thought to have favorable
cardiometabolic actions via their anti-inflammatory and anti-thrombotic properties, while saturated
fatty acids and trans fatty acids are supposed to contribute to the development and progression
of atherosclerotic cardiovascular diseases by inducing dyslipidemia and obesity. However, there is
much controversy about the effects of dietary intake and supplementation of fatty acids on cardiometabolic
disorders. Therefore, in the present study, we limited the scope of this review to metaanalyses
(1) of observational studies of dietary intake of fatty acids and (2) of interventional trials
with fatty acid supplements to scrutinize the role of fatty acids in various cardiometabolic disorders.
We discuss here the clinical effects of fatty acids from dietary intake or supplements on incidence of
diabetes, metabolic syndrome, obesity and body weight, cardiovascular diseases and total mortality,
and also review the association of fatty acid biomarkers with these cardiometabolic disorders.
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Affiliation(s)
- Sho-ichi Yamagishi
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume, Japan
| | - Takanori Matsui
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume, Japan
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10
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Validating fatty acid intake as estimated by an FFQ: how does the 24 h recall perform as reference method compared with the duplicate portion? Public Health Nutr 2018; 21:2568-2574. [PMID: 29734960 DOI: 10.1017/s1368980018001131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To compare the performance of the commonly used 24 h recall (24hR) with the more distinct duplicate portion (DP) as reference method for validation of fatty acid intake estimated with an FFQ. DESIGN Intakes of SFA, MUFA, n-3 fatty acids and linoleic acid (LA) were estimated by chemical analysis of two DP and by on average five 24hR and two FFQ. Plasma n-3 fatty acids and LA were used to objectively compare ranking of individuals based on DP and 24hR. Multivariate measurement error models were used to estimate validity coefficients and attenuation factors for the FFQ with the DP and 24hR as reference methods. SETTING Wageningen, the Netherlands. SUBJECTS Ninety-two men and 106 women (aged 20-70 years). RESULTS Validity coefficients for the fatty acid estimates by the FFQ tended to be lower when using the DP as reference method compared with the 24hR. Attenuation factors for the FFQ tended to be slightly higher based on the DP than those based on the 24hR as reference method. Furthermore, when using plasma fatty acids as reference, the DP showed comparable to slightly better ranking of participants according to their intake of n-3 fatty acids (0·33) and n-3:LA (0·34) than the 24hR (0·22 and 0·24, respectively). CONCLUSIONS The 24hR gives only slightly different results compared with the distinctive but less feasible DP, therefore use of the 24hR seems appropriate as the reference method for FFQ validation of fatty acid intake.
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11
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Harris WS, Tintle NL, Etherton MR, Vasan RS. Erythrocyte long-chain omega-3 fatty acid levels are inversely associated with mortality and with incident cardiovascular disease: The Framingham Heart Study. J Clin Lipidol 2018; 12:718-727.e6. [PMID: 29559306 PMCID: PMC6034629 DOI: 10.1016/j.jacl.2018.02.010] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 02/14/2018] [Accepted: 02/19/2018] [Indexed: 11/05/2022]
Abstract
BACKGROUND The extent to which omega-3 fatty acid status is related to risk for death from any cause and for incident cardiovascular disease (CVD) remains controversial. OBJECTIVE To examine these associations in the Framingham Heart Study. DESIGN Prospective and observational. SETTING Framingham Heart Study Offspring cohort. MEASUREMENTS The exposure marker was red blood cell levels of eicosapentaenoic and docosahexaenoic acids (the Omega-3 Index) measured at baseline. Outcomes included mortality (total, CVD, cancer, and other) and total CVD events in participants free of CVD at baseline. Follow-up was for a median of 7.3 years. Cox proportional hazards models were adjusted for 18 variables (demographic, clinical status, therapeutic, and CVD risk factors). RESULTS Among the 2500 participants (mean age 66 years, 54% women), there were 350 deaths (58 from CVD, 146 from cancer, 128 from other known causes, and 18 from unknown causes). There were 245 CVD events. In multivariable-adjusted analyses, a higher Omega-3 Index was associated with significantly lower risks (P-values for trends across quintiles) for total mortality (P = .02), for non-CVD and non-cancer mortality (P = .009), and for total CVD events (P = .008). Those in the highest (>6.8%) compared to those in the lowest Omega-3 Index quintiles (<4.2%) had a 34% lower risk for death from any cause and 39% lower risk for incident CVD. These associations were generally stronger for docosahexaenoic acid than for eicosapentaenoic acid. When total cholesterol was compared with the Omega-3 Index in the same models, the latter was significantly related with these outcomes, but the former was not. LIMITATIONS Relatively short follow-up time and one-time exposure assessment. CONCLUSIONS A higher Omega-3 Index was associated with reduced risk of both CVD and all-cause mortality.
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Affiliation(s)
- William S Harris
- Department of Internal Medicine, Sanford School of Medicine, University of South Dakota; and OmegaQuant Analytics, LLC, Sioux Falls, SD, USA.
| | - Nathan L Tintle
- Department of Mathematics & Statistics, Dordt College, Sioux Center, IA, USA
| | - Mark R Etherton
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ramachandran S Vasan
- National Heart Lung and Blood Institute's, Boston University's Framingham Heart Study, Framingham, MA, USA; Departments of Cardiology and Preventive Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
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12
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de Pablo P, Romaguera D, Fisk HL, Calder PC, Quirke AM, Cartwright AJ, Panico S, Mattiello A, Gavrila D, Navarro C, Sacerdote C, Vineis P, Tumino R, Ollier WE, Michaud DS, Riboli E, Venables PJ, Fisher BA. High erythrocyte levels of the n-6 polyunsaturated fatty acid linoleic acid are associated with lower risk of subsequent rheumatoid arthritis in a southern European nested case–control study. Ann Rheum Dis 2018; 77:981-987. [DOI: 10.1136/annrheumdis-2017-212274] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 01/17/2018] [Accepted: 01/24/2018] [Indexed: 11/04/2022]
Abstract
ObjectivesFindings relating to dietary intake of n-3 polyunsaturated fatty acids (PUFA) and risk of rheumatoid arthritis (RA) are mixed. Erythrocyte membrane PUFA is an accurate objective biomarker of PUFA status; however, there are little data on erythrocyte membrane PUFA and risk of RA. The objective was therefore to compare erythrocyte membrane PUFA between pre-RA individuals and matched controls from a population-based sample, and specifically to test the hypothesis that higher levels of longer chain n-3 PUFA are associated with lower risk of RA.MethodsThe European Prospective Investigation into Cancer and Nutrition (EPIC) is a large European prospective cohort study of apparently healthy populations. We undertook a nested case–control study by identifying RA cases with onset after enrolment (pre-RA) in four EPIC cohorts in Italy and Spain. Confirmed pre-RA cases were matched with controls by age, sex, centre, and date, time and fasting status at blood collection. Conditional logistic regression analysis was used to estimate associations of PUFA with the development of RA, adjusting for potential confounders including body mass index, waist circumference, education level, physical activity, smoking status and alcohol intake.ResultsThe study analysed samples from 96 pre-RA subjects and 258 matched controls. In this analysis, the median time to diagnosis (defined as time between date of blood sample and date of diagnosis) was 6.71 years (range 0.8–15). A significant inverse association was observed with n-6 PUFA linoleic acid (LA) levels and pre-RA in the fully adjusted model (highest tertile: OR 0.29; 95% CI 0.12 to 0.75; P for trend 0.01). No association was observed with any individual n-3 PUFA, total n-3 PUFA or total n-3:n-6 ratio.ConclusionsErythrocyte levels of the n-6 PUFA LA were inversely associated with risk of RA, whereas no associations were observed for other n-6 or n-3 PUFA. Further work is warranted to replicate these findings and to investigate if lower LA levels are a bystander or contributor to the process of RA development.
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13
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Clifton PM, Keogh JB. A systematic review of the effect of dietary saturated and polyunsaturated fat on heart disease. Nutr Metab Cardiovasc Dis 2017; 27:1060-1080. [PMID: 29174025 DOI: 10.1016/j.numecd.2017.10.010] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 09/26/2017] [Accepted: 10/09/2017] [Indexed: 12/25/2022]
Abstract
AIMS Over the last 7 years there has been intense debate about the advice to reduce saturated fat and increase polyunsaturated fat to reduce CVD risk. The aim of this review was to examine systematic reviews and meta-analyses since 2010 on this topic plus additional cohort studies and interventions not included in these reviews. DATA SYNTHESIS High saturated and trans fat intake (which elevates LDL like saturated fat) in the Nurses and Health Professional Follow-Up Studies combined is associated with an 8-13% higher mortality and replacement of saturated fat with any carbohydrate, PUFA and MUFA is associated with lower mortality with PUFA being more effective than MUFA (19% reduction versus 11%). With CVD mortality only PUFA and fish oil replacement of saturated fat lowers risk with a 28% reduction in CVD mortality per 5% of energy. Replacing saturated fat with PUFA or MUFA is equally effective at reducing CHD events and replacement with whole grains will lower events while replacement with sugar and starch increases events. Replacement of saturated fat with carbohydrate has no effect on CHD events or death. Only PUFA replacement of saturated fat lowers CHD events and CVD and total mortality. Replacing saturated fat with linoleic acid appears to be beneficial based on the Hooper Cochrane meta-analysis of interventions although other analyses with fewer studies have shown no effect. CONCLUSIONS Reducing saturated fat and replacing it with carbohydrate will not lower CHD events or CVD mortality although it will reduce total mortality. Replacing saturated fat with PUFA, MUFA or high-quality carbohydrate will lower CHD events.
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Affiliation(s)
- P M Clifton
- School of Pharmacy and Medical Sciences, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Sansom Institute for Health Science, University of South Australia, GPO Box 2471 Adelaide, SA, 5000, Australia.
| | - J B Keogh
- School of Pharmacy and Medical Sciences, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Sansom Institute for Health Science, University of South Australia, GPO Box 2471 Adelaide, SA, 5000, Australia
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14
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Marklund M, Pingel R, Rosqvist F, Lindroos AK, Eriksson JW, Vessby B, Oscarsson J, Lind L, Risérus U. Fatty Acid Proportions in Plasma Cholesterol Esters and Phospholipids Are Positively Correlated in Various Swedish Populations. J Nutr 2017; 147:2118-2125. [PMID: 28931585 DOI: 10.3945/jn.117.254250] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 06/07/2017] [Accepted: 08/28/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Fatty acid (FA) proportions in cholesterol esters (CEs) and plasma phospholipids are widely used as dietary biomarkers. Information on how proportions in these fractions correlate could have implications for interpretation and use of FA biomarkers in observational and interventional studies.Objective: We investigated correlations between FA proportions in CEs and phospholipids in free-living individuals and assessed how diet-induced alterations of FA proportions correlate between fractions.Methods: Spearman's rank correlation coefficients (rs) between FA proportions (percentage of total FAs) in circulating CEs and phospholipids were calculated separately in 8 individual study populations including Swedish females and males (N = 2052; age range: 11-84 y), and pooled by inverse-variance weighted meta-analysis. In addition, study populations were stratified by age, sex, body mass index (BMI; in kg/m2), and diabetes status, and strata-specific rs were pooled by meta-analysis. In 2 randomized trials (N = 79) in which dietary saturated FAs were isocalorically replaced with unsaturated FAs, treatment-wise calculations of rs were conducted between FA changes in CEs and phospholipids.Results: Overall, FA proportions in CEs and phospholipids correlated well and especially strongly for polyunsaturated FAs (PUFAs), with pooled rs (95% CIs) ranging from 0.74 (0.72, 0.76) for α-linolenic acid to 0.92 (0.91, 0.93) for eicosapentaenoic acid. Weak correlations (pooled rs < 0.4) were observed only for palmitic acid and stearic acid, with pooled rs (95% CIs): 0.29 (0.24, 0.33) and 0.30 (0.25, 0.34), respectively. Overall, correlations were not affected by age, sex, BMI, or diabetes status. Strong correlations (rs ≥ 0.6) between diet-induced FA changes in CEs and phospholipids were observed for most PUFAs.Conclusions: Proportions of most FAs in CEs and phospholipids ranked individuals similarly, suggesting that FA proportions in these fractions can be used interchangeably in populations of diverse age, sex, body composition, and diabetes status. Caution is advised, however, when comparing results from studies assessing palmitic acid or stearic acid in different lipid fractions.
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Affiliation(s)
- Matti Marklund
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism Unit
| | - Ronnie Pingel
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism Unit
| | - Fredrik Rosqvist
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism Unit
| | - Anna Karin Lindroos
- National Food Agency, Uppsala, Sweden.,Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden; and
| | - Jan W Eriksson
- Department of Medical Sciences, Clinical Diabetes, and Metabolism, and
| | - Bengt Vessby
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism Unit
| | | | - Lars Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism Unit,
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The Ratio of Eicosapentaenoic Acid (EPA) to Arachidonic Acid may be a Residual Risk Marker in Stable Coronary Artery Disease Patients Receiving Treatment with Statin Following EPA Therapy. Am J Cardiovasc Drugs 2017. [PMID: 28634822 DOI: 10.1007/s40256-017-0238-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND We investigated the relationship between the eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratio and non-high-density lipoprotein cholesterol (non-HDL-C) level, a major residual risk of coronary artery disease (CAD), in statin-treated CAD patients following EPA therapy. METHODS We conducted a 6-month, prospective, randomized clinical trial to investigate the effect of the additional administration of EPA on the EPA/AA ratio and the serum non-HDL-C level in stable CAD patients receiving statin treatment. We assigned CAD patients already receiving statin therapy to an EPA group (1800 mg/day; n = 50) or a control group (n = 50). RESULTS A significant reduction in the serum non-HDL-C level was observed in the EPA group, compared with the control group (-9.7 vs. -1.2%, p = 0.01). A multiple-regression analysis with adjustments for coronary risk factors revealed that achieved EPA/AA ratio was more reliable as an independent and significant predictor of a reduction in the non-HDL-C level at a 6-month follow-up examination (β = -0.324, p = 0.033) than the absolute change in the EPA/AA ratio. Interestingly, significant negative correlations were found between the baseline levels and the absolute change values of both non-HDL-C and triglyceride-rich lipoproteins, both markers of residual risk of CAD, indicating that patients with a higher baseline residual risk achieved a greater reduction. CONCLUSION The present results suggest that the achieved EPA/AA ratio, but not the absolute change in EPA/AA ratio, following EPA therapy might be a useful marker for the risk stratification of CAD among statin-treated patients with a high non-HDL-C level. CLINICAL TRIAL REGISTRATION UMIN ( http://www.umin.ac.jp/ ) Study ID: UMIN000010452.
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16
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Genome-Wide Interaction Study of Omega-3 PUFAs and Other Fatty Acids on Inflammatory Biomarkers of Cardiovascular Health in the Framingham Heart Study. Nutrients 2017; 9:nu9080900. [PMID: 28820441 PMCID: PMC5579693 DOI: 10.3390/nu9080900] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 08/05/2017] [Accepted: 08/10/2017] [Indexed: 11/21/2022] Open
Abstract
Numerous genetic loci have been identified as being associated with circulating fatty acid (FA) levels and/or inflammatory biomarkers of cardiovascular health (e.g., C-reactive protein). Recently, using red blood cell (RBC) FA data from the Framingham Offspring Study, we conducted a genome-wide association study of over 2.5 million single nucleotide polymorphisms (SNPs) and 22 RBC FAs (and associated ratios), including the four Omega-3 FAs (ALA, DHA, DPA, and EPA). Our analyses identified numerous causal loci. In this manuscript, we investigate the extent to which polyunsaturated fatty acid (PUFA) levels moderate the relationship of genetics to cardiovascular health biomarkers using a genome-wide interaction study approach. In particular, we test for possible gene–FA interactions on 9 inflammatory biomarkers, with 2.5 million SNPs and 12 FAs, including all Omega-3 PUFAs. We identified eighteen novel loci, including loci which demonstrate strong evidence of modifying the impact of heritable genetics on biomarker levels, and subsequently cardiovascular health. The identified genes provide increased clarity on the biological functioning and role of Omega-3 PUFAs, as well as other common fatty acids, in cardiovascular health, and suggest numerous candidate loci for future replication and biological characterization.
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La Gamba F, Corrao G, Romio S, Sturkenboom M, Trifirò G, Schink T, de Ridder M. Combining evidence from multiple electronic health care databases: performances of one-stage and two-stage meta-analysis in matched case-control studies. Pharmacoepidemiol Drug Saf 2017; 26:1213-1219. [PMID: 28799196 DOI: 10.1002/pds.4280] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 04/11/2017] [Accepted: 07/04/2017] [Indexed: 12/11/2022]
Abstract
PURPOSE Clustering of patients in databases is usually ignored in one-stage meta-analysis of multi-database studies using matched case-control data. The aim of this study was to compare bias and efficiency of such a one-stage meta-analysis with a two-stage meta-analysis. METHODS First, we compared the approaches by generating matched case-control data under 5 simulated scenarios, built by varying: (1) the exposure-outcome association; (2) its variability among databases; (3) the confounding strength of one covariate on this association; (4) its variability; and (5) the (heterogeneous) confounding strength of two covariates. Second, we made the same comparison using empirical data from the ARITMO project, a multiple database study investigating the risk of ventricular arrhythmia following the use of medications with arrhythmogenic potential. In our study, we specifically investigated the effect of current use of promethazine. RESULTS Bias increased for one-stage meta-analysis with increasing (1) between-database variance of exposure effect and (2) heterogeneous confounding generated by two covariates. The efficiency of one-stage meta-analysis was slightly lower than that of two-stage meta-analysis for the majority of investigated scenarios. Based on ARITMO data, there were no evident differences between one-stage (OR = 1.50, CI = [1.08; 2.08]) and two-stage (OR = 1.55, CI = [1.12; 2.16]) approaches. CONCLUSIONS When the effect of interest is heterogeneous, a one-stage meta-analysis ignoring clustering gives biased estimates. Two-stage meta-analysis generates estimates at least as accurate and precise as one-stage meta-analysis. However, in a study using small databases and rare exposures and/or outcomes, a correct one-stage meta-analysis becomes essential.
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Affiliation(s)
- Fabiola La Gamba
- Janssen Pharmaceutica NV, Beerse, Belgium.,Center for Statistics, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Campus Diepenbeek, Diepenbeek, Belgium
| | - Giovanni Corrao
- Department of Statistics and Quantitative Methods, Unit of Biostatistics, Epidemiology, and Public Health, and Centre of Public Health, University of Milano-Bicocca, Milan, Italy
| | - Silvana Romio
- Department of Statistics and Quantitative Methods, Unit of Biostatistics, Epidemiology, and Public Health, and Centre of Public Health, University of Milano-Bicocca, Milan, Italy.,Department of Medical Informatics, Erasmus University Medical School, Rotterdam, The Netherlands
| | - Miriam Sturkenboom
- Department of Medical Informatics, Erasmus University Medical School, Rotterdam, The Netherlands
| | - Gianluca Trifirò
- Department of Medical Informatics, Erasmus University Medical School, Rotterdam, The Netherlands.,Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Tania Schink
- Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Maria de Ridder
- Department of Medical Informatics, Erasmus University Medical School, Rotterdam, The Netherlands
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18
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Omega-6 fatty acids: Opposing associations with risk—The Ludwigshafen Risk and Cardiovascular Health Study. J Clin Lipidol 2017. [DOI: 10.1016/j.jacl.2017.05.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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19
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Impact of Adding Eicosapentaenoic Acid to Statin Therapy on Plasma Pentraxin 3 Level in Patients with Stable Coronary Artery Disease: A 6-Month, Randomized Controlled Study. Am J Cardiovasc Drugs 2017; 17:49-59. [PMID: 27778191 DOI: 10.1007/s40256-016-0195-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND We hypothesized that the additional administration of eicosapentaenoic acid (EPA) in patients with stable coronary artery disease (CAD) receiving statin has the potential to lower the serum pentraxin 3 (PTX3) level, an indicator of plaque stabilization. METHODS We randomly assigned CAD patients already receiving statin therapy to an EPA group (1800 mg/day, n = 53) or control group (n = 53). RESULTS No significant difference was found in the change in the plasma PTX3 level between the groups. However, in a subgroup analysis, a significant percentage reduction in the plasma PTX3 level was observed in patients receiving strong statin compared with the patients receiving moderate statin in the EPA group (-5.6 vs. 14.7 %, p = 0.0082), while no such difference in the percentage change in the plasma PTX3 level was noted between the two same statin subgroups in the control group. A multiple logistic regression analysis identified the addition of EPA to ongoing strong statin treatment as an independent predictor of PTX3 level reduction. Furthermore, even in patients with relatively well-controlled serum lipid levels, pretreatment with EPA added to ongoing statin therapy reduced serum non-high-density lipoprotein cholesterol and triglyceride-rich lipoproteins as residual risk factors. CONCLUSION Through this study design, the results could not support the hypothesis that adding EPA in patients with stable CAD receiving varying degrees of statin treatment reduces the plasma PTX3 level comprehensively. However, addition of EPA to ongoing strong statin treatment, but not ongoing moderate statin treatment, may reduce the plasma PTX3 level, possibly leading to coronary plaque stabilization. CLINICAL TRIAL REGISTRATION INFORMATION UMIN ( http://www.umin.ac.jp/ ), Study ID: UMIN000010452.
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Baker EJ, Miles EA, Burdge GC, Yaqoob P, Calder PC. Metabolism and functional effects of plant-derived omega-3 fatty acids in humans. Prog Lipid Res 2016; 64:30-56. [DOI: 10.1016/j.plipres.2016.07.002] [Citation(s) in RCA: 224] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 07/28/2016] [Accepted: 07/29/2016] [Indexed: 12/17/2022]
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21
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Miura K, Hughes MCB, Ungerer JP, Green AC. Plasma eicosapentaenoic acid is negatively associated with all-cause mortality among men and women in a population-based prospective study. Nutr Res 2016; 36:1202-1209. [PMID: 27865614 DOI: 10.1016/j.nutres.2016.09.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 08/18/2016] [Accepted: 09/12/2016] [Indexed: 11/28/2022]
Abstract
Omega-3 polyunsaturated fatty acids (PUFAs) have anti-inflammatory properties, whereas omega-6 PUFAs appear to have proinflammatory properties. We aimed to assess plasma omega-3 and omega-6 PUFA status in relation to all-cause mortality in an Australian community-based study. We hypothesized that omega-3 PUFA would be inversely associated, and omega-6 PUFA positively associated with all-cause mortality. Plasma phospholipid omega-3 (eicosapentaenoic acid [EPA], docosapentaenoic acid [DPA], docosahexaenoic acid, α-linolenic acid, and total) and omega-6 PUFAs (linoleic acid, arachidonic acid, and total) were measured among 1008 adults (44% men) in 1996. Plasma PUFA composition was quantified using gas chromatography. During 17-year follow-up, 98 men and 81 women died. After adjustment for potential confounding factors, plasma EPA was inversely associated with all-cause mortality overall (adjusted hazard ratio [HR] per 1-SD increase, 0.81; 95% confidence interval [CI], 0.68-0.95), in men (HR, 0.78; 95% CI, 0.62-0.98), and in women (HR, 0.78; 95% CI, 0.65-0.94), separately. Inverse associations with mortality among men were also seen for DPA (HR, 0.76; 95% CI, 0.60-0.97) and α-linolenic acid (HR, 0.73; 95% CI, 0.57-0.94). No omega-6 PUFAs were significantly associated with mortality. Our findings of reduced all-cause mortality in men and women who have high EPA in plasma, and in men with high plasma DPA and α-linolenic acid, partially support our hypothesis that omega-3 PUFAs help reduce mortality but provide no evidence that omega-6 PUFAs may increase mortality.
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Affiliation(s)
- Kyoko Miura
- QIMR Berghofer Medical Research Institute, Cancer and Population Studies Group, 300 Herston Rd, Herston, Brisbane, Queensland 4006, Australia.
| | - Maria Celia B Hughes
- QIMR Berghofer Medical Research Institute, Cancer and Population Studies Group, 300 Herston Rd, Herston, Brisbane, Queensland 4006, Australia
| | | | - Adèle C Green
- QIMR Berghofer Medical Research Institute, Cancer and Population Studies Group, 300 Herston Rd, Herston, Brisbane, Queensland 4006, Australia; CRUK Manchester Institute, University of Manchester, Wilmslow Rd, Manchester, UK
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22
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Bork CS, Jakobsen MU, Lundbye-Christensen S, Tjønneland A, Schmidt EB, Overvad K. Dietary intake and adipose tissue content of α-linolenic acid and risk of myocardial infarction: a Danish cohort study. Am J Clin Nutr 2016; 104:41-8. [PMID: 27169831 DOI: 10.3945/ajcn.115.127019] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 04/12/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Intake of the plant-derived ω-3 (n-3) fatty acid α-linolenic acid (ALA, 18:3; n-3) may reduce coronary heart disease (CHD) risk, but the results of previous studies have been inconsistent. OBJECTIVE We aimed to investigate the association between dietary intake of ALA, adipose tissue content of ALA, and risk of incident myocardial infarction (MI). DESIGN A total of 57,053 participants, aged 50-64 y, were enrolled in the prospective Danish cohort study Diet, Cancer and Health between 1993 and 1997. Dietary intake of ALA was assessed with the use of a validated semiquantitative food-frequency questionnaire in the full cohort, whereas the adipose tissue content of ALA was determined with the use of gas chromatography in all incident MI cases and in a random sex-stratified sample of the total cohort (n = 3500). RESULTS During a median of 17 y of follow-up, we identified 2177 male and 912 female cases of MI. After appropriate exclusions, we included 2124 men and 854 women for analyses of dietary intake of ALA, whereas 1994 men and 770 women were included in the analysis of the adipose tissue content of ALA. In multivariate analyses that were conducted with the use of restricted cubic splines and adjusted for established CHD risk factors, weak positive associations in men and weak U-shaped associations in women were shown between both dietary intake and the adipose tissue content of ALA and risk of MI, but these associations were not statistically significant. Additional adjustments for dietary factors did not influence the observed associations numerically. CONCLUSION This study suggests that ALA has no appreciable association with risk of incident MI in either men or women.
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Affiliation(s)
| | - Marianne U Jakobsen
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark; and
| | - Søren Lundbye-Christensen
- Unit of Clinical Biostatistics, and Aalborg AF Study Group, Aalborg University Hospital, Aalborg, Denmark
| | | | | | - Kim Overvad
- Department of Cardiology, Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark; and
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Sun Y, Koh HWL, Choi H, Koh WP, Yuan JM, Newman JW, Su J, Fang J, Ong CN, van Dam RM. Plasma fatty acids, oxylipins, and risk of myocardial infarction: the Singapore Chinese Health Study. J Lipid Res 2016; 57:1300-7. [PMID: 27371261 DOI: 10.1194/jlr.p066423] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Indexed: 11/20/2022] Open
Abstract
We aimed to examine the prospective association between plasma FAs, oxylipins, and risk of acute myocardial infarction (AMI) in a Singapore Chinese population. A nested case-control study with 744 incident AMI cases and 744 matched controls aged 47-83 years was conducted within the Singapore Chinese Health Study. Nineteen plasma FAs and 12 oxylipins were quantified using MS. These were grouped into 12 FA clusters and 5 oxylipin clusters using hierarchical clustering, and their associations with AMI risk were assessed. Long-chain n-3 FAs [odds ratio (OR) = 0.67 per SD increase, 95% confidence interval (CI): 0.53-0.84, P < 0.001] and stearic acid (OR = 0.65, 95% CI: 0.44-0.97, P = 0.03) were inversely associated with AMI risk, whereas arachidonic acid (AA) was positively associated with AMI risk (OR = 1.25, 95% CI: 1.03-1.52, P = 0.02) in the multivariable model with adjustment for other FAs. Further adjustment for oxylipins did not substantially change these associations. An inverse association was observed between AA-derived oxylipin, thromboxane (TX)B2, and AMI risk (OR = 0.81, 95% CI: 0.71-0.93, P = 0.003). Circulating long-chain n-3 FAs and stearic acid were associated with a lower and AA was associated with a higher AMI risk in this Chinese population. The association between the oxylipin TXB2 and AMI requires further research.
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Affiliation(s)
- Ye Sun
- Saw Swee Hock School of Public Health National University of Singapore and National University Health System, Singapore NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore Departments of Psychological Medicine National University of Singapore and National University Health System, Singapore
| | - Hiromi W L Koh
- Saw Swee Hock School of Public Health National University of Singapore and National University Health System, Singapore
| | - Hyungwon Choi
- Saw Swee Hock School of Public Health National University of Singapore and National University Health System, Singapore
| | - Woon-Puay Koh
- Saw Swee Hock School of Public Health National University of Singapore and National University Health System, Singapore Duke-NUS Graduate Medical School Singapore, Singapore
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute and Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh PA
| | - John W Newman
- Department of Nutrition, University of California Davis and US Department of Agriculture, Agricultural Research Sservice, Western Human Nutrition Research Center, Davis CA
| | - Jin Su
- Saw Swee Hock School of Public Health National University of Singapore and National University Health System, Singapore
| | - Jinling Fang
- Saw Swee Hock School of Public Health National University of Singapore and National University Health System, Singapore
| | - Choon Nam Ong
- Saw Swee Hock School of Public Health National University of Singapore and National University Health System, Singapore National University of Singapore Environmental Research Institute, National University of Singapore, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health National University of Singapore and National University Health System, Singapore Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
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24
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Reinders I, Murphy RA, Song X, Mitchell GF, Visser M, Cotch MF, Garcia ME, Launer LJ, Eiriksdottir G, Gudnason V, Harris TB, Brouwer IA. Higher Plasma Phospholipid n-3 PUFAs, but Lower n-6 PUFAs, Are Associated with Lower Pulse Wave Velocity among Older Adults. J Nutr 2015; 145:2317-24. [PMID: 26311808 PMCID: PMC4580955 DOI: 10.3945/jn.115.212282] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 07/30/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Higher intake of polyunsaturated fatty acids (PUFAs) and higher circulating PUFAs are associated with lower cardiovascular disease (CVD) risk. The positive influence of PUFAs might be via lowering arterial stiffness, resulting in a better CVD risk profile; however, studies investigating circulating PUFAs in relation to arterial stiffness in a general population are limited. OBJECTIVE We investigated the associations of plasma phospholipid n-3 (ω-3) and n-6 PUFAs and fish oil intake with arterial stiffness. METHODS We used data from a subgroup of the Age, Gene/Environment Susceptibility-Reykjavik (AGES-Reykjavik) Study (n = 501, 75.0 ± 4.96 y, 46% men), a population-based study of community-dwelling older adults. Plasma phospholipid PUFAs were measured by GC at baseline, and fish oil intake was assessed at 3 time points: early life (ages 14-19 y), midlife (ages 40-50 y), and late life (ages 66-96 y, AGES-Reykjavik baseline) with the use of a validated food-frequency questionnaire. Arterial stiffness was determined as carotid-femoral pulse wave velocity (cf-PWV) with the use of an electrocardiogram after a mean follow-up of 5.2 ± 0.3 y. Regression coefficients (95% CIs), adjusted for demographics, follow-up time, risk factors, cholesterol, triglycerides, and serum vitamin D, were calculated by linear regression per SD increment in PUFAs. RESULTS Plasma total n-3 PUFAs, eicosapentaenoic acid, and docosahexaenoic acid were associated with lower cf-PWV [β (95% CI): -0.036 (-0.064, -0.008); -0.031 (-0.059, -0.003); -0.036 (-0.064, -0.009), respectively]. In contrast, plasma total n-6 PUFAs and linoleic acid were associated with higher cf-PWV [0.035 (0.009, 0.061) and 0.034 (0.008, 0.059)]. Regular fish oil consumption at early-, mid-, and late-life was not associated with cf-PWV. CONCLUSIONS Our results show a positive association between plasma n-6 PUFAs and arterial stiffness, and suggest that higher concentrations of plasma long-chain n-3 PUFAs are associated with less arterial stiffness and therein may be one of the mechanisms underlying the association between plasma n-3 PUFAs and lower CVD risk.
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Affiliation(s)
- Ilse Reinders
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD; Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, Netherlands;
| | - Rachel A Murphy
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD
| | - Xiaoling Song
- Division of Public Health Sciences, Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Marjolein Visser
- Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, Netherlands;,Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, Netherlands
| | - Mary Frances Cotch
- Division of Epidemiology and Clinical Applications, National Eye Institute, Bethesda, MD
| | - Melissa E Garcia
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD
| | | | - Vilmundur Gudnason
- Icelandic Heart Association Research Institute, Kopavogur, Iceland; and,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD
| | - Ingeborg A Brouwer
- Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, Netherlands
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Wolfram G, Bechthold A, Boeing H, Ellinger S, Hauner H, Kroke A, Leschik-Bonnet E, Linseisen J, Lorkowski S, Schulze M, Stehle P, Dinter J. Evidence-Based Guideline of the German Nutrition Society: Fat Intake and Prevention of Selected Nutrition-Related Diseases. ANNALS OF NUTRITION AND METABOLISM 2015; 67:141-204. [PMID: 26414007 DOI: 10.1159/000437243] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
As nutrition-related chronic diseases have become more and more frequent, the importance of dietary prevention has also increased. Dietary fat plays a major role in human nutrition, and modification of fat and/or fatty acid intake could have a preventive potential. The aim of the guideline of the German Nutrition Society (DGE) was to systematically evaluate the evidence for the prevention of the widespread diseases obesity, type 2 diabetes mellitus, dyslipoproteinaemia, hypertension, metabolic syndrome, coronary heart disease (CHD), stroke, and cancer through the intake of fat or fatty acids. The main results can be summarized as follows: it was concluded with convincing evidence that a reduced intake of total and saturated fat as well as a larger intake of polyunsaturated fatty acids (PUFA) at the expense of saturated fatty acids (SFA) reduces the concentration of total and low-density lipoprotein cholesterol in plasma. Furthermore, there is convincing evidence that a high intake of trans fatty acids increases risk of dyslipoproteinaemia and that a high intake of long-chain polyunsaturated n-3 fatty acids reduces the triglyceride concentration in plasma. A high fat intake increases the risk of obesity with probable evidence when total energy intake is not controlled for (ad libitum diet). When energy intake is controlled for, there is probable evidence for no association between fat intake and risk of obesity. A larger intake of PUFA at the expense of SFA reduces risk of CHD with probable evidence. Furthermore, there is probable evidence that a high intake of long-chain polyunsaturated n-3 fatty acids reduces risk of hypertension and CHD. With probable evidence, a high trans fatty acid intake increases risk of CHD. The practical consequences for current dietary recommendations are described at the end of this article.
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Marventano S, Kolacz P, Castellano S, Galvano F, Buscemi S, Mistretta A, Grosso G. A review of recent evidence in human studies of n-3 and n-6 PUFA intake on cardiovascular disease, cancer, and depressive disorders: does the ratio really matter? Int J Food Sci Nutr 2015; 66:611-22. [PMID: 26307560 DOI: 10.3109/09637486.2015.1077790] [Citation(s) in RCA: 156] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Polyunsaturated fatty acids (PUFAs) have been considered of great interest for human health due to their potential anti-inflammatory action that may protect from a number of chronic-degenerative diseases with an inflammatory pathogenesis. This review aimed to report the most updated evidence of both n-3 and n-6 PUFAs effect on cardiovascular disease, cancer, and depression in humans. Attention has been also paid to those studies exploring the effects of the ratio intake. Results from pooled analyses of human studies reported a general positive effect of n-3 PUFAs intake on all outcomes considered. In contrast, the role of n-6 PUFAs on human health needs to be better assessed in order to clearly identify which compound exerts beneficial/harmful effects. Only a limited number of clinical studies considered the n-3:n-6 PUFAs ratio, rather reporting contrasting results. A number of limitations when considering the ratio between these two families of PUFAs have risen.
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Affiliation(s)
- Stefano Marventano
- a Department of Medical, Surgical Sciences, and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Public Health , University of Catania , Catania , Italy
| | - Paulina Kolacz
- b Department of Human Nutrition , Jagiellonian University Medical College in Krakow , Krakow , Poland
| | - Sabrina Castellano
- c Department of Biomedical and Biotechnological Sciences, Section of Pharmacology and Biochemistry , University of Catania , Catania , Italy , and
| | - Fabio Galvano
- c Department of Biomedical and Biotechnological Sciences, Section of Pharmacology and Biochemistry , University of Catania , Catania , Italy , and
| | - Silvio Buscemi
- d Department of Internal Medicine , University of Palermo , Palermo , Italy
| | - Antonio Mistretta
- a Department of Medical, Surgical Sciences, and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Public Health , University of Catania , Catania , Italy
| | - Giuseppe Grosso
- a Department of Medical, Surgical Sciences, and Advanced Technologies "G.F. Ingrassia", Section of Hygiene and Public Health , University of Catania , Catania , Italy
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Bier DM. Saturated Fats and Cardiovascular Disease: Interpretations Not as Simple as They Once Were. Crit Rev Food Sci Nutr 2015; 56:1943-6. [DOI: 10.1080/10408398.2014.998332] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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28
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Chromatographic and Enzymatic Method to Quantify Individual Plasma Free and Triacylglycerol Fatty Acids. Chromatographia 2014. [DOI: 10.1007/s10337-014-2820-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Benatar JR, Stewart RAH. The effects of changing dairy intake on trans and saturated fatty acid levels- results from a randomized controlled study. Nutr J 2014; 13:32. [PMID: 24708591 PMCID: PMC3977898 DOI: 10.1186/1475-2891-13-32] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 03/28/2014] [Indexed: 11/16/2022] Open
Abstract
Background Dairy food is an important natural source of saturated and trans fatty acids in the human diet. This study evaluates the effect of dietary advice to change dairy food intake on plasma fatty acid levels known to be present in milk in healthy volunteers. Methods Twenty one samples of whole fat dairy milk were analyzed for fatty acids levels. Changes in levels of plasma phospholipid levels were evaluated in 180 healthy volunteers randomized to increase, not change or reduce dairy intake for one month. Fatty acids were measured by gas chromatography–mass spectrometry and levels are normalized to d-4 alanine. Results The long chain fatty acids palmitic (13.4%), stearic (16.7%) and myristic (18.9%) acid were most common saturated fats in milk. Four trans fatty acids constituted 3.7% of the total milk fat content. Increased dairy food intake by 3.0 (± 1.2) serves/ day for 1 month was associated with small increases in plasma levels of myristic (+0.05, 95% confidence level-0.08 to 0.13, p = 0.07), pentadecanoic (+0.014, 95% confidence level -0.016 to 0.048, p = 0.02) and margaric acid (+0.02, -0.03 to 0.05, p = 0.03). There was no significant change in plasma levels of 4 saturated, 4 trans and 10 unsaturated fatty acids. Decreasing dairy food intake by 2.5 (± 1.2) serves per day was not associated with change in levels of any plasma fatty acid levels. Conclusion Dietary advice to change dairy food has a minor effect on plasma fatty acid levels. Trial registration ACTRN12612000574842.
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Affiliation(s)
- Jocelyne R Benatar
- Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.
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