N-6 Fatty acids and cardiovascular health: A review of the evidence for dietary intake recommendations

Nutritional Epidemiology Research Unit, UMR INSERM U557, INRA U1125, CNAM, UP13, CRNH-IdF, Faculté SMBH, 74 rue Marcel Cachin, 93017 Bobigny, France.
The British journal of nutrition (Impact Factor: 3.45). 09/2010; 104(6):788-96. DOI: 10.1017/S0007114510002096
Source: PubMed


n-6 PUFA are well known for their critical role in many physiological functions and seem to reduce risks of CHD. However, some argue that excessive consumption of n-6 PUFA may lead to adverse effects on health and therefore recommend reducing dietary n-6 PUFA intake or fixing an upper limit. In this context, the present work aimed to review evidence on the link between n-6 PUFA and risks of CVD. Epidemiological studies show that n-6 PUFA dietary intake significantly lowers blood LDL-cholesterol levels. In addition, n-6 PUFA intake does not increase several CVD risk factors such as blood pressure, inflammatory markers, haemostatic parameters and obesity. Data from prospective cohort and interventional studies converge towards a specific protective role of dietary n-6 PUFA intake, in particular linoleic acid, against CVD. n-6 PUFA benefits are even increased when SFA intake is also reduced. In regards to studies examined in this narrative review, recommendation for n-6 PUFA intake above 5 %, and ideally about 10 %, of total energy appears justified.

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    • "It is also argued that higher dietary intake of n-6 PUFA may lead to a competition between n-6 and n-3 metabolism resulting in a reduced production of anti-inflammatory molecules from n-3 PUFA.[47] However, in human subjects, higher intakes of n-6 fatty acids do not appear to be associated with elevated levels of inflammatory markers and there are no data from human studies that support a detrimental effect of dietary n-6 fatty acids on coronary heart disease.[4849] The present results are in contrast to customary assumption that high intake of n-6 fatty acids antagonizes the anti-inflammatory effects of n-3 fatty acids. "
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    ABSTRACT: Background: Atherosclerosis, with its major manifestation, coronary artery disease (CAD) is a chronic inflammatory disease. Dietary fatty acids intakes favorably effect on inflammatory responses. This study was conducted to examine the association between dietary fatty acid intakes and inflammatory markers, interleukin 6 (IL-6) and high sensitivity C-reactive protein (hs-CRP), in CAD patients among Iranian population. Materials and Methods: This hospital-based, cross-sectional study was conducted in Chamran Heart Hospital, Isfahan, Iran in 2012. Patients aged ≥45 years with first ever symptomatic CAD confirmed by angiography were included. A semi-quantitative food frequency questionnaire (FFQ) was used to assess the usual intakes of dietary fatty acids. Results: The energy-adjusted daily intakes (mean ± SD) of saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), linoleic acid, α-linolenic acid, and eicosapentaenoic acid and docosahexaenoic acid (EPA + DHA) were 27 ± 9, 22 ± 6, 21 ± 5, 0.4 ± 0.32, and 0.85 ± 0.82 g/d; respectively. After adjustment for potential confounders, SFA was directly related to hs-CRP (P = 0.01) and IL-6 (P < 0.001) concentrations. Intakes of EPA + DHA and MUFA, were significantly adversely related to plasma hs-CRP concentration (P = 0.002 and 0.001, respectively) but not IL-6, albeit MUFA was modestly inversely related to IL-6 (P = 0.08). No significant relationships were observed for other fatty acids, α-linolenic acid, and linoleic acid. Conclusions: These findings suggest that saturated fatty acids, EPA + DHA and MUFA were significantly related to plasma inflammatory markers in CAD patients.
    09/2014; 3:148. DOI:10.4103/2277-9175.137818
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    • "We did not expect the elevated risk of male cardiovascular mortality associated with higher intake of n-6 PUFA, as several studies have shown inverse associations between n-6 PUFA intake and CVD [43]. This finding could represent a chance phenomenon, since it was not observed in women. "
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    ABSTRACT: It may be useful to examine associations of fat intakes with total mortality as a basis for dietary recommendations. We aimed to elucidate associations between dietary fat and total mortality among Japanese populations with low fat intake. We conducted a prospective study consisting of 58,672 men and women aged 40 to 79 years. Fat intakes were estimated using a food frequency questionnaire. Multivariate-adjusted hazard ratios (HRs) for mortality by sex were computed according to quintiles of energy-adjusted fat intakes. During the follow-up period (median duration, 19.3 years), 11,656 deaths were recorded. In men, we found no clear association between total fat and total mortality. HRs across quintiles of total fat intake were 1.00, 1.03 (95% confidence interval [CI], 0.95-1.12), 1.02 (0.94-1.10), 0.98 (0.90-1.07), and 1.07 (0.98-1.17). No significant association was detected in regard to types of fat. In women, HR was lowest in the fourth quintile of total fat intake followed by the top quintile; HRs across quintiles were 1.00, 1.03 (0.94-1.11), 1.00 (0.92-1.09), 0.88 (0.81-0.96), and 0.94 (0.86-1.03). Regarding types of fat in women, total mortality was inversely associated with intakes of saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), and polyunsaturated fatty acids (PUFA); the lowest HR was in the top quintile of intake for SFA, MUFA, and PUFA: 0.91 (95% CI, 0.83-1.00), 0.91 (0.83-0.99) and 0.88 (0.80 - 0.97), respectively (trend P across quintiles, 0.020, 0.012, and 0.029, respectively). Causes of death other than cancer and cardiovascular disease contributed most to decreases in HRs for total and types of fat. In women, analysis with finer categories revealed that the lowest risk for total mortality appeared at total fat intake of 28% of energy. Our findings from a large cohort study among populations with relatively low fat intake provide evidence regarding optimal levels of fat intakes.
    Nutrition & Metabolism 03/2014; 11(1):12. DOI:10.1186/1743-7075-11-12 · 3.26 Impact Factor
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    • "In cell culture and animal studies, the incorporation of ω3-PUFA into membrane phospholipids alters the physicochemical properties of membrane rafts and caveolae, thereby favoring membrane associated protein localization and function [5]. Additionally, serum phospholipid AA together with total ω-6PUFAs was found significantly higher in stroke patients than in non-stroke controls [26], because AA, one of the major long chain ω-6PUFAs has pro-inflammatory effects, thereby being harmful for cardiovascular system [27]. In our study, plasma adiponectin and LDL particle size which have anti-atherogenic and anti-inflammatory effects were positively associated with LA and DHA, and negatively with AA and DGLA. "
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    ABSTRACT: Blood or dietary polyunsaturated fatty acids (PUFAs), particularly ω3-PUFAs were known for cardiovascular protective effect. However, the results are still controversial. We aimed to investigate the association of serum phospholipid PUFAs with cardiometabolic risk through cross-sectional/experimental studies. Design/Methods Serum phospholipid FA compositions and cardiometabolic risk parameters were measured in controls [healthy: n=987, metabolic syndrome (MetS): n=214] and CAD patients (CAD-only: n=152, CAD+MetS: n=56). Experimental assays were performed in vascular smooth muscle cells (VSMCs). Major cardiometabolic risk markers, i.e. insulin resistance, hs-C-reactive proteins, malonedialdehyde were higher, and adiponectin and LDL particle size were lower in CAD patients, particularly those with MetS than in healthy controls. Serum linoleic acid (LA, C18:2ω-6) was lowest and dihomo-γ-linolenic acids (DGLAs, C20:3ω-6) was highest in CAD patients with MetS among the 4 groups. Docosahexaenoic acid (DHA, C22:6ω-3) was lower and arachidonic acid (AA, C20:4ω-6) and ω6/ω3-PUFAs were higher in CAD patients than in controls. ω3-PUFAs were significantly lower in CAD patients, particularly those with MetS than in healthy controls. Multiple regression analysis revealed that AA and DHA among serum FAs, were mainly associated with the cardiometabolic risk (β'-coefficients for AA:0.336; DHA:-0.296) together with age, MetS factors, LA, DGLA and gender (r=0.529, p<0.001). Under LPS-induced stress condition, LA and DHA significantly suppressed VSMC proliferation. DHA also up-regulated phosphorylation of p38 and ERK, and dramatically inhibited nuclear translocation of NF-κB-p65 in VSMCs. AA and DHA were mainly associated with cardiometabolic risk. Particularly, DHA may be effective on suppression of vascular proliferation and inflammation.
    Clinical biochemistry 01/2014; 47(6). DOI:10.1016/j.clinbiochem.2014.01.005 · 2.28 Impact Factor
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