Omega-3 Fatty Acid Supplementation Appears to Attenuate Particulate Air Pollution–Induced Cardiac Effects and Lipid Changes in Healthy Middle-Aged Adults

Environmental Public Health Division, National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, USA.
Environmental Health Perspectives (Impact Factor: 7.98). 04/2012; 120(7):952-7. DOI: 10.1289/ehp.1104472
Source: PubMed


Air pollution exposure has been associated with adverse cardiovascular health effects. Findings of a recent epidemiological study suggested that omega-3 fatty acid (fish oil) supplementation blunted cardiac responses to air pollution exposure.
We conducted a randomized, controlled exposure study to evaluate the efficacy of fish oil supplements in attenuating adverse cardiac effects of exposure to concentrated ambient fine and ultrafine particulate matter (CAP).
Twenty-nine healthy middle-aged participants (mean, 58 ± 1 years of age) were supplemented in a randomized, double-blinded manner with 3 g/day of either fish oil or olive oil for 4 weeks before sequential chamber exposure to filtered air and CAP (mean mass concentration 278 ± 19 µg/m3) for 2 hr. Cardiac responses were assessed by comparing time and frequency domain changes in heart rate variability (HRV) and electrocardiographic repolarization changes measured before, immediately after, and 20 hr after exposure. Changes in plasma lipids were also evaluated at these time points.
Fish oil supplementation appeared to attenuate CAP-induced reductions in high-frequency/low-frequency ratio, as well as elevations in normalized low-frequency HRV and prolongation of the QT interval corrected for heart rate (QTc). Very low-density lipoprotein and triglyceride concentrations increased significantly immediately after exposure to CAP in participants supplemented with olive oil, but not in those supplemented with fish oil.
Exposure of healthy middle-aged adults to CAP for 2 hr induced acute cardiac and lipid changes after supplementation with olive oil, but not fish oil. Our findings suggest that omega-3 fatty acid supplements offer protection against the adverse cardiac and lipid effects associated with air pollution exposure.

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    • "This observation was tested in an experimental chamber study. A randomized, double blind study of Tong and colleagues investigated the potential protective effects of 3 gm/day omega-3 fatty acids when healthy middle aged adults were exposed to 2 hours of air pollution in an experimental chamber [45]. This study revealed that exposure to concentrated ambient fine and ultrafine particulate matter (CAP) induced acute cardiac and lipid changes that included significant elevations in triglycerides and VLDL-C as well as lowering of heart rate variability and QT interval changes. "
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    ABSTRACT: The potential benefit of fish oil (omega-3 fatty acids) consumption to reduce cardiovascular disease (CVD) risk remains controversial. Some investigations report reduced CVD risk associated with fish or fish oil consumption while others report no benefit. This controversy is in part resolved when consideration is given to omega-3 blood levels in relation to CVD risk as well as blood levels achieved in clinical trials of omega-3 supplementation and CVD benefit. There is a wide variation in omega-3 blood levels achieved between individuals in response to a given dose of an omega-3 supplement. Many studies tested a daily dose of 1 gram omega-3 supplementation. The individual variation in blood omega-3 levels achieved in response to a fixed daily dose helps to explain why some individuals may obtain CVD protection benefit while others do not due to failure to achieve a therapeutic threshold. Recent development of a population range in a United States population helps to provide clinical guidance since population omega-3 blood level ranges may vary due to environmental and genetic reasons. Omega-3 supplementation may also be of benefit in reducing the adverse impact of air pollution on CVD risk.
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    • "Omega-3 LC-PUFA supplementation has been used to increase the serum levels of ω-3 LC-PUFA, which consequently produced a positive effect on the resolution of inflammation [6]. Tong et al. [14] observed that healthy patients supplemented with 3 g/day of fish oil for 1 month showed 6.5 times higher EPA levels compared to a placebo group. Dawczynski et al. [15] showed that ω-3 LC-PUFA supplementation for 3 months significantly increased the serum levels of DHA and EPA in women with rheumatoid arthritis. "
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    ABSTRACT: Purpose: We aimed to investigate the impact of nonsurgical periodontal treatment combined with one-year dietary supplementation with omega (ω)-3 on the serum levels of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), docosapentaenoic acid (DPA), and arachidonic acid (AA). Methods: Fifteen patients with chronic generalized periodontitis were treated with scaling and root planing. The test group consisted of seven patients (43.1±6.0 years) supplemented with ω-3, consisting of EPA plus DHA, three capsules, each of 300 mg of ω-3 (180-mg EPA/120-mg DHA), for 12 months. The control group was composed of eight patients (46.1±11.6 years) that took a placebo capsule for 12 months. The periodontal examination and the serum levels of DPA, EPA, DHA, and AA were performed at baseline (T0), and 4 (T1), and 12 (T2) months after therapy. Results: In the test group, AA and DPA levels had been reduced significantly at T1 (P<0.05). AA and EPA levels had been increased significantly at T2 (P<0.05). The ΔEPA was significantly higher in the test compared to the placebo group at T2-T0 (P=0.02). The AA/EPA had decreased significantly at T1 and T2 relative to baseline (P<0.05). Conclusions: Nonsurgical periodontal treatment combined with ω-3 supplementation significantly increased the EPA levels and decreased the AA/EPA ratio in serum after one year follow-up. However, no effect on the clinical outcome of periodontal therapy was observed.
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    • "Due to technical difficulties thrombomodulin, E-selectin and Pselectin were only performed on 19 participants. Continuous ambulatory electrocardiograms (Holter ECGs) were collected for ∼24 h using a Mortara H12+ 12-Lead ECG Recorder (Mortara Instrument Co., Milwaukee, WI) as described earlier (Tong et al., 2012). The digitally recorded ECGs were sampled at 1000 Hz and a trained research nurse blinded to the exposure randomization manually edited the sequence of ECG complexes to ensure proper labeling of each QRS complex . "
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    ABSTRACT: Background: Many studies have reported associations between air pollution particles with an aerodynamic diameter less than 2.5 microns (fine PM) and adverse cardiovascular effects. However there is increased concern that so-called ultrafine PM which comprises the smallest fraction of fine PM (aerodynamic diameter less than 0.1 micron) may be disproportionately toxic relative to the 0.1 to 2.5 micron fraction. Ultrafine PM is not routinely measured in state monitoring networks and is not homogenously dispersed throughout an airshed but rather located in hot spots such as near combustion sources (e.g.roads), making it difficult for epidemiology studies to associate exposure to ultrafine PM with adverse health effects.Methods and Results: Thirty four middle-aged individuals with metabolic syndrome were exposed for two hours while at rest in a randomized crossover design to clean air and concentrated ambient ultrafine particles (UCAPS) for two hours. To further define potential risk, study individuals carrying the null allele for GSTM1 (a prominent antioxidant gene) were identified by genotyping. Blood was obtained immediately prior to exposure, and at one hour and 20 hours afterward. Continuous Holter monitoring began immediately prior to exposure and continued for 24 hours. Based on changes we observed in previous CAPS studies, we hypothesized that ultrafine CAPS would cause changes in markers of blood inflammation and fibrinolysis as well as changes in heart rate variability and cardiac repolarization. GSTM1 null individuals had altered cardiac repolarization as seen by a change in QRS complexity following exposure to UCAPS and both the entire study population as well as GSTM1 null individuals had increased QT duration. Blood plasminogen and thrombomodulin were decreased in the whole population following UCAPS exposure, while C reactive protein and SAA were increased.Conclusions: This controlled human exposure study is the first to show that ambient ultrafine particles can cause cardiovascular changes in people with metabolic syndrome, which affects nearly a quarter of the U.S. adult population.
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