Article

Micallef MA, Garg ML. Anti-inflammatory and cardioprotective effects of n-3 polyunsaturated fatty acids and plant sterols in hyperlipidemic individuals. Atherosclerosis 204, 476-482

Nutraceuticals Research Group, School of Biomedical Sciences, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia.
Atherosclerosis (Impact Factor: 3.99). 10/2008; 204(2):476-82. DOI: 10.1016/j.atherosclerosis.2008.09.020
Source: PubMed

ABSTRACT

Risk factors of cardiovascular disease such as lipid aberrations, hypertension, abdominal adiposity and elevations in systemic inflammation, are prominent aetiologies in hyperlipidemia. Supplementation with n-3 PUFA is associated with a reduction in cardiovascular events through its hypotriglyceridemic, anti-aggregatory and anti-inflammatory properties. Plant sterols have potent hypocholesterolemic properties, although their effect on the inflammatory cascade is uncertain. This study investigated the effect of combined supplementation with n-3 PUFA and plant sterols on cardiovascular risk factors, blood pressure, body composition, markers of systemic inflammation and overall risk, in hyperlipidemic individuals.
The study was a 3-week randomised, double-blind, placebo-controlled, 2 x 2 factorial design, in four parallel groups. Sixty hyperlipidemic participants were randomised to receive either sunola oil or 1.4 g/d n-3 PUFA capsules with or without 2g plant sterols per day.
The combination of n-3 PUFA and plant sterols reduced several inflammatory markers. High sensitivity C-reactive protein (hs-CRP) was reduced by 39% (P=0.009), tumor necrosis factor-alpha (TNF-alpha) by 10% (P=0.02), interleukin-6 (IL-6) by 10.7% (P=0.009), leukotriene B(4) (LTB(4)) by 29.5% (P=0.01) and adiponectin was increased by 29.5% (P=0.05). Overall cardiovascular risk was reduced by 22.6% (P=0.006) in the combination group.
We have demonstrated, for the first time that dietary intervention with n-3 PUFA and plant sterols reduces systemic inflammation in hyperlipidemic individuals. Furthermore, our results suggest that reducing inflammation provides a potential mechanism by which the combination of n-3 PUFA and plant sterols are cardioprotective.

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    • "In some instances, sole DHA and/or EPA supplements were provided [31] [43] [46] [60] or the EPA+DHA was combined with sterols [45] [46]. A variety of placebo control oils were also used, including: safflower oil [26] [37] [63], olive oil [27] [30] [42] [43] [49] [54] [57] [59] [68], sunflower oil [29] [39] [44] [60], linoleic acid [31], coconut oil [32] [52], soybean oil [33] [35] [64], higholeic sunflower [36], corn oil [38] [50] [53] [62] [66]; butter [41], paraffin [67], and combinations of soybean and canola oil [34]; linoleic and oleic acid [40]; olive and sunflower oil [45]; sucrose, mannitol , and mineral salts [47] [48]; Sunola oil [46]; corn and olive oil [55]; palm and sunflower oil [58]; and medium-chain triglycerides [61]. It is interesting to note that studies that enrolled a larger number of participants did not demonstrate an ability of EPA+DHA to reduce plasma CRP, with the exception of two relatively large (n ≥ 78/group) 6-month long studies of 2.6 g/d EPA+DHA conducted by Derosa et al. in people with dyslipidemia [47] [48]. "
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    • "Dietary lipids play a key role in human health and disease and this role is controversial and depends on the type and the amount of ingested fat. Specifically, n-3 long-chain polyunsaturated fatty acids (PUFAs) have been suggested to promote or maintain cardiovascular health [1] [2], mainly due to their antilipidemic [3] [4], anti-inflammatory [5] [6], antiplatelet [7] [8], and antiarrhythmic [9] [10] effects. Unlike the commonly accepted cardio protective role of n-3 PUFAs, other dietary lipids are more controversial. "
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