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Scientific Opinion of the Panel on Dietetic Products, Nutrition and Allergies on a request from the Commission related to labelling reference intake values for n-3 and n-6 polyunsaturated fatty acids 1

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SUMMARY Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies was asked to review and provide advice on labelling reference intake values for n-3 and n-6 polyunsaturated fatty acids (PUFA). The proposed labelling reference intake values for n-3 and n-6 PUFA provided by the Commission in the terms of reference are intended to represent typical recommended daily intakes (adults). These values can be used in food labelling to facilitate comparison of the PUFA content of food products and to help convey the relative significance of the food as a source of PUFA in the context of a total daily diet, and can also be used to set appropriate conditions of use for health claims on PUFA. For practical application, a single reference intake value is proposed for each nutrient using rounded values for ease of calculation. The PUFA for which advice on labelling reference intakes is requested are the n-3 PUFA α- linolenic acid (ALA), the long chain n-3 PUFA (mainly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)), and the n-6 PUFA (mainly linoleic acid (LA)). Labeling reference intake values for PUFA may be derived from science-based intake recommendations for the general population established by national and international authorities taking into account observed intakes in the population. For these PUFA, intake recommendations for the general population are sometimes aimed at the avoidance of 1 For citation purposes: Scientific Opinion of the Panel on Dietetic products, Nutrition and Allergies on a request from European Commission related to labelling reference intake values for n-3 and n-6 polyunsaturated fatty acids. The EFSA
The EFSA Journal (2009) 1176, 1-11
© European Food Safety Authority, 2009
SCIENTIFIC OPINION
Labelling reference intake values for n-3 and n-6 polyunsaturated fatty
acids
Scientific Opinion of the Panel on Dietetic Products, Nutrition and Allergies
on a request from the Commission related to labelling reference intake
values for n-3 and n-6 polyunsaturated fatty acids 1
(Question No EFSA-Q-2009-00548)
Adopted on 30 June 2009
PANEL MEMBERS
Jean-Louis Bresson, Albert Flynn, Marina Heinonen, Karin Hulshof, Hannu Korhonen,
Pagona Lagiou, Martinus Løvik, Rosangela Marchelli, Ambroise Martin, Bevan Moseley,
Hildegard Przyrembel, Seppo Salminen, Sean (J.J.) Strain, Stephan Strobel, Inge Tetens,
Henk van den Berg, Hendrik van Loveren and Hans Verhagen.
SUMMARY
Following a request from the European Commission, the Panel on Dietetic Products,
Nutrition and Allergies was asked to review and provide advice on labelling reference intake
values for n-3 and n-6 polyunsaturated fatty acids (PUFA).
The proposed labelling reference intake values for n-3 and n-6 PUFA provided by the
Commission in the terms of reference are intended to represent typical recommended daily
intakes (adults). These values can be used in food labelling to facilitate comparison of the
PUFA content of food products and to help convey the relative significance of the food as a
source of PUFA in the context of a total daily diet, and can also be used to set appropriate
conditions of use for health claims on PUFA. For practical application, a single reference
intake value is proposed for each nutrient using rounded values for ease of calculation.
The PUFA for which advice on labelling reference intakes is requested are the n-3 PUFA α-
linolenic acid (ALA), the long chain n-3 PUFA (mainly eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA)), and the n-6 PUFA (mainly linoleic acid (LA)).
Labeling reference intake values for PUFA may be derived from science-based intake
recommendations for the general population established by national and international
authorities taking into account observed intakes in the population. For these PUFA, intake
recommendations for the general population are sometimes aimed at the avoidance of
1 For citation purposes: Scientific Opinion of the Panel on Dietetic products, Nutrition and Allergies on a request from
European Commission related to labelling reference intake values for n-3 and n-6 polyunsaturated fatty acids. The EFSA
Journal (2009) 1176, 1-11.
Labelling reference intake values for n-3 and n-6 polyunsaturated fatty acids
The EFSA Journal (2009) 1176, 2-11
deficiency symptoms but more usually are based on evidence of relationships between intake
and neurodevelopment and/or cardiovascular health. PUFA intake recommendations for the
general population established by national authorities in different EU countries are not
uniform and reflect the different criteria on which they are based.
n-3 polyunsaturated fatty acids
The n-3 fatty acid most abundant in food is ALA. The proposed labelling reference intake
value for ALA (2g) is towards the upper end of the range of average intakes observed in
adults in some European countries (0.7 - 2.3 g/d or ~0.4-0.8 E%). Intake recommendations for
ALA based on considerations of cardiovascular health and neurodevelopment are about 1 E%,
corresponding to 2 - 3 g ALA/day for energy intakes 1800-2700 kcal/day. The Panel
considers that the proposed labelling reference intake value for the n-3 PUFA ALA (2g) is
consistent with recommended intakes for individuals in the general population in some
European countries based on considerations of cardiovascular health.
Long-chain n-3 polyunsaturated fatty acids
The quantitatively most important long-chain n-3 PUFA in the diet are EPA and DHA.
Most recent evidence shows that the intake of EPA plus DHA is negatively related to
cardiovascular risk in a dose-dependent way up to about 250mg/d (1–2 servings of oily fish
per week) in healthy populations. The proposed labelling reference intake value for long
chain n-3 PUFA (200 mg) is lower than this value, as are observed average intakes of EPA
plus DHA in adults in some European countries, which vary between 80mg/d and 420 mg/d.
The Panel proposes 250mg/d as the labelling reference intake value for the long-chain n-3
PUFAs EPA plus DHA, which is in agreement with most recent evidence on the relationship
between the intake of these fatty acids and cardiovascular health in healthy populations.
n-6 polyunsaturated fatty acids
n-6 PUFA mainly include LA, and to a lesser extent arachidonic acid (ARA).
The proposed labelling reference intake value of 6g of n-6 PUFA is lower than mean intakes
observed in Europe (between 7 and 19 g/d). It is also lower than the lower bound of intake
recommended for individuals in the general population by some national and international
authorities based on considerations of cardiovascular health (4 E%, equivalent to 8-12 g/d for
adults).
The Panel proposes 10g as labelling reference intake value for the n-6 PUFA LA, which is
consistent with recommended intakes for adult individuals in the general population in
European countries based on considerations of cardiovascular health.
Key words: labelling reference intake values, n-3 polyunsaturated fatty acids, n-6
polyunsaturated fatty acids, essential fatty acids, alpha-linolenic acid, linoleic
acid, long-chain polyunsaturated fatty acids, eicosapentaenoic acid,
docosahexaenoic acid, dietary reference values, dietary recommendations.
Labelling reference intake values for n-3 and n-6 polyunsaturated fatty acids
The EFSA Journal (2009) 1176, 3-11
TABLE OF CONTENTS
Panel Members ............................................................................................................................................ 1
Summary ..................................................................................................................................................... 1
n-3 polyunsaturated fatty acids ............................................................................................................... 2
Long-chain n-3 polyunsaturated fatty acids ............................................................................................ 2
n-6 polyunsaturated fatty acids ............................................................................................................... 2
Table of Contents ........................................................................................................................................ 3
Background as provided by the EC ............................................................................................................. 4
Terms of reference as provided by the EC .................................................................................................. 4
Assessment .................................................................................................................................................. 5
1.Introduction ........................................................................................................................................ 5
2.Polyunsaturated fatty acids ................................................................................................................. 8
2.1.n-3 polyunsaturated fatty acids .................................................................................................. 8
2.2.Long-chain n-3 polyunsaturated fatty acids ............................................................................... 8
2.3.n-6 polyunsaturated fatty acids .................................................................................................. 8
Conclusions ................................................................................................................................................. 9
References ................................................................................................................................................... 9
Glossary / Abbreviations ........................................................................................................................... 11
Labelling reference intake values for n-3 and n-6 polyunsaturated fatty acids
The EFSA Journal (2009) 1176, 4-11
BACKGROUND AS PROVIDED BY THE EC
In the context of the procedure for the authorisation of health claims under Regulation (EC)
No 1924/2006, the Member States discussed and voted at a meeting of 20 February 2009 in
the Standing Committee of the Food Chain and Animal on the first batch of health claims
applications to be either authorised or rejected.
To this end, the Member States and the Commission discussed concerns expressed by some
Member States in relation to the conditions of use for the health claim on essential fatty acids
(α-linolenic acid and linoleic acid) and normal growth and development of children.
The Member States and the Commission agreed that EFSA should be asked to give general
advice on reference values for the purpose of labelling for fatty acids to enable the review of
the conditions of use for the health claim referred to, but equally important to be able to set
appropriate conditions of use for the foreseen health claims on fatty acids, both for health
claims pursuant to Article 14 of Regulation (EC) No 1924/2006 but also for health claims
covered by Article 13 of that Regulation.
EFSA has already provided advice on nutrition claims concerning omega-3 fatty acids,
monounsaturated fat, polyunsaturated fat and unsaturated fat (EFSA-Q-2004-1073),
commented on the Recommended Nutritional Intake (RNI) for essential fatty acids, and
advised to distinguish RNI for α-linolenic acid in the range of 2 g/day for adults, and RNI for
long chain n-3 polyunsaturated fatty acids (LC n-3 PUFA), mainly eicosapentaenoic acid
(EPA) and docosahexaenoic acid (DHA), for which recommended intakes for cardio-
protective effects are in the range of 200-500 mg/day.
SCF defined in 1993 Population Reference Intakes (PRI) of 2 E% for omega-6
polyunsaturated fatty acids (n-6 PUFA). The corresponding amounts far n-6 PUFA are 4.5
g/day for females and 6 g/day for males, respectively. Considering that the point of reference
for the omega-3 fatty acids in the EFSA opinion is the daily intake for an adult male, 6 g/day
is included into the terms of reference.
TERMS OF REFERENCE AS PROVIDED BY THE EC
EFSA is requested to provide an opinion in accordance with Article 29(1)(a) of Regulation
(EC) No 178/2002 on the following aspects:
¾ Whether reference values for the purpose of labelling for essential fatty acids can be
established.
To this end, EFSA is asked in particular to consider the appropriateness of:
¾ 2 g for short-chain omega-3 fatty acids
¾ 200 mg for long chain omega-3 fatty acids
¾ 6 g for omega-6 fatty acids
Labelling reference intake values for n-3 and n-6 polyunsaturated fatty acids
The EFSA Journal (2009) 1176, 5-11
ASSESSMENT
1. Introduction
The proposed labelling reference intake values for n-3 and n-6 polyunsaturated fatty acids
(PUFA) provided by the Commission in the terms of reference are intended to represent
typical recommended daily intakes (adults). These values can be used in food labelling to
facilitate comparison of the PUFA content of food products and to help to convey the relative
significance of the food as a source of PUFAs in the context of a total daily diet, and can also
be used to set appropriate conditions of use for health claims on PUFAs. For practical
application, a single reference intake value is proposed for each type of PUFA using rounded
values for ease of calculation.
The PUFAs for which advice on labelling reference values is requested are the n-3 PUFA α-
linolenic acid (ALA), the long chain n-3 PUFAs (mainly eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA)) and n-6 PUFAs (mainly linoleic acid (LA)). Labelling
reference intake values for PUFA may be derived from science-based intake
recommendations for the general population established by national and international
authorities (DoH, 1991; GR, 2006; NNR, 2004; AFSSA, 2001; DACH, 2008; Eurodiet, 2000;
WHO, 2003; USDA, 2005) taking into account observed intakes in the population. For these
PUFA, intake recommendations for the general population are sometimes aimed at the
prevention of deficiency symptoms but are more usually based on evidence of relationships
between intake and neurodevelopment and/or risk of cardiovascular diseases. PUFA intake
recommendations for the general population established by national authorities in different
EU countries are not uniform and reflect the different criteria on which they are based (Table
1).
Table 2 compiles dietary intakes of n-3 and n-6 PUFAs among adults according to recent
dietary surveys in some European countries. National dietary surveys from most European
countries report intakes of total PUFAs, whereas only some provide data for n-6 PUFAs
and/or LA, and for n-3 PUFAs and/or ALA, EPA and DHA.
Labelling reference intake values for n-3 and n-6 polyunsaturated fatty acids
The EFSA Journal (2009) 1176, 6-11
Table 1. Proposed labelling reference intake values for n-3 and n-6 PUFAs and
recommended dietary intakes from national and international bodies (adults).
n-3 PUFA ALA EPA+DHA n-6 PUFA
(mainly LA)
% of
energy g/day % of
energy g/day % of
energy
mg/da
y
% of
energy g/day
Reference intake
value in ToR
- - - 2 - 200 - 6
SCF, 1993 0.5 - - - - - 2 -
WHO, 2003 1-2 - - - - - 5-8 -
United Kingdom
DoH, 1991
>0.2
>1
SACN, 2004 - - - - - 450 - -
Eurodiet, 2000 - - - 2 - 200 4-8 -
The Netherlands
(GR, 2001 and
2006)
- - 1 - - 450 2 -
Nordic Countries
(NNR, 2004)
1 - 1 - - 450
4 -
France, (AFSSA,
2001)
Adult men 0.8 2 - - 0.2 500 4 -
Adult women 0.8 1.6 - - 0.2 400 4 -
USA (FNB, 2002)
Adult men
Adult women
0.6-1.2
1.6
1.1
- - 5-10 -
14-17
11-12
Germany, Austria,
Switzerland
(D-A-CH, 2008)
0.5 - - - - - 2.5 -
The EFSA Journal (2009) 1176, 7-11
© European Food Safety Authority, 2009
Table 2. Mean dietary intake of n3- and n-6 polyunsaturated fatty acids (and clusters) among adults according to recent dietary
surveys in some European countries
ALA EPA + DHA LA References
Men Women Men Women Men Women
g/d E% g/d E% mg/d E% mg/d E% g/d E% g/d E%
Austria 1.2 0.5 1.1 0.6 280 NA 251 NA 17 7.1 14 7.1
Elmadfa et al., 2009
France 0.9 0.36 0.7 0.38 420 0.17 350 0.18
10.6 4.1 8.1 4.2
Astorg et al., 2004
Finland 2.5 1.0 1.8 1.0 NA NA NA NA 9.9 3.9 7.2 3.9 Paturi M et al., 2008.
Germany * 1.59 0.6 1.32 0.6 290 0.11 210 0.10 14.3 5.2 10.9 5.2 Linseisen et al., 2003
** 2.25 0.8 1.51 0.8 340 0.12 220 0.11 18.6 6.5 11.6 5.8 Linseisen et al., 2003
The
Netherlands
1.95 0.6 1.26 0.6 100 0.03 80 0.05 17.8 5.8 12.0 5.5 Kruizinga et al., 2007
Sweden # 1.5 NA 1.2 NA - - - - 9.7 NA 7.8 NA Becker and Pearson,
1998
* German EPIC Cohort from centre H and ** centre P
# median intake; median intake of EPA = 100 mg for males and females; median intake of DHA = 240 mg for males and 210 mg for
females.
NA = not available
The EFSA Journal (2009) 1176, 8-11
© European Food Safety Authority, 2009
2. Polyunsaturated fatty acids
2.1. n-3 polyunsaturated fatty acids
The n-3 fatty acid most abundant in food is ALA. ALA is considered to be nutritionally
essential because of its specific function as precursor for the long-chain n-3 PUFA EPA and
DHA.
The proposed labelling reference intake value for ALA (2 g) is towards the upper end of the
range of average intakes observed in adults in some European countries (0.7 - 2.3 g/d or ~0.4-
0.8 E%) (Table 2). Intake recommendations for ALA range from a minimum of 0.2 E%
(aimed at the prevention of deficiency symptoms) to about 1 E% (based on considerations of
cardiovascular health) (Table 1). One E% corresponds to between 2 and 3 g /day for energy
intakes of 1800 kcal/day for women and 2700 kcal/day for men (EFSA, 2005).
The Panel considers that the proposed labelling reference intake value for the n-3 PUFA ALA
(2 g) is consistent with recommended intakes for individuals in the general population in
European countries based on considerations of cardiovascular health.
2.2. Long-chain n-3 polyunsaturated fatty acids
In most European populations the quantitatively most important long-chain n-3 PUFA in the
diet are EPA and DHA. Dietary long-chain n-3 PUFAs also include DPA. Long-chain n-3
PUFAs can also be synthesised from ALA in animal tissues through the sequential action of
various desaturases and elongases. Together with the n-6 PUFAs, long-chain n-3 PUFAs are
important structural components of cell membranes and contribute to their functions. EPA is
also a precursor of eicosanoids.
National and international bodies have based their recommendations for dietary intake of
EPA and DHA on the inverse relationship observed between the consumption of these long-
chain n-3 PUFAs (primarily from fish and fish oils) and a lower risk of coronary artery
disease. Such recommendations range from 200 mg to 500 mg per day (Table 1; EFSA,
2005). Most recent evidence derived form meta-analysis of randomized trials and large
prospective studies shows that, when only healthy subjects are considered, the intake of EPA
plus DHA is negatively related to cardiovascular risk in a dose-dependent way up to about
250 mg/d (1–2 servings of oily fish per week), with little additional benefit observed at higher
intakes (Mozaffarian and Rimm, 2006; Mozaffarian, 2008; Harris et al., 2008, 2009a and
2009b). The proposed labelling reference intake value for long chain n-3 PUFAs (200 mg) is
lower than this value, as are observed average intakes of EPA plus DHA in adults in some
European countries, which vary between 80 mg/d and 420 mg/d (Table 2).
The Panel proposes 250 mg/d as the labelling reference intake value for the long-chain n-3
PUFAs EPA plus DHA, which is in agreement with most recent evidence on the relationship
between the intake of these fatty acids and cardiovascular health in healthy populations.
2.3. n-6 polyunsaturated fatty acids
n-6 PUFAs mainly include LA, and to a lesser extent arachidonic acid (ARA). Strictly
speaking, only LA is essential. Since the synthesis of ARA from LA seems to be sufficient in
humans after 6 months of age under the current lifestyle and dietary habits, no requirement
Labelling reference intake values for n-3 and n-6 polyunsaturated fatty acids
The EFSA Journal (2009) 1176, 9-11
for preformed ARA can be defined. Linoleic acid, when incorporated into skin ceramides, is
essential for maintaining the water-permeability barrier of the skin thereby avoiding excessive
trans-epidermal water loss and the accompanying energy loss from water evaporation. AA is
the precursor for series 2 prostanoids and series 4 leukotrienes.
In Europe, average intakes of cis n-6 PUFAs range between 3.8 E% to nearly 6 E%.
Distribution of intakes were only available for the Netherlands, ranging from 2.6 to 9.8 E% at
the 5th and the 95th percentile, and for the UK, ranging from 1.9 to 10.5 E% at the 2.5th and
97.5th percentile, respectively. Since LA is the primary n-6 PUFA, the intake of LA might be
only slightly lower than the intake of total n-6 PUFA. In some European countries, average
LA intakes in adults range from nearly 7 g/day to approximately 19 g/day, corresponding to
3.9 to 6.5 E% (Table 2).
No intake recommendations have been specifically set for ARA in adults. Intake
recommendations for LA range from a minimum of 1 E% (aimed at the prevention of
deficiency symptoms) to about 4-10 E% (based on considerations of cardiovascular health
and mean observed intakes in healthy populations), which correspond to 2-3 and 8-30 g
LA/day, respectively, for energy intakes of 1800-2700 kcal/day. The lower bound of intake
recommendations based both on considerations of cardiovascular health and on average
observed intakes in healthy populations is 4 E%, which corresponds to about 8-12 g/d (Table
2).
The proposed labelling reference value of 6 g has been calculated from the SCF (1993)
Population Reference Intake (PRI) of 2 E% for n-6 PUFA (mainly LA), which was based on
rough estimates from feeding studies in infants, extrapolated to a reference energy intake of
2700 kcal/day (adult male). This amount is lower than mean intakes observed in Europe
(between 7 and 19 g/d). It is also lower than intakes recommended for individuals in the
general population based on considerations of cardiovascular health (4 E%; equivalent to 8-12
g/d for adults) by some national and international authorities (Table 1).
The Panel proposes 10 g as labelling reference intake value for the n-6 PUFA LA, which is
consistent with recommended intakes for individuals in the general population in European
countries based on considerations of cardiovascular health.
CONCLUSIONS
The Panel concludes that:
The proposed labelling reference value for the n-3 PUFA ALA (2 g) is consistent with
recommended intakes for individuals in the general population in European countries
based on considerations of cardiovascular health.
The Panel proposes 250 mg/d as the labelling reference intake value for the long-
chain n-3 PUFAs EPA plus DHA, which is in agreement with most recent evidence
on the relationship between the intake of these fatty acids and cardiovascular health in
healthy populations.
The Panel proposes 10 g as labelling reference intake value for n-6 PUFA LA, which
is consistent with recommended intakes for individuals in the general population in
European countries based on considerations of cardiovascular health.
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GLOSSARY / ABBREVIATIONS
E% expressed as % of energy intake
EU European Union
kcal Kilocalories
... Such a deficiency in the n-3 PUFA intake and the altered ratios of n-6 to n-3 PUFA are still seen in many parts of the world especially if a person is not a fish eater. 10,11 The intake of the long-chain n-3 fatty acids in many countries is lower than the recommended level. 11 The vegetarian sections of the population do not eat fish to get DHA. ...
... 10,11 The intake of the long-chain n-3 fatty acids in many countries is lower than the recommended level. 11 The vegetarian sections of the population do not eat fish to get DHA. They mostly derive their n-3 fatty acids from vegetable sources such as flaxseed oil which contains α-linolenic acid (ALA). ...
Article
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Long chain n-3 fatty acids such as docosahexaenoic acid (DHA) are essential for the normal functioning of the brain. The vegetarian sections of the population get only alpha-linolenic acid (ALA) through their diet as a source of n-3 fatty acids. Hence, in this group of the population, the ALAs need to be converted to DHA through the action of the desaturase and the elongase enzymes. However, the conversion of the ALA to the DHA is very minimal (<2%) in mammals. Our recent studies have shown that the conversion of the ALA to the DHA can be enhanced significantly when given in the microemulsion forms. This work was undertaken to study the feasibility of enriching the synaptic membranes of rat brain with the DHA by providing the microemulsions of linseed oil (LSO) containing ALA. The rats were fed LSO as microemulsions in whey protein or in lipoid for 60 days through gavage. The rats given LSO microemulsions in lipoid showed higher levels of the DHA in the brain synaptic membrane when compared to rats given LSO without emulsion formation. This decreased the n-6/n-3 fatty acid ratio of the brain synaptic membrane. This also increased the membrane fluidity, Na(+)-K(+) ATPase activity, and acetylcholine esterase activity in the synaptic membranes. Furthermore, Ca(2+)-Mg(2+) ATPase activity, monoamine oxidase A and monoamine oxidase B activity was lowered in the rats given LSO in the microemulsion form. The dopamine and the serotonin levels in the brain were increased in the rats given LSO in the microemulsion form with lipoid as compared to those given LSO without the preemulsion formation. This study indicates that the LSO microemulsions in the lipoid can enhance the synaptic membrane DHA levels and influence the functions associated with the brain in a beneficial manner.
... Recommendations for total EPA and DHA are between 200 mg/d and 500 mg/d [16,17]. The estimated current intake in the European population varies between 80 mg/d to 420 mg/d [16]. ...
... However, the recommended intake for the marine-derived LC PUFA eicosapentaenoic acid (C20:5 n-3; EPA) and docosahexaenoic acid (C22:6 n-3; DHA) as well as for total intake of n-3 PUFA varies between the different scientific panels. Recommendations for total EPA and DHA are between 200 mg/d and 500 mg/d [16,17]. The estimated current intake in the European population varies between 80 mg/d to 420 mg/d [16]. ...
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Background The imbalance of the n-3/n-6 ratio in the Western diet is characterised by a low intake of n-3 long-chain (LC) PUFA and a concurrent high intake of n-6 PUFA. Fish, in particular marine fish, is a unique source of n-3 LC PUFA. However, FA composition of consumed fish changed, due to the increasing usage of n-6 PUFA-rich vegetable oils in aquaculture feed and in fish processing (frying) which both lead to a further shift in n-6 PUFA to the detriment of n-3 LC PUFA. The aim of this study was to determine the ratio of n-3/n-6 including the contents of EPA and DHA in fish fillets and fish products from the German market (n=123). Furthermore, the study focussed on the FA content in farmed salmon compared to wild salmon as well as in processed Alaska pollock fillet, e.g., fish fingers. Results Total fat and FA content in fish products varied considerably depending on fish species, feed management, and food processing. Mackerel, herring and trout fillets characteristically contained adequate dietary amounts of absolute EPA and DHA, due to their high fat contents. However, despite a lower fat content, tuna, pollock, and Alaska pollock can contribute considerable amounts of EPA and DHA to the human supply. Farmed salmon are an appropriate source of EPA and DHA owing to their higher fat content compared to wild salmon (12.3 vs. 2.1 wt %), however with elevated SFA, n-9 and n-6 FA contents representing the use of vegetable oils and oilseeds in aquaculture feed. The n-3/n-6 ratio was deteriorated (2.9 vs. 12.4) but still acceptable. Compared to pure fish fillets, breaded and pre-fried Alaska pollock fillet contained extraordinarily high fat and n-6 PUFA levels. Conclusions Since fish species vary with respect to their n-3 LC PUFA contents, eating a variety of fish is advisable. High n-6 PUFA containing pre-fried fish support the imbalance of n-3/n-6 ratio in the Western diet. Thus, consumption of pure fish fillets is to be favoured. The lower n-3 PUFA portion in farmed fish can be offset by the higher fat content, however, with an unfavourable FA distribution compared to wild fellows.
... Comparing to the labelling reference intake, quantities per day of n-6 PUFA are 2.4 g higher and n-3 PUFA is 1.2 g lower. Even if these quantities are included in the reference range, it leads to an unbalanced n-6/n-3 PUFA ratio [28]. A total of 13 vitamins and 15 minerals are provided in significant quantities, but it is not the case for sodium, potassium, and fluorides. ...
Article
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Crohn's disease is an inflammatory bowel disease whose prevalence is increasing worldwide. Among medical strategies, dietary therapy with exclusive enteral nutrition is recommended as a first-line option, at least for children, because it induces clinical remission and mucosal healing. Modulen®, a polymeric TGF-β2 enriched formula, has good palatability and is widely used. For the first time in the literature, this review outlines and discusses the clinical outcomes obtained with this therapy, as well as the potential mechanisms of action of its compounds. It can be explained by its TGF-β2 content, but also by its protein and lipid composition. Further well-designed studies are required to improve our knowledge and to optimize therapeutic strategies.
... The marine n-3 PUFA eicosapentaenoic acid (20:5n-3, EPA) and docosahexanoic acid (22:6n-3, DHA) occur mainly in FO and are commercially available as food supplements. The European Food Safety Agency (EFSA) recommends a daily intake of 250 mg/d of EPA and DHA for adults, because such an intake is linked to lower incidences of cardiovascular disease (CVD) [1]. There is abundant evidence that EPA and DHA from either fish or FO supplements have potentially beneficial effects on some markers of metabolic syndrome risk, a major public health problem that is increasing in prevalence worldwide [2][3][4]. ...
Article
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Dietary supplementation with marine omega-3 polyunsaturated fatty acids (n-3 PUFA) can have beneficial effects on a number of risk factors for cardiovascular disease (CVD). We compared the effects of two n-3 PUFA rich food supplements (freeze-dried Odontella aurita and fish oil) on risk factors for CVD. Male rats were randomly divided into four groups of six animals each and fed with the following diets: control group (C) received a standard diet containing 7 % lipids; second group (HF high fat) was fed with a high-fat diet containing 40 % lipids; third group (HFFO high fat+fish oil) was fed with the high-fat diet supplemented with 0.5 % fish oil; and fourth group (HFOA high fat+O. aurita) received the high-fat diet supplemented with 12 % of freeze-dried O. aurita. After 8 weeks rats fed with the high-fat diet supplemented with O. aurita displayed a significantly lower bodyweight than those in the other groups. Both the microalga and the fish oil significantly reduced insulinemia and serum lipid levels. O. aurita was more effective than the fish oil in reducing hepatic triacyglycerol levels and in preventing high-fat diet-induced steatosis. O. aurita and fish oil also reduced platelet aggregation and oxidative status induced by high fat intake. After an OA supplementation, the adipocytes in the HFOA group were smaller than those in the HF group. Freeze-dried O. aurita showed similar or even greater biological effects than the fish oil. This could be explained by a potential effect of the n-3 PUFA but also other bioactive compounds of the microalgae.
... The supplemented dose fish oils was in agreement with the European Union's recommendation on omega-3 PUFA [26]. All supplements had a similar fat and energy content (55-66 mg of PUFA per 100 mg of total fatty acid) as is specified in a previous study recently published by our group [27]. ...
Article
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Marine polyunsaturated fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been associated with improvement in the Metabolic Syndrome (MS). The aim of this study is to evaluate how three fish-oil diets with different eicosapentaenoic acid /docosahexaenoic acid ratios (EPA/DHA ratio) affect the histology of liver, kidney, adipose tissue and aorta in a preliminary morphological study. This work uses an animal model of metabolic syndrome in comparison with healthy animals in order to provide information about the best EPA:DHA ratio to prevent or to improve metabolic syndrome symptoms. 35 Wistar rats, as a control, and 35 spontaneously hypertensive obese rats (SHROB) were fed for 13 weeks with 3 different suplemmentation of fish oil containing EPA and DHA ratios (1:1, 2:1 and 1:2, respectively). All samples were stained with haematoxylin/eosin stain, except aorta samples, which were stained also with Verhoeff and van Gieson's stain. A histological study was carried out to evaluate changes. These changes were statistically analyzed using SPSS IBM 19 software. The quantitative data were expressed by mean +/- SD and were compared among groups and treatments using ANOVA with post-hoc tests for parametric data and the U-Mann-Whitney for non-parametric data. Qualitative data were expressed in frequencies, and compared with contingency tables using chi2 statistics. EPA:DHA 1:1 treatment tended to improve the density and the wrinkling of elastic layers in SHROB rats. Only Wistar rats fed with EPA:DHA 1:1 treatment did not show mast cells in adipose tissue and has less kidney atrophy. In both strains EPA:DHA 1:1 treatment improved inflammation related parameters in liver and kidney. EPA:DHA 1:1 treatment was the most beneficial treatment since improved many histological parameters in both groups of rats.
... Dietary n-3 LCPUFAs are predominantly present in fish and seafood, in which oily fish is a major source. Existing international guidelines recommend an n-3 LCPUFA intake of at least 250 mg/day or two servings of oily fish per week [39]. Despite the observed associations between dietary n-3 LCPUFAs and AMI risk, no clear associations could be seen for fish intake. ...
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A beneficial effect of a high n-3 long-chain polyunsaturated fatty acid (LCPUFA) intake has been observed in heart failure patients, who are frequently insulin resistant. We investigated the potential influence of impaired glucose metabolism on the relation between dietary intake of n-3 LCPUFAs and risk of acute myocardial infarction (AMI) in patients with coronary artery disease. This prospective cohort study was based on the Western Norway B-Vitamin Intervention Trial and included 2,378 patients with coronary artery disease with available baseline glycosylated hemoglobin (HbA1c) and dietary data. Patients were sub-grouped as having no diabetes (HbA1c <5.7%), pre-diabetes (HbA1c >=5.7%), or diabetes (previous diabetes, fasting baseline serum glucose >=7.0, or non-fasting glucose >=11.1 mmol/L). AMI risk was evaluated by Cox regression (age and sex adjusted), comparing the upper versus lower tertile of daily dietary n-3 LCPUFA intake. The participants (80% males) had a mean age of 62 and follow-up of 4.8 years. A high n-3 LCPUFA intake was associated with reduced risk of AMI (hazard ratio 0.38, 95%CI 0.18, 0.80) in diabetes patients (median HbA1c = 7.2%), whereas no association was observed in pre-diabetes patients. In patients without diabetes a high intake tended to be associated with an increased risk (hazard ratio1.45, 95%CI 0.84, 2.53), which was significant for fatal AMI (hazard ratio 4.79, 95%CI 1.05, 21.90) and associated with lower HbA1c (mean +/- standard deviation 4.55 +/-0.68 versus 4.92 +/-0.60, P = 0.02). No such differences in HbA1c were observed in those with pre-diabetes or diabetes. A high intake of n-3 LCPUFAs was associated with a reduced risk of AMI, independent of HbA1c, in diabetic patients, but with an increased risk of fatal AMI and lower HbA1c among patients without impaired glucose metabolism. Further studies should investigate whether patients with diabetes may benefit from having a high intake of n-3 LCPUFAs and whether patients with normal glucose tolerance should be careful with a very high intake of these fatty acids.Trial registration: This trial is registered at clinicaltrials.gov as NCT00354081.
Article
The nutritional profile of dorsal and ventral portions of fillets from farmed yellowtail kingfish (YTK) (Seriola lalandi, Valenciennes, 1833) was assessed in winter and summer months to evaluate if there were differential distributions of proximate constituents, fatty acid composition and mineral content seasonally and through the dorso-ventral axis. The proximate composition of YTK fillets varied between the two anatomical locations examined. In particular, a relatively large variation was observed in crude fat content, which decreased significantly from ventral to dorsal portions of the fillet and was inversely proportional to moisture and protein content. Higher crude fat content was also observed in the fish sampled in summer, compared to those sampled in winter. The omega 3/6 ratio remained constant between fillet portions but was significantly different between seasons (summer > winter). The index of nutritional quality for EPA and DHA was markedly different regarding to fillet portion and season (summer > winter, ventral > dorsal), and significant differences in the levels of potassium, phosphorus, magnesium and iron were also evident between the seasons examined. This study clearly shows differences in nutritional profiles of fillets from farmed YTK in South Australia relative to anatomical location and season. The increase in knowledge gained from this study may lead to improved farm management practices of YTK, which may extend to other commercially relevant species to enhance the production of premium farmed products.
Article
This study examined whether the lipid composition of common carp muscle can be improved and become an important source of n‐3 highly unsaturated fatty acids (HUFA) in human nutrition. Carp from three pond production systems in South Bohemia were given access to plankton, plankton with the addition of cereals, or pellets containing rapeseed cake suggested to enhance lipid nutritional value. White muscle fatty acid composition was investigated and compared among treatments. Fish with no supplements were characterized by a high content of n‐3 HUFA, especially eicosapentaenoic (EPA) and docosahexaenoic acid (DHA). Fish supplemented with rapeseed pellets had a moderate n‐3 HUFA level, while those supplemented with cereals were characterized by a high oleic acid content and low level of n‐3 fatty acids. The pond plankton populations contained high proportions of n‐3 fatty acids, including EPA and DHA, with an n‐3/n‐6 ratio around three. In summary, the rapeseed‐based pellet resulted in a more polyunsaturated lipid composition of the fish flesh, also with regard to n‐3 fatty acids. The conclusion is that the novel rapeseed‐based supplement is beneficial to human health.
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Background: Seafood (fish and shellfish) is an excellent source of several essential nutrients for pregnant and lactating women. A short food frequency questionnaire (FFQ) that can be used to quantitatively estimate seafood consumption would be a valuable tool to assess seafood consumption in this group. Currently there is no such validated FFQ in Norway. Objective: The objective of this study was to establish and validate a seafood index from a seafood FFQ against blood biomarkers (the omega-3 index, the omega-3 HUFA score, and serum 25OH vitamin D). Design: We assessed maternal seafood consumption during the 28th gestation week in healthy Norwegian women (n=54) with a seafood FFQ. A seafood index was developed to convert ordinal frequency data from the FFQ into numerical scale data. The following blood biomarkers were used as a validation method: omega-3 index, omega-3 HUFA score, and the serum 25OH vitamin D. Results: The reported frequency of seafood as dinner and as spread was strongly correlated with the estimated frequencies of seafood as dinner and as spread. This indicated that the seafood index is a valuable tool to aggregate reported frequencies from the seafood FFQ. The seafood index composed of the frequency of seafood consumption and intake of omega-3 supplements, termed the total seafood index, correlated positively with the omega-3 index, omega-3 HUFA score, and 25OH vitamin D. Conclusion: We established and validated a seafood index from a seafood FFQ. The developed seafood index can be used when studying health effects of seafood consumption in large populations. This seafood FFQ captures seafood consumption and omega-3 supplement intake considerably well in a group of pregnant women.
Article
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There is considerable interest in the impact of (n-3) long-chain PUFA in mitigating the morbidity and mortality caused by chronic diseases. In 2002, the Institute of Medicine concluded that insufficient data were available to define Dietary Reference Intakes (DRI) for eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA), noting only that EPA and DHA could contribute up to 10% toward meeting the Adequate Intake for alpha-linolenic acid. Since then, substantial new evidence has emerged supporting the need to reassess this recommendation. Therefore, the Technical Committee on Dietary Lipids of the International Life Sciences Institute North America sponsored a workshop on 4-5 June 2008 to consider whether the body of evidence specific to the major chronic diseases in the United States--coronary heart disease (CHD), cancer, and cognitive decline--had evolved sufficiently to justify reconsideration of DRI for EPA+DHA. The workshop participants arrived at these conclusions: 1) consistent evidence from multiple research paradigms demonstrates a clear, inverse relation between EPA+DHA intake and risk of fatal (and possibly nonfatal) CHD, providing evidence that supports a nutritionally achievable DRI for EPA+DHA between 250 and 500 mg/d; 2) because of the demonstrated low conversion from dietary ALA, protective tissue levels of EPA+DHA can be achieved only through direct consumption of these fatty acids; 3) evidence of beneficial effects of EPA+DHA on cognitive decline are emerging but are not yet sufficient to support an intake level different from that needed to achieve CHD risk reduction; 4) EPA+DHA do not appear to reduce risk for cancer; and 5) there is no evidence that intakes of EPA+DHA in these recommended ranges are harmful.
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The Health Council of the Netherlands published new Dutch dietary reference intakes (DRIs) for energy, proteins, fats and digestible carbohydrates (Table 1; Health Council of the Netherlands, 2001). The previous Dutch values were primarily aimed at the prevention of deficiency symptoms, whereas the current Dutch values aim at the prevention of both deficiency and chronic diseases. Values were specified for infants, young children, adolescents, adults, elderly people and for pregnant and lactating women. The age groups are similar to those used in the United States (Institute of Medicine, 2002). The report provides a comparison of the new Dutch dietary reference intakes with previous Dutch values and with the values used in Scandinavia, Germany, Switzerland, Austria, Great Britain and the European Community. At that time, the new American DRIs for energy and macronutrients were not yet available. Therefore, we now present a comparison with the new American values (Institute of Medicine, 2002). The full report can be read and downloaded from internet site www.gr.nl.
Conference Paper
Large observational studies, randomized clinical trials, and experimental studies have evaluated the effects of fish and n-3 fatty acid consumption on fatal coronary heart disease (CHD) and sudden cardiac death (SCD), clinically defined events that most often share the final common pathway of fatal ventricular arrhythmia. These different study designs, each having complementary strengths and limitations, provide strong concordant evidence that modest consumption of fish or fish oil (1-2 servings/wk of oily fish, or similar to 250 mg/d of EPA+DHA) substantially reduces the risk of CHD death and SCD. Pooled analysis of prospective cohort studies and randomized clinical trials demonstrates the magnitude and dose-response of this effect, with 36% lower risk of CHD death comparing 0 and 250 mg/d of EPA+DHA consumption (P < 0.001), but then little additional benefit with higher intakes. Reductions in risk are even larger in observational studies utilizing tissue biomarkers of n-3 fatty acids that more accurately measure dietary consumption. The concordance of findings from different studies also suggests that effects of fish or fish oil on CHD death and SCD do not vary depending on presence or absence of established CHD. The strength and consistency of the evidence, and the magnitude of this effect are each notable. Because more than one-half of all CHD deaths and two-thirds of SCD occur among individuals without recognized heart disease, modest consumption of fish or fish oil, together with smoking cessation and regular moderate physical activity, should be among the first-line treatments for prevention of CHD death and SCD.
Article
The intake of individual n-6 and n-3 polyunsaturated fatty acids (PUFA) have been estimated in 4,884 adult subjects of both sexes, volunteers from the French SUVIMAX intervention trial. On an energy basis, both men and women consumed 4.2% energy as linoleic acid, 0.38% as α-linolenic acid, 0.08% as arachidonic acid, 0.06% as eicosapentaenoic acid (EPA), 0.03% as docosapentaenoic acid (DPA) and 0.11% as docosahexaenoic acid (DHA), with a mean linoleic/α-linolenic acid ratio of 11.3. The intake of α-linolenic acid was well below the current recommendations (0.8% of energy) for almost all subjects, as a consequence of the low consumption of α-linolenic acid-rich oils and fats. The mean intake levels of long-chain n-3 PUFA were higher than the recommended levels, but showed great interindividual variations, due to very large differences in the consumption of fish, especially of fatty fish.
Article
A large body of literature suggests that higher intakes of omega-6 (or n-6) polyunsaturated fatty acids (PUFAs) reduce risk for coronary heart disease (CHD). However, for the reasons outlined below, some individuals and groups have recommended substantial reductions in omega-6 PUFA intake.1–4 The purpose of this advisory is to review evidence on the relationship between omega-6 PUFAs and the risk of CHD and cardiovascular disease. Omega-6 PUFAs are characterized by the presence of at least 2 carbon-carbon double bonds, with the first bond at the sixth carbon from the methyl terminus. Linoleic acid (LA), an 18-carbon fatty acid with 2 double bonds (18:2 omega-6), is the primary dietary omega-6 PUFA. LA cannot be synthesized by humans, and although firm minimum requirements have not been established for healthy adults, estimates derived from studies in infants and hospitalized patients receiving total parenteral nutrition suggest that an LA intake of ≈0.5% to 2% of energy is likely to suffice. After consumption, LA can be desaturated and elongated to form other omega-6 PUFAs such as γ-linolenic and dihomo-γ-linolenic acids. The latter is converted to the metabolically important omega-6 PUFA arachidonic acid (AA; 20:4 omega-6), the substrate for a wide array of reactive oxygenated metabolites. Because LA accounts for 85% to 90% of the dietary omega-6 PUFA, this advisory focuses primarily on this fatty acid, recognizing that dietary AA, which can affect tissue AA levels,5 may have physiological sequelae.6–8 LA comes primarily from vegetable oils (eg, corn, sunflower, safflower, soy). The average US intake of LA, according to National Health and Nutrition Examination Survey 2001 to 2002 data for adults ≥19 years of age, is 14.8 g/d.9 On the basis of an average intake of 2000 kcal/d, LA intake is 6.7% of energy. AA (≈0.15 g/d) is consumed preformed in meat, …
Numerous organizations and national health agencies have begun to recommend consumption of the long-chain omega-3 fatty acids (FAs) eicosapentaenoic acid and docosahexaenoic acid (EPA and DHA), respectively, in pill or fish form for general cardiovascular health. The purpose of this article is to present a rationale for an official target intake of 400 to 500 mg/d of EPA + DHA in the United States. Six epidemiologic studies reporting EPA + DHA intake and risk of coronary heart disease (CHD) death have been conducted in the United States, and five studies reported statistically significant inverse trends. Meta-analysis of these data showed a significant dose-response relationship between risk for CHD death and intake (P = 0.03), with relative risk reductions of 37% at an average EPA + DHA intake of 566 mg/d. Coincidentally, two servings per week of oily fish (the current American Heart Association recommendation) would provide 400 to 500 mg/d. We conclude, therefore, that an intake of 400 to 500 mg/d of EPA + DHA is achievable by diet alone and would be expected to significantly reduce risk for death from CHD in healthy adults.
Article
This evaluation aims to describe the quantity and quality of dietary fat, carbohydrate and fiber intake in both German cohorts participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). Estimates are based on standardized computer-guided 24-hour dietary recalls from 1,078 women and 1,013 men in Heidelberg and 898 women and 1,032 men in Potsdam. In a subsample, plasma phospholipid (PL) fatty acids were analyzed as well. Adjusted mean dietary intake estimates demonstrated that the contribution of fat as well as n-6 and n-3 polyunsaturated fatty acids (PUFA) to the total daily energy intake was higher in both women and men of EPIC-Potsdam compared to EPIC-Heidelberg. Surprisingly, the dietary n-6/n-3 PUFA ratio was lower in the Potsdam cohort. These results were confirmed by means of the PL fatty acid pattern. Besides the higher contribution of polysaccharides to total energy intake in EPIC-Heidelberg, women of the Heidelberg cohort revealed a significantly lower contribution of mono- and disaccharides (sucrose) to total energy intake. Although total fiber intake data were similar in both cohorts, analysis by food groups showed differences in dietary fiber intake originating from the food groups cereals, fruits and potatoes. The results demonstrate distinct differences in the dietary fat, carbohydrate and fiber intake between both German EPIC cohorts, which contribute to the exposure variation in the whole of EPIC.