Fatty Acids and Other Nutritional Supplements; New Research Making Health Affordable. See presentations by Dariush Mozaffarian, MD, Ron Watson, PhD, Vijaya Juturu, PhD, Penny Kris-Etherton, PhD, Bruce Holub, PhD.
Trans Fatty Acids in Cardiovascular Health and Disease – Informed Opinion
By Dariush Mozaffarian, MD, Harvard School of Public Health. Conference paper presented at the American Oil Chemists Society (AOCS) Symposium, May 2005. Theme: Fatty Acids and Other Nutritional Supplements; New Research Making Health Affordable. A significant proportion of coronary heart disease deaths could be prevented by replacing partially hydrogenated fats with polyunsaturated fats.
Several physiologic effects of Trans Fatty Acids (TFAs) may influence cardiovascular risk. Adverse effects on serum lipids are well established, including lowering of HDL cholesterol and raising of LDL cholesterol, triglycerides and lipoprotein(a). Recent studies indicate that TFA intake also increases systemic inflammation, a potent risk factor for atherosclerosis, sudden death, and diabetes. In experimental studies, TFAs also worsen insulin resistance, reduce anti-coagulant activity, impair endothelial cell function, and increase lipid oxidation. The molecular mechanisms underlying the physiologic effects of TFAs are not yet well understood. TFAs may directly influence macrophage membrane phospholipids and signaling pathways and also bind to tissue-specific intranuclear receptors such as PPAR-gamma. TFAs are also incorporated into endothelial cell membranes, which have numerous tissue-specific pathways relating to inflammatory activation, insulin sensitivity, atherogenesis, and plaque stability. Consumption of TFAs independently predicts poor cardiovascular health, including higher incidence of coronary heart disease, sudden death, and diabetes mellitus. While further research is needed to continue to characterize the relations between TFAs and cardiovascular health, the evidence from experimental and observational studies indicates that a significant proportion of coronary heart disease deaths and possibly new cases of diabetes would be prevented by replacing partially hydrogenated fats in the food supply with unhydrogenated polyunsaturated fats.
Vitamin E Moderation of Heart Disease by Cytokine Regulation
Written by Ronald R. Watson, Ph.D., University of Arizona. Conference paper presented at the American Oil Chemists Society (AOCS) Symposium, May 2005. Theme: Fatty Acids and Other Nutritional Supplements; New Research Making Health Affordable.
Using mouse models we have shown that vitamin E alone, and especially with other antioxidants can reduce cytokine dysregulation as they provide partial protection to the heart from oxidative damage. Mice exposed to second hand tobacco smoke have increased oxidative damage, IL-6, and cardiac dysfunction. Treatment with multiple antioxidants partially restored heart and immune function. Similarly murine AIDS as well as aging cause dramatic losses in vitamin E as well as Th1 cytokines with elevation of Th2 ones and premature death from heart failure. Cytokine dysregulation in these mice was associated with loss of resistance to the cardiotrophic virus, Coxsackie for heart failure. Using a T-cell receptor peptide oxidation and vitamin E loss were reduced. These changes helped restore resistance to Coxsackievirus, delaying premature death and cardiac pathology. By overcoming losses in antioxidants toxic Th2 cytokines are reduced partially protecting the heart and prolonging survival.S
Supported in part by Wallace Research Foundation
Nutrients Modulating Metabolic Syndrome Risk Factors
Written by Vijaya Juturu, Ph.D., Nutrition 21, Inc. Conference paper presented at the American Oil Chemists Society (AOCS) Symposium, May 2005. Theme: Fatty Acids and Other Nutritional Supplements; New Research Making Health Affordable
The importance of the syndrome is due to its increased rates of cardiovascular morbidity and mortality. Insulin resistance is characterized by central (abdominal) obesity, impaired glucose tolerance, hypertension, and dyslipidemia (elevated free fatty acid (FFA) levels and triglycerides and low high-density lipoprotein cholesterol). Each independent risk factor can amplify the risk of CVD. In addition, the proinflammatory and prothrombotic mediators potentiate atherosclerosis through the aggression of independent metabolic disorders. Prevention of metabolic syndrome risk factors (MSRF) with non-pharmacological interventions may reduce the risk of MS. Some of the nutritional supplements such as policosanol, soy proteins, plant stanols and esters, isoflavones, omega 3 fatty acids and chromium potentially alter metabolic disease risk factors and related consequences. Aggressive management of MSRF is often necessary to reduce the risk of CVD. Although there is no conclusive evidence for all MSRF yet, it seems plausible that nutritional supplements modulating MSRF exhibits most of the desired attributes for reducing the risk of MSRF.
Impact of Omega-3 fatty Acids on Cardiovascular Disease Risk Factors
By Penny M. Kris-Etherton, Ph.D., Penn State College of Health, Human Services. Conference paper presented at the American Oil Chemists Society (AOCS) Symposium, May 2005. Theme: Fatty Acids and Other Nutritional Supplements; New Research Making Health Affordable
Collectively, evidence from five U.S. epidemiologic studies reported that the average intake of EPA and DHA (estimated from fish consumption) associated with the lowest risk of coronary events (including CHD death, primary cardiac arrest and ischemic heart disease death) was approximately 500 mg/day. A meta-analysis of five prospective cohort studies reported that a high intake of Alpha-Linolenic Acid (ALA) was associated with a reduced risk of fatal heart disease. Evidence from randomized secondary prevention trials indicates that about 1 g/day of fish oil reduces total and CHD mortality. The clinical trial evidence for plant-derived omega-3 fatty acids (i.e., ALA) is suggestive of a cardioprotective effect, although this awaits confirmation in well-controlled intervention trials. The mechanisms by which EPA and DHA exert cardioprotective effects are due to antiarrhythmic and antithrombotic effects, reduced progression of atherosclerosis, and improvements in endothelial function. In addition, fish-derived omega-3 fatty acids decrease plasma triglycerides (fasting and postprandial), reduce adhesion molecules, and decrease inflammation. The available evidence on the beneficial effects of omega-3 fatty acids has resulted in national and international expert panels and health organizations recommending increased EPA and DHA intakes. Consumption of between 450 and 1000 mg/day is recommended for persons without CHD and those with CHD, respectively.
Prevention to Lower Healthcare Costs
By Bruce Holub, Ph.D., University of Guelph. Conference paper presented at the American Oil Chemists Society (AOCS) Symposium, May 2005. Preventative nutrition might save 300 billion dollars per year in North America in healthcare costs.
The current ‘medical model’ that predominates our North American health-care system focuses on latent disease and risk factor management using costly medical/pharmaceutical strategies and liberal cut-off points for risk factor management (e.g., blood triglyceride levels, cholesterol levels, etc.). Since chronic disorders are soaring in our society at even younger ages than ever before (early-stage cardiovascular disease, type 2 diabetes, etc.), it is apparent that the early introduction of an aggressive ‘preventive model’ needs to enter our healthcare system. This would include the early introduction of risk factor-modifying nutraceuticals and functional foods which can provide the moderate attenuation of various risk factors using cut-off points that are much more conservative than previously used.
The early modification of these ‘high-normal’ risk factors can be readily implemented in our young adults before they enter the predicted pathway over much of their lives toward chronic diseases. For example, numerous evidence-based nutraceutical opportunities already exist which can provide moderate reductions in LDL-cholesterol levels through the use of selected natural fibres, plant sterols, and other ingredients.
Fish oil enriched with omega-3 fatty acids can be used in the early attenuation of moderately-elevated blood triglyceride levels in our young people when consumed in supplemental form or as various functional foods for minimal cost. Omega-3 fatty acids from fish oil have been shown to lower circulating triglyceride levels in cardiovascular and diabetic patients (including those on statin drugs) with efficiencies approaching that of patented/synthetic pharmaceutical agents.
It is estimated that such a ‘preventive model’ utilizing nutraceuticals and functional foods for both the prevention and complimentary management of chronic disorders could provide a minimum of $300 billion dollars annually in health-care cost savings in North America.
