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Journal of Translational Medicine Jun 2023Docosahexaenoic acid (DHA) supplementation is recommended for women during pregnancy because of its neurological, visual, and cognitive effects. Previous studies have... (Review)
Review
Docosahexaenoic acid (DHA) supplementation is recommended for women during pregnancy because of its neurological, visual, and cognitive effects. Previous studies have suggested that DHA supplementation during pregnancy may prevent and treat certain pregnancy complications. However, there are contradictions in the current related studies, and the specific mechanism by which DHA acts remains unclear. This review summarizes the research on the relationship between DHA intake during pregnancy and preeclampsia, gestational diabetes mellitus, preterm birth, intrauterine growth restriction, and postpartum depression. Furthermore, we explore the impact of DHA intake during pregnancy on the prediction, prevention, and treatment of pregnancy complications as well as its impact on offspring neurodevelopment. Our results suggest that there is limited and controversial evidence for the protective effect of DHA intake on pregnancy complications, with the exception of preterm birth and gestational diabetes mellitus. However, additional DHA supplementation may improve long-term neurodevelopmental outcomes in the offspring of women with pregnancy complications.
Topics: Pregnancy; Infant, Newborn; Humans; Female; Docosahexaenoic Acids; Diabetes, Gestational; Premature Birth; Dietary Supplements; Pregnancy Complications
PubMed: 37330569
DOI: 10.1186/s12967-023-04239-8 -
Best Practice & Research. Clinical... May 2023Despite cardiovascular disease (CVD) reductions with high-intensity statins, there remains residual risk among patients with metabolic disorders. Alongside low-density... (Review)
Review
Despite cardiovascular disease (CVD) reductions with high-intensity statins, there remains residual risk among patients with metabolic disorders. Alongside low-density lipoproteins (LDL-C), elevated triglycerides (TG) are associated with incident CVD events. Omega-3 fatty acids (n3-FAs), specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), lower TG levels, but their ability to reduce CV risk has been highly inconsistent. Trials using icosapent ethyl (IPE), a purified EPA ethyl ester, produced reductions in CVD events and atherosclerotic plaque regression compared with mixed EPA/DHA formulations despite similar TG-reductions. The separate effects of EPA and DHA on tissue distribution, oxidative stress, inflammation, membrane structure and endothelial function may contribute to these discordant outcomes. Additional mechanistic trials will provide further insights into the role of n3-FAs in reducing CVD risk beyond TG lowering.
Topics: Humans; Cardiovascular Diseases; Triglycerides; Fatty Acids, Omega-3; Hypertriglyceridemia; Docosahexaenoic Acids
PubMed: 35739003
DOI: 10.1016/j.beem.2022.101681 -
Annual Review of Pharmacology and... Jan 2023The long-chain omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are found in seafood, supplements, and concentrated pharmaceutical... (Review)
Review
The long-chain omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are found in seafood, supplements, and concentrated pharmaceutical preparations. Prospective cohort studies demonstrate an association between higher intakes of EPA+DHA or higher levels of EPA and DHA in the body and lower risk of developing cardiovascular disease (CVD), especially coronary heart disease and myocardial infarction, and of cardiovascular mortality in the general population. The cardioprotective effect of EPA and DHA is due to the beneficial modulation of a number of risk factors for CVD. Some large trials support the use of EPA+DHA (or EPA alone) in high-risk patients, although the evidence is inconsistent. This review presents key studies of EPA and DHA in the primary and secondary prevention of CVD, briefly describes potential mechanisms of action, and discusses recently published RCTs and meta-analyses. Potential adverse aspects of long-chain omega-3 fatty acids in relation to CVD are discussed.
Topics: Humans; Prospective Studies; Fatty Acids, Omega-3; Cardiovascular System; Docosahexaenoic Acids; Eicosapentaenoic Acid; Cardiovascular Diseases
PubMed: 36662586
DOI: 10.1146/annurev-pharmtox-051921-090208 -
Journal of the American Heart... Jun 2022Background Current evidence might support the use of omega-3 fatty acids (preferably docosahexaenoic acid and eicosapentaenoic acid) for lowering blood pressure (BP),... (Meta-Analysis)
Meta-Analysis Review
Background Current evidence might support the use of omega-3 fatty acids (preferably docosahexaenoic acid and eicosapentaenoic acid) for lowering blood pressure (BP), but the strength and shape of the dose-response relationship remains unclear. Methods and Results This study included randomized controlled trials published before May 7, 2021, that involved participants aged ≥18 years, and examined an association between omega-3 fatty acids (docosahexaenoic acid, eicosapentaenoic acid, or both) and BP. A random-effects 1-stage cubic spline regression model was used to predict the average dose-response association between daily omega-3 fatty acid intake and changes in BP. We also conducted stratified analyses to examine differences by prespecified subgroups. Seventy-one trials were included, involving 4973 individuals with a combined docosahexaenoic acid+eicosapentaenoic acid dose of 2.8 g/d (interquartile range, 1.3 g/d to 3.6 g/d). A nonlinear association was found overall or in most subgroups, depicted as J-shaped dose-response curves. The optimal intake in both systolic BP and diastolic BP reductions (mm Hg) were obtained by moderate doses between 2 g/d (systolic BP, -2.61 [95% CI, -3.57 to -1.65]; diastolic BP, -1.64 [95% CI, -2.29 to -0.99]) and 3 g/d (systolic BP, -2.61 [95% CI, -3.52 to -1.69]; diastolic BP, -1.80 [95% CI, -2.38 to -1.23]). Subgroup studies revealed stronger and approximately linear dose-response relations among hypertensive, hyperlipidemic, and older populations. Conclusions This dose-response meta-analysis demonstrates that the optimal combined intake of omega-3 fatty acids for BP lowering is likely between 2 g/d and 3 g/d. Doses of omega-3 fatty acid intake above the recommended 3 g/d may be associated with additional benefits in lowering BP among groups at high risk for cardiovascular diseases.
Topics: Adolescent; Adult; Blood Pressure; Docosahexaenoic Acids; Eicosapentaenoic Acid; Fatty Acids, Omega-3; Humans; Randomized Controlled Trials as Topic
PubMed: 35647665
DOI: 10.1161/JAHA.121.025071 -
Nutrients Nov 2020Dietary components are essential for the structural and functional development of the brain. Among these, docosahexaenoic acid, 22:6n-3 (DHA), is critically necessary... (Randomized Controlled Trial)
Randomized Controlled Trial
Dietary components are essential for the structural and functional development of the brain. Among these, docosahexaenoic acid, 22:6n-3 (DHA), is critically necessary for the structure and development of the growing fetal brain . DHA is the major n-3 long-chain polyunsaturated fatty acid in brain gray matter representing about 15% of all fatty acids in the human frontal cortex. DHA affects neurogenesis, neurotransmitter, synaptic plasticity and transmission, and signal transduction in the brain. Data from human and animal studies suggest that adequate levels of DHA in neural membranes are required for maturation of cortical astrocyte, neurovascular coupling, and glucose uptake and metabolism. Besides, some metabolites of DHA protect from oxidative tissue injury and stress in the brain. A low DHA level in the brain results in behavioral changes and is associated with learning difficulties and dementia. In humans, the third trimester-placental supply of maternal DHA to the growing fetus is critically important as the growing brain obligatory requires DHA during this window period. Besides, DHA is also involved in the early placentation process, essential for placental development. This underscores the importance of maternal intake of DHA for the structural and functional development of the brain. This review describes DHA's multiple roles during gestation, lactation, and the consequences of its lower intake during pregnancy and postnatally on the 2019 brain development and function.
Topics: Adult; Biomarkers; Breast Feeding; Child Development; Docosahexaenoic Acids; Double-Blind Method; Female; Humans; Infant; Lutein; Maternal Nutritional Physiological Phenomena; Micronutrients; Milk, Human; Young Adult
PubMed: 33255561
DOI: 10.3390/nu12123615 -
Essays in Biochemistry Sep 2020Today, persistent and uncontrolled inflammation is appreciated to play a pivotal role in many diseases, such as cardiovascular diseases, neurodegenerative diseases,... (Review)
Review
Today, persistent and uncontrolled inflammation is appreciated to play a pivotal role in many diseases, such as cardiovascular diseases, neurodegenerative diseases, metabolic syndrome and many other diseases of public health concern (e.g. Coronavirus Disease 2019 (COVID-19) and periodontal disease). The ideal response to initial challenge in humans is a self-limited inflammatory response leading to complete resolution. The resolution phase is now widely recognized as a biosynthetically active process, governed by a superfamily of endogenous chemical mediators that stimulate resolution of inflammatory responses, namely specialized proresolving mediators (SPMs). Because resolution is the natural ideal response, the SPMs have gained attention. SPMs are mediators that include ω-6 arachidonic acid-derived lipoxins, ω-3 eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)-derived resolvins, protectins and maresins, cysteinyl-SPMs, as well as n-3 docosapentaenoic acid (DPA)-derived SPMs. These novel immunoresolvents, their biosynthetic pathways and receptors have proven to promote resolution of inflammation, clearance of microbes, reduce pain and promote tissue regeneration via specific cellular and molecular mechanisms. As of 17 August, 2020, PubMed.gov reported >1170 publications for resolvins, confirming their potent protective actions from many laboratories worldwide. Since this field is rapidly expanding, we provide a short update of advances within 2-3 years from human and preclinical animal studies, together with the structural-functional elucidation of SPMs and identification of novel SPM receptors. These new discoveries indicate that SPMs, their pathways and receptors could provide a basis for new approaches for treating inflammation-associated diseases and for stimulating tissue regeneration via resolution pharmacology and precision nutrition.
Topics: Animals; Betacoronavirus; COVID-19; Coronavirus Infections; Docosahexaenoic Acids; Humans; Inflammation; Inflammation Mediators; Pandemics; Pneumonia, Viral; SARS-CoV-2
PubMed: 32885825
DOI: 10.1042/EBC20200018 -
Nutrients Mar 2021Brain structure and function depend on a constant and sufficient supply with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) by blood. Blood levels of EPA and... (Review)
Review
Brain structure and function depend on a constant and sufficient supply with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) by blood. Blood levels of EPA and DHA reflect dietary intake and other variables and are preferably assessed as percentage in erythrocytes with a well-documented and standardized analytical method (HS-Omega-3 Index). Every human being has an Omega-3 Index between 2 and 20%, with an optimum of 8-11%. Compared to an optimal Omega-3 Index, a lower Omega-3 Index was associated with increased risk for total mortality and ischemic stroke, reduced brain volume, impaired cognition, accelerated progression to dementia, psychiatric diseases, compromises of complex brain functions, and other brain issues in epidemiologic studies. Most intervention trials, and their meta-analyses considered EPA and DHA as drugs with good bioavailability, a design tending to produce meaningful results in populations characterized by low baseline blood levels (e.g., in major depression), but otherwise responsible for many neutral results and substantial confusion. When trial results were evaluated using blood levels of EPA and DHA measured, effects were larger than comparing EPA and DHA to placebo groups, and paralleled epidemiologic findings. This indicates future trial design, and suggests a targeted use EPA and DHA, based on the Omega-3 Index.
Topics: Brain; Docosahexaenoic Acids; Eicosapentaenoic Acid; Humans
PubMed: 33806218
DOI: 10.3390/nu13041074 -
International Journal of Molecular... Jun 2023Neurodegenerative diseases are characterized by neuroinflammation, neuronal depletion and oxidative stress. They coincide with subtle chronic or flaring inflammation,... (Review)
Review
Neurodegenerative diseases are characterized by neuroinflammation, neuronal depletion and oxidative stress. They coincide with subtle chronic or flaring inflammation, sometimes escalating with infiltrations of the immune system cells in the inflamed parts causing mild to severe or even lethal damage. Thus, neurodegenerative diseases show all features of autoimmune diseases. Prevalence of neurodegenerative diseases has dramatically increased in recent decades and unfortunately, the therapeutic efficacy and safety profile of available drugs is moderate. The beneficial effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) polyunsaturated fatty acids (omega-3 PUFAs) are nowadays highlighted by a plethora of studies. They play a role in suppression of inflammation, gene expression, cellular membrane fluidity/permeability, immune functionality and intracellular/exocellular signaling. The role of omega-6 polyunsaturated fatty acids, such as linoleic acid (LA), gamma linolenic acid (GLA), and arachidonic acid (AA), on neuroprotection is controversial, as some of these agents, specifically AA, are proinflammatory, whilst current data suggest that they may have neuroprotective properties as well. This review provides an overview of the existing recent clinical studies with respect to the role of omega-3 and omega-6 PUFAs as therapeutic agents in chronic, inflammatory, autoimmune neurodegenerative diseases as well as the dosages and the period used for testing.
Topics: Humans; Eicosapentaenoic Acid; Docosahexaenoic Acids; Neurodegenerative Diseases; Fatty Acids, Omega-3; Fatty Acids, Unsaturated; Arachidonic Acid; Linoleic Acids; Inflammation
PubMed: 37445890
DOI: 10.3390/ijms241310717 -
Journal of the International Society of... Dec 2023Resistance exercise training (RET) is a common and well-established method to induce hypertrophy and improvement in strength. Interestingly, fish oil supplementation... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Resistance exercise training (RET) is a common and well-established method to induce hypertrophy and improvement in strength. Interestingly, fish oil supplementation (FOS) may augment RET-induced adaptations. However, few studies have been conducted on young, healthy adults.
METHODS
A randomized, placebo-controlled design was used to determine the effect of FOS, a concentrated source of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), compared to placebo (PL) on RET-induced adaptations following a 10-week RET program (3 days·week). Body composition was measured by dual-energy x-ray absorptiometry (LBM, fat mass [FM], percent body fat [%BF]) and strength was measured by 1-repetition maximum barbell back squat (1RM) and bench press (1RM) at PRE (week 0) and POST (10 weeks). Supplement compliance was assessed via self-report and bottle collection every two weeks and via fatty acid dried blood spot collection at PRE and POST. An α-level of 0.05 was used to determine statistical significance and Cohen's was used to quantify effect sizes (ES).
RESULTS
Twenty-one of 28 male and female participants (FOS, = 10 [4 withdrawals]; PL, = 11 [3 withdrawals]) completed the 10-week progressive RET program and PRE/POST measurements. After 10-weeks, blood EPA+DHA substantially increased in the FOS group (+109.7%, < .001) and did not change in the PL group (+1.3%, = .938). Similar between-group changes in LBM (FOS: +3.4%, PL: +2.4%, = .457), FM (FOS: -5.2%, PL: 0.0%, = .092), and %BF (FOS: -5.9%, PL: -2.5%, = .136) were observed, although, the between-group ES was considered large for FM ( = 0.84). Absolute and relative (kg·kg [body mass]) 1RM was significantly higher in the FOS group compared to PL (FOS: +17.7% vs. PL: +9.7%, = .047; FOS: +17.6% vs. PL: +7.3%, = .011; respectively), whereas absolute 1RM was similar between conditions (FOS: +28.8% vs. PL: +20.5%, = .191). Relative 1RM was higher in the FOS group (FOS: +29.3% vs. PL: +17.9%, = .045).
CONCLUSIONS
When combined with RET, FOS improves absolute and relative 1RM upper-body and relative 1RM lower-body strength to a greater extent than that observed in the PL group of young, recreationally trained adults.
Topics: Female; Humans; Male; Body Composition; Dietary Supplements; Docosahexaenoic Acids; Eicosapentaenoic Acid; Fish Oils; Muscle Strength; Muscle, Skeletal; Resistance Training
PubMed: 36822153
DOI: 10.1080/15502783.2023.2174704 -
Advances in Nutrition (Bethesda, Md.) Jul 2023The current guidelines recommend that people consume 2 or more servings of fat-rich fish per week to obtain enough omega-3 (ω-3) polyunsaturated fatty acids to prevent... (Meta-Analysis)
Meta-Analysis Review
The current guidelines recommend that people consume 2 or more servings of fat-rich fish per week to obtain enough omega-3 (ω-3) polyunsaturated fatty acids to prevent cardiovascular events. However, the cardiovascular benefits of ω-3 polyunsaturated fatty acids in patients with diabetes are unclear, and related large-scale trials have produced conflicting results. We aimed to perform a meta-analysis of all randomized controlled trials that attempted to assess the effects of ω-3 fatty acid supplementation on cardiovascular outcomes in patients with diabetes. In PubMed, EMBASE, and the Cochrane Library, we searched for data from all randomized controlled trials on ω-3 fatty acids and cardiovascular outcomes in patients with diabetes published before July 2022. Eight eligible studies involving 57,754 participants were ultimately included. Meta-analysis showed that ω-3 fatty acid supplementation reduces cardiovascular disease (CVD) risk in patients with diabetes (rate ration [RR] = 0.93; 95% confidence interval [CI]: 0.90, 0.97; P = 0.0009). Among them, eicosapentaenoic acid (EPA), but not EPA plus docosahexaenoic acid (DHA), significantly reduced the risk of CVD in patients with diabetes (EPA [RR = 0.81; 95% CI: 0.73, 0.90; P=0.0001]). This meta-analysis suggests that ω-3 fatty acid supplementation is an effective strategy to prevent CVD in patients with diabetes, but further well-designed, large-scale randomized controlled trials are necessary to evaluate the safety of ω-3 fatty acid supplementation, and its effect on atrial fibrillation. This study was registered with PROSPERO as CRD42022346302.
Topics: Humans; Dietary Supplements; Randomized Controlled Trials as Topic; Fatty Acids, Omega-3; Eicosapentaenoic Acid; Docosahexaenoic Acids; Diabetes Mellitus; Cardiovascular Diseases
PubMed: 37121469
DOI: 10.1016/j.advnut.2023.04.009