ESPEYB16 12. Type 2 Diabetes, Metabolic Syndrome and Lipid Metabolism Lipid Metabolism (4 abstracts)
12.13. Marine n-3 fatty acids and prevention of cardiovascular disease and cancer
Manson JE , Cook NR , Lee IM , Christen W , Bassuk SS , Mora S , Gibson H , Albert CM , Gordon D , Copeland T , D’Agostino D , Friedenberg G , Ridge C , Bubes V , Giovannucci EL , Willett WC , Buring JE & Buring VITAL Research Group
To read the full abstract: N Engl J Med 2019;380:23-32.
Summary: In this randomized primary prevention placebo-controlled trial of 25,871 US adults, with a two-by-two factorial design, supplements with omega-3 did not lower the overall incidence of adverse cardiovascular events or cancer compared to a placebo.
Comment: Omega-3 fatty acids are polyunsaturated fatty acids (PUFAs). Three types of omega-3 fatty acids are involved in human physiology: α-linolenic acid (ALA), found in plant oils; and eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), both commonly found in marine oils. Mammals are unable to synthesize the essential omega-3 fatty acid ALA and must obtain it through diet; they can then use ALA to form the long-chain omega-3 fatty acids, EPA and then from EPA make DHA. Omega-3 fatty acids play important roles in the body as components of the phospholipids that form the structures of cell membranes. DHA, in particular, is especially high in the retina, brain and sperm. EPA acts as a precursor for prostaglandin-3 which inhibits platelet aggregation,
Laboratory and animal studies suggest that omega-3 fatty acids have antithrombotic, hypotriglyceridemic, blood-pressure–lowering and antiinflammatory effects; and thus may impede growth of atherosclerotic plaques, slow heart rate and reduce susceptibility to cardiac arrhythmias. It is no wonder, therefore, that 7.8% of U.S. adults (18.8 million) consume fish oil/omega-3/DHA, EPA fatty acids supplements.
The current study examined effects of such supplements among 26,000 adults (mean age, 67 years) with no history of cardiovascular disease, cancer or other serious disorders who received either daily fish-oil capsules (containing 460 mg of eicosapentaenoic acid and 380 mg of docosahexaenoic acid) or placebo. Supplementation with n-3 fatty acids did not result in a lower incidence of major cardiovascular events or cancer than placebo. There still may benefit to n-3 supplementation than with placebo among participants with low fish consumption.
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ESPE Yearbook of Paediatric Endocrinology
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