Beyond Fish Oil Supplementation: The Effects of Alternative Plant Sources of Omega-3 Polyunsaturated Fatty Acids upon Lipid Indexes and Cardiometabolic Biomarkers-An Overview.

Heitor O Santos,Allain A Bueno,James C Price

doi:10.3390/nu12103159

Heitor O Santos, Allain A Bueno + Show 1 more

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https://doi.org/10.3390/nu12103159

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Abstract

Cardiovascular diseases remain a global challenge, and lipid-associated biomarkers can predict cardiovascular events. Extensive research on cardiovascular benefits of omega-3 polyunsaturated fatty acids (n3-PUFAs) is geared towards fish oil supplementation and fish-rich diets. Nevertheless, vegetarianism and veganism are becoming more popular across all segments of society, due to reasons as varied as personal, ethical and religious values, individual preferences and environment-related principles, amongst others. Due to the essentiality of PUFAs, plant sources of n3-PUFAs warrant further consideration. In this review, we have critically appraised the efficacy of plant-derived n3-PUFAs from foodstuffs and supplements upon lipid profile and selected cardiometabolic markers. Walnuts and flaxseed are the most common plant sources of n3-PUFAs, mainly alpha-linolenic acid (ALA), and feature the strongest scientific rationale for applicability into clinical practice. Furthermore, walnuts and flaxseed are sources of fibre, potassium, magnesium, and non-essential substances, including polyphenols and sterols, which in conjunction are known to ameliorate cardiovascular metabolism. ALA levels in rapeseed and soybean oils are only slight when compared to flaxseed oil. Spirulina and Chlorella, biomasses of cyanobacteria and green algae, are important sources of n3-PUFAs; however, their benefits upon cardiometabolic markers are plausibly driven by their antioxidant potential combined with their n3-PUFA content. In humans, ALA is not sufficiently bioconverted into eicosapentaenoic and docosahexaenoic acids. However, evidence suggests that plant sources of ALA are associated with favourable cardiometabolic status. ALA supplementation, or increased consumption of ALA-rich foodstuffs, combined with reduced omega-6 (n6) PUFAs intake, could improve the n3/n6 ratio and improve cardiometabolic and lipid profile.

Highlights

Cardiovascular diseases remain a major Public Health concern, with lipid-associated biomarkers being trusted predictors of major cardiovascular events [1,2]
Spirulina led to significant improvements in lipid profile by reducing total cholesterol (TC) in ≈47 mg/dL, low-density lipoprotein cholesterol (LDL-C) in ≈41 mg/dL, TG in ≈44 mg/dL, whilst increasing high-density lipoprotein cholesterol (HDL-C) in ≈6 mg/dL
Seven placebo-controlled clinical trials with duration of 2–4 months were included in that meta-analysis, and the population appraised consisted of patients with diabetes, cardiac diseases, nephrotic syndrome and HIV infection, illnesses whose pathophysiologies are related to dyslipidaemia [103,104,105]

Summary

Introduction

Cardiovascular diseases remain a major Public Health concern, with lipid-associated biomarkers being trusted predictors of major cardiovascular events [1,2]. The dietary replacement of saturated fats for polyunsaturated fatty acids (PUFAs) has shown beneficial effects upon lipid profile [10], as well as long-term protective benefits against. Nutrients 2020, 12, 3159 major cardiovascular events and associated clinical complications [11,12]. Omega-3 polyunsaturated fatty acids (n3-PUFAs) from either marine sources or fish oil (FO) supplementation were broadly referred to in cardiology guidelines [13,14,15]. Amongst several clinical investigations, Sagara et al in 2011 showed that 2 g of DHA daily for five weeks improved blood pressure and lipid profile in a sample population of 38 middle-age men with hypertension and hypercholesterolaemia [16].

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