Eicosapentaenoic acid and docosahexaenoic acid in whole blood are differentially and sex-specifically associated with cardiometabolic risk markers in 8-11-year-old danish children.

Camilla T Damsgaard,Anders Sjödin,Rikke Andersen,Lotte Lauritzen,Kim F Michaelsen,Malene R Andersen,Mads F Hjorth,Arne Astrup,Inge Tetens,Ken D Stark,Maj B Eidner,Jean-Luc Desseyn

doi:10.1371/journal.pone.0109368

Camilla T Damsgaard, Anders Sjödin + Show 10 more

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https://doi.org/10.1371/journal.pone.0109368

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Abstract

n-3 long-chain polyunsaturated fatty acids improve cardiovascular risk markers in adults. These effects may differ between eicosapentaenoic acid (EPA, 20∶5n-3) and docosahexaenoic acid (DHA, 22∶6n-3), but we lack evidence in children. Using baseline data from the OPUS School Meal Study we 1) investigated associations between EPA and DHA in whole blood and early cardiometabolic risk markers in 713 children aged 8–11 years and 2) explored potential mediation through waist circumference and physical activity and potential dietary confounding. We collected data on parental education, pubertal stage, 7-day dietary records, physical activity by accelerometry and measured anthropometry, blood pressure, and heart rate. Blood samples were analyzed for whole blood fatty acid composition, cholesterols, triacylglycerol, insulin resistance by the homeostatic model of assessment (HOMA-IR), and inflammatory markers. Whole blood EPA was associated with a 2.7 mmHg (95% CI 0.4; 5.1) higher diastolic blood pressure per weight% EPA, but only in boys. Heart rate was negatively associated with both EPA and DHA status (P = 0.02 and P = 0.002, respectively). Whole blood EPA was negatively associated with triacylglycerol (P = 0.003) and positively with total cholesterol, low density and high density lipoprotein (HDL) cholesterol and HDL:triacylglycerol (all P<0.01) whereas DHA was negatively associated with insulin and HOMA-IR (P = 0.003) and tended to be negatively associated with a metabolic syndrome-score (P = 0.05). Adjustment for waist circumference and physical activity did not change the associations. The association between DHA and HOMA-IR was attenuated but remained after adjustment for fiber intake and none of the other associations were confounded by dietary fat, protein, fiber or energy intake. This study showed that EPA status was negatively associated with triacylglycerol and positively with cholesterols whereas DHA was negatively associated with insulin resistance, and both were inversely associated with heart rate in children. The sex-specific associations with blood pressure confirm our previous findings and warrant further investigation.

Highlights

Intake of n-3 long-chain polyunsaturated fatty acids (LCPUFA) from fish and fish oils have been shown to improve cardiovascular risk markers in adults, most pronouncedly plasma triacylglycerol and blood pressure, and may reduce coronary heart disease mortality [1], not all meta analyses agree [2]
In the boys of the fish oilsupplemented lactating mothers we observed lower physical activity and higher energy intake compared to the control group [8], and the increases in blood pressure may have been mediated through reduced physical activity or increased energy intake
In contrast with our previous findings [38] the present study showed that EPA was the strongest predictor of blood pressure and that both n-3 LCPUFA were negatively associated with heart rate and

Summary

Introduction

Intake of n-3 long-chain polyunsaturated fatty acids (LCPUFA) from fish and fish oils have been shown to improve cardiovascular risk markers in adults, most pronouncedly plasma triacylglycerol and blood pressure, and may reduce coronary heart disease mortality [1], not all meta analyses agree [2]. Comparable results were seen among the boys of our crosssectional study of Danish 17-year-olds [10] and in 7-year-old boys of mothers who were supplemented with n-3 LCPUFA during lactation [8] Overall, this indicates that effects related to n-3 LCPUFA in children may be sex-specific, and that the two major dietary n-3 LCPUFA, eicosapentaenoic acid (EPA, 20:5n-3) and DHA, may differentially affect the individual components of the MetS cluster in children. N-3 LCPUFA status is positively associated with protein intake [13] and may be linked to total fat intake and to key components in a healthy diet such as fiber [14] These components have been associated with cardiometabolic risk markers in children [15,16], and should be considered as potential confounders when investigating associations between n-3 LCPUFA and early cardiometabolic markers

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