Abstract
The long-chain omega-3 polyunsaturated fatty acids (LC-omega-3 PUFAs) eicosapentaenoic acid and docosahexaenoic acid are the most popular dietary supplements recommended for the prevention/management of lipid dysmetabolisms and related diseases. However, remarkable inconsistencies exist among the outcomes of the human intervention studies in this field, which contrast with the impressive homogeneity of positive results of most of the preclinical studies. In the present review, we will firstly examine a series of factors—such as background diet composition, gut microbiota and genetic/epigenetic variants, which may lie beneath these inconsistencies. Moreover, we will discuss the recent advance in the knowledge of possible specific biomarkers (genetic-, epigenetic- and microbiota-related) that are being investigated with the goal to apply them in a personalized supplementation with omega-3 PUFAs. We will also consider the possibility of using already available parameters (Omega-3 index, Omega-6 PUFA/Omega-3 PUFA ratio) able to predict the individual responsiveness to these fatty acids and will discuss the optimal timing for their use. Finally, we will critically examine the results of those human studies that have already adopted the distinction of the subjects into omega-3 PUFA responders and non-responders and will discuss the advantage of using such an approach.
Highlights
The long-chain omega-3 polyunsaturated fatty acids (LC-omega-3 PUFAs) eicosapentaenoic acid (EPA, 20:5 n-3) and docosahexaenoic acid (DHA, 22:6 n-3) are the most popular over-the-counter dietary supplements recommended for the prevention and management of lipid dysmetabolisms and related cardiovascular diseases (CVDs) [1,2]
One intriguing point regarding these LC-omega-3 PUFAs is that, in spite of their large use as dietary supplements, especially for the prevention of blood lipid dysmetabolism and CVDs, remarkable inconsistencies exist among the outcomes of human intervention studies investigating their ability to reduce the development and progression of these disorders [2,4]
The first aim of this review is to examine a series of factors which may lie beneath the inconsistency observed in the intervention human studies vs. the preclinical studies performed with omega-3 PUFAs in the field of lipid dysmetabolism and CVDs
Summary
The long-chain omega-3 polyunsaturated fatty acids (LC-omega-3 PUFAs) eicosapentaenoic acid (EPA, 20:5 n-3) and docosahexaenoic acid (DHA, 22:6 n-3) are the most popular over-the-counter dietary supplements recommended for the prevention and management of lipid dysmetabolisms and related cardiovascular diseases (CVDs) [1,2]. Compared to other widely used nutritional supplements, such as polyphenols or carotenoids, these fatty acids, besides being normal components of our diet (especially found in fish and seafood), can be endogenously produced by sequential elongation and desaturation steps from their precursor, the shorter-chain and essential nutrient α-linolenic acid (ALA, 18:3 n-3), widely found in foods of vegetable origin [3]. They are structural constituents of our cell membranes, and can be metabolically converted into a series of bioactive compounds. Clarity regarding whether supplementation or an increased dietary intake of LC-omega-3 PUFAs may be useful for the prevention of these pathologies is still lacking
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