Abstract

BackgroundThe Dietary Guidelines for Americans (DGA) recommends consuming ~225 g/wk of a variety of seafood providing >1.75 g/wk of long-chain omega-3 fatty acids to reduce cardiovascular disease risk, however individual responses to treatment vary.ObjectiveThis study had three main objectives. First, to determine if a DGA-conforming diet (DGAD), in comparison to a typical American diet (TAD), can increase the omega-3 index (OM3I), i.e., the red blood cell mol% of eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA). Second, to identify factors explaining variability in the OM3I response to dietary treatment. Third to identify factors associated with the baseline OM3I.DesignThis is a secondary analysis of a randomized, double-blind 8 wk dietary intervention of overweight/obese women fed an 8d rotating TAD (n = 20) or DGAD (n = 22) registered at www.clinicaltrials.gov as NCT02298725. The DGAD-group consumed 240 g/wk of Atlantic farmed salmon and albacore tuna in three meals with an estimated EPA + DHA of 3.7 ± 0.6 g/wk. The TAD-group consumed ~160 g/wk of farmed white shrimp and a seafood salad containing imitation crab in three meal with an estimated EPA + DHA of 0.45 ± 0.05 g/wk. Habitual diet was determined at baseline, and body composition was determined at 0 and 8wks. Red blood cell fatty acids were measured at 0, 2 and 8 wk.ResultsAt 8 wk, the TAD-group OM3I was unchanged (5.90 ± 1.35–5.80 ± 0.76%), while the DGAD-group OM3I increased (5.63 ± 1.27–7.33 ± 1.36%; p < 0.001). In the DGAD-group 9 of 22 participants achieved an OM3I >8%. Together, body composition and the baseline OM3I explained 83% of the response to treatment variability. Baseline OM3I (5.8 ± 1.3%; n = 42) was negatively correlated to the android fat mass (p = 0.0007) and positively correlated to the FFQ estimated habitual (EPA+DHA) when expressed as a ratio to total dietary fat (p = 0.006).ConclusionsAn 8 wk TAD did not change the OM3I of ~6%, while a DGAD with 240 g/wk of salmon and albacore tuna increased the OM3I. Body fat distribution and basal omega-3 status are primary factors influencing the OM3I response to dietary intake in overweight/obese women.

Highlights

  • Cardiovascular disease (CVD) is a leading cause of mortality, accounting for nearly 18 million deaths worldwide in [https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)]

  • The typical American diet (TAD) was based on the 50th percentile of the National Health and Nutrition Examination Survey (i.e., NHANES) “What We Eat in America” dietary survey and the DGAconforming diet (DGAD) was based on food-group recommendations in the 2010 Dietary Guidelines for Americans (DGA)

  • Results were missing for one baseline and one terminal red blood cells (RBCs) fatty acid measurement from two distinct individuals in the TAD group due to poor analytical performance

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Summary

Introduction

Cardiovascular disease (CVD) is a leading cause of mortality, accounting for nearly 18 million deaths worldwide in [https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)]. Systematic reviews of the existent body of evidence support a dose response in CVD risk reduction, with EPA+DHA levels of between. 0.25 and 0.5 g/d being sufficient for primary prevention [4, 5] These omega-3 fatty acid levels can be obtained through the consumption of one to three seafood containing meals per week, habits expected to reduce CVD risk, especially when seafood replaces less healthy foods [6]. Dietary modulation of omega-3 fatty acid status by adherence to a healthful diet with high intermittent doses of foods rich in these lipids provides a strategy for CVD risk reduction in the general population. The Dietary Guidelines for Americans (DGA) recommends consuming ∼225 g/wk of a variety of seafood providing >1.75 g/wk of long-chain omega-3 fatty acids to reduce cardiovascular disease risk, individual responses to treatment vary

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