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Meta-analysis of dietary essential fatty acids and long-chain polyunsaturated fatty acids as they relate to visual resolution acuity in healthy preterm infants.

OBJECTIVE: To derive combined estimates of visual resolution acuity differences between healthy preterm infants consuming different compositions and ratios of essential fatty acids (EFAs) and docosahexaenoic acid (DHA), an omega-3 (n-3) long-chain polyunsaturated fatty acid (LCPUFA). DATA SOURCES: Electronic biomedical reference database (Medline and Health Star from 1965 to July 1999) searches with index terms omega-3, n-3, infant, vision, acuity, and human. Current review article, monograph, and book chapter bibliography/reference section hand searches. STUDY SELECTION: A total of 5 original articles and 4 review chapters were reviewed for details on study design, conduct, and outcome. Four prospective trials of EFA/LCPUFA supplementation were included in these analyses. For behaviorally based outcomes, there were 2 randomized comparisons each at </=1, 2, 6, 9, and 12 months of corrected age and 4 randomized comparisons at 4 months of corrected age. For electrophysiologically based outcomes (visual-evoked potential), there were 2 randomized comparisons each at </=1 and approximately 4 months of corrected age. DATA EXTRACTION: Dietary composition and EFA/LCPUFA balance, study design, and analytic characteristics (duration of feeding, source of EFAs/LCPUFAs, number of subjects in study population, number of subjects analyzed, and basis for estimating age), and experiment-based characteristics (location, number or sites, design, vision tests employed, testing protocol, and ophthalmic examination) were recorded independently by 2 researchers with a standardized protocol. DATA SYNTHESIS: The relative difference in visual resolution acuity between groups of infants who received a source of dietary EFAs/LCPUFAs and groups who did not was computed and then analyzed with the DerSimonian and Laird random-effects method. RESULTS: Analysis of the randomized comparisons (DHA-supplemented formula vs DHA-free formula) showed significant differences in visual resolution acuity at 2 and 4 months of age. Combined estimates of behaviorally based visual resolution acuity differences at these ages were.47 +/-.14 octaves and.28 +/-.08 octaves, respectively. A 1-octave difference is a reduction in the width of the stimulus elements by 50%. CONCLUSION: These results support efficacy of n-3 LCPUFA intake in early visual system development, although supplementation safety issues still must be addressed through larger randomized trials. Whether n-3 intake confers lasting advantage in visually based process development across the life-span is still to be determined.

Dietary Supplements↗

Effects of N-6 essential fatty acids on glioma invasion and growth: experimental studies with glioma spheroids in collagen gels.

OBJECT: Intracranial infusions of gamma-linolenic acid (GLA), an essential fatty acid, have been used as an adjuvant therapy following malignant glioma resection; however, little is known about the dose response of glioma cells to this therapy. In this in vitro study the authors address this important pharmacological question. METHODS: Glioma spheroids derived from U87, U373, MOG-G-CCM, and C6 cell lines were grown in collagen gel and exposed to a range of GLA concentrations (0-1 mM) for 5 days. The diameter of glioma spheroids was measured, the apoptotic index was assessed using both the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling technique and cell morphological testing, and the levels of proliferating cell nuclear antigen were also measured. CONCLUSIONS: The dose-response patterns were similar for all four glioma spheroids. Low concentrations of GLA (<100 microM) increased both apoptosis and proliferation with a net increase in tumor growth and invasion, whereas high-dose GLA (>100 microM) significantly impaired spheroid cell growth. The proliferative effects of low-dose GLA could be a hazard in the clinical treatment of malignant glioma; however, because of the low toxicity of GLA against normal cells, local delivery of millimolar doses of GLA could significantly reduce tumor size.

Animals↗

Influence of sex and gonadal hormones on rat-liver and carcass lipids during the development of an essential fatty acid deficiency.

1. Groups of intact male and female rats and castrated rats injected with oestradiol or testosterone were given a diet containing hydrogenated coconut oil for 9 weeks, and at intervals the amounts and fatty acid compositions of the carcass and liver lipids were determined. 2. Male rats grew faster and larger, and exhibited typical external essential fatty acid deficiency symptoms sooner than did females. Testosterone-treated castrated male rats were similar to males, and oestradiol-injected castrated male rats resembled females. 3. Intact females maintained a higher linoleic acid concentration in their carcass than did males. Total amounts of carcass linoleic acid remained similar for all groups, only 200mg. being removed in 9 weeks regardless of body size. 4. The amounts of total cholesteryl esters were independent of liver size. They were higher in males and testosterone-treated castrated male rats than in females and oestrogen-treated castrated male rats. 5. Phospholipids represented about 80% of the liver lipids. The total amounts of the phospholipid linoleic acid and arachidonic acid were similar for all groups regardless of liver size, and were not affected appreciably by the deficiency. Females and oestrogen-treated castrated male rats maintained a higher proportion of phospholipid arachidonic acid for longer periods than did their male counterparts. Both the total amounts and the proportions of eicosatrienoic acid and palmitic acid were higher in males than in females. 6. Supplementation of the essential fatty acid-deficient diet with linoleic acid caused a rapid loss of eicosatrienoic acid and palmitic acid with a concomitant increase in stearic acid and arachidonic acid. 7. There were no obvious differences in the way that the essential fatty acids were metabolized or mobilized from adipose tissue of male or female rats during essential fatty acid deficiency. 8. The results indicated that the greater growth rate of the male rats caused them to require and synthesize more phospholipids than did the females. In the absence of adequate amounts of arachidonic acid, eicosatrienoic acid was substituted into the additional phospholipid. The earlier symptoms of essential fatty acid deficiency in the male rat could therefore be ascribed to the higher tissue concentrations of this unnatural phospholipid and its inability to perform the normal metabolic functions of phospholipids.

Journal Article↗

Effect of essential fatty acids on proliferation of two neural tumor lines.

A combination of linoleic and linolenic acids has been shown to be able to partly replace serum in maintaining cell division of neural tumor lines. Addition of essential fatty acids to C-6 rat astrocytoma cells grown in serum-deprived medium increased the rate of cell proliferation and restored morphological appearance. Essential fatty acids also restored the rate of 3H-thymidine uptake by N-18 neuroblastoma cells grown in a serum-deprived medium. In the complete absence of serum, neuroblastoma cells were unable to proliferate despite addition of essential fatty acids. These studies indicate the importance of essential fatty acids in controlling the rate of neural tumor proliferation.

Animals↗

Atopic dermatitis and essential fatty acids: a biochemical basis for atopy?

The effects of dietary supplementation with evening primrose oil (Efamol) in 99 patients with atopic dermatitis were investigated in a double blind, controlled crossover study. Simultaneously, plasma phospholipid essential fatty acid status was determined in 50 of these patients before and after treatment. In a separate study, lymphocyte subsets and mitogen responses were investigated in 15 atopic patients before and after treatment. The conclusion is that evening primrose oil improves atopic dermatitis; an abnormality of the enzyme delta-6-desaturase is proposed to explain the biochemical findings. Finally, it is concluded that the therapeutic effect of evening primrose oil is unlikely to be mediated through a primarily immunological mechanism.

Adult↗

Pathogenesis and treatment of pancreatitis due to essential fatty acid deficiency.

Pathogenesis of pancreatitis was studied in experimental animals and essential fatty acid deficiency was condemned as an etiological factor, since it caused pathological changes in permeability of cell membrane of the pancreatic acinar cells. Favorable effects of intravenous fat emulsion was clearly demonstrated in treatment for acute and chronic pancreatitis.

Acute Disease↗

Effects of low-zinc status and essential fatty acid deficiency on bone development and mineralization.

1. The effects of essential fatty acids (EFAs) and zinc on the development and mineralization of bones were studied in young growing rats. 2. Female weaning rats were maintained on the diets deficient in EFAs, low in zinc (6 ppm) or both deficient in EFAs and low in zinc. 3. The low-zinc status accentuated signs of EFA deficiency including reduction of the growth rate and weights of bones and resulted in greater incidences of dental caries. 4. There were qualitative and quantitative differences in the fatty acid components of lipids extracted from the femur of the rats. 5. The overall effect was that eicosatrienoic (C20:3) and arachidonic (C20:4) acids were accumulated in EFA deficiency and low-zinc state respectively. 6. Bones of rats fed a low-zinc diet containing no EFAs were totally hypomineralized while those maintained on a diet that was either low in zinc or deficient in EFAs was partially hypomineralized. 7. Dietary zinc may have some roles to play in the biosynthesis of prostaglandins from EFAs and the process of bone mineralization.

Aging↗

A biochemical basis for alcoholism and alcohol-induced damage including the fetal alcohol syndrome and cirrhosis: interference with essential fatty acid and prostaglandin metabolism.

Alcohol has at least two actions on essential fatty acid (EFA) and Prostaglandin (PG) metabolism. It enhances the conversion of dihomogammalinolenic acid (DGLA) to PGE1 but it blocks the activity of the delta-6-desaturase, an enzyme necessary for replenishment of DGLA stores from dietary precursors. The acute effect of ethanol is therefore an increased production of PGE1 but chronic consumption will lead to depletion of DGLA and PGE1. Withdrawal from alcohol will lead to a precipitous fall in PGE1. PGE1 is known to have profound effects on the nervous system and behaviour. Patients with mania produce more PGE1 than normal while those with depression make less. Alcoholics may drink to maintain a normal PGE1 level, something which will require more and more ethanol as DGLA is depleted. In both animals and humans PGE1 or its precursor, gamma-linolenic acid (GLA) have been shown to attenuate the acute withdrawal syndrome. PGE1 injections prevent the development of fatty liver in alcohol-treated animals. Defective EFA and PGE1 metabolism are known to lead to increased fibrosis, reproductive failure, cardiomyopathy, cardiovascular disorders, gastritis and pancreatitis and could therefore be the basis for these disorders in alcoholics. A PGE1 deficiency could also be responsible for the fetal alcohol syndrome. Three other agents are known to produce constellations of fetal defects very similar to those found in the alcohol syndrome. These other factors are dihphenylhydantoin, lithium, and a deficiency of zinc. These three factors and excessive alcohol consumption all lead to PGE1 deficiency by different routes. If this concept is correct, the key to the management of alcoholism and its medical complications lies in the provision of GLA or DGLA, fatty acids which by-pass the alcohol blocked step and which are unfortunately unlikely to be present in any normal diet. Unlike many concepts of alcoholism and alcohol damage, the EFA/PGE1 idea is very readily testable and already has considerable experimental support.

8,11,14-Eicosatrienoic Acid↗

The possible role of essential fatty acids in the pathophysiology of malnutrition: a review.

Biochemical evidence of essential fatty acid deficiency (EFAD) may exist in protein-energy malnutrition (PEM). EFAD is characterised by low 18:2omega6, often in combination with low 20:4omega6 and 22:6omega3, and high 18:1omega9 and 20:3omega9. Some PEM symptoms, notably skin changes, impaired resistance to infections, impaired growth rate and disturbed development may at least partly be explained by EFAD. One or more of the following factors could induce EFAD in PEM: low EFA intake, poor lipid digestion, absorption, transport, desaturation and increased EFA beta-oxidation and peroxidation. EFAD may perpetuate itself by decreasing lipid absorption and transport, and aggravate PEM by impairing nutrient absorption and dietary calorie utilisation. Micronutrient deficiencies may contribute to the impaired EFA bioavailability and metabolism. Nutritional rehabilitation strategies in PEM may consider adequate intakes of EFA and micronutrients, e.g. by promoting breastfeeding. More research is required to gain detailed insight into the role of EFAD in PEM.

Animals↗

Development and characterization of essential fatty acid deficiency in human endothelial cells in culture.

We induced an essential fatty acid deficiency (EFAD) in human umbilical vein endothelial cells by culture in medium with 20% (vol/vol) delipidated fetal calf serum. EFAD, reflected by decreased cellular linoleic acid (18:2 omega 6) and arachidonic acid (20:4 omega 6) and emergence of the oleic acid derivative 5,8,11-eicosatrienoic acid (20:3 omega 9; Mead's acid), was evident after 1 week of culture and became pronounced after 2 weeks. Beyond that time point, control cells (cultured in 20% normal fetal calf serum) grew deficient of 18:2 omega 6, and EFAD cells died. 18:2 omega 6 addition to EFAD cells resulted in dose-dependent increases of 18:2 omega 6 and 20:4 omega 6. 20:4 omega 6 or 5,8,11,14,17-eicosapentaenoic acid (20:5 omega 3) additions resulted in normalization of these acids, and conversion of 20:5 omega 3 to 4,7,10,13,16,19-docosahexaenoic acid (22:6 omega 3) was noted. Agonist-induced increases in concentrations of prostacycline (prostaglandin I2; PGI2) and cytosolic Ca2+, [Ca2+]i, were reduced in EFAD cells and not restored by 18:2 omega 6 or 20:4 omega 6 additions. Change of the medium in EFAD cultures 1 day before the experiments decreased 20:3 omega 9 and normalized the PGI2 production and [Ca2+]i changes, whereas addition of 20:3 omega 9 to control cells impaired the [Ca2+]i response, indicating a suppressive effect of 20:3 omega 9. Thus, EFAD in endothelial cells is associated with abnormalities of eicosanoid and second-messenger production partly attributable to 20:3 omega 9 accumulation. Moreover, the gradual emergence of 18:2 omega 6 deficiency in regularly grown control cells underlines the need for careful analysis of fatty acids in long-term cell cultures.

Calcium↗

Essential fatty acids in the plasma phospholipids of patients with leprosy.

Plasma phospholipid essential fatty acids were investigated in 40 patients with leprosy and 40 controls. A significant reduction in linoleic acid was found in the leprosy patients, with an increase in its metabolite dihomo-gamma-linolenic acid. No difference was found between patients with multibacillary and paucibacillary leprosy. Patients treated for less than 6 months were found to have low levels of linoleic acid and high levels of dihomo-gamma-linolenic and arachidonic acid compared with patients treated for more than 6 months.

Fatty Acids, Essential↗

Essential fatty acid supplementation during early alcohol abstinence.

Interactions between ethanol, prostaglandins, and essential fatty acids (EFA) have led to the hypothesis that acute alcohol withdrawal and the sequelae of chronic alcoholism may be related to an EFA/prostaglandin deficiency. To test this hypothesis, EFA profiles in blood-lipid fractions, serum liver enzymes, cognitive function, and alcohol craving were measured in 27 acutely abstinent alcoholics before and after a 3-week double-blind trial of EFA supplementation. Upon entry into the study, alcoholics had significant differences in EFA levels as compared to normal controls, and serum levels of liver enzymes tended to correlate with these EFA levels. After 21 days, cognitive function, alcohol craving, and liver enzymes all improved in both the EFA and placebo groups; most EFA levels also approached normal values. There were no treatment effects of EFA supplementation at the dose used.

Adult↗

Effects of essential fatty acid deficiency on rat molar pulp cells.

In rats fed an essential fatty acid deficient (EFAD) diet, either during pregnancy (DN) or for 4 wk postnatally (ND), the cell density in the central part of the pulp increased about two- and threefold, respectively, of that in rats who had received a conventional diet containing sunflower oil. Cells were especially numerous around capillaries. The cell density was also increased twofold in the subodontoblastic layer in the outer part of the pulp, cells being smaller in ND compared with DN. In contrast, the odontoblasts were reduced in height, and the Höhl cells formed a thin layer in EFAD rats. This emphasizes some aspects of pulp specificity which reacted differently from odontoblasts. We suggest that the function of killer cells which normally destroy cells at the periphery of the pulp may be impaired by the diet, leading to cell accumulation.

Animals↗

Relation between membrane phospholipid composition, fluidity and function in mitochondria of rat brown adipose tissue. Effect of thermal adaptation and essential fatty acid deficiency.

Male weanling rats were maintained either at 28 degrees C (thermoneutrality) or at 5 degrees C (cold adaptation). During 9 weeks they were fed either a 2% hydrogenated coconut oil diet deficient in essential fatty acids or a diet containing 2% sunflower oil. The respective incidences of cold adaptation and of EFA deficiency on lipid composition of mitochondrial membranes from brown adipose tissue (BAT) were investigated. Using 1,6 diphenylhexatriene (DPH) as a probe, the parameters of membrane fluidity were estimated by steady-state fluorescence polarization measurements (rs) and by time-resolved fluorescence anisotropy decay (order parameter S). Cold acclimation induced a decrease of phosphatidylcholine to phosphatidylethanolamine (PC/PE ratio), an increase of the total fatty acid unsaturation index (T.U.). EFA deficiency had the same effect as cold on the PC/PE ratio, but decreased T.U. Cold adaptation induced a larger decrease of S than of rs, whereas EFA deficiency only increased rs and did not modify S. In liposomes prepared from mitochondrial lipids, rs values were smaller than in whole mitochondria. Both in cold-adapted and in EFA-deficient rats the variations of rs were correlated with lipid unsaturation. Comparison between BAT thermogenic activity, assessed by GDP binding and proportions of PE and PC showed a high correlation suggesting a change in the membrane occurring with the increase of mitochondrial activity that could be related to phospholipid composition rather than to membrane fluidity.

Adaptation, Physiological↗

Urinary excretion of arginine-vasopressin and prostaglandin E2 in essential fatty acid-deficient rats after oral supplementation with unsaturated fatty acid esters.

Essential fatty acid-deficient rats were supplemented with 300 mg/d of pure fatty acid esters: oleate (O), linoleate (L), arachidonate (A), and columbinate (C) for 10 d. The 24-h urine collections from each animal, collected 3 d before supplementations and again the last 3 d of the 10-d supplementation period, were analyzed for volume, and by radioimmunoassay for arginine-vasopressin (AVP) and prostaglandin E2 (PGE2). Linoleate and arachidonate supplements both decreased the initial high urinary AVP excretion, whereas it was further increased by the oleate supplement. There was no effect of columbinate supplementation on urinary AVP excretion. Urinary PGE2 excretion was increased ca. twofold by both linoleate and oleate supplements, increased ca. fivefold by arachidonate supplementation but was unaffected by columbinate supplementation. There was no effect of any of the supplemented fatty acids on urine output. Fatty acid analysis of total kidney lipids revealed a low percentage of 20:3(n-9) in the rats supplemented with (n-6) fatty acid (L, A and C). The triene-tetraene ratio was 1.8 +/- 0.6 (n = 6) in the kidneys of the oleate-supplemented rats. No relationship was found between urinary PGE2 excretion and the percentage of arachidonate or the ratio of 20:3 (n-9)/20:4(n-6) in total kidney lipids. It is suggested that increased urinary AVP excretion in EFA-deficient rats is mainly caused by a change in the renal excretatory mechanism of AVP rather than reflecting an increased plasma AVP concentration. Furthermore it is suggested that renal PGE2 synthesis in vivo is unaffected by high levels of 20:3(n-9) in kidney lipids.

Animals↗

Essential fatty acids and the complications of diabetes mellitus.

In animals and humans with diabetes mellitus there is evidence that normal metabolism of essential fatty acids is impaired. The main dietary essential fatty acids, linoleic acid of the n-6 series and alpha-linolenic acid of the n-3 series, must both be 6-desaturated and converted to further metabolites if they are to exert all their desirable effects on the body. 6-desaturation is impaired in diabetes and a lack of adequate rates of formation of the 6-desaturated metabolites may be involved in the abnormalities in membrane function, in lipid metabolism and in haemostasis and the microcirculatory system which are seen in diabetes. Attempts to overcome the block by giving very large amounts of dietary linoleic acid, or to by-pass the block by giving 6-desaturated metabolites such as gamma-linolenic acid and eicosapentaenoic acid, have both given promising results.

Animals↗

Comparison of short-term effects of insulin and essential fatty acids on the slowed nerve conduction of streptozotocin diabetes in rats.

Early effects of insulin and essential fatty acids on nerve conduction were studied. Insulin-dependent diabetes was induced in rats using streptozocin (65 mg/kg, i.p.); control rats were treated with buffer. Five weeks later, diabetic rats were divided into 5 groups. Two groups were given oral essential fatty acids (75% linoleic and 9% gamma-linolenic acids) for a further 3 and 5 days, respectively. Two other groups received subcutaneous insulin for a further 3 or 5 days. A group of diabetic rats were left without further treatment. Motor nerve conduction velocity was measured terminally in all rats by stimulating the sciatic nerve and recording EMGs in the gastrocnemius muscle under urethane anaesthesia. Sensory nerve conduction velocity was measured by stimulating and recording from the saphenous nerve trunk. Diabetic rats had significantly slowed motor and sensory nerve conduction velocities after 5 weeks (16.7%, P less than 0.001). Three days treatment with either insulin or fatty acids corrected the slowed motor nerve conduction velocity to a normal level. Conduction velocity in myelinated sensory nerves was still 10% slower in diabetic rats treated with insulin for 3 days (P less than 0.01). It was above the control level by 11% in diabetic rats treated with fatty acids for the same period (P less than 0.01). Conduction velocities in both sensory and motor nerves were normal in diabetic rats treated with either insulin or fatty acids for 5 days. It was concluded that both insulin and essential fatty acids had early effects on nerve conduction in diabetic rats. The speed of their actions, and the magnitudes of responses were different in sensory and motor nerves.

Animals↗