Additive benefits of long-chain n-3 polyunsaturated fatty acids and weight-loss in the management of cardiovascular disease risk in overweight hyperinsulinaemic women

Krebs, Jeremy; Browning, Lucy M.; McLean, Nathaniel; Rothwell, J L; Mishra, Gita D.; Moore, Carmel; Jebb, Susan A.

doi:10.1038/sj.ijo.0803309

Cited by 203 publications

(195 citation statements)

References 50 publications

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“…The higher statistical power can explain our significant findings. Significant weight loss was achieved in our study, and it can be speculated that LC n-3 PUFA exert their positive health effects on insulin sensitivity best during weight loss; however, similar or greater amounts of weight loss were achieved in similar studies [34,35] that did not report significant effects of LC n-3 PUFA on insulin sensitivity. We cannot explain why endpoint fasting insulin and HOMA-IR values for the salmon group were not significantly different from those for the control group, despite the fact that salmon provided the highest dose of LC n-3 PUFA in our study.…”

Section: Discussionsupporting

confidence: 39%

“…However, there were no independent effects of fish on glucose or insulin. A similar intervention study involving 116 overweight insulin-resistant women showed independent (from weight loss) effects of LC n-3 PUFA supplementation on triacylglycerol and adiponectin levels, but not insulin sensitivity [35]. The Kuopio, Aarhus, Naples, Wollongong and Uppsala (KANWU) study, a controlled multi-centre isoenergetic dietary intervention study focusing on dietary fat composition but not weight loss in 162 individuals, showed that decreasing dietary saturated fatty acid intake and increasing monounsaturated fatty acid intake improves insulin sensitivity, but no effect of fish oil supplementation on insulin sensitivity was found, despite reduced plasma triacylglycerol concentrations [36].…”

Section: Discussionmentioning

confidence: 89%

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Beneficial effects of long-chain n-3 fatty acids included in an energy-restricted diet on insulin resistance in overweight and obese European young adults

et al. 2008

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Aims/hypothesis Epidemiological research indicates that long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFA) improve insulin resistance. The aim of this study was to investigate the effects of seafood consumption on insulin resistance in overweight participants during energy restriction. Methods In this 8 week dietary intervention, 324 participants (20-40 years, BMI 27.5-32.5 kg/m 2 , from Iceland, Spain and Ireland) were randomised by computer to one of four energyrestricted diets (−30E%) of identical macronutrient composition but different LC n-3 PUFA content: control (n=80; no seafood; single-blinded); lean fish (n=80; 150 g cod, three times/week); fatty fish (n=84; 150 g salmon, three times/ week); (4) fish oil (n=80; daily docosahexaenoic/eicosapentaenoic acid capsules, no other seafood; single-blinded). Fasting glucose, insulin, adiponectin, plasma triacylglycerol and fatty acids in erythrocyte membrane were measured at baseline and endpoint. Insulin resistance was calculated using the homeostasis model assessment of insulin resistance (HOMA-IR). Linear models with fixed effects and covariates were used to investigate the effects of seafood consumption on fasting insulin and HOMA-IR at endpoint in comparison with the control group. Results Of the participants, 278 (86%) completed the intervention. Fish oil intake was a significant predictor of fasting insulin and insulin resistance after 8 weeks, and this finding remained significant even after including weight loss, triacylglycerol reduction, increased LC n-3 PUFA in membranes or adiponectin changes as covariates in the statistical analysis. Weight loss was also a significant predictor of improvements. Conclusions/interpretation LC n-3 PUFA consumption during energy reduction exerts positive effects on insulin resistance in young overweight individuals, independently from changes in body weight, triacylglycerol, erythrocyte membrane or adiponectin.Trial registration: ClinicalTrials.gov NCT00315770.

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Section: Discussionsupporting

confidence: 39%

Section: Discussionmentioning

confidence: 89%

Beneficial effects of long-chain n-3 fatty acids included in an energy-restricted diet on insulin resistance in overweight and obese European young adults

et al. 2008

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“…The fall in TG in the salmon group and the fish oil group is therefore in agreement with the extensive literature on the TG-lowering effects of LC n-3 PUFAs and results from recent trials, showing beneficial effects of LC n-3 PUFA supplementation on cardiovascular risk factors during weight loss. [6][7][8] However, TG-lowering effect of the lean cod diet shown in this study has not been seen previously in a human study. The different components of fish contributing to cardiovascular health have been assessed in the rat, where cod protein has been shown to lower hepatic TG concentration and TG secretion rate when compared with casein.…”

Section: Discussionmentioning

confidence: 69%

“…4,5 Long-chain n-3 poly-unsaturated fatty acids (LC n-3 PUFAs), given as supplements, have in recent trials been shown to have beneficial effects on cardiovascular disease risk factors as an additional therapy to calorie restriction in overweight and obese individuals. [6][7][8] The triacylglycerol (TG) lowering effects of n-3 fatty acids are well documented, 9 and the beneficial effects of fish intake seen on blood lipids in previous trials have primarily been attributed to the presence of n-3 fatty acids. The role of other seafood constituents, such as fish proteins, has been studied in animals.…”

Section: Introductionmentioning

confidence: 99%

Inclusion of fish or fish oil in weight-loss diets for young adults: effects on blood lipids

et al. 2008

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Objective: To assess the effects of fish (lean or oily) and fish oil consumption on blood lipid concentration during weight loss. Design: Randomized, controlled 8-week trial of energy-restricted diet varying in fish and fish oil content. Subjects, 324 men and women, aged 20-40 years, body mass index 27.5-32.5 kg m À2 , from Iceland, Spain and Ireland, were randomized to one of four groups: (1) control (sunflower oil capsules, no seafood), (2) cod diet (3 Â 150 g week À1 ), (3) salmon diet (3 Â 150 g week À1 ), (4) fish oil (DHA/EPA capsules, no seafood). The macronutrient composition of the diets was similar between the groups and the capsule groups were single-blinded. Measurements: Total cholesterol (TC), high-density lipoprotein (HDL) and low-density lipoprotein cholesterol, triacylglycerol (TG) and anthropometrics were measured at baseline and end point. Results: The difference in logTG lowering between the control group and the cod diet, salmon diet and fish oil from baseline to end point was À0.036 (95% CI À0.079 to 0.006), À0.060 (À0.101 to À0.018) and À0.037 (À0.079 to 0.006), respectively. Reduction in TC was about 0.2 mmol l À1 greater in the fish groups (cod and salmon) than in the control group, but only of borderline significance when adjusting for weight loss. HDL tended to decrease less in the diet groups consuming a significant amount of n-3 fatty acids (salmon and fish oil). Conclusion: Weight-loss diet including oily fish resulted in greater TG reduction than did a diet without fish or fish oil. Controlled trials using whole fish as a test meal are encouraged to be able to elucidate the role of different constituents of fish for human health.

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“…3 g EPA and 2 . 9 g DHA (administered as EPAX 2050 TG; EPAX AS) in overweight patients who were simultaneously undertaking a weight-loss programme (75) . The induction of adiponectin could contribute to the beneficial effect of n-3 LC PUFA on systemic insulin sensitivity.…”

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confidence: 99%

n-3 PUFA: bioavailability and modulation of adipose tissue function

et al. 2009

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Adipose tissue has a key role in the development of metabolic syndrome (MS), which includes obesity, type 2 diabetes, dyslipidaemia, hypertension and other disorders. Systemic insulin resistance represents a major factor contributing to the development of MS in obesity. The resistance is precipitated by impaired adipose tissue glucose and lipid metabolism, linked to a low-grade inflammation of adipose tissue and secretion of pro-inflammatory adipokines. Development of MS could be delayed by lifestyle modifications, while both dietary and pharmacological interventions are required for the successful therapy of MS. The n-3 long-chain (LC) PUFA, EPA and DHA, which are abundant in marine fish, act as hypolipidaemic factors, reduce cardiac events and decrease the progression of atherosclerosis. Thus, n-3 LC PUFA represent healthy constituents of diets for patients with MS. In rodents n-3 LC PUFA prevent the development of obesity and impaired glucose tolerance. The effects of n-3 LC PUFA are mediated transcriptionally by AMP-activated protein kinase and by other mechanisms. n-3 LC PUFA activate a metabolic switch toward lipid catabolism and suppression of lipogenesis, i.e. in the liver, adipose tissue and small intestine. This metabolic switch improves dyslipidaemia and reduces ectopic deposition of lipids, resulting in improved insulin signalling. Despite a relatively low accumulation of n-3 LC PUFA in adipose tissue lipids, adipose tissue is specifically linked to the beneficial effects of n-3 LC PUFA, as indicated by (1) the prevention of adipose tissue hyperplasia and hypertrophy, (2) the induction of mitochondrial biogenesis in adipocytes, (3) the induction of adiponectin and (4) the amelioration of adipose tissue inflammation by n-3 LC PUFA.

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Additive benefits of long-chain n-3 polyunsaturated fatty acids and weight-loss in the management of cardiovascular disease risk in overweight hyperinsulinaemic women

Cited by 203 publications

References 50 publications

Beneficial effects of long-chain n-3 fatty acids included in an energy-restricted diet on insulin resistance in overweight and obese European young adults

Beneficial effects of long-chain n-3 fatty acids included in an energy-restricted diet on insulin resistance in overweight and obese European young adults

Inclusion of fish or fish oil in weight-loss diets for young adults: effects on blood lipids

n-3 PUFA: bioavailability and modulation of adipose tissue function

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