N-3 to n-6 fatty acids for managing hyperlipidemia, diabetes, hypertension and atherosclerosis: Is there evidence?

Abstract

IntroductionThe aim of this review is to cover the role of fatty acids (FA) in atherosclerosis and related disorders from the perspective of a clinician. It will therefore be almost exclusively focussed on human data. It will also necessarily reflect the experience gained at an institution located in the Mediterranean area, which devoted more than 30 years of nutritional research in relation to cardiovascular disease under the guidance of Mario Mancini. The Mediterranean area remains a southern relative of the industrialized countries of northern Europe. It has become integrated in the common cultural structure of the European Union unlike Magreb to the south and some countries such as Albania to the east [1-3]. FA and hyperlipidemiaThe relationship between dietary FA, serum cholesterol and coronary heart disease (CHD) has been first demonstrated by cross cultural comparisons [4,5]. The Seven Countries Study, started in the '60s, showed that cohorts of middle-aged men from South Europe (Italy, Greece, Yugoslavia) had a daily FA intake in the range of 24-27% of total energy (approximately 9% of saturated FA, 11% of monounsaturated FA, 3% of polyunsaturated FA). These figures were markedly less than those of population samples from northern Europe (such as Finland or the Netherlands), whose total fat intake was 34-38% (approximately 20% of saturated FA, 12% of monounsaturated FA, 3-5% of polyunsaturated FA). Circulating cholesterol and death rates from all causes or CHD were lower in cohorts from the Mediterranean area [4,5]. In a large study of several population samples representative of different Italian regions, a more frequent consumption of foods high in saturated FA was associated with higher plasma cholesterol [6]. retard early relapse in ulcerative colitis. Dig. Dis. Sci. 41(10) (1996) 2087-2094. [72] H.