Plasma essential fatty acids, cigarette smoking, and dietary antioxidants in peripheral arterial disease. A population-based case-control study.

Abstract

The aim of this study was to determine the levels of plasma fatty acids in patients with peripheral arterial disease and in control subjects and to identify whether any risks of disease related to these differences were influenced by smoking and antioxidant intake. A random sample of 1592 men and women aged 55 to 74 years was selected from the general population (the Edinburgh Artery Study), from which 153 cases of peripheral arterial disease were identified by the presence of intermittent claudication and low ankle systolic pressures at rest and during reactive hyperemia; these were matched by age and sex to 153 control subjects with no evidence of cardiovascular disease. In 113 case and 122 control subjects, fatty acid levels were measured in three plasma fractions (triglyceride, cholesteryl ester, and phospholipid), and smoking habits and dietary antioxidant intake were determined by questionnaire. Arachidonic acid, eicosapentaenoic acid, docosahexaenoic acid, and docosapentaenoic acid (DPA/ T he main dietary essential fatty acids are linoleic acid (18:2 n-6) and a-linolenic acid (18:3 n-3), both found mainly in vegetable oils. Within the body, these parent essential fatty acids are metabolized by a series of reactions to form arachidonic acid and eicosapentaenoic acid (EPA), which are further metabolized to prostacyclins and thromboxanes (Figure), substances known to exert opposing physiological effects on the cardiovascular system. An important rate-limiting step in the metabolism of linoleic acid and a-linolenic acid is the initial desaturation reaction, where the two parent fatty acids compete for the A-6-desaturase enzyme. This step may also be inhibited by several factors associated with cardiovascular disease, such as high cholesterol levels, catecholamines, high saturated-fat intake, and aging.1 It is therefore possible for some individuals to be effectively lacking in essential fatty acid metabolites, despite an adequate dietary intake of linoleic and a-linolenic acids.

Dietary intake and peripheral arterial disease incidence in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study ,

“…Food groups have been examined in relation to PAD in few previous studies, although associations between dietary intake of nutrients and PAD have been studied more extensively (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). In a large sample of adults who completed vascular screening tests, nut consumption was inversely associated with prevalent PAD (20).…”

“…Several dietary factors support a strong causal link with coronary artery disease, including the protective effect of the Mediterranean diet, a high-quality diet, a "prudent" diet, vegetables, and nuts and the harmful effect of the "Western" diet, trans-fatty acids, and high-glycemic index or load (5). Crosssectional and case-control studies have suggested that PAD is inversely associated with several nutrients, including fiber from cereal (6)(7)(8), vegetable oil (9), vitamin A (8, 10), vitamin C (8,(11)(12)(13), vitamin D (14)(15)(16), vitamin E (7-9, 13), and folate (8,10,(17)(18)(19), although the relation may not be causal. Recent research on dietary patterns and food groups has found that increased nut intake is cross-sectionally associated with lower PAD prevalence (20), whereas higher meat consumption has been associated with a lower mean ankle-brachial index (ABI) (7).…”

Effect of intensive vs. free range production on the fat and fatty acid composition of whole birds and edible portions of retail chickens in the UK

“…Consumption of meat rather than fish generally leads to increased consumption of DPA (Howe, Meyer, Record, & Baghurst, 2006), although the implications of this in relation to CVD risk are not clear. One study (Leng et al, 1994) compared subjects with peripheral arterial disease (case) with healthy controls and found that plasma EPA, DPA and DHA concentrations were all significantly lower in the cases than in control subjects, but only DPA showed a relationship with the disease independent of smoking and only DPA reduced the risks associated with smoking. Also Sun et al (2008) showed that higher plasma EPA and DPA (but not DHA) concentrations were associated with a lower risk of nonfatal myocardial infarction.…”

A review of the biologic and pharmacologic role of docosapentaenoic acid n-3

“…Besides heart disease, stroke prevention and arterial blockage also comprise a significant part of cardiovascular health. Plasma levels of DPA are inversely related to blocked arteries and DPA the only n-3 fatty acid that has been shown to significantly reduce blocked arteries regardless of lifetime smoking 45 . A cross-sectional study with carotid ultrasonography revealed that carotid artery wall thickness was inversely associated with DPA intake 46 .…”