The Physiological Effect of n-3 Polyunsaturated Fatty Acids (n-3 PUFAs) Intake and Exercise on Hemorheology, Microvascular Function, and Physical Performance in Health and Cardiovascular Diseases; Is There an Interaction of Exercise and Dietary n-3 PUFA Intake?

Abstract

Physical activity has a beneficial effect on systemic hemodynamics, physical strength, and cardiac function in cardiovascular (CV) patients. Potential beneficial effects of dietary intake of n-3 polyunsaturated fatty acids (n-3 PUFAs), such as α-linolenic acid, eicosapentaenoic acid, and docosahexaenoic acid on hemorheology, vascular function, inflammation and potential to improve physical performance as well as other CV parameters are currently investigated. Recent meta-analysis suggests no effect of n-3 PUFA supplementation on CV function and outcomes of CV diseases. On the other hand, some studies support beneficial effects of n-3 PUFAs dietary intake on CV and muscular system, as well as on immune responses in healthy and in CV patients. Furthermore, the interaction of exercise and dietary n-3 PUFA intake is understudied. Supplementation of n-3 PUFAs has been shown to have antithrombotic effects (by decreasing blood viscosity, decreasing coagulation factor and PAI-1 levels and platelet aggregation/reactivity, enhancing fibrinolysis, but without effects on erythrocyte deformability). They decrease inflammation by decreasing IL-6, MCP-1, TNFα and hsCRP levels, expression of endothelial cell adhesion molecules and significantly affect blood composition of fatty acids. Treatment with n-3 PUFAs enhances brachial artery blood flow and conductance during exercise and enhances microvascular post-occlusive hyperemic response in healthy humans, however, the effects are unknown in cardiovascular patients. Supplementation of n-3 PUFAs may improve anaerobic endurance and may modulate oxygen consumption during intense exercise, may increase metabolic capacity, enhance endurance capacity delaying the onset of fatigue, and improving muscle hypertrophy and neuromuscular function in humans and animal models. In addition, n-3 PUFAs have anti-inflammatory and anti-nociceptive effects and may attenuate delayed-onset muscle soreness and muscle stiffness, and preserve joint mobility. On the other hand, effects of n-3 PUFAs were variably observed in men and women and they vary depending on dietary protocol, type of supplementation and type of sports activity undertaken, both in healthy and cardiovascular patients. In this review we will discuss the physiological effects of n-3 PUFA intake and exercise on hemorheology, microvascular function, immunomodulation and inflammation and physical performance in healthy persons and in cardiovascular diseases; elucidating if there is an interaction of exercise and diet.

Anthropometric and Biochemical Parameters in Relation to Dietary Habits as Early Indicator of Cardiovascular Impairment in Young Adult Cohort

“…Interestingly, students with normal cholesterol blood levels consumed a high-carbohydrate diet, while high cholesterol subgroup consumed more proteins and dairy products. Results of present study suggest that students consumed extremely low amounts of omega-3 rich foods (fish and nuts), which are rather discouraging, considering the known beneficial effect of polyunsaturated fatty acids on microvascular reactivity, oxidative stress reduction, and lipid profile repairment [ 28 , 29 , 30 , 31 ]. Consequently, there are only few similarities between diets of participants in present study and elements of Mediterranean diet.…”

“…For example, n-3 PUFAs supplements and in functional food have been associated with increased anti-inflammatory and antioxidant function and may provide other benefits in diabetes and obesity prevention [ 59 , 60 , 61 ]. Currently, the progress is being made in this field through studying the effect of human consumption of n-3 PUFAs enriched hen eggs on microvascular reactivity, lipid profile, oxidative stress, and antioxidative capacity [ 29 , 30 , 62 ]. Results of this study suggest that students consume extremely low amounts of n-3 PUFAs rich foods (fish and nuts) which are rather discouraging considering the mentioned beneficial effect on overall health.…”

The Anti-Inflammatory and Antioxidant Properties of n-3 PUFAs: Their Role in Cardiovascular Protection

“…Although beneficial anti-platelet effects [52,53], it was proposed that an high intake of fish oil could increase bleeding time [109][110][111][112][113] and that the consumption of 3-4 g/die of EPA and DHA (helpful in patients with hypertriglyceridemia), moderately increase bleeding times, suggesting that particular attention is needed in patients with anticoagulant drugs therapy [63,[113][114][115]. On the other hand, several studies suggest n-3 PUFA are not bleeding risk factor [116,117].…”

Omega 3 versus Omega 6 Polyunsaturated Fatty Acids in Cardio-Metabolic Health

“…Available studies indicate that the Eskimo diet that is rich in intake of seafood contains high levels polyunsaturated fatty acids which have been directly linked with low incidences of cardiovascular diseases as well as a decrease in thrombogenesis [48,49]. Most of the above effects have been described in populations found in different areas although the inverse relationship between intake of omega-3 polyunsaturated fatty acids has been associated with platelet aggregation, fibrinolysis, and coagulation has not been completely elucidated [50]. Nonetheless, in-vitro and in vivo studies reveal that the use of polyunsaturated fatty acids supplementation reduces the synthesis of thromboxane 2, platelet adhesion and activation and decreases the concentration and activity of plasminogen activator inhibitor-1 [16,51].…”