Precision Nutrition and Omega-3 Polyunsaturated Fatty Acids: A Case for Personalized Supplementation Approaches for the Prevention and Management of Human Diseases

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Abstract

Background: Dietary essential omega-6 ( n-6) and omega-3 ( n-3) 18 carbon (18C-) polyunsaturated fatty acids (PUFA), linoleic acid (LA) and α-linolenic acid (ALA), can be converted (utilizing desaturase and elongase enzymes encoded by FADS and ELOVL genes) to biologically-active long chain (LC; >20)-PUFAs by numerous cells and tissues. These n-6 and n-3 LC-PUFAs and their metabolites (ex, eicosanoids and endocannabinoids) play critical signaling and structural roles in almost all physiologic and pathophysiologic processes. Methods: This review summarizes: (1) the biosynthesis, metabolism and roles of LC-PUFAs; (2) the potential impact of rapidly altering the intake of dietary LA and ALA; (3) the genetics and evolution of LC-PUFA biosynthesis; (4) Gene–diet interactions that may lead to excess levels of n-6 LC-PUFAs and deficiencies of n-3 LC-PUFAs; and (5) opportunities for precision nutrition approaches to personalize n-3 LC-PUFA supplementation for individuals and populations. Conclusions: The rapid nature of transitions in 18C-PUFA exposure together with the genetic variation in the LC-PUFA biosynthetic pathway found in different populations make mal-adaptations a likely outcome of our current nutritional environment. Understanding this genetic variation in the context of 18C-PUFA dietary exposure should enable the development of individualized n-3 LC-PUFA supplementation regimens to prevent and manage human disease.

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Most cited references 139

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Geocoding and monitoring of US socioeconomic inequalities in mortality and cancer incidence: does the choice of area-based measure and geographic level matter?: the Public Health Disparities Geocoding Project.

N Krieger (2002)

Despite the promise of geocoding and use of area-based socioeconomic measures to overcome the paucity of socioeconomic data in US public health surveillance systems, no consensus exists as to which measures should be used or at which level of geography. The authors generated diverse single-variable and composite area-based socioeconomic measures at the census tract, block group, and zip code level for Massachusetts (1990 population: 6,016,425) and Rhode Island (1990 population: 1,003,464) to investigate their associations with mortality rates (1989-1991: 156,366 resident deaths in Massachusetts and 27,291 in Rhode Island) and incidence of primary invasive cancer (1988-1992: 140,610 resident cases in Massachusetts; 1989-1992: 19,808 resident cases in Rhode Island). Analyses of all-cause and cause-specific mortality rates and all-cause and site-specific cancer incidence rates indicated that: 1) block group and tract socioeconomic measures performed comparably within and across both states, but zip code measures for several outcomes detected no gradients or gradients contrary to those observed with tract and block group measures; 2) similar gradients were detected with categories generated by quintiles and by a priori categorical cutpoints; and 3) measures including data on economic poverty were most robust and detected gradients that were unobserved using measures of only education and wealth.

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State of disparities in cardiovascular health in the United States.

George Mensah, Ali Mokdad, Earl S. Ford … (2005)

Reducing health disparities remains a major public health challenge in the United States. Having timely access to current data on disparities is important for policy and program development. Accordingly, we assessed the current magnitude of disparities in cardiovascular disease (CVD) and its risk factors in the United States. Using national surveys, we determined CVD and risk factor prevalence and indexes of morbidity, mortality, and overall quality of life in adults > or =18 years of age by race/ethnicity, sex, education level, socioeconomic status, and geographic location. Disparities were common in all risk factors examined. In men, the highest prevalence of obesity (29.2%) was found in Mexican Americans who had completed a high school education. Black women with or without a high school education had a high prevalence of obesity (47.3%). Hypertension prevalence was high among blacks (39.8%) regardless of sex or educational status. Hypercholesterolemia was high among white and Mexican American men and white women in both groups of educational status. Ischemic heart disease and stroke were inversely related to education, income, and poverty status. Hospitalization was greater in men for total heart disease and acute myocardial infarction but greater in women for congestive heart failure and stroke. Among Medicare enrollees, congestive heart failure hospitalization was higher in blacks, Hispanics, and American Indians/Alaska Natives than among whites, and stroke hospitalization was highest in blacks. Hospitalizations for congestive heart failure and stroke were highest in the southeastern United States. Life expectancy remains higher in women than men and higher in whites than blacks by approximately 5 years. CVD mortality at all ages tended to be highest in blacks. Disparities in CVD and related risk factors remain pervasive. The data presented here can be invaluable for policy development and in the planning, implementation, and evaluation of interventions designed to eliminate health disparities.

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Distribution, interconversion, and dose response of n−3 fatty acids in humans

Linda Arterburn, Eileen Hall, Harry Oken (2006)

n-3 Fatty acids have important visual, mental, and cardiovascular health benefits throughout the life cycle. Biodistribution, interconversion, and dose response data are reviewed herein to provide a basis for more rational n-3 dose selections. Docosahexaenoic acid (DHA) is the principal n-3 fatty acid in tissues and is particularly abundant in neural and retinal tissue. Limited storage of the n-3 fatty acids in adipose tissue suggests that a continued dietary supply is needed. A large proportion of dietary alpha-linolenic acid (ALA) is oxidized, and because of limited interconversion of n-3 fatty acids in humans, ALA supplementation does not result in appreciable accumulation of long-chain n-3 fatty acids in plasma. Eicosapentaenoic acid (EPA) but not DHA concentrations in plasma increase in response to dietary EPA. Dietary DHA results in a dose-dependent, saturable increase in plasma DHA concentrations and modest increases in EPA concentrations. Plasma DHA concentrations equilibrate in approximately 1 mo and then remain at steady state throughout supplementation. DHA doses of approximately 2 g/d result in a near maximal plasma response. Both dietary DHA and EPA reduce plasma arachidonic acid concentrations. Tissue contents of DHA and EPA also increase in response to supplementation with these fatty acids. Human milk contents of DHA are dependent on diet, and infant DHA concentrations are determined by their dietary intake of this fatty acid. We conclude that the most predictable way to increase a specific long-chain n-3 fatty acid in plasma, tissues, or human milk is to supplement with the fatty acid of interest.

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Author and article information

Journal

Journal ID (nlm-ta): Nutrients

Journal ID (iso-abbrev): Nutrients

Journal ID (publisher-id): nutrients

Title: Nutrients

Publisher: MDPI

ISSN (Electronic): 2072-6643

Publication date (Electronic): 25 October 2017

Publication date Collection: November 2017

Volume: 9

Issue: 11

Electronic Location Identifier: 1165

Affiliations

[1 ]Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA

[2 ]Department of Urology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; rdutta@ 123456wakehealth.edu

[3 ]Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; lireynol@ 123456wakehealth.edu

[4 ]Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; ssergean@ 123456wakehealth.edu

[5 ]GeneSTAR Research Program, General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA; rmathias@ 123456jhmi.edu

[6 ]Department of Internal Medicine, Section on Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; mseeds@ 123456wakehealth.edu

Author notes

[* ]Correspondence: schilton@ 123456wakehealth.edu ; Tel.: +1-336-713-7106

Article

Publisher ID: nutrients-09-01165

DOI: 10.3390/nu9111165

PMC ID: 5707637

PubMed ID: 29068398

SO-VID: fb15a7ba-c1c9-47d6-93e8-719db14b99d1

License:

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

Precision Nutrition and Omega-3 Polyunsaturated Fatty Acids: A Case for Personalized Supplementation Approaches for the Prevention and Management of Human Diseases

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Most cited references 139

Geocoding and monitoring of US socioeconomic inequalities in mortality and cancer incidence: does the choice of area-based measure and geographic level matter?: the Public Health Disparities Geocoding Project.

State of disparities in cardiovascular health in the United States.

Distribution, interconversion, and dose response of n−3 fatty acids in humans

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