N-6 Fatty acids and cardiovascular health: A review of the evidence for dietary intake recommendations

British Journal of Nutrition

Volumn 104, Issue 6, 2010, Pages 788-796

  Czernichow, Sébastien ^a,b   Thomas, Daniel ^c   Bruckert, Eric ^c  

^a Institut National de la Recherche Agronomique   (France)

^b UNIVERSITÉ PARIS 13   (France)

^c PITIÉ SALPÊTRIÈRE HOSPITAL   (France)

Author keywords

CVD; Diet; n 6 PUFA

Indexed keywords

CHOLESTEROL; HIGH DENSITY LIPOPROTEIN CHOLESTEROL; LEUKOTRIENE B4; LINOLEIC ACID; LOW DENSITY LIPOPROTEIN CHOLESTEROL; OMEGA 6 FATTY ACID; PROSTAGLANDIN E2; SATURATED FATTY ACID; THROMBOXANE A2; FATTY ACID;

ATHEROSCLEROSIS; CALORIC INTAKE; CARDIOVASCULAR DISEASE; CARDIOVASCULAR FUNCTION; CARDIOVASCULAR RISK; CHOLESTEROL BLOOD LEVEL; CLINICAL TRIAL; DIASTOLIC BLOOD PRESSURE; DIET SUPPLEMENTATION; DIETARY INTAKE; DISEASE PREDISPOSITION; FAT INTAKE; HEMOSTASIS; HUMAN; INCIDENCE; INFLAMMATION; ISCHEMIC HEART DISEASE; LIPID PEROXIDATION; NON INSULIN DEPENDENT DIABETES MELLITUS; OBESITY; OXIDATIVE STRESS; PREVALENCE; REVIEW; SYSTOLIC BLOOD PRESSURE; THROMBOCYTE AGGREGATION; THROMBUS; HEALTH CARE POLICY; RISK FACTOR;

CARDIOVASCULAR DISEASES; DIETARY FATS; FATTY ACIDS; FATTY ACIDS, OMEGA-6; HUMANS; LINOLEIC ACID; NUTRITION POLICY; RISK FACTORS;

EID: 77957268439     PISSN: 00071145     EISSN: 14752662     Source Type: Journal    
DOI: 10.1017/S0007114510002096     Document Type: Review

References (110)

1. Kris-Etherton PM, Taylor DS, Yu-Poth S, et al. (2000) Polyunsaturated fatty acids in the food chain in the United States. Am J Clin Nutr 71, 179S-188S.
2. Harris WS, Mozaffarian D, Rimm E, et al. (2009) Omega-6 fatty acids and risk for cardiovascular disease: A science advisory from the American Heart Association Nutrition Subcommittee of the Council on Nutrition, Physical Activity, and Metabolism; Council on Cardiovascular Nursing; and Council on Epidemiology and Prevention. Circulation 119, 902-907.
3. Simopoulos AP (2008) The importance of the omega-6/omega- 3 fatty acid ratio in cardiovascular disease and other chronic diseases. Exp Biol Med (Maywood) 233, 674-688.
4. Hamazaki T & Okuyama H (2003) The Japan Society for Lipid Nutrition recommends to reduce the intake of linoleic acid. A review and critique of the scientific evidence. World Rev Nutr Diet 92, 109-132.
5. Ailhaud G (2008) Omega-6 fatty acids and excessive adipose tissue development. World Rev Nutr Diet 98, 51-61.
6. Holman RT (1961) How essential are fatty acids? JAMA 178, 930-933.
7. Williard DE, Nwankwo JO, Kaduce TL, et al. (2001) Identification of a fatty acid delta6-desaturase deficiency in human skin fibroblasts. J Lipid Res 42, 501-508.
8. Moshfegh A, Goldman J & Cleveland L (2005) What we Eat in America: NHANES 2001-2002: Usual Nutrient Intakes from Food Compared to Dietary Reference Intakes. Beltsville, MD: US Department of Agriculture, Agricultural Research Service.
9. Astorg P, Bertrais S, Laporte F, et al. (2008) Plasma n-6 and n-3 polyunsaturated fatty acids as biomarkers of their dietary intakes: A cross-sectional study within a cohort of middleaged French men and women. Eur J Clin Nutr 62, 1155-1161.
10. Poudel-Tandukar K, Nanri A, Matsushita Y, et al. (2009) Dietary intakes of alpha-linolenic and linoleic acids are inversely associated with serum C-reactive protein levels among Japanese men. Nutr Res 29, 363-370.
11. Rosell MS, Lloyd-Wright Z, Appleby PN, et al. (2005) Longchain n-3 polyunsaturated fatty acids in plasma in British meateating, vegetarian, and vegan men. Am J Clin Nutr 82, 327-334.
12. Baylin A, Kim MK, Donovan-Palmer A, et al. (2005) Fasting whole blood as a biomarker of essential fatty acid intake in epidemiologic studies: Comparison with adipose tissue and plasma. Am J Epidemiol 162, 373-381.
13. Astorg P, Bertrais S, Laporte F, et al. (2008) Plasma n-6 and n-3 polyunsaturated fatty acids as biomarkers of their dietary intakes: A cross-sectional study within a cohort of middleaged French men and women. Eur J Clin Nutr 62, 1155-1161.
14. Calder PC (2007) Dietary arachidonic acid: Harmful, harmless or helpful? Br J. Nutr 98, 451-453.
15. Kusumoto A, Ishikura Y, Kawashima H, et al. (2007) Effects of arachidonate-enriched triacylglycerol supplementation on serum fatty acids and platelet aggregation in healthy male subjects with a fish diet. Br J. Nutr 98, 626-635.
16. Williams ES, Baylin A & Campos H (2007) Adipose tissue arachidonic acid and the metabolic syndrome in Costa Rican adults. Clin Nutr 26, 474-482.
17. Sprecher H, Luthria DL, Mohammed BS, et al. (1995) Reevaluation of the pathways for the biosynthesis of polyunsaturated fatty acids. J Lipid Res 36, 2471-2477.
18. Nakamura MT & Nara TY (2004) Structure, function, and dietary regulation of delta6, delta5, and delta9 desaturases. Annu Rev Nutr 24, 345-376.
19. Cunnane SC, Keeling PW, Thompson RP, et al. (1984) Linoleic acid and arachidonic acid metabolism in human peripheral blood leucocytes: Comparison with the rat. Br J. Nutr 51, 209-217.
20. Demmelmair H, Iser B, Rauh-Pfeiffer A, et al. (1999) Comparison of bolus versus fractionated oral applications of [13C]-linoleic acid in humans. Eur J Clin Invest 29, 603-609.
21. Emken EA, Adlof RO & Gulley RM (1994) Dietary linoleic acid influences desaturation and acylation of deuterium-labeled linoleic and linolenic acids in young adult males. Biochim Biophys Acta 1213, 277-288.
22. Hussein N, Ah-Sing E, Wilkinson P, et al. (2005) Long-chain conversion of [13C]linoleic acid and alpha-linolenic acid in response to marked changes in their dietary intake in men. J Lipid Res 46, 269-280.
23. Sarkkinen ES, Agren JJ, Ahola I, et al. (1994) Fatty acid composition of serum cholesterol esters, and erythrocyte and platelet membranes as indicators of long-term adherence to fat-modified diets. Am J Clin Nutr 59, 364-370.
24. NCEP NCaEP (2001) Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).
25. Briel M, Ferreira-Gonzalez I, You JJ, et al. (2009) Association between change in high density lipoprotein cholesterol and cardiovascular disease morbidity and mortality: Systematic review and meta-regression analysis. BMJ 338, b92.
26. Katan MB, Zock PL & Mensink RP (1994) Effects of fats and fatty acids on blood lipids in humans: An overview. Am J Clin Nutr 60, 1017S-1022S.
27. Nichaman MZ, Sweeley CC & Olson RE (1967) Plasma fatty acids in normolipemic and hyperlipemic subjects during fasting and after linoleate feeding. Am J Clin Nutr 20, 1057-1069.
28. Shepherd J, Packard CJ, Grundy SM, et al. (1980) Effects of saturated and polyunsaturated fat diets on the chemical composition and metabolism of low density lipoproteins in man. J Lipid Res 21, 91-99. (Pubitemid 10120441)
29. Mensink RP, Zock PL, Katan MB, et al. (1992) Effect of dietary cis and trans fatty acids on serum lipoprotein[a] levels in humans. J Lipid Res 33, 1493-1501.
30. Mensink RP, Zock PL, Kester AD, et al. (2003) Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: A meta-analysis of 60 controlled trials. Am J Clin Nutr 77, 1146-1155.
31. Clarke R, Frost C, Collins R, et al. (1997) Dietary lipids and blood cholesterol: Quantitative meta-analysis of metabolic ward studies. BMJ 314, 112-117.
32. Hodson L, Skeaff CM & Chisholm WA (2001) The effect of replacing dietary saturated fat with polyunsaturated or monounsaturated fat on plasma lipids in free-living young adults. Eur J Clin Nutr 55, 908-915.
33. Franceschini G (2001) Epidemiologic evidence for highdensity lipoprotein cholesterol as a risk factor for coronary artery disease. Am J Cardiol 88, 9N-13N.
34. Yusuf S, Hawken S, Ounpuu S, et al. (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study. Lancet 364, 937-952.
35. Siguel E (1996) A new relationship between total/high density lipoprotein cholesterol and polyunsaturated fatty acids. Lipids 31, S51-S56.
36. Jakobsen MU, O'Reilly EJ, Heitmann BL, et al. (2009) Major types of dietary fat and risk of coronary heart disease: A pooled analysis of 11 cohort studies. Am J Clin Nutr 89, 1425-1432.
37. Hodson L, Skeaff CM & Chisholm WA (2001) The effect of replacing dietary saturated fat with polyunsaturated or monounsaturated fat on plasma lipids in free-living young adults. Eur J Clin Nutr 55, 908-915.
38. Salonen JT, Salonen R, Ihanainen M, et al. (1988) Blood pressure, dietary fats, and antioxidants. Am J Clin Nutr 48, 1226-1232.
39. Oster P, Arab L, Schellenberg B, et al. (1980) Linoleic acid and blood pressure. Prog Food Nutr Sci 4, 39-40.
40. Grimsgaard S, Bonaa KH, Jacobsen BK, et al. (1999) Plasma saturated and linoleic fatty acids are independently associated with blood pressure. Hypertension 34, 478-483.
41. Simon JA, Fong J & Bernert JT Jr (1996) Serum fatty acids and blood pressure. Hypertension 27, 303-307.
42. Iacono JM, Dougherty RM & Puska P (1982) Reduction of blood pressure associated with dietary polyunsaturated fat. Hypertension 4, III34-III42.
43. Hall WL (2009) Dietary saturated and unsaturated fats as determinants of blood pressure and vascular function. Nutr Res Rev 22, 18-38.
44. Hornstra G, Chait A, Karvonen MJ, et al. (1973) Influence of dietary fat on platelet function in men. Lancet 1, 1155-1157.
45. Knapp HR (1997) Dietary fatty acids in human thrombosis and hemostasis. Am J Clin Nutr 65, 1687S-1698S.
46. Thijssen MA, Hornstra G & Mensink RP (2005) Stearic, oleic, and linoleic acids have comparable effects on markers of thrombotic tendency in healthy human subjects. J. Nutr 135, 2805-2811.
47. Halliwell B & Chirico S (1993) Lipid peroxidation: Its mechanism, measurement, and significance. Am J Clin Nutr 57, 715S-724S.
48. Steinberg D, Parthasarathy S, Carew TE, et al. (1989) Beyond cholesterol. Modifications of low-density lipoprotein that increase its atherogenicity. N Engl J Med 320, 915-924.
49. Navab M, Ananthramaiah GM, Reddy ST, et al. (2004) The oxidation hypothesis of atherogenesis: The role of oxidized phospholipids and HDL. J Lipid Res 45, 993-1007.
50. Abbey M, Belling GB, Noakes M, et al. (1993) Oxidation of low-density lipoproteins: Intraindividual variability and the effect of dietary linoleate supplementation. Am J Clin Nutr 57, 391-398.
51. Berry EM, Eisenberg S, Haratz D, et al. (1991) Effects of diets rich in monounsaturated fatty acids on plasma lipoproteins - the Jerusalem Nutrition Study: High MUFAs vs high PUFAs. Am J Clin Nutr 53, 899-907.
52. Bonanome A, Pagnan A, Biffanti S, et al. (1992) Effect of dietary monounsaturated and polyunsaturated fatty acids on the susceptibility of plasma low density lipoproteins to oxidative modification. Arterioscler Thromb 12, 529-533.
53. Kleemola P, Freese R, Jauhiainen M, et al. (2002) Dietary determinants of serum paraoxonase activity in healthy humans. Atherosclerosis 160, 425-432.
54. Damsgaard CT, Frokiaer H, Andersen AD, et al. (2008) Fish oil in combination with high or low intakes of linoleic acid lowers plasma triacylglycerols but does not affect other cardiovascular risk markers in healthy men. J. Nutr 138, 1061-1066.
55. Calder PC & Grimble RF (2002) Polyunsaturated fatty acids, inflammation and immunity. Eur J Clin Nutr 56, Suppl. 3, S14-S19.
56. Tilley SL, Coffman TM & Koller BH (2001) Mixed messages: modulation of inflammation and immune responses by prostaglandins and thromboxanes. J Clin Invest 108, 15-23.
57. De Caterina R, Liao JK & Libby P (2000) Fatty acid modulation of endothelial activation. Am J Clin Nutr 71, 213S-223S.
58. Serhan CN (2005) Lipoxins and aspirin-triggered 15-epilipoxins are the first lipid mediators of endogenous antiinflammation and resolution. Prostaglandins Leukot Essent Fatty Acids 73, 141-162.
59. Pischon T, Hankinson SE, Hotamisligil GS, et al. (2003) Habitual dietary intake of n-3 and n-6 fatty acids in relation to inflammatory markers among US men and women. Circulation 108, 155-160.
60. Ferrucci L, Cherubini A, Bandinelli S, et al. (2006) Relationship of plasma polyunsaturated fatty acids to circulating inflammatory markers. J Clin Endocrinol Metab 91, 439-446.
61. Thies F, Miles EA, Nebe-von-Caron G, et al. (2001) Influence of dietary supplementation with long-chain n-3 or n-6 polyunsaturated fatty acids on blood inflammatory cell populations and functions and on plasma soluble adhesion molecules in healthy adults. Lipids 36, 1183-1193.
62. Lewis CE, McTigue KM, Burke LE, et al. (2009) Mortality, health outcomes, and body mass index in the overweight range: A science advisory from the American Heart Association. Circulation 119, 3263-3271.
63. Romero-Corral A, Somers VK & Sierra-Johnson J (2009) Normal weight obesity: A risk factor for cardiometabolic dysregulation and cardiovascular mortality. Eur Heart J 31, 737-746.
64. DiGirolamo M, Fine JB, Tagra K, et al. (1998) Qualitative regional differences in adipose tissue growth and cellularity in male Wistar rats fed ad libitum. Am J Physiol 274, R1460-R1467.
65. Hausman DB, DiGirolamo M, Bartness TJ, et al. (2001) The biology of white adipocyte proliferation. Obes Rev 2, 239-254.
66. Tchoukalova YD, Sarr MG & Jensen MD (2004) Measuring committed preadipocytes in human adipose tissue from severely obese patients by using adipocyte fatty acid binding protein. Am J Physiol Regul Integr Comp Physiol 287, R1132-R1140.
67. Cleary MP, Phillips FC & Morton RA (1999) Genotype and diet effects in lean and obese Zucker rats fed either safflower or coconut oil diets. Proc Soc Exp Biol Med 220, 153-161.
68. Massiera F, Saint-Marc P, Seydoux J, et al. (2003) Arachidonic acid and prostacyclin signaling promote adipose tissue development: A human health concern? J Lipid Res 44, 271-279.
69. Gaillard D, Negrel R, Lagarde M, et al. (1989) Requirement and role of arachidonic acid in the differentiation of pre-adipose cells. Biochem J 257, 389-397.
70. Miller CW, Casimir DA & Ntambi JM (1996) The mechanism of inhibition of 3T3-L1 preadipocyte differentiation by prostaglandin F2alpha. Endocrinology 137, 5641-5650.
71. Serrero G, Lepak NM & Goodrich SP (1992) Paracrine regulation of adipose differentiation by arachidonate metabolites: Prostaglandin F2 alpha inhibits early and late markers of differentiation in the adipogenic cell line 1246. Endocrinology 131, 2545-2551.
72. Serrero G, Lepak NM & Goodrich SP (1992) Prostaglandin F2 alpha inhibits the differentiation of adipocyte precursors in primary culture. Biochem Biophys Res Commun 183, 438-442.
73. Matsuo T, Takeuchi H, Suzuki H, et al. (2002) Body fat accumulation is greater in rats fed a beef tallow diet than in rats fed a safflower or soybean oil diet. Asia Pac J Clin Nutr 11, 302-308.
74. Okuno M, Kajiwara K, Imai S, et al. (1997) Perilla oil prevents the excessive growth of visceral adipose tissue in rats by downregulating adipocyte differentiation. J. Nutr 127, 1752-1757.
75. Hernandez-Morante JJ, Larque E, Lujan JA, et al. (2009) N-6 from different sources protect from metabolic alterations to obese patients: A factor analysis. Obesity (Silver Spring) 17, 452-459.
76. Shekelle RB, Shryock AM, Paul O, et al. (1981) Diet, serum cholesterol, and death from coronary heart disease. The Western Electric study. N Engl J Med 304, 65-70.
77. Hu FB, Stampfer MJ, Manson JE, et al. (1997) Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 337, 1491-1499.
78. Oh K, Hu FB, Manson JE, et al. (2005) Dietary fat intake and risk of coronary heart disease in women: 20 years of follow-up of the nurses' health study. Am J Epidemiol 161, 672-679.
79. Laaksonen DE, Nyyssonen K, Niskanen L, et al. (2005) Prediction of cardiovascular mortality in middle-aged men by dietary and serum linoleic and polyunsaturated fatty acids. Arch Intern Med 165, 193-199.
80. Harris WS, Poston WC & Haddock CK (2007) Tissue n-3 and n-6 fatty acids and risk for coronary heart disease events. Atherosclerosis 193, 1-10.
81. Block RC, Harris WS, Reid KJ, et al. (2008) Omega-6 and trans fatty acids in blood cell membranes: A risk factor for acute coronary syndromes? Am Heart J 156, 1117-1123.
82. Frantz ID Jr, Dawson EA, Ashman PL, et al. (1989) Test of effect of lipid lowering by diet on cardiovascular risk. The Minnesota Coronary Survey. Arteriosclerosis 9, 129-135.
83. Leren P (1966) The effect of plasma cholesterol lowering diet in male survivors of myocardial infarction. A controlled clinical trial. Acta Med Scand Suppl 466, 1-92.
84. Woodhill JM, Palmer AJ, Leelarthaepin B, et al. (1978) Low fat, low cholesterol diet in secondary prevention of coronary heart disease. Adv Exp Med Biol 109, 317-330.
85. Rose GA, Thomson WB & Williams RT (1965) Corn oil in treatment of ischaemic heart disease. Br Med J 1, 1531-1533.
86. Turpeinen O, Karvonen MJ, Pekkarinen M, et al. (1979) Dietary prevention of coronary heart disease: The Finnish Mental Hospital Study. Int J Epidemiol 8, 99-118.
87. Miettinen M, Turpeinen O, Karvonen MJ, et al. (1983) Dietary prevention of coronary heart disease in women: The Finnish Mental Hospital Study. Int J Epidemiol 12, 17-25.
88. Dayton S, Pearce ML, Goldman H, et al. (1968) Controlled trial of a diet high in unsaturated fat for prevention of atherosclerotic complications. Lancet 2, 1060-1062.
89. Siri-Tarino PW, Sun Q, Hu FB, et al. (2010) Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr 91, 535-546.
90. Kris-Etherton PM, Innis S, Ammerican DA, et al. (2007) Position of the American Dietetic Association and Dietitians of Canada: Dietary fatty acids. J Am Diet Assoc 107, 1599-1611.
91. Trumbo P, Schlicker S, Yates AA, et al. (2002) Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. J Am Diet Assoc 102, 1621-1630.
92. National Health and Medical Research Council (2006) Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intakes. Canberra: ISBN Print.
93. Sasaki S (2008) Dietary Reference Intakes (DRIs) in Japan. Asia Pac J Clin Nutr 17, Suppl. 2, 420-444.
94. Eurodiet Project (2001) Eurodiet Core Report.
95. U.S. Department of Health and Human Services & U.S. Department of Agriculture (2005) Dietary Guidelines for Americans, 6th ed. Washington, DC: U.S. Government Printing Office.
96. Stanley JC, Elsom RL, Calder PC, et al. (2007) UK Food Standards Agency Workshop Report: The effects of the dietary n-6:n-3 fatty acid ratio on cardiovascular health. Br J. Nutr 98, 1305-1310.
97. Harris WS (2006) The omega-6/omega-3 ratio and cardiovascular disease risk: Uses and abuses. Curr Atheroscler Rep 8, 453-459.
98. Katan MB (2009) Omega-6 polyunsaturated fatty acids and coronary heart disease. Am J Clin Nutr 89, 1283-1284.
99. Tunstall-Pedoe H (2006) Preventing Chronic Diseases. A Vital Investment: WHO Global Report. Geneva: World Health Organization pp. 200. CHF 30̇00. ISBN 92 4 1563001. Also published on http://www.who.int/chp/chronic-disease- report/ en/. Int J Epidemiol.
100. McGee DL, Reed DM, Yano K, et al. (1984) Ten-year incidence of coronary heart disease in the Honolulu Heart Program. Relationship to nutrient intake. Am J Epidemiol 119, 667-676. (Pubitemid 14142805)
101. Kushi LH, Lew RA, Stare FJ, et al. (1985) Diet and 20-year mortality from coronary heart disease. The Ireland-Boston Diet-Heart Study. N Engl J Med 312, 811-818.
102. Posner BM, Cobb JL, Belanger AJ, et al. (1991) Dietary lipid predictors of coronary heart disease in men. The Framingham Study. Arch Intern Med 151, 1181-1187.
103. Dolecek TA (1992) Epidemiological evidence of relationships between dietary polyunsaturated fatty acids and mortality in the multiple risk factor intervention trial. Proc Soc Exp Biol Med 200, 177-182.
104. Esrey KL, Joseph L & Grover SA (1996) Relationship between dietary intake and coronary heart disease mortality: lipid research clinics prevalence follow-up study. J Clin Epidemiol 49, 211-216.
105. Ascherio A, Rimm EB, Giovannucci EL, et al. (1996) Dietary fat and risk of coronary heart disease in men: Cohort follow up study in the United States. BMJ 313, 84-90.
106. Pietinen P, Ascherio A, Korhonen P, et al. (1997) Intake of fatty acids and risk of coronary heart disease in a cohort of Finnish men. The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Am J Epidemiol 145, 876-887.
107. Medical Research Council (1968) Controlled trial of soya-bean oil in myocardial infarction: Report of a research committee to the Medical Research Council. Lancet 292, 693-700.
108. Watts GF, Lewis B, Brunt JN, et al. (1992) Effects on coronary artery disease of lipid-lowering diet, or diet plus cholestyramine, in the St Thomas' Atherosclerosis Regression Study (STARS). Lancet 339, 563-569.
109. AgenceFrançaise deSécurité Sanitaire desAliments (2003) Acides gras de la famille oméga 3 et système cardiovasculaire: Intérêt nutritionnel et allégations. (Fatty acids, omega 3 family and the cardiovascular system: nutritional interest and allegations).
110. British Nutrition Foundation (2004) Nutrient Requirements and Recommendations.