Seafood Long-Chain n-3 Polyunsaturated Fatty Acids and Cardiovascular Disease: A Science Advisory From the American Heart Association

Circulating polyunsaturated fatty acids percentages and coronary artery disease incidence and mortality: Observational and Mendelian randomization analyses

BACKGROUND

The roles of polyunsaturated fatty acids (PUFAs) in preventing coronary artery disease (CAD) remain controversial. This study aimed to investigate the relationships between circulating PUFA percentages and CAD outcomes using observational and Mendelian randomization (MR) approaches.

METHODS

We analyzed data from 203,373 UK Biobank participants without CAD at baseline. Four PUFA percentages (docosahexaenoic acid [DHA]%, omega-3%, linoleic acid [LA]%, and omega-6%) were examined in relation to incident CAD and CAD mortality. MR analyses included one-sample linear and nonlinear approaches, as well as two-sample univariable and multivariable methods. Observational and one-sample MR analyses were conducted overall and stratified by age and sex.

RESULTS

During a median follow-up of 13.2 years, 16,098 incident CAD cases and 1243 CAD deaths occurred. Observationally, all PUFA percentages were inversely associated with both CAD outcomes. In one-sample MR, genetically predicted DHA% was strongly associated with decreased risk of CAD mortality (hazard ratio [HR] 0.31, 95 % confidence interval [CI] 0.15-0.62, P = 9.71 × 10-4), with a pronounced effect in individuals aged ≥58 years (HR 0.20, 95 % CI 0.09-0.43, P = 4.75 × 10-5). Genetically predicted omega-6% was associated with a decreased risk of incident CAD (HR 0.84, 95 % CI 0.76-0.92, P = 1.26 × 10-4), with a significant effect in females but not in males. Two-sample MR confirmed these findings, suggesting partial mediation through lipid pathways. Nonlinear MR analyses validated these linear associations without threshold effects.

CONCLUSIONS

Observational and genetically predicted high DHA% protects against CAD mortality, particularly in older adults. Omega-6% and incident CAD exhibited sex-specific inverse associations. These findings underscore the importance of considering age and sex in PUFA-based strategies for CAD prevention.

Lake depth influences mercury and omega-3 levels in Walleye via resource utilization shifts

Elevated mercury levels in fish are correlated with their body size and trophic position, and with environmental parameters (e.g., catchment and lake properties). Much less is known how the variation of polyunsaturated fatty acids (PUFA) in fish is intertwined with environmental variables and mercury levels. We studied the linkages between catchment and lake properties and the variation of eicosapentaenoic acid (EPA), docosahexanenoic acid (DHA) and mercury levels in Walleye (Percidae, Sander vitreus) from 30 lakes in the Province of Ontario, Canada. Walleye mercury and DHA levels correlated with fish length; thus, we used length-standardized mass fractions in the correlation analyses of lake and catchment properties and the intraspecific variation of mercury, EPA and DHA in Walleye. Overall, the data indicated that mercury, EPA and DHA levels in Walleye are linked to habitat availability, i.e., relative abundance of pelagic vs. littoral areas, and consequently, to differences of the reliance on pelagic vs. littoral or benthic food webs. The length-standardized mass fractions of mercury, EPA, and DHA increased with increasing maximum depth of a lake, which explained 35% of the total variation. Habitat availability may be integral in determining the foraging grounds and diet selection of Walleye, which in turn is linked with muscle EPA, DHA, and mercury levels, as well as the risk and benefits of consuming Walleye for humans. Thus, the findings have direct applicability to informing lake-specific consumption advisories for Walleye.

Do physiological changes in fatty acid composition alter cellular ferroptosis susceptibility and influence cell function?

Ferroptosis is an iron-dependent form of cell death driven by the excessive peroxidation of poly-unsaturated fatty acids (PUFAs) within membrane phospholipids. Ferroptosis is a hallmark of many diseases and preventing or inducing ferroptosis has considerable therapeutic potential. Like other forms of cell death, the pathological importance and therapeutic potential of ferroptosis is well appreciated. However, while cell death modalities such as apoptosis and necroptosis have critical physiological roles, such as in development and tissue homeostasis, whether ferroptosis has important physiological roles is largely unknown. In this regard, key questions for field are as follows: Is ferroptosis used for physiological processes? Are certain cell-types purposely adapted to be either resistant or sensitive to ferroptosis to be able to function optimally? Do physiological perturbations such as aging and diet impact ferroptosis susceptibility? Herein, we have reviewed emerging evidence that supports the idea that being able to selectively and controllably induce or resist ferroptosis is essential for development and cell function. While several factors regulate ferroptosis, it appears that the ability of cells and tissues to control their lipid composition, specifically the abundance of phospholipids containing PUFAs, is crucial for cells to be able to either resist or be sensitized to ferroptosis. Finally, aging and diets enriched in specific PUFAs lead to an increase in cellular PUFA levels which may sensitize cells to ferroptosis. Therefore, changes in dietary PUFAs or againg may impact the pathogenesis of diseases where ferroptosis is involved.

Recent developments, challenges, and prospects of dietary omega-3 PUFA-fortified foods: Focusing on their effects on cardiovascular diseases

Dietary omega-3 polyunsaturated fatty acids (Dω-3 PUFAs) have been extensively studied and have been proven to offer notable benefits for heart health. Scientific meta-analysis strongly endorses them as potent bioactive agents capable of preventing and managing cardiovascular diseases (CVDs). Fortification of foods with Dω-3 PUFAs is a potential strategy for enhancing Dω-3 PUFA intake in an effort to continue strengthening public health outcomes. This review analyzed recent trends in the fortification of foods with Dω-3 PUFAs in relation to technological developments, challenges linked to the method, and future scope. Additionally, recent clinical trials and research on the effect of Dω-3 PUFA-fortified food consumption on cardiovascular health are reviewed. Technological trends in fortification methods, namely microencapsulation- and nanoencapsulation, have made considerable progress to date, along with excellent stability in both processing and storage conditions and favorable bioaccessibility and sensory attributes of fortified foods. There is a tremendous deal of promise for cardiovascular health based on recent clinical trial findings that fortifying food with Dω-3 PUFAs decreased the incidence of heart disease, blood pressure, and lipid profiles. In summary, substantial progress has been made in addressing the challenges of Dω-3 PUFA fortification. However, further multidisciplinary research is needed to inculcate effectiveness toward achieving the maximum possible Dω-3 PUFAs to protect against the harmful effects of CVDs and continue global health progress.

Nutritional Support of Chronic Obstructive Pulmonary Disease

Background: COPD is a heterogenous disease of the respiratory tract caused by diverse genetic factors along with environmental and lifestyle-related effects such as industrial dust inhalation and, most frequently, cigarette smoking. These factors lead to airflow obstruction and chronic respiratory symptoms. Additionally, the increased risk of infections exacerbates airway inflammation in COPD patients. As a consequence of the complex pathomechanisms and difficulty in treatment, COPD is among the leading causes of mortality both in the western countries and in the developing world. Results: The management of COPD is still a challenge for the clinicians; however, alternative interventions such as smoking cessation and lifestyle changes from a sedentary life to moderate physical activity with special attention to the diet may ameliorate patients' health. Here, we reviewed the effects of different dietary components and supplements on the conditions of COPD. Conclusions: COPD patients are continuously exposed to heavy metals, which are commonly present in cigarette smoke and polluted air. Meanwhile, they often experience significant nutrient deficiencies, which affect the detoxification of these toxic metals. This in turn can further disrupt nutritional balance by interfering with the absorption, metabolism, and utilization of essential micronutrients. Therefore, awareness and deliberate efforts should be made to check levels of micronutrients, with special attention to ensuring adequate levels of antioxidants, vitamin D, vitamin K2, magnesium, and iron, as these may be particularly important in reducing the risk of COPD development and limiting disease severity.

Personalized Nutrition in Chronic Kidney Disease

A personalized approach to nutrition in patients with chronic kidney disease (CKD) represents a promising paradigm shift in disease management, moving beyond traditional one-size-fits-all dietary recommendations. Patients with CKD often have other comorbidities and face unique nutritional challenges, including protein-energy wasting (PEW), sarcopenia, and impaired renal excretion of nutrients, which complicate dietary planning. Current guidelines focus primarily on nutrient restrictions-such as limiting protein, sodium, potassium, and phosphorus. However, these generalized recommendations often result in suboptimal adherence and outcomes. Personalized nutrition, which adapts dietary recommendations to individual characteristics, such as genotype, phenotype, and socio-cultural preferences, has gained traction across various chronic diseases. However, its application in nephrology remains underexplored, and despite promising results from studies such as Food4Me, questions remain about the real-world impact of such strategies. The aims of this review are (1) to summarize the evidence on the current state of nutritional recommendations in CKD, (2) to discuss the emerging role of multi-omics approaches in informing personalized nutrition advice in CKD, and (3) to provide an opinion on nutritional challenges faced by patients with CKD and the importance of collaboration with the renal dietician. We conclude that despite barriers, such as the cost and data integration, personalized nutrition holds the potential to improve CKD outcomes, enhance quality of life, and empower patients through tailored dietary strategies for better disease management.

Dietary Intakes Among University Students in Iceland: Insights from the FINESCOP Project

Objectives: Using data from the Food Insecurity among European University Students during the COVID-19 Pandemic (FINESCOP) project, this study aims to investigate the dietary intakes among university students in Iceland, focusing specifically on their current diet after March 2020. Additionally, it examines correlations among different food groups to reveal associations in dietary patterns. Methods: The investigation uses data from the observational FINESCOP project in Iceland. Spearman's correlation coefficients were used to identify associations between different dietary intakes. p values show significance at a level of <0.05. Results: Icelandic university students have a low intake of vegetables and salad ("3-4 times per week", n = 159, 24.8%), fruit ("1-2 times per week", n = 164, 25.6%), and whole wheat ("3-4 times per week", n = 147, 23.2%). Lower than these was legume intake ("Never/seldom", n = 203, 32.0%). Meat and eggs were consumed more frequently ("3-4 times per week", n = 231, 36.3%) compared to fish and seafood ("1-2 times per week", n = 277, 43.5%). While the findings do indicate a significant correlation between vegetables and salad and fruit intake (p < 0.001) and between vegetable and salad and legume intake (p < 0.001), causal relationships cannot be established. Among discretionary foods, sweets and snacks were moderately and significantly correlated (p < 0.001). Conclusions: This study explores dietary intakes and correlations between dietary factors among university students in Iceland. Further research is needed to explore the potential for causal inferences and better understand these dietary behaviors of university students in Iceland.

Examining the Influence of Omega-3 Fatty Acids on Performance, Recovery, and Injury Management for Health Optimization: A Systematic Review Focused on Military Service Members

BACKGROUND/OBJECTIVES

Omega-3 fatty acids (n-3), recognized for their anti-inflammatory and brain health benefits, are being studied to enhance cognitive function, aid physical recovery, and reduce injury rates among military service members (SMs). Given the unique demands faced by this tactical population, this systematic review aims to evaluate the evidence of n-3 to support physical and mental resilience and overall performance.

METHODS

This review was conducted in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and includes articles that assessed n-3 status or implemented n-3 interventions in relation to physical and cognitive performance, recovery, and injury outcomes (2006 to 2024). Of the 1606 articles yielded in screening through Covidence, 755 were irrelevant, leaving 226 studies for full-text eligibility. Of those 226 studies, 165 studies were excluded, and 61 studies were included in this review.

RESULTS

The results highlighted evidence-based findings in five key areas where omega-3 fatty acids are being evaluated to benefit military service members. These key areas include cardiopulmonary function, exercise recovery, cognitive function, injury recovery, and strength and power. While existing research suggests promising benefits, the most significant evidence was seen with cardiopulmonary function, exercise recovery, and cognitive function.

CONCLUSIONS

Current research is promising and shows potential benefits, but the results are inconclusive and inconsistent. Future research is needed to determine optimal n-3 status, dose, and possibly type of n-3 across the various performance outcomes. Understanding these gaps in research will be essential to creating evidence-based n-3 guidelines for optimal performance of SMs.

Balancing Nutritional and Environmental Sustainability Through the Evaluation of the Water Footprint of the Recommended Italian, Spanish, and American Diets

Background/Objectives: The water footprint (WF) provides information on the impact of individual foods on water consumption, but to better direct food production toward water saving, we need to understand how to reduce the WF of our diets while keeping it healthy. In this study, we compared the WF of healthy diets based on national food-based dietary guidelines with the aim of highlighting changes in dietary patterns that could reduce water requirements without compromising nutritional adequacy. Methods: Three 2000 kcal/day dietary patterns were elaborated following the Italian, Spanish, and American dietary guidelines, and their total, green, blue, and grey WFs were calculated. Results: The Italian dietary pattern showed the lowest total WF (2806 L per capita/day), with the American and Spanish patterns being 8% and 10.5% higher, respectively. The food groups contributed differently to the total WF. In the USA, animal foods were the main contributor (56% versus 41% in Spain and 38% in Italy). The contribution of plant foods was higher in Italy (61%) than in Spain (54%) and the USA (38%). The distribution of the total WF between WFgreen, WFblue, and WFgrey was similar across the dietary patterns. Within each food group, and mainly in the animal-origin food group, the type of product significantly modulated the WF. Conclusions: Different diets can be equally nutritionally sustainable but have different impacts on environmental sustainability. The comparison of their WFs can be the starting point to promote dialogue between nutritionists, operators in the environmental sector, and the agri-food industry to ensure a healthy and balanced approach.

Tissue-specific distribution and fatty acid content of PFAS in the northern Bohai Sea fish: Risk-benefit assessment of legacy PFAS and emerging alternatives

This study aimed to examine the distribution of poly- and perfluoroalkyl substances (PFAS) in 15 marine fish species from the northern Bohai Sea, investigate their sources of contamination, and evaluate the benefits-risks associated with the concurrent consumption of fish fatty acids and PFAS. The ∑PFAS concentrations in fish ranged from 9.38 to 262.92 ng·g-1 (dry weight). The highest PFAS levels were found in the viscera and gills, while the lowest levels were found in the muscles. Industrial effluents and sewage treatment plant discharges were the primary sources of PFAS contamination. The individual PFAS concentrations in fish were insignificantly correlated with their trophic levels (p > 0.05). However, the concentrations of hexafluoropropylene oxide dimer acid (HFPO-DA) or long-chain PFAS (C > 8) significantly increased with fish size (e.g., total length, weight) and lipid content (p < 0.001). The benefit-risk analysis suggests that HPFO-DA poses a higher health risk than perfluorooctanoic acid (PFOA) in fish (p < 0.05). Long-term consumption of contaminated fish may significantly increase human serum PFOA concentration and kidney cancer risk (p < 0.05). Daily consumption of 5 g (wet weight) muscle from Ditrema temmincki and Konosirus punctatus is recommended to meet the requirements for fatty acid supplementation without posing health risks.

Enzymatic Interesterification of Cold-Pressed Maqui (Aristotelia chilensis (Mol.) Stuntz) Seed Oil and Belly Oil from Rainbow Trout (Oncorhynchus mykiss) Through Supercritical CO2

A new antioxidant lipid (AL) was synthesized from rainbow trout (Oncorhynchus mykiss) belly oil and cold-pressed maqui (CPM) (Aristotelia chilensis (Mol.) Stuntz) seed oil via enzymatic interesterification using Thermomyces lanuginosus in supercritical CO2 medium. A Box-Behnken design with 15 experiments was employed, with the independent variables being the following: belly oil/CPM oil ratio (10/90, 50/50, and 90/10, w/w), supercritical CO2 temperature (40.0, 50.0, and 60.0 °C), and supercritical CO2 pressure (100.0, 200.0, and 300.0 bar) for enzymatic interesterification. A multiple optimization was conducted based on the response variables yield and eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and tocopherol contents. The optimized conditions for the AL synthesis were: 81.4/18.6 (w/w), 40.0 °C and 299.99 bar, respectively. The corresponding responses variables were: 77.10% for yield, 5.12 and 4.95 g·100 g-1 total fatty acids for EPA and DHA, respectively, and 217.96, 4.28, 3.48, 64.48, and 6.39 mg·kg-1 oil for α-tocopherol, α-tocotrienol, β-tocopherol, γ-tocopherol, and δ-tocopherol, respectively. A novel AL was successfully synthesized starting from two abundant natural resources commonly considered as by-products during industrial processing. In agreement with the high EPA, DHA, and tocopherol presence, this AL can be recommended to be employed in nutritional and therapeutic supplements, according to its health benefits, particularly concerning antioxidant and anti-inflammatory properties.

Association of Plasma Omega-3 Levels With Incident Heart Failure and Related Mortalities

OBJECTIVE

To investigate the association between plasma omega-3 levels and incident heart failure (HF) and to examine their relationship with total and cardiovascular (CV) mortality among patients with preexisting HF.

PATIENTS AND METHODS

The UK Biobank is an ongoing prospective cohort study of individuals recruited in the United Kingdom between April 1, 2007, and December 31. 2010. We used Cox proportional hazards models to predict incident HF in those without baseline HF and total and CV mortality in those with baseline HF, all as a function of baseline plasma omega-3 levels.

RESULTS

In participants without HF at baseline (n=271,794), a generally linear inverse association was observed between omega-3 levels and incident HF during a median follow-up of 13.7 years. The risk was 21% lower in the highest quintile of omega-3 compared with the lowest quintile (hazard ratio, 0.79; 95% CI, 0.74 to 0.84; P<.001) in multivariable models. In parallel models in participants with prevalent HF (n=1239), risk for all-cause and CV mortality were both reduced by approximately 50% comparing top to bottom omega-3 quintiles (hazard ratio, 0.53; 95% CI, 0.33 to 0.86; and hazard ratio, 0.50; 95% CI, 0.31 to 0.79, respectively; both P<.01).

CONCLUSION

Higher plasma levels of marine omega-3 fatty acids were associated with a lower incidence of HF. Furthermore, among patients with preexisting HF, higher omega-3 levels were associated with lower risks of all-cause mortality and CV mortality. These findings suggest that increasing plasma omega-3 levels, whether by diet or supplementation, could reduce both risk for development of HF and death in those with prevalent HF.

Fish oil supplementation, genetic susceptibility and risk of new-onset hypertension

OBJECTIVES

The risk of new-onset hypertension is influenced by habitual fish oil supplementation, but whether the association is modified by genetic predisposition is unknown.

METHODS

A total of 213,604 participants without hypertension were identified at baseline from the UK Biobank between 2006 and 2010. The weighted polygenetic risk score (PRS) comprising 118 identified single-nucleotide polymorphisms (SNPs) was used to quantify genetic susceptibility. Cox regression models were applied to determine the association between fish oil supplementation, PRS, and hypertension and evaluate the effect modification of genetic susceptibility.

RESULTS

During a median follow-up of 13.8 years, 18,498 new-onset hypertension cases were identified. Approximately 30.6 % (65,452) of participants were habitual fish oil users. The hazard ratio (HR) of habitual fish oil users for hypertension was 0.94 (95 % confidence interval [CI], 0.91-0.98). Fish oil nonusers with a high genetic risk had an increased risk of hypertension (HR, 1.52; 95 % CI, 1.41-1.64) compared to fish oil users with a low genetic risk. In addition, an interaction on the additive scale between the fish oil use and intermediate or high levels of genetic susceptibility was observed. The interactive effects accounted for approximately 7 % and 22 % of the risk of developing hypertension, respectively.

CONCLUSIONS

This cohort study indicates regular fish oil supplementation could be beneficial in preventing hypertension, particularly among individuals with intermediate or high genetic susceptibility on an additive scale.

Longitudinal study of seafood and fish oil supplement intake and risk of persistent tinnitus

BACKGROUND

Persistent tinnitus is common, disabling, and difficult to treat. Diet has been implicated in tinnitus etiology, but studies are inconsistent, and longitudinal data are scarce. Seafood intake is associated with a lower risk of hearing loss, but the longitudinal association with tinnitus is unknown.

OBJECTIVES

We examined the independent associations of seafood intake, fish oil supplement use, and risk of developing persistent tinnitus.

METHODS

This prospective cohort study followed 73,482 females in the Nurses' Health Study II from 1991 to 2021. Diet was assessed using a validated food frequency questionnaire every 4 y. Multivariable-adjusted Cox proportional hazards regression was used to evaluate independent associations between total seafood intake, specific types of fish, shellfish, fish oil supplements, and risk of persistent tinnitus (defined as tinnitus experienced daily).

RESULTS

After 1,998,421 person-y of follow-up, 9362 cases of incident persistent tinnitus were reported. Seafood intake was independently associated with a lower risk of developing persistent tinnitus. Compared with participants who never or rarely consumed seafood, the multivariable-adjusted hazard ratios (MVHRs; 95% confidence interval) for tinnitus were 0.87 (0.78, 0.95) among participants who consumed 1 serving/wk, 0.77 (0.68, 0.86) for 2-4 servings/wk, and 0.79 (0.64, 0.96) for 5+/servings/wk (P-trend < 0.0001). Examined individually, higher intakes of tuna fish, light-meat fish and shellfish were associated with lower risk. Compared with participants who never or rarely consumed the specific type, the MVHRs for consumption of 1+ servings/wk were 0.84 (0.78, 0.90) (P-trend < 0.0001) for tuna fish, 0.91 (0.83, 0.99) (P-trend = 0.04) for light-meat fish, and 0.82 (0.72, 0.93) (P-trend < 0.0001) for shellfish. A higher risk for dark-meat fish intake was suggested [MVHR: 1.09 (0.99, 1.21) (P-trend = 0.04)]. Fish oil supplement use (yes/no) was associated with higher risk [MVHR: 1.12 (1.06, 1.19)].

CONCLUSIONS

Regular consumption of tuna fish, light-meat fish, or shellfish is associated with a lower risk of developing persistent tinnitus in females. Fish oil supplement use is associated with higher risk.

Omega-3 and Risk of atrial fibrillation: Vagally-mediated double-edged sword

OBJECTIVE

Studies regarding effects of omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on risk of atrial fibrillation (AF) have reported discordant results. The aim of this review is to clarify effects of marine omega-3 intake on risk of AF.

PATIENTS AND METHODS

A PubMed search was performed using terms: atrial fibrillation, omega-3, EPA, DHA, vagal tone. We summarized findings from randomized clinical trials (RCTs), epidemiology studies, and meta-analyses evaluating effects/associations of DHA + EPA on risk of AF. Also, vagal tone was explored as a mediator between omega-3 and risk of AF.

RESULTS

Meta-analyses of 8 RCTs and 17 prospective cohort studies comprised of 83,112 and 54,799 individuals, respectively, investigated the link between omega-3 intake and incident AF. The RCTs reported that treatment with DHA and/or EPA was associated with a 24 % increased relative risk of AF (absolute risk 4.0 % vs 3.3 %; relative risk [RR] 1.24, 95 % confidence interval [CI] 1.11-1.38, p = 0.0002). This was dose-dependent; DHA + EPA doses of ∼1000 mg/d increased AF risk ∼12 %, whereas 1800 to 4000 mg/d increased AF risk by ∼50 %. In contrast, observational studies focused on DHA + EPA blood levels or dietary intake have generally reported that higher omega-3 levels/consumption are associated with lower AF risk. Maximal AF risk reduction. (12 %) occurred at ∼650 mg/d of dietary DHA + EPA. Other studies have indicated that omega-3 fatty acids can dose-dependently increase vagal tone, which could explain the biphasic relationship between DHA + EPA and AF risk. Experimental studies show that low-level vagal stimulation decreases risk of AF, whereas high-level vagal stimulation increases risk of AF.

CONCLUSION

Higher consumption of dietary omega-3 is associated with decreased AF risk. In contrast, pharmaceutical dosing of omega-3 increases AF in a dose-dependent manner, which may be mediated by vagal tone.

Effects of Increasing Farmed Salmon Intake to the Recommended Fish-Intake Amounts on Lipid Profile in Young Women: An 8-Week Intervention Study

BACKGROUND/OBJECTIVES

Habitual dietary changes that could help reduce the potential consequences of excessive body mass, such as hyperlipidemia and increased cardiovascular disease risk, are needed. The aim of this study is to assess the impact of a farmed-salmon-based dietary intervention on lipid profile parameters in young women with excessive body mass.

METHODS

The 8-week intervention involved 38 pair-matched women aged 18-30 years with excessive body weight defined as BMI ≥ 25.0 kg/m2. Participants were randomly assigned to the intervention (200 g of smoked salmon weekly) or the control group. Lipid profile parameters (total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TAG)), as well as atherogenic indices (Atherogenic Index of Plasma (AIP), Atherogenic Coefficient (AC), Cholesterol Index (Cholindex), Castelli Risk Index 1 (CRI-1), Castelli Risk Index 2 (CRI-2) and the TAG/HDL ratio) were assessed before, during, and after the intervention.

RESULTS

At baseline, 47% of participants had at least one of the lipid profile parameters outside the recommended range. No statistically significant differences were observed in the TC, HDL, non-HDL, LDL, or TAG concentrations or in the various atherogenic indices between the intervention and the control group after the 8-week-long intervention. However, differences in the change of the LDL concentration were noted, with a decrease of 8.2 ± 20.7 mg/dL in the intervention group compared to an increase of 9.5 ± 20.0 mg/dL in the control group (p = 0.011), as well as in the change of the Cholindex for which a median decrease of 4.4 mg/dL was noted in the intervention group, while a median increase of 0.8 mg/dL in the control group was observed (p = 0.040). Additionally, across participants with a waist-to-height ratio (WHtR) greater than 0.5, an increase of 50.0 ± 68.3 mg/dL in the intervention group and a decrease of 8.6 ± 56.6 mg/dL in the control group was noted for the TAG concentration change (p = 0.040).

CONCLUSIONS

Concerning the observed beneficial influence of increasing farmed salmon intake to the recommended fish-intake amounts on decreasing LDL and Cholindex in young women with excessive body weight after 8 weeks, it seems that such a diet alteration might be recommended for this group to decrease their risk of cardiovascular disease in the future. Nonetheless, regarding the diverse influence on TAG, further studies are needed to assess the influence of increasing the intake of fatty fish available on the market at present on human health.

Farmed blue mussels (Mytilus edulis)-a nutrient-dense resource retaining nutritional value through processing

This study investigated how farmed blue mussels (Mytilus edulis) can optimize human nutrient intake. A particular focus was on assessing nutrient preservation during steaming and freeze-drying, processes that could deplete nutrients. The study compared the content of essential amino acids and fatty acids in steamed and freeze-dried blue mussels to the nutritional needs of humans and farmed Atlantic salmon (Salmo salar). Additionally, it assessed the ethyl acetate method versus the traditional, more toxic Folch method for lipid extraction from blue mussels. Both steaming and freeze-drying effectively preserved essential amino acids and fatty acids in blue mussels. A 100 g serving of steamed blue mussels contributes from 26.8 ± 0.78% (Phe) to 54.9 ± 1.66% (Thr) of the daily recommended intake of essential amino acids (EAA). For steamed freeze-dried blue mussels, over 100% of the recommended intake is met for all EAA and as much as 243% for threonine. The 100 g serving will also provide 271 mg eicosapentaenoic acid (EPA; 20:5n-3) and 220 mg docosahexaenoic acid (DHA; 22:6n-3), thus covering the required intake of n-3 long-chain polyunsaturated fatty acids for adults as well as the recommended intake for pregnant and lactating women. Mussels are non-fed filter feeders that generally provide these nutrients with significantly lower environmental footprints, measured as global warming, eutrophication, and acidification, compared to farmed Atlantic salmon. Blue mussels can also be a valuable feed ingredient for farmed Atlantic salmon. Finally, it was demonstrated that the ethyl acetate method is not suited for lipid extraction from blue mussels, as the lipid yield was only half compared to the lipid yield using the Folch method.

Functional Foods in Preventing Human Blood Platelet Hyperactivity-Mediated Diseases-An Updated Review

Backgrounds/Objectives: Abnormal platelet functions are associated with human morbidity and mortality. Platelets have emerged as critical regulators of numerous physiological and pathological processes beyond their established roles in hemostasis and thrombosis. Maintaining physiological platelet function is essential to hemostasis and preventing platelet-associated diseases such as cardiovascular disease, cancer metastasis, immune disorders, hypertension, diabetes, sickle cell disease, inflammatory bowel disease, sepsis, rheumatoid arthritis, myeloproliferative disease, and Alzheimer's disease. Platelets become hyperactive in obesity, diabetes, a sedentary lifestyle, hypertension, pollution, and smokers. Platelets, upon activation, can trawl leukocytes and progenitor cells to the vascular sites. Platelets release various proinflammatory, anti-inflammatory, and angiogenic factors and shed microparticles in the circulation, thus promoting pathological reactions. These platelet-released factors also maintain sustained activation, further impacting these disease processes. Although the mechanisms are unknown, multiple stimuli induce platelet hyperreactivity but involve the early pathways of platelet activation. The exact mechanisms of how hyperactive platelets contribute to these diseases are still unclear, and antiplatelet strategies are inevitable for preventing these diseases. Reducing platelet function during the early stages could significantly impact these diseases. However, while this is potentially a worthwhile intervention, using antiplatelet drugs to limit platelet function in apparently healthy individuals without cardiovascular disease is not recommended due to the increased risk of internal bleeding, resistance, and other side effects. The challenge for therapeutic intervention in these diseases is identifying factors that preferentially block specific targets involved in platelets' complex contribution to these diseases while leaving their hemostatic function at least partially intact. Since antiplatelet drugs such as aspirin are not recommended as primary preventives, it is essential to use alternative safe platelet inhibitors without side effects.

METHODS

A systematic search of the PUBMED database from 2000 to 2023 was conducted using the selected keywords: "functional foods", "polyphenols", "fatty acids", "herbs", fruits and vegetables", "cardioprotective agents", "plant", "platelet aggregation", "platelet activation", "clinical and non-clinical trial", "randomized", and "controlled".

RESULTS

Potent natural antiplatelet factors have been described, including omega-3 fatty acids, polyphenols, and other phytochemicals. Antiplatelet bioactive compounds in food that can prevent platelet hyperactivity and thus may prevent several platelet-mediated diseases, including cardiovascular disease.

CONCLUSIONS

This narrative review describes the work during 2000-2023 in developing functional foods from natural sources with antiplatelet effects.

Association of fish intake with all-cause mortality according to CRP levels or inflammation in older adults: a prospective cohort study

BACKGROUND

The relationship between inflammatory response, fish consumption, and mortality risk in older individuals is unclear. We investigated whether C-reactive protein (CRP) levels ≥ 0.1 mg/dL, fish intake, and inflammatory responses are associated with all-cause mortality risk in older adults.

METHODS

This prospective cohort study included older adults aged 85-89 years from the Kawasaki Aging and Wellbeing Project, who did not require daily care. Cohort was recruited from March 2017 to December 2018 (follow-up ended on December 31, 2021). Dietary assessment was conducted using the Brief Self-Administered Diet History Questionnaire. Multivariate Cox proportional hazards regression was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for all-cause mortality in the CRP ≥ 0.1 mg/dL group; the CRP < 0.1 mg/dL group was used for reference. Within CRP ≥ 0.1 and < 0.1 mg/dL groups, participants were categorized into tertiles of fish intake. HRs and 95% CIs for all-cause mortality in the other groups were estimated using the lower tertile group as a reference.

RESULTS

The study included 996 participants (mean [standard deviation] age, 86.5 [1.37] years; 497 [49.9%] women) with a median CRP level of 0.08 (interquartile range [IQR] = 0.04-0.16). There were 162 deaths during 4,161 person-years of observation; the multivariable-adjusted HR for all-cause mortality in the CRP ≥ 0.1 mg/dL group was 1.86 (95% CI, 1.32-2.62); P < 0.001. In 577 individuals with median (IQR) fish intake of 39.3 g/1000 kcal (23.6-57.6) and CRP level of < 0.1 mg/dL, the multivariable-adjusted HR for all-cause mortality in the higher tertile group of fish intake was 1.15 (0.67-1.97); P = 0.59, non-linear P = 0.84. In 419 individuals with median (IQR) fish intake of 40.7 g/1000 kcal (25.0-60.1) and CRP level of ≥ 0.1 mg/dL, the multivariate-adjusted HR for all-cause mortality in the higher tertile group of fish intake was 0.49 (0.26-0.92); P = 0.026, non-linear P = 0.38, P-value for interaction = 0.040.

CONCLUSIONS

A negative association between fish intake and all-cause mortality was seen in older adults with elevated CRP levels, which is a mortality risk factor. While the results may be limited owing to stringent methods ensuring impartiality, they offer valuable insights for future research.

TRIAL REGISTRATION

UMIN000026053. Registered February 24, 2017.

Comparative analysis for nutrients, flavor compounds, and lipidome revealed the edible value of pond-cultured male Pelodiscus sinensis with different ages

Pelodiscus sinensis is an aquatic product with a long growth cycle in pond culture and high nutritional value meat. The flavor compounds, nutrients, and lipidome were investigated to explore the edible value changes of turtle meat aged 3 to 6 years (Y3 to Y6). Typically, P. sinensis meat is rich in high-quality protein (EAAI ≥81.22, AAS ≥86.47). Y6 has the highest level of Se, protein, amino acids, and high unsaturated fatty acids, including EPA + DHA. Y5 has the most delicious amino acids, polyunsaturated fatty acids, and key odorant content. The stronger flavor of Y5 may be mainly related to C18:2n6t and C18:2n6c. Further, triacylglycerols (TAG) and phosphatidylcholine (PC) were significant changes in Y5. Additionally, PI (16:0/18:1) was identified as the potential biomarker. These results provided available information on P. sinensis marketing age and revealed the potential impact of nutrients on the formation of VOCs.

Association between food consumption and serum aryl hydrocarbon receptor ligand activity among middle-aged Korean adults

BACKGROUND/OBJECTIVES

The diet is an important route of exposure to endocrine-disrupting chemicals (EDCs). However, few studies have investigated the association between dietary intake and EDC exposure levels among Koreans. In an earlier study, we showed that the bioactivity of serum aryl hydrocarbon receptor ligands (AhRLs) could be a surrogate biomarker to indicate exposure to EDCs and that they inhibit mitochondrial function. We also found that the mitochondria-inhibiting substances (MIS) in serum ascertained by intracellular adenosine triphosphate (MIS-ATP) and reactive oxygen species (MIS-ROS) levels could be biomarkers of exposure to EDCs, as they showed a strong correlation with AhRL and the levels of EDCs in the blood. Here, we investigated the association between the consumption of specific foods and surrogate serum biomarkers for EDCs, namely AhRL, MIS-ATP, and MIS-ROS, among middle-aged Korean adults.

SUBJECTS/METHODS

A total of 1,466 participants aged 45-76 yrs from the Ansung cohort of the Korean Genome and Epidemiology Study were included. Food consumption, including that of meat, fish, vegetables, and fruits, was measured using a semiquantitative food frequency questionnaire.

RESULTS

Fish intake was positively associated with AhRL (β = 0.0035, P = 0.0166), whereas cruciferous vegetable intake was negatively associated with AhRL (β = -0.0007, P = 0.0488). Cruciferous vegetable intake was positively associated with the MIS-ATP levels (β = 0.0051, P = 0.0420). A higher intake of fish was significantly associated with an increased risk of high AhRL (tertile: odds ratio [OR], 1.49; 95% confidence intervals (CIs), 1.08-2.06; P for trend = 0.0305). In addition, the second-highest tertile of cruciferous vegetable intake had lower odds of high AhRL than the lowest tertile (OR, 0.73; 95% CIs, 0.54-0.97), although no significant linear trend was observed.

CONCLUSION

Consumption of different types of foods may be differentially associated with EDC exposure in middle-aged Korean adults.

Sustainable-use marine protected areas to improve human nutrition

Coral reef fisheries are a vital source of nutrients for thousands of nutritionally vulnerable coastal communities around the world. Marine protected areas are regions of the ocean designed to preserve or rehabilitate marine ecosystems and thereby increase reef fish biomass. Here, we evaluate the potential effects of expanding a subset of marine protected areas that allow some level of fishing within their borders (sustainable-use MPAs) to improve the nutrition of coastal communities. We estimate that, depending on site characteristics, expanding sustainable-use MPAs could increase catch by up to 20%, which could help prevent 0.3-2.85 million cases of inadequate micronutrient intake in coral reef nations. Our study highlights the potential add-on nutritional benefits of expanding sustainable-use MPAs in coral reef regions and pinpoints locations with the greatest potential to reduce inadequate micronutrient intake level. These findings provide critical knowledge given international momentum to cover 30% of the ocean with MPAs by 2030 and eradicate malnutrition in all its forms.

Fish Consumption and DHA Supplementation during Pregnancy: Study of Gestational and Neonatal Outcomes

Several studies have explored the association between fish consumption during pregnancy and favorable neonatal outcomes, although some yield conflicting results. The American College of Obstetricians and Gynecologists recommends two to three servings of low-mercury fish per week for pregnant or breastfeeding women. However, fish can be a source of pollutants, like methylmercury, impacting neurological development. Conflicting studies on docosahexaenoic acid (DHA) supplementation exist in the literature, possibly due to varied supplement dosages. This survey, involving 501 women, investigated fish consumption and DHA supplement intake concerning gestational and neonatal outcomes. Notably, 92.1% of participants consumed fish weekly, with significant differences observed in gestational weight gain, birth weight, and length for those eating fish ≥3 times weekly compared to non-consumers. This study supports the recommendation for pregnant women to include fish in their diet while limiting exposure to environmental pollutants. Omega-3 fatty acid supplements are suggested to attain nutritional benefits without mercury risk.

Role of Omega-3 Fatty Acids in Improving Metabolic Dysfunctions in Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a common endocrine disorder that impacts women of reproductive age. In addition to reproductive and psychological complications, women with PCOS are also at a higher risk of developing metabolic diseases such as obesity, type 2 diabetes and cardiovascular disease. While weight reduction can help manage these complications in overweight or obese women, many weight loss interventions have been ineffective due to weight stigma and its psychological impact on women with PCOS. Therefore, exploring alternative dietary strategies which do not focus on weight loss per se is of importance. In this regard, omega-3 polyunsaturated fatty acids of marine origin (n-3 PUFAs), which are known for their hypotriglyceridemic, cardioprotective and anti-inflammatory effects, have emerged as a potential therapy for prevention and reversal of metabolic complications in PCOS. Several clinical trials showed that n-3 PUFAs can improve components of metabolic syndrome in women with PCOS. In this review, we first summarize the available clinical evidence for different dietary patterns in improving PCOS complications. Next, we summarize the clinical evidence for n-3 PUFAs for alleviating metabolic complications in PCOS. Finally, we explore the mechanisms by which n-3 PUFAs improve the metabolic disorders in PCOS in depth.

Plant Omega-3 Fatty Acids May Lower Risk of Atrial Fibrillation in Individuals with a Low Intake of Marine Omega-3 Fatty Acids

BACKGROUND

Omega-3 fatty acids derived from seafood acids may influence cardiac arrhythmogenesis, whereas the role of the major plant-derived omega-3 fatty acid, alpha-linolenic acid (ALA), on atrial fibrillation (AF) is largely unknown.

OBJECTIVES

We aimed to investigate the association between ALA intake and risk of incident AF overall and in subjects with a low intake of marine omega-3 fatty acids.

METHODS

We followed a total of 54,260 middle-aged men and women enrolled into the Danish Diet, Cancer, and Health cohort for development of AF using nationwide registries. Intake of ALA was assessed using a validated food frequency questionnaire and modeled as a restricted cubic spline. Statistical analyses were conducted using Cox proportional hazards regression.

RESULTS

We identified a total of 4902 incident AF events during a median of 16.9 y of follow-up. In multivariable analyses, we observed indications of a statistically nonsignificant inverse association between ALA intake and risk of AF up to an ALA intake of 2.5 g/d, whereas no appreciable association was found for higher intakes of ALA. A statistically significant dose-dependent negative association was found between ALA intake and risk of AF in individuals consuming < 250 mg marine omega-3 fatty acids daily, whereas no association was found in those with a higher intake of marine omega-3 fatty acids.

CONCLUSIONS

Intake of ALA was associated with a lower risk of AF in individuals consuming a low intake of marine omega-3 fatty acids. This finding is novel and warrants further investigation.

Blood metabolites mediate effects of breakfast skipping on heart failure via Mendelian randomization analysis

Numerous observational studies have suggested a potential causal relationship between skipping breakfast and cardiovascular diseases, including heart failure (HF). However, these studies are susceptible to inherent confounders and the challenge of reverse causation, and the underlying metabolic factors are not yet clear. Therefore, our aim is to assess the causal impact of breakfast skipping on HF and the role of potential mediating metabolic products from a genetic perspective, by conducting Mendelian Randomization (MR) studies and mediation analysis. We leveraged summary data from the most extensive genome-wide association studies to date on breakfast skipping (with 193,860 participants), blood metabolites (with 118,461 participants), and HF (involving 47,309 cases and 930,014 controls). To explore the causal relationship between breakfast skipping and HF, as well as the role of 249 potential blood metabolite mediators, we conducted bidirectional MR and mediation MR analyses. We primarily employed the Inverse Variance Weighted (IVW) method, complemented by various other techniques to ensure the comprehensiveness and reliability of our analysis. Our research confirms a causal association between breakfast skipping and an increased risk of HF (odds ratio [OR]: 1.378, 95% confidence interval [CI]: 1.047-1.813; p = 0.022). Furthermore, our research findings demonstrate that breakfast skipping is positively correlated with 6 blood metabolites and negatively correlated with 2 others. Notably, our mediation MR analysis further reveals that three blood metabolites act as mediators in the relationship between breakfast skipping and the risk of HF. Specifically, the mediating effects are attributed to the ratio of docosahexaenoic acid (DHA) to total fatty acids (proportion mediated = 9.41%, 95% CI: 2.10-28.61%), glucose (proportion mediated = 6.17%, 95% CI: 0.97-28.53%), and glycoprotein acetyls (GlycA) (proportion mediated = 5.68%, 95% CI: 0.94-21.62%). The combined mediating effects of these three factors total 20.53% (95%CI: 8.59-91.06%). Our research confirms the causal relationship between genetically instrumented breakfast skipping and HF, underscoring the potential mediating roles played by three key blood metabolites: ratio of DHA to total fatty acids, glucose and GlycA. This discovery offers valuable perspectives for clinical strategies targeting HF.

Associations of fish oil with cardiovascular disease events: results from the Taiwan longitudinal study in aging

BACKGROUND

The effectiveness of fish oil in preventing cardiovascular events is still debating. Some studies indicate a correlation between the use of fish oil supplements and reduced mortality or decreased incidence of stroke. However, other studies show no significant association between fish oil intake and stroke prevention, indicating an ongoing debate. This study aimed at exploring which subjects may benefit more from fish oil supplementation.

METHODS

This study utilized the data obtained through face-to-face interview from the Taiwan Longitudinal Study in Aging (TLSA). A total of 3,652 participants were included from the 2003 baseline data, after excluding patients with pre-existing ischemic heart disease or stroke. Participants were divided into two groups based on whether taking fish oil supplement or not. Participants were followed until 2015, estimating and comparing the all-cause mortality and cumulative incidence rate of stroke between both groups.

RESULTS

The results of the 12-year longitudinal study showed that the cumulative incidence rate of stroke in the fish oil supplementation group was 5.7%, compared to 7.7% in the non-supplemented group (P < 0.05). Additionally, the crude hazard ratio for stroke was significantly lower in the fish oil supplementation group (HR = 0.686;95% CI 0.476-0.987). However, after adjusting potential confounders, the adjusted risk of stroke was lower only for the diabetic patients supplemented with fish oil (aHR = 0.123; 95% CI 0.016-0.930) compared to non-diabetic patients (aHR = 0.917; 95% CI 0.616-1.364).

CONCLUSION

This study suggests that there is an association between fish oil supplementation and a lower cumulative incidence rate of subsequent stroke among diabetic patients.

HIARA study protocol: impacts of artificial coral reef development on fisheries, human livelihoods and health in southwestern Madagascar

The Health Impacts of Artificial Reef Advancement (HIARA; in the Malagasy language, "together") study cohort was set up in December 2022 to assess the economic and nutritional importance of seafood for the coastal Malagasy population living along the Bay of Ranobe in southwestern Madagascar. Over the course of the research, which will continue until at least 2026, the primary question we seek to answer is whether the creation of artificial coral reefs can rehabilitate fish biomass, increase fish catch, and positively influence fisher livelihoods, community nutrition, and mental health. Through prospective, longitudinal monitoring of the ecological and social systems of Bay of Ranobe, we aim to understand the influence of seasonal and long-term shifts in marine ecological resources and their benefits to human livelihoods and health. Fourteen communities (12 coastal and two inland) were enrolled into the study including 450 households across both the coastal (n = 360 households) and inland (n = 90 households) ecosystems. In the ecological component, we quantify the extent and health of coral reef ecosystems and collect data on the diversity and abundance of fisheries resources. In the social component, we collect data on the diets, resource acquisition strategies, fisheries and agricultural practices, and other social, demographic and economic indicators, repeated every 3 months. At these visits, clinical measures are collected including anthropometric measures, blood pressure, and mental health diagnostic screening. By analyzing changes in fish catch and consumption arising from varying distances to artificial reef construction and associated impacts on fish biomass, our cohort study could provide valuable insights into the public health impacts of artificial coral reef construction on local populations. Specifically, we aim to assess the impact of changes in fish catch (caused by artificial reefs) on various health outcomes, such as stunting, underweight, wasting, nutrient intake, hypertension, anxiety, and depression.

Type 2 Diabetes, Circulating Metabolites, and Calcific Aortic Valve Stenosis: A Mendelian Randomization Study

Epidemiological studies have shown an association between type 2 diabetes (T2D) and calcific aortic valve stenosis (CAVS), but the potential causal relationship and underlying mechanisms remain unclear. Therefore, we conducted a two-sample and two-step Mendelian randomization (MR) analysis to evaluate the association of T2D with CAVS and the mediating effects of circulating metabolites and blood pressure using genome-wide association study (GWAS) summary statistics. The inverse variance weighted (IVW) method was used for the primary MR analysis, and comprehensive sensitivity analyses were performed to validate the robustness of the results. Our results showed that genetically predicted T2D was associated with increased CAVS risk (OR 1.153, 95% CI 1.096-1.214, p < 0.001), and this association persisted even after adjusting for adiposity traits in multivariable MR analysis. Furthermore, the two-step MR analysis identified 69 of 251 candidate mediators that partially mediated the effect of T2D on CAVS, including total branched-chain amino acids (proportion mediated: 23.29%), valine (17.78%), tyrosine (9.68%), systolic blood pressure (8.72%), the triglyceride group (6.07-11.99%), the fatty acid group (4.78-12.82%), and the cholesterol group (3.64-11.56%). This MR study elucidated the causal impact of T2D on CAVS risk independently of adiposity and identified potential mediators in this association pathways. Our findings shed light on the pathogenesis of CAVS and suggest additional targets for the prevention and intervention of CAVS attributed to T2D.

Trimethylamine N-Oxide in Aquatic Foods

Trimethylamine N-oxide (TMAO), a characteristic nonprotein nitrogen compound, is widely present in seafood, which exhibits osmoregulatory effects for marine organisms in vivo and plays an important role in aquaculture and aquatic product preservation. However, much attention has been focused on the negative effect of TMAO since it has recently emerged as a putative promoter of chronic diseases. To get full knowledge and maximize our ability to balance the positive and negative aspects of TMAO, in this review, we comprehensively discuss the TMAO in aquatic products from the aspects of physiological functions for marine organisms, flavor, quality, the conversion of precursors, the influences on human health, and the seafood ingredients interaction consideration. Though the circulating TMAO level is inevitably enhanced after seafood consumption, dietary seafood still exhibits beneficial health effects and may provide nutraceuticals to balance the possible adverse effects of TMAO.

The ω-3 Polyunsaturated Fatty Acid Docosahexaenoic Acid Enhances NK-Cell Antitumor Effector Functions

ω-3 polyunsaturated fatty acids (PUFA) are known to directly repress tumor development and progression. In this study, we explored whether docosahexaenoic acid (DHA), a type of ω-3 PUFA, had an immunomodulatory role in inhibiting tumor growth in immunocompetent mice. The number of natural killer (NK) cells but not the number of T or B cells was decreased by DHA supplementation in various tissues under physiologic conditions. Although the frequency and number of NK cells were comparable, IFNγ production by NK cells in both the spleen and lung was increased in DHA-supplemented mice in the mouse B16F10 melanoma tumor model. Single-cell RNA sequencing revealed that DHA promoted effector function and oxidative phosphorylation in NK cells but had no obvious effects on other immune cells. Using Rag2-/- mice and NK-cell depletion by PK136 antibody injection, we demonstrated that the suppression of B16F10 melanoma tumor growth in the lung by DHA supplementation was dependent mainly on NK cells. In vitro experiments showed that DHA directly enhanced IFNγ production, CD107a expression, and mitochondrial oxidative phosphorylation (OXPHOS) activity and slightly increased proliferator-activated receptor gamma coactivator-1α (PGC-1α) protein expression in NK cells. The PGC-1α inhibitor SR-18292 in vitro and NK cell-specific knockout of PGC-1α in mice reversed the antitumor effects of DHA. In summary, our findings broaden the current knowledge on how DHA supplementation protects against cancer growth from the perspective of immunomodulation by upregulating PGC-1α signaling-mediated mitochondrial OXPHOS activity in NK cells.

Association of aquatic food consumption, long-chain polyunsaturated n-3 fatty acid intake, and blood mercury levels with cognitive function in middle-aged and older adults

BACKGROUND & AIMS

Aquatic food is rich in nutrients which benefit the human brain and cognitive health; however, concerns about heavy metal accumulation in aquatic food remain. This study evaluated the associations between aquatic food consumption, long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFAs) intake, and blood mercury levels with cognition in middle-aged and older adults.

METHODS

This cross-sectional study used baseline data from the Lifestyle and Healthy Aging of Chinese Square Dancer Study. Aquatic food consumption and LC n-3 PUFAs intake were obtained from a food frequency questionnaire. Blood mercury levels were measured using inductively coupled plasma mass spectrometry. A composite z-score was developed to represent global cognition by averaging the z-scores for each cognitive domain. Participants with mild cognitive impairment (MCI) were diagnosed according to Petersen's criteria. Multivariate linear and logistic regression models were used to examine the association between the exposure factors and cognitive performance including cognitive scores and MCI.

RESULTS

Of 2621 middle-aged and older adults, the mean (SD) age was 63.71 (5.15) years, and 85.73% were females. Compared with the lowest quartile, those in the highest quartile for aquatic food consumption were associated with higher composite z-scores (β = 0.156, 95% CI: 0.088-0.225) and lower MCI odds (OR = 0.598, 95% CI: 0.425-0.841). A similar positive relationship between LC n-3 PUFAs intake and composite z-score and an inverse association between LC n-3 PUFAs intake and MCI were also observed. In addition, the participants in the highest quartile for blood mercury levels had higher composite z-scores than those in the lowest quartile.

CONCLUSIONS

In this cross-sectional study, higher aquatic food consumption, LC n-3 PUFAs intake, and blood mercury levels were related to better cognitive function. Further studies in Chinese populations are required to confirm these findings.

Thraustochytrids as a promising source of fatty acids, carotenoids, and sterols: bioactive compound biosynthesis, and modern biotechnology

Thraustochytrids are eukaryotes and obligate marine protists. They are increasingly considered to be a promising feed additive because of their superior and sustainable application in the production of health-benefiting bioactive compounds, such as fatty acids, carotenoids, and sterols. Moreover, the increasing demand makes it critical to rationally design the targeted products by engineering industrial strains. In this review, bioactive compounds accumulated in thraustochytrids were comprehensively evaluated according to their chemical structure, properties, and physiological function. Metabolic networks and biosynthetic pathways of fatty acids, carotenoids, and sterols were methodically summarized. Further, stress-based strategies used in thraustochytrids were reviewed to explore the potential methodologies for enhancing specific product yields. There are internal relationships between the biosynthesis of fatty acids, carotenoids, and sterols in thraustochytrids since they share some branches of the synthetic routes with some intermediate substrates in common. Although there are classic synthesis pathways presented in the previous research, the metabolic flow of how these compounds are being synthesized in thraustochytrids still remains uncovered. Further, combined with omics technologies to deeply understand the mechanism and effects of different stresses is necessary, which could provide guidance for genetic engineering. While gene-editing technology has allowed targeted gene knock-in and knock-outs in thraustochytrids, efficient gene editing is still required. This critical review will provide comprehensive information to benefit boosting the commercial productivity of specific bioactive substances by thraustochytrids.

ω-3 Polyunsaturated Fatty Acid Status Testing in Humans: A Narrative Review of Commercially Available Options

There is an increasing body of evidence supporting a link between low intakes of ω-3 long-chain polyunsaturated fatty acids (LCPUFA) and numerous diseases and health conditions. However, few people are achieving the levels of fish/seafood or eicosapentaenoic acid and docosahexaenoic acid intake recommended in national and international guidelines. Knowledge of a person's ω-3 LCPUFA status will benefit the interpretation of research results and could be expected to lead to an increased effort to increase intake. Dietary intake survey methods are often used as a surrogate for measuring ω-3 PUFA tissue status and its impact on health and functional outcomes. However, because individuals vary widely in their ability to digest and absorb ω-3 PUFA, analytical testing of biological samples is desirable to accurately evaluate ω-3 PUFA status. Adipose tissue is the reference biospecimen for measuring tissue fatty acids, but less-invasive methods, such as measurements in whole blood or its components (e.g., plasma, serum, red blood cell membranes) or breast milk are often used. Numerous commercial laboratories provide fatty acid testing of blood and breast milk samples by different methods and present their results in a variety of reports such as a full fatty acid profile, ω-3 and ω-6 fatty acid profiles, fatty acid ratios, as well as the Omega-3 Index, the Holman Omega-3 Test, OmegaScore, and OmegaCheck, among others. This narrative review provides information about the different ways to measure ω-3 LCPUFA status (including both dietary assessments and selected commercially available analytical tests of blood and breast milk samples) and discusses evidence linking increased ω-3 LCPUFA intake or status to improved health, focusing on cardiovascular, neurological, pregnancy, and eye health, in support of recommendations to increase ω-3 LCPUFA intake and testing.

The Role of Nutrition in the Development and Management of Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a prevalent lung condition associated with significant morbidity and mortality. The management of COPD classically involves pulmonary rehabilitation, bronchodilators, and corticosteroids. An aspect of COPD management that is currently lacking in the literature is nutritional management, despite the prevalence of inadequate nutritional status in patients with COPD. In addition, certain nutritional imbalances have been reported to increase the risk of COPD development. This review summarizes the current literature on the role diet and nutrients may play in the risk and management of COPD development.

Association between Fish Consumption during Pregnancy and Maternal and Neonatal Outcomes: A Statistical Study in Southern Italy

Background: This research aimed to evaluate the association between the monthly consumption of fish (differentiated by type) and both gestational and neonatal outcomes. Methods: Women who were admitted for delivery in the last 6 months of 2023 were prospectively included and divided according to type of fish consumed (based on DHA and mercury content) and frequency of consumption. Neonatal outcomes included weight, length, head circumference, and 1st and 5th minute Apgar scores. Maternal outcomes were threats of abortion, preterm birth, gestational diabetes and hypertension, cesarean section, and differential body mass index (BMI). Results: Small-size oily fish with high DHA and low mercury content (type B fish) consumption was positively associated with neonatal weight and head circumference, and less weight gain in pregnancy. It was also significantly associated with lower incidences of gestational diabetes and hypertension, and cesarean section. Correlation between differential BMI and monthly consumption of fish resulted in statistical significance, especially in type B fish consumers. Conclusions: The consumption of type B fish was significantly associated with increased neonatal weight and head circumference and better maternal outcomes.

Association of Serum Unsaturated Fatty Acid Patterns with the Risk of Diabetic Nephropathy

Introduction

Unsaturated fatty acids play an essential role in the progression of diabetic nephropathy (DN). However, previous studies were mainly focused on the role of individual unsaturated fatty acid. The serum unsaturated fatty acid patterns (FAPs) in patients with DN remain to be determined.

Methods

A total of 135 patients with DN (DN group) and 322 patients with type II diabetes without nephropathy (non-DN group) were included in this study. Clinical data, serum levels of unsaturated fatty acids, and other laboratory indicators were collected. Multivariate logistic regression was applied to identify risk factors for serum unsaturated fatty acid level in both groups. Serum unsaturated fatty acids were subjected to factor analysis to identify distinct FAPs. Multivariable logistic regression was employed to assess the risk of DN associated with different serum FAPs.

Results

After adjusting for confounders, three types of unsaturated fatty acid including C20:5 (eicosapentaenoic acid [EPA]), C22:6 (docosahexaenoic acid [DHA]), and C22:5 n-3 (docosapentaenoic acid n-3) were significantly associated with DN in the population. The odds ratios (ORs) (95% confidence interval [CI]) of DN were 0.583 (0.374, 0.908), 0.826 (0.716, 0.954), and 0.513 (0.298, 0.883), respectively. Factor analysis revealed five major FAPs, among which FAP2 (enriched with EPA and DHA) exhibited a significant inverse association with DN. In the multivariate-adjusted model, the OR (95% CI) was 0.678 (0.493, 0.933). Additionally, a combination of DHA and EPA enriched in FAP2 further decreased extracellular matrix production induced by transforming growth factor beta 1 in podocytes and tubular cells.

Conclusions

Our findings suggest that FAP2 which is enriched with DHA and EPA is associated with a reduced risk of DN. This highlights the potential of targeting FAP2 for the patients with DN.

Circulating Docosahexaenoic Acid and Risk of All-Cause and Cause-Specific Mortality

OBJECTIVE

To assess the associations of docosahexaenoic acid (DHA), a marine omega-3 fatty acid, with long-term all-cause mortality, cardiovascular (CV) mortality, and cancer mortality.

PATIENTS AND METHODS

We analyzed data from UK Biobank, which included 117,702 subjects with baseline plasma DHA levels and 12.7 years of follow-up between April 2007 and December 2021. Associations with risk for mortality endpoints were analyzed categorically by quintile of DHA plasma levels.

RESULTS

Comparing the lowest to highest quintiles of circulating levels of DHA, there was 21% lower risk of all-cause mortality (HR, 0.79; 95% CI, 0.74 to 0.85; P<.0001). In a secondary analysis, we merged the UK Biobank findings with those from a recent FORCE (Fatty Acid and Outcome Research Consortium) meta-analysis that included 17 prospective cohort studies and 42,702 individuals examining DHA and mortality associations. The cumulative sample population included 160,404 individuals and 24,342 deaths during a median of 14 years of follow-up. After multivariable adjustment for relevant risk factors comparing the lowest to the highest quintiles of DHA, there was 17% lower risk of all-cause mortality (95% CI, 0.79 to 0.87; P<.0001), 21% lower risk for CV disease mortality (95% CI, 0.73 to 0.87; P<.001), 17% lower risk for cancer mortality (95% CI, 0.77 to 0.89; P<.0001), and 15% lower risk for all other mortality (95% CI, 0.79 to 0.91; P<.001).

CONCLUSION

Higher DHA levels were associated with significant risk reductions in all-cause mortality, as well as reduced risks for deaths due to CV disease, cancer, and all other causes. The findings strengthen the hypothesis that DHA, a marine-sourced omega-3, may support CV health and lifespan.

Fish - a scoping review for Nordic Nutrition Recommendations 2023

The aim of this scoping review was to conduct evidence-based documentation between fish intake and health outcomes for food-based dietary guidelines (FBDGs) in the Nordic Nutrition Recommendations (NNR) 2023. For most health outcomes, the evidence for fish oil and n-3 long chain (LC) polyunsaturated fatty acids (PUFA) supplementation was included when examining evidence between fish intake and health. In this review, conclusions from qualified systematic reviews (qSR) approved by NNR2023 are included. In addition, conclusions of a de novo systematic reviews on the topic of n-3 LC-PUFA, asthma, and allergy are included. Finally, a systematic literature search was performed limited to systematic reviews and meta-analysis published between 2011 and September 2021. In total, 21 papers from the systematic literature search, four qSR, and eight reports were included addressing the association between fish intake, fish oil, and n-3 LC-PUFA supplementation on several health outcomes. These included cardiovascular disease (CVD), type 2 diabetes, cancers (colorectal, breast, and prostate), metabolic syndrome, obesity, mortality, cognition and mental health, pregnancy-related outcomes (preterm birth and birth weight), and outcomes specific for children (neurodevelopment, and risk of food allergies, and asthma). In addition, intermediate risk factors such as blood lipids, glucose, C-reactive protein, and blood pressure were reviewed. Based on current evidence, fish consumption can have beneficial effects to prevent coronary heart disease (CHD) and stroke incidence, and lower mortality from CVD, CHD, myocardial infarction (MI), and stroke, as well as total mortality risk. In addition, fish consumption is beneficial for preventing cognitive decline in adults (e.g. dementia and Alzheimer's disease). Fish intake may also prevent metabolic syndrome, supported by an observed association between fish intake and reduction in plasma triglycerides and increase in high-density lipoprotein (HDL) cholesterol levels. Data from fish oil and n-3 LC-PUFA supplementation studies supports the conclusions on the effects of fish consumption on most of the health outcomes.

Uncovering the microbiome landscape in sashimi delicacies

It is widely believed that a significant portion of the gut microbiota, which play crucial roles in overall health and disease, originates from the food we consume. Sashimi is a type of popular raw seafood cuisine. Its microbiome, however, remained to be thoroughly explored. The objective of this study is to explore the microbiome composition in sashimi at the time when it is served and ready to be eaten. Specifically, our tasks include investigating the diversity and characteristics of microbial profiles in sashimi with respect to the fish types. We utilized the Sanger-sequencing based DNA barcoding technology for fish species authentication and next-generation sequencing for sashimi microbiome profiling. We investigated the microbiome profiles of amberjack, cobia, salmon, tuna and tilapia sashimi, which were all identified using the MT-CO1 DNA sequences regardless of their menu offering names. Chao1 and Shannon indexes, as well as Bray-Curtis dissimilarity index were used to evaluate the alpha and beta diversities of sashimi microbiome. We successfully validated our previous observation that tilapia sashimi has a significantly higher proportions of Pseudomonas compared to other fish sashimi, using independent samples (P = 0.0010). Salmon sashimi exhibited a notably higher Chao1 index in its microbiome in contrast to other fish species (P = 0.0031), indicating a richer and more diverse microbial ecosystem. Non-Metric Multidimensional Scaling (NMDS) based on Bray-Curtis dissimilarity index revealed distinct clusters of microbiome profiles with respect to fish types. Microbiome similarity was notably observed between amberjack and tuna, as well as cobia and salmon. The relationship of microbiome similarity can be depicted as a tree which resembles partly the phylogenetic tree of host species, emphasizing the close relationship between host evolution and microbial composition. Moreover, salmon exhibited a pronounced relative abundance of the Photobacterium genus, significantly surpassing tuna (P = 0.0079), observed consistently across various restaurant sources. In conclusion, microbiome composition of Pseudomonas is significantly higher in tilapia sashimi than in other fish sashimi. Salmon sashimi has the highest diversity of microbiome among all fish sashimi that we analyzed. The level of Photobacterium is significantly higher in salmon than in tuna across all the restaurants we surveyed. These findings provide critical insights into the intricate relationship between the host evolution and the microbial composition. These discoveries deepen our understanding of sashimi microbiota, facilitating our decision in selecting raw seafood.

Dietary assessment of type 2 diabetic patients using healthful plant-based diet score in the Eastern Province of Saudi Arabia

BACKGROUND

Diabetes mellitus is a chronic disease characterized by a wide range of metabolic problems. The current study sought to assess nutritional habits of Saudi patients with type 2 diabetes (T2D) and to propose recommendations to improve these patients' dietary habits and delay possible disease complications.

METHODS

Over a period of three years, (2017-2019) 577 patients with T2D attending the outpatient's diabetic clinics at King Fahd Hospital of the University, Al Khobar, Saudi Arabia were invited to participate in this study. Data of dietary intake were collected by trained nurses using a pretested structured validated semi quantitative food frequency questionnaire. The dietary data were collected using 7-day dietary recall questionnaire. A modified score system that associates dietary habits with glycemic control and lipid profile was used.

RESULTS

Overall, a high healthful plant-based diet score was associated with a significant (P = 0.018) reduction in triglycerides (TG) level (mean difference - 3.78%; 95% CI, -0.65% to -6.81%) and a statistically non-significant (P = 0.06) increase in high density lipoprotein (HDL) levels (mean difference 1.87%; 95% CI -0.06-3.84%) in T2D patients from the Eastern Province of Saudi Arabia. Additionally, in our patient group, the prevalence of coronary artery disease, stroke, peripheral artery disease, and chronic kidney disease in T2D patients was 11.3%, 6.2%, 3.3%, and 8.4%, respectively and were higher when compared to the prevalence in the general population.

CONCLUSION

The present study showed that adherence to a healthful plant-based diet, when compared to high glycemic index diet, is associated with a favorable outcome in glycemic control and lipid profile in T2D patients. Prior assessment of total diet quality may be beneficial when giving nutritional advice to T2D patients with the possibility of improving glycemic control and lipid profile.

Dyslipidemia and its associated factors among community adults located in Shangcheng district, Zhejiang province

Dyslipidemia is highly prevalent and an important modifiable risk factor of cardiovascular disease in China. However, there is little information on the dyslipidemia in Shangcheng district, eastern China. Therefore, this study aims to investigate the prevalence and associated factors of dyslipidemia among community adults in this area. A community based cross-sectional study was conducted from August 1 to November 30, 2020. The study utilized a multi-stage probability sampling method to enroll permanent residents (those who have resided in this region for 6 months or more) who were 18 years old or above. Firstly, five streets were selected randomly, and then two communities were randomly selected from each of the chosen streets, finally, systematic sampling at the household level was conducted. All participants were interviewed by trained investigators and underwent anthropometric and biochemical measurements using standard criteria. LASSO (least absolute shrinkage and selection operator) and multivariate binary logistic regression were employed to identify the factors associated with dyslipidemia. In total, 3153 participants were enrolled into this study, resulting in a response rate of 93.28%. 33 subjects were excluded because of incomplete data. Finally, 3120 participants with a mean age of 55.26 (SD = 17.97) years were included into analysis. The overall prevalence of dyslipidemia was 35.96%. 21 variables were screened to multivariate binary logistic regression through the implementation of LASSO method. The multivariate binary logistic regression analysis revealed that individuals aged 40-49 [adjusted odds ratio (aOR) = 2.197, 95% confidence interval (CI) 1.445-3.341], 50-59 (aOR = 3.213, 95% CI 2.121-4.868), 60-69 (aOR = 4.777, 95% CI 3.169-7.201), and 70 and above (aOR = 5.067, 95% CI 3.301-7.777), with an educational level of junior middle school (aOR = 1.503, 95% CI 1.013-2.229), with an educational level of senior middle school (aOR = 1.731, 95% CI 1.25-2.397), with an educational level of under graduate and above (aOR = 2.125, 95% CI 1.46-3.095), without hypertension (aOR = 0.627, 95% CI 0.517-0.76), without diabetes (aOR = 0.625, 95% CI 0.498-0.785), obesity (aOR = 1.887, 95% CI 1.13-3.154), frequent smoking (aOR = 1.727, 95% CI 1.293-2.308), frequent drinking (aOR = 0.738, 95% CI 0.556-0.981), without family history of CVD (aOR = 0.505, 95% CI 0.342-0.744), and daily seafood intakes between 42.87 and 71.43 g (aOR = 1.31, 95% CI 1.05-1.634) were significantly associated with dyslipidemia. Gender-stratified analyses showed that aged 70 and above (aOR = 2.127, 95% CI 1.195-3.785), without hypertension (aOR = 0.643, 95% CI 0.484-0.854), without diabetes (aOR = 0.603, 95% CI 0.436-0.834), without CVD (aOR = 0.494, 95% CI 0.309-0.791), without stroke (aOR = 1.767, 95% CI 1.036-3.012), frequent smoking (aOR = 1.951, 95% CI 1.415-2.691), former smoking (aOR = 1.703, 95% CI 1.16-2.502) were significantly associated with dyslipidemia in male. Aged 40-49 (aOR = 3.51, 95% CI 1.789-6.887), 50-59 (aOR = 7.03, 95% CI 3.584-13.791), 60-69 (aOR = 15.728, 95% CI 8.005-30.9), and 70 and above (aOR = 12.929, 95% CI 6.449-25.921), with an educational level of senior middle school (aOR = 1.926, 95% CI 1.288-2.881), with an educational level of under graduate and above (aOR = 2.91, 95% CI 1.75-4.837), without hypertension (aOR = 0.592, 95% CI 0.45-0.779), without diabetes (aOR = 0.619, 95% CI 0.443-0.865), without family history of CVD (aOR = 0.429, 95% CI 0.251-0.733), without family history of cancer (aOR = 0.542, 95% CI 0.316-0.929), daily vegetables intakes between 251 and 500 g (aOR = 0.734, 95% CI 0.545-0.99), daily seafood intakes between 42.87 and 71.43 g (aOR = 1.421, 95% CI 1.04-1.942) were significantly associated with dyslipidemia in female. In the age-stratified analyses, it was found that without hypertension (aOR = 0.522, 95% CI 0.375-0.727) or diabetes (aOR = 0.445, 95% CI 0.267-0.744), obesity (aOR = 2.956, 95% CI 1.258-6.942), frequent smoking (aOR = 1.826, 95% CI 1.196-2.787), showed a significant association with dyslipidemia in individuals aged younger than 60 years. Female (aOR = 1.764, 95% CI 1.316-2.366), with an educational level of junior middle school (aOR = 1.793, 95% CI 1.169-2.749), with an educational level of senior middle school (aOR = 2.002, 95% CI 1.406-2.849), with an educational level of under graduate and above (aOR = 2.849, 95% CI 1.791-4.532), without hypertension (aOR = 0.604, 95% CI 0.477-0.764), without diabetes (aOR = 0.63, 95% CI 0.486-0.818), without CVD (aOR = 0.66, 95% CI 0.473-0.921), frequent smoking (aOR = 1.513, 95% CI 1.02-2.245), former smoking (aOR = 1.647, 95% CI 1.089-2.491), without family history of CVD (aOR = 0.406, 95% CI 0.239-0.692), daily seafood intakes between 42.87 and 71.43 g (aOR = 1.376, 95% CI 1.018-1.859) were significantly associated with dyslipidemia among participants aged 60 and above. Dyslipidemia is a prevalent condition observed among adults residing in Shangcheng district. Risk factors such as gender, age, education, hypertension, diabetes, cardiovascular disease, stroke, obesity, smoking, drinking, family history of cardiovascular disease, family history of cancer, daily vegetables intakes, daily seafood intakes were associated with dyslipidemia and varied across population of different gender and age groups. Enhancing education and promoting self-awareness regarding the necessity of behavior modification and regular medication intake would be beneficial in reducing the occurrence of dyslipidemia among adults in the Shangcheng district.

Do patients benefit from omega-3 fatty acids?

Omega-3 fatty acids (O3FAs) possess beneficial properties for cardiovascular (CV) health and elevated O3FA levels are associated with lower incident risk for CV disease (CVD.) Yet, treatment of at-risk patients with various O3FA formulations has produced disparate results in large, well-controlled and well-conducted clinical trials. Prescription formulations and fish oil supplements containing low-dose mixtures of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have routinely failed to prevent CV events in primary and secondary prevention settings when added to contemporary care, as shown most recently in the STRENGTH and OMEMI trials. However, as observed in JELIS, REDUCE-IT, and RESPECT-EPA, EPA-only formulations significantly reduce CVD events in high-risk patients. The CV mechanism of action of EPA, while certainly multifaceted, does not depend solely on reductions of circulating lipids, including triglycerides (TG) and LDL, and event reduction appears related to achieved EPA levels suggesting that the particular chemical and biological properties of EPA, as compared to DHA and other O3FAs, may contribute to its distinct clinical efficacy. In vitro and in vivo studies have shown different effects of EPA compared with DHA alone or EPA/DHA combination treatments, on atherosclerotic plaque morphology, LDL and membrane oxidation, cholesterol distribution, membrane lipid dynamics, glucose homeostasis, endothelial function, and downstream lipid metabolite function. These findings indicate that prescription-grade, EPA-only formulations provide greater benefit than other O3FAs formulations tested. This review summarizes the clinical findings associated with various O3FA formulations, their efficacy in treating CV disease, and their underlying mechanisms of action.

Genetic improvement in edible fish: status, constraints, and prospects on CRISPR-based genome engineering

Conventional selective breeding in aquaculture has been effective in genetically enhancing economic traits like growth and disease resistance. However, its advances are restricted by heritability, the extended period required to produce a strain with desirable traits, and the necessity to target multiple characteristics simultaneously in the breeding programs. Genome editing tools like zinc finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs), and clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR/Cas9) are promising for faster genetic improvement in fishes. CRISPR/Cas9 technology is the least expensive, most precise, and well compatible with multiplexing of all genome editing approaches, making it a productive and highly targeted approach for developing customized fish strains with specified characteristics. As a result, the use of CRISPR/Cas9 technology in aquaculture is rapidly growing, with the main traits researched being reproduction and development, growth, pigmentation, disease resistance, trans-GFP utilization, and omega-3 metabolism. However, technological obstacles, such as off-target effects, ancestral genome duplication, and mosaicism in founder population, need to be addressed to achieve sustainable fish production. Furthermore, present regulatory and risk assessment frameworks are inadequate to address the technical hurdles of CRISPR/Cas9, even though public and regulatory approval is critical to commercializing novel technology products. In this review, we examine the potential of CRISPR/Cas9 technology for the genetic improvement of edible fish, the technical, ethical, and socio-economic challenges to using it in fish species, and its future scope for sustainable fish production.

Snack quality and snack timing are associated with cardiometabolic blood markers: the ZOE PREDICT study

BACKGROUND

Snacking is a common diet behaviour which accounts for a large proportion of daily energy intake, making it a key determinant of diet quality. However, the relationship between snacking frequency, quality and timing with cardiometabolic health remains unclear.

DESIGN

Demography, diet, health (fasting and postprandial cardiometabolic blood and anthropometrics markers) and stool metagenomics data were assessed in the UK PREDICT 1 cohort (N = 1002) (NCT03479866). Snacks (foods or drinks consumed between main meals) were self-reported (weighed records) across 2-4 days. Average snacking frequency and quality [snack diet index (SDI)] were determined (N = 854 after exclusions). Associations between snacking frequency, quality and timing with cardiometabolic blood and anthropometric markers were assessed using regression models (adjusted for age, sex, BMI, education, physical activity level and main meal quality).

RESULTS

Participants were aged (mean, SD) 46.1 ± 11.9 years, had a mean BMI of 25.6 ± 4.88 kg/m2 and were predominantly female (73%). 95% of participants were snackers (≥ 1 snack/day; n = 813); mean daily snack intake was 2.28 snacks/day (24 ± 16% of daily calories; 203 ± 170 kcal); and 44% of participants were discordant for meal and snack quality. In snackers, overall snacking frequency and quantity of snack energy were not associated with cardiometabolic risk markers. However, lower snack quality (SDI range 1-11) was associated with higher blood markers, including elevated fasting triglycerides (TG (mmol/L) β; - 0.02, P = 0.02), postprandial TGs (6hiAUC (mmol/L.s); β; - 400, P = 0.01), fasting insulin (mIU/L) (β; - 0.15, P = 0.04), insulin resistance (HOMA-IR; β; - 0.04, P = 0.04) and hunger (scale 0-100) (β; - 0.52, P = 0.02) (P values non-significant after multiple testing adjustments). Late-evening snacking (≥ 9 pm; 31%) was associated with lower blood markers (HbA1c; 5.54 ± 0.42% vs 5.46 ± 0.28%, glucose 2hiAUC; 8212 ± 5559 vs 7321 ± 4928 mmol/L.s, P = 0.01 and TG 6hiAUC; 11,638 ± 8166 vs 9781 ± 6997 mmol/L.s, P = 0.01) compared to all other snacking times (HbA1c remained significant after multiple testing).

CONCLUSION

Snack quality and timing of consumption are simple diet features which may be targeted to improve diet quality, with potential health benefits.

CLINICAL TRIAL REGISTRY NUMBER AND WEBSITE

NCT03479866, https://clinicaltrials.gov/ct2/show/NCT03479866?term=NCT03479866&draw=2&rank=1.

Dietary patterns derived by reduced rank regression are associated with lipid disorders among Korean adults: a cross-sectional analysis

BACKGROUND

Lipid disorders are a potent risk factor for cardiovascular diseases. Moreover, the intake of dietary fatty acids has been closely related to blood lipid levels. Therefore, this cross-sectional study examined the associations between dietary patterns related to fatty acid intake and lipid disorders in Korean adults.

METHODS

From the 2013-2019 Korea National Health and Nutrition Examination Surveys data, 8399 men and 11404 women (aged ≥ 19 years) were selected. Reduced rank regression was employed to identify dietary patterns from 26 food groups, aiming to explain the maximum variation in the intake of saturated fatty acids (SFA), polyunsaturated fatty acids (PUFA), omega-3 fatty acids, and the PUFA/SFA ratio. Associations of quintiles (Q) of dietary pattern scores with lipid disorders were examined using multiple logistic regression stratified by sex.

RESULTS

Three dietary patterns were identified: dietary pattern 1 showed positive factor loadings for vegetable oils, seasonings, legumes, nuts, and fish; dietary pattern 2 was high in consumption of red meat, bread and snacks, and milk and dairy products; and dietary pattern 3 was rich in fish and milk and dairy products. In men, dietary pattern 3 was inversely associated with elevated triglycerides (Q5 vs. Q1: odds ratio [OR] = 0.82, 95% confidence interval [CI] = 0.69-0.97, P-trend = 0.008). In women, dietary pattern 2 was positively associated with elevated total cholesterol (OR = 1.31, 95% CI = 1.12-1.52, P-trend < 0.001) but inversely associated with low HDL-cholesterol (OR = 0.70, 95% CI = 0.59-0.83, P-trend < 0.001).

CONCLUSION

In this study, dietary patterns explaining the intake of various types of fatty acids were differentially associated with lipid disorders in Korean adults. Dietary pattern characterized by higher intakes of red meat, bread and snacks and milk and dairy products were positively associated with elevated total cholesterol, whereas dietary pattern rich in fish consumption showed an inverse association with elevated triglycerides. These findings could be instrumental in developing dietary guidelines and strategies for preventing and managing lipid disorders in this population.

Bioactive Exploration in Functional Foods: Unlocking Nature's Treasures

BACKGROUND

Functional foods offer an appealing way to improve health and prevent chronic diseases, and this subject has received much attention lately. They are effective in preventing chronic diseases like cancer, diabetes, heart disease, and obesity, according to research.

OBJECTIVE

This work presents an in-depth analysis of functional foods, covering key challenges from a scientific, legal, and commercial perspective.

METHODS

Multiple databases were searched to find studies on functional foods included in the systematic literature review. Various aspects of functional foods, from their classification, impact on human wellness, effectiveness in inhibiting chronic diseases, the regulatory environment, global market trends, and industry challenges, are all clarified in this thorough review.

RESULTS

This study aims to enhance understanding and establish a pathway for functional foods to be acknowledged as valid choices in the field of dietary supplements. It provides a thorough investigation of bioactive compounds present in functional foods, including but not limited to polyphenols, carotenoids, omega fatty acids, prebiotics, probiotics, and dietary fiber, along with an overview of their potential to mitigate chronic illnesses. We engage in an in-depth exploration of regulatory frameworks, shed light on groundbreaking research advancements, and meticulously examine strategies for commercialization and the variety of global challenges that accompany them. Establishing scientific consensus, navigating complex regulatory processes, dealing with skeptical consumers, and rising levels of competition are all problems that need to be solved in this field.

CONCLUSION

The field of functional foods can advance further, promoting better public health outcomes, by deeply comprehending and addressing these complex dimensions.

Latin-American guidelines of recommendations at discharge from an acute coronary syndrome

The diagnostic criteria, treatments at the time of admission, and drugs used in patients with acute coronary syndrome are well defined in countless guidelines. However, there is uncertainty about the measures to recommend during patient discharge planning. This document brings together the most recent evidence and the standardized and optimal treatment for patients at the time of discharge from hospitalization for an acute coronary syndrome, for comprehensive and safe care in the patient's transition between care from the acute event to the outpatient care, with the aim of optimizing the recovery of viable myocardium, guaranteeing the most appropriate secondary prevention, reducing the risk of a new coronary event and mortality, as well as the adequate reintegration of patients into daily life.

Essential omega-3 fatty acids are depleted in sea ice and pelagic algae of the Central Arctic Ocean

Microalgae are the main source of the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), essential for the healthy development of most marine and terrestrial fauna including humans. Inverse correlations of algal EPA and DHA proportions (% of total fatty acids) with temperature have led to suggestions of a warming-induced decline in the global production of these biomolecules and an enhanced importance of high latitude organisms for their provision. The cold Arctic Ocean is a potential hotspot of EPA and DHA production, but consequences of global warming are unknown. Here, we combine a full-seasonal EPA and DHA dataset from the Central Arctic Ocean (CAO), with results from 13 previous field studies and 32 cultured algal strains to examine five potential climate change effects; ice algae loss, community shifts, increase in light, nutrients, and temperature. The algal EPA and DHA proportions were lower in the ice-covered CAO than in warmer peripheral shelf seas, which indicates that the paradigm of an inverse correlation of EPA and DHA proportions with temperature may not hold in the Arctic. We found no systematic differences in the summed EPA and DHA proportions of sea ice versus pelagic algae, and in diatoms versus non-diatoms. Overall, the algal EPA and DHA proportions varied up to four-fold seasonally and 10-fold regionally, pointing to strong light and nutrient limitations in the CAO. Where these limitations ease in a warming Arctic, EPA and DHA proportions are likely to increase alongside increasing primary production, with nutritional benefits for a non-ice-associated food web.

Habitual fish consumption and healthy lifestyle behaviours may be associated with higher total serum bilirubin level and anti-inflammatory activity: a cross-sectional study

Habitual fish consumption and a healthy lifestyle are associated with lower atherosclerotic CVD (ASCVD) risk. Mildly elevated bilirubin, an end product of Hb metabolism, may be associated with anti-inflammatory effects, suppressing ASCVD risk. No data exist on the relationship between fish consumption, total serum bilirubin (TSB) and inflammation in clinical settings. We conducted a cross-sectional study between April 2019 and March 2020 in a cohort of 8292 participants (average age, 46·7 (sd 12·9) years and 58·9 % men) with no history of ASCVD and TSB concentrations < 2·0 mg/dl. Multiple stepwise regression analysis showed Hb concentrations were a solid positive determinant of TSB concentrations (β = 0·302, P< 0·0001). Fish consumption (β = 0·025, P= 0·019) and aerobic exercise (β = 0·021, P= 0·043) were statistically weak but significantly positive determinants of TSB concentrations. Cigarette smoking negatively affected TSB concentrations (β = −0·104, P< 0·0001). Moreover, with increasing fish consumption, the proportion of participants with a habit of cigarette smoking decreased, and that of participants who engaged in aerobic exercises increased (P< 0·0001 for both). Furthermore, as TSB concentrations increased, the leukocyte counts and C-reactive protein concentrations decreased (P< 0·0001 for both). In conclusion, despite the lesser relevance given to TSB concentrations than Hb concentrations, higher fish consumption and healthier lifestyle behaviours related to fish consumption habits may be additively or synergistically associated with higher TSB concentrations and anti-inflammatory activity, leading to attenuated ASCVD risk. Further investigations are needed to clarify the causal relationships between these factors.