Transcript Slide 1

LJETNJI UNIVERZITET U TUZLI Hranom do zdravlja, 01.07.2011.

UTICAJ OMEGA-3 MASNIH KISELINA NA INFLAMATORNE PROCESE

Dizdarević Kemal, Hot Nadja, Dizdarević Adisa, Jašić Jasminka

Omega-3 masne kiseline

Esencijalne polinezasićene masne kiseline

Termin"esencijalne" masne kiseline jer

 ljudsko tijelo ih ne može sintetizirati  ali su neophodne za ljudsko zdravlje

Omega-3 masne kiseline

1. Alfa-linolenska kiselina– “ALA”

Izvor: zeleno lisnato povrće, orasi, lan, bundeva

2. Dokosaheksaenoična kiselina – “DHA” 3. Eikosapentaenoična kiselina – “EPA”

Izvori: losos, sardine, haringe, pastrmka(masne ribe)

Thompson, et al. (2008) The science of nutrition. Berkeley: University of California Press. University of Maryland Medical Center - http://www.umm.edu/altmed/articles/omega-3-000316.htm

Linus Pauling Institute at Oregon State University http://lpi.oregonstate.edu/infocenter/othernuts/omega3fa/index.html#intro

Značaj omega 3 masnih kiselina

Značaj omega 3 masnih kiselina u prehrani primijećen je početkom dvadesetog stoljeća pri proučavanju zdravlja i ishrane Eskima

Kasnije su njihov značaj potvrdile brojne studije kod: smanjenja triglicerida, prevenciji srčanog udara, reumatoidnog artritisa, osteoporoze, ateroskleroze, moždanog udara ......

Infarkt miokarda i unos masti kod Eskima i Danaca

Eskimi Danci Infarkt miokarda 3 40 Energija iz masti (%) 39 42 n-6 PUFA (g/d) 5 10 n-3 PUFA (g/d) 14 3 n-3/n-6 2.8 0.3

Holesterol (mg/d) 790 420

Bolji izbor omega 3 masnih kiselina povrće ili riba

ALA je prekursor DHA i EPA

Riba sadržiu DHA & EPA

Naše tijelo konvertuje ALA u DHA & EPA ALA enzimi EPA + DHA

Konverzija je insuficijentna

DHA & EPA mnogo efikasniji izvor NIH Office of Dietary Supplements http://ods.od.nih.gov/factsheets/Omega3FattyAcidsandHealth/ Linus Pauling Institute at OSU http://lpi.oregonstate.edu/infocenter/othernuts/omega3fa/index.html#intro

Kako djeluju omega 3 masne kiseline?

Važna komponenta ćelijske membrane

Prekursori eikozanoida koji sudjeluju:

 vazodilatacija/konstrikcija  inflanflamacija  koagulacija  vaskularna permeabilnost

Kris-Etherton, P. M., Harris, W. S., Appel, L. J., & for the AHA Nutrition Committee. (2003). Omega-3 Fatty Acids and Cardiovascular Disease: New Recommendations From the American Heart Association. Arterioscler Thromb Vasc Biol, 23(2), 151-152.

Kako djeluju omega 3 masne kiseline?

 Djeluju kao antiupalni i imunostimulirajući agensi preko sinteze eikozanoida kao što su prostaglandini,

leukotrieni i tromboksani

Iz omega 3 masnih kiselina (EPA) se sintetiziraju

antiinflamatorni leukotrien 3 i prostaglandin 3

Iz arahidonske kiseline (AA) koja pripada omega 6 masnim kiselinama sintetiziraju se

proinflamatorni leukotrieni B4 (LTB4) i prostaglandina E2 (PGE2)

Omega-6 masne kiseline

 Omega-6 masne kiseline su takođe esencijalne masne kiseline  Omega 6 masne kiseline su:  linolna (LA) i arahidonska (AA)  LA se unosi konzumiranjem suncokretovog i sličnih ulja

Simopoulos, A. P. (2008). The Importance of the Omega-6/Omega-3 Fatty Acid Ratio [...]. Exp. Biol. Med.

, 233 (6), 674-688.

International Omega-3 Learning and Education Consortium for Health and Medicine. (n.d.) from http://www.omega3learning.purdue.edu/

Pojednostavljeni dijagram strukture omega 3 i omega 6 masne kiseline

Omega-3 naspram omega-6 ?

 Današnji naučni izvori sugeriraju važnost odnosa unosa O-6 : O-3  Zapadna ishrana sadrži vrlo visoke količine omega-6 masnih kiselina  Ne unosi se dovoljno omega-3 masnih kiselina  Deficit Omega-3 postaje problem današnje ishrane

Simopoulos, A. P. (2008). The Importance of the Omega-6/Omega-3 Fatty Acid Ratio [...]. Exp. Biol. Med.

, 233 (6), 674-688.

International Omega-3 Learning and Education Consortium for Health and Medicine. (n.d.) from http://www.omega3learning.purdue.edu/

Kako djeluju omega 3 i omega 6 masne kiseline?

 Na stupanj sinteze anti i pro inflamatornih metabolita utiče kompozicija odnosa omega 3 i omega 6 masnih kiselina pri unosu 

Ove dvije vrste masnih kiselina koriste iste enzime i transportne sisteme tokom metaboliranja u tijelu

Balans se narušava ako nedostaju masne kiseline poput EPA kad dolazi do pretjeranog djelovanja proupalnih medijatora jer nedostaju protivupalni medijatori

Kako djeluju odnos omega 3 i omega 6 masnih kiselina?

 Odnos omega 3 i omega 6 masnih kiselina u prehrani bi trebao biti 1:2 do 1:4, no međutim on je često 1:10 do 1:20  Bitan je i odnos metabolita AA i EPA i ukoliko je previsok ukazuje na veliku mogućnost razvoja upalnih procesa i određenih hroničnih bolesti  DHA je dominantna u mozgu i mrežnici i njena niska razina se vezuje za Alzheimerovu bolest

Zaključak

Balansiran unos omega 3 masnih kiselina hranom ili dodacima prehrani u duljem vremenskom razdoblju osigurava organizmu prevenciju od upalnih kao i drugih hroničnih sistemskih bolesti

Zaključak

Preporuka je:

da najmanje 2%, ali ne više od 3% svih kalorija treba da se dobije iz LA omega-6 masne kiseline

da 1% od svih kalorija treba da se dobije iz ALA., omega-3 esencijalne masne kiseline

da po 0,1% svih kalorija dolazi od omega-3 masna kiselina EPA i DHA

Neke studije sa omega 3 masnim kiselinama

• • •

Hipertenzija

Von Schacky C. (March 2003). "The role of omega-3 fatty acids in cardiovascular disease.". Curr. Atheroscler. Rep. 5 (2): 139– 45.

doi : 10.1007/s11883-003-0086-y .

PMID 12573200 .

Morris, Martha C.; Sacks, Frank; Rosner, Bernard (1993).

lower blood pressure? A meta-analysis of controlled trials" .

Circulation

88 (2): 523–533.

PMID 8339414 .

"Does fish oil Mori, Trevor A.; Bao, Danny Q.; Burke, Valerie; Puddey, Ian B.; Beilin, Lawrence J. (1993).

humans" "Docosahexaenoic acid but not eicosapentaenoic acid lowers ambulatory blood pressure and heart rate in . Hypertension 34 (2): 253-260.

PMID 10454450 .

Hiperholesterolemia

• • • Davidson MH, Stein EA, Bays HE, Maki KC, Doyle RT, Shalwitz RA, Ballantyne CM, Ginsberg HN (2007). "Efficacy and tolerability of adding prescription omega-3 fatty acids 4 g/d to Simvastatin 40 mg/d in hypertriglyceridemic patients: An 8-week, randomized, double-blind, placebo-controlled study". Clin Ther. 29 (7): 1354– 1367.

doi : 10.1016/j.clinthera.2007.07.018

.

PMID 17825687 . McKenney, James M.; Sica, Domenic (2007). "Prescription omega-3 fatty acids for the treatment of hypertriglyceridemia". Am J Health-Sys Pharm 64 (6): 595–605.

doi : 10.2146/ajhp060164 .

PMID 17353568 .

Yokoyama, M; Origasa H, Matsuzaki M, Matsuzawa Y, Saito Y, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Itakura H, Kita T, Kitabatake A, Nakaya N, Sakata T, Shimada K, Shirato K (March 2007). "Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis". Lancet 369 (9567): 1090–1098.

doi : 10.1016/S0140-6736(07)60527-3 .

PMID 17398308 .

• • • • • •

Srčane bolesti

Bucher HC, Hengstler P, Schindler C, Meier G. (2002). "n−3 polyunsaturated fatty acids in coronary heart disease: a meta-analysis of randomized controlled trials".Am J Med 112 (4): 298–304.

doi : 10.1016/S0002-9343(01)01114-7 .

PMID 11893369 .

Burr, Michael L.; Sweetham, P.M.; Fehily, Ann M. (August 1994).

reinfarction" . European Heart Journal 15 (8): 1152–1153.

"Diet and PMID 7988613 .

Willett, Walter C.; Stampfer, M.J.; Colditz, G.A.; Speizer, F.E.; Rosner, B.A.; Hennekens, C.H. (1993). "Intake of trans fatty acids and risk of coronary heart disease among women".

The Lancet

341 (8845): 581–585.

doi : 10.1016/0140-6736(93)90350-P .

PMID 8094827 .

Stone, Neil J. (1996).

disease" .

Circulation

"Fish consumption, fish oil, lipids, and coronary heart 94 (9): 2337–2340.

PMID 8901708 .

Christensen, Jeppe H.; Gustenhoff, Peter; Korup, Eva; Aarøe, Jens; Toft, Egon; Møller, Torn; Rasmussen, Klaus; Dyerberg, Jørn; Schmidt, Erik B. (1996-03-16).

trial." . BMJ 312 (7032): 677–678.

PMID 8597736 .

PMC 2350515 . "Effect of fish oil on heart rate variability in survivors of myocardial infarction: a double blind randomised controlled Christensen, Jeppe H.; Gustenhoff, Peter; Korup, Eva; Aarøe, Jens; Toft, Egon; Møller, Torn; Rasmussen, Klaus; Dyerberg, Jørn; Schmidt, Erik B. (1996-03-16).

trial." . BMJ 312 (7032): 677–678.

PMID 8597736 .

PMC 2350515 .

"Effect of fish oil on heart rate variability in survivors of myocardial infarction: a double blind randomised controlled

• •

Arthritis

Fortin PR, Lew RA, Liang MH, Wright EA, Beckett LA, Chalmers TC, Sperling RI. (1995). "Validation of a meta-analysis: The effects of fish oil in rheumatoid arthritis".J Clin Epidemiol 48 (11): 1379– 1390.

doi : 10.1016/0895-4356(95)00028-3 .

PMID 7490601 .

Kremer, Joel M.; Bigauoette, J.; Michalek, A.V.; Timchalk, M.A.; Lininger, L.; Rynes, R.I.; Huyck, C.; Zieminski, J.; Bartholomew, L.E. (1985). "Effects of manipulation of dietary fatty acids on clinical manifestations of rheumatoid arthritis.".

The Lancet

( Elsevier ) 1 (8422): 184– 187.

doi : 10.1016/S0140-6736(85)92024-0 .

PMID 2857265 .

• • • • • •

Karcinom

Augustsson, Katarina; et al. (2003). "A prospective study of intake of fish and marine fatty acids and prostate cancer". Cancer Epidemiology, Biomarkers & Prevention 12 (1): 64–67.

PMID 12540506 .

De Deckere, E.A. (1999). "Possible beneficial effect of fish and fish n−3 polyunsaturated fatty acids in breast and colorectal cancer". Eur J Cancer Prev 8 (3): 213–221.

doi : 10.1097/00008469-199906000-00009 .

PMID 10443950 .

Caygill, C.P.; Hill, M.J. (1995). "Fish, n−3 fatty acids and human colorectal and breast cancer mortality". Eur J Cancer Prev 4 (4): 329–332.

doi : 10.1097/00008469 199508000-00008 .

PMID 7549825 .

Yong Q. Chen, et al. (2007).

"Modulation of prostate cancer genetic risk by omega-3 and omega-6 fatty acids" . J Clin Invest 117 (7): 1866– 75.

doi : 10.1172/JCI31494 .

PMID 1890998 . Retrieved 2008-11-30.

Pala V, et al. (2001).

"Erythrocyte Membrane Fatty Acids and Subsequent Breast Cancer: a Prospective Italian Study" . JNCL 93 (14): 1088.

doi : 10.1093/jnci/93.14.1088

.

PMID 11459870 . Retrieved 2008-11-30.

MacLean, Catherine H. et al. (2006).

Risk" . JAMA 295 (4): 403–415.

"Effects of n−3 Fatty Acids on Cancer doi : 10.1001/jama.295.4.403

.

PMID 16434631 .

Karcinom

• Lee Hooper et al. (2006).

"Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review" . BMJ 332 (7544): 752– 760.

doi : 10.1136/bmj.38755.366331.2F

Retrieved 2006-07-07.

.

PMID 16565093 .

PMC 1420708 . • Colomer R, Moreno-Nogueira JM, García-Luna PP, et al. (May 2007). "N-3 fatty acids, cancer and cachexia: a systematic review of the literature". Br. J. Nutr. 97(5): 823–31.

doi : 10.1017/S000711450765795X .

PMID 17408522 .

• Ryan AM, Reynolds JV, Healy L, et al. (2009). "Enteral nutrition enriched with eicosapentaenoic acid (EPA) preserves lean body mass following esophageal cancer surgery: results of a double-blinded randomized controlled trial". Ann. Surg. 249 (3): 355–63.

doi : 10.1097/SLA.0b013e31819a4789

.

PMID 19247018 .