Effects of fish oil-derived fatty acids on suboptimal cardiovascular health: A multicenter, randomized, double-blind, placebo-controlled trial
Introduction
A recent study reported the presence of a preclinical state between health and disease, defined as a suboptimal health status [1]. Suboptimal health status is characterized by self-reported general weakness, low energy, and ambiguous health complaints but absence of a diagnosable condition, which has been reported to be common in the general population [2], [3]. People with this health status may be more vulnerable to chronic diseases because of the association between suboptimal health, cardiovascular risk, and chronic psychosocial stress [4], [5]. Nevertheless, suboptimal health is reversible [6]. The early management of suboptimal health may prevent the development of clinical diseases and promote the maintenance of health.
Metabolic disorders are closely related to cardiovascular disease (CVD) [7]. Similar to suboptimal health, metabolic disorders are modifiable and were actually defined as characterizing suboptimal health in the literature [8]. Considering the relationships between both suboptimal health and metabolic disorders with cardiovascular risk, we defined a status of suboptimal cardiovascular health characterized by the presence of both suboptimal health and metabolic disorders. With regard to the evaluation of cardiovascular risk, suboptimal cardiovascular health status may be superior to metabolic disorders or suboptimal health status alone because it reflects not only metabolic index levels but also self-reported health status. Thus, the prevention of suboptimal cardiovascular health status may significantly reduce CVD risk.
Numerous prospective cohort studies and randomized, controlled clinical trials have shown a beneficial association between n-3 long-chain polyunsaturated fatty acids (LCPUFA) and CVD [9], [10]. The American Heart Association (AHA) recommended the administration of n-3 fatty acids for cardiovascular risk modification due to the ability of these compounds to lower triglyceride concentrations, prevent serious arrhythmias, and lower blood pressure [11], [12], [13]. We hypothesize that the intake of n-3 LCPUFA may be beneficial with respect to suboptimal cardiovascular health.
In a multicenter, randomized, double-blind, and placebo-controlled trial of participants with suboptimal cardiovascular health, we investigated whether n-3 LCPUFA consumption improved suboptimal cardiovascular health and reduced cardiovascular risk.
Section snippets
Participants
Participants were recruited from the clinic of Sichuan Provincial People's Hospital in Chengdu, Sichuan, as well as the clinic of the First Affiliated Hospital of Harbin Medical University in Harbin, Heilongjiang in China. Men and women, 18–60 years of age, with suboptimal cardiovascular health were eligible for participation. The exclusion criteria included a history of diagnosed somatic or psychiatric diseases, such as CVD, stroke, hypertension, hyperlipidemia, diabetes, hyperthyroidism,
Baseline characteristics and adherence
Between September 2014 and April 2015, a total of 422 participants were enrolled and randomly assigned to the n-3 LCPUFA group or the placebo group. The baseline characteristics of the enrolled participants were balanced between the two clinics (Table S1).The treatment groups were also well matched at baseline (Table 1).
By the end of the trial, among 422 enrolled participants, 6.6% (n = 28) dropped out (Fig. 1). The dropout rates were similar between the n-3 LCPUFA group (6.2%) and the placebo
Discussion
In this randomized, placebo-controlled, double-blind trial, we observed that the intake of n-3 LCPUFA over three months decreased BMI levels and improved suboptimal health and suboptimal cardiovascular health in participants with suboptimal cardiovascular health. However, cardiovascular risk was not significantly decreased by fish oil treatment when compared with placebo.
According to the World Health Organization definition, health is a state of complete physical, mental, and social well-being,
Disclosure
The authors declared no conflict of interest.
Acknowledgements
The authors thank By-health Co. (Zhuhai, Guangdong, China) and all participants for their valuable contributions to the study. This study was supported by the State Science and Technology Support Program (No. 2012BAI37B04) and the Military Healthcare Programs (No. 15BJZ48 and No. 16BJZ40).
References (30)
- et al.
Prevalence of somatoform disorders and medically unexplained symptoms in old age populations in comparison with younger age groups: a systematic review
Ageing Res Rev
(2013) - et al.
Traditional Chinese medicine and new concepts of predictive, preventive and personalized medicine in diagnosis and treatment of suboptimal health
EPMA J
(2014) - et al.
Management of functional somatic syndromes
Lancet
(2007) - et al.
Omega-3 fatty acids and adipose tissue function in obesity and metabolic syndrome
Prostagl Other Lipid Mediat
(2015) - et al.
China suboptimal health cohort study: rationale, design and baseline characteristics
J Transl Med
(2016) - et al.
Development and evaluation of a questionnaire for measuring suboptimal health status in urban Chinese
J Epidemiol
(2009) - et al.
Association of lifestyle factors and suboptimal health status: a cross-sectional study of Chinese students
BMJ Open
(2014) - et al.
Association of suboptimal health status and cardiovascular risk factors in urban Chinese workers
J Urban Health
(2012) - et al.
Association of suboptimal health status with psychosocial stress, plasma cortisol and mRNA expression of glucocorticoid receptor alpha/beta in lymphocyte
Stress
(2015) - et al.
Worldwide exposures to cardiovascular risk factors and associated health effects: current knowledge and data gaps
Circulation
(2016)
Association of psychosocial work hazards with depression and suboptimal health in executive employees
J Occup Environ Med
Effect of Omega-3 acid ethyl esters on left ventricular remodeling after acute myocardial infarction: the OMEGA-REMODEL randomized clinical trial
Circulation
Association of specific dietary fats with total and cause-specific mortality
JAMA Intern Med
n-3 fatty acid dietary recommendations and food sources to achieve essentiality and cardiovascular benefits
Am J Clin Nutr
Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and blood pressure: a meta-analysis of randomized controlled trials
Am J Hypertens
Cited by (6)
A critical review on the health benefits of fish consumption and its bioactive constituents
2022, Food ChemistryCitation Excerpt :Wang et al. (2004) found that fish oil possesses a therapeutic effect in reducing atherosclerotic lesions by in vivo studies, mainly attributed to enhancing the antioxidant enzyme activities, not reducing lipid. Zeng et al. (2017), Zeng et al. (2017) evaluated that the intake of omega-3 long-chain polyunsaturated fatty acids (LCPUFA) isolated from fish oils can significantly improve the suboptimal cardiovascular risk. Lee et al. (2008) investigated that omega-3 fatty acids supplementation could significantly reduce the incidence of major coronary events.
Improving the oxidative stability of fish oil nanoemulsions by co-encapsulation with curcumin and resveratrol
2021, Colloids and Surfaces B: BiointerfacesCitation Excerpt :Tuna fish oil (TFO) is abundantly comprised of polyunsaturated fatty acids particularly DHA (Docosahexaenoic acid) and EPA (Eicosapentaenoic acid). These fatty acids are very important and recognized as essential nutrients for human’s diet [1]; because they can improve the human health by preventing from several serious disorders, such as cardiovascular disease, cancer, inflammation, arthritis, diabetes, allergies and Alzheimer disease [2–6]. Also, they assist in improving the infant’s nervous system and visionary development.
Fatty acids and cardiometabolic health: a review of studies in Chinese populations
2021, European Journal of Clinical Nutrition
- 1
These authors contributed equally to this work.