Excesso de peso pré-gestacional e ácidos graxos poli-insaturados no leite humano: modelo teórico de causalidade / Pre-gestational overweight and polyunsaturated fatty acids in human milk: theoretical causality model

Resumo Inúmeros estudos têm se detido na avaliação da associação entre o excesso de peso pré-gestacional e os ácidos graxos poli-insaturados no leite humano. Todavia, diante da complexidade de fatores de risco potencialmente confundidores, é recomendável a utilização de ferramentas gráficas para identificar possíveis vieses. O objetivo deste artigo é propor um modelo teórico de causalidade utilizando o gráfico acíclico direcionado entre o excesso de peso pré-gestacional e os ácidos graxos poli-insaturados no leite humano. Foi realizada ampla revisão da literatura para identificar as variáveis com relações causais com a exposição e/ou desfecho. A escolha das variáveis para ajuste seguiu o algoritmo gráfico que compreende seis critérios para a seleção de um conjunto mínimo de variáveis potencialmente confundidoras. Condições socioeconômicas, intervalo interpartal, idade materna e padrão de consumo alimentar foram as variáveis ajustadas a fim de se estimar o efeito total do excesso de peso pré-gestacional sobre o conteúdo dos ácidos graxos poli-insaturados no leite humano. O conjunto mínimo de variáveis encontrado pelo presente estudo pode ser utilizado na análise de outros estudos que avaliem essa associação.

Abstract A number of studies have focused on the evaluation of the relationship between pre-pregnancy overweight and polyunsaturated fatty acids content in human milk. However, given the complexity of potentially confounding risk factors, the use of graphical tools is recommended to identify possible biases. This article aims to propose a theoretical model of causality using the directed acyclic graph between pre-pregnancy overweight and polyunsaturated fatty acids content in human milk. Methods: An extensive literature review was performed to identify variables with causal relationships with exposure and/or outcome. The choice of variables for adjustment followed the graphic algorithm that comprises six criteria for selecting a minimum set of potentially confounding variables. Socioeconomic conditions, interpartum interval, maternal age and food consumption pattern were the variables that would have to be adjusted in order to estimate the total effect of pre-pregnancy overweight on polyunsaturated fatty acids content in human milk. The minimum set of variables found in the present study can be used in the analysis of other studies that evaluate this association.

Effect of long-term intake of ω-3 polyunsaturated fatty acids on activation of hippocampal microglia in a mouse model of POCD / 中华麻醉学杂志

Objective:To evaluate the effect of long-term intake of ω-3 polyunsaturated fatty acids (ω-3 PUFAs) on the activation of hippocampal microglia in a mouse model of postoperative cognitive dysfunction (POCD).Methods:Ninety-six clean-grade healthy male C57BL/6 mice, aged 8 weeks, weighing 18-24 g, were stratified according to body weight and divided into 4 groups ( n=24 each) by a random number table method: control diet group (group C), ω-3 PUFAs group (group ω), control diet plus POCD group (group C+ P) and ω-3 PUFAs plus POCD group (group ω+ P). Mice were fed a special ω-3 PUFAs diet (DHA 0.14 g/100 g, EPA 0.03 g/100 g) for 12 weeks in group ω and group ω+ P, while mice were fed with a control diet for 12 weeks in group C and group C+ P.Tibial fracture procedures were performed under isoflurane anesthesia to develop the POCD model after 12 weeks of feeding.The fear conditioning test and Y maze test were performed on 1st and 3rd days after developing the model.The mice were sacrificed after behavioral tests, and the hippocampal tissues were removed for determination of the contents of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) (by gas chromatography-mass spectroscopy), density of Iba-1 positive microglia (by immunofluorescence staining), and expression of mature brain-derived neurotrophic factor (mBDNF) and precursor brain-derived neurotrophic factor (pro-BDNF) (by Western blot), and contents of interleukin-1beta (IL-1β) and interleukin-6 (IL-6) (by enzyme-linked immunosorbent assay). Results:Compared with group C, the contents of DHA and EPA were significantly increased, the percentage of freezing time in the contextual test was increased, mBDNF/pro-BDNF ratio was increased ( P<0.05), no significant change was found in the rotation accuracy in Y maze test, density of Iba-1 positive microglia and contents of IL-1β and IL-6 in hippocampus ( P>0.05) in group ω ( P<0.05), and no significant change was found in the contents of DHA and EPA ( P>0.05), the percentage of freezing time in the contextual test and accuracy of rotation in Y maze test were decreased on 1st and 3rd days after operation, the density of Iba-1 positive microglia and contents of IL-1β and IL-6 were increased, and mBDNF/pro-BDNF ratio was decreased in group C+ P ( P<0.05). Compared with group C+ P, the contents of DHA and EPA were significantly increased, the percentage of freezing time in the contextual test and accuracy of rotation in Y maze test were increased on 1st and 3rd days after operation, the density of Iba-1 positive microglia and contents of IL-1β and IL-6 were decreased, and mBDNF/pro-BDNF ratio was increased in group ω+ P ( P<0.05). Conclusions:Long-term intake of ω-3 PUFAs can improve cognitive function in a mouse model of POCD, and the mechanism may be related to inhibition of activation of hippocampal microglia, reduction of inflammatory responses, and thus increasing the mBDNF/Pro-BDNF ratio.

Efectos de Omega-3 en el Sueño: Revisión Sistemática

RESUMEN: Objetivo: Determinar el efecto de omega-3 sobre la calidad/cantidad de sueño en humanos. Métodos: Se realizó la búsqueda sistemática de artículos (2010-2019), incluyendo pacientes sin limitación de edad/sexo, sometidos a cambio o suplemento de dieta con omega-3 y evaluaciones de sueño. La revisión se realizó bajo los criterios PICOT y PRISMA, la calidad de la evidencia y riego de sesgo fueron evaluados con criterios GRADE. Resultados: Seis ensayos superaron todos los filtros, dos estudios incluyeron pescado en la dieta y cuatro ingesta de cápsulas de omega-3. En cuatro estudios Omega-3 favorece el sueño presentando impacto moderadamente positivo en calidad y alto en cantidad. Los estudios fueron efectuados con variables de alta heterogeneidad, imposibilitando el análisis cuantitativo de los datos. El riesgo de sesgo fue moderado-alto. Conclusión: Omega-3, como suplemento dietético o directamente en los alimentos, interviene como coadyuvante para mejorar el sueño. No se pudo concluir sobre su recomendación de uso clínico en la gestión del sueño debido a la heterogeneidad de las metodologías para medir la intervención, las poblaciones estudiadas y cantidad de ingesta. Se necesitan estudios con mayor estandarización metodológica, para determinar dosis óptima, período de intervención y proporción de ácidos eicosapentaenoico/docosahexaenoico, necesarios para mejorar la calidad y la cantidad del sueño.

ABSTRACT: Objective: To determine the effect of omega-3 on the quality/quantity of sleep in humans. Methods: We conducted a systematic search for articles (2010-2019), including patients without age or sex limitation, undergoing omega-3 diet change or supplementation and sleep assessments. The review was conducted under the PICOT and PRISMA criteria, the quality of evidence and risk of bias were evaluated with GRADE criteria. Results: Six trials passed all filters. Two studies included dietary fish and four omega-3 capsule intake. In four studies, omega-3 favored sleep with moderately positive impact on quality and high impact on quantity. The studies were conducted with highly heterogeneous variables, making a quantitative analysis of the data impossible. The risk of bias was moderate to high. Conclusion: Omega-3 as a dietary supplement or directly in food intervenes as an adjuvant to improve sleep. We could not conclude on its recommendation for clinical use in sleep management due to the heterogeneity of the methodologies to measure the intervention, the populations studied and amount of intake. Studies with greater methodological standardization are needed, to determine optimal dose, intervention period and eicosapentaenoic/docosahexaenoic acid ratio, needed to improve sleep quality and quantity.

Maternal Intake of Flaxseed During Lactation and Exercise Training Protect Against Salt Overload-Induced Aortic Remodeling in Adult Offspring

Abstract Background High dietary sodium intake can induce endothelial stiffness even without changes in blood pressure. Objectives To evaluate the effects of exercise training and chronic intake of sodium chloride solution on aortic morphology of male offspring of rat dams who consumed flaxseed during lactation. Methods Female rats were fed with a control diet or a flaxseed diet during lactation. At weaning, two male offspring of each rat dam were allocated into eight groups for 180 days: four groups received a control diet e four received a flaxseed diet, with /without exercise and with/without NaCl solution supply. Aorta was collected for histomorphometric analysis. The one-way analysis of variance was used and P value < 0.05 was considered statistically significant. Results The chronic use of 1% NaCl solution led to changes in aortic histoarchitecture in the control group: increase in aortic intima-media thickness (10,4%, p<0.0001) and reduced number of elastic lamellae (-8,1%, p<0.0001). Groups of offspring of mother that consumed flaxseed during lactation, the chronic use of 1% NaCl alone did not lead to an increase in the aortic intima-media thickness. Exercise training of adult offspring increased aortic intima-media thickness (13.3%, p<0.0001), with preservation of elastic components and aortic flexibility. Conclusion Chronic salt overload caused adverse effects on the aorta of rats, and maternal consumption of the flaxseed diet during lactation protected against aortic remodeling. Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0

New tendencies in non-surgical periodontal therapy

Abstract The aim of this review was to update the evidence of new approaches to non-surgical therapy (NSPT) in the treatment of periodontitis. Preclinical and clinical studies addressing the benefits of adjunctive antimicrobial photodynamic therapy, probiotics, prebiotics/synbiotics, statins, pro-resolving mediators, omega-6 and -3, ozone, and epigenetic therapy were scrutinized and discussed. Currently, the outcomes of these nine new approaches, when compared with subgingival debridement alone, did not demonstrate a significant added clinical benefit. However, some of these new alternative interventions may have the potential to improve the outcomes of NSPT alone. Future evidence based on randomized controlled clinical trials would help clinicians and patients in the selection of different adjunctive therapies.

Research advances in omega-3 polyunsaturated fatty acids in treatment of nonalcoholic fatty liver disease / 临床肝胆病杂志

With the changes in people’s lifestyle and dietary structure, the incidence rate of nonalcoholic fatty liver disease (NAFLD) has been increasing year by year, and NAFLD has become a serious threat to human health. The treatment of NAFLD has always been a hot topic of basic and clinical research on liver diseases. In recent years, many studies have revealed that omega-3 polyunsaturated fatty acids (ω3-PUFA) can promote fatty acid oxidation, improve intestinal homeostasis, and thus improve lipid metabolism and liver inflammation, and therefore, more and more clinical studies have applied ω3-PUFA in the treatment of NAFLD. However, the mechanism of ω3-PUFA in the treatment of NAFLD is still unclear, and there are certain limitations in related clinical studies. This article mainly introduces the role of ω3-PUFA in NAFLD and the results of related clinical studies and further discusses the problems that need to be solved in ω3-PUFA for the treatment of NAFLD.

Efficacy and Safety of Omega-3 Fatty Acids in Patients Treated with Statins for Residual Hypertriglyceridemia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

BACKGROUND: Cardiovascular risk remains increased despite optimal low density lipoprotein cholesterol (LDL-C) level induced by intensive statin therapy. Therefore, recent guidelines recommend non-high density lipoprotein cholesterol (non-HDL-C) as a secondary target for preventing cardiovascular events. The aim of this study was to assess the efficacy and tolerability of omega-3 fatty acids (OM3-FAs) in combination with atorvastatin compared to atorvastatin alone in patients with mixed dyslipidemia.METHODS: This randomized, double-blind, placebo-controlled, parallel-group, and phase III multicenter study included adults with fasting triglyceride (TG) levels ≥200 and <500 mg/dL and LDL-C levels <110 mg/dL. Eligible subjects were randomized to ATOMEGA (OM3-FAs 4,000 mg plus atorvastatin calcium 20 mg) or atorvastatin 20 mg plus placebo groups. The primary efficacy endpoints were the percent changes in TG and non-HDL-C levels from baseline at the end of treatment.RESULTS: After 8 weeks of treatment, the percent changes from baseline in TG (−29.8% vs. 3.6%, P<0.001) and non-HDL-C (−10.1% vs. 4.9%, P<0.001) levels were significantly greater in the ATOMEGA group (n=97) than in the atorvastatin group (n=103). Moreover, the proportion of total subjects reaching TG target of <200 mg/dL in the ATOMEGA group was significantly higher than that in the atorvastatin group (62.9% vs. 22.3%, P<0.001). The incidence of adverse events did not differ between the two groups.CONCLUSION: The addition of OM3-FAs to atorvastatin improved TG and non-HDL-C levels to a significant extent compared to atorvastatin alone in subjects with residual hypertriglyceridemia.

Efficacy and Safety of Prescription Omega-3 Fatty Acids Added to Stable Statin Therapy in Korean Patients with Type 2 Diabetes and Hypertriglyceridemia: a Randomized Controlled Trial

OBJECTIVE: The aim of this study was to investigate the effects of omega-3 fatty acids added to statin monotherapy in Korean patients with type 2 diabetes who have persistent hypertriglyceridemia despite statin therapy. METHODS: This study was a randomized controlled trial conducted in 4 clinical sites between February 2009 and February 2011. The inclusion criteria were patients with type 2 diabetes who had received ≥6 weeks of statin therapy and had fasting triglyceride (TG) levels ≥1.7mmol/L and low-density lipoprotein (LDL) cholesterol levels <2.6 mmol/L. The study regimen consisted of 16 weeks of randomized treatment with omega-3 fatty acids (4 g/day) plus a statin (n=26) or statin only (n=30). The primary endpoint was the change from baseline to final visit in mean TG level. RESULTS: A total of 56 participants were analyzed. At week 16, the change in the TG level in the combination therapy group differed significantly from the change in the statin monotherapy group (−34.8% vs. −15.2%, p=0.0176). Treatment with omega-3 fatty acids plus a statin was also associated with a significant decrease in non-high-density lipoprotein cholesterol compared with baseline, but the difference was not significant compared with the statin monotherapy group (−8.0% vs. −2.5%, p=0.165). The changes in LDL cholesterol and HbA1c levels did not differ significantly between groups. The study medications were well tolerated, and adverse events were comparable between two groups. CONCLUSION: Adding omega-3 fatty acids to statin treatment reduced TG levels more effectively than statin monotherapy without undesirable effects in Korean type 2 diabetic patients who had hypertriglyceridemia despite well-controlled LDL cholesterol on stable statin therapy. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02305355

Effects of dietary polyunsaturated fatty acid intake on serum lipoprotein, C-reactive protein and homocysteine in patients with acute ischemic stroke or transient ischemic attack / 国际脑血管病杂志

Objective@#To investigate the relationship between dietary polyunsaturated fatty acid (PUFA) intake and blood lipid, C-reactive protein (CRP) and homocysteine (Hcy) in patients with acute ischemic stroke or transient ischemic attack (TIA).@*Methods@#Patients with acute ischemic stroke or TIA were enrolled consecutively from Nanjing Stroke Registry Program. The total dietary PUFA intake level was assessed by the food semi-quantitative frequency questionnaire. Venous blood samples were collected in the morning of the day after admission to the hospital to detect the levels of serum total cholesterol, triacylglycerol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, Hcy, and CRP. According to the median level of total PUFA intake, the patients were divided into low PUFA group and high PUFA group. The relationship between PUFA intake and blood lipid, CRP and Hcy was analyzed by Spearman correlation analysis, and multiple linear regression analysis was used to determine the independent correlation.@*Results@#A total of 170 patients (85.1%) with acute ischemic stroke and 31 patients with TIA (14.9%) were enrolled. Their age was 62.9±14.1 years, 143 were males (71.1%), and the median PUFA daily intake was 12.8 g (interquartile range: 8.05-17.5 g). Compared with the high PUFA group (n=100), patients in the low PUFA group (n=101) were older, serum high-density lipoprotein cholesterol levels were lower, and CRP and Hcy levels were higher. The above differences were statistically significant (all P<0.05). Spearman correlation analysis showed that total dietary PUFA intake was significantly negatively correlated with the serum CRP (r=-0.24, P=0.001) and Hcy (r=-0.17, P=0.013) levels, and there was no significant correlation with the blood lipid levels. Multiple linear regression analysis showed that CRP was significantly negatively correlated with PUFA intake after adjusting for confounding factors (B=-0.28, P=0.012).@*Conclusions@#Dietary PUFA intake in patients with acute ischemic stroke or TIA may affect blood metabolism index and oxidative stress index. It is necessary to adjust the dietary structure of patients with low PUFA intake to reduce the risk of stroke recurrence.

Effects of dietary polyunsaturated fatty acid intake on serum lipoprotein, C-reactive protein and homocysteine in patients with acute ischemic stroke or transient ischemic attack / 国际脑血管病杂志

Objective To investigate the relationship between dietary polyunsaturated fatty acid (PUFA) intake and blood lipid,C-reactive protein (CRP) and homocysteine (Hcy) in patients with acute ischemic stroke or transient ischemic attack (TIA).Methods Patients with acute ischemic stroke or TIA were enrolled consecutively from Nanjing Stroke Registry Program.The total dietary PUFA intake level was assessed by the food semi-quantitative frequency questionnaire.Venous blood samples were collected in the morning of the day after admission to the hospital to detect the levels of serum total cholesteroI,triacylglycerol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,Hcy,and CRP.According to the median level of total PUFA intake,the patients were divided into low PUFA group and high PUFA group.The rehtionship between PUFA intake and blood lipid,CRP and Hcy was analyzed by Spearman correhtion analysis,and multiple linear regression analysis was used to determine the independent correhtion.Results A total of 170 patients (85.1％) with acute ischemic stroke and 31 patients with TIA (14.9％) were enrolled.Their age was 62.9 ± 14.1 years,143 were males (71.1％),and the median PUFA daily intake was 12.8 g (interquartile range:8.05-17.5 g).Compared with the high PUFA group (n =100),patients in the low PUFA group (n =101) were older,serum high-density lipoprotein cholesterol levels were lower,and CRP and Hcy levels were higher.The above differences were statistically significant (all P ＜ 0.05).Spearman correlation analysis showed that total dietary PUFA intake was significantly negatively correhted with the serum CRP (r =-0.24,P =0.001) and Hey (r =-0.17,P =0.013) levels,and there was no significant correlation with the blood lipid levels.Multiple linear regression analysis showed that CRP was significantly negatively correlated with PUFA intake after adjusting for confounding factors (B =-0.28,P =0.012).Conclusions Dietary PUFA intake in patients with acute ischemic stroke or TIA may affect blood metabolism index and oxidative stress index.It is necessary to adjust the dietary structure of patients with low PUFA intake to reduce the risk of stroke recurrence.

Effects of omega-6/3 and omega-9/6 nutraceuticals on pain and fertility in peritoneal endometriosis in rats

Abstract Purpose: To evaluate the effects of the nutraceuticals omega-6/3 and omega-9/6 on endometriosis-associated infertility and pain. Methods: Controlled experimental study, with each group composed of eight female rats. Fertility groups: sham-operated control (0.9% saline solution); control with endometriosis (0.9% saline); omega-6/3 (1.2 g/kg/day); omega-9/6 (1.2 g/kg/day); and meloxicam (0.8 mg/kg/day). Pain groups: sham-operated control (0.9% saline); control with endometriosis (0.9% saline); omega-6/3 (1.2 g/kg/day); omega-9/6 (1.2 g/kg/day); medroxyprogesterone acetate (5 mg/kg/every 3 days); and meloxicam (0.8 mg/kg/day). Peritoneal endometriosis was surgically induced. Pain was evaluated with the writhing test. Fertility was evaluated by counting the number of embryos in the left hemi-uterus. Results: The mean number of writhings was as follows: sham-operated, 11.1 ± 2.9; control with endometriosis, 49.3 ± 4.4; omega-6/3, 31.5 ± 2.7; omega-9/6, 34.1 ± 4.5; medroxyprogesterone acetate, 2.1 ± 0.8; meloxicam, 1 ± 0.3. There was a significant difference between both controls and all drugs used for treatment. Regarding fertility, the mean values were as follows: sham-operated, 6.8 ± 0.6; control with endometriosis, 4.2 ± 0.7; omega-6/3, 4.7 ± 1; omega-9/6, 3.8 ± 0.9; and meloxicam, 1.8 ± 0.9. Conclusions: The omega-6/3 and omega-9/6 nutraceuticals decreased pain compared to the controls. There was no improvement in fertility in any of the tested groups.

Efeitos da suplementação de ômega 3 na resistência à insulina em mulheres com síndrome do ovário policístico: revisão sistemática / Effects of omega 3 supplementation on insulin resistance in women with polycystic ovary syndrome: systematic review

Introdução: A síndrome do ovário policístico (SOP) é uma disfunção hormonal que acomete mulheres em idade reprodutiva podendo causar infertilidade, alterações no ciclo menstrual, hirsutismo, presença de cistos nos ovários, amenorreia e distúrbios metabólicos. Dentre as alterações metabólicas, resistência à insulina (RI) está presente em 70,5% das brasileiras com SOP. Objetivo: Revisar sistematicamente a literatura para descrever os efeitos da suplementação de ômega-3 na RI em mulheres com SOP. Materiais e métodos: As buscas pela informação foram realizadas na base de dados PubMed e LILACS utilizando os descritores "síndrome do ovário policístico"; "ácidos graxos ômega-3" e "resistência à insulina", em português e inglês. Resultados: Foram encontrados sessenta estudos e após o crivo metodológico seis foram selecionados para compor esta revisão. Ao total dos ensaios clínicos incluídos nesta revisão, 326 mulheres com faixa etária correspondente a 18-45 anos foram avaliadas com variações de índice de massa corporal entre 25 e 45 kg/m2. A variação de tempo de acompanhamento entre os estudos foi de 2 a 6 meses. Discussão: Em todos os estudos incluídos nesta revisão, a homeostase da glicose sérica foi avaliada pelo índice HOMA. Apenas 1 estudo avaliou o índice quantitativo de verificação da sensibilidade à insulina (QUICK1); 2 estudos avaliaram hemoglobina glicada e índice de sensibilidade à insulina (ISI de Matsuda). A avaliação da insulinemia de jejum foi realizada em 4 estudos. Metade dos estudos incluídos suplementou os pacientes com 1.000 mg de ômega-3 ao dia, enquanto 25% dos estudos utilizou a dosagem de 2000 mg/dia 25% utilizou 4000 mg/dia. A maioria das pesquisas encontradas (67%) descreveu efeito positivo entre a suplementação de ômega-3 e melhora da RI de mulheres com SOP, utilizando os diferentes métodos de dosagem da homeostase da glicose sérica. Conclusão: Conclui-se que o consumo de ômega-3 pode ter efeito positivo sobre a RI.

Introduction: Polycystic ovarian syndrome (PCOS) is a hormonal dysfunction that affects women of childbearing age and can cause infertility, changes in the menstrual cycle, hirsutism, ovarian cysts, amenorrhea, and metabolic disorders. Among the metabolic changes insulin resistance (IR) is present in 70.5% of Brazilians with PCOS. Objective:To systematically review the literature to describe the effects of omega-3 supplementation on IR in women with PCOS. Materials and methods: Information searches were performed in the PubMed and LILACS database using the descriptors "polycystic ovarian syndrome"; "fatty acids omega-3" and "insulin resistance", in Portuguese and English. Results: Sixty studies were found and six were selected to compose this review. In the total of the clinical trials included in this review, 326 women aged 18-45 years were evaluated with variations in body mass index between 25 and 45 kg/m2. The variation in follow-up time between the studies was from 2 to 6 months. Discussion: In all studies included in this review, serum glucose homeostasis was assessed by the HOMA index. Only 1 study evaluated the quantitative index of insulin sensitivity (QUICK1); 2 studies evaluated glycated hemoglobin and insulin sensitivity index (Matsuda ISI). The evaluation of fasting insulinemia was performed in 4 studies. Half of the included studies supplemented patients with 1000 mg omega-3 daily, while 25% of the studies used the dosage of 2000 mg / day 25% used 4000 mg / day. Most of the researches (67%) described a positive effect between omega-3 supplementation and improvement of IR in women with PCOS, using the different dosing methods for serum glucose homeostasis. Conclusion: It is concluded that omega-3 consumption may have a positive effect on IR.

Actividad citotóxica y genotóxica de ácidos grasos omega en células de cáncer de próstata PC-3 / Cytotoxic and Genotoxic Activity of Omega Fatty Acids in Prostate Cancer Cells PC-3

RESUMEN Introducción: en el mundo, el cáncer de próstata es la principal causa de muerte en hombres. Algunas evidencias sugieren que los ácidos grasos omega-3 reducen la viabilidad de las células tumorales mientras que los ácidos omega-6 promueven su proliferación; al respecto, otros estudios han mostrado resultados controvertidos. Objetivo: evaluar los efectos citotóxicos, genotóxicos y anticlonogénicos de ácidos omega-3: α-linolénico (ALA), eicosapentaenoico (EPA) y docosahexaenoico (DHA), omega-6: linoleico (LA), araquidónico (AA) y omega-9: oleico (OA) en células de cáncer de próstata (PC-3). Metodología: se evaluó el efecto sobre la viabilidad celular relativa mediante las pruebas de MTT y Azul de Tripano, el efecto genotóxico mediante intercambios de cromátidas hermanas (ICHs) y ensayo cometa, y el efecto anticlonogénico in vitro, en diferentes concentraciones (25, 50, 100 y 150 µM) de seis ácidos grasos omega en células de cáncer de próstata (PC-3). Resultados: la viabilidad relativa por MTT mostró valores ≤ IC50 con las concentraciones mayores (100 y 150 µM) para los ácidos grasos omega-3 EPA y DHA y omega-6 AA (150 µM), mientras que la viabilidad relativa, evaluada con Azul de Tripano, con estos mismos ácidos, redujeron la viabilidad a 0 %. DHA y EPA mostraron efecto genotóxico y la disminución de la clonogenicidad celular (p < 0,01). Por otro lado, LA y AA disminuyeron la viabilidad relativa observada con Azul de Tripano, sugiriendo diferentes mecanismos de acción de los ácidos grasos en la membrana celular. Conclusión: los resultados mostraron que los ácidos grasos omega-3, EPA, DHA, y omega-6, AA, disminuyen la formación de colonias, reducen la viabilidad celular y aumentan el efecto genotóxico respecto al control no tratado, en el modelo in vitro de células tumorales de próstata PC-3.

SUMMARY Introduction: Prostate cancer is the main cause of cancer related deaths in men worldwide. Previous studies have suggested that omega-3 fatty acids reduce cell viability in tumour cells, whereas omega-6 fatty acids increase clonogenicity. Nevertheless, other reports have shown controversial results. Objective: Evaluate cytotoxicity, genotoxicity and clonogenicity in a prostate cancer derived human cell line (PC-3), treated with fatty acids omega-3: α-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA); omega-6: linoleic acid (LA) and arachidonic acid (AA); omega-9: oleic acid (OA). Methods: The tests included (a) cytotoxicity assays by MTT and Trypan Blue; (b) genotoxicity evaluation by the sister-chromatid exchanges technique (SCE) and the DNA-comet assay; and (c) in vitro clonogenic assay of six fatty acids in prostate cancer cell (PC-3) at different concentrations (25 µM, 50 µM, 100 µM and 150 µM). Results: The cell viability by MTT data showed ≤ IC50 values for the omega-3 EPA and DHA and omega-6 AA fatty acids at the two major concentrations (100 µM and 150 µM). Moreover, the same fatty acids viability values dropped to 0 % with Trypan Blue test. EPA and DHA showed genotoxic effect and a clonogenic cell decrease (p<0,01). The latter test also revealed a viability diminishment for LA and AA, suggesting different mechanisms of action of fatty acids on cell membrane. Conclusion: The in vitro evaluation revealed that EPA, DHA and AA reduce the clonogenicity and cell viability of prostate tumour cells and cause genotoxicity in prostate tumour derived PC-3 cells.

Effects of ω-3 fatty acid on liver function in patients undergoing hepatectomy: a Meta-analysis / 中国医师进修杂志

Objective To study the effects of ω-3 fatty acid on liver function in patients undergoing hepatectomy. Methods A PubMed, Embase and Cochrane Library database search was performed to retrieve all of the randomized controlled trial (RCT) evaluating the value of perioperative ω-3 fatty acid in patients undergoing hepatectomy until the end of September 2016. Data extraction and quality assessment of RCT were performed in accordance with PRISMA guidelines. The quality of evidence for each postoperative outcome was assessed using the GRAD Profiler system. A random-effects model was used to conduct a Meta-analysis with RevMan 5.3.5 software. Results Five documents were identified according to the inclusion criteria. Meta- analysis results showed that ω- 3 fatty acid significantly reduced the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) on the third day of the operation in patients undergoing hepatectomy: mean difference ( MD ) = -74.89 and-60.87, 95% CI-110.02?39.76 and-96.05?-25.68, P＜0.01; ω-3 fatty acid significantly increased the level of prealbumin (Pre-Alb) on the third day of the operation: MD＝9.61, 95% CI 4.22?15.00, P＜0.01; but ω-3 fatty acid did not improve the levels of total bilirubin (TBil) and albumin (Alb) on the third day of the operation: MD=-1.13 and 1.16, 95% CI-2.48?0.21 and-0.35?2.68, P＞0.05. Conclusions The ω-3 fatty acid is potentially beneficial in reducing the levels of ALT and AST, and increases the level of Pre-Alb on the third day of the operation in patients undergoing hepatectomy, but does not improve the levels of TBil and Alb.

Effects of Omega-3 Supplementation on Adipocytokines in Prediabetes and Type 2 Diabetes Mellitus: Systematic Review and Meta-Analysis of Randomized Controlled Trials

BACKGROUND: The objective of this systematic review and meta-analysis was to determine the effects of omega-3 supplementation on adipocytokine levels in adult prediabetic and diabetic individuals. METHODS: We searched PubMed, Medline, EMBASE, Scopus, Web of Science, Google Scholar, Cochrane Trial Register, World Health Organization Clinical Trial Registry Platform, and Clinicaltrial.gov Registry from inception to August 1, 2017 for randomized controlled trials. Pooled effects of interventions were assessed as mean difference using random effects model. We conducted a sensitivity, publication bias and subgroup analysis. RESULTS: Fourteen studies individuals (n = 685) were included in the meta-analysis. Omega-3 supplementation increased levels of adiponectin (0.48 µg/mL; 95% confidence interval [CI], 0.27 to 0.68; P < 0.00001, n = 10 trials), but effects disappeared after sensitivity analysis. Tumor necrosis factor α (TNF-α) levels were reduced (−1.71; 95% CI, −3.38 to −0.14; P = 0.03, n = 8 trials). Treatment duration shorter than 12 weeks was associated with greater reduction than longer treatment duration. Levels of other adipocytokines were not significantly affected. Publication bias could generally not be excluded. CONCLUSION: Eicosapentaenoic acid and docosahexaenoic acid supplementation may increase adiponectin and reduce TNF-α levels in this population group. However, due to overall study heterogeneity and potential publication bias, a cautious interpretation is needed.

ω-3 polyunsaturated fatty acids inhibits RHO-ROCK1 signaling pathway in SGC7901 gastric cancer cells / 中国医师杂志

Objective This study was aimed to investigate the effects of ω-3 polyunstaurated fatty acids (ω-3 PUFAs) on the growth of gastric cancer cells in nude mice,and to find whether the Ros homolog gene Rho-associated coiled-coil containing protein kinase 1 (RHO-ROCK1) signaling pathway is involved.Methods 16 BALB/C nude mice were injected subcutaneously with SGC7901 gastric cancer cells to establish the tumor-bearing mouse model.The mice were randomized:control group (normal saline) and intervention group (ω-3 PUFAs).The mRNA expression of Ros homolog gene family,member A (RHOA),RHOC,and ROCK1 in tumor tissue were detected by quantitative polymerase chain reaction (qPCR).Immunofluorescence and Western blot were used to detect RHOA,RHOC,and ROCK1 protein expression.Results The volume and weight of the tumors in the ω-3 PUFAs group were slightly smaller than that in the control group (P ＞ 0.05).Compared to the control group,hematoxylin and eosin staining showed multifocal tumor necrosis in the ω-3 PUFAs group,while the tumors of the control group showed abundant blood supply.qPCR and Western blot showed that the mRNA and proteins expression of RHOA and ROCK1 in the ω-3 PUFAs group was significantly lower than those in the control group (P ＜ 0.05).The immunofluorescence redults also showed that the expression of these proteins in the ω-3 PUFAs group was slightly lower than that in the control group.Conclusions These results suggested that ω-3 PUFAs may affect the growth of gastric cancer in nude mice by affecting the expression of RHOA,RHOC and ROCK1,thus inhibiting the excessive proliferation of gastric cancer cells and leading to tumor necrosis.

Impacto do uso de dieta imunomoduladora e dieta enteral em adultos, durante a quimioterapia e radioterapia em pacientes com câncer de cabeça e pescoço: uma revisão da literatura / Diet use of immunomodulatory impact and enteral diet in adults during chemotherapy and radiotherapy in patients with head and neck cancer: a literature review

Objetivo: Analisar, a partir de evidências científicas, se o uso de imunonutrição é benéfico para pacientes com câncer de cabeça e pescoço. Método: Revisão de literatura, a partir da base de dados Academic Google, com a seguinte frase: Diet immunonutrition in head and neck cancer. A consulta à base de dados foi realizada durante o período janeiro a agosto de 2016. Os critérios de inclusão foram: últimos cinco anos, em seres humanos, artigos originais, inglês, português, espanhol; adultos e idosos entre 18 e 89 anos. Foram lidos na íntegra 17 artigos e selecionados para esta revisão 11 artigos. Dentre estes, 10 estudos tiveram consenso para o uso de imunonutrição de arginina e ácidos graxos ômega 3 em relação aos benefícios para pacientes com câncer de cabeça e pescoço, enquanto um não encontrou resultados significativos. Resultados: Observamos melhora no estado imunológico e inflamatório, a prevenção de mucosite, principalmente nos pacientes com tratamento de quimioterapia e radioterapia com uso de imunonutrição de arginina e ômega 3 no câncer de cabeça e pescoço. Conclusão: Evidencia-se a importância do acompanhamento nutricional, do início até o final do tratamento, em pacientes com câncer de cabeça e pescoço por desenvolver perda de peso importante com causas multifatoriais, aumentando o risco nutricional, morbidade e mortalidade.(AU)

Objective: To analyze, from scientific evidences, if the use of immunonutrition is beneficial for patients with head and neck cancer. Methods: A literature review from the Academic Google database, using the following phrase: Diet immunonutrition in head and neck cancer. The query the database was conducted during the period from January to August 2016. The criteria inclusion were the last five years, in humans, original articles, in English, Portuguese, Spanish and adults and the elderly of 18-89 years. They were read in full 17 articles and selected for this review, 11 articles. Among the findings, 10 of the 11 studies had consensus for the use of immunonutrition arginine and ômega 3 fatty acids in relation to the benefits for patients with head and neck cancer, while one did not find significant results. Results: We observed an improvement in the imune and inflammatory state, prevention of mucositis in patients primarily with chemotherapy and radiation therapy with the use of immunonutrition, arginine and ômega 3 in head and neck cancer. Conclusion: Therefore, highlights the importance of nutritional monitoring from the beginning to the end of treatment in patients with head and neck cancer by developing important weight loss; the causes are multifactorial increasing nutritional risk, morbidity and mortality.(AU)

Insufficient intake of alpha-linolenic fatty acid (18:3n-3) during pregnancy: and associated factors / Ingestão insuficiente de ácido graxo alfa-linolênico (18:3n-3) durante a gestação: e fatores associados

ABSTRACT Objective: To analyze alpha-linolenic fatty acid intake in two cohorts of pregnant women, and to identify factors associated with alpha-linolenic acid intake. Methods: This is a cohort study involving pregnant women with low obstetric risk (N=353) in public health system from a municipality of São Paulo state, Brazil. In each trimester, two 24-hour food recalls were collected. Descriptive analyses of dietary lipid profiles were performed, followed by a multiple comparison test. According to the trimester of pregnancy, differences were assessed using the mean difference test. To evaluate the adequacy of linoleic fatty acid and alpha-linolenic acid intake, the adequate intake test was used. The association between alpha-linolenic acid intake adequacy and maternal characteristics was investigated using a binary logistic regression model. Results: Total lipids intake and the percentage contribution to dietary energy met recommended levels. One-third of the diets demonstrated a lower than daily recommended intake of alpha-linolenic acid. Overweight pregnant women were twice as likely to have inadequate alpha-linolenic acid intake. Pregnant women from a more disadvantaged socioeconomic situation had greater risks of inadequate intake. Conclusion: Over-intake of lipids is not problematic, but quality is an issue, with one third of the pregnant women and their fetuses exposed to adverse effects due to low intake of omega-3 fatty acids, indicating important nutritional vulnerability in this population.

RESUMO Objetivo: Analisar a ingestão ácidos graxos alfa-linolênico e identificar fatores associados à ingestão inadequada em duas coortes de gestantes acompanhadas trimestralmente. Métodos: Estudo de coorte com gestantes de baixo risco obstétrico (N=353) representativas das usuárias da rede pública de saúde de um município paulista. Nos três trimestres gestacionais foram coletados dois recordatórios alimentares de 24 horas. Análises descritivas do perfil lipídico da dieta foram processadas seguidas do teste de comparações múltiplas. As diferenças, segundo trimestre gestacional, foram avaliadas pelo teste de diferença de médias. Para avaliação da adequação do consumo foi utilizada a ingestão recomendável. A associação entre a adequação da ingestão de ácido alfa-linolênico e características maternas foi investigada por meio de modelo de regressão logística binária. Resultados: A contribuição percentual de lipídeos totais mostrou-se adequada;1/3 das gestantes não alcançou a recomendação de ingestão diária de ácido alfa-linolênico. Gestantes com excesso de peso apresentam o dobro de chances de consumo inadequado de ácido alfa-linolênico. Comparadas às gestantes das classes D/E, as pertencentes a classe C têm menores chances de consumo inadequado. Conclusão: Não há um problema de excesso de consumo de lipídeos e sim da qualidade destes, cerca de 1/3 das gestantes acompanhadas e seus conceptos estão expostos aos efeitos adversos do baixo consumo de ácidos graxos de cadeia ômega-3 na gestação, indicando importante vulnerabilidade nutricional nessa população.

Efeito da ingestão de ômega-3 sobre a ansiedade em estudantes universitários / The effect of ingest of omega-3 on anxiety in university students

Introdução: A ansiedade pode ser observada por meio de alterações psicológicas, podendo ocorrer manifestações de medo e do sentimento de insegurança. Os estudantes universitários correspondem a um grupo de risco para o desenvolvimento da ansiedade, pois o mercado de trabalho atual exige um profissional que, além da capacidade técnica da área em que estuda, também tenha habilidade cognitiva, técnica especializada e comportamental. O estudo teve como objetivo analisar o efeito da ingestão de ômega-3 sobre a ocorrência e intensidade da sensação subjetiva de ansiedade em estudantes da Universidade Potiguar. Método: Participaram do estudo 20 estudantes do curso de Nutrição, dos gêneros masculino e feminino, com idade média de 25±3 anos. Os participantes foram distribuídos aleatoriamente entre o grupo experimental e controle. Os alunos do grupo experimental receberam 1000 mg de ômega-3 na forma de cápsula em dose única. A ansiedade foi induzida pelo Teste de Simulação de Falar em Público. Para mensurar a ocorrência e intensidade da sensação de ansiedade foi utilizado o Inventário de Ansiedade Traço ­ Estado (IDATE-T e E). Para a análise estatística foi utilizado o software IBM SPSS® v. 22.0 para Microsoft Windows®. Resultados: No momento da indução da ansiedade, os estudantes do grupo experimental apresentaram média no escore do IDATE-E de 60,1±3,4 pontos. Os escores do IDATE-E mantiveram-se entre as categorias de média e alta ansiedade no decorrer do experimento, sugerindo que a quantidade do ácido graxo ofertada não provocou efeito ansiolítico. Conclusões: O ômega-3 não representa um tratamento alternativo para a ansiedade.(AU)

Introduction: The anxiety can be observed through of psychological changes, may occur manifestations of fear and sense of insecurity. The university students represent a risk group for the development of anxiety because the current labor market requires a professional who, in addition to the technical capacity of the area that studies, also have cognitive, specialized, and behavioral abilities. The study aimed to analyze the effect of omega-3 intake on the occurrence and intensity of the subjective feeling of anxiety in students at the Universidade Potiguar. Methods: The study included 20 undergraduate students of nutrition male and female, mean age of 25±3 years old. Participants were distributed randomly between the experimental and control groups, whose experimental group received 1000 mg of ômega-3 in capsule form as a single dose. Anxiety was induced speaking simulation test in public. For measuring the occurrence and intensity of sensation of anxiety was used Inventário de Ansiedade Traço ­ Estado (IDATE-T e E). For the statistical analysis software IBM SPSS® v.22.0 for Microsoft Windows® was used. Results: In the results, it was possible to observe na increase in the IDATE-E score once the numbers were maintained above the anxiety group during the test (average=60.1±3.4 points), suggesting that the fatty acid did not have an anxiolytics effect on the psychological parameter that alters anxiety. Conclusions: Thus, the supplied amount of omega-3 showed no effect in the treatment of anxiety.(AU)