Skip to main content

Advertisement

SpringerLink
Log in

Role of omega-3 fatty acids in obesity, metabolic syndrome, and cardiovascular diseases: a review of the evidence

  • Mini Review
  • Published:
Journal of Physiology and Biochemistry Aims and scope Submit manuscript

Abstract

The present review aims to illustrate current knowledge about the efficacy of omega-3 long-chain polyunsaturated fatty acids (n−3 LC-PUFAs) in treating/preventing several metabolic pathologies. We reviewed systematically the published evidence on the effectiveness of n−3 LC-PUFAs fish consumption or n−3 LC-PUFAs supplementation on prevention/treatment of obesity, metabolic syndrome, and cardiovascular diseases. Most of the reviewed studies were randomized-controlled interventional trials, although some relevant prospective and cross-sectional studies as well as some meta-analysis were also reviewed. Supplementation with n−3 LC-PUFAs might improve some obesity-associated metabolic syndrome features such as insulin resistance, hypertension and dyslipidemia by decreasing plasma triglycerides. Moreover, the blood pressure-lowering and anti-inflammatory properties of these fatty acids and their benefits in vascular function might confer cardioprotection. However, the efficacy of n−3 LC-PUFA on reducing myocardial infarction, arrhythmia, cardiac and sudden death, or stroke is controversial. Due to the beneficial actions of n−3 LC-PUFAs, several worldwide government and health organizations have established some recommendations of n−3 LC-PUFAs intake for groups of population. In general, the recommended levels for diseases prevention are lower than those advised for particular treatments. However, more clinical trials are necessary to recommend the most effective dosages and formulas (type of n−3 LC-PUFA, EPA/DHA ratio) for specific pathologies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Abete I, Goyenechea E, Zulet MA, Martinez JA (2011) Obesity and metabolic syndrome: potential benefit from specific nutritional components. Nutr Metab Cardiovasc Dis 21(Suppl 2):B1–B15

    Article  PubMed  CAS  Google Scholar 

  2. Aranceta J, Perez-Rodrigo C (2012) Recommended dietary reference intakes, nutritional goals and dietary guidelines for fat and fatty acids: a systematic review. Br J Nutr 107(Suppl 2):S8–S22

    Article  PubMed  CAS  Google Scholar 

  3. Australia and New Zealand National Health and Medical Research Council (2006) Nutrient reference values of Australia and New Zealand including recommended dietary intakes

  4. Bang HO, Dyerberg J, Hjoorne N (1976) The composition of food consumed by Greenland Eskimos. Acta Med Scand 200:69–73

    Article  PubMed  CAS  Google Scholar 

  5. Bang HO, Dyerberg J, Sinclair HM (1980) The composition of the Eskimo food in north western Greenland. Am J Clin Nutr 33:2657–2661

    PubMed  CAS  Google Scholar 

  6. Bantle JP, Wylie-Rosett J, Albright AL, Apovian CM, Clark NG, Franz MJ, Hoogwerf BJ, Lichtenstein AH, Mayer-Davis E, Mooradian AD, Wheeler ML (2008) Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care 31(Suppl 1):S61–S78

    PubMed  CAS  Google Scholar 

  7. Baumann KH, Hessel F, Larass I, Muller T, Angerer P, Kiefl R, von Schacky C (1999) Dietary omega-3, omega-6, and omega-9 unsaturated fatty acids and growth factor and cytokine gene expression in unstimulated and stimulated monocytes. A randomized volunteer study. Arterioscler Thromb Vasc Biol 19:59–66

    Article  PubMed  CAS  Google Scholar 

  8. Burr ML, Ashfield-Watt PA, Dunstan FD, Fehily AM, Breay P, Ashton T, Zotos PC, Haboubi NA, Elwood PC (2003) Lack of benefit of dietary advice to men with angina: results of a controlled trial. Eur J Clin Nutr 57:193–200

    Article  PubMed  CAS  Google Scholar 

  9. Burr ML, Fehily AM, Gilbert JF, Rogers S, Holliday RM, Sweetnam PM, Elwood PC, Deadman NM (1989) Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet 2:757–761

    Article  PubMed  CAS  Google Scholar 

  10. Calder PC (2006) n−3 polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am J Clin Nutr 83:1505S–1519S

    PubMed  CAS  Google Scholar 

  11. Calder PC (2008) Polyunsaturated fatty acids, inflammatory processes and inflammatory bowel diseases. Mol Nutr Food Res 52:885–897

    Article  PubMed  CAS  Google Scholar 

  12. Calo L, Bianconi L, Colivicchi F, Lamberti F, Loricchio ML, de Ruvo E, Meo A, Pandozi C, Staibano M, Santini M (2005) n−3 Fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a randomized, controlled trial. J Am Coll Cardiol 45:1723–1728

    Article  PubMed  CAS  Google Scholar 

  13. Cao H, Wang X, Huang H, Ying SZ, Gu YW, Wang T, Huang CX (2012) Omega-3 fatty acids in the prevention of atrial fibrillation recurrences after cardioversion: a meta-analysis of randomized controlled trials. Intern Med 51:2503–2508

    Article  PubMed  CAS  Google Scholar 

  14. Chan DC, Watts GF, Nguyen MN, Barrett PH (2006) Factorial study of the effect of n−3 fatty acid supplementation and atorvastatin on the kinetics of HDL apolipoproteins A-I and A-II in men with abdominal obesity. Am J Clin Nutr 84:37–43

    PubMed  CAS  Google Scholar 

  15. Cheng JW, Santoni F (2008) Omega-3 fatty acid: a role in the management of cardiac arrhythmias? J Altern Complement Med 14:965–974

    Article  PubMed  Google Scholar 

  16. Claria J, Dalli J, Yacoubian S, Gao F, Serhan CN (2012) Resolvin D1 and resolvin D2 govern local inflammatory tone in obese fat. J Immunol 189:2597–2605

    Article  PubMed  CAS  Google Scholar 

  17. Cottin SC, Sanders TA, Hall WL (2011) The differential effects of EPA and DHA on cardiovascular risk factors. Proc Nutr Soc 70:215–231

    Article  PubMed  CAS  Google Scholar 

  18. Couet C, Delarue J, Ritz P, Antoine JM, Lamisse F (1997) Effect of dietary fish oil on body fat mass and basal fat oxidation in healthy adults. Int J Obes Relat Metab Disord 21:637–643

    Article  PubMed  CAS  Google Scholar 

  19. Council for Responsible Nutrition (2006) A voluntary monograph on long chain Omega-3 EPA and DHA. https://www.crnusa.org/. Access 27 Nov 2010

  20. Dallongeville J, Yarnell J, Ducimetiere P, Arveiler D, Ferrieres J, Montaye M, Luc G, Evans A, Bingham A, Hass B, Ruidavets JB, Amouyel P (2003) Fish consumption is associated with lower heart rates. Circulation 108:820–825

    Article  PubMed  Google Scholar 

  21. Das UN (2001) Is obesity an inflammatory condition? Nutrition 17:953–966

    Article  PubMed  CAS  Google Scholar 

  22. 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 29:1354–1367

    Article  PubMed  CAS  Google Scholar 

  23. De Backer G, Ambrosioni E, Borch-Johnsen K, Brotons C, Cifkova R, Dallongeville J, Ebrahim S, Faergeman O, Graham I, Mancia G, Manger Cats V, Orth-Gomer K, Perk J, Pyorala K, Rodicio JL, Sans S, Sansoy V, Sechtem U, Silber S, Thomsen T, Wood D (2003) European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J 24:1601–1610

    Article  PubMed  Google Scholar 

  24. De Caterina R (2011) n−3 fatty acids in cardiovascular disease. N Engl J Med 364:2439–2450

    Article  PubMed  Google Scholar 

  25. DeFina LF, Marcoux LG, Devers SM, Cleaver JP, Willis BL (2011) Effects of omega-3 supplementation in combination with diet and exercise on weight loss and body composition. Am J Clin Nutr 93:455–462

    Article  PubMed  CAS  Google Scholar 

  26. Delgado-Lista J, Perez-Martinez P, Lopez-Miranda J, Perez-Jimenez F (2012) Long chain omega-3 fatty acids and cardiovascular disease: a systematic review. Br J Nutr 107(Suppl 2):S201–S213

    Article  PubMed  CAS  Google Scholar 

  27. Dyerberg J, Bang HO (1979) Lipid metabolism, atherogenesis, and haemostasis in Eskimos: the role of the prostaglandin−3 family. Haemostasis 8:227–233

    PubMed  CAS  Google Scholar 

  28. Engler MM, Engler MB, Pierson DM, Molteni LB, Molteni A (2003) Effects of docosahexaenoic acid on vascular pathology and reactivity in hypertension. Exp Biol Med (Maywood) 228:299–307

    CAS  Google Scholar 

  29. Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G, D'Armiento M, D'Andrea F, Giugliano D (2004) Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 292:1440–1446

    Article  PubMed  CAS  Google Scholar 

  30. Feskens EJ, Bowles CH, Kromhout D (1991) Inverse association between fish intake and risk of glucose intolerance in normoglycemic elderly men and women. Diabetes Care 14:935–941

    Article  PubMed  CAS  Google Scholar 

  31. Fetterman JW Jr, Zdanowicz MM (2009) Therapeutic potential of n−3 polyunsaturated fatty acids in disease. Am J Health Syst Pharm 66:1169–1179

    Article  PubMed  CAS  Google Scholar 

  32. Flachs P, Horakova O, Brauner P, Rossmeisl M, Pecina P, Franssen-van Hal N, Ruzickova J, Sponarova J, Drahota Z, Vlcek C, Keijer J, Houstek J, Kopecky J (2005) Polyunsaturated fatty acids of marine origin upregulate mitochondrial biogenesis and induce beta-oxidation in white fat. Diabetologia 48:2365–2375

    Article  PubMed  CAS  Google Scholar 

  33. Food and Agriculture Organization of the United Nations Technical Report N (2003) Diet, nutrition, and the prevention of chronic diseases World Health Organization, Geneva, Switzerland

  34. Friedberg CE, Janssen MJ, Heine RJ, Grobbee DE (1998) Fish oil and glycemic control in diabetes. A meta-analysis. Diabetes Care 21:494–500

    Article  PubMed  CAS  Google Scholar 

  35. Geelen A, Brouwer IA, Schouten EG, Maan AC, Katan MB, Zock PL (2005) Effects of n−3 fatty acids from fish on premature ventricular complexes and heart rate in humans. Am J Clin Nutr 81:416–420

    PubMed  CAS  Google Scholar 

  36. Geleijnse JM, Giltay EJ, Grobbee DE, Donders AR, Kok FJ (2002) Blood pressure response to fish oil supplementation: metaregression analysis of randomized trials. J Hypertens 20:1493–1499

    Article  PubMed  CAS  Google Scholar 

  37. Gillies PJ, Bhatia SK, Belcher LA, Hannon DB, Thompson JT, Vanden Heuvel JP (2012) Regulation of inflammatory and lipid metabolism genes by eicosapentaenoic acid-rich oil. J Lipid Res 53:1679–1689

    Article  PubMed  CAS  Google Scholar 

  38. Gonzalez-Periz A, Horrillo R, Ferre N, Gronert K, Dong B, Moran-Salvador E, Titos E, Martinez-Clemente M, Lopez-Parra M, Arroyo V, Claria J (2009) Obesity-induced insulin resistance and hepatic steatosis are alleviated by omega-3 fatty acids: a role for resolvins and protectins. FASEB J 23:1946–1957

    Article  PubMed  CAS  Google Scholar 

  39. Goodfellow J, Bellamy MF, Ramsey MW, Jones CJ, Lewis MJ (2000) Dietary supplementation with marine omega-3 fatty acids improve systemic large artery endothelial function in subjects with hypercholesterolemia. J Am Coll Cardiol 35:265–270

    Article  PubMed  CAS  Google Scholar 

  40. Gorjao R, Azevedo-Martins AK, Rodrigues HG, Abdulkader F, Arcisio-Miranda M, Procopio J, Curi R (2009) Comparative effects of DHA and EPA on cell function. Pharmacol Ther 122:56–64

    Article  PubMed  CAS  Google Scholar 

  41. Goyens PL, Spilker ME, Zock PL, Katan MB, Mensink RP (2006) Conversion of alpha-linolenic acid in humans is influenced by the absolute amounts of alpha-linolenic acid and linoleic acid in the diet and not by their ratio. Am J Clin Nutr 84:44–53

    PubMed  CAS  Google Scholar 

  42. Griffin MD, Sanders TA, Davies IG, Morgan LM, Millward DJ, Lewis F, Slaughter S, Cooper JA, Miller GJ, Griffin BA (2006) Effects of altering the ratio of dietary n−6 to n−3 fatty acids on insulin sensitivity, lipoprotein size, and postprandial lipemia in men and postmenopausal women aged 45-70 y: the OPTILIP Study. Am J Clin Nutr 84:1290–1298

    PubMed  CAS  Google Scholar 

  43. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico (1999) Dietary supplementation with n−3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 354:447–455

    Article  Google Scholar 

  44. Guo W, Xie W, Lei T, Hamilton JA (2005) Eicosapentaenoic acid, but not oleic acid, stimulates beta-oxidation in adipocytes. Lipids 40:815–821

    Article  PubMed  CAS  Google Scholar 

  45. Halvorsen BL, Blomhoff R (2011) Determination of lipid oxidation products in vegetable oils and marine omega-3 supplements. Food Nutr Res 55. doi:10.3402/fnr.v3455i3400.5792. Epub 2011 Jun 3410

  46. Harris WS (1997) n−3 fatty acids and serum lipoproteins: human studies. Am J Clin Nutr 65:1645S–1654S

    PubMed  CAS  Google Scholar 

  47. Hartweg J, Farmer AJ, Perera R, Holman RR, Neil HA (2007) Meta-analysis of the effects of n−3 polyunsaturated fatty acids on lipoproteins and other emerging lipid cardiovascular risk markers in patients with type 2 diabetes. Diabetologia 50:1593–1602

    Article  PubMed  CAS  Google Scholar 

  48. Hartweg J, Perera R, Montori V, Dinneen S, Neil HA, Farmer A (2008) Omega-3 polyunsaturated fatty acids (PUFA) for type 2 diabetes mellitus. Cochrane Database Syst Rev:CD003205

  49. He K, Rimm EB, Merchant A, Rosner BA, Stampfer MJ, Willett WC, Ascherio A (2002) Fish consumption and risk of stroke in men. JAMA 288:3130–3136

    Article  PubMed  CAS  Google Scholar 

  50. Hill AM, Buckley JD, Murphy KJ, Howe PR (2007) Combining fish-oil supplements with regular aerobic exercise improves body composition and cardiovascular disease risk factors. Am J Clin Nutr 85:1267–1274

    PubMed  CAS  Google Scholar 

  51. Howell G 3rd, Deng X, Yellaturu C, Park EA, Wilcox HG, Raghow R, Elam MB (2009) n−3 polyunsaturated fatty acids suppress insulin-induced SREBP-1c transcription via reduced trans-activating capacity of LXRalpha. Biochim Biophys Acta 1791:1190–1196

    Article  PubMed  CAS  Google Scholar 

  52. International Society for the Study of Fatty Acids and Lipids (2004) Recommendations for intake of polyunsaturated fatty acids in healthy adults

  53. Iso H, Rexrode KM, Stampfer MJ, Manson JE, Colditz GA, Speizer FE, Hennekens CH, Willett WC (2001) Intake of fish and omega-3 fatty acids and risk of stroke in women. JAMA 285:304–312

    Article  PubMed  CAS  Google Scholar 

  54. Jacobson TA (2008) Role of n−3 fatty acids in the treatment of hypertriglyceridemia and cardiovascular disease. Am J Clin Nutr 87:1981S–1990S

    PubMed  CAS  Google Scholar 

  55. Kabir M, Skurnik G, Naour N, Pechtner V, Meugnier E, Rome S, Quignard-Boulange A, Vidal H, Slama G, Clement K, Guerre-Millo M, Rizkalla SW (2007) Treatment for 2 mo with n 3 polyunsaturated fatty acids reduces adiposity and some atherogenic factors but does not improve insulin sensitivity in women with type 2 diabetes: a randomized controlled study. Am J Clin Nutr 86:1670–1679

    PubMed  CAS  Google Scholar 

  56. Kahn R (2008) Metabolic syndrome—what is the clinical usefulness? Lancet 371:1892–1893

    Article  PubMed  Google Scholar 

  57. Kelley DS, Siegel D, Vemuri M, Mackey BE (2007) Docosahexaenoic acid supplementation improves fasting and postprandial lipid profiles in hypertriglyceridemic men. Am J Clin Nutr 86:324–333

    PubMed  CAS  Google Scholar 

  58. Khawaja O, Gaziano JM, Djousse L (2012) A meta-analysis of omega-3 fatty acids and incidence of atrial fibrillation. J Am Coll Nutr 31:4–13

    Article  PubMed  CAS  Google Scholar 

  59. Kim HK, Della-Fera M, Lin J, Baile CA (2006) Docosahexaenoic acid inhibits adipocyte differentiation and induces apoptosis in 3T3-L1 preadipocytes. J Nutr 136:2965–2969

    PubMed  CAS  Google Scholar 

  60. Knapp HR (1997) Dietary fatty acids in human thrombosis and hemostasis. Am J Clin Nutr 65:1687S–1698S

    PubMed  CAS  Google Scholar 

  61. Konig A, Bouzan C, Cohen JT, Connor WE, Kris-Etherton PM, Gray GM, Lawrence RS, Savitz DA, Teutsch SM (2005) A quantitative analysis of fish consumption and coronary heart disease mortality. Am J Prev Med 29:335–346

    Article  PubMed  Google Scholar 

  62. Krebs JD, Browning LM, McLean NK, Rothwell JL, Mishra GD, Moore CS, Jebb SA (2006) Additive benefits of long-chain n−3 polyunsaturated fatty acids and weight-loss in the management of cardiovascular disease risk in overweight hyperinsulinaemic women. Int J Obes (Lond) 30:1535–1544

    Article  CAS  Google Scholar 

  63. Kris-Etherton PM, Harris WS, Appel LJ (2002) Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation 106:2747–2757

    Article  PubMed  Google Scholar 

  64. Kris-Etherton PM, Innis S (2007) Position of the American Dietetic Association and Dietitians of Canada: dietary fatty acids. J Am Diet Assoc 107:1599–1611

    Article  PubMed  CAS  Google Scholar 

  65. Kromhout D, Giltay EJ, Geleijnse JM (2010) n−3 fatty acids and cardiovascular events after myocardial infarction. N Engl J Med 363:2015–2026

    Article  PubMed  CAS  Google Scholar 

  66. Kunesova M, Braunerova R, Hlavaty P, Tvrzicka E, Stankova B, Skrha J, Hilgertova J, Hill M, Kopecky J, Wagenknecht M, Hainer V, Matoulek M, Parizkova J, Zak A, Svacina S (2006) The influence of n−3 polyunsaturated fatty acids and very low calorie diet during a short-term weight reducing regimen on weight loss and serum fatty acid composition in severely obese women. Physiol Res 55:63–72

    PubMed  CAS  Google Scholar 

  67. Leaf A, Albert CM, Josephson M, Steinhaus D, Kluger J, Kang JX, Cox B, Zhang H, Schoenfeld D (2005) Prevention of fatal arrhythmias in high-risk subjects by fish oil n−3 fatty acid intake. Circulation 112:2762–2768

    Article  PubMed  CAS  Google Scholar 

  68. Lee TH, Hoover RL, Williams JD, Sperling RI, Ravalese J 3rd, Spur BW, Robinson DR, Corey EJ, Lewis RA, Austen KF (1985) Effect of dietary enrichment with eicosapentaenoic and docosahexaenoic acids on in vitro neutrophil and monocyte leukotriene generation and neutrophil function. N Engl J Med 312:1217–1224

    Article  PubMed  CAS  Google Scholar 

  69. Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S, Franch HA, Franklin B, Kris-Etherton P, Harris WS, Howard B, Karanja N, Lefevre M, Rudel L, Sacks F, Van Horn L, Winston M, Wylie-Rosett J (2006) Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation 114:82–96

    Article  PubMed  Google Scholar 

  70. Lopez-Alvarenga JC, Ebbesson SO, Ebbesson LO, Tejero ME, Voruganti VS, Comuzzie AG (2010) Polyunsaturated fatty acids effect on serum triglycerides concentration in the presence of metabolic syndrome components. The Alaska-Siberia Project. Metabolism 59:86–92

    Article  PubMed  CAS  Google Scholar 

  71. Lorente-Cebrian S, Bustos M, Marti A, Martinez JA, Moreno-Aliaga MJ (2009) Eicosapentaenoic acid stimulates AMP-activated protein kinase and increases visfatin secretion in cultured murine adipocytes. Clin Sci (Lond) 117:243–249

    Article  CAS  Google Scholar 

  72. Lorente-Cebrian S, Bustos M, Marti A, Martinez JA, Moreno-Aliaga MJ (2010) Eicosapentaenoic acid up-regulates apelin secretion and gene expression in 3T3-L1 adipocytes. Mol Nutr Food Res 54(Suppl 1):S104–S111

    Article  PubMed  CAS  Google Scholar 

  73. Lorente-Cebrián S, Pérez-Matute P, Martínez JA, Marti A, Moreno-Aliaga MJ (2006) Effects of eicosapentaenoic acid (EPA) on adiponectin gene expression and secretion in primary cultured rat adipocytes. J Physiol Biochem 62:61–69

    Article  PubMed  Google Scholar 

  74. Lovegrove JA, Lovegrove SS, Lesauvage SV, Brady LM, Saini N, Minihane AM, Williams CM (2004) Moderate fish-oil supplementation reverses low-platelet, long-chain n−3 polyunsaturated fatty acid status and reduces plasma triacylglycerol concentrations in British Indo-Asians. Am J Clin Nutr 79:974–982

    PubMed  CAS  Google Scholar 

  75. Madden J, Williams CM, Calder PC, Lietz G, Miles EA, Cordell H, Mathers JC, Minihane AM (2011) The impact of common gene variants on the response of biomarkers of cardiovascular disease (CVD) risk to increased fish oil fatty acids intakes. Annu Rev Nutr 31:203–234

    Article  PubMed  CAS  Google Scholar 

  76. Mahaffey KR, Sunderland EM, Chan HM, Choi AL, Grandjean P, Marien K, Oken E, Sakamoto M, Schoeny R, Weihe P, Yan CH, Yasutake A (2011) Balancing the benefits of n−3 polyunsaturated fatty acids and the risks of methylmercury exposure from fish consumption. Nutr Rev 69:493–508

    Article  PubMed  Google Scholar 

  77. Martin A (ed) (2001) Apports nutritionnels conseilles pour la population Francaise, 3rd edn. Tech. & Doc Lavoisier, France

    Google Scholar 

  78. Micallef MA, Garg ML (2008) The lipid-lowering effects of phytosterols and (n−3) polyunsaturated fatty acids are synergistic and complementary in hyperlipidemic men and women. J Nutr 138:1086–1090

    PubMed  CAS  Google Scholar 

  79. Micallef M, Munro I, Phang M, Garg M (2009) Plasma n−3 polyunsaturated fatty acids are negatively associated with obesity. Br J Nutr 102:1370–1374

    Article  PubMed  CAS  Google Scholar 

  80. Moreno-Aliaga MJ, Lorente-Cebrian S, Martinez JA (2010) Regulation of adipokine secretion by n−3 fatty acids. Proc Nutr Soc 69:324–332

    Article  PubMed  CAS  Google Scholar 

  81. Mori TA, Bao DQ, Burke V, Puddey IB, Watts GF, Beilin LJ (1999) Dietary fish as a major component of a weight-loss diet: effect on serum lipids, glucose, and insulin metabolism in overweight hypertensive subjects. Am J Clin Nutr 70:817–825

    PubMed  CAS  Google Scholar 

  82. Mori TA, Burke V, Puddey IB, Watts GF, O'Neal DN, Best JD, Beilin LJ (2000) Purified eicosapentaenoic and docosahexaenoic acids have differential effects on serum lipids and lipoproteins, LDL particle size, glucose, and insulin in mildly hyperlipidemic men. Am J Clin Nutr 71:1085–1094

    PubMed  CAS  Google Scholar 

  83. Mori TA, Watts GF, Burke V, Hilme E, Puddey IB, Beilin LJ (2000) Differential effects of eicosapentaenoic acid and docosahexaenoic acid on vascular reactivity of the forearm microcirculation in hyperlipidemic, overweight men. Circulation 102:1264–1269

    Article  PubMed  CAS  Google Scholar 

  84. Mori TA, Woodman RJ (2006) The independent effects of eicosapentaenoic acid and docosahexaenoic acid on cardiovascular risk factors in humans. Curr Opin Clin Nutr Metab Care 9:95–104

    Article  PubMed  CAS  Google Scholar 

  85. Mozaffarian D (2009) Fish, mercury, selenium and cardiovascular risk: current evidence and unanswered questions. Int J Environ Res Public Health 6:1894–1916

    Article  PubMed  CAS  Google Scholar 

  86. Mozaffarian D, Psaty BM, Rimm EB, Lemaitre RN, Burke GL, Lyles MF, Lefkowitz D, Siscovick DS (2004) Fish intake and risk of incident atrial fibrillation. Circulation 110:368–373

    Article  PubMed  Google Scholar 

  87. Munro IA, Garg ML (2012) Dietary supplementation with n−3 PUFA does not promote weight loss when combined with a very-low-energy diet. Br J Nutr:1–9

  88. Navas-Carretero S, Perez-Granados AM, Schoppen S, Vaquero MP (2009) An oily fish diet increases insulin sensitivity compared to a red meat diet in young iron-deficient women. Br J Nutr 102:546–553

    Article  PubMed  CAS  Google Scholar 

  89. Nestel P, Shige H, Pomeroy S, Cehun M, Abbey M, Raederstorff D (2002) The n−3 fatty acids eicosapentaenoic acid and docosahexaenoic acid increase systemic arterial compliance in humans. Am J Clin Nutr 76:326–330

    PubMed  CAS  Google Scholar 

  90. Oliver E, McGillicuddy FC, Harford KA, Reynolds CM, Phillips CM, Ferguson JF, Roche HM (2012) Docosahexaenoic acid attenuates macrophage-induced inflammation and improves insulin sensitivity in adipocytes-specific differential effects between LC n−3 PUFA. J Nutr Biochem 23:1192–1200

    Article  PubMed  CAS  Google Scholar 

  91. Oster RT, Tishinsky JM, Yuan Z, Robinson LE (2010) Docosahexaenoic acid increases cellular adiponectin mRNA and secreted adiponectin protein, as well as PPARgamma mRNA, in 3T3-L1 adipocytes. Appl Physiol Nutr Metab 35:783–789

    Article  PubMed  CAS  Google Scholar 

  92. Oterhals A, Kvamme B, Berntssen MH (2010) Modeling of a short-path distillation process to remove persistent organic pollutants in fish oil based on process parameters and quantitative structure properties relationships. Chemosphere 80:83–92

    Article  PubMed  CAS  Google Scholar 

  93. Parra D, Ramel A, Bandarra N, Kiely M, Martinez JA, Thorsdottir I (2008) A diet rich in long chain omega-3 fatty acids modulates satiety in overweight and obese volunteers during weight loss. Appetite 51:676–680

    Article  PubMed  CAS  Google Scholar 

  94. Perez-Echarri N, Perez-Matute P, Marcos-Gomez B, Baena MJ, Marti A, Martinez JA, Moreno-Aliaga MJ (2008) Differential inflammatory status in rats susceptible or resistant to diet-induced obesity: effects of EPA ethyl ester treatment. Eur J Nutr 47:380–386

    Article  PubMed  CAS  Google Scholar 

  95. Perez-Echarri N, Perez-Matute P, Marcos-Gomez B, Marti A, Martinez JA, Moreno-Aliaga MJ (2009) Down-regulation in muscle and liver lipogenic genes: EPA ethyl ester treatment in lean and overweight (high-fat-fed) rats. J Nutr Biochem 20:705–714

    Article  PubMed  CAS  Google Scholar 

  96. Perez-Echarri N, Perez-Matute P, Marcos-Gomez B, Martinez JA, Moreno-Aliaga MJ (2009) Effects of eicosapentaenoic acid ethyl ester on visfatin and apelin in lean and overweight (cafeteria diet-fed) rats. Br J Nutr 101:1059–1067

    Article  PubMed  CAS  Google Scholar 

  97. Popp-Snijders C, Schouten JA, Heine RJ, van der Meer J, van der Veen EA (1987) Dietary supplementation of omega-3 polyunsaturated fatty acids improves insulin sensitivity in non-insulin-dependent diabetes. Diabetes Res 4:141–147

    PubMed  CAS  Google Scholar 

  98. Priori SG, Aliot E, Blomstrom-Lundqvist C, Bossaert L, Breithardt G, Brugada P, Camm JA, Cappato R, Cobbe SM, Di Mario C, Maron BJ, McKenna WJ, Pedersen AK, Ravens U, Schwartz PJ, Trusz-Gluza M, Vardas P, Wellens HJ, Zipes DP (2003) Update of the guidelines on sudden cardiac death of the European Society of Cardiology. Eur Heart J 24:13–15

    Article  PubMed  Google Scholar 

  99. Ramel A, Martinez A, Kiely M, Morais G, Bandarra NM, Thorsdottir I (2008) Beneficial effects of long-chain n−3 fatty acids included in an energy-restricted diet on insulin resistance in overweight and obese European young adults. Diabetologia 51:1261–1268

    Article  PubMed  CAS  Google Scholar 

  100. Ratnayake WM, Galli C (2009) Fat and fatty acid terminology, methods of analysis and fat digestion and metabolism: a background review paper. Ann Nutr Metab 55:8–43

    Article  PubMed  CAS  Google Scholar 

  101. Rius B, Lopez-Vicario C, Gonzalez-Periz A, Moran-Salvador E, Garcia-Alonso V, Claria J, Titos E (2012) Resolution of inflammation in obesity-induced liver disease. Front Immunol 3:257

    Article  PubMed  Google Scholar 

  102. Rivellese AA, Maffettone A, Iovine C, Di Marino L, Annuzzi G, Mancini M, Riccardi G (1996) Long-term effects of fish oil on insulin resistance and plasma lipoproteins in NIDDM patients with hypertriglyceridemia. Diabetes Care 19:1207–1213

    Article  PubMed  CAS  Google Scholar 

  103. Rizos EC, Ntzani EE, Bika E, Kostapanos MS, Elisaf MS (2012) Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: a systematic review and meta-analysis. JAMA 308:1024–1033

    Article  PubMed  CAS  Google Scholar 

  104. Russo GL (2009) Dietary n−6 and n−3 polyunsaturated fatty acids: from biochemistry to clinical implications in cardiovascular prevention. Biochem Pharmacol 77:937–946

    Article  PubMed  CAS  Google Scholar 

  105. Saldeen P, Saldeen T (2006) Omega-3 Fatty acids: structure, function, and relation to the metabolic syndrome, infertility, and pregnancy. Metab Syndr Relat Disord 4:138–148

    Article  PubMed  CAS  Google Scholar 

  106. Sanders TA, Lewis F, Slaughter S, Griffin BA, Griffin M, Davies I, Millward DJ, Cooper JA, Miller GJ (2006) Effect of varying the ratio of n−6 to n−3 fatty acids by increasing the dietary intake of alpha-linolenic acid, eicosapentaenoic and docosahexaenoic acid, or both on fibrinogen and clotting factors VII and XII in persons aged 45-70 y: the OPTILIP study. Am J Clin Nutr 84:513–522

    PubMed  CAS  Google Scholar 

  107. Saravanan P, Davidson NC (2010) The role of omega-3 fatty acids in primary prevention of coronary artery disease and in atrial fibrillation is controversial. J Am Coll Cardiol 55:410–411, author reply 411–412

    Article  PubMed  Google Scholar 

  108. Schmitz G, Ecker J (2008) The opposing effects of n−3 and n−6 fatty acids. Prog Lipid Res 47:147–155

    Article  PubMed  CAS  Google Scholar 

  109. Scientific Opinion on the substantiation of health claims related to EPA, DHA, DPA and maintenance of normal blood pressure (ID 502), maintenance of normal HDL-cholesterol concentrations (ID 515), maintenance of normal (fasting) blood concentrations of triglycerides (ID 517), maintenance of normal LDL-cholesterol concentrations (ID 528, 698) and maintenance of joints (ID 503, 505, 507, 511, 518, 524, 526, 535, 537) pursuant to Article 13(1) of Regulation (EC) No 1924/2006 (2009). European Food Safety Authority 7:1263

  110. Serhan CN, Arita M, Hong S, Gotlinger K (2004) Resolvins, docosatrienes, and neuroprotectins, novel omega-3-derived mediators, and their endogenous aspirin-triggered epimers. Lipids 39:1125–1132

    Article  PubMed  CAS  Google Scholar 

  111. Simopoulos AP (2008) The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Exp Biol Med (Maywood) 233:674–688

    Article  CAS  Google Scholar 

  112. Simopoulos AP (2009) Omega-6/omega-3 essential fatty acids: biological effects. World Rev Nutr Diet 99:1–16

    Article  PubMed  CAS  Google Scholar 

  113. Singh RB, Niaz MA, Sharma JP, Kumar R, Rastogi V, Moshiri M (1997) Randomized, double-blind, placebo-controlled trial of fish oil and mustard oil in patients with suspected acute myocardial infarction: the Indian experiment of infarct survival—4. Cardiovasc Drugs Ther 11:485–491

    Article  PubMed  CAS  Google Scholar 

  114. Stene LC, Joner G (2003) Use of cod liver oil during the first year of life is associated with lower risk of childhood-onset type 1 diabetes: a large, population-based, case-control study. Am J Clin Nutr 78:1128–1134

    PubMed  CAS  Google Scholar 

  115. Superior Health Council of Belgium (2004) Advisory report: recommendation and claims made on omega-3 fatty acids

  116. Surette ME, Stull D, Lindemann J (2008) The impact of a medical food containing gammalinolenic and eicosapentaenoic acids on asthma management and the quality of life of adult asthma patients. Curr Med Res Opin 24:559–567

    Article  PubMed  CAS  Google Scholar 

  117. Tagawa H, Shimokawa H, Tagawa T, Kuroiwa-Matsumoto M, Hirooka Y, Takeshita A (1999) Long-term treatment with eicosapentaenoic acid augments both nitric oxide-mediated and non-nitric oxide-mediated endothelium-dependent forearm vasodilatation in patients with coronary artery disease. J Cardiovasc Pharmacol 33:633–640

    Article  PubMed  CAS  Google Scholar 

  118. The Hague: Health Council of the Netherlands (2006) Health Council of the Netherlands, Guidelines to a healthy diet 2006

  119. Thies F, Garry JM, Yaqoob P, Rerkasem K, Williams J, Shearman CP, Gallagher PJ, Calder PC, Grimble RF (2003) Association of n−3 polyunsaturated fatty acids with stability of atherosclerotic plaques: a randomised controlled trial. Lancet 361:477–485

    Article  PubMed  CAS  Google Scholar 

  120. Thorsdottir I, Tomasson H, Gunnarsdottir I, Gisladottir E, Kiely M, Parra MD, Bandarra NM, Schaafsma G, Martinez JA (2007) Randomized trial of weight-loss-diets for young adults varying in fish and fish oil content. Int J Obes (Lond) 31:1560–1566

    Article  CAS  Google Scholar 

  121. Tishinsky JM, Ma DW, Robinson LE (2011) Eicosapentaenoic acid and rosiglitazone increase adiponectin in an additive and PPARgamma-dependent manner in human adipocytes. Obesity (Silver Spring) 19:262–268

    Article  CAS  Google Scholar 

  122. Todoric J, Loffler M, Huber J, Bilban M, Reimers M, Kadl A, Zeyda M, Waldhausl W, Stulnig TM (2006) Adipose tissue inflammation induced by high-fat diet in obese diabetic mice is prevented by n−3 polyunsaturated fatty acids. Diabetologia 49:2109–2119

    Article  PubMed  CAS  Google Scholar 

  123. Tsitouras PD, Gucciardo F, Salbe AD, Heward C, Harman SM (2008) High omega-3 fat intake improves insulin sensitivity and reduces CRP and IL6, but does not affect other endocrine axes in healthy older adults. Horm Metab Res 40:199–205

    Article  PubMed  CAS  Google Scholar 

  124. Ueshima H, Stamler J, Elliott P, Chan Q, Brown IJ, Carnethon MR, Daviglus ML, He K, Moag-Stahlberg A, Rodriguez BL, Steffen LM, Van Horn L, Yarnell J, Zhou B (2007) Food omega-3 fatty acid intake of individuals (total, linolenic acid, long-chain) and their blood pressure: INTERMAP study. Hypertension 50:313–319

    Article  PubMed  CAS  Google Scholar 

  125. United Kingdom Scientific Advisory Committee on Nutritions (2004) Advice on fish consumption: benefits and risk

  126. Vasickova L, Stavek P, Suchanek P (2011) Possible effect of DHA intake on body weight reduction and lipid metabolism in obese children. Neuro Endocrinol Lett 32(Suppl 2):64–67

    PubMed  CAS  Google Scholar 

  127. Wang C, Harris WS, Chung M, Lichtenstein AH, Balk EM, Kupelnick B, Jordan HS, Lau J (2006) n−3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. Am J Clin Nutr 84:5–17

    PubMed  CAS  Google Scholar 

  128. Wang S, Ma AQ, Song SW, Quan QH, Zhao XF, Zheng XH (2008) Fish oil supplementation improves large arterial elasticity in overweight hypertensive patients. Eur J Clin Nutr 62:1426–1431

    Article  PubMed  CAS  Google Scholar 

  129. Warner JG Jr, Ullrich IH, Albrink MJ, Yeater RA (1989) Combined effects of aerobic exercise and omega-3 fatty acids in hyperlipidemic persons. Med Sci Sports Exerc 21:498–505

    PubMed  Google Scholar 

  130. Weber HS, Selimi D, Huber G (2006) Prevention of cardiovascular diseases and highly concentrated n−3 polyunsaturated fatty acids (PUFAs). Herz 31(Suppl 3):24–30

    PubMed  Google Scholar 

  131. Woodman RJ, Mori TA, Burke V, Puddey IB, Watts GF, Beilin LJ (2002) Effects of purified eicosapentaenoic and docosahexaenoic acids on glycemic control, blood pressure, and serum lipids in type 2 diabetic patients with treated hypertension. Am J Clin Nutr 76:1007–1015

    PubMed  CAS  Google Scholar 

  132. 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 (2007) Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 369:1090–1098

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We gratefully acknowledge partial financial support from the Minister of Science and Innovation of the Government of Spain (AGL2009-10873/ALI), Línea Especial of the University of Navarra “Nutrición, Obesidad y Salud” (LE/97) and the SEAFOODplus project (FOOD-CT-2004-506359).

Conflict of interest

The authors disclose no relevant conflict of interest. Actually, the authors have no financial benefits in the sale of any fish oil or omega-3 containing products. The authors are, however, grateful to the companies (Solutex and Brudy) that have freely and generously provided unrestricted samples of EPA/DHA during the last few years for performing the experimental research of the authors, and declare that the writing of this review was initially promoted by Rovi Laboratories. The views expressed are entirely those of the authors who established the format and content of the review and were entirely free to express whatsoever views they thought appropriate.

Statement of authorship

All authors have made substantial contributions to the writing and/or review of the manuscript. All authors have approved the final manuscript.

Author information

Authors and Affiliations

  1. Department of Nutrition, Food Science and Physiology, University of Navarra, 31008, Pamplona, Spain

    Silvia Lorente-Cebrián, André G. V. Costa, Santiago Navas-Carretero, María Zabala, J. Alfredo Martínez & María J. Moreno-Aliaga

  2. Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa, MG, Brazil

    André G. V. Costa

  3. CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain

    Santiago Navas-Carretero, J. Alfredo Martínez & María J. Moreno-Aliaga

Authors
  1. Silvia Lorente-Cebrián
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. André G. V. Costa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Santiago Navas-Carretero
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. María Zabala
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Alfredo Martínez
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. María J. Moreno-Aliaga
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to María J. Moreno-Aliaga.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lorente-Cebrián, S., Costa, A.G.V., Navas-Carretero, S. et al. Role of omega-3 fatty acids in obesity, metabolic syndrome, and cardiovascular diseases: a review of the evidence. J Physiol Biochem 69, 633–651 (2013). https://doi.org/10.1007/s13105-013-0265-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13105-013-0265-4

Keywords

Search

Navigation