Skip to main content

Advertisement

SpringerLink
Log in

Docosahexaenoic acid supplementation in vegetarians effectively increases omega-3 index: A randomized trial

  • Articles
  • Published:
Lipids

Abstract

Low red blood cell (RBC) membrane content of FPA+DHA (hereafter called omega-3 index) has recently been described as an indicator for increased risk of death from coronary heart disease. The relationship between plasma and RBC FA, focusing on omega-3 index, and the response to DHA supplementation were investigated in a double-blind, randomized, placebo-controlled, intervention study. Healthy vegetarians (87 f, 17 m) consumed daily a microalgae oil from Ulkenia sp. (0.94 g DHA/d) or olive oil (placebo) for 8 wk. DHA supplementation significantly increased DHA in RBC total lipids (7.9 vs. 4.4 wt%), in RBC PE (12.1 vs. 6.5 wt%), in RBC PC (3.8 vs. 1.4 wt%), and in plasma phospholipids (PL) (7.4 vs. 2.8 wt%), whereas EPA levels rose to a much lesser extent. Microalgae oil supplementation increased the omega-3 index from 4.8 to 8.4 wt%. After intervention, 69% of DHA-supplemented subjects (but no subject of the placebo group) reached an omega-3 index above the desirable value of 8 wt%. Omega-3 index and EPA+DHA levels in RBC PE, RBC PC, and plasma PL were closely correlated (r always >0.9). We conclude that an 8-wk supplementation with 0.94 g DHA/d from microalgae oil achieves a beneficial omega-3 index of ≥8% in most subjects with low basal EPA+DHA status. RBC total FA analyses can be used instead of RBC lipid fraction analyses for assessing essential FA status, e.g., in clinical studies.

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

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

AA:

arachidonic acid

ALA:

α-linolenic acid

BMI:

body mass index

CHD:

coronary heart disease

DPA:

docosapentaenoic acid

LA:

linoleic acid

LCPUFA:

long-chain polyunsaturated fatty acid

OA:

oleic acid, 18∶1n−9

PA:

palmitic acid, 16∶0

PL:

phospholipids

RBC:

red blood cells

SFA:

saturated fatty acid

References

  1. Bucher, H.C., Hengstler, P., Schindler, C., and Meier, G. (2002) n−3 Polyunsaturated Fatty Acids in Coronary Heart Disease: A Meta-Analysis of Randomized Controlled Trials, Am. J. Med. 112, 298–304.

    Article  PubMed  CAS  Google Scholar 

  2. Kris-Etherton, P.M., Harris, W.S., and Appel, L.J. (2002) Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease, Circulation 106, 2747–2757.

    Article  PubMed  Google Scholar 

  3. Whelton, S.P., He, J., Whelton, P.K., and Muntner, P. (2004) Meta-analysis of Observational Studies on Fish Intake and Coronary Heart Disease, Am. J. Cardiol. 93, 1119–1123.

    Article  PubMed  Google Scholar 

  4. Leaf, A., Kang, J.X., Xiao, Y., and Billman, G.E. (2003) Clinical Prevention of Sudden Cardiac Death by n−3 Polyunsaturated Fatty Acids and Mechanism of Prevention of Arrhythmias by n−3 Fish Oils, Circulation 107, 2646–2652.

    Article  PubMed  Google Scholar 

  5. Harris, W.S., Sands, S.A., Windsor, S.L., Ali, H.A., Stevens, T.L., Magalski, A., Porter, C.B., and Borkon, A.M. (2004) Omega-3 Fatty Acids in Cardiac Biopsies from Heart Transplantation Patients: Correlation with Erythrocytes and Response to Supplementation, Circulation 110, 1645–1649.

    Article  PubMed  CAS  Google Scholar 

  6. Harris, W.S., and von Schacky, C. (2004) The Omega-3 Index: A New Risk Factor for Death from Coronary Heart Disease? Prev. Med. 39, 212–220.

    Article  PubMed  CAS  Google Scholar 

  7. Conquer, J.A., and Holub, B.J. (1997) Docosahexaenoic Acid (omega-3) and Vegetarian Nutrition, Veg. Nutr. Int. J. 1/2, 42–49.

    Google Scholar 

  8. Li, D., Sinclair, A.J., Wilson, A., Nakkote, S., Kelly, F., Abedin, L., Mann, N.J., and Turner, A. (1999) Effect of Dietary α-Linolenic Acid on Thrombotic Risk Factors in Vegetarian Men, Am. J. Clin. Nutr. 69, 872–882.

    PubMed  CAS  Google Scholar 

  9. Burdge, G.C., and Wootton, S.A. (2002) Conversion of α-Linolenic Acid to Eicosapentaenoic, Docosapentaenoic and Docosahexaenoic Acids in Young Women, Br. J. Nutr. 88, 411–420.

    PubMed  CAS  Google Scholar 

  10. Burdge, G.C., Jones, A.E., and Wootton, S.A. (2002) Eicosapentaenoic and Docosapentaenoic Acids Are the Principal Products of α-Linolenic Acid Metabolism in Young Men, Br. J. Nutr. 88, 355–363.

    Article  PubMed  CAS  Google Scholar 

  11. Emken, E.A., Adlof, R.O., and Gulley, R.M. (1994) Dietary Linoleic Acid Influences Desaturation and Acylation of Deuterium-Labeled Linoleic and Linolenic Acids in Young Adult Males, Biochim. Biophys. Acta 1213, 277–288.

    PubMed  CAS  Google Scholar 

  12. Hussein, N., Ah-Sing, E., Wilkinson, P., Leach, C., Griffin, B.A., and Millward, D.J. (2005) Long-Chain Conversion of [13C]Linoleic Acid and α-Linolenic Acid in Response to Marked Changes in Their Dietary Intake in Men, J. Lipid Res. 46, 269–280.

    Article  PubMed  CAS  Google Scholar 

  13. Pawlosky, R.J., Hibbeln, J.R., Novotny, J.A., and Salem, N., Jr. (2001) Physiological Compartmental Analysis of α-Linolenic Acid Metabolism in Adult Humans, J. Lipid Res. 42, 1257–1265.

    PubMed  CAS  Google Scholar 

  14. Pawlosky, R.J., Hibbeln, J.R., Lin, Y., Goodson, S., Riggs, P., Sebring, N., Brown, G.L., and Salem, N., Jr. (2003) Effects of Beef- and Fish-Based Diets on the Kinetics of n−3 Fatty Acid Metabolism in Human Subjects, Am. J. Clin. Nutr. 77, 565–572.

    PubMed  CAS  Google Scholar 

  15. Burdge, G.C., Finnegan, Y.E., Minihane, A.M., Williams, C.M., and Wootton, S.A. (2003) Effect of Altered Dietary n−3 Fatty Acid Intake upon Plasma Lipid Fatty Acid Composition, Conversion of [13C]α-Linolenic Acid to Longer-Chain Fatty Acids and Partitioning Towards β-Oxidation in Older Men, Br. J. Nutr. 90, 311–321.

    Article  PubMed  CAS  Google Scholar 

  16. Sanders, T.A.B., and Roshanai, F. (1992) Platelet Phospholipid Fatty Acid Composition and Function in Vegans Compared with Age- and Sex-Matched Omnivore Controls, Eur. J. Clin. Nutr. 46, 823–831.

    PubMed  CAS  Google Scholar 

  17. Agren, J.J., Törmälä, M.L., Nenonen, M.T., and Hänninen, O.O. (1995) Fatty Acid Composition of Erythrocyte, Platelet, and Serum Lipids in Strict Vegans, Lipids 30, 365–369.

    Article  PubMed  CAS  Google Scholar 

  18. Krajcovicova-Kudlackova, M., Simoncic, R., Bederova, A., and Klvanova, J. (1997) Plasma Fatty Acid Profile and Alternative Nutrition, Ann. Nutr. Metab. 41, 365–370.

    Article  PubMed  CAS  Google Scholar 

  19. Li, D., Ball, M., Bartlett, M., and Sinclair, A.J. (1999) Lipoprotein(a), Essential Fatty Acid Status and Lipoprotein Lipids in Female Australian Vegetarians, Clin. Sci. 97, 175–181.

    Article  PubMed  CAS  Google Scholar 

  20. Lee, H.Y., Woo, J., Chen, Z.Y., Leung, S.F., and Peng, X.H. (2000) Serum Fatty Acid, Lipid Profile and Dietary Intake of Hong Kong Chinese Omnivores and Vegetarians, Eur. J. Clin. Nutr. 54, 768–773.

    Article  PubMed  CAS  Google Scholar 

  21. Manjari, V., Suresh, Y., Sailaja Devi, M.M., and Das, U.N. (2001) Oxidant Stress, Anti-oxidants and Essential Fatty Acids in South Indian Vegetarians and Non-vegetarians, Prostaglandins Leukotrienes Essent. Fatty Acids 64, 53–59.

    Article  CAS  Google Scholar 

  22. Carnielli, V.P., Pederzini, F., Vittorangeli, R., Luijendijk, I.H., Boomaars, W.E., Pedrotti, D., and Sauer, P.J. (1996) Plasma and Red Blood Cell Fatty Acid of Very Low Birth Weight Infants Fed Exclusively with Expressed Preterm Human Milk, Pediatr. Res. 39, 671–679.

    PubMed  CAS  Google Scholar 

  23. Conquer, J.A., and Holub, B.J. (1996) Supplementation with an Algae Source of Docosahexaenoic Acid Increases (n−3) Fatty Acid Status and Alters Selected Risk Factors for Heart Disease in Vegetarian Subjects, J. Nutr. 126, 3032–3039.

    PubMed  CAS  Google Scholar 

  24. Conquer, J.A., and Holub, B.J. (1997) Dietary Docosahexaenoic Acid as a Source of Eicosapentaenoic Acid in Vegetarians and Omnivores, Lipids 32, 341–345.

    Article  PubMed  CAS  Google Scholar 

  25. Conquer, J.A., and Holub, B.J. (1998) Effect of Supplementation with Different Doses of DHA on the Levels of Circulating DHA as Non-esterified Fatty Acid in Subjects of Asian Indian Background, J. Lipid Res. 39, 286–292.

    PubMed  CAS  Google Scholar 

  26. Theobald, H.E., Chowienczyk, P.J., Whittall, R., Humphries, S.E., and Sanders, T.A.B. (2004) LDL Cholesterol-Raising Effect of Low-Dose Docosahexaenoic Acid in Middle-Aged Men and Women, Am. J. Clin. Nutr. 79, 558–563.

    PubMed  CAS  Google Scholar 

  27. Stark, K.D., and Holub, B.J. (2004) Differential Eicosapentaenoic Acid Elevations and Altered Cardiovascular Disease Risk Factor Responses After Supplementation with Docosahexaenoic Acid in Postmenopausal Women Receiving and Not Receiving Hormone Replacement Therapy, Am. J. Clin. Nutr. 79, 765–773.

    PubMed  CAS  Google Scholar 

  28. Buckley, R., Shewring, B., Turner, R., Yaqoob, P., and Minihane, A.M. (2004) Circulating Triacylglycerol and ApoE Levels in Response to EPA and Docosahexaenoic Acid Supplementation in Adult Human Subjects, Br. J. Nutr. 92, 477–483.

    Article  PubMed  CAS  Google Scholar 

  29. Conquer, J.A., Cheryk, L.A., Chan, E., Gentry, P.A., and Holub, B.J. (1999) Effect of Supplementation with Dietary Seal Oil on Selected Cardiovascular Risk Factors and Hemostatic Variables in Healthy Male Subjects, Thromb. Res. 96, 239–250.

    Article  PubMed  CAS  Google Scholar 

  30. Laidlaw, M., and Holub, B.J. (2003) Effects of Supplementation with Fish Oil-Derived n−3 Fatty Acids and γ-Linolenic Acid on Circulating Plasma Lipids and Fatty Acid Profiles in Women, Am. J. Clin. Nutr. 77, 37–42.

    PubMed  CAS  Google Scholar 

  31. German Nutrition Society (2002) Reference Values for Nutrient Intake, 1st end., pp. 45–49, Umschau Braus GmbH, Frankfurt am Main, Germany.

    Google Scholar 

  32. Arab, L. (2003) Biomarkers of Fat and Fatty Acid Intake, J. Nutr. 133, 925S-993S.

    PubMed  CAS  Google Scholar 

  33. Verkleij, A.J., Zwaal, R.F.A., Roelofsen, B., Comfurius, P., Kastelijn, D., and Van Deenen, L.L.M. (1973) The Asymmetric Distribution of Phospholipids in the Human Red Cell Membrane. A Combined Study Using Phospholipases and Freeze-Etch Electron Microscopy, Biochim. Biophys. Acta 323, 178–193.

    Article  PubMed  CAS  Google Scholar 

  34. Renooij, W., and Van Golde, L.M.G. (1977) The Transposition of Molecular Classes of Phosphatidylcholine Across the Rat Erythrocyte Membrane and Their Exchange Between the Red Cell Membrane and Plasma Lipoproteins, Biochim. Biophys. Acta 470, 465–474.

    Article  PubMed  CAS  Google Scholar 

  35. Renooij, W., Van Golde, L.M.G., Zwaal, R.F.A., Roelofsen, B., and Van Deenen, L.L.M. (1974) Preferential Incorporation of Fatty Acids at the Inside of Human Erythrocyte Membranes, Biochim. Biophys. Acta 363, 287–292.

    Article  PubMed  CAS  Google Scholar 

  36. Alberts, B., Johnson, A., Lewis, J., Raff, M., Roberts, K., and Walter, P. (1995) Molekularbiologie der Zelle, 3rd edn., pp. 675–685, Wiley-VCH, Weinheim.

    Google Scholar 

  37. Vlaardingerbroek, H., and Hornstra, G. (2004) Essential Fatty Acids in Erythrocyte Phospholipids During Pregnancy and at Delivery in Mothers and Their Neonates: Comparison with Plasma Phospholipids, Prostaglandins Leukotrienes Essent. Fatty Acids 71, 363–374.

    Article  CAS  Google Scholar 

  38. Leichsenring, M., Hardenack, M., and Laryea, M.D. (1992) Relationship Among the Fatty Acid Composition of Various Lipid Fractions in Normally Nourished German Adults, Int. J. Vitam. Nutr. Res. 62, 181–185.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Div. Metabolic Diseases and Nutrition, Dr. von Hauner Children’s Hospital, Ludwig Maximilians University of Munich, Lindwurmstraße 4, D-80337, Munich, Germany

    Julia Geppert, Veronika Kraft, Hans Demmelmair & Berthold Koletzko

Authors
  1. Julia Geppert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Veronika Kraft
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hans Demmelmair
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Berthold Koletzko
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Berthold Koletzko.

About this article

Cite this article

Geppert, J., Kraft, V., Demmelmair, H. et al. Docosahexaenoic acid supplementation in vegetarians effectively increases omega-3 index: A randomized trial. Lipids 40, 807–814 (2005). https://doi.org/10.1007/s11745-005-1442-9

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11745-005-1442-9

Keywords

Search

Navigation