Current Atherosclerosis Reports

, Volume 8, Issue 6, pp 453–459 | Cite as

The omega-6/omega-3 ratio and cardiovascular disease risk: Uses and abuses

Abstract

The cardioprotective effects of omega-3 fatty acids (n-3 FAs) are well known, but the role that the n-6 FAs play in coronary heart disease is unclear. These two classes of essential FAs compete for a number of enzyme systems, and their metabolites can powerfully influence (often in different directions) inflammatory responses, vascular reactivity, and platelet aggregation. Accordingly, the n-6/n-3 FA ratio may be of value in interpreting biomarker data and in making nutritional recommendations. Although initially appealing, there are few human experimental and clinical trial data to support this view. This paper reviews a variety of studies that, in the aggregate, suggest that the ratio is, both on theoretical and evidential grounds, of little value. Metrics that include the n-3 FAs alone, especially eicosapentaenoic and docosahexaenoic acids, appear to hold the greatest promise.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Simopoulos AP, Cleland LG: Omega-6/Omega-3 Essential Fatty Acid Ratio. Karger: Farmington, CT; 2003.CrossRefGoogle Scholar
  2. 2.
    Lands WE: Fish and Human Health, edn 2. Champaign, IL: AOCS Press; 2005.Google Scholar
  3. 3.
    Sears B: The Omega Rx Zone: The Miracle of the New High-Dose Fish Oil. New York: HarperCollins; 2003.Google Scholar
  4. 4.
    Kang JX: Balance of omega-6/omega-3 essential fatty acids is important for health. The evidence from gene transfer studies. World Rev Nutr Diet 2005, 95:93–102.PubMedGoogle Scholar
  5. 5.
    Simopoulos AP: Importance of the ratio of omega-6/omega-3 essential fatty acids: evolutionary aspects. World Rev Nutr Diet 2003, 92:1–22.PubMedGoogle Scholar
  6. 6.
    de Lorgeril M, Salen P: Dietary prevention of coronary heart disease: focus on omega-6/omega-3 essential fatty acid balance. World Rev Nutr Diet 2003, 92:57–73.PubMedGoogle Scholar
  7. 7.
    Horrobin DF: Commentary on the workshop statement: are we really sure that arachidonic acid and linoleic acid are bad things? Prostaglandins Leukot Essent Fatty Acids 2000, 63:145–147.PubMedCrossRefGoogle Scholar
  8. 8.
    von Schacky C: Clinical trials, not n-6 to n-3 ratios, will resolve whether fatty acids prevent coronary heart disease. Eur J Lipid Sci Technol 2001, 103:423–427.CrossRefGoogle Scholar
  9. 9.
    Knapp HR: Polyunsaturates, endogenous eicosanoids, and cardiovascular disease. J Am Coll Nutr 1990, 9:344–351.PubMedGoogle Scholar
  10. 10.
    Broughton KS, Whelan J, Hardardottir I, Kinsella JE: Effect of increasing the dietary (n-3) to (n-6) polyunsaturated fatty acid ratio on murine liver and peritoneal cell fatty acids and eicosanoid formation. J Nutr 1991, 121:155–164.PubMedGoogle Scholar
  11. 11.
    Louheranta AM, Porkkala-Sarataho EK, Nyyssonen MK, et al.: Linoleic acid intake and susceptibility of very-low-density and low density lipoproteins to oxidation in men. Am J Clin Nutr 1996, 63:698–703.PubMedGoogle Scholar
  12. 12.
    Suzukawa M, Abbey M, Howe PR, Nestel PJ: Effects of fish oil fatty acids on low density lipoprotein size, oxidizability, and uptake by macrophages. J Lipid Res 1995, 36:473–484.PubMedGoogle Scholar
  13. 13.
    Cleland LG, James MJ, Neumann MA, et al.: Linoleate inhibits EPA incorporation from dietary fish-oil supplements in human subjects. Am J Clin Nutr 1992, 55:395–399.PubMedGoogle Scholar
  14. 14.
    Dwyer JH, Allayee H, Dwyer KM, et al.: Arachidonate 5-lipoxygenase promoter genotype, dietary arachidonic acid, and atherosclerosis. N Engl J Med 2004, 350:29–37.PubMedCrossRefGoogle Scholar
  15. 15.
    Kang JX, Wang J, Wu L, Kang ZB: Transgenic mice: fat-1 mice convert n-6 to n-3 fatty acids. Nature 2004, 427:504.PubMedCrossRefGoogle Scholar
  16. 16.
    Lai L, Kang JX, Li R, et al.: Generation of cloned transgenic pigs rich in omega-3 fatty acids. Nat Biotechnol 2006, 24:435–436.PubMedCrossRefGoogle Scholar
  17. 17.
    Weiss LA, Barrett-Connor E, von Muhlen D: Ratio of n-6 to n-3 fatty acids and bone mineral density in older adults: the Rancho Bernardo Study. Am J Clin Nutr 2005, 81:934–938.PubMedGoogle Scholar
  18. 18.
    Yamashita T, Oda E, Sano T, et al.: Varying the ratio of dietary n-6/n-3 polyunsaturated fatty acid alters the tendency to thrombosis and progress of atherosclerosis in apoE-/- LDLR-/- double knockout mouse. Thromb Res 2005, 116:393–401.PubMedCrossRefGoogle Scholar
  19. 19.
    Wensing AG, Mensink RP, Hornstra G: Effects of dietary n-3 polyunsaturated fatty acids from plant and marine origin on platelet aggregation in healthy elderly subjects. Br J Nutr 1999, 82:183–191.PubMedGoogle Scholar
  20. 20.
    Wilkinson P, Leach C, Ah-Sing EE, et al.: Influence of alpha-linolenic acid and fish-oil on markers of cardiovascular risk in subjects with an atherogenic lipoprotein phenotype. Atherosclerosis 2005, 181:115–124.PubMedCrossRefGoogle Scholar
  21. 21.
    Wendland E, Farmer A, Glasziou P, Neil A: Effect of alpha linolenic acid on cardiovascular risk markers: a systematic review. Heart 2006, 92:166–169.PubMedCrossRefGoogle Scholar
  22. 22.
    Djousse L, Pankow JS, Eckfeldt JH, et al.: Relation between dietary linolenic acid and coronary artery disease in the National Heart, Lung, and Blood Institute Family Heart Study. Am J Clin Nutr 2001, 74:612–619.PubMedGoogle Scholar
  23. 23.
    Mozaffarian D, Ascherio A, Hu FB, et al.: Interplay between different polyunsaturated fatty acids and risk of coronary heart disease in men. Circulation 2005, 111:166–173.CrossRefGoogle Scholar
  24. 24.
    Ascherio A, Rimm EB, Giovannucci EL, et al.: Dietary fat and risk of coronary heart disease in men: cohort follow up study in the United States. BMJ 1996, 313:84–90.PubMedGoogle Scholar
  25. 25.
    Hu FB, Stampfer MJ, Manson JE, et al.: Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 1997, 337:1491–1499.PubMedCrossRefGoogle Scholar
  26. 26.
    Shekelle RB, Shryock AM, Paul O, et al.: Diet, serum cholesterol and death from coronary heart disease. N Engl J Med 1981, 304:65–70.PubMedCrossRefGoogle Scholar
  27. 27.
    Sacks FM, Katan M: Randomized clinical trials on the effects of dietary fat and carbohydrate on plasma lipoproteins and cardiovascular disease. Am J Med 2002, 113 (Suppl 9B):13S-24S.PubMedCrossRefGoogle Scholar
  28. 28.
    Dayton S, Pearce ML, Goldman H, et al.: Controlled trial of a diet high in unsaturated fat for prevention of atherosclerotic complications. Lancet 1968, 2:1060–1062.PubMedCrossRefGoogle Scholar
  29. 29.
    Leren P: The Oslo diet-heart study. Eleven-year report. Circulation 1970, 42:935–942.PubMedGoogle Scholar
  30. 30.
    Turpeinen O, Karvonen MJ, Pekkarinen M, et al.: Dietary prevention of coronary heart disease: the Finnish Mental Hospital Study. Int J Epidemiol 1979, 8:99–118.PubMedCrossRefGoogle Scholar
  31. 31.
    Medical Research Council: Controlled trial of soya-bean oil in myocardial infarction. Lancet 1968, 2:693–699.Google Scholar
  32. 32.
    Lennie TA, Chung ML, Habash DL, Moser DK: Dietary fat intake and proinflammatory cytokine levels in patients with heart failure. J Card Fail 2005, 11:613–618.PubMedCrossRefGoogle Scholar
  33. 33.
    Pischon T, Hankinson SE, Hotamisligil GS, et al.: Habitual dietary intake of n-3 and n-6 fatty acids in relation to inflammatory markers among US men and women. Circulation 2003, 108:155–160.PubMedCrossRefGoogle Scholar
  34. 34.
    Ferrucci L, Cherubini A, Bandinelli S, et al.: Relationship of plasma polyunsaturated fatty acids to circulating inflammatory markers. J Clin Endocrinol Metab 2006, 91:439–446.PubMedCrossRefGoogle Scholar
  35. 35.
    Miettinen TA, Naukkarinen V, Huttunen JK, et al.: Fatty-acid composition of serum lipids predicts myocardial infarction. BMJ 1982, 285:993–996.PubMedCrossRefGoogle Scholar
  36. 36.
    Harris WS, Assaad B, Poston WC: Tissue omega-6/omega-3 fatty acid ratio and risk for coronary heart disease. Am J Cardiol 2006, In press.Google Scholar
  37. 37.
    Hamazaki T, Okuyama H: The Japan Society for Lipid Nutrition recommends to reduce the intake of linoleic acid. A review and critique of the scientific evidence. World Rev Nutr Diet 2003, 92:109–132.PubMedCrossRefGoogle Scholar
  38. 38.
    Cuthbertson WF: Essential fatty acid requirements in infancy. Am J Clin Nutr 1976, 29:559–568.PubMedGoogle Scholar
  39. 39.
    Raatz SK, Bibus D, Thomas W, Kris-Etherton P: Total fat intake modifies plasma fatty acid composition in humans. J Nutr 2001, 131:231–234.PubMedGoogle Scholar
  40. 40.
    Sarkkinen ES, Agren JJ, Ahola I, et al.: Fatty acid composition of serum cholesterol esters, and erythrocyte and platelet membranes as indicators of long-term adherence to fat-modified diets. Am J Clin Nutr 1994, 59:364–370.PubMedGoogle Scholar
  41. 41.
    Krauss RM, Eckel RH, Howard B, et al.: AHA Dietary Guidelines. Revision 2000: A statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Circulation 2000, 102:2284–2299.PubMedGoogle Scholar
  42. 42.
    US Government Dietary Guidelines. http://www.healthierus.gov/dietaryguidelines/. Accessed on May 15, 2006.Google Scholar
  43. 43.
    Katan MB, Deslypere JP, van Birgelen AP, et al.: Kinetics of the incorporation of dietary fatty acids into serum cholesteryl esters, erythrocyte membranes, and adipose tissue: an 18-month controlled study. J Lipid Res 1997, 38:2012–2022.PubMedGoogle Scholar

Copyright information

© Current Science Inc 2006

Authors and Affiliations

  1. 1.Nutrition and Metabolic Diseases Research Institute, South Dakota Health Research FoundationUniversity of South DakotaSioux FallsUSA

Personalised recommendations