NDLI: Cardiac physiology and clinical efficacy of dietary fish oil clarified through cellular mechanisms of omega-3 polyunsaturated fatty acids

Content Provider	Springer Nature Link
Author	McLennan, Peter L.
Copyright Year	2014
Abstract	Reduced cardiac mortality and morbidity have long been observed in association with omega-3 long chain polyunsaturated fatty acids (LC-PUFA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) from fish consumption, without clear physiological explanation. This review seeks to identify mechanisms of action based on evidence: of physiological effects, active components and effective intakes. Fish oil pleiotropic effects reveal actions that are either intrinsic: effects on cardiac function dependent upon membrane incorporation; or extrinsic: indirect cardiac effects through vascular disease. Extrinsic actions require EPA + DHA doses >3 g/day. Intrinsic effects derive from usual dietary intakes, <1 g/day and include improved myocardial oxygen efficiency, heart rate, nutritional preconditioning against ischaemic injury, arrhythmias and heart failure. Myocardial Na+ and K+ currents are non-selectively modulated by omega-3 and omega-6 PUFA to stabilise cells in vitro, but not by fish oil-induced membrane change. In contrast, cellular Ca2+ overload involved in ischaemic injury, arrhythmia and spontaneous pacemaker activity are modulated by both dietary fish oil and in vitro omega-3 LC-PUFA. A potential linking role of bioactive epoxy and hydroxy PUFA derivatives requires investigation. Omega-3 DHA predominates over EPA in population intake, is preferentially incorporated into myocardium and is selectively active in heart rate and arrhythmia modulation, but EPA predominates in clinical trials. Myocardial selectivity for DHA and independent intrinsic and extrinsic physiological mechanisms underpinning diverse clinical endpoints can explain some contradictory outcomes of clinical trials. Intrinsic modulation of intracellular Ca2+ handling provides a unifying physiologically plausible basis for intrinsic fish oil actions and insight to nutritional optimisation of cardiac function.
Starting Page	1333
Ending Page	1356
Page Count	24
File Format	PDF
ISSN	14396319
Journal	European Journal of Applied Physiology
Volume Number	114
Issue Number	7
e-ISSN	14396327
Language	English
Publisher	Springer Berlin Heidelberg
Publisher Date	2014-04-04
Publisher Place	Berlin/Heidelberg
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Omega-3 polyunsaturated fatty acid Dietary fish oil Docosahexaenoic acid DHA Fatty acid metabolites Oxygen uptake Calcium overload Ion channel Heart rate Sudden cardiac death Heart failure Human Physiology Occupational Medicine/Industrial Medicine Sports Medicine
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Physiology (medical) Public Health, Environmental and Occupational Health Sports Science

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