Useful Facts About Eicosapentaenoic Acid (EPA)
Eicosapentaenoic Acid (EPA) is a member of the Omega-3 fatty
acid family. EPA is required for the production of a special group of
substances in the body called prostaglandins, which control blood
clotting and other arterial functions. EPA also provides a natural
approach to lower blood cholesterol and triglycerides.
Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are
long-chain, polyunsaturated fatty acids found in fish and fish oils.
The intake of dietary EPA/DHA is enhanced by eating coldwater fish
regularly, such as salmon, herring, mackerel, or sardines that feed on
certain plankton, or by taking additional oil supplements.
Since studies on the health of Greenland Eskimos in the 1970s, these
compounds have been purported to have many health benefits when
included in ones diet on a regular basis. The Eskimos eat large amounts
of DHA and EPA in their diets. As all natural fish and fish oils
contain both substances, learning which of them are the major
contributors to the health benefits claimed for fish or fish oil has
been hard, or if both are needed to produce these benefits.
Epidemiological evidence suggest that populations consuming marine
diets rich in the n-3 PUFA eicosapentaenoic acid (EPA) have a low
incidence of cancer. A potential anti-cancer activity of EPA is further
supported by in vitro and in vivo experimental studies.
These lipid-lowering effects, along with some benefits in reducing
platelet aggregation and clotting potential, make the use of EPA/DHA
very important in the treatment or prevention of cardiovascular disease
or in anyone with high blood fats or low HDL. The decreased blood
viscosity and lower fat levels help reduce the risk of heart attacks.
The mild anti-inflammatory effects, possibly a result of increased PGE1
and PGE3 prostaglandins, may also be helpful and has suggested the
possible use of EPA/DHA in arthritis and other inflammatory conditions.
In rheumatoid arthritis, for example, EPA/DHA supplementation has been
shown to reduce joint stiffness and soreness and to improve flexibility.
There is now also good evidence that EPA and DHA found in fish oils
may protect against CHD. In Japan, the incidence of CHD and cerebral
thrombosis have been found to be inversely proportional to blood levels
of EPA. These levels are generally ten times as high among Japanese as
among Americans. Both West and East Germany and Czechoslovakia now
include linoleic acid or essential fatty acids in their tables of RDA;
the recommended daily intake is about 10 grams.
Thrombotic disorders are currently treated and prevented by
utilising pharmacological concentrations of eicosapentaenoic acid (EPA;
C20:5w 3). Controversy and disagreement about the beneficial effects of
this essential fatty acid are legion. EPA has been shown to lower,
elevate or have no effect on cholesterol metabolism. Supplementation of
EPA to different diets may be the reason for the inconsistency of
effects.
Dietary polyunsaturated fatty acids (PUFAs) have been reported as a
potential group of natural products which modulate tumor cell growth.
In present study, EPA was found to inhibit proliferation of human
leukemic HL-60 and K-562 cells in vitro.
In this study, we investigated the hypolipidemic action of EPA and
its mechanism. Three types of 5% fat diets (stearic acid, linoleic
acid, and EPA) were prepared in our laboratory. Rats that weighed
170-190 g were fed one of these diets for 20 weeks at an equivalent
calorie value (groups S, L, and E). Weight gain occurred in the
following order: group E < group S < group L. Serum levels of
total cholesterol, triglycerides, phospholipids and total lipids were
significantly lower in group E than in the other groups. Analysis of
the fatty acid composition of adipose tissue showed that the level of
C18:1 was significantly higher in group S, that of C18:2 was
significantly higher in group L, and that of C16:0 was significantly
higher in group E than in the other groups. These results indicated
that EPA had a hypolipidemic action, higher ketogenicity, and lower
lipogenicity than the other fatty acids. Inclusion of EPA in the diet
of hyperlipidemic subjects may thus help in the primary prevention of
hyperlipidemia and, in turn, morbid obesity.
Epidemiological studies suggest that a diet high in marine fatty
acids (fish oil) may have beneficial effects on inflammatory conditions
such as rheumatoid arthritis and possibly asthma...The single study
performed in children also combined dietary manipulation with fish oil
supplementation and showed improved peak flow and reduced asthma
medication use. There were no adverse events associated with fish oil
supplements.
There is little evidence to recommend that people with asthma
supplement or modify their dietary intake of marine n-3 fatty acids
(fish oil) in order to improve their asthma control. Equally, there is
no evidence that they are at risk if they do so.
n-3 Fatty acids have been shown to modify several key risk factors
for cardiovascular disease. However, it is not clear whether the
apparent protection against cardiovascular disease is directly related
to antiatherogenic functions of these fatty acids or is mediated
through their modification of the risk factors through mechanisms not
directly related to lipids. A major question concerns the importance of
lipid modification, which is a potent outcome of fish-oil
supplementation. On balance, lipid modification is likely to represent
a significant antiatherogenic factor. The benefits include increased
HDL2-cholesterol concentrations, reduced triacylglycerol-rich
lipoprotein concentrations, reduced postprandial lipemia, and reduced
remnant concentrations. In contrast, LDL-cholesterol concentrations
have often been noted to rise and the potential of increased
oxidizability of LDLs is potentially adverse with lipid modification,
but this potential can be overcome with vitamin E supplementation. The
characteristic lipid changes and the underlying mechanisms are
reviewed. Additional benefits of fish oils include improved endothelial
function and better arterial compliance (elasticity). Future trials
will be needed to determine minimum effective dosages of
eicosapentaenoic and docosahexaenoic acids over lengthy periods and to
show cardiovascular disease reduction through intervention.
It has been postulated that patients with ulcerative colitis (UC)
have altered reactivity of gut-associated lymphoid tissue. In such
cases there is intense infiltration of the mucosa with immune competent
cells and associated tissue damage. We have shown previously that the
dietary supplementation with the n-3 polyunsaturated fatty acids (n-3
PUFAs), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA)
results in significant systemic immune suppression. The aim of this
study, therefore, was to evaluate the in situ effect of n-3 PUFAs on
distal proctocolitis...In patients receiving n-3 PUFA supplementation,
there was improvement in the disease activity and histological scores,
compared with pretreatment evaluation. This study has demonstrated both
evidence of suppression of in situ immune reactivity and concurrent
reduction in disease activity in patients with proctocolitis receiving
n-3 PUFA supplementation. This may have important implication for
therapy in patients with ulcerative colitis.
Limited evidence gives support to an hypothesis suggesting that the
symptoms of schizophrenia may result from altered neuronal membrane
structure and metabolism. The latter are dependent on blood plasma
levels of certain essential fatty acids (EFAs) and their metabolites.
Several studies have shown those with schizophrenia often have low
levels of the particular EFAs necessary for normal nerve cell membrane
metabolism... Early results from a few trials suggest a positive effect
of eicosapentaenoic acid (EPA) over placebo for scale-derived mental
state outcomes. The data, however, is limited making these results
difficult to analyse and interpret with confidence. A single small
study (n=30) investigated the value of using EPA as sole treatment for
people hospitalised for relapse. Results suggest that EPA may help one
third of people avoid instigation of standard antipsychotic drugs for
12 weeks (RR 0.6, CI 0.4-0.91). REVIEWER'S CONCLUSIONS: All data are
preliminary, but results look encouraging for fish oil. EPA does not
seem harmful, may be acceptable to people with schizophrenia and have
moderately positive effect. A further trial is soon to be reported from
the USA and more are underway or planned in the South Africa and
Norway. Considering that EPA may be an acceptable intervention, large,
long simple studies reporting clincially meaningful data should be
anticipated.
The administration of the omega-3 fatty acid eicosapentaenoic acid
(EPA) to a drug-naive patient with schizophrenia, untreated with
conventional antipsychotic medication, led to a dramatic and sustained
clinical improvement in both positive and negative symptoms. This was
accompanied by a correction in erythrocyte membranes of abnormalities
in both n-3 and n-6 highly unsaturated fatty acids (HUFAs). Therefore
EPA is able to reverse the phospholipid abnormalities previously
described in schizophrenia. This reversal is associated with, and is
likely to be the cause of, the clinical improvement. In particular, EPA
appears to have reversed the depletion of not only n-3 HUFAs, but also
of membrane arachidonic acid, possibly via inhibition of HUFA-specific
phospholipase A(2), an enzyme which removes HUFAs from the S(N)2
position of membrane phospholipids, or by activation of a fatty acid
coenzyme A ligase. Correction by EPA of abnormalities in both enzyme
systems is not ruled out.
Eicosapentaenoic Acid (EPA) is a member of the Omega-3 fatty
acid family. EPA is required for the production of a special group of
substances in the body called prostaglandins, which control blood
clotting and other arterial functions. EPA also provides a natural
approach to lower blood cholesterol and triglycerides.
Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are
long-chain, polyunsaturated fatty acids found in fish and fish oils.
The intake of dietary EPA/DHA is enhanced by eating coldwater fish
regularly, such as salmon, herring, mackerel, or sardines that feed on
certain plankton, or by taking additional oil supplements.
Since studies on the health of Greenland Eskimos in the 1970s, these
compounds have been purported to have many health benefits when
included in ones diet on a regular basis. The Eskimos eat large amounts
of DHA and EPA in their diets. As all natural fish and fish oils
contain both substances, learning which of them are the major
contributors to the health benefits claimed for fish or fish oil has
been hard, or if both are needed to produce these benefits.
Epidemiological evidence suggest that populations consuming marine
diets rich in the n-3 PUFA eicosapentaenoic acid (EPA) have a low
incidence of cancer. A potential anti-cancer activity of EPA is further
supported by in vitro and in vivo experimental studies.
These lipid-lowering effects, along with some benefits in reducing
platelet aggregation and clotting potential, make the use of EPA/DHA
very important in the treatment or prevention of cardiovascular disease
or in anyone with high blood fats or low HDL. The decreased blood
viscosity and lower fat levels help reduce the risk of heart attacks.
The mild anti-inflammatory effects, possibly a result of increased PGE1
and PGE3 prostaglandins, may also be helpful and has suggested the
possible use of EPA/DHA in arthritis and other inflammatory conditions.
In rheumatoid arthritis, for example, EPA/DHA supplementation has been
shown to reduce joint stiffness and soreness and to improve flexibility.
There is now also good evidence that EPA and DHA found in fish oils
may protect against CHD. In Japan, the incidence of CHD and cerebral
thrombosis have been found to be inversely proportional to blood levels
of EPA. These levels are generally ten times as high among Japanese as
among Americans. Both West and East Germany and Czechoslovakia now
include linoleic acid or essential fatty acids in their tables of RDA;
the recommended daily intake is about 10 grams.
Thrombotic disorders are currently treated and prevented by
utilising pharmacological concentrations of eicosapentaenoic acid (EPA;
C20:5w 3). Controversy and disagreement about the beneficial effects of
this essential fatty acid are legion. EPA has been shown to lower,
elevate or have no effect on cholesterol metabolism. Supplementation of
EPA to different diets may be the reason for the inconsistency of
effects.
Dietary polyunsaturated fatty acids (PUFAs) have been reported as a
potential group of natural products which modulate tumor cell growth.
In present study, EPA was found to inhibit proliferation of human
leukemic HL-60 and K-562 cells in vitro.
In this study, we investigated the hypolipidemic action of EPA and
its mechanism. Three types of 5% fat diets (stearic acid, linoleic
acid, and EPA) were prepared in our laboratory. Rats that weighed
170-190 g were fed one of these diets for 20 weeks at an equivalent
calorie value (groups S, L, and E). Weight gain occurred in the
following order: group E < group S < group L. Serum levels of
total cholesterol, triglycerides, phospholipids and total lipids were
significantly lower in group E than in the other groups. Analysis of
the fatty acid composition of adipose tissue showed that the level of
C18:1 was significantly higher in group S, that of C18:2 was
significantly higher in group L, and that of C16:0 was significantly
higher in group E than in the other groups. These results indicated
that EPA had a hypolipidemic action, higher ketogenicity, and lower
lipogenicity than the other fatty acids. Inclusion of EPA in the diet
of hyperlipidemic subjects may thus help in the primary prevention of
hyperlipidemia and, in turn, morbid obesity.
Epidemiological studies suggest that a diet high in marine fatty
acids (fish oil) may have beneficial effects on inflammatory conditions
such as rheumatoid arthritis and possibly asthma...The single study
performed in children also combined dietary manipulation with fish oil
supplementation and showed improved peak flow and reduced asthma
medication use. There were no adverse events associated with fish oil
supplements.
There is little evidence to recommend that people with asthma
supplement or modify their dietary intake of marine n-3 fatty acids
(fish oil) in order to improve their asthma control. Equally, there is
no evidence that they are at risk if they do so.
n-3 Fatty acids have been shown to modify several key risk factors
for cardiovascular disease. However, it is not clear whether the
apparent protection against cardiovascular disease is directly related
to antiatherogenic functions of these fatty acids or is mediated
through their modification of the risk factors through mechanisms not
directly related to lipids. A major question concerns the importance of
lipid modification, which is a potent outcome of fish-oil
supplementation. On balance, lipid modification is likely to represent
a significant antiatherogenic factor. The benefits include increased
HDL2-cholesterol concentrations, reduced triacylglycerol-rich
lipoprotein concentrations, reduced postprandial lipemia, and reduced
remnant concentrations. In contrast, LDL-cholesterol concentrations
have often been noted to rise and the potential of increased
oxidizability of LDLs is potentially adverse with lipid modification,
but this potential can be overcome with vitamin E supplementation. The
characteristic lipid changes and the underlying mechanisms are
reviewed. Additional benefits of fish oils include improved endothelial
function and better arterial compliance (elasticity). Future trials
will be needed to determine minimum effective dosages of
eicosapentaenoic and docosahexaenoic acids over lengthy periods and to
show cardiovascular disease reduction through intervention.
It has been postulated that patients with ulcerative colitis (UC)
have altered reactivity of gut-associated lymphoid tissue. In such
cases there is intense infiltration of the mucosa with immune competent
cells and associated tissue damage. We have shown previously that the
dietary supplementation with the n-3 polyunsaturated fatty acids (n-3
PUFAs), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA)
results in significant systemic immune suppression. The aim of this
study, therefore, was to evaluate the in situ effect of n-3 PUFAs on
distal proctocolitis...In patients receiving n-3 PUFA supplementation,
there was improvement in the disease activity and histological scores,
compared with pretreatment evaluation. This study has demonstrated both
evidence of suppression of in situ immune reactivity and concurrent
reduction in disease activity in patients with proctocolitis receiving
n-3 PUFA supplementation. This may have important implication for
therapy in patients with ulcerative colitis.
Limited evidence gives support to an hypothesis suggesting that the
symptoms of schizophrenia may result from altered neuronal membrane
structure and metabolism. The latter are dependent on blood plasma
levels of certain essential fatty acids (EFAs) and their metabolites.
Several studies have shown those with schizophrenia often have low
levels of the particular EFAs necessary for normal nerve cell membrane
metabolism... Early results from a few trials suggest a positive effect
of eicosapentaenoic acid (EPA) over placebo for scale-derived mental
state outcomes. The data, however, is limited making these results
difficult to analyse and interpret with confidence. A single small
study (n=30) investigated the value of using EPA as sole treatment for
people hospitalised for relapse. Results suggest that EPA may help one
third of people avoid instigation of standard antipsychotic drugs for
12 weeks (RR 0.6, CI 0.4-0.91). REVIEWER'S CONCLUSIONS: All data are
preliminary, but results look encouraging for fish oil. EPA does not
seem harmful, may be acceptable to people with schizophrenia and have
moderately positive effect. A further trial is soon to be reported from
the USA and more are underway or planned in the South Africa and
Norway. Considering that EPA may be an acceptable intervention, large,
long simple studies reporting clincially meaningful data should be
anticipated.
The administration of the omega-3 fatty acid eicosapentaenoic acid
(EPA) to a drug-naive patient with schizophrenia, untreated with
conventional antipsychotic medication, led to a dramatic and sustained
clinical improvement in both positive and negative symptoms. This was
accompanied by a correction in erythrocyte membranes of abnormalities
in both n-3 and n-6 highly unsaturated fatty acids (HUFAs). Therefore
EPA is able to reverse the phospholipid abnormalities previously
described in schizophrenia. This reversal is associated with, and is
likely to be the cause of, the clinical improvement. In particular, EPA
appears to have reversed the depletion of not only n-3 HUFAs, but also
of membrane arachidonic acid, possibly via inhibition of HUFA-specific
phospholipase A(2), an enzyme which removes HUFAs from the S(N)2
position of membrane phospholipids, or by activation of a fatty acid
coenzyme A ligase. Correction by EPA of abnormalities in both enzyme
systems is not ruled out.
- Chiu LC; Wan JM. Induction of apoptosis in HL-60 cells by
eicosapentaenoic acid (EPA) is associated with downregulation of bcl-2
expression. Cancer Lett 1999 Oct 18;145(1-2):17-27 - Mitsuyoshi K, Et al. Effects of Eicosapentaenoic Acid on Lipid Metabolism in Obesity Treatment. Obes Surg 1991 Jun;1(2):165-169
- Woods
RK, Thien FC, Abramson MJ. Dietary marine fatty acids (fish oil) for
asthma. Department of Epidemiolgy and Preventative Medicine, Monash
Medical School, Alfred Hospital, Victoria, AUSTRALIA - Paul J
Nestel. Fish oil and cardiovascular disease: lipids and arterial
function. American Journal of Clinical Nutrition, Vol. 71, No. 1,
228-231, January 2000 - Almallah YZ, Ewen SW. Et al. Distal
proctocolitis and n-3 polyunsaturated fatty acids (n-3 PUFAs): the
mucosal effect in situ. J Clin Immunol 2000 Jan;20(1):68-76 - Joy
CB, Mumby-Croft R, Joy LA. Polyunsaturated fatty acid (fish or evening
primrose oil) for schizophrenia. Cochrane Schizophrenia Group, Oxford,
UK, OX2 7LG - Richardson AJ, Easton T, Puri BK. Red cell and
plasma fatty acid changes accompanying symptom remission in a patient
with schizophrenia treated with eicosapentaenoic acid. Eur
Neuropsychopharmacol 2000 May 1;10(3):189-193
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