Aleix Sala-Vila, Jennifer Fleming, Penny Kris-Etherton, Emilio Ros
{"title":"Impact of α-Linolenic Acid, the Vegetable ω-3 Fatty Acid, on Cardiovascular Disease and Cognition.","authors":"Aleix Sala-Vila, Jennifer Fleming, Penny Kris-Etherton, Emilio Ros","doi":"10.1093/advances/nmac016","DOIUrl":null,"url":null,"abstract":"<p><p>Given the evidence of the health benefits of plant-based diets and long-chain n-3 (ω-3) fatty acids, there is keen interest in better understanding the role of α-linolenic acid (ALA), a plant-derived n-3 fatty acid, on cardiometabolic diseases and cognition. There is increasing evidence for ALA largely based on its major food sources (i.e., walnuts and flaxseed); however, this lags behind our understanding of long-chain n-3 fatty acids. Meta-analyses of observational studies have shown that increasing dietary ALA is associated with a 10% lower risk of total cardiovascular disease and a 20% reduced risk of fatal coronary heart disease. Three randomized controlled trials (RCTs) [AlphaOmega trial, Prevención con Dieta Mediterránea (PREDIMED) trial, and Lyon Diet Heart Study] all showed benefits of diets high in ALA on cardiovascular-related outcomes, but the AlphaOmega trial, designed to specifically evaluate ALA effects, only showed a trend for benefit. RCTs have shown that dietary ALA reduced total cholesterol, LDL cholesterol, triglycerides, and blood pressure, and epidemiologic studies and some trials also have shown an anti-inflammatory effect of ALA, which collectively account for, in part, the cardiovascular benefits of ALA. A meta-analysis reported a trend toward diabetes risk reduction with both dietary and biomarker ALA. For metabolic syndrome and obesity, the evidence for ALA benefits is inconclusive. The role of ALA in cognition is in the early stages but shows promising evidence of counteracting cognitive impairment. Much has been learned about the health benefits of ALA and with additional research we will be better positioned to make strong evidence-based dietary recommendations for the reduction of many chronic diseases.</p>","PeriodicalId":72101,"journal":{"name":"Advances in nutrition (Bethesda, Md.)","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9526859/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in nutrition (Bethesda, Md.)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/advances/nmac016","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Given the evidence of the health benefits of plant-based diets and long-chain n-3 (ω-3) fatty acids, there is keen interest in better understanding the role of α-linolenic acid (ALA), a plant-derived n-3 fatty acid, on cardiometabolic diseases and cognition. There is increasing evidence for ALA largely based on its major food sources (i.e., walnuts and flaxseed); however, this lags behind our understanding of long-chain n-3 fatty acids. Meta-analyses of observational studies have shown that increasing dietary ALA is associated with a 10% lower risk of total cardiovascular disease and a 20% reduced risk of fatal coronary heart disease. Three randomized controlled trials (RCTs) [AlphaOmega trial, Prevención con Dieta Mediterránea (PREDIMED) trial, and Lyon Diet Heart Study] all showed benefits of diets high in ALA on cardiovascular-related outcomes, but the AlphaOmega trial, designed to specifically evaluate ALA effects, only showed a trend for benefit. RCTs have shown that dietary ALA reduced total cholesterol, LDL cholesterol, triglycerides, and blood pressure, and epidemiologic studies and some trials also have shown an anti-inflammatory effect of ALA, which collectively account for, in part, the cardiovascular benefits of ALA. A meta-analysis reported a trend toward diabetes risk reduction with both dietary and biomarker ALA. For metabolic syndrome and obesity, the evidence for ALA benefits is inconclusive. The role of ALA in cognition is in the early stages but shows promising evidence of counteracting cognitive impairment. Much has been learned about the health benefits of ALA and with additional research we will be better positioned to make strong evidence-based dietary recommendations for the reduction of many chronic diseases.
鉴于有证据表明植物性膳食和长链 n-3 脂肪酸(ω-3)对健康有益,人们对更好地了解源自植物的 n-3 脂肪酸 α-亚麻酸(ALA)对心脏代谢疾病和认知能力的作用产生了浓厚的兴趣。有关 ALA 的证据越来越多,主要基于其主要食物来源(即核桃和亚麻籽);然而,这落后于我们对长链 n-3 脂肪酸的了解。对观察性研究的元分析表明,增加膳食中的 ALA 可使罹患心血管疾病的风险降低 10%,并使罹患致命性冠心病的风险降低 20%。三项随机对照试验(RCT)[AlphaOmega 试验、Prevención con Dieta Mediterránea (PREDIMED) 试验和里昂饮食心脏研究]均显示,高 ALA 饮食对心血管相关结果有益,但专门评估 ALA 效果的 AlphaOmega 试验仅显示出有益趋势。研究表明,膳食中的 ALA 可降低总胆固醇、低密度脂蛋白胆固醇、甘油三酯和血压,流行病学研究和一些试验也表明 ALA 有抗炎作用,这些都是 ALA 对心血管有益的部分原因。一项荟萃分析报告显示,膳食和生物标记 ALA 有降低糖尿病风险的趋势。对于代谢综合征和肥胖症,ALA 的益处尚无定论。ALA 在认知方面的作用尚处于早期阶段,但有证据表明,ALA 有助于对抗认知障碍。关于 ALA 对健康的益处,我们已经了解了很多,随着更多研究的深入,我们将更有能力为减少许多慢性疾病提出强有力的循证膳食建议。