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Providing perspectives on recent research into vitamins and nutritionals


Increasing EPA and DHA Concentrations in Blood to Modify Diabetes Risk

By Michael McBurney

Fats are carried in the blood in many forms (chylomicrons, lipoproteins, etc). The enzyme, lipoprotein lipase, found in blood vessels, muscle and fat cells releases free fatty acids, also known as nonesterified fatty acids (NEFA), which serve as a fuel source. NEFA can be chronically elevated and have pathological consequences in individuals who are obese or diabetic. Elevated NEFA are an independent risk factor for sudden death.

A new study confirms NEFA are a marker of type 2 diabetes. More importantly, increasing omega-3 fatty acid status, i.e. eicosapentaenoic (EPA) and docosahexaenoic (DHA) acid concentrations in blood, may help protect against diabetes. Steffen and colleagues measured fasting NEFA concentrations from 5,697 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) over an average period of 11.4y. They observed significant differences in outcomes between those in the low (<75 percentile) and high (≥75 percentile).

The low and high group mean n-3 fatty acid phospholipid concentrations were 3.9% and 7.5%, respectively. The benefit seen in the high group is consistent with recommendations by Harris who characterized a low-risk profile as a red blood cell omega-3 index > 8%. Generally, most people have an omega-3 index of 3-5% unless they supplement with EPA+DHA.

This new study provides more evidence that EPA and DHA may play a role in healthy aging.

Main Citation

Steffen BT, Steffen LM, Zhou Z, Ouyang P, Weir NL, Tsai MY. n-3 fatty acids attenuate the risk of diabetes associated with elevated serum non-esterified fatty acids: the Multi-Ethnic Study of Atherosclerosis. 2015 Diab Care doi: 10.2337/dc14-1919

Other Citations

Boden G, Shulman GI. Free fatty acids in obesity and type 2 diabetes: defining their role in the development of insulin resistance and β-cell dysfunction. 2002 EJCN doi: 10.1046/j.1365-2362.32.s3.3.x

Jouven X, Charles M-A, Desnos M, Ducimetiere P. Circulating nonesterified fatty acid level as a predictive factor for sudden death in the population. 2001 Circulation doi: 10.1161/hc3201.094151

Harris WS. The omega-3 index as a risk factor for coronary heart disease. 2008 Am J Clin Nutr 87:19975-20025

Skulas-Ray AC, Kris-Etherton PM, Harris WS, Vanden Heuvel JP, Wagner PR, West SG. Dose-response effects of omega-3 fatty acids on triglycerides, inflammation, and endothelial function in healthy persons with moderate hypertriglyceridemia. 2011 Am J Clin Nutr doi: 10.3945/ajcn.110.003871