Abstract
Recommendations to consume fish for prevention of cardiovascular disease (CVD), along
with the U.S. Food and Drug Administration-approved generally recognized as safe (GRAS)
status for long chain omega-3 fatty acids, may have had the unanticipated consequence
of encouraging long-chain omega-3 (ω-3) fatty acid [(eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA)] supplementation and fortification practices. While there
is evidence supporting a protective role for EPA/DHA supplementation in reducing sudden
cardiac events, the safety and efficacy of supplementation with LCω-3PUFA in the context
of other disease outcomes is unclear. Recent studies of bacterial, viral, and fungal
infections in animal models of infectious disease demonstrate that LCω-3PUFA intake
dampens immunity and alters pathogen clearance and can result in reduced survival.
The same physiological properties of EPA/DHA that are responsible for the amelioration
of inflammation associated with chronic cardiovascular pathology or autoimmune states,
may impair pathogen clearance during acute infections by decreasing host resistance
or interfere with tumor surveillance resulting in adverse health outcomes. Recent
observations that high serum LCω-3PUFA levels are associated with higher risk of prostate
cancer and atrial fibrillation raise concern for adverse outcomes. Given the widespread
use of supplements and fortification of common food items with LCω-3PUFA, this review
focuses on the immunomodulatory effects of the dietary LCω-3PUFAs, EPA and DHA, the
mechanistic basis for potential negative health outcomes, and calls for biomarker
development and validation as rational first steps towards setting recommended dietary
intake levels.
Abbreviations:
TLR (Toll-like receptor), RA (Rheumatoid arthritis), CHD (Coronary heart disease)Keywords
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Article info
Publication history
Published online: October 31, 2013
Accepted:
September 21,
2013
Received in revised form:
September 18,
2013
Received:
June 13,
2013
Footnotes
☆Financial support for this research was provided by NIH R03CA162427 and the Canadian Diabetes Association.
Identification
Copyright
© 2013 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
