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certain vegetable oils, fish, fish oils (mixture of DHA & EPA) ! !-6 FAs ! safflower oil & corn oil ! Longer-chain !3 FAs ! cod liver oil & salmon oil ! Both !-6 and !-3 FAs ! canola oil & soybean oil ! Meat and eggs (smaller amounts) ! Nuts and nut oils
FUNCTIONS
Cell membrane formation Reproduction Transport of metabolites !!i.e. cholesterol Precursors of prostaglandins
Name of Study: "-Linolenic acid and long-chain !-3 fatty acids supplementation in three patients with !-3 fatty acid deficiency: effect on lymphocyte function, plasma and red cell lipids, and prostanoid formation Authors: Kristian S Bjerve, Sven Fischer, Finn Wammer, and Torstein Egeland Year: 1989
OBJECTIVES To extend their knowledge of the essentiality of !-3 fatty acids in humans. To figure out the effects of supplementing incremental amounts of "-linolenate followed by incremental amounts of long-chain !-3 fatty acids given to three patients with !-3 fatty acid deficiency.
SUBJECTS
!-3 fatty acid deficiency Five adults age 59-90 years old One 6 year-old child One 7 year-old girl Patients 1, 2, and 3 awake during the day not coming in contact with anything around her or having any spontaneous muscular activity
PATIENT 1 Male born in 1959 (~114 lbs. at start of study) Gastric tube feeding since Feb. 1973 (brain damage) 200g powdered nutrient mixed w/2L whole milk for 4 mo., 100 g w/1L whole milk, 0.75L skimmed milk, 0.25L 120 g glucose/L for 5 mo., 100 g w/1.5L skimmed milk & 0.5L of 120 g glucose/L for 3 mo. Deficiency signs: dermatitis on face & legs, heavily seborrhoeic scalp & partly hemorrhagic folliculitis
PATIENT 2
Female born in 1956 (~112 lbs. at start of study) Brain damage, confined to bed with gastric tube 300 g Collett spesialdiett with 2.4L/day of H2O for 72 months. Deficiency signs: Slight, scaly dermatitis on arms & dorsal side of feet, 73 by 48 mm pressure ulcer on buttocks & edemas in surrounding areas. Ulcer was noncompliant with treatment for 1.5 y
PATIENT 3
Female born in 1946 (~132 lbs. 6 mo. start of study) Diagnosed w/Multiple sclerosis in 1972 2000 kcal/day of a nutrient with 16.2% of calories from 18:2 !-6 & 0.07 % from 18:3 !-3 until 1984 200 g Collett spesialdiett w/2L of whole milk Deficiency signs: scaly & erythematous intertriginous lesions in palms, partly hemorrhagic folliculitis in scalp & severe seborrhea, slight scaly dermatitis on hands & feet
DESIGN OF STUDY Began in March 1986 3 oldest patients lived in same senior home All on same gastric tube feeding commercially available powdered nutrient (Colletts spesialdiett) mixed w/H2O and skimmed milk !!Composed of dried skimmed milk, corn oil, maltodextrin, saccharose, vitamins, and minerals.
0.38 mg vitamin A 5 #g vitamin D 9.9 mg vitamin E 0.83 mg thiamin 1.02 mg riboflavin 1.14 mg vitamin B6 ! 3.19 #g vitamin B12 ! 8.0 mg niacin ! ! ! ! ! !
! ! ! ! ! ! !
! 526 mg inorganic phosphorous ! 18 mmol calcium ! 2.8 mmol magnesium ! 13.7 mmol sodium ! 22.3 mmol potassium ! 15.1 mg iron 5.0 mg pantothenic acid ! 0.53 mg copper ! 2.9 mg zinc 22.0 #g folic acid ! 0.76 mg manganese 116 #g biotin ! 33.3 #g iodine 7.32 mg choline 73.2 mg inositol 90.3 mg p-aminobenzoic acid 33.3 mg vitamin C
SUPPLEMENTS
0.12 mL ethyl "-linolenate for 14 days # to 0.5 mL each day for 14 days. highly purified fish oil (49.4 wt % as long-chain !-3 acids & 5.3 wt. % of !-6 acids) 0.5 mL EPA-oil/day for 2 weeks 2.5 mL/day for the following 2 weeks !!Post-study the subjects received 10 mL soya oil and 5 mL cod liver oil split into doses.
RESULTS
Only needed 0.12 mL/day of "-linolenate to: !!reduce hemorrhagic folliculitis in patients 1 & 2 !!induce epidermal growth in the third patient !!Skin changes began to normalize when "linolenate intake was >115 mg/d of total calories !!Skin of patients 2 & 3 healed with 500-550 mg/d !!470 mg/d partly normalized facial dermatitis in patient 1
HOW THEY FOUND THE AI $! Estimated 350-400 mg per day of long-chain !-3 fatty acids will allow adults to maintain a normal amount of !-3 FAs $! For 18:3!-3 acids, they calculated 405-1655 mg/day (average of 990 mg/day & 1% of cals) $! 1.1-1.2% in the 7-year-old girl with !-3 deficiency who received 16.2% of her calories from linoleic acid
1.6 g/d of "-linolenic acid 1.6 g/d of "-linolenic acid 1.6 g/d of "-linolenic acid 1.6 g/d of "-linolenic acid 1.1 g/d of "-linolenic acid 1.1 g/d of "-linolenic acid 1.1 g/d of "-linolenic acid 1.1 g/d of "-linolenic acid
REFERENCES
Bjerve KS. 1989. n-3 Fatty acid deficiency in man. J Intern Med 1989; 225:171175. Bjerve KS, Fischer S, Wammer F, and Egeland T. "-Linolenic acid and long-chain !-3 fatty acids supplementation in three patients with !-3 fatty acid deficiency: effect on lymphocyte function, plasma and red cell lipids, and prostanoid formation. Am J Clin Nutr 1989; 49: 290-300. Bjerve KS, Mostad IL, Thoresen L. Alpha-linolenic acid deficiency in patients on long-term gastrictube feeding: Estimation of linolenic acid and long-chain unsaturated n-3 fatty acid requirement in man. Am J Clin Nutr 1987a.; 45:6677. Bjerve KS, Thoresen L, Mostad IL, Alme K. Alpha-linolenic acid deficiency in man: Effect of essential fatty acids on fatty acid composition. Adv Prostaglandin Thromboxane Leukot Res 1987b.; 17:862865. Dietary fats: Total fat and fatty acids. (2005). In Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (pp. 422-541). Gropper, S. S., & Smith, J. L. (2013). Lipids. In Advanced nutrition and human metabolism (Sixth ed., pp. 137-182). Yolanda Cossio. ! Kris-Etherton PM, Taylor DS, Yu-Poth S, Huth P, Moriarty K, Fishell V, Hargrove RL, Zhao G, Etherton TD. 2000. Polyunsaturated fatty acids in the food chain in the United States. Am J Clin Nutr 71:179S188S. Omega-3 fatty acids. (2011, May 10). Retrieved October 30, 2013, from University of Maryland Medical Center website: http://umm.edu/health/medical/altmed/supplement/omega3-fattyacids#ixzz2is3feOfn