High-fat meals rich in EPA plus DHA compared with DHA only have differential effects on postprandial lipemia and plasma 8-isoprostane F2α concentrations relative to a control high-oleic acid meal: a randomized controlled trial

Robert Purcell, Sally H Latham, Kathleen M Botham, Wendy L Hall, Caroline P D Wheeler-Jones, Robert Purcell, Sally H Latham, Kathleen M Botham, Wendy L Hall, Caroline P D Wheeler-Jones

Abstract

Background: Eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) supplementation has beneficial cardiovascular effects, but postprandial influences of these individual fatty acids are unclear.

Objectives: The primary objective was to determine the vascular effects of EPA + DHA compared with DHA only during postprandial lipemia relative to control high-oleic acid meals; the secondary objective was to characterize the effects of linoleic acid-enriched high-fat meals relative to the control meal.

Design: We conducted a randomized, controlled, double-blind crossover trial of 4 high-fat (75-g) meals containing 1) high-oleic acid sunflower oil (HOS; control), 2) HOS + fish oil (FO; 5 g EPA and DHA), 3) HOS + algal oil (AO; 5 g DHA), and 4) high-linoleic acid sunflower oil (HLS) in 16 healthy men (aged 35-70 y) with higher than optimal fasting triacylglycerol concentrations (mean ± SD triacylglycerol, 1.9 ± 0.5 mmol/L).

Results: Elevations in triacylglycerol concentration relative to baseline were slightly reduced after FO and HLS compared with the HOS control (P < 0.05). The characteristic decrease from baseline in plasma nonesterified fatty acids after a mixed meal was inhibited after AO (Δ 0-3 h, P < 0.05). HLS increased the augmentation index compared with the other test meals (P < 0.05), although the digital volume pulse-reflection index was not significantly different. Plasma 8-isoprostane F2α analysis revealed opposing effects of FO (increased) and AO (reduced) compared with the control (P < 0.05). No differences in nitric oxide metabolites were observed.

Conclusions: These data show differential postprandial 8-isoprostane F2α responses to high-fat meals containing EPA + DHA-rich fish oil compared with DHA-rich AO, but these differences were not associated with consistent effects on postprandial vascular function or lipemia. More detailed analyses of polyunsaturated fatty acid-derived lipid mediators are required to determine possible divergent functional effects of single meals rich in either DHA or EPA. This trial was registered at clinicaltrials.gov as NCT01618071.

Figures

FIGURE 1.
FIGURE 1.
Consolidated Standards of Reporting Trials flow diagram. AIxao, central augmentation index; AIxbr, peripheral augmentation index; Arteriograph, Arteriograph 24 upper-arm cuff device (TensioMed); DBPbr, peripheral diastolic blood pressure; SBPao, central systolic blood pressure; SBPbr, peripheral systolic blood pressure.
FIGURE 2.
FIGURE 2.
Total plasma EPA (A), DHA (B), DPA (C), EPA + DHA (D), oleic (E), and linoleic (F) fatty acids after the 4 high-fat meals. Values are expressed as means (±SEMs) as assessed by gas chromatography; n = 16. Each fatty acid shown changed significantly with time (P < 0.0001) and differed according to treatment (P < 0.0001), and there was a treatment × time interaction (P < 0.0001) as analyzed by 2-factor repeated-measures ANOVA. AO, algal oil meal; DPA, docosapentaenoic acid; FO, fish-oil meal; HLS, high–linoleic acid sunflower oil meal; HOS, high–oleic acid sunflower oil meal.
FIGURE 3.
FIGURE 3.
Change in postprandial plasma TAG (A) and NEFAs (B) after the 4 high-fat meals. Values for plasma TAG concentrations are mean (±SEM) changes in natural log-transformed data relative to fasting baseline values; n = 16. Values for plasma NEFA concentrations are mean (±SEM) changes in relation to fasting baseline values. Results were analyzed by 2-factor repeated measures ANOVA with Bonferroni post hoc analysis to determine which meals differed from control and at which time points. Both NEFAs and TAG changed with time (P < 0.0001) and differed according to treatment (P < 0.05), and there was a treatment × time interaction (P < 0.05). There was a reduction in (Ln)TAG after FO and HLS relative to HOS at 4, 5, and 6 h, whereas AO had no effect relative to HOS. NEFA concentrations were suppressed relative to baseline after all 4 meals, but AO diminished the reduction in NEFAs at 1, 2, and 3 h relative to HOS. FO compared with HOS: *P < 0.05, **P < 0.01; HLS compared with HOS: #P < 0.05, ##P < 0.01, ###P < 0.001; AO compared with HOS: $P < 0.05, $$P < 0.01. AO, algal oil meal; FO, fish-oil meal; HLS, high–linoleic acid sunflower oil meal; HOS, high–oleic acid sunflower oil meal; NEFA, nonesterified fatty acid; TAG, triacylglycerol.
FIGURE 4.
FIGURE 4.
Change in aortic (A) and brachial (B) AIx after the 4 high-fat meals. Values are mean (±SEM) changes relative to fasting baseline values at 1–6 h after test meals; n = 14. Data were analyzed by 2-factor repeated-measures ANOVA with a Bonferroni post hoc test to determine which meals differed from control and at which time points. Both AIxao and AIxbr were statistically significantly different over time (P < 0.0001). There was a statistically significant treatment effect with AIxao (P < 0.05), but the effect of treatment was not significant for AIxbr (P = 0.14). There was no treatment × time interaction for either AIxao or AIxbr. AIxao, central augmentation index; AIxbr, peripheral augmentation index; AO, algal oil meal; FO, fish-oil meal; HLS, high–linoleic acid sunflower oil meal; HOS, high–oleic acid sunflower oil meal.
FIGURE 5.
FIGURE 5.
Change in plasma 8-isoprostane F2α concentrations after 4 high-fat test meals. Values are mean (±SEM) changes relative to fasting baseline values at 2, 4, and 6 h after test meals; n = 16. Data were analyzed by 2-factor repeated-measures ANOVA with a Bonferroni post hoc test to determine which meals differed from control and at which time points. There were significant effects of time (P < 0.05) and a treatment × time interaction for values unadjusted for baseline (P < 0.05), and there was a trend for a treatment effect on change from baseline data (P = 0.052). Mean values after FO were increased relative to HOS and, after AO, were decreased relative to HOS. FO compared with HOS: *P < 0.05; AO compared with HOS: $P < 0.05. AO, algal oil meal; FO, fish-oil meal; HLS, high–linoleic acid sunflower oil meal; HOS, high–oleic acid sunflower oil meal.

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