Additive benefits of long-chain n-3 polyunsaturated fatty acids and weight-loss in the management of cardiovascular disease risk in overweight hyperinsulinaemic women.
BACKGROUND
Obesity, inflammation, insulin resistance and cardiovascular disease (CVD) risk are inter-related. Both weight-loss and long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFA) are independently known to reduce metabolic risk, but the combined effects are unclear.


OBJECTIVE
This study examines whether addition of LC n-3 PUFA to a low fat/high carbohydrate weight-loss programme results in greater improvements in inflammation, insulin sensitivity and CVD risk, than weight-loss alone.


METHODS
One hundred and sixteen overweight insulin-resistant women entered a 24-week randomised intervention study. Thirty-nine women were randomised to a weight-loss programme, with LC n-3 PUFA (WLFO), 38 to a weight-loss programme with placebo oil (WLPO), and 39 to receive placebo oil, with no weight-loss programme (control).


RESULTS
Ninety-three women completed the study (35 WLFO, 32 WLPO and 26 control), with significant weight-loss in WLFO (10.8+/-1.0%) and WLPO (12.4+/-1.0%) compared to the control group (P<0.0001). The WLFO, but not WLPO or control group, showed significant increases in adipose tissue LC n-3 PUFA (0.34+/-0.20 vs 0.17+/-0.10 and 0.16+/-0.10 %DHA, P<0.0001). Weight-loss showed significant improvements in insulin sensitivity (P<0.001), lipid profile (triglycerides P<0.05) and inflammation (sialic acid P<0.05). Time*group effects showed significant decreases in triglycerides (P<0.05) and increases in adiponectin (P<0.01) with LC n-3 PUFA, in the WLFO vs WLPO groups.


CONCLUSIONS
Weight-loss improved risk factors associated with CVD, with some additional benefits of LC n-3 PUFA on triglycerides and adiponectin. Given the current low dietary intake of LC n-3 PUFA, greater attention should be given to increase these fatty acids in the treatment of obesity.
Krebs
J D
JD
MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK.
Browning
L M
LM
McLean
N K
NK
Rothwell
J L
JL
Mishra
G D
GD
Moore
C S
CS
Jebb
S A
SA
D000273:Adipose Tissue / Q000378:metabolism; D000328:Adult; D000368:Aged; D000886:Anthropometry / Q000379:methods; D001824:Body Constitution; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003131:Combined Modality Therapy; D004038:Diet, Reducing; D004311:Double-Blind Method; D002149:Energy Intake; D005227:Fatty Acids / Q000378:metabolism; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000150:complications / Q000628:therapy*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000628:therapy*; D050177:Overweight; D012307:Risk Factors; D015431:Weight Loss
D005227:Fatty Acids; D015525:Fatty Acids, Omega-3; D007328:Insulin