Volume 04 Issue 01 Jan-March 2011
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ADVANCES
 In EPA & DHA Research
In Scotland, levels of fish consumption are amongst the lowest in the world; whereas, levels of CHD are amongst the highest.
 
DHA supplementation demonstrated significantly beneficial changes for multiple independent risk factors of CHD, including blood pressure and heart rate.  
 
DHA incorporated into foods, such as bread rolls, is a successful strategy for increasing people’s DHA lipid status where fish intake is relatively low. 
Quarterly Journal of Significant Omega-3 Research
Pregnancy and developmental outcomes
Effect of DHA enriched bread on multiple CHD risk factors  

Review of:
Sagara M, Njelekela et al. Effects of Docosahexaenoic Acid in Supplementation on Blood Pressure, Heart Rate, and Serum Lipids in Scottish Men with Hypertension and Hypercholoesterolemia. International Journal of Hypertension, 2011, doi:10.4061/2011/809198. 

Introduction
Death rates from coronary heart disease (CHD) in Scotland are amongst the highest in Europe [1]; whereas, levels of fish consumption in Scotland are amongst the lowest in the world [2]. Previous epidemiological studies have demonstrated an inverse relationship between death from CHD and fish consumption [3], consequently this study aimed to assess the potential benefit of DHA supplementation on a range of CHD risk factors in Scottish men with pre-existing hypertension and/or hypercholesterolemia.

Design
Fifty-six hypertensive and/or hypercholesterolemic men were initially enrolled in the study and randomly assigned to receive either 2g/day of DHA or 1g/day of olive oil.  The oils were incorporated into bread rolls, which were supplied on alternate days for a total of five weeks. Systolic and diastolic blood pressure, heart rate, and lipid proļ¬les were measured at the end of the supplementation period. 


Results
Of the 56 men that enrolled in the study, results from 38 of the men were available for analysis. Results demonstrated that men given DHA-enriched bread rolls showed significant reductions in systolic (5.8%) and diastolic (3.7%) blood pressure as well as heart rate (7.5%) when compared to baseline. The olive oil group also demonstrated reductions in these parameters but these did not reach statistical significance (see figure below from Sagara et al., 2011).
 
Analysis of serum lipid profiles also demonstrated beneficial results in the DHA supplemented group, with significant increases in HDL cholesterol (16.7%) and significant decreases in both the total cholesterol to HDL cholesterol ratio and the non-HDL cholesterol to HDL cholesterol ratio when compared to baseline. These beneficial changes in serum cholesterol composition were also demonstrated in the olive oil supplemented group.  

  

 
Strengths
  • Randomized, double-bind, placebo-controlled design
  • Assessment of multiple risk factors
  • Placebo and active administered in bread rolls which improved compliance and blinding whilst also demonstrating the ability to supplement omega 3s in food
  • Beneficial results over relatively short period of supplementation (5 weeks)

Weaknesses

  • Use of olive oil placebo made it difficult to detect differences between groups
  • Relatively small sample size
  • Some of the lipid profile indicators, such as apolipoproteins, were not assessed


 Summary
In this randomized, double-blind, placebo-controlled study, supplementation of DHA incorporated into bread rolls significantly reduced multiple independent risk factors for CHD in men with hypertension and/or hypercholesterolemia. Therefore, dietary supplementation of DHA in food is an effective method for reducing the risk of CHD in people who do not frequently eat fish. 
 

Suggested Citation
Weatherhead G, Byelashov A, Rice HB.  Advances in EPA & DHA Research: Effect of DHA enriched bread on multiple CHD risk factors. Quarterly Journal of Significant Omega-3 Research, 04;(01), 2011.


References

1. Scottish Public Health Observatory, Scotland and European Health for All Database 2009. 
2. Yamori Y, Liu L, Ikeda K, et al. Distribution of twenty four hour urinary taurine excretion and association with ischemic heart disease mortality in 24 populations of 16 countries: Results from the WHO-CARDIAC study. Hypertension Research 2001; 24:453-457.
3. Yamori Y, Nara Y, Ikeda K, Mizushima S. Is taurine a preventive nutritional factor of cardiovascular disease or just a biological marker of nutrition? Advances in Experimental Medicine and Biology 1996; 403:623-629.
 

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