Long-chain omega-3 fatty acid serum concentrations across life stages in the USA: an analysis of NHANES 2011-2012.

OBJECTIVE: To determine reference ranges of circulating long-chain (LC) omega-3 fatty acids: eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA) in a nationally representative population of Americans. To provide context, serum concentrations of LC omega-3 were compared with concentrations associated with consuming the recommended amount of EPA and DHA by the Dietary Guidelines for Americans (DGA) and the Omega-3 Index (EPA+DHA). DESIGN: Cross-sectional population-based study. SETTING: The National Health and Nutrition Examination Survey 2011-2012 cycle. PARTICIPANTS: Participants with fatty acids measured in serum: 945 children, age 3-19 years, and 1316 adults, age 20 and older. MAIN MEASURE: Serum EPA, DPA, DHA and sum of LC omega-3 fatty acids expressed as per cent of total fatty acids. RESULTS: Among children, mean (SE) serum concentrations of EPA, DHA and omega-3s were 0.28% (0.01), 1.07% (0.02) and 1.75% (0.03). Among adults, mean (SE) of EPA, DHA and omega-3s were 0.61% (0.02), 1.38% (0.05) and 2.43% (0.08), all of which were significantly higher than corresponding serum fatty acid concentrations in children (p<0.001). Despite recommendations for higher intake, pregnant and/or breastfeeding women had mean (SE) EPA, DHA and LC omega-3 concentrations of 0.34% (0.07), 1.52% (0.08) and 2.18% (0.15), which were comparable to women of childbearing age; p=0.17, p=0.10 and p=0.73. Over 95% of children and 68% of adults had LC omega-3 concentrations below those associated with the DGA recommendation. Approximately 89% of adults had an Omega-3 Index in the high cardiovascular risk category. CONCLUSIONS: Contemporary reference ranges for circulating LC omega-3s are critical for setting public health recommendations. Our findings show the need for continued emphasis on regular consumption of LC omega-3s among Americans, particularly considering the importance of LC omega-3s in cardiovascular health, brain health and development throughout life.

Cost-Effectiveness of Nutrient Supplementation in Cancer Survivors.

Cancer patients are at risk for malnutrition; the aim of this study was to provide a cost-effectiveness analysis of dietary supplementation in cancer survivors. We estimated prevalence of supplementation, hospitalization rates, quality of life (QOL), cost of care and mortality among cancer survivors. We built a decision analytic model to simulate life-long costs of health care and supplementation and QOL among cancer survivors with and without supplementation. Cost of supplements was derived from national pharmacy databases including single- and multivitamin formularies. One-way and probabilistic sensitivity analysis were performed to evaluate the robustness of the incremental cost-effectiveness ratio (ICER) to changes in supplementation costs and duration. The study cohort represented the national cancer survivor population (average age 61 years, 85% white, 52% male, and 94% insured). Hospitalization rates for supplement users and non-users were 12% and 21%, respectively. The cost of hospitalization was $4030. Supplementation was associated with an additional 0.48 QALYs (10.26 vs. 9.78) at the incremental cost of $2094 ($236,933 vs. $234,839) over the remaining lifetime of survivors (on average 13 years). Adequate nutrition provides a cost-effective strategy to achieving potentially optimum health. Further studies are needed to determine the effects of specific nutrient doses and supplementation on long-term outcomes per cancer type.

Inhibition of Toxic IAPP Amyloid by Extracts of Common Fruits.

The aggregation of the 37-amino acid polypeptide islet amyloid polypeptide (IAPP, amylin), as either insoluble amyloid or as small oligomers, appears to play a direct role in the death of pancreatic ß-islet cells in type 2 diabetes. It is believed that inhibiting the aggregation of IAPP may slow down, if not prevent entirely, the progression of this disease. Extracts of thirteen different common fruits were analyzed for their ability to prevent the aggregation of amyloidogenic IAPP. Thioflavin T binding, immuno-detection and circular dichroism assays were performed to test the in vitro inhibitory potential of each extract. Atomic force microscopy was used to visualize the formation of amyloid fibrils with and without each fruit extract. Finally, extracts were tested for their ability to protect living mammalian cells from the toxic effects of amyloid IAPP. Several fruits showed substantial ability to inhibit IAPP aggregation and protect living cells from toxic IAPP amyloid.