Cardio-Protective Properties and Health Benefits of Fish Lipid Bioactives; The Effects of Thermal Processing
Abstract
:1. Introduction
2. Fish Lipid Bioactives and Health Benefits
2.1. Fatty Acid Content of Fish
2.1.1. Saturated Fatty Acids (SFA) in Fish
2.1.2. Monounsaturated Fatty Acids (MUFA) in Fish
2.1.3. Polyunsaturated Fatty Acids (PUFA) of Fish and the Importance of the n-6/n-3 PUFA Ratio
2.2. Fish Polar Lipids (Phospholipids and Glycolipids)
2.3. Fish Alkylacylglycerols
2.4. Lipid Vitamins in Fish
2.4.1. The Lipid Vitamin D
2.4.2. The Lipid Vitamin E
2.4.3. The Lipid Vitamin A and Marine Carotenoids
3. The Effects of Thermal Processing—Cooking on the Bio-Functionality of Fish Lipid Content
4. Current and Future Perspectives on Green Extraction Methodologies for the Recovery of High-Quality Fish Lipid Bioactives
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Acknowledgments
Conflicts of Interest
References
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Reference | Study Design | Fish/Fish Oil/Fish Lipid Bioactives (Dose/Amount per Day in Cases of In Vivo Trials) | Health Effects Studied | Cell-Models (In Vitro)—Participants (In Vivo) (Duration) | Main Effects on Health | Other Health Observations—Benefits |
---|---|---|---|---|---|---|
[41] | Prospective study | n-3 PUFA | Risk of CVD | 57,972 participants (12.7 years) | Reduced risk of mortality | Lowered blood pressure and inflammatory markers |
[42] | Randomized crossover feeding trial | Salmon (113 g, twice/wk) | Incident of CHD | 25 participants (4 weeks) | Lower cholesterol and triglyceride conc. | Increased HDL-cholesterol |
[43] | Randomised controlled trial | Fish | Secondary prevention of MI | 2033 participants (2 years) | 29% reduction all-cause mortality | 3–4% lower serum cholesterol |
[44] | Randomised, placebo-controlled trial | Fish oil | Prevention of MI | 122, 120, and 118 patients (1 year) | Decrease in total cardiac events | Reduced left ventricular enlargement and angina pectoris |
[45] | Randomised controlled trial | n-3 PUFA | Prevention of MI | 11,324 participants (3.5 years) | Lowered risk of primary endpoint | Reduced cholesterol and triglyceride |
[46] | Randomized, double- blind, placebo-controlled clinically controlled trial | Fish oil concentrate (6 g/d for 3 months and 3 g/d for 21 months) | Effect on CHD | 223 patients (2 years) | Lowering in CHD events | Loss in minimal luminal diameter |
[47] | Meta-analysis | Dietary and non-dietary intake of n-3 PUFA | Effect on CHD | 7951 participants in the intervention, 7855 participants controlled (1966–1999) | Reduction in overall mortality | Reduction in MI and sudden death |
[48] | Cross-sectional study | n-3 PUFA | Effect on inflammatory biomarkers | 1024 patients (2 years) | Inverse association of n-3 intake and levels of inflammatory biomarkers | |
[49] | Epidemiological study | n-3 PUFA | Effect on inflammatory markers | 1123 patients | Intake associated with lower levels of pro-inflammatory markers | Intake associated with high levels of anti-inflammatory markers |
[50] | Cross-sectional study | n-3 PUFA and fish | Effect on inflammation and its related markers | 5677 men and women | Lowered levels of inflammation and endothelial activation | Intake inversely associated with IL-6 levels |
[51] | Cross-sectional study | n-3 PUFA and fish | Effect on low-grade inflammation, atheroclerosis and CVD | 2000 participants | Inverse association with inflammatory marker levels | Triglycerides decreased across n-3 tertiles |
[52] | Cross-sectional study | Fish | Inflammatory markers | 3042 men and women | Associated with lower inflammatory marker levels | Significant results attained even in lower quantities on fish consumed |
[53] | Meta-analysis | Fish oil | Inflammatory markers | 7 trials included | Decreased levels of TNF-a and IL-6 | C-reactive protein not significantly affected |
[54] | Quantitative analysis | Fish | CHD mortality | 8 studies | Reduced risk of CHD | 3.9% reduction associated with each additional serving per week |
[55] | Meta-analysis | Fish | CHD mortality | 11 eligible and 13 cohort studies (11.5 years average follow up) | Inverse association with CHD mortality | Benefits achieved by consuming fish just once per week |
[56] | Randomised controlled trial | Mediterranean diet supplemented with fatty fish | Inflammation in paediatric asthma | 64 children (effects noticed after 6 months) | Reduced airway inflammation in childhood asthma | |
[57] | Randomised controlled trial | Mediterranean diet supplemented with fish oil | Mental health | 95 participants (6 months) | Improved mental health in people with depression | At 3 months significant inverse correlation between Med-scores and depression |
[58] | Cross-sectional analysis | Fish | Rheumatoid arthritis | 176 participants | Lowered disease activity and risk for CVD in RA patients | |
[59] | Meta-analysis | EPA+DHA | Blood pressure | 7 RCTs (2012–2014) | Reduced systolic blood pressue | >2 g reduces diastolic blood pressure |
[60] | In vitro study | Polar lipids from salmon under thermal treatment (cooking) versus raw untreated salmon | Anti-inflammatory and anti-thrombotic properties | Human platelets | Εffects of thermal treatment on the anti-inflammatory and antithrombotic potency of salmon polar lipids | Salmon PL rich in n-3 PUFA retain their ability to inhibit human platelet aggregation induced by the inflammatory and thrombotic mediators PAF and thrombin, but also by well-established platelet agonists such as ADP and collagen, after heat treatment |
[9] | In vitro study | Fish by-products | Anti-inflammatory and anti-thrombotic properties | Human platelets | PL from fish by-products inhibited human platelet aggregation induced by the inflammatory and thrombotic mediators PAF and thrombin, but also by well-established platelet agonists such as ADP and collagen | PL bioactives from fish by-products are putative candidates for the sustainable development of novel supplements and nutraceuticals with cardio-protective properties |
[30,31] | In vitro study | Salmon PL | Anti-inflammatory and anti-thrombotic cardio-protective properties | Human platelets | Food grade extracted salmon PL bioactives inhibited human platelet aggregation induced by the inflammatory and thrombotic mediators PAF and thrombin, at the same levels as the conventional extracted salmon PL | Food grade extracted PL bioactives rich in n-3 PUFA from fish sources are putative candidates for developing novel supplements and nutraceuticals with cardio-protective properties, according to EFSA and EU legislations, in contrast to conventional extracted salmon PL |
[26,61] | Ex vivo trial in hypercholesterolaemic rabbits | Fish polar lipids | Formation of Atherosclerotic plaques Serum Lipid profile Inflammatory levels and metabolism of PAF | 12 rabbits (fish polar lipids were included in the diet of 66 rabbits versus another 6 that were not administered fish polar lipids (control) (45 days) | Evaluation of anti-atherogenic properties of fish PL: rabbits fed with hypercholesterolemic diet with fish PL developed atherosclerotic lessions of lower degree than the control ones, which were fed a hypercholesterolemic diet without the presence of fish PL. The inclusion of fish PL in the diet of these rabbits increased HDL levels as well | Fish PL modulated the metabolism of the inflammatory and thrombotic mediator, PAF, towards a reduction of PAF-levels to homeostatic lower levels in rabbits fed with hypercholesterolemic diet with fish PL, which reduced inflammation and thus reduced atherosclerosis progression |
[62] | In vitro study | Sardine lipid bioactives and cod liver oil | Anti-platelet properties | Evaluation of the anti-platelet properties of an oily fish (sardines) and of a fish oil (cod liver oil) lipid bioactives as putative candidates for anti-atherogenic agents | Inhibition of rabbit platelet aggregation induced by the inflammatory and thrombotic mediator PAF | |
[63] | In vitro study | Fish lipids | Anti-platelet properties | Rabbit platelets | Evaluation of anti-platelet properties of fish lipid bioactives as putative candidates for anti-atherogenic agents | Inhibition of rabbit platelet aggregation induced by the inflammatory and thrombotic mediator PAF |
[27] | In vitro study | Fish polar lipids | Inflammatory levels and metabolism of PAF | Human mesangial cells | Reduction of inflammatory activation of mesangial cells and thus reduction of risk for glomerulosclerosis and other kidney disorders | Effect on PAF metabolism towards reduction of PAF-levels to homeostatic ones, which reduced inflammation |
[21] | Systematic review, Meta-analysis | Supplementation of n-3 PUFA | Risk of major cardiovascular disease events | 20 studies—randomized trials that enrolled 68,680 patients throughout 2012 | Lack of evidence to suggest the beneficial effect of n-3 PUFA supplementation in respect of cardiovascular events and other measurable changes in health | n-3 PUFA supplementation was not associated with a lower risk of all-cause mortality, cardiac death, sudden death, myocardial infarction, or stroke based on relative and absolute measures of association |
[22] | Meta-analysis | Supplementation of n-3 PUFA | Risk of major cardiovascular disease events and complications in peripheral arterial disease (PAD) | Randomized trials throughout 2013 that enrolled 396 individuals and lasted more than 12 weeks in adults with PAD | Insufficient evidence exists to suggest a beneficial effect of n-3 PUFA supplementation in adults with PAD with regard to cardiovascular events and other serious clinical outcomes | There was no evidence of a protective association of n-3 PUFA supplementation against major adverse cardiac events or other serious clinical outcomes. Any adverse events and compliance were poorly reported |
[23] | Systematic review | Supplementation of n-3 PUFA | Prevention of cardiovascular disease | 2 meta-analysis studies on RCTs and 8 placebo-controlled RCTs, with more than 1000 patients and follow-up of more than a year, between 1999 and 2015, were included | There is currently a lack of evidence to support the routine use of omega-3 PUFAs in both the primary and secondary prevention of CVD. Safety of omega-3 PUFA supplementation should be considered and it was proposed that Pharmacists are ideally situated to engage patients in the discussion of the lack of benefit and possible risk of omega-3 PUFA | No reduction in CV events with n-3 PUFAs, in addition to standard, evidence-based therapy in patients after myocardial infarction. While data from RCTs have not demonstrated serious safety concerns, omega-3 PUFAs can increase the risk of bleeding and may interact with other medications that affect hemostasis, such as antiplatelet agents and warfarin |
[24] | Meta-analysis | Supplementation of n-3 PUFA | Secondary prevention of cardiovascular disease | 14 randomized, double-blind, placebo-controlled trials (involving 20,485 patients with a history of CVD) since April 2011 | Insufficient evidence of a secondary preventive effect of n-3 PUFA supplements against overall cardiovascular events among patients with a history of cardiovascular disease | No reduction of the risk of overall cardiovascular events, all-cause mortality, sudden cardiac death, myocardial infarction, congestive heart failure, or transient ischemic attack and stroke |
[25] | Systematic review, Meta-analysis | Consumption of fish and long chain n-3 PUFA | Risk of cerebrovascular disease | 26 prospective cohort studies and 12 randomised controlled trials with aggregate data on 794,000 non-overlapping people and 34,817 cerebrovascular outcomes, were included | Μoderate, inverse associations of fish consumption and long chain omega 3 fatty acids with cerebrovascular risk. The beneficial effect of fish intake on cerebrovascular risk is likely to be mediated through the interplay of a wide range of nutrients abundant in fish | Long chain n-3 PUFA measured as circulating biomarkers in observational studies or supplements in primary and secondary prevention trials were not associated with cerebrovascular disease |
[20] | Randomized, placebo-controlled trial, VITAL (Vitamin D and Omega-3 Trial) | A two-by-two factorial design, of vitamin D3 (at a dose of 2000 IU per day) and fish n-3 PUFA (at a dose of 1 g per day) | Primary prevention of cardiovascular disease and cancer | A total of 25,871 participants of men 50 years of age or older and women 55 years of age or older in the United States | Supplementation with n-3 PUFA did not result in a lower incidence of major cardiovascular events or cancer than placebo | |
[35] | A population-based cohort study (the Singapore Chinese Health Study) | Dietary n−3 PUFA | Association with cardiovascular death | 63,257 Chinese adults aged 45–74 years from 1993 to 1998 | Higher intakes of marine (EPA/DHA) and plant (ALA) omega-3 fatty acids are both associated with reduced risk of cardiovascular mortality in a Chinese population. The associations were similar for deaths from CHD and stroke and persisted in participants who were free of CVD at the baseline | High dietary intake of both marine and non-marine-based omega-3 fatty acids is associated with reduced risk of cardiovascular death in the Chinese population, particularly for deaths from coronary heart disease and in individuals without cardiovascular disease at baseline The beneficial effects of fish consumption of CVD risk and other chronic disease is due to the interplay of an array of different lipid nutrients instead of just n-3 PUFA in their neutral form |
[64] | A 2-by-2 factorial randomised control trial (Alpha Omega Trial), and no significant effect was found for either EPA/DHA or ALA | 2 g ALA or 400 mg EPA/DHA as the interventions | Cardiovascular events after myocardial infarction | 4837 post-myocardial infarction patients | No significant beneficial effect was found for all n-3 PUFA assessed (either EPA/DHA or ALA) | |
[65] | Randomised control trial for Prevention of Post-operative Atrial Fibrillation (OPERA) | Peri-operative oral n-3 PUFA supplementation (8–10g of n-3 PUFA or placebo divided over 2–5 days followed by 2 g per day until discharged from hospital or post-operative day 10) | Reduction of the occurrence of post-operative atrial fibrillation | 1516 patients receiving cardiac surgery | n-3 PUFA administration did not reduce the risk of post-operative atrial fibrillation, in comparison to the placebo | |
[66] | Randomised control trial, ORIGIN (Outcome Reduction with an Initial Glargine Intervention) | Long term supplementation of n-3 PUFA (1g capsules per day, containing at least 900 mg of ethyl esters of n-3 PUFA) | Reduction of the rate of cardiovascular events in patients with either Type II diabetes, impaired fasting glucose or impaired glucose intolerance | 12,537 participants during an average follow-up of 6.2 years | Incidences of death from cardiovascular causes did not decrease significantly amongst patients that received n-3 PUFA, in comparison to the control group that received the placebo | During >6 years of treatment followed by >2.5 years of observation, omega-3 fatty acid supplementation had no effect on health outcomes and salutary effects on metabolic control |
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Tsoupras, A.; Brummell, C.; Kealy, C.; Vitkaitis, K.; Redfern, S.; Zabetakis, I. Cardio-Protective Properties and Health Benefits of Fish Lipid Bioactives; The Effects of Thermal Processing. Mar. Drugs 2022, 20, 187. https://doi.org/10.3390/md20030187
Tsoupras A, Brummell C, Kealy C, Vitkaitis K, Redfern S, Zabetakis I. Cardio-Protective Properties and Health Benefits of Fish Lipid Bioactives; The Effects of Thermal Processing. Marine Drugs. 2022; 20(3):187. https://doi.org/10.3390/md20030187
Chicago/Turabian StyleTsoupras, Alexandros, Chloe Brummell, Ciara Kealy, Karolis Vitkaitis, Shane Redfern, and Ioannis Zabetakis. 2022. "Cardio-Protective Properties and Health Benefits of Fish Lipid Bioactives; The Effects of Thermal Processing" Marine Drugs 20, no. 3: 187. https://doi.org/10.3390/md20030187