- Therapie und Dosierung
EPA oder gem. DACH-Referenzwerte
Fachzeitschriften wurden folgende Artikel über Omega-3 publiziert.
Die Liste dieser Publikationen wurde im April 2003 kompiliert
und erhebt keinen Anspruch auf Vollständigkeit. Quelle: MEDLINE.
Die Daten dienen als Referenz für
Ärzte, Therapeuten und für eine therapeutische Dosis
bei Alzheimer und Parkinson.
and differences between Alzheimer's disease and vascular dementia
from the viewpoint of nutrition.
Otsuka M: Department of Neurology,
Jichi Medical School, Omiya Medical Center; Yamaguchi K,
Ann N Y Acad Sci 2002 Nov 977:155-61
Dietary habits were compared in patients with Alzheimer's
disease (AD) and those with vascular dementia (VaD). Twenty-seven
patients with AD, 15 patients with VaD, and 49 age-matched controls
were enrolled. Nutritional status was assessed using a semiquantified
food-frequency questionnaire. Dietary habits were very similar
in male patients with AD and VaD. Both groups had significantly
higher energy intake than their energy demands: +25% for AD and
+35% for VaD, respectively. However, major sources of energy were
different: grains and animal fats for AD versus only grains for
VaD. Calculation of nutrients revealed excess intake of n-6 polyunsaturated
fatty acids (PUFA) and relative deficiencies of multiple vitamins
including antioxidants, vitamin C and carotene, and the vitamin
B group. In contrast, dietary habits in female patients with AD
differed significantly from those of male patients. Female patients
consumed significantly lower amounts of fish and green vegetables.
Calculation of nutrients showed absolute deficiencies of n-3 PUFA,
multiple vitamins, and minerals. Our results show that AD and
VaD are similar from the viewpoint of nutrition, except for the
higher consumption of animal fats for AD patients, probably reflecting
Westernization of dietary habits in recent years. Nutrition may
be relevant to the pathogenesis of dementia through many processes.
Higher intake of energy and lower intake of antioxidants may exaggerate
the process of dementia through oxidative stress. Excessive amounts
of n-6 PUFA or deficiency of n-3 PUFA may cause chronic inflammation,
platelet aggregation, or endothelial dysfunction of microvasculature.
Nutrition may be useful for preventing dementia, although gender-specific
differences must be taken into account.
of dietary factors in Alzheimer's disease: clinical use of nutritional
intervention for prevention and treatment of dementia.
Otsuka M: Department of Neurology,
Jichi Medical School, Omiya Medical Center
Nippon Ronen Igakkai Zasshi 2000 Dec 37:970-3
To determine dietary factors involved in the pathological
process of Alzheimer's disease (AD), we analyzed food consumption
and intake of nutrients using Self-administered Diet History Questionnaire
(DHQ) developed for Japanese. Sixty four AD patients and 80 age-matched
healthy subjects were enrolled in this study. AD was diagnosed
according to the criteria of DSM-IV. Dietary behaviors of AD patients
was markedly deviated from those of age-matched healthy elderly.
AD patients disliked fish and green-yellow vegetables and took
more meats than controls. Energy-adjusted analysis of nutrients
revealed that AD patients took less vitamin C and carotene. Most
conspicuously, AD patients took significantly smaller amount of
n-3 polyunsaturated fatty acid (PUFA) reflecting low consumption
of fish, and their n-6/n-3 ratio was significantly increased.
These habits started from 3 months to 44 years before the onset
of dementia, suggesting these dietary abnormalities are not merely
the consequence of dementia. Rather, it implies that AD might
be a life style-related disease such as coronary heart disease,
western style diet-associated cancer and hyperallergy. To see
if cognitive function was improved by correcting the n-6/n-3 ratio,
we prescribed eicossapentaenoic acid (EPA), one type of n-3 PUFA,
for AD patients. Cognitive function was evaluated using MMSE.
Administration of EPA (900 mg/day)
improved MMSE significantly with maximal effects at 3 months and
the effects lasted 6 months. However, the score of MMSE decreased
after 6 months. The present study showed
that nutritional intervention is useful for the prevention of
AD, and also for the therapy of dementia, though it has some limitation.
fatty acid composition shows delta-6-desaturase abnormalities
in Alzheimer's disease.
Nakada T: Department of Veterans Affairs
Medical Center, Martinez, CA 94553, USA; Kwee IL, Ellis WG
Neuroreport 1990 Oct 1:153-5
Brain membrane phospholipid fatty acid composition is investigated
in Alzheimer's disease using fresh pathologically proven autopsy
material. The most striking abnormalities in Alzheimer brains
compared to age-matched controls are found in the n - 6 line of
polyunsaturated fatty acids (PUFA) showing an elevation of 18:2
(n - 6) associated with a reduction of 20:4 (n - 6) and 22:4 (n
- 6). The findings strongly indicate abnormalities in delta 6-desaturation.
The decrease in 22:6 (n - 3) also supports delta 6-desaturase
abnormalities. Alteration in PUFA desaturation/elongation processes
and resultant membrane abnormalities may play a key role in the
pathogenesis of Alzheimer's disease.
beta-oxidation of arachidonic acid and the synthesis of docosahexaenoic
acid are selectively and consistently altered in skin fibroblasts
from three Zellweger patients versus X-adrenoleukodystrophy, Alzheimer
and control subjects.
Petroni A: Institute of Pharmacological
Sciences, University of Milan, Italy; Bertagnolio B, La Spada P,
Blasevich M, Papini N, Govoni S, Rimoldi M,
Neurosci Lett 1998 Jul 250:145-8
The beta-oxidation of [3H] arachidonic acid (AA; 20:4 n-6)
and the conversion of [1-14C]eicosapentaenoic acid (EPA, 20:5
n-3) to docosahexaenoic acid (DHA, 22:6 n-3) have been studied
in skin fibroblasts from patients with inherited peroxisomal diseases,
such as Zellweger (ZW) and X-linked adrenoleukodystrophy (X-ALD),
from patients with Alzheimer's disease (AD), a non-inherited neuropathology,
and from controls. EPA is not converted to DHA, while there is
enhanced formation of the intermediate product 22:5 n-3 in ZW,
when compared to X-ALD, AD and controls. We also confirmed that
AA is not beta-oxidized to 4,7,10-hexadecatrienoic acid (16:3),
a metabolite produced by peroxisomes, while being more effectively
converted to the elongation product 22:4, in ZW, in comparison
to X-ALD, AD and controls. The data demonstrate a defect in DHA
synthesis and in AA beta-oxidation, and the occurrence of associated
adaptative modifications in the metabolism of these long chain
PUFA, in three Italian ZW patients.
fatty acids and the brain: possible health implications.
Youdim KA: Laboratory of Neuroscience,
United States Department of Agriculture, Jean Mayer Human Nutrition
Research Center on Aging at Tufts University, Boston, MA, USA;
Martin A, Joseph JA
Int J Dev Neurosci 2000 Jul-Aug 18:383-99
Linoleic and alpha-linolenic acid are essential for normal
cellular function, and act as precursors for the synthesis of
longer chained polyunsaturated fatty acids (PUFAs) such as arachidonic
(AA), eicosapentaenoic (EPA) and docosahexaenoic acids (DHA),
which have been shown to partake in numerous cellular functions
affecting membrane fluidity, membrane enzyme activities and eicosanoid
synthesis. The brain is particularly rich in PUFAs such as DHA,
and changes in tissue membrane composition of these PUFAs reflect
that of the dietary source. The decline in structural and functional
integrity of this tissue appears to correlate with loss in membrane
DHA concentrations. Arachidonic acid, also predominant in this
tissue, is a major precursor for the synthesis of eicosanoids,
that serve as intracellular or extracellular signals. With aging
comes a likely increase in reactive oxygen species and hence a
concomitant decline in membrane PUFA concentrations, and with
it, cognitive impairment. Neurodegenerative disorders such as
Parkinson's and Alzheimer's disease also appear to exhibit membrane
loss of PUFAs. Thus it may be that an optimal diet with a balance
of n-6 and n-3 fatty acids may help to delay their onset or reduce
the insult to brain functions which these diseases elicit.
acids of plasma lipids, red cells and platelets in Alzheimer's
disease and vascular dementia.
Tilvis RS, Erkinjuntti T, Sulkava R,
Atherosclerosis 1987 Jun 65:237-45
Fatty acids of plasma lipids, red cells and platelets were
analyzed from 38 demented patients (age 53-88 years), comprising
11 patients with Alzheimer's disease (AD), 19 with multi-infarct
dementia (MID) and 8 with probable vascular dementia (PVD). The
mean age, body mass index, duration of dementia and content of
triglycerides, total cholesterol and HDL-cholesterol in plasma
were similar in AD and MID. The patients with PVD were older.
As compared to AD, in MID and PVD the linoleic acid (LA) and other
n-6 and n-3 polyunsaturated fatty acids (PUFA) were significantly
lower in red cells and tended to be lower also in serum triglycerides,
cholesterol esters (CHE) and phospholipids (PL), and platelets.
The LA content of red cells was significantly correlated with
that of serum CHE and PL, and n-6 PUFA (including arachidonic
acid) of red cells. The low LA content of red cells was associated
with old age, coronary heart disease and heart failure, but not
with the severity of dementia.
fat intake and the risk of incident dementia in the Rotterdam Study.
Kalmijn S: Department of Epidemiology and Biostatistics, Erasmus
University Medical School, Rotterdam, The Netherlands; Launer LJ,
Ott A, Witteman JC, Hofman A, Breteler MM
Ann Neurol 1997 Nov 42:776-82
A high intake of saturated fat and cholesterol and a low intake
of polyunsaturated fatty acids have been related to an increased
risk of cardiovascular disease. Cardiovascular disease has been
associated with dementia. We investigated the association between
fat intake and incident dementia among participants, age 55 years
or older, from the population-based prospective Rotterdam Study.
Food intake of 5,386 nondemented participants was assessed at baseline
with a semiquantitative food-frequency questionnaire. At baseline
and after an average of 2.1 years of follow-up, we screened for
dementia with a three-step protocol that included a clinical examination.
The risk of dementia at follow-up (RR [95% CI]) was assessed with
logistic regression. After adjustment for age, sex, education, and
energy intake, high intakes of the following nutrients were associated
with an increased risk of dementia: total fat (RR = 2.4 [1.1-5.2]),
saturated fat (RR = 1.9 [0.9-4.0]), and cholesterol (RR = 1.7 [0.9-3.2]).
Dementia with a vascular component was most strongly related to
total fat and saturated fat. Fish consumption, an important source
of n-3 polyunsaturated fatty acids, was inversely related to incident
dementia (RR = 0.4 [0.2-0.91), and in particular to Alzheimer's
disease (RR = 0.3 [0.1-0.9]). This study suggests that a high saturated
fat and cholesterol intake increases the risk of dementia, whereas
fish consumption may decrease this risk.
acid therapy in docosahexaenoic acid-deficient patients with disorders
of peroxisomal biogenesis.
Martinez M: Biomedical Research Unit, University Maternity-Children's
Hospital, Barcelona, Spain
Lipids 1996 Mar 31 Suppl:S145-52
A patient with classic Zellweger syndrome was treated with docosahexaenoic
acid ethyl ester (DHA-EE) for three months. Five other patients
with Zellweger variants (four of them less than one-year-old and
a five-year-old) were treated with DHA-EE until normalization of
the DHA levels in erythrocytes. When arachidonic acid (AA) concentration
decreased, AA was added to the diet. Thereafter, a combined treatment
with DHA plus AA followed, in a variable proportion that allowed
the high levels of DHA in erythrocytes to be maintained. In the
patient with Zellweger syndrome, DHA therapy produced an increase
in plasmalogen and a decrease in 26:0 and 26:1. No clear clinical
improvement could be detected in this patient during the short period
of treatment with DHA-EE. The most consistent clinical effect produced
by DHA therapy in the other patients with disorders of peroxisomal
biogenesis was visual improvement, even in those patients that were
virtually blind before the treatment. In general, the developmental
curve began to accelerate. The infants became more alert, acquired
better visual and social contact and muscular tone improved, with
the beginning of good head control. The liver tests tended to normalize
and some patients showed a reduction of hepatomegaly. All these
favorable changes occurred when the patients were taking the DHA-EE
alone. In some of the patients, muscular tone seemed to improve
further after introducing AA supplements. From the biochemical point
of view, the plasmalogen levels increased in most cases in erythrocytes,
and the two ratios 26:0/22:0 and 26:1/22:0 decreased in plasma.
In some patients there was a tendency for 26:1 to increase in plasma
and for 18:0 plasmalogen to decrease in erythrocytes when AA was
introduced in the diet. The significance of these findings remains
to be elucidated, but they stress the importance of strict monitoring
and control of the polyunsaturated fatty acids status during DHA
analysis of blood plasma of patients with Alzheimer's disease, other
types of dementia, and cognitive impairment.
Conquer JA: Department of Human Biology and Nutritional Sciences,
University of Guelph, Ontario, Canada; Tierney MC, Zecevic J, Bettger
WJ, Fisher RH
Lipids 2000 Dec 35:1305-12
Fatty acid differences, including docosahexaenoic acid (DHA; 22:6n-3)
have been shown in the brains of Alzheimer's patients (AD) as compared
with normal age-matched individuals. Furthermore, low serum DHA
is a significant risk factor for the development of AD. The relative
concentration of DHA and other fatty acids, however, in the plasma
of AD patients compared with patients with other kinds of dementias
(other dementias; OD), patients who are cognitively impaired but
nondemented (CIND), or normal patients is not known. In this study
we analyzed the total phospholipid, phosphatidylcholine (PC), phosphatidylethanolamine
(PE), and lysophosphatidylcholine (lysoPC) fractions of plasma from
patients diagnosed with AD, OD, or CIND and compared them with a
group of elderly control subjects with normal cognitive functioning.
Plasma phospholipid and PC levels of 20:5n-3, DHA, total n-3 fatty
acids, and the n-3/n-6 ratio were lower in the AD, OD, and CIND
groups. Plasma phospholipid 24:0 was lower in the AD, OD, and CIND
groups as compared with the group of control patients, and total
n-6 fatty acid levels were higher in the AD and CIND groups only.
In the plasma PE fraction, levels of 20:5n-3, DHA, and the total
n-3 fatty acid levels were significantly lower in the AD, OD, and
CIND groups. DHA levels were lower in the lysoPC fraction of CIND
individuals only. There were no other differences in the fatty acid
compositions of the different phospholipid fractions. Therefore,
in AD, OD, and CIND individuals, low levels of n-3 fatty acids in
the plasma may be a risk factor for cognitive impairment and/or
dementia. Interestingly, a decreased level of plasma DHA was
not limited to the AD patients but appears to be common in cognitive
impairment with aging.