Abstract
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.
Design:
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.
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Acknowledgements
This study was funded by the Medical Research Council. None of the authors had any conflicts of interest. We thank Ms J Cooke, HNR volunteer suite staff and Dieticians at Addenbrooke's Hospital for the volunteer work, Mr N Matthews for the fatty acid analysis, Mr I Halsall for the insulin analysis, Mr C Charalambos and the Nutritional Biochemistry Laboratory for other biochemical analyses. We also thank Pronova (Norway) for supplying the capsules for the intervention and SMILES for funding the development of the dietary advice programme.
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Author contributions: JD Krebs was responsible for all aspects of the study design, data collection, analysis and writing the manuscript. SA Jebb was involved in study design, data analysis and writing the manuscript. LM Browning was involved in data collection, data analysis and writing the manuscript. N McLean was involved in the developing the weight-loss programme and reviewing the manuscript. JL Rothwell, CS Moore and GD Mishra were involved in data collection, analysis and reviewing the manuscript.
Supplementary information is available on the International Journal of Obesity website (http://www.nature.com/ijo)
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Krebs, J., Browning, L., McLean, N. et al. Additive benefits of long-chain n-3 polyunsaturated fatty acids and weight-loss in the management of cardiovascular disease risk in overweight hyperinsulinaemic women. Int J Obes 30, 1535–1544 (2006). https://doi.org/10.1038/sj.ijo.0803309
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DOI: https://doi.org/10.1038/sj.ijo.0803309
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