Lanzmann-Petithory D
Hôpital Emile Roux, Pavillon Buisson-Jacob, Service de Gériatrie, 1 avenue de Verdun, 94456 Limeil-Brévannes Cedex France EU.
J Nutr Health Aging. 2001;5(3):179-83.
The intake of saturated fat was postulated to be the main environmental factor for coronary heart disease. It was also postulated that the noxious effects of saturated fatty acids (FA) was primarily through the increase in serum cholesterol. Nevertheless intervention trials either in coronary patients or even in primary prevention did not observe significant reduction in cardiac mortality, especially sudden death, when the diet was markedly enriched in linoleic acid (LA), the most efficient FA to lower serum cholesterol. In intervention trials, It is only when the diet was enriched in n-3 FA, especially alphalinolenic acid (ALA) that cardiac death was reduced. Studies in animals as well as in vitro on myocytes in culture, have shown that ALA was preventing ventricular fibrillation, the chief mechanism of cardiac death. Furthermore, studies in rats have observed that among n-3 FA, ALA, the precursor of the n-3 family, may be more efficient to prevent ventricular fibrillation than eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). In addition it was demonstrated that ALA was the main FA lowering platelet aggregation, an important step in thrombosis, i. e. non fatal myocardial infarction and stroke. Thus, without side effects, a higher intake of ALA (2g / day) with a ratio of 5/1 for LA/ALA, could possibly constitute a nutritional answer to the main cause of morbidity and mortality in industrialized countries.
饱和脂肪的摄入被假定为冠心病的主要环境因素。也有人假定饱和脂肪酸(FA)的有害影响主要是通过血清胆固醇的升高。然而,无论是在冠心病患者中还是在一级预防中进行的干预试验,当饮食中显著富含亚油酸(LA)(最有效的降低血清胆固醇的脂肪酸)时,都未观察到心脏死亡率有显著降低,尤其是猝死。在干预试验中,只有当饮食中富含n-3脂肪酸,尤其是α-亚麻酸(ALA)时,心脏死亡才会减少。对动物以及体外培养的心肌细胞的研究表明,ALA可预防心室颤动,这是心脏死亡的主要机制。此外,对大鼠的研究观察到,在n-3脂肪酸中,n-3家族的前体ALA可能比二十碳五烯酸(EPA)和二十二碳六烯酸(DHA)更有效地预防心室颤动。此外,已证明ALA是降低血小板聚集的主要脂肪酸,血小板聚集是血栓形成(即非致命性心肌梗死和中风)中的重要步骤。因此,在没有副作用的情况下,较高的ALA摄入量(2克/天)以及LA/ALA为5/1的比例,可能构成对工业化国家发病和死亡主要原因的一种营养应对措施。