Caramia G
Dipartimento di Pediatria e Neonatologia, Azienda Ospedaliera Specializzata Materno Infantile ''G. Salesi'', Ancona, Italia.
Minerva Pediatr. 2008 Aug;60(4):443-55.
The leading role of cod-liver oil on rickets was a relevant factor in the knowledge of this disease. In 1922 the preventive and therapeutic value of cod-liver oil and sunlight against rickets in young infants was confirmed. The seasonal variation in the incidence of rickets, the role of skin pigmentation, of diet and the fact that breast milk was not an adequate source of vitamin D were understood. The discovery of essential fatty acids omega-6 and omega-3 have shown that deficiencies, mainly of omega-3 long chain polyunsaturated fatty acids, result in visual and cognitive impairment and disturbances in mental functions in infants and also in cognitive function in adults, as fatty acids are beneficial to vascular health and may forestall cerebrovascular disease and thus dementia. An adequate ratio of n-6 and n-3 fatty acids may promote a healthier balance of eicosanoids, which would protect membrane function with a nutraceutical function. Dietary lipids not only influence the biophysical state of the cell membranes but, via direct and indirect routes, they also act on multiple pathways including signalling, gene and protein activities, protein modifications and they probably play important role in modulating protein aggregation. Significant advances have been made in understanding the relation between dietary factors and inflammation, which is a central component of many chronic diseases, including coronary artery disease, rheumatoid arthritis, cancer prevention. However, the identification of those who will or will not benefit from dietary intervention strategies remains a major obstacle. Adequate knowledge about how the responses depend on an individual's genetic background (nutrigenetic effects), the cumulative effects of food components on genetic expression profiles through nutrigenomics mechanism, may assist in identifying responders and non-responders. Thus, fish and fish oil consumption might encourage brain development and gene expression to brain maintenance during aging through nutrigenomic mechanism.
鱼肝油在佝偻病防治方面的主导作用是人们认识这种疾病的一个重要因素。1922年，鱼肝油和阳光对幼儿佝偻病的预防和治疗价值得到了证实。人们了解到佝偻病发病率的季节性变化、皮肤色素沉着的作用、饮食情况以及母乳并非充足的维生素D来源这一事实。必需脂肪酸ω-6和ω-3的发现表明，缺乏（主要是ω-3长链多不饱和脂肪酸缺乏）会导致婴儿出现视觉和认知障碍以及心理功能紊乱，在成人中还会影响认知功能，因为脂肪酸对血管健康有益，可能预防脑血管疾病进而预防痴呆症。n-6和n-3脂肪酸的适当比例可能促进类二十烷酸形成更健康的平衡，从而通过营养保健功能保护膜功能。膳食脂质不仅影响细胞膜的生物物理状态，还通过直接和间接途径作用于包括信号传导、基因和蛋白质活性、蛋白质修饰等多种途径，它们可能在调节蛋白质聚集方面发挥重要作用。在理解饮食因素与炎症之间的关系方面已经取得了重大进展，炎症是包括冠状动脉疾病、类风湿性关节炎、癌症预防在内的许多慢性疾病的核心组成部分。然而，确定哪些人会或不会从饮食干预策略中受益仍然是一个主要障碍。充分了解反应如何取决于个体的遗传背景（营养遗传学效应），以及食物成分通过营养基因组学机制对基因表达谱的累积影响，可能有助于识别反应者和无反应者。因此，食用鱼类和鱼油可能通过营养基因组学机制促进大脑发育，并在衰老过程中维持大脑基因表达。
