School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK.
Lipids. 2022 Nov;57(6):267-287. doi: 10.1002/lipd.12355. Epub 2022 Jul 31.
α-linolenic acid (αLNA) conversion into the functionally important ω-3 polyunsaturated fatty acids (PUFA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), has been regarded as inadequate for meeting nutritional requirements for these PUFA. This view is based on findings of small αLNA supplementation trials and stable isotope tracer studies that have been interpreted as indicating human capacity for EPA and, in particular, DHA synthesis is limited. The purpose of this review is to re-evaluate this interpretation. Markedly differing study designs, inconsistent findings and lack of trial replication preclude robust consensus regarding the nutritional adequacy of αLNA as a source of EPC and DHA. The conclusion that αLNA conversion in humans is constrained is inaccurate because it presupposes the existence of an unspecified, higher level of metabolic activity. Since capacity for EPA and DHA synthesis is the product of evolution it may be argued that the levels of EPA and DHA it maintains are nutritionally appropriate. Dietary and supra-dietary EPA plus DHA intakes confer health benefits. Paradoxically, such health benefits are also found amongst vegetarians who do not consume EPA and DHA, and for whom αLNA conversion is the primary source of ω-3 PUFA. Since there are no reported adverse effects on health or cognitive development of diets that exclude EPA and DHA, their synthesis from αLNA appears to be nutritionally adequate. This is consistent with the dietary essentiality of αLNA and has implications for developing sustainable nutritional recommendations for ω-3 PUFA.
α-亚麻酸(αLNA)转化为具有重要功能的ω-3 多不饱和脂肪酸(PUFA),二十碳五烯酸(EPA)和二十二碳六烯酸(DHA),其转化效率一直被认为不足以满足这些 PUFA 的营养需求。这种观点基于小型 αLNA 补充试验和稳定同位素示踪研究的结果,这些结果被解释为表明人类 EPA 合成能力,特别是 DHA 合成能力有限。本文旨在重新评估这种解释。由于研究设计差异显著、结果不一致且缺乏试验重复,因此对于 αLNA 作为 EPA 和 DHA 的来源是否具有充足的营养,尚未达成稳健共识。认为人类 αLNA 转化受到限制的结论是不准确的,因为它假设存在未指定的、更高水平的代谢活性。由于 EPA 和 DHA 的合成能力是进化的产物,因此可以说它维持的 EPA 和 DHA 水平在营养上是适当的。饮食和超饮食 EPA 加 DHA 摄入可带来健康益处。矛盾的是,这种健康益处也存在于不吃 EPA 和 DHA 的素食者中,而 αLNA 转化是 ω-3 PUFA 的主要来源。由于没有报告排除 EPA 和 DHA 的饮食对健康或认知发育有不良影响,因此从 αLNA 合成它们在营养上似乎是足够的。这与 αLNA 的饮食必需性一致,并对制定可持续的 ω-3 PUFA 营养建议具有重要意义。