
DOI: 10.1055/s-0040-1718995
Benefícios do ômega 3 na prevenção de doença cardiovascular: Revisão integrativa de literatura
Benefits of Omega 3 in Cardiovascular Disease Prevention: Integrative Literature Review
Resumo
Introdução Os ácidos graxos poliinsaturados-3, ou ômega 3, como o ácido alfa-linolênico (ALA, na sigla em inglês), uma gordura encontrada em alimentos vegetais, o ácido eicosapentaenoico (EPA, na sigla em inglês) e o ácido docosahexaenoico (DHA, na sigla em inglês), ambos encontrados em peixes, vêm sendo considerados substâncias relevantes para a manutenção da saúde, de modo que a suplementação vem sendo aventada como relevante para redução de riscos cardiovasculares.
Objetivo Identificar e analisar as evidências científicas disponíveis na literatura sobre a contribuição do ômega 3 na prevenção e no tratamento de doenças cardiovasculares.
Materiais e Métodos Revisão integrativa de literatura, com deferência a materiais publicados nas bases de dados da Scielo e PubMed, em que se considerou como critério de inclusão artigos publicados nos últimos 5 anos, disponíveis na íntegra, nos idiomas inglês, espanhol e português, que abordassem a temática proposta; os critérios de exclusão foram editoriais, cartas ao editor, estudos de revisão, teses, dissertações, artigos repetidos e que não correspondessem à temática.
Resultados Com base nas evidências científicas mencionadas, os índices de ômega 3 no organismo são relevantes para identificar possível risco cardiovascular, de modo que pode, portanto, ser usado como objetivo para o tratamento quando de possível risco para estas manifestações. Esse fator de risco pode ser modificado pela ingestão de EPA e DHA. A dose padrão de 1 g/dia de EPA e DHA recomendada pelas sociedades cardíacas, no entanto, provavelmente está longe de ser ideal para todos, já que não apenas essa dose padrão, mas também dieta, histórico genético individual, índice de massa corporal, ingestão e descarte de calorias, e outros fatores, todos juntos, provavelmente determinam o nível de ácidos graxos ômega 3 de uma determinada pessoa. Sugere-se, portanto, que o índice de ômega-3 atue não apenas como fator de risco para as doenças cardiovasculares, mas que outros contextos aliados ao estilo de vida do paciente sejam considerados.
Conclusão A dieta ou suplementação desses nutrientes pode resultar em benefícios cardiovasculares e outros para a sociedade como um todo.
Abstract
Introduction Omega-3 polyunsaturated fatty acids such as alpha-linolenic acid (ALA), a fat found in plant foods, and eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), both found in fish, have been considered relevant substances for the maintenance of health, so that supplementation is being considered relevant for the reduction of cardiovascular risks.
Objective To identify and analyze the scientific evidence available in the literature on the contribution of omega 3 in the prevention and treatment of cardiovascular disease.
Materials and Methods Integrative literature review, with deference to materials published in the Scielo and PubMed databases, which considered as inclusion criteria articles published in the last 5 years, available in full, in English, Spanish, and Portuguese, which addressed the proposed theme; the exclusion criteria were editorials, letters to the editor, review studies, theses, dissertations, and duplicate articles that did not correspond to the theme.
Results Based on the aforementioned scientific evidence, the body's omega-3 indices are relevant to identify possible cardiovascular risk, so it can therefore be used as an objective for treatment when there is a possible risk for these manifestations. This risk factor can be modified by taking EPA and DHA. The standard 1 g/day dose of EPA and DHA recommended by cardiac societies is, however, probably far from ideal for everyone, as not only this standard dose but also diet, individual genetic history, body mass index, calorie intake and disposal, and other factors all together probably determine a person's level of omega-3 fatty acids. Therefore, it is suggested that the omega-3 index acts not only as a risk factor for cardiovascular disease, but that other contexts allied to the patient's lifestyle should be considered.
Conclusion Diet or supplementation of these nutrients may result in cardiovascular and other types of benefits to society as a whole.
Publication History
Received: 14 August 2020
Accepted: 25 August 2020
Publication Date:
08 December 2020 (online)
© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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Referências
- 1 Mozaffarian D, Wu JH. Omega-3 fatty acids and cardiovascular disease: effects on risk factors, molecular pathways, and clinical events. J Am Coll Cardiol 2011; 58 (20) 2047-2067
- 2 Weylandt KH, Chiu CY, Gomolka B, Waechter SF, Wiedenmann B. Omega-3 fatty acids and their lipid mediators: towards an understanding of resolvin and protectin formation. Prostaglandins Other Lipid Mediat 2012; 97 (3-4): 73-82
- 3 Mohebi-Nejad A, Bikdeli B. Omega-3 supplements and cardiovascular diseases. Tanaffos 2014; 13 (01) 6-14
- 4 Adkins Y, Kelley DS. Mechanisms underlying the cardioprotective effects of omega-3 polyunsaturated fatty acids. J Nutr Biochem 2010; 21 (09) 781-792
- 5 Massaro M, Scoditti E, Carluccio MA, De Caterina R. Basic mechanisms behind the effects of n-3 fatty acids on cardiovascular disease. Prostaglandins Leukot Essent Fatty Acids 2008; 79 (3-5): 109-115
- 6 Cohen MG, Rossi JS, Garbarino J. et al. Insights into the inhibition of platelet activation by omega-3 polyunsaturated fatty acids: beyond aspirin and clopidogrel. Thromb Res 2011; 128 (04) 335-340
- 7 Jacobson TA, Glickstein SB, Rowe JD, Soni PN. Effects of eicosapentaenoic acid and docosahexaenoic acid on low-density lipoprotein cholesterol and other lipids: a review. J Clin Lipidol 2012; 6 (01) 5-18
- 8 Mozaffarian D, Prineas RJ, Stein PK, Siscovick DS. Dietary fish and n-3 fatty acid intake and cardiac electrocardiographic parameters in humans. J Am Coll Cardiol 2006; 48 (03) 478-484
- 9 Kris-Etherton PM, Fleming JA. Emerging nutrition science on fatty acids and cardiovascular disease: nutritionists' perspectives. Adv Nutr 2015; 6 (03) 326S-337S
- 10 Mozaffarian D, Rimm EB. Fish intake, contaminants, and human health: evaluating the risks and the benefits. JAMA 2006; 296 (15) 1885-1899
- 11 Hopia H, Latvala E, Liimatainen L. Reviewing the methodology of an integrative review. Scand J Caring Sci 2016; 30 (04) 662-669
- 12 Balk EM, Lichtenstein AH. Omega-3 Fatty Acids and Cardiovascular Disease: Summary of the 2016 Agency of Healthcare Research and Quality Evidence Review. Nutrients 2017; 9 (08) 865-870
- 13 Manson JE, Cook NR, Lee IM. et al; VITAL Research Group. Marine n-3 fatty acids and prevention of cardiovascular disease and cancer. N Engl J Med 2019; 380 (01) 23-32
- 14 Abdelhamid AS, Brown TJ, Brainard JS. et al. Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. J Nutr Biochem 2018; •••: CD003177
- 15 Poreba M, Mostowik M, Siniarski A. et al. Treatment with high-dose n-3 PUFAs has no effect on platelet function, coagulation, metabolic status or inflammation in patients with atherosclerosis and type 2 diabetes. Cardiovasc Diabetol 2017; 16 (01) 50
- 16 Wang DD, Li Y, Chiuve SE. et al. Association of specific dietary fats with total and cause-specific mortality. JAMA Intern Med 2016; 176 (08) 1134-1145
- 17 Paoli A, Moro T, Bosco G. et al. Effects of n-3 polyunsaturated fatty acids (ω-3) supplementation on some cardiovascular risk factors with a ketogenic Mediterranean diet. Mar Drugs 2015; 13 (02) 996-1009
- 18 Harris WS, Tintle NL, Etherton MR, Vasan RS. Erythrocyte long-chain omega-3 fatty acid levels are inversely associated with mortality and with incident cardiovascular disease: The Framingham Heart Study. J Clin Lipidol 2018; 12 (03) 718-727.e6
- 19 Alfaddagh A, Elajami TK, Ashfaque H, Saleh M, Bistrian BR, Welty FK. Effect of Eicosapentaenoic and Docosahexaenoic Acids Added to Statin Therapy on Coronary Artery Plaque in Patients With Coronary Artery Disease: A Randomized Clinical Trial. J Am Heart Assoc 2017; 6 (12) 67-75
- 20 Damasceno NRT. Impacto da suplementação com ácidos graxos ômega-3 nas subfrações da lipoproteína de alta densidade de indivíduos tabagistas. Rev Nutr 2016; 29 (04) x
- 21 Erkkilä AT, Schwab US, Lehto S. et al. Effect of fatty and lean fish intake on lipoprotein subclasses in subjects with coronary heart disease: a controlled trial. J Clin Lipidol 2014; 8 (01) 126-133
- 22 See VHL, Mori TA, Prescott SL, Beilin LJ, Burrows S, Huang RC. Cardiometabolic Risk Factors at 5 Years After Omega-3 Fatty Acid Supplementation in Infancy. Pediatrics 2018; 142 (01) e20162623
- 23 Karasawa T, Takahashi M. Role of NLRP3 inflammasomes in atherosclerosis. J Atheroscler Thromb 2017; 24 (05) 443-451
- 24 Mason RP, Jacob RF. Eicosapentaenoic acid inhibits glucose-induced membrane cholesterol crystalline domain formation through a potent antioxidant mechanism. Biochim Biophys Acta 2015; 1848 (02) 502-509