Effects of Dietary Milled Seed Mixture on Fatty Acid Status and Inflammatory Markers in Patients on Hemodialysis

January 1, 2014 Human Health and Nutrition Data 0 Comments

Effects of Dietary Milled Seed Mixture on Fatty Acid Status and Inflammatory Markers in Patients on Hemodialysis

Year: 2014
Authors: Perunicic-Pekovic, G. Rasic-Milutinovic, Z. Takic, M. Popovic, T. Arsic, A. Glibetic, M.
Publication Name: Sci World Jour.
Publication Details: doi:10.1155/2014/563576


Plant seeds have gained interest for their health benefits due to their fatty acid content. The objective of this study was to determine the effects of dietary consumption of milled sesame/pumpkin/flax seed mixture on glycemic control, serum lipids, phospholipid fatty acid status, and inflammatory factors in patients on hemodialysis. Thirty patients with well nutrition status (18male, 12 female) were enrolled in the study. Participants consumed 30 g of milled sesame/pumpkin/flax (6 g/6 g/18 g, resp.) seeds mixture added to their habitual diet. Total n 6 and n 3 polyunsaturated fatty acids and levels of linoleic, dihomogamma linolenic (DGLA), arachidonic, alpha linolenic (ALA), eicosapentaenoic, docosapentaenoic, and docosahexaenoic (DHA) acid were increased after 12 weeks of supplementation. A significant decrease of the serum triglyceride level, glucose, insulin, calculated IR HOMA, and inflammatory markers (TNF alpha, IL 6, and hs CRP) was observed after seed mixture treatment. The serum levels of CRP and TNF alpha negative correlate with ALA, DHA, and DGLA. Results of this study indicated that dietary milled sesame/pumpkin/flax seed mixture added to a habitual diet lowered triglyceride and CRP, TNF alpha, IL 6 levels, affect glycemic control and improved fatty acid profile and pruritus symptoms in hemodialysis patients. (Authors abstract)
Fatty acid composition in serum phospholipids can be used not only as a biomarker of dietary fat intake quality, but also as an indicator of disease risk. There are many limitations in the published studies which deal with changes in fatty acid (FA) metabolism and PUFA content in chronic renal failure. However, in general, it can be concluded that patients on hemodialysis need nutritional care programs with an adequate n 6 to n 3 PUFA ratio in their diet.  The use of the plant based n 3 fatty acid to be alternative to consummation of fish may be important for maintaining optimal EPA and DHA status in plasma and cell membranes. The ideal ratio of LA n 6 and ALA n 3 in diet is not known, but ratio of 1 to 1 to 2 has been considered beneficial to health with effects on cell membrane fluidity and membrane function. The balance required in the diet between n 6 and n 3 fatty acid is important due to their competitive nature and their different biological roles. The purpose of the present study was prospective evaluation of the effects of milled sesame/pumpkin/flax seed mixture dietary treatments on nutrition status, plasma lipids, phospholipids fatty acid profile, inflammatory markers, and symptoms of pruritus in patients on hemodialysis.
The results demonstrated that dietary treatment with milled sesame/pumpkin/flax seeds mixture (30 g; rich in n 6 and n 3 FA) for 12 weeks has the capacity to improve traditional lipid levels, inflammatory markers, and serum fatty acid composition as biomarker of status in hemodialysis patients. The efficacy of increasing levels of not only EPA, but also DHA in plasma phospholipids by providing its precursor ALA (3.0 g) from seed mixture was also shown. That was inconsistent with reports that EPA can limitedly be converted to DHA. These patients have low intake of fish, once every two weeks. Human clinical studies show that an increase in dietary ALA leads to significant increases in ALA, EPA, and DPA n 3 in the blood and they are carried out using daily intakes of greater than 5 g ALA. It is well known that fatty acid composition of the serum phospholipids clearly reflects the change of dietary habits. In this study, adding seed mixture to the diets of hemodialysis patients resulted in large drops in blood pressure (BP) of around 11mmHg systolic and 6mmHg diastolic after 12 weeks. The decrease in frequency symptoms of pruritus in these patients indicated that balanced dietary n 6 and n 3 fatty acid intake improves symptoms of pruritus.
The study results indicate that sesame/pumpkin/flax diet treatment in hemodialyzed patients could be beneficial in prevention of CVD as the observed lowering of triglyceride level is an important factor that has been implicated in the pathogenesis of cardiovascular complication. The results demonstrated that a dietary treatment with milled sesame/pumpkin/flax seeds decreased CRP, IL 6, TNF alpha levels, and the changes in serum ALA and DHA levels, and ALA plus DPA  plus EPA  plus DHA (total n 3 FA) were inversely associated with changes in inflammatory CRP and TNF alpha. Therefore, decreasing CRP levels, by dietary interventions, can improve the lipid responses, thereby reducing overall CVD risk. The biomarker of dietary fatty acid intake showed patients’ compliance. In conclusion, milled 6 g sesame/6 g pumpkin/18 g flax seeds mixture per day have possible health promoting effects due to increased levels of n 3 fatty acids in the serum and decreased inflammatory markers. (Editors comments)

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