Eicosapentaenoic Acid Increases Plasma ω‐3 Fatty Acids in Hyperlipidemic Children: A Cardioprotective Nutrient?

Background Hyperlipidemic children are at high risk for early coronary heart disease (CHD). Low tissue levels of ω‐3 fatty acids are inversely associated with CHD. Previous studies show that high levels of plasma ω‐3 fatty acids, eicosapentaenoic acid (EPA) and docosapentaenoic acid (DPA) from a seafood diet, are associated with an increased likelihood of healthy aging. The Mediterranean diet rich in EPA and docosahexaenoic (DHA) acids is also associated with decreased risk of CHD. These long chain fatty acids positively influence vascular function and reduce CHD by altering membrane fluidity, receptor activity, gene expression and eicosanoid synthesis. The purpose of this study was to determine the effect of the Mediterranean diet alone or combined with EPA on the plasma fatty acid profile of hyperlipidemic children. Methods A randomized, double‐blind, placebo‐controlled trial was conducted in 6 children (9‐16 yrs) with hyperlipidemia. The Mediterranean diet was consumed for 6 wks, followed by the diet combined with EPA supplements (1.2 gms/day) for 6 wks. A Mediterranean diet score was obtained at baseline and after the diet. Plasma phospholipid fatty acid composition was also determined. Plasma was extracted in chloroform:methanol and thin‐layer chromatography was used to separate phospholipid fractions. Fatty acid methyl esters were quantified using gas chromatography and identified with standards and expressed as % of total fatty acids. Results Mean Mediterranean diet scores were significantly increased (Baseline: 5.5 ± 0.5 vs Diet: 8.0 ± 1.3; P <.002) verifying dietary compliance. A significant increase in plasma EPA and DPA and a significant decrease in total ω‐6 fatty acids and the Arachidonic Acid/EPA Ratio were observed in hyperlipidemic children following EPA supplementation. Conclusion This is the first study to show that EPA supplementation favorably alters the plasma fatty acid composition in hyperlipidemic children by increasing circulating ω‐3 fatty acids, EPA, DPA, but not DHA. Studies suggest that increased plasma EPA and DPA are associated with decreased risk of CHD events and greater likelihood of healthy aging. Therefore, these changes may favorably alter pathophysiological vascular processes in hyperlipidemic children and prevent the development of early CHD.