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Home , Arachidic acid, Behenic acid, Capric acid, Docosatetraenoic acid, Elaidic acid, Essential fatty acid

Interpretive Guide for Fatty Acids

Name Potential Responses Metabolic Association Omega-3 Polyunsaturated Alpha Linolenic L Add and/or Essential Eicosapentaenoic L substrate Docosapentaenoic L Add Nerve membrane function Docosahexaenoic L Neurological development Omega-6 Polyunsaturated Linoleic L Add corn or black currant oil Gamma Linolenic L Add evening primrose oil Eicosanoid precursor Eicosadienoic Dihomogamma Linolenic L Add black currant oil Eicosanoid substrate Arachidonic H Reduce red meats Eicosanoid substrate Docosadienoic Docosatetraenoic H Weight control Increase in Omega-9 Polyunsaturated Mead (plasma only) H Add corn or black Essential fatty acid status Monounsaturated Myristoleic Palmitoleic Vaccenic Oleic H See comments Membrane fluidity 11-Eicosenoic Erucic L Add Nerve membrane function Nervonic L Add fish or Neurological development Saturated Even-Numbered H Assure B3 adequacy Lauric H Peroxisomal oxidation Myristic H Palmitic H Reduce sat. ; add niacin Cholesterogenic Stearic H Reduce sat. fats; add niacin Elevated Arachidic H Check eicosanoid ratios Behenic H Δ6 desaturase inhibition Lignoceric H Consider rape or mustard seed oils Nerve membrane function Hexacosanoic H Saturated Odd-Numbered Pentadecanoic H Heptadecanoic H Nonadecanoic H Add B12 and/or Propionate accumulation Heneicosanoic H Omega oxidation Tricosanoic H Trans Isomers from Hydrogenated Oils Palmitelaidic H Eicosanoid interference Eliminate hydrogenated oils Total C18 Trans Isomers H Calculated Ratios LA/DGLA H Add black currant oil Δ6 desaturase, Zn deficiency EPA/DGLA H Add black currant oil L Add fish oil Eicosanoid imbalance AA/EPA (Omega-6/Omega-3) H Add fish oil Stearic/Oleic (RBC only) L See Comments Cancer Marker Triene/Tetraene Ratio (plasma only) H Add corn or black currant oil Essential fatty acid status ©2007 Metametrix, Inc. All rights reserved 22040 rev 0807 Interpretive Guide for Fatty Acids 2

Table 1: Signs and Symptoms Associated with Fatty Acid Abnormalities SIGNS & SYMPTOMS FATTY ACID ASSOCIATION ACTION Emaciation, weakness, disorentation Caloric deprivation Add balanced in , , and . Reduced growth, renal dysplasia, repro- Classic essential fatty acid deficiency Add good quality fats and oils ductive deficiency, scaly skin Eczema-like skin eruptions, loss of hair, insufficiency Add corn or oils liver degradation, behavorial disturbances, kidney degeneration, increased thirst, frequent infections, poor wound healing, sterility, miscarriage, arthralgia, cardiovas- cular disease, growth retardation Growth retardation, weakness, impair- Alpha or gamma linolenic acid insuf- Add flax, primrose, or black currant oil ment of vision, learning disability, poor ficiency coordination, tingling in arms/legs, behavorial changes, mental disturbances, low metabolic rate, high , immune dysfunction Depression, anxiety, learning, behavorial Long chain PUFA-dependent neuro- Add fish oils and visual development, cardiovascular membrane function, imbalanced pros- disease risk tanoids Cancer Low stearic/oleic ratio, loss of Add omega 3 PUFAs cell controls (RBC only) Use omega 6 PUFAs with caution B12 and/or carnitine deficiencies Increased odd numbered FAs Add vitamin B12 and carnitine Myelinated nerve degeneration Increased very long chain FAs Add high-erucate rape oil, mustard seed oils Fatty liver Saturated and omega 9 family accumula- Restrict consumption, and in- tion in hepatic cells crease and methionine intake Accelerated aging High polyunsaturated acid intake with- Increase E and C and the out increased antioxidants minerals Se, Mn, and Zn Obesity Various imbalances resulting from using Re-establish proper fat-to-protein bal- processed oils (high elaidic with low ance using like nuts, seeds, and GLA) fresh whole .

Polyunsaturated Omega-3 of individuals in western societies. would be indicated if EPA is low and Low levels in plasma or especially ALA is normal or high. High levels of Alpha Linolenic Acid in erythrocytes are indicative of saturated, monounsaturated, trans fatty One of the most common essential insufficiency. Arthritis, heart disease, acids, and also slow the fatty acid deficiencies is that of alpha and general aging result from direct conversion of ALA to EPA (as well as linolenic acid (18:3n3), abbreviated as or indirect effects of unchecked GLA to DGLA). ALA or LNA. It is found in flax, , inflammatory response. rape (canola) seed, soybean, , and dark green leaves and must be (EPA) is anti- supplied by such foods. Because of the inflammatory and should balance the The growth and development of the central importance of this fatty acid levels of pro-inflammatory arachidonic central nervous system is particularly and its counterpart, GLA, see the table acid. Although EPA can be produced dependent upon the presence of an of clinical associations with dietary from the essential fatty acid, ALA, adequate amount of the very long insufficiencies (Table 1). dietary intakes of this fatty acid are chain, highly unsaturated fatty acids, generally poor. The conversion also docosapentaenoic (22:5n3) and Eicosapentaenoic Acid requires the action of the Δ6 desaturase docosahexaenoic acids (22:6n3) (1,2). Deficiency of eicosapentaenoic acid (20: that may be low due to Attention deficit hyperactivity 5n3) is likely the most prevalent fatty inadequate Zn, Mg, or vitamins B3, B6, disorder (3) and failures in the acid abnormality affecting the health and C. Such an enzyme impairment development of the visual system in

For more information on amino acids see Laboratory Evaluations in Molecular Medicine; , Toxicants, and Cell Regulators, Chapter Five - Fatty Acids. Interpretive Guide for Fatty Acids 3

EFA deficiencies are two examples of direct precursor of DGLA. Levels of (22:4n6). this dependency. Docosahexaenoic this fatty acid reflect levels of other acid (DHA) is an important member polyunsaturated omega-6 fatty acids. Polyunsaturated Omega-9 of the very long chain fatty acids (C22 Plasma levels are significantly lower to C26) that characteristically occur than those present in erythrocytes, Mead Acid (plasma only) in glycosphingolipids, particularly in which indicates that the conversion of Mead acid (20:3n9) is a marker for the brain. Since this fatty acid is so linoleic to eicosadienoic acid occurs at overall, essential fatty acid status. It is important in early development, it is a higher rate than the conversion of produced in human tissues from oleic worth noting that the levels in breast eicosadienoic acid to DGLA. acid and, therefore, is not considered are correlated with the mother’s essential. The essential fatty acids, intake of fish oils (4), which are rich Dihomogamma-linolenic Acid linoleic and alpha linolenic, prevent sources of both of these fatty acids. DHA Low levels of dihomogamma-linolenic Mead acid formation in individuals intake may also help to lower blood acid (20:3n6) result from diets low with good dietary fat intake. When pressure (5). in both essential fatty acids, LA, and essential fatty acids are depleted, higher dihomogamma-linolenic acid (DGLA). levels of Mead acid are detected. During Polyunsaturated Omega-6 DGLA is also anti-inflammatory, so an essential fatty acid deficiency, Mead insufficiency of this fatty acid impairs acid serves as a structural component Linoleic Acid a wide range of cellular functions and in cell membranes as a substitute for Linoleic acid (18:2n6) is by far the most tissue responses. When testing reveals the normal polyunsaturated fatty acids abundant polyunsaturated fatty acid in low levels of DGLA, supplementation derived from essential precursors. It most human tissues. Linoleic acid (LA) with black currant or evening primrose cannot substitute, however, in the is an essential fatty acid, and low levels oils should be considered, but if a critical role of precursor to eicosanoid indicate dietary insufficiency, which history of tumor formation is known, cell regulators. Mead acid formulation can lead to a variety of symptoms (see always consider ALA sources (black may also be stimulated by high intake of Table 1). Some of these symptoms result currant) as well (9). omega 3 fatty acids. from lack of LA in membranes, where it plays a role in structural integrity. Most, Monounsaturated however, are from failure to produce Because of the prevalence of corn and , which are cell regulators. products in feed for and LA is the starting point for this pathway. hogs, diets high in these red meats The medium-chain unsaturated Normal neonatal status of this fatty are rich in arachidonic acid (20:4n6). myristoleic acid (14:1n5) accumulates acid is marginal, if not insufficient Arachidonic acid (AA) is a 20- or in adipose tissue with the consumption (6). Since dietary sources (especially fatty acid that serves as the principal of milk products, which are rich sources corn oil) are abundant, however, LA pro-inflammatory fatty acid. Its of the fatty acid. Myristoleic acid is may be found above normal. Excessive synthesis is inhibited by non-steroidal particularly good at increasing cell LA can contribute to . anti-inflammatory drugs (NSAIDs). High membrane fluidity because of its short Supplementation with LA has been AA promotes gallstone formation by chain length and unsaturated status. shown to increase body weight and stimulating mucin production in the Diets high in lead to low essential fatty acid status in patients gallbladder mucosa (10). membrane fluidity. Therefore, increased with cystic fibrosis (7). membrane fluidity is generally a Docosadienoic Acid favorable health consequence. However, Gamma Linolenic Acid Docosatetraenoic Acid high levels of myristoleic acid may raise Gamma linolenic acid (18:3n6), Docosadienoic acid (22:2n6) is a very concern when found in cancer patients abbreviated GLA, is the precursor of long-chain fatty acid (VLCFA). It is the because of the tumor-promoting effect DGLA, an anti-inflammatory fatty acid, elongation product of DGLA. Elevated of high membrane fluidity. and it’s also the precursor of arachidonic levels of docosadienoic acid should acid, a pro-inflammatory fatty acid. It is appear only under conditions of dietary found in hemp, , black currant, adequacy of LA and DGLA, together Palmitoleic acid (16:1n7) is the and evening primrose oils. It can be with stimulation of elongation. The desaturation product of . produced in human tissues by the latter is one effect of resistance. Since palmitic acid is predominant in action of desaturase on LA. See Metametrix is currently researching human tissues where desaturase enzyme Table 1 for clinical associations. GLA the additional clinical relevance of activity is present, one might expect corrects most of the biological effects docosadienoic acid. relatively high levels of palmitoleic acid. of deficiency (8), highlighting the Such levels are not found in healthy zinc requirement of the Δ5 desaturase When omega-6 dietary fatty acids are humans. Palmitoleic acid formation is enzyme. consumed in abundance, there is an increased only when intake of essential accumulation of desaturation and fatty acids is low. Thus, high palmitoleic Eicosadienoic Acid elongation intermediates. Diets high acid is a marker of essential fatty acid Eicosadienoic acid (20:2n6) is the in fat and simple contribute to deficiency. elongation product of GLA and the obesity and to the accumulation of

For more information on amino acids see Laboratory Evaluations in Molecular Medicine; Nutrients, Toxicants, and Cell Regulators, Chapter Five - Fatty Acids. Interpretive Guide for Fatty Acids 4

Vaccenic Acid amounts in plant oils and . The long chain fatty acids (VLCFAs) is MCFAs are virtually nonexistent in associated with degenerative diseases (18:1n7) is a positional meats because animals oxidize them of the central nervous system like isomer of oleic acid – they have the very rapidly from plants consumed, . There are a same number of carbon molecules but and do not accumulate in the tissues. number of genetic disorders involving the double bond is shifted. Vaccenic Various “medium chain ” accumulation of , usually acid also plays a role in maintaining products have become available for due to the lack of enzymes necessary membrane fluidity. digestive disorders and have found for the turnover of membrane VLCFAs, use in athletic training. They contain which include behenic (22:0), lignoceric Oleic acid (18:1n9) is present in the MCFAs that are assimilated rapidly (24:0), and hexacosanoic (26:0) acids as fat of all foods and is also produced without the normal acid dispersal well as the unsaturated members of the from essential fatty acids in normal requirement. In human tissues, capric, C22-24 classes, particularly nervonic human liver cells and fat cells. Oleic lauric, and myristic acids are oxidized acid. acid makes up 15% of the fatty acids in by peroxisomal oxidative pathways to a the membranes of red blood cells and, larger extent than the longer chain fatty The common lifestyle of low physical because of the presence of one double acids. Elevated levels could indicate exertion and high fat diet sets a bond in the center of the molecule, general suppression of peroxisomal metabolic pattern that can lead to helps maintain critical membrane oxidation which utilizes riboflavin- increasing levels of VLCFAs in plasma fluidity. Low levels of oleic acid have derived cofactors. and erythrocyte membranes. The effect an impact on this function and can be is mediated by hormonal responses, corrected by increasing dietary intake Palmitic Acid mainly norepinephrine and insulin, (). For erythrocyte abnormalities, The liver can convert fatty acids into and is exacerbated by drugs that read about the stearic/ oleic ratio below. cholesterol. Although any fatty acid modulate energy such as the can enter this pathway, palmitic acid antianginal drug, trimetazidine (11). 11-Eicosenoic Acid (16:0) is the most stimulatory one 11-Eicosenoic acid (20:1n11) is the known. Palmitic acid is high in palm Saturated Odd Chain elongation product of oleic acid. kernel and oils. High levels Metametrix is currently researching its can lead to increased serum cholesterol Pentadecanoic Acid clinical relevance. and increased risk of atherosclerosis, Heptadecanoic Acid , and . Nonadecanoic Acid In contrast to saturated fatty acids, Heneicosanoic Acid Since erucic acid (22:1n9) is one of unsaturated fatty acids cause either Tricosanoic Acid the components responsible for the no reaction or actually lower serum Fatty acids with odd numbers of favorable response of individuals with cholesterol (as in the case of EPA). carbon atoms are produced primarily adrenoleukodystrophy to preparations by initiating the synthetic series with containing rape and mustard seed the three carbon compound, propionic oils (Lorenzo’s Oil), low levels may Stearic acid (18:0) is a saturated fatty acid. Vitamin B12 is required for the occur with this disease, and increased acid that is two carbon atoms longer conversion of propionate into succinate consumption of erucic acid may offset than palmitic acid. Diets high in for oxidation in the central energy the metabolic effects of the disease. saturated fat contribute to elevated pathways. Deficiency of vitamin 12B levels of stearic acid in the body. High results in accumulation of propionate levels in plasma occur with high serum and subsequent buildup of the odd Nervonic acid (24:1n9) has the longest triglycerides, which is a risk factor in numbered fatty acids, pentadecanoic carbon chain of all monounsaturated atherosclerotic vascular disease. (See (15:0), heptadecanoic (17:0), fatty acids. It is found in highest palmitic acid above.) nonadecanoic (19:0), heneicosanoic (21: concentrations in nerve membranes, 0), and tricosanoic (23:0) acids. particularly in the myelin sheath. Factors like high carbohydrate diets that Arachidic acid (20:0), the elongation The bacteria in the gut of inhibit cause low product of stearic acid, can be utilized as (grazing animals like cows and sheep) levels, and conditions like insulinemia an energy source to build membranes. produce large amounts of propionate, stimulate fatty acid synthesis resulting Its accumulation can interfere with which is absorbed and enters the in higher levels. essential , as it metabolism of the animal. High intake inhibits the Δ6 desaturase enzyme of animal and dairy products favor high Saturated Even Numbered needed to produce DGLA, EPA, and AA. levels of these fatty acids. Alternatively, Similar effects occur with other long it is possible that the bacteria in the Capric Acid chain, saturated fatty acids. human gut could produce sufficient amounts of propionate to lead to elevation in the odd-carbon fatty acids. Capric (10:0), lauric (12:0), and myristic This would only occur under conditions (14:0) acids, the medium chain fatty Hexacosanoic Acid of significant gut dysbiosis. acids (MCFAs), are present in small Accumulation of certain very

For more information on amino acids see Laboratory Evaluations in Molecular Medicine; Nutrients, Toxicants, and Cell Regulators, Chapter Five - Fatty Acids. Interpretive Guide for Fatty Acids 5

Carnitine is required for fatty acid Calculated ratios is used to monitor the effectiveness of oxidation. In carnitine insufficiency, cancer therapy (16). Values below 1.1 are fatty acids are oxidized via an omega LA/DGLA Ratio associated with malignancy. oxidation pathway that creates odd The ratio of LA to DGLA increases when chain units. Therefore, odd chain the Δ6 desaturase enzyme is inhibited by Triene/Tetraene Ratio (plasma only) fatty acid accumulation may indicate zinc and magnesium deficiency, elevated The Triene/Tetraene (T/T) ratio is carnitine deficiency and the need for insulin, or dietary excess of saturated, another marker for essential fatty acid carnitine supplementation (12). monoenoic, or trans fatty acid. Under status. It is calculated as the ratio of these conditions, the enzyme cannot Mead acid to arachidonic acid. This Trans Isomers from convert the substrate (LA) to its product ratio, combined with measurements Hydrogenerated Oils (DGLA) fast enough. The production of the essential fatty acids and Mead of all desaturation products is affected, acid, gives a more complete picture Palmitelaidic Acid including GLA, EPA and AA. These of the degree and nature of fatty acid Total C18 Trans Isomers longer chain polyunsaturated fatty acids, deficiency. An elevated ratio shows a The trans fatty acids are prevalent in then must be supplied from the diet or relative excess of triene (3 double bonds) most diets because of the widespread supplements. compared to tetraene (4 double bonds), use of hydrogenated oils used by which results from essential fatty acid manufacturers of , bakery EPA/DGLA Ratio deficiency. products, and peanut . The balance of 20-carbon or eicosanoic fatty acids is critical for proper supply Palmitelaidic acid (16:1:7t) is the shorter of the prostanoid and 1-, and less abundant member of the trans 2-, and 3-series local hormones that fats, because oils used in control a host of cellular functions and contain very little of its precursor, responses. The EPA/DGLA ratio will be palmitoleic acid. low when DGLA is elevated relative to EPA, indicating a need for EPA sources The total C18 trans isomers include like fish oils. When the ratio is high, , petroselaidic, and trans- sources of DGLA (black currant or vaccenic acids. The presence of these evening primrose oil) are indicated. eighteen-carbon long trans fatty acids in human tissue can disrupt or impair cell AA/EPA (Omega-6/Omega-3) Ratio membrane function. A patient with high AA and EPA are the most critical levels of total C18 trans isomers should fatty acids for maintaining the ratio be told to avoid hydrogenated oils. of the omega-6 and omega-3 classes because they compete for enzymes These fatty acids contain one double that make cell regulators. A high ratio bond and thus are included in the indicates an overabundance of the unsaturated category. Because of the pro-inflammatory, omega-6 fatty acid, geometry of the trans bond, however, AA. An overabundance of AA is quite they behave like saturated fats on common in Western high meat and corn the one hand, leading to elevated oil diets and can result in an imbalance cholesterol levels (13). On the other in the AA/EPA ratio. This is one of the hand they mimic unsaturated fats indicators that extra omega-3 fatty acids, that bind to desaturase enzymes and including EPA of fish oils, would be antagonize the normal production of beneficial. necessary products. The net effect is to raise plasma LDL cholesterol and Stearic/Oleic Ratio (RBC only) lower HDL. It is now the consensus The stearic acid/oleic acid ratio from red among experts in lipid nutrition that blood cells is a marker for the presence foods containing hydrogenated oils of malignant tissue, particularly with are to be avoided. These fatty acids are prostate cancer (14). In tumors, the also produced by the bacteria in the net result of changes in fatty acid gut of animals which is the metabolism is low stearic acid and reason that beef and milk contain small high oleic acid, causing a profound amounts (13%) of elaidic acid. Moderate shift in the ratio of stearic to oleic use of these foods is unlikely to provide acids (15). One likely outcome of this trans fatty acids at levels that are of shift is increased fluidity of the tumor concern. , resulting in more rapid movement of nutrients and waste products and allowing for faster metabolic rate. The stearic/oleic ratio

For more information on amino acids see Laboratory Evaluations in Molecular Medicine; Nutrients, Toxicants, and Cell Regulators, Chapter Five - Fatty Acids. Interpretive Guide for Fatty Acids 6 Resources Information on the clinical effects of fatty acids, lipoproteins and glycolipids is rapidly expanding. The following sources are recommended for further study. Erasmus (17): Excellent general review of structure and function of dietary and physiological fats. Horrobin (18): Symposium proceedings emphasizing clinical uses of evening primrose oil. Murray et. al. (19) : A brief comprehensive review of the metabolism of fatty acids and related compounds. Contributing authors to Annual Reviews (20): In depth reviews with extensive references.

Recommended Review Articles: Fenton WS, Hibbeln J, Knable M. Essential fatty acids, lipid membrane abnormalities, and the diagnosis and treatment of schizophrenia. Biological Psychiatry. 47(1):8-21, 2000 Jan 1. Leaf A, Kang JX, Xiao YF, Billman GE, Voskuyl RA. The antiarrhythmic and anticonvulsant effects of dietary N-3 fatty acids. Journal of Membrane Biology. 172(1):1-11, 1999 Nov 1. Rose DP and Connolly JM. Omega-3 fatty acids as cancer chemopreventive agents. Pharmacology & Therapeutics. 83(3):217-44, 1999 Sep. Valenzuela A, Morgado N. Trans fatty acid isomers in human health and in the . Biological Research. 32(4):273-87, 1999. Youdim KA. Martin A. Joseph JA. Essential fatty acids and the brain: possible health implications. International Journal of Developmental Neuroscience. 18(4-5): 383-99, 2000 Jul-Aug.

References: 1. Hoffman DR and Uauy R. Essentiality of dietary w3 fatty 10. Hayes KC, Livingston A, and Trautwein EA. Dietary impact acids for premature infants: plasma and red blood cell fatty on biliary and gallstones, Annu Rev Nutr, 12:299-326 acid composition, Lipids, 27 (11):886 (1992). (1992). 2. Innis S. n-3 Fatty acid requirements of the newborn, Lipids, 11. Kantor, P.F., et al., The antianginal drug trimetazidine shifts 27(11):879-887 (1992). cardiac energy metabolism from fatty acid oxidation to 3. Stevens LJ, Zentall SS, Deck JL, Abate ML, Watkins BA, Lipp glucose oxidation by inhibiting mitochondrial long-chain 3- SR, and Burgess JR. Essential fatty acid metabolism in boys ketoacyl thiolase. Circ Res, 86(5): p. 580-8 (2000). with attention-deficit hyperactivity disorder, Am J Clin Nutr, 12. Duran M., et al., Systemic carnitine deficiency: benefit of oral 62:761-8 (1995). carnitine supplements vs. persisting biochemical 4. Henderson RA, Jensen RG, Lammi-Keefe CJ, Ferris AM and abnormalities, Eur J Pediatr, 142(3):224-8 (1984). Dardick KR. Effect of fish oil on the fatty acid composition of 13. Abbey M, Nestel PJ. Plasma cholesterol transfer protein human milk and maternal and infant erythrocytes, Lipids, activity is increased when trans-elaidic acid is substituted for 27(11):863-869 (1992). cis-oleic acid in the diet. Atherosclerosis, 106:99-107 (1994). 5. Mori TA, Bao DQ, Burke V, Puddey IB and Beilin LJ. 14. Persad RA, et al. Erythrocyte stearic to oleic acid ratio in Docosahexaenoic Acid but Not Eicosapentaenoic Acid prostatic carcinoma. Br J Urol, 65(3).268-70 (1990). Lowers Ambulatory Blood Pressure and Heart Rate in 15. Wood CB, Habib NA, Thompson A, Bradpiece H, Smadja Humans, Hypertension, 34(2):253-260 (1999). C, Hershman M, Barker W, Apostolov K. Increase of oleic acid 6. Houwelingen AC, Puls J, and Hornstra G. Essential fatty acid in erythrocytes associated with malignancies, Br Med J, 291: status during early human development, Early Human Dev, 163 (1985). 31:97-Ill (1992). 16. Apostolov K, et al. Reduction in the stearic to oleic acid 7. Steinkamp G, Demmelmair H, Ruhl-Bagheri I, von der Hardt ratio in leukaemic cells -- a possible chemical marker for H, and Koletzko B. Energy Supplements Rich in Linoleic Acid malignancy, Blut, 50(6). 349-54 (1985). Improve Body Weight and Essential Fatty Acid Status of 17. Erasmus U. Fats that Heal, Fats That Kill, Alive Books, Burnaby Cystic Fibrosis Patients, J of Pediatr Gastroenterol Nutr, 31(4): BC (1993). 418-423 (2000). 18. Horrobin DF. Clinical Uses of Essential Fatty Acids, Eden Press, 8. Huang YS, Cunnane SC, Horrobin DF, and Davignon J. Most Montreal (1982). biological effects of corrected by g-linolenic 19. Murray RK, Granner DK, Mayes PA, Rodweli VW. Harper’s acid (18:3w6) but not by linoleic acid (18:2w6), , 23rd Ed., Apleton & Lange, E. Norwalk, CN Atherosclerosis, 41:193-207 (1982). (1993). 9. Noguchi M, Rose DP, Earashi M, Miyazaki I, The role of fatty 20. Annual Review of Nutrition, Annual Reviews Inc., Palo Alto, acids and eicosanoid synthesis inhibitors in breast carcinoma, CA Clark SD and Jump DB. Dietary polyunsaturated fatty acid Oncology, 52(4):265-71 (1995). regulation of gene transcription. ibid, 14:83-98 (1994).

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