WINTER 2010 dialogAn informative newsletter for the specialized clients of Doctor’s Data, Inc. Scientific Support The Science behind DDI’s new Fatty Acids Analysis by Chuck Masur, MD, Scientific Support Department atty acids (FA) are long chain fatty acids” (VLCFA; make other longer chain fatty monocarboxylic acids longer than 22 carbon atoms). acids. Diets high in palmitic that have the general This categorization generally acid may be associated with F formula CnH2n+1COOH. holds true except in the case of increased risk of developing They may be either saturated essential fatty acids (EFA) where cardiovascular disease (this is David Quig, PhD (no carbon-to-carbon double short-chain EFAs are 18 carbons somewhat controversial as palm Vice President bonds; e.g. palmitic and stearic long and long-chain EFAs are oil also has a number of healthy acids) or unsaturated (one or 20 or more carbons in length. attributes). Stearic acid (18:0) more carbon-to-carbon double FAs with more than one C=C is another common saturated bonds; e.g. eicosapentaenoic double bond are referred to as fatty acid that is found in many acid and docosahexaenoic polyunsaturated fatty acids vegetable and animal fats and acid). FAs either are absorbed (PUFA). oils. It can be produced by during fat digestion or made in processing animal fat in water the body from other fats that Fatty acid nomenclature under high temperature and are absorbed. They are a major varies but most readers will be pressure (e.g. pressure cooking source of substrate for the familiar with the omega-x (ω-x) produces stearic acid by the production of energy; during system which is correctly read hydrolysis of triglycerides); prolonged exercise they are the as “omega (ω) minus x”—the and it can be produced by Chuck Masur, MD main nutrient mobilized from fat first carbon-to-carbon double the hydrogenation of some stores. Erythrocyte fatty acid bond is at the xth position, unsaturated vegetable oils. analysis is superior to plasma counting from the terminal Stearic acid can be oxidatively fatty acid testing as erythrocyte methyl. Linoleic acid [CH3(CH2)4 desaturated back to oleic FA levels better reflect long-term CH=CHCH2CH=CH(CH2)7COO acid, more readily so than the fatty acid intake because of less H] for example, is an omega-6 desaturation of palmitic acid sensitivity to recent intake and (ω-6) FA and, using the same back to palmitoleic acid), and a slower turnover rate (Qi Sun et convention, alpha-linolenic acid thus may be “less unhealthy” al (2007), American Journal of [CH3CH2CH=CHCH2CH=CHC than other saturated fatty acids. Clinical Nutrition 86(1):74-81). H2CH=CH(CH2)7COOH] is an FAs may be as short as 4 omega-3 (ω-3) FA. Unsaturated fatty acids have carbons in length (e.g. butyric at least one carbon-to-carbon Barb Berta, MS, RD acid) but most fatty acids, at Saturated fatty acids have double bonds—their carbon least those from natural sources no carbon-to-carbon double atoms are bound in either a (fats and oils), generally are at bonds. For example, palmitic — continued on next page Doctor’s Data, Inc. least 8 carbons in length (e.g. acid (16 carbons long and with 3755 Illinois Avenue octanoic, or caprylic, acid) but no carbon-to-carbon double INSIDE St. Charles, IL 60174-2420 may comprise chains of 4 to as bonds; i.e. 16:0) is one of the 800.323.2784 (US & Canada) Meet Karen Urek, many as 28 carbon atoms. FAs most common saturated fatty Vice President of Operations 3 630.377.8139 (Elsewhere) may be “short” (SCFA; less than acids found in animals and 44.(0)8712.180.052 (UK) 6 carbons), “medium” (MCFA; plants. It is the first fatty acid Comprehensive Vaginosis Profile 3 630.587.7860 (fax) 6 to 12 carbons), “long” (LCFA; produced during fatty acid [email protected] 12 to 22 carbons) or “very synthesis and can be used to Frequently Asked Questions 4 www.doctorsdata.com WINTER 2010 DOCTOR’S DATA INC. The Science behind DDI’s new Fatty Acids Analysis — continued from page 1 cis- (hydrogen atoms are on the same side of a carbon-to-carbon SOME SAMPLE FATTY ACID RATIOS Worst ω-6 to ω-3 Ratio Poor Ratio Better Ratio Best Ratio bond) or trans- (hydrogen atoms on opposite sides of the double Sunflower – No ω-3 Cottonseed – almost no ω-3 Canola (rapeseed) oil 2:1 Flax seed oil 1:3 bond) configuration. Cis- fatty Peanut – No ω-3 Grapeseed – almost no ω-3 Olive 3:1 to 13:1 acids (i.e. those FAs with one Corn 46:1 Soybean 7:1 or more cis configurations) can be quite curved and are less flexible and are less able an ω-6 (or visa versa) is possible bodies for fuel. Ketone bodies (DHA) and, being non-animal to be closely packed (as in nor is it possible to convert can be produced in the liver by in origin, the DHA produced in membrane structures). Trans- saturated fats into ω-3 or ω-6 metabolism of FAs. this fashion is acceptable to fatty acids, on the contrary, unsaturated FAs. those on strict vegetarian diets. are relatively straight. Most EFAs are used in the Digestion and uptake of fatty In a similar vein, the oil from trans- FAs (trans- fats) are not productions of hormone-like acids is complex. SCFAs and brown alga (kelp) is high in ω-3 found in and are produced substances that regulate a wide MCFAs are absorbed directly eicosapentaenoic acid (EPA). through human intervention by range of functions including via the intestinal capillaries The ω -6 to ω-3 ratio (see hydrogenation (processing) of blood pressure, coagulation, and travel through the portal chart above) in dietary intake will unsaturated fatty acids. Trans- lipid levels, immune response circulation; LCFAs are too large ultimately influence the ratio of fats are found in margarines, and inflammatory responses to be absorbed directly and the ensuing eicosanoids such as fried foods, commercially to injury and infection. but are absorbed through the prostaglandins, thromboxanes prepared foods, baked goods Unfortunately, a typical Western lipid membranes of the cells of and leukotrienes. Clearly then, and partially hydrogenated diet may be high in ω-6 FAs the microvilli, reassembled into ω-3 and ω-6 fatty acids should vegetable oils. Diets high in but low in ω-3 FAs (e.g. EPA, triglycerides and then coated be consumed in the appropriate trans- fats may be associated DHA) and may be associated with cholesterol and protein— proportions. Healthy ratios of with increased rick of coronary with depression and behavioral the complexes formed are called ω-6 to ω-3 range from 1:1 to 1:4 heart disease. Examples of changes including violence. chylomicrons. Chylomicrons while the ratios in the standard/ unsaturated FAs include alpha- FAs play an important role in enter the lymphatic capillaries typical western diet (SAD) may linolenic acid (18:3 ω-3), heart health as they provide and travel via the thoracic duct range from 10:1 to 30:1 (i.e. eicosapentaenoic acid (20:5 the substrates for mechanical into the left subclavian vein and dramatically skewed toward ω-3), docosahexaenoic acid and electrical activity in cardiac are distributed directly from the ω-6 predominance. (22:6 ω-3 ), arachidonic acid tissue. heart throughout the circulatory (20:4 ω-6), linoleic acid (18:2), tree without a first pass The new Fatty Acids; and oleic acid (20:4 ω-6) —all Free fatty acids (FFA) are FAs through the liver. Chylomicrons, Erythrocyte panel from DDI are cis- unsaturated FAs. that are not bound, or attached eventually, are processed by provides individual assessments in some fashion, to other the liver into very low density of important saturated and Essential fatty acids (EFA) are molecules such as triglycerides lipoproteins (VLDL) and low unsaturated FAs and gives FAs that cannot be synthesized or phospholipids. They are not density and lipoproteins (LDL). helpful commentary on these within an organism and must be water soluble therefore can findings. In addition, the panel obtained from dietary sources. only be transported within the The standard American diet presents important FA ratios, There are two families of EFAs: circulatory system bound to (SAD) is high in carbohydrates provides information about their omega-3 and omega-6, all of albumin in plasma. FAs can be and, as grains are high in ω-6 clinical importance and assists which are polyunsaturated FAs stored in fat cells (adipocytes) and low in ω-3 FAs, the ratio of the clinician in making evidence- (PUFA). Humans can produce and, upon being released ω-6 to ω-3 FAs usually is higher based decisions and more all but two FAs (linoleic acid from adipocyte storage, can than optimal. Oily fish, fish oils, effective treatment plans for (18:2 ω-6) and alpha-linolenic become FFAs. FFAs are utilized wild game (i.e. not grain-fed), their patients. acid (18:3 ω-3); both are widely as substrate for energy (ATP) free-range beef and their dairy found in plant oils and are the production. Heart and skeletal products as well as range-fed parent compounds of the ω-3 muscle energy production sheep and poultry all contain and ω-6 FA series. It is possible pathways prefer FFAs over more prominent levels of ω-3 to convert one ω-3 FA to another glucose for ATP production; FAs. The microalgae C cohnii ω-3 or one ω-6 to another ω-6 brain can’t use FFAs so it and Schizochytrium sp.