Abstract
Atherosclerosis begins at the fragile blood vessel endothelia, which may be the Achilles’ Heel of the circulation. The endothelia are thin cell sheets vulnerable to injury, yet from their cell membranes come fatty acid metabolites (prostanoids, other eicosanoids) that coordinate vessel wall homeostasis and help protect against atherosclerosis. Oxidation products of fatty foods threaten endothelial integrity, and dietary fatty acids protected by dietary antioxidants can slow or perhaps even reverse atherosclerosis. Eicosanoid messenger molecules, generated from 20-carbon fatty acids associated with membrane phospholipids, are among the major factors ensuring vessel wall homeostasis. Among their functions is to help control blood vessel tone, retard platelet aggregation, and discourage white blood cells and platelets from adhering to the vessel wall. Eicosanoid balance is delicately poised between anti-inflammation and pro-inflammation, with the dietary intake of fatty acids and antioxidants influencing this balance. The 2-series metabolites from arachidonic acid are quantitatively the most abundant, while the 1-series (from DGLA) and the 3-series (from EPA) counterbalance the 2-series and enhance atherosclerosis protection and heart disease prevention. Dietary long-chain, unsaturated fatty acids also benefit the blood vessel wall by enhancing cell membrane fluidity and regulating membrane receptors. Inconsistent clinical results with the dietary fatty acids may be related to dose. High doses of any one of the n-3, n-6, or n-9 FAs may create deficiencies of others. For consistent, effective nutritional support against atherosclerosis, a diversified intake of fatty acids should only be undertaken in conjunction with a generous intake of antioxidants. (Alt Med Rev 1996;1(3):148-167.)
