There is considerable interest in the impact of (n-3) long-chain PUFA in mitigating the morbidity and mortality caused by chronic diseases. In 2002, the Institute of Medicine concluded that insufficient data were available to define Dietary Reference Intakes (DRI) for eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA), noting only that EPA and DHA could contribute up to 10% toward meeting the Adequate Intake for alpha-linolenic acid. Since then, substantial new evidence has emerged supporting the need to reassess this recommendation. Therefore, the Technical Committee on Dietary Lipids of the International Life Sciences Institute North America sponsored a workshop on 4-5 June 2008 to consider whether the body of evidence specific to the major chronic diseases in the United States--coronary heart disease (CHD), cancer, and cognitive decline--had evolved sufficiently to justify reconsideration of DRI for EPA+DHA. The workshop participants arrived at these conclusions: 1) consistent evidence from multiple research paradigms demonstrates a clear, inverse relation between EPA+DHA intake and risk of fatal (and possibly nonfatal) CHD, providing evidence that supports a nutritionally achievable DRI for EPA+DHA between 250 and 500 mg/d; 2) because of the demonstrated low conversion from dietary ALA, protective tissue levels of EPA+DHA can be achieved only through direct consumption of these fatty acids; 3) evidence of beneficial effects of EPA+DHA on cognitive decline are emerging but are not yet sufficient to support an intake level different from that needed to achieve CHD risk reduction; 4) EPA+DHA do not appear to reduce risk for cancer; and 5) there is no evidence that intakes of EPA+DHA in these recommended ranges are harmful.

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BackgroundLinoleic acid, with a DRI of 12-17 g/d, is the most highly consumed polyunsaturated fatty acid in the Western diet and is found in virtually all commonly consumed foods. The concern with dietary linoleic acid, being the metabolic precursor of arachidonic acid, is its consumption may enrich tissues with arachidonic acid and contribute to chronic and overproduction of bioactive eicosanoids. However, no systematic review of human trials regarding linoleic acid consumption and subsequent changes in tissue levels of arachidonic acid has been undertaken.ObjectiveIn this study, we reviewed the human literature that reported changes in dietary linoleic acid and its subsequent impact on changing tissue arachidonic acid in erythrocytes and plasma/serum phospholipids.DesignWe identified, reviewed, and evaluated all peer-reviewed published literature presenting data outlining changes in dietary linoleic acid in adult human clinical trials that reported changes in phospholipid fatty acid composition (specifically arachidonic acid) in plasma/serum and erythrocytes within the parameters of our inclusion/exclusion criteria.ResultsDecreasing dietary linoleic acid by up to 90% was not significantly correlated with changes in arachidonic acid levels in the phospholipid pool of plasma/serum (p = 0.39). Similarly, when dietary linoleic acid levels were increased up to six fold, no significant correlations with arachidonic acid levels were observed (p = 0.72). However, there was a positive relationship between dietary gamma-linolenic acid and dietary arachidonic acid on changes in arachidonic levels in plasma/serum phospholipids.ConclusionsOur results do not support the concept that modifying current intakes of dietary linoleic acid has an effect on changing levels of arachidonic acid in plasma/serum or erythrocytes in adults consuming Western-type diets.

The therapeutic and health-promoting effects of (n-3) long-chain PUFA (LCPUFA) from fish are well known, although these same benefits may not be shared by their precursor, alpha-linolenic acid (ALA). World-wide agencies and scientific organizations (i.e. FDA, AHA, International Society for the Study of Fatty Acids and Lipids, Institute of Medicine, WHO, etc.) have made similar dietary recommendations for (n-3) LCPUFA; however, due to concerns regarding the safety of consuming fish, alternative sources of (n-3) LCPUFA are being investigated. One such lipid is stearidonic acid (SDA), a naturally occurring (n-3) PUFA that may have similar biological properties to eicosapentaenoic acid (EPA), a major (n-3) PUFA in fish oil. Existing and novel plant sources rich in SDA are being cultivated and promoted as potential alternatives to marine-based (n-3) PUFA. This critical review provides a direct comparison of SDA with other dietary (n-3) PUFA under similar experimental conditions. The comparative results suggest that SDA shares many of the biological effects of (n-3) LCPUFA and functions most similarly to dietary EPA compared with ALA when consumed in a typical Western diet. Therefore, although SDA may not replace fish as a major dietary source of (n-3) LCPUFA, it could become a prominent surrogate for EPA in the commercial development of foods fortified with (n-3) PUFA.