FATTY ACIDS

Essential Fatty Acids

Why determination in blood not in serum?

In the (essential) fatty acid analyzes (package) in blood, the levels of the (essential) fatty acids and of the trans fatty acids in the membrane of red blood cells are determined. The provisions give the (average) status over a longer period. The determinations are therefore not snapshots such as the determination in serum, which gives information about the status at the moment of blood collection only. The fatty acid levels are given as a percentage of the total (of fatty acids) - so as the amount of the fatty acid compared to the other fatty acids.
The omega-6 fatty acid linoleic acid (LA) and the omega-3 fatty acid alpha-linolenic acid (ALA) are the essential fatty acids for humans. The terms omega-6 and omega-3 refer to the location of the first unsaturated bond, calculated from the terminal carbon atom. People are not able to make the omega-6 and omega-3 fatty acid structures themselves and are therefore dependent on the nutrition for the 'mother structures' of these fatty acids. Linoleic acid (the mother structure for the omega-6 series) is fairly common in vegetable products, especially in seeds and the oil that is made from them. Alpha-linolenic acid (the mother structure for the omega-3 series) is also present in vegetable products, but is less common in this. Alpha-linolenic acid is found mainly in green-leaved plants, linseed (oil), walnuts and soya.
Also the omega-6 fatty acid arachidonic acid (AA) is considered to be the essential fatty acids because this fatty acid is formed only to a very limited extent in the body from linoleic acid. In the diet, arachidonic acid is found in meat. The saturated fatty acids and fatty acids with an omega-9 structure can be formed by humans themselves.

In the liver, (lactic acid and linolenic acid, through extension and desaturation, (other) fatty acids are formed from the omega-6 and omega-3 series, respectively. These fatty acids are in turn important precursors of eicosanoids (prostaglandins, thromboxanes, prostacyclins and leukotrienes). The eicosanoids perform important (regulatory) functions in a large number of metabolic processes, including allergic reactions, blood clotting and inflammatory reactions. From linoleic acid, via GLA, prostaglandin E1 (PGE1) is formed and alpha-linolenic acid is formed, among others, via EPA and DHA, prostaglandin E3 (PGE3). From the fatty acid arachidonic acid also present in the body, prostaglandin E2 (PGE2) is formed.

Because the eicosanoids formed from linoleic acid, alpha-linolenic acid and arachidonic acid have different, often opposite effects, not only shortages, but also disturbances in the ratio (s) of the fatty acids and the substances derived from them can lead to disturbances in body functions.

Nomenclature and structure of the fatty acids
The fatty acids are subdivided into polyunsaturated fatty acids, monounsaturated fatty acids and saturated fatty acids, depending on the number of unsaturated bonds that they contain.

On the basis of their length and the number of unsaturated bonds that they contain, fatty acids are also referred to as 'number: number', the first number being the length of the fatty acid (in C-atoms) and the second number the number of unsaturated bonds. that contains fatty acid. EPA, for example, is designated C 20: 5 - it is 20 C atoms long and contains 5 unsaturated bonds.

The natural fatty acids all have the cis-form. Trans fatty acids do not occur in nature, but they can occur in procedures for hardening fats. Trans fatty acids are metabolically 'unnatural' and are harmful because they interfere with normal fatty acid metabolism.
WHEN CAN THE MEANINGFUL (ESSENTIAL) FATTY ACIDS BE DETERMINED IN BLOOD?
The essential fatty acid analysis can be used for:
  • Determining a deficiency of (essential) fatty acids or disruptions in the conversion of essential fatty acids (to eicosanoids).
  • Determining a load with trans fatty acids.
  • To investigate the effect of a supplementation aimed at the recovery of essential fatty acid levels or levels of the substances derived from the essential fatty acids.
It may be useful to have an (essential) fatty acid analysis carried out when there are complaints that can be related to a deficiency of (essential) fatty acids or a disturbance in the balance of the (essential) fatty acids and the derived substances, such as :
  • Skin problems such as dry skin, eczema, psoriasis, dandruff and ulcers
  • Problems of the heart and blood vessels, such as high blood pressure and atherosclerosis
  • Problems with and diseases of the immune system
  • Allergic complaints
  • Problems with the (energy) metabolism, such as hypoglycaemia, diabetes, fatigue, obesity and lagging growth and development
  • Inflammation (also of the joints)
  • Mental complaints, learning and behavioral disorders
  • Schizophrenia
  • Menstrual complaints (PMS)
  • Cancer
  • Alcoholism and fatty liver

The following essential fatty acids and fatty acid metabolites are determined 

Omega -3 family
18:3 Alpha-linolenic acid (ALA)
20:3 Eicosatrienoic acid    
20:5 Eicosapentaenoic acid(EPA)
22:6 Docosahexaenoic acid (DHA)

Omega-6 family
18:2 Linoleic acid (LA)
18:3 Gammalinolenic (GLA)
20:2 Eicosadienoic acid (EDA)   
20:3 Dihomogammalinolenic acid (DGLA)
20:4 Arachidonic acid (AA)

Omega-9 family
18:1 Trans Elaidic acid (TEA)
18:1 Cis Oleic acid
20:1 Eicosenoic acid
22:1 Erucic acid
24:1 Nervonic acid

Saturated:
16:0 Palmitic acid
18:0 Stearic acid

 
22:4 Docosatetraenoic acid (DTA)
Ratio: AA/EPA

COMPLEMENTARY TESTS:

  • Vitamins in blood: Disturbances of fatty acid metabolism may be the cause of deficiencies of nutrients that function as cofactors of enzymes necessary for the conversions, such as vitamin B3, vitamin B6 and vitamin C. Vitamin E is necessary to treat the polyunsaturated fatty acids ( MOV) to protect against oxidation. The intake of MOVs and vitamin E must be in proportion to each other.
  •  (trace) elements / toxic elements in blood / hair: Disturbances of fatty acid metabolism may be the cause of deficiencies of nutrients that function as cofactors of enzymes involved in the conversions, such as magnesium and zinc.
  • Stresstest (cortisol and DHEA in saliva): Stress can have a disruptive effect on fatty acid metabolism (inhibits the enzyme delta-6-desaturase, which is necessary for the formation of gamma-linolenic acid). The stress test can provide more insight into the stress load.
  • MDA (malondialdehyde) in blood: this test measures the body's oxidative (anti-oxidant) load. Oxidative stress (among others as a result of smoking) may be the cause of a decrease in the amount of polyunsaturated fatty acids in the cell membrane.

LITERATURE:

  1. Melvyn R. Werbach. Nutritional influences on mental Illness. A sourcebook of clinical research. Third Line Press. USA, 1999.
  2. Reddy RD, Yao JK. Environmental factors and membrane polyunsaturated fatty acids in schizophrenia. Prostaglandins Leukot Essent Fatty Acids. 2003 Dec;69(6):385-91.
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