Cath Lab Digest

Login to Download
PDF version

  The National Center for Health Statistics (NCHS) and National Center for Complementary and Alternative Medicine (NCCAM) conducted a survey in 2007 to determine the extent of complementary and alternative medicine use in America.¹ The findings indicated omega-3 fatty acid supplements were the most commonly used nonvitamin/nonmineral product among adults; 37% who had used natural products in the last 30 days had taken an omega-3 supplement for health reasons. The benefits of omega-3 fatty acid supplementation have been well documented for improving heart health and triglyceride levels. As a result, clinicians have been looking to broaden its use for managing the inflammatory response during wound healing. This article presents the key factors involved in the inflammatory process and the role omega-3 fatty acids play in wound healing.

Omega-3 Fatty Acid Basics

  Dietary fat is comprised of fatty acids that contain various numbers of carbon atoms and double bonds. These chemical properties give rise to short- or long-chain fatty acids that are saturated (no double bonds) or unsaturated. Unsaturated fatty acids are either monounsaturated (one double bond) or polyunsaturated (multiple bonds). The two types of polyunsaturated fatty acids (PUFAs), omega-3 and omega-6, are distinguished by the location of the first double bond from the methyl end of the fatty acid. Omega-3 and omega-6 fatty acids are essential fatty acids—ie, they are not synthesized in the body and thus must be obtained from the diet. In general, omega-6 fatty acids, found in vegetable oils, dairy products, meat, and processed foods, are abundant in the diet. Omega-3 fatty acids include the plant-derived a-linolenic acid (ALA) and marine-derived eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). They are found in less-consumed foods such as nuts, seeds, and fish; therefore, they are not as common in a typical Western diet.

  Epidemiologic, clinical, and experimental studies have shown multiple health benefits of omega-3 fatty acids. In particular, EPA and DHA may confer protective effects against coronary heart disease. Several mechanisms may be responsible for the cardioprotective effects of EPA and DHA, including prevention of arrhythmias, lowering heart rate and blood pressure, decreasing platelet aggregation, and lowering plasma triglyceride levels. Additional putative beneficial effects of omega-3 fatty acids have been demonstrated in inflammatory conditions such as rheumatoid arthritis and for mental health. High concentrations of DHA are found in the brain and other parts of the central nervous system; prospective studies have linked both all-cause dementia and Alzheimer’s disease to decreased fish intake and low plasma phospholipid DHA levels.²

Inflammation: Key Factors

  The complexities of the wound healing process are reflected in nutrition interventions. The first phase of healing, the inflammatory response, is the body’s initial reaction to injury. Inflammation is essential for normal healing because it initiates the cascade of molecular and cellular processes necessary for a wound to heal. However, unresolved or chronic inflammation can delay wound healing; thus, cellular communication and activity must be highly regulated and controlled. Initially, eicosanoids, key mediators and regulators of inflammation, provide this control. Eicosanoids include prostaglandins, thromboxanes, leukotrienes, and other hydroxyl fatty acids. They are generated from PUFAs and are involved in determining the intensity and duration of the inflammatory phase.³

  PUFAs are essential components of the phospholipid bilayer, regulate a wide range of bodily functions, and are precursors to several molecules involved in the inflammatory process.