Hostname: page-component-848d4c4894-4hhp2 Total loading time: 0 Render date: 2024-06-03T05:29:50.449Z Has data issue: false hasContentIssue false
  • English
  • Français

Dietary PUFA and the metabolic syndrome in Indian Asians living in the UK

Published online by Cambridge University Press:  07 March 2007

Louise M. Brady ,
Christine M. Williams  and
Julie A. Lovegrove
Louise M. Brady*
Affiliation:
Hugh Sinclair Human Nutrition Unit, School of Food Biosciences, PO Box 226, University of Reading, White Knights, Reading RG6 6AP, UK
Christine M. Williams
Affiliation:
Hugh Sinclair Human Nutrition Unit, School of Food Biosciences, PO Box 226, University of Reading, White Knights, Reading RG6 6AP, UK
Julie A. Lovegrove
Affiliation:
Hugh Sinclair Human Nutrition Unit, School of Food Biosciences, PO Box 226, University of Reading, White Knights, Reading RG6 6AP, UK
*
*Corresponding author: Ms Louise M. Brady, fax + 44 118 931 0080, email l.brady@reading.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Indian Asians living in the UK have a 50% higher CHD mortality rate compared with the indigenous Caucasian population, which cannot be attributed to traditional risk factors. Instead, features of the metabolic syndrome, including raised plasma triacylglycerol, reduced HDL-cholesterol (HDL-C) and an increased proportion of small dense LDL particles, together with insulin resistance and central obesity, are prevalent among this population. The present review examines evidence to support the hypothesis that an imbalance in dietary PUFA intake, specifically a higher intake of n-6 PUFA in combination with the lower intake of the long-chain (LC) n-3 PUFA, plays an important role in the prevalence of the metabolic syndrome observed in Indian Asians. Data are presented to illustrate the impact of manipulation of the background n-6 PUFA intake (moderate or high n-6 PUFA) and the subsequent response to supplementation with LC n-3 PUFA on blood lipids and insulin action in a group of Indian Asian volunteers. The results demonstrate that supplementation with LC n-3 PUFA had no impact on insulin action in those subjects consuming either the moderate- or high-n-6 PUFA diet. In the postprandial phase reductions in plasma triacylglycerol concentrations were greater in those consuming the high-n-6 PUFA background diet subsequent to fish oil supplementation. The present study concludes that, contrary to the central hypothesis, the prevalence of metabolic abnormalities in Indian Asians compared with Caucasians may not be attributable to differences in intakes of n-6 and n-3 PUFA.

Keywords

Indian AsiansMetabolic syndromePUFAFish oilsInsulin sensitivity
Type
Meeting Report
Information
Proceedings of the Nutrition Society , Volume 63 , Issue 1 , February 2004 , pp. 115 - 125
Copyright
Copyright © The Nutrition Society 2004

References

Anderson, RL, Hamman, RF, Savage, PJ, Saad, MF, Laws, A, Kades, WW, Sands, RE & Cefalu, W (1995) Exploration of simple insulin sensitivity measures derived from frequently sampled intravenous glucose tolerance (FSIGT) tests. American Journal of Epidemiology 142, 724–732.CrossRefGoogle ScholarPubMed
Ascherio, A, Rimm, EB, Giovannucci, EL, Spiegelman, D, Stampfer, MJ & Willett, WC (1996) Dietary fat and risk of coronary heart disease in men: cohort follow-up study in the United States. British Medical Journal 313, 84–90.CrossRefGoogle ScholarPubMed
Banerji, MA, Faridi, N, Atluri, R, Chaiken, RL & Lebovitz, HE (1999) Body composition, visceral fat, leptin and insulin resistance in Asian Indian men. Journal of Clinical Endocrinology and Metabolism 84, 137–144.Google ScholarPubMed
Behme, MT (1996) Dietary fish oil enhances insulin sensitivity in miniature pigs. Journal of Nutrition 126, 1549–1553.CrossRefGoogle ScholarPubMed
Boberg, M, Vessby, B & Selinus, I (1986) Effects of dietary supplementation with n-6 and n-3 long-chain polyunsaturated fatty acids on serum lipoproteins and platelet function in hypertriglyceridaemic patients. Acta Medica Scandinavica 220, 153–160.CrossRefGoogle ScholarPubMed
Bonora, E, Targher, G, Alberiche, M, Bonadonna, RC, Saggiani, F, Zenere, MB, Monauni, T & Muggeo, M (2000) Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity. Diabetes Care 23, 57–63.CrossRefGoogle ScholarPubMed
Brady, LM, Lesauvage, SVM, Saini, N, Williams, CM, Lovegrove, JA, (2003a) Comparison of dietary fat and fatty acid intake estimated by the duplicate diet collection technique and estimated dietary records. Journal of Human Nutrition and Dietetics 3, 393–401.CrossRefGoogle Scholar
Brady, LM, Lesauvage, SVM, Williams, CM & Lovegrove, JA (2002) Duplicate diet comparison of total fat and fatty acid intake between Caucasians and Sikhs living in the UK. Proceedings of the Nutrition Society 61 53A.Google Scholar
Brady, LM, Lovegrove, SS, Gower, BA, Williams, CM & Lovegrove, JA, (2003b) Comparison of surrogate measures of insulin sensitivity and resistance with the minimal model in Indian Asians and Caucasians. Proceedings of the Nutrition Society 62 50A.Google Scholar
Brady, LM, Lovegrove, SS, Lesauvage, SVM, Gower, BA, Minihane, AM, Williams, CM & Lovegrove, JA, (2003c) Increased dietary n-6 PUFA does not attenuate effects of long chain n-3 PUFA on insulin sensitivity or triacylglycerol reduction in Indian Asians. American Journal of Clinical Nutrition. (In the Press).Google Scholar
British Heart Foundation (2003) Coronary Heart Disease Statistics. London: British Heart Foundation.Google Scholar
British Nutrition Foundation (1999) n-3 Fatty Acids and Health. The Report of the British Nutrition Foundation's Task Force. London: Chapman and Hall.Google Scholar
Brown, AJ & Roberts, DC (1991) Moderate fish oil intake improves lipemic response to a standard fat meal. A study in 25 healthy men. Arteriosclerosis and Thrombosis 11, 457–466.CrossRefGoogle Scholar
Burr, MI, Gilbert, JF, Holliday, RM, Elwood, PC, Fehily, AM, Rogers, S, Sweetnam, PM & Deadman, NM (1989) Effects of changes of fat, fish and fibre intakes on death and myocardial reinfarction: Diet and Reinfarction Trial (DART). Lancet ii, 757–761.CrossRefGoogle Scholar
Caro, J (1991) Insulin resistance in obese and nonobese man. Journal of Clinical Endocrinology and Metabolism 73, 691–695.CrossRefGoogle ScholarPubMed
Chambers, JC, Obeid, OA, Refsum, H, Uciand, P, Hackett, D & Hooper, J (2000) Plasma homocysteine concentrations and risk of coronary heart disease in UK Indian Asian and European men. Lancet 355, 523–527.CrossRefGoogle ScholarPubMed
Clarke, SD (2000) Polyunsaturated fatty acid regulation of gene transcription: a mechanism to improve energy balance and insulin resistance. British Journal of Nutrition 83, S59–S66.CrossRefGoogle ScholarPubMed
Connor, SL & Connor, WE (1997) Are fish oils beneficial in the prevention and treatment of coronary artery disease?. American Journal of Clinical Nutrition 66, Suppl., 1020S–1031S.CrossRefGoogle ScholarPubMed
Conquer, JA & Holub, BJ (1998) Effect of supplementation with different doses of DHA on the levels of circulating DHA as non-esterified fatty acid in subjects of Asian Indian background. Journal of Lipid Research 39, 286–292.CrossRefGoogle ScholarPubMed
Das, UN, Kumar, KV & Ramesh, G (1994) Essential fatty acid metabolism in South Indians. Prostaglandins Leukotrienes and Essential Fatty Acids 50, 253–255.CrossRefGoogle ScholarPubMed
DeDeckere, EAM Korver, O, Verschuren, PM & Katan, MB (1998) Health aspects of fish and n-3 polyunsaturated fatty acids from plant and marine origin. European Journal of Clinical Nutrition 52, 749–753.CrossRefGoogle Scholar
DeFronzo, RA Toin, JD & Andres, R (1979) Glucose clamp technique: A method for quantifying insulin secretion and resistance. American Journal of Physiology 237, 214–223.Google ScholarPubMed
de Lorgeril, M, Renaud, S, Mamelle, N, Salen, P, Martin, JL, Monjaud, I, Guidollet, J, Touboul, P & Delaye, J (1994) Mediterranean alpha linolenic acid rich diet in secondary prevention of coronary heart disease. Lancet 343, 1454–1459.CrossRefGoogle ScholarPubMed
Denkins, YM, Lovejoy, JC & Smith, SR (2002) Omega 3 PUFA supplementation and insulin sensitivity. FASEB 16, A24.Google Scholar
Dhawan, J & Petkar, S (1998) Epidemiology of coronary heart disease in South Asians. Current Science in India 74, 1060–1063.Google Scholar
Dolecek, TA (1992) Epidemiological evidence of relationships between dietary polyunsaturated fatty acids and mortality in the multiple risk factor intervention trial. Proceedings of the Society for Experimental Biology and Medicine 200, 177–182.CrossRefGoogle ScholarPubMed
Dyerberg, J & Bang, HO (1982) A hypothesis on the development of acute myocardial infarction in Greenlanders. Scandinavian Journal of Clincal and Laboratory Investigation 161, Suppl., 7–13.CrossRefGoogle ScholarPubMed
Emken, EA, Adlof, RO & Gulley, RM (1994) Dietary linoleic acid influences desaturation and acylation of deuterium-labeled linoleic acid and linolenic acids in young adult males. Biochimica et Biophysica Acta 1213, 277–288.CrossRefGoogle ScholarPubMed
Eritsland, J, Seljeflot, I, Abdelnoor, M, Arnesen, H & Torjesen, PA (1994) Long term metabolic effects of n-3 fatty acids on serum lipids and glycaemic control. Scandinavian Journal of Clinical and Laboratory Investigation 54, 273–280.CrossRefGoogle ScholarPubMed
Fasching, P, Ratheiser, K, Waldhausl, W, Rohac, M, Osterrode, W, Nowotny, P & Vierhapper, H (1991) Metabolic effects of fish oil supplementation in patients with impaired glucose tolerance. Diabetes 40, 583–589.CrossRefGoogle ScholarPubMed
Feskens, EJM, Bowles, CH & Kromhout, D (1991) Inverse association between fish intake and risk of glucose intolerance in normoglycaemic elderly men and women. Diabetes Care 14, 935–941.CrossRefGoogle Scholar
Feskens, EJM, Virtanen, SM, Rasanen, L, Tuomilehto, J, Stengard, J, Pekkanen, J, Nissinen, A & Kromhout, D (1995) Dietary factors determining diabetes and impaired glucose tolerance – A 20 year follow up of the Finnish and Dutch cohorts of the 7 Countries Study. Diabetes Care 18, 1104–1112.CrossRefGoogle Scholar
Folsom, AR, Eckfeldt, JH, Weitzman, S, Ma, J, Chambless, LE, Barnes, RW, Cram, KB & Hutchinson, RG (1994) Relation of carotid wall thickness to diabetes mellitus, fasting glucose and insulin, body size and physical activity. Atherosclerosis Risk in Communities (ARIC) Study Investigators. Stroke 25, 66–73.CrossRefGoogle ScholarPubMed
Frayn, KN, Summers, LKM & Fielding, BA (1997) Regulation of the plasma non-esterified fatty acid composition in the postprandial state. Proceedings of the Nutrition Society 56, 713–721.CrossRefGoogle Scholar
Friedewald, WT & Levy, RI (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clinical Chemistry 18, 499–502.CrossRefGoogle ScholarPubMed
Frost, GS, Keogh, BE, Smith, D, Leeds, AR & Dornhurst, A (1998) Reduced adipocyte insulin sensitivity in Caucasians and Asian subjects with coronary heart disease. Diabetic Medicine 15, 1003–1009.3.0.CO;2-2>CrossRefGoogle ScholarPubMed
Fukushima, M, Taniguchi, A, Sakai, M, Doi, K, Nagata, I, Nagasaka, S, Tokuyama, K, Nakai, Y (2000) Assessment of insulin sensitivity from a single sample. Diabetes Care 23, 1434–1435.CrossRefGoogle ScholarPubMed
Garg, ML, Wierzbicki, AA, Thompson, ABR & Clandinin, MT (1989) Dietary saturated fat level alters the competition between alpha linolenic acid and linoleic acid. Lipids 24, 334–339.CrossRefGoogle ScholarPubMed
Ghafoorunissa, (1998) Requirements of dietary fats to meet nutritional needs and prevent the risk of atherosclerosis – An Indian perspective. Indian Journal of Medical Research 108, 191–202.Google ScholarPubMed
GISSI-Prevenzione Investigators (1999) Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione Trial. Lancet 354, 447–455.CrossRefGoogle Scholar
Griffin, BA (1999) Lipoprotein atherogenicity: an overview of current mechanisms. Proceedings of the Nutrition Society 58, 163–169.CrossRefGoogle ScholarPubMed
Griffin, BA, Caslake, MJ, Yip, B, Tait, GW, Packard, CJ, Shepherd, J (1990) Rapid isolation of low density lipoprotein (LDL) subfractions from plasma by density gradient ultracentrifugation. Atherosclerosis 83, 59–67.CrossRefGoogle ScholarPubMed
Gronn, M, Gorbitz, C, Christensen, E, Levorsen, A, Ose, L, Hagve, TA & Christopherson, BO (1991) Dietary n-6 fatty acids inhibit the incorporation of dietary n-3 fatty acids in thrombocyte and serum phospholipids in humans: a controlled dietetic study. Scandinavian Journal of Clinical and Laboratory Investigation 51, 255–263.CrossRefGoogle ScholarPubMed
Haffner, SM, D'Agostino, R, Saad, MF, Rewers, M, Mykkanen, L, Selby, J, Howard, G, Savage, PJ, Hamman, RF, Wagenknecht, LE (1996) Increased insulin resistance and insulin secretion in nondiabetic African-Americans and Hispanics compared with non-Hispanic whites: The insulin resistance atherosclerosis study. Diabetes 45, 742–748.CrossRefGoogle ScholarPubMed
Harris, WS, Windsor, SL & Dujovne, CA (1991) Effects of four doses of n-3 fatty acids given to hyperlipidaemic patients for six months. Journal of the American College of Nutrition 10, 220–227.CrossRefGoogle Scholar
Horrobin, DF (1991) Interaction between n-3 and n-6 essential fatty acids in regulation of cardiovascular disorders and inflammation. Prostaglandins Leukotrienes and Essential Fatty Acids 44, 127–131.CrossRefGoogle ScholarPubMed
Ikeda, Y, Suehiro, T, Nakamura, T, Kumon, Y & Hashimoto, K (2001) Clinical significance of the insulin resistance index as assessed by the homeostasis model assessment. Endocrinology Journal 48, 81–86.Google Scholar
Indu, M & Ghafoorunissa, (1992) n-3 fatty acids in Indian diets – Comparison of the effects of precursor (alpha-linolenic acid) vs product (long chain n-3 polyunsaturated fatty acids). Nutrition Research 12, 569–582.CrossRefGoogle Scholar
Isaksson, B (1993) A critical evaluation of the duplicate portion technique in dietary surveys. European Journal of Clinical Nutrition 47, 457–460.Google ScholarPubMed
Jucker, BM, Cline, GW, Barucci, M & Shulman, GI (1999) Differential effects of safflower oil versus fish oil feeding on insulin stimulated glycogen synthesis, glycolysis and pyruvate dehydrogenase flux in skeletal muscle. Diabetes 48, 134–140.CrossRefGoogle ScholarPubMed
Karpe, F (1999) Postprandial lipoprotein metabolism and atherosclerosis. Journal of Internal Medicine 246, 341–355.CrossRefGoogle ScholarPubMed
Katz, A, Nambi, SS, Mather, K, Baron, AD, Follmann, DA, Sullivan, G & Quon, MJ (2000) Quantitative insulin sensitivity check index: A simple accurate method for assessing insulin sensitivity in humans. Journal of Clinical Endocrinology and Metabolism 85, 2402–2410.CrossRefGoogle ScholarPubMed
Kromhout, D, Bosschieter, EB de Lezenne Coulander, C (1985) The inverse relation between fish consumption and 20 year mortality from coronary heart disease. New England Journal of Medicine 312, 1205–1209.CrossRefGoogle ScholarPubMed
Kulkarni, K, Markovitz, J, Nanda, NC & Segrest, JP (1999) Increased prevalence of smaller and denser LDL particles in Asian Indians. Arteriosclerosis, Thrombosis and Vascular Biology 19, 2749–2755.CrossRefGoogle ScholarPubMed
Laasko, M (1993) How good a marker is insulin level for insulin resistance. American Journal of Epidemiology 137, 959–964.Google Scholar
Lam, TKT, Carpentier, A, Lewis, GF, Van de Werve, G, Fantus, IG & Giacca, A (2003) Mechanism of the free fatty acid induced increase in hepatic glucose production. American Journal of Physiology 284, E863–E873.Google ScholarPubMed
Lovegrove, JA, Brady, LM, Lesauvage, SVM, Lovegrove, SS, Minihane, AM, Williams, CM (2003a) Lack of association between central adiposity and lipaemia in UK Sikh men. International Journal of Obesity 27, 1373–1382.CrossRefGoogle ScholarPubMed
Lovegrove, JA, Lovegrove, SS, Lesauvage, SVM, Brady, LM, Minihane, AM, Saini, N & Williams, CM (2003b) Moderate fish oil supplementation reverses low platelet membrane long chain PUFA status and reduces plasma triacylglycerol status in British Indian Asians. American Journal of Clinical Nutrition (In the Press).Google Scholar
Lovejoy, JC (2002) The influence of dietary fat on insulin resistance. Current Diabetic Reports 2, 435–440.CrossRefGoogle ScholarPubMed
McAuley, KA Williams, SM, Mann, JI, Walker, RJ Lewis-Barned, NJ, Temple, LA & Duncan, AW (2001) Diagnosing insulin resistance in the general population. Diabetes Care 24, 460–464.CrossRefGoogle ScholarPubMed
MacDiarmid, JI Blundell, JE (1997) Dietary under reporting: what people say about recording their food intake. European Journal of Clinical Nutrition 51, 199–200.CrossRefGoogle ScholarPubMed
McKeigue, PM Marmot, MG, Adelstein, AM, Hunt, SP, Shipley, MJ, Butler, SM, Riemersma, RA, Turner, PR (1985) Diet and risk factors for coronary heart disease in Asians in North-West London. Lancet ii, 1086–1090.CrossRefGoogle Scholar
McKeigue, PM, Miller, GJ & Marmot, MG (1989) Coronary heart disease in South Asians overseas: a review. Journal of Clinical Epidemiology 42, 597–609.CrossRefGoogle ScholarPubMed
McKeigue, PM, Shah, B & Marmot, MG (1991) Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet 337, 382–386.CrossRefGoogle ScholarPubMed
Matthews, DR, Hosker, JP, Rudenski, AS, Naylor, BA, Treacher, DF, Turner, RC (1985) Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentration in man. Diabetologia 28, 412–419.CrossRefGoogle ScholarPubMed
Mertz, W (1992) Food intake measurements: Is there a gold standard. Journal of the American Dietetic Association 92, 1463–1465.CrossRefGoogle ScholarPubMed
Miller, GJ, Kotecha, S, Wilkinson, WH, Wilkes, H, Stirling, Y, Sanders, TA, Broadhurst, A, Allison, J & Meade, TW (1988) Dietary and other characteristics relevant for coronary heart disease in men of Indian, West Indian and European descent in London. Atherosclerosis 70, 63–72.CrossRefGoogle Scholar
Murphy, MC, Brooks, CN, Rockett, JC, Chapman, C, Lovegrove, JA, Gould, BJ, Wright, JW & Williams, CM (1999) The quantitation of lipoprotein lipase mRNA in biopsies of human adipose tissue, using polymerase chain reaction and the effect of increased consumption on n-3 polyunsaturated fatty acids. European Journal of Clinical Nutrition 53, 441–447.CrossRefGoogle ScholarPubMed
O'Keefe, JH & Harris, WS (2000) From Inuit to implementation: Omega-3 fatty acids come of age. Mayo Foundation for Medical Education and Research 75, 607–614.Google ScholarPubMed
Pacini, G & Bergman, RN (1986) MINMOD: a computer program to calculate insulin sensitivity and pancreatic responsivity from the frequently sampled intravenous glucose tolerance test. Computing Methods and Programs in Biomedicine 23, 113–122.CrossRefGoogle ScholarPubMed
Perseghin, G, Caumo, A, Caloni, M, Testolin, G & Luzi, L (2001) Incorporation of the fasting plasma FFA concentration into QUICKI improves its association with insulin sensitivity in nonobese individuals. Journal of Clinical Endocrinology and Metabolism 86, 4776–4781.CrossRefGoogle ScholarPubMed
Popp-Snijders, C, Schouten, JA, Heine, RJ, van der Meer, J van der Veen, EA (1987) Dietary supplementation of omega 3 polyunsaturated fatty acids improves insulin sensitivity in non insulin dependant diabetes. Diabetes Research 4, 141–147.Google Scholar
Rivellese, AA (2000) Effects of n-3 fatty acids on carbohydrate and lipid metabolism in healthy people: The Kanwu Study. Diabetologia 43, 11S.Google Scholar
Rustan, AC, Nenester, MS & Drevon, CA (1997) Omega-3 and omega-6 fatty acids in the insulin resistance syndrome. Lipid and lipoprotein metabolism and atherosclerosis. Annals of the New York Academy of Sciences 827, 310–326.CrossRefGoogle ScholarPubMed
Saad, MF, Anderson, RL, Laws, A, Watanabe, RM, Kades, WW, Chen, I Evan-Sands, R Pei, D, Savage, PJ & Bergman, RN (1994) A comparison between the minimal model and the glucose clamp in the assessment of insulin sensitivity across the spectrum of glucose tolerance. Diabetes 43, 1114–1121.CrossRefGoogle ScholarPubMed
Schmidt, EB, Varming, K, Ernst, E, Madsen, P & Dyerberg, J (1990) Dose response studies on the effect of n-3 polyunsaturated fatty acids on lipids and hemostasis. Thrombosis and Hemostasis 63, 1–5.Google Scholar
Sevak, L, McKeigue, P & Marmot, MG (1994) Relationship of hyperinsulinaemia to dietary intake in South Asian and European men. American Journal of Clinical Nutrition 59, 1069–1074.CrossRefGoogle ScholarPubMed
Simopolous, AP (1991) Omega 3 fatty acids in health and disease and in growth and development. American Journal of Clinical Nutrition 54, 438–463.CrossRefGoogle Scholar
Singh, RB, Niaz, MA, Sharma, JP, Kumar, R, Rastogi, V, Moshiri, M (1997) Randomized, double-blind, placebo controlled trial of fish oil and mustard oil in patients with suspected acute myocardial infarction: the Indian experiment of infarct survival. Cardiovascular Drugs Therapy 11, 485–491.CrossRefGoogle ScholarPubMed
Somova, L, Moodley, K, Channa, MC & Nada, A (1999) Dose dependent effect of dietary fish oil (n-3) polyunsaturated fatty acids on in vivo insulin sensitivity in rat. Methods and Findings in Experimental and Clinical Pharmacology 21, 275–278.CrossRefGoogle ScholarPubMed
Storlien, LH, Higgins, JA, Thomas, TC, Brown, MA, Wang, HQ, Huang, XF & Else, PL (2000) Diet composition and insulin action in animal models. British Journal of Nutrition 83, Suppl. 1, S85–S90.CrossRefGoogle ScholarPubMed
Storlien, LH, Kraegen, EW, Chisholm, DJ, Ford, GL, Bruce, DG & Pascoe, WS (1987) Fish oil prevents insulin resistance induced by high fat feeding in rats. Science 237, 885–888.CrossRefGoogle ScholarPubMed
Storlien, LH, Pan, DA, Kriketos, AD, O'Connor, J, Caterson, ID, Cooney, GJ, Jenkins, AB & Baur, LA (1996) Skeletal muscle membrane lipids and insulin resistance. Lipids 31, 261S–265S.CrossRefGoogle ScholarPubMed
Toft, I, Bonaa, KH, Ingebretsen, OC, Nordoy, A & Jenssen, T (1995) Effects of n-3 polyunsaturated fatty acids on glucose homeostasis and blood pressure in essential hypertension: a randomised controlled trial. Annals of Internal Medicine 123, 911–918.CrossRefGoogle Scholar
Vessby, B (2000) Dietary fat and insulin action in humans. British Journal of Nutrition 83, Suppl., 1 S91–S96.CrossRefGoogle ScholarPubMed
Wajchenberg, BL (2000) Subcutaneous and visceral adipose tissue and their relation to the metabolic syndrome. Endocrine Reviews 21, 697–738.CrossRefGoogle ScholarPubMed
Waldhausl, W, Ratheiser, K, Komjati, P, Nowotny, P, Pirich, K & Vierhapper, H (1989) In Health Effects of Fish and Fish Oils, pp. 171–187. [Chandra, RK, editor]. St Johns, Nfld: ARTS Biomedical Publishers.Google Scholar
Weber, P & Raederstorff, D (2000) Triglyceride lowering effect of omega 3 LC n-3 polyunsaturated fatty acids – A review. Nutrition Metabolism and Cardiovascular Diseases 10, 28–37.Google Scholar
Westphal, S, Orth, M, Ambrosch, A, Osmundsen, K & Luley, C (2000) Postprandial chylomicrons and VLDLs in severe hypertriacylglycerolemia are lowered more effectively than are chylomicron remnants after treatment with n-3 fatty acids. American Journal of Clinical Nutrition 74, 914–920.CrossRefGoogle Scholar
Zampelas, A, Williams, CM, Morgan, LM, Wright, J & Quinlan, PT (1994) The effect of triacylglycerol fatty acid positional distribution on postprandial plasma metabolite and hormone responses in normal adult men. British Journal of Nutrition 71, 401–410.CrossRefGoogle ScholarPubMed
Zoratti, R, Godsland, I, Chaturvedi, N, Crook, D, Stevenson, JC & McKeigue, P (2000) Relation of plasma lipids to insulin resistance, non esterified fatty acid levels and body fat in men from three different ethnic groups: Relevance to variation in risk of diabetes and coronary disease. Metabolism 49, 245–252.CrossRefGoogle ScholarPubMed