脂質栄養 : 過去と将来の研究の長期的展望

―日本脂質栄養学会第15回大会ランズ博士基調講演の記録―

抄録

Two preventable imbalances in lipid nutrition cause cardiovascular and cerebrovascular disease (http://efaeducation.nih.gov/sig/dietdisease.html)-the major disability of people worldwide. Preventing the imbalances in childhood saves future generations from progressively impaired vascular function that eventually needs lifelong treatment with expensive medication. One imbalance is large meals with more energy than is burned. Biomarkers of this are high blood triglycerides, obesity, type 2 diabetes and high blood cholesterol. Another imbalance is eating more n-6 than n-3 fats. These form 20- and 22-carbon highly unsaturated fatty acids (HUFA) that affect formation of eicosanoids. The biomarker of n-6 in HUFA of blood reflects essential fats eaten, predicts likely intensity of n-6 eicosanoid actions and strongly predicts risk of cardiovascular death.
A 25-year study showed cholesterol predicted death only to the degree that n-6 exceeded n-3 in HUFA. When tissue n-3 suppressed n-6-mediated inflammation and thrombosis, diet imbalances that elevate mevalonate and isoprenoid metabolites (and blood cholesterol) seemed no longer fatal. Interactive menu planning software, KIM-2, helps find personally palatable foods that balance tissue HUFA at any desired level. It manages details to prevent the two imbalances (see http://efaeducation.nih.gov/sig/kim.html). A good goal is 30% n-6 in tissue HUFA, near that from traditional Japanese foods. Many food combinations can reach this goal. Economical high-throughput assays of HUFA in a finger-tip drop of blood will give fast progress in clinical trials to correct n-3 imbalance. Eventually, we can show that primary prevention saves more and costs less than treatment.