Text Box: Use of Omega-3 Fatty Acids to Reduce the Risk of Cardiovascular Disease in Hispanic Type 2 Diabetes in Northeast Tennessee Principle Investigator: W. Andrew Clark, PhD Abstract Numerous studies have shown that consumption of omega three (n-3) fatty acids help to reduce the incidence of cardiovascular disease, however the typical western diet is rich in omega six (n-6) fatty acids and lacking in n-3. Randomized control trials have demonstrated that n-3 fatty acid supplementation (either through consumption of fish or through fish oil supplementation) can reduce cardiac events (eg. Death, nonfatal MI, nonfatal stroke) and decrease the progression of atherosclerosis in coronary patients. It has been well documented that diabetics are at an increases risk for developing cardiovascular disease. The magnitude of the diabetes problem in Hispanic Americans is alarming. About 10.2 percent of the Hispanic American population is diabetic and Hispanic Americans are 1.9 times more likely to develop diabetes than non-Hispanic whites of similar age. In addition, many Hispanic Americans are of a lower socioeconomic status and health care and preventative health measure may be unavailable or cost prohibitive. Our proposal is to evaluate the impact of supplementing Hispanic type 2 diabetic patients with approximately 2 grams of fish oil per day (equivalent of 360 mg eicosapentaenoic acid (EPA), C20:5n-3, and 240 mg docosahexaenoic acid (DHA), C22:6n-3) for a period of 90 days. EPA and DHA are GRAS (generally recognized as safe) compounds and are found in many cold water fishes, shellfish and various nuts. Patients (60 desired (30 treatment (fish oil) /30 placebo capsule)) will be identified at the Johnson City Downtown Clinic and questioned to determine their willingness to participate in the trial. Each patient would receive a supply of either fish oil gelatin capsules or placebo capsules, fill out a dietary preference survey, submit to an pre (time zero) and post (time 90 days) venipuncture for standard lipid panel (ETSU) and serum EPA/DHA concentration (Purdue University), submit to a pre (time zero) and post (time 90 days) respired air sample and determine height and weight (to calculate ideal body weight). For their participation in the trial, the patients will receive a gift certificate ($20.00 to Wal-Mart) and be able to attend nutrition education to determine how changing the diet can impact their cardiovascular health. Individual patients will receive feedback regarding the impact of fish oil supplementation ion their blood profile and the potential impact these changes could have on cardiovascular health. Respired air samples will be analyzed for alkanes (ethane and pentane). The level of alkanes in the respired air and their ratio is an indication of the body’s peroxidation of n-3 and n-6 fatty acid composition and is a potential non-invasive technique for collecting the data. Aims of the research are three-fold. Aim 1 is to correlate alkanes in the respired air to n-3/n-6 fatty acids identified in the blood samples for both the pre and post sampling periods. A strong correlation will enable research scientists to use a non-invasive technique (respired air) for evaluating a patient’s fatty acid profile, particularly in children where obesity is a growing concern. Aim 2 is to observe changes in the blood parameters before and after supplementation of n-3 acids and to evaluate the potential impact of those changes for the improved health of the type 2 diabetic. Supplementation of 2 grams of fish oil per day may be a cost effective adjunctive treatment for type 2 diabetics with an out of pocket cost of $50 or less per individual per year. Aim 3 will be the addition of an educational component where the patient’s diet will be evaluated and educational classes will be scheduled to evaluate potential changes in the diet that could improve the cardiovascular health of the type 2 diabetic patient.