Essential & Metabolic Fatty Acids Analysis

Assess the Balance between Critical Fatty Acids

The Essential & Metabolic Fatty Acids Analysis (EMFA) evaluates the levels of essential and non-essential red blood cell membrane fatty acids important in metabolism and cellular function. Fatty acid imbalances can be a causative factor in a variety of chronic health conditions. The Essential and Metabolic Fatty Acids Analysis can indicate the need for fatty acid supplementation and/or dietary modification.

When should testing for EMFAs be considered?

Dietary fat is emerging as one of the most important nutritional modifiers for overall health. There are many health implications which make measuring fatty acids vitally important. Relying on dietary recall may not be accurate since fatty acids can not only be obtained from the diet, but also created endogenously. Imbalances in fatty acids have been implicated in many clinical conditions including but not limited to:1-18

  • Cardiovascular disease
  • Chronic inflammatory conditions
  • Autoimmune diseases
  • Osteoporosis
  • Cognitive decline
  • Mood disorders
  • Neurologic disease
  • Cancer
  • Diabetes
  • Eczema and Psoriasis
  • Metabolic syndrome
  • Polycystic ovary syndrome
  • Chronic obstructive pulmonary disease
  • Asthma

What is a Fatty Acid?

Fatty acids are used as energy storage units, structural components of cell membranes, and precursors to eicosanoids, which are important signaling molecules in the inflammatory cascade. Fatty acids are obtained from dietary fat or synthesized endogenously. 'Essential' fatty acids must come from dietary intake and cannot be made in the body. Dietary fat is digested and broken down into fatty acids which are then absorbed into circulation. In circulation, they can undergo beta-oxidation to become Acetyl CoA to be used as energy in the citric acid cycle. They can also join in circulation to form triglyceride molecules.

The EMFA Biomarkers

The comprehensive EMFA profile includes:

  • Omega 3 Fatty Acids are anti-inflammatory, and are essential for brain function and cardiovascular health
  • Omega 6 Fatty Acids are involved in the balance of inflammation
  • Omega 9 Fatty Acids are important for brain growth, nerve cell myelin, and reducing inflammation
  • Saturated Fatty Acids are involved in lipoprotein metabolism and the inflammatory cascade
  • Monounsaturated Fats include beneficial omega 7 fats and unhealthy trans fats
  • Delta-6 Desaturase Activity assesses efficiency of this enzyme to metabolize omega 6s and omega 3s via the Linoleic/DGLA Ratio
  • Cardiovascular Risk includes specific ratios and the Omega 3 Index
    • Omega 6/Omega 3 Ratio has changed with diets over time from a 1:1 balance throughout history, to a 20:1 imbalance in the modern day that correlates with many chronic diseases.19-23
    • AA/EPA Ratio assess the balance between inflammatory arachidonic acid (AA) and anti-inflammatory eicosapentaenoic acid (EPA) and is associated with cardiovascular disease as well as mood disorders and cancer.24-29
    • Omega 3 Index is the RBC percentage sum of EPA + DHA and assesses risk for coronary artery disease. It is studied in other diseases as well, such as obesity, mood disorder, and insulin resistance.30-36

What Advantage Does the EMFA Offer Compared to Other Diagnostics?

The unique EMFA report provides:

A chart showing the EMFA pathways.
  • Multicolored reporting of biomarker results – allows clinicians to quickly determine potential areas of concern
  • Essential Fatty Acid Metabolism Infographic – provides listings of cofactor nutrients required by key enzymes involved in EFA elongation and desaturation

Fatty acids are measured in red blood cells for the EMFA profile and are reported as a weight percentage. Fatty acids measured in plasma are reported by concentration. Though research is done using both methods, fatty acid compositions are generally expressed on a weight percentage basis rather than as weight or μmol. When reporting as a percentage the report of each fatty acid is affected by the other fatty acids. When reported as a quantity, changes in fatty acids are independent of each other, but it does not identify the percentage of the total. Plasma fatty acids are more influenced by recent dietary intake. RBC fatty acid are commonly used to determine the presence of long-term insufficiencies and imbalances.

Genova's Methodology

The Essential and Metabolic Fatty Acid Markers are measured utilizing packed red blood cells and are reported as weight percentages. Fatty Acids are measured utilizing Gas Chromatography/Mass Spectrometry (GC-MS) methodology.

What Can Clinicians and Patients Expect from EMFA Testing?

Essential and Metabolic Fatty Acids testing can indicate the need for fatty acid supplementation and dietary modification. Clinically significant fatty acid imbalances are precisely identified on a clear, easy-to interpret test report that serves as the foundation for designing an effective, customized dietary and supplementation program to support fatty acid sufficiency and balance.

References

  1. Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2960-2984.
  2. Romano A, Koczwara JB, Gallelli CA, et al. Fats for thoughts: An update on brain fatty acid metabolism. Int J Biochem Cell Biol. 2017;84:40-45.
  3. Brasky TM, Darke AK, Song X, et al. Plasma phospholipid fatty acids and prostate cancer risk in the SELECT trial. J Nat Cancer Inst. 2013;105(15):1132-1141.
  4. Liu J, Ma DW. The role of n-3 polyunsaturated fatty acids in the prevention and treatment of breast cancer. Nutrients. 2014;6(11):5184-5223.
  5. Gan RW, Demoruelle MK, Deane KD, et al. Omega-3 fatty acids are associated with a lower prevalence of autoantibodies in shared epitope-positive subjects at risk for rheumatoid arthritis. Ann Rheum Dis. 2017;76(1):147-152.
  6. Calder PC. New evidence that omega-3 fatty acids have a role in primary prevention of coronary heart disease. J Public Health Emerg. 2017;1:35-35.
  7. Muley P, Shah M, Muley A. Omega-3 Fatty Acids Supplementation in Children to Prevent Asthma: Is It Worthy?-A Systematic Review and Meta-Analysis. J Allergy. 2015;2015:312052.
  8. Xu Y, Qian SY. Anti-cancer activities of Ψ-6 polyunsaturated fatty acids. Biomed J. 2014;37(3):112.
  9. Patterson E, Wall R, Fitzgerald GF, Ross RP, Stanton C. Health implications of high dietary omega-6 polyunsaturated Fatty acids. J Nutr Metab. 2012;2012:539426.
  10. Lavado-García J, Roncero-Martin R, Moran JM, et al. Long-chain omega-3 polyunsaturated fatty acid dietary intake is positively associated with bone mineral density in normal and osteopenic Spanish women. PloS one. 2018;13(1):e0190539-e0190539.
  11. Beydoun MA, Kaufman JS, Satia JA, Rosamond W, Folsom AR. Plasma n-3 fatty acids and the risk of cognitive decline in older adults: the Atherosclerosis Risk in Communities Study. The Am J Clin Nutr. 2007;85(4):1103-1111.
  12. Gillingham LG, Harris-Janz S, Jones PJ. Dietary monounsaturated fatty acids are protective against metabolic syndrome and cardiovascular disease risk factors. Lipids. 2011;46(3):209-228.
  13. Su K-P, Matsuoka Y, Pae C-U. Omega-3 Polyunsaturated Fatty Acids in Prevention of Mood and Anxiety Disorders. Clin Psychopharmacol Neurosci. 2015;13(2):129-137.
  14. Griel AE, Kris-Etherton PM, Hilpert KF, Zhao G, West SG, Corwin RL. An increase in dietary n-3 fatty acids decreases a marker of bone resorption in humans. Nutr J. 2007;6:2-2.
  15. Calder PC. Polyunsaturated fatty acids, inflammatory processes and inflammatory bowel diseases. Mol Nutr Food Res. 2008;52(8):885-897.
  16. Rahman M, Beg S, Ahmad MZ, et al. Omega-3 fatty acids as pharmacotherapeutics in psoriasis: current status and scope of nanomedicine in its effective delivery. Curr Drug Targets. 2013;14(6):708-722.
  17. Calder PC. Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology? Br J Clin Pharmacol. 2013;75(3):645-662.
  18. Schwingshackl L, Strasser B. High-MUFA Diets Reduce Fasting Glucose in Patients with Type 2 Diabetes. Ann Nutr Metab. 2012;60(1):33-34.
  19. Simopoulos AP. The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Exp Biol Med. 2008;233(6):674-688.
  20. Simopoulos AP. The omega-6/omega-3 fatty acid ratio, genetic variation, and cardiovascular disease. Asia Pacif J Clin Nutr. 2008;17:131-134.
  21. Lluís L, Taltavull N, Muñoz-Cortés M, et al. Protective effect of the omega-3 polyunsaturated fatty acids: Eicosapentaenoic acid/Docosahexaenoic acid 1: 1 ratio on cardiovascular disease risk markers in rats. Lipids Health Dis. 2013;12(1):140.
  22. Simopoulos AP. An increase in the omega-6/omega-3 fatty acid ratio increases the risk for obesity. Nutrients. 2016;8(3):128.
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  24. Tutino V, De Nunzio V, Caruso MG, et al. Elevated aa/epa ratio represents an inflammatory biomarker in tumor tissue of metastatic colorectal cancer patients. Int J Mol Sci. 2019;20(8):2050.
  25. Rizzo AM, Corsetto PA, Montorfano G, et al. Comparison between the AA/EPA ratio in depressed and non depressed elderly females: omega-3 fatty acid supplementation correlates with improved symptoms but does not change immunological parameters. Nutr J. 2012;11(1):82.
  26. Adams PB, Lawson S, Sanigorski A, Sinclair AJ. Arachidonic acid to eicosapentaenoic acid ratio in blood correlates positively with clinical symptoms of depression. Lipids. 1996;31(1Part2):S157-S161.
  27. Harris WS, Assaad B, Poston WC. Tissue omega-6/omega-3 fatty acid ratio and risk for coronary artery disease. Am J Cardiol. 2006;98(4):19-26.
  28. Rupp H, Wagner D, Rupp T, Schulte L-M, Maisch B. Risk Stratification by the "EPA+ DHA Level" and the "EPA/AA Ratio". Herz. 2004;29(7):673-685.
  29. Sorgi PJ, Hallowell EM, Hutchins HL, Sears B. Effects of an open-label pilot study with high-dose EPA/DHA concentrates on plasma phospholipids and behavior in children with attention deficit hyperactivity disorder. Nutr J. 2007;6(1):16.
  30. Harris WS, Von Schacky C. The Omega-3 Index: a new risk factor for death from coronary heart disease? Prev Med. 2004;39(1):212-220.
  31. Harris WS. The omega-3 index: from biomarker to risk marker to risk factor. Curr Atheroscler Rep. 2009;11(6):411.
  32. Harris WS. The omega-3 index: clinical utility for therapeutic intervention. Curr Cardiol Rep. 2010;12(6):503-508.
  33. Burrows T, Collins C, Garg M. Omega-3 index, obesity and insulin resistance in children. Int J Ped Obesity. 2011;6(sup3):e532-539.
  34. Baghai TC, Varallo-Bedarida G, Born C, et al. Major depressive disorder is associated with cardiovascular risk factors and low Omega-3 Index. J Clin Psych. 2010;72(9):1242-1247.
  35. Parletta N, Zarnowiecki D, Cho J, et al. People with schizophrenia and depression have a low omega-3 index. Prostaglandins, Leukotrienes and Essential Fatty Acids. 2016;110:42-47.
  36. Albert BB, Derraik JG, Brennan CM, et al. Higher omega-3 index is associated with increased insulin sensitivity and more favourable metabolic profile in middle-aged overweight men. Sci Rep. 2014;4:6697.
Analyte List
Arachidic
Arachidonic
Behenic
Dihomo-gamma-linolenic
Docosahexaenoic
Docosapentaenoic
Docosatetraenoic
Eicosadienoic
Eicosapentaenoic
Elaidic
Gamma-Linolenic
Lignoceric
Linoleic
Margaric
Nervonic
Oleic
Palmitic
Palmitoleic
Pentadecanoic
Stearic
Tricosanoic
Vaccenic
alpha-Linolenic
Specimen Requirements
2 EDTA tubes each of 6ml whole blood