Oxygen, The Ultimate Measure of Longevity

Jesse Oswald • February 24, 2024

The Vital Role of Oxygen in Sustaining Life and Promoting Longevity

Oxygen is the molecule of life. It’s involved in every reaction in our body necessary to sustain life and movement. It’s also the foundational element for a long and high-quality life.

 

Without oxygen, death is inevitable. Luckily, our body houses a unique computer system that allows us to breathe without thinking about inhaling and exhaling. Our brain and neurons ensure that oxygen exchange and transport of oxygenated blood across every cell in our body happens seamlessly in the background.

 

In this article, we will do a deep dive into the mechanisms through which oxygen is the cornerstone of longevity, the research that stands behind this statement, and how its absorption by our body can be measured to provide a clear assessment of longevity and health.

The Oxygen Chain

To better understand the statement “Oxygen is the molecule of life,” we should first understand how and why our bodies use oxygen. Oxygen is the catalyst for energy release in every cell, a process necessary to sustain life and power movement. This mechanism involves using oxygen to oxidize or, in other words, “burn” nutrients we consume. These nutrients consist primarily of fats and carbohydrates. This burning process is similar to what happens in your fireplace when you set a piece of wood aflame, and oxygen interacts with wood in a chemical reaction to release energy, in this case, heat. The oxidation of nutrients releases our cells' energy to stay alive, move, and power other vital functions. Although this process may sound simple, it involves several systems in our body and employs most of the core organs. Here’s how this process works:

 

  1. First, oxygen molecules enter the lungs through inhalation.
  2. The lungs then absorb oxygen molecules through specialized alveoli membranes and transfer them into the bloodstream. Their transfer into the bloodstream occurs through a specialized hormone called hemoglobin, which can attract and retain oxygen molecules onto its surface and thus act as a transport mechanism. As hemoglobin draws oxygen molecules, the blood becomes rich in oxygen that can be transferred around the body.
  3. Oxygenated, or oxygen-rich blood, is pumped with the help of the heart across the body, helping oxygen molecules reach every cell.
  4. Once oxygen molecules reach their destination, they detach from hemoglobin and enter the cell. Inside the cell are dedicated systems called mitochondria responsible for using the newly delivered oxygen to oxidize and break down the fats and carbohydrates we have consumed.
  5. The breakdown of fats and carbohydrates releases energy used to maintain the proper temperature across our body and move (e.g., movement of muscles).
  6. The oxidation of fats and carbohydrates releases carbon dioxide (CO2), which must be cleared from our bodies. Consequently, CO2 is expelled from the cell and released into the bloodstream, where it’s carried back to the lungs. CO2-carrying blood is then pumped back into the lungs. There, through the opposite mechanism of oxygen used to enter the bloodstream, CO2 exists in blood circulation into the inner cavity of the lungs. Lastly, through exhalation, this CO2 is expelled into the environment.

 

This process is also known as Aerobic Metabolic or Cellular Respiration. Aerobic comes from the Greek word “Aερας” (aˈe.ɾas), which means air and refers to the presence of oxygen in the energy release process. Aerobic metabolism accounts for more than 95% of our overall energy generation. It is distinct from the secondary energy release mechanism called Anaerobic Metabolism, which will be covered in a separate post.

 

What’s important to keep in mind from the process described above is that:

  • Oxygen is a hard requirement for our body to release the energy it needs to stay alive, regulate its temperature, and move.
  • Four significant systems are involved for oxygen to be absorbed, delivered, and utilized in the “burning” of fats and carbohydrates: lungs, heart, blood, and cells.
  • Metabolism is the collective function of all these systems. A “broken” metabolism may mean that any part of this chain may be problematic and hampering the most fundamental process in the human body, the oxygen chain.

Chronic disease & Oxygen Chain

To understand how oxygen plays a crucial role in regulating the quality and length of one’s life, one should examine the relationship between the ability to utilize oxygen and the primary factors hampering longevity, namely chronic diseases.

 

Chronic diseases are typically conditions caused by lifestyle factors such as poor nutrition, lack of exercise, or tobacco use and inflict an ongoing reduction in quality and duration of life. The four most common, deadly, and costly chronic conditions are heart disease, lung disease, cancer, and diabetes.

 

Besides cancer, the scientific community now openly acknowledges that heart disease, lung disease, and diabetes are highly interlinked in terms of their underlying lifestyle drivers and their high degree of comorbidity (i.e., one leads to the other). The term used to characterize this collective disorder is “Cardio-metabolic Syndrome.”

 

Cardio-metabolic syndrome is driven primarily by lifestyle factors, which, for the most part, can be traced to poor nutrition and lack of exercise. No matter the contribution of exercise or nutrition to the cardiometabolic syndrome, its advent can always be traced to the oxygen chain. Specifically, a disruption of the oxygen chain in any of the three fundamental components, namely heart, lungs, and cells, is directly related to the rise of the equivalent cardio-metabolic syndrome’s facet, namely heart disease, lung disease, and diabetes.

 

The implications of this phenomenon are significant for the early detection and prevention of these conditions. In short, analyzing and monitoring the oxygen chain can help early detect a predisposition for heart disease, lung disease, or diabetes. Here’s a brief description of how oxygen denotes deterioration in each system.

Heart Disease

The heart is our body’s blood pump and helps push oxygen-rich blood from the lungs to every cell. It also moves carbon dioxide-rich blood from the cells back to the lungs. Nearly every form of heart disease, including Ischemic Heart Disease and Heart Failure, causes the heart to be less effective in pumping oxygen-rich blood into your body. This manifests through reducing the amount of oxygen your body consumes per heartbeat. This is measured during a graded breath analysis test through a variable called O2pulse. A separate blog post covers a detailed review of how breath analysis can help detect heart conditions. 

Lung Disease

Nearly every form of lung disease will cause the lungs to be less effective in absorbing oxygen. Whether it’s Asthma, Chronic Pulmonary Obstructive Disorder (i.e., COPD), or Pulmonary Embolism, the effects are a reduced ability to absorb oxygen and deliver it to the bloodstream. The main breath variables used to detect this deficiency include the maximum amount of air lungs can exchange with the environment (i.e., MVV or maximum voluntary ventilation), the amount of oxygen transferred into the blood (i.e., SpO2 or blood oxygen saturation), and the maximum amount of air one can exhale during exercise (i.e., Peak VT or maximum tidal volume). A separate blog post covers a detailed review of how breath analysis can help detect lung conditions.

Diabetes

Diabetes is a condition in which cells cannot metabolize carbohydrates, thus leaving them in the bloodstream. The presence of carbohydrates in the bloodstream is toxic as it causes gradual degradation of every tissue in the body. The onset of diabetes can also be traced back to the oxygen chain, but this time on a cellular basis. When cells become less able to absorb and utilize oxygen, they become less able to oxidize fat as a fuel source. This leads to increased intramyocellular lipids levels (i.e., fat within muscles and tissue) and a higher blood concentration of free fatty acids. This, in turn, stimulates higher glucose release in the liver and further insulin secretion by the pancreas. Exposing your body to a constant state of increased insulin concentration in the blood makes your cells less “sensitive” to insulin, leading to insulin resistance and, consequently, diabetes. A separate blog post covers a detailed review of how breath analysis can help detect a predisposition to diabetes.

Quantifying Longevity Through Oxygen

The importance of oxygen for long-term health has been established through studies examining the function of individual elements found in the oxygen chain (i.e., heart, lungs, cells) and its global function (i.e., overall oxygen consumption). The latter has been scrutinized through epidemiological studies that have examined the correlation between mortality risk and the total amount of oxygen one’s body can absorb. After decades of rigorous scientific research measuring peak oxygen consumption among individuals of various backgrounds, ethnicities, and ages and subsequently tracking their fatality rates over several decades, the scientific community concluded that cardio-respiratory fitness, AKA VO2peak or peak oxygen consumption, is the strongest predictor of how well and long someone will live. Although a low VO2 peak can’t reveal the exact sub-system (e.g., heart, lungs, or cells) causing its deterioration, it can certainly indicate that at least one is facing an underlying problem and is thus a strong indicator of chronic disease onset. This immediately translates into a reduction in expected lifespan and quality of life. The findings of these studies were summarized in a landmark scientific statement published by the American Heart Association in 2016, which elevated VO2peak into a critical vital sign that provides the most substantial evidence about life expectancy and quality. Specifically, for every unit increase in VO2peak, measured in Metabolic Equivalent (i.e., METs), one’s likelihood of death and onset of chronic disease declines by ~15%. Such is its predictive power that the American Heart Association openly called for implementing VO2peak in annual physical examinations.

Conclusion

Most people train for life, meaning that a longer and better life is the motivation behind picking up a workout routine or cleaning up their diets. Therefore, assessing how effective a wellness routine is for one’s longevity goals is essential to success. Breath analysis provides the gold standard in determining how the oxygen chain and its components work globally, thus indicating whether a wellness routine leads to a longer and better life. It does so while also pinpointing the sub-systems of the oxygen chain, namely lungs, heart, and cells that may have been impacted by age, lifestyle, or other factors requiring a closer medical examination. Ultimately, oxygen is the molecule of life. How it flows through the body is the best picture of one’s health, and breath analysis is its most reliable measurement tool.

An Ounce of Prevention - Hyperion Health Blog

A woman is helping an older woman do exercises on an exercise ball in a gym.

What is a Kinesiologist?

By Jesse Oswald • January 29, 2025
What is a Kinesiologist?
A woman is wearing an oxygen mask while running on a treadmill.

Predicting Medical Costs with VO2max

By Jesse Oswald • January 20, 2025
Highlights Healthcare expenses are skyrocketing, with consumers and employers facing the significant brunt. Identifying those likely to get sick is critical as our resource-strapped healthcare system should focus on those likely to become the most significant burden to the system. VO2 max is a crucial longevity indicator that can also accurately predict healthcare expenses. The rampant chronic disease epidemic and the resulting surge in medical expenses is one of the most dire problems of modern societies, probably only second to climate change. Healthcare inflation is on a meteoric rise, and for those with limited or no healthcare coverage, a medical emergency is the equivalent of personal bankruptcy. A dire problem for employers In the US, employers and consumers who face rising health insurance premiums and astronomical out-of-pocket medical expenses feel the brunt of rising healthcare costs. Such is the problem that even large, well-capitalized corporations choose to send employees overseas for specific medical procedures since the cost of traveling and treatment in a foreign country is lower than the cost of care in the US. Another startling example is the infamous "northern caravan," a term that describes people with diabetes in the northern states who travel to Canada to secure their insulin supply. According to McKinsey , a survey conducted among over 300 employers highlighted that the average increase in the cost of health benefits over the past three years has been within the range of 6 to 7 percent. This survey also indicated that any rate increases exceeding 4 to 5 percent were deemed unsustainable. Interestingly, 95 percent of the surveyed employers expressed willingness to contemplate reducing benefits if costs surged by 4 percent or more. The primary cost-control measures that these employers indicated they might explore included elevating the portion of premium costs covered by employees and a potential transition to high-deductible health plans. Why is Breath Analysis relevant? Vis-a-vis this problem, the early and accurate estimation of who will get sick and how much they will cost is as critical as the treatment itself. The reason is that no other method of accurately identifying at-risk populations exists; it helps focus our scarce prevention resources and attention on those most in need. Breath analysis, AKA VO2max or metabolic testing, is an assessment that reveals two key biomarkers that provide significant predictive value for one's likelihood of developing costly chronic conditions. These two biomarkers are VO2max and the Respiratory Exchange Ratio. In this article, we will dive into VO2max to understand why it's a critical reflection of our overall health and, consequently, a window into our future healthcare spend. What is VO2max? Let's start with the basics. What is VO2max? VO2 max is the maximum amount of oxygen the human body can absorb. It is measured in terms of milliliters of oxygen consumed per kilogram of body weight. The below formula below indicates how VO2max is calculated: The numerator indicates the volume of oxygen your heart, lungs, and cells can absorb, expressed in milliliters per minute. The denominator indicates the weight of the individual represented in kilograms. 
There are many different types of fats in this picture.

Dietary Fat: An Essential Dietary Component Rather than the root of all Nutritional Health Issues

By Jesse Oswald • January 13, 2025
Key points A total fat intake between 20-35% ensures sufficient intake of essential fatty acids and fat-soluble vitamins Omega-6 PUFAs are primarily found in vegetable oils, while omega-3 PUFAs are primarily found in fatty fish and fish oils Both omega-3 PUFAs and MUFAs have established benefits for cardiovascular disease TFAs are the only dietary lipids that have a strong positive relationship with cardiovascular disease Omega-3 PUFA supplementation increases the beneficial bacteria of the human microbiome Over the last three decades, there has been a great revolution against fat due to its suspected association with several nutritional health issues, especially cardiovascular disease. There was a tremendous amount of evidence that indicated dietary cholesterol and saturated fat as the main culprits of cardiovascular disease, thus morbidity and mortality. It was when all the low-fat and no-fat dairy products started to launch, promising even complete substitution of the cholesterol-lowering heart medication if these products were exclusively consumed. Let’s start from the beginning. Dietary fat intake can vary significantly and still meet energy and nutrient needs. International guidelines suggest a total fat intake between 20% and 35% of the daily caloric consumption. This range ensures sufficient intake of essential fatty acids and fat-soluble vitamins. Not only does the quantity of the ingested fat matter, but most importantly, its quality. Some dietary fats have beneficial effects, with a significant role in maintaining good health, while others may threaten it. Which are, after all, the dietary fats? Dietary fats is a rather heterogeneous group of organic compounds, including four main types of fat, which are elaborately described in the following sections of this article. Polyunsaturated fatty acids (PUFAs) Polyunsaturated fatty acids (PUFAs) have two or more carbon-carbon double bonds. Omega-6 PUFAs and omega-3 PUFAs are the main types of PUFAs and are classified according to the location of the first unsaturated bond (sixth and third carbon atom, respectively). Alpha-Linolenic acid (ALA), docosahexaenoic acid (DHA), docosapentaenoic acid (DPA), and eicosapentaenoic acid (EPA) are the most important omega-3 PUFAs. ALA is an essential fatty acid that can only be obtained from diet and can be converted into EPA and then to DHA, but the rate of this conversion is finite, approximately 7.0%–21% for EPA and 0.01%–1% for DHA. In the same way, the most important omega-6 PUFAs are linoleic acid (LA) and arachidonic acid (ARA). LA is an essential fatty acid that, in order to give rise to ARA, needs to be ingested through the diet as the human body cannot synthesize it. The recommended intake for total PUFA ranges between 5% and 10% of the total energy intake, while a total omega-3 PUFA intake of 0.5%–2% and a total omega-6 PUFA intake of 2.5%-5% is suggested. A dietary ratio of omega−6/omega−3 PUFA is recommended to be 1:1–2:1 to balance their competing roles and achieve health benefits. Omega-6 and omega-3 PUFAs Omega-6 PUFAs, in the form of LA, are plentiful in most crop seeds and vegetable oils, such as canola, soybean, corn, and sunflower oils. In contrast to omega-6 PUFAs, omega-3 PUFAs are obtained from a limited range of dietary sources. Flax, chia, and perilla seeds are rich in ALA, with significant amounts also detected in green leafy vegetables. The consumption of fatty fish, such as salmon, sardines, tuna, trout, and herring, provides high amounts of EPA and DHA. Besides fish and their oils, small amounts of omega-3 PUFAs are also detected in red meat like beef, lamb, and mutton. All the above dietary sources provide EPA, DPA, DHA, LA, and ARA in different amounts, and their intake is necessary for normal physiological function. PUFAs play a critical role in many chronic diseases, affecting human cells by regulating inflammation, immune response, and angiogenesis. Omega-3 PUFAs’ role against hypertriglyceridemia has been clarified, and research indicates that systematically consuming oily fish can contribute to general heart protection. Supplementation with omega-3 PUFAs could potentially lower the risk of several cardiovascular outcomes, but the evidence is stronger for individuals with established coronary heart disease. Moreover, adequate EPA and DHA levels are necessary for brain anatomy, metabolism, and function. Although the mechanisms underlying omega-3 PUFAs' cardioprotective effects are still poorly understood, several studies have been conducted in this direction. Unfortunately, that does not hold true for their omega-6 counterparts, for which controversial emerging data tend to show anti-inflammatory behavior that needs to be further studied. Monounsaturated fatty acids (MUFAs) In contrast to PUFAs, monounsaturated fatty acids (MUFAs) are easily produced by the liver in response to the ingestion of carbohydrates. The main MUFA is oleic acid, found in plant sources, such as olive oil, olives, avocado, nuts, and seeds, while minimal amounts are also present in meat, eggs, and dairy products. Specific guidelines around MUFAs’ dietary consumption do not exist. Therefore, MUFAs are recommended to cover the remaining fat intake requirements to reach the total daily fat intake goal. A growing body of research shows that dietary MUFAs reduce or prevent the risk of metabolic syndrome, cardiovascular disease (CVD), and hypertension by positively affecting insulin sensitivity, blood lipid levels, and blood pressure, respectively. Moreover, olive oil contains several bioactive substances, possessing anti-tumor, anti-inflammatory, and antioxidant qualities. According to a meta-analysis, consuming olive oil was linked to a lower risk of developing any sort of cancer, especially breast cancer and cancer of the digestive system. Another study found that an isocaloric replacement of 5% of the energy from saturated fatty acids (SFAs) with plant MUFAs led to an 11% drop in cancer mortality over a 16-year follow-up period. Therefore, including MUFAs in the everyday diet offers multifaceted benefits in chronic disease prevention and management, including cancer and general health promotion.  Saturated fatty acids (SFAs) Saturated fatty acids (SFAs) form a heterogeneous group of fatty acids that contain only carbon-to-carbon single bonds. Whole-fat dairy, (unprocessed) red meat, milk chocolate, coconut, and palm kernel oil are all SFA-rich foods. These fatty acids have distinct physical and chemical profiles and varying effects on serum lipids and lipoproteins. Stearic, palmitic, myristic, and lauric acids are the principal SFAs found in most natural human diets. Dietary practice and guidelines recommend limiting SFA intake to <10% of the total energy (E%), while the American Heart Association suggests an even lower intake of <7 E% because total saturated fat consumption and LDL-C levels are positively correlated. However, the role of SFAs in CVDs is quite complex, and the evidence is heterogeneous. In a recent study with a 10.6-year follow-up period, which included 195,658 participants, there was no proof that consuming SFAs was linked to developing CVD while replacing saturated fat with polyunsaturated fat was linked to an increased risk of CVD. Moreover, according to 6 systematic reviews and meta-analyses, cardiovascular outcomes and total mortality were not significantly impacted by substituting saturated fat with polyunsaturated fat. Even if these analyses were to be challenged, due to heterogenous evidence, the possible reduction in CVD risk associated with replacing SFAs with PUFAs in several studies may not necessarily be an outcome of SFAs’ negative effect but rather a potential positive benefit of PUFAs. Regarding SFAs' effect on different types of cancers, associations of their intake with an increased risk of prostate and breast cancer have been indicated. Conversely, a meta-analysis showed no link between SFA intake and a higher risk of colon cancer; similarly, consuming MUFAs, PUFAs, or total fat did not affect colon cancer risk. Hence, the role of SFA consumption in preventing, promoting, or having a neutral role in serious chronic diseases has not been fully elucidated yet. Trans fatty acids (TFAs) Trans fatty acids (TFAs) are created industrially by partially hydrogenating liquid plant oils or can be naturally derived from ruminant-based meat and dairy products. TFAs are highly found in commercial baked goods, biscuits, cakes, fried foods, etc. Guidelines regarding TFAs are stringent and limit TFA intake to <1% of energy or as low as possible. In 2015, the US Food and Drug Administration declared that industrial TFAs are no longer generally recognized as safe and should be eliminated from the food supply as their consumption is strongly linked to various CVD risk factors. Specifically, TFA intake raises triglycerides and increases inflammation, endothelial dysfunction, and hepatic fat synthesis, leading to a significantly increased risk of coronary heart disease (CHD). A meta-analysis suggested that increased TFA intake led to an increase in total and LDL-cholesterol and a decrease in HDL-cholesterol concentrations. Data also indicates that TFAs may influence carcinogenesis through inflammatory pathways, but the reported data are debatable. A recent study investigated the effects of all types of dietary fat intake on CVD risk. While PUFA, MUFA, and SFA intake were not linked to higher CVD risk, dietary TFA intake showed a strong association with CVD risk. Analysis indicated PUFA intake and CVD risk were inversely correlated, and the relative risk of CVD was reduced by 5% in studies with a 10-year follow-up. Dietary lipids and the human microbiome Dietary lipids also affect human microbiota composition. Studies have identified a close association between the human microbiome and metabolic diseases, including obesity and type 2 diabetes. Diets with a high omega-6 PUFA, SFA, and TFA intake increase the amount of many detrimental bacteria in the microbiome and reduce the amount of the beneficial ones, altering the microbiota composition and inducing inflammation via the secretion of pro-inflammatory cytokines. These bacteria may disrupt the gut barrier function, allowing lipopolysaccharides (LPS) translocation, which are bacterial toxins. This condition is linked to metabolic perturbations such as dyslipidemia, insulin resistance, non-alcoholic fatty liver disease (NAFLD), and CVD. On the contrary, omega-3 PUFA (EPA and DHA) supplementation increases beneficial bacteria and limits harmful ones, enhancing intestinal barrier functioning and preventing LPS translocation and its implications. Omega-3 PUFA supplementation has also been studied as a means of mental health disorders management, but the evidence is still controversial. A possible protective impact of fish consumption on depression has been suggested by various studies, as well as a possible protective effect of dietary PUFAs on moderate cognitive impairment. A recent review of meta-analyses indicated that omega-3 PUFA supplementation might have potential value in mental health disorders, but data credibility is still weak. Dietary lipids and obesity Last but not least, obesity and its management is another field that dietary lipids intake seems to impact with their mechanisms. A diet high in PUFA has been shown to lower the total mass of subcutaneous white adipose tissue (the predominant fat type in human bodies), reduce blood lipid levels, and improve insulin sensitivity. In a study comparing PUFA and MUFA isocaloric intake, PUFA was more advantageous and lowered visceral adiposity in patients with central obesity. By stimulating brown adipose tissue, which aids energy expenditure through its elevated thermogenic activity, omega-3 PUFAs seem to elicit these positive effects in fat tissue, thus being useful in preventing and/or managing obesity. Another related study compared PUFA to SFA overfeeding in dietary surplus conditions that aimed to increase weight by 3%. While SFA overfeeding led to weight gain, primarily through the expansion of the visceral adipose tissue, PUFA overfeeding also led to weight gain, but because of a greater expansion of lean tissue mass. To sum up, dietary fats are an essential part of the human diet with many important physiologic functions, including cell function, hormone production, energy, and nutrient absorption. Moreover, dietary fat consumption is associated with positive outcomes in regard to cardiovascular disease, metabolic syndrome, cancer, and depression. Therefore, there is no reason to demonize this valuable dietary component, incriminating it for irrelevant adverse health outcomes, primarily weight loss failure and obesity. References 1. Astrup A, Magkos F, Bier DM, Brenna JT, de Oliveira Otto MC, Hill JO, King JC, Mente A, Ordovas JM, Volek JS, Yusuf S, Krauss RM. Saturated fats and health: A reassessment and proposal for food-based recommendations: JACC State-of-the-Art review. J Am Coll Cardiol. 2020;76(7):844-857. DOI: 10.1016/j.jacc.2020.05.077 2. Bojková B, Winklewski PJ, Wszedybyl-Winlewska M. Dietary fat and cancer-Which is good, which is bad, and the body of evidence. Int J Mol Sci. 2020;21(11):4114. DOI: 10.3390/ijms21114114 3. Custers, Emma EM, Kiliaan, Amanda J. Dietary lipids from body to brain. Prog Lipid Res. 2022;85:101144. DOI: 10.1016/j.plipres.2021.101144 4. de Souza RJ, Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T, Uleryk E, Budylowski P, Schünemann H, Beyene J, Anand SS. Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ. 2015;351:h3978. DOI: 10.1136/bmj.h3978 5. Gao X, Su X, Han X, Wen X, Cheng C, Zhang S, Li W, Cai J, Zheng L, Ma J, Liao M, Ni W, Liu T, Liu D, Ma W, Han S, Zhu S, Ye Y, Zeng F-F. Unsaturated fatty acids in mental disorders: An umbrella review of meta-analyses. Adv Nutr. 2022;13(6):2217-2236. DOI: 10.1093/advances/nmac084 6. Liu AG, Ford NA, Hu FB, Zelman KM, Mozaffarian D, Kris-Etherton PM. A healthy approach to dietary fats: understanding the science and taking action to reduce consumer confusion. Nutr J. 2017;16(1):53. DOI: 10.1186/s12937-017-0271-4 7. Poli A, Agostoni C, Visioli F. Dietary fatty acids and inflammation: Focus on the n-6 series. Int J Mol Sci. 2023;24(5):4567. DOI: 10.3390/ijms24054567 8. Saini RK, Keum Y-S. Omega-3 and omega-6 polyunsaturated fatty acids: Dietary sources, metabolism, and significance-A review. Life Sci. 2018;203:255-267. DOI: 10.1016/j.lfs.2018.04.049 9. Saini RK, Prasad P, Sreedhar RV, Naidu KA, Shang X, Keum Y-S. Omega-3 polyunsaturated fatty acids (PUFAS): Emerging plant and microbial sources, oxidative stability, bioavailability, and health benefits-A review. Antioxidants (Basel). 2021;10(10):1627. DOI: 10.3390/antiox10101627 10. Zhao M, Chiriboga D, Olendzki B, Xie B, Li Y, McGonigal LJ, Maldonado-Contreras A, Ma Y. Substantial increase in compliance with saturated fatty acid intake recommendations after one year following the American Heart Association diet. Nutrients. 2018;10(10):1486. DOI: 10.3390/nu10101486 11. Zhu Y, Bo Y, Liu Y. Dietary total fat, fatty acids intake, and risk of cardiovascular disease: a dose-response meta-analysis of cohort studies. Lipids Health Dis. 2019;18:91. DOI: 10.1186/s12944-019-1035-2
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