Low Dietary Omega-6 to Omega-3 Fatty Acid Intake Ratio Enhances Adiponectin Level in Obesity

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Helena Fabiani
Ninik Mudjihartini
Wiji Lestari


Every year around the world, the prevalence of obesity is increasing. Obesity and its associated diseases have become some of the most pressing health problems in developed and developing countries. In its development, adipocytes dysfunction and chronic low-grade inflammation occur in obesity will stimulate diseases at higher risk including type 2 diabetes mellitus (T2DM), atherosclerosis, hypertension, and metabolic syndrome. Western diet and sedentary lifestyle are thought to have significantly contributed to the increase in obesity recently. Diet modification is a sound method to prevent obesity and its complications. Nevertheless, the concern lies in the ratio of omega-6 towards omega-3 fatty acids intake, which in its current state indicates an imparity. Omega-3 and omega-6 are two essential fatty acids that emerge as dominant factors in obesity through adiponectin. Adiponectin refers to a protein hormone conceived by adipocytes to prevent obesity and its subsequent complications by increasing insulin sensitivity, fatty acid oxidation, anti-inflammatory, and antiaterogenic. This study aims to determine the mechanism and the role of fatty acids in omega-6 towards those within omega-3 by using adiponectin as the indicator of advancement to obesity and its underlying diseases.


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Author Biographies

Helena Fabiani, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia Faculty of Medicine, Universitas Kristen Krida Wacana, Indonesia

Department of Nutrition 

Ninik Mudjihartini, Universitas Indonesia

Department of Biochemistry and Molecular Biology, Faculty of Medicine

Wiji Lestari, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia

Department of Nutrition


WHO. Obesity and overweight [Internet]. 2018 [cited 2019 Oct 20]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

Wulansari A, Mardiana D, Baliwati Y. Kerugian ekonomi akibat biaya perawatan kesehatan langsung pada orang dewasa obesitas di Indonesia. Media Kesehat Masy Indones Univ Hasanuddin. 2016;12(4):20–215.

Farimani AR, Hariri M, Azimi-Nezhad M, Borji A, Zarei S, Hooshmand E. The effect of n-3 PUFAs on circulating adiponectin and leptin in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Acta Diabetol. 2018;55(7):641–52.

Paniagua JA. Nutrition, insulin resistance and dysfunctional adipose tissue determine the different components of metabolic syndrome. World J Diabetes. 2016;7(19):483.

Alzeidan R, Rabiee F, Mandil A, Hersi A, Fayed A. Non-communicable disease risk factors among employees and their families of a Saudi University: An epidemiological study. PLoS One. 2016;11(11):1–13.

Kosaka S, Suda K, Gunawan B, Raksanagara A, Watanabe C, Umezaki M. Urban-rural difference in the determinants of dietary and energy intake patterns: A case study in west Java, Indonesia. PLoS One. 2018;13(5):1–18.

Wang L. Omega-3 and omega-6 fatty acids : Role in body fat gain and development of obesity. North Am J Med Sci. 2015;8(4):163–71.

Meiliana A, Dewi NM, Wijaya A. Adipose Tissue, Inflammation (Meta-inflammation) and Obesity Management. Indones Biomed J. 2015;7(3):129.

Torre-Villalvazo I, Bunt AE, Aleman G, Marques-Mota CC, Diaz-Villasenor A, Noriega LG. Adiponectin synthesis and secretion by subcutaneous adipose tissue is impaired during obesity by endoplasmic reticulum stress. J Cell Biochem. 2018;1–15.

Nigro E, Scudiero O, Monaco ML, Palmieri A, Mazzarella G, Costagliola C, et al. New insight into adiponectin role in obesity and obesity-related diseases. Biomed Res Int. 2014;2014:1–14.

Gariballa S, Alkaabi J, Yasin J, Al Essa A. Total adiponectin in overweight and obese subjects and its response to visceral fat loss. BMC Endocr Disord. 2019;19(1):1–6.

Torres-Castillo N, Silva-Gómez JA, Campos-Perez W, Barron-Cabrera E, Hernandez-Cañaveral I, Garcia-Cazarin M, et al. High dietary ω-6:ω-3 PUFA ratio is positively associated with excessive adiposity and waist circumference. Obes Facts. 2018;11(4):344–53.

Ostrowska L, Fiedorczuk J, Adamska E. Effect of diet and other factors on serum adiponectin concentrations in patients with type 2 diabetes. Rocz Państwowego Zakładu Hig. 2013;64(1):61–6.

Gray B, Steyn F, Davies PSW, Vitetta L. Omega-3 fatty acids: A review of the effects on adiponectin and leptin and potential implications for obesity management. Eur J Clin Nutr. 2013;67(12):1234–42.

Simopoulos AP, DiNicolantonio JJ. The importance of a balanced omega-6 to omega-3 ratio in the prevention and management of obesity. Open Hear. 2016;3(2):1–6.

Spector AA, Kim HY. Discovery of essential fatty acids. J Lipid Res. 2015;56(1):11–21.

Simopoulos AP. A high omega-6/ omega-3 fatty acids ratio increases the risk for obesity. Interv Obes Diabetes. 2018;1(2):28–39.

FAO. Fats and Fatty Acids in Human Nutrition. Vol. 91, Food Agriculture Organization Food and Nutrition Paper. Geneva; 2010.

Gallagher M. The nutrients and their metabolism. In: Mahan L, Escott-Stump S, Raymond J, editors. Krause’s Food and Nutrition Care Proccess. 13th ed. Missouri: Elsevier; 2013. p. 50–6.

Gropper S, Smith J. Lipids. In: Gropper S, Smith J, editors. Advanced Nutrition and Human Metabolism. 6th ed. Australia: Wadsworth Cengage Learning; 2013. p. 138–40.

Ghoshal K. Adiponectin: Probe of the molecular paradigm associating diabetes and obesity. World J Diabetes. 2015;6(1):151.

Tumminia A, Vinciguerra F, Parisi M, Graziano M, Sciacca L, Baratta R, et al. Adipose tissue, obesity and adiponectin: Role in endocrine cancer risk. Int J Mol Sci. 2019;20(12).

van Andel M, Heijboer A, Drent M. Adiponectin and its isoform in pathophysiology. In: Makowski G, editor. Advances in Clinical Chemistry. 85th ed. Cambridge: Elsevier; 2018. p. 117–24.

Dinicolantonio JJ, O’Keefe JH. Importance of maintaining a low omega-6/omega-3 ratio for reducing inflammation. Open Hear. 2018;5(2):3–6.

Song J, Li C, Lv Y, Zhang Y, Amakye WK, Mao L. DHA increases adiponectin expression more effectively than EPA at relative low concentrations by regulating PPARγ and its phosphorylation at Ser273 in 3T3-L1 adipocytes. Nutr Metab (Lond). 2017;14(1):1–11.

Simopoulos AP. An increase in the omega-6/omega-3 fatty acid ratio increases the risk for obesity. Nutrients. 2016;8(3):1–17.

An W, Son Y, Kim S, Kim K, Bae H, Lee S, et al. Association of adiponectin and leptin with serum lipids and erythrocyte omega-3 and omega-6 fatty acids in dialysis patients. Clin Nephrol. 2011;75(3):195–203.

Qin Y, Zhou Y, Chen SH, Zhao XL, Ran L, Zeng XL, et al. Fish oil supplements lower serum lipids and glucose in correlation with a reduction in plasma fibroblast growth factor 21 and prostaglandin E2 in nonalcoholic fatty liver disease associated with hyperlipidemia: A randomized clinical trial. PLoS One. 2015;10(7):1–13.

Sabour H, Javidan AN, Latifi S, Shidfar F, Heshmat R, Emami Razavi SH, et al. Omega-3 fatty acids’ effect on leptin and adiponectin concentrations in patients with spinal cord injury: A double-blinded randomized clinical trial. J Spinal Cord Med. 2015;38(5):599–606.

Balfegò M, Canivell S, Hanzu FA, Sala-Vila A, Martínez-Medina M, Murillo S, et al. Effects of sardine-enriched diet on metabolic control, inflammation and gut microbiota in drug-naïve patients with type 2 diabetes: A pilot randomized trial. Lipids Health Dis. 2016;15(1):1–11.

Jacobo-Cejudo MG, Valdés-Ramos R, Guadarrama-López AL, Pardo-Morales RV, Martínez-Carrillo BE, Harbige LS. Effect of n-3 polyunsaturated fatty acid supplementation on metabolic and inflammatory biomarkers in type 2 diabetes mellitus patients. Nutrients. 2017;9(6):1–11.

Becic T, Studenik C. Effects of omega-3 supplementation on adipocytokines in prediabetes and type 2 diabetes mellitus: Systematic review and meta-analysis of randomized controlled trials. Diabetes Metab J. 2018;42(2):101–16.

Yang K, Zeng L, Bao T, Ge J. Effectiveness of Omega-3 fatty acid for polycystic ovary syndrome: A systematic review and meta-analysis. Reprod Biol Endocrinol. 2018;16(1):1–13.

Sedláček P, Plavinová I, Langmajerová J, Dvořáková J, Novák J, Trefil L, et al. Effect of N-3 fatty acids supplementation during life style modification in women with overweight. Cent Eur J Public Health. 2018;26(4):265–71.

Brayner B, Kaur G, Keske MA, Livingstone KM. FADS polymorphism, omega-3 fatty acids and diabetes risk: A systematic review. Nutrients. 2018;10(6):1–11.

Alsaleh A, Sanders TAB, O’Dell SD. Effect of interaction between PPARG, PPARA and ADIPOQ gene variants and dietary fatty acids on plasma lipid profile and adiponectin concentration in a large intervention study. Proc Nutr Soc. 2012;71(1):141–53.