Omega-3 as an Anti-Inflammatory Modality: Literature Review

Omega-3 fatty acids are polyunsaturated fatty acids that have multiple double bonds, the first double bond is located on the third carbon atom of the omega-methyl group, the next double bond is located at the third carbon atom from the previous double bond. The methyl omega group is the last group in the fatty acid chain. Omega-3 fatty acids are nutrients that play a vital role in the growth and development process of brain neuron cells for the intelligence of the born baby.


Introduction
These omega-3 fatty acids are derived from their precursors, namely linoleic and linolenic essential fatty acids. Essential fatty acids cannot be formed in the body and must be supplied directly from food. 1-4 Then the precursors enter the elongate and desaturate processes which produce three forms of omega-3 fatty acids: LNA (alpha-linolenic acid (C 18: 3, n -3)), EPA (eicosapentaenoate (C20: 5, n-3)), and DHA (docosahexaenoate (C22: 6, n-3). [5][6][7][8] The parent of omega-3 fatty acids is alpha linolenic acid (ALA). ALA with the help of the delta-6-desaturase enzyme can be converted into stearidonic acid, then by the delta-5-desaturase enzyme the body is converted to eicosapentaenoic acid (EPA) and by the delta4desaturase enzyme it is converted to docosahexaenoic acid (DHA). 9-10 The process of making DHA and AA facilitated by the enzymes desaturase and elongase.
The activity of these two enzymes is still lacking in premature infants, even in term infants up to the age of 4-6 months. Therefore, the addition of DHA and AA in premature infants is highly recommended at a dose that refers to the fatty acid content in breast milk. 11 The activity of both desaturase and elongase enzymes is influenced by the fatty acids found in food.
Fish oil that contains a lot of DHA will inhibit the activity of this enzyme so that it can inhibit the formation of AA. 12 In contrast, corn oil or saf-flower stimulates the activity of the desaturase enzyme, thereby increasing the formation of AA1. The physical and chemical properties of the metabolism, digestion, absorption and secretion of omega-3s are the same as those of fat. [13][14][15] The physical properties of triglycerides are determined by the proportion and chemical structure of the fatty acids that make up them. The more shortchain fatty acids and unsaturated bonds there are, the softer and more fluid the fats are. Preferably, the more long-chain saturated fatty acids, such as plammic acid (CI 6: 0) and stearic acid (18: 0) that are found in animal

Biomedical Journal of Indonesia
Journal Homepage: https://www.jurnalkedokteranunsri.id/index.php/BJI/index fat, the denser the fat. Triglyceride properties are also determined by the position (omega) and the position of fatty acids on the glycerol molecule. 16,17 Classification, source of omega-3 and nomenclature Fatty acids are distinguished according to the number of carbon they contain, namely short chain fatty acids (6 carbon atoms or less), medium chain (8 to 12 carbon), long chain (14 -18 carbon), and very long chain (20 carbon atoms or more). 18  Essential fatty acids are especially important for normal growth and development of fetuses and babies, as well as for brain development and vision. 33

Benefits of Omega-3
The advantage of omega-3 is very important for health, even most important among other fatty acids because it has anti-inflammatory and anti-clotting effects, is also good for the central nervous system and brain and can prevent CVD. In premature babies who are underweight (2.500 g) and whose brain size is smaller than average. Because the number of neuron cells is also small, the baby can be deformed, have low quality and the process of brain cell growth and development is not normal or below optimal. Omega-3 fatty acids, EPA are also reported to play a role in preventing degenerative diseases since the fetus and during adulthood. 40 When the fetus is in the womb, EPA is indispensable in the formation of blood vessel and heart cells.
Meanwhile, as an adult, EPA functions to nourish blood, work mechanism of blood vessels and work of sacs that regulate blood circulation. Therefore, due to a deficiency of omega-3 EPA, you can be at risk of suffering from blood vessel and heart disease. The balance of the ratio of EPA, DHA, and AA in the blood of infants, adolescents, or adults can be used as an indicator to predict the risk of vascular system disorders and heart disease in the future. 41 Preventive measures are highly recommended from an early age in order to avoid this degenerative disease.