Overview |
Omega-3 fatty acids are considered essential fatty acids because our bodies need them but cannot manufacture them on its own which simply means we must get them from our diets. Omega-3 fatty acids can be found in fish, such as salmon, tuna, and halibut, other seafood including algae and krill, some plants, and nut oils. Also known as polyunsaturated fatty acids (PUFAs), omega-3 fatty acids play a crucial role in brain function as well as normal growth and development. They have also become popular because they may reduce the risk of heart disease. The American Heart Association recommends eating fish (particularly fatty fish such as mackerel, lake trout, herring, sardines, albacore tuna, and salmon) at least two times a week.
Another major consideration is how well our bodies convert plant sources of omega-3's. For a number of reasons, our bodies are not altogether efficient in converting ALA into its more useful derivatives, DHA and EPA. While ALA has good anti-inflammatory effects, it is not as protective or instrumental in our health as either EPA or DHA
What is Omega3?
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Chemical structure of alpha-linolenic acid (ALA), an essential n−3 fatty acid, (18:3Δ9c,12c,15c, which means a chain of 18 carbons with 3 double bonds on carbons numbered 9, 12 and 15). Although chemists count from the carbonyl carbon (Blue Numbering), physiologists count from the n (ω) carbon (red numbering). Note that from the n end (diagram right), the first double bond appears as the third carbon-carbon bond (line segment), hence the name "n−3". This is explained by the fact that the n end is almost never changed during physiologic transformations in the human body, as it is more stable energetically, and other carbohydrates compounds can be synthesized from the other carbonyl end, for example in glycerides, or from double bonds in the middle of the chain. (Source: Wikipedia) |
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Chemical structure of eicosapentaenoic acid (EPA) |
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Chemical structure of docosahexaenoic acid (DHA) |
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Omega-3 fatty acids are mad up of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and alpha-linolenic acid (ALA).
Eicosapentaenoic acid (EPA) is a long chain of Omega 3 polyunsaturated essential fatty acid that is found in fish.
DHA is an omega-3 long chain polyunsaturated fatty acid (not to be confused with the hormone DHEA). It is the primary structural fat in both the gray matter of the brain and the retina of the eye. DHA is essential for brain and eye development and function.
Despite the fact ALA can be converted into EPA and DHA, this pathway is extremely ineffective. In fact, only 5% of ALA is changed into EPA and only 0.5% of alpha-linolenic acid can be converted to DHA. This is unfortunate for vegetarians and vegans that have thought they needed to use flax oil as their source of omega-3 fats. The reason this process inefficient is the polypeptide doing the conversion, delta-6-desaturase, is a rate limiting step. Delta-6-desaturase also competitively binds to omega-6 fatty acids, thereby making it less available to bind to and alter alpha-linolenic acid.
(http://www.jlr.org/content/42/8/1257.full.pdf )
How is it Made?
Omega 3 is made by extracting oil from cold water oily fish such as herring, salmon, mackerel, anchovies and sardines.
Where is it Found?
Omega 3 is found in Fat fish such as: salmon, trout, mackerel, sardines, pilchards, herring, kipper, eel and whitebait. For vegetarians: Flaxseed, hempseed and canola oils, and nuts like walnuts all contain omega-3's in the form of ALA. Flaxseed provides the richest plant source of ALA, and walnuts are the best nut source. The essential fatty acids, EPA and DHA, are primarily found in fatty fish, such as salmon. Alternatively, ALA is found in flaxseed, walnuts, and soybeans. Typically, vegetarians depend on flax seed oil as a source of omega-3 fatty acids. Unfortunately, flax oil only contains ALA and does not consist of EPA or DHA.
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Benefits / Uses
Let's take a look at some of its benefits taken directly from MedlinePlus, which is a service of the US National Library of Medicine: |
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lowers blood triglyceride levels |
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reduces the risk of heart attack |
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reduces the risk of dangerous abnormal heart rhythms |
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reduces the risk of strokes |
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slows the buildup of atherosclerotic plaques |
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lowers blood pressure |
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reduces stiffness and joint tenderness associated with Rheumatoid arthritis | |
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An omega 3 fish oil supplement also help improve or prevent Alzheimer's disease and dementia, depression, heart disease, cancer , arthritis, diabetes , hyperactivity and ADHD.
Pregnant or Nursing Mothers
It's irrefutable now that for the fetus brain to develop properly, it needs a great deal of the omega 3′s, DHA and EPA. If you are a pregnant mother, you should strongly consider using a molecularly distilled fish oil supplement so your fetus's brain has the best chance of developing properly. If you are a nursing mother, you should also be taking an omega 3 supplement or eating enough omega 3 foods because they are an essential fatty acid.
High cholesterol
Cholesterol is important for our body as it helps in the secretion of hormones, makes bile salts and Vitamin D. Cholesterol is mainly produced by the liver and is of two types - LDL or Bad Cholesterol and HDL or good cholesterol. LDL cholesterol levels are increased by the intake of saturated and hydrogenated fats, whereas HDL cholesterol levels are increased by consuming polyunsaturated fats or omega 3 fatty acids. LDL or the bad cholesterol forms plaques and blocks the arteries leading to severe heart problems and strokes. HDL or the good cholesterol carries the excess cholesterol back to the liver to be excreted. It also removes some of the cholesterol attached to the artery walls thus improving blood flow. Increase in HDL cholesterol can reduce the risk of coronary heart diseases.
Omega 3 fatty acids are a natural remedy that can control and lower high cholesterol levels in the body. The DHA and EPA fats obtained from fish oils play an important role in controlling cholesterol levels and maintaining heart health. Omega 3 fatty acids reduce the triglycerides or the LDL cholesterol level in the blood. They also help in increasing the HDL or good cholesterol in our blood stream. Thus, the cholesterol level in our body is balanced.
People who follow a Mediterranean-style diet tend to have higher HDL or “good†cholesterol levels, which help promote heart health. Inuit Eskimos, who get high amounts of omega-3 fatty acids from eating fatty fish, also tend to have increased HDL cholesterol and decreased triglycerides (fats in the blood). Several studies have shown that fish oil supplements reduce triglyceride levels. Finally, walnuts (which are rich in alpha linolenic acid or LNA, a type of omega-3 fatty acid) have been reported to lower total cholesterol and triglycerides in people with high cholesterol levels. Regular intake of omega 3 fish oils increases the metabolism rate in our body and burns away excess fat. This helps in shedding off excess weight and maintaining a healthy cholesterol level.
High blood pressure
Several clinical studies suggest that diets or fish oil supplements rich in omega-3 fatty acids lower blood pressure in people with hypertension. An analysis of 17 clinical studies using fish oil supplements found that taking 3 or more grams of fish oil daily may reduce blood pressure in people with untreated hypertension. One study entitled, "Omega-3: Effects On Blood Pressure in Subjects At Increased Risk Of Cardiovascular Disease" was conducted by participants of the Department of Medicine, University of Western Australia, Royal Perth Hospital, revealed a greater fall in both systolic and diastolic blood pressures in participants eating fish or taking fish oil, particularly in the low-fat groups, compared with control subjects.
Heart disease
“Omega 3 fatty acids benefit the heart of healthy people, and those at high risk of - or who have - cardiovascular disease.†- American Heart Association
One of the best ways to help prevent heart disease is to eat a diet low in saturated fat and to eat foods that are rich in monounsaturated and polyunsaturated fats (including omega-3 fatty acids). Clinical evidence suggests that EPA and DHA (eicosapentaenoic acid and docosahexaenoic acid, the two omega-3 fatty acids found in fish oil) help reduce risk factors for heart disease, including high cholesterol and high blood pressure. Fish oil has been shown to lower levels of triglycerides (fats in the blood), and to lower risk of death, heart attack, stroke, and abnormal heart rhythms in people who have already had a heart attack. Fish oil also appears to help prevent and treat atherosclerosis (hardening of the arteries) by slowing the development of plaque and blood clots, which can clog arteries.
Diabetes
People with diabetes often have high triglyceride and low HDL levels. Omega-3 fatty acids from fish oil can help lower triglycerides and lipoproteins (markers of diabetes), and raise HDL, so eating foods or taking fish oil supplements may help people with diabetes. Another type of omega-3 fatty acid, ALA (from flaxseed, for example) may not have the same benefit as fish oil.
Rheumatoid arthritis
Rheumatoid arthritis is an inflammatory condition that causes the body's immune system to attack its own joints and sometimes other parts of the body. The condition affects people of all ages and ethnicities. Traditionally anti-inflammatory medication and aspirin were given to treat rheumatoid arthritis, but both of these medicines are hard on the stomach. Recently, studies have shown that Omega 3 supplements like the supplement found here may treat rheumatoid arthritis without the harmful side effects to the stomach.
Laboratory studies suggest that diets rich in omega-3 fatty acids (and low in the inflammatory omega-6 fatty acids) may help people with osteoarthritis.
Systemic lupus erythematosus (SLE)
BELFAST, NORTHERN IRELAND. Systemic lupus erythematosus (SLE) is a chronic inflammatory disease. It can manifest itself via a photosensitive facial rash, fatigue, anorexia, weight loss, and night sweats and can progress to life-threatening involvement of the heart, lungs, kidneys or central nervous system. Flare-ups of SLE are typically followed by periods of clinical remission. Fish oils and copper have both been found useful in the treatment of other inflammatory diseases, so researchers at the University of Ulster decided to see if supplementation with one or both of these would help alleviate SLE symptoms.
Their clinical trial involved 52 SLE patients who were randomly assigned to receive 3 grams/day of fish oil providing 540 mg/day of EPA (eicosapentaenoic acid) and 360 mg/day of DHA (docosahexaenoic acid), 3 mg/day of copper in the form of a copper di-glycinate amino acid complex, both fish oil and copper, or a placebo. The study lasted 24 weeks and participants were assessed at baseline, 6, 12 and 24 weeks.
The researchers found that disease activity at 24 weeks, as measured by the SLAM-R score, was significantly less in the groups that had supplemented with fish oil than in the placebo and copper only groups. They conclude that supplementation with fish oil may be effective in favorably modifying the symptomatic disease activity in SLE.
Duffy, EM, et al. The clinical effect of dietary supplementation with omega-3 fish oils and/or copper in systemic lupus erythematosus. Journal of Rheumatology, Vol. 31, August 2004, pp. 1551-56
Osteoporosis,
Some studies suggest that omega-3 fatty acids may help increase levels of calcium in the body and improve bone strength, although not all results were positive. Some studies also suggest that people who don' t get enough of some essential fatty acids (particularly EPA and gamma-linolenic acid [GLA], an omega-6 fatty acid) are more likely to have bone loss than those with normal levels of these fatty acids. In a study of women over 65 with osteoporosis, those who took EPA and GLA supplements had less bone loss over 3 years than those who took placebo. Many of these women also experienced an increase in bone density.
Depression
Studies have found mixed results as to whether taking omega-3 fatty acids can help depression symptoms. Several studies have found that people who took omega-3 fatty acids in addition to prescription antidepressants had a greater improvement in symptoms than those who took antidepressants alone.
Bipolar disorder
In a clinical study of 30 people with bipolar disorder, those who took fish oil in addition to standard prescription treatments for bipolar disorder for 4 months experienced fewer mood swings and relapse than those who received placebo.
Schizophrenia
Preliminary clinical evidence suggests that people with schizophrenia may have an improvement in symptoms when given omega-3 fatty acids.
Attention deficit/hyperactivity disorder (ADHD)
Children with attention deficit/hyperactivity disorder (ADHD) may have low levels of certain essential fatty acids (including EPA and DHA). In a clinical study of nearly 100 boys, those with lower levels of omega-3 fatty acids had more learning and behavioral problems (such as temper tantrums and sleep disturbances) than boys with normal omega-3 fatty acid levels.
However, studies examining whether omega-3 fatty acids help improve symptoms of ADHD have found mixed results. A few studies have found that omega-3 fatty acids helped improve behavioral symptoms, but most were not well designed. More research is needed, but eating foods that are high in omega-3 fatty acids is a reasonable approach for someone with ADHD.
Skin disorders
Psoriasis is a chronic skin condition that is characterized by itchy, scaly patches. The symptoms Usually occur at the elbows, knees and/or scalp. The condition is associated with an autoimmune disorder, but no one really knows what causes it.
Studies are showing that diet may be an important part of psoriasis and essential fatty acids play a critical role. Omega 3 fatty acids play an essential part in the body's regulation of prostaglandins. Research shows that Omega-3 fatty acids may reduce the inflammation that is associated with psoriasis and essential fatty acids may actually prevent the condition.
Inflammatory bowel disease (IBD)
Results are mixed as to whether omega-3 fatty acids can help reduce symptoms of Crohn' s disease and ulcerative colitis, the two types of IBD. Some studies suggest that omega-3 fatty acids may help when added to medication, such as sulfasalazine (a standard medication for IBD). Others find no effect. More studies are needed. Fish oil supplements can cause side effects that are similar to symptoms of IBD (such as flatulence, belching, bloating, and diarrhea).
Asthma
In one small, well-designed clinical study of 29 children with asthma, those who took fish oil supplements rich in EPA and DHA for 10 months reduced their symptoms compared to children who took placebo.
Macular Degeneration
A questionnaire given to more than 3,000 people over the age of 49 found that those who ate more fish were less likely to have macular degeneration (a serious age-related eye condition that can progress to blindness) than those who ate less fish. Similarly, a clinical study comparing 350 people with macular degeneration to 500 without the eye disease found that those with a healthy dietary balance of omega-3 and omega-6 fatty acids and more fish in their diets were less likely to have macular degeneration.
Menstrual pain
In one study of 42 women, they had less menstrual pain when they took fish oil supplements than when they took placebo.
Colon cancer
Eating foods rich in omega-3 fatty acids seems to reduce the risk of colorectal cancer. For example, Eskimos, who tend to have a high-fat diet but eat significant amounts of fish rich in omega-3 fatty acids, have a low rate of colorectal cancer. Animal studies and laboratory studies have found that omega-3 fatty acids prevent worsening of colon cancer. Preliminary studies suggest that taking fish oil daily may help slow the progression of colon cancer in people with early stages of the disease. If you have colorectal cancer, ask your doctor before taking any supplements.
Breast cancer
Women who eat foods rich in omega-3 fatty acids over many years may be less likely to develop breast cancer. More research is needed to understand the effect that omega-3 fatty acids may have on the prevention of breast cancer.
Prostate cancer
Population based studies of groups of men suggest that a low-fat diet including omega-3 fatty acids from fish or fish oil help prevent the development of prostate cancer.
Dosage
Do not take more than 3 grams daily of omega-3 fatty acids from capsules without the supervision of a health care provider, due to an increased risk of bleeding.
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For adults with coronary heart disease: The American Heart Association recommends an omega-3 fatty acid supplement (as fish oils), 1 gram daily of EPA and DHA. It may take 2 - 3 weeks for benefits of fish oil supplements to be seen. |
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For adults with high cholesterol levels: The American Heart Association recommends an omega-3 fatty acid supplement (as fish oils), 2 - 4 grams daily of EPA and DHA. It may take 2 - 3 weeks for benefits of fish oil supplements to be seen. |
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The American Heart Association (AHA) recommends that people with high triglycerides take a supplement with 2 to 4 grams (2000 to 4000 mg) of EPA and DHA daily. The AHA does not provide a recommendation for DHA only, probably because there is more evidence that the combination is effective for triglycerides (opposed to DHA alone). | |
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Supplementing with fish oils has been found to be entirely safe even for periods as long as 7 years and no significant adverse effects have been reported in hundreds of clinical trials, using as much as 18 grams/day of fish oils.
Side-Effects / Precautions / Possible Interactions:
Omega 3 has negligible side-effect as compared to benefits of it. However you may consider reading some as below:
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There is a possibility that very high doses could excessively thin the blood and cause bleeding. |
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Anyone who suffers from a cardiovascular condition should speak to a physician before taking fish oil supplements. |
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There is also the possibility of occasional nosebleeds as well as easy bruising. However these side-effects were reported by people taking huge daily doses sometimes up to 12 grams. |
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If you are currently being treated with any of the following medications, you should not use omega-3 fatty acid supplements, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (ALA), without first talking to your health care provider. | |
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Fish Oil - Possible Interactions
Blood-thinning medications
Omega-3 fatty acids may increase the effects of blood thinning medications, including aspirin, warfarin (Coumadin), and clopedigrel (Plavix). Taking aspirin and omega-3 fatty acids may be helpful in some circumstances (such as in heart disease), but they should only be taken together under the supervision of a health care provider.
Diabetes medications
Taking High doses of omega-3 fatty acid supplements may increase fasting blood sugar levels. Use with caution if taking medications to lower blood sugar, such as glipizide, glyburide, Metformin, or insulin. Your doctor may need to increase your medication dose.
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Aspirin. In combination with aspirin, omega-3 fatty acids could be helpful in the treatment of some forms of coronary artery disease. Consult your doctor about whether this combination would be appropriate for you if you have coronary artery disease. |
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Cyclosporine. Omega 3 may reduce some of the side effects associated with cyclosporine therapy, which is often used to reduce the chances of rejection in transplant recipients. |
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Blood thinning medicines (Examples: warfarin (Coumadin(R); dicumarol (Dicumarol(R)). |
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Bleeding disorder. If you have one, always ask your doctor about. |
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Olive oil may decrease the ability of DHA to decrease inflammation (pain swelling, redness). | |
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Research Studies / References |
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Angerer P, von Schacky C. n-3 polyunsaturated fatty acids and the cardiovascular system. Curr Opin Lipidol. 2000;11(1):57-63. |
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Aronson WJ, Glaspy JA, Reddy ST, Reese D, Heber D, Bagga D. Modulation of omega-3/omega-6 polyunsaturated ratios with dietary fish oils in men with prostate cancer. Urology. 2001;58(2):283-288. |
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Balk EM, Lichtenstein AH, Chung M et al. Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: A systematic review. Atherosclerosis. 2006 Nov;189(1):19-30. |
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Bays HE. Safety considerations with omega-3 Fatty Acid therapy. Am J Cardiol. 2007;99(6A):S35-43. |
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Belluzzi A, Boschi S, Brignola C, Munarini A, Cariani C, Miglio F. Polyunsaturated fatty acids and inflammatory bowel disease. Am J Clin Nutr. 2000;71(suppl):339S-342S. |
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Berbert AA, Kondo CR, Almendra CL et al. Supplementation of fish oil and olive oil in patients with rheumatoid arthritis. Nutrition. 2005;21:131-6. |
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Berson EL, Rosner B, Sandberg MA, et al. Clinical trial of docosahexaenoic acid in patients with retinitis pigmentosa receiving vitamin A treatment. Arch Ophthalmol. 2004;122(9):1297-1305. |
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Boelsma E, Hendriks HF. Roza L. Nutritional skin care: health effects of micronutrients and fatty acids. Am J Clin Nutr. 2001;73(5):853-864. |
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Boskou, D. Olive oil. World Rev Nutr Diet. 2000;87:56-77. |
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Bradbury J, Myers SP, Oliver C et al. An adaptogenic role for omega-3 fatty acids in stress; a randomised placebo controlled double blind intervention study (pilot)ISRCTN22569553. Nutr J. 2004 Nov 28;3:20. |
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Buckley MS, Goff AD, Knapp WE, et al. Fish oil interaction with warfarin. Ann Pharmacother. 2004;38:50-2. |
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Burgess J, Stevens L, Zhang W, Peck L. Long-chain polyunsaturated fatty acids in children with attention-deficit hyperactivity disorder. Am J Clin Nutr. 2000; 71(suppl):327S-330S. |
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Burr ML, Dunstan FD, George CH et al. Is fish oil good or bad for heart disease? Two trials with apparently conflicting results. J Membr Biol. 2006;206:155-63. |
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Calo L, Bianconi L, Colivicchi F et al. N-3 Fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a randomized, controlled trial. J Am Coll Cardiol. 2005;45:1723-8. |
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Caron MF, White CM. Evaluation of the antihyperlipidemic properties of dietary supplements. Pharmacotherapy. 2001;21(4):481-487. |
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Chan EJ, Cho L. What can we expect from omega-3 fatty acids? Cleve Clin J Med. 2009 Apr;76(4):245-51. Review. |
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Cho E, Hung S, Willet WC, Spiegelman D, Rimm EB, Seddon JM, et al. Prospective study of dietary fat and the risk of age-related macular degeneration. Am J Clin Nutr. 2001;73(2):209-218. |
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Christensen JH, Skou HA, Fog L, Hansen V, Vesterlund T, Dyerberg J, Toft E, Schmidt EB. Marine n-3 fatty acids, wine intake, and heart rate variability in patients referred for coronary angiography. Circulation. 2001;103:623-625. |
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Daniel CR, McCullough ML, Patel RC, Jacobs EJ, Flanders WD, Thun MJ, Calle EE. Dietary intake of omega-6 and omega-3 fatty acids and risk of colorectal cancer in a prospective cohort of U.S. men and women. Cancer Epidemiol Biomarkers Prev. 2009 Feb;18(2):516-25. |
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Dewailly E, Blanchet C, Lemieux S, et al. n-3 fatty acids and cardiovascular disease risk factors among the Inuit of Nunavik. Am J Clin Nutr. 2001;74(4):464-473. |
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Dichi I, Frenhane P, Dichi JB, Correa CR, Angeleli AY, Bicudo MH, et al. Comparison of omega-3 fatty acids and sulfasalazine in ulcerative colitis. Nutrition. 2000;16:87-90. |
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Dopheide JA, Pliszka SR. Attention-deficit-hyperactivity disorder: an update. Pharmacotherapy. 2009 Jun;29(6):656-79. (Epub ahead of print) |
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Fatty fish consumption and ischemic heart disease mortality in older adults: The cardiovascular heart study. Presented at the American Heart Association's 41st annual conference on cardiovascular disease epidemiology and prevention. AHA. 2001. |
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Fenton WS, Dicerson F, Boronow J, et al. A placebo controlled trial of omega-3 fatty acid (ethyl eicosapentaenoic acid) supplementation for residual symptoms and cognitive impairment in schizophrenia. Am J Psychiatry. 2001;158(12):2071-2074. |
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Fotuhi M, Mohassel P, Yaffe K. Fish consumption, long-chain omega-3 fatty acids and risk of cognitive decline or Alzheimer disease: a complex association. Nat Clin Pract Neurol. 2009 Mar;5(3):140-52. Review. |
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Frangou S, Lewis M, McCrone P et al. Efficacy of ethyl-eicosapentaenoic acid in bipolar depression: randomised double-blind placebo-controlled study. Br J Psychiatry. 2006;188:46-50 |
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Freeman VL, Meydani M, Yong S, Pyle J, Flanigan RC, Waters WB, Wojcik EM. Prostatic levels of fatty acids and the histopathology of localized prostate cancer. J Urol. 2000;164(6):2168-2172. |
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Freund-Levi YF, Eriksdotter-Jonhagen M, Cederholm T, et al. Omega-3 fatty acid treatment in 174 patients with mild to moderate Alzheimer disease: OmegAD Study. Arch Neurol. 2006;63:1402-8. |
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Freund-Levi Y, Hjorth E, Lindberg C, Cederholm T, Faxen-Irving G, Vedin I, Palmblad J, Wahlund LO, Schultzberg M, Basun H, Eriksdotter Jönhagen M. Effects of omega-3 fatty acids on inflammatory markers in cerebrospinal fluid and plasma in Alzheimer's disease: the OmegAD study. Dement Geriatr Cogn Disord. 2009;27(5):481-90. |
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Galli C, Risé P. Fish consumption, omega 3 fatty acids and cardiovascular disease. The science and the clinical trials. Nutr Health. 2009;20(1):11-20. Review. |
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Geelen A, Brouwer IA, Schouten EG et al. Effects of n-3 fatty acids from fish on premature ventricular complexes and heart rate in humans. Am J Clin Nutr. 2005;81:416-20. |
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Geerling BJ, Badart-Smook A, van Deursen C, et al. Nutritional supplementation with N-3 fatty acids and antioxidants in patients iwth Crohn's disease in remission: effects on antioxidant status and fatty acid profile. Inflamm Bowel Dis. 2000;6(2):77-84. |
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Goldberg RJ, Katz J. A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain. 2007 Feb 28; [Epub ahead of print]. |
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Hagen KB, Byfuglien MG, Falzon L, Olsen SU, Smedslund G. Dietary interventions for rheumatoid arthritis. Cochrane Database Syst Rev. 2009 Jan 21;(1):CD006400. Review. |
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Hall MN, Campos H, Li H, Sesso HD, Stampfer MJ, Willett WC, Ma J. Blood levels of long-chain polyunsaturated fatty acids, aspirin, and the risk of colorectal cancer. Cancer Epidemiol Biomarkers Prev. 2007;16(2):314-21. |
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Hartweg J, Farmer AJ, Holman RR, Neil A. Potential impact of omega-3 treatment on cardiovascular disease in type 2 diabetes. Curr Opin Lipidol. 2009 Feb;20(1):30-8. |
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Hooper L, Thompson R, Harrison R et al. Omega 3 fatty acids for prevention and treatment of cardiovascular disease. Cochrane Database Syst Rev. 2004;CD003177. |
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Iso H, Rexrode KM, Stampfer MJ, Manson JE, Colditz GA, Speizer FE et al. Intake of fish and omega-3 fatty acids and risk of stroke in women. JAMA. 2001;285(3):304-312. |
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Itomura M, Hamazaki K, Sawazaki S et al. The effect of fish oil on physical aggression in schoolchildren - a randomized, double-blind, placebo-controlled trial. J Nutr Biochem. 2005;16:163-71. |
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Jeschke MG, Herndon DN, Ebener C, Barrow RE, Jauch KW. Nutritional intervention high in vitamins, protein, amino acids, and omega-3 fatty acids improves protein metabolism during the hypermetabolic state after thermal injury. Arch Surg. 2001;136:1301-1306. |
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Joy CB, Mumby-Croft R, Joy LA. Polyunsaturated fatty acid supplementation for schizophrenia. Cochrane Database Syst Rev. 2006 Jul 19;3:CD001257. Review. |
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Kelley DS, Siegel D, Fedor DM, Adkins Y, Mackey BE. DHA supplementation decreases serum C-reactive protein and other markers of inflammation in hypertriglyceridemic men. J Nutr. 2009 Mar;139(3):495-501. |
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Krauss RM, Eckel RH, Howard B, et al. AHA Scientific Statement: AHA Dietary guidelines Revision 2000: A statement for healthcare professionals from the nutrition committee of the American Heart Association. Circulation. 2000;102(18):2284-2299. |
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Kremer JM. N-3 fatty acid supplements in rheumatoid arthritis. Am J Clin Nutr. 2000;(suppl 1):349S-351S. |
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Kris-Etherton P, Eckel RH, Howard BV, St. Jeor S, Bazzare TL. AHA Science Advisory: Lyon Diet Heart Study. Benefits of a Mediterranean-style, National Cholesterol Education Program/American Heart Association Step I Dietary Pattern on Cardiovascular Disease. Circulation. 2001;103:1823. |
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Mattar M, Obeid O. Fish oil and the management of hypertriglyceridemia. Nutr Health. 2009;20(1):41-9. Review. |
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Mitchell EA, Aman MG, Turbott SH, Manku M. Clinical characteristics and serum essential fatty acid levels in hyperactive children. Clin Pediatr (Phila). 1987;26:406-411. |
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Montori V, Farmer A, Wollan PC, Dinneen SF. Fish oil supplementation in type 2 diabetes: a quantitative systematic review. Diabetes Care. 2000;23:1407-1415. |
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Mozaffarian D, Geelen A, Brouwer IA et al. Effect of Fish Oil on Heart Rate in Humans. A Meta-Analysis of Randomized Controlled Trials. Circulation. 2005;112(13):1945-52. |
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Nagakura T, Matsuda S, Shichijyo K, Sugimoto H, Hata K. Dietary supplementation with fish oil rich in omega-3 polyunsaturated fatty acids in children with bronchial asthma. Eur Resp J. 2000;16(5):861-865. |
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Newcomer LM, King IB, Wicklund KG, Stanford JL. The association of fatty acids with prostate cancer risk. Prostate. 2001;47(4):262-268. |
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Olsen SF, Secher NJ. Low consumption of seafood in early pregnancy as a risk factor for preterm delivery: prospective cohort study. BMJ. 2002;324(7335): 447-451. |
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Riediger ND, Othman RA, Suh M, Moghadasian MH. A systemic review of the roles of n-3 fatty acids in health and disease. J Am Diet Assoc. 2009 Apr;109(4):668-79. Review. |
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