OMEGA 3 / DHA BUYERS' GUIDE
(Also available as a 1Mb PDF file)
This guide will give you information about fish oil that is not usually available to consumers. It contains transparent facts that will help you make a more informed decision when considering which omega-3 fish oil to choose in order to optimize the health of you and family; regardless of which product you are currently using or considering buying.
It will advise you how to choose the best fish oil supplement and give you a better understanding of the differences between the various fish oil supplements available.
You will also learn why Xtend-Life's Omega 3 / DHA Fish Oil is 'head and shoulders' above all other fish oils based on all the key parameters. But first, let us recap on why omega-3 fish oil is so good for you.
HEALTH BENEFITS FROM A SUPERIOR FISH OIL
Most scientists and health professionals agree that omega-3 fish oil contains an array of health benefits pertaining to areas of the body such as your:
"Omega-3 fatty acids may benefit heart health. Whether you are in good shape, at risk, or suffering cardiovascular disease".
(American Heart Association)
May help reduce the risk of arrhythmias and sudden death by a heart attack.
May provide better brain function though more efficient neurotransmitters leading to improved concentration, memory, less likelihood of depression and reduced risk of ADHD in children.
Cholesterol & Triglycerides
May lower triglycerides and help balancing your cholesterol.
Joints and Arthritis
May provide better joint function from reduced inflammation and a reduction in pain.
Skin and Beauty
May improve the health and appearance of your skin, helps keep nails strong, as well as your hair healthy and shiny.
Immune system and cancer
May provide a stronger immune system, proven to be beneficial for the body's immune function, lowered risk of breast and prostate cancer.
May improve focus, colour, perception and clarity of vision.
May improve intestinal health and reducing inflammation assisting those with IBS or Crohn's Disease.
Omega-3 fatty acid intake by mothers during pregnancy may protect babies against the development of allergies. It may also help people with existing allergies.
Fish oil may enhance insulin secretion from beta cells in the pancreas, regulating blood sugar levels. DHA plays a protective role in diabetic neuropathy in all forms of diabetes.
What is it about fish oil that gives rise to these health benefits?
Fish oil is packed with a variety of beneficial nutrients including omega-3 EFAs (essential fatty acids) ranging in complexity and functional properties for key parts of the body.
The body cannot readily produce these omega-3 EFAs on its own. They need to be introduced to the body through food and dietary supplements known to contain high levels of omega-3. We will be discussing these omega-3 EFAs and their key roles in more detail later on in this document. Xtend-Life's Omega 3 / DHA Fish Oil is arguably the most effective and most natural fish oil on the planet. It is also one of the purest and freshest products that the fish oil market has ever seen.
Xtend-Life Natural Products, a family-owned, integrated manufacturer and distributor of natural supplements and skin care products has been constantly raising the bar on standards pertaining to purity, freshness and the anti-inflammatory properties of omega-3 fish oils. For nearly 10 years, Xtend-Life has cemented itself as the preferred brand in the natural supplement industry.
The Xtend-Life Omega 3 / DHA Fish Oil is a product that is fast becoming a trusted health supplement among thousands of people who share our passion for health improvement and the many benefits associated with the daily intake of pure natural fish oil.
The following sections highlight the main reasons why we believe Xtend-Life's Omega 3 / DHA Fish Oil is the best fish oil supplement available on the market. We give you all the transparency and facts that you need in order to decide for yourself. We want you to establish trust, not only in our fish oil, but also in our policy that each one of our products should be as natural as nature itself.
WHY IS FISH OIL SO IMPORTANT?
Every effect has a cause. One thing leads to another - it's a fact. In terms of aging and deteriorating health conditions, your body's main culprit is almost always inflammation - which fish oil helps fight.
What makes inflammation so deadly is that it sneaks up on you and over time, the cumulative effect is a chain reaction of various health conditions ranging from arthritis and chronic pain to more serious issues such as atherosclerosis, aneurisms, strokes, brain disorders and ultimately, death.
The key is to accept that everyone has a certain amount of inflammation in the body, but often with no symptoms. More often than not it is the underlying cause behind sudden unexpected fatal heart attacks.
Fish oil fights inflammation
Most scientists and health professionals believe that it is the anti-inflammatory properties of fish oil that enable it to provide so many health benefits particularly in areas of the: heart, brain, joints, skin, immune system, vision and, digestion.
However, like any nutritional product on the market today there are good and bad ones. Fish oil is no exception. With a bad one you may be unwittingly introducing substances into your body that you do not want, for example: mercury, PCBs or even increasing your load of free radicals. You may also only be getting minimal anti-inflammatory benefits - or even none at all.
You owe it to yourself to use only the purest, and thus the safest omega-3 fish oil available, plus it also has to be the most effective in order for you to receive the benefits above. If you and your family want the best product possible there are certain guidelines that you need to follow.
- Anti-inflammatory properties: Does your current fish oil have the best possible anti-inflammatory properties?
- Bio-availability: It must be in its natural form NOT a synthetic triglyceride which many fish oils are.
- High content of quality omega-3 and DHA: Be reasonably high in omega-3 with the dominant essential fatty acid being DHA.
- Purity: The fish oil must be free from any contaminants with supporting evidence to prove it.
- Freshness: This means low oxidation levels; once again with cold, hard evidence to back-up such claims.
Xtend-Life's Omega 3 / DHA Fish Oil complies with all of the above guidelines.
Anti-Inflammatory Properties Second To None - Proven!
The researchers at Xtend-Life have focused their expertise on improving the anti-inflammatory properties of the Omega 3 / DHA Fish Oil with amazing success - as it is a product that is now setting new standards for fish oil products across the world.
The Xtend-Life Omega 3 / DHA Fish Oil stands head and shoulders above all other fish oils. In fact, it is two and half times better than most fish oils on the market. In addition to this, we even have the results from a recently completed clinical study to prove it!
These results were established as part of a clinical study carried out in 2009 by Trinity Bioactives, part of the Wellington School of Medicine in New Zealand.
The study tested the inflammation inhibition properties of three fish oils while using aspirin as a dose-related control.
The three fish oils were:
- A 'normal' consumer fish oil 18/12 consisting of 18% EPA and 12% DHA
- A concentrated tuna oil with 85% omega-3 content
- Xtend-Life's Omega 3 / DHA Fish Oil
Resultant Inhibition Properties (as illustrated in the graph below):
- 'Normal' consumer fish oil (consisting of 18% EPA and 12% DHA) - 14%
- Concentrated tuna oil - 20.6%
- Xtend-Life's Omega 3 / DHA Fish Oil - 38.1%
Xtend-Life's Omega 3 DHA Fish Oil had almost double anti-inflammatory properties compared with a highly concentrated oil and two and a half times more anti-inflammatory properties than a 'normal' fish oil.
*Aspirin was used as a control and it had an inflammation inhibition percentage of 38.6%. The Xtend-Life Omega 3 / DHA Fish Oil blend was just as good as aspirin with an inflammation inhibition percentage of 38.1%. The concentrated tuna oil and normal fish oil scored 20.6% and 14% respectively. Xtend-Life cannot chart aspirin's percentages as direct comparisons to the fish oils as the drug is dose-related.
(Ethyl Esters versus Triglyceride forms)
Your digestive system is probably the most efficient production line known to man, however it is as natural as nature itself. It converts food particles into natural molecules that the body recognises and therefore can easily absorb. The food particles are now said to be bio-available to the body.
Bio-availability is influenced by the molecular shape of fatty acids, sugars, proteins, and other nutrients that are easily absorbed by the body. When it comes to fish oil, the benefits associated with it can only start taking effect once the body has absorbed the nutrients contained within it. The more natural the molecular structure the better
So, when assessing how 'natural' fish oil is, it is important to know about the different forms currently available on the market:
- Natural fish oil comes in a triglyceride form. This is the oil that you get when you 'squeeze' the fish and extract the natural oil from it. The drawback from this particular form of fish oil is that it usually has low overall omega-3 content because it's not concentrated and generally has high levels of contaminants such as heavy metals, PCBs, dioxins etc.
- Ethyl ester oil occurs when you take natural triglyceride oil and concentrate it whilst molecularly distilling the oil to eliminate impurities. The concentration process cannot take place until the natural triglycerides are converted to an ester form. The ester form is still in a semi-natural state because it is the result of a process that naturally occurs in the body to allow for bio-availability. It's not uncommon to double or even triple the omega-3 content of fish oil using this concentration process.
- Synthetic triglyceride oil is another form of fish oil that is very common and marketed as 'natural' when in fact it isn't. It is a triglyceride, but not a natural one. It is produced after concentration. As mentioned above, the natural triglycerides are converted to ethyl esters for concentration. This is perfectly fine however; but some manufacturers then re-convert the esters back into triglycerides - a synthetic form which occurs as a result of this re-conversion process.
The original position of the triglyceride's carbon bonds change and the molecule's overall structure is altered. Part of it becomes foreign to what the body is used to - negatively impacting the bio-availability of the fish oil. Why do they do it? Because they can state that it is a triglyceride form and infers to the customer that it is natural - when in actual fact, it's not.
Xtend-Life's Omega 3 / DHA Fish Oil is the perfect blend of 50% exceptionally pure, natural hoki fish triglyceride oil and 50% highly purified molecularly distilled ethyl ester tuna oil.
XTEND-LIFE HAS THE 'X-FACTOR'
Xtend-Life.s natural hoki fish oil seems to have a synergistic effect when combined with the highly purified tuna oil that creates this remarkable increase in anti-inflammatory effects. We call it the x-factor.
Even though the total amount of omega-3 in our blend is lower than the concentrate (because we combine it with the natural non-concentrated hoki oil), the anti-inflammatory properties have actually doubled! For now, the 'x-factor' has to remain one of the mysteries of nature. We say 'nature' because it is something in the natural component of the hoki oil that is giving these benefits.
This is one of those rare situations in which we are able to get the best of both worlds - oil that is 100% natural and 100% safe with a subtle touch of mystery from Mother Nature herself.
PRISTINE AND PURE
Unbeaten Purity - Proven
Purity is measured by the amount of heavy metals, PCBs and dioxins present. One simply has to look at the locations where most fish oils come from to get a clear idea of why so many omega-3 fish oil products are tainted with toxins. They are often in the middle of major shipping routes and surrounded by large, heavily populated land masses, where pollution and waste is the inevitable outcome. Other fish oil areas are shared by deep sea oil rigs, hardly the sort of purity perceptions you would want as a customer.
The Southern Ocean is known for its rugged beauty, geographic isolation and unspoiled waters. Located in the 'roaring 40s' and 'raging 50s', this body of water off the coast of New Zealand is one of the most remote and purest oceans on earth with nothing but open water separating it from South America (over 9 000kms to the east) and Africa (10 000kms to the west) - ensuring that it experiences minimal 'ship traffic'. The entire population of New Zealand is also only a fraction of one major US city - have a look on your atlas to fully appreciate how remote New Zealand really is to the rest of the world.
When measuring the purity of fish oil products, four international standards are generally used. Interestingly enough, we at Xtend-Life have set our own specification standards because we don.t think that the normal standards are good enough as they have been set with the fish oil industry in mind rather than the wellbeing of the consumer.
You can view the tough standards we set by going to our website at www.xtend-life.com and going to Omega 3 / DHA Fish Oil and clicking on the purity tab.
There you will find that:
- Our levels for mercury are 10 times lower than the standards set by international organisations.
- Our PCB level is set at 18 times lower than the US CRN. In Europe they don't even set a minimum level.
- The dioxin levels are also set at a level four times lower.
|Below is a table which sets out the various international standards for purity |
|Component ||Xtend-Life Specifications ||International Fish Oil Standards (IFOS) ||Council for Responsible Nutrition (CRN) ||European Pharmacopoeia ||Norwegian Medicinal Standard |
|Arsenic (ppb) ||<90 ||100 ||100 ||100 ||100 |
|Cadmium (ppb) ||<10 ||100 ||100 ||100 ||100 |
|Mercury (ppb) ||<10 ||100 ||100 ||100 ||100 |
|Lead (ppb) ||<50 ||100 ||100 ||100 ||100 |
|Total PCBs (ppb) ||<5 ||45 ||90 ||N/A ||N/A |
|Total Dioxins &Furans (ppt) ||<0.5 ||1* ||2 ||2 ||2 |
* N/A means 'Not Available'
* '<' means less than the indicated Xtend-Life Specifications which are the minimal levels of detection for standard testing equipment.
* ppb means part per billion / ppt means part per trillion
* IFOS although included in the table is not a recognised entity. It is a private organisation and it is claimed by some 'observers' that it was established for the benefit of a few marketers of fish oil.
If you look at the column containing the Xtend-Life Specifications, it's important to remember that these figures are the minimum levels of detection for standard testing equipment.
Even at these low levels none of these contaminants are detected in our oil (hence the '<' symbol) – and we can prove it! Have a look at our current Certificate of Analysis which is on our website. We have the independent government-approved laboratory data on file.
WHAT MAKES XTEND-LIFE'S OMEGA 3 / DHA FISH OIL SO FRESH?
Exceptional Freshness Guaranteed
Professional product management and control is the answer. We handle our raw ingredients with the utmost care - from the boat to the bottle - ensuring that freshness is maintained throughout the manufacturing process. This is particularly crucial for our hoki oil and we are probably the only company in this industry that has full traceability for our hoki; which is critical as we use it in its natural form.
Unlike most fish which are caught by large factory ships and frozen at sea, our hoki fish are caught by smaller vessels fishing within seven hours travelling from the hoki fishing grounds. The catch is able to be kept fresh in ice and processed immediately upon arrival back on shore. Our hoki are only caught in the height of the season and there is no by-catch mixed into the oil.
At Xtend-Life, we endeavour to give you the freshest products possible. We are very proud of our 'fresh, pure and natural' policy and strive to maintain our exceptionally high standards. The fish oil remains fresh in the capsule because of a natural rosemary extract which is a very powerful anti-oxidant combined with a broad spectrum natural vitamin E oil.
Put us to the smell test
We are so confident that our fish oil is the freshest in the world, we encourage you to cut open a soft gel of Omega 3 / DHA Fish Oil and smell it. You should only smell a faint oceanic aroma - if anything at all. We don't add masking flavours or fragrances unlike other fish oil companies.
No rancidity = no repeating
Our Omega 3 / DHA Fish Oil is so fresh that we guarantee no repeating or 'burping'. If you don't have any digestive ailments which could compromise your system, we can definitely assure you that no 'fishy' repeats will occur. If you have experienced this rather unpleasant case of 'burping' due to a rancid product, we will be glad to introduce you to ours - the freshest fish oil in the world. We will even give you a refund on the return of the partially opened bottle should you not be entirely convinced.
How to determine the freshness of your fish oil
Freshness is measured by oxidation. Always look out for the total oxidation (TOTOX) value on the supplier's COA - it is made up of two components:
- Anisidine value
- Peroxide value
Some manufacturers in Europe do not publish their anisidine values and although the peroxide values may be reasonable, the overall TOTOX value can be very high.
Interestingly, some of them do their testing just for the peroxide value (conveniently after encapsulation and after an elapsed period of time). The peroxide values in a soft gel actually go down over time but the anisidine values go up, therefore pushing the TOTOX value up as well.
It is a trick of the trade that some manufacturers use. Although the 'N/A' indication on the COA may mean 'Not Available', it should really mean 'Not Acceptable' - don't be fooled.
- Our Omega 3 / DHA Fish Oil has oxidation specifications that are significantly lower than any international standard (the lower the better). However, the actual results of the oil are always better than the specification. Please refer to the COA for the actual values.
- When compared to the oxidation specifications set by a US-based monograph, our standards are nearly double the freshness levels - from the peroxide to TOTOX values, including the all important anisidine value.
- Our peroxide specifications are four times better than those set by the European Pharmacopoeia and Norwegian Medicinal Standard, while our anisidine and TOTOX values cannot even be compared to these organisations as they all list their respective values as N/A - and we all know what that means.
As an extra measure to ensure that freshness is maintained across the spectrum, each and every batch of the Omega 3 / DHA Fish Oil is comprehensively tested by independent government certified laboratories. The laboratory used depends on the test being carried out. Xtend-Life uses two labs, namely: Cawthron Laboratories and AsureQuality.
The following is a table that shows comparative oxidation specifications between acceptable international standards and Xtend-Life standards. All of the indicated values are absolute minimum standards.
|Component ||Xtend-Life Specifications ||International Fish Oil Standards (IFOS) ||Council for Responsible Nutrition (CRN) ||European Pharmacopoeia ||Norwegian Medicinal Standard |
|Peroxide Value (mEq/kg) ||2.5 ||3.75 ||5 ||10 ||10 |
|Anisidine Value ||12 ||15 ||20 ||N/A ||N/A |
|Total Oxidation (TOTOX) ||17 ||19.5 ||26 ||N/A ||N/A |
* N/A means 'Not Available'
* IFOS although included in the table is not a recognised entity. It is a private organisation and it is claimed by some 'observers' that it was established for the benefit of a few marketers of fish oil.
SERIOUS ABOUT SUSTAINABILITY
Our hoki fishery in New Zealand is controlled by the New Zealand government and is considered to be the best managed and sustainable fish resource in the world. The total allowable catch set for New Zealand is constantly reviewed by scientists at the various New Zealand fisheries every year. The hoki fishery is in such good shape that the government is considering raising the quota levels for the 2009 season.
The raw tuna oil which we use in our Omega 3 / DHA Fish Oil is sourced only from trusted suppliers. The tuna oil does not have any impact on tuna stocks as it is a by-product of the tuna caught for food. We put it through a proprietary purification process in addition to the molecular distillation and concentration system. This results in levels of purity not achieved by other 'normal' purification processes.
MORE ABOUT DHA AND EPA
DHA (Docosahexaenoic acid) is without a doubt the most complex and beneficial fatty acid (that has been isolated and studied) as far as the human body is concerned (more so than EPA) as it is a 22 carbon chain bond with six (cis) double bonds. DHA is essential for the growth and functional development of the brain in infants. It is also required for maintenance of normal brain function in adults.
The inclusion of plentiful DHA in the diet improves learning ability, whereas deficiencies of DHA are associated with deficits in learning. DHA is taken up by the brain more readily than any other fatty acid.
Other omega-3 fatty acids follow DHA in order of complexity, number of carbon chain bonds and overall efficacy for your body. They are:
EPA (Eicosapentaenoic acid) has 20 carbon bonds. It is difficult for the body to convert EPA to DHA because it has to add two carbon bonds. On the other hand the body only has to 'drop off' two carbon bonds from DHA to create EPA.
ALA (alpha linolenic acid) - commonly found in flaxseed oil, this omega-3 fatty acid only has 18 carbon bonds, making it almost impossible for the body to manufacture DHA from.
A special mention must be made with regards to another omega-3 fatty acid - DPA (Docosapentaenoic acid). It acts as the 'sidekick' for both DHA and EPA. There has not been a lot of research carried out on DPA; however, it does appear that there are some real benefits associated with DPA because - like DHA - it has 22 carbon bonds.
WHAT MAKES XTEND-LIFE'S OMEGA 3 / DHA FISH OIL SO UNIQUE?
There are two important reasons why it cannot be copied or duplicated by others:
- Xtend-Life has an agreement with New Zealand's largest fishing company to acquire all the oil extracted from freshly caught hoki. Other hoki oil from other sources has been frozen and is handled differently with different levels of purity and freshness.
- The tuna oil we use goes through a proprietary purification process prior to molecular distillation and concentration. This process removes impurities such as PCBs and dioxins to a level not possible by molecular distillation alone.
There are other points of difference as well; all of which - when combined with the above - make Xtend-Life's Omega 3 / DHA Fish Oil a product that cannot be matched or bettered.
A WORD FROM WARREN, CHAIRMAN OF XTEND-LIFE
"The search for a better and purer natural fish oil has been an ongoing 'labour of love' of mine for almost nine years. My family, our staff, friends and myself all rely on our Omega 3 / DHA Fish Oil to contribute to our overall general health. We make NO compromises. If you take it every day like we do, your body will thank you for it and you will feel the benefits".
To keep up to date with general health developments you may wish to subscribe to the Xtend-Life blog at http://www.xtend-life.com/news-blog
In good health,
Please note that the following studies relate primarily to the potential health benefits of 'normal' Omega 3 supplements. We believe that the Xtend-Life line of Omega-3 / DHA Fish Oil formulas are far superior.
Studies about the health benefits of fish oil supplements and omega 3 fatty acids are frequent and wide ranging. Clinical studies have shown that fish oil may protect against symptoms of hay fever, sinus infections, asthma, food allergies and allergic skin conditions such as hives and eczema. Studies have also shown improved control in asthmatics that eat fish that is rich in Omega-3 essential fatty acids on a weekly basis. Apparently, fish oil lowers the level of airway narrowing (which causes restriction of breathing during an asthma attack) and calms inflammation.
Also, studies show that omega-3 intake by mothers during pregnancy may protect babies against the development of allergies.
Published Clinical Studies
Allergies Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: A randomized, controlled trial.
Dunstan JA, Mori TA, Barden A, Beilin LJ, Taylor AL, Holt PG, Prescott SL.
BACKGROUND: There is growing interest in the potential role of anti-inflammatory n-3 polyunsaturated fatty acids (n-3 PUFAs) in the prevention of allergic disease. OBJECTIVE: We sought to determine whether maternal dietary supplementation with n-3 PUFAs during pregnancy could modify immune responses in infants. METHODS: In a randomized, controlled trial 98 atopic, pregnant women received fish oil (3.7 g n-3 PUFAs per day) or placebo from 20 weeks' gestation until delivery. Neonatal PUFA levels and immunologic response to allergens were measured at birth. RESULTS: Eighty-three women completed the study. Fish oil supplementation (n = 40) achieved significantly higher proportions of n-3 PUFAs in neonatal erythrocyte membranes (mean +/- SD, 17.75% +/- 1.85% as a percentage of total fatty acids) compared with the control group (n = 43, 13.69% +/- 1.22%, P <.001). All neonatal cytokine (IL-5, IL-13, IL-10, and IFN-gamma) responses (to all allergens) tended to be lower in the fish oil group (statistically significant only for IL-10 in response to cat). Although this study was not designed to examine clinical effects, we noted that infants in the fish oil group were 3 times less likely to have a positive skin prick test to egg at 1 year of age (odds ratio, 0.34; 95% confidence interval, 0.11 to 1.02; P =.055). Although there was no difference in the frequency of atopic dermatitis at 1 year of age, infants in the fish oil group also had significantly less severe disease (odds ratio, 0.09; 95% confidence interval, 0.01 to 0.94; P =.045). CONCLUSIONS: These data suggest a potential reduction in subsequent infant allergy after maternal PUFA supplementation. More detailed follow-up studies are required in larger cohorts to establish the robustness of these findings and to ascertain their significance in relation to longer-term modification of allergic disease in children.
PMID: 14657879 [PubMed - in process]
Dietary components with demonstrated effectiveness in decreasing the severity of exercise-induced asthma.
Mickleborough T, Gotshall R.
Department of Kinesiology, Indiana University, 1025 E. 7th Street, HPER 112, Bloomington, IN 47401, USA. email@example.com
Exercise-induced asthma (EIA) occurs in up to 90% of individuals with asthma and approximately 10% of the general population without asthma. EIA describes a condition in which vigorous physical activity triggers acute airway narrowing with heightened airway reactivity resulting in reductions in forced expiratory volume in 1 second of greater than 10% compared with pre-exercise values. Treatment of EIA almost exclusively involves the use of pharmacological medications. However, there is accumulating evidence that a dietary excess of salt and omega-6 fatty acids, and a dietary deficiency of antioxidant vitamins and omega-3 fatty acids, can modify the severity of EIA. The modification of these dietary factors has the potential to reduce the incidence and prevalence of this disease. The dietary component most studied to date is dietary salt. Recent studies have supported a role for dietary salt as a modifier of the severity of EIA, suggesting that salt-restrictive diets can reduce the severity of EIA. Since EIA is part of the asthmatic diathesis, it is possible that EIA may serve as a useful model for investigation of potential dietary interventions for reducing airway hyperresponsiveness.
PMID: 12846590 [PubMed - indexed for MEDLINE]
Back To Top
Arthritis & Gout
What else does fish oil do for the body? Fish oil supplements have been shown to be of benefit to persons with rheumatoid arthritis (RA), and other inflammatory forms of arthritis, such as occurs in some persons with psoriasis and gout. EPA and DHA in fish oil supplements may reduce the amount of compounds causing inflammation.
Published Clinical Studies
A biomarker of n-3 compliance in patients taking fish oil for rheumatoid arthritis.
Cleland LG, Proudman SM, Hall C, Stamp LK, McWilliams L, Wylie N, Neumann M, Gibson RA, James MJ.
Rheumatology Unit, Royal Adelaide Hospital, Adelaide, SA 5000, Australia. Lcleland@mail.rah.sa.gov.au
Dietary fish oil supplements have been shown to have benefits in rheumatoid arthritis (RA), other inflammatory diseases, and in cardiovascular disease. As with any medical advice, variability will exist with regard to adherence and consequent biochemical or pharmacophysiologic effects. The aim was to explore the utility of plasma phospholipid EPA as a measure of n-3 PUFA intake and response to standardized therapeutic advice given in an outpatient or office practice setting, to increase dietary n-3 PUFA, including a fish oil supplement. Patients with early RA were given verbal and written advice to alter their dietary n-3 PUFA intake, including ingestion of 20 mL of bottled fish oil on juice daily. The advice included instructions to increase n-3 PUFA and to avoid foods rich in n-6 PUFA. Every 3 mon, blood samples were obtained for analysis of plasma phospholipid FA. Plasma phospholipid EPA was used as the primary index of n-3 PUFA intake. A diverse response was seen, with about one-third of patients achieving a substantial elevation of plasma phospholipid EPA over the 12-mon study period. A third had little change, with the remainder achieving intermediate levels. Data obtained longitudinally from individual patients indicated that substantial elevations of EPA (> 5% total plasma phospholipid FA) could be maintained for more than 3 yr. Plasma phospholipid EPA is a convenient measure of adherence to advice to take a dietary n-3 PUFA-rich fish oil supplement This measure may prove a useful adjunct to intention to treat analyses in determining the effect of dietary fish oil supplements on long-term outcomes in arthritis and other chronic inflammatory diseases. It may also provide a guide to the effectiveness of therapeutic and preventive messages designed to increase n-3 PUFA intake.
PMID: 12848288 [PubMed - in process]
Back To Top
Depression: Persons with mood disorders such as depression benefit from fish oil supplementation. Lack of omega-3 fatty acids and in particular DHA has been linked by researchers to depression. The health benefits of omega 3 fatty acids on depressed patients has been proven via a range of studies.
Fatty acids are essential in the healthy formation of the brain's nerve cell membranes and membrane fluidity. The brain is the richest source of fatty acids in the body, and because nerve cell function depends on proper membrane functioning and membrane fluidity, changes in membrane fluidity have a negative effect on behavior, mood and mental function.
Aggression: A new study of teenagers has found that fish oil and DHA consumption relates to lower hostility rates in teenagers. Hostility has been shown to predict the development and manifestation of heart disease.
Attention Deficit-Hyperactivity Disorder (ADHD), dyslexia and dyspraxia: Like depression and other mood disorders, persons who suffer from ADHD, dyslexia and dyspraxia (absence of ability to perform coordinated skilled movements or clumsiness) all benefit from taking fish oil supplements.
ADHD has been linked by research to lack of omega 3 fatty acids, necessary for formation and repair of brain cell membranes, especially in the developing central nervous system of children. Fish oil may improve the efficiency of nerve impulses and neurotransmitters involved in brain function.
Memory, learning and Alzheimer's Disease: Studies have proven that omega-3 fatty acids improve brain function and that intake of fish oil and DHA is linked to a lowered risk of developing Alzheimer's disease. Studies suggest that the health benefits of fish oil and DHA may also include protecting the nervous system from degeneration.
DHA and fish oil have been proven to stimulate memory and learning abilities. Recent research learns that mothers who take DHA as a supplement during pregnancy and lactation may increase the IQ of their babies.
Published Clinical Studies
Recovery of brain docosahexaenoate leads to recovery of spatial task performance.
Moriguchi T, Salem N Jr.
Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland 20852, USA.
Infants fed vegetable oil-based formulas may have poorer visual function, lower cognitive scores and acquire learning tasks more slowly in comparison with those breast fed or those fed formulas supplemented with docosahexaenoate. The aim of the present study was to determine the reversibility of losses in brain function associated with the loss of brain DHA. Rats were fed very low or adequate levels of n-3 fatty acids through three generations. The n-3 fatty acid deficient animals of the F3 generation were then given an n-3 adequate diet containing alpha-linolenic and docosahexaenoic acids (DHA) at birth, weaning (3 weeks) or young adulthood (7 weeks). The spatial task performance of these animals returned to the n-3 adequate diet was then compared using the Morris water at two different ages, at 9 or 13 weeks. Our results indicate that animals repleted since birth or at weaning were able to achieve nearly the same level of brain DHA and spatial task performance as animals maintained for three generations on an n-3 adequate diet. In the case of young adult animals, the degree of DHA and behavioral performance recovery depended upon the duration of dietary repletion with substantial recovery in animals after 6 weeks but little recovery of function after two weeks. The significance of these findings is that they indicate that at least some of the adverse effects of DHA deficiency during neurodevelopment may be reversible with an n-3 fatty acid supplemented diet.
PMID: 14511107 [PubMed - indexed for MEDLINE]
Consumption of fish and n-3 fatty acids and risk of incident Alzheimer disease.
Morris MC, Evans DA, Bienias JL, Tangney CC, Bennett DA, Wilson RS, Aggarwal N, Schneider J.
Rush Institute for Healthy Aging, Department of Internal Medicine, Rush Alzheimer's Disease Center, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL 60612, USA. Marth_C_Morris@rush.edu
BACKGROUND: Dietary n-3 polyunsaturated fatty acids improve brain functioning in animal studies, but there is limited study of whether this type of fat protects against Alzheimer disease. OBJECTIVE: To examine whether fish consumption and intake of different types of n-3 fatty acids protect against Alzheimer disease. DESIGN: Prospective study conducted from 1993 through 2000, of a stratified random sample from a geographically defined community. Participants were followed up for an average of 3.9 years for the development of Alzheimer disease. PATIENTS: A total of 815 residents, aged 65 to 94 years, who were initially unaffected by Alzheimer disease and completed a dietary questionnaire on average 2.3 years before clinical evaluation of incident disease. MAIN OUTCOME MEASURES: Incident Alzheimer disease diagnosed in a structured neurologic examination by means of standardized criteria. RESULTS: A total of 131 sample participants developed Alzheimer disease. Participants who consumed fish once per week or more had 60% less risk of Alzheimer disease compared with those who rarely or never ate fish (relative risk, 0.4; 95% confidence interval, 0.2-0.9) in a model adjusted for age and other risk factors. Total intake of n-3 polyunsaturated fatty acids was associated with reduced risk of Alzheimer disease, as was intake of docosahexaenoic acid (22:6n-3). Eicosapentaenoic acid (20:5n-3) was not associated with Alzheimer disease. The associations remained unchanged with additional adjustment for intakes of other dietary fats and of vitamin E and for cardiovascular conditions. CONCLUSION: Dietary intake of n-3 fatty acids and weekly consumption of fish may reduce the risk of incident Alzheimer disease.
PMID: 12873849 [PubMed - indexed for MEDLINE]
Neuroprotective effect of docosahexaenoic acid on glutamate-induced cytotoxicity in rat hippocampal cultures.
Wang X, Zhao X, Mao ZY, Wang XM, Liu ZL.
School of Life Science, Nanjing University, Nanjing 210093.
SUMMARY: The neuroprotective effect of docosahexaenoic acid (DHA) on the glutamate-induced cytotoxicity in rat hippocampal cultures was investigated in the present study. DHA at 5-50 microg/ml successfully protected neurons against the cytotoxicity, markedly increased the cell viability, inhibited both nitric oxide (NO) production and calcium influx, and increased the activities of antioxidant enzymes of glutathione peroxidase (GSH-Px) and glutathione reductase (GR). However, it did not alter the levels of glutathione (GSH) as compared to the control. These results suggest that DHA might be a potent neuroprotector. In addition, they may help to improve our understanding of the effect of DHA on neurodegeneration.
PMID: 14663210 [PubMed - in process]
Omega-3 fatty acids in mood disorders: an overview.
Young C, Martin A.
Child Study Center. Yale University School of Medicine. New Haven, Connecticut 06520-7900, USA. firstname.lastname@example.org
This review addresses the potential role of omega-3 fatty acids in mood disorders, from the biochemical rationale for their use to the growing body of data supporting their clinical effectiveness.
PMID: 12975694 [PubMed - indexed for MEDLINE]
Dietary intake of n-3, n-6 fatty acids and fish: Relationship with hostility in young adults-the CARDIA study.
Iribarren C, Markovitz JH, Jacobs DR, Schreiner PJ, Daviglus M, Hibbeln JR.
1Division of Research, Kaiser Permanente, Oakland, CA, USA.
BACKGROUND:: Hostility has been shown to predict both the development and manifestation of coronary disease. Examining the inter-relation of dietary intake of fish and of polyunsaturated (n-3 and n-6) essential fatty acids with hostility may provide additional insights into the cardioprotective effect of dietary fish and polyunsaturated fatty acids. OBJECTIVE:: To examine the association of dietary n-3, n-6 fatty acids and fish with level of hostility in a sample of 3581 urban white and black young adults. DESIGN:: Cross-sectional observational study as part of an ongoing cohort study. A dietary assessment in 1992-1993 and measurement of hostility and other covariates in 1990-1991 were used in the analysis. RESULTS:: The multivariate odds ratios of scoring in the upper quartile of hostility (adjusting for age, sex, race, field center, educational attainment, marital status, body mass index, smoking, alcohol consumption and physical activity) associated with one standard deviation increase in docosahexaenoic acid (DHA, 22:6) intake was 0.90 (95% CI=0.82-0.98; P=0.02). Consumption of any fish rich in n-3 fatty acids, compared to no consumption, was also independently associated with lower odds of high hostility (OR=0.82; 95% CI=0.69-0.97; P=0.02). CONCLUSIONS:: These results suggest that high dietary intake of DHA and consumption of fish rich in n-3 fatty acids may be related to lower likelihood of high hostility in young adulthood. The association between dietary n-3 fatty acids and hostile personality merits further research.European Journal of Clinical Nutrition (2004) 58, 24-31. doi:10.1038/sj.ejcn.1601739
PMID: 14679363 [PubMed - in process]
Back To Top
General heart benefits: Heart disease is a widespread health problem in modern society. Fish oil, rich in omega-3 fatty acids (DHA and EPA) has been proven in many clinical studies to benefit heart health, also supported by the American Heart Association guidelines (http://www.americanheart.org/presenter.jhtml?identifier=4632) which recommend the benefits of consumption of fish and fish oil. They recommend two servings for healthy persons and a daily serving of fish or fish oil supplement containing at least 900mg of fish oil for persons with heart disease.
Lowers Triglycerides: The effectiveness of Fish oil in lowering blood triglycerides (fats) known to be a risk factor for cardiovascular disease has been well established in multiple clinical studies. Additionally, research has proven that DHA present in fish oil lowers the level of small, dense particles of LDL cholesterol, which are associated with heart disease. The level of large buoyant particles of LDL cholesterol (which pose no health problem) is increased. Total HDL cholesterol remains unchanged by DHA supplementation, while large, buoyant HDL particles are increased. HDL cholesterol benefits cardiovascular health.
Benefits Hypertension (High blood pressure): Fish oil has been shown to lower mild hypertension when it is due to cardiovascular disease, specifically high cholesterol and atherosclerosis (hardening of the artery walls).
Anti-clotting: Fish oil helps avoid thrombosis (blood clots) as it prevents platelets (smallest cells in the blood) sticking together and forming blood clots.
Reduces Heart Irregularities: Fish oil... especially the DHA content of it has been shown to lower heart rates and also prevent arrhythmias (disturbances of the normal rhythm in the heart's beating), thus decreasing the chance of sudden death by a heart attack.
Circulatory problems: Circulatory problems such as varicose veins and Raynaud's disease benefit from fish oil. Fish oil stimulates blood circulation and increases the breakdown of fibrin, a compound involved in clot and scar formation.
Published Clinical Studies
Non-drug therapy in prevention and control of hypertension.
Grant Medical College, Mumbai.
Non-drug therapy is a very vital aspect in prevention and treatment of hypertension. The successive reports of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of Hypertension, WHO scientific report on primary prevention of essential hypertension and national High Blood Pressure Education Program's working groups report on primary prevention of hypertension have stressed on the non-drug therapy. Today a busy family physician does not spend enough time to explain to the patient various dietary and lifestyle modifications but straightaway prescribes the drugs. Every patient of hypertension from the stage of pre-hypertension to grade 2 hypertension should follow non-drug therapy. If non-drug therapy is strictly adhered, one can prevent cases of pre-hypertension from progressing to hypertension stage and one can reduce or stop the medications in Grade I (mild) hypertension. We have discussed the role of low salt, high potassium diet, role of caffeine intake, calcium and magnesium supplements, fish oil intake, cigarette smoking, alcohol consumption, role of physical exercise, stress reduction and bio-feedback, yoga, meditation and acupuncture. These recommendations regarding diet and lifestyle modifications should be targeted to population at large through public health authorities, non-government organisations and news media.
PMID: 14719592 [PubMed - in process]
Heart Antiarrhythmic effects of omega-3 fatty acids: from epidemiology to bedside.
De Caterina R, Madonna R, Zucchi R, La Rovere MT.
University Cardiology Division, G. d'Annunzio University, Chieti, Italy. email@example.com
Omega-3 polyunsaturated fatty acids are emerging as a safe and effective means to reduce sudden death after acute myocardial infarction. This review summarizes the epidemiological background for the use of omega-3 fatty acids with this indication, clinical trials performed so far, and experimental data supporting their antiarrhythmic effectiveness.
PMID: 12947358 [PubMed - indexed for MEDLINE]
Fish consumption is associated with lower heart rates.
Dallongeville J, Yarnell J, Ducimetiere P, Arveiler D, Ferrieres J, Montaye M, Luc G, Evans A, Bingham A, Hass B, Ruidavets JB, Amouyel P.
INSERM U 508, Institut Pasteur de Lille, 1 rue du Pr Calmette, 59019 Lille Cedex, France. firstname.lastname@example.org
BACKGROUND: Fish consumption decreases risk of sudden death. The goal of the present study was to assess the relationship between fish consumption and heart rate. METHODS AND RESULTS: A cross-sectional analysis was conducted of 9758 men, age 50 to 59 years, without coronary heart disease (CHD) who were recruited in France and Belfast, Ireland, from 1991 to 1993. Heart rate and CHD risk factors were compared among 4 categories of fish consumption, as follows: (1) less than once per week (n=2662), (2) once per week (n=4576), (3) twice per week (n=1964), and (4) more than twice per week (n=556). Fatty acid profiles of erythrocyte phospholipids were determined in a random subsample of 407 subjects. In erythrocyte phospholipids, eicosapentaenoic acid (P<0.0005), docosahexaenoic acid (P<0.0001), and total n-3 fatty acid (P<0.0008) increased across the categories of fish intake. Triglycerides (P<0.0001), systolic blood pressure (P<0.006), and diastolic blood pressure (P<0.0001) were lower and HDL cholesterol levels (P<0.004) were higher in fish consumers than in nonconsumers. Similarly, heart rate decreased across the categories of fish intake (P<0.0001). After adjustment for age, center, education level, physical activity, smoking habit, alcohol consumption, body mass index, and antiarrhythmic medications, heart rate remained statistically lower among fish consumers than among nonconsumers (P for trend <0.0001). Docosahexaenoic acid content of erythrocyte phospholipids was inversely correlated with heart rate (P<0.03). CONCLUSIONS: Fish consumption is associated with decreased heart rate in men. Because heart rate is positively associated with risk of sudden death, this association may explain, at least in part, the lower risk of sudden death among fish consumers. Publication Types: " Multicenter Study
PMID: 12912821 [PubMed - indexed for MEDLINE]
Fish oil prevents the adrenal activation elicited by mental stress in healthy men.
Delarue J, Matzinger O, Binnert C, Schneiter P, Chiolero R, Tappy L.
Laboratoire regional de nutrition humaine, Hopital de la Cavale Blanche, Brest, France.
OBJECTIVES: A diet rich in n-3 fatty acids (fish oils) is associated with reduced risks of cardiovascular and metabolic diseases, but the mechanisms remain incompletely understood. Sympathoadrenal activation is postulated to be involved in the pathogenesis of these diseases, and may be inhibited by n-3 fatty acids. We therefore evaluated the effects of a diet supplemented with n-3 fatty acids on the stimulation of the sympathetic nervous system and of stress hormones elicited by a mental stress. METHODS: Seven human volunteers were studied on two occasions, before and after 3 weeks of supplementation with 7.2 g/day fish oil. On each occasion, the concentrations of plasma cortisol, and catecholamines, energy expenditure (indirect calorimetry), and adipose tissue lipolysis (plasma non esterified fatty acid concentrations) were monitored in basal conditions followed by a 30 min mental stress (mental arithmetics and Stroop's test) and a 30 min recovery period. RESULTS: In control conditions, mental stress significantly increased heart rate, mean blood pressure, and energy expenditure. It increased plasma epinephrine from 60.9 +/- 6.2 to 89.3 +/- 16.1 pg/ml (p<0.05), plasma cortisol from 291 +/- 32 to 372 +/- 37 micromol/l (p<0.05) and plasma non esterified fatty acids from 409 +/- 113 to 544 +/- 89 micromol/l (p<0.05). After 3 weeks of a diet supplemented with n-3 fatty acids, the stimulation by mental stress of plasma epinephrine, cortisol, energy expenditure, and plasma non esterified fatty acids concentrations, were all significantly blunted. CONCLUSION: Supplementation with n-3 fatty acids inhibits the adrenal activation elicited by a mental stress, presumably through effects exerted at the level of the central nervous system.
PMID: 12909818 [PubMed - indexed for MEDLINE]
The role of omega-3 fatty acids in the secondary prevention of cardiovascular disease.
Lee KW, Lip GY.
Haemostasis, Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, UK.
It has long been recognized from epidemiological studies that Greenland Eskimos have substantially reduced rates of acute myocardial infarction (MI) compared with Western controls. From these epidemiological observations, the benefits of fatty fish consumption have been explored in cell culture and animal studies, as well as randomized controlled trials investigating the cardioprotective effects of omega-3 fatty acids. Dietary omega-3 fatty acids seem to stabilize the myocardium electrically, resulting in reduced susceptibility to ventricular arrhythmias, thereby reducing the risk of sudden death. These fatty acids also have potent anti-inflammatory effects, and may also be antithrombotic and anti-atherogenic. Furthermore, the recent GISSI-Prevention study of 11 324 patients showed a marked decrease in risk of sudden cardiac death as well as a reduction in all-cause mortality in the group taking a highly purified form of omega-3 fatty acids, despite the use of other secondary prevention drugs, including beta-blockers and lipid-lowering therapy. The use of omega-3 fatty acids should be considered as part of a comprehensive secondary prevention strategy post-myocardial infarction.
PMID: 12881589 [PubMed - indexed for MEDLINE]
Back To Top
Diabetics suffering from non-insulin dependent diabetes or type II diabetes benefit from fish oil supplementation. Research shows that person's who consume 5-10 percent of their dietary energy consumption in the form of fish or fish oil, have less insulin resistance.
Diabetics suffering from non-insulin dependent diabetes or type II diabetes benefit from fish oil supplementation. Research show that persons who consume 5-10 percent of their dietary energy consumption in the form of fish or fish oil, have less insulin resistance, which causes diminished glucose uptake and glucose metabolism in non-insulin dependent diabetics. Fish oil enhances insulin secretion from beta-cells in the pancreas, regulating blood sugar levels. DHA plays a protective role in diabetic neuropathy in all forms of diabetes.
Published Clinical Studies
Effect of eicosapentaenoic acid and docosahexaenoic acid on oxidative stress and inflammatory markers in treated-hypertensive type 2 diabetic subjects.
Mori TA, Woodman RJ, Burke V, Puddey IB, Croft KD, Beilin LJ.
Department of Medicine, The University of Western Australia, The West Australian Heart Research Institute and The Western Australian Institute for Medical Research, Perth, Western Australia 6000, Australia.
au n-3 fatty acids reduce the risk of cardiovascular disease via a number of possible mechanisms. Despite this, there has been concern that these fatty acids may increase lipid peroxidation. The data in vivo are inconclusive, due in part to limitations in the methodologies. In this regard, the measurement of F2-isoprostanes provides a reliable assessment of in vivo lipid peroxidation and oxidant stress. This study aimed to assess the effects of supplementation with purified eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA), the two major n-3 fatty acids, on urinary F2-isoprostanes and markers of inflammation, in type 2 diabetic patients. In a double-blind, placebo controlled trial of parallel design, 59 nonsmoking, treated-hypertensive, type 2 diabetic subjects, were randomized to 4 g daily of purified EPA, DHA, or olive oil for 6 weeks, while maintaining their usual diet. F2-isoprostanes, measured using gas chromatography-mass spectrometry in 24 h urines and C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha), were measured before and after intervention. Thirty-nine men and 12 women aged 61.2 +/- 1.2 years, with body mass index (BMI), 29.5 +/- 0.5 kg/m2; 24 h blood pressure, 138/73 mmHg; HbA1c, 7.3 +/- 0.1% and fasting glucose, 7.9 +/- 0.2 mmol/l completed the intervention. Baseline urinary F2-isoprostanes were positively associated with HbA1c (p=.011) and fasting glucose (p=.032). Relative to the olive oil group, postintervention urinary F2-isoprostanes were decreased 19% by EPA (p=.017) and 20% by DHA (p=.014). There were no significant changes in CRP, IL-6, and TNF-alpha following EPA or DHA supplementation. In regression analysis, Delta F2-isoprostanes were positively associated with Delta HbA1c (p=.007) independent of treatment group; and with Delta TNF-alpha (p=.034) independent of age, gender, BMI, and treatment group. There were no associations with Delta CRP or Delta IL-6. This study is the first report demonstrating that either EPA or DHA reduce in vivo oxidant stress without changing markers of inflammation, in treated hypertensive, type 2 diabetic subjects.
PMID: 14583341 [PubMed - in process]
Neuroprotective effect of docosahexaenoic acid-enriched phospholipids in experimental diabetic neuropathy.
Coste TC, Gerbi A, Vague P, Pieroni G, Raccah D.
UPRES EA 2193, Faculte de Medecine Timone, Marseille, France. Thierry.Coste@medecine.univ-mrs.fr
A deficiency in essential fatty acid metabolism has been widely reported in both human and animal diabetes. Fish oil supplementations (n-3 fatty acids), containing docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), were less effective on diabetic neuropathy than (n-6) fatty acids. This partial effect of (n-3) fatty acids might be attributed to the presence of EPA, a competitor of arachidonic acid, which enhanced the diabetes-induced decrease of this fatty acid in serum and tissues. For determining whether a supplementation with DHA alone could prevent neuropathy in streptozotocin-induced diabetes, diabetic rats were given daily, by gavage, liposomes containing DHA phospholipids, at a dose of 60 mg/kg. Eight weeks of diabetes induced significant decreases in nerve conduction velocity (NCV), nerve blood flow (NBF), and sciatic nerve and erythrocyte (red blood cells [RBCs]) Na,K-ATPase activities. DHA phospholipids totally prevented the decrease in NCV and NBF observed during diabetes when compared with the nonsupplemented diabetic group. DHA phospholipids also prevented the Na,K-ATPase activity decrease in RBC but not in sciatic nerve. Moreover, DHA level in sciatic nerve membranes was correlated with NCV. These results demonstrate a protective effect of daily doses of DHA on experimental diabetic neuropathy. Thus, treatment with DHA phospholipids could be suitable for evaluation in clinical trials.
PMID: 14514643 [PubMed - indexed for MEDLINE]
Back To Top
Immune System & Cancer
The intake of fish oil may be beneficial for the body's immune function. Research has even linked intake of fish oil to a lowered risk of breast cancer and prostate cancer.
Published Clinical Studies
Inuit are protected against prostate cancer.
Dewailly E, Mulvad G, Sloth Pedersen H, Hansen JC, Behrendt N, Hart Hansen JP.
Public Health Research Unit, CHUQ-Laval University, Sainte-Foy, Quebec, G1V 5B3 Canada. email@example.com
Incidence and mortality rates for prostate cancer are reported to be low among Inuit, but this finding must be additionally supported given the difficulty of obtaining a precise medical diagnosis in the Arctic. We conducted an autopsy study in 1990-1994 among 61 deceased males representative of all deaths occurring in Greenland and found only one invasive prostate cancer. Histological data were available for 27 autopsies and revealed no latent carcinoma. Our results suggest that in situ carcinoma is rare among Inuit and that their traditional diet, which is rich in omega-3 polyunsaturated fatty acids and selenium, may be an important protective factor.
PMID: 14504206 [PubMed - indexed for MEDLINE]
Opposing effects of dietary n-3 and n-6 fatty acids on mammary carcinogenesis: The Singapore Chinese Health Study.
Gago-Dominguez M, Yuan JM, Sun CL, Lee HP, Yu MC.
USC/Norris Comprehensive Cancer Center, Keck School of Medicine of the University of Southern California, 1441 Eastlake Avenue, Los Angeles, CA 90089-9181, USA. firstname.lastname@example.org
We investigated the effects of individual fatty acids on breast cancer in a prospective study of 35,298 Singapore Chinese women aged 45-74 years, who were enrolled during April 1993 to December 1998 (The Singapore Chinese Health Study). At recruitment, each study subject was administered, in-person, a validated, semiquantitative food frequency questionnaire consisting of 165 food and beverage items. As of December 31, 2000, 314 incident cases of breast cancer had occurred. We used the Cox regression methods to examine individual fatty acids in relation to breast cancer risk, with adjustment for age at baseline interview, year of interview, dialect group, level of education, daily alcohol drinking, number of live births, age when menstrual periods became regular, and family history of breast cancer. Consumption of saturated, monounsaturated or polyunsaturated fat overall was unrelated to risk. On the other hand, high levels of dietary n-3 fatty acids from fish/shellfish (marine n-3 fatty acids) were significantly associated with reduced risk. Relative to the lowest quartile of intake, individuals in the higher three quartiles exhibited a 26% reduction in risk (relative risk (RR)=0.74, 95% confidence interval (CI)=0.58, 0.94)); RRs were similar across the top three quartiles of intake (0.75, 0.75, 0.72, respectively). Overall, there was no association between n-6 fatty acids and breast cancer risk. However, among subjects who consumed low levels of marine n-3 fatty acids (lowest quartile of intake), a statistically significant increase in risk was observed in individuals belonging to the highest vs the lowest quartile of n-6 fatty acid consumption (RR=1.87, 95% CI=1.06-3.27); the corresponding RR for advanced breast cancer was 2.45 (95% CI=1.20-4.97, P for trend=0.01). To our knowledge, these are the first prospective findings linking the intake of marine n-3 fatty acids to breast cancer protection.
PMID: 14583770 [PubMed - indexed for MEDLINE]
Back To Top
Inflammatory Bowel Disease
Fish oil has been proven to be beneficial in intestinal health. Fish oil has an anti-inflammatory effect in inflammatory bowel disease (Ulcerative colitis and Crohn's disease).
Published Clinical Studies
Decreased oxidative stress in patients with ulcerative colitis supplemented with fish oil omega-3 fatty acids.
Barbosa DS, Cecchini R, El Kadri MZ, Rodriguez MA, Burini RC, Dichi I.
Laboratory of Biochemistry, Londrina State University, Londrina, Parana, Brazil.
OBJECTIVE: The potential pathogenicity of free radicals may have a pivotal role in ulcerative colitis. Fish oil omega-3 fatty acids exert anti-inflammatory effects on patients with ulcerative colitis (UC), but the precise mechanism of the action of fish oil on oxidative stress is still controversial. The aim of the present work was to verify the blood oxidative stress in patients with UC and determine whether the association of sulfasalazine to fish oil omega-3 fatty acids is more effective than isolated use of sulfasalazine to reduce the oxidative stress. METHODS: Nine patients (seven female and two male; mean age = 40 +/- 11 y) with mild or moderate active UC were studied in a randomized crossover design. In addition to their usual medication (2 g/d of sulfasalazine), they received fish oil omega-3 fatty acids (4.5 g/d) or placebo for 2-mo treatment periods that were separated by 2 mo, when they only received sulfasalazine. Nine healthy individuals served as control subjects to study the oxidative stress status. Disease activity was assessed by laboratory indicators (C-reactive protein, alpha1-acid glycoprotein, alpha1-antitrypsin, erythrocyte sedimentation rate, albumin, hemoglobin, and platelet count), sigmoidoscopy, and histology scores. Analysis of oxidative stress was assessed by plasma chemiluminescence and erythrocyte lipid peroxidation, both induced by tert butyl hydroperoxide (t-BuOOH) and by plasma malondialdehyde. Antioxidant status was assayed by total plasma antioxidant capacity (TRAP) and microsomal lipid peroxidation inhibition (LPI). Superoxide dismutase (SOD) and catalase erythrocyte enzymatic activities were also determined. RESULTS: No significant changes were observed in any laboratory indicator or in the sigmoidoscopy or histology scores, with the exception of erythrocyte sedimentation rate, which decreased with both treatments. Oxidative stress was demonstrated by significant decreases in TRAP and LPI levels, increased chemiluminescence induced by t-BuOOH, and higher SOD activity in patients with UC. Treatment with fish oil omega-3 fatty acids reverted the chemiluminescence induced by t-BuOOH and LPI to baseline levels but that did not occur when patients received only sulfasalazine. Levels of plasma malondialdehyde, erythrocyte lipid peroxidation, and catalase were not different from those in the control group. CONCLUSIONS: The results indicated that plasma oxidative stress occurs in patients with UC, and there was a significant decrease when the patients used sulfasalazine plus fish oil omega-3 fatty acids. However, there was no improvement in most laboratory indicators, sigmoidoscopy, and histology scores. The results suggested that omega-3 fatty acids may act as free radical scavengers protecting the patients against the overall effect of oxidative stress.
PMID: 14559317 [PubMed - in process]
Back To Top
Skin Disorders & Skin Health
Skin disorders such as psoriasis have been shown to improve with the intake of fish oils. In the skin of persons with psoriasis the amount of compounds causing inflammation is many times greater than normal. Fish oil inhibits the production of these inflammatory compounds. Fish oil intake may also improve the health of skin, nails and hair.
Published Clinical Studies
n-3 fatty acids in psoriasis.
Mayser P, Grimm H, Grimminger F.
Department of Dermatology and Andrology, Justus Liebig University, Giessen, Germany. Peter.Mayser@derma.med.uni-giessen.de Increased concentrations of free arachidonic acid (AA) and its proinflammatory metabolites have been observed in psoriatic lesions. Replacement of arachidonic acid by alternative precursor polyunsaturated fatty acids (PUFA), especially eicosapentaenoic acid (EPA), which can be metabolized via the same enzymatic pathways as AA, might be a therapeutic option in psoriasis. However the results of studies evaluating the therapeutic benefit of dietary fish oil have been conflicting and not clearly dose-dependent. To overcome the slow kinetics and limited availability of oral supplementation, we have performed three studies to assess the effectiveness and safety of an intravenously administered fish oil derived lipid emulsion on different forms of psoriasis. Patients received daily infusions of either an n-3 fatty acid-based lipid emulsion (Omegaven) or a conventional n-6 lipid emulsion (Lipoven) in different time and dose regimens. In addition to an overall assessment of the clinical course of psoriasis, EPA- and AA-derived neutrophil 5-lipoxygenase (LO)--products, thromboxane (TX) B2/B3, PAF and plasma free fatty acids were investigated. Treatment with n-3 fatty acids resulted in a considerably higher response rate than infusion of n-6 lipids. A more than 10-fold increase in neutrophil EPA-derived 5-LO product formation was noted in the n-3 group, accompanied by a rapid increase in plasma-free EPA within the first days. In conclusion, intravenous n-3-fatty acid administration causes reduction of psoriasis, which may be related to changes in inflammatory eicosanoid generation. The rapidity of the response to intravenous n-3 lipids exceeds by orders of magnitude the hitherto reported kinetics of improvement of psoriatic lesions upon use of oral supplementation.
PMID: 11895157 [PubMed - indexed for MEDLINE]
Effects of micronutrient supplements on u.v.-induced skin damage.
Jackson MJ, Jackson MJ, McArdle F, Storey A, Jones SA, McArdle A, Rhodes LE.
Department of Medicine, University of Liverpool, Liverpool L69 3GA, UK. email@example.com
Development of an orally-administered systemic agent that could reduce the effects of u.v. exposure on skin could potentially have a major effect on the incidence of skin cancers and photo-ageing. A number of micronutrients have been suggested to have metabolic properties that could induce this protection, and our data indicate that n-3 polyunsaturated fatty acids are particularly effective in this role. The mechanisms of action of n-3 polyunsaturated fatty acids appear to depend on their anti-inflammatory properties, acting to reduce the u.v.-induced release of cytokines and other mediators from a variety of skin cell types.
PMID: 12133200 [PubMed - indexed for MEDLINE]
The significance of polyunsaturated fatty acids in cutaneous biology.
Department of Dermatology, University of California, Davis, USA.
The skin epidermis displays a highly active metabolism of polyunsaturated fatty acids (PUFA). Dietary deficiency of linoleic acid (LA) and 18-carbon (n-6) PUFA results in characteristic scaly skin disorder and excessive epidermal water loss. Arachidonic acid, a 20-carbon (n-6) PUFA is metabolized via the cyclooxygenase pathway into predominantly prostaglandin E2 (PGE2) PGF2 alpha, and PGD2 and via the lipoxygenase pathway into predominantly 15-hydroxyeicosatetraenoic acid (15-HETE). The prostaglandins modulate normal skin physiological processes at low concentrations and inflammatory reactions at high concentrations. Similarly, the very active epidermal 15-lipoxygenase transforms dihomogammalinolenic acid (DGLA) into 15-hydroxy eicosatrienoic acid (15-HETrE), eicosapentaenoic acid (EPA) into 15-hydroxyeicosapentaenoic acid (15-HEPE) and docosahexaenoic acid (DHA) into 17-hydroxydocosahexaenoic acid (17-HDoHE), respectively. These monohydroxy acids exhibit anti-inflammatory properties. In contrast, the 18-carbon (n-6) PUFA is transformed into 13-hydroxy-9,11-octadecadienoic acid (13-HODE), which exerts antiproliferative properties in the tissue. Thus, the supplementation of diets with appropriate purified vegetable oils and/or fish oil may generate local cutaneous anti-inflammatory metabolites which could serve as a less toxic in vivo monotherapy or as adjuncts to standard therapeutic regimens for the management of skin inflammatory disorders.
PMID: 8729128 [PubMed - indexed for MEDLINE]
Back To Top
Research has shown that consumption of fish oil is linked to lowered risk of age related macular degeneration, an eye condition which is the leading cause of severe visual loss in people over age 50.
The macula is the central area in the retina of the eye used for fine focus such as reading. Omega-3 fatty acids form an important part of the building blocks of the retina and studies show that fish oil intake may well improve focus, color, perception and clarity of vision.
Published Clinical Studies
Scotopic electroretinogram in term infants born of mothers supplemented with docosahexaenoic acid during pregnancy.
Malcolm CA, Hamilton R, McCulloch DL, Montgomery C, Weaver LT.
Department of Vision Sciences, Glasgow Caledonian University, Glasgow, United Kingdom. firstname.lastname@example.org
PURPOSE: To test the hypothesis that the supplementation of the diets of pregnant women with a fish oil rich in docosahexaenoic acid (DHA) enhances retinal development in their healthy term infants, as measured during the early postnatal period by the electroretinogram (ERG). METHODS: One hundred pregnant women were randomized to receive either a fish oil (n = 50) or a placebo oleic acid dietary supplement (n = 50) from 15 weeks of pregnancy until delivery. Total fatty acids in red blood cells (RBCs) and plasma were measured in mothers at 15 and 28 weeks of pregnancy and at delivery and in their infants in umbilical cord blood. Infant retinal development was assessed within the first week of life with full-field ERGs that included a scotopic blue intensity series (n = 41) and a bright white flash (2.0 log cd-s/m(2); n = 44). RESULTS: Infants born of mothers who received supplements did not differ at birth in weight, gestational age, or any other standard variable. Infant DHA status at birth, as measured from umbilical cord blood, did not differ significantly between maternal supplementation groups. ERG implicit times, amplitudes, and parameters of the stimulus-response function did not differ significantly between infants in the maternal supplemented and placebo groups. There was, however, a relationship between infant DHA status and maturity of the retina at birth, regardless of maternal supplementation group. A measure of retinal sensitivity (log sigma) correlated significantly (P < 0.005) with DHA status (as a percentage of total fatty acid; TFA) in infant cord blood. Infants in the highest quartile for cord blood DHA had higher retinal sensitivity compared with infants in the lowest quartile. Infants in the highest quartile for plasma DHA, both as a percentage of TFA and concentration, were born at a significantly later gestational age than were infants in the lower quartiles. CONCLUSIONS: These findings demonstrate an association between the DHA status of term infants and retinal sensitivity, suggesting an essential role of this long-chain polyunsaturated fatty acid (LCPUFA) in the development and function of the retina. However, maternal DHA status was not significantly associated with infant retinal sensitivity and no direct effect of maternal supplementation was observed.
- Clinical Trial
- Randomized Controlled Trial
PMID: 12882824 [PubMed - indexed for MEDLINE]
Docosahexaenoic and arachidonic acid influence on preterm baboon retinal composition and function.
Diau GY, Loew ER, Wijendran V, Sarkadi-Nagy E, Nathanielsz PW, Brenna JT.
Division of Nutritional Sciences, Cornell University, Ithaca, New York 14853, USA.
PURPOSE. Dietary n-3 polyunsaturated fatty acid deficiency and prematurity are both associated with suboptimal visual function in nonhuman primates and in humans. This study reports measurements of retinal long chain polyunsaturate (LCP) concentrations and electroretinogram (ERG) parameters for term and preterm neonatal baboons consuming clinically relevant diets. METHODS. ERGs and retinal fatty acid compositions were obtained from baboon neonates in four groups: term-delivered/breast-fed (B), term/formula-fed (T-), preterm/formula-fed (P-), and preterm/formula (P+) supplemented with long chain polyunsaturates. Initial a-wave slope change (a), a-wave amplitude (a(amp)) and implicit time (a(i)), and b-wave amplitude (b(amp)) and implicit time (b(i)) were determined and correlations to retinal fatty acid concentrations were evaluated. RESULTS. The P+ group a and b(amp) significantly improved between 0 and 4 weeks' adjusted age, whereas no P- group parameter improved with age. At four weeks, both a(amp) and b(amp) were significantly greater in group B than in all other groups, and a and a(i) were greater for P+ than for P-. Concentrations of 22:6n-3, 22:5n-3, and Sigman-3 and the 22:5n-6/22:6n-3 ratio correlated positively with improved retinal response parameters, whereas 22:5n-6, 22:4n-6, 20:4n-6, 20:3n-6, 20:2n-9, 20:1n-9, and 18:1n-9 all correlated negatively (P < 0.05); saturates were uncorrelated. The parameters most linearly related to retinal 22:6n-3 were a, a(i), and a(amp). Retinal 20:4n-6 concentrations were not influenced by prematurity or supplementation. CONCLUSIONS. Breast-feeding optimizes retinal response in 4-week-old baboons. Formula supplemented with 22:6n-3 prevents a decrease in retinal 22:6n-3 and improves preterm ERG parameters compared with unsupplemented formula. Retinal 22:6n-3 status is most closely associated with a-wave parameters.
PMID: 14507905 [PubMed - indexed for MEDLINE]
Dietary docosahexaenoic acid protects against N-methyl-N-nitrosourea-induced retinal degeneration in rats.
Moriguchi K, Yuri T, Yoshizawa K, Kiuchi K, Takada H, Inoue Y, Hada T, Matsumura M, Tsubura A.
Department of Pathology II, Kansai Medical University, Moriguchi, Osaka 570-8506, Japan.
The effect of dietary intake of specific types of fatty acids on retinal degeneration due to N-methyl-N-nitrosourea (MNU)-induced photoreceptor cell apoptosis was evaluated. Fifty-day-old female Sprague-Dawley rats were given a single intraperitoneal injection of 50 mg kg(-1) body weight of MNU, and were then switched to one of five different diets containing the following fatty acids at the following weight percentages: 10% linoleic acid (LA); 9.5% palmitic acid (PA) and 0.5% LA; 9.5% eicosapentaenoic acid (EPA) and 0.5% LA; 4.75% EPA, 4.75% docosahexaenoic acid (DHA) and 0.5% LA; or 9.5% DHA and 0.5% LA. When rats developed MNU-induced mammary tumors with a diameter of > or =1 cm, or at the termination of the experiment (20 weeks after MNU injection), retinal tissue samples were obtained and examined. Incidence and severity of retinal damage were compared by histologic examination. MNU-induced retinal degeneration was prevented in rats fed the diet containing 9.5% DHA (4.75% DHA was less effective), whereas it was accelerated in rats fed the 10% LA diet. Over the course of the 20-week experimental period, the fatty acid composition of serum reflected differences in dietary fatty acids. The present results indicate that a diet containing 9.5% DHA can counteract MNU retinotoxicity in the rat retina. DHA may play a role in protection against MNU-induced photoreceptor cell apoptosis in the rat retina.
PMID: 12873446 [PubMed - indexed for MEDLINE]
Protective effect of docosahexaenoic acid on oxidative stress-induced apoptosis of retina photoreceptors.
Rotstein NP, Politi LE, German OL, Girotti R.
Institute of Biochemical Research and Universidad Nacional del Sur, Bahia Blanca, Buenos Aires, Argentina. email@example.com
PURPOSE: In a recent study, it was demonstrated that docosahexaenoic acid (DHA) promotes the survival of retinal photoreceptors in vitro, delaying apoptosis. However, lipid enrichment in DHA is known to contribute to retina vulnerability to oxidative stress. In this study, the effect of oxidative damage on rat retina neurons in vitro and whether DHA enhances or diminishes this damage were investigated. METHODS: Rat retina neurons in 3-day cultures, with or without DHA, were treated with the oxidant paraquat. After 24 hours, apoptosis, mitochondrial membrane integrity, and Bcl-2 and Bax expression were immunocytochemically determined. RESULTS: Paraquat induced apoptosis in amacrine and photoreceptor neurons, major neuronal types in the culture. Neuronal apoptosis was accompanied by mitochondrial membrane depolarization, an increase in the amount of photoreceptors expressing Bax, and a decrease in those expressing Bcl-2. Addition of DHA reduced photoreceptor apoptosis by almost half, simultaneously preserving their mitochondrial membrane integrity. DHA blocked the paraquat-induced increase in Bax expression and remarkably upregulated Bcl-2 expression. Glia-derived neurotrophic factor, a photoreceptor trophic factor, only slightly increased Bcl-2 expression and did not protect photoreceptors from oxidative damage. Similarly, other fatty acids tested did not prevent photoreceptor apoptosis. CONCLUSIONS: These results show that oxidative damage induces apoptosis in retinal neurons during their early development in culture and suggest that the loss of mitochondrial membrane integrity is crucial in the apoptotic death of these cells. DHA activates intracellular mechanisms that prevent this loss and by modulating the levels of pro- and antiapoptotic proteins of the Bcl-2 family selectively protect photoreceptors from oxidative stress.
PMID: 12714668 [PubMed - indexed for MEDLINE]
Cell cycle regulation in retinal progenitors by glia-derived neurotrophic factor and docosahexaenoic acid.
Insua MF, Garelli A, Rotstein NP, German OL, Arias A, Politi LE.
Institute of Biochemical Research (INIBIBB) and Universidad Nacional del Sur, Bahia Blanca, Buenos Aires, Argentina.
PURPOSE: A recent study has shown that glia-derived neurotrophic factor (GDNF) and docosahexaenoic acid (DHA) promote the survival and differentiation of retina photoreceptors. The current study was undertaken to investigate whether these molecules participate in cell cycle regulation in retinal progenitors in vitro. METHODS: Developmental changes in the expression of the stem cell marker nestin and of cell cycle and differentiated neuron markers were analyzed in neuroblasts obtained from 1-day-old rat retinas. The effects of GDNF and DHA on those changes were then determined. RESULTS: Expression of nestin, found in more than one third of neuroblasts at day 1, rapidly decreased during development, with most neuroblasts acquiring the photoreceptor phenotype. GDNF increased the percentage of photoreceptor progenitors expressing nestin, whereas DHA reduced it, simultaneously enhancing photoreceptor differentiation. Several markers of cell cycle progression indicated that photoreceptor progenitors maintained an active cell cycle during the first 2 days in vitro. GDNF stimulated the cell cycle, increasing the number of dividing cells and generating more photoreceptor progenitors, whereas DHA induced cell cycle exit and photoreceptor differentiation. Analysis of the expression of the cyclin-Cdk inhibitor p27(Kip1) confirmed these results. CONCLUSIONS: GDNF and DHA acted as molecular cues, counterbalancing the decision of photoreceptors to remain in or exit the cell cycle. The results strongly suggest that both factors participate in determining the number of photoreceptors in vitro, regulating the cell cycle and survival at early and late stages of development, respectively. Hence, GDNF and DHA may coordinately control the histogenesis of photoreceptors in the retina by modulating both neurogenesis and apoptosis.
PMID: 12714666 [PubMed - indexed for MEDLINE]
Retinal pigment epithelial acid lipase activity and lipoprotein receptors: effects of dietary omega-3 fatty acids.
Department of Ophthalmology, University of Michigan, Ann Arbor, USA.
PURPOSE: To show that fish oil-derived omega-3 polyunsaturated fatty acids, delivered to the retinal pigment epithelium (RPE) by circulating low-density lipoproteins (LDL), enhance already considerable RPE lysosomal acid lipase activity, providing for more efficient hydrolysis of intralysosomal RPE lipids, an effect that may help prevent development of age-related macular degeneration (ARMD). METHODS: Colorimetric biochemical and histochemical techniques were used to demonstrate RPE acid lipase in situ, in vitro, and after challenge with phagocytic stimuli. Receptor-mediated RPE uptake of fluorescently labeled native, aceto-acetylated, and oxidized LDL was studied in vitro and in vivo. LDL effects on RPE lysosomal enzymes were assessed. Lysosomal enzyme activity was compared in RPE cells from monkeys fed diets rich in fish oil to those from control animals and in cultured RPE cells exposed to sera from these monkeys. RESULTS: RPE acid lipase activity was substantial and comparable to that of mononuclear phagocytes. Acid lipase activity increased significantly following phagocytic challenge with photoreceptor outer segment (POS) membranes. Receptor-mediated RPE uptake of labeled lipoproteins was determined in vitro. Distinctive uptake of labeled lipoproteins occurred in RPE cells and mononuclear phagocytes in vivo. Native LDL enhanced RPE lysosomal enzyme activity. RPE lysosomal enzymes increased significantly in RPE cells from monkeys fed fish oil-rich diets and in cultured RPE cells exposed to their sera. CONCLUSIONS: RPE cells contain substantial acid lipase for efficient metabolism of lipids imbibed by POS phagocytosis and LDL uptake. Diets rich in fish oil-derived omega-3 fatty acids, by enhancing acid lipase, may reduce RPE lipofuscin accumulation, RPE oxidative damage, and the development of ARMD.
PMID: 12545699 [PubMed - indexed for MEDLINE]
Back To Top
The benefits of fish oil extend across all age groups. Consumption of fish oil may lower the risk for cardiovascular disease and osteoporosis in post-menopausal women. (Pre)Menstrual symptoms such as menstrual pain are often alleviated from the use of fish oil supplementation. Omega 3 fatty acids are converted into pain relieving substances (prostaglandins type-3) that control contractions of the uterus, which cause the cramping.
Published Clinical Studies
Dietary fish oil decreases C-reactive protein, interleukin-6, and triacylglycerol to HDL-cholesterol ratio in postmenopausal women on HRT.
Ciubotaru I, Lee YS, Wander RC.
Department of Nutrition, The University of North Carolina at Greensboro, Greensboro, NC 27402, USA.
BACKGROUND: Atherogenesis is a complex process involving both a low-grade inflammation and a disturbed lipid profile. Although dietary fish and fish oil improve the latter of these two risk factors, their impact on the former is less clear. OBJECTIVE: This study addressed the effect of supplementation with fish oil in doses achievable with diet on serum C-reactive protein (CRP), interleukin-6 (IL-6), and the lipid profile. METHODS AND RESULTS: Thirty healthy subjects taking HRT were randomly divided into three groups and supplemented for five weeks with 14 g/day safflower oil (SO), 7 g/day of both safflower oil and fish oil (LFO), or 14 g/day fish oil (HFO). Measurements included serum high-sensitivity CRP, IL-6 in plasma and in cell culture supernatant collected from 24-hr lipopolysaccharide (LPS)-stimulated whole blood, and lipid profile markers. CRP and IL-6 were adjusted for body mass index (BMI). Fish oil supplementation significantly decreased CRP and IL-6 compared to SO, with a greater effect in the LFO than HFO groups. Plasma triacylglycerol (TG) and the TG/HDL-C ratio were significantly lower in the HFO compared to the SO group. CONCLUSIONS: These results suggest that dietary fish oil may decrease the risk for cardiovascular disease through the modulation of both plasma lipids and inflammatory markers in healthy postmenopausal women.
PMID: 14505813 [PubMed - in process]
Back To Top