Omega-3 Fatty Acids
Comprehensive information on omega-3 fatty acids for treating depression, ADHD, bipolar disorder and schizophrenia. Learn about the usage, dosage, side-effects of omega-3 fatty acids.
Also Known As:essential fatty acids (EFAs), polyunsaturated fatty acids (PUFAs)
- Dietary Sources
- Available Forms
- How to Take It
- Possible Interactions
- Supporting Research
Omega-3 fatty acids are considered essential fatty acids, which means that they are essential to human health but cannot be manufactured by the body. For this reason, omega-3 fatty acids must be obtained from food. Omega-3 fatty acids can be found in fish and certain plant oils. It is important to maintain an appropriate balance of omega-3 and omega-6 (another essential fatty acid) in the diet as these two substances work together to promote health. Also known as polyunsaturated fatty acids (PUFAs), omega-3 and omega-6 fatty acids play a crucial role in brain function as well as normal growth and development.
There are three major types of omega 3 fatty acids that are ingested in foods and used by the body: alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). Once eaten, the body converts ALA to EPA and DHA, the two types of omega-3 fatty acids more readily used by the body. Extensive research indicates that omega-3 fatty acids reduce inflammation and help prevent certain chronic diseases such as heart disease and arthritis. These essential fatty acids are highly concentrated in the brain and appear to be particularly important for cognitive and behavioral function. In fact, infants who do not get enough omega-3 fatty acids from their mothers during pregnancy are at risk for developing vision and nerve problems.
As mentioned previously, it is very important to maintain a balance between omega-3 and omega-6 fatty acids in the diet. Omega-3 fatty acids help reduce inflammation and most omega-6 fatty acids tend to promote inflammation. An inappropriate balance of these essential fatty acids contributes to the development of disease while a proper balance helps maintain and even improve health. A healthy diet should consist of roughly one to four times more omega-6 fatty acids than omega-3 fatty acids. The typical American diet tends to contain 11 to 30 times more omega-6 fatty acids than omega-3 fatty acids and many researchers believe this imbalance is a significant factor in the rising rate of inflammatory disorders in the United States.
In contrast, however, the Mediterranean diet consists of a healthier balance between omega-3 and omega-6 fatty acids and many studies have shown that people who follow this diet are less likely to develop heart disease. The Mediterranean diet does not include much meat (which is high in omega-6 fatty acids) and emphasizes foods rich in omega-3 fatty acids including whole grains, fresh fruits and vegetables, fish, olive oil, garlic, as well as moderate wine consumption.
Studies suggest that omega-3 fatty acids may be helpful in treating a variety of conditions. The evidence is strongest for heart disease and problems that contribute to heart disease, but the range of possible uses for omega-3 fatty acids include:
Those who follow a Mediterranean-style diet tend to have higher HDL ("good") cholesterol levels. Similar to those who follow a Mediterranean diet, Inuit Eskimos, who consume high amounts of omega-3 fatty acids from fatty fish, also tend to have increased HDL cholesterol and decreased triglycerides (fatty material that circulates in the blood). In addition, fish oil supplements containing EPA and DHA have been shown to reduce LDL ("bad") cholesterol and triglycerides. Finally, walnuts (which are rich in ALA) have been shown to lower total cholesterol and triglycerides in people with high cholesterol.
High Blood Pressure
Several studies suggest that diets and/or supplements rich in omega-3 fatty acids lower blood pressure significantly in people with hypertension. Fish high in mercury (such as tuna) should be avoided, however, because they may increase blood pressure.
One of the best ways to help prevent and treat heart disease is to eat a low-fat diet and to replace foods rich in saturated and trans-fat with those that are rich in monounsaturated and polyunsaturated fats (including omega-3 fatty acids). Evidence suggests that EPA and DHA found in fish oil help reduce risk factors for heart disease including high cholesterol and high blood pressure. There is also strong evidence that these substances can help prevent and treat atherosclerosis by inhibiting the development of plaque and blood clots, each of which tends to clog arteries. Studies of heart attack survivors have found that daily omega-3 fatty acid supplements dramatically reduce the risk of death, subsequent heart attacks, and stroke. Similarly, people who eat an ALA-rich diet are less likely to suffer a fatal heart attack.
Strong evidence from population-based studies suggests that omega-3 fatty acid intake (primarily from fish), helps protect against stroke caused by plaque buildup and blood clots in the arteries that lead to the brain. In fact, eating at least two servings of fish per week can reduce the risk of stroke by as much as 50%. However, people who eat more than three grams of omega-3 fatty acids per day (equivalent to 3 servings of fish per day) may be at an increased risk for hemorrhagic stroke, a potentially fatal type of stroke in which an artery in the brain leaks or ruptures.
People with diabetes tend to have high triglyceride and low HDL levels. Omega-3 fatty acids from fish oil can help lower triglycerides and raise HDL, so people with diabetes may benefit from eating foods or taking supplements that contain DHA and EPA. ALA (from flaxseed, for example) may not have the same benefit as DHA and EPA because some people with diabetes lack the ability to efficiently convert ALA to a form of omega-3 fatty acids that the body can use readily.
Many people who are overweight suffer from poor blood sugar control, diabetes, and high cholesterol. Studies suggest that overweight people who follow a weight loss program including exercise tend to achieve better control over their blood sugar and cholesterol levels when fish rich in omega-3 fatty acids (such as salmon, mackerel, and herring) is a staple in their low fat diet.
Most clinical studies investigating the use of omega-3 fatty acid supplements for inflammatory joint conditions have focused almost entirely on rheumatoid arthritis. Several articles reviewing the research in this area conclude that omega-3 fatty acid supplements reduce tenderness in joints, decrease morning stiffness, and allow for a reduction in the amount of medication needed for people with rheumatoid arthritis.
In addition, laboratory studies suggest that diets rich in omega-3 fatty acids (and low in omega-6 fatty acids) may benefit people with other inflammatory disorders, such as osteoarthritis. In fact, several test tube studies of cartilage-containing cells have found that omega-3 fatty acids decrease inflammation and reduce the activity of enzymes that destroy cartilage. Similarly, New Zealand green lipped mussel (Perna canaliculus), another potential source of omega-3 fatty acids, has been shown to reduce joint stiffness and pain, increase grip strength, and enhance walking pace in a small group of people with osteoarthritis. In some participants, symptoms worsened before they improved.
Studies suggest that omega-3 fatty acids such as EPA help increase levels of calcium in the body, deposit calcium in the bones, and improve bone strength. In addition, studies also suggest that people who are deficient in certain essential fatty acids (particularly EPA and gamma-linolenic acid [GLA], an omega-6 fatty acid) are more likely to suffer from bone loss than those with normal levels of these fatty acids. In a study of women over 65 with osteoporosis, those given EPA and GLA supplements experienced significantly less bone loss over three years than those who were given a placebo. Many of these women also experienced an increase in bone density.
Omega-3 for depression
People who do not get enough omega-3 fatty acids or do not maintain a healthy balance of omega-3 to omega-6 fatty acids in their diet may be at an increased risk for depression. The omega-3 fatty acids are important components of nerve cell membranes. They help nerve cells communicate with each other, which is an essential step in maintaining good mental health.
Levels of omega-3 fatty acids were found to be measurably low and the ratio of omega-6 to omega-3 fatty acids were particularly high in a study of patients hospitalized for depression. In a study of people with depression, those who ate a healthy diet consisting of fatty fish two to three times per week for 5 years experienced a significant reduction in feelings of depression and hostility.
Omega-3 for Bipolar (Manic/depression)
In a study of 30 people with bipolar disorder, those who were treated with EPA and DHA (in combination with their usual mood stabilizing medications) for four months experienced fewer mood swings and recurrence of either depression or mania than those who received placebo. A similar but larger study is currently underway at the University of California- Los Angeles School of Medicine.
Omega-3 for Schizophrenia
Preliminary evidence suggests that people with schizophrenia experience an improvement in symptoms when given omega-3 fatty acids. However, a recent well-designed study concluded that EPA supplements are no better than placebo in improving symptoms of this condition. The conflicting results suggest that more research is needed before conclusions can be drawn about the benefit of omega-3 fatty acids for schizophrenia. Similar to diabetes, people with schizophrenia may not be able to convert ALA to EPA or DHA efficiently.
Omega-3 for 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 their bodies. In a study of nearly 100 boys, those with lower levels of omega-3 fatty acids demonstrated more learning and behavioral problems (such as temper tantrums and sleep disturbances) than boys with normal omega-3 fatty acid levels. In animal studies, low levels of omega-3 fatty acids have been shown to lower the concentration of certain brain chemicals (such as dopamine and serotonin) related to attention and motivation. Studies that examine the ability of omega-3 supplements to improve symptoms of attention deficit/hyperactivity disorder (ADHD) are still needed. At this point in time, eating foods high in omega-3 fatty acids is a reasonable approach for someone with attention deficit/hyperactivity disorder (ADHD).
Omega-3 for Eating Disorders
Studies suggest that men and women with anorexia nervosa have lower than optimal levels of polyunsaturated fatty acids (including ALA and GLA). To prevent the complications associated with essential fatty acid deficiencies, some experts recommend that treatment programs for anorexia nervosa include PUFA-rich foods such as fish and organ meats (which include omega-6 fatty acids).
Essential fatty acids have been used to reduce inflammation and promote wound healing in burn victims. Animal research indicates that omega-3 fatty acids help promote a healthy balance of proteins in the body -- protein balance is important for recovery after sustaining a burn. Further research is necessary to determine whether omega 3s benefit people in the same way.
In one study, 13 people with a particular sensitivity to the sun known as photodermatitis showed significantly less sensitivity to UV rays after taking fish oil supplements. Still, research indicates that topical sunscreens are much better at protecting the skin from damaging effects of the sun than omega-3 fatty acids.In another study of 40 people with psoriasis, those who were treated with medications and EPA supplements did better than those treated with the medications alone. In addition, many clinicians believe that flaxseed (which contains omega-3 fatty acids) is helpful for treating acne.
Inflammatory Bowel Disease (IBD)
When added to medication, such as sulfasalazine (a standard medication for IBD), omega-3 fatty acids may reduce symptoms of Crohn's disease and ulcerative colitis -- the two types of IBD. More studies to investigate this preliminary finding are under way. In animals, it appears that ALA works better at decreasing bowel inflammation than EPA and DHA. Plus, fish oil supplements can cause side effects that are similar to symptoms of IBD (such as flatulence and diarrhea). Time-release preparations may help reduce these unwanted effects.
Preliminary research suggests that omega-3 fatty acid supplements (in the form of perilla seed oil, which is rich in ALA) may decrease inflammation and improve lung function in adults with asthma. Omega-6 fatty acids have the opposite effect: they tend to increase inflammation and worsen respiratory function. In a small, well-designed study of 29 children with asthma, those who took fish oil supplements rich in EPA and DHA for 10 months had improvement in their symptoms compared to children who took a placebo pill.
A questionnaire administered to more than 3,000 people over the age of 49 found that those who consumed more fish in their diet were less likely to have macular degeneration (a serious age-related eye condition that can progress to blindness) than those who consumed less fish. Similarly, a study comparing 350 people with macular degeneration to 500 without found that those with a healthy dietary balance of omega-3 and omega-6 fatty acids and higher intake of fish in their diets were less likely to have this particular eye disorder. Another larger study confirms that EPA and DHA from fish, four or more times per week, may reduce the risk of developing macular degeneration. Notably, however, this same study suggests that ALA may actually increase the risk of this eye condition.
In a study of nearly 200 Danish women, those with the highest dietary intake of omega-3 fatty acids had the mildest symptoms during menstruation.
Consuming significant amounts of foods rich in omega-3 fatty acids appears to reduce the risk of colorectal cancer. For example, Eskimos, who tend to follow 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 while omega-6 fatty acids promote the growth of colon tumors. Daily consumption of EPA and DHA also appeared to slow or even reverse the progression of colon cancer in people with early stages of the disease.
However, in an animal study of rats with metastatic colon cancer (in other words, cancer that has spread to other parts of the body such as the liver), omega-3 fatty acids actually promoted the growth of cancer cells in the liver. Until more information is available, it is best for people with advanced stages of colorectal cancer to avoid omega-3 fatty acid supplements and diets rich in this substance.
Although not all experts agree, women who regularly consume foods rich in omega-3 fatty acids over many years may be less likely to develop breast cancer. In addition, the risk of dying from breast cancer may be significantly less for those who eat large quantities of omega-3 from fish and brown kelp seaweed (common in Japan). This is particularly true among women who substitute fish for meat. The balance between omega-3 and omega-6 fatty acids appears to play an important role in the development and growth of breast cancer. Further research is still needed to understand the effect that omega-3 fatty acids may have on the prevention or treatment of breast cancer. For example, several researchers speculate that omega-3 fatty acids in combination with other nutrients (namely, vitamin C, vitamin E, beta-carotene, selenium, and coenzyme Q10) may prove to be of particular value for preventing and treating breast cancer.
Laboratory and animal studies indicate that omega-3 fatty acids (specifically, DHA and EPA) may inhibit the growth of prostate cancer. Similarly, population based studies of groups of men suggest that a low-fat diet with the addition of omega-3 fatty acids from fish or fish oil help prevent the development of prostate cancer. Like breast cancer, the balance of omega-3 to omega-6 fatty acids appears to be particularly important for reducing the risk of this condition. ALA, however, may not offer the same benefits as EPA and DHA. In fact, one recent study evaluating 67 men with prostate cancer found that they had higher levels of ALA compared to men without prostate cancer. More research in this area is needed.
Although further research is needed, preliminary evidence suggests that omega-3 fatty acids may also prove helpful in protecting against certain infections and treating a variety of conditions including ulcers, migraine headaches, preterm labor, emphysema, psoriasis, glaucoma, Lyme disease, lupus, and panic attacks.
Fish oils and plant oils are the primary dietary source of omega-3 fatty acids. Another potential source of omega-3 fatty acids is New Zealand green lipped mussels (Perna canaliculus),used for centuries by the Maories to promote good health. EPA and DHA are found in cold-water fish such as salmon, mackerel, halibut, sardines, and herring. ALA is found in flaxseeds, flaxseed oil, canola (rapeseed) oil, soybeans, soybean oil, pumpkin seeds, pumpkin seed oil, purslane, perilla seed oil, walnuts, and walnut oil.
In addition to the dietary sources described, EPA and DHA can be taken in the form of fish oil capsules. Flaxseed, flaxseed oil, and fish oil should be kept refrigerated. Whole flaxseeds must be ground within 24 hours of use, otherwise the ingredients lose their activity. Flaxseeds are also available in ground form in a special mylar package so that the components in the flaxseeds stay active.
Be sure to buy omega-3 fatty acid supplements made by established companies who certify that their products are free of heavy metals such as mercury.
The precise safe and effective doses of all types of omega-3 fatty acid supplements in children have not been established.
EPA and DHA
- EPA and DHA are naturally found in breast milk; therefore, infants that are breastfed should receive sufficient amounts of these substances.
- Formula for infants should contain less than 0.1% EPA.
- Formula for infants should contain 0.35% DHA.
- Infants that are breastfed should receive sufficient amounts of ALA if the mother has an adequate intake of this fatty acid.
- Infant formula should contain 1.5% ALA.
- Flaxseed oil may be added to a child's diet to help balance fatty acids. If an infant is breastfed, the mother may ingest oil or fresh ground seed to increase fat content in breast milk. See adult dosage below.
- Children (2 to 12 years): 1 tsp daily of ground flaxseeds or 1 tsp of fresh flaxseed oil for constipation
EPA and DHA
- The adequate daily intake of EPA and DHA for adults should be at least 220 mg of each per day.
- Two to three servings of fatty fish per week (roughly 1,250 mg EPA and DHA per day) are generally recommended to treat certain health conditions.
Fish oil supplements
- 3,000 to 4,000 mg standardized fish oils per day. (This amount corresponds to roughly 2 to 3 servings of fatty fish per week.)
- Typically, a 1,000 mg fish oil capsule has 180 mg EPA and 120 mg DHA
- The adequate daily intake of ALA for adults should be roughly 2,220 mg per day.
- One or two Tbsp of flaxseed oil per day is recommended for general health.
- Doses up to 3,000 mg per day are recommended to prevent certain conditions and doses up to 6,000 mg per day may be recommend to treat these conditions.
- 1 Tbsp two to three times per day or 2 to 4 tbsp one time per day. Grind before eating and take with lots of water.
- Decoction (liquid prepared by boiling down the flaxseed in water): A rounded Tbsp of whole seed simmered in 1 cup water for 10 to 15 minutes, strain and drink.
- 100 grams of raw flaxseed provides 22,800 mg of ALA
Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable healthcare provider.
Omega-3 fatty acids should be used cautiously by people who bruise easily, have a bleeding disorder, or take blood-thinning medications because excessive amounts of omega-3 fatty acids may lead to bleeding. In fact, people who eat more than three grams of omega-3 fatty acids per day (equivalent to 3 servings of fish per day) may be at an increased risk for hemorrhagic stroke, a potentially fatal condition in which an artery in the brain leaks or ruptures.
Fish oil can cause flatulence and diarrhea. Time-release preparations may reduce these side effects, however.
People with either diabetes or schizophrenia may lack the ability to convert ALA to EPA and DHA, the forms more readily used in the body. Therefore, people with these conditions should obtain their omega-3 fatty acids from dietary sources rich in EPA and DHA.
Although studies have found that regular consumption of fish (which includes the omega-3 fatty acids EPA and DHA) may reduce the risk of macular degeneration, a recent study including two large groups of men and women found that diets rich in ALA may substantially increase the risk of this disease. More research is needed in this area. Until this information becomes available, it is best for people with macular degeneration to obtain omega-3 fatty acids from sources of EPA and DHA, rather than ALA.
Similar to macular degeneration, fish and fish oil may protect against prostate cancer, but ALA may be associated with increased risk of prostate cancer in men. More research in this area is needed.
It is best to use lipid extracts rather than the powder form of New Zealand green lipped mussels because there is less chance of an allergic reaction. People who are allergic to seafood should avoid New Zealand green lipped mussels. In some individuals who take New Zealand green lipped mussels, arthritis symptoms may worsen before they improve.
If you are currently being treated with any of the following medications, you should not use omega-3 fatty acid supplements without first talking to your healthcare provider.
Omega-3 fatty acids may increase the blood-thinning effects of aspirin or warfarin. While the combination of aspirin and omega-3 fatty acids may actually be helpful under certain circumstances (such as heart disease), they should only be taken together under the guidance and supervision of your healthcare provider.
Taking omega-3 fatty acids during cyclosporine therapy may reduce toxic side effects (such as high blood pressure and kidney damage) associated with this medication in transplant patients.
Etretinate and Topical Steroids
The addition of omega-3 fatty acids (specifically EPA) to a drug regimen of etretinate and topical corticosteroids may improve symptoms of psoriasis.
Following certain nutritional guidelines, including increasing the amount of omega-3 fatty acids in your diet and reducing the omega-6 to omega-3 ratio, may allow a group of cholesterol lowering medications known as "statins" (such as atorvastatin, lovastatin, and simvastatin) to work more effectively.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
In an animal study, treatment with omega-3 fatty acids reduced the risk of ulcers from nonsteroidal anti-inflammatory drugs (NSAIDs). More research is needed to evaluate whether omega-3 fatty acids would have the same effects in people.
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Al-Harbi MM, Islam MW, Al-Shabanah OA, Al-Gharably NM. Effect of acute administration of fish oil (omega-3 marine triglyceride) on gastric ulceration and secretion induced by various ulcerogenic and necrotizing agents in rats. Fed Chem Toxic. 1995;33(7):555-558.
Albert CM, Hennekens CH, O'Donnell CJ, et al. Fish consumption and risk of sudden cardiac death. JAMA. 1998;279(1):23-28.
Ando H, Ryu A, Hashimoto A, Oka M, Ichihashi M. Linoleic acid and alpha-linolenic acid lightens ultraviolet-induced hyperpigmentation of the skin. Arch Dermatol Res. 1998;290(7):375-381.
Andreassen AK, Hartmann A, Offstad J, Geiran O, Kvernebo K, Simonsen S. Hypertension prophylaxis with omega-3 fatty acids in heart transplant recipients. J Am Coll Cardiol. 1997;29:1324-1331.
Angerer P, von Schacky C. n-3 polyunsaturated fatty acids and the cardiovascular system. Curr Opin Lipidol. 2000;11(1):57-63.
Anti M, Armelau F, Marra G, et al. Effects of different doses of fish oil on rectal cell proliferation in patients with sporadic colonic adenomas. Gastroenterology. 1994;107(6):1892-1894.
Appel LJ. Nonpharmacologic therapies that reduce blood pressure: a fresh perspective. Clin Cardiol. 1999;22(Suppl. III):III1-III5.
Arnold LE, Kleykamp D, Votolato N, Gibson RA, Horrocks L. Potential link between dietary intake of fatty acid and behavior: pilot exploration of serum lipids in attention-deficit hyperactivity disorder. J Child Adolesc Psychopharmacol. 1994;4(3):171-182.
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.
Badalamenti S, Salerno F, Lorenzano E, et al. Renal Effects of Dietary Supplementation With Fish Oil in Cyclosporine-Treated Liver Transplant Patients. Hepatol. 1995;2(6):1695-1701.
Baumgaertel A. Alternative and controversial treatments for attention-deficit/hyperactivity disorder. Pediatr Clin of North Am. 1999;46(5):977-992.
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.
Belluzzi A, Brignolia C, Campieri M, Pera A, Boschi S, Miglioli M. Effect of an enteric-coated fish-oil preparation on relapses in Crohn's disease. New Engl J Med. 1996;334(24):1558-1560.
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.
Bonaa KH, Bjerve KS, Nordoy A. Docosahexaenoic and eicosapentaenoic acids in plasma phospholipids are divergently associated with high density lipoprotein in humans. Arterioscler Thromb. 1992;12(6):675-681.
Broadhurst CL, Cunnane SC, Crawford MA. Rift Valley lake fish and shellfish provided brain-specific nutrition for early Homo. Br J Nutr. 1998;79(1):3-21.
Brown DJ, Dattner AM. Phytotherapeutic approaches to common dermatologic conditions. Arch Dermtol. 1998;134:1401-1404.
Bruinsma KA, Taren DL. Dieting, essential fatty acid intake, and depression. Nutrition Rev. 2000;58(4):98-108.
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.
Calder PC. n-3 polyunsaturated fatty acids, inflammation and immunity: pouring oil on troubled waters or another fishy tale? Nut Res. 2001;21:309-341.
Caron MF, White CM. Evaluation of the antihyperlipidemic properties of dietary supplements. Pharmacotherapy. 2001;21(4):481-487.
Cellini M, Caramazzu N, Mangiafico P, Possati GL, Caramazza R. Fatty acid use in glaucomatous optic neuropathy treatment. Acta Ophthalmol Scand Suppl. 1998;227:41-42.
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.
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.
Clark WF, Kortas C, Heidenheim AP, Garland J, Spanner E, Parbtani A. Flaxseed in lupus nephritis: a two - Å“year nonplacebo-controlled crossover study. J Am Coll Nutr. 2001;20(2 Suppl):143-148.
Connolly JM, Gilhooly EM, Rose DP. Effects of reduced dietary linoleic acid intake, alone or combined with an algal source of docosahexaenoic acid, on MDA-MD-231 breast cancer cell growth and apoptosis in nude mice. Nutrition Can. 1999;35(1):44-49.
Connor SL, Connor WE. Are fish oils beneficial in the prevention and treatment of coronary artery disease? Am J Clin Nutr. 1997;66(suppl):1020S-1031S.
Curtis CL, Hughes CE, Flannery CR, Little CB, Harwood JL, Caterson B. N-3 fatty acids specifically modulate catabolic factors involved in articular cartilage degradation. J Biol Chem. 2000;275(2):721-724.
Danao-Camara TC, Shintani TT. The dietary treatment of inflammatory arthritis: case reports and review of the literature. Hawaii Med J. 1999;58(5):126-131.
Danno K, Sugie N. Combination therapy with low-dose etretinate and eicosapentaenoic acid for psoriasis vulgaris. J Dermatol. 1998;25:703-705.
Davidson MH, Maki KC, Kalkowski J, Schaefer EJ, Torri SA, Drennan KB. Effects of docosahexeaenoic acid on serum lipoproteins in patients with combined hyperlipidemia. A randomized, double-blind, placebo-controlled trial. J Am Coll Nutr. 1997;16:3:236-243.
de Deckere EAM. Possible beneficial effect of fish and fish n-3 polyunsaturated fatty acids in breast and colorectal cancer. Eur J Cancer Prev. 1999;8:213-221.
deDeckere EAM, Korver O, Verschuren PM, Katan MB. Health aspects of fish and n-3 polyunsaturated fatty acids from plant and marine origin. Eur J Clin Nutr. 1998;52(10):749-753.
de Logeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999;99(6):779-785.
De-Souza DA, Greene LJ. Pharmacological nutrition after burn injury. J Nutr. 1998;128:797-803.
Deutch B. Menstrual pain in Danish women correlated with low n-3 polyunsaturated fatty acid intake. Eur J Clin Nutr. 1995;49(7):508-516.
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.
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.
Edwards R, Peet M, Shay J, Horrobin D. Omega-3 polyunsaturated fatty acid levels in the diet and in red blood cell membranes of depressed patients. J Affect Disord. 1998;48(2-3):149-155.
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.
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.
Foulon T, Richard MJ, Payen N, et al. Effects of fish oil fatty acids on plasma lipids and lipoproteins and oxidant-antioxidant imbalance in healthy subjects. Scan J Clin Lab Invest. 1999;59(4):239-248.
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.
Friedberg CE, Janssen MJ, Heine RJ, Grobbee DE. Fish oil and glycemic control in diabetes: a meta-analysis. Diabetes Care. 1998;21:494-500.
Frieri G, Pimpo MT, Palombieri A, Melideo D, Marcheggiano A, Caprilli R, et al. Polyunsaturated fatty acid dietary supplementation: an adjuvant approach to treatment of Helicobacter pylori infection. Nut Res. 2000;20(7):907-916.
Gamez-Mez N, Higuera-Ciapara I, Calderon de la Barca AM, Vazquez-Moreno L, Noriega-Rodriquez J, Angulo-Guerrero O. Seasonal variation in the fatty acid composition and quality of sardine oil from Sardinops sagax caeruleus of the Gulf of California. Lipids. 1999;34)6_:639-642.
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.
Geerling BJ, Houwelingen AC, Badart-Smook A, StockbrÃƒÆ’Ã‚ ¼gger RW, Brummer R-JM. Fat intake and fatty acid profile in plasma phospholipids and adipose tissue in patients with Crohn's disease, compared with controls. Am J Gastroenterol. 1999;94(2):410-417.
Gibson SL, Gibson RG. The treatment of arthritis with a lipid extract of Perna canaliculus: a randomized trial. Complement Ther Med. 1998;6:122-126.
Griffini P, Fehres O, Klieverik L, et al. Dietary omega-3 polyunsaturated fatty acids promote colon carcinoma metastasis in rat liver. Can Res. 1998;58(15):3312-3319.
GISSI-Prevenzione Investigators. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet. 1999;354:447-455
Halpern G-M. Anti-inflammatory effects of a stabilized lipid extract of Perna canaliculus (Lyprinol). Allerg Immunol (Paris). 2000;32(7):272-278.
Harper CR, Jacobson TA. The fats of life: the role of omega-3 fatty acids in the prevention of coronary heart disease. Arch Intern Med. 2001;161(18):2185-2192.
Harris WS. N-3 fatty acids and serum lipoproteins: human studies. Am J Clin Nutr. 1997;65(5):1645S (10).
Hayashi N, Tsuguhiko T, Yamamori H, et al. Effect of intravenous w-6 and w-3 fat emulsions on nitrogen retention and protein kinetics in burned rats. Nutrition. 1999;15(2):135-139.
Hibbeln JR. Fish consumption and major depression. Lancet. 1998;351(9110):1213.
Hibbeln JR, Salem N, Jr. Dietary polyunsaturated fatty acids and depression: when cholesterol does not satisfy. Am J Clin Nut. 1995;62(1):1-9.
Holman RT, Adams CE, Nelson RA, et al. Patients with anorexia nervosa demonstrate deficiencies of selected essential fatty acids, compensatory changes in nonessential fatty acids and decreased fluidity of plasma lipids. J Nutr. 1995;125:901-907.
Homan van der Heide JJ, Bilo HJ, Tegzess AM, Donker AJ. The effects of dietary supplementation with fish oil on renal function in cyclosporine-treated renal transplant recipients. Transplantation. 1990;49:523-527.
Horrobin DF. The membrane phospholipid hypothesis as a biochemical basis for the neurodevelopmental concept of schizophrenia. Schizophr Res. 1998;30(3):193-208.
Horrobin DF, Bennett CN. depression and bipolar disorder: relationships to impaired fatty acid and phospholipid metabolism and to diabetes, cardiovascular disease, immunological abnormalities, cancer, ageing and osteoporosis. Prostaglandins Leukot Essent Fatty Acids. 1999;60(4):217-234.
Horrocks LA, Yeo YK. Health benefits of docosahexaenoic acid. Pharmacol Res. 1999;40(3):211-225.
Howe PR. Can we recommend fish oil for hypertension? Clin Exp Pharmacol Physiol. 1995;22(3):199-203.
Hrboticky N, Zimmer B, Weber PC. Alpha-Linolenic acid reduces the lovastatin-induced rise in arachidonic acid and elevates cellular and lipoprotein eicosapentaenoic and docosahexaenoic acid levels in Hep G2 cells. J Nutr Biochem. 1996;7:465-471.
Hu FB, Stampfer MJ, Manson JE et al. Dietary intake of alpha-linolenic acid and risk of fatal ischemic heart disease among women. Am J Clin Nutr. 1999;69:890-897.
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.
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.
Juhl A, Marniemi J, Huupponen R, Virtanen A, Rastas M, Ronnemaa T. Effects of diet and simvistatin on serum lipids, insulin, and antioxidants in hypercholesterolemic men; a randomized controlled trial. JAMA. 2002;2887(5):598-605.
Klurfeld DM, Bull AW. Fatty acids and colon cancer in experimental models. Am J Clin Nut. 1997;66(6 Suppl):1530S-1538S.
Kooijmans-Coutinho MF, Rischen-Vos J, Hermans J, Arndt JW, van der Woude FJ. Dietary fish oil in renal transplant recipients treated with cyclosporin-A: no beneficial effects shown. J Am Soc Nephrol. 1996;7(3):513-518.
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.
Kremer JM. N-3 fatty acid supplements in rheumatoid arthritis. Am J Clin Nutr. 2000;(suppl 1):349S-351S.
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.
Kris-Etherton PM, Taylor DS, Yu-Poth S, et al. Polyunsaturated fatty acids in the food chain in the United States. Am J Clin Nutr. 2000;71(1 Suppl):179S-188S.
Kruger MC, Coetzer H, de Winter R, Gericke G, van Papendorp DH. Calcium, gamma-linolenic acid and eicosapentaenoic acid supplementation in senile osteoporosis. Aging Clin Exp Res. 1998;10:385-394.
Kruger MC, Horrobin DF. Calcium metabolism, osteoporosis and essential fatty acids: a review. Prog Lipid Res. 1997;36:131-151.
Kulkarni PS, Srinivasan BD. Cyclooxygenase and lipoxygenase pathways in anterior uvea and conjunctiva. Prog Clin Biol Res. 1989;312:39-52.
Kuroki F, Iida M, Matsumoto T, Aoyagi K, Kanamoto K, Fujishima M. Serum n3 polyunsaturated fatty acids are depleted in Crohn's disease. Dig Dis Sci. 1997;42(6):1137-1141.
Laugharne JD, Mellor JE, Peet M. Fatty acids and schizophrenia. Lipids. 1996;31(Suppl):S-163-165.
Levy E, Rizwan Y, Thibault L, et al. Altered lipid profile, lipoprotein composition, and oxidant and antioxidant status in pediatric Crohn disease. Am J Clin Nutr. 2000;71:807-815.
Lockwood K, Moesgaard S, Hanioka T, Folkers K. Apparent partial remission of breast cancer in 'high risk' patients supplemented with nutritional antioxidants, essential fatty acids, and coenzyme Q10. Mol Aspects Med. 1994;15Suppl:s231-s240.
Lopez-Miranda J, Gomez P, Castro P, et al. Mediterranean diet improves low density lipoproteins' susceptibility to oxidative modifications. Med Clin (Barc) [in Spanish]. 2000;115(10):361-365.
Lorenz-Meyer H, Bauer P, Nicolay C, Schulz B, Purrmann J, Fleig WE, et al. Omega-3 fatty acids and low carbohydrate diet for maintenance of remission in Crohn's disease. A randomized controlled multicenter trial. Study Group Members (German Crohn's Disease Study Group). Scan J Gastroenterol. 1996;31(8):778-785.
Mabile L, Piolot A, Boulet L, Fortin LJ, Doyle N, Rodriquez C, et al. Moderate intake of omega-3 fatty acids is associated with stable erythrocyte resistance to oxidative stress in hypertriglyceridemic subjects. Am J Clin Nutr. 2001;7494):449-456.
Mayser P, Mrowietz U, Arenberger P, Bartak P, Buchvald J, Christophers E, et al. Omega-3 fatty acid-based lipid infusion in patients with chronic plaque psoriasis: results of a double-blind, randomized, placebo controlled, multicenter trial. J Am Acad Dermatol. 1998;38(4):539-547.
Meydani M. Omega-3 fatty acids alter soluble markers of endothelial function in coronary heart disease patients. Nutr Rev. 2000;58(2 pt 1):56-59.
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.
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.
Mori TA, Bao, DQ, Burke V, et al. Dietary fish as a major component of a weight-loss diet: effect on serum lipids, glucose, and insulin metabolism in overweight hypertensive subjects. Am J Clin Nutr. 1999;70:817-825.
Morris MC, Sacks F, Rosner B. Does fish oil lower blood pressure? A meta-analysis of controlled trials. Circulation. 1993;88:523-533.
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.
Nestel PJ, Pomeroy SE, Sasahara T, et al. Arterial compliance in obese subjects is improved with dietary plant n-3 fatty acid from flaxseed oil despite increased LDL oxidizability. Arterioscler Thromb Vasc Biol. July 1997;17(6):1163-1170.
Newcomer LM, King IB, Wicklund KG, Stanford JL. The association of fatty acids with prostate cancer risk. Prostate. 2001;47(4):262-268.
Okamoto M, Misunobu F, Ashida K, et al. Effects of dietary supplementation with n-3 fatty acids compared with n-6 fatty acids on bronchial asthma. Int Med. 2000;39(2):107-111.
Okamoto M, Misunobu F, Ashida K, et al. Effects of perilla seed oil supplementation on leukotriene generation by leucocytes in patients with asthma associated with lipometabolism. Int Arch Allergy Immunol. 2000;122(2):137-142.
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.
Prisco D, Paniccia R, Bandinelli B, et al. Effect of medium term supplementation with a moderate dose of n-3 polyunsaturated fatty acid on blood pressure in mild hypertensive patients. Thromb Res. 1998;91:105-112.
Paul KP, Leichsenring M, Pfisterer M, Mayatepek E, Wagner D, Domann M, et al. Influence of n-6 and n-3 polyunsaturated fatty acids on the resistance to experimental tuberculosis. Metabolism. 1997;46(6):619-624.
Peet M, Laugharne JD, Mellor J, et al. Essential fatty acid deficiency in erythrocyte membranes from chronic schizophrenic patients, and the clinical effects of dietary supplementation. Prostaglandins Leukot Essent Fatty Acids. 1996;55(1-2):71-75.
Puri B, Richardson AJ, Horrobin DF, et al. Eicosapentaenoic acid treatment in schizophrenia associated with symptom remission, normalisation of blood fatty acids, reduced neuronal membrane phospholipid turnover and structural brain changes. Int J Clin Pract. 2000;54(1):57-63.
Rhodes LE, Durham BH, Fraser WD, Friedmann PS. Dietary fish oil reduces basal and ultraviolet B-generated PGE2 levels in skin and increases the threshold to provocation of polymorphic light eruption. J Invest Dermatol. 1995;105(4):532-535.
Rhodes LE, White SI. Dietary fish oil as a photoprotective agent in hydroa vacciniforme. Br J Dermatol. 1998;138(1):173-178.
Richardson AJ, Puri BK. The potential role of fatty acids in attention-deficit/hyperactivity disorder. Prostaglandins Leukot Essent Fatty Acids. 2000;63(1/2):79-87.
Rose DP, Connolly JM, Coleman M. Effect of omega-3 fatty acids on the progression of metastases after the surgical excision of human breast cancer cell solid tumors growing in nude mice. Clin Cancer Res. 1996;2:1751-1756.
Sakaguchi K, Morita I, Murota S. Eicosapentaenoic acid inhibits bone loss due to ovariectomy in rats. Prostaglandins Leukot Essent Fatty Acids. 1994;50:81-84.
Sanders TA, Hinds A. The influence of a fish oil high in docosahexaenoic acid on plasma lipoprotein and vitamin E concentrations and haemostatic function in healthy male volunteers. Br J Nutr. 1992;68(1):163-173.
Seddon JM, Rosner B, Sperduto RD, Yannuzzi L, Haller JA, Blair NP, Willett W. Dietary fat and risk for advanced age-related macular degeneration. Arch Opthalmol. 2001;119(8):1191-1199.
Shils ME, Olson JA, Shike M, Ross AC. Modern Nutrition in Health and Disease. 9th ed. Baltimore, Md: Williams & Wilkins; 1999:90-92, 1377-1378.
Shoda R, Matsueda K, Yamato S, Umeda N. Therapeutic efficacy of N-3 polyunsaturated fatty acid in experimental Crohn's disease. J Gastroenterol. 1995;30(Suppl 8):98-101.
Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin Nutr. 1999;70(30 Suppl):560S-569S.
Simopoulos AP. Human requirement for N-3 polyunsaturated fatty acids. Poult Sci. 2000;79(7):961-970.
Smith W, Mitchell P, Leeder SR. Dietary fat and fish intake and age-related maculopathy. Arch Opthamol. 2000;118(3):401-404.
Soyland E, Funk J, Rajka G, Sandberg M, Thune P, Ruistad L, et al. Effect of dietary supplementation with very-long chain n-3 fatty acids in patients with psoriasis. N Engl J Med. 1993;328(25):1812-1816.
Stampfer MJ, Hu FB, Manson JE, Rimm EB, Willett WC. Primary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med. 2000;343(1):16-22
Stark KD, Park EJ, Maines VA, et al. Effect of fish-oil concentrate on serum lipids in postmenopausal women receiving and not receiving hormone replacement therapy in a placebo-controlled, double blind trial. Am J Clin Nutr. 2000;72:389-394.
Stevens LJ, Zentall SS, Abate ML, Kuczek T, Burgess JR. Omega-3 fatty acids in boys with behavior, learning and health problems. Physiol Behav. 1996;59(4/5):915-920.
Stevens LJ, Zentall SS, Deck JL, et al. Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder. Am J Clin Nutr. 1995;62:761-768.
Stoll AL, Severus WE, Freeman MP, et al. Omega 3 fatty acids in bipolar disorder: a preliminary double-blind placebo-controlled trial. Arch Gen Psychiatry. 1999:56(5):407-412.
Stoll BA. Breast cancer and the Western diet: role of fatty acids and antioxidant vitamins. Eur J Cancer. 1998;34(12):1852-1856.
Terry P, Lichtenstein P, Feychting M, Ahlbom A, Wolk A. Fatty fish consumption and risk of prostate cancer. Lancet. 2001;357(9270):1764-1766.
Tsai W-S, Nagawa H, Kaizaki S, Tsuruo T, Muto T. Inhibitory effects of n-3 polyunsaturated fatty acids on sigmoid colon cancer transformants. J Gastroenterol. 1998;33:206-212.
Tsujikawa T, Satoh J, Uda K, Ihara T, Okamoto T, Araki Y, et al. Clinical importance of n-3 fatty acid-rich diet and nutritional education for the maintenance of remission in Crohn's disease. J Gastroenterol. 2000;35(2):99-104.
Ventura HO, Milani RV, Lavie CJ, Smart FW, Stapleton DD, Toups TS, Price HL. Cyclosporine induced hypertension. Efficacy of omega-3 fatty acids in patients after cardiac transplantation. Circulation. 1993;88(5 Pt 2):II281-II285.
von Schacky C, Angere P, Kothny W, Theisen K, Mudra H. The effect of dietary omega-3 fatty acids on coronary atherosclerosis: a randomized, double-blind, placebo-controlled trial. Ann Intern Med. 1999;130:554-562.
Voskuil DW, Feskens EJM, Katan MB, Kromhout D. Intake and sources of alpha-linolenic acid in Dutch elderly men. Euro J Clin Nutr. 1996;50(12):784-787.
Wagner W, Nootbaar-Wagner U. Prophylactic treatment of migraine with gamma-linolenic and alpha-linolenic acids. Cephalalgia. 1997;17(2):127-130.
Werbach MR. Nutritional Influences on Illness. 2nd ed. Tarzana, Calif: Third Line Press; 1993:13-22, 655-671.
Yehuda S, Rabinovitz S, Carasso RL, Mostofsky DI. Fatty acids and brain peptides. Peptides. 1998;19(2):407-419.
Yosefy C, Viskoper JR, Laszt A, Priluk R, Guita E, Varon D, et al. The effect of fish oil on hypertension, plasma lipids and hemostasis in hypertensive, obese, dyslipidemic patients with and without diabetes mellitus. Prostaglandins Leukot Essent Fatty Acids. 1999;61(2):83-87.
ZambÃƒÆ’Ã‚ ³n D, Sabate J, Munoz S, et al. Substituting walnuts for monounsaturated fat improves the serum lipid profile of hypercholesterolemic men and women. Ann Intern Med. 2000;132:538-546.
Zimmerman R, Radhakrishnan J, Valeri A, Appel G. Advances in the treatment of lupus nephritis. Ann Rev Med. 2001;52:63-78.
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Staff, H. (2008, December 21). Omega-3 Fatty Acids, HealthyPlace. Retrieved on 2020, January 28 from https://www.healthyplace.com/alternative-mental-health/supplements-vitamins/omega-3-fatty-acids