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n-3 fatty acids and cardiovascular disease. Breslow JL. Am J Clin Nutr. 2006 Jun;83(6 Suppl):1477S-1482S. Review. PMID: 16841857 The results of prospective cohort studies indicate that consuming fish or fish oil containing the n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) is associated with decreased cardiovascular death, whereas consumption of the vegetable oil-derived n-3 fatty acid {alpha}-linolenic acid is not as effective. Randomized control trials (RCTs) in the context of secondary prevention also indicate that the consumption of EPA plus DHA is protective at doses 3 g/d, EPA plus DHA can improve cardiovascular disease risk factors, including decreasing plasma triacylglycerols, blood pressure, platelet aggregation, and inflammation, while improving vascular reactivity. Mainly on the basis of the results of RCTs, the American Heart Association recommends that everyone eat oily fish twice per week and that those with coronary heart disease eat 1 g/d of EPA plus DHA from oily fish or supplements. Directions for future research include 1) RCTs to confirm the initial trials showing that EPA plus DHA decreases cardiovascular death and additional studies to determine whether this effect is due to EPA, DHA, or the combination; the dosage of the effective components; and whether the mechanism of action in humans is prevention of fatal arrhythmias. 2) Clinical studies to determine whether the reduction in cardiovascular disease risk factors is due to EPA, DHA, or the combination and the dosage of the effective components. 3) Clinical studies to determine whether vegetable oil-derived {alpha}-linolenic acid added to a diet enriched in n-6 fatty acids can effectively substitute for fish oil-derived EPA plus DHA.

"The affirmation that the omega-3 DHA can benefit cognitive and eye health offers hope to previously rejected claims. And it's business as usual regarding the overall health claims process, despite ratification of the Lisbon Treaty, said a European Commission representative. At the NutraIngredients Health Claims 2010 conference in Brussels, the EC's Lars Korsholm explained the regulatory state-of-play for DHA claims. "I think it will offer some hope to previously rejected claims in the sense that these claims that are now subject for discussion are generic in the sense that if other food business operators than those who actually submitted the application can claim to fulfill the conditions of use then they are equally entitled to use the claim," explains Korsholm. The statements come in relation to an October decision whereby the European Food Safety Authority (EFSA) affirmed that the omega-3 fatty acids, DHA and ALA, can benefit eye and cognitive development in babies. Responding to the public comment period for Merck Selbstmedikation GmbH's article 14 cognitive development claim that was rejected in March, EFSA affirmed its original stance that there was no need for additional supplementation of DHA (docosahexaenoic acid) and ALA (alpha-linolenic acid) because it already existed at adequate levels in the diet. It supported their role in foetal and newborn eye and brain development but said there was an adequate supply in breast milk. "

This study reinforces the principle that consumers will get a lot benefit from DHA supplementation, if DHA supplement taken regularly.

n-3 fatty acid dietary recommendations and food sources to achieve essentiality and cardiovascular benefits. Gebauer SK, Psota TL, Harris WS, Kris-Etherton PM. Am J Clin Nutr. 2006 Jun;83(6 Suppl):1526S-1535S. Review. PMID: 16841863 Dietary recommendations have been made for n-3 fatty acids, including {alpha}-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) to achieve nutrient adequacy and to prevent and treat cardiovascular disease. These recommendations are based on a large body of evidence from epidemiologic and controlled clinical studies. The n-3 fatty acid recommendation to achieve nutritional adequacy, defined as the amount necessary to prevent deficiency symptoms, is 0.6-1.2% of energy for ALA; up to 10% of this can be provided by EPA or DHA. To achieve recommended ALA intakes, food sources including flaxseed and flaxseed oil, walnuts and walnut oil, and canola oil are recommended. The evidence base supports a dietary recommendation of {approx}500 mg/d of EPA and DHA for cardiovascular disease risk reduction. For treatment of existing cardiovascular disease, 1 g/d is recommended. These recommendations have been embraced by many health agencies worldwide. A dietary strategy for achieving the 500-mg/d recommendation is to consume 2 fish meals per week (preferably fatty fish). Foods enriched with EPA and DHA or fish oil supplements are a suitable alternate to achieve recommended intakes and may be necessary to achieve intakes of 1 g/d.

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Egg fortification with n-3 polyunsaturated fatty acids (PUFA): nutritional benefits versus high n-6 PUFA western diets, and consumer acceptance. Shapira N, Weill P, Loewenbach R. Isr Med Assoc J. 2008 Apr;10(4):262-5. PMID: 18548978 Egg fortification with n-3 polyunsaturated fatty acids (PUFA): nutritional benefits versus high n-6 PUFA western diets, and consumer acceptance. Shapira N, Weill P, Loewenbach R. Isr Med Assoc J. 2008 Apr;10(4):262-5. PMID: 18548978 CONCLUSIONS: Effective concentration and transformation of supplemental n-3 PUFA/LCPUFA from feed to egg substantially enhanced egg n-3 PUFA %DRI, particularly of DHA, critical for health but often deficient. Such land-based n-3 PUFA/LCPUFA fortification may be applicable to high n-6 PUFA diets, fitting within cholesterol limitations and market criteria. It may contribute to general health and specific requirements (i.e., pregnancy and lactation), with possibilities of wide accessibility and standardization.

Docosahexaenoic acid-enriched egg consumption induces accretion of arachidonic acid in erythrocytes of elderly patients. Payet M, Esmail MH, Polichetti E, Le Brun G, Adjemout L, Donnarel G, Portugal H, Pieroni G. Br J Nutr. 2004 May;91(5):789-96. PMID: 15137931 doi:10.1079/BJN20041106

Omega-3 augmentation of sertraline in treatment of depression in patients with coronary heart disease: a randomized controlled trial. Carney RM, Freedland KE, Rubin EH, Rich MW, Steinmeyer BC, Harris WS. JAMA. 2009 Oct 21;302(15):1651-7. PMID: 19843899 Conclusions Treatment of patients with CHD and major depression with sertraline and omega-3 fatty acids did not result in superior depression outcomes at 10 weeks, compared with sertraline and placebo. Whether higher doses of omega-3 or sertraline, a different ratio of EPA to DHA, longer treatment, or omega-3 monotherapy can improve depression in patients with CHD remains to be determined

Effect of docosahexaenoic acid-rich fish oil supplementation on human leukocyte function. Gorjão R, Verlengia R, Lima TM, Soriano FG, Boaventura MF, Kanunfre CC, Peres CM, Sampaio SC, Otton R, Folador A, Martins EF, Curi TC, Portiolli EP, Newsholme P, Curi R. Clin Nutr. 2006 Dec;25(6):923-38. Epub 2006 May 11. PMID: 16697494 doi:10.1016/j.clnu.2006.03.004

Wang C, Harris WS, Chung M, Lichtenstein AH, Balk EM, Kupelnick B, Jordan HS, Lau J. \nn-3 Fatty acids from fish or fish-oil supplements, but not \nalpha-linolenic acid, benefit cardiovascular disease outcomes in \nprimary- and secondary-prevention studies: a systematic review. \nAm J Clin Nutr. 2006 Jul;84(1):5-17. Review. \nPMID: 16825676

Prostaglandin E2 production and T cell function after fish-oil supplementation: response to antioxidant cosupplementation. Trebble TM, Wootton SA, Miles EA, Mullee M, Arden NK, Ballinger AB, Stroud MA, Burdge GC, Calder PC. Am J Clin Nutr. 2003 Sep;78(3):376-82. PMID: 12936918

Short-term fish oil supplementation improved innate immunity, but increased ex vivo oxidation of LDL in man--a pilot study. Turini ME, Crozier GL, Donnet-Hughes A, Richelle MA. Eur J Nutr. 2001 Apr;40(2):56-65. PMID: 11518200 DOI: 10.1007/s003940170016

Omega-3 fatty acid supplementation decreases matrix metalloproteinase-9 production in relapsing-remitting multiple sclerosis(,). Shinto L, Marracci G, Baldauf-Wagner S, Strehlow A, Yadav V, Stuber L, Bourdette D. Prostaglandins Leukot Essent Fatty Acids. 2009 Feb-Mar;80(2-3):131-6. Epub 2009 Jan 25. PMID: 19171471 doi:10.1016/j.plefa.2008.12.001

Hemostatic factors and platelet aggregation after a fish-enriched diet or fish oil or docosahexaenoic acid supplementation. Agren JJ, Väisänen S, Hänninen O, Muller AD, Hornstra G. Prostaglandins Leukot Essent Fatty Acids. 1997 Oct;57(4-5):419-21. PMID: 9430389 doi:10.1016/S0952-3278(97)90421-X    

Hallahan B, Hibbeln JR, Davis JM, Garland MR. Omega-3 fatty acid supplementation in patients with recurrent self-harm. Single-centre double-blind randomised controlled trial. Br J Psychiatry. 2007 Feb;190:118-22. PMID: 17267927 [PubMed - indexed for M

Dietary supplementation with eicosapentaenoic acid, but not with other long-chain n-3 or n-6 polyunsaturated fatty acids, decreases natural killer cell activity in healthy subjects aged >55 y. Thies F, Nebe-von-Caron G, Powell JR, Yaqoob P, Newsholme EA, Calder PC. Am J Clin Nutr. 2001 Mar;73(3):539-48. PMID: 11237929

Arachidonic acid and docosahexaenoic acid supplementation increases coronary flow velocity reserve in Japanese elderly individuals. Oe H, Hozumi T, Murata E, Matsuura H, Negishi K, Matsumura Y, Iwata S, Ogawa K, Sugioka K, Takemoto Y, Shimada K, Yoshiyama M, Ishikura Y, Kiso Y, Yoshikawa J. Heart. 2008 Mar;94(3):316-21. Epub 2007 Jun 25. PMID: 17591648 doi:10.1136/hrt.2006.113159

Dietary omega-3 polyunsaturated fatty acids plus vitamin E restore immunodeficiency and prolong survival for severely ill patients with generalized malignancy: a randomized control trial. Gogos CA, Ginopoulos P, Salsa B, Apostolidou E, Zoumbos NC, Kalfarentzos F. Cancer. 1998 Jan 15;82(2):395-402. PMID: 9445198 DOI: 10.1002/(SICI)1097-0142(19980115)82:23.0.CO;2-1 Dietary supplementation with omega-3 PUFA (18 g/day) restored both the Th/Ts cell ratio and TNF production by endotoxin-stimulated PBMC. Our finding is not in accordance with former reports that long term consumption of omega-3 PUFA decreases T cell mitogenic response, DTH, and the percentage of T-helper cells,[28] and this may be the result of the parallel antioxidant effect of vit E. Most significantly, omega-3 PUFA increased the survival of all our patients, ...

Association of n-3 polyunsaturated fatty acids with stability of atherosclerotic plaques: a randomised controlled trial. Thies F, Garry JM, Yaqoob P, Rerkasem K, Williams J, Shearman CP, Gallagher PJ, Calder PC, Grimble RF. Lancet. 2003 Feb 8;361(9356):477-85. PMID: 12583947 doi:10.1016/S0140-6736(03)12468-3 Interpretation Atherosclerotic plaques readily incorporate n-3 PUFAs from fish-oil supplementation, inducing changes that can enhance stability of atherosclerotic plaques. By contrast, increased consumption of n-6 PUFAs does not affect carotid plaque fatty-acid composition or stability over the time course studied here. Stability of plaques could explain reductions in non-fatal and fatal cardiovascular events associated with increased n-3 PUFA intake