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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.

Fish oil-derived fatty acids, docosahexaenoic acid and docosapentaenoic acid, and the risk of acute coronary events: the Kuopio ischaemic heart disease risk factor study. Rissanen T, Voutilainen S, Nyyssönen K, Lakka TA, Salonen JT. Circulation. 2000 Nov 28;102(22):2677-9. PMID: 11094031 Methods and Results-We studied this association in the Kuopio Ischaemic Heart Disease Risk Factor Study, a prospective population study in Eastern Finland. Subjects were randomly selected and included 1871 men aged 42 to 60 years who had no clinical coronary heart disease at baseline examination. A total of 194 men had a fatal or nonfatal acute coronary event during follow-up. In a Cox proportional hazards' model adjusting for other risk factors, men in the highest fifth of the proportion of serum DHA+DPA in all fatty acids had a 44% reduced risk (P=0.014) of acute coronary events compared with men in the lowest fifth. Men in the highest fifth of DHA+DPA who had a low hair content of mercury (2.0 µg/g). There was no association between proportion of eicosapentaenoic acid and the risk of acute coronary events. Conclusions-Our data provide further confirmation for the concept that fish oil-derived fatty acids reduce the risk of acute coronary events. However, a high mercury content in fish could attenuate this protective effect.

Effect of fish oil on heart rate in humans: a meta-analysis of randomized controlled trials. Mozaffarian D, Geelen A, Brouwer IA, Geleijnse JM, Zock PL, Katan MB. Circulation. 2005 Sep 27;112(13):1945-52. Epub 2005 Sep 19. PMID: 16172267 doi: 10.1161/CIRCULATIONAHA.105.556886 Conclusions- In randomized controlled trials in humans, fish oil reduces HR, particularly in those with higher baseline HR or longer treatment duration. These findings provide firm evidence that fish oil consumption directly or indirectly affects cardiac electrophysiology in humans. Potential mechanisms such as effects on the sinus node, ventricular efficiency, or autonomic function deserve further investigation.

"ScienceDaily (Dec. 7, 2009) - Long-chain omega-3 fatty acids, primarily found in fish and seafood, may have a role in colorectal cancer prevention, according to results presented at the American Association for Cancer Research Frontiers in Cancer Prevention Research Conference, held Dec. 6-9, 2009, in Houston."

"Nov 14, 2005 | Michael O'Riordan. Dallas, TX - The addition of eicosapentaenoic acid (EPA) to low-dose statin therapy significantly reduced the incidence of major coronary events, largely driven by a reduction in unstable angina, when compared with patients taking statins alone. A subgroup analysis of the study, which involved a large number of primary-prevention patients, revealed that statin-treated secondary-prevention patients gained the most benefit from fish-oil supplementation. Dr Mitsuhiro Yokoyama Presenting the results of the Japan EPA Lipid Intervention Study (JELIS) during the late-breaking clinical-trials session at the American Heart Association Scientific Sessions 2005, Dr Mitsuhiro Yokoyama (Kobe University Graduate School of Medicine, Japan) said that the mechanism of benefit with EPA, a seafood-based, long-chain, n-3 polyunsaturated fatty acid, appears to be unrelated to the effects of cholesterol lowering. Commenting on the results of the study for heartwire, Dr Lawrence Appel (Johns Hopkins University School of Medicine, Baltimore, MD) said the findings are impressive given that the benefit of fish oil was observed on top of a regimen of statin therapy. He added that there are still some unknowns about which patient population would benefit most from fish oil."

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

Severus WE. Effects of omega-3 polyunsaturated fatty acids on depression. Herz. 2006 Dec;31 Suppl 3:69-74. Review. PMID: 17575808 [PubMed - indexed for MEDLINE]

"DENVER, March 3 - Omega-3 polyunsaturated fatty acids may influence mood, personality and behavior, according to results of a study presented today by University of Pittsburgh School of Medicine researchers at the 64th Annual Scientific Meeting of the American Psychosomatic Society in Denver."

Fish intake is associated with a reduced progression of coronary artery atherosclerosis in postmenopausal women with coronary artery disease. Erkkilä AT, Lichtenstein AH, Mozaffarian D, Herrington DM. Am J Clin Nutr. 2004 Sep;80(3):626-32. PMID: 15321802 Conclusions: Consumption of fish is associated with a significantly reduced progression of coronary artery atherosclerosis in women with coronary artery disease.

Clinical prevention of sudden cardiac death by n-3 polyunsaturated fatty acids and mechanism of prevention of arrhythmias by n-3 fish oils. Leaf A, Kang JX, Xiao YF, Billman GE. Circulation. 2003 Jun 3;107(21):2646-52. Review. PMID: 12782616 doi: 10.1161/01.CIR.0000069566.78305.33 This review will be limited specifically to the beneficial prevention by the n-3 polyunsaturated fatty acids (PUFAs) of arrhythmic deaths, including sudden cardiac death, which annually causes some 300 000 deaths in the United States and millions more worldwide. We will also show that the growing body of positive clinical studies is supported by what has been learned in animal and laboratory studies regarding the mechanism by which n-3 PUFAs prevent cardiac arrhythmias.

Immunologic effects of national cholesterol education panel step-2 diets with and without fish-derived N-3 fatty acid enrichment. Meydani SN, Lichtenstein AH, Cornwall S, Meydani M, Goldin BR, Rasmussen H, Dinarello CA, Schaefer EJ. J Clin Invest. 1993 Jul;92(1):105-13. PMID: 8325975 doi:10.1172/JCI116537 the low-fat, high-fish diet significantly decreased the percentage of helper T cells whereas the percentage of suppressor T cells increased

Benefits of Krill oil. It contains DHA, EPA, omega-3 fatty acids. Reduces risk of high blood pressure, heart attack, blood sugar levels and cardiovascular diseases

This section contains fact sheets that provide a detailed description of vitamins, minerals and macronutrients as well as fad diets. The In Focus section addresses omega-3 fats and mercury levels in different varieties of fish.

Nutritional intervention with omega-3 Fatty acids in a case of malignant fibrous histiocytoma of the lungs. Pardini RS, Wilson D, Schiff S, Bajo SA, Pierce R. Nutr Cancer. 2005;52(2):121-9. PMID: 16201843

Lin PY, Su KP. A meta-analytic review of double-blind, placebo-controlled trials of antidepressant efficacy of omega-3 fatty acids. J Clin Psychiatry. 2007 Jul;68(7):1056-61. PMID: 17685742 [PubMed - in process]

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

Because of their health-promoting abilities, omega-3 fatty acids have received recognition from some of the top medical organizations in the world including, the American Heart Association, American Diabetes Association, World Health Organization, United Kingdom Scientific Advisory Committee on Nutrition, European Society for Cardiology, and The British Nutrition Foundation.

Fish consumption and risk of major chronic disease in men. Virtanen JK, Mozaffarian D, Chiuve SE, Rimm EB. Am J Clin Nutr. 2008 Dec;88(6):1618-25. PMID: 19064523 doi:10.3945/ajcn.2007.25816 Conclusions: Modest fish consumption was associated with a lower risk of total cardiovascular disease, consistent with cardiac mortality benefits but not with total cancer or overall major chronic disease; n-6 fatty acid consumption did not influence these relations.