Article Figures & Data
Figures
- Figure 1.
Arachidonic acid is converted to leukotrienes by the enzyme lipoxygenase (LPO) and to thromboxane A2 and prostaglandins by the enzyme cyclooxygenase (COX). Ω-3 fatty acids, in essence, reduce the breakdown of arachidonic acids.
Tables
Patient Population Recommendations Patients WITHOUT documented coronary heart disease Eat a variety of (preferably fatty) fish at least twice a week. Include oils and foods rich in α-linolenic acid (flaxseed, canola, and soybean oils; flaxseed and walnuts) Patients WITH documented coronary heart disease Consume approximately 1 g of EPA+DHA per day, preferably from fatty fish. EPA+DHA supplements could be considered in consultation with the physician. Patients who need to lower triglycerides 2–4 g of EPA+DHA per day provided as capsules under a physician’s care. Clinical Use Dosage Comments Strength of Recommendation Secondary prevention of cardiovascular disease 1–2 g/day May encourage dietary intake, or fish oil supplementation A19,20 Hypertriglyceridemia Initial 2–4 g; up to 12 g For doses greater than 3 g, consider monitoring for bleeding side effects, LDL, and glycemic response A23 Rheumatoid arthritis 2.6–6 g may initiate at 90 mg/kg; maintenance dose 45 mg/kg May take 8–12 weeks for clinical response; consider tapering NSAIDs; compliance may be an issue A29,30 Infants (not breast-feeding) 0.35% of dietary fat as DHA Consider Ω-3 and Ω-6 enriched infant formula B42,43 Women (pregnant and of childbearing age) 2 fatty fish meals a week (up to 12 oz) Avoid shark, tile fish, king mackerel, swordfish. Limit albacore tuna to 6 oz per week. C47,48,66 Fish EPA & DHA† (mg per 100 g of edible fish; ∼3–4 oz.) Herring‡ 1700 Salmon§ 1600 Mackerel‖ 1400 Flounder 500 Halibut¶ 500 Tuna** 300 Bluefin 1500 Canned white 900 Canned light 300 Cod 200 Catfish 200 Haddock 200 * Approximated to nearest 100 mg (http://www.nal.usda.gov/fnic/foodcomp/index.html).
† EPA and DHA; EPA=20:5 Ω-3; DHA=22:6 Ω-3.
‡ Average; Atlantic and Pacific.
§ Average; Atlantic (wild and farmed), Chinook, pink, coho.
‖ Average; Atlantic, Jack; Pacific, Spanish.
¶ Greenland halibut, 1100 mg.
** Skipjack/yellowfin, 300 mg.
Brand Amount of EPA & DHA (mg per capsule) Cost* ($) Number of capsules/day Web Site GNC Fish body oil 180/120 6.00 3–4 http://www.drugstore.com Natrol Omega-3 complex 180/120 6.00 3–4 http://www.drugstore.com Twinlab Omega-3 234/125 15.00 3 http://www.drugstore.com Mega Twin EPA† 600/240 15.00 1–2 http://www.drugstore.com OmegaRx† 400/200 25.00 2 http://www.zonenetonline.com/fishoil_detail.asp?realname= Ultimate Omega† 350/250 26.95 2 https://www.nordicnaturals.com/direct/prodsummary.asp?ID=30 TriOmega† 500 (total) 20.00 2 http://www.triomega.com Kirkland Fish Oil‡ 180/120 5.00 3–4 http://www.costco.com Nature Made Fish Oil‡ 216/144 7.00 3–4 http://www.drugstore.com * 1-month supply, supplying 1 g of EPA/DHA.
† Pharmaceutical grade or makes claim regarding manufacturing process.
‡ United States Pharmacopeia-branded.
