Review ArticleClinical Review

Practical Applications of Fish Oil (Ω-3 Fatty Acids) in Primary Care

Robert Oh
The Journal of the American Board of Family Practice January 2005, 18 (1) 28-36; DOI: https://doi.org/10.3122/jabfm.18.1.28

References

  1. ↵
    Bang HO, Dyerberg J, Nielsew AB. Plasma lipids and lipoprotein pattern in Greenlandic west-coast Eskimos. Lancet 1971; 1: 1143–6.
    OpenUrlPubMedWeb of Science
  2. ↵
    Bang HO, Dyerberg J, Sinclair HM. The composition of the Eskimo food in north western Greenland. Am J Clin Nutr 1980; 33: 2657–61.
    OpenUrlAbstract/FREE Full Text
  3. ↵
    PubMed [database on the Internet]. Bethesda (MD): National Library of Medicine (US); 2002 [cited 2004 May 11]. Fish oil OR omega-3 OR docosahexaenoic OR eicosapentaenoic, limited to title/abstract [about 499 p.]. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi.
  4. ↵
    PubMed [database on the Internet]. Bethesda (MD): National Library of Medicine (US); 2002 [cited 2004 May 11]. Fish oil OR omega-3 OR docosahexaenoic OR eicosapentaenoic, limited to title/abstract, human, clinical trials [about52 p.]. Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi.
  5. ↵
    Holub BJ. Clinical nutrition: 4. Omega-3 fatty acids in cardiovascular care. CMAJ 2002; 166: 608–15.
    OpenUrlFREE Full Text
  6. ↵
    Endres S, Ghorbani R, Kelly VE, et al. The effect of dietary supplementation with n-3 fatty acids on the synthesis of interleukin-1 and tumor necrosis factor by mononuclear cells. N Engl J Med 1989; 320: 265–70.
    OpenUrlCrossRefPubMedWeb of Science
  7. ↵
    Trebble TM, Wootton SA, Miles EA, et al. Prostaglandin E2 production and T cell function after fish-oil supplementation: response to antioxidant cosupplementation. Am J Clin Nutr 2003; 78: 376–82.
    OpenUrlAbstract/FREE Full Text
  8. ↵
    Leaf A, Kang JX, Xiao YF, Billman GE. Clinical prevention of sudden cardiac death by n-3 polyunsaturated fatty acids and mechanism of prevention of arrhythmias by n-3 fish oils. Circulation 2003; 107: 2646–52.
    OpenUrlFREE Full Text
  9. ↵
    Kromhout D, Bosschieter EB, de Lezenne CC. The inverse relation between fish consumption and 20-year mortality from coronary heart disease. N Engl J Med 1985; 312: 1205–9.
    OpenUrlCrossRefPubMedWeb of Science
  10. Daviglus ML, Stamler J, Orencia AJ, et al. Fish consumption and the 30-year risk of fatal myocardial infarction. N Engl J Med 1997; 336: 1046–53.
    OpenUrlCrossRefPubMedWeb of Science
  11. Hu FB, Bronner L, Willett WC, et al. Fish and omega-3 fatty acid intake and risk of coronary heart disease in women. JAMA 2002; 287: 1815–21.
    OpenUrlCrossRefPubMedWeb of Science
  12. ↵
    Albert CM, Hennekens CH, O’Donnell CJ, et al. Fish consumption and risk of sudden cardiac death. JAMA 1998; 279: 23–8.
    OpenUrlCrossRefPubMedWeb of Science
  13. ↵
    Albert CM, Campos H, Stampfer MJ, et al. Blood levels of long-chain n-3 fatty acids and the risk of sudden death. N Engl J Med 2002; 346: 1113–8.
    OpenUrlCrossRefPubMedWeb of Science
  14. ↵
    Kris-Etherton PM, Harris WS, Appel LJ. AHA scientific statement: fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation 2002; 106: 2747–57.
    OpenUrlFREE Full Text
  15. ↵
    Singh RB, Niaz MA, Sharma JP, Kumar R, Rastogi V, Moshiri M. Randomized, double-blind, placebo-controlled trial of fish oil and mustard oil in patients with suspected acute myocardial infarction: the Indian experiment of infarct survival—4. Cardiovasc Drugs Ther 1997; 11: 485–91.
    OpenUrlCrossRefPubMedWeb of Science
  16. ↵
    Burr ML, Fehily AM, Gilbert JF, et al. Effects of changes in fat, fish and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet 1989; 2: 757–61.
    OpenUrlPubMedWeb of Science
  17. ↵
    Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 1999; 354: 447–55.
    OpenUrlCrossRefPubMedWeb of Science
  18. ↵
    Marchioli R, Barzi F, Bomba E, et al. Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (GISSI)-Prevenzione. Circulation 2002; 105: 1897–903.
    OpenUrlAbstract/FREE Full Text
  19. ↵
    Bucher HC, Hengstler P, Schindler C, Meier G. N-3 polyunsaturated fatty acids in coronary heart disease: a meta-analysis of randomized controlled trials. Am J Med 2002; 112: 298–304.
    OpenUrlCrossRefPubMedWeb of Science
  20. ↵
    Wang C, Chung M, Lichtenstein A, et al. Effects of omega-3 fatty acids on cardiovascular disease. Evidence report/technology assessment number 94. AHRQ publication number 04-E009-1. Rockville (MD): Agency for Healthcare Research and Quality; 2004.
  21. ↵
    National Cholesterol Education Program. Third report of the expert panel on detection, evaluation, and treatment of high blood cholesterol in adults. National Institutes of Health publication no. 02–5215. Bethesda (MD): National Heart, Lung, and Blood Institute; 2002. Available from: http://www.nhlbi.nih.gov/guidelines/cholesterol/index.htm
  22. ↵
    Harris WS. N-3 fatty acids and human lipoprotein metabolism: an update. Lipids 1999; 34S: S257–8.
    OpenUrl
  23. ↵
    Balk E, Chung M, Lichtenstein A, et al. Effects of omega-3 fatty acids on cardiovascular risk factors and intermediate markers of cardiovascular disease. Evidence report/technology assessment no. 93. AHRQ publication no. 04-E010-2. Rockville (MD): Agency for Healthcare Research and Quality; 2004.
  24. ↵
    Phillipson BE, Rothrock DW, Connor WE, Harris WS, Illingworth DR. Reduction of plasma lipids, lipoproteins, and apoproteins by dietary fish oils in patients with hypertriglyceridemia. N Engl J Med 1985; 312: 1210–6.
    OpenUrlCrossRefPubMedWeb of Science
  25. ↵
    Harris WS, Ginsberg HN, Arunakul N, et al. Safety and efficacy of Omacor in severe hypertriglyceridemia. J Cardiovasc Risk 1997; 4: 385–91.
    OpenUrlCrossRefPubMed
  26. ↵
    Contacos C, Barter PJ, Sullivan DR. Effect of pravastatin and omega-3 fatty acids on plasma lipids and lipoproteins in patients with combined hyperlipidemia. Arterioscler Thromb 1993; 12: 1755–62.
    OpenUrl
  27. ↵
    Durrington PN, Bhatnagar D, Mackness MI, et al. An omega-3 polyunsaturated fatty acid concentrate administered for one year decreased triglycerides in simvastatin treated patients with coronary heart disease and persisting hypertriglyceridemia. Heart 2001; 85: 544–8.
    OpenUrlAbstract/FREE Full Text
  28. ↵
    Nordoy A, Hansen JB, Brox J, Svensson B. Effects of atorvastatin and omega-3 fatty acids on LDL subfractions and postprandial hyperlipemia in patients with combined hyperlipemia. Nutr Metab Cardiovasc Dis 2001; 11: 7–16.
    OpenUrlPubMedWeb of Science
  29. ↵
    Fortin PR, Lew RA, Liang MH, et al. Validation of a meta-analysis: the effects of fish oil in rheumatoid arthritis. J Clin Epidemiol 1995; 48: 1379–90.
    OpenUrlCrossRefPubMedWeb of Science
  30. ↵
    MacLean CH, Mojica WA, Morton SC, et al. Effects of omega-3 fatty acids on lipids and glycemic control in type ii diabetes and the metabolic syndrome and on inflammatory bowel disease, rheumatoid arthritis, renal disease, systemic lupus erythematosus, and osteoporosis. Evidence report/technology assessment no. 89. AHRQ publication no. 04-E012-1. Rockville (MD): Agency for Healthcare Research and Quality; 2004.
  31. ↵
    Lau CS, Morley KD, Belch JJ. Effects of fish oil supplementation on non-steroidal anti-inflammatory drug requirement in patients with mild rheumatoid arthritis—a double blind placebo controlled study. Br J Rheumatol 1993; 32: 982–9.
    OpenUrlAbstract/FREE Full Text
  32. ↵
    Kremer JM, Lawrence DA, Petrillo GF, et al. Effects of high-dose fish oil on rheumatoid arthritis after stopping nonsteroidal anti-inflammatory drugs. Arthritis Rheum 1995; 38: 1107–14.
    OpenUrlCrossRefPubMedWeb of Science
  33. ↵
    Volker D, Fitzgerald P, Major G, Garg M. Efficacy of fish oil concentrate in the treatment of rheumatoid arthritis. J Rheumatol 2000; 27: 2343–6.
    OpenUrlPubMedWeb of Science
  34. ↵
    Adam O, Beringer C, Kless T, et al. Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis. Rheumatol Int 2003; 23: 27–36.
    OpenUrlPubMedWeb of Science
  35. ↵
    Kremer JM. N-3 fatty acid supplements in rheumatoid arthritis. Am J Clin Nutr 2000; 71: 349S–51S.
    OpenUrlAbstract/FREE Full Text
  36. ↵
    James MJ, Cleland LG. Dietary n-3 fatty acids and therapy for rheumatoid arthritis. Semin Arthritis Rheum 1997; 27: 85–97.
    OpenUrlCrossRefPubMedWeb of Science
  37. ↵
    Olsen SF, Secher NJ. Low consumption of seafood in early pregnancy as a risk factor for preterm delivery: prospective cohort study. BMJ 2002; 324: 1–5.
    OpenUrlAbstract/FREE Full Text
  38. ↵
    Smuts CM, Huang M, Mundy D, Plasse T, Major S, Carlson SE. A randomized trial of docosahexaenoic acid supplementation during the third trimester of pregnancy. Obstet Gynecol 2003; 101: 469–79.
    OpenUrlCrossRefPubMedWeb of Science
  39. ↵
    Olsen SF, Secher NJ, Tabor A, Weber T, Walker JJ, Gluud C. Randomised clinical trials of fish oil supplementation in high risk pregnancies. Fish Oil Trials In Pregnancy (FOTIP) Team. BJOG 2000; 107: 382–95.
    OpenUrlCrossRefPubMed
  40. ↵
    SanGiovanni JP, Parra-Cabrera S, Colditz GA, Berkey CS, Dwyer JT. Meta-analysis of dietary essential fatty acids and long-chain polyunsaturated fatty acids as they relate to visual resolution acuity in healthy preterm infants. Pediatrics 2000; 105: 1292–8.
    OpenUrlAbstract/FREE Full Text
  41. ↵
    Koo WW. Efficacy and safety of docosahexaenoic acid and arachidonic acid addition to infant formulas: can one buy better vision and intelligence? J Am Coll Nutr 2003; 22: 101–7.
    OpenUrlPubMed
  42. ↵
    Uauy R, Hoffman DR, Mena P, Llanos A, Birch EE. Term infant studies of DHA and ARA supplementation on neurodevelopment: results of randomized controlled trials. J Pediatr 2003; 143: S17–S25.
    OpenUrlPubMedWeb of Science
  43. ↵
    SanGiovanni JP, Berkey CS, Dwyer JT, Colditz GA. Dietary essential fatty acids, long-chain polyunsaturated fatty acids, and visual resolution acuity in healthy fullterm infants: a systematic review. Early Hum Dev 2000; 57: 165–88.
    OpenUrlCrossRefPubMedWeb of Science
  44. ↵
    Hoffman DR, Birch EE, Castañeda YS, et al. Visual function in breast-fed term infants weaned to formula with or without long-chain polyunsaturates at 4 to 6 months: a randomized clinical trial. J Pediatr 2003; 142: 669–77.
    OpenUrlCrossRefPubMedWeb of Science
  45. ↵
    Helland IB, Smith L, Saarem K, Saugstad OD, Drevon CA. Maternal supplementation with very long chain n-3 fatty acids during pregnancy and lactation augments children’s IQ at 4 years of age. Pediatrics 2003; 111: E39–E44.
  46. ↵
    Innis SM, Gilley J, Werker J. Are human milk long-chain polyunsaturated acids related to visual and neural development in breast-fed term infants? J Pediatr 2001; 139: 532–8.
    OpenUrlCrossRefPubMedWeb of Science
  47. ↵
    FDA announces the revised consumer advisory on methylmercury in fish. Rockville (MD): Food and Drug Administration; 2004 [cited 2004 May 13]. Available from: http://www.fda.gov/bbs/topics/news/2004/NEW01038.html
  48. ↵
    Crawford LM. Fish is an important part of a balanced diet [monograph on the Internet]. Rockville (MD): Food and Drug Administration; 2004 [cited 2004 May 13]. Available from: http://www.fda.gov/oc/opacom/hottopics/mercury/mercuryop-ed.html.
  49. ↵
    Simopoulos AP, Leaf A, Salem N Jr. Workshop statement on the essentiality of and recommended dietary intakes for omega-6 and omega-3 fatty acids. Prostaglandins Leukot Essent Fatty Acids 2000; 63: 119–21.
    OpenUrlCrossRefPubMedWeb of Science
  50. ↵
    Aslan A, Triadafilopoulos G. Fish oil fatty acid supplementation in active ulcerative colitis: a double blind, placebo-controlled, crossover study. Am J Gastroenterol 1992; 87: 432–7.
    OpenUrlPubMedWeb of Science
  51. Belluzzi A, Brignola C, Campieri M, Pera A, Boschi S, Miglioli M. Effect of an enteric-coated fish-oil preparation on relapses in Crohn’s disease. N Engl J Med 1996; 334: 1557–60.
    OpenUrlCrossRefPubMedWeb of Science
  52. Belluzzi A, Boschi S, Brignola C, Munarini A, Cariani G, Miglio F. Polyunsaturated fatty acids and inflammatory bowel disease. Am J Clin Nutr 2000; 71S: 339S–42S.
    OpenUrl
  53. ↵
    Woods RK, Thien FC, Abramson MJ. Dietary marine fatty acids (fish oil) for asthma in adults and children. Cochrane Database Syst Rev 2002; (3): CD001283.
  54. ↵
    Schachter H, Reisman J, Tran K, et al. Health effects of omega-3 fatty acids on asthma. Evidence report/technology assessment no. 91. AHRQ publication no. 04-E013-2. Rockville (MD): Agency for Healthcare Research and Quality; 2004.
  55. ↵
    Van Gool CJ, Zeegers MP, Thijs C. Oral essential fatty acid supplementation in atopic dermatitis—a meta-analysis of placebo-controlled trials. Br J Dermatol 2004; 150: 728–40.
    OpenUrlCrossRefPubMed
  56. ↵
    Soyland E, Funk J, Rajka G, Sandberg M, Thune P, Rustad 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: 1812–6.
    OpenUrlCrossRefPubMedWeb of Science
  57. ↵
    Mayser P, Mrowietz U, Arenberger P, 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: 539–47.
    OpenUrlCrossRefPubMedWeb of Science
  58. ↵
    Donadio JV Jr, Grande JP, Bergstralh EJ, Dart RA, Larson TS, Spencer DC. The long-term outcome of patients with IgA nephropathy treated with fish oil in a controlled trial. Mayo Nephrology Collaborative Group. J Am Soc Nephrol 1999; 10: 1772–7.
    OpenUrlAbstract/FREE Full Text
  59. ↵
    Strippoli GF, Manno C, Schena FP. An “evidence-based” survey of therapeutic options for IgA nephropathy: assessment and criticism. Am J Kidney Dis 2003; 41: 1129–39.
    OpenUrlCrossRefPubMedWeb of Science
  60. ↵
    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: 407–12.
    OpenUrlCrossRefPubMedWeb of Science
  61. ↵
    Su KP, Huang SY, Chiu CC, Shen WW. Omega-3 fatty acids in major depressive disorder. A preliminary double-blind placebo-controlled trial. Eur Neuropsychopharmacol 2003; 13: 267–71.
    OpenUrlCrossRefPubMedWeb of Science
  62. ↵
    Iso H, Rexrode KM, Stampfer MJ, et al. Intake of fish and omega-3 fatty acids and risk of stroke in women. JAMA 2001; 285: 304–12.
    OpenUrlCrossRefPubMedWeb of Science
  63. ↵
    He K, Rimm EB, Merchant A, et al. Fish consumption and risk of stroke in men. JAMA 2002; 288: 3130–6.
    OpenUrlCrossRefPubMedWeb of Science
  64. ↵
    Morris MC, Evans DA, Bienias JL, et al. Consumption of fish and n-3 fatty acids and risk of incident Alzheimer disease. Arch Neurol 2003; 60: 940–6.
    OpenUrlCrossRefPubMedWeb of Science
  65. ↵
    Hites RA, Foran JA, Carpenter DO, Hamilton MC, Knuth BA, Schwager SJ. Global assessment of organic contaminants in farmed salmon. Science 2004; 303: 226–9.
    OpenUrlAbstract/FREE Full Text
  66. ↵
    Advice on fish consumption: benefits and risks [monograph on the internet]. London: United Kingdom Food Standards Agency; 2004 [cited 2004 Jul 20] Available from: http://www.food.gov.uk/news/newsarchive/2004/jun/fishreport2004.
  67. ↵
    Guideline for assessing chemical contaminant data for use in fish advisories. Volume 2: risk assessment and fish consumption limits, 3rd ed. Washington DC: Environmental Protection Agency; [cited 2004 May 13]. Available from: http://www.epa.gov/waterscience/fishadvice/volume2/index.html.
  68. ↵
    Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994; 344: 1383–9.
    OpenUrlCrossRefPubMedWeb of Science
  69. ↵
    Sacks FM, Pfeffer MA, Moye L, et al. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events Trial Investigators. N Engl J Med 1996; 335: 1001–9.
    OpenUrlCrossRefPubMedWeb of Science
  70. ↵
    Guallar E, Sanz-Gallardo MI, van’t Veer P, et al. Mercury, fish oils, and the risk of myocardial infarction. N Engl J Med 2003; 347: 1747–54.
    OpenUrl
  71. ↵
    Yoshizawa K, Rimm EB, Morris JS, et al. Mercury and the risk of coronary heart disease in men. N Engl J Med 2002; 347: 1755–60.
    OpenUrlCrossRefPubMedWeb of Science
  72. ↵
    Substances affirmed as generally recognized as safe: menhaden oil, 21 C.F.R. Sect. 184.1472 (2001).
  73. ↵
    Conner WE. Fish oil in hypertriglyceridemia: safety and recommendations [abstract]. Lipids 1999; 34S: 271.
    OpenUrl
  74. ↵
    Montori VM, Farmer A, Wollan P, Dinneen SF. Fish oil supplementation in type 2 diabetes: a quantitative systematic review. Diabetes Care 2000; 23: 1407–15.
    OpenUrlAbstract/FREE Full Text
  75. ↵
    Foran SE, Flood JG. Lewandrowski KB. Measurement of mercury levels in concentrated over-the-counter fish oil preparations. Arch Pathol Lab Med 2003; 127: 1603–5.
    OpenUrlPubMedWeb of Science
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