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Concept: Fish oil


BACKGROUND: Given that acne is a rare condition in societies with higher consumption of omega-3 (n-3) relative to omega-6 (n-6) fatty acids, supplementation with n-3 may suppress inflammatory cytokine production and thereby reduce acne severity. METHODS: 13 individuals with inflammatory acne were given three grams of fish oil containing 930 mg of EPA to their unchanged diet and existing acne remedies for 12 weeks. Acne was assessed using an overall severity grading scale, total inflammatory lesion counts, and colorimetry. FINDINGS: There was no significant change in acne grading and inflammatory counts at week 12 compared to baseline. However, there was a broad range of response to the intervention on an individual basis. The results showed that acne severity improved in 8 individuals, worsened in 4, and remained unchanged in 1. Interestingly, among the individuals who showed improvement, 7 were classified as having moderate to severe acne at baseline, while 3 of the 4 whose acne deteriorated were classified as having mild acne. CONCLUSION: There is some evidence that fish oil supplementation is associated with an improvement in overall acne severity, especially for individuals with moderate to severe acne. Divergent responses to fish oil in our pilot study indicates that dietary and supplemental lipids are worthy of further investigation in acne.

Concepts: Nutrition, Fatty acid, Essential fatty acid, Omega-3 fatty acid, Fat, Eicosapentaenoic acid, Omega-6 fatty acid, Fish oil


Arthritis patients often take fish oil supplements to alleviate symptoms, but limited evidence exists regarding their efficacy. The objective was to evaluate whether marine oil supplements reduce pain and/or improve other clinical outcomes in patients with arthritis. Six databases were searched systematically (24 February 2015). We included randomized trials of oral supplements of all marine oils compared with a control in arthritis patients. The internal validity was assessed using the Cochrane Risk of Bias tool and heterogeneity was explored using restricted maximum of likelihood (REML)-based meta-regression analysis. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to rate the overall quality of the evidence. Forty-two trials were included; 30 trials reported complete data on pain. The standardized mean difference (SMD) suggested a favorable effect (-0.24; 95% confidence interval, CI, -0.42 to -0.07; heterogeneity, I² = 63%. A significant effect was found in patients with rheumatoid arthritis (22 trials; -0.21; 95% CI, -0.42 to -0.004) and other or mixed diagnoses (3 trials; -0.63; 95% CI, -1.20 to -0.06), but not in osteoarthritis patients (5 trials; -0.17; 95% CI, -0.57-0.24). The evidence for using marine oil to alleviate pain in arthritis patients was overall of low quality, but of moderate quality in rheumatoid arthritis patients.

Concepts: Evidence-based medicine, Systematic review, Randomized controlled trial, Rheumatoid arthritis, Osteoarthritis, Arthritis, Meta-analysis, Fish oil


Fish currently supplies only 40% of the eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) required to allow all individuals globally to meet the minimum intake recommendation of 500 mg/d. Therefore, alternative sustainable sources are needed.

Concepts: Omega-3 fatty acid, Seed, Source code, Eicosapentaenoic acid, Docosahexaenoic acid, Seafood, Source, Fish oil


Omega-3 fatty acids found in fish oil have been suggested to protect against cardiovascular disease, yet underlying mechanisms remain unclear. Despite the well documented link between mental stress and cardiovascular risk, no study has examined neural cardiovascular reactivity to mental stress after fish oil supplementation. We hypothesized that fish oil would blunt the blood pressure, heart rate (HR), and muscle sympathetic nerve activity (MSNA) responsiveness to mental stress and/or augment limb vasodilation associated with mental stress. Blood pressure, HR, MSNA, forearm vascular conductance (FVC) and calf vascular conductance (CVC) responses were recorded during a 5 minute mental stress protocol in 67 non-hypertensive subjects before and after 8 weeks of fish oil (n=33) or placebo supplementation (n=34). Fish oil blunted HR reactivity to mental stress (group x condition x time interactions, P=0.012), but did not alter blood pressure reactivity to mental stress (interactions, P>0.05). Fish oil blunted total MSNA reactivity to mental stress (interaction, P=0.039), but did not alter MSNA burst frequency and burst incidence reactivity (interactions, P>0.05). Finally, fish oil significantly blunted CVC reactivity to mental stress (interaction, P=0.013), but did not alter FVC reactivity (interaction, P>0.05). In conclusion, 8 weeks of fish oil supplementation significantly attenuated both HR and total MSNA reactivity to mental stress, and elicited a paradoxical blunting of calf vascular conductance. These findings support and extend the growing evidence that fish oil may have positive health benefits regarding neural cardiovascular control in humans.

Concepts: Fatty acid, Myocardial infarction, Blood vessel, Cardiovascular disease, Omega-3 fatty acid, Sympathetic nervous system, Eicosapentaenoic acid, Fish oil


The impact of the fish-derived omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on cardiovascular disease (CVD) and type 2 diabetes incidence and risk has been widely investigated. Although the balance of evidence suggests substantial benefits with respect to CVD mortality, there is little evidence for an impact of these fatty acids on insulin sensitivity and diabetes incidence, despite very promising data from animal models. The focus here will be the plasma lipid modulatory effects of EPA and DHA and will include an exploration of the potential and demonstrated complementarity between statins and EPA/DHA on overall CVD risk and the plasma cholesterol and triglyceride profile. Although there is some justification for greater general population and patient EPA+DHA intakes, an often overlooked major obstacle is that global fish stocks are limited and insufficient to meet demands. The potential of emerging ‘non-fish foods’ to provide affordable and sustainable sources of EPA+DHA will also be briefly discussed.European Journal of Clinical Nutrition advance online publication, 13 February 2013; (2013) 0, 000-000. doi:10.1038/ejcn.2013.19.

Concepts: Nutrition, Fatty acid, Obesity, Triglyceride, Omega-3 fatty acid, Eicosapentaenoic acid, Docosahexaenoic acid, Fish oil


Research suggests that cancer survivors have an interest in lifestyle changes following a diagnosis. However, few studies have prospectively investigated whether these changes result in positive outcomes. The objective of this study was to examine the associations between fish oil supplementation and quality of life (QoL), cancer recurrence, and all-cause mortality in Stage 2 colorectal cancer (CRC) patients following diagnosis. Four hundred fifty-three patients were enrolled from the North Carolina Cancer Registry from 2009 to 2011. Data on demography, treatment, and health behaviors were collected at diagnosis, 12-, and 24 mo postdiagnosis. Generalized estimating equations were performed to examine fish oil supplementation in relation to QoL, recurrence, and all-cause mortality. An increase in fish oil supplementation over 24 mo postdiagnosis was associated with an increase in the physical component score of the 12-item Medical Outcomes Short Form (β = 2.43, 95% CI: 0.10-4.76). Supplementation showed no association with the Functional Assessment of Cancer-Colorectal, cancer recurrence or mortality across the 24-mo follow-up. This study suggests that fish oil supplementation may improve symptom-related QoL (i.e., physical functioning) in Stage 2 CRC patients following diagnosis. Future research should address the dose-dependent effects of this relationship.

Concepts: Cancer, Oncology, Cancer staging, Quality, Quality of life, Colorectal cancer, Physical examination, Fish oil


We evaluated the quality and content of fish oil supplements in New Zealand. All encapsulated fish oil supplements marketed in New Zealand were eligible for inclusion. Fatty acid content was measured by gas chromatography. Peroxide values (PV) and anisidine values (AV) were measured, and total oxidation values (Totox) calculated. Only 3 of 32 fish oil supplements contained quantities of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) that were equal or higher than labelled content, with most products tested (69%) containing <67%. The vast majority of supplements exceeded recommended levels of oxidation markers. 83% products exceeded the recommended PV levels, 25% exceeded AV thresholds, and 50% exceeded recommended Totox levels. Only 8% met the international recommendations, not exceeding any of these indices. Almost all fish oil supplements available in the New Zealand market contain concentrations of EPA and DHA considerably lower than claimed by labels. Importantly, the majority of supplements tested exceeded the recommended indices of oxidative markers. Surprisingly, best-before date, cost, country of origin, and exclusivity were all poor markers of supplement quality.

Concepts: Carbon dioxide, Hydrogen, Oxidizing agent, Electrochemistry, Omega-3 fatty acid, Eicosapentaenoic acid, Docosahexaenoic acid, Fish oil


To examine whether fish and fish oil consumption across the lifespan is associated with a lower risk of prostate cancer.

Concepts: Cancer, Metastasis, Obesity, Prostate cancer, Radiation therapy, BRCA2, Screening, Fish oil


To test the hypothesis that higher levels of red blood cell (RBC) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) have a protective association with domain-specific cognitive function in women aged 65 years and older.

Concepts: Fatty acid, Fatty acids, Red blood cell, Triglyceride, Omega-3 fatty acid, Eicosapentaenoic acid, Docosahexaenoic acid, Fish oil


Long-chain n-3 polyunsaturated fatty acids (LC n-3-PUFA), docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) provide multiple health benefits for heart, brain and eyes. However, consumption of fatty fish, the main source of LC n-3-PUFAs is low in Western countries. Intakes of LC n-3-PUFA can be increased by taking dietary supplements, such as fish oil, algal oil, or krill oil. Recently, conflicting information was published on the relative bioavailability of these omega-3 supplements. A few studies suggested that the phospholipid form (krill) is better absorbed than the fish oil ethyl ester (EE) or triglyceride (TG) forms. Yet studies did not match the doses administered nor the concentrations of DHA and EPA per supplement across such comparisons, leading to questionable conclusions. This study was designed to compare the oral bioavailability of the same dose of both EPA and DHA in fish oil-EE vs. fish oil-TG vs. krill oil in plasma at the end of a four-week supplementation.

Concepts: Nutrition, Fatty acid, Fatty acids, Essential fatty acid, Omega-3 fatty acid, Eicosapentaenoic acid, Docosahexaenoic acid, Fish oil