Health benefits
September 8, 2004, the U.S. Food and Drug Administration gave "qualified health claim" status to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) ω−3 fatty acids, stating that "supportive but not conclusive research shows that consumption of EPA and DHA ω−3 fatty acids may reduce the risk of coronary heart disease."[2] This updated and modified their health risk advice letter of 2001 (see below).
People with certain circulatory problems, such as varicose veins, benefit from fish oil. Fish oil stimulates blood circulation, increases the breakdown of fibrin, a compound involved in clot and scar formation, and additionally has been shown to reduce blood pressure.[3][4] There is strong scientific evidence, that ω−3 fatty acids significantly reduce blood triglyceride levels[5][6][7][8] and regular intake reduces the risk of secondary and primary heart attack.[9][10][11][12]
Some benefits have been reported in conditions such as rheumatoid arthritis[13][14] and cardiac arrhythmias.[15][16][17]
There is a promising preliminary evidence, that ω−3 fatty acids supplementation might be helpful in cases of depression[18][19] and anxiety.[20][21] Studies report highly significant improvement from ω−3 fatty acids supplementation alone and in conjunction with medication.[22]
Some research suggests that fish oil intake may reduce the risk of ischemic and thrombotic stroke.[23][24][25] However, very large amounts may actually increase the risk of hemorrhagic stroke (see below). Lower amounts are not related to this risk.[26] 3 grams of total EPA/DHA daily are considered safe with no increased risk of bleeding involved[27] and many studies used substantially higher doses without major side effects (for example: 4.4 grams EPA/2.2 grams DHA in 2003 study).[28]
Several studies report possible anti-cancer effects of ω−3 fatty acids (particularly breast, colon and prostate cancer).[29][30][31] No clear conclusion can be drawn at this time, however.
A 2006 report in the Journal of the American Medical Association concluded that their review of literature covering cohorts from many countries with a wide variety of demographic characteristics demonstrating a link between ω−3 fatty acids and cancer prevention gave mixed results.[32] This is similar to the findings of a review by the British Medical Journal of studies up to February 2002 that failed to find clear effects of long and shorter chain ω−3 fats on total mortality, combined cardiovascular events and cancer.[33]
In 1999, the GISSI-Prevenzione Investigators reported in the Lancet, the results of major clinical study in 11,324 patients with a recent myocardial infarction. Treatment with omega-3 fatty acids 1 g/d reduced the occurrence of death, cardiovascular death and sudden cardiac death by 20%, 30% and 45% respectively. [34] These beneficial effects were seen already from three months onwards.[35]
In April 2006, a team led by Lee Hooper at the University of East Anglia in Norwich, UK, published a review of almost 100 separate studies into ω−3 fatty acids, found in abundance in oily fish. It concluded that they do not have a significant protective effect against cardiovascular disease.[36] This meta-analysis was controversial and stands in stark contrast with two different reviews also performed in 2006 by the American Journal of Clinical Nutrition[37] and a second JAMA review[38] that both indicated decreases in total mortality and cardiovascular incidents (i.e. myocardial infarctions) associated with the regular consumption of fish and fish oil supplements. In addition ω−3 has shown to aid in other mental disorders such as aggression and ADHD (Attention-deficit hyperactivity disorder).[citation needed]
Several studies published in 2007 have been more positive. In the March 2007 edition of the journal Atherosclerosis, 81 Japanese men with unhealthy blood sugar levels were randomly assigned to receive 1800 mg daily of eicosapentaenoic acid (EPA - an ω−3 essential fatty acid from fish oil) with the other half being a control group. The thickness of the carotid arteries and certain measures of blood flow were measured before and after supplementation. This went on for approximately two years. A total of 60 patients (30 in the EPA group and 30 in the control group) completed the study. Those given the EPA had a statistically significant decrease in the thickness of the carotid arteries along with improvement in blood flow. The authors indicated that this was the first demonstration that administration of purified EPA improves the thickness of carotid arteries along with improving blood flow in patients with unhealthy blood sugar levels.[citation needed]
In another study published in the American Journal of Health System Pharmacy March 2007, patients with high triglycerides and poor coronary artery health were given 4 grams a day of a combination of EPA and DHA along with some monounsaturated fatty acids. Those patients with very unhealthy triglyceride levels (above 500 mg/dl) reduced their triglycerides on average 45% and their VLDL cholesterol by more than 50%. VLDL is a bad type of cholesterol and elevated triglycerides can also be deleterious for cardiovascular health.[citation needed]
There was another study published on the benefits of EPA in The Lancet in March 2007. This study involved over 18,000 patients with unhealthy cholesterol levels. The patients were randomly assigned to receive either 1,800 mg a day of EPA with a statin drug or a statin drug alone. The trial went on for a total of five years. It was found at the end of the study those patients in the EPA group had superior cardiovascular function. Non-fatal coronary events were also significantly reduced in the EPA group. The authors concluded that EPA is a promising treatment for prevention of major coronary events,especially non-fatal coronary events.[39]
Another study regarding fish oil was published in the journal Nutrition in April 2007. Sixty four healthy Danish infants received either cow's milk or infant formula alone or with fish oil from nine to twelve months of age. It was found that those infants supplemented with fish oil had improvement in immune function maturation with no apparent reduction in immune activation.[citation needed]
There was yet another study on ω−3 fatty acids published in the April 2007 Journal of NeuroScience. A group of mice were genetically modified to develop accumulation of amyloid and tau proteins in the brain similar to that seen in people with poor memory. The mice were divided into four groups with one group receiving a typical American diet (with high ratio of ω−6 to ω−3 fatty acids being 10 to 1). The other three groups were given food with a balanced 1 to 1 ω−6 to ω−3 ratio and two additional groups supplemented with DHA plus long chain ω−6 fatty acids. After three months of feeding, all the DHA supplemented groups were noted to have a lower accumulation of beta amyloid and tau protein. It is felt that these abnormal proteins may contribute to the development of memory loss in later years.[citation needed]
There is also a study published regarding ω−3 supplementation in children with learning and behavioral problems. This study was published in the April 2007 edition of the Journal of the Developmental and Behavioral Pediatrics (5), where 132 children, between the ages of seven to twelve years old, with poor learning, participated in a randomized, placebo-controlled, double-blinded interventional trial. A total of 104 children completed the trial. For the first fifteen weeks of this study, the children were given polyunsaturated fatty acids (ω−3 and ω−6, 3000 mg a day), polyunsaturated fatty acids plus multi-vitamins and minerals or placebo. After fifteen weeks, all groups crossed over to the polyunsaturated fatty acids (PUFA) plus vitamins and mineral supplement. Parents were asked to rate their children's condition after fifteen and thirty weeks. After thirty weeks, parental ratings of behavior improved significantly in nine out of fourteen scales. The lead author of the study, Dr. Sinn, indicated the present study is the largest PUFA trial to date with children falling in the poor learning and focus range. The results support those of other studies that have found improvement in poor developmental health with essential fatty acid supplementation. [40] [41][42] [43] [44] [45]
Research in 2005 and 2006 has suggested that the in-vitro anti-inflammatory activity of ω−3 acids translates into clinical benefits. Cohorts of neck pain patients and of rheumatoid arthritis sufferers have demonstrated benefits comparable to those receiving standard NSAIDs[citation needed]. Those who follow a Mediterranean-style diet tend to have less heart disease, higher HDL ("good") cholesterol levels [46] and higher proportions of ω−3 in tissue highly unsaturated fatty acids [47]. Similar to those who follow a Mediterranean diet, Arctic-dwelling Inuit - who consume high amounts of ω−3 fatty acids from fatty fish - also tend to have higher proportions of ω−3, increased HDL cholesterol and decreased triglycerides (fatty material that circulates in the blood) and less heart disease. Eating walnuts (the ratio of ω−3 to ω−6 is circa 1:4 respectively [48] [49] ) was reported to lower total cholesterol by 4% relative to controls when people also ate 27% less cholesterol.[50]
A study carried out involving 465 women showed serum levels of eicosapentaenoic acid is inversely related to the levels of anti-oxidized-LDL antibodies. Oxidative modification of LDL is thought to play an important role in the development of atherosclerosis
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