Fish oil: Difference between revisions

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imported>Robert Badgett
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==Benefit to human health==
==Benefit to human health==
The benefit of fish oil on [[coronary heart disease]] and mortality is controversial with conflicting conclusions reached by a negative [[meta-analysis]]<ref name="pmid16565093">{{cite journal |author=Hooper L, Thompson RL, Harrison RA, Summerbell CD, Ness AR, Moore HJ, Worthington HV, Durrington PN, Higgins JP, Capps NE, Riemersma RA, Ebrahim SB, Davey Smith G |title=Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review |journal=BMJ |volume=332 |issue=7544 |pages=752-60 |year=2006 |pmid=16565093 |doi=10.1136/bmj.38755.366331.2F}}</ref><ref name="pmid15495044">{{cite journal |author=Hooper L, Thompson RL, Harrison RA, ''et al'' |title=Omega 3 fatty acids for prevention and treatment of cardiovascular disease |journal=Cochrane Database Syst Rev |volume= |issue=4 |pages=CD003177 |year=2004 |pmid=15495044 |doi=10.1002/14651858.CD003177.pub2}}</ref> of [[randomized controlled trial]]s by the international [[Cochrane Collaboration]] and a partially positive [[systematic review]]<ref name="pmid16825676">{{cite journal |author=Wang C, Harris WS, Chung M, Lichtenstein AH, Balk EM, Kupelnick B, Jordan HS, Lau J |title=n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review |journal=Am. J. Clin. Nutr. |volume=84 |issue=1 |pages=5-17 |year=2006 |pmid=16825676 |doi=}} http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat1a.chapter.38290</ref> by the [[Agency for Healthcare Research and Quality]].
The benefit of fish oil on [[coronary heart disease]] and mortality is controversial with conflicting conclusions reached by a negative [[meta-analysis]] (search date February, 2002)<ref name="pmid16565093">{{cite journal |author=Hooper L, Thompson RL, Harrison RA, Summerbell CD, Ness AR, Moore HJ, Worthington HV, Durrington PN, Higgins JP, Capps NE, Riemersma RA, Ebrahim SB, Davey Smith G |title=Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review |journal=BMJ |volume=332 |issue=7544 |pages=752-60 |year=2006 |pmid=16565093 |doi=10.1136/bmj.38755.366331.2F}}</ref><ref name="pmid15495044">{{cite journal |author=Hooper L, Thompson RL, Harrison RA, ''et al'' |title=Omega 3 fatty acids for prevention and treatment of cardiovascular disease |journal=Cochrane Database Syst Rev |volume= |issue=4 |pages=CD003177 |year=2004 |pmid=15495044 |doi=10.1002/14651858.CD003177.pub2}}</ref> of [[randomized controlled trial]]s by the international [[Cochrane Collaboration]], a partially positive [[systematic review]] (search date July, 2005)<ref name="pmid16825676">{{cite journal |author=Wang C, Harris WS, Chung M, Lichtenstein AH, Balk EM, Kupelnick B, Jordan HS, Lau J |title=n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review |journal=Am. J. Clin. Nutr. |volume=84 |issue=1 |pages=5-17 |year=2006 |pmid=16825676 |doi=}} http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat1a.chapter.38290</ref> by the [[Agency for Healthcare Research and Quality]], and a positive [[systematic review]] (search date March, 2007)<ref name="pmid19106137">{{cite journal |author=León H, Shibata MC, Sivakumaran S, Dorgan M, Chatterley T, Tsuyuki RT |title=Effect of fish oil on arrhythmias and mortality: systematic review |journal=BMJ |volume=337 |issue= |pages=a2931 |year=2008 |pmid=19106137 |pmc=2612582 |doi= |url=http://bmj.com/cgi/pmidlookup?view=long&pmid=19106137 |issn=}}</ref>.


Since these two reviews, a [[randomized controlled trial]] reported a reduction on coronary events in Japanese hypercholesterolemic patients.<ref name="pmid17398308">{{cite journal |author=Yokoyama M, Origasa H, Matsuzaki M, ''et al'' |title=Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis |journal=Lancet |volume=369 |issue=9567 |pages=1090-8 |year=2007 |pmid=17398308 |doi=10.1016/S0140-6736(07)60527-3}}</ref>
Three subsequent [[randomized controlled trial]]s not included in the above [[systematic review]]s have also had conflicting results finding both benefit (reduction on coronary events in Japanese hypercholesterolemic patients<ref name="pmid17398308">{{cite journal |author=Yokoyama M, Origasa H, Matsuzaki M, ''et al'' |title=Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis |journal=Lancet |volume=369 |issue=9567 |pages=1090–8 |year=2007 |pmid=17398308 |doi=10.1016/S0140-6736(07)60527-3}}</ref> and improvement in patients with [[heart failure]]<ref name="pmid18757090">{{cite journal |author=Gissi-Hf Investigators |title=Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial |journal=Lancet |volume= |issue= |pages= |year=2008 |month=August |pmid=18757090 |doi=10.1016/S0140-6736(08)61239-8 |url=http://linkinghub.elsevier.com/retrieve/pii/S0140-6736(08)61239-8 |issn=}}</ref>) and harm<ref name="pmid15956633">{{cite journal |author=Raitt MH, Connor WE, Morris C, ''et al'' |title=Fish oil supplementation and risk of ventricular tachycardia and ventricular fibrillation in patients with implantable defibrillators: a randomized controlled trial |journal=JAMA |volume=293 |issue=23 |pages=2884–91 |year=2005 |pmid=15956633 |doi=10.1001/jama.293.23.2884}}</ref>.
 
Subsequent [[randomized controlled trial]]s have also had conflicting results finding both benefit<ref name="pmid17398308">{{cite journal |author=Yokoyama M, Origasa H, Matsuzaki M, ''et al'' |title=Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis |journal=Lancet |volume=369 |issue=9567 |pages=1090–8 |year=2007 |pmid=17398308 |doi=10.1016/S0140-6736(07)60527-3}}</ref> and harm<ref name="pmid15956633">{{cite journal |author=Raitt MH, Connor WE, Morris C, ''et al'' |title=Fish oil supplementation and risk of ventricular tachycardia and ventricular fibrillation in patients with implantable defibrillators: a randomized controlled trial |journal=JAMA |volume=293 |issue=23 |pages=2884–91 |year=2005 |pmid=15956633 |doi=10.1001/jama.293.23.2884}}</ref>. Fish oil may benefit people with chronic [[heart failure]].<ref name="pmid18757090">{{cite journal |author=Gissi-Hf Investigators |title=Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial |journal=Lancet |volume= |issue= |pages= |year=2008 |month=August |pmid=18757090 |doi=10.1016/S0140-6736(08)61239-8 |url=http://linkinghub.elsevier.com/retrieve/pii/S0140-6736(08)61239-8 |issn=}}</ref>


==References==
==References==
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Fish oils, including Omega-3 fatty acids, are dietary "oils high in unsaturated fats extracted from the bodies of fish or fish parts, especially the livers. Those from the liver are usually high in vitamin A. The oils are used as dietary supplements, in soaps and detergents, as protective coatings, and as a base for other food products such as vegetable shortenings."[1]

Biochemistry

(PD) Image: National Library of Medicine (NLM)
Polyunsaturated fatty acids (PUFAs) metabolic pathways in humans.[2]

Dietary fatty acids can be divided into saturated fatty acids and unsaturated fatty acids.[2] Unsaturated fatty acids can be further divided into monounsaturated and polyunsaturated fatty acids (PUFAs).

PUFAs are divided into two groups: omega-3 fatty acids and omega-6 fatty acids. Whereas omega-3 fatty acid have health benefits due to several mechanisms; omega-6 fatty acids are precursors to arachidonic acid (AA) which leads to thrombaxanes which promote platelet aggregation and vasoconstriction.

Two PUFAs, alpha-linolenic acid (ALA) and linoleic acid (LA) are called essential fatty acids because human function requires them, yet humans cannot synthesize then in vivo.[2] ALA is a omega-3 fatty acid while AL is a omega-6 fatty acid. In North America, LA comprises 89% of the total PUFAs consumed, while ALA comprises 9%.[2] LA is in many commonly used oils, including safflower, sunflower, soy, and corn oil. ALA is in leafy green vegetables and in canola and soybean oil.

Dietary fish oils are converted to eicosapentaenoic acid (EPA) which is further converted to docosahexaenoic acid (DHA). Both EPA and HHA are omega-3 fatty acids.

Benefit to human health

The benefit of fish oil on coronary heart disease and mortality is controversial with conflicting conclusions reached by a negative meta-analysis (search date February, 2002)[3][4] of randomized controlled trials by the international Cochrane Collaboration, a partially positive systematic review (search date July, 2005)[2] by the Agency for Healthcare Research and Quality, and a positive systematic review (search date March, 2007)[5].

Three subsequent randomized controlled trials not included in the above systematic reviews have also had conflicting results finding both benefit (reduction on coronary events in Japanese hypercholesterolemic patients[6] and improvement in patients with heart failure[7]) and harm[8].

References

  1. ↑ Anonymous (2024), Fish oil (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 Wang C, Harris WS, Chung M, Lichtenstein AH, Balk EM, Kupelnick B, Jordan HS, Lau J (2006). "n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review". Am. J. Clin. Nutr. 84 (1): 5-17. PMID 16825676. [e] http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat1a.chapter.38290
  3. ↑ Hooper L, Thompson RL, Harrison RA, Summerbell CD, Ness AR, Moore HJ, Worthington HV, Durrington PN, Higgins JP, Capps NE, Riemersma RA, Ebrahim SB, Davey Smith G (2006). "Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review". BMJ 332 (7544): 752-60. DOI:10.1136/bmj.38755.366331.2F. PMID 16565093. Research Blogging.
  4. ↑ Hooper L, Thompson RL, Harrison RA, et al (2004). "Omega 3 fatty acids for prevention and treatment of cardiovascular disease". Cochrane Database Syst Rev (4): CD003177. DOI:10.1002/14651858.CD003177.pub2. PMID 15495044. Research Blogging.
  5. ↑ León H, Shibata MC, Sivakumaran S, Dorgan M, Chatterley T, Tsuyuki RT (2008). "Effect of fish oil on arrhythmias and mortality: systematic review". BMJ 337: a2931. PMID 19106137. PMC 2612582. [e]
  6. ↑ Yokoyama M, Origasa H, Matsuzaki M, et al (2007). "Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis". Lancet 369 (9567): 1090–8. DOI:10.1016/S0140-6736(07)60527-3. PMID 17398308. Research Blogging.
  7. ↑ Gissi-Hf Investigators (August 2008). "Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial". Lancet. DOI:10.1016/S0140-6736(08)61239-8. PMID 18757090. Research Blogging.
  8. ↑ Raitt MH, Connor WE, Morris C, et al (2005). "Fish oil supplementation and risk of ventricular tachycardia and ventricular fibrillation in patients with implantable defibrillators: a randomized controlled trial". JAMA 293 (23): 2884–91. DOI:10.1001/jama.293.23.2884. PMID 15956633. Research Blogging.
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