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Li J, Hu R, Luo H, Guo Y, Zhang Z, Luo Q, Xia P. Associations between dietary habits and bipolar disorder: a diet-wide mendelian randomization study. Front Psychiatry 2024; 15:1388316. [PMID: 38800064 PMCID: PMC11116565 DOI: 10.3389/fpsyt.2024.1388316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Background Diet/nutrition is critically important in the pathogenesis, progression, and treatment outcomes of various mental disorders. Current research predominantly focuses on the role of diet in the development and treatment of depression, with less attention given to the relationship between diet and Bipolar Disorder (BD). Method We employed Mendelian Randomization (MR) to investigate the relationship between 28 dietary habits and BD. An analysis was conducted using publicly available genome-wide association study data from the UK Biobank dataset. Various dietary habits were analyzed as exposures with BD as the outcome, mainly using the Inverse Variance Weighted (IVW) method. Results Intake of non-oily fish and sponge pudding both have a positive association with BD. Oily fish, dried fruit, apples, salt, and cooked vegetables intake also appeared potentially risky for BD, although the possibility of false positives cannot be ruled out. Sensitivity analysis further confirmed the robustness of these findings. Conclusion Our research provides evidence of a relationship between various dietary habits and BD. It underscores the need for careful dietary management and balance to reduce the risk of BD, suggesting caution with dietary preferences for fish and sponge pudding. Furthermore, more detailed studies are needed to further understand the potential impacts of high-sugar and high-protein diets on BD development.
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Affiliation(s)
- Junyao Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Renqin Hu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huirong Luo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yanwei Guo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zheng Zhang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Luo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Pingyou Xia
- Yongchuan District Mental Health Center, Chongqing, China
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Hrebień‐Filisińska A. Application of natural antioxidants in the oxidative stabilization of fish oils: A mini‐review. J FOOD PROCESS PRES 2021. [DOI: 10.1111/jfpp.15342] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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3
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Costa JG, Vidovic B, Saraiva N, do Céu Costa M, Del Favero G, Marko D, Oliveira NG, Fernandes AS. Contaminants: a dark side of food supplements? Free Radic Res 2019; 53:1113-1135. [PMID: 31500469 DOI: 10.1080/10715762.2019.1636045] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Food supplements (FS) are often consumed as one of the strategies to fight ageing-associated pathologies, especially in the case of oxidative stress-related diseases. Despite the popularity of FS, some concerns about their quality and safety have been raised, especially regarding the presence of contaminants. This paper reviews and discusses the occurrence of contaminants in marketed samples of FS in the last two decades, considering both scientific literature and notifications registered on RASFF portal. The most relevant classes of contaminants were included namely metals, toxins, pesticides, dioxins and PCBs, as well as pharmacologically active ingredients. Variable amounts of contaminants were reported in a significant number of commercially available FS. Although the presence of contaminants does not necessarily mean that their levels exceed the regulatory limits or that the FS intake constitutes a risk to human health, it alerts for the need to further monitor FS safety. The evaluation of the risk associated to the consumption of FS, especially in the elderly population, is particularly challenging due to the frequent exposure to multiple toxicants and to different exposure sources, as well as due to possible pre-existing diseases and respective therapeutics. Therefore, improved quality control procedures and monitoring programs should be pursued in order to avoid undesirable products and assure the safety of FS.
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Affiliation(s)
- João Guilherme Costa
- CBIOS, Universidade Lusófona Research Center for Biosciences & Health Technologies, Lisboa, Portugal
| | - Bojana Vidovic
- Department of Bromatology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Nuno Saraiva
- CBIOS, Universidade Lusófona Research Center for Biosciences & Health Technologies, Lisboa, Portugal
| | - Maria do Céu Costa
- CBIOS, Universidade Lusófona Research Center for Biosciences & Health Technologies, Lisboa, Portugal.,ASAE/ONRE, National Observatory for Emerging Risks, Lisboa, Portugal
| | - Giorgia Del Favero
- Department of Food Chemistry and Toxicology, Faculty of Chemistry, University of Vienna, Vienna, Austria
| | - Doris Marko
- Department of Food Chemistry and Toxicology, Faculty of Chemistry, University of Vienna, Vienna, Austria
| | - Nuno G Oliveira
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisboa, Portugal
| | - Ana Sofia Fernandes
- CBIOS, Universidade Lusófona Research Center for Biosciences & Health Technologies, Lisboa, Portugal.,ASAE/ONRE, National Observatory for Emerging Risks, Lisboa, Portugal
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Gucalp A, Zhou XK, Cook ED, Garber JE, Crew KD, Nangia JR, Bhardwaj P, Giri DD, Elemento O, Verma A, Wang H, Lee JJ, Vornik LA, Mays C, Weber D, Sepeda V, O'Kane H, Krasne M, Williams S, Morris PG, Heckman-Stoddard BM, Dunn BK, Hudis CA, Brown PH, Dannenberg AJ. A Randomized Multicenter Phase II Study of Docosahexaenoic Acid in Patients with a History of Breast Cancer, Premalignant Lesions, or Benign Breast Disease. Cancer Prev Res (Phila) 2018; 11:203-214. [PMID: 29453232 PMCID: PMC6290902 DOI: 10.1158/1940-6207.capr-17-0354] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/02/2018] [Accepted: 02/02/2018] [Indexed: 12/12/2022]
Abstract
Obesity, a cause of subclinical inflammation, is a risk factor for the development of postmenopausal breast cancer and is associated with poorer cancer outcomes. Docosahexaenoic acid (DHA), an omega-3 fatty acid, possesses anti-inflammatory properties. We hypothesized that treatment with DHA would reduce the expression of proinflammatory genes and aromatase, the rate-limiting enzyme for estrogen biosynthesis, in benign breast tissue of overweight/obese women. A randomized, placebo-controlled, double-blind phase II study of DHA given for 12 weeks to overweight/obese women with a history of stage I-III breast cancer, DCIS/LCIS, Paget's disease, or proliferative benign breast disease was carried out. In this placebo controlled trial, the primary objective was to determine whether DHA (1,000 mg by mouth twice daily) reduced breast tissue levels of TNFα. Secondary objectives included evaluation of the effect of DHA on breast tissue levels of COX-2, IL1β, aromatase, white adipose tissue inflammation, and gene expression by RNA-seq. Red blood cell fatty acid levels were measured to assess compliance. From July 2013 to November 2015, 64 participants were randomized and treated on trial (32 women per arm). Increased levels of omega-3 fatty acids in red blood cells were detected following treatment with DHA (P < 0.001) but not placebo. Treatment with DHA did not alter levels of TNFα (P = 0.71), or other biomarkers including the transcriptome in breast samples. Treatment with DHA was overall well-tolerated. Although compliance was confirmed, we did not observe changes in the levels of prespecified biomarkers in the breast after treatment with DHA when compared with placebo. Cancer Prev Res; 11(4); 203-14. ©2018 AACRSee related editorial by Fabian and Kimler, p. 187.
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Affiliation(s)
- Ayca Gucalp
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Xi K Zhou
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York
| | - Elise D Cook
- Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Judy E Garber
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Katherine D Crew
- Departments of Medicine/Epidemiology, New York-Presbyterian/Columbia University Medical Center, New York, New York
| | - Julie R Nangia
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Priya Bhardwaj
- Department of Medicine, Weill Cornell Medical College, New York, New York
| | - Dilip D Giri
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Olivier Elemento
- Departments of Physiology and Biophysics/Computational Biomedicine, Weill Cornell Medical College, New York, New York
| | - Akanksha Verma
- Departments of Physiology and Biophysics/Computational Biomedicine, Weill Cornell Medical College, New York, New York
| | - Hanhan Wang
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York
| | - J Jack Lee
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lana A Vornik
- Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Carrie Mays
- Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Diane Weber
- Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Valerie Sepeda
- Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Holly O'Kane
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Margaret Krasne
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Samantha Williams
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Patrick G Morris
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Barbara K Dunn
- Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
| | - Clifford A Hudis
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
- American Society of Clinical Oncology, Alexandria, Virginia
| | - Powel H Brown
- Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston, Texas
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Culture media optimization of Porphyridium purpureum: production potential of biomass, total lipids, arachidonic and eicosapentaenoic acid. Journal of Food Science and Technology 2016; 53:2270-8. [PMID: 27407193 DOI: 10.1007/s13197-016-2185-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 01/07/2016] [Accepted: 01/20/2016] [Indexed: 10/21/2022]
Abstract
Porphyridium purpureum a red marine microalga is known for phycobiliproteins (PB), polyunsaturated fatty acids and sulphated exopolysaccharides. In the present study, effects of media constituents for the production of different polyunsaturated fatty acids from P. purpureum were considered using a response surface methodology (RSM). A second order polynomial was used to predict the response functions in terms of the independent variables such as the concentrations of sodium chloride, magnesium sulphate, sodium nitrate and potassium dihydrogen phosphate. The response functions were production of biomass yield, total lipid and polyunsaturated fatty acids like arachidonic acid (AA 20:4) and eicosapentaenoic acid (EPA 20:5). Results corroborated that maximum Biomass (0.95 gL(-1)) yield was at the concentrations of sodium chloride (14.89 gL(-1)), magnesium sulfate (3.93 gL(-1)) and sodium nitrate (0.96 gL(-1)) and potassium dihydrogen phosphate (0.09 gL(-1)). Optimum total lipid (17.9 % w/w) and EPA (34.6 % w/w) content was at the concentrations of sodium chloride (29.98 gL(-1)), magnesium sulfate (9.34 gL(-1)) and sodium nitrate (1.86 gL(-1)). Variation in concentration of potassium dihydrogen phosphate for both lipid (0.01gL(-1)) and EPA content (0.20 gL(-1)) was observed. The optimum conditions for biomass, total lipid, AA and EPA varied indicating their batch mode of growth and interaction effect of the salt.
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6
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Ganesh V, Hettiarachchy NS. A Review: Supplementation of Foods with Essential Fatty Acids—Can It Turn a Breeze without Further Ado? Crit Rev Food Sci Nutr 2015; 56:1417-27. [DOI: 10.1080/10408398.2013.765383] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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7
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Vidyashankar S, Sireesha E, Chauhan VS, Sarada R. Evaluation of microalgae as vegetarian source of dietary polyunsaturated fatty acids under autotrophic growth conditions. Journal of Food Science and Technology 2015. [DOI: 10.1007/s13197-015-1781-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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8
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Manzetti S, van der Spoel ER, van der Spoel D. Chemical Properties, Environmental Fate, and Degradation of Seven Classes of Pollutants. Chem Res Toxicol 2014; 27:713-37. [DOI: 10.1021/tx500014w] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Sergio Manzetti
- Uppsala
Center for Computational Chemistry, Science for Life Laboratory, Department
of Cell and Molecular Biology, University of Uppsala, Box 596, SE-75124 Uppsala, Sweden
- Fjordforsk A.S., Midtun, 6894 Vangsnes, Norway
| | - E. Roos van der Spoel
- Uppsala
Center for Computational Chemistry, Science for Life Laboratory, Department
of Cell and Molecular Biology, University of Uppsala, Box 596, SE-75124 Uppsala, Sweden
| | - David van der Spoel
- Uppsala
Center for Computational Chemistry, Science for Life Laboratory, Department
of Cell and Molecular Biology, University of Uppsala, Box 596, SE-75124 Uppsala, Sweden
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9
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Lev‐Tzion R, Griffiths AM, Ledder O, Turner D. Omega 3 fatty acids (fish oil) for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev 2014; 2014:CD006320. [PMID: 24585498 PMCID: PMC8988157 DOI: 10.1002/14651858.cd006320.pub4] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND The anti-inflammatory effects of n-3 (omega-3 fatty acids, fish oil) have been suggested to be beneficial in chronic inflammatory disorders such as inflammatory bowel disease. This review is an update of a previously published Cochrane review. OBJECTIVES To systematically review the efficacy and safety of n-3 for maintenance of remission in Crohn's disease (CD). SEARCH METHODS The following databases were searched from inception to November 2013 without language restriction: CENTRAL, MEDLINE, EMBASE, HealthSTAR, PubMed, and ACP journal club. SELECTION CRITERIA Randomized placebo-controlled trials (RCT) of n-3 for maintenance of remission in CD were included. Studies must have enrolled patients of any age group, who were in remission at the time of recruitment, and were followed for at least six months. The intervention must have been fish oil or n-3 given in pre-defined dosage. Co-interventions were allowed only if they were balanced between the study groups. DATA COLLECTION AND ANALYSIS The primary outcome was the relapse rate and secondary outcomes included change in disease activity scores, time to first relapse and adverse events. Two independent investigators reviewed studies for eligibility, extracted the data and assessed study quality using the Cochrane risk of bias tool. The overall quality of the evidence supporting the primary and selected secondary outcomes was reassessed for the current update using the GRADE system. We used the RevMan software for analyses. We calculated the risk ratio (RR) and corresponding 95% confidence interval (CI) for dichotomous outcomes and the hazard ratio and 95% CI for time-to-event outcomes. Random-effects or fixed-effect models were used according to degree of heterogeneity and sensitivity analyses were performed in an attempt to explore possible sources of heterogeneity. MAIN RESULTS Six studies with a total of 1039 patients were eligible for inclusion. The two largest studies were rated as low risk of bias for all assessed items. Four studies were rated as unclear risk of bias for randomization and allocation concealment. Two studies were rated as high risk of bias for incomplete outcome data and selective reporting. There was a marginal significant benefit of n-3 therapy for maintenance of remission. Thirty-nine per cent of patients in the n-3 group relapsed at 12 months compared to 47% of placebo patients (6 studies, 1039 patients; RR 0.77, 95% CI 0.61 to 0.98). A GRADE analysis rated the overall quality of the evidence for the primary outcome (i.e. relapse) as very low due to unexplained heterogeneity (I2 = 58%), publication bias, and a high or unknown risk of bias in four studies in the pooled analysis. When two large studies at low risk of bias were considered the benefit was no longer statistically significant. Thirty-seven per cent of patients in the n-3 group relapsed at 12 months compared to 42% of placebo patients (2 studies, 738 patients; RR 0.88, 95% CI 0.74 to 1.05). No significant heterogeneity was identified for this pooled analysis ( I2 = 0%). A GRADE analysis indicated that the overall quality of the evidence supporting this outcome was moderate due to sparse data (294 events). No serious adverse events were recorded in any of the studies but in a pooled analyses there was a significantly higher rate of diarrhea (4 studies, 862 patients; RR 1.36 95% CI 1.01 to 1.84) and upper gastrointestinal tract symptoms (5 studies, 999 patients; RR 1.65, 95% CI 1.25 to 2.18) in the n-3 treatment group. AUTHORS' CONCLUSIONS Evidence from two large high quality studies suggests that omega 3 fatty acids are probably ineffective for maintenance of remission in CD. Omega 3 fatty acids appear to be safe although they may cause diarrhea and upper gastrointestinal tract symptoms.
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Affiliation(s)
- Raffi Lev‐Tzion
- Shaare Zedek Medical CenterPediatric Gastroenterology UnitJerusalemIsrael
| | - Anne Marie Griffiths
- The Hospital for Sick ChildrenDivision of Gastroenterology, Hepatology & Nutrition555 University Ave.TorontoONCanadaM5G 1X8
| | - Oren Ledder
- Shaare Zedek Medical CenterPediatric Gastroenterology UnitJerusalemIsrael
| | - Dan Turner
- Shaare Zedek Medical CenterPediatric Gastroenterology UnitJerusalemIsrael
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Ashley JT, Ward JS, Anderson CS, Schafer MW, Zaoudeh L, Horwitz RJ, Velinsky DJ. Children's daily exposure to polychlorinated biphenyls from dietary supplements containing fish oils. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2013; 30:506-14. [DOI: 10.1080/19440049.2012.753161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Cai K, Whittle SL, Richards BL, Ramiro S, Falzon L, Buchbinder R. Marine oil supplements for rheumatoid arthritis. Hippokratia 2012. [DOI: 10.1002/14651858.cd010250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Ken Cai
- Royal Prince Alfred Hospital; Institute of Rheumatology and Orthopedics; Missenden Road Camperdown New South Wales Australia 2050
| | - Samuel L Whittle
- Queen Elizabeth Hospital; Rheumatology Unit; 28 Woodville Road Woodville South South Australia Australia 5011
| | - Bethan L Richards
- Royal Prince Alfred Hospital; Institute of Rheumatology and Orthopedics; Missenden Road Camperdown New South Wales Australia 2050
| | - Sofia Ramiro
- Leiden University Medical Center; Department of Rheumatology; Leiden Netherlands
- Zuyderland Medical Center; Heerlen Netherlands
| | - Louise Falzon
- Columbia University Medical Center; Center for Behavioral Cardiovascular Health; PH9 Room 322 622 West 168th St New York NY USA 10032
| | - Rachelle Buchbinder
- Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine; Melbourne Australia
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Nutritional Interventions to Prevent and Treat Osteoarthritis. Part I: Focus on Fatty Acids and Macronutrients. PM R 2012; 4:S145-54. [DOI: 10.1016/j.pmrj.2012.02.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 02/27/2012] [Indexed: 02/06/2023]
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Huang JJ, Cheung PC. Enhancement of polyunsaturated fatty acids and total carotenoid production in microalgae by ultraviolet band A (UVA, 365 nm) radiation. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2011; 59:4629-4636. [PMID: 21443261 DOI: 10.1021/jf200910p] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Two microalgae, Porphyridium cruentum and Platymonas subcordiformis , were subjected to a 3-day exposure of ultraviolet band A (UVA) radiation at 365 nm (∼1.32-1.35 W/m(2)) and photosynthetically active radiation (PAR) (∼11.56-11.62 W/m(2)) followed by a 3-day UVA-free (exposure to PAR only) treatment. UVA inhibited the growth of P. subcordiformis and P. cruentum during the UVA-exposure period. Significant increases (p < 0.05) of total polyunsaturated fatty acids (PUFAs), saturated fatty acids (SFAs), and lipid content were found in P. cruentum during the UVA exposure period, whereas such increases in P. subcordiformis were observed only at the end of the UVA-free period. Concentrations of individual PUFAs including linoleic acid, eicosatrienoic acid, and eicosapentaenoic acid as well as total carotenoids were significantly increased (p < 0.05) at different stages of the UVA treatment in both microalgae. UVA (365 nm) radiation has the potential application for producing microalgal biomass rich in PUFAs and carotenoids as a natural functional ingredient.
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Affiliation(s)
- Jim Junhui Huang
- Biology Programme, School of Life Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, People's Republic of China
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Assmuth T. Policy and science implications of the framing and qualities of uncertainty in risks: toxic and beneficial fish from the Baltic Sea. AMBIO 2011; 40:158-69. [PMID: 21446394 PMCID: PMC3357784 DOI: 10.1007/s13280-010-0127-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Policy and research issues in the framing and qualities of uncertainties in risks are analyzed, based on the assessments of dioxin-like compounds (DLCs) and other ingredients in Baltic Sea fish, a high-profile case of governance. Risks are framed broadly, to then focus on dioxins and beneficial fatty acids, fish consumption, human health, and science-management links. Hierarchies of uncertainty (data, model, decision rule, and epistemic) and ambiguity (of values) are used to identify issues of scientific and policy contestation and opportunities for resolving them. The associated complexity of risks is illustrated by risk-benefit analyses of fish consumption and by evaluations of guideline values, highlighting value contents and policy factors in presumably scientific decision criteria, and arguments used in multi-dimensional risk and benefit comparisons. These comparisons pose challenges to narrow assessments centered, for e.g., on toxicants or on food benefits, and to more many-sided and balanced risk communication and management. It is shown that structured and contextualized treatment of uncertainties and ambiguities in a reflexive approach can inform balances between wide and narrow focus, detail and generality, and evidence and precaution.
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Affiliation(s)
- Timo Assmuth
- Finnish Environment Institute, Helsinki, Finland.
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15
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Perspectives on the use of marine and freshwater hydrobiont oils for development of drug delivery systems. Biotechnol Adv 2011; 29:548-57. [PMID: 21315143 DOI: 10.1016/j.biotechadv.2011.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 01/26/2011] [Accepted: 01/27/2011] [Indexed: 01/13/2023]
Abstract
Marine foods represent a unique source of poly-unsaturated fatty acids (PUFA) of the omega-3 (n-3) family. Today it is generally accepted that fish oil is important in a healthy and balanced omnivorous human diet. This favorable health perception of fish oil is however troubled by the high level of PUFA oxidation and low absorption in the gastro-intestinal tract. In this work we present and described various types of delivery systems which are used to improve PUFA and fish oil availability and oxidative stability.
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Qin YY, Leung CKM, Leung AOW, Zheng JS, Wong MH. Persistent organic pollutants in food items collected in Hong Kong. CHEMOSPHERE 2011; 82:1329-1336. [PMID: 21193217 DOI: 10.1016/j.chemosphere.2010.12.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Revised: 11/24/2010] [Accepted: 12/03/2010] [Indexed: 05/30/2023]
Abstract
This study aims to investigate levels of POPs in meat, edible oils, nuts, milk and wine collected from Hong Kong. Naphthalene, pp-DDE, beta-, gamma-HCH and PBDE 47 were detected in most of the food items. Goose liver accumulated the highest PAHs (47.9ngg(-1) wet wt), DDTs (25.6), HCHs (13.0), PCBs (4.17), PBDEs (468pgg(-1) wet wt) among all the selected food. Meat and nut groups had significant (p<0.01 or 0.05) correlations between lipid contents and concentrations of PAHs (meat: r=0.878), HCHs (meat: r=0.753), DDTs (meat: r=0.937; nuts: r=0.968) and PCBs (meat: r=0.832; nut: r=0.946). The concentrations of DDTs, HCHs and PCBs in vegetable oil were lower, but HCHs in fish oil were higher, when compared with other countries. The concentrations of PAHs, DDTs, PCBs and PBDEs in food tested in the present study were all below various safety guidelines.
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Affiliation(s)
- Yan Yan Qin
- Croucher Institute for Environmental Sciences, and Department of Biology, Hong Kong Baptist University, Hong Kong, PR China
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Turner D, Shah PS, Steinhart AH, Zlotkin S, Griffiths AM. Maintenance of remission in inflammatory bowel disease using omega-3 fatty acids (fish oil): a systematic review and meta-analyses. Inflamm Bowel Dis 2011; 17:336-45. [PMID: 20564531 DOI: 10.1002/ibd.21374] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The objective was to systematically review the efficacy and safety of n-3 (omega-3 fatty acids, fish oil) for maintaining remission in Crohn's disease (CD) and ulcerative colitis (UC). Electronic databases were searched systematically for randomized controlled trials of n-3 for maintenance of remission in inflammatory bowel disease (IBD). Studies of patients of any age group who were in remission at the time of recruitment and were followed for at least 6 months were included. The primary outcome was relapse rate at the end of the follow-up period. Nine studies were eligible for inclusion; six studies of CD (n = 1039) and three of UC (n = 138). There was a statistically significant benefit for n-3 in CD (relative risk [RR] 0.77; 95% confidence interval [CI] 0.61-0.98); however, the studies were heterogeneous (I(2) = 58%). The absolute risk reduction was -0.14 (95% CI: -0.25 to -0.02). Opinions may vary on whether this is a clinically significant effect. Two well-done studies with a larger sample size reported no benefit. A sensitivity analysis excluding a small pediatric study resulted in the pooled RR being no longer statistically significant. A funnel plot analysis suggested publication bias for the smaller studies. For UC, there was no difference in the relapse rate between the n-3 and control groups (RR 1.02; 95% CI: 0.51-2.03). The pooled analysis showed a higher rate of diarrhea (RR 1.36; 95% CI: 1.01-1.84) and symptoms of the upper gastrointestinal tract (RR 1.96; 95% CI: 1.37-2.80) in the n-3 treatment group. There are insufficient data to recommend the use of omega 3 fatty acids for maintenance of remission in CD and UC.
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Affiliation(s)
- Dan Turner
- Pediatric Gastroenterology Unit, Shaare Zedek Medical Center, Hebrew University of Jerusalem, Israel.
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Dovydaitis T. Fish Consumption During Pregnancy: An Overview of the Risks and Benefits. J Midwifery Womens Health 2010; 53:325-30. [DOI: 10.1016/j.jmwh.2008.02.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Polychlorinated biphenyls (PCBs) contamination and aryl hydrocarbon receptor (AhR) agonist activity of Omega-3 polyunsaturated fatty acid supplements: Implications for daily intake of dioxins and PCBs. Food Chem Toxicol 2010; 48:3093-7. [DOI: 10.1016/j.fct.2010.07.051] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 07/06/2010] [Accepted: 07/31/2010] [Indexed: 11/17/2022]
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Ashley J, Ward J, Schafer M, Stapleton H, Velinsky D. Evaluating daily exposure to polychlorinated biphenyls and polybrominated diphenyl ethers in fish oil supplements. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2010; 27:1177-85. [DOI: 10.1080/19440041003793298] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Omacor (prescription omega-3-acid ethyl esters 90): From severe rhythm disorders to hypertriglyceridemia. Adv Ther 2009; 26:675-90. [PMID: 19629408 DOI: 10.1007/s12325-009-0045-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Indexed: 01/19/2023]
Abstract
Despite progress made in post-myocardial infarction (MI) revascularization and background therapy for the failing heart, the prevention of adverse cardiac remodeling associated with severe rhythm disorders remains an important drug target. Part of the remodeling can be counteracted by modulating the activity of ion channels and exchangers by omega-3 acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). In the GISSI-Prevenzione and GISSI-HF trials, omega-3 fatty acids were administered as ethyl esters (Omacor Solvay Pharmaceuticals) and not as triglycerides present in fish oil. Ethyl esters result in a sustained intestinal absorption of EPA and DHA and require various purification steps during production, thereby minimizing the content of environmental toxins. Also the rather high (38%) DHA content of Omacor should not be ignored since in rats with low dose intake of omega-3 acids, DHA but not EPA inhibited ischemia-induced arrhythmias. In patients on multiple tablets, 840 mg EPA+DHA in one capsule is preferred to increase compliance. It is not justified to refer to Omacor as "n-3 polyunsaturated fatty acid supplementation" or even "fish oil" and, based on controlled clinical trials, there is no evidence that fish oil could be a substitute of Omacor. To avoid further confusion, guidelines should be precise and refer to the medication, eg, as in NICE guideline CG48: "Omega-3-acid ethyl esters treatment licensed for secondary prevention post-MI." The anti-arrhythmogenic action of Omacor should be seen in the context of implantable cardioverter-defibrillator trials (DINAMIT, IRIS) where non-sudden death was increased and total mortality unaltered. However, Omacor administered in the GISSI-HF trial reduced the incidence of severe arrhythmic events and mortality. Also in the GISSI-Prevenzione trial, arrhythmic death and mortality were reduced. At higher dosages (daily, 3-4 g) Omacor exhibits more pronounced cardiovascular benefits and, as a licensed indication, improves hypertriglyceridemia and related lipid parameters.
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Brulotte J, Bukutu C, Vohra S. Complementary, holistic, and integrative medicine: fish oils and neurodevelopmental disorders. Pediatr Rev 2009; 30:e29-33. [PMID: 19339384 DOI: 10.1542/pir.30-4-e29] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Jayna Brulotte
- Complementary and Alternative Research and Education Program, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
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Turner D, Zlotkin SH, Shah PS, Griffiths AM. Omega 3 fatty acids (fish oil) for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev 2009:CD006320. [PMID: 19160277 DOI: 10.1002/14651858.cd006320.pub3] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The anti-inflammatory effects of n-3 (omega-3 fatty acids, fish oil) have been suggested to be beneficial in chronic inflammatory disorders such as inflammatory bowel disease. OBJECTIVES To systematically review the efficacy and safety of n-3 for maintenance of remission in Crohn's disease (CD). SEARCH STRATEGY The following databases were searched from their inception without language restriction: Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Healthstar, PubMed, and ACP journal club. Experts were contacted for unpublished data. SELECTION CRITERIA Randomized placebo-controlled trials (RCT) of n-3 for maintenance of remission in CD were included. Studies must have enrolled patients of any age group, who were in remission at the time of recruitment, and were followed for at least six months. The intervention must have been fish oil or n-3 given in pre-defined dosage. Co-interventions were allowed only if they were balanced between the study groups. The primary outcome was the relapse rate and secondary outcomes included change in disease activity scores, time to first relapse and adverse events. DATA COLLECTION AND ANALYSIS Two independent investigators reviewed studies for eligibility, extracted the data and assessed study quality using Jadad's criteria. Meta-analyses were performed using RevMan 4.2 software weighted by the Mantel-Haenszel method. Random or fixed effect models were used according to degree of heterogeneity and subgroup analyses were performed in an attempt to explore possible sources of heterogeneity. MAIN RESULTS Six studies were eligible for inclusion. There was a marginal significant benefit of n-3 therapy for maintaining remission (RR 0.77 0.; 95%CI 0.61 to 0.98; P = 0.03). However, the studies were both clinically and statistically heterogeneous (P = 0.03, I(2) = 58%). Two large studies showed negative results. When considering the estimated rather than the observed 1-year relapse rate of these two studies, the benefit was no longer statistically significant (RR 0.59; 95% CI 0.34 to 1.03; P=0.06). A funnel plot suggested publication bias. No serious adverse events were recorded in any of the studies but in a pooled analyses there was a significantly higher rate of diarrhea (RR 1.36 95% CI 1.01 to 1.84) and symptoms of the upper gastrointestinal tract (RR 1.98 95% CI 1.38 to 2.85) in the n-3 treatment group. AUTHORS' CONCLUSIONS Omega 3 fatty acids are safe but probably ineffective for maintenance of remission in CD. The existing data do not support routine maintenance treatment of Crohn's disease with omega 3 fatty acids.
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Affiliation(s)
- Dan Turner
- Pediatric Gastroenterology Unit, Shaare Zedek Medical Center, P.O.B 3235, Jerusalem, Israel, 91031.
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Andreescu C, Mulsant BH, Emanuel JE. Complementary and alternative medicine in the treatment of bipolar disorder--a review of the evidence. J Affect Disord 2008; 110:16-26. [PMID: 18456339 DOI: 10.1016/j.jad.2008.03.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2007] [Revised: 03/20/2008] [Accepted: 03/26/2008] [Indexed: 11/26/2022]
Abstract
A growing number of patients with mood disorders are using complementary and alternative medicine (CAM) interventions. In this paper, we review the published scientific evidence on the benefits and risks of CAM for the treatment of patients with bipolar disorder. Since very few studies of CAM have involved patients with bipolar disorder, most available evidence is derived from trials conducted in patients with major depressive disorder. The use of omega-3 fatty acids has been studied in two controlled studies in bipolar disorder while St. John's wort (Hypericum perforatum), S-adenosyl-l-methionine (SAMe), and acupuncture have been studied in a series of randomized controlled trials in patients with major depression. Overall, the best evidence supports the use of St. John's wort for the treatment of mild to moderate depression. SAMe may also be effective for depression. However, both of these products have the potential to induce mania; the extent of this risk needs to be quantified. St. John's wort can also interact with a variety of medications. Evidence regarding the benefits of omega-3 fatty acids or acupuncture is inconsistent. Data regarding other CAM interventions (e.g., aromatherapy massage, massage therapy, yoga) are almost entirely lacking. In conclusion, better studies are needed before CAM interventions can be recommended to patients with bipolar disorder. In the meantime, patients need to be informed about the possible risks associated with the use of these interventions.
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Affiliation(s)
- Carmen Andreescu
- The Advanced Center for Interventions and Services Research for Late-life Mood Disorders, Department of Psychiatry, University of Pittsburgh School of Medicine, USA
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Abstract
With greater focus on chronic disease prevention, renewed attention has been directed toward understanding the pathophysiology of various medical conditions and the development of newer medical treatments to prevent and treat complications. There has been immense interest in evaluating societal lifestyles, cultural attitudes toward health, and dietary influences on health conditions. The omega-3 fatty acids have become a focus of interest, and recent research and trial evidence have highlighted their effects, including potential clinical advantages. Despite this progress, the precise mechanisms through which omega-3 fatty acids act remain poorly understood. These agents are now recommended as secondary prevention after acute myocardial infarction, and ongoing large clinical trials should provide insight into the use of omega-3 fatty acids in heart failure and the primary prevention of cardiovascular disease.
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Affiliation(s)
- Puneet Kakar
- University Department of Medicine, City Hospital, Birmingham B18 7QH, UK.
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Turner D, Zlotkin SH, Shah PS, Griffiths AM. Omega 3 fatty acids (fish oil) for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev 2007:CD006320. [PMID: 17443620 DOI: 10.1002/14651858.cd006320.pub2] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND The anti-inflammatory effects of n-3 (omega-3 fatty acids, fish oil) have been suggested to be beneficial in chronic inflammatory disorders such as inflammatory bowel disease. OBJECTIVES To systematically review the efficacy and safety of n-3 for maintaining remission in Crohn's disease (CD). SEARCH STRATEGY The following databases were searched from their inception without language restriction: Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Healthstar, PubMed, and ACP journal club. Experts were contacted for unpublished data. SELECTION CRITERIA Randomized placebo-controlled trials (RCT) of n-3 for maintenance of remission in CD were included. Studies must have enrolled patients of any age group, who were in remission at the time of recruitment, and were followed for at least six months. The intervention must have been fish oil or n-3 given in pre-defined dosage. Co-interventions were allowed only if they were balanced between the study groups. The primary outcome was relapse rate and secondary outcomes were change in disease activity scores, time to first relapse and adverse events. DATA COLLECTION AND ANALYSIS Two independent investigators reviewed studies for eligibility, extracted the data and assessed study quality using Jadad's criteria. Meta-analysis was performed using RevMan 4.2 software, weighted by the Mantel-Haenszel method. Random or fixed effect models were used according to degree of heterogeneity and subgroup analyses were performed to address heterogeneity. MAIN RESULTS Four studies were eligible for inclusion. There was a non statistically significant benefit of n-3 therapy for maintaining remission (RR 0.64; 95%CI 0.4 to 1.03; P = 0.07). However, the studies were both clinically and statistically heterogeneous (P = 0.01, I(2) = 72%). Three studies used enteric coated capsules (positive effects) and one ordinary gelatin capsules (no advantage). Subgroup analyses of studies which used enteric coated capsules revealed a statistically significant benefit for maintenance of remission (RR 0.49; 95% CI 0.35 to 0.69; RD 0.31; 95% CI 0.19 to 0.43); number needed to treat to prevent relapse in 1 year was 3 (95% CI 2 to 5; I(2) = 19%). However, the total number of patients enrolled in these studies was small (n = 166). No significant adverse events were recorded in any of the studies and not enough data were available to analyze the other secondary outcomes. AUTHORS' CONCLUSIONS Omega 3 fatty acids are safe and may be effective for maintenance of remission in CD when used in enteric coated capsules. However, there are not sufficient data to recommend the routine use of n-3 for maintenance of remission in CD. The small number of patients in the included studies warrants further larger RCTs.
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Affiliation(s)
- D Turner
- Hospital for Sick Children, Division of Gastroenterology, Hepatology and Nutrition, 555 University Ave., Toronto, Ontario, CANADA, M5G 1X8.
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Abstract
It has been suggested that the potential antithrombotic effect of fish oils may theoretically increase the risk for bleeding, which may be a safety concern for individual patients. However, clinical trial evidence has not supported increased bleeding with omega-3 fatty acid intake, even when combined with other agents that might also increase bleeding (such as aspirin and warfarin). Another potential safety concern is the susceptibility of omega-3 fatty acid preparations to undergo oxidation, which contributes to patient intolerance and potential toxicity. Finally, large amounts of fish consumption may result in adverse experiences due to the potential presence of environmental toxins such as mercury, polychlorinated biphenyls, dioxins, and other contaminants. The risks of exposure to environmental toxins and hypervitaminosis with fish consumption are substantially reduced through purification processes used to develop selected concentrated fish oil supplements and prescription preparations. Thus, in choosing which fish oil therapies to recommend, clinicians should be aware of available information to best assess their relative safety, which includes the US Food and Drug Administration (FDA) and Environmental Protection Agency (EPA) advisory statement regarding fish consumption, the meaning of certain labeling (such as "verification" through the US Pharmacopeia) and the differences in FDA regulatory requirements between nonprescription fish oil supplements and prescription fish oil preparations, and how all of this is important to the optimal treatment of patients.
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Affiliation(s)
- Harold E Bays
- Louisville Metabolic and Atherosclerosis Research Center, Louisville, Kentucky 40213, USA.
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Abstract
There is a general belief among doctors, in part grounded in experience, that patients with arthritis need nonsteroidal anti-inflammatory drugs (NSAIDs). Implicit in this view is that these patients require the symptomatic relief provided by inhibiting synthesis of nociceptive prostaglandin E2, a downstream product of the enzyme cyclo-oxygenase (COX), which is inhibited by NSAIDs. However, the concept of 'safe' NSAIDs has collapsed following a multiplicity of observations establishing increased risk for cardiovascular events associated with NSAID use, especially but not uniquely with the new COX-2-selective NSAIDs. This mandates greater parsimony in the use of these agents. Fish oils contain a natural inhibitor of COX, reduce reliance on NSAIDs, and reduce cardiovascular risk through multiple mechanisms. Fish oil thus warrants consideration as a component of therapy for arthritis, especially rheumatoid arthritis, in which its symptomatic benefits are well established. A major barrier to the therapeutic use of fish oil in inflammatory diseases is ignorance of its mechanism, range of beneficial effects, safety profile, availability of suitable products, effective dose, latency of effects and instructions for administration. This review provides an evidence-based resource for doctors and patients who may choose to prescribe or take fish oil.
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Affiliation(s)
- Leslie G Cleland
- Rheumatology Unit, Royal Adelaide Hospital, North Terrace, Adelaide, Australia
| | - Michael J James
- Rheumatology Unit, Royal Adelaide Hospital, North Terrace, Adelaide, Australia
| | - Susanna M Proudman
- Rheumatology Unit, Royal Adelaide Hospital, North Terrace, Adelaide, Australia
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Rindfleisch JA. Neck Pain. Integr Med (Encinitas) 2007. [DOI: 10.1016/b978-1-4160-2954-0.50068-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Gebauer SK, Psota TL, Harris WS, Kris-Etherton PM. n-3 fatty acid dietary recommendations and food sources to achieve essentiality and cardiovascular benefits. Am J Clin Nutr 2006; 83:1526S-1535S. [PMID: 16841863 DOI: 10.1093/ajcn/83.6.1526s] [Citation(s) in RCA: 357] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Dietary recommendations have been made for n-3 fatty acids, including alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) to achieve nutrient adequacy and to prevent and treat cardiovascular disease. These recommendations are based on a large body of evidence from epidemiologic and controlled clinical studies. The n-3 fatty acid recommendation to achieve nutritional adequacy, defined as the amount necessary to prevent deficiency symptoms, is 0.6-1.2% of energy for ALA; up to 10% of this can be provided by EPA or DHA. To achieve recommended ALA intakes, food sources including flaxseed and flaxseed oil, walnuts and walnut oil, and canola oil are recommended. The evidence base supports a dietary recommendation of approximately 500 mg/d of EPA and DHA for cardiovascular disease risk reduction. For treatment of existing cardiovascular disease, 1 g/d is recommended. These recommendations have been embraced by many health agencies worldwide. A dietary strategy for achieving the 500-mg/d recommendation is to consume 2 fish meals per week (preferably fatty fish). Foods enriched with EPA and DHA or fish oil supplements are a suitable alternate to achieve recommended intakes and may be necessary to achieve intakes of 1 g/d.
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Affiliation(s)
- Sarah K Gebauer
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA 16802, USA
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Garg M, Wood L, Singh H, Moughan P. Means of Delivering Recommended Levels of Long Chain n-3 Polyunsaturated Fatty Acids in Human Diets. J Food Sci 2006. [DOI: 10.1111/j.1750-3841.2006.00033.x] [Citation(s) in RCA: 146] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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