The human organism needs adequate fatty acids to survive the daily bodily processes. Omega-3 fatty acids that are usually obtained from cold-water fish or flax seed oil have demonstrated in clinical research to thwart the production of mediators, such as bad prostaglandins. Omega-3's are best measured for its active EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) content and not to be mistaken with the total fill weight of the average fish oil capsule found in the super markets.

Since the western diet primarily consists of omega 6's and 9's (meat and vegetable oils) it becomes vitally important for those who are interested in offsetting bad prostaglandin production to consume extra Omega-3's that are rich in EPA and DHA content. Recent clinical research demonstrated, that population groups who consumed large amount of fish had considerably less heart and circulatory problems than those who eat none. It was concluded that the EPA and DHA content in these fish provided the necessary substrates for the beneficial health effects.

Behavioral and concentration problems in young adults are associated with the active DHA content in the blood plasma. Dyslexics showed remarkable improvement while supplementing EFA's that were rich in DHA and EPA fatty acids. The most interesting study we came across noted that individuals with problems in perception and thought processes improved while supplementing an extra 3-5 grams of EPA and DHA daily. DHA is a structural component of the central nervous system. It is also known that DHA is a responsible substrate in facilitating optimum brain and eye development and therefore essential for pregnant women and young children. On a side-note, it was documented that the breast milk of the average American women is the lowest in the world.

Consumption of fish oil alters the body's production of certain substances in the class of chemicals called prostaglandins. Some prostaglandins increase inflammation while others decrease it. The prostaglandins whose production is enhanced by fish oil fall into the anti-inflammatory category. Based on this, fish oil has been tried as a treatment for early stages of rheumatoid arthritis, with positive results. It is thought to significantly reduce symptoms without causing side effects and may magnify the benefits of standard arthritis drugs. However, while some standard medications can slow the progression of the disease, there is no evidence that fish oil can do this. Much weaker evidence hints that fish oil might be helpful for the related disease ankylosing spondylitis.

Fish oil's apparent anti-inflammatory properties are the likely explanation for its apparent benefit in dysmenorrhea (menstrual pain), as seen in two studies. Similarly, fish oil may be helpful for the autoimmune disease lupus. (However, two studies failed to find fish oil helpful for kidney disease caused by lupus. Evidence is mixed regarding whether fish oil is beneficial for Crohn's disease or ulcerative colitis, conditions in which parts of the digestive tract are highly inflamed.

Incomplete evidence hints but does not prove that fish or fish oil might help prevent death caused by heart disease.This effect, if it exists, seems to result from several separate actions. The best documented involves reducing high triglyceride levels; studies enrolling more than 2,000 people have substantiated this use.1 In addition, fish oil might raise HDL ("good") cholesterol levels, "thin" the blood, lower levels of homocysteine, prevent dangerous heart arrhythmias, slow heart rate, improve blood vessel tone, and decrease blood pressure. These effects also support findings that fish oil may help prevent strokes. However, results are conflicting on whether people with angina should take fish oil or increase intake of fatty fish; one large study actually found that fish oil increased risk of sudden death.

For reasons that are almost entirely unclear, fish oil might have positive effects on various psychiatric disorders. According to one small double-blind study, high doses of fish oil may produce benefits in  bipolar disorder (more commonly known as manic-depressive illness), reducing risk of relapse and improving emotional state. It might also offer benefits in depression, schizophrenia and borderline personality disorder. In one study, DHA failed to augment the effectiveness of standard therapy for attention deficit disorder (ADD). However, two studies that evaluated the potential benefits of fish oil combined with omega-6 fatty acids found some evidence of benefit.

Small studies also suggest that fish oil may be helpful in Raynaud's phenomenon (a condition in which a person's hands and feet show abnormal sensitivity to cold temperatures), sickle-cell anemia, and a form of kidney disease called IgA nephropathy.

According to some, but not all studies, fish oil may help treat the undesired weight loss often experienced by people with cancer. In addition, highly preliminary evidence hints that DHA might enhance the effects of the cancer chemotherapy drug doxorubicin and decrease side effects of the chemotherapy drug irinotecan.

Use of fish oil by pregnant women might help prevent premature birth, although evidence is somewhat inconsistent. In addition, use of fish oil by pregnant women may support healthy brain function183 and help prevent eczema and allergies in offspring.

Intriguing, but not yet at all reliable, evidence hints that fish oil, or its constituents, might be helpful for treating kidney stones, alleviating the symptoms of chronic fatigue syndrome, reducing the risk of prostate cancer, and decreasing seizure frequency in people with epilepsy.

Fish oil has also been proposed as a treatment for many other conditions, including diabetic neuropathy, allergies, and gout, but there has been little real scientific investigation of these uses.

Some, but not all, studies suggest that fish oil combined with may augment the effectiveness of calcium in the treatment of osteoporosis. One promising, but highly preliminary, double-blind, placebo-controlled study suggests that the same combination therapy may improve symptoms of the severe neurological illness called Huntington's disease.

Use of a fish oil product as part of a total parenteral nutrition regimen (intravenous feeding) may help speed recovery after major abdominal surgery.

Heart Disease Prevention

A gigantic study (over 18,000 participants) published in 2007 was widely described in the media as finally proving beyond a shadow of a doubt that fish oil helps prevent heart problems. Unfortunately, this study lacked a placebo group, and therefore failed to provide reliable evidence.

As noted earlier, fish oil is hypothesized to exert several separate effects that act together to help protect the heart. The most important action of fish oil may be its apparent ability to reduce. Like cholesterol, triglycerides are a type of fat in the blood that tends to damage the arteries, leading to heart disease. According to most, though not all, studies, fish oil supplements can reduce triglycerides by about 25% to 30%.

Some but not all studies suggest that fish, fish oil, or EPA or DHA separately may additionally raise the level of HDL ("good") cholesterol and possibly improve other aspects of cholesterol profile as well. This too should help prevent heart disease.

Additionally, fish oil may help the heart by "thinning" the blood and by reducing blood levels of homocysteine, although not all studies have found a positive effect.

Studies contradict one another on whether fish oil can lower blood pressure, but on balance the supplement does seem to exert a modest positive effect. A 6-week, double-blind, placebo-controlled study of 59 overweight men suggests that the DHA in fish oil, but not the EPA, is responsible for this benefit.

Fish oil may slightly reduce heart rate. This effect could contribute to preventing heart attacks and other heart problems.

Rheumatoid Arthritis

The results of numerous small double-blind trials indicate that omega-3 fatty acids in fish oil can help reduce the symptoms of rheumatoid arthritis. The benefits of the fish oil effect may be enhanced by a vegetarian diet. Simultaneous supplementation with olive oil (about two teaspoons daily) may further increase the benefits. However, unlike some conventional treatments, fish oil probably does not slow the progression of rheumatoid arthritis.

Menstrual Pain

Regular use of fish oil may reduce the pain of menstrual cramps.

In a 4-month study of 42 young women aged 15 to 18, half the participants received a daily dose of 6 g of fish oil, providing 1,080 mg of EPA and 720 mg of DHA daily. After 2 months, they were switched to placebo for another 2 months. The other group received the same treatments in reverse order. The results showed that these young women experienced significantly less menstrual pain while they were taking fish oil.

Another double-blind study followed 78 women, who received either fish oil, seal oil, fish oil with vitamin B12 (7.5 mcg daily), or placebo for three full menstrual periods.Significant improvements were seen in all treatment groups, but the fish oil plus vitamin B12 proved most effective, and its benefits continued for the longest time after treatment was stopped (3 months). The researchers offered no explanation why vitamin B12 should be helpful.

Bipolar Disorder

A 4-month, double-blind, placebo-controlled study of 30 individuals suggests that fish oil can enhance the effects of standard treatments for bipolar disorder, reducing risk of relapse and improving emotional state.130 Eleven of the 14 individuals who took fish oil improved or remained well during the course of the study, while only 6 out of the 16 given placebo responded similarly.

Another small study found that ethyl-EPA (a modified form of EPA) is helpful for the depressive phase of bipolar disease.

Depression

A 4-week, double-blind, placebo-controlled trial evaluated the potential benefits of fish oil in 20 individuals with depression.154 All but one participant were also taking standard antidepressants and had been taking them for at least 3 months. By week 3, the level of depression had improved to a significantly greater extent in the fish oil group than in placebo group. Six of 10 participants given fish oil, but only one of 10 given placebo, showed at least a 50% reduction in depression scores by the end of the trial. (A reduction of this magnitude is considered a "cure.")

A double-blind, placebo-controlled study of 70 people who were still depressed despite standard therapy found that additional treatment with ethyl-EPA (a modified form of EPA) improved symptoms. Similar add-on benefits were also seen in other double-blind studies of ethyl-EPA or mixed essential fatty acids.

Schizophrenia

Five double-blind, placebo-controlled studies have been performed on EPA for the treatment of schizophrenia, with benefits seen in four out of the five.

Osteoporosis

There is some evidence that essential fatty acids may enhance the effectiveness of calcium in osteoporosis. In one study, 65 postmenopausal women were given calcium along with either placebo or a combination of omega-6 fatty acids (from evening primrose oil) and omega-3 fatty acids (from fish oil) for a period of 18 months. At the end of the study period, the group receiving essential fatty acids had higher bone density and fewer fractures than the placebo group.

However, a 12-month, double-blind trial of 42 postmenopausal women found no benefit.

The explanation for the discrepancy may lie in the differences between the women studied. The first study involved women living in nursing homes, while the second studied healthier women living on their own. The latter group of women may have been better nourished and already received enough essential fatty acids in their diet.

Lupus

Lupus is a serious autoimmune disease that can cause numerous problems, including fatigue, joint pain, and kidney disease. One small, 34-week, double-blind, placebo-controlled crossover study compared placebo against daily doses of EPA (20 g) from fish oil. A total of 17 individuals completed the trial. Of these, 14 showed improvement when taking EPA, while only 4 did so when treated with placebo. Another small study found similar benefits with fish oil over a 24-week period. However, two small studies failed to find fish oil helpful for lupus nephritis (kidney damage caused by lupus).

Attention Deficit and Hyperactivity Disorder (ADHD)

Based on evidence that essential fatty acids are necessary for the proper development of brain function in growing children, EFAs have been tried for the treatment of ADHD and related conditions.

A preliminary double-blind, placebo-controlled trial found some evidence that a supplement containing fish oil and evening primrose oil might improve ADHD symptoms. However, a high dropout rate makes the results of this trial somewhat unreliable. Another small study examined fish oil in children with ADHD who had thirst and skin problems. Benefits were seen with fish oil, but they also occurred with placebo and to about the same extent.

Relevant Studies

1. Harris WS. N-3 fatty acids and serum lipoproteins: human studies. Am J Clin Nutr. 1997;65(suppl 5 ):S1645-S1654.

2. Shekelle RB, Shryock AM, Paul O, et al. Diet, serum cholesterol, and death from coronary heart disease. The Western Electric Study. N Engl J Med. 1981;304:65-70.

3. Kromhout D, Bosschieter EB, De Lezenne Coulander C. The inverse relation between fish consumption and 20- year mortality from coronary heart disease. N Engl J Med. 1985;312:1205-1209.

4. Harris WS. N-3 fatty acids and serum lipoproteins: human studies. Am J Clin Nutr. 1997;65(suppl 5):S1645-S1654.

5. Cobiac L, Clifton PM, Abbey M, et al. Lipid, lipoprotein, and hemostatic effects of fish vs fish-oil n-3 fatty acids in mildly hyperlipidemic males. Am J Clin Nutr. 1991;53:1210-1216.

6. Dyerberg J. N-3 fatty acids and coronary artery disease: potentials and problems. In: Omega-3, Lipoproteins, and Atherosclerosis. Paris, France: John Libbey Eurotext; 1996; 27: 251-258.

7. Lungershausen YK, Abbey M, Nestel PJ, et al. Reduction of blood pressure and plasma triglycerides by omega-3 fatty acids in treated hypertensives. J Hypertens. 1994;12:1041-1045.

8. Radack K, Deck C, Huster G. The effects of low doses of n-3 fatty acid supplementation on blood pressure in hypertensive subjects. A randomized controlled trial. Arch Intern Med. 1991;151:1173-1180.

9. Singer P, Jaeger W, Wirth M, et al. Lipid and blood pressure-lowering effect of mackerel diet in man. Atherosclerosis. 1983;49:99-108.

10. Singer P, Melzer S, Goschel M, et al. Fish oil amplifies the effect of propranolol in mild essential hypertension. Hypertension. 1990;16:682-691.

11. Whelton PK, Kumanyika SK, Cook NR, et al. Efficacy of nonpharmacologic interventions in adults with high-normal blood pressure: results from phase 1 of the Trials of Hypertension Prevention. Am J Clin Nutr. 1997;65(suppl 2):S652-S660.

12. von Schacky C, Angerer P, Kothny W, et al. The effect of dietary omega-3 fatty acids on coronary atherosclerosis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 1999;130:554-562.

13. Mori TA, Bao DQ, Burke V, et al. Docosahexaenoic acid but not eicosapentaenoic acid lowers ambulatory blood pressure and heart rate in humans. Hypertension. 1999;34:253-260.

14. Montori VM, Farmer A, Wollan PC, et al. Fish oil supplementation in type 2 diabetes: a quantitative systematic review. Diabetes Care. 2000;23:1407-1415.

15. 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 hypertriglyceridaemia. Heart. 2001;85:544-548.

16. Harris WS. N-3 fatty acids and lipoproteins: comparison of results from human and animal studies. Lipids. 1996;31:243-252.

17. Nenseter MS, Osterud B, Larsen T, et al. Effect of Norwegian fish powder on risk factors for coronary heart disease among hypercholesterolemic individuals. Nutr Metab Cardiovasc Dis. 2000;10:323-330.

18. van Dam M, Stalenhoef AF, Wittekoek J, et al. Efficacy of concentrated n-3 fatty acids in hypertriglyceridaemia: a comparison with gemfibrozil. Clin Drug Invest. 2001;21:175-181.

19. Guallar E, Hennekens CH, Sacks FM, et al. A prospective study of plasma fish oil levels and incidence of myocardial infarction in US male physicians. J Am Coll Cardiol. 1995;25:387-394.

20. Iso H, Rexrode KM, Stampfer MJ, et al. Intake of fish and omega-3 fatty acids and risk of stroke in women. JAMA. 2001;285:304-312.

21. Shekelle RB, Missell LV, Paul O, et al. Fish consumption and mortality from coronary heart disease [letter]. N Engl J Med. 1985;313:820-821.

22. Dolecek TA, Granditis G. Dietary polyunsaturated fatty acids and mortality in the Multiple Risk Factor Intervention Trial (MRFIT). World Rev Nutr Diet. 1991;66:205-216.

23. Kromhout D, Feskens EJ, Bowles CH. The protective effect of a small amount of fish on coronary heart disease mortality in an elderly population. Int J Epidemiol. 1995;24:340-345.

24. Vollset SE, Heuch I, Bjelke E. Fish consumption and mortality from coronary heart disease [letter]. N Engl J Med. 1985;313:820-821.

25. Curb JD, Reed DM. Fish consumption and mortality from coronary heart disease [letter]. N Engl J Med. 1985;313:821-822.

26. 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;2:757-761.

27. Ascherio A, Rimm EB, Stampfer MJ, et al. Dietary intake of marine n-3 fatty acids, fish intake, and the risk of coronary disease among men. N Engl J Med. 1995;332:977-982.

28. Leaf A, Jorgensen MB, Jacobs AK, et al. Do fish oils prevent restenosis after coronary angioplasty? Circulation. 1994;90:2248-2257.

29. Sacks FM, Stone PH, Gibson CM, et al. Controlled trial of fish oil for regression of human coronary atherosclerosis. HARP Research Group. J Am Coll Cardiol. 1995;25:1492-1498.

30. [No authors listed]. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico. Lancet. 1999;354:447-455.

31. de Lorgeril M, Renaud S, Mamelle N, et al. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet. 1994;343:1454-1459.

32. Siscovick DS, Raghunathan TE, King I, et al. Dietary intake and cell membrane levels of long-chain n-3 polyunsaturated fatty acids and the risk of primary cardiac arrest. JAMA. 1995;274:1363-1367.

33. Billman GE, Hallaq H, Leaf A. Prevention of ischemia-induced ventricular fibrillation by omega 3 fatty acids. Proc Natl Acad Sci USA. 1994;91:4427-4430.

34. Sellmayer A, Witzgall H, Lorenz RL, et al. Effects of dietary fish oil on ventricular premature complexes. Am J Cardiol. 1995;76:974-977.

35. Nilsen DW, Albrektsen G, Landmark K, et al. Effects of a high-dose concentrate of n-3 fatty acids or corn oil introduced early after an acute myocardial infarction on serum triacylglycerol and HDL cholesterol. Am J Clin Nutr. 2001;74:50-56.

36. Angerer P, Stork S, Kothny W, et al. Effect of marine omega-3 fatty acids on peripheral atherosclerosis in patients with coronary artery disease—a randomised 2 year intervention trial [abstract]. Eur Heart J. 2001;22(suppl):162.

37. James MJ, Cleland LG. Dietary n-3 fatty acids and therapy for rheumatoid arthritis. Semin Arthritis Rheum. 1997;27:85-97.

38. Volker D, Fitzgerald P, Major G, et al. Efficacy of fish oil concentrate in the treatment of rheumatoid arthritis. J Rheumatol. 2000;27:2343-2346.

39. Harel Z, Biro FM, Kottenhahn RK, et al. Supplementation with omega-3 polyunsaturated fatty acids in the management of dysmenorrhea in adolescents. Am J Obstet Gynecol. 1996;174:1335-1338.

40. Deutch B, Jorgensen EB, Hansen JC. Menstrual discomfort in Danish women reduced by dietary supplements of omega-3 PUFA and B12 (fish oil or seal oil capsules). Nutr Res. 2000;20:621-631.

41. 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;56:407-412.

42. DiGiacomo RA, Kremer JM, Shah DM. Fish-oil dietary supplementation in patients with Raynaud's phenomenon: a double-blind, controlled, prospective study. Am J Med. 1989;86:158-164.

43. Ringer TV, Hughes GS, Spillers CR, et al. Fish oil blunts the pain response to cold pressor testing in normal males [abstract]. J Am Coll Nutr. 1989;8:435.

44. Bittiner SB, Cartwright I, Tucker WFG, et al. A double-blind, randomised, placebo-controlled trial of fish oil in psoriasis. Lancet. 1988;1:378-380.

45. Tomer A, Kasey S, Connor WE, et al. Reduction of pain episodes and prothrombotic activity in sickle cell disease by dietary n-3 fatty acids. Thromb Haemost. 2001;85:966-974.

46. Walton AJE, Snaith ML, Locniskar M, et al. Dietary fish oil and the severity of symptoms in patients with systemic lupus erythematosus. Ann Rheum Dis. 1991;50:463-466.

47. Donadio JV Jr, Grande JP, Bergstralh EJ, et al. The long-term outcome of patients with IgA nephropathy treated with fish oil in a controlled trial. J Am Soc Nephrol. 1999;10:1772-1777.

48. Peet M, Brind J, Ramchand CN, et al. Two double-blind placebo-controlled pilot studies of eicosapentaenoic acid in the treatment of schizophrenia. Schizophr Res. 2001;49:243-251.

49. Belluzzi A, Brignola C, Campieri M, et al. Effect of an enteric-coated fish-oil preparation on relapses in Crohn's disease. N Engl J Med. 1996;334:1557-1560.

50. Lorenz-Meyer H, Bauer P, Nicolay C, et al. Omega-3 fatty acids and low carbohydrate diet for maintenance of remission in Crohn's disease. A randomized controlled multicenter trial. Study Group Members (German Crohn's Disease Study Group). Scand J Gastroenterol. 1996;31:778-785.

51. Lorenz R, Weber PC, Szimnau P, et al. Supplementation with n-3 fatty acids from fish oil in chronic inflammatory bowel disease—a randomized, placebo-controlled, double-blind cross-over trial. J Intern Med Suppl. 1989;225:225-232.

52. Iso H, Rexrode KM, Stampfer MJ, et al. Intake of fish and omega-3 fatty acids and risk of stroke in women. JAMA. 2001;285:301-312.

54. Hibbeln JR, Salem N Jr. Dietary polyunsaturated fatty acids and depression: when cholesterol does not satisfy. Am J Clin Nutr. 1995;62:1-9.

56. Buck AC, Jenkins A, Lingam K, et al. The treatment of idiopathic recurrent urolithiasis with fish oil (EPA) and evening primrose oil (GLA)—a double blind study. J Urol. 1993;149:253A.

57. Norrish AE, Skeaff CM, Arribas GLB, et al. Prostate cancer risk and consumption of fish oils: a dietary biomarker-based case-control study. Br J Cancer. 1999;81:1238-1242.

58. Behan PO, Behan WM, Horrobin D. Effect of high doses of essential fatty acids on the postviral fatigue syndrome. Acta Neurol Scand. 1990;82:209-216.

59. Warren G, McKendrick M, Peet M. The role of essential fatty acids in chronic fatigue syndrome. A case-controlled study of red-cell membrane essential fatty acids (EFA) and a placebo-controlled treatment study with high dose of EFA. Acta Neurol Scand. 1999;99:112-116.

60. Gerbi A, Maixent JM, Ansaldi JL, et al. Fish oil supplementation prevents diabetes-induced nerve conduction velocity and neuroanatomical changes in rats. J Nutr. 1999;129:207-213.

61. Halsted CH, Ghandi G, Tamura T. Sulfasalazine inhibits the absorption of folates in ulcerative colitis. N Engl J Med. 1981;305:1513-1517.

62. Aslan A, Triadafilopoulos G. Fish oil fatty acid supplementation in active ulcerative colitis: a double-blind, placebo-controlled, crossover study. Am J Gastroenterol. 1992;87:432-437.

63. Almallah YZ, El-Tahir A, Heys SD, et al. Distal procto-colitis and n-3 polyunsaturated fatty acids: the mechanism(s) of natural cytotoxicity inhibition. Eur J Clin Invest. 2000;30:58-65.

64. Stenson WF, Cort D, Rodgers J, et al. Dietary supplementation with fish oil in ulcerative colitis. Ann Intern Med. 1992;116:609-614.

65. Hawthorne AB, Daneshmend TK, Hawkey CJ, et al. Treatment of ulcerative colitis with fish oil supplementation: a prospective 12-month randomised controlled trial. Gut. 1992;33:922-928.

66. Greenfield SM, Green AT, Teare JP, et al. A randomized controlled study of evening primrose oil and fish oil in ulcerative colitis. Aliment Pharmacol Ther. 1993;7:159-166.

67. Hawthorne AB, Daneshmend TK, Hawkey CJ, et al. Treatment of ulcerative colitis with fish oil supplementation: a prospective 12-month randomised controlled trial. Gut. 1992;33:922-928.

68. Loeschke K, Ueberschaer B, Pietsch A, et al. n-3 fatty acids only delay early relapse of ulcerative colitis in remission. Dig Dis Sci. 1996;41:2087-2094.

69. Thien FC, Woods RK, Walters EH. Oily fish and asthma—a fishy story? Med J Aust. 1996;164:135-136.

70. Arm JP, Thien FC, Lee TH. Leukotrienes, fish-oil, and asthma. Allergy Proc. 1994;15:129-134.

71. Picado C, Castillo JA, Schinca N, et al. Effects of a fish oil enriched diet on aspirin intolerant asthmatic patients: a pilot study. Thorax. 1988;43:93-97.

72. Woods RK, Thien FC, Abramson MJ. Dietary marine fatty acids (fish oil) for asthma. Cochrane Database Syst Rev. 2000;CD001283.

73. Dry J, Vincent D. Effect of a fish oil diet on asthma: results of a one-year double-blind study. Int Arch Allergy Immunol. 1991;95:156-157.

74. Stenius-Aarniala B, Aro A, Hakulinen A, et al. Evening primrose oil and fish oil are ineffective as supplementary treatment of bronchial asthma. Ann Allergy. 1989;62:534-547.

75. Arm J. The effects of dietary supplementation with fish oil on asthmatic responses to antigen. J Allergy Clin Immunol. 1988;81:183.

76. Stenius-Aarniala B, Aro A, Hakulinen A, et al. Symptomatic effects of evening primrose oil, fish oil, and olive oil in patients with bronchial asthma. Ann Allergy. 1985;55:330.

77. Lee TH, Arm JP. Prospects for modifying the allergic response by fish oil diets. Clin Allergy. 1986;16:89-100.

78. Pichard C, Sudre P, Karsegard V, et al. A randomized double-blind controlled study of 6 months of oral nutritional supplementation with arginine and omega-3 fatty acids in HIV-infected patients. Swiss HIV Cohort Study. AIDS. 1998;12:53-63.

79. Scevola D, Oberto L, Faggi A, et al. Fish oil in the treatment of wasting syndrome. Int Conf AIDS. 1996;11:122.

80. Nightingale S, Woo E, Smith AD, et al. Red blood cell and adipose tissue fatty acids in mild inactive multiple sclerosis. Acta Neurol Scand. 1990;82:43-50.

81. Cunnane SC, Ho SY, Dore-Duffy P, et al. Essential fatty acid and lipid profiles in plasma and erythrocytes in patients with multiple sclerosis. Am J Clin Nutr. 1989;50:801-806.

82. Gallai V, Sarchielli P, Trequattrini A, et al. Cytokine secretion and eicosanoid production in the peripheral blood mononuclear cells of MS patients undergoing dietary supplementation with n-3 polyunsaturated fatty acids. J Neuroimmunol. 1995;56:143-153.

83. Goldberg P, Fleming MC, Picard EH. Multiple sclerosis: decreased relapse rate through dietary supplementation with calcium, magnesium and vitamin D. Med Hypotheses. 1986;21:193-200.

84. Bates D. Dietary lipids and multiple sclerosis. Ups J Med Sci Suppl. 1990;48:173-187.

85. Conquer JA, Martin JB, Tummon I, et al. Effect of DHA supplementation on DHA status and sperm motility in asthenozoospermic males. Lipids. 2000;35:149-154.

86. Kruger MC, Coetzer H, de Winter R, et al. Calcium, gamma-linolenic acid and eicosapentaenoic acid supplementation in senile osteoporosis. Aging (Milano). 1998;10:385-394.

87. Bassey EJ, Littlewood JJ, Rothwell MC, et al. Lack of effect of supplementation with essential fatty acids on bone mineral density in healthy pre- and postmenopausal women: two randomized controlled trials of Efacal v. calcium alone. Br J Nutr. 2000;83:629-635.

88. Richardson AJ, Puri BK. A randomized double-blind, placebo-controlled study of the effects of supplementation with highly unsaturated fatty acids on ADHD-related symptoms in children with specific learning difficulties. Prog Neuropsychopharmacol Biol Psychiatry. 2002;26:233-239.

89. Voigt RG, Llorente AM, Jensen CL, et al. A randomized, double-blind, placebo-controlled trial of docosahexaenoic acid supplementation in children with attention-deficit/hyperactivity disorder. J Pediatr. 2001;139:189-196.

90. Harris WS. N-3 fatty acids and serum lipoproteins: human studies. Am J Clin Nutr. 1997;65(suppl 5):S1645-S1654.

91. 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 hypertriglyceridaemia. Heart. 2001;85:544-548.

92. Harris WS. N-3 fatty acids and lipoproteins: comparison of results from human and animal studies. Lipids. 1996;31:243-252.

93. Nenseter MS, Osterud B, Larsen T, et al. Effect of Norwegian fish powder on risk factors for coronary heart disease among hypercholesterolemic individuals. Nutr Metab Cardiovasc Dis. 2000;10:323-330.

94. van Dam M, Stalenhoef AF, Wittekoek J, et al. Efficacy of concentrated n-3 fatty acids in hypertriglyceridaemia: a comparison with gemfibrozil. Clin Drug Invest. 2001;21:175-181.

95. Montori VM, Farmer A, Wollan PC, et al. Fish oil supplementation in type 2 diabetes: a quantitative systematic review. Diabetes Care. 2000;23:1407-1415.

96. Cobiac L, Clifton PM, Abbey M, et al. Lipid, lipoprotein, and hemostatic effects of fish vs fish-oil n-3 fatty acids in mildly hyperlipidemic males. Am J Clin Nutr. 1991;53:1210-1216.

97. Harris WS. N-3 fatty acids and serum lipoproteins: human studies. Am J Clin Nutr. 1997;65(suppl 5):S1645-S1654.

98. Dyerberg J. N-3 fatty acids and coronary artery disease: potentials and problems. In: Omega-3, Lipoproteins, and Atherosclerosis. Paris, France: John Libbey Eurotext; 1996; 27: 251-258.

99. Lungershausen YK, Abbey M, Nestel PJ, et al. Reduction of blood pressure and plasma triglycerides by omega-3 fatty acids in treated hypertensives. J Hypertens. 1994;12:1041-1045.

100. Radack K, Deck C, Huster G. The effects of low doses of n-3 fatty acid supplementation on blood pressure in hypertensive subjects. A randomized controlled trial. Arch Intern Med. 1991;151:1173-1180.

101. Singer P, Jaeger W, Wirth M, et al. Lipid and blood-pressure-lowering effect of mackerel diet in man. Atherosclerosis. 1983;49:99-108.

102. Singer P, Melzer S, Goschel M, et al. Fish oil amplifies the effect of propranolol in mild essential hypertension. Hypertension. 1990;16:682-691.

103. Appel LJ, Miller ER III, Seidler AJ, et al. Does supplementation of diet with 'fish oil' reduce blood pressure? A meta-analysis of controlled clinical trials. Arch Intern Med. 1993;153:1429-1438.

104. Whelton PK, Kumanyika SK, Cook NR, et al. Efficacy of nonpharmacologic interventions in adults with high-normal blood pressure: Results from phase 1 of the Trials of Hypertension Prevention. Am J Clin Nutr. 1997;65(suppl 2):S652-S660.

105. Mori TA, Bao DQ, Burke V, et al. Docosahexaenoic acid but not eicosapentaenoic acid lowers ambulatory blood pressure and heart rate in humans. Hypertension. 1999;34:253-260.

106. Guallar E, Hennekens CH, Sacks FM, et al. A prospective study of plasma fish oil levels and incidence of myocardial infarction in US male physicians. J Am Coll Cardiol. 1995;25:387-394.

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