Omega-3 Fatty Acids: A Growing Ocean of Choices

  • Hassan Fares
  • Carl J. Lavie
  • James J. DiNicolantonio
  • James H. O’Keefe
  • Richard V. Milani
Nonstatin Drugs (WB Borden, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Nonstatin Drugs


There has been increasing interest in the health benefits of supplemental and/or dietary omega-3 polyunsaturated fatty acids (PUFAs), particularly in their role in disease prevention. This interest escalated once their effects on cardiovascular health were observed from numerous observational studies in populations whose diet consisted mainly of fish. Research has since been undertaken on omega-3 PUFAs to investigate their health benefits in a vast array of medical conditions, including primary and secondary prevention. This article discusses the evidence and controversies concerning omega-3 PUFAs in various health conditions. In addition to the effects on cardiovascular health, omega-3 PUFAs have been shown to prevent the development of dementia, reduce systemic inflammatory diseases, prevent prostate cancer, and possibly have a role in the treatment of depression and bipolar disorder.


Polyunsaturated fatty acids Cardiovascular disease 



Atrial fibrillation


α-Linolenic acid


Coronary heart disease


C-reactive protein


Cardiovascular disease


Docosahexaenoic acid


Fish Oil Research with Omega-3 for Atrial Fibrillation Recurrence Delaying


Eicosapentaenoic acid


Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico–Heart Failure


High-density lipoprotein


Heart failure


Japan Eicosapentaenoic Acid Lipid Intervention Study


Linoleic acid


Low-density lipoprotein


Multi-Center, Placebo-Controlled, Randomized, Double-Blind, 12-Week Study with an Open-Label Extension


Myocardial infarction


Outcome Reduction with Initial Glargine Intervention


Polyunsaturated fatty acids


Sudden cardiac death


Type 2 diabetes




Compliance with Ethics Guidelines

Conflict of Interest

Hassan Fares, James DiNicolantonio, and Richard V. Milani declare that they have no conflict of interest.

Carl J. Lavie is a consultant to GlaxoSmithKline, Amarin, and Abbott.

James H. O’Keefe has received honoraria from GlaxoSmithKline and is Chief Medical Officer and the founder of CardioTabs, in which he has a major ownership interest that is nonmonetary. CardioTabs sells products that contain omega-3 fatty acids.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Rombaldi Bernardi J, de Souza Escobar R, Ferreira CF, Pelufo Silveira P. Fetal and neonatal levels of omega-3: effects on neurodevelopment, nutrition, and growth. Sci World J. 2012;2012:202473.Google Scholar
  2. 2.
    Crawford MA, Costeloe K, Ghebremeskel K, Phylactos A, Skirvin L, Stacey F. Are deficits of arachidonic and docosahexaenoic acids responsible for the neural and vascular complications of preterm babies? Am J Clin Nutr. 1997;66(4 Suppl):1032S–41S.PubMedGoogle Scholar
  3. 3.
    Holman RT. The slow discovery of the importance of omega 3 essential fatty acids in human health. J Nutr. 1998;128(2 Suppl):427S–33S.PubMedGoogle Scholar
  4. 4.
    Friedman A, Moe S. Review of the effects of omega-3 supplementation in dialysis patients. Clin J Am Soc Nephrol. 2006;1(2):182–92.PubMedGoogle Scholar
  5. 5.
    Pereira SL, Leonard AE, Huang Y-S, Chuang L-T, Mukerji P. Identification of two novel microalgal enzymes involved in the conversion of the ω3-fatty acid, eicosapentaenoic acid, into docosahexaenoic acid. Biochem J. 2004;384(2):357–66.PubMedGoogle Scholar
  6. 6.
    Burdge GC, Wootton SA. Conversion of α-linolenic acid to eicosapentaenoic, docosapentaenoic and docosahexaenoic acids in young women. Br J Nutr. 2002;88(4):411–20.PubMedGoogle Scholar
  7. 7.
    Blake GJ, Ridker PM. Novel clinical markers of vascular wall inflammation. Circ Res. 2001;89(9):763–71.PubMedGoogle Scholar
  8. 8.
    Ross R. Atherosclerosis—an inflammatory disease. N Engl J Med. 1999;340(2):115–26.PubMedGoogle Scholar
  9. 9.
    Rivard A, Andrés V. Vascular smooth muscle cell proliferation in the pathogenesis of atherosclerotic cardiovascular diseases. Histol Histopathol. 2000;15(2):557–71.PubMedGoogle Scholar
  10. 10.
    Davignon J, Ganz P. Role of endothelial dysfunction in atherosclerosis. Circulation. 2004;109(23 Suppl 1):III27–32.PubMedGoogle Scholar
  11. 11.
    Ridker PM, Rifai N, Stampfer MJ, Hennekens CH. Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men. Circulation. 2000;101(15):1767–72.PubMedGoogle Scholar
  12. 12.
    Ridker PM, Hennekens CH, Roitman-Johnson B, Stampfer MJ, Allen J. Plasma concentration of soluble intercellular adhesion molecule 1 and risks of future myocardial infarction in apparently healthy men. Lancet. 1998;351(9096):88–92.PubMedGoogle Scholar
  13. 13.
    Ridker PM, Buring JE, Rifai N. Soluble P-selectin and the risk of future cardiovascular events. Circulation. 2001;103(4):491–5.PubMedGoogle Scholar
  14. 14.
    Lee TH, Hoover RL, Williams JD, et al. Effect of dietary enrichment with eicosapentaenoic and docosahexaenoic acids on in vitro neutrophil and monocyte leukotriene generation and neutrophil function. N Engl J Med. 1985;312(19):1217–24.PubMedGoogle Scholar
  15. 15.
    Sperling RI, Benincaso AI, Knoell CT, Larkin JK, Austen KF, Robinson DR. Dietary omega-3 polyunsaturated fatty acids inhibit phosphoinositide formation and chemotaxis in neutrophils. J Clin Invest. 1993;91(2):651–60.PubMedCentralPubMedGoogle Scholar
  16. 16.
    Sigal LH. Basic science for the clinician 39: NF-κB—function, activation, control, and consequences. J Clin Rheumatol. 2006;12(4):207–11.PubMedGoogle Scholar
  17. 17.
    Schmidt EB, Varming K, Pedersen JO, et al. Long-term supplementation with n-3 fatty acids, II: effect on neutrophil and monocyte chemotaxis. Scand J Clin Lab Invest. 1992;52(3):229–36.PubMedGoogle Scholar
  18. 18.
    Calder PC. The role of marine omega-3 (n-3) fatty acids in inflammatory processes, atherosclerosis and plaque stability. Mol Nutr Food Res. 2012;56(7):1073–80.PubMedGoogle Scholar
  19. 19.
    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(19):1205–9.PubMedGoogle Scholar
  20. 20.
    Järvinen R, Knekt P, Rissanen H, Reunanen A. Intake of fish and long-chain n-3 fatty acids and the risk of coronary heart mortality in men and women. Br J Nutr. 2006;95(4):824–9.PubMedGoogle Scholar
  21. 21.
    Wang C, Harris WS, Chung M, et al. n-3 fatty acids from fish or fish-oil supplements, but not α-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. Am J Clin Nutr. 2006;84(1):5–17.PubMedGoogle Scholar
  22. 22.
    Mozaffarian D, Ascherio A, Hu FB, et al. Interplay between different polyunsaturated fatty acids and risk of coronary heart disease in men. Circulation. 2005;111(2):157–64.PubMedCentralPubMedGoogle Scholar
  23. 23.
    Hu FB, Stampfer MJ, Manson JE, et al. Dietary intake of α-linolenic acid and risk of fatal ischemic heart disease among women. Am J Clin Nutr. 1999;69(5):890–7.PubMedGoogle Scholar
  24. 24.
    Dolecek TA. Epidemiological evidence of relationships between dietary polyunsaturated fatty acids and mortality in the multiple risk factor intervention trial. Proc Soc Exp Biol Med. 1992;200(2):177–82.PubMedGoogle Scholar
  25. 25.
    Bemelmans WJE, Lefrandt JD, Feskens EJM, et al. Increased α-linolenic acid intake lowers C-reactive protein, but has no effect on markers of atherosclerosis. Eur J Clin Nutr. 2004;58(7):1083–9.PubMedGoogle Scholar
  26. 26.
    Zhao G, Etherton TD, Martin KR, West SG, Gillies PJ, Kris-Etherton PM. Dietary α-linolenic acid reduces inflammatory and lipid cardiovascular risk factors in hypercholesterolemic men and women. J Nutr. 2004;134(11):2991–7.PubMedGoogle Scholar
  27. 27.
    Leaf A, Xiao YF, Kang JX, Billman GE. Prevention of sudden cardiac death by n-3 polyunsaturated fatty acids. Pharmacol Ther. 2003;98(3):355–77.PubMedGoogle Scholar
  28. 28.
    Albert CM, Hennekens CH, O’Donnell CJ, et al. Fish consumption and risk of sudden cardiac death. JAMA. 1998;279(1):23–8.PubMedGoogle Scholar
  29. 29.
    Albert CM, Oh K, Whang W, et al. Dietary α-linolenic acid intake and risk of sudden cardiac death and coronary heart disease. Circulation. 2005;112(21):3232–8.PubMedGoogle Scholar
  30. 30.
    Rizos EC, Ntzani EE, Bika E, Kostapanos MS, Elisaf MS. Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: a systematic review and meta-analysis. JAMA. 2012;308(10):1024–33.PubMedGoogle Scholar
  31. 31.
    Jenkins DJA, Josse AR, Beyene J, et al. Fish-oil supplementation in patients with implantable cardioverter defibrillators: a meta-analysis. CMAJ. 2008;178(2):157–64.PubMedGoogle Scholar
  32. 32.
    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(8666):757–61.PubMedGoogle Scholar
  33. 33.
    De Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999;99(6):779–85.PubMedGoogle Scholar
  34. 34.
    GISSI-Prevenzione Investigators. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet. 1999;354(9177):447–55.Google Scholar
  35. 35.
    Sacks FM, Stone PH, Gibson CM, Silverman DI, Rosner B, Pasternak RC, et al. Controlled trial of fish oil for regression of human coronary atherosclerosis. J Am Coll Cardiol. 1995;25(7):1492–8.PubMedGoogle Scholar
  36. 36.
    Von Schacky C, Angerer P, Kothny W, Theisen K, Mudra H. The effect of dietary omega-3 fatty acids on coronary atherosclerosis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 1999;130(7):554–62.Google Scholar
  37. 37.
    Balk E, Chung M, Lichtenstein A, et al. Effects of omega-3 fatty acids on cardiovascular risk factors and intermediate markers of cardiovascular disease. Evid Rep Technol Assess (Summ). 2004;(93):1–6.Google Scholar
  38. 38.••
    DiNicolantonio JJ, Niazi AK, Keefe JHO, Lavie CJ. Explaining the recent fish oil trial “failures”. J Glycomics Lipidomics. 2012;2(4):10–3. This article demonstrates the flaws in study designs of trials which showed no benefits of PUFAs. Google Scholar
  39. 39.
    Bosch J, Gerstein HC, Dagenais GR, et al. n-3 fatty acids and cardiovascular outcomes in patients with dysglycemia. N Engl J Med. 2012;367(4):309–18.PubMedGoogle Scholar
  40. 40.
    Kromhout D, Giltay EJ, Geleijnse JM. n-3 fatty acids and cardiovascular events after myocardial infarction. N Engl J Med. 2010;363(21):2015–26.PubMedGoogle Scholar
  41. 41.
    Roncaglioni MC, Tombesi M, Avanzini F, et al. n-3 fatty acids in patients with multiple cardiovascular risk factors. N Engl J Med. 2013;368(19):1800–8.PubMedGoogle Scholar
  42. 42.
    Mozaffarian D, Bryson CL, Lemaitre RN, Burke GL, Siscovick DS. Fish intake and risk of incident heart failure. J Am Coll Cardiol. 2005;45(12):2015–21.PubMedGoogle Scholar
  43. 43.
    Yamagishi K, Nettleton JA, Folsom AR. Plasma fatty acid composition and incident heart failure in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) study. Am Heart J. 2008;156(5):965–74.PubMedCentralPubMedGoogle Scholar
  44. 44.
    Tavazzi L, Maggioni AP, Marchioli R, et al. 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. 2008;372(9645):1223–30.PubMedGoogle Scholar
  45. 45.
    Yamagishi K, Iso H, Date C, et al. Fish, omega-3 polyunsaturated fatty acids, and mortality from cardiovascular diseases in a nationwide community-based cohort of Japanese men and women the JACC (Japan Collaborative Cohort Study for Evaluation of Cancer Risk) study. J Am Coll Cardiol. 2008;52(12):988–96.PubMedGoogle Scholar
  46. 46.
    Djoussé L, Akinkuolie AO, Wu JHY, Ding EL, Gaziano JM. Fish consumption, omega-3 fatty acids and risk of heart failure: a meta-analysis. Clin Nutr. 2012;31(6):846–53.PubMedCentralPubMedGoogle Scholar
  47. 47.•
    Nodari S, Triggiani M, Manerba A, Milesi G, Dei Cas L. Effects of supplementation with polyunsaturated fatty acids in patients with heart failure. Intern Emerg Med. 2011;6 Suppl 1:37–44. This article illustrates the mechanism of action of PUFAs in arrhythmia prevention in HF patients.PubMedGoogle Scholar
  48. 48.
    Landmark K, Alm CS. Fisk og omega-3-fettsyrer ved hjertesvikt (Fish and omega-3 fatty acids and heart failure). Tidsskr Nor Laegeforen. 2012;132(20):2281–4.PubMedGoogle Scholar
  49. 49.
    Shahzad K, Chokshi A, Schulze PC. Supplementation of glutamine and omega-3 polyunsaturated fatty acids as a novel therapeutic intervention targeting metabolic dysfunction and exercise intolerance in patients with heart failure. Curr Clin Pharmacol. 2011;6(4):288–94.PubMedGoogle Scholar
  50. 50.
    Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;128(16):1810–52.PubMedGoogle Scholar
  51. 51.
    Keli SO, Feskens EJ, Kromhout D. Fish consumption and risk of stroke. The Zutphen Study. Stroke. 1994;25(2):328–32.PubMedGoogle Scholar
  52. 52.
    Gillum RF, Mussolino ME, Madans JH. The relationship between fish consumption and stroke incidence. The NHANES I Epidemiologic Follow-up Study (National Health and Nutrition Examination Survey). Arch Intern Med. 1996;156(5):537–42.PubMedGoogle Scholar
  53. 53.
    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(3):304–12.PubMedGoogle Scholar
  54. 54.
    He K, Song Y, Daviglus ML, et al. Fish consumption and incidence of stroke: a meta-analysis of cohort studies. Stroke. 2004;35(7):1538–42.PubMedGoogle Scholar
  55. 55.
    He K, Rimm EB, Merchant A, et al. Fish consumption and risk of stroke in men. JAMA. 2002;288(24):3130–6.PubMedGoogle Scholar
  56. 56.
    Morris MC, Manson JE, Rosner B, Buring JE, Willett WC, Hennekens CH. Fish consumption and cardiovascular disease in the physicians’ health study: a prospective study. Am J Epidemiol. 1995;142(2):166–75.PubMedGoogle Scholar
  57. 57.
    Orencia AJ, Daviglus ML, Dyer AR, Shekelle RB, Stamler J. Fish consumption and stroke in men. 30-year findings of the Chicago Western Electric Study. Stroke. 1996;27(2):204–9.PubMedGoogle Scholar
  58. 58.
    Myint PK, Welch AA, Bingham SA, et al. Habitual fish consumption and risk of incident stroke: the European Prospective Investigation into Cancer (EPIC)-Norfolk prospective population study. Public Health Nutr. 2006;9(7):882–8.PubMedGoogle Scholar
  59. 59.
    Tanaka K, Ishikawa Y, Yokoyama M, et al. Reduction in the recurrence of stroke by eicosapentaenoic acid for hypercholesterolemic patients: subanalysis of the JELIS trial. Stroke. 2008;39(7):2052–8.PubMedGoogle Scholar
  60. 60.
    Marchioli R, Barzi F, Bomba E, et al. Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (GISSI)-Prevenzione. Circulation. 2002;105(16):1897–903.PubMedGoogle Scholar
  61. 61.
    Jahangiri A, Leifert WR, Patten GS, McMurchie EJ. Termination of asynchronous contractile activity in rat atrial myocytes by n-3 polyunsaturated fatty acids. Mol Cell Biochem. 2000;206(1–2):33–41.PubMedGoogle Scholar
  62. 62.
    Nodari S, Triggiani M, Campia U, et al. n-3 polyunsaturated fatty acids in the prevention of atrial fibrillation recurrences after electrical cardioversion: a prospective, randomized study. Circulation. 2011;124(10):1100–6.PubMedGoogle Scholar
  63. 63.
    Cao H, Wang X, Huang H, et al. Omega-3 fatty acids in the prevention of atrial fibrillation recurrences after cardioversion: a meta-analysis of randomized controlled trials. Intern Med. 2012;51(18):2503–8.PubMedGoogle Scholar
  64. 64.•
    He Z, Yang L, Tian J, Yang K, Wu J, Yao Y. Efficacy and safety of omega-3 fatty acids for the prevention of atrial fibrillation: a meta-analysis. Can J Cardiol. 2013;29(2):196–203. This trial showed a decrease in the incidence of AF with the use of PUFAs after open heart surgery.PubMedGoogle Scholar
  65. 65.
    Khawaja O, Gaziano JM, Djoussé L. A meta-analysis of omega-3 fatty acids and incidence of atrial fibrillation. J Am Coll Nutr. 2012;31(1):4–13.PubMedGoogle Scholar
  66. 66.
    Armaganijan L, Lopes RD, Healey JS, Piccini JP, Nair GM, Morillo CA. Do omega-3 fatty acids prevent atrial fibrillation after open heart surgery? A meta-analysis of randomized controlled trials. Clin (Sao Paulo). 2011;66(11):1923–8.Google Scholar
  67. 67.
    Benedetto U, Angeloni E, Melina G, et al. n-3 polyunsaturated fatty acids for the prevention of postoperative atrial fibrillation: a meta-analysis of randomized controlled trials. J Cardiovasc Med (Hagerstown). 2013;14(2):104–9.Google Scholar
  68. 68.
    Liu T, Korantzopoulos P, Shehata M, Li G, Wang X, Kaul S. Prevention of atrial fibrillation with omega-3 fatty acids: a meta-analysis of randomised clinical trials. Heart. 2011;97(13):1034–40.PubMedGoogle Scholar
  69. 69.
    Borghi C, Pareo I. Omega-3 in antiarrhythmic therapy : cons position. High Blood Press Cardiovasc Prev. 2012;19(4):207–11.PubMedGoogle Scholar
  70. 70.
    Guerra F, Shkoza M, Scappini L, Roberti L, Capucci A. Omega-3 PUFAs and atrial fibrillation: have we made up our mind yet? Ann Noninvasive Electrocardiol. 2013;18(1):12–20.PubMedGoogle Scholar
  71. 71.
    Rix TA, Christensen JH, Schmidt EB. Omega-3 fatty acids and cardiac arrhythmias. Curr Opin Clin Nutr Metab Care. 2013;16(2):168–73.PubMedGoogle Scholar
  72. 72.
    Bianconi L, Calò L, Mennuni M, et al. n-3 polyunsaturated fatty acids for the prevention of arrhythmia recurrence after electrical cardioversion of chronic persistent atrial fibrillation: a randomized, double-blind, multicentre study. Europace. 2011;13(2):174–81.PubMedGoogle Scholar
  73. 73.
    Kowey PR, Reiffel JA, Ellenbogen KA, Naccarelli GV, Pratt CM. Efficacy and safety of prescription omega-3 fatty acids for the prevention of recurrent symptomatic atrial fibrillation: a randomized controlled trial. JAMA. 2010;304(21):2363–72.PubMedGoogle Scholar
  74. 74.
    Ozaydın M, Erdoğan D, Tayyar S, et al. n-3 polyunsaturated fatty acids administration does not reduce the recurrence rates of atrial fibrillation and inflammation after electrical cardioversion: a prospective randomized study. Anadolu Kardiyol Derg. 2011;11(4):305–9.PubMedGoogle Scholar
  75. 75.•
    Macchia A, Grancelli H, Varini S, et al. Omega-3 fatty acids for the prevention of recurrent symptomatic atrial fibrillation: results of the FORWARD (randomized trial to assess efficacy of PUFA for the maintenance of sinus rhythm in persistent atrial fibrillation) trial. J Am Coll Cardiol. 2013;61(4):463–8. This trial refutes the benefits of PUFAs in AF prevention.PubMedGoogle Scholar
  76. 76.
    Davidson MH, Stein EA, Bays HE, et al. Efficacy and tolerability of adding prescription omega-3 fatty acids 4 g/d to simvastatin 40 mg/d in hypertriglyceridemic patients: an 8-week, randomized, double-blind, placebo-controlled study. Clin Ther. 2007;29(7):1354–67.PubMedGoogle Scholar
  77. 77.••
    Ballantyne CM, Bays HE, Kastelein JJ, et al. Efficacy and safety of eicosapentaenoic acid ethyl ester (AMR101) therapy in statin-treated patients with persistent high triglycerides (from the ANCHOR study). Am J Cardiol. 2012;110(7):984–92. This is one of two key trials demonstrating the beneficial effects of PUFAs on hypertriglyceridemia.PubMedGoogle Scholar
  78. 78.••
    Bays HE, Ballantyne CM, Kastelein JJ, Isaacsohn JL, Braeckman RA, Soni PN. Eicosapentaenoic acid ethyl ester (AMR101) therapy in patients with very high triglyceride levels (from the Multi-center, plAcebo-controlled, Randomized, double-blINd, 12-week study with an open-label Extension [MARINE] trial). Am J Cardiol. 2011;108(5):682–90. This is the second of two major trials demonstrating the beneficial effects of PUFAs on hypertriglyceridemia.PubMedGoogle Scholar
  79. 79.
    Dayspring TD. Understanding hypertriglyceridemia in women: clinical impact and management with prescription omega-3-acid ethyl esters. Int J Womens Health. 2011;3:87–97.PubMedCentralPubMedGoogle Scholar
  80. 80.
    Koski RR. Omega-3-acid ethyl esters (Lovaza) for severe hypertriglyceridemia. Pharm Ther. 2008;33(5):271.Google Scholar
  81. 81.
    Glueck CJ, Khan N, Riaz M, Padda J, Khan Z, Wang P. Titrating Lovaza from 4 to 8 to 12 grams/day in patients with primary hypertriglyceridemia who had triglyceride levels >500 mg/dl despite conventional triglyceride lowering therapy. Lipids Health Dis. 2012;11:143.PubMedCentralPubMedGoogle Scholar
  82. 82.
    Barter P, Ginsberg HN. Effectiveness of combined statin plus omega-3 fatty acid therapy for mixed dyslipidemia. Am J Cardiol. 2008;102(8):1040–5.PubMedCentralPubMedGoogle Scholar
  83. 83.
    Bays H. Clinical overview of Omacor: a concentrated formulation of omega-3 polyunsaturated fatty acids. Am J Cardiol. 2006;98(4A):71i–6i.PubMedGoogle Scholar
  84. 84.
    Montori VM, Farmer A, Wollan PC, Dinneen SF. Fish oil supplementation in type 2 diabetes: a quantitative systematic review. Diabetes Care. 2000;23(9):1407–15.PubMedGoogle Scholar
  85. 85.
    MacLean CH, Mojica WA, Morton SC, et al. Effects of omega-3 fatty acids on lipids and glycemic control in type II diabetes and the metabolic syndrome and on inflammatory bowel disease, rheumatoid arthritis, renal disease, systemic lupus erythematosus, and osteoporosis. Evid Rep Technol Assess (Summ). 2004;(89):1–4.Google Scholar
  86. 86.
    Hartweg J, Farmer AJ, Perera R, Holman RR, Neil HAW. Meta-analysis of the effects of n-3 polyunsaturated fatty acids on lipoproteins and other emerging lipid cardiovascular risk markers in patients with type 2 diabetes. Diabetologia. 2007;50(8):1593–602.PubMedGoogle Scholar
  87. 87.
    Hu FB, Cho E, Rexrode KM, Albert CM, Manson JE. Fish and long-chain omega-3 fatty acid intake and risk of coronary heart disease and total mortality in diabetic women. Circulation. 2003;107(14):1852–7.PubMedGoogle Scholar
  88. 88.
    Nettleton JA, Katz R. n-3 long-chain polyunsaturated fatty acids in type 2 diabetes: a review. J Am Diet Assoc. 2005;105(3):428–40.PubMedGoogle Scholar
  89. 89.•
    Shannon J, O’Malley J, Mori M, Garzotto M, Palma AJ, King IB. Erythrocyte fatty acids and prostate cancer risk: a comparison of methods. Prostaglandins Leukot Essent Fatty Acids. 2010;83(3):161–9. This article investigates the mechanisms of action of PUFAs in chemoprevention in prostate cancer.PubMedCentralPubMedGoogle Scholar
  90. 90.
    Clarke SD. The multi-dimensional regulation of gene expression by fatty acids: polyunsaturated fats as nutrient sensors. Curr Opin Lipidol. 2004;15(1):13–8.PubMedGoogle Scholar
  91. 91.
    Covey TM, Edes K, Fitzpatrick FA. Akt activation by arachidonic acid metabolism occurs via oxidation and inactivation of PTEN tumor suppressor. Oncogene. 2007;26(39):5784–92.PubMedGoogle Scholar
  92. 92.
    Gerber M. Omega-3 fatty acids and cancers: a systematic update review of epidemiological studies. Br J Nutr. 2012;107(Suppl):S228–39.PubMedGoogle Scholar
  93. 93.
    Ukoli FA, Fowke JH, Akumabor P, et al. The association of plasma fatty acids with prostate cancer risk in African Americans and Africans. J Health Care Poor Underserved. 2010;21(1 Suppl):127–47.PubMedGoogle Scholar
  94. 94.
    Park S-Y, Murphy SP, Wilkens LR, Henderson BE, Kolonel LN. Fat and meat intake and prostate cancer risk: the multiethnic cohort study. Int J Cancer. 2007;121(6):1339–45.PubMedGoogle Scholar
  95. 95.
    Fradet V, Cheng I, Casey G, Witte JS. Dietary omega-3 fatty acids, cyclooxygenase-2 genetic variation, and aggressive prostate cancer risk. Clin Cancer Res. 2009;15(7):2559–66.PubMedCentralPubMedGoogle Scholar
  96. 96.
    Chavarro JE, Stampfer MJ, Li H, Campos H, Kurth T, Ma J. A prospective study of polyunsaturated fatty acid levels in blood and prostate cancer risk. Cancer Epidemiol Biomarkers Prev. 2007;16(7):1364–70.PubMedGoogle Scholar
  97. 97.
    Wallström P, Bjartell A, Gullberg B, Olsson H, Wirfält E. A prospective study on dietary fat and incidence of prostate cancer (Malmö, Sweden). Cancer Causes Control. 2007;18(10):1107–21.PubMedGoogle Scholar
  98. 98.
    Brasky TM, Darke AK, Song X, et al. Plasma phospholipid fatty acids and prostate cancer risk in the SELECT trial. J Natl Cancer Inst. 2013;105(15):1132–41.PubMedGoogle Scholar
  99. 99.•
    DiNicolantonio JJ, McCarty MF, Lavie CJ, O’Keefe JH. Do omega-3 fatty acids cause prostate cancer? Mo Med. 2013;110(4):293–5. This article challenges reports that PUFAs have been implicated in increasing prostate cancer risk.PubMedGoogle Scholar
  100. 100.
    Wainwright PE. Dietary essential fatty acids and brain function: a developmental perspective on mechanisms. Proc Nutr Soc. 2007;61(01):61–9.Google Scholar
  101. 101.
    SanGiovanni JP, Parra-Cabrera S, Colditz GA, Berkey CS, Dwyer JT. Meta-analysis of dietary essential fatty acids and long-chain polyunsaturated fatty acids as they relate to visual resolution acuity in healthy preterm Infants. Pediatrics. 2000;105(6):1292–8.PubMedGoogle Scholar
  102. 102.
    Liperoti R, Landi F, Fusco O, Bernabei R, Onder G. Omega-3 polyunsaturated fatty acids and depression: a review of the evidence. Curr Pharm Des. 2009;15(36):4165–72.PubMedGoogle Scholar
  103. 103.
    Tiemeier H, van Tuijl HR, Hofman A, Kiliaan AJ, Breteler MMB. Plasma fatty acid composition and depression are associated in the elderly: the Rotterdam Study. Am J Clin Nutr. 2003;78(1):40–6.PubMedGoogle Scholar
  104. 104.
    Maes M, Christophe A, Delanghe J, Altamura C, Neels H, Meltzer HY. Lowered ω3 polyunsaturated fatty acids in serum phospholipids and cholesteryl esters of depressed patients. Psychiatry Res. 1999;85(3):275–91.PubMedGoogle Scholar
  105. 105.
    Marangell LB, Martinez JM, Zboyan HA, Kertz B, Kim HFS, Puryear LJ. A double-blind, placebo-controlled study of the omega-3 fatty acid docosahexaenoic acid in the treatment of major depression. Am J Psychiatry. 2003;160(5):996–8.PubMedGoogle Scholar
  106. 106.
    Grenyer BFS, Crowe T, Meyer B, et al. Fish oil supplementation in the treatment of major depression: a randomised double-blind placebo-controlled trial. Prog Neuropsychopharmacol Biol Psychiatry. 2007;31(7):1393–6.PubMedGoogle Scholar
  107. 107.
    Silvers KM, Woolley CC, Hamilton FC, Watts PM, Watson RA. Randomised double-blind placebo-controlled trial of fish oil in the treatment of depression. Prostaglandins Leukot Essent Fatty Acids. 2005;72(3):211–8.PubMedGoogle Scholar
  108. 108.
    Conquer JA, Tierney MC, Zecevic J, Bettger WJ, Fisher RH. Fatty acid analysis of blood plasma of patients with Alzheimer’s disease, other types of dementia, and cognitive impairment. Lipids. 2000;35(12):1305–12.PubMedGoogle Scholar
  109. 109.
    Hashimoto M, Hossain S. Neuroprotective and ameliorative actions of polyunsaturated fatty acids against neuronal diseases: beneficial effect of docosahexaenoic acid on cognitive decline in Alzheimer’s disease. J Pharmacol Sci. 2011;116(2):150–62.PubMedGoogle Scholar
  110. 110.
    Schaefer EJ, Bongard V, Beiser AS, et al. Plasma phosphatidylcholine docosahexaenoic acid content and risk of dementia and Alzheimer disease: the Framingham Heart Study. Arch Neurol. 2006;63(11):1545–50.PubMedGoogle Scholar
  111. 111.
    Kalmijn S, van Boxtel MPJ, Ocké M, Verschuren WMM, Kromhout D, Launer LJ. Dietary intake of fatty acids and fish in relation to cognitive performance at middle age. Neurology. 2004;62(2):275–80.PubMedGoogle Scholar
  112. 112.
    Morris MC, Evans DA, Bienias JL, et al. Consumption of fish and n-3 fatty acids and risk of incident Alzheimer disease. Arch Neurol. 2003;60(7):940–6.PubMedGoogle Scholar
  113. 113.
    Kalmijn S, Launer LJ, Ott A, Witteman JC, Hofman A, Breteler MM. Dietary fat intake and the risk of incident dementia in the Rotterdam Study. Ann Neurol. 1997;42(5):776–82.PubMedGoogle Scholar
  114. 114.
    Quinn JF, Raman R, Thomas RG, et al. Docosahexaenoic acid supplementation and cognitive decline in Alzheimer disease: a randomized trial. JAMA. 2010;304(17):1903–11.PubMedCentralPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Hassan Fares
    • 1
  • Carl J. Lavie
    • 2
    • 3
    • 6
  • James J. DiNicolantonio
    • 4
  • James H. O’Keefe
    • 5
  • Richard V. Milani
    • 2
  1. 1.Department of Hospital MedicineOchsner Medical CenterNew OrleansUSA
  2. 2.Department of Cardiovascular Diseases, John Ochsner Heart and Vascular InstituteOchsner Clinical School–University of Queensland School of MedicineNew OrleansUSA
  3. 3.Department of Preventive Medicine, Pennington Biomedical Research CenterLouisiana State University SystemBaton RougeUSA
  4. 4.Mid America Heart Institute at Saint Luke’s HospitalKansas CityUSA
  5. 5.Mid America Heart Institute, University of Missouri-Kansas CityKansas CityUSA
  6. 6.Cardiac Rehabilitation, Exercise Laboratories, John Ochsner Heart and Vascular InstituteOchsner Clinical School–University of Queensland School of MedicineNew OrleansUSA

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