Convenience Drinks Fortified with n-3 Fatty Acids: A Systematic Review

  • Clemens von SchackyEmail author
Part of the Nutrition and Health book series (NH)


Omega-3 or n-3 fatty acids are a family of essential fatty acids comprising, among others, alpha-linolenic acid, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Plant-derived alpha-linolenic acid has little, if any, cardiovascular benefit, and is poorly, if at all, converted to the longer-chain EPA, which, in turn, is not converted to DHA [1, 2]. Therefore, this review focuses on EPA and DHA.


Eicosapentaenoic acid Docosahexaenoic acid Fortified drinks Omega-3 Index Systematic review 



C-reactive protein


Docosahexaenoic acid


Eicosapentaenoic acid


Intercellular adhesion molecule


Plasminogen activator inhibitor-1


Vascular cell adhesion molecule


  1. 1.
    von Schacky C. Omega-3 Index and cardiovascular disease prevention: principle and rationale. Lipid Technol. 2010;22:151–4.CrossRefGoogle Scholar
  2. 2.
    von Schacky C. The Omega-3 Index as a risk factor for cardiovascular diseases. Prostaglandins Other Lipid Mediat. 2011;96(1–4):94–8.CrossRefGoogle Scholar
  3. 3.
    Koletzko B, Cetin I, Brenna JT, Perinatal Lipid Intake Working Group, Child Health Foundation, Diabetic Pregnancy Study Group, et al. Dietary fat intakes for pregnant and lactating women. Br J Nutr. 2007;98:873–7.PubMedCrossRefGoogle Scholar
  4. 4.
  5. 5.
    Visioli F, Risè P, Plasmati E, Pazzucconi F, Sirtori CR, Galli C. Very low intakes of N-3 fatty acids incorporated into bovine milk reduce plasma triacylglycerol and increase HDL-cholesterol concentrations in healthy subjects. Pharmacol Res. 2000;41:571–6.PubMedCrossRefGoogle Scholar
  6. 6.
    Baró L, Fonollá J, Peña JL, Martínez-Férez A, Lucena A, Jiménez J, et al. n-3 Fatty acids plus oleic acid and vitamin supplemented milk consumption reduces total and LDL cholesterol, homocysteine and levels of endothelial adhesion molecules in healthy humans. Clin Nutr. 2003;22:175–82.PubMedCrossRefGoogle Scholar
  7. 7.
    Carrero JJ, Baró L, Fonollá J, González-Santiago M, Martínez-Férez A, Castillo R, et al. Cardiovascular effects of milk enriched with omega-3 polyunsaturated fatty acids, oleic acid, folic acid, and vitamins E and B6 in volunteers with mild hyperlipidemia. Nutrition. 2004;20:521–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Carrero JJ, López-Huertas E, Salmerón LM, et al. Daily supplementation with (n-3) PUFAs, oleic acid, folic acid, and vitamins B-6 and E increases pain-free walking distance and improves risk factors in men with peripheral vascular disease. J Nutr. 2005;135:1393–9.PubMedGoogle Scholar
  9. 9.
    Carrero JJ, Fonollá J, Marti JL, et al. Intake of fish oil, oleic acid, folic acid, and vitamins B-6 and E for 1 year decreases plasma C-reactive protein and reduces coronary heart disease risk factors in male patients in a cardiac rehabilitation program. J Nutr. 2007;137:384–90.PubMedGoogle Scholar
  10. 10.
    Martin-Bautista E, Muñoz-Torres M, Fonolla J, Quesada M, Poyatos A, Lopez-Huertas E. Improvement of bone formation biomarkers after 1-year consumption with milk fortified with eicosapentaenoic acid, docosahexaenoic acid, oleic acid, and selected vitamins. Nutr Res. 2010;30:320–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Fujioka S, Hamazaki K, Itomura M, Huan M, Nishizawa H, Sawazaki S, et al. The effects of eicosapentaenoic acid-fortified food on inflammatory markers in healthy subjects—a randomized, placebo-controlled, double-blind study. J Nutr Sci Vitaminol (Tokyo). 2006;52:261–5.CrossRefGoogle Scholar
  12. 12.
    Osendarp SJ, Baghurst KI, Bryan J, Calvaresi E, Hughes D, Hussaini M, et al. Effect of a 12-mo micronutrient intervention on learning and memory in well-nourished and marginally nourished school-aged children: 2 parallel, randomized, placebo-controlled studies in Australia and Indonesia. Am J Clin Nutr. 2007;86:1082–93.PubMedGoogle Scholar
  13. 13.
    Hawthorne KM, Abrams SA, Heird WC. Docosahexaenoic acid (DHA) supplementation of orange juice increases plasma phospholipid DHA content of children. J Am Diet Assoc. 2009;109:708–12.PubMedCrossRefGoogle Scholar
  14. 14.
    García-Alonso FJ, Jorge-Vidal V, Ros G, Periago MJ. Effect of consumption of tomato juice enriched with n-3 polyunsaturated fatty acids on the lipid profile, antioxidant biomarker status, and cardiovascular disease risk in healthy women. Eur J Nutr. 2012;51(4):415–24.PubMedCrossRefGoogle Scholar
  15. 15.
    Kirkhus B, Lamglait A, Eilertsen KE, Falch E, Haider T, Vik H, et al. Effects of similar intakes of marine n-3 fatty acids from enriched food products and fish oil on cardiovascular risk markers in healthy human subjects. Br J Nutr. 2011 Sept 15:1–11. [Epub ahead of print].Google Scholar
  16. 16.
    McCowen KC, Ling PR, Ollero M, Tawa N, Bistrian BR. Effect of a fish oil-containing beverage on changes in plasma lipid fatty acids in patients with malabsorption. Nutr Clin Pract. 2010;25:517–23.PubMedCrossRefGoogle Scholar
  17. 17.
    Köhler A, Bittner D, Löw A, von Schacky C. Effects of a convenience drink fortified with n-3 fatty acids on the n-3 index. Br J Nutr. 2010;104:729–36.PubMedCrossRefGoogle Scholar
  18. 18.
    Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, et al. Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA. 1996;276:637–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Neubronner J, Schuchardt P, Merkel M, Kressel G, von Schacky C, Hahn A. Enhanced increase of omega-3 index in response to long-term n-3 fatty acid supplementation from triacylglycerides versus ethyl esters. Eur J Clin Nutr. 2010;65:247–54.PubMedCrossRefGoogle Scholar
  20. 20.
    Dyerberg J, Madsen P, Møller JM, Aardestrup I, Schmidt EB. Bioavailability of marine n-3 fatty acid formulations. Prostaglandins Leukot Essent Fatty Acids. 2010;83:137–41.PubMedCrossRefGoogle Scholar
  21. 21.
    Schuchardt JP, Schneider I, Meyer H, Neubronner J, von Schacky C, Hahn A. Incorporation of EPA and DHA into plasma phospholipids in response to different omega-3 fatty acid formulations—a comparative bioavailability study of fish oil vs. krill oil. Lipids Health Dis. 2011;10:145.PubMedCrossRefGoogle Scholar
  22. 22.
    Schuchardt JP, Neubronner J, Kressel G, Merkel M, von Schacky C, Hahn A. Moderate doses of EPA and DHA from re-esterified triacylglycerols but not from ethyl-esters lower fasting serum triacylglycerols in statin-treated dyslipidemic subjects: results from a six month randomized controlled trial. Prostaglandins Leukot Essent Fatty Acids. 2011;85(6):381–6.PubMedCrossRefGoogle Scholar
  23. 23.
    Haug IJ, Sagmo LB, Zeiss D, Olsen IC, Draget KI, Seternes T. Bioavailability of EPA and DHA delivered by gelled emulsions and by soft gel capsules. Eur J Lipid Sci Technol. 2011;113:137–45.CrossRefGoogle Scholar
  24. 24.
    Harris WS, Von Schacky C. The Omega-3 Index: a new risk factor for death from coronary heart disease? Prev Med. 2004;39:212–20.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Medizinische Klinik and Poliklinik InnenstadtLudwig Maximilians-University MunichMunichGermany

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