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Omega-3 in the press


A flurry of national and international media articles was based on an epidemiologic, i.e. observatory study, stating that the higher eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in plasma phospholipd fatty acids, the higher the risk to develop prostate cancer (Brasky TM et al, J Natl Cancer Inst. 2013 Aug 7;105:1132). It was suggested that this was due to high intake of EPA and DHA, which might also have other risks.


The levels of EPA and DHA measured by Brasky et al in plasma were very low, basically excluding high intake of EPA and DHA. Moreover, differences between groups were very small: differences were within the large variability when measuring fatty acids in plasma. In other words: Brasky et al heard a signal, when there was only noise. And then they falsely interpreted their data. This was uncritically repeated by the media.


In Japan and Korea, we measured the HS-Omega-3 Index in many healthy populations in the suggested target range of 8 -11 %. In these countries, the incidence of prostate cancer is 10 per 100.000 men, while in the USA, it is 63 per 100.000 white men, and 102 per 100.000 black men. (source: World Foundation of Urology, Prostate Cancer Prevention). In the USA, we found a mean HS-Omega-3 Index of 4.5% in 160.000 measurements (Harris et al, PLEFA 2013;88:257). Our figures indicate that facts are the reverse of what the media reported: A high HS-Omega-3 Index correlates with a low risk for prostate cancer.


Even if the figures of Brasky et al were true: A HS-Omega-3 Index of 8 - 11% means a longer life than a lower HS-Omega-3 Index, prostate cancer included.


A recent meta-analysis found omega-3 fatty acids to be associated with a low risk for breast cancer (Zheng et al, Br Med J 2013; 346:f3706, e-pub 27.06.13).



Omega-3 Fatty Acid Intakes Are Inversely Related to Elevated Depressive Symptoms among United States Women


May A. Beydoun5,*, Marie T. Fanelli Kuczmarski6, Hind A. Beydoun7,Joseph R. Hibbeln8, Michele K. Evans5, and Alan B. Zonderman


Evidence that depressive symptoms are inversely related to n-3 (ω3) fatty acids is growing among United States adults. We assessed whether self-reported depressive symptoms were inversely associated with n-3 fatty acid intakes by using a cross-sectional study in 1746 adults (aged 30-65 y) in Baltimore City, MD (2004-2009). The 20-item Center for Epidemiologic Studies-Depression Scale (CES-D) was used, with a CES-D score ≥16 suggestive of elevated depressive symptoms (EDS). By using the mean of two 24-h dietary recalls, n-3 highly unsaturated fatty acids (HUFAs; ≥20 carbons), n-3 polyunsaturated fatty acids (PUFAs; ≥18 carbons), and plausible ratios with n-6 (ω6) fatty acids were estimated. EDS prevalence was 18.1% among men and 25.6% among women. In women, the uppermost tertile (tertile 3) of n-3 PUFAs (compared with tertile 1) was associated with reduced odds of EDS by 49%, with a substantial sex differential. The n-3 PUFA:n-6:PUFA ratio was inversely related to EDS among women (tertile 2 vs. tertile 1, OR: 0.74; 95% CI: 0.41, 1.32; tertile 3 vs. tertile 1, OR: 0.47; 95% CI: 0.27, 0.83). A similar pattern was noted for n-3 HUFA:n-6 HUFA among women. For CES-D subscales, n-3 PUFA (% of energy) was inversely related to somatic complaints, whereas positive affect was directly related to n-3 HUFA (% of energy; total population and among women), n-3 HUFA:n-6 HUFA (women), and n-3 HUFA:n-6 PUFA (total population and among women). In sum, among United States women, higher intakes of n-3 fatty acids [absolute (n-3) and relative to n-6 fatty acids (n-3:n-6)] were associated with lower risk of elevated depressive symptoms, specifically in domains of somatic complaints (mainly n-3 PUFAs) and positive affect (mainly n-3 HUFAs).



The Omega-3 Index: a new risk factor for death from coronary heart disease?

Harris WS, Von Schacky C.




Lipid and Diabetes Research Center, Mid America Heart Institute of Saint Luke's Hospital, University of Missouri-KC School of Medicine, Kansas City, MO 64111, USA.


BACKGROUND:Low intakes or blood levels of eicosapentaenoic and docosahexaenoic acids (EPA + DHA) are independently associated with increased risk of death from coronary heart disease (CHD). In randomized secondary prevention trials, fish or fish oil have been demonstrated to reduce total and CHD mortality at intakes of about 1 g/day. Red blood cell (RBC) fatty acid (FA) composition reflects long-term intake of EPA + DHA. We propose that the RBC EPA + DHA (hereafter called the Omega-3 Index) be considered a new risk factor for death from CHD.
METHODS:We conducted clinical and laboratory experiments to generate data necessary for the validation of the Omega-3 Index as a CHD risk predictor. The relationship between this putative marker and risk for CHD death, especially sudden cardiac death (SCD), was then evaluated in several published primary and secondary prevention studies.

RESULTS:The Omega-3 Index was inversely associated with risk for CHD mortality. An Omega-3 Index of > or = 8% was associated with the greatest cardioprotection, whereas an index of < or = 4% was associated with the least.
CONCLUSION:The Omega-3 Index may represent a novel, physiologically relevant, easily modified, independent, and graded risk factor for death from CHD that could have significant clinical utility.

Copyright 2004 The Institute for Cancer Prevention and Elsevier Inc.


High potency fish oil supplement improves omega-3 fatty acid status in healthy adults: an open-label study using a web-based, virtual platform.




BACKGROUND:The health benefits of omega-3 fatty acids from fish are well known, and fish oil supplements are used widely in a preventive manner to compensate the low intake in the general population. The aim of this open-label study was to determine if consumption of a high potency fish oil supplement could improve blood levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and impact SF-12 mental and physical health scores in healthy adults.

METHODS:A novel virtual clinical research organization was used along with the HS-Omega-3 Index, a measure of EPA and DHA in red blood cell membranes expressed as a percentage of total fatty acids that has been shown to correlate with a reduction in cardiovascular and other risk factors. Briefly, adult subjects (mean age 44 years) were recruited from among U.S. health food store employees and supplemented with 1.1 g/d of omega-3 from fish oil (756 mg EPA, 228 mg DHA, Minami Nutrition(R) MorEPA(R) Platinum) for 120 days (n = 157).
RESULTS:Omega-3 status and mental health scores increased with supplementation (p < 0.001), while physical health scores remained unchanged.

CONCLUSIONS:The use of a virtual, web-based platform shows considerable potential for engaging in clinical research with normal, healthy subjects. A high potency fish oil supplement may further improve omega-3 status in a healthy population regularly consuming an omega-3 supplement.


Dietary intake and food sources of total and individual polyunsaturated fatty acids in the Belgian population over 15 years old.


Sioen I, Vyncke K, De Maeyer M, Gerichhausen M, De Henauw S.



Department of Pu

blic Health, Ghent University, Ghent, Belgium.



Advances in our knowledge of the physiological functions of dietary polyunsaturated fatty acids (PUFAs) have led to an increased interest in food sources and the level of dietary intake of these nutrients. Up to now, no representative data was available for the Belgian adult population. This study aimed to describe data on the intake and food sources of total and individual omega-6 and omega-3 PUFA for the Belgian population over 15 years old. PUFA intakes were assessed for 3,043 Belgian adults, based on two non-consecutive 24 h recalls. Usual intakes were calculated using the multiple source method. The results showed that the intake of linoleic acid (LA) is in accordance with the recommendation for almost all Belgianadults. However, the intake of omega-3 PUFA is suboptimal for a large part of the studied population and also the intake of total PUFA should be increased for a part of the population. The main food source of LA and α-linolenic acid (ALA) was the group of fats and oils (60.6 % for LA and 53.1 % for ALA). Fish and fish products were the most important sources of long chain omega-3 PUFA. Age influenced fatty acids intake, with higher intake of omega-3 PUFA in the older age groups. To fill the gap between the intake and recommendation of total PUFA, and in particular omega-3PUFA, sustainable strategies and efficient consumer communication strategies will be needed.


The influence of n-3 PUFA supplements and n-3 PUFA enriched foods on the n-3 LC PUFA intake of Flemish women.


Sioen I, Devroe J, Inghels D, Terwecoren R, De Henauw 




Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, UZ-2 Blok A, De Pintelaan 185, 9000 Ghent, Belgium.


Food consumption data of Flemish women of reproductive age collected in 2002 showed a large deficit for ALA and n-3 LC PUFA compared to the recommendations (mean ALA and EPA + DHA intake 1.4 g/day and 209 mg/day, respectively) and indicated a need to tackle the problem of low n-3 PUFA intake. Another recent Belgian study demonstrated that enrichment of commonly eaten food items with n-3 PUFA provides the opportunity to increase the n-3 PUFA intake up to 6.5 g/day and decrease the n-6/n-3 ratio. Since a large supply of n-3 PUFA supplements and n-3 PUFA enriched foods exists on the Belgian market, this study aimed at assessing the influence of these products on the n-3 LC PUFA intake for Flemish women of reproductive age. It was found that n-3 supplements are consumed by 5% of the Flemish women. Of all the n-3 PUFA enriched foods on the Flemish market, margarines and cooking fat are most frequently consumed by young women. The results indicated that a big gap remains between the EPA&DHA intake (mean = 276 mg/day) and the recommendation. Seafood remains the most important source of EPA&DHA. Only 11.6% of the population sample reached an intake level of 500 mg EPA&DHA per day. The study showed that other strategies will be needed to increase the EPA&DHA intake in the long term.Enhanced increase of omega-3 index in response to long-term n-3 fatty acid supplementation from triacylglycerides versus ethyl esters

J Neubronner1, JP Schuchardt1, G Kressel1, M Merkel2, C von Schacky3 and A Hahn1
1Institute of Food Science and Human Nutrition, Leibniz Universita¨t Hannover, Am Kleinen Felde 30, Hannover, Germany; 2Asklepios
Klinik St. Georg, 1. Medizinische Abteilung, Haus O, Lohmu¨hlenstra_e 5, Hamburg, Germany and 3Preventive Cardiology,
Medizinische Klinik und Poliklinik Innenstadt, Ludwig Maximilians University, Munich, Ziemssenstr. 1, Mu¨nchen, Germany

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Bioavailability of marinen-3 fatty acid formulations

J. Dyerberg a,n, P.Madsen b, J.M.Møller c, I.Aardestrup b, E.B.Schmidt d a Department ofHumanNutrition,FacultyofLifeSciences,UniversityofCopenhagen,Copenhagen,Denmark b Department ofClinicalBiochemistry,CenterforCardiovascularResearchAalborgHospital,Aalborg,Denmark c Department ofGastroenterology,AalborgHospital,Aalborg,Denmark d Department ofCardiology,CenterforCardiovascularResearchAalborgHospital,Aalborg,Denmark

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