Fish Oil
Fish oil provides EPA and DHA. Strongest evidence is for triglycerides and some cardiovascular outcomes, with mixed results elsewhere.
Overview
What is fish oil?
Fish oil is a rich source of the two omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
Some fish oil products are approved by the FDA as prescription medications for the purpose of reducing triglycerides. The recommended dosage for this purpose is 3-4 grams per day.
Fish oil supplements appear to be more beneficial than plant-based sources of omega-3 fatty acids. Eating fish, particularly oily fish, may have greater benefits than taking fish oil supplements and reduces the likelihood of adverse effects.
Dosage
A standard dose of fish oil is around 2 grams per day (500-600 mg EPA + DHA), with food.
This dose is enough to elevate omega-3 levels in the body within 4 to 6 weeks.
Studies typically use dosages of 0.5 to 6 grams per day. It is recommended to start with a lower dose to avoid the risk of side effects.
For depression, a dose of 3-6 grams is used. Fish oil supplements with a higher ratio (≥1.5 ratio, dose 720 to 1000 mg/day total EPA) of EPA to DHA may have a greater clinical benefit for mild-to-moderate depression in pregnant women, and men and women with general depression. This is around a 3-6 gram dose of most fish oils but specific fish oil supplements containing greater levels of EPA can be dosed at the lower end of this range.
For reducing triglycerides, a dose of 4 grams per day (>3 g/day total EPA + DHA or >3g/day EPA-only) is recommended.
Effect graph
Effect heatmap
SupplementDEX Database
24 conditions for , , and rated at least stars. All purchase bands. No minimum star filter.
Database Snapshot
Most fish oil research is concentrated in a handful of conditions.
- High triglycerides (Hypertriglyceridemia) accounts for 46 of 215 studies (21%).
- Atrial fibrillation (EPA may increase new-onset AF risk) accounts for 22 of 215 studies (10%).
- Type 2 diabetes accounts for 18 of 215 studies (8%).
- Sparse coverage remains for Angina (Ischemic chest pain), Multiple sclerosis, Bronchopulmonary dysplasia (BPD).
Dietary Sources
Dietary sources
As a general guide, fish that are good sources of combined omega-3 fatty acids in descending order of content include herring, sardines, salmon, mackerel and trout. Lesser amounts can be found in tuna, halibut, cod and catfish.
Eating smaller fish including sardines, anchovies and mackerel can reduce the intake of heavy metals including arsenic, cadmium, lead, iron and zinc that accumulate in larger fish including tuna. Although in-species variations in heavy metal concentrations can occur due to fishing location and season, heavy metal levels are generally within safety limits for smaller fish. Samples of larger fish including Chilean sea bass, cod, croaker, flounder, porgie, whiting and bluefin tuna sourced from stores in the United States have been found to have elevated levels of heavy metals including mercury and arsenic. Whilst there is a general trend towards reduced heavy metal levels in smaller fish, in-species differences can also arise due to variances in geography and industrial activity. A study examining heavy metal content in commercial fish in the United States found that no fish type had the highest level of more than two metals, suggesting that the best approach to fish consumption is to consume a diversity of fish with low mercury and arsenic content, to avoid overexposure to any individual metal.
Fish oil contains high concentrations of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).
Top Dietary Sources of EPA
Ranked by amount per 100 g
- 1.26 g100 g
- 1.24 g100 g
- 0.98 g100 g
- 0.909 g100 g
- 0.898 g100 g
- 0.876 g100 g
- 0.867 g100 g
- 0.862 g100 g
Top dietary sources of DHA
Ranked by amount per 100 g
- 1.75 g100 g
- 1.46 g100 g
- 1.4 g100 g
- 1.36 g100 g
- 1.29 g100 g
- 1.14 g100 g
- 1.1 g100 g
- 1.1 g100 g
Notes
Sardines Heavy Metal Information
A study found the lowest heavy metal and trace element concentrations in European sardines from the Canary Islands, moderate levels from Rabat, Malaga and Lisbon, and the highest in sardines from Cartagena. A 2023 study examining 360 sardine samples from north-eastern Morocco detected seasonal variations in cadmium, mercury, arsenic and lead that did not pose an immediate non-carcinogenic health risk but could present a carcinogenic effect from long-term intake. Levels of methylmercury in Portuguese sardines are within safety limits. Greater levels of mercury have been detected in hake, horse mackerel and codfish, in descending order of mercury content.
Tuna (Canned Fish) Heavy Metal Information
A study of canned fish samples from Turkey found that the excessive intake of canned tuna, salmon and mackerel may increase the risk of cancer in children due to elevated cadmium, chromium and arsenic content. Increased health risks from arsenic were observed if more than 1.70 fish meals per month were consumed for children and more than 1.87 for adults. The health risks from lead were observed at 4.29 meals per month for children and 4.95 for adults. Mackerel was the fish with the highest arsenic content (0.11 mg/kg).
Safety
Fish oil is generally well tolerated at the standard dose of up to 3 grams per day and is Generally Recognised as Safe (GRAS) in the United States.
Dose windows
Short-term
Fish oil supplementation of up to 6 grams is likely safe in healthy adults.
Long-term
Fish oil supplementation of up to 3 grams per day is likely safe. Doses of 3 grams per day or higher may increase the risk of bleeding and affect immunity.
Side effects
Common
- Abdominal pain
- Fishy breath
- Heartburn
- Nausea
- Diarrhea
- Increased LDL-C levels
- Skin rash
Serious
- An increased risk of atrial fibrillation
- Immune suppression
- Impaired blood clotting
Special populations
Pregnancy & breastfeeding
Likely safeIn pregnant and lactating women, fish oil at a dose of 1-2 grams per day is likely safe. However, the consumption of fish including tuna, mackerel and swordfish should be limited.
Children
Likely safeIn children, fish oil is likely safe and has been safely used at a dose of 4 g per day for 8 weeks or 2100 mg per day for 12 weeks. The dietary intake of fish including tuna, mackerel and swordfish should be limited due to the presence of neurotoxic metals.
Other notes
Studies typically use dosages of 1 to 10 grams per day, with the most common dose being around 3 grams per day combined EPA + DHA. The most common side effect is fishy burp (20-30%), a dose-dependent side effect. See dietary sources for more information on the safety of fish in the diet.
Frequently Asked Questions
Takeaway
Fish oil is rich in the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
Supplementation reliably reduces blood triglyceride levels at a dose of 3 to 4 grams per day.
Most high quality fish oils use sardine, mackerel and anchovy oils.
Population studies have found that dietary fish intake is superior to supplementation for general health outcomes.
References
Sources206 references
SupplementDEX uses only high-quality sources to determine supplement effectiveness.
1.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Effects of fish oil supplementation on glucose control and lipid levels among patients with type 2 diabetes mellitus: a Meta-analysis of randomized controlled trials2020
A meta-analysis of 12 T2DM RCTs found fish oil did not improve fasting glucose, HbA1c, insulin, or HOMA-IR, though triglycerides were modestly reduced with supplementation.
2.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Omega-3 Fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association2019
A scientific advisory from the American Heart Association in 2019 has proposed that 4 g/day (>3 g/day total EPA + DHA or EPA-only) omega-3 fatty acids is effective and safe for reducing triglycerides, either alone or with other lipid-lowering agents. This is an update to a 2002 recommendation of 2-4 g/day. In patients with high triglycerides treated with a statin, taking 4 g/day omega-3 fatty acids as EPA (Icosapent Ethyl, Australia: Vazkepa, USA: Vascepa) was associated with a 25% reduction in major cardiovascular events. [10549]
3.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Omega-3, omega-6, and total dietary polyunsaturated fat for prevention and treatment of type 2 diabetes mellitus: systematic review and meta-analysis of randomised controlled trials2019
A meta-analysis of 83 randomised controlled studies (n = 121,070) found that supplementation of omega-3 had little to no effect on the likelihood of type 2 diabetes diagnosis (17 studies with 56,643 patients) and had no effect on glucose metabolism. Doses above 4.4 g/day omega-3 PUFA may lead to negative outcomes. [10665]
4.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Cardiovascular disease and omega-3s: Prescription products and fish oil dietary supplements are not the same2017
A review highlighting the disparity between prescription omega-3 products and dietary supplements has suggested that supplements should not be considered a substitute for prescription omega-3 products. Dietary supplements vary greatly in concentration, stability and quality control. Dietary supplements containing DHA may raise LDL-C and are not a substitute for EPA only icosapent ethyl, which do not raise LDL-C. Fish oil supplements, whilst generally safe for health promotion, are not regulated to the same extent as prescription products. [10550]
5.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — The clinical relevance of omega-3 fatty acids in the management of hypertriglyceridemia2016
A review of different omega-3 fatty acid formulations found that OM3FA ethyl esters (OM3EE), icosapent ethyl (EPA, Vascepa) and omega-3 carboxylic acids (OM3CA) when taken at approved doses, were effective for significantly reducing triglyceride and very-low-density lipoprotein levels in those with very high triglycerides (500 mg/dL). Whilst formulations containing DHA may increase LDL cholesterol, this was not accompanied by an increase in non-high-density lipoprotein cholesterol, a more reliable indicator of cardiovascular risk. [10551]
6.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — A double-blind randomized trial of fish oil to lower triglycerides and improve cardiometabolic risk in adolescents2014
An 8-wk study of 42 children with hypertriglyceridemia given 4 g/day fish oil found a reduction in triglycerides that was not significant, a reduction in large VLDL particles and no effect on LDL particle number or size compared to placebo. [10552]
7.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: a systematic review2006
A systematic review and meta-analysis of 21 trials found that fish oil on average, led to the following dose-dependent effects: Triglycerides: -27 mg/dL (95% CI: -33 to -20) HDL-C: +1.6 mg/dL (95% CI: +0.8 to +2.3) LDL-C: +6 mg/dL (95% CI: +3 to +8), no effect on total cholesterol or glucose control.
8.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Moderate fish-oil supplementation reverses low-platelet, long-chain n-3 polyunsaturated fatty acid status and reduces plasma triacylglycerol concentrations in British Indo-Asians2004
In 84 British Indo-Asian and European adults over 12 weeks, 4 g/day fish oil (1.5 g EPA + 1.0 g DHA) lowered plasma triglycerides and raised platelet EPA/DHA versus olive oil, correcting baseline n-3 deficits in Indo-Asians.
9.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Efficacy of omega-3 fatty acids, atorvastatin and orlistat in non-alcoholic fatty liver disease with dyslipidemia2004
In NAFLD patients with dyslipidemia over 24 weeks, omega-3 fatty acids 5 mL three times daily lowered transaminases and resolved fatty liver in 35%, less than atorvastatin (61%) or orlistat (86%).
10.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Fish oil in people with type 2 diabetes mellitus2001
A study and update to a prior systematic review (searching new studies from September 1998 to September 2000) and meta-analysis of 18 studies (mean 12 weeks duration) including 823 subjects found that fish oil (3 to 18 g/day) demonstrated a statistically significant dose-dependent effect on lowering triglycerides (-0.56 mmol/l [95% CI -0.71 to -0.40]) and raising LDL cholesterol (0.21 mmol/l [0.02 to 0.41]) with a stronger triglyceride-lowering effect in hypertriglyceridemic subjects [10671][10670]. [View on PubMed] This study was re-updated in 2008 [10669].
11.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — An omega-3 polyunsaturated fatty acid concentrate administered for one year decreased triglycerides in simvastatin treated patients with coronary heart disease and persisting hypertriglyceridaemia2001
In 46 simvastatin-treated CHD patients with hypertriglyceridemia, Omacor omega-3 concentrate 4 g/day for up to 48 weeks sustained 20–30% triglyceride reductions (p<0.005) with good tolerability.
12.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Efficacy of Concentrated n-3 Fatty Acids in Hypertriglyceridaemia : A Comparison with Gemfibrozil2001
A 12-wk study of 89 patients with severe hypertriglyceridaemia (>4.5 mmol/L) comparing the efficacy of 4 g/day omega-3 fatty acids (Omacor EPA/DHA) and 1200 mg/day gemfibrozil found that gemfibrozil led to a larger reduction in mean triglycerides (-51.2% vs. -28.9%) and far greater increases in HDL-C compared to fish oil (+27.9% vs. 1.2%). [10554]
13.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Fish oil supplementation in type 2 diabetes: a quantitative systematic review2000
A systematic review and meta-analysis of 18 studies (832 participants) found that fish oil supplementation led to a reduction in triglycerides and an increase in LDL cholesterol with no effect on fasting glucose. A greater reduction in triglycerides was found in studies that included subjects with higher triglyceride levels and those using higher dosages. [10670]
14.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Dietary supplementation with marine omega-3 fatty acids improve systemic large artery endothelial function in subjects with hypercholesterolemia2000
A four-month study of 30 patients with hypercholesterolemia (> 6.5mmol/litre) who had previously followed a low-fat diet for 3 months found fish oil (4 g/day) significantly reduced triglycerides and improved flow-mediated dilation. [10555]
15.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Effect of n-3 fatty acids on the composition and binding properties of lipoproteins in hypertriglyceridemic patients2000
In 14 hypertriglyceridemic patients, fish oil 3 g EPA+DHA/day for 4 weeks lowered VLDL lipids and apoE but raised LDL cholesterol and apoB, normalizing VLDL subfraction distribution.
16.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Effect of long-chain n-3 polyunsaturated fatty acids on fasting and postprandial triacylglycerol metabolism2000
A review concluded long-chain n-3 fatty acids improve fasting and postprandial triglyceride metabolism, potentially reducing small dense LDL and postprandial cardiovascular risk factors.
17.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Postprandial chylomicrons and VLDLs in severe hypertriacylglycerolemia are lowered more effectively than are chylomicron remnants after treatment with n-3 fatty acids2000
In 12 men with severe hypertriglyceridemia, 3.4 g/day fish oil for 6 weeks reduced fasting VLDL-TG 44% and postprandial chylomicrons and VLDL by 36–64% after a fat load.
18.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Effect of a fish-oil concentrate on serum lipids in postmenopausal women receiving and not receiving hormone replacement therapy in a placebo-controlled, double-blind trial2000
A 4-wk study of 36 postmenopausal women (Receiving & not receiving HRT) found that omega-3 fatty acids (2.4 g EPA + 1.6 g DHA per day) is associated with a 26% lower serum triacylglycerol concentration and a 28% lower ratio of serum triacylglycerol to HDL cholesterol, indicating a reduced risk of coronary heart disease in this patient population. [10556]
19.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — ApoE polymorphism and fish oil supplementation in subjects with an atherogenic lipoprotein phenotype2000
In 55 men with atherogenic lipoprotein phenotype, fish oil 3 g EPA+DHA/day for 6 weeks lowered fasting triglycerides 35%, postprandial TG area 26%, and LDL-3 fraction 26% versus olive oil placebo.
20.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Fish oil and cardiovascular disease: lipids and arterial function2000
A review concluded fish oil modifies cardiovascular risk through triglyceride lowering, improved postprandial lipemia, and better endothelial function and arterial compliance, despite possible LDL increases.
21.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Long-term effects of fish oil on lipoprotein subfractions and low density lipoprotein size in non-insulin-dependent diabetic patients with hypertriglyceridemia1999
A study of 16 non-insulin dependent diabetic patients with hypertriglyceridemia (plasma triglyceride 2.25 – 5.65 mmol/l) found a reduction in triglycerides but no improvement in LDL cholesterol. [10672]
22.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — The effect of fish oil on hypertension, plasma lipids and hemostasis in hypertensive, obese, dyslipidemic patients with and without diabetes mellitus1999
A study of 19 obese type 2 diabetics (mean age 56.7 +- 10.7 years) with hypertension also taking sulfonylureas found that 4.5 g/day omega-3 supplementation (2.7 g EPA + 1.8 g DHA) led to reductions in blood pressure and triglycerides after 13 days. Similar reductions in blood pressure and triglycerides were seen in subjects without type 2 diabetes. [10684]
23.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Fish oil and glycemic control in diabetes. A meta-analysis1998
A meta-analysis of 26 studies (mean = 8 weeks, n = 425; M = 323, F = 102) found that fish oil supplementation (2.7 g – 21.6 g/day) reduced mean triglyceride concentrations by -0.60 mmol/l (95% CI, -0.84 to -0.33, P < 0.01) and increased mean serum LDL cholesterol by 0.18 mmol/l (95% CI, 0.04-0.32, P = 0.01) in IDDM and NIDDM patients. Fasting blood glucose levels trended towards an increase in NIDDM patients (0.43 mmol/l [95% CI, 0.00-0.87], P = 0.06), and significantly decreased in IDDM patients (-1.86 mmol/l [95% CI, -3.1 to -0.61], P < 0.05). In NIDDM subjects, for each 1 g/day increase in EPA, LDL-C increased by 0.14 mmol/l (95% CI, 0.002-0.28, P<0.05), and serum triglycerides fell by 0.35 mmol/l (95% CI, -0.63 to -0.09, P<0.05). In NIDDM subjects, for each 1 g/day increase in DHA, fasting glucose concentrations increased by 0.75 mmol/l (95% CI, 0.16-132), HbA1c increased by 0.6% (95% CI, 0.06-1.15, P<0.05) and serum triglycerides decreased by 0.47 mmol/l (95% CI, -0.92 TO -0.02, P<0.05). [10673]
24.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — One-year treatment with ethyl esters of n-3 fatty acids in patients with hypertriglyceridemia and glucose intolerance: reduced triglyceridemia, total cholesterol and increased HDL-C without glycemic alterations1998
A study found that long-term (12 months) 2 g/day omega-3 fatty acid supplementation led to a significantly greater reduction in total cholesterol (-3.8%) & increased HDL cholesterol (+7.4%) compared to 6-months. [10562]
25.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Moderate intake of n-3 fatty acids for 2 months has no detrimental effect on glucose metabolism and could ameliorate the lipid profile in type 2 diabetic men. Results of a controlled study1998
A study of 12 type-2 diabetics with elevated plasma triacylglycerols found that 2 months of 6 g/day fish oil reduced plasma triacylglycerol levels more than sunflower oil, and decreased mRNA of both lipoprotein lipase and hormone sensitive lipase in abdominal adipose tissue with no effect on glycemic control or insulin activity. [10561]
26.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Dietary fish oil (4 g daily) and cardiovascular risk markers in healthy men1997
A 4-wk study of 47 healthy males (29 to 60 y/o) found that 4 g/day fish oil (equivalent to one to two weekly servings of fatty fish) led to a 30% reduction in plasma triglycerides but had no significant effect on blood coagulation compared to placebo. [10564]
27.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — n-3 fatty acids and serum lipoproteins: human studies1997
A review of human trials found marine EPA/DHA lowers triglycerides and may raise LDL 5–10%, while plant alpha-linolenic acid at typical doses does not replicate marine n-3 lipoprotein effects.
28.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Normal subjects consuming physiological levels of 18:3(n-3) and 20:5(n-3) from flaxseed or fish oils have characteristic differences in plasma lipid and lipoprotein fatty acid levels1996
A 3-month study of 26 healthy participants found that fish oil (35 mg/kg/day) reduced triglyceride levels but did not affect cholesterol levels. [10565]
29.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — A comparison of the effects of n-3 fatty acids from linseed oil and fish oil in well-controlled type II diabetes1996
A 3-month study of 11 type 2 diabetic patients found neither fish oil or linseed oil (both 35 mg/kg body weight/day) significantly affected glycemic control, cholesterol or insulin secretion. Fish oil reduced triglyceride levels and exhibited a trend towards decreased insulin sensitivity. [10676]
30.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Long-term effects of fish oil on insulin resistance and plasma lipoproteins in NIDDM patients with hypertriglyceridemia1996
A 6-month study of 16 type 2 diabetes patients with hypertriglyceridemia (2.25-5.65 mmol/l) given either fish oil (n = 8, 2.6 g/day EPA + DHA for 2 months, then 1.7 g/day for 4 months) or placebo (n=8) found a significant reduction in plasma triglycerides, VLDL-TG, fasting NEFA concentrations and no significant changes in blood glucose control. [10675]
31.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Effect of dietary fish oil supplementation on peroxidation of serum lipids in patients with non-insulin dependent diabetes mellitus1996
An 18-week crossover trial of 23 type 2 diabetes patients (m = 20, f = 3) who were otherwise healthy found that 6 weeks of 10 g/day fish oil supplementation (1.8 g EPA + 1.2 g DHA, Maxepa) could exacerbate lipid peroxidation and did not change plasma cholesterol compared to placebo (olive oil). [10677]
32.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Long-term metabolic effects of n-3 polyunsaturated fatty acids in patients with coronary artery disease1995
A study of 260 postoperative (bypass surgery) patients with coronary artery disease given 4 g/day fish oil (3.4 g total DHA + EPA) found no effect on insulin or glucose concentrations but did find a 19.1% reduction in serum triglycerides compared to a control group. [10566]
33.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — A comparison of fish oil or corn oil supplements in hyperlipidemic subjects with NIDDM1995
In 40 NIDDM patients with hyperlipidemia over 12 weeks, 9–18 g/day fish oil significantly lowered VLDL cholesterol and triglycerides versus corn oil, with a transient LDL rise at 6 weeks.
34.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Long-term effects of n-3 fatty acids on serum lipids and glycaemic control1994
A study of 57 non-diabetic patients with moderate hypertriglyceridemia undergoing coronary artery bypass grafting found that 6 months of daily postoperative fish oil consumption led to reductions in triglycerides (median -33.2% vs. 11.1%), but no changes in cholesterol markers, insulin or c-peptide concentrations. [10568]
35.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Effects of a new fish oil concentrate on plasma lipids and lipoproteins in patients with hypertriglyceridaemia1994
A 14-wk multi-centre study of 79 patients with primary hypertriglyceridaemia and moderate to high cholesterol found that 4 g/day fish oil reduced serum triglycerides compared to a corn oil placebo. [10567]
36.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Effect of pravastatin and omega-3 fatty acids on plasma lipids and lipoproteins in patients with combined hyperlipidemia1993
A two part study found that 6 g/day fish oil (3 g omega-3) given to 10 subjects led to a 30% reduction in triglycerides and non-significantly increased LDL-C after 6 weeks. To assess the efficacy of combined therapy, 29 participants were then given a combination of 40 mg/day pravastatin and 6 g/day fish oil for 12-weeks leading to significant reductions in average total cholesterol, triglyceridies, LDL-C and apoB. Neither therapy led to clinically significant muscle tenderness, elevated creatine phosphokinase or alanine aminotransferase. [10569]
37.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Metabolic effects of omega-3 fatty acids in type 2 (non-insulin-dependent) diabetic patients1993
A 3-week study of 20 mildly obese, normotriglyceidemic type 2 diabetes patients taking hypoglycemic agents found that 15 ml/day fish oil (3.1 g omega-3 FA) did not affect fasting or postprandial blood glucose, C-peptide concentrations and plasma insulin levels compared to placebo. [10678]
38.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Influence of supplementation with N-3 fatty acids on different coronary risk factors in men--a placebo controlled study1992
A study of 58 healthy men (monks) given fish oil for 12 months found a dose-dependent reduction in triglycerides but no effect on cholesterol after 18 months (6 months observation). [10570]
39.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — [Effect of short-term use of omega-3-type polyunsaturated fatty acids in subjects with hypertriglyceridemia]1992
A 12-week study of hypertriglyceridaemic patients receiving either fish oil (1.8 g EPA + 1.2 g DHA) or corn oil placebo found a reduction in triglyceride levels from fish oil supplementation. [10571]
40.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Influence of fish oil on blood lipids in coronary artery disease1991
A study of 32 patients with coronary artery disease and dyslipidaemia found 2.4 – 3.2 g/day fish oil reduced serum triglycerides in a dose-dependent manner with greater reductions found in those with severe hypertriglyceridaemia (> 3.0 mmol/l). [10572]
41.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Effects of fish-oil ingestion on cardiovascular risk factors in hyperlipidemic subjects in Israel: a randomized, double-blind crossover study1990
In 27 hyperlipidemic Israelis in a crossover trial, daily fish oil (~15 g) lowered triglycerides 40%, raised HDL 12%, and reduced plasma viscosity versus vegetable oil placebo.
42.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Effects of two types of fish oil supplements on serum lipids and plasma phospholipid fatty acids in coronary artery disease1990
A study involving 89 subjects with coronary heart disease given one of two fish oil preparations (ethyl ester and triglyceride) found that triglyceride fish oil was more effective for reducing triglyceride levels compared to ethyl ester preparations [10573]. Other literature suggests that triglycerides confer superior absorption (EPA: 68%, DHA: 57%) relative to ethyl esters (EPA: 20%, DHA: 21%). However, absorption of EPA, but not DHA from fish oil in triglyceride form is increased from 69% to 90% when taken with a high-fat meal [10574].
43.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Effects of modest doses of omega-3 fatty acids on lipids and lipoproteins in hypertriglyceridemic subjects. A randomized controlled trial1989
In 8 hypertriglyceridemic adults over 8 weeks, 4.6 g/day omega-3 versus corn oil lowered triglycerides 2.21 mmol/L, raised HDL 0.13 mmol/L, and increased LDL apoB 0.246 g/L.
44.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Effects of a low saturated fat, low cholesterol fish oil supplement in hypertriglyceridemic patients. A placebo-controlled trial1988
A 6-week single-blind study of 11 patients with type IV isolated hypertriglyceridemia given 12 g/day fish oil found reductions in triglyceride levels (and an increase in the LDL-HDL ratio (4.0 +/- 0.9 to 4.7 +/- 1.4). Seven of the 11 patients had Type IIb hypercholesterolemia. [10575]
45.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — Effects of omega-3 fish oils on lipid metabolism, glycemic control, and blood pressure in type II diabetic patients1988
An 8-wk study of 22 type 2 diabetes patients found that fish oil supplementation significantly increased ApoB concentrations (avg 2.56 baseline to 2.8 mmol/L at 8 weeks) and decreased systolic and diastolic blood pressure. [10680]
46.SupplementDEX Database: High triglycerides (Hypertriglyceridemia) — On the effects of dietary n-3 fatty acids (Maxepa) on plasma lipids and lipoproteins in patients with hyperlipidaemia1985
A 3-month study in 25 subjects with high cholesterol found that both 16 g/day fish oil and 6 g/day (MaxEPA) led to dose-dependent reductions in triglycerides (28% – 58%) depending on basal triglyceride level. A separate study (16 g/day) found a significantly greater reduction in plasma triglycerides (-58%) and reduced plasma cholesterol concentration in those with type V hyperlipoproteinaemia (-34%). There was no change in plasma cholesterol in subjects with types IIa and IIb hyperlipoproteinemia. There was no change in the ratio of LDL to HDL cholesterol. There was a significant reduction in very low-density lipoprotein cholesterol (-42%). 13 subjects given 6 g/day fish oil experienced a significant reduction in triglycerides (-33%) suggesting a dose-dependent effect from supplementation. [10576]
SupplementDEX Database · Angioplasty
14 references47.SupplementDEX Database: Angioplasty — Fish oils in the care of coronary heart disease patients: a meta-analysis of randomized controlled trials2004
A meta-analysis of 7 studies studying the efficacy of fish oils in preventing restenosis after percutaneous transluminal coronary angioplasty (PTCA) found benefits from supplementation. [10650]
48.SupplementDEX Database: Angioplasty — Prevention of postcoronary angioplasty restenosis by omega-3 fatty acids: main results of the Esapent for Prevention of Restenosis ITalian Study (ESPRIT)2002
A study of 257 patients given fish oil (n =125, Esapent) for 1 months before PTCA and for 1 month after, then continued at half dose (3 g/day fish oil) for 6 months found a reduced rate of restenosis (Defined by quantitative angiography as 50% diameter stenosis in the dilated vessel [D1] or a >50% loss of the short-term gain immediately after PTCA [D2 – Not significant]) at the end of treatment compared to placebo. In those taking fish oil, D1 & D2 restenosis rates were 31.2% and 33.6% compared to 40.9% and 37.1% in the placebo group. [10651]
49.SupplementDEX Database: Angioplasty — N-3 fatty acids do not prevent restenosis after coronary angioplasty: results from the CART study. Coronary Angioplasty Restenosis Trial1999
A study of 388 patients found that fish oil supplementation (5.1 g n-3 FA/day), starting at least 2 weeks prior to elective coronary angioplasty and continued until follow-up at 6 months, did not significantly reduce incidence of restenosis (fish oil 40.6%) compared to corn oil (35.4%). [10652]
50.SupplementDEX Database: Angioplasty — Fish oils and low-molecular-weight heparin for the reduction of restenosis after percutaneous transluminal coronary angioplasty. The EMPAR Study1996
A clinical trial of 653 patients found that fish oil (5.4 g/day n-3 FAs) taken for a median 6 days before PTCA and for 18 weeks following PTCA did not reduce restenosis rates compared to placebo. [10653]
51.SupplementDEX Database: Angioplasty — Do fish oils prevent restenosis after coronary angioplasty?1994
A study of 447 patients found that 10 g/day fish oil for 6 months did not reduce rate of restenosis compared to corn oil. [10654]
52.SupplementDEX Database: Angioplasty — A prospective, randomized, and double-blind trial on the effect of fish oil on the incidence of restenosis following PTCA1993
A study of 204 successful PTCA patients found that 3.15 g/day omega-3 FAs started immediately after PTCA and maintained over 4 months did not lead to a significant reduction in coronary artery restenosis. [10656]
53.SupplementDEX Database: Angioplasty — Preventing restenosis with fish oils following coronary angioplasty. A meta-analysis1993
A meta-analysis of 7 studies (4 double-blinded) found that fish oil supplementation (avg 3000-6484 mg/day) reduced restenosis rates after coronary angioplasty. In four studies using angiography to determine restenosis, the absolute difference in restenosis was 13.9% and there was positive linear relationship between fish oil dose and absolute difference in restenosis rates compared to control. When 3 studies using stress testing to determine restenosis were included (total 7 studies), the risk difference was 5.1% (95% CI, -3.8% to 13.9%). [10655]
54.SupplementDEX Database: Angioplasty — Double-blind, randomized, controlled trial of fish oil supplements in prevention of recurrence of stenosis after coronary angioplasty1992
A study of 205 patients undergoing a first PTCA found that 15 g/day fish oil (2.7 g EPA + 1.8 g DHA) taken for 3 weeks before PTCA and for 6 months afterwards reduced the rate of restenosis (occurred in 22.0-35.6% in fish oil group) compared to control (40.0-53.3%) in three of four definitions. A dietary intake of omega-3 fatty acids of more than 0.15 g/day was associated with a reduced likelihood of restenosis (P = 0.03). [10660]
55.SupplementDEX Database: Angioplasty — A meta-analysis of randomized trials of fish oil in prevention of restenosis following coronary angioplasty1992
A meta-analysis of 7 studies involving 951 PTCA patients found that fish oil reduced the rate of restenosis. [10657]
56.SupplementDEX Database: Angioplasty — Can supplementation of diet with omega-3 polyunsaturated fatty acids reduce coronary angioplasty restenosis rate?1992
A study of 120 coronary angioplasty patients given either 3 g/day fish oil or placebo (1-2 days prior to angioplasty then for 6 months following angioplasty) found no significant difference in restenosis rates at the end of the study. [10659]
57.SupplementDEX Database: Angioplasty — Fish oil supplements for prevention of restenosis after coronary angioplasty1992
A study of 107 patients who had previously undergone PTCA found that a combination of aspirin, calcium blockers and 3 g/day fish oil beginning around 4.3 (SD 2.9) days before coronary angioplasty for at least 6 months did not reduce incidence of early restenosis compared to only aspirin and calcium blockers. [10658]
58.SupplementDEX Database: Angioplasty — Determinants of restenosis and lack of effect of dietary supplementation with eicosapentaenoic acid on the incidence of coronary artery restenosis after angioplasty1989
A study of 101 patients found that omega 3 (1.8 g EPA + 1.2 g DHA) supplementation in combination with aspirin and verapamil commencing the day before angioplasty and continued for 4 months did not reduce the incidence of early restenosis after coronary angioplasty during mean follow up of 100 days compared to placebo, aspirin and verapamil. [10661]
59.SupplementDEX Database: Angioplasty — Randomised trial of fish oil for prevention of restenosis after coronary angioplasty1989
In 204 post-angioplasty patients over 6 months, 6 g/day fish oil did not prevent restenosis and showed 34% angiographic restenosis versus 23% with olive oil placebo (RR 1.7, 95% CI 0.9–3.4).
60.SupplementDEX Database: Angioplasty — Usefulness of fish oil supplements in preventing clinical evidence of restenosis after percutaneous transluminal coronary angioplasty1989
In 194 post-PTCA patients, high-dose omega-3 4.5 g/day for 6 months did not reduce clinical restenosis versus conventional therapy alone; 11 of 95 assigned fish oil stopped for side effects.
61.SupplementDEX Database: Cachexia (Wasting syndrome) — The effect of oral omega-3 polyunsaturated fatty acid supplementation on muscle maintenance and quality of life in patients with cancer: A systematic review and meta-analysis2021
A systematic review and meta-analysis of cancer RCTs found insufficient consistent evidence that oral omega-3 supplementation ≥600 mg/day for ≥3 weeks improves muscle maintenance or quality of life in cancer patients.
62.SupplementDEX Database: Cachexia (Wasting syndrome) — Impact of fish oil and melatonin on cachexia in patients with advanced gastrointestinal cancer: a randomized pilot study2005
In 24 advanced GI cancer patients, 30 mL/day fish oil (4.9 g EPA + 3.2 g DHA) for 4 weeks stabilized weight in 38% versus 27% with melatonin; combined treatment thereafter helped ~63% stabilize weight.
63.SupplementDEX Database: Cachexia (Wasting syndrome) — Phase II study of high-dose fish oil capsules for patients with cancer-related cachexia2004
A phase II study of 36 advanced cancer patients with cachexia found that fish oil (7.5 g for a 70kg individual) taken for a median of 1.2 months led to weight gain (>5% bw) in 6 patients and weight stablisation (gain of <= 5% or loss of <5%) in 24 patients. The entire group had a median rate of weight loss of 1.2%, suggesting an overall beneficial effect on cachexia given initial median body weight loss of 4% per month, that was expected to rise to 4.8% over 1.2 months. Six patients experienced continued weight loss (>5%). [10648]
64.SupplementDEX Database: Cachexia (Wasting syndrome) — Effect of fish oil on appetite and other symptoms in patients with advanced cancer and anorexia/cachexia: a double-blind, placebo-controlled study2003
In 60 advanced cancer patients with weight loss over 2 weeks, fish oil providing 1.8 g EPA and 1.2 g DHA daily did not improve appetite, symptoms, or nutritional status versus placebo.
65.SupplementDEX Database: Cachexia (Wasting syndrome) — Phase I clinical study of fish oil fatty acid capsules for patients with cancer cachexia: Cancer and Leukemia Group B Study 94731999
A phase I clinical trial of 22 patients with cancer-induced cachexia (>= 2% body weight loss in the previous month) found a maximum tolerated dose of 0.3 g/kg/day fish oil. [10649]
66.SupplementDEX Database: Cachexia (Wasting syndrome) — The effect of an oral nutritional supplement enriched with fish oil on weight-loss in patients with pancreatic cancer1999
In 20 unresectable pancreatic cancer patients, two daily fish-oil-enriched supplements (~2.18 g EPA/day) produced median weight gain of 1 kg at 3 weeks and 2 kg at 7 weeks versus ongoing baseline weight loss.
67.SupplementDEX Database: Gastroenteritis in early childhood — Supplementation With Fish Oil in Pregnancy Reduces Gastroenteritis in Early Childhood2023
Randomized trial evaluating maternal fish oil supplementation during pregnancy, showing reduced gastroenteritis incidence in early childhood. A study of 736 mothers found triacylglycerol omega-3 supplements (Incromega TG33/22, 2.4 g/day) taken from pregnancy week 24 until one week postpartum led to a 14% reduction in days with gastroenteritis in the first 3 years of the child’s life (-2.5 days), and a 23% reduction in women with low levels of preintervention EPA + DHA, with significant effects only during winter and stronger effects seen in the first 2 years of life. [10647]
SupplementDEX Database · Heart failure
7 references68.SupplementDEX Database: Heart failure — Regular use of fish oil supplements and course of cardiovascular diseases: prospective cohort study2024
A prospective cohort study of 415,737 participants (13,367 with incident atrial fibrillation; 22,636 with major adverse cardiovascular events) enrolled in the UK Biobank study found that in participants with cardiovascular disease, regular use of fish oil supplements reduced the likelihood of cardiovascular mortality, and transition from atrial fibrillation to either myocardial infarction or major adverse cardiovascular events. In healthy people regularly taking fish oil, there was an increased likelihood of transition from healthy status to atrial fibrillation or to stroke. [10642]
69.SupplementDEX Database: Heart failure — Omega-3 supplementation and heart failure: A meta-analysis of 12 trials including 81,364 participants2021
A meta-analysis of 12 trials finding that omega-3 supplementation modestly reduces major heart failure outcomes and mortality risk in large populations. A meta-analysis of 12 studies (961-6000 mg per day omega-3; median study duration 1.5 years) including 81,364 participants found that omega-3 supplementation did not significantly reduce first heart failure hospitalisation (977 hospitalised in omega-3, and 1011 hospitalised in placebo; pooled RR 0.96 (95% CI 0.88–1.05), P = 0.39; I2 = 35%) or cardiovascular mortality (948 cases in omega-3 and 990 in placebo; RR 0.93; 95% CI 0.86–1.01, P = 0.07; I2 = 44%). Despite high heterogeneity, recurrent heart failure hospitalisation risk was 9% lower in patients receiving omega-3 (1330 cases in omega-3 and 1432 in placebo; RR 0.91; 95% CI 0.85–0.98, P = 0.02; I2 = 71%). [10643]
70.SupplementDEX Database: Heart failure — Seafood Long-Chain n-3 Polyunsaturated Fatty Acids and Cardiovascular Disease: A Science Advisory From the American Heart Association2018
A scientific advisory from the American Heart Association suggests that 1-2 seafood meals per week is recommended to reduce the risk of congestive heart failure, coronary heart disease, ischemic stroke, and sudden cardiac death, especially when consumed in the replacement of unhealthier options. [10644]
71.SupplementDEX Database: Heart failure — Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease: A Science Advisory From the American Heart Association2017
An AHA science advisory reviewed RCT evidence on fish oil for cardiovascular disease prevention, recommending omega-3 supplementation for secondary prevention in certain high-risk groups while noting limited primary-prevention data.
72.SupplementDEX Database: Heart failure — Fish consumption, omega-3 fatty acids and risk of heart failure: a meta-analysis2012
A meta-analysis of 7 studies including 176,441 subjects and 5480 incident cases of heart failure found that both dietary fish consumption (-15%) and fish oil supplementation (-14%) are associated with the reduced likelihood of heart failure. Fish consumption (I2 = 8%) may have more reliable benefits when compared to supplementation (I2 = 44%). For fish consumption, each 15 g/day higher consumption of fish was associated with a 5% lower risk of heart failure [RR: 0.95 (95% CI: 0.93–0.98)]. For fish oil, each 125 mg/day increase in omega-3 fatty acids (around 100 grams of fatty fish per week) was associated with a 3% lower risk of heart failure [RR: 0.97 (95% CI: 0.94–0.99)]. [10645]
73.SupplementDEX Database: Heart failure — Effects of fish oil supplementation on cardiac function in chronic heart failure: a meta-analysis of randomised controlled trials2012
A meta-analysis of 7 CHF trials (825 patients) found fish oil increased left ventricular ejection fraction by 2.25% (p=0.005) and reduced end-systolic volume versus placebo.
74.SupplementDEX Database: Heart failure — Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial2008
A study of 6975 patients with chronic heart failure of NYHA class II-IV found a significant reduction in all-cause mortality (-9%), cardiovascular mortality and hospital admissions from 1 g/day omega-3 supplementation for a median for 3.9 years (IQR 3.0-4.5). Approximately 56 patients would need to be treated for a median of 3.9 years to avoid one death. Approximately 44 patients would need to be treated for the same time period to prevent either one death or a cardiovascular-associated admission to hospital. In both groups, around 3% of participants experienced gastrointestinal disorders from fish oil supplementation. [10646]
75.SupplementDEX Database: High blood pressure (Hypertension) — Associations of baseline use of fish oil with progression of cardiometabolic multimorbidity and mortality among patients with hypertension: a prospective study of UK Biobank2022
A study of 81,579 hypertensive participants found the use of fish oil was associated with an 8% lower risk of cardiometabolic multimorbidity, a 9% lower risk of type 2 diabetes, a 14% lower risk of cardiac mortality, no significant association with cancer mortality, an 11% lower risk of coronary heart disease and a 10% lower risk of all-cause mortality compared to non fish oil users over 9 years. [10681]
76.SupplementDEX Database: High blood pressure (Hypertension) — Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and blood pressure: a meta-analysis of randomized controlled trials2014
A meta-analysis of 70 RCTs found that EPA + DHA reduced systolic blood pressure and diastolic blood pressure compared to placebo. Doses of larger than or equal to 2 g/day reduce diastolic blood pressure. Greater effects were found in untreated hypertensive subjects, but blood pressure was also reduced in healthy subjects. [10682]
77.SupplementDEX Database: High blood pressure (Hypertension) — A systematic review of fish-oil supplements for the prevention and treatment of hypertension2013
A systematic review and meta-analysis of 17 studies with at least 8 weeks’ follow up examined the effects of fish oil supplementation in 9 studies of healthy participants and 8 studies of hypertensive patients (>= BP 140/85). There was a statistically significant reduction in systolic and diastolic blood pressure in the hypertensive patients without a significant dose-dependent effect. [10683]
78.SupplementDEX Database: High blood pressure (Hypertension) — Effect of medium-term supplementation with a moderate dose of n-3 polyunsaturated fatty acids on blood pressure in mild hypertensive patients1998
A 4-month study of 16 mild essential hypertensive, non-diabetic, normolipidemic male outpatients and 16 normotensive males found that EPA and DHA ethyl ester supplementation (2.04 g EPA and 1.4 g DHA per day) was able to maximally reduce blood pressure after 2 months. Both systolic pressure (-6 mm Hg) and diastolic pressure (-5 mm Hg) fell significantly and no further effect was seen at 4 months. Blood pressure levels returned to baseline at 2 months after fish oil discontinuation. [10685]
79.SupplementDEX Database: High blood pressure (Hypertension) — Fish oil as an adjuvant in the treatment of hypertension1996
A study of 21 men whose blood pressure was not optimally controlled with antihypertensive drugs found that a moderate dose of fish oil did not affect blood pressure after 8 weeks compared to placebo. After 4 weeks, there was a reduction in triglyceride levels (-40.9%) and platelet counts (-8.7%) with an increase in LDL cholesterol at 4 weeks (+13.5%) and 8 weeks (+19.1%) in the fish oil group. Fish oil supplementation in uncontrolled hypertension did not confer an antihypertensive benefit. [10686]
80.SupplementDEX Database: High blood pressure (Hypertension) — Effects of n-3 polyunsaturated fatty acids on glucose homeostasis and blood pressure in essential hypertension. A randomized, controlled trial1995
A study of 78 subjects with untreated hypertension found that 4 g/day EPA + DHA significantly lowered systolic blood pressure by 3.8 mm Hg (P = 0.04) after 16 weeks compared to a corn oil placebo. [10687]
81.SupplementDEX Database: High blood pressure (Hypertension) — Effect of sodium restriction and fish oil supplementation on BP and thrombotic risk factors in patients treated with ACE inhibitors1994
A study of patients with hypertension also taking ACE inhibitors found that fish oil (5 g/day omega-3 PUFAs) did not affect blood pressure after 6 weeks. Sodium restriction (1800 mg/day) significantly decreased systolic blood pressure by 4.2 mm Hg compared to normal sodium intake. [10688]
82.SupplementDEX Database: High blood pressure (Hypertension) — Reduction of blood pressure and plasma triglycerides by omega-3 fatty acids in treated hypertensives1994
In 42 hypertensive patients on beta-blockers or diuretics in a crossover trial, Omacor omega-3 concentrate 4 g/day for 6 weeks lowered systolic/diastolic blood pressure and plasma triglycerides versus corn oil.
83.SupplementDEX Database: High blood pressure (Hypertension) — The effect of fish oil on blood pressure in mild hypertensive subjects: a randomized crossover trial1993
Randomized crossover trial examining whether fish oil supplementation reduces blood pressure in mild hypertension. A 12-wk study of 18 healthy, untreated mildly hypertensive subjects given either 6 or 12 g/day fish oil (50% n-3), or olive oil placebo found minimal changes in blood pressure between each group. The high dose fish oil group experienced a small but insubstantial decrease in blood pressure. [10691]
84.SupplementDEX Database: High blood pressure (Hypertension) — Does supplementation of diet with 'fish oil' reduce blood pressure? A meta-analysis of controlled clinical trials1993
A meta-analysis of 17 studies found that omega-3 supplementation (> 3 g/day) can lead to clinically relevant reductions in blood pressure. Subjects with higher baseline blood pressure had a greater reduction in blood pressure from fish oil supplementation. [10689]
85.SupplementDEX Database: High blood pressure (Hypertension) — Does fish oil lower blood pressure? A meta-analysis of controlled trials1993
A meta-analysis of 31 placebo-controlled trials with 1356 subjects found a dose-dependent reduction in blood pressure from fish oil in hypertensive subjects. Blood pressure changes from fish oil supplementation were -1.3/-0.7 mmHg at doses of less than or equal to 3 g/day, -2.9/-1.6 mmHg at 3.3 to 7 g/day and -8.1/-5.8 mmHg at 15 g/day. [10690]
86.SupplementDEX Database: High blood pressure (Hypertension) — Effect of eicosapentaenoic and docosahexaenoic acids on blood pressure in hypertension. A population-based intervention trial from the Tromsø study1990
Population-based intervention study from the Tromsø cohort assessing whether EPA and DHA reduce blood pressure in hypertensive individuals. A 10-wk study of 156 participants with mild essential hypertension found that 6 g/day fish oil (5.1 g EPA + DHA) lowered mean systolic pressure by 4.6 mm Hg and diastolic pressure by 3.0 mm Hg, with no significant change from corn oil placebo. There were no changes in mean blood pressure from fish oil supplementation in subjects who ate fish three or more times per week in their usual diet. [10692]
87.SupplementDEX Database: High blood pressure (Hypertension) — Fish oil produces an atherogenic lipid profile in hypertensive men1990
A crossover study of 13 hypertensive patients and 13 normal subjects given 10 g/day fish oil (containing 50% omega-3 PUFAs) or placebo for 30 days found no changes in blood pressure in either group. Compared to placebo, fish oil increased total cholesterol by 8%, LDL cholesterol by 19% and ApoB by 18% in the hypertensive group. [10693]
88.SupplementDEX Database: High blood pressure (Hypertension) — Fish oil amplifies the effect of propranolol in mild essential hypertension1990
A study of 47 male patients with mild essential hypertension found that fish oil (9 g/day containing 2.9 g omega-3) was comparably effective to propranolol (80 mg/day) after 36 weeks. A combination of FO and propranolol was more effective than either individual treatment after 12 weeks. [10694]
89.SupplementDEX Database: High blood pressure (Hypertension) — The antihypertensive effects of fish oil. A controlled study of polyunsaturated fatty acid supplements in essential hypertension1989
A study of 32 male subjects found that 50 ml/day fish oil (15 g/day omega-3) reduced systolic blood pressure (avg -6.5 mm Hg) and diastolic blood pressure (avg -4.4 mm Hg). [10695]
90.SupplementDEX Database: Menstrual cramps (Dysmenorrhea) — The impact of omega-3 polyunsaturated fatty acids on primary dysmenorrhea: a systematic review and meta-analysis of randomized controlled trials2022
A systematic review and meta-analysis showing omega-3 supplementation significantly reduces pain severity in primary dysmenorrhea compared with placebo. A systematic review and meta-analysis found that omega-3 supplementation slightly reduced the severity of primary dysmenorrhea with considerable heterogeneity. Greater effectiveness was seen in studies using lower doses. Supplementation was less effective in older women for reducing primary dysmenorrhea severity. [10634]
91.SupplementDEX Database: Menstrual cramps (Dysmenorrhea) — Vitamin E and fish oil, separately or in combination, on treatment of primary dysmenorrhea: a double-blind, randomized clinical trial2018
In 100 university students with primary dysmenorrhea, daily omega-3 (180 mg EPA + 120 mg DHA), vitamin E 200 IU, or combined therapy all reduced menstrual pain versus placebo, with the combination most effective.
92.SupplementDEX Database: Menstrual cramps (Dysmenorrhea) — The effects of fish oil capsules and vitamin B1 tablets on duration and severity of dysmenorrhea in students of high school in Urmia-Iran2014
In 240 high-school girls with dysmenorrhea over 2 months, fish oil 500 mg/day and vitamin B1 100 mg/day each significantly reduced pain intensity and duration versus placebo.
93.SupplementDEX Database: Menstrual cramps (Dysmenorrhea) — A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain2007
A meta-analysis of 17 RCTs found omega-3 supplementation for 3–4 months modestly reduced inflammatory joint pain intensity (SMD −0.26), morning stiffness, tender joint count, and NSAID use.
95.SupplementDEX Database: Menstrual cramps (Dysmenorrhea) — Supplementation with omega-3 polyunsaturated fatty acids in the management of dysmenorrhea in adolescents1996
An RCT in adolescents showing omega-3 supplementation significantly reduced dysmenorrhea symptoms compared with placebo. A study of 42 adolescents with menstrual cramps (dysmenorrhea) found that fish oil (1.8 g omega-3 + 1.5 mg vitamin E per day) led to a significant reduction in Cox Menstrual Symptom score from 69.9 to 44.0 after 2 months. There was a significant decrease in the use of ibuprofen tablets consumed during fish oil treatment than during placebo. [10636]
94.Menstrual discomfort in Danish women reduced by dietary supplements of omega-3 PUFA and B12 (fish oil or seal oil capsules). See external sourceExternal source
96.SupplementDEX Database: Nonalcoholic fatty liver disease (NAFLD) — The effects of fish oil plus vitamin D3 intervention on non-alcoholic fatty liver disease: a randomized controlled trial2022
In 111 NAFLD patients over 3 months, fish oil 2.34 g/day EPA+DHA with or without 1,680 IU vitamin D3 lowered ALT, triglycerides, and TNF-alpha versus corn oil; combined FO+D also reduced insulin and IL-1beta.
97.SupplementDEX Database: Nonalcoholic fatty liver disease (NAFLD) — Effects of Omega-3 Polyunsaturated Fatty Acid Supplementation on Non-Alcoholic Fatty Liver: A Systematic Review and Meta-Analysis2020
A systematic review and meta-analysis reporting that omega-3 supplementation reduces liver fat and improves liver enzyme levels in NAFLD patients compared with control treatments. A meta-analysis of small studies found omega-3 supplementation may improve liver fat (as measured by ultrasonography). [10638]
98.SupplementDEX Database: Nonalcoholic fatty liver disease (NAFLD) — Omega-3 polyunsaturated fatty acid supplementation and non-alcoholic fatty liver disease: A meta-analysis of randomized controlled trials2018
A meta-analysis of RCTs demonstrating that omega-3 supplementation significantly reduces hepatic fat content and improves lipid markers in NAFLD patients. A meta-analysis of 18 studies (median 6 months) involving 1424 patients found omega-3 supplementation (median 2.7 g/d; range 0.25-5.00g/d) led to improvements in liver fat and liver enzymes with high heterogeneity. [10639]
99.SupplementDEX Database: Nonalcoholic fatty liver disease (NAFLD) — Omega-3 fatty acids as a treatment for non-alcoholic fatty liver disease in children: A systematic review and meta-analysis of randomized controlled trials2018
A systematic review and meta-analysis finding that omega-3 supplementation improves liver fat and triglyceride levels in pediatric NAFLD populations. A meta-analysis of 4 studies with 263 participants (children with NAFLD) found that fish oil is associated with a significant improvement in hepatic steatosis grade. Decreases in ALT levels were found after 12 months whilst decreases in AST levels were found after 6 months. There were no significant changes in CRP or components of metabolic syndrome. [10640]
SupplementDEX Database · Rheumatoid arthritis
13 references100.SupplementDEX Database: Rheumatoid arthritis — Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial2022
In the VITAL trial (25,871 adults, median 5.3 years), 1,000 mg/day marine omega-3 reduced confirmed autoimmune disease incidence by 18% (HR 0.82) versus placebo in prespecified analysis.
101.SupplementDEX Database: Rheumatoid arthritis — Fish oil in recent onset rheumatoid arthritis: a randomised, double-blind controlled trial within algorithm-based drug use2015
A double-blind RCT in early rheumatoid arthritis showing that high-dose fish oil improved clinical outcomes and reduced the need for triple DMARD therapy. A 12-month study of 140 patients with RA <12 months’ duration found that 10 mL/day fish oil (mean reported intake 3.7 g/EPA + DHA day exceeding the effective anti-inflammatory dose of at least 2.7 g/day) taken for 12 months with methotrexate (MTX), sulfasalazine and hydroxychloroquine was able to delay time to therapy failure and increase American College of Rheumatology (ACR) remission compared to control (10 mL/day Sunola). [10609][10610]
102.SupplementDEX Database: Rheumatoid arthritis — Supplementation of fish oil and olive oil in patients with rheumatoid arthritis2005
A 24-wk study of 43 rheumatoid arthritis patients administered patients one of three groups: 1) Placebo (soy oil) 2) Fish oil (3 g/day) 3) Fish oil + olive oil. Compared to placebo, those taking fish oil or fish oil + olive oil had a greater reduction in joint pain and improvements in function. Those taking fish oil + olive oil had even greater improvements in morning stiffness, global patient assessment and rheumatoid factor compared to only fish oil. [10612]
103.SupplementDEX Database: Rheumatoid arthritis — Validation of a meta-analysis: the effects of fish oil in rheumatoid arthritis1995
A meta-analysis found that dietary fish oil supplementation for 3 months significantly reduced morning stiffness and tender joints compared to heterogeneous control oils. [10613]
104.SupplementDEX Database: Rheumatoid arthritis — Effects of high-dose fish oil on rheumatoid arthritis after stopping nonsteroidal antiinflammatory drugs. Clinical and immune correlates1995
A trial in RA patients discontinuing NSAIDs showing that high-dose fish oil improved clinical symptoms and modulated inflammatory markers. A study of 66 rheumatoid arthritis patients taking NSAIDs at baseline, found that 130 mg/kg/day ethyl ester omega-3 (8.45 g/day for a 65 kg person) + diclofenac led to significant improvements in morning stiffness duration, tender joints and physician’s evaluation of pain after 18 to 22 weeks. The decrease in number of tender joints remained significant at 8 weeks after discontinuing diclofenac with continued fish oil supplementation. [10614]
105.SupplementDEX Database: Rheumatoid arthritis — [Fish oils and rheumatoid arthritis. A randomized and double-blind study]1994
A randomized double-blind trial showing that fish oil supplementation reduced rheumatoid arthritis symptoms and improved clinical assessments. A 12-wk study of 51 patients with active rheumatoid arthritis found that 3.6 g/day omega-3 fatty acids led to small but significant improvements in morning stiffness and joint tenderness. [10615]
106.SupplementDEX Database: Rheumatoid arthritis — Effects of fish oil supplementation on non-steroidal anti-inflammatory drug requirement in patients with mild rheumatoid arthritis--a double-blind placebo controlled study1993
A double-blind placebo-controlled study showing that fish oil supplementation reduced the need for NSAIDs in mild rheumatoid arthritis. A 12-month study of 64 rheumatoid arthritis patients requiring NSAID therapy found that fish oil (MaxEPA) led to a significant reduction in NSAID usage when compared with placebo from month 3, without any deterioration in clinical RA measures. The reduction in NSAID usage was greatest at month 12. Subjects were instructed to gradually reduce NSAID usage on the condition that there was no worsening of symptoms. [10616]
107.SupplementDEX Database: Rheumatoid arthritis — Dietary omega-3 fatty acid supplementation and naproxen treatment in patients with rheumatoid arthritis1992
A controlled trial examining combination omega-3 supplementation with naproxen, showing additive symptom improvement in RA. A study of 67 rheumatoid arthritis patients found that fish oil and naproxen was able to reduce morning stiffness duration after 16 weeks. [10618]
108.SupplementDEX Database: Rheumatoid arthritis — Effect of six months of fish oil supplementation in stable rheumatoid arthritis. A double-blind, controlled study1992
A six-month double-blind controlled trial finding that fish oil improved joint tenderness and morning stiffness in stable RA. A study of 43 patients found that fish oil (10 g/day) reduced consumption of NSAIDs after 3 and 6 months, and global arthritic status at 3 months in physician’s assessment. The control patients experienced increased global arthritic activity at 6 months. There were no changes in duration of morning stiffness, patient reported pain or functional capacity. [10617]
109.SupplementDEX Database: Rheumatoid arthritis — [Active rheumatoid arthritis: effect of dietary supplementation with omega-3 oils. A controlled double-blind trial]1991
In 8 active rheumatoid arthritis patients over 12 weeks, EPA supplementation improved prehensile function versus 8 placebo controls, without other significant clinical changes or side effects.
110.SupplementDEX Database: Rheumatoid arthritis — Effects of fish oil supplementation in rheumatoid arthritis1990
A crossover study of 16 patients with rheumatoid arthritis found that addition of fish oil (2.04 g EPA + 1.32 g DHA) to existing treatment (including NSAIDs and other disease modifying drugs) reduced joint swelling and duration of early morning stiffness after 12 weeks compared to fractionated coconut oil placebo. [10621]
111.SupplementDEX Database: Rheumatoid arthritis — Dietary fish oil and olive oil supplementation in patients with rheumatoid arthritis. Clinical and immunologic effects1990
A comparative trial showing fish oil produced greater improvements in RA symptoms and inflammatory markers than olive oil. A study of 49 patients with active rheumatoid arthritis assigned patients to one of three treatments: 1) Low-dose fish oil (27 mg/kg EPA and 18 mg/kg DHA) 2) High-dose fish oil (54 mg/kg EPA and 36 mg/kg DHA) 3) Placebo (Olive oil). It found a significant improvement in number of tender joints in the high-dose group (2) at 18 weeks (P=0.04) and in the low-dose group (1) at 24 weeks (P=0.05). Significant decreases in the number of swollen joints were noted in both the low-dose group (P=0003) and the high dose group (P=0.0001) by week 12. [10620]
112.SupplementDEX Database: Rheumatoid arthritis — Fish-oil fatty acid supplementation in active rheumatoid arthritis. A double-blinded, controlled, crossover study1987
A nonrandomised crossover study of 33 rheumatoid arthritis patients found that 14 weeks supplementation of fish oil (2.7 g EPA + 1.8 g DHA) improved mean time to onset of fatigue and decreased the number of tender joints by 3.5 (95% Cl, -6.0 to -1.0). [10622]
113.SupplementDEX Database: Age-related Macular Degeneration (AMD) — Dietary omega-3 polyunsaturated fatty acids and fish intake and risk of age-related macular degeneration2021
A meta-analysis of 21 studies up to December 2020 found that higher dietary intake of omega-3 was significantly associated with a 14% and 29% lower risk of early and late AMD, respectively. The reduction in AMD risk was dose-dependent, with every 15 g/day of fish consumption associated with a 13% and 14% lower risk of early and late AMD, respectively. [10577]
114.SupplementDEX Database: Age-related Macular Degeneration (AMD) — Effect of Vitamin D and ω-3 Fatty Acid Supplementation on Risk of Age-Related Macular Degeneration: An Ancillary Study of the VITAL Randomized Clinical Trial2020
A study of 25,871 participants (avg age 67.1 years, 71.3% non-Hispanic White, 20.2% Black) found that 1 g/day fish oil (Omacor 450 mg DHA + 550 mg EPA) taken for 3.8 to 6.1 years did not reduce AMD risk or symptoms. [10578]
115.SupplementDEX Database: Age-related Macular Degeneration (AMD) — Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial2013
A study of 4203 participants (Aged 50 to 85) at risk of progression to advanced AMD found that 1 g/day omega-3 fatty acids (DHA 350 mg + EPA 650 mg) in addition to the AREDS formulation did not reduce the risk of progression to advanced AMD after 6 years. [10580]
116.SupplementDEX Database: Age-related Macular Degeneration (AMD) — Oral docosahexaenoic acid in the prevention of exudative age-related macular degeneration: the Nutritional AMD Treatment 2 study2013
A 3-year study of 263 patients given 840 mg/day DHA and 270 mg/day EPA as fish oil capsules found no effect on visual acuity, drusen progression, geographic atrophy or CNV incidence compared to placebo (olive oil). [10579]
117.SupplementDEX Database: Age-related Macular Degeneration (AMD) — Oily fish consumption, dietary docosahexaenoic acid and eicosapentaenoic acid intakes, and associations with neovascular age-related macular degeneration2008
An observational study of 105 patients with neovascular AMD found that eating oily fish at least once per week compared with less than once per week was associated with half the odds of neovascular AMD. [10581]
118.SupplementDEX Database: Age-related Macular Degeneration (AMD) — Dietary fatty acids and the 5-year incidence of age-related maculopathy2006
An observational study of 3654 subjects aged 49 or older found that fish consumption at least once per week was associated with a 42% reduction in early age-related maculopathy (ARM) risk after five years compared to those who ate fish less than once per month. There was no significant effect on ARM from butter, margarine or nut consumption in this Australian cohort. [10582]
119.SupplementDEX Database: Age-related Macular Degeneration (AMD) — Cigarette smoking, fish consumption, omega-3 fatty acid intake, and associations with age-related macular degeneration: the US Twin Study of Age-Related Macular Degeneration2006
In 681 elderly male twins, current smoking raised AMD risk ~1.9-fold and fish ≥2 servings/week lowered AMD risk; higher dietary omega-3 intake was inversely associated with AMD (OR 0.55).
120.SupplementDEX Database: Age-related Macular Degeneration (AMD) — Dietary fat and fish intake and age-related maculopathy2000
In 3,654 adults aged ≥49, fish consumption more than once weekly halved odds of late age-related maculopathy (OR 0.5) versus less than monthly; higher cholesterol intake raised late ARM risk (OR 2.7 top quintile).
121.SupplementDEX Database: Angina (Ischemic chest pain) — Lack of benefit of dietary advice to men with angina: results of a controlled trial2003
A study of 3114 men with angina (< 70 years old) advised to take up to 3 g/day found that fish oil supplementation may increase the risk of cardiac death and sudden cardiac death compared to those advised to eat more fruit, vegetables or oily fish alone. [10583]
122.SupplementDEX Database: Angina (Ischemic chest pain) — Fish oil in angina pectoris1987
A 12-wk study of 36 patients with stable angina pectoris given fish oil found no significant effects on frequency of angina compared to placebo. Neither treatment affected blood pressure. [10584]
SupplementDEX Database · Atherosclerosis
3 references123.SupplementDEX Database: Atherosclerosis — Effect of dietary supplementation with omega-3 fatty acids on progression of atherosclerosis in carotid arteries2002
A 2-year study of 171 patients found that 1.65 g/day omega-3 PUFA did not decrease intima-media thickness of the carotid arteries or slow progression of atherosclerosis compared to placebo. [10590]
124.SupplementDEX Database: Atherosclerosis — The effect of dietary omega-3 fatty acids on coronary atherosclerosis. A randomized, double-blind, placebo-controlled trial1999
A study of 162 patients with angiographically proven coronary artery disease found that 6 g/day fish oil for 3 months and then 3 g/day for 21 months may modestly slow the progression of coronary atherosclerosis compared to placebo. [10591]
125.SupplementDEX Database: Atherosclerosis — Controlled trial of fish oil for regression of human coronary atherosclerosis. HARP Research Group1995
A study of 59 patients with angiographically proven coronary heart disease and normal plasma lipids were given 6 g/day omega-3 fatty acids for an average of 28 months. Despite increases in EPA adipose tissue concentrations (0.91% vs 0.20%) and reduced triglycerides (-30%), there was no effect on mean minimal diameter of atherosclerotic coronary arteries and percent stenosis compared to placebo. [10592]
127.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Omega-3 fatty acid supplements and risk of atrial fibrillation and 'micro-atrial fibrillation': A secondary analysis from the OMEMI trial2023
A 2-year secondary analysis study examining 1014 patients (75% without AF history) with a recent myocardial infarction found that 1.8 g/day EPA/DHA supplementation led to increases in atrial fibrillation (AF) or micro-AF compared to a corn oil placebo (11.9% omega-3 vs 6.5% placebo). The change in serum EPA but not DHA largely mediated the effect, with higher serum EPA levels more predictive of atrial fibrillation or micro-AF. [10595]
128.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Do Fish Oil Supplements Reduce A-Fib?2022
A review evaluated whether fish oil supplements reduce atrial fibrillation risk, summarizing available clinical evidence on omega-3 supplementation and AF incidence.
129.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Habitual fish oil supplementation and the risk of incident atrial fibrillation: findings from a large prospective longitudinal cohort study2022
A prospective cohort analysis of 468,665 subjects without baseline atrial fibrillation (AF) from the UK Biobank cohort found an association between habitual fish oil supplementation and the risk of developing atrial fibrillation, even after controlling for genetic AF predisposition and dietary oily fish intake. At a median follow-up time of 11.1 years, fish oil users had an higher risk of AF (6.2% vs 5.2%) compared to non-users. In subjects with high genetic AF risk, fish oil users had a higher rate of incident AF (9.7% vs 8.1%). [10596]
130.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Effect of Marine Omega-3 Fatty Acid and Vitamin D Supplementation on Incident Atrial Fibrillation: A Randomized Clinical Trial2021
A study involving 24,127 participants aged 50 years or older without prior atrial fibrillation, cardiovascular disease or cancer randomly assigned participants either EPA-DHA and vitamin D (460 mg/day EPA, 380 mg/day DHA, 2000 IU/day D3), EPA-DHA and placebo, vitamin D3 and placebo, or 2 placebos. It found that after a median of 5.3 years treatment, there was no significant effect on the risk of incident AF but supplementation with both EPA-DHA (hazard ratio 1.09, P = 0.19) and vitamin D (hazard radio 1.09, P = 0.19) trended towards increased incident AF risk. [10598]
131.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Omega-3 fatty acids supplementation and risk of atrial fibrillation: an updated meta-analysis of randomized controlled trials2021
A meta-analysis of 5 studies found that omega-3 supplementation was linked to an increased risk of atrial fibrillation in patients with elevated plasma triglycerides and those with elevated cardiovascular risk. [10599]
132.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Effect of Long-Term Marine ɷ-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis2021
A systematic review of 4049 records and meta-analysis of 7 studies, with a median follow up of at least 1 year and minimum sample size of 500 patients was conducted with 81,210 patients. It was found after an average of 4.9 years, that omega-3 fatty acid supplements were associated with an increased risk of atrial fibrillation (>1 g/d HR, 1.49 & ≤1 g/d HR, 1.12) especially at doses exceeding 1 gram per day. [10597]
133.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Effect of omega-3 fatty acids on cardiovascular outcomes: A systematic review and meta-analysis2021
A meta-analysis of 38 RCTs and 149,051 participants given either EPA or EPA + DHA therapy found that EPA was more effective than combined therapy for improving cardiovascular outcomes and reducing cardiovascular mortality. EPA + DHA increased incident AF (RR 1.26) whilst EPA was associated with a higher risk of total bleeding and AF (RR 1.35) compared to placebo. Many studies included in this meta-analysis were manufacturer-funded. [10600]
134.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Effect of High-Dose Omega-3 Fatty Acids vs Corn Oil on Major Adverse Cardiovascular Events in Patients at High Cardiovascular Risk: The STRENGTH Randomized Clinical Trial2020
A 2020 study found that 4 g/day omega-3 (Epanova, discontinued) taken for up to five years was associated with an increased risk for atrial fibrillation (2.2% vs 1.3%; HR, 1.69 [95% CI, 1.29-2.21]; nominal P < .001) compared to corn oil placebo. There were no significant differences with regards to new-onset heart failure or venous thromboembolic events (0.41% vs 0.26%; HR, 1.62; nominal P = .12). [10594]
135.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Fish oil for the reduction of atrial fibrillation recurrence, inflammation, and oxidative stress2014
A study of 337 patients (also not taking conventional antiarrhythmic therapy) with symptomatic paroxysmal or persistent atrial fibrillation within the 6 months prior to the study found that 4 g/day fish oil did not reduce either the time to first symptomatic or asymptomatic AF recurrence lasting more than 30 seconds. [10601]
136.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Fish oil increase the risk of recurrent atrial fibrillation: result from a meta-analysis2013
A meta-analysis of 8 RCTs with 1990 persistent AF and post-cardioversion patients found that short-term fish oil supplementation of less than 4 weeks prior to cardioversion did not reduce the risk of recurrent atrial fibrillation following cardioversion and slightly increased atrial fibrillation risk. However, longer term supplementation of at least 4 weeks before cardioversion decreased the absolute risk of recurrent atrial fibrillation compared to placebo. [10602]
137.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Fish oil and post-operative atrial fibrillation: a meta-analysis of randomized controlled trials2013
A meta-analysis of randomized trials assessed whether perioperative fish oil reduces post-operative atrial fibrillation after cardiac surgery.
138.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Fish oil and atrial fibrillation after cardiac surgery: a meta-analysis of randomized controlled trials2013
A meta-analysis of 8 RCTs (2,687 cardiac surgery patients) found perioperative fish oil did not significantly reduce postoperative atrial fibrillation (RR 0.86, 95% CI 0.71–1.03) or hospital stay.
139.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — A randomized controlled trial to prevent post-operative atrial fibrillation by antioxidant reinforcement2013
In 203 on-pump cardiac surgery patients, combined n-3 fatty acids 2 g/day plus vitamins C and E reduced postoperative atrial fibrillation to 9.7% versus 32% with placebo (p<0.001).
140.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — A meta-analysis of omega-3 fatty acids and incidence of atrial fibrillation2012
A meta-analysis of 11 RCTs found that fish oil did not have a significant effect on the risk of atrial fibrillation (Odds ratio 0.79, 95% confidence interval = 0.56-1.12, p = 0.19). [10603]
141.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Regulation by interleukin-3 of human monocyte pro-inflammatory mediators. Similarities with granulocyte-macrophage colony-stimulating factor2012
An in vitro study found IL-3 stimulated monocyte u-PA and, with IFN-gamma, TNF-alpha production, showing selective pro-inflammatory mediator regulation similar in part to GM-CSF.
142.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Long-term omega-3 polyunsaturated fatty acid supplementation reduces the recurrence of persistent atrial fibrillation after electrical cardioversion2011
An open-label, randomised study of 178 cardioversion patients with persistent atrial fibrillation (> 1 month duration) found that 6 g/day fish oil reduced AF recurrence with or without concurrent antiarrhythmic drugs. Patients took fish oil for an average of 56 days precardioversion and a total of 242 days in follow up. At 90 days, the fish oil group had a 39% reduced risk of recurrent atrial fibrillation compared to placebo. [10605]
143.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Prevention of atrial fibrillation with omega-3 fatty acids: a meta-analysis of randomised clinical trials2011
A meta-analysis of 10 studies with 1955 patients found that omega-3 supplementation did not have any significant effects on the risk of atrial fibrillation. [10604]
144.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Do omega-3 fatty acids prevent atrial fibrillation after open heart surgery? A meta-analysis of randomized controlled trials2011
A meta-analysis of 4 RCTs (538 cardiac surgery patients) found perioperative n-3 PUFA supplementation did not significantly reduce postoperative atrial fibrillation, with conflicting trial results noted.
145.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — n-3 Fatty acids consumed from fish and risk of atrial fibrillation or flutter: the Danish Diet, Cancer, and Health Study2005
In 47,949 Danish adults followed 5.7 years, higher fish-derived n-3 intake showed no consistent linear association with atrial fibrillation or flutter risk across quintiles.
146.SupplementDEX Database: Atrial fibrillation (EPA may increase new-onset AF risk) — Fish intake and risk of incident atrial fibrillation2004
In 4,815 adults ≥65 followed 12 years, eating tuna or baked fish 1–4 times/week lowered incident AF risk 28% (HR 0.72) and ≥5 times/week lowered it 31% (HR 0.69) versus less than monthly intake.
126.Meeting highlights from the Pharmacovigilance Risk Assessment Committee (PRAC) 25-28 September 2023. See external sourceExternal source
147.SupplementDEX Database: Bronchopulmonary dysplasia (BPD) — Omega-3 Long-chain Polyunsaturated Fatty Acids for Bronchopulmonary Dysplasia: A Meta-analysis2019
A meta-analysis of 14 studies with 3531 preterm infants found that fish oil supplementation did not reduce the incidence of BPD in preterm infants. [10606]
SupplementDEX Database · Eczema
11 references148.SupplementDEX Database: Eczema — Prenatal Fish Oil Supplementation, Maternal COX1 Genotype, and Childhood Atopic Dermatitis: A Secondary Analysis of a Randomized Clinical Trial2024
A secondary analysis of 635 mother-child pairs found prenatal fish oil 2.4 g/day did not significantly alter childhood atopic dermatitis risk overall, with exploratory analyses by maternal COX1 genotype.
149.SupplementDEX Database: Eczema — Fish Oil-Derived Fatty Acids in Pregnancy and Wheeze and Asthma in Offspring2016
A study of 695 pregnant women found that when taken from 24 weeks’ gestation to 1 week after labor, 2.4 g/day triacylglycerol fish oil (Incromega TG33/22, Croda Health Care, 55% EPA and 37% DHA) was not associated with a reduction in infant eczema at 3-5 years of age. [10697]
150.SupplementDEX Database: Eczema — Randomized controlled trial of fish oil supplementation in pregnancy on childhood allergies2013
A study of 706 children at hereditary risk of allergic disease found that fish oil (900 mg omega-3) taken from 21 week’s gestation to birth reduced the rate of eczema with sensitisation from 19.0% to 13.8% but this result not significant (adjusted relative risk 0.75, 95% CI 0.53-1.05, P=0.10). [10701]
151.SupplementDEX Database: Eczema — Dietary supplements for established atopic eczema2012
A meta-analysis of two studies including 176 patients found that fish oil improved subjective quality of life but had no significant effect on pruritis or induration in adults with moderate to severe eczema. [10698]
152.SupplementDEX Database: Eczema — Postnatal fish oil supplementation in high-risk infants to prevent allergy: randomized controlled trial2012
A study of 323 infants at high atopic risk found that fish oil taken from birth to 6 months did not reduce eczema risk at 12 months of age. [10699]
153.SupplementDEX Database: Eczema — Effect of n-3 long chain polyunsaturated fatty acid supplementation in pregnancy on infants' allergies in first year of life: randomised controlled trial2012
An Australian study of 706 infants at high risk of allergic disease found that fish oil (900 mg omega-3) taken from 21 weeks’ gestation to birth reduced the likelihood of atopic eczema from 12% to 7% in offspring (unadjusted relative risk 0.61, 0.38 – 0.98, p = 0.04 adjusted relative risk 0.64, 0.40 – 1.02, P=0.06) [10700]. The subjects in this study were re-evaluated at 3 years of age in a later study [10701].
154.SupplementDEX Database: Eczema — Atopy risk in infants and children in relation to early exposure to fish, oily fish, or long-chain omega-3 fatty acids: a systematic review2011
A systematic review found maternal fish intake during pregnancy was consistently associated with protective atopic outcomes in infants/children, while intervention evidence from fish oil supplements was more mixed.
155.SupplementDEX Database: Eczema — The effect of perinatal omega-3 fatty acid supplementation on inflammatory markers and allergic diseases: a systematic review2011
A systematic review of 5 perinatal omega-3 RCTs (949 participants) found insufficient evidence that n-3 supplementation during pregnancy/lactation reduces childhood food allergy, atopy, or asthma.
156.SupplementDEX Database: Eczema — Do early intake of fish and fish oil protect against eczema and doctor-diagnosed asthma at 2 years of age? A cohort study2010
In 3,086 Norwegian children followed to age 2, eating fish ≥1 time/week after age 1 reduced eczema risk (aOR 0.62); oily fish showed stronger protection (aOR 0.21), without clear effects on doctor-diagnosed asthma.
157.SupplementDEX Database: Eczema — Oral essential fatty acid supplementation in atopic dermatitis-a meta-analysis of placebo-controlled trials2004
A meta-analysis found that EFA fish oil did not improve itch, scaling or lichenification in atopic dermatitis. [10702]
158.SupplementDEX Database: Eczema — Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: a randomized, controlled trial2003
A study of 83 women found that fish oil supplementation (from 20 week’s gestation to delivery) reduced the risk of severe disease in infants at 1 year of age but did not affect the frequency of atopic dermatitis. [10703]
159.SupplementDEX Database: Gestational hypertension — Fish oil supplementation during pregnancy and postpartum in mothers with overweight and obesity to improve body composition and metabolic health during infancy: A double-blind randomized controlled trial2023
In 98 infants from mothers with overweight/obesity, 6 g/day fish oil from mid-pregnancy through 3 months postpartum did not change infant body fat percentage at 2 weeks versus olive oil placebo.
160.SupplementDEX Database: Gestational hypertension — Fish Oil Supplementation does not Reduce Risks of Gestational Diabetes Mellitus, Pregnancy-Induced Hypertension, or Pre-Eclampsia: A Meta-Analysis of Randomized Controlled Trials2015
A meta-analysis of 11 trials (>5,000 pregnancies) found fish oil supplementation did not reduce gestational diabetes (RR 1.06), pregnancy-induced hypertension (RR 1.03), or preeclampsia (RR 0.93).
161.SupplementDEX Database: Gestational hypertension — Randomised clinical trials of fish oil supplementation in high risk pregnancies. Fish Oil Trials In Pregnancy (FOTIP) Team2000
A multicentre study of women with high risk pregnancies (twin pregnancy or previously experienced either pregnancy-induced hypertension, intrauterine growth retardation or pre-term delivery) found that fish oil (2.7 – 6.1 g/day omega-3 fatty acids) reduced recurrence risk of pre-term delivery but did not affect recurrence risk of other outcomes. [10633]
162.SupplementDEX Database: Gestational hypertension — A randomised double blind placebo controlled trial of fish oil in high risk pregnancy1995
In 233 high-risk pregnancies, 2.7 g/day MaxEpa fish oil did not reduce proteinuric or nonproteinuric hypertension or birthweight below the 3rd centile versus air-filled placebo capsules.
163.SupplementDEX Database: Gestational hypertension — The effects of 3g eicosapentaenoic acid daily on recurrence of intrauterine growth retardation and pregnancy induced hypertension1995
In 63 women with prior IUGR, 3 g/day EPA from 12–14 weeks gestation did not prevent recurrent IUGR or pregnancy-induced hypertension compared with placebo in a multicenter trial.
164.SupplementDEX Database: Helicobacter pylori (H. pylori) — Fish oil (Eicosapen) is less effective than metronidazole, in combination with pantoprazole and clarithromycin, for Helicobacter pylori eradication2001
A randomized trial comparing fish oil (Eicosapen) to metronidazole within a triple-therapy regimen, finding fish oil markedly less effective for Helicobacter pylori eradication. A study of 199 non-ulcer dyspepsia patients with normal upper endoscopy and positive 13C urea breath test found that fish oil (Eicosapen) combined with pantoprazole and clarithromycin (PCE) was inferior to a combination of pantoprazole, clarithromycin and metronidazole (PCM) for eradicating H.pylori. PCM eradiated H. Pylori in 78% of patients compared to only 34% (P < 0.001) in those taking fish oil (PCE). [10607]
SupplementDEX Database · Multiple sclerosis
2 references165.SupplementDEX Database: Multiple sclerosis — Evaluating the effect of adding Fish oil to Fingolimod on TNF-α, IL1β, IL6, and IFN-γ in patients with relapsing-remitting multiple sclerosis: A double-blind randomized placebo-controlled trial2017
A 12-month study of MS patients (RRMS) also taking fingolimod found that the addition of fish oil (1 g/day) did not improve symptoms. [10624]
166.SupplementDEX Database: Multiple sclerosis — A double-blind controlled trial of long chain n-3 polyunsaturated fatty acids in the treatment of multiple sclerosis1989
A double-blind controlled trial testing long-chain n-3 PUFA supplementation in MS patients reported modest symptomatic and inflammatory improvements versus placebo but no major change in disease progression. A 2-year trial of 312 (292 completed the study) ambulant MS patients (RRMS) found that fish oil (20 capsules, 10 g/day Maxepa) did not significantly improve overall deterioration, attack severity, duration and frequency compared to olive oil placebo. [10625]
SupplementDEX Database · Osteoarthritis
8 references167.SupplementDEX Database: Osteoarthritis — Effect of omega-3 on painful symptoms of patients with osteoarthritis of the synovial joints: systematic review and meta-analysis2021
A meta-analysis of 6 RCTs including 454 patients with osteoarthritis found in 4 studies that omega-3 fatty acids may reduce pain compared to placebo. [10626]
168.SupplementDEX Database: Osteoarthritis — The Effects of Vitamin D and Marine Omega-3 Fatty Acid Supplementation on Chronic Knee Pain in Older US Adults: Results From a Randomized Trial2020
A large randomized trial found no significant benefit of vitamin D or omega-3 supplementation on chronic knee pain outcomes in older adults. A study of 1398 participants from the United States taking 1 g/day Omacor (365 mg DHA + 475 mg EPA) or placebo for an average of 5.3 years found no reductions in knee stiffness, function or pain. [10704]
169.SupplementDEX Database: Osteoarthritis — Fish oil supplementation reduces osteoarthritis-specific pain in older adults with overweight/obesity2020
In 152 sedentary overweight/obese older adults over 16 weeks, fish oil 2,000 mg DHA + 400 mg EPA significantly reduced osteoarthritis-specific pain (P=0.002, d=0.56) and OA burden versus placebo.
170.SupplementDEX Database: Osteoarthritis — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee2020
The American College of Rheumatology/Arthritis Foundation conditionally recommends against the use of fish oil in patients with knee, hip or hand OA. [10627]
171.SupplementDEX Database: Osteoarthritis — Fish oil in knee osteoarthritis: a randomised clinical trial of low dose versus high dose2016
A 24-month multicentre trial of 202 patients with knee osteoarthritis and regular knee pain given either high-dose fish oil (4.5 g omega-3 fatty acids) or low-dose fish oil blend (fish oil and sunola oil; 1:9, 0.45 omega-3 fatty acids) found that the low-dose group had a greater improvement in WOMAC pain and function scores at 2 but not 1 years. There were no differences in cartilage volume loss or use of pain medication between treatment groups. [10628]
172.SupplementDEX Database: Osteoarthritis — A randomized, double-blinded, placebo-controlled study of the effect of a combination of lemon verbena extract and fish oil omega-3 fatty acid on joint management2011
In 45 adults with joint discomfort over 9 weeks, a lemon verbena plus fish oil supplement significantly improved WOMAC and Lequesne pain and function scores weekly versus placebo.
173.SupplementDEX Database: Osteoarthritis — Effect of glucosamine sulfate with or without omega-3 fatty acids in patients with osteoarthritis2009
A randomized trial where glucosamine plus omega-3 provided greater pain reduction than glucosamine alone in OA patients. A 6-month study including 177 patients with moderate to severe hip or knee arthritis found that a combination of fish oil and glucosamine sulfate (200 mg omega-3 fatty acids & 500 mg glucosamine sulfate 3 times per day) led to a non-significant greater reduction in morning stiffness and pain over time compared to glucosamine sulfate alone. [10629]
174.SupplementDEX Database: Osteoarthritis — Phytalgic, a food supplement, vs placebo in patients with osteoarthritis of the knee or hip: a randomised double-blind placebo-controlled clinical trial2009
In 81 knee/hip osteoarthritis patients over 3 months, Phytalgic (fish oil, vitamin E, nettle) reduced analgesic use to 6.5 versus 16.5 paracetamol-equivalent tablets/week and lowered WOMAC dysfunction versus placebo.
SupplementDEX Database · Preeclampsia
3 references175.SupplementDEX Database: Preeclampsia — The effect of Omega-3 supplementation and fish oil on preeclampsia: A systematic review and meta-analysis2024
A meta-analysis of 16 trials (8,004 intervention, 8,233 control subjects) found omega-3/fish oil supplementation did not show consistent significant reduction in preeclampsia risk across included studies.
176.SupplementDEX Database: Preeclampsia — Fish-oil supplementation in pregnancy does not reduce the risk of gestational diabetes or preeclampsia2012
A prospective study showing that fish-oil supplementation during pregnancy did not reduce gestational diabetes or preeclampsia risk. A multicentre study of 2399 pregnant women of <21 wk gestation found that DHA-enriched fish oil (800 mg/day) taken until birth, did not reduce the risk of preeclampsia or gestational diabetes mellitus compared to placebo. [10632]
177.SupplementDEX Database: Preeclampsia — Effects of a combination of evening primrose oil (gamma linolenic acid) and fish oil (eicosapentaenoic + docahexaenoic acid) versus magnesium, and versus placebo in preventing pre-eclampsia1992
In pregnant women supplemented 6 months, combined evening primrose and fish oil reduced edema incidence to 13% versus 29% placebo (p=0.004); magnesium reduced hypertension, and all 3 eclampsia cases occurred in placebo.
SupplementDEX Database · Ventricular arrhythmia
8 references178.SupplementDEX Database: Ventricular arrhythmia — Assessing the impact of omega-3 fatty acids on ventricular tachyarrhythmia and survival in patients with ICDs: A systematic review and meta-analysis2024
A systematic review and meta-analysis found that fish oil had no significant antiarrhythmic properties and conferred no survival advantages for individuals with ICDs. [10585]
179.SupplementDEX Database: Ventricular arrhythmia — Do omega-3 polyunsaturated fatty acids reduce risk of sudden cardiac death and ventricular arrhythmias? A meta-analysis of randomized trials2013
A meta-analysis including a total of 32,919 patients (16,645 receiving omega-3 PUFA and 16,454 receiving placebo) found no significant effects for sudden cardiac death (SCD) or ventricular arrhythmia risk. There was a reduced risk of SCD or ventricular arrhythmias but this was non-significant (p = 0.21). [10586]
180.SupplementDEX Database: Ventricular arrhythmia — Fish-oil supplementation in patients with implantable cardioverter defibrillators: a meta-analysis2008
A meta-analysis of 3 ICD trials (573 patients, 1–2 years) found fish oil did not significantly reduce ventricular arrhythmia episodes requiring ICD discharge versus placebo.
181.SupplementDEX Database: Ventricular arrhythmia — Effect of fish oil on arrhythmias and mortality: systematic review2008
A meta-analysis of 12 studies including 32,779 patients found that fish oil supplementation had no significant effect on arrhythmias or all-cause mortality. Fish oil was associated with a significant reduction in deaths (20% to 26%) from cardiovascular events in patients after myocardial infarction or with coronary artery disease. The study authors recommend a daily formulation similar to that used in the GISSI-Prevenzione trial or 465 mg EPA/386 mg DHA. [10587]
182.SupplementDEX Database: Ventricular arrhythmia — Effect of fish oil on ventricular tachyarrhythmia and death in patients with implantable cardioverter defibrillators: the Study on Omega-3 Fatty Acids and Ventricular Arrhythmia (SOFA) randomized trial2006
In 546 ICD patients over ~1 year, 2 g/day fish oil did not reduce ventricular tachyarrhythmia or death versus placebo (30% vs 33%, HR 0.86, P=0.33) in the SOFA trial.
183.SupplementDEX Database: Ventricular arrhythmia — Effects of n-3 fatty acids from fish on premature ventricular complexes and heart rate in humans2005
A 14-week study of 84 patients (≥ 1440 premature ventricular contractions/24 h) found that 1.5 g/day omega-3 fatty acids from fish oil reduced the number of PVCs by 867/24 hr more than placebo, but this result was not significant. There was a significant reduction in heart rate of 2.1 beats/min from omega-3 supplementation. [10588]
184.SupplementDEX Database: Ventricular arrhythmia — Prevention of fatal arrhythmias in high-risk subjects by fish oil n-3 fatty acid intake2005
In 402 ICD patients over 12 months, fish oil versus olive oil did not significantly prolong time to first ventricular tachycardia/fibrillation event or death in the primary intention-to-treat analysis.
185.SupplementDEX Database: Ventricular arrhythmia — Fish oil supplementation and risk of ventricular tachycardia and ventricular fibrillation in patients with implantable defibrillators: a randomized controlled trial2005
A study of 200 patients with implantable cardioverter defibrillators (ICDs) found that 1.8 g/day fish oil (72% omega-3 content) did not reduce the risk of recurrent ventricular tachycardia and ventricular fibrillation. For recurrent VT/VF, fish oil may be proarrhythmic after 6, 12 and 24 months daily intake. [10589]
SupplementDEX Database · Type 2 diabetes
14 references186.SupplementDEX Database: Type 2 diabetes — Comparison of the efficacy of fish oil and probiotic supplementation on glucose and lipid metabolism in patients with type 2 diabetes: a systematic review and network meta-analysis2024
A meta-analysis of 60 RCTs involving 3845 type 2 diabetes patients compared the efficacy of fish oil or probiotic supplementation on lipid metabolism and blood glucose control. It found that fish oil was superior to probiotics for lowering triglyceride and total cholesterol levels. A specific probiotic, Bifidobacterium, demonstrated the highest efficacy in reducing HbA1c levels. Probiotics were more effective for reducing HOMA-IR whilst fish oil led to greater increases in adiponectin levels and larger reductions in leptin and TNF-α. [10662]
187.SupplementDEX Database: Type 2 diabetes — Fish oil supplementation and risk of dementia among diabetic patients: a prospective study of 16,061 older patients2024
In 16,061 UK Biobank diabetic patients ≥60 followed ~7.7 years, habitual fish oil use was associated with 24% lower dementia risk (HR 0.76, 95% CI 0.60–0.98) versus non-users.
188.SupplementDEX Database: Type 2 diabetes — Effect of fish-oil supplementation on the glycemic and lipidemic profiles of pregnant women: a systematic review and meta-analysis2024
A meta-analysis of 15 pregnancy trials found fish oil had no overall effect on glycemic or lipid profiles, though subgroup analysis showed modest improvements in insulin and HOMA-IR.
189.SupplementDEX Database: Type 2 diabetes — The impact of fish oil and/or probiotics on serum fatty acids and the interaction with low-grade inflammation in pregnant women with overweight and obesity: secondary analysis of a randomised controlled trial2024
In 439 pregnant women with overweight/obesity, fish oil 1.9 g DHA + 0.22 g EPA/day raised serum EPA and DHA in phospholipids and cholesteryl esters versus placebo, with or without probiotics.
190.SupplementDEX Database: Type 2 diabetes — Effect of coadministration of omega-3 fatty acids with glimepiride on glycemic control, lipid profile, irisin, and sirtuin-1 in type 2 diabetes mellitus patients: a randomized controlled trial2023
In 70 type 2 diabetes patients on glimepiride over 12 weeks, added fish oil 1,000 mg/day improved lipid profile and metabolic markers including irisin and sirtuin-1 versus corn oil placebo.
191.SupplementDEX Database: Type 2 diabetes — Effect of fish oil supplementation combined with high-intensity interval training in newly diagnosed non-obese type 2 diabetes: a randomized controlled trial2020
A 3-mth study assigned 173 newly diagnosed type 2 diabetes patients to a fish oil group (2 g/day), fish oil + HIIT group (Mon, Wed, Fri; 10 x 60-sec cycling bouts) or a control group. The high-intensity interval training + 2 g/day fish oil group experienced significant additive beneficial effects on haemoglobin A1c, fasting glucose, HOMA-IR, adiponectin, fat mass and total cholesterol, but not fasting insulin compared to fish oil without exercise. [10664]
192.SupplementDEX Database: Type 2 diabetes — Omega-3 fatty acid supplementation does not prevent serious vascular events in people with diabetes2019
The ASCEND trial reported that omega-3 fatty acid supplementation did not prevent serious vascular events in people with diabetes compared with olive oil placebo.
193.SupplementDEX Database: Type 2 diabetes — Effect of Omega-3 Fatty Acid on the Fatty Acid Content of the Erythrocyte Membrane and Proteinuria in Patients with Diabetic Nephropathy2015
A 12-wk study of 19 diabetic nephropathy patients taking angiotensin converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARB) for at least 6 months found that omega-3 supplementation (Omacar, 3 g/day) did not reduce proteinuria compared to placebo. Omega-3 supplementation significantly increased erythrocyte membrane concentrations of omega-3 fatty acids, and decreased omega-6 : omega-3 fatty acid ratio. [10666]
194.SupplementDEX Database: Type 2 diabetes — Fish-oil supplement has neutral effects on vascular and metabolic function but improves renal function in patients with Type 2 diabetes mellitus2010
A 12-week study of 97 type 2 diabetes patients without cardiovascular disease found 4 g/day fish oil did not improve vascular function as measured by flow-mediated dilation. Those taking fish oil had lower serum creatinine (-4.5 micromol/l) compared to placebo. There was a significant reduction in serum triglycerides from omega-3 supplementation (-0.46 mmol/l). [10667]
195.SupplementDEX Database: Type 2 diabetes — Omega-3 polyunsaturated fatty acids (PUFA) for type 2 diabetes mellitus2008
A meta-analysis of 23 randomised controlled trials with 1075 participants with mean duration of 8.9 weeks given a mean dose of 3.5 g/day omega-3 PUFA found no significant effect on glycemic control. [10669]
196.SupplementDEX Database: Type 2 diabetes — Effects of omega-3 fatty acid supplements on serum lipids, apolipoproteins and malondialdehyde in type 2 diabetes patients2008
A 10-week study of 50 type 2 diabetes patients found that 2 g/day omega-3 fatty acids had no significant effect on serum lipid levels, glucose, insulin, ApoA-I and HbA1c. [10668]
197.SupplementDEX Database: Type 2 diabetes — Effect of omega 3 fatty acid on plasma lipids, cholesterol and lipoprotein fatty acid content in NIDDM patients1997
A cross-over study of 28 type 2 diabetes patients found that 35 mg/kg bw/day EPA + DHA (for 60 kg person this is 2.1 g/day) taken for 3 months did not affect insulin, glucagon, C-peptide, HDL-C or LDL-C levels compared to olive oil placebo. [10674]
198.SupplementDEX Database: Type 2 diabetes — The independent and combined effects of aerobic exercise and dietary fish intake on serum lipids and glycemic control in NIDDM. A randomized controlled study1997
In 49 dyslipidemic NIDDM patients over 8 weeks, adding one daily fish meal (3.6 g omega-3) to a low-fat diet reduced triglycerides 0.80 mmol/L; moderate exercise improved fitness without additive glycemic harm.
199.SupplementDEX Database: Type 2 diabetes — Supplementation with n-3 fatty acids reduces triglycerides but increases PAI-1 in non-insulin-dependent diabetes mellitus1992
A 16-week (2 x 8-wk treatment period) cross-over study of 14 type 2 diabetics found that 10 g/day MaxEPA (3 g omega-3 fatty acids) led to a significant reduction in triglyceride concentrations (-27%), an increase in LDL cholesterol (+6%) no change in insulin levels and a significant increase in PAI-1 activity (+21%) after 8 weeks. [10679]
200.SupplementDEX Database: Attention deficit hyperactivity disorder (ADHD) — Omega-3 Polyunsaturated Fatty Acids for Core Symptoms of Attention-Deficit/Hyperactivity Disorder: A Meta-Analysis of Randomized Controlled Trials2023
A meta-analysis of 22 studies including 1,789 subjects found that omega-3 PUFAs did not significantly improve ADHD core symptoms compared to placebo. However in studies using a treatment duration at least 4 months, omega-3 PUFAs were significantly more effective than placebo. Neither higher EPA dosage or high EPA/DHA ratio was found to improve ADHD. Long-term supplementation may have potential benefits. [10719]
201.SupplementDEX Database: Attention deficit hyperactivity disorder (ADHD) — Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce2022
WFSBP/CANMAT 2022 guidelines rated acetyl-L-carnitine as not recommended for ADHD based on Grade A evidence from meta-analyses and RCTs.
202.SupplementDEX Database: Attention deficit hyperactivity disorder (ADHD) — Fish oil supplementation may improve attention, working memory and attention-deficit/hyperactivity disorder symptoms in adults with autism spectrum disorder: a randomised crossover trial2022
Randomized crossover trial assessing whether fish oil supplementation improves attention, working memory, and ADHD symptoms in adults with autism spectrum disorder. In adults with autism spectrum disorder, fish oil (5.2 g/day, 2 x 4 week crossover design) may improve attention and working memory and ameliorate ADHD symptoms in those with comorbid ADHD. [10720]
203.SupplementDEX Database: Attention deficit hyperactivity disorder (ADHD) — Correlation between changes in blood fatty acid composition and visual sustained attention performance in children with inattention: effect of dietary n-3 fatty acids containing phospholipids2008
A 3-month study of 60 participants (children aged 8-13 years with impaired visual sustained attention performance) assigned subjects either placebo, 250 mg/day EPA + DHA esterified to PL-n-3 (300 mg/day phosphatidylserine) or only fish oil. Only the groups receiving fish oil experienced increases in EPA (1.5-2.2-fold), DPA (1.2-fold) and DHA (1.3-fold) however improvements in attention were limited to PL-n-3. [10717]
204.SupplementDEX Database: Attention deficit hyperactivity disorder (ADHD) — Effect of supplementation with polyunsaturated fatty acids and micronutrients on learning and behavior problems associated with child ADHD2007
A 15-week study found that fish oil (400 mg) + evening primrose oil (100 mg) improved parent ratings of core ADHD symptoms, hyperactivity/impulsivity and inattention in 132 Australian children aged 7 to 12 year with scores >= 2 SD above the population average of the Conners ADHD Index. [10721]
205.SupplementDEX Database: Attention deficit hyperactivity disorder (ADHD) — 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 difficulties2002
A 12-week study including 41 children aged 8-12 years with specific learning difficulties and above-average ADHD ratings found that HUFA supplementation led to significant improvements in cognitive problems and general behaviour problems compared to placebo. [10722]
206.SupplementDEX Database: Cyclical mastalgia (Breast pain) — Evening primrose oil and fish oil for severe chronic mastalgia: a randomized, double-blind, controlled trial2002
A 6-mth study of 120 premenopausal women with severe chronic mastalgia (>=7 mean with at least 5 days with pain per menstrual cycle) found that neither evening primrose oil or fish oil were more effective than placebo (corn oil or corn oil with wheat germ oil) for reducing days with pain. [10623]