CardioTabs develops nutritional supplements for cardiovascular health. Their Omega-3 Fish Oil supplement contains high levels of DHA and EPA similar to fish, and is purified and enteric-coated to reduce burping and aftertaste. Studies show their Omega-3 supplement raises DHA and EPA levels similarly to eating fatty fish. Their multivitamin, CardioDaily, now contains 2000 IU of Vitamin D3, and provides vitamins and minerals safely for those on blood thinners without iron, calcium, or excess vitamin K. Studies support vitamins D, B, and folic acid in reducing cardiovascular disease risk.
Optimizing Warfighter performance, health, and well beingJA Larson
This document summarizes research on key nutrients for female soldiers, including iron, calcium, vitamin D, and folate. It discusses how deficiencies in these nutrients can impact female soldiers' health and performance. For iron, deficiencies are common in women due to menstrual blood loss and can reduce cognitive and physical performance. Studies found iron status declined in female soldiers during basic training, but supplements attenuated these declines and improved outcomes. Calcium and vitamin D are important for bone health and preventing stress fractures more common in women. Folate requirements are higher in women before pregnancy to prevent neural tube defects. The document recommends screening, treatment, and education to support female soldiers' nutritional needs.
1. Diet lower in carbohydrates seems to lead to increased LDL particle size. However, the effect of diet on LDL particle size is controversial.
2. When carbohydrate intake is high and comparable between groups, the effects of fatty acids like saturated fat, monounsaturated fat, and polyunsaturated fat on LDL particle size are also controversial.
3. When on a low carbohydrate diet high in red meat, replacing saturated fat with monounsaturated fat increases LDL particle size.
In this slide deck I demonstrate the effects of carbohydrate restriction on different lipoproteins such as HDL, LDL, non-HDL-cholesterol and apolipoprotein B (apoB). The effect of butter and saturated fat as such are compared to unsaturated fat and especially to canola oil. Meta-analysis by Mensink et al. 2003 is the primary reference for the analysis.
Individuals engaging in weight loss through exercise and a hypocaloric diet risk losing lean muscle mass in addition to fat mass. Branched-chain amino acids (BCAAs), which include leucine, isoleucine, and valine, may help retain lean muscle mass by stimulating protein synthesis through the Mammalian Target of Rapamycin (mTOR) pathway. Several studies have found that BCAA supplementation post-exercise, compared to carbohydrate supplementation, resulted in fat mass loss but maintenance of lean muscle mass in those on a hypocaloric diet. BCAA intake above the recommended daily allowance while resistance training on a calorie-restricted diet may prevent lean muscle loss during weight loss efforts.
The United States Army Medical Command (MEDCOM) oversees a $10 billion annual budget and international healthcare organization of 70,000 staff providing medical services to 3.5 million beneficiaries worldwide. MEDCOM is responsible for medical research, logistics, training, public health services, and industry-leading healthcare. Its mission is to promote, sustain, and enhance soldier health, train medical forces, and deliver leading healthcare to warriors and families. MEDCOM maintains a healthy culture based on core values of loyalty, duty, respect, and more. It provides seamless medical care from field units to fixed hospitals in the U.S. and Europe.
Coconut oil was taken off the shelves for much of the 20th century due to concerns over its fat content. But by the turn of the century, coconut oil has exploded into one of the trendiest foods over the last 10-15 years. Learn the science behind the myths that coconut oil is bad for you.
The document discusses maintaining lean muscle mass during weight loss through exercise and a hypocaloric diet. It finds that individuals often lose both fat and lean muscle mass through this process. However, consuming branched-chain amino acids (BCAAs), especially after resistance training, may help increase protein synthesis and retain lean muscle mass by stimulating the mTOR pathway. Several studies cited showed that BCAA supplementation led to increased muscle protein synthesis and less muscle loss compared to a control group during weight loss efforts.
CardioTabs develops nutritional supplements for cardiovascular health. Their Omega-3 Fish Oil supplement contains high levels of DHA and EPA similar to fish, and is purified and enteric-coated to reduce burping and aftertaste. Studies show their Omega-3 supplement raises DHA and EPA levels similarly to eating fatty fish. Their multivitamin, CardioDaily, now contains 2000 IU of Vitamin D3, and provides vitamins and minerals safely for those on blood thinners without iron, calcium, or excess vitamin K. Studies support vitamins D, B, and folic acid in reducing cardiovascular disease risk.
Optimizing Warfighter performance, health, and well beingJA Larson
This document summarizes research on key nutrients for female soldiers, including iron, calcium, vitamin D, and folate. It discusses how deficiencies in these nutrients can impact female soldiers' health and performance. For iron, deficiencies are common in women due to menstrual blood loss and can reduce cognitive and physical performance. Studies found iron status declined in female soldiers during basic training, but supplements attenuated these declines and improved outcomes. Calcium and vitamin D are important for bone health and preventing stress fractures more common in women. Folate requirements are higher in women before pregnancy to prevent neural tube defects. The document recommends screening, treatment, and education to support female soldiers' nutritional needs.
1. Diet lower in carbohydrates seems to lead to increased LDL particle size. However, the effect of diet on LDL particle size is controversial.
2. When carbohydrate intake is high and comparable between groups, the effects of fatty acids like saturated fat, monounsaturated fat, and polyunsaturated fat on LDL particle size are also controversial.
3. When on a low carbohydrate diet high in red meat, replacing saturated fat with monounsaturated fat increases LDL particle size.
In this slide deck I demonstrate the effects of carbohydrate restriction on different lipoproteins such as HDL, LDL, non-HDL-cholesterol and apolipoprotein B (apoB). The effect of butter and saturated fat as such are compared to unsaturated fat and especially to canola oil. Meta-analysis by Mensink et al. 2003 is the primary reference for the analysis.
Individuals engaging in weight loss through exercise and a hypocaloric diet risk losing lean muscle mass in addition to fat mass. Branched-chain amino acids (BCAAs), which include leucine, isoleucine, and valine, may help retain lean muscle mass by stimulating protein synthesis through the Mammalian Target of Rapamycin (mTOR) pathway. Several studies have found that BCAA supplementation post-exercise, compared to carbohydrate supplementation, resulted in fat mass loss but maintenance of lean muscle mass in those on a hypocaloric diet. BCAA intake above the recommended daily allowance while resistance training on a calorie-restricted diet may prevent lean muscle loss during weight loss efforts.
The United States Army Medical Command (MEDCOM) oversees a $10 billion annual budget and international healthcare organization of 70,000 staff providing medical services to 3.5 million beneficiaries worldwide. MEDCOM is responsible for medical research, logistics, training, public health services, and industry-leading healthcare. Its mission is to promote, sustain, and enhance soldier health, train medical forces, and deliver leading healthcare to warriors and families. MEDCOM maintains a healthy culture based on core values of loyalty, duty, respect, and more. It provides seamless medical care from field units to fixed hospitals in the U.S. and Europe.
Coconut oil was taken off the shelves for much of the 20th century due to concerns over its fat content. But by the turn of the century, coconut oil has exploded into one of the trendiest foods over the last 10-15 years. Learn the science behind the myths that coconut oil is bad for you.
The document discusses maintaining lean muscle mass during weight loss through exercise and a hypocaloric diet. It finds that individuals often lose both fat and lean muscle mass through this process. However, consuming branched-chain amino acids (BCAAs), especially after resistance training, may help increase protein synthesis and retain lean muscle mass by stimulating the mTOR pathway. Several studies cited showed that BCAA supplementation led to increased muscle protein synthesis and less muscle loss compared to a control group during weight loss efforts.
This document outlines NASA's astrobiology strategy and identifies six major topics of research:
1) Identifying abiotic sources of organic compounds and understanding how these led to prebiotic chemistry and the origin of life on Earth.
2) Examining the synthesis and function of macromolecules like proteins and nucleic acids that were central to the origin of life.
3) Studying early life and increasing complexity to understand evolutionary processes in early life forms and innovations that allowed life to emerge.
4) Investigating the co-evolution of life and the physical environment through time to understand biological and geochemical interactions.
5) Identifying, exploring, and characterizing environments in our solar system and beyond to
Bionic systems for national defense and securityIlya Klabukov
"Бионические системы и оценка возможности их использования в интересах обороноспособности и безопасности государства" (Bionic systems for national defense and security)
Семинар Фонда перспективных исследований 16 января 2014 года.
Opportunities in Biotechnology for Future Army ApplicationsIlya Klabukov
Opportunities in Biotechnology for Future Army Applications. Committee on Opportunities in Biotechnology for Future Army Applications, Board on Army Science and Technology, National Research Council. ISBN: 0-309-50302-7, 118 pages, 8 1/2 x 11, (2001). This PDF is available from the National Academies Press at: http://www.nap.edu/catalog/10142.html
Living AeroSpace. Перспективная программа экспериментов в области космической...Ilya Klabukov
Конференция серии «Будущее индустрии» Living AeroSpace 2012
Создание космической техники нового поколения зачастую сталкивается с проблемой сохранения работоспособности агрегатов и функциональных схем в течение десятков лет. В то же время в природе можно увидеть аналогичные примеры живых систем, доказавших свою стабильность и устойчивую работоспособность в течение многих тысячелетий.
Материалы, системы, устройства и комплексы, созданные на основе новейших «life-like» принципов, способны нести уникальный запрограммированный функционал. Не вызывает сомнения, что в ближайшем будущем использование передовых достижений нанобиотехнологий для создания функциональных живых систем станет ключевым фактором успеха при реализации длительных космических миссий.
Вопрос лишь только в том, как скоро мы сможем это осуществить.
Научные тренды продления жизни. Обзор исследований в области биологии старенияIlya Klabukov
"Научные тренды продления жизни. Обзор исследований в области биологии старения", 2010 г.
Этот обзор охватывает исследования сотен лабораторий, которые изучают механизмы старения и ведут поиск различных подходов к продлению здоровой человеческой жизни.
Информация об уже полученных научных результатах и задачах на будущее показывает объективную, мозаичную картину экспериментов, которые ведутся на разных уровнях: молекула, клетка, ткань, орган, организм.
Несмотря на то, что до сих не существует международной комплексной программы изучения старения, основные направления исследований, представленные в этом обзоре, складываются в научные тренды продления жизни. Их реализация может привести к научному прорыву в решении проблемы старения.
Изучение механизмов старения и поиск методов продления здоровой жизни - не только самое перспективное научное направление, но и самое необходимое для общества, государства и каждого человека.
INTEGRATED SPACE PLAN (Preliminary), VERSION 1.1, Rockwell International, FEB...Ilya Klabukov
Красивая схема форсайта освоения космического пространства до 2100 г. со строительством крупномасштабных поселений на Марсе. Важно, что она была разработана по инициативе (заказу) аэрокосмической корпорации Rockwell International. На тот момент это была 27-я компания в списке Forbes 500.
This document summarizes a paper that reviews the DARPA model of innovation and applies lessons from it to the new ARPA-E agency. It discusses key features of DARPA's success, including its focus on developing technology visions and empowered program managers. It also notes less discussed features like multigenerational projects and building advocate communities. The document then reviews how ARPA-E has adopted the DARPA model while adapting to the unique energy sector, including sharpening research processes and building political support. It closes by noting both agencies face challenges in implementing technologies and fostering downstream partnerships.
Современное инженерное образование: учеб. пособие/ А. И. Боровков [и др.]. — СПб. : Изд-во Политехн. ун-та, 2012. — 80 с.
Изложенный в учебном пособии аналитический материал дополняет и раскрывает современное состояние и основные подходы к созданию наукоемких образовательных программ подготовки инженеров и магистерских программ нового поколения. Существенный акцент сделан на проектном подходе – обучении в процессе работы над реальными проектами (выполнение НИОКР по заказам промышленности) в рамках деятельности виртуальных проектно-ориентированных команд– MultiDisciplinary Team-Based Project Work. Представлены требования новых парадигм инженерного образования, раскрыты реальные “кейсы” инженерных компетенций XXI века, в том числе на примере ведущих промышленных фирм– Boeing, Холдинг“Сухой”. Впервые на основе многолетнего успешного опыта взаимодействия с ведущими отечественными и зарубежными промышленными организациями, имеющегося у НИУ СПбГПУ в рамках созданной Форсайт-структуры описан Алгоритм реализованного взаимодействия промышленности и университетов. Представлены и проиллюстрированы основные элементы и этапы эволюции Учебно-научно-инновационной Форсайт-структуры в области наукоемких технологий компьютерного инжиниринга. При написании учебного пособия широко использован многолетний успешный опыт реализации магистерской программы на кафедре “Механика и процессы управления” физико-механического факультета НИУ СПбГПУ в рамках деятельности учебно-научно-инновационной лаборатории“Вычислительная механика” (CompMechLab®) и учебно-научно-инновационного Центра наукоемких компьютерных технологий(CAD/FEA/CFD/CAE Centre of Excellence).
Издание подготовлено в рамках проекта “Промышленный и технологический форсайт Российской Федерации на долгосрочную перспективу”. Инициатор проекта– Министерство промышленности и торговли Российской Федерации.
Печатается по решению Совета по издательской деятельности Ученого совета Санкт-Петербургского государственного политехнического университета.
Знаменитый писатель-фантаст Айзек Азимов, ученый с мировым именем, великий популяризатор науки, автор около 500 научно-популярных, фантастических, детективных, исторических и юмористических изданий приглашает вас в увлекательный мир науки. Его книга - путеводитель по этому миру. Вы узнаете, как был изобретен маятник и что такое цепная реакция, как люди изучали законы природы и боролись с вирусами. Автор расскажет вам, как с помощью астрономии, физики, химии, геологии, океанографии и других наук изучают Вселенную, звездные скопления, Солнечную систему и нашу планету. На страницах книги разворачивается славная история научной мысли, предстают великие умы прошлого: Коперник, Ньютон, Кюри, Фарадей, Эйнштейн.
Книги А. Азимова - это оригинальное сочетание научной достоверности, яркой образности, мастерского изложения.
Vegetarian and vegan diets can meet the needs of athletes if properly planned to include a variety of nutrient-dense foods. Some athletes on these diets may not get enough total energy, protein, omega-3s, calcium, vitamins D and B12, iron or zinc. Careful food selection and supplements if needed can help ensure adequate intake of essential nutrients. While these diets may have some health benefits, there is limited evidence they directly improve athletic performance over omnivorous diets.
This document discusses the characteristics of the American diet compared to the Mediterranean diet and their effects on cardiovascular disease. It provides data showing that the average American diet is high in calories, added sugars, refined grains, and saturated fats. In contrast, the Mediterranean diet is high in vegetables, fruits, whole grains, fish, and olive oil. Studies have shown that following a Mediterranean diet is associated with lower rates of obesity, cholesterol, and cardiovascular risk factors compared to a low-fat diet. Adopting aspects of the Mediterranean diet may help reduce the prevalence of cardiovascular disease in the United States.
This document outlines NASA's astrobiology strategy and identifies six major topics of research:
1) Identifying abiotic sources of organic compounds and understanding how these led to prebiotic chemistry and the origin of life on Earth.
2) Examining the synthesis and function of macromolecules like proteins and nucleic acids that were central to the origin of life.
3) Studying early life and increasing complexity to understand evolutionary processes in early life forms and innovations that allowed life to emerge.
4) Investigating the co-evolution of life and the physical environment through time to understand biological and geochemical interactions.
5) Identifying, exploring, and characterizing environments in our solar system and beyond to
Bionic systems for national defense and securityIlya Klabukov
"Бионические системы и оценка возможности их использования в интересах обороноспособности и безопасности государства" (Bionic systems for national defense and security)
Семинар Фонда перспективных исследований 16 января 2014 года.
Opportunities in Biotechnology for Future Army ApplicationsIlya Klabukov
Opportunities in Biotechnology for Future Army Applications. Committee on Opportunities in Biotechnology for Future Army Applications, Board on Army Science and Technology, National Research Council. ISBN: 0-309-50302-7, 118 pages, 8 1/2 x 11, (2001). This PDF is available from the National Academies Press at: http://www.nap.edu/catalog/10142.html
Living AeroSpace. Перспективная программа экспериментов в области космической...Ilya Klabukov
Конференция серии «Будущее индустрии» Living AeroSpace 2012
Создание космической техники нового поколения зачастую сталкивается с проблемой сохранения работоспособности агрегатов и функциональных схем в течение десятков лет. В то же время в природе можно увидеть аналогичные примеры живых систем, доказавших свою стабильность и устойчивую работоспособность в течение многих тысячелетий.
Материалы, системы, устройства и комплексы, созданные на основе новейших «life-like» принципов, способны нести уникальный запрограммированный функционал. Не вызывает сомнения, что в ближайшем будущем использование передовых достижений нанобиотехнологий для создания функциональных живых систем станет ключевым фактором успеха при реализации длительных космических миссий.
Вопрос лишь только в том, как скоро мы сможем это осуществить.
Научные тренды продления жизни. Обзор исследований в области биологии старенияIlya Klabukov
"Научные тренды продления жизни. Обзор исследований в области биологии старения", 2010 г.
Этот обзор охватывает исследования сотен лабораторий, которые изучают механизмы старения и ведут поиск различных подходов к продлению здоровой человеческой жизни.
Информация об уже полученных научных результатах и задачах на будущее показывает объективную, мозаичную картину экспериментов, которые ведутся на разных уровнях: молекула, клетка, ткань, орган, организм.
Несмотря на то, что до сих не существует международной комплексной программы изучения старения, основные направления исследований, представленные в этом обзоре, складываются в научные тренды продления жизни. Их реализация может привести к научному прорыву в решении проблемы старения.
Изучение механизмов старения и поиск методов продления здоровой жизни - не только самое перспективное научное направление, но и самое необходимое для общества, государства и каждого человека.
INTEGRATED SPACE PLAN (Preliminary), VERSION 1.1, Rockwell International, FEB...Ilya Klabukov
Красивая схема форсайта освоения космического пространства до 2100 г. со строительством крупномасштабных поселений на Марсе. Важно, что она была разработана по инициативе (заказу) аэрокосмической корпорации Rockwell International. На тот момент это была 27-я компания в списке Forbes 500.
This document summarizes a paper that reviews the DARPA model of innovation and applies lessons from it to the new ARPA-E agency. It discusses key features of DARPA's success, including its focus on developing technology visions and empowered program managers. It also notes less discussed features like multigenerational projects and building advocate communities. The document then reviews how ARPA-E has adopted the DARPA model while adapting to the unique energy sector, including sharpening research processes and building political support. It closes by noting both agencies face challenges in implementing technologies and fostering downstream partnerships.
Современное инженерное образование: учеб. пособие/ А. И. Боровков [и др.]. — СПб. : Изд-во Политехн. ун-та, 2012. — 80 с.
Изложенный в учебном пособии аналитический материал дополняет и раскрывает современное состояние и основные подходы к созданию наукоемких образовательных программ подготовки инженеров и магистерских программ нового поколения. Существенный акцент сделан на проектном подходе – обучении в процессе работы над реальными проектами (выполнение НИОКР по заказам промышленности) в рамках деятельности виртуальных проектно-ориентированных команд– MultiDisciplinary Team-Based Project Work. Представлены требования новых парадигм инженерного образования, раскрыты реальные “кейсы” инженерных компетенций XXI века, в том числе на примере ведущих промышленных фирм– Boeing, Холдинг“Сухой”. Впервые на основе многолетнего успешного опыта взаимодействия с ведущими отечественными и зарубежными промышленными организациями, имеющегося у НИУ СПбГПУ в рамках созданной Форсайт-структуры описан Алгоритм реализованного взаимодействия промышленности и университетов. Представлены и проиллюстрированы основные элементы и этапы эволюции Учебно-научно-инновационной Форсайт-структуры в области наукоемких технологий компьютерного инжиниринга. При написании учебного пособия широко использован многолетний успешный опыт реализации магистерской программы на кафедре “Механика и процессы управления” физико-механического факультета НИУ СПбГПУ в рамках деятельности учебно-научно-инновационной лаборатории“Вычислительная механика” (CompMechLab®) и учебно-научно-инновационного Центра наукоемких компьютерных технологий(CAD/FEA/CFD/CAE Centre of Excellence).
Издание подготовлено в рамках проекта “Промышленный и технологический форсайт Российской Федерации на долгосрочную перспективу”. Инициатор проекта– Министерство промышленности и торговли Российской Федерации.
Печатается по решению Совета по издательской деятельности Ученого совета Санкт-Петербургского государственного политехнического университета.
Знаменитый писатель-фантаст Айзек Азимов, ученый с мировым именем, великий популяризатор науки, автор около 500 научно-популярных, фантастических, детективных, исторических и юмористических изданий приглашает вас в увлекательный мир науки. Его книга - путеводитель по этому миру. Вы узнаете, как был изобретен маятник и что такое цепная реакция, как люди изучали законы природы и боролись с вирусами. Автор расскажет вам, как с помощью астрономии, физики, химии, геологии, океанографии и других наук изучают Вселенную, звездные скопления, Солнечную систему и нашу планету. На страницах книги разворачивается славная история научной мысли, предстают великие умы прошлого: Коперник, Ньютон, Кюри, Фарадей, Эйнштейн.
Книги А. Азимова - это оригинальное сочетание научной достоверности, яркой образности, мастерского изложения.
Vegetarian and vegan diets can meet the needs of athletes if properly planned to include a variety of nutrient-dense foods. Some athletes on these diets may not get enough total energy, protein, omega-3s, calcium, vitamins D and B12, iron or zinc. Careful food selection and supplements if needed can help ensure adequate intake of essential nutrients. While these diets may have some health benefits, there is limited evidence they directly improve athletic performance over omnivorous diets.
This document discusses the characteristics of the American diet compared to the Mediterranean diet and their effects on cardiovascular disease. It provides data showing that the average American diet is high in calories, added sugars, refined grains, and saturated fats. In contrast, the Mediterranean diet is high in vegetables, fruits, whole grains, fish, and olive oil. Studies have shown that following a Mediterranean diet is associated with lower rates of obesity, cholesterol, and cardiovascular risk factors compared to a low-fat diet. Adopting aspects of the Mediterranean diet may help reduce the prevalence of cardiovascular disease in the United States.
This document is the Herbalife Fitness Manual. It provides an introduction and overview of the Herbalife nutrition and fitness program. The manual is based on concepts developed by Dr. David Heber who chairs Herbalife's Nutrition and Scientific Advisory Boards. The manual is intended as a guide to the science behind Herbalife's products and programs for nutrition and fitness. It is not intended as individual medical advice.
Wellness Nutrients
Nutritional Supplementation
SWU 351 Sustainable Living and Mindful Eating
Objectives
By the end of class you should be able to:
Identify a variety of “wellness supplements”
Identify populations who may and may not benefit from taking a multivitamin
Define “functional foods”
The Problem
The vast majority of Americans do not meet minimum RDA standards of vitamins and minerals
93% of vitamins D and E miss recommendations from diet
61% not enough magnesium
50% not enough Vitamin A and Calcium
Many subpopulations have lower than recommended intake
older adults (over 65+)
African Americans
Obese individuals
Those who are ill or injured
Do We Need Supplements
to be “Well”?
Health maintenance and prevention of disease
Almost 1/2 of the adult population takes supplements of one form or another
What supplements do people take to be well?
Deficiency Issues
Micronutrients (vitamins and minerals) provide:
maintenance of normal cell and tissue function, metabolism, growth and development
True Deficiency Diseases are Rare in the United States
more problems from over nutrition, not malnutrition
Supplements offer an unregulated promise of health in a bottle
It is BIG BUSINESS, with BIG PROFITS
Can a healthful diet provide adequate protection? Or, are supplements the answer?
Common Wellness Supplements
MVI’s
Fish Oil and Flax Oil
Vitamin D
Antioxidants such as vitamins C and E and beta carotene
Gene Polymorphisms
Since the mapping of the human genome, multiple single nucleotide polymorphisms (SNPs) have been identified that can affect nutritional status and potentially, overall health
Common SNPs
MTHFR
Vitamin D receptor
Fatty Acid Desaturases (FADS)
PEMT (choline)
Lipoprotein polymorphisms…
FASEB J. 2005 Oct;19(12):1602-16
Healthy Eating Index 2005
Measures adequacy, moderation and variety
(fat, cholesterol, sodium , FGP…)
Data set is from 1999 - 2000
74% of population has a diet that “needs improvement”
10% have a “good diet”
16% of population has a “poor diet”
http://www.cnpp.usda.gov/publications/HEI/HEI99-00report.pdf
Americans Do Not Meet Federal Dietary Recommendations
2001 – 2004 NHANES (16,338 ppl aged 2 and older)
24 hr recall translated into food groups using My Pyramid Equivalents Database
The population did not meet recommendations for all of the nutrient rich food groups except for total grains, meat and beans (categories: fruits, veg, dark green veg, orange veg, legume, starchy veg, other veg, milk, total grains, meat and beans, oils)
Dark greens, orange veg, legumes and whole grains had the poorest showing and 90% of the population did not meet recommendations for total veg and milk.
80 – 90% of Americans are over-consuming fat, sugar, & ETOH
Krebs-Smith et al. J Nutr. 2010 Oct;140(10):1832-8.
Toxic World?
Textbook of Functional Medicine. Institute for Functional Medicine. Gig Harbor, WA. 2005
Do we have evidence that taking MVI’s / Supplements provide benefit?
...
- Pollutants in fish may cancel out the beneficial effects of the ‘good’ omega-3 fats they contain
- ALA (from plant foods) can be converted into EPA and DHA, and has a protective effect against heart disease
- Cutting down on dietary cholesterol (eggs, meat and dairy products), processed foods, and hydrogenated vegetable oils will help your body to make best use of the omega-3 from plant foods
The document discusses the current medical paradigm that focuses on disease treatment rather than prevention. It notes America's declining health outcomes and rising rates of chronic diseases like cancer and cardiovascular disease. The new medical paradigm emphasizes healthy lifestyle choices, nutrition, supplementation and exercise to prevent disease. It provides examples of supplements and nutrients that can reduce risks of cancer and heart disease, such as omega-3 fish oil, vitamin E, CoQ10, grape seed extract and indole-3-carbinol. The document also discusses the obesity epidemic and metabolic syndrome/type 2 diabetes, highlighting the role of high glycemic diets and carbohydrate addiction. It compares different nutritional supplement products and ranks USANA Essentials as the highest scoring option
The document discusses omega-3 fatty acids and their potential benefits for cancer therapy and prevention. Preclinical studies show omega-3s may suppress cancer growth and increase the efficacy of chemotherapy or radiation. Potential mechanisms for this include reducing inflammation and oxidative stress, inhibiting cell proliferation and angiogenesis, and inducing cancer cell death. Limited clinical studies also provide some evidence that omega-3 supplements may benefit cancer patients by reducing cachexia and improving responses to treatment for cancers like breast cancer.
Of course, this special sale is only available for a limited time, so it makes sense to stock up now, especially considering this is the lowest price on LeanBelly 3X you'll find anywhere — lower than Amazon.com and our own website. With all that in mind, we highly recommend stocking up and saving more today with our 3- or 6-bottle options.
This document discusses medical nutrition therapy (MNT), which is the application of nutrition assessment, intervention, and counseling to manage disease and improve health outcomes. MNT is provided by registered dietitian nutritionists and involves a standardized process called the nutrition care process. This includes nutrition assessment, diagnosis, intervention, and monitoring. The nutrition assessment involves collecting information on diet, anthropometrics, labs, physical findings, and medical history. This information is used to determine a nutrition diagnosis and develop an individualized nutrition intervention plan to address any identified dietary contributors to disease. MNT has been shown to improve clinical outcomes and lower healthcare costs for many chronic conditions.
This document discusses medical nutrition therapy (MNT) which is the use of nutritional diagnostic, therapeutic, and counseling services by a registered dietitian nutritionist (RDN) for the purpose of disease management. MNT provides individualized dietary recommendations and interventions to treat medical conditions and associated symptoms. RDNs are trained experts who can help manage diseases through customized nutrition plans. Research shows MNT improves clinical outcomes and lowers healthcare costs for those with chronic diseases like diabetes and kidney disease.
This document discusses nutritional supplements used as ergogenic aids by athletes. It notes that while supplements are commonly used, adequate nutrition from food is generally safer and more effective. The document then summarizes the current research on some popular supplements, including androstenedione, branched chain amino acids, and caffeine, noting the claimed benefits and limitations of the evidence supporting ergogenic effects for athletes. It concludes that supplement claims are not always backed by strong evidence and some supplements may pose health risks.
This document provides information on malnutrition screening and treatment for elderly nursing home residents. It begins with definitions of malnutrition and consequences such as adverse health outcomes. Screening tools are discussed including BMI, unintentional weight loss thresholds, and more comprehensive tools. Causes of malnutrition like starvation, disease, and immobility are outlined. The TDIMP protocol is introduced as a way to monitor intake, weight, and escalate nutrition interventions for at-risk residents through a standardized workflow. Overall the document covers identifying and managing malnutrition in the elderly nursing home population.
Healthy Eating, Activity & Rest Together (HEART) Matterslibbe019
This document summarizes the HEART Matters research study which aims to characterize knowledge, practices, and attitudes regarding healthy behaviors among overweight/obese African American men, and determine the efficacy of a health coaching intervention. The study has enrolled 68 men so far and is using surveys based on health behavior theories to compare those meeting healthy standards to those who are not. Preliminary results show participants engage in physical activity 3 days per week on average but more coaching is needed to improve diet and sleep habits.
[Your Last Name] 1[Your Full Name]Professor ColisonDNT 200.docxgerardkortney
[Your Last Name] 1
[Your Full Name]
Professor Colison
DNT 200
June 24, 2019
[Title of your article]
[Text of your summary]
The Journal of Nutrition
Nutrient Requirements and Optimal Nutrition
Impact of Above-Average Proanabolic
Nutrients Is Overridden by High Protein
and Energy Intake in the Muscle-Tendon
Unit Characteristics of Middle- to
Older-Aged Adults
David J Tomlinson,1 Robert M Erskine,2,3 Christopher I Morse,1 and Gladys L Onambélé1
1Health, Exercise, and Active Living Research Center, Manchester Metropolitan University, Crewe, United Kingdom; 2Research Institute
for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; and 3Institute of Sport, Exercise, and
Health, University College London, London, United Kingdom
Abstract
Background: The impact, within a single cohort, of independent modulators of skeletal muscle quality, including age,
adiposity and obesity, habitual nutritional intake, and physical activity (PA), is unclear.
Objective: We examined the bivariate associations between age, adiposity, habitual nutritional intake, and PA against
11 key intrinsic muscle-tendon unit (MTU) characteristics to identify the strongest predictors. We also compared overall
profile differences between MTU categories with the use of z scores shown in radar graphs.
Methods: Fifty untrained independently living men (n = 15) and women (n = 35) aged 43–80 y (mean ± SD: 64 ±
9 y) were categorized by adiposity [men: normal adiposity (NA) <28%, high adiposity (HA) ≥28%; women: NA <40%,
HA ≥40%] and body mass index [BMI (in kg/m2); normal: 18 to <25; overweight: ≥25 to <30; and obese: ≥30].
Group differences were examined by body composition assessed with the use of dual-energy X-ray absorptiometry,
habitual nutritional intake through a 3-d food diary, PA (work, leisure, sport) using the Baecke questionnaire, 14 serum
cytokine concentrations using multiplex luminometry, and 11 MTU characteristics of the gastrocnemius medialis using
a combination of isokinetic dynamometry, electromyography, and ultrasonography.
Results: Interestingly, classification by BMI highlighted differences between normal and obese individuals in 6 of 11
MTU characteristics (P < 0.001 to P = 0.043). No significant differences were reported in serum cytokine concentrations
between adiposity and BMI classifications. BMI predicted 8 of 11 (r = 0.62–0.31, P < 0.001 to P = 0.032), daily energy
intake predicted 7 of 11 (r = 0.45–0.34, P = 0.002–0.036), age predicted 5 of 11 (r = −0.49–0.32, P < 0.001 to P = 0.032),
work-based PA predicted 5 of 11 (r = 0.43–0.32, P = 0.003–0.048), and adiposity predicted 4 of 11 (r = 0.51–0.33,
P < 0.001 to P = 0.022) MTU characteristics. Mathematical z scores and radar graphs showed how endocrine and
dietary profiles, but not PA, differed between the top and bottom ∼20% of muscle unit size and specific force.
Conclusions: Given the number of factors associated with MTU, education should be targeted to.
This document provides background information for a proposed instructional design project on whole grains and cardiovascular disease for patients at Marlborough Hospital. The target audience is patients over 65 years old with cardiovascular disease, many of whom are male and Portuguese. The goal is to improve heart health by increasing patients' intake of whole grains, which research shows can decrease cholesterol levels. The educational strategy will use verbal teaching, hands-on activities and large print handouts to motivate patients to understand what whole grains are, why they are heart healthy, how much is recommended per day, and how their current intake compares.
This document provides details about an instructional design project aimed at educating cardiovascular disease patients on the benefits of whole grains. The target audience is patients over 65 years old at Marlborough Hospital, which serves a large Portuguese population. Whole grains have been shown to decrease cholesterol and fiber is recommended to eat at least 3 servings daily, but Americans average less than 1 serving. The goal is to improve heart health by having patients increase whole grain intake through educational sessions using models like the Health Belief Model.
How Major Restaurant Chains Plan Their MenusMark Lyons
Major restaurant chains prioritize profit and sales over health when planning menus. Growing sales and increasing profits are the most important considerations for 61% of respondents. Only 21% noted health and nutrition as important factors. Restaurants may try to offer healthier options to attract "health seekers", but believe demand is low. Additional barriers to healthier menus include short produce shelf life, extra preparation time, and higher costs. Without increased consumer demand, the industry is unlikely to substantially increase healthy food offerings.
Similar to Nutritional armor: Omega-3 for the Warfighter (20)
Elevate Your Nonprofit's Online Presence_ A Guide to Effective SEO Strategies...TechSoup
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This presentation was provided by Racquel Jemison, Ph.D., Christina MacLaughlin, Ph.D., and Paulomi Majumder. Ph.D., all of the American Chemical Society, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
How to Download & Install Module From the Odoo App Store in Odoo 17Celine George
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إضغ بين إيديكم من أقوى الملازم التي صممتها
ملزمة تشريح الجهاز الهيكلي (نظري 3)
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تتميز هذهِ الملزمة بعِدة مُميزات :
1- مُترجمة ترجمة تُناسب جميع المستويات
2- تحتوي على 78 رسم توضيحي لكل كلمة موجودة بالملزمة (لكل كلمة !!!!)
#فهم_ماكو_درخ
3- دقة الكتابة والصور عالية جداً جداً جداً
4- هُنالك بعض المعلومات تم توضيحها بشكل تفصيلي جداً (تُعتبر لدى الطالب أو الطالبة بإنها معلومات مُبهمة ومع ذلك تم توضيح هذهِ المعلومات المُبهمة بشكل تفصيلي جداً
5- الملزمة تشرح نفسها ب نفسها بس تكلك تعال اقراني
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واخيراً هذهِ الملزمة حلالٌ عليكم وإتمنى منكم إن تدعولي بالخير والصحة والعافية فقط
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This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
How to Manage Reception Report in Odoo 17Celine George
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1. Guest Editors
Wayne B. Jonas, M.D. and Scott J. Montain, Ph.D.
NUTRITIONAL ARMOR:NUTRITIONAL ARMOR:
Omega-3 for the WarfighterOmega-3 for the Warfighter
Special Issue | Supplement to Military Medicine, Volume 179, Number 11 l November 2014
2. Encourage healthy eating habits in your patients with the latest in nutrition science.
Register for Healthy Kitchens, Healthy Lives™ and join faculty from Harvard, Samueli Institute,
and The Culinary Institute of America as we connect the science of health-promoting diets with
food preparation and patient education strategies.
Who should attend:
Clinicians from all specialities
Dietitians
Allied Health Professionals
Insurance and hospital executives
Foodservice executives
Conference highlights:
Latest research on diet, health, and lifestyle
Interactive culinary workshops in
the legendary CIA teaching kitchens
Sessions on educating patients
about healthier lifestyle choices
Don’t Miss Out—Register Today at ecpe.sph.harvard.edu/HKHL
A Leadership
Conference
Bridging
Nutrition
Science,
Health Care,
The Culinary
Arts
And
February 5 – 8, 2015 | Culinary Institute of America at Greystone
4. NUTRITIONAL ARMOR:
Omega-3 for the Warfighter
Nutritional Armor: Omega-3 for the Warfighter 1
Scott Montain, Wayne B. Jonas
The Effect of Omega-3 Fatty Acids on Biomarkers of Inflammation: A Rapid Evidence Assessment of the Literature 2
Raheleh Khorsan, Cindy Crawford, John A. Ives, Avi R. Walter, Wayne B. Jonas
Nutritional Armor in Evolution: Docosahexaenoic Acid as a Determinant of Neural, Evolution and Hominid Brain
Development 61
Michael A. Crawford, C. Leigh Broadhurst, Stephen Cunnane, David E. Marsh, Walter F. Schmidt, Annette Brand, Kebreab Ghebremeskel
Dietary Omega-3 and Omega-6 Fatty Acids Compete in Producing Tissue Compositions and Tissue Responses 76
Bill Lands
Omega-3 Fatty Acid Biochemistry: Perspectives From Human Nutrition 82
Sheila M. Innis
Nutritional Armor for the Injured Warfighter: Omega-3 Fatty Acids in Surgery, Trauma, and Intensive Care 88
Mary S. McCarthy, Brian B. Morgan, John T. Heineman, Robert G. Martindale
Long-Chain Omega-3 Fatty Acids and Optimization of Cognitive Performance 95
Matthew F. Muldoon, Christopher M. Ryan, Jeffrey K. Yao, Sarah M. Conklin, Stephen B. Manuck
Neuroprotection by Docosahexaenoic Acid in Brain Injury 106
Hee-Yong Kim
The Potential for DHA to Mitigate Mild Traumatic Brain Injury 112
Julian E. Bailes, Vimal Patel
The Potential for Military Diets to Reduce Depression, Suicide, and Impulsive Aggression: A Review of Current
Evidence for Omega-3 and Omega-6 Fatty Acids 117
Joseph R. Hibbeln, Rachel V. Gow
Omega-3 Fatty Acids and Stress-Induced Immune Dysregulation: Implications for Wound Healing 129
Janice K. Kiecolt-Glaser, Ronald Glaser, Lisa M. Christian
The Safety of Fish Oils for Those Whose Risk of Injury is High 134
Tomohito Hamazaki, Heather Colleran, Kei Hamazaki, Yutaka Matsuoka, Miho Itomura, Joseph Hibbeln
Metabolic Health Benefits of Long-Chain Omega-3 Polyunsaturated Fatty Acids 138
Peter Howe, Jon Buckley
Omega-3 Polyunsaturated Fatty Acids in the Optimization of Physical Performance 144
Ren-Jay Shei, Martin R. Lindley, Timothy D. Mickleborough
Considerations for Incorporating Eicosapentaenoic and Docosahexaenoic Omega-3 Fatty Acids into the Military
Food Supply Chain 157
Adam Ismail, Harry B. Rice
The Challenges of Incorporation of Omega-3 Fatty Acids into Ration Components and Their Prevalence in
Garrison Feeding 162
Betty A. Davis, Brian C. Prall
Understanding Diet and Modeling Changes in the Omega-3 and Omega-6 Fatty Acid Composition of U.S.
Garrison Foods for Active Duty Personnel 168
Bernadette P. Marriott, Karina Yu, Sharon Majchrzak-Hong, Jeremiah Johnson, Joseph R. Hibbeln
Omega-3 Fatty Acids: Nutritional Armor for the Warfighter and Historical Trends Behind Optimal Warrior
Performance 176
Richard H. Carmona
Summary Comments From Workshop Day 1: Nutritional Armor for the Warfighter—Can Omega-3 Fatty Acids
Enhance Stress Resilience, Wellness, and Military Performance? 181
Rhonda L. Cornum
Nutritional Armor for the Warfighter: Can Omega-3 Fatty Acids Enhance Stress Resilience, Wellness, and
Military Performance? 185
Patricia Deuster
The Response of an Expert Panel to Nutritional Armor for the Warfighter: Can Omega-3 Fatty Acids Enhance
Stress Resilience, Wellness, and Military Performance? 192
Ian D. Coulter
VOLUME 179 NOVEMBER 2014 SUPPLEMENT
MILITARY MEDICINE
The Association of Military Surgeons of the United States (AMSUS) should not be held responsible for statements made in its publication by contributors or advertisers.
Therefore the articles reported in this supplement to MILITARY MEDICINE do not necessarily reflect the endorsement, official attitude, or position of AMSUS or
the Editorial Board.
5. MILITARY MEDICINE, 179, 11:1, 2014
Nutritional Armor: Omega-3 for the Warfighter
Scott Montain, PhD*; Wayne B. Jonas, MD†
“Nutritional Armor: Omega-3 for the Warfighter” is a
special issue of Military Medicine containing peer-reviewed
articles, panel summaries, and expert commentaries about
omega-3 and omega-6 essential fatty acids, in dietary and
supplement protocols, and their relationship to health, brain
function, response to injury and trauma, and the enhancement
of performance. Much of this research was originally pre-
sented in 2009 at the “Nutritional Armor for the Warfighter
Conference,” jointly hosted by the Samueli Institute through
its Metabolic Defense Program and National Institute on
Alcohol Abuse and Alcoholism. At the conference, experts
in nutritional science, biochemistry, physiology and clinical
applications, as well as doctors and high-ranking military
personnel presented the latest research on essential fatty
acids. Subsequently, participants prepared manuscripts sum-
marizing their research and presented material. Updates on
these articles were obtained over the last year and peer
reviewed. Of particular interest was gathering evidence to
determine whether omega-3 and omega-6 intake should be
changed in the military and, if so, in what populations, pro-
portions, and through which methods.
Manuscripts in this special issue include information from
the following categories: (1) cellular and whole-body func-
tions of omega-3 and omega-6 and their potential to modulate
health; (2) nutritional sources, requirements, and conse-
quences of fatty acid balance, including nutritional modeling
of garrison feeding programs; and (3) how service members
and veterans can optimize health, fitness, and recovery
through nutritional protocols that incorporate omega-3-rich
foods or supplements into daily intake.
Although no final recommendations were sought, nor can
be made from the research presented in this issue, the articles
demonstrate an urgent need to examine the ratio of fatty
acid intake. Increasing evidence demonstrates a balance of
omega-3 and omega-6 is critical to mental and physical
health. Research reveals the possibility that modern western-
ized diets poor in omega-3 and rich in omega-6 fatty acids
may increase chronic diseases and diminish optimal function-
ing. These diets contain 80+% of their polyunsaturated fatty
acids (PUFA) as omega-6 linoleic acid (LA) and are low in
omega-3 fatty acids compared to Paleolithic and more bal-
anced diets with similar proportions of LA to a-linoleic acid
(ALA), and eicosapentaenoic acid (EPA) and docosahexaenoic
acid (DHA). Studies document that excessive consumption
and tissue levels of omega-6 compared to omega-3 may
adversely affect health in areas such as cardiovascular disease,
metabolic syndrome, depression, increased suicidal risk, sur-
gical recovery, immune function, wound healing, proper
inflammatory response, and other conditions. In addition,
adding omega-3 supplements under certain conditions can
enhance recovery.
It is our hope that the content in this special issue ele-
vates awareness about essential fatty acids and the potential
they offer in terms of providing “nutritional armor” for the
warfighter and veteran to promote health and well-being.
We urge scientists, clinicians, and military and veteran
leaders to increase their focus on improving our knowledge
about the optimal omega-3 and omega-6 intake and use. Our
country needs it and our service members and veterans
deserve it.
The Samueli Institute would like to thank the following
individuals for their role as Conference Organizers: CAPT
Joeseph R. Hibbeln, MD—Acting Chief, Section on Nutri-
tional Neurosciences LMBB, NIAAA, NIH. Dr. Bernadette
P. Marriott—Professor, Division of Gastroenterology and
Hepatology, Department of Medicine, and Military Division,
Department of Psychiatry and Behavioral Sciences, Medical
University of South Carolina.
*Military Nutrition Division, U.S. Army Research Institute of Environ-
mental Medicine, Building 42, Kansas Street, Natick, MA 01760-5007.
†Samueli Institute, 1737 King Street, Suite 600, Alexandria, VA 22314.
doi: 10.7205/MILMED-D-14-00452
MILITARY MEDICINE, Vol. 179, November Supplement 2014 1
6. MILITARY MEDICINE, 179, 11:2, 2014
The Effect of Omega-3 Fatty Acids on Biomarkers of Inflammation:
A Rapid Evidence Assessment of the Literature
Raheleh Khorsan, PhDc*†; Cindy Crawford, BA‡; John A. Ives, PhD‡;
Avi R. Walter, MSc‡; Wayne B. Jonas, MD‡
ABSTRACT Introduction: Previous studies of omega-3 fatty acids report improved outcomes where inflammation is
a key factor. The objective of this systematic review is to evaluate effects of omega-3s on inflammatory biomarkers.
Methods: Randomized clinical studies that measured the influence of omega-3 fatty acids on inflammatory biomarkers
were identified using a comprehensive search. Eligible studies were rated with the American Dietetic Association
Evidence Analysis Manual and Grading of Recommendations, Assessment, Development and Evaluation (GRADE)
process to examine study quality and risk/benefit. Results: 112 studies were included. Over 65% reported statistically
significant effects. The majority were scored as low risk of bias (high quality) and scored strong (cardiac populations
and critically ill) to weak (Alzheimer’s Disease, hypertriglyceridemia/diabetes, and obesity) on the risk/benefit ratio
evidence for modulation of inflammatory biomarkers. There was inadequate data to determine a GRADE for inflamma-
tory biomarker studies for some conditions (healthy individuals, rheumatoid arthritis, metabolic syndrome, renal
disease, pregnancy, or children). Conclusion: Clinical literature on the effects of omega-3 fatty acids on inflammatory
biomarkers contains mostly small sample sizes, is neutral to high quality, and report mixed effects. Larger studies
examining dose and delivery are needed.
INTRODUCTION
Omega-3 Fatty Acids
In 1946, the first major study of essential fatty acids (EFA)
identified vitamin-like properties of linoleic acid (18:2n-6)
(omega-6) and linolenic acid (18:3n-3) (omega-3) in human
infants.1
Today, there is much debate over assisting the
public in “identifying and preventing the current imbalanced
intakes of omega-3 and omega-6 nutrients that cause pre-
ventable clinical disorders and continue escalating healthcare
costs.”2
Indeed, studies continue to assess the importance
of the omega-6/omega-3 fatty acid ratio in cardiovascular
disease and other chronic diseases.3
Current studies advo-
cate lower intake of omega-6 compared to greater intake
of omega-3 fatty acids in reducing the risk of some of
the chronic diseases of high prevalence that are associated
with inflammation.1,3
Omega-3 fatty acids (also known as n-3 or w-3) include
a-linolenic acid (ALA), eicosapentaenoic acid (EPA), doco-
sahexaenoic acid (DHA), and docosapentaenoic acid (DPA).
Among fatty acids (FAs), long-chain omega-3 polyunsatu-
rated FAs (PUFAs) possess the most potent immunomodu-
latory activity,4
and among the omega-3 PUFAs, those from
fish oil (FO) are rich sources of the bioactive long-chain n-3
including EPA and DHA. The majority of DHA and EPA
are found in diets containing cold-water fatty fish, FOs, flax,
range-fed poultry, eggs and farm animals, and in supple-
ments and prescription formulations. Other less biologically
potent FAs include plant-based ALA with n-3 PUFA.4
The
major plant omega-3 ALA is found in walnuts, soybean,
canola oil, and flaxseed.
Epidemiological and experimental studies on the benefits
of FOs and omega-3 FA consumption has increased over
the past few decades.5
Diets enriched with high amounts of
both plant- and marine-derived omega-3 PUFAs seem to
be associated with a lower incidence of coronary heart dis-
ease (CHD)6,7
and a reduction in cardiovascular events.8
In addition, both animal and clinical studies support the use
of omega-3 FAs for inflammatory9
and autoimmune disease
management.10
There have been a number of clinical trials
assessing the benefits of dietary supplementation with FOs
in treating several inflammatory and autoimmune diseases
among humans,4
including rheumatoid arthritis (RA),11,12
Crohn’s disease,13,14
inflammatory bowel disease,13,15–17
as
well as other inflammatory conditions.18,19
Many of the
placebo-controlled trials of FO with chronic inflammatory dis-
eases report significant benefit, including decreased disease
activity and a lowered use of anti-inflammatory drugs.4,20
In 2012, a systematic review (SR) of randomized con-
trolled trials (RCTs) on omega-3 FAs and inflammatory bio-
markers in healthy and clinical populations was conducted
utilizing PubMed and LILACS databases.21
This study
selected 26 RCTs published over the preceding 10 years
and written in the English language that evaluated omega-3
diet supplementation or dietary manipulation. Studies were
excluded if a supplement was administered that could poten-
tially confound the effects of omega-3 FAs or if there was
*Samueli Institute, 2101 East Coast Highway, Suite 300, Corona del
Mar, CA 92625.
†Department of Planning, Policy and Design, School of Social Ecology,
University of California Irvine, Irvine, CA 92697.
‡Samueli Institute, 1737 King Street, Suite 600, Alexandria, VA 22314.
The views opinions and/or findings contained in this work are those of the
author(s) and should not be construed as an official Department of the Army
position, policy, or decision unless so designated by other documentation.
doi: 10.7205/MILMED-D-14-00339
MILITARY MEDICINE, Vol. 179, November Supplement 20142
9. participants and are presented in the emulsion section
(Table II).36,126,127
Of the twenty-one studies included, fourteen were scored
as high quality (+) with primarily mixed results or no effect.
Six studies scored a neutral quality, of which two showed
statistically significant results.22,67
The remaining study scored
low quality (−), which showed an effect in favor of
omega-3.61
The doses provided, the duration of adminis-
tration, and age range of participants varied widely across
studies (Table I). In addition, most studies had more male
participants (about 71% male participants completed) com-
pared to female participants. In fact, eight studies included
only male participants.12,22,24,60,61,67–69
Cardiac Patients
Twelve studies24,30,32,41,70–77
examined cardiac populations
of which eight were scored as high quality (+), six of
which (75%) were statistically significant in favor of
omega-3 in reducing inflammation across all biomarkers
assessed such as ICAM, sV-CAM-1, CRP, TNF, IL-6, or
IL-18,30,41,71,74,76,77
with the remaining having at least
one biomarker showing favorable reduction in inflamma-
tion. Four studies scored as neutral quality (0), with pri-
marily conflicting results across these studies (Table III).
There were no poor quality studies in this category. Simi-
lar to healthy subjects, most of the cardiac study subjects
were given capsules containing omega-3 FAs, but in some
studies, diet was manipulated.71,76
Dose for omega-3, EPA,
and DHA varied across studies. Also like in the healthy
subject studies, the majority of cardiac studies reported out-
comes based on male subjects. In total, cardiac studies had
about 78% of male participants complete the intervention.
Three studies did not report gender as a demographic.32,71,72
Rheumatoid Arthritis (RA) Patients
Eleven studies78–88
examined RA patients. Four scored
high quality (+) with primarily conflicting results across
studies.79–81,83
The other two studies showed nonsignifi-
cant effects on C-reactive protein (CRP) when given
FO supplements.79,83
There were five neutral quality (0)
studies,78,84,86–88
with one showing positive effects across
biomarkers,84
three with at least one biomarker with an
effect in favor of omega-3,78,86,87
and one showing no effect
across any biomarkers assessed.88
In addition, there were
two low quality (−) studies showing a reduction across
at least one of the several proinflammatory biomarkers
assessed82,84
(Table IV). Again, like most of the cardiac
study subjects, RA patients were given capsules con-
taining omega-3 FAs rather than a fatty fish diet. In
one study, patients received FO as part of their diets
intravenously.79
This single study is discussed both in
this section of the review as well as the emulsion sec-
tion (Table II). Unlike the healthy participants and car-
diac patient omega-3 studies, RA patients were primarily
female (about 78% females completed interventions). Two
studies did not describe gender.82,86
Functional and Other Conditions
Eleven studies42,59,89–97
of varying conditions (asthma, Crohn’s
disease, MetS, periodontitis, ulcerative colitis) were included
in our functional category (Table V). Seven studies (64%)
scored high quality (+) and four studies (36%) scored neutral
in quality (0) according to ADA criteria. Forty-two percent
(42%) of the completed participants in the functional con-
dition group were male. A few studies involved dietary
interventions of omega-392,94
compared to omega-3 sup-
plement capsules. Two studies administered omega-3 via
powder drinks.91,92
Asthma
Two studies89,90
involving asthmatic patients with statisti-
cally significant results scored as high quality (+). The
first study involved 60 patients with atopic asthma who
received lipid extract of New Zealand green-lipped mussel
or a matching placebo for a period of 8 weeks and reported
a significant decrease in daytime wheeze and the con-
centration of exhaled H2O2.89
The second study involved
23 dust mite allergic asthmatics receiving PUFA-enriched
fat blend or placebo for 5 weeks and reported significantly
lower exhaled NO (eNO) levels in the omega–3 PUFA-
supplemented group.90
These two studies measured what
we are terming “modulators” and not necessarily pro or
anti-inflammatory biomarkers.
Crohn’s Disease
Two studies91,92
examined Crohn’s disease, one scoring
high quality (+) and the other neutral (0). One of these
studies involved 31 patients who received either omega-3
or omega-6 Impact Powder (IP) and showed a significant
difference in concentration of IL-1b and in concentration
of monocyte chemoattractant protein (MCP-1) in week 9
for omega-3 supplementation.92
The second study was
neutral in quality (0) and had nonstatistically significant
results. These patients were provided with omega-3 or
omega-6 IP and both groups showed a decrease in CRP;
however, there was no statistically significant difference
between the two groups.91
Metabolic Syndrome
Four studies42,93–95
included patients with MetS, two of
which scored high quality94,95
and two scored neutral in
quality (0).42,93
Of those studies that were high quality (+),
one study94
examined the effect of four different diets
(including omega-3) on inflammation, reporting no statis-
tically significant dietary effects between the pre and post-
intervention on inflammatory status in fasting MCP-1, IL-6,
or IL-1b. The other high-quality score study,95
a four-arm
research design, found statistically significant decreases
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Omega-3 and Inflammatory Biomarkers REAL
10. between treatment groups ( p < 0.05) in DBP in the kinako
group after 90 days when compared to the results obtained
from the FO and kinako groups. Both studies, which scored
neutral in quality (0), did not find significant differences
between groups.42,93
Periodontitis
Two studies59,96
on periodontitis populations assessed modu-
lators as their inflammatory biomarkers instead of pro- or
anti-inflammatory biomarkers. One study involved partici-
pants who were asked to stop brushing their teeth for a
period of time and then provided with omega-3 PUFA or
olive oil (OO) for 8 days. This study scored high quality
according to ADA and showed a tendency toward improve-
ment in plaque and gingival index (GI), but no statistically
significant between-group differences were found.59
The other
study involved participants taking borage oil, EPA, or a com-
bination of both or a placebo oil where the use of borage oil
showed better results than EPA for plaque index (PI) and
GI,96
and received a neutral ADA score.
Ulcerative Colitis
The final study in this category included 18 patients with
ulcerative colitis who received FO capsules or a vegetable
oil placebo for 4 months. This study scored high quality (+)
and reported statistically significant results for reductions in
rectal dialysate leukotriene B4 levels, improvements in his-
tologic findings, and weight gain for the FO group.97
Long-Term Organic Conditions
We categorized twenty-seven studies29,31,33–35,46,98–118
as
long-term organic conditions (Table VI). These conditions
included AD, hypertriglyceridemia and diabetes, overweight
and obesity, peripheral arterial occlusive disease, renal disease,
and cancer and bone marrow transplant. Nineteen studies
(70%) scored high quality (+) and eight studies (30%) scored
neutral in quality (0) according to ADA criteria. Fifty-four
percent (54%) of the participants in the long-term organic
conditions were male participants.
Alzheimer’s Disease
Three studies34,35,98
assessed AD patients, all of which scored
high quality (+). One of these studies showed statistically
significant results with DHA-rich omega-3 FAs supplementa-
tion, which increased plasma concentrations of DHA (and
EPA), and were associated with reduced release of IL-1, IL-6,
and granulocyte colony-stimulating factor (G-CSF) from
peripheral blood mononuclear cells (PBMCs) for patients
receiving omega-3 FAs vs. placebo oil capsules.35
This is one
of the few studies with a relatively large sample size (N = 361)
and that measured blood levels of FA. In the other two studies,
patients received DHA and EPA or a placebo oil capsules
for 6 months, and showed no influence on inflammatory or
other measured biomarkers in CSF or plasma.34,98
Hypertriglyceridemia and Diabetes
There were eight studies on hypertriglyceridemia33,99–102
or
diabetes.31,103,104
Most of the studies (75%)31,99,101–104
in this
group scored high quality (+) according to ADA criteria. Of
the six studies that scored high quality, most reported reduc-
tions in inflammatory markers.99–101
Of the two studies33,100
that scored neutral (0) according to ADA criteria, one study
examined subjects with hypertriglyceridemia that were other-
wise healthy individuals and showed statistically significant
results with DHA supplementation in the absence of EPA,
which resulted in a reduction in the number of circulating
neutrophils and serum CRP and GM-CSF and an increase
in the concentration of matrix metalloproteinase (MMP-2)
according to ADA criteria.100
The other study compared two
different doses of DHA plus EPA and found that neither dose
statistically improved inflammatory markers (IL-1b, IL-6,
TNF-a, and high-sensitivity CRP) or the expression of inflam-
matory cytokine genes in isolated lymphocytes.33
There were three studies scoring high quality (+) involv-
ing patients with type 2 diabetes with or without hypertension
consuming EPA, DHA, or placebo capsules.31,103,104
Although
the serum IL-2 and TNF-a levels were reduced in the treatment
group serum, CRP levels varied across these studies.31,103,104
Overweight and Obesity
There were ten studies29,105–112,115
on overweight/obesity
patients, five scoring high quality (+) and five scoring neu-
tral quality (0). For the five high-quality studies, four (80%)
reported nonsignificant statistical results for TNF, IL-6, and
CRP inflammatory biomarkers in patients receiving omega-3
or a placebo29,108–110
(Table VI). For the neutral quality
studies, one showed statistically significant results across
various inflammatory biomarkers when patients consumed
flaxseed flour vs. a placebo.106
The other neutral quality studies
showed nonsignificant results for inflammatory biomarkers
when patients consumed omega-3 long-chain PUFA-enriched
versions of typical processed foods or placebo.105,111,112
Peripheral Arterial Occlusive Disease
One study addressed patients with peripheral arterial occlu-
sive disease where participants received canola oil or
sunflower oil, as placebo, added to their usual diets for
8 weeks. This study was scored as high quality and there
were no significant differences for either group for CRP
inflammatory biomarkers.116
Renal Disease
Three studies assessed omega-3 among patients with renal
disease.46,113,114
Two of the three studies (67%) scored high
quality (+) according to ADA criteria.46,113
For all three
studies, patients received pills of omega-3 FA or placebo
pills. The two high-quality studies concluded that consum-
ing omega-3 FA lowers CRP and IL-1b significantly more
than placebo.46,113
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Omega-3 and Inflammatory Biomarkers REAL
11. Cancer and Bone Marrow Transplant
Two studies reported on omega-3 interventions for cancer
and bone marrow transplant patients.117,118
Both studies
scored as high quality (+) according ADA criteria. The first
study where 16 patients underwent allergic bone marrow
transplant received EPA orally and showed significantly
lower levels of TNF-a, IFN-g, and IL-10 compared with
the non-EPA group.117
The second study investigated the
effects of an oral nutritional supplement containing n-3
PUFAs on nutritional status and inflammatory markers
where the EPA plus DHA group had greater weight loss
and lower IL-6 production after 5 week, though not statisti-
cally significant (B = 227.9; p = 0.08).
Parenteral Omega-3 (Emulsion Studies)
Our SR retrieved twenty-seven studies36,37,40,44,79,119–140
on
parenteral nutrition (PN) of omega-3 on participants to
reduce inflammation. Nineteen (68%) of these studies were
published since 2004. Twenty-three studies (85%) scored
high quality (+) and four studies (15%) scored neutral in
quality (0) according to ADA criteria. Emulsion studies were
done for healthy participants, patients with RA, and critically
ill patients. Four studies were categorized as healthy partici-
pants and patients with RA. The three healthy participant
emulsion studies are referenced in Table II and of the single
RA emulsion study is referenced in Tables II and IV. The
majority of the studies (n = 23) were on critically ill patients
or surgical patients. In fact, 16 of the 27 studies (59%) were
surgery-related studies and six studies (22%) included patients
in intensive care units (ICUs).
Studies of Parenteral Omega-3 in Healthy and RA Patients
Four studies, all assessed as high quality (+),36,79,126,127
addressed inflammatory responses and the composition of
platelets in healthy subjects and patients with RA given FO
intravenously or with usual treatment (soybean oil lipid emul-
sion). These studies reported that the use of omega-3-enriched
emulsions increases the serum concentration of alpha-
tocopherol and the percentage content of EPA and DHA
from start of study to end of study. In addition, these studies
also reported that omega-3 emulsion resulted in a greater
reduction in IL-6 and TNF-a, though most of these finding
were not significant.
Studies of Parenteral Omega-3 in Critically Ill Patients
Twenty-three studies (85%) were included in our critical
illness population category receiving PN (Table II). Six
studies that met our inclusion criteria involved patients in
the ICU and three with systemic inflammatory response
syndrome (SIRS). Nineteen (83%) of these studies were
scored high quality (+) according to ADA criteria. Four
(17%) scored natural (0) according to ADA criteria.
Of those that scored high quality (+), one high-quality
study demonstrated nonsignificant effects for the inflamma-
tory biomarker assessed (IL-6), showing that supplementa-
tion with FO did not affect this inflammatory biomarker.121
Two other high-quality studies on septic patients who were
given enteral nutrition received a standard soybean oil-based
emulsion or an emulsion containing FO (OmegavenÒ) for
540
or 10131
days. Within 2 days of FO infusion, free n-3
FAs increased, and the n-3/n-6 ratio was reversed and the
generation of proinflammatory cytokines by mononuclear
leukocytes was markedly elevated during n-6 and was sup-
pressed during n-3 lipid application.40
The authors reported
that both these studies “establish that infusion of long-chain
n-3 PUFA for patients with sepsis can modulate inflam-
matory mediator production and related inflammatory pro-
cesses”.147
Of the four studies that scored neutral in quality
(0) according to ADA criteria, two studies compared the
effects of a medium- and long-chain triglyceride fat infu-
sion on systemic inflammation and hepatic steatosis in ICU
patients. The first study44
found that plasma cytokine, PGE2,
LTB4, IL-1b, IL-6, IL-10, and TNF-a concentrations
decreased over time in both groups ( p < 0.05). The second
study included sepsis and SIRS patients who received PN
employing the MCT/LCT fat infusion or the FO-based fat
infusion over 7 days in the ICU. Groups receiving the
MCT/LCT PN had higher proinflammatory cytokine (TNF-a,
IL-1, and IL-6) values and lower anti-inflammatory cytokine
(IL-10) values than patients fed with FO, but statistical sig-
nificance was seen only at the middle and end of the study
periods in the septic groups. The results of this study may
support that FO could be more effective than MCT/LCT fat
emulsion, especially in patients with infectious conditions.136
Taken together, these studies indicate that inclusion of FO
in PN regimens for critically ill and surgical patients modu-
lates the generation of inflammatory eicosanoids and cytokines.
It seems there is a shift in the generation of leukotrienes
toward the leukotriene-5 series and an ameliorated LTB5:
LTB4 ratio, thereby reducing the incidence of systemic inflam-
matory response.148
Furthermore, the inclusion of FO in PN
regimens, “may help to counter the surgery-induced decline in
antigen presenting cell activity139
and T-lymphocyte cytokine
production.135
Importantly, these studies do not reveal any
deleterious effects of FO infusion in these patients.”147(p567)
Pediatric Populations
This review retrieved four studies128,141–143
on the effect on
omega-3 FAs in children. Two scored high quality (+) and
two studies scored neutral in quality (0) according to ADA
criteria. One study, neutral in quality, was unable to find
significant effect on biomarkers for inflammation for DHA
supplementation compared to corn and soy oil (control).141
The other remaining three studies reported mixed results.
A study on lipid omega-3 emulsion was administered
in infants for days 1 to 4 before open-heart surgery, and
10 days after surgery found that the plasma TNF-a con-
centration was significantly lower ( p = 0.003) in the treat-
ment compared to the control group. In infants without
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Omega-3 and Inflammatory Biomarkers REAL
12. sepsis, plasma TNF-a did not differ according to treat-
ment; however, when sepsis developed, mean plasma TNF-a
was significantly lower in treatment compared to control
( p = 0.0007).128
The two remaining studies in this group
of studies reported similar findings. In neonates that have
undergone surgery and are fed omega-3 FAs through a
nasogastric tube, it was found that although decreases of
cytokines during hospitalization were similar in both groups,
there was a greater decrease of IL-1b in the DHA group than in
the OO group after adjusting for confounders (p = 0.028)142
(Table VII).
Pregnant Women
The role of omega-3 on inflammation during pregnancy and
fetal development is not well studied. We retrieved three
studies on the effect of these EFAs on pregnancy inflam-
mation outcomes. During pregnancy, the immune tolerance
between the fetus and the mother is mediated by a number of
complex processes at the materno–fetal interface.149
Omega-3
FAs may play a part in a number of these pathways. Two
studies scored high quality (+) and one scored neutral in
quality (0) according to ADA criteria. Of the two high-
quality studies, one study145
on pregnant women (<19-week
gestation) asked that the control group to continue their
habitual diet until they gave birth, whereas the women in
the treatment group were asked to incorporate 2 portions
of farmed salmon (150 g/portion) into their diet per week
from study entry (week 20) until birth. Afterward, the
infants were clinically evaluated for immune responses at
6 months of age (n = 48 in the salmon group; n = 38 in
the control group). Intakes of salmon during pregnancy,
which effectively increased the n-3 long-chain polyunsatu-
rated fatty acids (LCPUFA) content of cord plasma, affected
neonatal cytokine production. To assess adaptive memory
responses, this study stimulated cord blood mononuclear cells
(CBMCs) with both inhalant Dermatophagoides pteronyssinus
allergen 1 (Derp1) and food ovalbumin (OVA) and salmon
parvalbumin (Sals1) allergens. CBMC IL-10 responses to
Derp1 (p = 0.022), OVA (p = 0.004), Sals1 (p =0.002), and
mitogen (phytohemagglutinin [PHA]) (p = 0.044) were all
significantly lower in the salmon group than in the control
group. However, in infants at age 6 months, the immune dif-
ferences identified at birth were no longer significant. There-
fore, the long-term effect of omega-3 on the neonates was not
established (Table VIII).145
The second high-quality study144
in this group compared
the plasma inflammatory and vascular homeostasis biomarker
status of pregnant women consuming a diet that included
2 portions of salmon per week from week 20 of pregnancy
until delivery. This study found that the dietary intervention
with oily fish in this study population had no effect on
plasma cytokine profiles.
The last study146
in this group scored neutral in quality (0)
according to ADA criteria. This study found that maternal
serum/plasma phospholipid FA proportions were altered by
omega-3 supplementation (capsules) compared to soybean
oil during pregnancy. (Table VIII).146
Quality Assessment of Overall Literature Pool by
Conditions (GRADE)
The quality assessment of the overall literature pool in this
REAL was conducted by SMEs and a review team (WBJ,
JAI and RK, CC) across the various categories of conditions
using the GRADE criteria (Table IX).54
A GRADE analysis
was conducted for each condition category if there were 3 or
more studies per category.
In general, supplementation with omega-3 FAs had limited
effect on inflammatory biomarkers among healthy indi-
viduals in most high-quality studies and mixed effects in
lower quality studies. Three studies in this group had a large
number of participants (>100). In total, there were twenty-
one studies and 1,191 participants in this group. Therefore,
we believe that further research is very unlikely to change
our confidence in the estimate of effect. Thus, we are unable
to recommend omega-3 to reduce inflammation in healthy par-
ticipants. In contrast, most high-quality studies in patients with
established cardiovascular disease had improved inflammatory
status (lower proinflammatory and higher anti-inflammatory)
biomarkers compared to controls. Three studies in this group
had a large number of participants (>100). In total, there were
12 studies and 1,121 participants in this group. This category
was dominated by one study with a large sample size and good
score.77
In this study, levels of IL-18 were decreased by diet
(−10.5% vs. baseline, p = 0.012 compared with no diet) and
by omega-3 PUFA supplementation (−9.9% vs. baseline, p =
0.008 compared with placebo). Levels of IL-18 were also
significantly reduced in each treatment group compared
with the control group ( p = 0.021 for both), with a poten-
tially additive effect of the 2 intervention principles ( p <
0.001). CRP, IL-6, and TNF-a were reduced vs. baseline in
all study groups, but with no between-group differences.77
Our review would recommend omega-3 for the reduction of
inflammation in cardiac patients.
There were eleven studies on the effect of omega-3 on
inflammation in patients with RA. These studies had mixed
results and have had a small number of participants (total
n = 453). Our study is unable to make a recommendation
in favor of using Omega-3s in this group. Currently, any
estimate of effect is very uncertain.
Long-term organic conditions (AD, hypertriglyceridemia/
diabetes, overweight/obesity, and renal disease) generally
showed favorable inflammatory biomarker modulator effects,
but almost all studies were small in size. This group of studies
was dominated by one Alzheimer’s study by Freund-Levi
et al,34
which was reasonably large and high quality. It reported
no effects on any biomarker of inflammation in serum or CSF.
Therefore, use of omega-3 for the reduction of inflammation in
AD patients, hypertriglyceridemia and type 2 diabetes patients,
and overweight and obese patients requires further research
and is likely to have an important impact on our confidence in
MILITARY MEDICINE, Vol. 179, November Supplement 20148
Omega-3 and Inflammatory Biomarkers REAL
13. the estimate of effect and may change the current estimate. We
can provide a weak recommendation for omega-3 for these
patients. More research is needed for this study group. We are
unable to make a recommendation for omega-3 for the reduc-
tion of inflammation in renal disease patients.
The lack of studies and mixed results of the few existing
studies does not allow for conclusive recommendation for
omega-3emulsions in healthy populations and RA patients.
In contrast, the quality and quantity of research on inflamma-
tion from omega-3 emulsions for surgical and critically ill
patients is significant. Omega-3 emulsions for the critically
ill reported very few and mostly minor adverse events. In
fact, intravenous lipid emulsions (mainly n-6 PUFAs including
soybean oil) “have been established for many years as an
integral part of parenteral nutrition due to their high energy
density and low osmolarity.”148
The mediators reported from
n-6 PUFA infusions (mainly arachidonic acid [AA]) seem to
favor an inflammatory response, whereas mediators stemming
from infusions of EPA and DHA seem to exert less proinflam-
matory actions.148
The high quality and positive results of
these studies suggest that omega-3 is an appropriate form of
PN for critically ill patients or those undergoing surgery.
Our review retrieved three studies measuring inflamma-
tion as a biomarker in pregnant women and four studies
on children. These studies had small numbers of participants
and the results were mixed. Therefore, further research is
very likely to have an important impact on our confidence in
the estimate of effect for these populations, and we are unable
to recommend omega-3 in reducing inflammation among preg-
nant women or for the use of children. All of the healthy or
condition categories scored either a B (moderate) or a C (low)
on confidence in the estimate of the effect size. This score is
interpreted to mean that in the current body of literature, con-
clusions could easily be altered by a single large, high-quality
study in almost any patient category. Most studies which
addressed specific illness conditions had small sample sizes
and we found only a few studies in each condition. There-
fore, at the current time, any new study with sufficient power
could change our estimation of the direction of the outcome
for the conditions included in Table IX. As a result of this
low level of confidence, all conclusions should be considered
tentative. The authors are not able to comment on the mag-
nitude of the effect since none of the studies reported effect
sizes for the relevant outcomes captured by GRADE. The
safety grade was marked as 0 for most studies as the majority
of studies did not report on any adverse effects. In fact, most
studies make no mention of adverse event assessment at all.
Adverse Events
Almost half of the RCTs included in this study (48%) made no
report of anything related to adverse events, leaving the reader
unsure if any were measured or occurred. Without this infor-
mation, it is difficult to make clear recommendations for use of
FAs. Some studies reported that there were no adverse events
associated with interventions (26%). Additionally, about
26% reported minor adverse events with omega-3, including
diarrhea, rash, nausea, constipation, gastrointestinal com-
plaints, bloating, prolonged bleeding, headache, muscle ache,
depression, fishy taste, vomiting, rictus, metallic taste, and
abdominal cramps. No major adverse event was reported.
Adverse events considered to be moderate or severe did not
appear to be related to the study medication, i.e., two wound
infections, urologic infections, respiratory tract infection,
intestinal infection,37
myocardial infarction,69
cellulitis, tran-
sient ischemic attack, and sustained fractures after falling.83
A small elevation of alanine aminotransferase was detected
in in a study among the omega-3 group (n = 23).107
DISCUSSION
This article reports the evidence from and the quality of
research of omega-3 FA supplementation on biomarkers of
inflammation in healthy individuals and inflammatory con-
ditions in human RCTs. The quality of the individual studies
is impressive overall. In addition, the overall evidence is
significant for several conditions. Supplementation with
long-chain n-3 PUFA produced no demonstrable effects on
inflammation for healthy participants, as measured by inflam-
matory biomarkers. At first glance, the outcome of these
clinical studies might suggest that omega-3 FA supplemen-
tation has no benefits in healthy groups. However, these
studies reported induced elevation of plasma n-3 and posi-
tive affects other health-related outcomes that were not
directly related to inflammation (i.e., inflammatory bio-
markers). In this respect, some consideration should be
given to the fact that healthy individuals may not exhibit
inflammation as compared to diseased participants.
In general, the 1980s were a period of pioneering expan-
sion in research about PUFAs in general and omega-3 FAs
in particular.4
However, about 80% of the studies in this
review were published in the last decade. The popular interest
around omega-3 in nutrition to reduce inflammation may
have caused this increase.
To date, there are no official recommendations for intake
of n-3 PUFAs, particularly EPA and DHA. Although there
are many international authorities and expert groups that
have issued dietary recommendations for them, doses vary
greatly.150
In 1994, the United Kingdom Committee on
Medical Aspects of Food Policy guidelines recommended
that the average n-3 PUFA intake should be increased from
0.1 to 0.2 g/d.151
In 2002 and 2005, the Institute of Medicine
(IOM) report concluded there was insufficient evidence to set
a dietary reference intake for EPA and DHA.152,153
Although
the omega-3 intakes were not specified by the IOM, they
have been estimated (n-3 PUFA [ALA]) at 0.5 g/d (infants
0–12 months), 0.7 to 0.9 g/d (children 1–3 years and 4–8 years,
respectively), 1.2 g/d (male children 9–13 years), 1.6 g/d
(male 14–70 years), 1.0 g/d (female children 9–13 years),
1.1 g/d (female 14–70 years), 1.4 g/d (pregnant women),
and 1.3 g/d (lactating woman).152,153
The IOM recom-
mendation for EPA plus DHA is about 140 mg/d.154
The
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Omega-3 and Inflammatory Biomarkers REAL
14. International Society for the Study of Fatty Acids and
Lipids report on specific recommendations for the intake
of polyunsaturates (PUFA): (1) an adequate linoleic acid
(LA) intake as 2 energy %; (2) a healthy intake of ALA as
0.7 energy %; and (3) for cardiovascular health, a minimum
intake of EPA and DHA combined as 500 mg/d.155
In 2010,
the Report of the Dietary Guidelines Advisory Committee on
the Dietary Guidelines for Americans recommends 8 oz of
seafood per week to contribute an average of 250 mg/d of
long-chain omega-3 FAs, for all Americans.156
Others recom-
mend “a dietary strategy for achieving the 500-mg/d recom-
mendation is to consume 2 fish meals per week (preferably
fatty fish). Foods enriched with EPA and DHA or FO sup-
plements are a suitable alternate to achieve recommended
intakes and may be necessary to achieve intakes of 1 g/d.”154
In addition, when discussing dosage the concurrent die-
tary intakes of LA, a-LNA, AA, EPA, and DHA should be
considered in predicting final tissue proportions of n-3 FAs
in long-chain FAs.157
Thus, a healthy dietary allowance for
n-3 long-chain FAs intake must take into account concur-
rent intakes of LA, a-LNA, and AA. In the United States per
capita, a healthy dietary allowance of 3.5 g EPA + DHA/d
could be reduced to one-tenth of that amount if the intake
of n-6 fatty acids, in particular LA, can be lowered to
<2% of energy.”158(p1489S)
In short, the dosage and dietary
recommendation for omega-3 varies greatly.
Similarly, the dosage for omega-3 lipid infusions also
varies. Currently, there are several lipid emulsions that
include FO as a component (i.e., Omegaven (Fresenius Kabi,
Bad Homberg, Germany, 100 g lipid/L); Lipoplus (also
known as Lipidem; B. Braun, Melsungen, Germany, 200 g
lipid/L); and SMOFLipid (Fresenius Kabi, Bad Homberg,
Germany,(200 g lipid/L).147
To date, there are no guidelines
or recommendation for omega-3 emulsions.
Omega- 3 use among military personnel is not well docu-
mented. A recent survey reported categories of CAM used by
U.S. active duty military personal and high-dose megavitamins
(8.4%) are among the top ten most popular CAM therapies.159
A 2011 study evaluated deficiencies of highly unsaturated
omega-3, in particular DHA, to the increased risk of suicide
death among a large random sample of active duty U.S. mili-
tary. This study found the U.S. military population had a very
low and narrow range of omega-3 status. They reported that,
among men, risk of suicide death was 62% greater with low
serum DHA status (adjusted odds ratio [OR] =1.62, 95% CI
1.12–2.34, p < 0.01, comparing DHA below 1.75% [n = 1,389]
to above [n = 141]).160
Another study reported that “improv-
ing omega-3 status through an increase in omega-3 intake
may improve neurocognitive performance and confer an
element of resilience to poor sleep.”161
There have been no
published studies on the impact of omega-3 in inflammatory
biomarkers among U.S. military personnel.
Emulsion studies of omega-3 may be especially impor-
tant to military health care. Warriors injured in combat may
benefit from omega-3 PN. Currently, most lipids used in PN
are soybean oil, in which n-6 linoleic acid comprises about
50% of the FAs. There has been some concern about the
potential harm of n-6 emulsions. These concerns are mainly
because of the proinflammatory and immune-suppressive
aspect of n-6 PUFA. In our study, omega-3 lipid emulsions
for parenteral applications were found to reduce inflamma-
tion, increase immune response, improve clinical outcomes,
and reduce cardiovascular risk.18,147
Lastly, some emulsion
studies have found a lower rate of infection and shorter
lengths of stay in the ICU. A decrease in length of hospital
stay would have important cost and policy implications for
the use of FO infusion in ICU and perioperative patients.147
Limitations and Challenges
It is clear that the inflammatory system is extremely compli-
cated and studies continue to reveal this complexity, often
with contradictory findings. For example, the proinflammatory
molecule TNF-a has shown therapeutic promise against RA
while failing against SIRS, leading researchers to devise com-
plex mathematical models to account for this behavior.162
This
complexity is not only an issue for individual biomarkers
but also evident in the complex dynamics of pro- and anti-
inflammatory interactions in living systems in general. As a
consequence, it was often a challenge to classify whether
some of the inflammatory biomarkers were proinflammatory,
anti-inflammatory, or modulators of both processes.
For the most part, this study reviewed RCTs where the
effects of omega-3 FAs were consumed in isolation via sup-
plementation. Omega-3 FAs are not usually consumed in
isolation. Indeed, clinical dietary guidelines advocate the
consummation of omega-3 FAs in foods, “the properties of
which will be influenced by the food matrix and its overall
nutrient composition.”163(p166)
Another limitation of this study is that we only examined
the inflammatory biomarker in clinical studies involving
humans, whether this was a primary outcome of the study
or not. Therefore, for those studies where the inflammatory
biomarkers captured were part of a secondary analysis of the
study, they did not represent the complete picture of the
original research. None of the studies reported on an effect
size for the inflammatory biomarkers of interest to our review
and therefore, we were not able to GRADE effect size for the
overall literature pool or conduct a meta-analysis.
It is difficult to assess whether omega-3 FA changes the
underlying state of inflammation, especially given the lack
of evidence in this review. Overall, the RCTs in this review
had small patient groups. Larger cohort studies or longitudi-
nal research were not assessed in our review. Therefore, we
are unable to address the long-term effects of omega-3 FA
response given the lack of larger population studies.
Finally, in part, because this is a rapidly changing field
but mostly because inflammatory/anti-inflammatory regula-
tion is both patently complex and just as obviously not well
understood, the existing literature leaves much to be desired.
Most of the studies in healthy populations asked the question
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