Oxidation of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) rich omega-3 oils (hereafter referred to as either EPA and DHA or omega-3) is a complicated topic, but an important one to understand. A significant number of consumers cite fishy burp and/or taste, thought to be the result of oxidation, as one of the main reasons they do not consume EPA and DHA rich oils. In addition, consumers note that some articles have raised concerns about the potential for adverse effects associated with consumption of oxidized oils. Measuring oxidation in omega-3 oils is complicated due to the differences in chemical and physical characteristics of many commercially available products, which means not all methods to determine quality are appropriate for all types of oils. A number of consumer advocacy groups, product quality seal programs and academic groups have published data on levels of oxidation in omega-3 oils. Overall, this data shows that commercially available omega-3 supplements are low in oxidation. If consumers have a poor sensory experience with their omega-3 product, they should try another product as an alternative.
In contrast to earlier long-chain (LC) omega-3 (i.e. EPA and DHA) investigations, some recent studies have not demonstrated significant effects of EPA and DHA on cardiovascular disease (CVD) outcomes. The neutral findings may have been due to experimental design issues, such as: maintenance on aggressive cardiovascular drug treatment overshadowing the benefits of LC omega-3s, high background LC omega-3 intake, too few subjects in the study, treatment duration too short, insufficient LC omega-3 dosage, increase in omega-6 fatty acid intake during the study, failure to assess the LC omega-3 status of the subjects prior to and during treatment and lack of clarity concerning which mechanisms were expected to produce benefits. At the 11th ISSFAL Congress, a workshop was held on conducting LC omega-3 clinical trials with cardiovascular outcomes, with the goal of gaining a better understanding concerning aspects of experimental design that should be considered when planning clinical studies related to EPA and DHA and potential cardiovascular benefits.
The objectives of this review were to determine whether the long-chain omega-3 fatty acids eicosapentaenoic acid and/or docosahexaenoic acid dose-dependently reduce fasting serum triglycerides (TG) and, if so, to create a mathematical model that may be used to predict potential percent reductions in fasting serum TG levels at the recommended intakes of 200-500 mg/day. The assessment included 15 randomized controlled trials that met pre-defined inclusion and exclusion criteria. Across these 15 studies, the dose-response was modeled using a first-order elimination curve. The response variable was defined as percent change from baseline in fasting serum TG, adjusted for the placebo effect. A weighting factor equal to the product of each study's sample size and quality score was used. Using the equation of the dose-response curve, predicted reductions in fasting serum TG levels at the recommended long-chain omega-3 fatty acid intakes of 200-500 mg/day are 3.1 to 7.2%.
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