Prepared by:
Tufts-New England Medical Center EPC
Boston, Massachusetts
Investigators
Chenchen Wang, M.D., M.Sc.
Mei Chung, M.P.H., Research Associate
Ethan Balk, M.D., M.P.H., Project Leader
Bruce Kupelnick, B.A., Research Associate
Deirdre DeVine, M.Litt., Project Manager
Amy Lawrence, B.A., Research Assistant
Alice Lichtenstein, D.Sc., Primary Technical Expert
Joseph Lau, M.D., Principal Investigator
File Name Description Software Version File Size ________________________________________________________________________________________________ 01front.doc Microsoft Word® Document MS Word® 2002 93KB 14 pages Contents: Title Page, Preface, Acknowledgments, Technical Expert Panel, Structured Abstract, Table of Contents ________________________________________________________________________________________________ 02body.doc Microsoft Word® Document MS Word® 2002 3.2MB 114 pages Contents: Chapter 1. Introduction: Background; Figure 1.1. Classical omega-3 and omega-6 fatty acid synthesis pathways and the role of omega-3 fatty acid in regulating health/disease markers; Table 1.1. Estimates of the meanąstandard error of the mean (SEM) intake of linoleic acid (LA), alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) in the US population, based on analyses of a single 24-hour dietary recall of NHANES III data; Table 1.2 Mean, range, and median usual daily intakes of linoleic acid (LA), total omega-3 fatty acids (n-3 FA), alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA) in the US population, based on CSFII data (1994-1996, 1998); Table 1.3. The omega-3 fatty acid content, in grams per 100 g food serving, of a representative sample of commonly consumed fish, shellfish, and fish oils, and nuts and seeds, and plant oils that contain at least 5 g omega-3 fatty acids per 100 g (http://www.nal.usda.gov/fnic/foodcomp); Overview of Effect of Omega-3 Fatty Acids on Cardiovascular Diseases; Chapter 2. Methods: Overview; Analytic Framework; Figure 2.1. Analytic framework for omega-3 fatty acid exposure and cardiovascular disease; Key Questions Addressed in this Report; Method to Assess the Dietary Intake of Omega-3 Fatty Acids in the US population; Literature Search Strategy; Study Selection; Data Extraction Process; Grading Evidence; Evidence Reporting Format; Chapter 3. Results: Population Intake of Omega-3 Fatty Acids in the United States; Table 3.1. The Sociodemographic Characteristics of the Participants in the Third National Health and Nutrition Survey, 1988-94; Table 3.2. Means and the Standard Error of the Mean (SEMs) for Usual Daily Intake of Linoleic Acid (LA, 18:2 n-6), United States, NHANES III (1988-94) and CSFII (1994-1996, 1998) Data; Table 3.3. Means and the Standard Error of the Mean (SEMs) for Usual Daily Intake of Linoleic Acid (LA, 18:2 n-6) (g/d), United States, NHANES III (1988-94) by Race/Ethnicity Groups; Table 3.4. Means and the Standard Error of the Mean (SEMs) for Usual Daily Intake of Alpha Linolenic Acid (ALA, 18:3 n-3), United States, NHANES III (1988-94) and CSFII (1994-1996, 1998) Data; Table 3.5. Means and the Standard Error of the Mean (SEMs) for Usual Daily Intake of Alpha Linolenic Acid (ALA, 18:3 n-3) (g/d), United States, NHANES III (1988-94) by Race/Ethnicity Groups; Table 3.6. Means and the Standard Error of the Mean (SEMs) for Usual Daily Intake of Eicosapentaenoic Acid (EPA, 20:5 n-3), United States, NHANES III (1988-94) and CSFII (1994-1996, 1998) Data; Table 3.7. Means and the Standard Error of the Mean (SEMs) for Usual Daily Intake of Eicosapentaenoic Acid (EPA, 20:5 n-3) (g/d), United States, NHANES III (1988-94) by Race/Ethnicity Groups; Table 3.8. eans and the Standard Error of the Mean (SEMs) for Usual Daily Intake of Docosahexaenoic Acid (DHA, 22:6 n-3), United States, NHANES III (1988-94) and CSFII (1994-1996, 1998) Data; Table 3.9. Means and the Standard Error of the Mean (SEMs) for Usual Daily Intake of Docosahexaenoic Acid (DHA, 22:6n-3) (g/d), United States, NHANES III (1988-94) by Race/Ethnicity Groups; Table 3.10. eans and the Standard Error of the Mean (SEMs) for Usual Daily Intake of Linoleic Acid (LA, 18:2 n-6) and Omega-3 PUFAs, United States, NHANES III (1988-94), Adults vs. Youths (Age < 18 y); Table 3.11. Means and the Standard Error of the Mean (SEMs) for Usual Daily Intake of Linoleic Acid (LA, 18:2 n-6) & Omega-3 PUFAs, United States, NHANES III (1988-94), Males vs. Females; Table 3.12. Means and the Standard Error of the Mean (SEMs) for Usual Daily Intake of Linoleic Acid (LA, 18:2n-6) & Omega-3 PUFAs, United States, NHANES III (1988-94), by Race/Ethnicity groups; Table 3.13. Means and the Standard Error of the Mean (SEMs) for Usual Daily Intake of Linoleic Acid (LA, 18:2 n-6) and Omega-3 PUFAs, United States, NHANES III (1988-94), Metro vs. Non-metro Areas; Table 3.14. Means and the Standard Error of the Mean (SEMs) for Usual Daily Intake of Linoleic Acid (LA, 18:2 n-6) & Omega-3 PUFAs, United States, NHANES III (1988-94), PIR ? 1.3 vs. PIR > 1.3; Table 3.15. The Demographic Characteristics of Adult Participants With and Without a History of Cardiovascular Diseases, United States, NHANES III (1988-94); Table 3.16. The Mean Intakes ± SEMs of Linoleic Acid (LA, 18:2n-6), Respondents With a History of CVD Compared to Those Without CVD, NHANES III (1988-94); Table 3.17. The Mean Intakes ± SEMs of Alpha Linolenic Acid (ALA, 18:3 n-3), Respondents With a History of CVD Compared to Those Without CVD, NHANES III (1988-94); Table 3.18. The Mean Intakes ± SEMs of Eicosapentaenoic Acid (EPA, 20:5 n-3), Respondents with a History of CVD Compared to Those Without CVD, NHANES III (1988-94); Table 3.19. The Mean Intakes ± SEMs of Docosahexaenoic Acid (DHA, 22:6 n-3), Respondents With a History of CVD Compared to Those Without CVD, NHANES III (1988-94); Effects of Consumption of Omega-3 Fatty Acid from Fish or Overall Diet, or from Supplements of Fish Oil or ALA, on Cardiovascular Disease Outcomes; Table 3.20. Randomized controlled trials of omega-3 fatty acid supplements on cardiovascular disease outcomes: all cause mortality, CVD death, cardiac death, sudden death (secondary prevention); Table 3.21. Randomized controlled trials of omega-3 fatty acid supplements on cardiovascular disease outcomes: myocardial infarction, stroke, all CVD events (secondary prevention); Table 3.22. Randomized controlled trials of omega-3 fatty acid diet or dietary advice on cardiovascular disease outcomes: all cause mortality, CVD death, cardiac death, sudden death (secondary prevention); Table 3.23. Randomized controlled trials of omega-3 fatty acid diet or dietary advice on cardiovascular disease outcomes: myocardial infarction, stroke, all CVD events (secondary prevention); Table 3.24. Association of estimates of fish consumption with all cause mortality, cardiovascular death, and myocardial infarction in prospective cohort studies (secondary prevention); Table 3.25. Randomized controlled trials of omega-3 fatty acid supplements on cardiovascular disease outcomes: all cause mortality, CVD death, cardiac death, sudden death (Primary intervention); Table 3.27. Association of estimates of omega-3 fatty acid consumption with all cause mortality in prospective cohort studies; Table 3.28. Association of estimates of fish consumption with all cause mortality in prospective cohort studies; Table 3.29. Association of estimates of omega-3 fatty acid consumption with cardiovascular death in prospective cohort studies; Table 3.30. Association of estimates of fish consumption with cardiovascular death in prospective cohort studies; Table 3.31. Association of estimates of omega-3 fatty acids with cardiac death in prospective cohort studies; Table 3.32. Association of estimates of fish consumption with cardiac death in prospective cohort studies; Table 3.33. Association of estimates of omega-3 fatty acids with sudden death in prospective cohort and case-control studies; Table 3.34. Association of estimates of fish consumption with sudden death in prospective cohort studies; Table 3.35. Association of estimates of omega-3 fatty acids consumption with myocardial infarction in prospective cohort and case-control studies; Table 3.36. Association of estimates of fish consumption with myocardial infarction in prospective cohort and case control studies; Table 3.37. Association of estimates of omega-3 fatty acid consumption with stroke in prospective cohort and case-control studies; Table 3.38. Association of estimates of fish consumption with stroke in prospective cohort and case-control studies; Table 3.39. Association of estimates of omega-3 fatty acid consumption with all CVD events in cross-sectional study; Table 3.40. Association of estimates of omega-3 fatty acid consumption with all cause mortality in prospective cohort studies of general population (based on data in Table 3.27); Table 3.41. Association of estimates of fish consumption with all cause mortality in prospective cohort studies of general population (based on data in Table 3.28); Table 3.42. Association of estimates of omega-3 fatty acid consumption with cardiovascular death in prospective cohort studies of general population (based on data in Table 3.29); Table 3.43. Association of estimates of fish consumption with cardiovascular death in prospective cohort studies of general population (based on data in Table 3.30); Table 3.44. Association of estimates of omega-3 fatty acid consumption with cardiac death in prospective cohort studies of general population (based on data in Table 3.31); Table 3.45. Association of estimates of fish consumption with cardiac death in prospective cohort studies of general population (based on data in Table 3.32); Table 3.46. Association of estimates of omega-3 fatty acid consumption with sudden death in prospective cohort studies of general population (based on data in Table 3.33); Table 3.47. Association of estimates of fish consumption with sudden death in prospective cohort studies of general population (based on data in Table 3.34); Table 3.48. Association of estimates of omega-3 fatty acid consumption with myocardial infarction in prospective cohort studies of general population (based on data in Table 3.35); Table 3.49. Association of estimates of fish consumption with myocardial infarction in prospective cohort studies of general population (based on data in Table 3.36); Table 3.50. Association of estimates of omega-3 fatty acid consumption with stroke in prospective cohort studies of general population (based on data in Table 3.37); Table 3.51. Association of estimates of fish consumption with stroke in prospective cohort studies of general population (based on data in Table 3.38); Answers to Specific Key Questions; Adverse Events Associated with Omega-3 Fatty Acid Consumption; Table 3.52. Randomized Controlled Trials That Reported Adverse Events with Consumption of Omega-3 Fatty Acid Supplements; Table 3.53. Adverse Events Reported in Non-randomized Studies of Omega-3 Fatty Acid Supplements; Table 3.54. Randomized Trials of Omega-3 Fatty Acid Supplements that Reported No Adverse Events; Table: 3.55. Non-Randomized Studies of Omega-3 Fatty Acid Supplements that Reported No Adverse Events Chapter 4. Discussion: Overview; Main Findings; Limitations; Research Recommendations; References and Bibliography ________________________________________________________________________________________________ 03exstud.doc Microsoft Word® Document MS Word® 2002 82KB 4 pages Contents: Excluded Studies ________________________________________________________________________________________________ 04acro.doc Microsoft Word® Document MS Word® 2002 96KB 2 pages Contents: Acronyms and Abbreviations ________________________________________________________________________________________________
AHRQ Publication No. 04-E009-2
Current as of March 2004
Internet Citation:
Effects of Omega-3 Fatty Acids on Cardiovascular Disease. File Inventory, Evidence Report/Technology Assessment Number 94. AHRQ Publication No. 04-E009-2, March 2004. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/o3cvdinv.htm
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