Prepared by:
Tufts-New England Medical Center EPC
Boston, Massachusetts
Investigators
Ethan Balk, M.D., M.P.H., Project Leader
Mei Chung, M.P.H., Research Associate
Alice Lichtenstein, D.Sc., Primary Technical Expert
Priscilla Chew, M.P.H., Research Associate
Bruce Kupelnick, B.A., Research Associate
Amy Lawrence, M.A., Research Assistant
Deirdre DeVine, M.Litt., Project Manager
Joseph Lau, M.D., Principal Investigator
File Name Description Software Version File Size ________________________________________________________________________________________________ 01front.doc Microsoft Word® Document MS Word® 2002 87KB 17 pages Contents: Title Page, Preface, Acknowledgments, Technical Expert Panel, Structured Abstract, Table of Contents ________________________________________________________________________________________________ 02body.doc Microsoft Word® Document MS Word® 2002 6.0MB 165 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 United States population, based on analyses of a single 24-hour dietary recall of NHANES III data; Table 1.2. Mean, range, median, and standard error of the mean (SEM) of 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); Relationship of Dietary Fat and Cardiovascular Disease; Omega-3 Fatty Acids and Cardiovascular Disease Risk Factors; 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 (from USDA website http://www.nal.usda. gov/fnic/foodcomp, 2003); Association of Omega-3 Fatty Acid Intake and Tissue Levels; Chapter 2. Methods: Overview; Key Questions Addressed in this Report; Analytic Framework; Figure 1.2. Analytic framework for omega-3 fatty acid exposure and cardiovascular disease; Literature Search Strategy; Study Selection; Data Extraction Process; Meta-Regression; Grading Evidence; Reporting Results; Evidence and Summary Tables; Methodological Limitations; Chapter 3. Results: Summary of Studies Found; Table 3.1. Numbers of studies of omega-3 fatty acids and cardiovascular risk factors; Lipids: Total Cholesterol; Table 3.2. Effects of omega-3 fatty acids on total cholesterol (mg/dL) in randomized trials (6 weeks to 2 years); Lipids: Low Density Lipoprotein; Table 3.3. Effects of omega-3 fatty acids on low density lipoprotein (mg/dL) in randomized trials (6 weeks to 2 years); Lipids: High Density Lipoprotein; Table 3.4. Effects of omega-3 fatty acids on high density lipoprotein (mg/dL) in randomized trials (6 weeks to 2 years); Lipids: Triglycerides; Table 3.5. Effects of omega-3 fatty acids on triglycerides (mg/dL) in randomized trials (6 weeks to 2 years); Figure 3.1. Meta-regression of baseline triglyceride (Tg) level versus net change in Tg; Figure 3.2. Meta-regression of dose of EPA+DHA intake versus net change in triglycerides (Tg); Lipoprotein(a); Table 3.6. Effects of omega-3 fatty acids on lipoprotein (a) (mg/dL) in randomized trials (4 weeks to 14 months); Apolipoprotein A-I; Table 3.7. Effects of omega-3 fatty Acids on apolipoprotein A-I (mg/dL) in randomized trials (4 weeks to 2 years); Apolipoprotein B, Apolipoprotein B-100, and LDL Apolipoprotein B; Table 3.8. Effects of omega-3 fatty acids on apolipoprotein B (mg/dL) in randomized trials (4 weeks to 2 years); Table 3.9. Effects of omega-3 fatty acids on apolipoprotein B-100 and LDL apolipoprotein B (mg/dL) in randomized trials (1 month to 14 months); Blood Pressure; Table 3.10. Effects of omega-3 fatty acids on systolic blood pressure (mm Hg) in randomized trials of diabetic subjects (6 weeks to 1 year); Table 3.11. Effects of omega-3 fatty acids on diastolic blood pressure (mm Hg) in randomized trials of diabetic subjects (6 weeks to 1 year); Hemoglobin A1c; Table 3.12. Effects of omega-3 fatty acids on hemoglobin A1c (%) in randomized trials (4 weeks to 1 year); Fasting Blood Sugar; Table 3.13. Effects of omega-3 fatty acids on fasting blood sugar (mg/dL) in randomized trials (4 weeks to 2 years); Fasting Insulin; Table 3.14. Effects of omega-3 fatty acids on fasting insulin (pmol/L) in randomized trials (4 weeks to 9 months); C-Reactive Protein; Table 3.15. Effects of omega-3 fatty acids on C-reactive protein (mg/L) in studies (4 wk to 3 mo or cross-sectional); Fibrinogen; Table 3.16. Effects of omega-3 fatty acids on fibrinogen (g/L) in randomized trials (4 weeks to 2 years); Factor VII, Factor VIII, and von Willebrand Factor; Table 3.17. Effects of omega-3 fatty acids on factor VII activity (%) in randomized trials (4 weeks to 9 months); Table 3.18. Effects of omega-3 fatty acids on factor VIII activity (%) in randomized trials (6 weeks to 1 year); Table 3.19. Effects of omega-3 fatty acids on von Willebrand factor in randomized trials (4 weeks to 2 years); Platelet Aggregation; Table 3.20. Effects of omega-3 fatty acids on platelet aggregation in randomized trials (4 to 15 weeks); Coronary Artery Restenosis; Table 3.21. Effects of omega-3 fatty acids on restenosis in randomized trials (approximately 3 months to 1 year); Figure 3.3. Random effects model of effect of fish oil on coronary artery restenosis following percutaneous transluminal coronary angioplasty; Carotid Intima-Media Thickness; Table 3.22. Effects of omega-3 fatty acids on carotid intima-media thickness (mm) in studies (2 yr or cross-sectional); Exercise Tolerance Test; Table 3.23. Effects of omega-3 fatty acids on treadmill and bicycle exercise tolerance tests in studies (6 weeks-6 months); Heart Rate Variability; Table 3.24. Effects of omega-3 fatty acids on heart rate variability - SD of RR (msec) - in studies (12 weeks or cross-sectional); Tissue Levels of Dietary Omega-3 Fatty Acids; Table 3.25. Studies reporting plasma/serum, platelet, erythrocyte, and other phospholipid changes; Table 3.26. Association of EPA+DHA consumption and tissue levels. Meta-Regression Results; Table 3.27. Effect of omega-3 fatty acid supplementation on fatty acid profile of serum/plasma phospholipids in randomized trials (6 weeks to 14 months); Table 3.28. Effect of omega-3 fatty acid supplementation on fatty acid profile of platelet phospholipids in randomized trials (6 weeks to 4 months); Table 3.28. Effect of omega-3 fatty acid supplementation on fatty acid profile of platelet phospholipids in randomized trials (6 weeks to 4 months); Table 3.29. Effect of omega-3 fatty acid supplementation on fatty acid profile of red blood cell (erythrocyte) membrane/ghosts in randomized trials (6 weeks to 2 years); Table 3.30. Effect of omega-3 fatty acid supplementation on fatty acid profile of granulocyte membrane in randomized trials (12 weeks); Table 3.31. Effect of omega-3 fatty acid supplementation on fatty acid profile of monocyte phospholipids in randomized trials (8 weeks); Figure 3.4. Association between EPA and/or DHA supplementation and changes in EPA+DHA composition in plasma or serum phospholipids (PL); Figure 3.5. Association between EPA and/or DHA supplementation and changes in EPA+DHA composition in platelet phospholipids (PL); Figure 3.6. Association between EPA and/or DHA supplementation and changes in EPA+DHA composition in red blood cell (RBC, erythrocyte) membrane phospholipids (PL); Chapter 4. Discussion: Overview; Main Findings; Limitations; Future Research; References and Included Studies; Bibliography of Included Studies; Listing of Excluded Studies ________________________________________________________________________________________________ 03acro.doc Microsoft Word® Document MS Word® 2002 90KB 3 pages Contents: List of Acronyms/Abbreviations ________________________________________________________________________________________________
AHRQ Publication No. 04-E010-2
Current as of March 2004
Internet Citation:
Effects of Omega-3 Fatty Acids on Cardiovascular Risk Factors and Intermediate Markers of Cardiovascular Disease. File Inventory, Evidence Report/Technology Assessment Number 93. AHRQ Publication No. 04-E010-2, March 2004. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/o3cvrinv.htm
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