Home' Australian Pharmacist : Australian Pharmacist April 2013 Contents 54
Australian Pharmacist April 2013 I ©Pharmaceutical Society of Australia Ltd.
THE COMPLEMENTARY APPROACH
of fish oil in CV health’. The implications
of these two studies do emphasise the
importance of adequate QC/QA in the
preparation of high quality fish oil products.
Recent research has generally confirmed
the benefits to be enjoyed following
consumption of fish oil, especially over the
Overall cardioprotection is observed
following marked reductions in TG,
HDL-cholesterol, the TG-HDL-cholesterol
ratio, all-cause mortality and adverse
cardiac outcomes. Based on general
literature recommendations, a dose of 3 g
per day high quality fish oil, containing
approximately 18% EPA and 12% DHA,
would be adequate.9,22 Higher doses would
be required if concurrently treating arthritis
symptoms.19 However, daily doses in excess
of 3 g omega-3 FA may induce bleeding
in some consumers, especially those on
anticoagulant therapy, and should only be
taken in consultation with one’s physician.9
Consumption of fish oil, in company with
lifestyle changes, would seem to be the ideal
prescription for a longer, healthy life.
1. Burri L, Hoem N, Banni S, et al. Marine omega-3 phospholipids:
metabolism and biological activities. Int J Mol Sci 2012;13(11):15401–19.
2. Franzen-Castle LD, Ritter-Gooder P. Omega-3 and omega-6 fatty acids.
University of Nebraska NebGuide G2032. At: http://ianrpubs.unl.edu/
3. Omega 3. Heart Foundation. At: www.heartfoundation.org.au/healthy-
4. Longmore B. A potluck of herbs II: the feast continues. Aust Pharmacist
5. Adams M. Questioning krill harvesting: Why krill oil isn’t an eco-friendly
or sustainable source of marine omega-3 oils. At: www.naturalnews.
6. Scoles B. Is krill oil your best new source for omega-3s? 2011. At: http://
7. MacKee N. Study fires fatty acid debate. At: www.mjainsight.com.au/vie
8. Simopoulos AP. Omega-3 fatty acids in health and disease and in growth
and development. Am J Clin Nutr Sept 1991;54(3):438–63.
9. University of Maryland Center. Omega-3 fatty acids. At: www.umm .edu/
10. Shaikh SR. Biophysical and biochemical mechanisms by which dietary
N-3 polyunsaturated fatty acids from fish oil disrupt membrane lipid rafts.
J Nutr Biochem. 2012;23(2):101–05.
11. Lavelle P, McCredie J. Heart disease – ABC Health and Wellbeing. At: www.
12. Roth EM, Harris WS. Fish oil for primar y and secondary prevention of
coronar y heart disease. Curr Atheroscler Rep 2010;12(1):66–72.
13. Hill AM, Buckley JD, Murphy K J, et al. Combining fish oil supplements
with regular aerobic exercise improves body composition and
cardiovascular disease risk factors. Am J Clin Nutr 2007;85(5):1267–74.
14. Bjerregaard P, Mulvad G, Pedersen HS. Cardiovascular risk factors in Inuit of
Greenland. Int J Epidemiol 1997;26(6):1182–90.
15. Hara M, Sakata Y, Nakatani D, et al. Low levels of serum n-3
polyunsaturated fatty acids are associated with worst heart failure-
free survival in patients after acute myocardial infarction. Circ J
16. Massaro M, Scoditi E, Carluccio MA, et al. Omega-3 fatty acids,
inflammation and angiogenesis. Basic mechanisms behind the
cardioprotective effects of fish and fish oils. Cell Mol Biol 2010;56(1):59–82.
17. Jump DB, Depner CM, Tripathy S. Omega-3 fatty acid supplementation
and cardiovascular disease. J Lipid Res 2012;53(12):2525–45.
18. Skulas-Ray AC, Kris-Etherton PM, Harris WS, et al. Effects of marine-derived
omega-3 fatty acids on systemic hemodynamics at rest and during stress:
a dose-response study. Ann Behav Med 2012;44(3):301–08.
19. Cleland LG, Caughey GE, James MJ, et al. Reduction of cardiovascular risk
factors with longterm fish oil treatment in early rheumatoid arthritis. J
20. Moreira EL, de Oliviera J, Dutra MF, et al. Does methyl-mercury-induced
hypercholesterolemia play a causal role in its neurotoxicity and
cardiovascular disease? Toxicol Sci 2012;130(2):373–82.
21. Virtanen JK, Voutilainen S, Rissanen TH, et al. Mercury, fish oils and risk of
acute coronar y events and cardiovascular disease, coronary heart disease,
and all-cause mortality in men in eastern Finland. Arterioscler Thromb
Vasc Biol 2005;25(1):228–33.
22. Langton N. What is the correct amount of fish oil to take? Livestrong
Foundation. At: www.livestrong.com/article/276714-what-is-the-
Key learning points
• Heart disease is a major cause of death
• Consumption of fish oil has beneficial
effects on haematological profile, with
decrease in triglycerides, HDL-cholesterol
levels, and a potential decrease in heart
rate and blood pressure.
• EPA and DHA are the important fatty
acid components of fish oil, and active in
• EPA and DHA are important as
essential omega-3 fatty acids in brain
development, cardiovascular health and
• Adequate consumption of fish oil is
required to maintain useful blood levels
of EPA and DHA.
• Lifestyle changes including exercise,
cessation of smoking and adjustment of
diet are recommended in reducing the
risk of cardiovascular disease.
1. Which one of the following
statements is CORRECT?
a) Fish oils are an important source
of essential omega-6 fatty acids,
including arachidonic acid.
b) Certain food plant materials such
as walnuts, flaxseed and selected
dark green vegetables provide a
useful source of essential omega-3
c) Because fish oils are lower in the food
chain than krill, then there is less
chance of toxic contamination by
d) It is necessary to balance the intake of
essential fatty acids so as to increase
the relative level of omega-6 fatty
2. Which ONE of the following
statements about coronary heart
disease (CHD) is CORRECT?
a) While diet, exercise and smoking have
deleterious effects, nevertheless they
do reduce the incidence of stroke.
b) CHD is principally a problem of
coronary arterial blockage by
atherosclerotic plaques, reducing
blood supply to cardiac muscle.
c) At present, CVD is only a minor cause
of death in Australia, but may worsen
d) Mortality seems independent of
the presence of methyl mercury
contamination in fish oils.
3. Which ONE of the following
statements is CORRECT?
a) Fish oil consumption eliminates the
need for dietary change in treatment
of heart disease.
b) While having little effect on blood
pressure and heart rate, fish oils reduce
blood HDL-cholesterol levels and
increase triglyceride levels.
c) Fish oils have a cardioprotective
action by reducing blood triglyceride
levels, increasing HDL-cholesterol and
exhibiting anti-inflammatory effects.
d) Fish oils destabilise atherosclerotic
plaques, allowing their facile removal
by increased arterial blood flow.
4. Which of the following statements
is TRUE with regard to purity of
a) The presence of small amounts of
contaminants such as polychlorinated
biphenyls and methyl mercury has no
major effect on biological activity of
b) Because fish are lower than krill in the
marine food chain, they are less likely
to biomagnify toxic contaminants.
c) Fish oils should meet rigid quality
control requirements of absence of
d) The higher in the food chain the fish
source of fish oil is, the less chance
there is of toxic contamination.
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