Fight Inflammation & Aging with Omega-3

inflammation effects








Elderly and patients affected by chronic diseases face a high risk of muscle loss and impaired physical function. Omega 3 fatty acids (FA) attenuate inflammation and age-associated muscle loss, prevent systemic insulin resistance and improve plasma lipids, potentially impacting on sarcopenia. This paper aims to review recent randomized clinical studies assessing the effects a chronic omega 3 FA supplementation on inflammatory and metabolic profile during conditions characterized by sarcopenia (aging, insulin resistance, type 2 diabetes, chronic renal failure). A comprehensive search of three online databases was performed to identify eligible trials published between 2012 and 2017. A total of 36 studies met inclusion criteria. Omega 3 FA yielded mixed results on plasma triglycerides in the elderly and no effects in renal patients. No changes in systemic insulin resistance were observed. Inflammation markers did not benefit from omega 3 FA in insulin resistant and in renal subjects while decreasing in obese and elderly. Muscle related parameters improved in elderly and in renal patients. In conclusion, in aging- and in chronic disease-associated sarcopenia omega 3 FA are promising independently of associated anabolic stimuli or of anti-inflammatory effects. The evidence for improved glucose metabolism in insulin resistant and in chronic inflammatory states is less solid.

1. Introduction

Declined muscle mass, functional status and metabolic demand with advancing age are prevalent in chronic disease states including the metabolic syndrome, type 2 diabetes, cancer and chronic renal failure [1,2,3,4]. These conditions are characterized by the activation of common pathways, which ultimately induce loss of muscle mass either because of blunted muscle protein synthesis or because of accelerated protein breakdown. Systemic low-grade inflammation, which characterizes disease- and age-related muscle decline induces muscle wasting by the activation of multiple pathways [5]. In addition, inflammation-induced insulin resistance may accentuate the metabolic dysfunction in skeletal muscle in the presence of preexisting type 2 diabetes mellitus (T2DM) [6]. Given that skeletal muscle accounts for up to 40% of total body mass, a significant change in its metabolic function may significantly impact systemic glucose disposal. Finally, excess oxidative damage, which is usually associated with inflammation may induce accumulation of dysfunctional proteins and DNA damage in muscle [7].

Interventions targeted at the correction of the aberrant activation of these pathways are therefore likely to preserve muscle mass and function resulting in improved systemic homeostasis, lifespan and progression of chronic age-related diseases. Clinical studies have shown that in humans specific nutrients can mechanistically interfere with the processes associated with muscle deterioration during aging and chronic diseases. In human and animal studies, omega 3 fatty acids (omega 3 FA) suppress muscle protein degradation [8], enhance the rate of muscle protein synthesis in response to anabolic stimuli (feeding or physical exercise) [9,10], quench systemic oxidative stress and inflammation [11,12], and improve insulin sensitivity and lipid profile [13]. Despite this evidence, results of clinical studies addressing the beneficial effects of omega 3 to counteract muscle mass decline are less clear-cut.

Therefore, the aim of the current work is to review and discuss the findings from the most recent human studies to determine the effects of omega 3 FA on significant determinants of muscle mass and function, systemic inflammation, metabolic and lipid profile in age-associated chronic diseases as compared to healthy individuals.

2. Results

2.1. Metabolic and Lipid Profile in Healthy, Elderly and Chronic Renal Failure

In healthy subjects, omega 3 supplementation resulted in divergent effects on glucose and lipid reduction depending on the dose of eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA). Short term supplementation (6 weeks) of different doses omega 3 (600 mg of EPA or 1800 mg EPA or 600 mg DHA daily) was provided to 121 healthy individuals randomly allocated to a 1:1:1:1 ratio, and was compared with an olive oil treatment [14]. Main results from the pairwise placebo comparison suggest that only DHA supplementation significantly affected metabolic profile, reducing post prandial triglyceride (TG) concentration by −52.2 mg/dL (−99.3, −5.0), equal to a −20.0% (−38.7, −1.4) reduction (p < 0.05). DHA also increased postprandial LDL levels by 18.5 mg/dL (10.0, 27.0) (p < 0.01) and postprandial total cholesterol (TC) by 10.9 mg/dL (0.8, 21.0) (p < 0.05. EPA affected metabolic profile only when administered at high dose of 1800 mg, reducing both fasting and post prandial triglyceride-rich lipoprotein (TRL) concentration when expressed as percentage of difference from baseline, respectively by −14.6% (−27.0, −2.2) and −12.6% (−25.2, 0) (p < 0.05) [14]. A study in obese women receiving 360 mg EPA and 1290 mg DHA compared with placebo for 3 months, found reduced triglyceride-rich-lipoprotein levels from 1.48 ± 0.61 mmol/L to 1.22 ± 0.45 mmol/L (p < 0.01), and reduced insulin concentration from 16.10 ± 5.44 µIU/mL to 14.15 ± 4.37 µIU/mL (p < 0.05). No effect was seen on TC, high density lipoproteins (HDL), low density lipoproteins (LDL) and fasting blood glucose (FBG) [15].

In the elderly omega 3 supplementation showed contrasting results on metabolic profile. Twenty-four elderly women received 360 mg EPA and 1290 mg DHA daily for 12 weeks, or placebo. Omega 3 treatment reduced TG concentration from 1.30 ± 0.14 to 1.01 ± 0.14 mmol/L (−29%) (p < 0.01), while compared with no effects observed in the placebo group [16]. No effects were observed on plasma insulin or FBG. Conversely, a 1860 mg EPA and 1500 mg DHA daily supplementation for 6 months was not effective in lowering TG, HDL, LDL and FBG, in healthy elderly [17]. Fish oil administration was also evaluated with or without vitamin E (vit E) supplementation, and compared to placebo. Seventy-four women transitioning through menopause received 540 mg EPA and 360 mg DHA daily, with or without addition of 400 mg vit E, or a placebo treatment for 3 months. Results indicated a decrease in TC (−5.4% for fish oil only, −7.5% for fish oil and vit E) and LDL concentration (−8.4% for fish oil only, −7.3% for fish oil and vit E) [18].

Omega 3 supplementation in end-stage renal disease on hemodialysis has been evaluated in different studies. Fifty-two patients received for 6 months 340 mg EPA and 360 mg DHA daily, or a placebo [19]. TC, LDL, TG, serum albumin and urea were unchanged after treatment in both groups [19]. The same data were confirmed in another study, using the same supplementation protocol [20]. In contrast, a different study, assessing the effects of 1080 mg EPA and 720 mg DHA daily compared to placebo for 4 months, demonstrated decreased HDL from 48.47 ± 18.52 to 33.58 ± 7.82 mg/dL (p < 0.01) in the omega 3 treatment group [21]. In this group authors also found decreased TC from 167.4 ± 46.4 to 156.3 ± 57.9 mg/dL (p < 0.05), while post-treatment TG values were not significantly different from baseline, although lower than in placebo group by −29.11 mg/dL (p < 0.05). No difference was observed in FBG, LDL, homeosis model assessment insulin resistance (HOMA-IR), insulin, leptin or adiponectin [21]. No effects of higher doses of omega 3 FA (1914 mg EPA and 957 mg DHA daily supplementation compared to placebo for 12 weeks), were also observed for FBG level and HOMA-IR [22]. A small dose of omega 3, consisting in 80 mg EPA and 120 mg DHA daily for 10 weeks, was compared with a placebo condition using vit E [23]. TC was found to be significantly decreased (p < 0.05) in both the treatment and the placebo group, with no significant difference between groups. No effect or difference was found in TG, HDL or LDL [23]. These results have been partly confirmed also in chronic ambulatory peritoneal dialysis (CAPD) patients using a low dose of omega 3 (540 mg EPA and 360 mg DHA daily for 8 weeks), in which no effect of treatment was found on serum TG, TC, HDL and LDL concentration [24,25]. Results are summarized in Table 1.

2.2. Metabolic and Lipid Profile in Impaired Glucose Metabolism (IGM) and T2DM

Impaired glucose metabolism (IGM) patients with coronary artery disease received 1800 mg EPA daily compared with placebo treatment for 6 months [27]. Results indicate an increase in HDL concentration by 2.0 mg/dL (−3.0, 8.0) (p = 0.05), and a decrease in fasting TG by −24.0 mg/dL (−54.0, −3.0) (p < 0.01) after omega 3 supplementation No effect was found for TC, LDL, HOMA-IR, Hb1Ac and FBG [27]. A higher dose including also DHA, consisting in 2388 mg EPA and 1530 mg DHA, was given daily to IGM patients for 9 months, and compared to placebo [28]. Despite the higher dose, no effect was found on FBG, fasting EGB, insulin concentration, HOMA-IR during hyperinsulinaemic-euglycemic-euaminoacidaemic clamp. Nevertheless, omega 3 treatment increased total protein disposal by 9.6% and endogenous whole-body protein turnover by 10.4% under insulin-stimulated conditions (p < 0.01).

In T2DM, supplementation of 1000 mg EPA and 1000 mg DHA daily for 3 months was compared with a placebo group [29]. No effects were seen on insulin concentration, HbA1c, C peptide, TC, LDL, HDL, leptin and adiponectin. At baseline, omega 3 group showed significantly higher TG levels than placebo, and those levels decreased after treatment from 1.79 mmol/L (1.8, 2.41) to 1.48 mmol/L (0.91, 2.08) although without reaching significant difference from placebo group [29]. Higher doses of EPA, consisting in 1548 mg EPA and 828 mg DHA daily for 2 months, compared to placebo, decreased HbA1c from 7.90 ± 0.2% to 7.25 ± 0.17% (p < 0.01), while in the placebo group HbA1c increased (p < 0.05) [30]. In another study, a dose of 1240 mg EPA and 840 mg DHA daily for 10 weeks, decreased retinol binding protein 4 by −10.85 ± 1.62 μg/mL (p < 0.01) compared with placebo [31]. Omega 3 treatment (750 mg EPA and 2000 mg DHA) has been also associated with or without 15 mg pioglitazone (Pio) daily for 24 weeks [32]. HbA1c decreased significantly (p < 0.05) after omega 3 treatment by −7 mmol/mol (1, 13) compared with placebo and Pio groups (p < 0.05). In contrast, FBG increased after omega 3 treatment by 1.07 mmol/L (0.18, 2.02), but it was significantly different only from Pio (p < 0.05). No difference was observed in TC, HDL, LDL, NEFA, leptin, adiponectin or TG in none of the groups [32]. Diabetic patients with non-alcoholic steatohepatitis received 2160 mg EPA and 1440 mg DHA daily, or placebo, for 48 weeks [33]. Compared to baseline levels, FBG and HOMA-IR increased in omega 3 treatment (from 129.9 ± 36.5 to 150.4 ± 43.7 mg/dL and from 12.0 ± 6.8 to 16.1 ± 10.3 respectively, p < 0.05), with no effect in the placebo group. HbA1c also tended to increase from 6.7 ± 0.9 to 7.5 ± 2.2 (p = 0.059). No difference was found in TG, TC, and HDL [33].

Patients with T2DM or metabolic syndrome participated to a study investigating omega 3 treatment with 3580 mg EPA and 2440 mg DHA daily, botanical oil, or corn oil for 8 weeks [34]. Omega 3 supplementation increased HDL from 40.7 ± 2.8 to 43.6 ± 2.8 mg/dL (p < 0.01), decreased TG from 187.2 ± 22.0 to 156.8 ± 14.7 mg/dL (p < 0.05), increased insulin from 19.1 ± 4.5 to 24.6 ± 6.8 mg/dL (p < 0.05), and slightly reduced HbA1c from 7.42 ± 0.33 to 7.20 ± 0.32 (p = 0.05). No effect was found on TC, LDL, leptin, FBG, and HOMA-IR [34]. Treatment of metabolic syndrome patients with 1800 mg EPA and 1200 mg DHA daily was also associated with or without 10 mL of extra virgin oil for 90 days [35]. Omega 3 treatment without olive oil had no effect on TG, TC, HDL, LDL, FBG, insulin and HOMA-IR; nevertheless, in association with olive oil it reduced TC and LDL (p < 0.05) [35]. Omega 3 supplementation of 1800 mg EPA and 1200 mg DHA was also associated with or without 29 g of kinako or placebo for 90 days, finding decreased TG, increased TC, LDL, FBG, fasting insulin, and HOMA-IR, with no effect on HDL [36]. Results are summarized in Table 2.

2.3. Inflammation and Oxidative Stress in in Healthy, Elderly and Chronic Renal Failure

In healthy individuals, 6 week omega 3 daily supplementation with 600 mg EPA or 1800 mg EPA or 600 mg DHA was compared with placebo [14]. Among the inflammatory markers, only Lp-PLA2 concentration was reduced by EPA in a dose-dependent manner with a non significant decrease of −13.0 ng/mL (−28.3, 2.2) compared with placebo in the low dose treatment, and −21.4 ng/mL (−34.9, −7.8) in the high dose treatment (p < 0.05 vs. placebo), while no effect was seen in the DHA or placebo groups. Other inflammatory markers as hsCRP, TNF-α, IL-6, VCAM-1, ICAM-1 and fibrinogen were unaffected by the dose or type of treatment [14]. Compared to placebo, administration of 1000 mg EPA and 400 mg DHA daily for 18 weeks failed to demonstrate any effect on inflammatory status expressed as hsCRP and IL-6 concentrations in a healthy population, although hsCRP levels at baseline were significantly higher in the omega 3 group than in placebo [37]. Again, different doses of combined EPA and DHA (i.e., 300, 600, 900 and 1800 mg daily for 5 months in healthy individuals) did not result in any difference from placebo or in a dose-response effect on IL-6, TNF-α and CRP levels [38]. In another study, obese women received 360 mg EPA and 1290 mg DHA daily for 3 months [15]. Compared with placebo, reduced sVCAM-1 (from 576.86 ± 114.59 to 553.36 ± 130.25 ng/mL, p < 0.01), sPECAM-1 (from 71.25 ± 12.11 to 65.27 ± 8.99 ng/mL, p < 0.01), and hsCRP (from 3.16 ± 1.99 to 2.52 ± 1.57 mg/mL, p < 0.05) were observed in the treatment group. Difference was not significant between post treatment effect compared with placebo, or in IL-6 [15].

Elderly individuals with mild cognitive impairment received either 720 mg EPA and 480 mg DHA daily for 6 months, or placebo [39]. Compared to placebo, the treatment group showed reduced levels of IL-6 (−34.94 ± 46.18 pg/mL, p < 0.05), TNFα (−5.91 ± 9.03 fmol/mL, p < 0.05), and a tendency for reduced sPLA2 (−113.58 ± 249.81 ng/L, p = 0.052). No significant difference was observed in IL-10, COX and LOX [39]. Oxidative stress was studied in women transitioning through menopause receiving 540 mg EPA and 360 mg DHA daily, with or without addition of 400 mg vit E, or a placebo treatment for 3 months. Following EPA and DHA supplementation TBARS levels increased by 0.05 ± 0.01 μg/L, compared with both placebo (p < 0.01) and EPA and DHA with vit E (p < 0.05) [18].

In hemodialysis patients receiving for 6 months 340 mg EPA and 360 mg DHA daily, or a placebo, active treatment decreased vascular cell adhesion molecule (VCAM) from 34.1 ± 31.4 U/mL to 21.3 ± 12.9 U/mL (p < 0.05), while no effects where seen in the placebo group or in ICAM values [19]. In patients receiving 1080 mg EPA and 720 mg DHA daily, compared with placebo for 4 months, no effect was observed on CRP levels [21]. Similarly, no effect on hsCRP and IL-6 were observed in hemodialysis patients receiving higher dose of omega 3 (1914 mg EPA and 957 mg DHA daily), compared with placebo for 12 weeks [22]. Conversely, some effects on inflammatory status were observed in patients treated with 1080 mg EPA and 720 mg DHA daily, compared with placebo, for 4 months [40]. Authors found increased IL-10/IL-6 (by 0.64 ± 1.14 respect to baseline p < 0.01 and to placebo p < 0.05). IL-6 levels were reduced respect to baseline (by −7.53 ± 126.01, p < 0.05), but no difference was observed compared with placebo. No difference was observed respect to baseline or placebo in TNFα, IL-10 and CRP [41]. When omega 3 treatment with 1600 mg EPA and 300 mg DHA was associated with or without 400 IU of α-tocopherol, and compared with placebo for 12 weeks, increased plasma nitric oxide (+31.0 ± 40.0 µmol/L, p < 0.01), and increased total antioxidant capacity (TAC) (+57.6 ± 157.8 mmol/L, p < 0.01) were observed. No effect was seen on hsCRP and glutathione (GSH), while albumin and malnonyldialdehyde (MDA) levels where changed only when EPA and DHA were associated with α-tocopherol [42]. Omega 3 treatment in chronic kidney disease patients with 1840 mg EPA and 1520 mg DHA daily was also associated with or without 200 mg coenzyme Q10 (CoQ) for 8 weeks, and compared to placebo [43]. Oxidative stress was determined by F2-isoprostanes, whose values were reduced after omega 3 treatment (from 1714 to 1215 pmol/L, p < 0.01), with no effect of CoQ and no significant changes in placebo. No effect was seen on hsCRP concentration [43]. Moreover, no effect in inflammatory status, determined with CRP and IL-6, or oxidative stress, expressed as superoxide dismutase (SOD) and GSH, was observed in CAPD patients receiving 540 mg EPA and 360 mg DHA daily for 8 weeks/2 months compared to placebo [24,25]. Results are summarized in Table 3.

2.4. Inflammation and Oxidative Stress in IGM, Diabetes, and Metabolic Syndrome

Patients with IGM allocated either to treatment with 1800 mg EPA daily or to placebo for 3 months, presented in the omega 3 group reduced hsCRP concentrations compared to baseline of −0.01 mg/dL (−0.08, 0.00) (p < 0.01), although the same effect was observed also in the placebo group [27]. No effect on inflammatory status, expressed as IL-1β, IL-6 and hsCRP, was observed with a higher dose of omega 3 consisting in 2388 mg EPA and 1530 mg DHA daily compared to placebo for 9 months [28].

In T2DM, 1000 mg EPA and 1000 mg DHA daily, compared to placebo for 3 months, did not affect systemic inflammatory status determined by hsCRP, IL-6, and TNFα [29]. Omega 3 treatment effect was also evaluated with separated doses of 1000 mg EPA or 1000 mg DHA daily, and compared with placebo, for 12 weeks [44]. Neither EPA nor DHA significantly affected systemic inflammatory status (determined by CRP) and oxidative stress (determined by MDA) in type 1 diabetes (T1DM) patients. However, MDA increased in the placebo group, and omega 3 may help preventing MDA increase [44]. These results confirm a previous study in which patients received 900 mg EPA daily for 12 weeks and were compared to placebo, showing no effect of treatment in none of the inflammatory markers (i.e., CRP, IL-6 and TNFα) and on oxidative stress (expressed by reactive oxygen species, MDA, GSSG/GSH and SOD [45]. Omega 3 treatment with 750 mg EPA and 2000 mg DHA daily was also associated with or without 15 mg pioglitazone (Pio) for 24 weeks and compared to placebo; none of the treatments showed any effect on oxidative stress expressed by superoxide dismutase activity, TBARS and GSSG/GSH [32].

Similarly, patients with metabolic syndrome receiving 800 mg EPA and 1200 mg DHA daily with or without the addition of 10 mL extra virgin oil for 90 days showed no effect on CRP levels and oxidative stress markers when compared with placebo [35]. Results are summarized in Table 4.


1. Sinclair A.J., Abdelhafiz A.H., Rodriguez-Manas L. Frailty and sarcopenia—Newly emerging and high impact complications of diabetes. J. Diabetes Complicat. 2017;31:1465–1473. doi: 10.1016/j.jdiacomp.2017.05.003. [PubMed] [Cross Ref]
2. Chow L.S., Nair K.S. Sarcopenia of male aging. Endocrinol. Metab. Clin. N. Am. 2005;34:833–852. doi: 10.1016/j.ecl.2005.07.007. [PubMed] [Cross Ref]
3. Johns N., Stephens N.A., Fearon K.C.H. Muscle wasting in cancer. Int. J. Biochem. Cell Biol. 2013;45:2215–2229. doi: 10.1016/j.biocel.2013.05.032. [PubMed] [Cross Ref]
4. Cohen S., Nathan J.A., Goldberg A.L. Muscle wasting in disease: Molecular mechanisms and promising therapies. Nat. Rev. Drug Discov. 2015;14:58–74. doi: 10.1038/nrd4467. [PubMed] [Cross Ref]
5. Jo E., Lee S.-R., Park B.-S., Kim J.-S. Potential mechanisms underlying the role of chronic inflammation in age-related muscle wasting. Aging Clin. Exp. Res. 2012;24:412–422. doi: 10.3275/8464. [PubMed][Cross Ref]
6. Wu H., Ballantyne C.M. Skeletal muscle inflammation and insulin resistance in obesity. J. Clin. Investig. 2017;127:43–54. doi: 10.1172/JCI88880. [PMC free article] [PubMed] [Cross Ref]
7. Jackson M.J. Reactive oxygen species in sarcopenia: Should we focus on excess oxidative damage or defective redox signalling? Mol. Asp. Med. 2016;50:33–40. doi: 10.1016/j.mam.2016.05.002. [PubMed][Cross Ref]
8. Oh S.-L., Lee S.-R., Kim J.-S. Effects of conjugated linoleic acid/n-3 and resistance training on muscle quality and expression of atrophy-related ubiquitin ligases in middle-aged mice with high-fat dietinduced obesity. J. Exerc. Nutr. Biochem. 2017;21:11–18. doi: 10.20463/jenb.2017.0028. [PMC free article][PubMed] [Cross Ref]
9. Smith G.I., Atherton P., Reeds D.N., Mohammed B.S., Rankin D., Rennie M.J., Mittendorfer B. Omega-3 polyunsaturated fatty acids augment the muscle protein anabolic response to hyperinsulinaemia-hyperaminoacidaemia in healthy young and middle-aged men and women. Clin. Sci. 2011;121:267–278. doi: 10.1042/CS20100597. [PMC free article] [PubMed] [Cross Ref]
10. Di Girolamo F.G., Situlin R., Mazzucco S., Valentini R., Toigo G., Biolo G. Omega-3 fatty acids and protein metabolism: Enhancement of anabolic interventions for sarcopenia. Curr. Opin. Clin. Nutr. Metab. Care. 2014;17:145–150. doi: 10.1097/MCO.0000000000000032. [PubMed] [Cross Ref]
11. Farias J.G., Molina V.M., Carrasco R.A., Zepeda A.B., Figueroa E., Letelier P., Castillo R.L. Antioxidant Therapeutic Strategies for Cardiovascular Conditions Associated with Oxidative Stress. Nutrients. 2017;9 doi: 10.3390/nu9090966. [PMC free article] [PubMed] [Cross Ref]
12. Calder P.C. Omega-3 fatty acids and inflammatory processes: From molecules to man. Biochem. Soc. Trans. 2017;45:1105–1115. doi: 10.1042/BST20160474. [PubMed] [Cross Ref]
13. Lucero D., Olano C., Bursztyn M., Morales C., Stranges A., Friedman S., Macri E.V., Schreier L., Zago V. Supplementation with n-3, n-6, n-9 fatty acids in an insulin-resistance animal model: Does it improve VLDL quality? Food Funct. 2017;8:2053–2061. doi: 10.1039/C7FO00252A. [PubMed] [Cross Ref]
14. Asztalos I.B., Gleason J.A., Sever S., Gedik R., Asztalos B.F., Horvath K.V., Dansinger M.L., Lamon-Fava S., Schaefer E.J. Effects of eicosapentaenoic acid and docosahexaenoic acid on cardiovascular disease risk factors: A randomized clinical trial. Metabolism. 2016;65:1636–1645. doi: 10.1016/j.metabol.2016.07.010. [PubMed] [Cross Ref]
15. Polus A., Zapala B., Razny U., Gielicz A., Kiec-Wilk B., Malczewska-Malec M., Sanak M., Childs C.E., Calder P.C., Dembinska-Kiec A. Omega-3 fatty acid supplementation influences the whole blood transcriptome in women with obesity, associated with pro-resolving lipid mediator production. Biochim. Biophys. Acta. 2016;1861:1746–1755. doi: 10.1016/j.bbalip.2016.08.005. [PubMed] [Cross Ref]
16. Logan S.L., Spriet L.L. Omega-3 Fatty Acid Supplementation for 12 Weeks Increases Resting and Exercise Metabolic Rate in Healthy Community-Dwelling Older Females. PLoS ONE. 2015;10:e0144828 doi: 10.1371/journal.pone.0144828. [PMC free article] [PubMed] [Cross Ref]
17. Smith G.I., Julliand S., Reeds D.N., Sinacore D.R., Klein S., Mittendorfer B. Fish oil-derived n-3 PUFA therapy increases muscle mass and function in healthy older adults. Am. J. Clin. Nutr. 2015;102:115–122. doi: 10.3945/ajcn.114.105833. [PMC free article] [PubMed] [Cross Ref]
18. Alves Luzia L., Mendes Aldrighi J., Teixeira Damasceno N.R., Rodrigues Sampaio G., Aparecida Manolio Soares R., Tande Silva I., De Queiroz Mello A.P., Ferreira Carioca A.A., Ferraz da Silva Torres E.A. Fish oil and vitamin e change lipid profiles and anti-LDL-antibodies in two different ethnic groups of women transitioning through menopause. Nutr. Hosp. 2015;32:165–174. doi: 10.3305/nh.2015.32.1.9079.[PubMed] [Cross Ref]
19. Moeinzadeh F., Shahidi S., Mortazavi M., Dolatkhah S., Kajbaf M., Haghjooy Javanmard S., Moghtaderi A. Effects of Omega-3 Fatty Acid Supplementation on Serum Biomarkers, Inflammatory Agents, and Quality of Life of Patients on Hemodialysis. Iran. J. Kidney Dis. 2016;10:381–387. [PubMed]
20. Kajbaf M.H., Khorvash F., Mortazavi M., Shahidi S., Moeinzadeh F., Farajzadegan Z., Tirani S.A. Does Omega-3 supplementation decrease carotid intima-media thickening in hemodialysis patients? J. Res. Pharm. Pract. 2016;5:252–256. doi: 10.4103/2279-042X.192451. [PMC free article] [PubMed] [Cross Ref]
21. Gharekhani A., Dashti-Khavidaki S., Lessan-Pezeshki M., Khatami M.-R. Potential Effects of Omega-3 Fatty Acids on Insulin Resistance and Lipid Profile in Maintenance Hemodialysis Patients: A Randomized Placebo-Controlled Trial. Iran. J. Kidney Dis. 2016;10:310–318. [PubMed]
22. Deger S.M., Hung A.M., Ellis C.D., Booker C., Bian A., Chen G., Abumrad N.N., Ikizler T.A. High Dose Omega-3 Fatty Acid Administration and Skeletal Muscle Protein Turnover in Maintenance Hemodialysis Patients. Clin. J. Am. Soc. Nephrol. 2016;11:1227–1235. doi: 10.2215/CJN.04150415.[PMC free article] [PubMed] [Cross Ref]
23. Omrani H.R., Pasdar Y., Raisi D., Najafi F., Esfandiari A. The effect of omega-3 on serum lipid profile in hemodialysis patients. J. Ren. Inj. Prev. 2015;4:68–72. doi: 10.12861/jrip.2015.14. [PMC free article][PubMed] [Cross Ref]
24. Naini A.E., Asiabi R.E.K., Keivandarian N., Moeinzadeh F. Effect of omega-3 supplementation on inflammatory parameters in patients on chronic ambulatory peritoneal dialysis. Adv. Biomed. Res. 2015;4:167. doi: 10.4103/2277-9175.162544. [PMC free article] [PubMed] [Cross Ref]
25. Taheri S., Keyvandarian N., Moeinzadeh F., Mortazavi M., Naini A.E. The effect of omega-3 fatty acid supplementation on oxidative stress in continuous ambulatory peritoneal dialysis patients. Adv. Biomed. Res. 2014;3:143. doi: 10.4103/2277-9175.135160. [PMC free article] [PubMed] [Cross Ref]
26. Naini A.E., Keyvandarian N., Mortazavi M., Taheri S., Hosseini S.M. Effect of Omega-3 fatty acids on blood pressure and serum lipids in continuous ambulatory peritoneal dialysis patients. J. Res. Pharm. Pract. 2015;4:135–141. doi: 10.4103/2279-042X.162356. [PMC free article] [PubMed] [Cross Ref]
27. Sawada T., Tsubata H., Hashimoto N., Takabe M., Miyata T., Aoki K., Yamashita S., Oishi S., Osue T., Yokoi K., et al. Effects of 6-month eicosapentaenoic acid treatment on postprandial hyperglycemia, hyperlipidemia, insulin secretion ability, and concomitant endothelial dysfunction among newly-diagnosed impaired glucose metabolism patients with coronary artery disease. A. Cardiovasc. Diabetol. 2016;15:121. doi: 10.1186/s12933-016-0437-y. [PMC free article] [PubMed] [Cross Ref]
28. Clark L.F., Thivierge M.C., Kidd C.A., McGeoch S.C., Abraham P., Pearson D.W.M., Horgan G.W., Holtrop G., Thies F., Lobley G.E. Fish oil supplemented for 9 months does not improve glycaemic control or insulin sensitivity in subjects with impaired glucose regulation: A parallel randomised controlled trial. Br. J. Nutr. 2016;115:75–86. doi: 10.1017/S0007114515004274. [PubMed] [Cross Ref]
29. Poreba M., Mostowik M., Siniarski A., Golebiowska-Wiatrak R., Malinowski K.P., Haberka M., Konduracka E., Nessler J., Undas A., Gajos G. Treatment with high-dose n-3 PUFAs has no effect on platelet function, coagulation, metabolic status or inflammation in patients with atherosclerosis and type 2 diabetes. Cardiovasc. Diabetol. 2017;16:50. doi: 10.1186/s12933-017-0523-9. [PMC free article][PubMed] [Cross Ref]
30. Toorang F., Djazayery A., Djalali M. Effects of Omega-3 Fatty Acids Supplement on Antioxidant Enzymes Activity in Type 2 Diabetic Patients. Iran. J. Public Health. 2016;45:340–345. [PMC free article][PubMed]
31. Farahbakhsh-Farsi P., Djazayery A., Eshraghian M.R., Koohdani F., Zarei M., Javanbakht M.H., Derakhshanian H., Djalali M. Effect of Omega-3 Supplementation on Lipocalin 2 and Retinol-Binding Protein 4 in Type 2 Diabetic Patients. Iran. J. Public Health. 2016;45:179–185. [PMC free article][PubMed]
32. Veleba J., Kopecky J.J., Janovska P., Kuda O., Horakova O., Malinska H., Kazdova L., Oliyarnyk O., Skop V., Trnovska J., et al. Combined intervention with pioglitazone and n-3 fatty acids in metformin-treated type 2 diabetic patients: Improvement of lipid metabolism. Nutr. Metab. 2015;12:52. doi: 10.1186/s12986-015-0047-9. [PMC free article] [PubMed] [Cross Ref]
33. Dasarathy S., Dasarathy J., Khiyami A., Yerian L., Hawkins C., Sargent R., McCullough A.J. Double-blind randomized placebo-controlled clinical trial of omega 3 fatty acids for the treatment of diabetic patients with nonalcoholic steatohepatitis. J. Clin. Gastroenterol. 2015;49:137–144. doi: 10.1097/MCG.0000000000000099. [PMC free article] [PubMed] [Cross Ref]
34. Lee T.C., Ivester P., Hester A.G., Sergeant S., Case L.D., Morgan T., Kouba E.O., Chilton F.H. The impact of polyunsaturated fatty acid-based dietary supplements on disease biomarkers in a metabolic syndrome/diabetes population. Lipids Health Dis. 2014;13:196. doi: 10.1186/1476-511X-13-196.[PMC free article] [PubMed] [Cross Ref]
35. Venturini D., Simao A.N.C., Urbano M.R., Dichi I. Effects of extra virgin olive oil and fish oil on lipid profile and oxidative stress in patients with metabolic syndrome. Nutrition. 2015;31:834–840. doi: 10.1016/j.nut.2014.12.016. [PubMed] [Cross Ref]
36. Simao A.N.C., Lozovoy M.A.B., Dichi I. Effect of soy product kinako and fish oil on serum lipids and glucose metabolism in women with metabolic syndrome. Nutrition. 2014;30:112–115. doi: 10.1016/j.nut.2013.05.024. [PubMed] [Cross Ref]
37. Muldoon M.F., Laderian B., Kuan D.C.H., Sereika S.M., Marsland A.L., Manuck S.B. Fish oil supplementation does not lower C-reactive protein or interleukin-6 levels in healthy adults. J. Intern. Med. 2016;279:98–109. doi: 10.1111/joim.12442. [PMC free article] [PubMed] [Cross Ref]
38. Flock M.R., Skulas-Ray A.C., Harris W.S., Gaugler T.L., Fleming J.A., Kris-Etherton P.M. Effects of supplemental long-chain omega-3 fatty acids and erythrocyte membrane fatty acid content on circulating inflammatory markers in a randomized controlled trial of healthy adults. Prostaglandins Leukot. Essent. Fatty Acids. 2014;91:161–168. doi: 10.1016/j.plefa.2014.07.006. [PMC free article] [PubMed] [Cross Ref]
39. Bo Y., Zhang X., Wang Y., You J., Cui H., Zhu Y., Pang W., Liu W., Jiang Y., Lu Q. The n-3 Polyunsaturated Fatty Acids Supplementation Improved the Cognitive Function in the Chinese Elderly with Mild Cognitive Impairment: A Double-Blind Randomized Controlled Trial. Nutrients. 2017;9 doi: 10.3390/nu9010054. [PMC free article] [PubMed] [Cross Ref]
40. Gharekhani A., Khatami M.-R., Dashti-Khavidaki S., Razeghi E., Noorbala A.-A., Hashemi-Nazari S.-S., Mansournia M.-A. The effect of omega-3 fatty acids on depressive symptoms and inflammatory markers in maintenance hemodialysis patients: A randomized, placebo-controlled clinical trial. Eur. J. Clin. Pharmacol. 2014;70:655–665. doi: 10.1007/s00228-014-1666-1. [PubMed] [Cross Ref]
41. Gharekhani A., Khatami M.-R., Dashti-Khavidaki S., Razeghi E., Abdollahi A., Hashemi-Nazari S.-S., Mansournia M.-A. Potential effects of omega-3 fatty acids on anemia and inflammatory markers in maintenance hemodialysis patients. DARU J. Pharm. Sci. 2014;22:11. doi: 10.1186/2008-2231-22-11.[PMC free article] [PubMed] [Cross Ref]
42. Asemi Z., Soleimani A., Shakeri H., Mazroii N., Esmaillzadeh A. Effects of omega-3 fatty acid plus alpha-tocopherol supplementation on malnutrition-inflammation score, biomarkers of inflammation and oxidative stress in chronic hemodialysis patients. Int. Urol. Nephrol. 2016;48:1887–1895. doi: 10.1007/s11255-016-1399-4. [PubMed] [Cross Ref]
43. Barden A., O’Callaghan N., Burke V., Mas E., Beilin L.J., Fenech M., Irish A.B., Watts G.F., Puddey I.B., Huang R.-C., et al. n-3 Fatty Acid Supplementation and Leukocyte Telomere Length in Patients with Chronic Kidney Disease. Nutrients. 2016;8:175 doi: 10.3390/nu8030175. [PMC free article] [PubMed][Cross Ref]
44. Azizi-Soleiman F., Jazayeri S., Eghtesadi S., Rajab A., Heidari I., Vafa M.R., Gohari M.R. Effects of pure eicosapentaenoic and docosahexaenoic acids on oxidative stress, inflammation and body fat mass in patients with type 2 diabetes. Int. J. Prev. Med. 2013;4:922–928. [PMC free article] [PubMed]
45. Mocking R.J.T., Assies J., Bot M., Jansen E.H.J.M., Schene A.H., Pouwer F. Biological effects of add-on eicosapentaenoic acid supplementation in diabetes mellitus and co-morbid depression: A randomized controlled trial. PLoS ONE. 2012;7:e49431 doi: 10.1371/journal.pone.0049431. [PMC free article][PubMed] [Cross Ref]
46. Bostock E.L., Morse C.I., Winwood K., McEwan I.M., Onambele G.L. Omega-3 Fatty Acids and Vitamin D in Immobilisation: Part B- Modulation of Muscle Functional, Vascular and Activation Profiles. J. Nutr. Health Aging. 2017;21:59–66. doi: 10.1007/s12603-016-0711-4. [PMC free article] [PubMed][Cross Ref]
47. Bostock E.L., Morse C.I., Winwood K., McEwan I.M., Onambélé-Pearson G.L. Omega-3 fatty acids and vitamin D in immobilisation: Part A—Modulation of appendicular mass content, composition and structure. J. Nutr. Health Aging. 2017;21:51–58. doi: 10.1007/s12603-016-0710-5. [PMC free article][PubMed] [Cross Ref]
48. Gerling C.J., Whitfield J., Mukai K., Spriet L.L. Variable effects of 12 weeks of omega-3 supplementation on resting skeletal muscle metabolism. Appl. Physiol. Nutr. Metab. 2014;39:1083–1091. doi: 10.1139/apnm-2014-0049. [PubMed] [Cross Ref]
49. Krzyminska-Siemaszko R., Czepulis N., Lewandowicz M., Zasadzka E., Suwalska A., Witowski J., Wieczorowska-Tobis K. The Effect of a 12-Week Omega-3 Supplementation on Body Composition, Muscle Strength and Physical Performance in Elderly Individuals with Decreased Muscle Mass. Int. J. Environ. Res. Public Health. 2015;12:10558–10574. doi: 10.3390/ijerph120910558. [PMC free article][PubMed] [Cross Ref]
50. Mozaffarian D., Rimm E.B. Fish intake, contaminants, and human health: Evaluating the risks and the benefits. JAMA. 2006;296:1885–1899. doi: 10.1001/jama.296.15.1885. [PubMed] [Cross Ref]
51. Sharp R.P., Gales B.J., Sirajuddin R. Comparing the Impact of Prescription Omega-3 Fatty Acid Products on Low-Density Lipoprotein Cholesterol. Am. J. Cardiovasc. Drugs. 2017 doi: 10.1007/s40256-017-0253-0. [PubMed] [Cross Ref]
52. Wei M.Y., Jacobson T.A. Effects of eicosapentaenoic acid versus docosahexaenoic acid on serum lipids: A systematic review and meta-analysis. Curr. Atheroscler. Rep. 2011;13:474–483. doi: 10.1007/s11883-011-0210-3. [PubMed] [Cross Ref]
53. Jacobson T.A., Glickstein S.B., Rowe J.D., Soni P.N. Effects of eicosapentaenoic acid and docosahexaenoic acid on low-density lipoprotein cholesterol and other lipids: A review. J. Clin. Lipidol. 2012;6:5–18. doi: 10.1016/j.jacl.2011.10.018. [PubMed] [Cross Ref]
54. Mori T.A., Burke V., Puddey I.B., Watts G.F., O’Neal D.N., Best J.D., Beilin L.J. Purified eicosapentaenoic and docosahexaenoic acids have differential effects on serum lipids and lipoproteins, LDL particle size, glucose, and insulin in mildly hyperlipidemic men. Am. J. Clin. Nutr. 2000;71:1085–1094. [PubMed]
55. Abbott K.A., Burrows T.L., Thota R.N., Acharya S., Garg M.L. Do omega-3 PUFAs affect insulin resistance in a sex-specific manner? A systematic review and meta-analysis of randomized controlled trials. Am. J. Clin. Nutr. 2016;104:1470–1484. doi: 10.3945/ajcn.116.138172. [PubMed] [Cross Ref]
56. Endres S., Ghorbani R., Kelley V.E., Georgilis K., Lonnemann G., van der Meer J.W., Cannon J.G., Rogers T.S., Klempner M.S., Weber P.C. The effect of dietary supplementation with n-3 polyunsaturated fatty acids on the synthesis of interleukin-1 and tumor necrosis factor by mononuclear cells. N. Engl. J. Med. 1989;320:265–271. doi: 10.1056/NEJM198902023200501. [PubMed] [Cross Ref]
57. Akchurin O.M., Kaskel F. Update on inflammation in chronic kidney disease. Blood Purif. 2015;39:84–92. doi: 10.1159/000368940. [PubMed] [Cross Ref]
58. Yoshino J., Smith G.I., Kelly S.C., Julliand S., Reeds D.N., Mittendorfer B. Effect of dietary n-3 PUFA supplementation on the muscle transcriptome in older adults. Physiol. Rep. 2016;4 doi: 10.14814/phy2.12785. [PMC free article] [PubMed] [Cross Ref]
59. Jankowska M., Cobo G., Lindholm B., Stenvinkel P. Inflammation and Protein-Energy Wasting in the Uremic Milieu. Contrib. Nephrol. 2017;191:58–71. doi: 10.1159/000479256. [PubMed] [Cross Ref]
60. Rice H.B., Bernasconi A., Maki K.C., Harris W.S., von Schacky C., Calder P.C. Conducting omega-3 clinical trials with cardiovascular outcomes: Proceedings of a workshop held at ISSFAL 2014. Prostaglandins Leukot. Essent. Fatty Acids. 2016;107:30–42. doi: 10.1016/j.plefa.2016.01.003. [PubMed][Cross Ref]
61. Jeromson S., Gallagher I.J., Galloway S.D.R., Hamilton D.L. Omega-3 Fatty Acids and Skeletal Muscle Health. Mar. Drugs. 2015;13:6977–7004. doi: 10.3390/md13116977. [PMC free article] [PubMed][Cross Ref]

NOT ALL OMEGA-3s ARE CREATED EQUAL. Contact for the most potent and right dosage of Omega-3 for you and your family.

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