Fish Oil

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Fish Oil

It is established that dietary fatty acids determine the composition of lipids

in the cell membranes, which influences the production of prostaglandins and

leukotrienes that regulate inflammation, a fact that has given rise to interest

in the potential of these dietary substances.

Omega-3 oils, such as fish oil (EPA and DHA) and flaxseed oil, have the ability

to suppress the production of inflammatory mediators and thereby influence the

course of chronic inflammatory diseases such as RA (Kremer et al., 1985 and

1992).

A new enteric-coated fish-oil preparation was used in a 1-year, double-blind

study of 78 patients with inflammatory bowel disease. The absorption rate and

tolerability was high with this preparation, and after 1 year 59% of the

fish-oil group remained in remission compared to 36% in the placebo group,

indicating a significant anti- inflammatory effect (Belluzzi et al., 1996)

In recent studies, dietary omega-3 oils have shown a suppressive effect on the

production of the cytokines IL-1B and TNF-a, which stimulate the production of

collagenase and proinflammatory prostaglandins (PGE2) ( et al., 1997;

Caugey et al., 1996). When fish oil supplementation was given to rheumatoid

arthritis patients, arachidonic acid levels were reduced by 33% compared to

presupplement values (Sperling et al., 1987), suggesting that increase of

dietary omega-3 oils can be complementary in treating rheumatoid arthritis.

A large number of publications from around the world have confirmed the

usefulness of dietary supplementation with omega-3 oils in relieving tender

joints and morning stiffness in patients with RA, in some cases eliminating the

need for NSAID medication (Kremer et al., 1995). Skoldstam et al. (1992) and Lau

et al. (1993) found that patients consuming fish oil were able to significantly

reduce their NSAID dose compared with a control group.

Of 12 published double-blind and placebo-controlled studies with a duration of

12 to 52 weeks, decreased joint tenderness was the most common favorable outcome

reported. Fish oil supplementation significantly decreased the use of NSAIDs in

the three studies in which NSAIDs was used. Unlike NSAID use, fish-oil

consumption is not associated with gastrointestinal toxicity. The results of the

studies suggest that the effective dose of fish oil is approximately 3 to 6

grams a day. Higher dosages did not give better results. There are indications

that the combination of EPA and DHA, as it is found in fish oil, has a

synergistic effect ( et al., 1989).

A study by et al. (1997) emphasizes the potential for increased efficacy

of anti- inflammatory drugs when using omega-3 oils in the diet. It was observed

that diets rich in omega-3 oils and low in omega-6 fats had a drug- sparing

effect with decreased side effects. Drug toxicity is estimated to contribute 60%

of the total cost of treating RA patients in the United States (Prashker et al.,

1995). Use of omega-3 oils in the diet would appear to offer a simple, safe, and

inexpensive way to reduce toxicity and side effects from RA medications.