Research: CLELAND and co-workers,

Listed in Issue 94

Abstract

CLELAND and co-workers, Rheumatology Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia, Lcleland@mail.rah.sa.gov.au, have reviewed (47 references) the role of fish oil in the treatment of rheumatoid arthritis. Fish oils are a rich source of n-3 polyunsaturated fatty acids. Some of these are homologues of the n-6 polyunsaturated fatty acid, arachidonic acid. This explains why n-3 polyunsaturates counteract the pro-inflammatory and pro-thrombic n-6 polyunsaturates. In addition, n-3 polyunsaturates can suppress the production of pro-inflammatory cytokines and cartilage degrading enzymes. In accordance with this biochemical evidence, beneficial anti-inflammatory effects of dietary fish oils have been demonstrated in randomized controlled trials in rheumatoid arthritis, and protective clinical effects have been shown in cardiovascular disease for which rheumatoid arthritis patients are at an increased risk. Implementation of fish oil supplementation has been poor. There is no great profit to be made by pharmaceutical companies, and therefore no incentive for marketing strategies that inform doctors of their anti-inflammatory benefits. Accordingly many prescribers remain ignorant of their biochemistry, therapeutic effects, formulations, principles of application and complementary dietary modifications. Evidence is presented that an increased uptake of this approach can be achieved using bulk fish oil. In addition, an index of n-3 nutrition can be used to provide helpful feedback to patients.

Background

Methodology

Results

Conclusion

References

Cleland LG, James MJ, Proudman SM. The role of fish oils in the treatment of rheumatoid arthritis. Drugs 63 (9): 845-853, 2003.

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