Current Clinical Applications of Ω‐6 and Ω‐3 Fatty Acids

Lee, Sang; Gura, Kathleen M.; Kim, Sendia; Arsenault, Danielle A.; Bistrian, Bruce R.; Puder, Mark

doi:10.1177/0115426506021004323

Cited by 100Fatty Acid Research and HealthEdible Oils Quality and AnalysisAquaculture Nutrition and Growth

Current Clinical Applications of Ω‐6 and Ω‐3 Fatty Acids

Lee, Sang, Gura, Kathleen M., Kim, Sendia, Arsenault, Danielle A., Bistrian, Bruce R., Puder, Mark·2006·Nutrition in Clinical Practice

DOI 10.1177/0115426506021004323

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Abstract

BACKGROUND: Recent years have brought a resurgence of research interest in fatty acids, with studied fields running the gamut of human disease. This movement has run in parallel with an increased interest in using nutrition modalities as therapeutic measures, as opposed to their conventional role as energy sources. The aim of this manuscript is to provide a basic review of current clinical applications of omega-6 and omega-3 fatty acids, with a particular focus on the latter. METHODS: A selective review of the voluminous literature, including randomized controlled trials, meta-analyses, population studies, and case reports, was used to compile data and identify trends in pertinent clinical applications of fatty acid therapy. CONCLUSIONS: There are a myriad of disorders and maladies that seem to benefit from fatty acid supplementation, specifically omega-3 fatty acids. It has clearly been shown that omega-3 fatty acid supplementation provides a protective benefit in heart disease, and in particular sudden cardiac death. Rheumatoid arthritis (RA) is another disease entity that has been proven to benefit from this nutrition intervention, with improvement in symptoms and diminished nonsteroidal antiinflammatory drug (NSAID) usage. In addition, many psychiatric disorders, particularly schizophrenia and major depressive disorder (MDD), have shown positive results when supplementation has been used as an adjunct to standard pharmacotherapy. The remainder of clinical applications for omega-3 fatty acids requires further investigation. Specifically, according to preliminary clinical evidence, parenteral administration of fatty acids warrants further study.

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The differences in effects of EPA and DHA could be due to structural characteristics of the two fatty acids and their ability to produce different metabolite species.
“The differences identified could be due to structural characteristics of the two fatty acids as well as their ability to produce different metabolite species [137,138].”
From Potential Roles of n-3 PUFAs during Skeletal Muscle Growth and Regeneration (2018) · cites this paper as [138]

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Dietary n−6 and n−3 polyunsaturated fatty acids: From biochemistry to clinical implications in cardiovascular prevention
Russo, G. L. (2008) · Biochemical Pharmacology · doi:10.1016/j.bcp.2008.10.020 · Cited by 843 · see citing works
The plasma lipidomic signature of nonalcoholic steatohepatitis
Puri, P., Wiest, M. M., Cheung, O., Mirshahi, F., Sargeant, C., Min, H., Contos, M. J., Sterling, R. K., Fuchs, M., Zhou, H., et al. (2009) · Hepatology · doi:10.1002/hep.23229 · Cited by 655 · see citing works
A New Intravenous Fat Emulsion Containing Soybean Oil, Medium‐Chain Triglycerides, Olive Oil, and Fish Oil
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Abundance of active ingredients in sea-buckthorn oil
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Supplementation with Omega-3 Fatty Acids in Psychiatric Disorders: A Review of Literature Data
Bozzatello, P., Brignolo, E., Grandi, E. D., & Bellino, S. (2016) · Journal of Clinical Medicine · doi:10.3390/jcm5080067 · Cited by 180 · see citing works
Fish Oil–Based Lipid Emulsions Prevent and Reverse Parenteral Nutrition–Associated Liver Disease: The Boston Experience
de Meijer, V. E., Gura, K. M., Le, H. D., Meisel, J. A., & Puder, M. (2009) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607109332773 · Cited by 166 · see citing works
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A.S.P.E.N. Position Paper
Vanek, V. W., Seidner, D. L., Allen, P., Bistrian, B. R., Collier, S. B., Gura, K. M., Miles, J. M., Valentine, C. J., Kochevar, M., Novel Nutrient Task Force, I. F. E. W., et al. (2012) · Nutrition in Clinical Practice · doi:10.1177/0884533612439896 · Cited by 167 · see citing works
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The essentiality of arachidonic acid and docosahexaenoic acid
Le, H. D., Meisel, J. A., de Meijer, V. E., Gura, K. M., & Puder, M. (2009) · Prostaglandins Leukotrienes and Essential Fatty Acids · doi:10.1016/j.plefa.2009.05.020 · Cited by 162 · see citing works
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Role of biological modifiers regulating the immune response after trauma
Stahel, P. F., Smith, W. R., & Moore, E. E. (2007) · Injury · doi:10.1016/j.injury.2007.09.023 · Cited by 121 · see citing works
The role of lipid biomarkers in major depression
Parekh, A., Smeeth, D., Milner, Y., & Thuret, S. (2017) · Healthcare · doi:10.3390/healthcare5010005 · Cited by 120 · see citing works
Epidemiology of bloodstream infection associated with parenteral nutrition
Opilla, M. (2008) · American Journal of Infection Control · doi:10.1016/j.ajic.2008.10.007 · Cited by 106 · see citing works
Potential Roles of n-3 PUFAs during Skeletal Muscle Growth and Regeneration
Tachtsis, B., Camera, D., & Lacham-Kaplan, O. (2018) · Nutrients · doi:10.3390/nu10030309 · Cited by 104 · see citing works
Parenteral Fish Oil as Monotherapy Prevents Essential Fatty Acid Deficiency in Parenteral Nutrition–dependent Patients
de Meijer, V. E., Le, H. D., Meisel, J. A., Gura, K. M., & Puder, M. (2010) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0b013e3181bbf51e · Cited by 104 · see citing works
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RAR/RXR and PPAR/RXR signaling in neurological and psychiatric diseases
van Neerven, S., Kampmann, E., & Mey, J. (2008) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2008.04.006 · Cited by 101 · see citing works
Intravenous Fat Emulsion Formulations for the Adult and Pediatric Patient
Anez‐Bustillos, L., Dao, D. T., Baker, M. A., Fell, G. L., Puder, M., & Gura, K. M. (2016) · Nutrition in Clinical Practice · doi:10.1177/0884533616662996 · Cited by 90 · see citing works
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Redefining essential fatty acids in the era of novel intravenous lipid emulsions
Anez‐Bustillos, L., Dao, D. T., Fell, G. L., Baker, M. A., Gura, K. M., Bistrian, B. R., & Puder, M. (2017) · Clinical Nutrition · doi:10.1016/j.clnu.2017.07.004 · Cited by 86 · see citing works
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Parenteral fish-oil–based lipid emulsion improves fatty acid profiles and lipids in parenteral nutrition–dependent children
Le, H. D., de Meijer, V. E., Robinson, E. M., Zurakowski, D., Potemkin, A. K., Arsenault, D. A., Fallon, E. M., Malkan, A. D., Bistrian, B. R., Gura, K. M., et al. (2011) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.110.008557 · Cited by 85 · see citing works
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Failure of Resolution of Portal Fibrosis during Omega-3 Fatty Acid Lipid Emulsion Therapy in Two Patients with Irreversible Intestinal Failure
Soden, J. S., Lovell, M. A., Brown, K., Partrick, D. A., & Sokol, R. J. (2010) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2009.08.033 · Cited by 84 · see citing works
Pathologic metabolism
Peltz, E. D., D’Alessandro, A., Moore, E. E., Chin, T. L., Silliman, C. C., Sauaia, A., Hansen, K. C., & Banerjee, A. M. (2015) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0000000000000589 · Cited by 75 · see citing works
Polyunsaturated Fatty Acids: What is Their Role in Treatment of Psychiatric Disorders?
Bozzatello, P., Rocca, P., Mantelli, E., & Bellino, S. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20215257 · Cited by 73 · see citing works
Metabolic changes after polytrauma: an imperative for early nutritional support
Hasenboehler, E. A., Williams, A., Leinhase, I., Morgan, S. J., Smith, W. R., Moore, E. E., & Stahel, P. F. (2006) · World Journal of Emergency Surgery · doi:10.1186/1749-7922-1-29 · Cited by 71 · see citing works
Impact of Fish Oil-Based Lipid Emulsion on Serum Triglyceride, Bilirubin, and Albumin Levels in Children With Parenteral Nutrition-Associated Liver Disease
Lee, S. I., Valim, C., Johnston, P. R., Le, H. D., Meisel, J. A., Arsenault, D. A., Gura, K. M., & Puder, M. (2009) · Pediatric Research · doi:10.1203/pdr.0b013e3181bbdf2b · Cited by 68 · see citing works
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Omega‐3 fatty acids and liver disease†‡
Lee, S., Gura, K. M., & Puder, M. (2007) · Hepatology · doi:10.1002/hep.21645 · Cited by 64 · see citing works
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Oral phosphatidylcholine pretreatment alleviates the signs of experimental rheumatoid arthritis
Erős, G., Ibrahim, S. M., Siebert, N., Boros, M., & Vollmar, B. (2009) · Arthritis Research & Therapy · doi:10.1186/ar2651 · Cited by 60 · see citing works
Fish oil prevents essential fatty acid deficiency and enhances growth: clinical and biochemical implications
Strijbosch, R. A. M., Lee, S., Arsenault, D. A., Andersson, C., Gura, K. M., Bistrian, B. R., & Puder, M. (2008) · Metabolism · doi:10.1016/j.metabol.2008.01.008 · Cited by 56 · see citing works
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Nutraceuticals and Bioactive Compounds from Seafood Processing Waste
Menon, V. V., & Lele, S. (2015) · Springer eBooks · doi:10.1007/978-3-642-53971-8_65 · Cited by 54 · see citing works
Pharmaceutical and clinical aspects of parenteral lipid emulsions in neonatology
Driscoll, D. F., Bistrian, B. R., Demmelmair, H., & Koletzko, B. V. (2008) · Clinical Nutrition · doi:10.1016/j.clnu.2008.05.003 · Cited by 53 · see citing works
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Relative bioavailability and pharmacokinetics of two oral formulations of docosahexaenoic acid/eicosapentaenoic acid after multiple-dose administration in healthy volunteers
Rusca, A., Stefano, A. F. D. D., Doig, M. V., Scarsi, C., & Perucca, E. (2009) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-008-0605-4 · Cited by 49 · see citing works
Cytokines Driven Anti-Inflammatory and Anti-Psoriasis Like Efficacies of Nutraceutical Sea Buckthorn (Hippophae rhamnoides) Oil
Balkrishna, A., Sakat, S. S., Joshi, K., Joshi, K., Sharma, V. K., Ranjan, R., Bhattacharya, K., & Varshney, A. (2019) · Frontiers in Pharmacology · doi:10.3389/fphar.2019.01186 · Cited by 48 · see citing works
Reversal of Intestinal Failure–Associated Liver Disease by Switching From a Combination Lipid Emulsion Containing Fish Oil to Fish Oil Monotherapy
Lee, S., Park, H. J., Yoon, J., Hong, S. H., Oh, C., Lee, S., & Seo, J. (2015) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607114567200 · Cited by 47 · see citing works
Self-citation
Sea Buckthorn Oil—A Valuable Source for Cosmeceuticals
Koskovac, M., Cupara, S., Kipic, M., Barjaktarevic, A. M., Milovanovic, O. Z., Kojičić, K., & Marković, M. S. (2017) · Cosmetics · doi:10.3390/cosmetics4040040 · Cited by 47 · see citing works
Formulation, Stability, and Administration of Parenteral Nutrition With New Lipid Emulsions
Hardy, G., & Puzovic, M. (2009) · Nutrition in Clinical Practice · doi:10.1177/0884533609342445 · Cited by 45 · see citing works
The Prevention and Treatment of Intestinal Failure-associated Liver Disease in Neonates and Children
Nehra, D., Fallon, E. M., & Puder, M. (2011) · Surgical Clinics of North America · doi:10.1016/j.suc.2011.02.003 · Cited by 43 · see citing works
Self-citation
Trim the fat: the role of omega-3 fatty acids in psychopharmacology
Nasir, M., & Bloch, M. H. (2019) · Therapeutic Advances in Psychopharmacology · doi:10.1177/2045125319869791 · Cited by 37 · see citing works
Medical Update and Potential Advances in the Treatment of Pediatric Intestinal Failure
Youssef, N. N., Mezoff, A. G., Carter, B. A., & Cole, C. R. (2012) · Current Gastroenterology Reports · doi:10.1007/s11894-012-0262-8 · Cited by 37 · see citing works
Pediatric Intestinal Failure and Vascular Access
Modi, B. P., & Jaksic, T. (2012) · Surgical Clinics of North America · doi:10.1016/j.suc.2012.03.012 · Cited by 32 · see citing works
Cost-effectiveness of collaborative care for chronically ill patients with comorbid depressive disorder in the general hospital setting, a randomised controlled trial
Horn, E. K., van Benthem, T. B., Roijen, L. H., van Marwijk, H., Beekman, A. T. F., Rutten, F., & Feltz-Cornelis, C. M. V. D. (2007) · BMC Health Services Research · doi:10.1186/1472-6963-7-28 · Cited by 31 · see citing works
Mental Health in Childhood and Adolescence: The Role of Polyunsaturated Fatty Acids
Bozzatello, P., Blua, C., Rocca, P., & Bellino, S. (2021) · Biomedicines · doi:10.3390/biomedicines9080850 · Cited by 30 · see citing works
Impact of omega-6 fatty acids on cardiovascular outcomes: A review.
Khandelwal, S., Kelly, L., Malik, R., Prabhakaran, D., & Reddy, S. (2013) · PubMed · Cited by 31 · see citing works
Rapid Infusion of Fish Oil–Based Emulsion in Infants Does Not Appear to be Associated With Fat Overload Syndrome
Gura, K. M., & Puder, M. (2010) · Nutrition in Clinical Practice · doi:10.1177/0884533610373770 · Cited by 28 · see citing works
Self-citation
Gas chromatography–mass spectrometry (GC–MS) profiling reveals substantial metabolome diversity in seabuckthorn ( Hippophae rhamnoides L.) berries originating from different geographical regions in the Indian Himalayas
Singh, S., & Sharma, P. C. (2021) · Phytochemical Analysis · doi:10.1002/pca.3081 · Cited by 27 · see citing works
Nutraceuticals in Psychiatric Disorders: A Systematic Review
Bozzatello, P., Novelli, R., Montemagni, C., Rocca, P., & Bellino, S. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25094824 · Cited by 28 · see citing works
Healthy lifestyle interventions in general practice
Derman, E., Patel, D. N., Nossel, C., & Schwellnus, M. P. (2008) · South African Family Practice · doi:10.1080/20786204.2008.10873732 · Cited by 24 · see citing works
High fish consumption in French Polynesia and prenatal exposure to metals and nutrients.
Dewailly, É., Suhas, E., Mou, Y., Dallaire, R., Chateau-Degat, L., & Chansin, R. (2008) · PubMed · Cited by 23 · see citing works
Liver Disease Secondary to Intestinal Failure
Abu‐Wasel, B., & Molinari, M. (2014) · BioMed Research International · doi:10.1155/2014/968357 · Cited by 22 · see citing works
The Effects of an Oral Supplement Enriched With Fish Oil, Prebiotics, and Antioxidants on Nutrition Status in Crohn's Disease Patients
Wiese, D. M., Lashner, B. A., Lerner, E., DeMichele, S. J., & Seidner, D. L. (2011) · Nutrition in Clinical Practice · doi:10.1177/0884533611413778 · Cited by 22 · see citing works
Review paper The preventive role of coenzyme Q10 and other antioxidants in injuries caused by oxidative stress
Fehér, J., Németh, E., Nagy, V., & Lengyel, G. (2008) · Archives of Medical Science · Cited by 19 · see citing works
Omega-3 Supplementation and Heart Disease: A Population-Based Diet by Gene Analysis of Clinical Trial Outcomes
Fernández, M. L., Blomquist, S. A., Hallmark, B., & Chilton, F. H. (2021) · Nutrients · doi:10.3390/nu13072154 · Cited by 17 · see citing works
The effect of ω-3 polyunsaturated fatty acids on the liver lipidome, proteome and bile acid profile: parenteral versus enteral administration
Bechyňská, K., Ďásková, N., Vrzáčková, N., Harant, K., Heczková, M., Podzimkova, K., Brátová, M., Daňková, H., Berková, Z., Kosek, V., et al. (2019) · Scientific Reports · doi:10.1038/s41598-019-54225-8 · Cited by 16 · see citing works
The Impact of Omega-3 Fatty Acids on Depressive Disorders and Suicidality: Can we Reconcile Two Studies with Seemingly Contradictory Results?
Mischoulon, D. (2011) · Journal of Clinical Psychiatry · doi:10.4088/jcp.11com07463 · Cited by 14 · see citing works
Eicosapentaenoic Acid and Docosahexaenoic Acid Synergistically Attenuate Bile Acid–Induced Hepatocellular Apoptosis
Tillman, E. M., Helms, R. A., & Black, D. D. (2011) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607111409588 · Cited by 16 · see citing works
16S rRNA gene sequencing is a non-culture method of defining the specific bacterial etiology of ventilator-associated pneumonia.
Xia, L., Bian, L.-Y., Xu, M., Liu, Y., Tang, A., & Wen-qin, Y. (2015) · PubMed Central · Cited by 16 · see citing works
Mixed Oil–Based Lipid Emulsions vs Soybean Oil–Based Lipid Emulsions on Incidence and Severity of Intestinal Failure–Associated Liver Disease in a Neonatal Intensive Care Unit
Ferguson, C. L., Perry, C., Subramanian, M., Gillette, C., Ayers, K., & Welch, C. D. (2020) · Journal of Parenteral and Enteral Nutrition · doi:10.1002/jpen.1831 · Cited by 13 · see citing works
Enhancement of shortening velocity, power, and acto‐myosin crossbridge (CB) kinetics following long‐term treatment with propionyl‐ L ‐carnitine, coenzyme Q10, and omega‐3 fatty acids in BIO TO‐2 cardiomyopathic Syrian hamsters papillary muscle
Vargiu, R., Littarru, G. P., Fraschini, M., Perinu, A., Tiano, L., Capra, A., & Mancinelli, R. (2010) · BioFactors · doi:10.1002/biof.95 · Cited by 12 · see citing works
n-3 PUFA Fortification of High n-6 PUFA Farmed Tilapia with Linseed Could Significantly Increase Dietary Contribution and Support Nutritional Expectations of Fish
Shapira, N., Weill, P., Sharon, O., Loewenbach, R., & Berzak, O. (2009) · Journal of Agricultural and Food Chemistry · doi:10.1021/jf8029258 · Cited by 12 · see citing works
The study of n-3PUFAs protecting the intestinal barrier in rat HS/R model
Li, Y., Wang, X., Li, N., & Li, J. (2014) · Lipids in Health and Disease · doi:10.1186/1476-511x-13-146 · Cited by 12 · see citing works
Fatty acid composition of marine macroalgae from the Black Sea and Dardanelles
Yazici, Z., Aysel, V., Öksüz, E., Köse, A., Cumalı, S., & Güven, K. C. (2007) · Toxicological & Environmental Chemistry Reviews · doi:10.1080/02772240601012366 · Cited by 12 · see citing works
Clinical use of Capilen, a liposomal cream based on fresh plant extracts enriched with omega fatty acids
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Additional file 2 of Cost-effectiveness of collaborative care for chronically ill patients with comorbid depressive disorder in the general hospital setting, a randomised controlled trial
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Additional file 3 of Cost-effectiveness of collaborative care for chronically ill patients with comorbid depressive disorder in the general hospital setting, a randomised controlled trial
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Authors: Lee, S., Gura, K. M., Kim, S., Arsenault, D. A., Bistrian, B. R., & Puder, M.
Affiliations: Boston Children's Hospital (US)
Beth Israel Deaconess Medical Center (US)
Corresponding author: Puder, Mark
ORCID: Gura, Kathleen M.
Bistrian, Bruce R.
Puder, Mark
Venue: Nutrition in Clinical Practice
Publisher: Wiley
Published: 2006-08
Volume: 21
Issue: 4
Pages: 323-341
ISSN: 0884-5336 (ISSN-L)
1941-2452
DOI: 10.1177/0115426506021004323
OpenAlex: W2345098798
Cited by: 100
References: 218
Citations by year: 2026: 1 · 2024: 3 · 2022: 2 · 2021: 10 · 2020: 2 · 2019: 5 · 2018: 2 · 2017: 5 · 2016: 4 · 2015: 4 · 2014: 5 · 2013: 1 · 2012: 4
FWCI: 1.16
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Nutrition in Clinical Practice (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
Physical Sciences › Chemistry › Organic Chemistry › Edible Oils Quality and Analysis
Life Sciences › Agricultural and Biological Sciences › Aquatic Science › Aquaculture Nutrition and Growth
Keywords: omega-3 fatty acids, omega-6 fatty acids, fatty acid supplementation, dietary therapy, cardiovascular disease, sudden cardiac death, rheumatoid arthritis, NSAID use, schizophrenia, major depressive disorder, mental illness
MeSH terms: Animals, Arthritis, Rheumatoid, Mental Disorders, Disease Models, Animal, Heart Diseases, Humans, Fatty Acids, Omega-3, Randomized Controlled Trials as Topic, Treatment Outcome, Dietary Supplements, Fatty Acids, Omega-6

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Current Clinical Applications of Ω‐6 and Ω‐3 Fatty Acids

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