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Also Known As: essential fatty acids (EFAs), polyunsaturated fatty acids (PUFAs)
Omega-3 fatty acids are considered essential fatty acids, which means that
they are essential to human health but cannot be manufactured by the body. For
this reason, omega-3 fatty acids must be obtained from food. Omega-3 fatty acids
can be found in fish and certain plant oils. It is important to maintain an
appropriate balance of omega-3 and omega-6 (another essential fatty acid) in the
diet as these two substances work together to promote health. Also known as
polyunsaturated fatty acids (PUFAs), omega-3 and omega-6 fatty acids play a
crucial role in brain function as well as normal growth and development.
There are three major types of omega 3 fatty acids that are ingested in foods
and used by the body: alpha-linolenic acid (ALA),
eicosapentaenoic acid (EPA),
and docosahexaenoic acid (DHA). Once eaten, the body converts ALA to EPA and DHA,
the two types of omega-3 fatty acids more readily used by the body. Extensive
research indicates that omega-3 fatty acids reduce inflammation and help prevent
certain chronic diseases such as heart disease and arthritis. These essential
fatty acids are highly concentrated in the brain and appear to be particularly
important for cognitive and behavioral function. In fact, infants who do not get
enough omega-3 fatty acids from their mothers during pregnancy are at risk for
developing vision and nerve problems.
As mentioned previously, it is very important to maintain a balance between
omega-3 and omega-6 fatty acids in the diet. Omega-3 fatty acids help reduce
inflammation and most omega-6 fatty acids tend to promote inflammation. An
inappropriate balance of these essential fatty acids contributes to the
development of disease while a proper balance helps maintain and even improve
health. A healthy diet should consist of roughly one to four times more omega-6
fatty acids than omega-3 fatty acids. The typical American diet tends to contain
11 to 30 times more omega-6 fatty acids than omega-3 fatty acids and many
researchers believe this imbalance is a significant factor in the rising rate of
inflammatory disorders in the United States.
In contrast, however, the Mediterranean diet consists of a healthier balance
between omega-3 and omega-6 fatty acids and many studies have shown that people
who follow this diet are less likely to develop heart disease. The Mediterranean
diet does not include much meat (which is high in omega-6 fatty acids) and
emphasizes foods rich in omega-3 fatty acids including whole grains, fresh
fruits and vegetables, fish, olive oil, garlic, as well as moderate wine
consumption.
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Studies suggest that omega-3 fatty acids may be helpful in treating a variety
of conditions. The evidence is strongest for heart disease and problems that
contribute to heart disease, but the range of possible uses for omega-3 fatty
acids include:
High Cholesterol
Those who follow a Mediterranean-style diet tend to have
higher HDL ("good") cholesterol levels. Similar to those who follow a
Mediterranean diet, Inuit Eskimos, who consume high amounts of omega-3 fatty
acids from fatty fish, also tend to have increased HDL cholesterol and decreased
triglycerides (fatty material that circulates in the blood). In addition, fish
oil supplements containing EPA and DHA have been shown to reduce LDL ("bad")
cholesterol and triglycerides. Finally, walnuts (which are rich in ALA) have
been shown to lower total cholesterol and triglycerides in people with high
cholesterol.
High Blood Pressure
Several studies suggest that diets and/or supplements
rich in omega-3 fatty acids lower blood pressure significantly in people with
hypertension. Fish high in mercury (such as tuna) should be avoided, however,
because they may increase blood pressure.
Heart Disease
One of the best ways to help prevent and treat heart disease is
to eat a low-fat diet and to replace foods rich in saturated and trans-fat with
those that are rich in monounsaturated and polyunsaturated fats (including
omega-3 fatty acids). Evidence suggests that EPA and DHA found in fish oil help
reduce risk factors for heart disease including high cholesterol and high blood
pressure. There is also strong evidence that these substances can help prevent
and treat atherosclerosis by inhibiting the development of plaque and blood
clots, each of which tends to clog arteries. Studies of heart attack survivors
have found that daily omega-3 fatty acid supplements dramatically reduce the
risk of death, subsequent heart attacks, and stroke. Similarly, people who eat
an ALA-rich diet are less likely to suffer a fatal heart attack.
Stroke
Strong evidence from population-based studies suggests that omega-3
fatty acid intake (primarily from fish), helps protect against stroke caused by
plaque buildup and blood clots in the arteries that lead to the brain. In fact,
eating at least two servings of fish per week can reduce the risk of stroke by
as much as 50%. However, people who eat more than three grams of omega-3 fatty
acids per day (equivalent to 3 servings of fish per day) may be at an increased
risk for hemorrhagic stroke, a potentially fatal type of stroke in which an
artery in the brain leaks or ruptures.
Diabetes
People with diabetes tend to have high triglyceride and low HDL
levels. Omega-3 fatty acids from fish oil can help lower triglycerides and raise
HDL, so people with diabetes may benefit from eating foods or taking supplements
that contain DHA and
EPA.
ALA (from flaxseed, for example) may not have the same
benefit as DHA and EPA because some people with diabetes lack the ability to
efficiently convert ALA to a form of omega-3 fatty acids that the body can use
readily.
Weight Loss
Many people who are overweight suffer from poor blood sugar
control, diabetes, and high cholesterol. Studies suggest that overweight people
who follow a weight loss program including exercise tend to achieve better
control over their blood sugar and cholesterol levels when fish rich in omega-3
fatty acids (such as salmon, mackerel, and herring) is a staple in their low fat
diet.
Arthritis
Most clinical studies investigating the use of omega-3 fatty acid
supplements for inflammatory joint conditions have focused almost entirely on
rheumatoid arthritis. Several articles reviewing the research in this area
conclude that omega-3 fatty acid supplements reduce tenderness in joints,
decrease morning stiffness, and allow for a reduction in the amount of
medication needed for people with rheumatoid arthritis.
In addition, laboratory studies suggest that diets rich in omega-3 fatty
acids (and low in omega-6 fatty acids) may benefit people with other
inflammatory disorders, such as osteoarthritis. In fact, several test tube
studies of cartilage-containing cells have found that omega-3 fatty acids
decrease inflammation and reduce the activity of enzymes that destroy cartilage.
Similarly, New Zealand green lipped mussel (Perna canaliculus), another
potential source of omega-3 fatty acids, has been shown to reduce joint
stiffness and pain, increase grip strength, and enhance walking pace in a small
group of people with osteoarthritis. In some participants, symptoms worsened
before they improved.
Osteoporosis
Studies suggest that omega-3 fatty acids such as EPA help
increase levels of calcium in the body, deposit calcium in the bones, and
improve bone strength. In addition, studies also suggest that people who are
deficient in certain essential fatty acids (particularly EPA and gamma-linolenic
acid [GLA], an omega-6 fatty acid) are more likely to suffer from bone loss than
those with normal levels of these fatty acids. In a study of women over 65 with
osteoporosis, those given EPA and GLA supplements experienced significantly less
bone loss over three years than those who were given a placebo. Many of these
women also experienced an increase in bone density.
Omega-3 for depression
People who do not get enough omega-3 fatty acids or do not
maintain a healthy balance of omega-3 to omega-6 fatty acids in their diet may
be at an increased risk for depression. The omega-3 fatty acids are important
components of nerve cell membranes. They help nerve cells communicate with each
other, which is an essential step in maintaining good mental health.
Levels of omega-3 fatty acids were found to be measurably low and the ratio
of omega-6 to omega-3 fatty acids were particularly high in a study of patients
hospitalized for depression. In a study of people with depression, those who ate
a healthy diet consisting of fatty fish two to three times per week for 5 years
experienced a significant reduction in feelings of depression and hostility.
Omega-3 for Bipolar (Manic/depression)
In a study of 30 people with bipolar
disorder, those who were treated with EPA and DHA (in combination with their
usual mood stabilizing medications) for four months experienced fewer mood
swings and recurrence of either depression or mania than those who received
placebo. A similar but larger study is currently underway at the University of
California- Los Angeles School of Medicine.
Omega-3 for Schizophrenia
Preliminary evidence suggests that people with schizophrenia experience an
improvement in symptoms when given omega-3 fatty acids. However, a recent
well-designed study concluded that EPA supplements are no better than placebo in
improving symptoms of this condition. The conflicting results suggest that more
research is needed before conclusions can be drawn about the benefit of omega-3
fatty acids for schizophrenia. Similar to diabetes, people with schizophrenia
may not be able to convert ALA to EPA or DHA efficiently.
Omega-3 for attention deficit/hyperactivity disorder (ADHD)
Children with attention deficit/hyperactivity disorder (ADHD) may have
low levels of certain essential fatty acids (including EPA and DHA) in their
bodies. In a study of nearly 100 boys, those with lower levels of omega-3 fatty
acids demonstrated more learning and behavioral problems (such as temper
tantrums and sleep disturbances) than boys with normal omega-3 fatty acid
levels. In animal studies, low levels of omega-3 fatty acids have been shown to
lower the concentration of certain brain chemicals (such as dopamine and
serotonin) related to attention and motivation. Studies that examine the ability
of omega-3 supplements to improve symptoms of attention deficit/hyperactivity disorder (ADHD) are still needed. At this
point in time, eating foods high in omega-3 fatty acids is a reasonable approach
for someone with attention deficit/hyperactivity disorder (ADHD).
Omega-3 for Eating Disorders
Studies suggest that men and women with
anorexia nervosa
have lower than optimal levels of polyunsaturated fatty acids (including ALA and GLA). To prevent the complications associated with essential fatty acid
deficiencies, some experts recommend that treatment programs for anorexia
nervosa include PUFA-rich foods such as fish and organ meats (which include
omega-6 fatty acids).
Burns
Essential fatty acids have been used to reduce inflammation and promote
wound healing in burn victims. Animal research indicates that omega-3 fatty
acids help promote a healthy balance of proteins in the body -- protein balance
is important for recovery after sustaining a burn. Further research is necessary
to determine whether omega 3s benefit people in the same way.
Skin Disorders
In one study, 13 people with a particular sensitivity to the
sun known as photodermatitis showed significantly less sensitivity to UV rays
after taking fish oil supplements. Still, research indicates that topical
sunscreens are much better at protecting the skin from damaging effects of the
sun than omega-3 fatty acids. In another study of 40 people with psoriasis,
those who were treated with medications and EPA supplements did better than
those treated with the medications alone. In addition, many clinicians believe
that flaxseed (which contains omega-3 fatty acids) is helpful for treating acne.
Inflammatory Bowel Disease (IBD)
When added to medication, such as sulfasalazine (a standard medication for IBD), omega-3 fatty acids may reduce
symptoms of Crohn's disease and ulcerative colitis -- the two types of IBD. More
studies to investigate this preliminary finding are under way. In animals, it
appears that ALA works better at decreasing bowel inflammation than
EPA and DHA.
Plus, fish oil supplements can cause side effects that are similar to symptoms
of IBD (such as flatulence and diarrhea). Time-release preparations may help
reduce these unwanted effects.
Asthma
Preliminary research suggests that omega-3 fatty acid supplements (in
the form of perilla seed oil, which is rich in ALA) may decrease inflammation
and improve lung function in adults with asthma. Omega-6 fatty acids have the
opposite effect: they tend to increase inflammation and worsen respiratory
function. In a small, well-designed study of 29 children with asthma, those who
took fish oil supplements rich in EPA and DHA for 10 months had improvement in
their symptoms compared to children who took a placebo pill.
Macular Degeneration
A questionnaire administered to more than 3,000 people
over the age of 49 found that those who consumed more fish in their diet were
less likely to have macular degeneration (a serious age-related eye condition
that can progress to blindness) than those who consumed less fish. Similarly, a
study comparing 350 people with macular degeneration to 500 without found that
those with a healthy dietary balance of omega-3 and omega-6 fatty acids and
higher intake of fish in their diets were less likely to have this particular
eye disorder. Another larger study confirms that EPA and DHA from fish, four or
more times per week, may reduce the risk of developing macular degeneration.
Notably, however, this same study suggests that ALA may actually increase the
risk of this eye condition.
Menstrual Pain
In a study of nearly 200 Danish women, those with the highest
dietary intake of omega-3 fatty acids had the mildest symptoms during
menstruation.
Colon Cancer
Consuming significant amounts of foods rich in omega-3 fatty
acids appears to reduce the risk of colorectal cancer. For example, Eskimos, who
tend to follow a high fat diet but eat significant amounts of fish rich in
omega-3 fatty acids, have a low rate of colorectal cancer. Animal studies and
laboratory studies have found that omega-3 fatty acids prevent worsening of
colon cancer while omega-6 fatty acids promote the growth of colon tumors. Daily
consumption of EPA and DHA also appeared to slow or even reverse the progression
of colon cancer in people with early stages of the disease.
However, in an animal study of rats with metastatic colon cancer (in other
words, cancer that has spread to other parts of the body such as the liver),
omega-3 fatty acids actually promoted the growth of cancer cells in the liver.
Until more information is available, it is best for people with advanced stages
of colorectal cancer to avoid omega-3 fatty acid supplements and diets rich in
this substance.
Breast Cancer
Although not all experts agree, women who regularly consume
foods rich in omega-3 fatty acids over many years may be less likely to develop
breast cancer. In addition, the risk of dying from breast cancer may be
significantly less for those who eat large quantities of omega-3 from fish and
brown kelp seaweed (common in Japan). This is particularly true among women who
substitute fish for meat. The balance between omega-3 and omega-6 fatty acids
appears to play an important role in the development and growth of breast
cancer. Further research is still needed to understand the effect that omega-3
fatty acids may have on the prevention or treatment of breast cancer. For
example, several researchers speculate that omega-3 fatty acids in combination
with other nutrients (namely, vitamin C, vitamin E, beta-carotene, selenium, and
coenzyme Q10) may prove to be of particular value for preventing and treating
breast cancer.
Prostate Cancer
Laboratory and animal studies indicate that omega-3 fatty
acids (specifically, DHA and EPA) may inhibit the growth of prostate cancer.
Similarly, population based studies of groups of men suggest that a low-fat diet
with the addition of omega-3 fatty acids from fish or fish oil help prevent the
development of prostate cancer. Like breast cancer, the balance of omega-3 to
omega-6 fatty acids appears to be particularly important for reducing the risk
of this condition. ALA, however, may not offer the same benefits as EPA and DHA.
In fact, one recent study evaluating 67 men with prostate cancer found that they
had higher levels of ALA compared to men without prostate cancer. More research
in this area is needed.
Other
Although further research is needed, preliminary evidence suggests that
omega-3 fatty acids may also prove helpful in protecting against certain
infections and treating a variety of conditions including ulcers, migraine
headaches, preterm labor, emphysema, psoriasis, glaucoma, Lyme disease, lupus,
and panic attacks.
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Fish oils and plant oils are the primary dietary source of omega-3 fatty
acids. Another potential source of omega-3 fatty acids is New Zealand green
lipped mussels (Perna canaliculus),used for centuries by the Maories to promote
good health. EPA and DHA are found in cold-water fish such as salmon, mackerel,
halibut, sardines, and herring. ALA is found in flaxseeds, flaxseed oil, canola
(rapeseed) oil, soybeans, soybean oil, pumpkin seeds, pumpkin seed oil, purslane,
perilla seed oil, walnuts, and walnut oil.
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In addition to the dietary sources described, EPA and DHA can be taken in the
form of fish oil capsules. Flaxseed, flaxseed oil, and fish oil should be kept
refrigerated. Whole flaxseeds must be ground within 24 hours of use, otherwise
the ingredients lose their activity. Flaxseeds are also available in ground form
in a special mylar package so that the components in the flaxseeds stay active.
Be sure to buy omega-3 fatty acid supplements made by established companies
who certify that their products are free of heavy metals such as mercury.
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Pediatric
The precise safe and effective doses of all types of omega-3 fatty acid
supplements in children have not been established.
EPA and DHA
- EPA and DHA are naturally found in breast milk; therefore, infants that are
breastfed should receive sufficient amounts of these substances.
- Formula for
infants should contain less than 0.1% EPA.
- Formula for infants should contain
0.35% DHA.
ALA
- Infants that are breastfed should receive sufficient amounts of ALA if the
mother has an adequate intake of this fatty acid.
- Infant formula should contain
1.5% ALA.
Flaxseed Oil
- Flaxseed oil may be added to a child's diet to help balance fatty acids. If
an infant is breastfed, the mother may ingest oil or fresh ground seed to
increase fat content in breast milk. See adult dosage below.
Flaxseed
- Children (2 to 12 years): 1 tsp daily of ground flaxseeds or 1 tsp of fresh
flaxseed oil for constipation
Adult
EPA and DHA
- The adequate daily intake of EPA and DHA for adults should be at least 220 mg
of each per day.
- Two to three servings of fatty fish per week (roughly 1,250 mg
EPA and DHA per day) are generally recommended to treat certain health
conditions.
Fish oil supplements
- 3,000 to 4,000 mg standardized fish oils per day. (This amount corresponds to
roughly 2 to 3 servings of fatty fish per week.)
- Typically, a 1,000 mg fish oil
capsule has 180 mg EPA and 120 mg DHA
ALA
- The adequate daily intake of ALA for adults should be roughly 2,220 mg per
day.
Flaxseed oil
- One or two Tbsp of flaxseed oil per day is recommended for general health.
- Doses up to 3,000 mg per day are recommended to prevent certain conditions and
doses up to 6,000 mg per day may be recommend to treat these conditions.
Flaxseed
- 1 Tbsp two to three times per day or 2 to 4 tbsp one time per day. Grind
before eating and take with lots of water.
- Decoction (liquid prepared by boiling
down the flaxseed in water): A rounded Tbsp of whole seed simmered in 1 cup
water for 10 to 15 minutes, strain and drink.
- 100 grams of raw flaxseed provides
22,800 mg of ALA
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Because of the potential for side effects and interactions with medications,
dietary supplements should be taken only under the supervision of a
knowledgeable healthcare provider.
Omega-3 fatty acids should be used cautiously by people who bruise easily,
have a bleeding disorder, or take blood-thinning medications because excessive
amounts of omega-3 fatty acids may lead to bleeding. In fact, people who eat
more than three grams of omega-3 fatty acids per day (equivalent to 3 servings
of fish per day) may be at an increased risk for hemorrhagic stroke, a
potentially fatal condition in which an artery in the brain leaks or ruptures.
Fish oil can cause flatulence and diarrhea. Time-release preparations may
reduce these side effects, however.
People with either diabetes or schizophrenia may lack the ability to convert
ALA to EPA and DHA, the forms more readily used in the body. Therefore, people
with these conditions should obtain their omega-3 fatty acids from dietary
sources rich in EPA and DHA.
Although studies have found that regular consumption of fish (which includes
the omega-3 fatty acids EPA and DHA) may reduce the risk of macular
degeneration, a recent study including two large groups of men and women found
that diets rich in ALA may substantially increase the risk of this disease. More
research is needed in this area. Until this information becomes available, it is
best for people with macular degeneration to obtain omega-3 fatty acids from
sources of EPA and DHA, rather than ALA.
Similar to macular degeneration, fish and fish oil may protect against
prostate cancer, but ALA may be associated with increased risk of prostate
cancer in men. More research in this area is needed.
It is best to use lipid extracts rather than the powder form of New Zealand
green lipped mussels because there is less chance of an allergic reaction.
People who are allergic to seafood should avoid New Zealand green lipped
mussels. In some individuals who take New Zealand green lipped mussels,
arthritis symptoms may worsen before they improve.
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If you are currently being treated with any of the following medications, you
should not use omega-3 fatty acid supplements without first talking to your
healthcare provider.
Blood-thinning Medications
Omega-3 fatty acids may increase the
blood-thinning effects of aspirin or warfarin. While the combination of aspirin
and omega-3 fatty acids may actually be helpful under certain circumstances
(such as heart disease), they should only be taken together under the guidance
and supervision of your healthcare provider.
Cyclosporine
Taking omega-3 fatty acids during cyclosporine therapy may reduce toxic side
effects (such as high blood pressure and kidney damage) associated with this
medication in transplant patients.
Etretinate and Topical Steroids
The addition of omega-3 fatty acids
(specifically EPA) to a drug regimen of etretinate and topical corticosteroids
may improve symptoms of psoriasis.
Cholesterol-lowering Medications
Following certain nutritional guidelines,
including increasing the amount of omega-3 fatty acids in your diet and reducing
the omega-6 to omega-3 ratio, may allow a group of cholesterol lowering
medications known as "statins" (such as atorvastatin, lovastatin, and
simvastatin) to work more effectively.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
In an animal study, treatment
with omega-3 fatty acids reduced the risk of ulcers from nonsteroidal
anti-inflammatory drugs (NSAIDs). More research is needed to evaluate whether
omega-3 fatty acids would have the same effects in people.
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Al-Harbi MM, Islam MW, Al-Shabanah OA, Al-Gharably NM. Effect of acute
administration of fish oil (omega-3 marine triglyceride) on gastric ulceration
and secretion induced by various ulcerogenic and necrotizing agents in rats. Fed
Chem Toxic. 1995;33(7):555-558.
Albert CM, Hennekens CH, O'Donnell CJ, et al. Fish consumption and risk of
sudden cardiac death. JAMA. 1998;279(1):23-28.
Ando H, Ryu A, Hashimoto A, Oka M, Ichihashi M. Linoleic acid and
alpha-linolenic acid lightens ultraviolet-induced hyperpigmentation of the skin.
Arch Dermatol Res. 1998;290(7):375-381.
Andreassen AK, Hartmann A, Offstad J, Geiran O, Kvernebo K, Simonsen S.
Hypertension prophylaxis with omega-3 fatty acids in heart transplant
recipients. J Am Coll Cardiol. 1997;29:1324-1331.
Angerer P, von Schacky C. n-3 polyunsaturated fatty acids and the
cardiovascular system. Curr Opin Lipidol. 2000;11(1):57-63.
Anti M, Armelau F, Marra G, et al. Effects of different doses of fish oil on
rectal cell proliferation in patients with sporadic colonic adenomas.
Gastroenterology. 1994;107(6):1892-1894.
Appel LJ. Nonpharmacologic therapies that reduce blood pressure: a fresh
perspective. Clin Cardiol. 1999;22(Suppl. III):III1-III5.
Arnold LE, Kleykamp D, Votolato N, Gibson RA, Horrocks L. Potential link
between dietary intake of fatty acid and behavior: pilot exploration of serum
lipids in attention-deficit hyperactivity disorder. J Child Adolesc
Psychopharmacol. 1994;4(3):171-182.
Aronson WJ, Glaspy JA, Reddy ST, Reese D, Heber D, Bagga D. Modulation of
omega-3/omega-6 polyunsaturated ratios with dietary fish oils in men with
prostate cancer. Urology. 2001;58(2):283-288.
Badalamenti S, Salerno F, Lorenzano E, et al. Renal Effects of Dietary
Supplementation With Fish Oil in Cyclosporine-Treated Liver Transplant Patients.
Hepatol. 1995;2(6):1695-1701.
Baumgaertel A. Alternative and controversial treatments for
attention-deficit/hyperactivity disorder. Pediatr Clin of North Am.
1999;46(5):977-992.
Belluzzi A, Boschi S, Brignola C, Munarini A, Cariani C, Miglio F.
Polyunsaturated fatty acids and inflammatory bowel disease. Am J Clin Nutr.
2000;71(suppl):339S-342S.
Belluzzi A, Brignolia C, Campieri M, Pera A, Boschi S, Miglioli M. Effect of
an enteric-coated fish-oil preparation on relapses in Crohn's disease. New Engl
J Med. 1996;334(24):1558-1560.
Boelsma E, Hendriks HF. Roza L. Nutritional skin care: health effects of
micronutrients and fatty acids. Am J Clin Nutr. 2001;73(5):853-864.
Bonaa KH, Bjerve KS, Nordoy A. Docosahexaenoic and eicosapentaenoic acids in
plasma phospholipids are divergently associated with high density lipoprotein in
humans. Arterioscler Thromb. 1992;12(6):675-681.
Broadhurst CL, Cunnane SC, Crawford MA. Rift Valley lake fish and shellfish
provided brain-specific nutrition for early Homo. Br J Nutr. 1998;79(1):3-21.
Brown DJ, Dattner AM. Phytotherapeutic approaches to common dermatologic
conditions. Arch Dermtol. 1998;134:1401-1404.
Bruinsma KA, Taren DL. Dieting, essential fatty acid intake, and depression.
Nutrition Rev. 2000;58(4):98-108.
Burgess J, Stevens L, Zhang W, Peck L. Long-chain polyunsaturated fatty acids
in children with attention-deficit hyperactivity disorder. Am J Clin Nutr. 2000;
71(suppl):327S-330S.
Calder PC. n-3 polyunsaturated fatty acids, inflammation and immunity:
pouring oil on troubled waters or another fishy tale? Nut Res. 2001;21:309-341.
Caron MF, White CM. Evaluation of the antihyperlipidemic properties of
dietary supplements. Pharmacotherapy. 2001;21(4):481-487.
Cellini M, Caramazzu N, Mangiafico P, Possati GL, Caramazza R. Fatty acid use
in glaucomatous optic neuropathy treatment. Acta Ophthalmol Scand Suppl.
1998;227:41-42.
Cho E, Hung S, Willet WC, Spiegelman D, Rimm EB, Seddon JM, et al.
Prospective study of dietary fat and the risk of age-related macular
degeneration. Am J Clin Nutr. 2001;73(2):209-218.
Christensen JH, Skou HA, Fog L, Hansen V, Vesterlund T, Dyerberg J, Toft E,
Schmidt EB. Marine n-3 fatty acids, wine intake, and heart rate variability in
patients referred for coronary angiography. Circulation. 2001;103:623-625.
Clark WF, Kortas C, Heidenheim AP, Garland J, Spanner E, Parbtani A. Flaxseed
in lupus nephritis: a two–year nonplacebo-controlled crossover study. J Am Coll
Nutr. 2001;20(2 Suppl):143-148.
Connolly JM, Gilhooly EM, Rose DP. Effects of reduced dietary linoleic acid
intake, alone or combined with an algal source of docosahexaenoic acid, on
MDA-MD-231 breast cancer cell growth and apoptosis in nude mice. Nutrition Can.
1999;35(1):44-49.
Connor SL, Connor WE. Are fish oils beneficial in the prevention and
treatment of coronary artery disease? Am J Clin Nutr.
1997;66(suppl):1020S-1031S.
Curtis CL, Hughes CE, Flannery CR, Little CB, Harwood JL, Caterson B. N-3
fatty acids specifically modulate catabolic factors involved in articular
cartilage degradation. J Biol Chem. 2000;275(2):721-724.
Danao-Camara TC, Shintani TT. The dietary treatment of inflammatory
arthritis: case reports and review of the literature. Hawaii Med J.
1999;58(5):126-131.
Danno K, Sugie N. Combination therapy with low-dose etretinate and
eicosapentaenoic acid for psoriasis vulgaris. J Dermatol. 1998;25:703-705.
Davidson MH, Maki KC, Kalkowski J, Schaefer EJ, Torri SA, Drennan KB. Effects
of docosahexeaenoic acid on serum lipoproteins in patients with combined
hyperlipidemia. A randomized, double-blind, placebo-controlled trial. J Am Coll
Nutr. 1997;16:3:236-243.
de Deckere EAM. Possible beneficial effect of fish and fish n-3
polyunsaturated fatty acids in breast and colorectal cancer. Eur J Cancer Prev.
1999;8:213-221.
deDeckere EAM, Korver O, Verschuren PM, Katan MB. Health aspects of fish and
n-3 polyunsaturated fatty acids from plant and marine origin. Eur J Clin Nutr.
1998;52(10):749-753.
de Logeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N.
Mediterranean diet, traditional risk factors, and the rate of cardiovascular
complications after myocardial infarction: final report of the Lyon Diet Heart
Study. Circulation. 1999;99(6):779-785.
De-Souza DA, Greene LJ. Pharmacological nutrition after burn injury. J Nutr.
1998;128:797-803.
Deutch B. Menstrual pain in Danish women correlated with low n-3
polyunsaturated fatty acid intake. Eur J Clin Nutr. 1995;49(7):508-516.
Dewailly E, Blanchet C, Lemieux S, et al. n-3 fatty acids and cardiovascular
disease risk factors among the Inuit of Nunavik. Am J Clin Nutr.
2001;74(4):464-473.
Dichi I, Frenhane P, Dichi JB, Correa CR, Angeleli AY, Bicudo MH, et al.
Comparison of omega-3 fatty acids and sulfasalazine in ulcerative colitis.
Nutrition. 2000;16:87-90.
Edwards R, Peet M, Shay J, Horrobin D. Omega-3 polyunsaturated fatty acid
levels in the diet and in red blood cell membranes of depressed patients. J
Affect Disord. 1998;48(2-3):149-155.
Fatty fish consumption and ischemic heart disease mortality in older adults:
The cardiovascular heart study. Presented at the American Heart Association's
41st annual conference on cardiovascular disease epidemiology and prevention.
AHA. 2001.
Fenton WS, Dicerson F, Boronow J, et al. A placebo controlled trial of
omega-3 fatty acid (ethyl eicosapentaenoic acid) supplementation for residual
symptoms and cognitive impairment in schizophrenia. Am J Psychiatry.
2001;158(12):2071-2074.
Foulon T, Richard MJ, Payen N, et al. Effects of fish oil fatty acids on
plasma lipids and lipoproteins and oxidant-antioxidant imbalance in healthy
subjects. Scan J Clin Lab Invest. 1999;59(4):239-248.
Freeman VL, Meydani M, Yong S, Pyle J, Flanigan RC, Waters WB, Wojcik EM.
Prostatic levels of fatty acids and the histopathology of localized prostate
cancer. J Urol. 2000;164(6):2168-2172.
Friedberg CE, Janssen MJ, Heine RJ, Grobbee DE. Fish oil and glycemic control
in diabetes: a meta-analysis. Diabetes Care. 1998;21:494-500.
Frieri G, Pimpo MT, Palombieri A, Melideo D, Marcheggiano A, Caprilli R, et
al. Polyunsaturated fatty acid dietary supplementation: an adjuvant approach to
treatment of Helicobacter pylori infection. Nut Res. 2000;20(7):907-916.
Gamez-Mez N, Higuera-Ciapara I, Calderon de la Barca AM, Vazquez-Moreno L,
Noriega-Rodriquez J, Angulo-Guerrero O. Seasonal variation in the fatty acid
composition and quality of sardine oil from Sardinops sagax caeruleus of the
Gulf of California. Lipids. 1999;34)6_:639-642.
Geerling BJ, Badart-Smook A, van Deursen C, et al. Nutritional
supplementation with N-3 fatty acids and antioxidants in patients iwth Crohn's
disease in remission: effects on antioxidant status and fatty acid profile.
Inflamm Bowel Dis. 2000;6(2):77-84.
Geerling BJ, Houwelingen AC, Badart-Smook A, Stockbrügger RW, Brummer R-JM.
Fat intake and fatty acid profile in plasma phospholipids and adipose tissue in
patients with Crohn's disease, compared with controls. Am J Gastroenterol.
1999;94(2):410-417.
Gibson SL, Gibson RG. The treatment of arthritis with a lipid extract of
Perna canaliculus: a randomized trial. Complement Ther Med. 1998;6:122-126.
Griffini P, Fehres O, Klieverik L, et al. Dietary omega-3 polyunsaturated
fatty acids promote colon carcinoma metastasis in rat liver. Can Res.
1998;58(15):3312-3319.
GISSI-Prevenzione Investigators. Dietary supplementation with n-3
polyunsaturated fatty acids and vitamin E after myocardial infarction: results
of the GISSI-Prevenzione trial. Lancet. 1999;354:447-455
Halpern G-M. Anti-inflammatory effects of a stabilized lipid extract of Perna
canaliculus (Lyprinol). Allerg Immunol (Paris). 2000;32(7):272-278.
Harper CR, Jacobson TA. The fats of life: the role of omega-3 fatty acids in
the prevention of coronary heart disease. Arch Intern Med.
2001;161(18):2185-2192.
Harris WS. N-3 fatty acids and serum lipoproteins: human studies. Am J Clin
Nutr. 1997;65(5):1645S (10).
Hayashi N, Tsuguhiko T, Yamamori H, et al. Effect of intravenous w-6 and w-3
fat emulsions on nitrogen retention and protein kinetics in burned rats.
Nutrition. 1999;15(2):135-139.
Hibbeln JR. Fish consumption and major depression. Lancet.
1998;351(9110):1213.
Hibbeln JR, Salem N, Jr. Dietary polyunsaturated fatty acids and depression:
when cholesterol does not satisfy. Am J Clin Nut. 1995;62(1):1-9.
Holman RT, Adams CE, Nelson RA, et al. Patients with anorexia nervosa
demonstrate deficiencies of selected essential fatty acids, compensatory changes
in nonessential fatty acids and decreased fluidity of plasma lipids. J Nutr.
1995;125:901-907.
Homan van der Heide JJ, Bilo HJ, Tegzess AM, Donker AJ. The effects of
dietary supplementation with fish oil on renal function in cyclosporine-treated
renal transplant recipients. Transplantation. 1990;49:523-527.
Horrobin DF. The membrane phospholipid hypothesis as a biochemical basis for
the neurodevelopmental concept of schizophrenia. Schizophr Res.
1998;30(3):193-208.
Horrobin DF, Bennett CN. depression and bipolar disorder: relationships to
impaired fatty acid and phospholipid metabolism and to diabetes, cardiovascular
disease, immunological abnormalities, cancer, ageing and osteoporosis.
Prostaglandins Leukot Essent Fatty Acids. 1999;60(4):217-234.
Horrocks LA, Yeo YK. Health benefits of docosahexaenoic acid. Pharmacol Res.
1999;40(3):211-225.
Howe PR. Can we recommend fish oil for hypertension? Clin Exp Pharmacol
Physiol. 1995;22(3):199-203.
Hrboticky N, Zimmer B, Weber PC. Alpha-Linolenic acid reduces the
lovastatin-induced rise in arachidonic acid and elevates cellular and
lipoprotein eicosapentaenoic and docosahexaenoic acid levels in Hep G2 cells. J
Nutr Biochem. 1996;7:465-471.
Hu FB, Stampfer MJ, Manson JE et al. Dietary intake of alpha-linolenic acid
and risk of fatal ischemic heart disease among women. Am J Clin Nutr.
1999;69:890-897.
Iso H, Rexrode KM, Stampfer MJ, Manson JE, Colditz GA, Speizer FE et al.
Intake of fish and omega-3 fatty acids and risk of stroke in women. JAMA.
2001;285(3):304-312.
Jeschke MG, Herndon DN, Ebener C, Barrow RE, Jauch KW. Nutritional
intervention high in vitamins, protein, amino acids, and omega-3 fatty acids
improves protein metabolism during the hypermetabolic state after thermal
injury. Arch Surg. 2001;136:1301-1306.
Juhl A, Marniemi J, Huupponen R, Virtanen A, Rastas M, Ronnemaa T. Effects of
diet and simvistatin on serum lipids, insulin, and antioxidants in
hypercholesterolemic men; a randomized controlled trial. JAMA.
2002;2887(5):598-605.
Klurfeld DM, Bull AW. Fatty acids and colon cancer in experimental models. Am
J Clin Nut. 1997;66(6 Suppl):1530S-1538S.
Kooijmans-Coutinho MF, Rischen-Vos J, Hermans J, Arndt JW, van der Woude FJ.
Dietary fish oil in renal transplant recipients treated with cyclosporin-A: no
beneficial effects shown. J Am Soc Nephrol. 1996;7(3):513-518.
Krauss RM, Eckel RH, Howard B, et al. AHA Scientific Statement: AHA Dietary
guidelines Revision 2000: A statement for healthcare professionals from the
nutrition committee of the American Heart Association. Circulation.
2000;102(18):2284-2299.
Kremer JM. N-3 fatty acid supplements in rheumatoid arthritis. Am J Clin
Nutr. 2000;(suppl 1):349S-351S.
Kris-Etherton P, Eckel RH, Howard BV, St. Jeor S, Bazzare TL. AHA Science
Advisory: Lyon Diet Heart Study. Benefits of a Mediterranean-style, National
Cholesterol Education Program/American Heart Association Step I Dietary Pattern
on Cardiovascular Disease. Circulation. 2001;103:1823.
Kris-Etherton PM, Taylor DS, Yu-Poth S, et al. Polyunsaturated fatty acids in
the food chain in the United States. Am J Clin Nutr. 2000;71(1 Suppl):179S-188S.
Kruger MC, Coetzer H, de Winter R, Gericke G, van Papendorp DH. Calcium,
gamma-linolenic acid and eicosapentaenoic acid supplementation in senile
osteoporosis. Aging Clin Exp Res. 1998;10:385-394.
Kruger MC, Horrobin DF. Calcium metabolism, osteoporosis and essential fatty
acids: a review. Prog Lipid Res. 1997;36:131-151.
Kulkarni PS, Srinivasan BD. Cyclooxygenase and lipoxygenase pathways in
anterior uvea and conjunctiva. Prog Clin Biol Res. 1989;312:39-52.
Kuroki F, Iida M, Matsumoto T, Aoyagi K, Kanamoto K, Fujishima M. Serum n3
polyunsaturated fatty acids are depleted in Crohn's disease. Dig Dis Sci.
1997;42(6):1137-1141.
Laugharne JD, Mellor JE, Peet M. Fatty acids and schizophrenia. Lipids.
1996;31(Suppl):S-163-165.
Levy E, Rizwan Y, Thibault L, et al. Altered lipid profile, lipoprotein
composition, and oxidant and antioxidant status in pediatric Crohn disease. Am J
Clin Nutr. 2000;71:807-815.
Lockwood K, Moesgaard S, Hanioka T, Folkers K. Apparent partial remission of
breast cancer in 'high risk' patients supplemented with nutritional
antioxidants, essential fatty acids, and coenzyme Q10. Mol Aspects Med.
1994;15Suppl:s231-s240.
Lopez-Miranda J, Gomez P, Castro P, et al. Mediterranean diet improves low
density lipoproteins' susceptibility to oxidative modifications. Med Clin (Barc)
[in Spanish]. 2000;115(10):361-365.
Lorenz-Meyer H, Bauer P, Nicolay C, Schulz B, Purrmann J, Fleig WE, et al.
Omega-3 fatty acids and low carbohydrate diet for maintenance of remission in
Crohn's disease. A randomized controlled multicenter trial. Study Group Members
(German Crohn's Disease Study Group). Scan J Gastroenterol. 1996;31(8):778-785.
Mabile L, Piolot A, Boulet L, Fortin LJ, Doyle N, Rodriquez C, et al.
Moderate intake of omega-3 fatty acids is associated with stable erythrocyte
resistance to oxidative stress in hypertriglyceridemic subjects. Am J Clin Nutr.
2001;7494):449-456.
Mayser P, Mrowietz U, Arenberger P, Bartak P, Buchvald J, Christophers E, et
al. Omega-3 fatty acid-based lipid infusion in patients with chronic plaque
psoriasis: results of a double-blind, randomized, placebo controlled,
multicenter trial. J Am Acad Dermatol. 1998;38(4):539-547.
Meydani M. Omega-3 fatty acids alter soluble markers of endothelial function
in coronary heart disease patients. Nutr Rev. 2000;58(2 pt 1):56-59.
Mitchell EA, Aman MG, Turbott SH, Manku M. Clinical characteristics and serum
essential fatty acid levels in hyperactive children. Clin Pediatr (Phila).
1987;26:406-411.
Montori V, Farmer A, Wollan PC, Dinneen SF. Fish oil supplementation in type
2 diabetes: a quantitative systematic review. Diabetes Care. 2000;23:1407-1415.
Mori TA, Bao, DQ, Burke V, et al. Dietary fish as a major component of a
weight-loss diet: effect on serum lipids, glucose, and insulin metabolism in
overweight hypertensive subjects. Am J Clin Nutr. 1999;70:817-825.
Morris MC, Sacks F, Rosner B. Does fish oil lower blood pressure? A
meta-analysis of controlled trials. Circulation. 1993;88:523-533.
Nagakura T, Matsuda S, Shichijyo K, Sugimoto H, Hata K. Dietary
supplementation with fish oil rich in omega-3 polyunsaturated fatty acids in
children with bronchial asthma. Eur Resp J. 2000;16(5):861-865.
Nestel PJ, Pomeroy SE, Sasahara T, et al. Arterial compliance in obese
subjects is improved with dietary plant n-3 fatty acid from flaxseed oil despite
increased LDL oxidizability. Arterioscler Thromb Vasc Biol. July
1997;17(6):1163-1170.
Newcomer LM, King IB, Wicklund KG, Stanford JL. The association of fatty
acids with prostate cancer risk. Prostate. 2001;47(4):262-268.
Okamoto M, Misunobu F, Ashida K, et al. Effects of dietary supplementation
with n-3 fatty acids compared with n-6 fatty acids on bronchial asthma. Int Med.
2000;39(2):107-111.
Okamoto M, Misunobu F, Ashida K, et al. Effects of perilla seed oil
supplementation on leukotriene generation by leucocytes in patients with asthma
associated with lipometabolism. Int Arch Allergy Immunol. 2000;122(2):137-142.
Olsen SF, Secher NJ. Low consumption of seafood in early pregnancy as a risk
factor for preterm delivery: prospective cohort study. BMJ. 2002;324(7335):
447-451.
Prisco D, Paniccia R, Bandinelli B, et al. Effect of medium term
supplementation with a moderate dose of n-3 polyunsaturated fatty acid on blood
pressure in mild hypertensive patients. Thromb Res. 1998;91:105-112.
Paul KP, Leichsenring M, Pfisterer M, Mayatepek E, Wagner D, Domann M, et al.
Influence of n-6 and n-3 polyunsaturated fatty acids on the resistance to
experimental tuberculosis. Metabolism. 1997;46(6):619-624.
Peet M, Laugharne JD, Mellor J, et al. Essential fatty acid deficiency in
erythrocyte membranes from chronic schizophrenic patients, and the clinical
effects of dietary supplementation. Prostaglandins Leukot Essent Fatty Acids.
1996;55(1-2):71-75.
Puri B, Richardson AJ, Horrobin DF, et al. Eicosapentaenoic acid treatment in
schizophrenia associated with symptom remission, normalisation of blood fatty
acids, reduced neuronal membrane phospholipid turnover and structural brain
changes. Int J Clin Pract. 2000;54(1):57-63.
Rhodes LE, Durham BH, Fraser WD, Friedmann PS. Dietary fish oil reduces basal
and ultraviolet B-generated PGE2 levels in skin and increases the threshold to
provocation of polymorphic light eruption. J Invest Dermatol.
1995;105(4):532-535.
Rhodes LE, White SI. Dietary fish oil as a photoprotective agent in hydroa
vacciniforme. Br J Dermatol. 1998;138(1):173-178.
Richardson AJ, Puri BK. The potential role of fatty acids in
attention-deficit/hyperactivity disorder. Prostaglandins Leukot Essent Fatty
Acids. 2000;63(1/2):79-87.
Rose DP, Connolly JM, Coleman M. Effect of omega-3 fatty acids on the
progression of metastases after the surgical excision of human breast cancer
cell solid tumors growing in nude mice. Clin Cancer Res. 1996;2:1751-1756.
Sakaguchi K, Morita I, Murota S. Eicosapentaenoic acid inhibits bone loss due
to ovariectomy in rats. Prostaglandins Leukot Essent Fatty Acids. 1994;50:81-84.
Sanders TA, Hinds A. The influence of a fish oil high in docosahexaenoic acid
on plasma lipoprotein and vitamin E concentrations and haemostatic function in
healthy male volunteers. Br J Nutr. 1992;68(1):163-173.
Seddon JM, Rosner B, Sperduto RD, Yannuzzi L, Haller JA, Blair NP, Willett W.
Dietary fat and risk for advanced age-related macular degeneration. Arch
Opthalmol. 2001;119(8):1191-1199.
Shils ME, Olson JA, Shike M, Ross AC. Modern Nutrition in Health and Disease.
9th ed. Baltimore, Md: Williams & Wilkins; 1999:90-92, 1377-1378.
Shoda R, Matsueda K, Yamato S, Umeda N. Therapeutic efficacy of N-3
polyunsaturated fatty acid in experimental Crohn's disease. J Gastroenterol.
1995;30(Suppl 8):98-101.
Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin
Nutr. 1999;70(30 Suppl):560S-569S.
Simopoulos AP. Human requirement for N-3 polyunsaturated fatty acids. Poult
Sci. 2000;79(7):961-970.
Smith W, Mitchell P, Leeder SR. Dietary fat and fish intake and age-related
maculopathy. Arch Opthamol. 2000;118(3):401-404.
Soyland E, Funk J, Rajka G, Sandberg M, Thune P, Ruistad L, et al. Effect of
dietary supplementation with very-long chain n-3 fatty acids in patients with
psoriasis. N Engl J Med. 1993;328(25):1812-1816.
Stampfer MJ, Hu FB, Manson JE, Rimm EB, Willett WC. Primary prevention of
coronary heart disease in women through diet and lifestyle. N Engl J Med.
2000;343(1):16-22
Stark KD, Park EJ, Maines VA, et al. Effect of fish-oil concentrate on serum
lipids in postmenopausal women receiving and not receiving hormone replacement
therapy in a placebo-controlled, double blind trial. Am J Clin Nutr.
2000;72:389-394.
Stevens LJ, Zentall SS, Abate ML, Kuczek T, Burgess JR. Omega-3 fatty acids
in boys with behavior, learning and health problems. Physiol Behav.
1996;59(4/5):915-920.
Stevens LJ, Zentall SS, Deck JL, et al. Essential fatty acid metabolism in
boys with attention-deficit hyperactivity disorder. Am J Clin Nutr.
1995;62:761-768.
Stoll AL, Severus WE, Freeman MP, et al. Omega 3 fatty acids in bipolar
disorder: a preliminary double-blind placebo-controlled trial. Arch Gen
Psychiatry. 1999:56(5):407-412.
Stoll BA. Breast cancer and the Western diet: role of fatty acids and
antioxidant vitamins. Eur J Cancer. 1998;34(12):1852-1856.
Terry P, Lichtenstein P, Feychting M, Ahlbom A, Wolk A. Fatty fish
consumption and risk of prostate cancer. Lancet. 2001;357(9270):1764-1766.
Tsai W-S, Nagawa H, Kaizaki S, Tsuruo T, Muto T. Inhibitory effects of n-3
polyunsaturated fatty acids on sigmoid colon cancer transformants. J
Gastroenterol. 1998;33:206-212.
Tsujikawa T, Satoh J, Uda K, Ihara T, Okamoto T, Araki Y, et al. Clinical
importance of n-3 fatty acid-rich diet and nutritional education for the
maintenance of remission in Crohn's disease. J Gastroenterol. 2000;35(2):99-104.
Ventura HO, Milani RV, Lavie CJ, Smart FW, Stapleton DD, Toups TS, Price HL.
Cyclosporine induced hypertension. Efficacy of omega-3 fatty acids in patients
after cardiac transplantation. Circulation. 1993;88(5 Pt 2):II281-II285.
von Schacky C, Angere P, Kothny W, Theisen K, Mudra H. The effect of dietary
omega-3 fatty acids on coronary atherosclerosis: a randomized, double-blind,
placebo-controlled trial. Ann Intern Med. 1999;130:554-562.
Voskuil DW, Feskens EJM, Katan MB, Kromhout D. Intake and sources of alpha-linolenic
acid in Dutch elderly men. Euro J Clin Nutr. 1996;50(12):784-787.
Wagner W, Nootbaar-Wagner U. Prophylactic treatment of migraine with gamma-linolenic
and alpha-linolenic acids. Cephalalgia. 1997;17(2):127-130.
Werbach MR. Nutritional Influences on Illness. 2nd ed. Tarzana, Calif: Third
Line Press; 1993:13-22, 655-671.
Yehuda S, Rabinovitz S, Carasso RL, Mostofsky DI. Fatty acids and brain
peptides. Peptides. 1998;19(2):407-419.
Yosefy C, Viskoper JR, Laszt A, Priluk R, Guita E, Varon D, et al. The effect
of fish oil on hypertension, plasma lipids and hemostasis in hypertensive,
obese, dyslipidemic patients with and without diabetes mellitus. Prostaglandins
Leukot Essent Fatty Acids. 1999;61(2):83-87.
Zambón D, Sabate J, Munoz S, et al. Substituting walnuts for monounsaturated
fat improves the serum lipid profile of hypercholesterolemic men and women. Ann
Intern Med. 2000;132:538-546.
Zimmerman R, Radhakrishnan J, Valeri A, Appel G. Advances in the treatment of
lupus nephritis. Ann Rev Med. 2001;52:63-78.
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