Practical Applications of Fish Oil (Omega-3 Fatty Acids) in Primary Care

Robert Oh, MD


J Am Board Fam Med. 2005;18(1):28-36. 

In This Article

Abstract and Introduction


Background: Fish oil (Ω-3 fatty acids) has been studied for more than 30 years. However, recent concerns of mercury and environmental toxins have clouded fish oil's potential clinical benefits. This article aims to review practical, evidence-based applications of fish oil for the primary care physician.
Methods: PubMed search using key words 'fish oil,' 'docosahexaenoic,' and 'eicosapentaenoic' in title/abstract. Limited to human clinical trials. Articles were further scanned for relevant sources.
Results: For secondary prevention of cardiovascular disease,1 g of fishoil has shown to reduce overall and cardiovascular mortality, myocardial infarction, and sudden cardiac death. Higher doses may be used for its potent triglyceride-lowering effects and for patients with rheumatoid arthritis to reduce nonsteroidal anti-inflammatory use. Ω-3 fatty acid supplementation of infant formula has shown benefit in infant neural growth and development. With the potential health benefits of fish, women of childbearing age should be encouraged to eat 1 to 2 low-mercury fish meals per week.
Conclusions: Fish oil has numerous practical applications for the primary care physician. Understanding the diverse clinical research of Ω-3 fatty acids and fish oil is important in determining its role in primary care practices.


More than 30 years ago, Danish researchers hypothesized that lower rates of heart disease of Greenland Eskimos were associated with higher consumption of whale, seal, and fish.[1,2] Since then, from research unraveling the mechanism of Ω-3 fatty acids, to clinical trials in cardiovascular disease, treatments of hyperlipidemia, rheumatoid arthritis, and the prevention of preterm labor, there have been more than 7000 reports—including nearly 900 human clinical trials on the study of fish oil and Ω-3 fatty acids.[3,4] However, recent concerns regarding mercury and other environmental toxins have clouded the waters of fish oil research and its potential health benefits. This article will discuss the evidence behind fish oil—emphasizing current, practical information for conditions family physicians can effectively impact today.


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