The Omega-6/Omega-3 Ratio and Dementia or Cognitive Decline: A Systematic Review on Human Studies and Biological Evidence

Journal of Nutrition in Gerontology and Geriatrics

Volumn 32, Issue 1, 2013, Pages 1-23

  Loef, Martin ^a,b   Walach, Harald ^a,b  

^a EUROPEAN UNIVERSITY VIADRINA   (Germany)

^b Samueli Institute   (Germany)

Author keywords

Alzheimer's disease; dementia; omega 3 fatty acids; omega 6 fatty acids; ratio of n6:n3

Indexed keywords

OMEGA 3 FATTY ACID; OMEGA 6 FATTY ACID;

ANIMAL; BLOOD; BRAIN; COGNITIVE DEFECT; DEMENTIA; DIET SUPPLEMENTATION; DISEASE MODEL; DRUG EFFECT; HUMAN; INCIDENCE; PATHOPHYSIOLOGY; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; RISK FACTOR;

ANIMALS; BRAIN; COGNITION DISORDERS; DEMENTIA; DIETARY SUPPLEMENTS; DISEASE MODELS, ANIMAL; FATTY ACIDS, OMEGA-3; FATTY ACIDS, OMEGA-6; HUMANS; INCIDENCE; RANDOMIZED CONTROLLED TRIALS AS TOPIC; RISK FACTORS;

ANIMALIA;

EID: 84876342098     PISSN: 21551197     EISSN: 21551200     Source Type: Journal    
DOI: 10.1080/21551197.2012.752335     Document Type: Review

References (107)

1. Querfurth HW, LaFerla FM. Alzheimer's disease. NEJM. 2010; 362: 329-44.
2. Alzheimer's Disease International. World Alzheimer Report 2009. London: Author; 2009.
3. Hirtz D, Thurman DJ, Gwinn-Hardy K, Mohamed M, Chaudhuri AR, Zalutsky R. How common are the "common" neurologic disorders? Neurol. 2007; 68 (5): 326-37.
4. Brouwers N, Sleegers K, Van Broeckhoven C. Molecular genetics of Alzheimer's disease: an update. Ann Med. 2008; 40 (8): 562-83.
5. Burr G, Burr M. On the nature and the role of the fatty acids essential in nutrition. J Biologic Chem. 1930; 86: 587-621.
6. Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin Nutr. 1999; 70 (Suppl. 3): 560S-69S.
7. Kuehl FJ, Egan R. Prostaglandins, arachidonic acid, and inflammation. Science. 1980; 210 (4473): 978-84.
8. Bang HO, Dyerberg J, Nielsen AB. Plasma lipid and lipoprotein pattern in Greenlandic West-coast Eskimos. Lancet. 1971; 1 (7710): 1143-5.
9. Dyerberg J, Bang HO, Hjorne N. Fatty acid composition of the plasma lipids in Greenland Eskimos. Am J Clin Nutr. 1975; 28 (9): 958-66.
10. Fotuhi M, Mohassel P, Yaffe K. Fish consumption, long-chain omega-3 fatty acids and risk of cognitive decline or Alzheimer disease: a complex association. Nat Clin Pract Neurol. 2009; 5 (3): 140-52.
11. Huang TL. Omega-3 fatty acids, cognitive decline, and Alzheimer's disease: a critical review and evaluation of the literature. J Alzheimer's Dis. 2010; 21 (3): 673-90.
12. Cole GM, Frautschy SA. DHA may prevent age-related dementia. J Nutr. 2010; 140 (4): 869-74.
13. Rees D, Miles EA, Banerjee T, Wells SJ, Roynette CE, et al Dose-related effects of eicosapentaenoic acid on innate immune function in healthy humans: a comparison of young and older men. Am J Clin Nutr. 2006; 83 (2): 331-42.
14. Lewis RA, Austen KF, Soberman RJ. Leukotrienes and other products of the 5-lipoxygenase pathway. Biochemistry and relation to pathobiology in human diseases. NEJM. 1990; 323 (10): 645-55.
15. Dubois RN, Abramson SB, Crofford L, Gupta RA, Simon LS, et al Cyclooxygenase in biology and disease. FASEB Journal. 1998; 12(12):1063-73.
16. Schmitz G, Ecker J. The opposing effects of n-3 and n-6 fatty acids. Prog Lipid Res. 2008; 47 (2): 147-55.
17. Simopoulos AP. The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Exp Biol Med (Maywood). 2008; 233 (6): 674-88.
18. Drewnowski A, Popkin BM. The nutrition transition: new trends in the global diet. Nutr Rev. 1997; 55 (2): 31-43.
19. Sanders TA. Polyunsaturated fatty acids in the food chain in Europe. Am J Clin Nutr. 2000; 71 (Suppl. 1): 176S-8S.
20. Meyer BJ, Mann NJ, Lewis JL, Milligan GC, Sinclair AJ, Howe PR. Dietary intakes and food sources of omega-6 and omega-3 polyunsaturated fatty acids. Lipids. 2003; 38 (4): 391-8.
21. Hammen C. Stress and depression. Ann Rev Clin Psychol. 2005; 1: 293-319.
22. Popkin BM, Gordon-Larsen P. The nutrition transition: worldwide obesity dynamics and their determinants. Int J Obesity Related Metabol Dis. 2004; 28 (Suppl. 3): S2-9.
23. Du S, Lu B, Zhai F, Popkin BM. A new stage of the nutrition transition in China. Publ Health Nutr. 2002; 5 (1A): 169-74.
24. Féart C, Barberger-Gateau P. Epidemiological studies on cognition and the omega-6/omega-3 balance. In: Simopoulous A, ed. Healthy Agriculture, Healthy Nutrition, Healthy People. Basel: Karger Publishers; 2011: 92-7.
25. Di Paolo G, Kim TW. Linking lipids to Alzheimer's disease: cholesterol and beyond. Nature Review. Neuroscience. 2011; 12 (5): 284-96.
26. Beydoun MA, Kaufman JS, Satia JA, Rosamond W, Folsom AR. Plasma n-3 fatty acids and the risk of cognitive decline in older adults: the Atherosclerosis Risk in Communities Study. Am J Clin Nutr. 2007; 85 (4): 1103-11.
27. Samieri C, Feart C, Letenneur L, Dartigues JF, Peres K, et al Low plasma eicosapentaenoic acid and depressive symptomatology are independent predictors of dementia risk. Am J Clin Nutr. 2008; 88 (3): 714-21.
28. Beydoun MA, Kaufman JS, Sloan PD, Heiss G, Ibrahim J. n-3 Fatty acids, hypertension and risk of cognitive decline among older adults in the Atherosclerosis Risk in Communities (ARIC) study. Pub Health Nutr. 2008; 11 (1): 17-29.
29. Barberger-Gateau P, Raffaitin C, Letenneur L, Berr C, Tzourio C, et al Dietary patterns and risk of dementia: the Three-City cohort study. Neurol. 2007; 69 (20): 1921-30.
30. Vercambre MN, Boutron-Ruault MC, Ritchie K, Clavel-Chapelon F, Berr C. Long-term association of food and nutrient intakes with cognitive and functional decline: a 13-year follow-up study of elderly French women. Br J Nutr. 2009; 102 (03): 419-27.
31. Heude B, Ducimetiere P, Berr C. Cognitive decline and fatty acid composition of erythrocyte membranes-The EVA Study. Am J Clin Nutr. 2003; 77 (4): 803-8.
32. Whalley LJ, Deary IJ, Starr JM, Wahle KW, Rance KA, et al n-3 Fatty acid erythrocyte membrane content, APOE varepsilon4, and cognitive variation: an observational follow-up study in late adulthood. Am J Clin Nutr. 2008; 87 (2): 449-54.
33. Conquer JA, Tierney MC, Zecevic J, Bettger WJ, Fisher RH. Fatty acid analysis of blood plasma of patients with Alzheimer's disease, other types of dementia, and cognitive impairment. Lipids. 2000; 35(12):1305-12.
34. Cherubini A, Andres-Lacueva C, Martin A, Lauretani F, Iorio AD, et al Low plasma N-3 fatty acids and dementia in older persons: the InCHIANTI study. J Gerontol A Biol Sci Med Sci. 2007; 62 (10): 1120-6.
35. Gonzalez S, Huerta JM, Fernandez S, Patterson AM, Lasheras C. The relationship between dietary lipids and cognitive performance in an elderly population. Int J Food Sci Nutr. 2010; 61 (2): 217-25.
36. Kotani S, Sakaguchi E, Warashina S, Matsukawa N, Ishikura Y, et al Dietary supplementation of arachidonic and docosahexaenoic acids improves cognitive dysfunction. Neurosci Res. 2006; 56 (2): 159-64.
37. Milte CM, Sinn N, Street SJ, Buckley JD, Coates AM, Howe PR. Erythrocyte polyunsaturated fatty acid status, memory, cognition and mood in older adults with mild cognitive impairment and healthy controls. Prostaglandins Leukotrienes and Essential Fatty Acids. 2011; 84 (5-6): 153-61.
38. Brooksbank BW, Martinez M. Lipid abnormalities in the brain in adult Down's syndrome and Alzheimer's disease. Mol Chem Neuropathol. 1989; 11 (3): 157-85.
39. Igarashi M, Ma K, Gao F, Kim HW, Rapoport SI, Rao JS. Disturbed choline plasmalogen and phospholipid Fatty Acid concentrations in Alzheimer's disease prefrontal cortex. J Alzheimer's Dis. 2011; 24 (3): 507-17.
40. Feart C, Torres MJ, Samieri C, Jutand MA, Peuchant E, et al Adherence to a Mediterranean diet and plasma fatty acids: data from the Bordeaux sample of the Three-City study. Br J Nutr. 2011; 8: 1-10.
41. Arsenault D, Julien C, Tremblay C, Calon F. DHA improves cognition and prevents dysfunction of entorhinal cortex neurons in 3xTg-AD mice. PLoS One. 2011; 6 (2): e17397.
42. Arsenault D, Julien C, Chen CT, Bazinet RP, Calon F. Dietary intake of unsaturated fatty acids modulates physiological properties of entorhinal cortex neurons in mice. J Neurochem. 2012; 122 (2): 427-43.
43. Hooijmans CR, Rutters F, Dederen PJ, Gambarota G, Veltien A, et al Changes in cerebral blood volume and amyloid pathology in aged Alzheimer APP/PS1 mice on a docosahexaenoic acid (DHA) diet or cholesterol enriched Typical Western Diet (TWD). Neurobiol Dis. 2007; 28 (1): 16-29.
44. Hooijmans CR, Van der Zee CEEM, Dederen PJ, Brouwer KM, Reijmer YD, et al DHA and cholesterol containing diets influence Alzheimer-like pathology, cognition and cerebral vasculature in APPswe/PS1dE9 mice. Neurobiol Dis. 2009; 33 (3): 482-98.
45. Perez SE, Berg BM, Moore KA, He B, Counts SE, et al DHA diet reduces AD pathology in young APPswe/PS1ΔE9 transgenic mice: possible gender effects. J Neurosci Res. 2010; 88 (5): 1026-40.
46. Calon F, Lim G, Yang F, Morihara T, Teter B, et al Docosahexaenoic acid protects from dendritic pathology in an Alzheimer's disease mouse model. Neuron. 2004; 43 (5): 633-45.
47. Calon F, Lim GP, Morihara T, Yang F, Ubeda O, et al Dietary n-3 polyunsaturated fatty acid depletion activates caspases and decreases NMDA receptors in the brain of a transgenic mouse model of Alzheimer's disease. Eur J Neurosci. 2005; 22(3):617-26.
48. Oksman M, Iivonen H, Hogyes E, Amtul Z, Penke B, et al Impact of different saturated fatty acid, polyunsaturated fatty acid and cholesterol containing diets on beta-amyloid accumulation in APP/PS1 transgenic mice. Neurobiol Dis. 2006; 23 (3): 563-72.
49. Hooijmans CR, Pasker-de Jong PCM, de Vries RBM, Ritskes-Hoitinga M. The effects of long-term omega-3 fatty acid supplementation on cognition and Alzheime's pathology in animal models of Alzheimer's disease: a systematic review and meta-analysis. J Alzheimer's Dis. 2012; 28 (1): 191-209.
50. Phivilay A, Julien C, Tremblay C, Berthiaume L, Julien P, et al High dietary consumption of trans fatty acids decreases brain docosahexaenoic acid but does not alter amyloid-β and tau pathologies in the 3xTg-AD model of Alzheimer's disease. Neurosci. 2009; 159 (1): 296-307.
51. Lim GP, Calon F, Morihara T, Yang F, Teter B, et al A diet enriched with the omega-3 fatty acid docosahexaenoic acid reduces amyloid burden in an aged Alzheimer mouse model. J Neurosci. 2005; 25 (12): 3032-40.
52. Julien C, Tremblay C, Phivilay A, Berthiaume L, Émond V, et al High-fat diet aggravates amyloid-beta and tau pathologies in the 3xTg-AD mouse model. Neurobiol Aging. 2010; 31 (9): 1516-31.
53. Lebbadi M, Julien C, Phivilay A, Tremblay C, Emond V, et al Endogenous conversion of omega-6 into omega-3 fatty acids improves neuropathology in an animal model of Alzheimer's disease. J Alzheimers Dis. 2011; 13: 13.
54. van de Rest O, Geleijnse JM, Kok FJ, van Staveren WA, Dullemeijer C, et al Effect of fish oil on cognitive performance in older subjects: a randomized, controlled trial. Neurol. 2008; 71 (6): 430-8.
55. Dangour AD, Allen E, Elbourne D, Fasey N, Fletcher AE, et al Effect of 2-y n-3 long-chain polyunsaturated fatty acid supplementation on cognitive function in older people: a randomized, double-blind, controlled trial. Am J Clin Nutr. 2010; 91 (6): 1725-32.
56. Chiu CC, Su KP, Cheng TC, Liu HC, Chang CJ, et al The effects of omega-3 fatty acids monotherapy in Alzheimer's disease and mild cognitive impairment: a preliminary randomized double-blind placebo-controlled study. Prog Neuropsychopharmacol Biol Psychiatry. 2008; 32 (6): 1538-44.
57. Freund-Levi Y, Eriksdotter-Jönhagen M, Cederholm T, Basun H, Faxén-Irving G, et al Omega-3 fatty acid treatment in 174 patients with mild to moderate Alzheimer disease: OmegAD study: a randomized double-blind trial. Arch Neurol. 2006; 63 (10): 1402-8.
58. Quinn J, Raman R, Thomas RG, Yurko-Mauro K, Nelson EB, et al Docosahexaenoic acid supplementation and cognitive decline in Alzheimer disease: a randomized trial. JAMA. 2010; 304 (17): 1903-11.
59. Yurko-Mauro K, McCarthy D, Rom D, Nelson EB, Ryan AS, et al Beneficial effects of docosahexaenoic acid on cognition in age-related cognitive decline. Alzheimers Dement. 2010; 6 (6): 456-64.
60. Gu Y, Nieves JW, Stern Y, Luchsinger JA, Scarmeas N. Food combination and Alzheimer disease risk. Arch Neurol. 2010; 67 (6): 699-706.
61. Loef M, Walach H. Fatty acids and dementia: systematic review and meta-analyses. BMC Complement Altern Med. 2012; 12(Suppl. 1):P318.
62. Kalmijn S, Feskens EJ, Launer LJ, Kromhout D. Polyunsaturated fatty acids, antioxidants, and cognitive function in very old men. Am J Epidemiol. 1997; 145 (1): 33-41.
63. Loef M, Schrauzer GN, Walach H. Selenium and Alzheimer's disease: a systematic review. J Alzheimer's Dis. 2011; 26 (1): 81-104.
64. Annweiler C, Le Gall D, Fantino B, Beauchet O. Fish consumption and dementia: keep the vitamin D in memory. Eur J Neurol. 2010; 17 (6): e40.
65. Kalmijn S, Launer L, Ott A, Witteman J, Hofman A, Breteler M. Dietary fat intake and the risk of incident dementia in the Rotterdam Study. Ann Neurol. 1997; 42 (5): 776-82.
66. Sanchez-Mejia R, Mucke L. Phospholipase A2 and arachidonic acid in Alzheimer's disease. Biochimica et Biophysica Acta. 2010; 1801 (8): 784-90.
67. Sanchez-Mejia RO, Newman JW, Toh S, Yu GQ, Zhou Y, et al Phospholipase A2 reduction ameliorates cognitive deficits in a mouse model of Alzheimer's disease. Nature Neurosci. 2008; 11 (11): 1311-8.
68. Esposito G, et al Imaging neuroinflammation in Alzheimer's disease with radiolabeled arachidonic acid and PET. J Nucl Med. 2008; 49 (9): 1414-21.
69. Fujishima H, et al.Cytosolic phospholipase A2 is essential for both the immediate and the delayed phases of eicosanoid generation in mouse bone marrow-derived mast cells. Proc Natl Acad Sci U S A. 1999; 96 (9): 4803-7.
70. Pasinetti GM, Aisen PS. Cyclooxygenase-2 expression is increased in frontal cortex of Alzheimer's disease brain. Neurosci. 1998; 87 (2): 319-24.
71. McNaull BB, Todd S, McGuinness B, Passmore AP. Inflammation and anti-inflammatory strategies for Alzheimer's disease-a mini-review. Gerontol. 2010; 56 (1): 3-14.
72. Lu DY, Tsao YY, Leung YM, Su KP. Docosahexaenoic acid suppresses neuroinflammatory responses and induces heme oxygenase-1 expression in BV-2 microglia: implications of antidepressant effects for omega-3 fatty acids. Neuropsychopharmacol. 2010; 35 (11): 2238-48.
73. Yavin E, Brand A, Green P. Docosahexaenoic acid abundance in the brain: a biodevice to combat oxidative stress. Nutr Neurosci. 2002; 5 (3): 149-57.
74. Stark DT, Bazan NG. Neuroprotectin D1 induces neuronal survival and downregulation of amyloidogenic processing in Alzheimer's disease cellular models. Mol Neurobiol. 2011; 43 (2): 131-8.
75. Dyall SC, Michael GJ, Michael-Titus AT. Omega-3 fatty acids reverse age-related decreases in nuclear receptors and increase neurogenesis in old rats. J Neurosci Res. 2010; 88 (10): 2091-102.
76. Hashimoto M, Hossain S, Shimada T, Shido O. Docosahexaenoic acid-induced protective effect against impaired learning in amyloid beta-infused rats is associated with increased synaptosomal membrane fluidity. Clin Experiment Pharmacol Physiol. 2006; 33 (10): 934-9.
77. Kitajka K, Sinclair AJ, Weisinger RS, Weisinger HS, Mathai M, et al Effects of dietary omega-3 polyunsaturated fatty acids on brain gene expression. Proc Natl Acad Sci U S A. 2004; 101 (30): 10931-6.
78. Kim HW, Rao JS, Rapoport SI, Igarashi M. Dietary n-6 PUFA deprivation downregulates arachidonate but upregulates docosahexaenoate metabolizing enzymes in rat brain. Biochimica et Biophysica Acta. 2011; 1811(2):111-7.
79. Rao JS, Ertley RN, DeMar JC Jr, Rapoport SI, Bazinet RP, Lee HJ. Dietary n-3 PUFA deprivation alters expression of enzymes of the arachidonic and docosahexaenoic acid cascades in rat frontal cortex. Mol Psychiatry. 2007; 12 (2): 151-7.
80. Nakamura MT, Nara TY. Structure, function, and dietary regulation of delta6, delta5, and delta9 desaturases. Ann Rev Nutr. 2004; 24345-76.
81. Bourre JM, Piciotti M, Dumont O. Delta 6 desaturase in brain and liver during development and aging. Lipids. 1990; 25 (6): 354-6.
82. Cook HW. Brain metabolism of alpha-linolenic acid during development. Nutr. 1991; 7 (6): 440-2.
83. Das U. A defect in the activity of [Delta] 6 and [Delta] 5 desaturases may be a factor predisposing to the development of insulin resistance syndrome. Prostaglandins, Leukotrienes and Essential Fatty Acids. 2005; 72 (5): 343-350.
84. Devlin AM, Singh R, Wade RE, Innis SM, Bottiglieri T, Lentz SR. Hypermethylation of Fads2 and altered hepatic fatty acid and phospholipid metabolism in mice with hyperhomocysteinemia. J Bio Chem. 2007; 282 (51): 37082-90.
85. Suzanne C. Insulin resistance syndrome and Alzheimer's disease: age- and obesity-related effects on memory, amyloid, and inflammation. Neurobiol Aging. 2005; 26 (Suppl. 1): 65-69.
86. Kuusisto J, Koivisto K, Mykkänen L, Helkala E-L, Vanhanen M, et al Association between features of the insulin resistance syndrome and Alzheimer's disease independently of apolipoprotein e4 phenotype: cross sectional population based study. BMJ. 1997; 315 (7115): 1045-9.
87. Basha M, Wei W, Bakheet S, Benïtez N, Siddiqi H, et al The fetal basis of amyloidogenesis: exposure to lead and latent overexpression of amyloid precursor protein and β-amyloid in the aging brain. J Neurosci. 2005; 25 (4): 823-829.
88. Abela J, Hankin B. Handbook of depression in children and adolescents. New York: The Guilford Press; 2008.
89. Hashimoto M, Hossain S, Shimada T, Sugioka K, Yamasaki H, et al Docosahexaenoic acid provides protection from impairment of learning ability in Alzheimer's disease model rats. J Neurochem. 2002; 81 (5): 1084-91.
90. Gamoh S, Hashimoto M, Sugioka K, Shahdat Hossain M, Hata N, et al Chronic administration of docosahexaenoic acid improves reference memory-related learning ability in young rats. Neurosci. 1999; 93 (1): 237-41.
91. Ikemoto A, Ohishi M, Sato Y, Hata N, Misawa Y, et al Reversibility of n-3 fatty acid deficiency-induced alterations of learning behavior in the rat: level of n-6 fatty acids as another critical factor. J Lipid Res. 2001; 42 (10): 1655-63.
92. Petursdottir AL, Farr SA, Morley JE, Banks WA, Skuladottir GV. Effect of dietary n-3 polyunsaturated fatty acids on brain lipid fatty acid composition, learning ability, and memory of senescence-accelerated mouse. J Gerontol A Biol Sci Med Sci. 2008; 63 (11): 1153-60.
93. Kariv-Inbal Z, Yacobson S, Berkecz R, Peter M, Janaky T, et al The isoform-specific pathological effects of APOE4 in vivo are prevented by a fish oil (DHA) diet and are modified by cholesterol. J Alzheimer's Dis. 2012; 28 (3): 667-83.
94. Chytrova G, Ying Z, Gomez-Pinilla F. Exercise contributes to the effects of DHA dietary supplementation by acting on membrane-related synaptic systems. Brain Res. 2010; 1341:32-40.
95. Laitinen MH, Ngandu T, Rovio S, Helkala EL, Uusitalo U, et al Fat intake at midlife and risk of dementia and Alzheimer's disease: a population-based study. Dement Geriatr Cogn Disord. 2006; 22 (1): 99-107.
96. Amtul Z, Uhrig M, Beyreuther K. Additive effects of fatty acid mixtures on the levels and ratio of amyloid β40/42 peptides differ from the effects of individual fatty acids. J Neurosci Res. 2011; 89 (11): 1795-801.
97. Lane RM, Farlow MR. Lipid homeostasis and apolipoprotein E in the development and progression of Alzheimer's disease. J Lipid Res. 2005; 46 (5): 949-68.
98. Simopoulos AP. Evolutionary aspects of diet: the omega-6/omega-3 ratio and the brain. Molec Neurobiol. 2011; 29: 29.
99. Horrocks LA, Yeo YK. Health benefits of docosahexaenoic acid (DHA). Pharmacol Res. 1999; 40 (3): 211-25.
100. FAO/WHO. Report, fats and oils in human nutrition. Rome: Food and Agricultural Organization of the United Nations; 1993.
101. Surai PF, Sparks NHC. Designer eggs: from improvement of egg composition to functional food. Trends Food Sci Technol. 2001; 12 (1): 7-16.
102. Hauswirth CB, Scheeder MRL, Beer JH. High ω-3 fatty acid content in alpine cheese. Circulation. 2004; 109 (1): 103-7.
103. Wright T, McBride B, Holub B. Docosahexaenoic acid-enriched milk. World Rev Nutr Dietetics. 1998; 83: 160-5.
104. Lai L, Kang JX, Li R, Wang J, Witt WT, et al Generation of cloned transgenic pigs rich in omega-3 fatty acids. Nat Biotech. 2006; 24 (4): 435-6.
105. Simopoulos A. New products from the agri-food industry: the return of n-3 fatty acids into the food supply. Lipids. 1999; 34: S297-S301.
106. Moghadasian MH. Advances in dietary enrichment with n-3 fatty acids. Crit Rev Food Sci Nutr. 2008; 48 (5): 402-10.
107. Simopoulos AP, Norman HA, Gillaspy JE, Duke JA. Common purslane: a source of omega-3 fatty acids and antioxidants. J Am Col Nutr. 1992; 11 (4): 374-82.