FitSugar

Healthy Recipe: Halibut Stir Fry

FitSugar — Mon, 01 Jun 2009 06:00:00 -0700

After buying some fine-looking frozen halibut at Trader Joe's last week, I went in search of an unexpected but healthy way to prepare it. I turned to the spiral-bound basic wok cookbook I recently purchased along with my new wok. Since it imparts a lot of flavor with not a lot of oil, a wok is a great piece of equipment to have in your healthy kitchen.

The black bean paste adds a salty flavor to the sweet marinade; if you can't find it at your local Asian food market, try using soybean paste instead for a similar effect. To up the nutrition factor, toss in even more types of veggies. To get the recipe, read more.

Delicious Sliced Fish With Black Bean Sauce
Wok Cooking Made Easy: Delicious Meals in Minutes

Ingredients

1 1/2 pounds fish steaks of fillets (such as tuna, halibut, snapper, sea bass, or swordfish)
2 tablespoons oil
3 to 4 cloves garlic, minced
1 1/2 to 2 tablespoons black bean paste (tau cheo)
6 green onions, cut into sections
1 teaspoon sugar
1 teaspoon coarsely ground black pepper
2 sprigs fresh cilantro, minced, as garnish (optional)

Marinade
2 tablespoons rice wine
1 teaspoon sesame oil
3 tablespoons fresh ginger, minced

Directions
Serves 4.

Cut the fish into bite-sized chunks. If using steaks, remove the bones. Place the fish in a mixing bowl.

Mix the marinade ingredients, pour over the fish, and turn to coat fish evenly. Cover and set aside to marinate for about 30 minutes.

Heat the oil in a wok over high heat, and add the marinated fish and garlic. Stir-fry for 1 to 2 minutes, until the fish changes color. Add the black bean paste and continue to cook for another 1 to 2 minutes.

Add the green onions, sugar, and coarsely ground black pepper, stirring for 1 more minute to blend the flavors. Transfer to a serving dish.

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Healthy Recipe: Poached Halibut with Fennel and Cauliflower

FitSugar — Sat, 05 Jul 2008 03:30:00 -0700

My first foray into poaching fish (Salmon with Yogurt Curry Sauce) was such a success I decided to branch out.

This poached halibut recipe is mild, lovely and features fennel, which is one of my favorite flavors. Halibut is a great fish to add to your diet. It is high in omega-3 fatty acids. However, since it is a large fish, its mercury levels can be high. It is recommended that pregnant women and nursing mothers limit their halibut consumption to once a month.

To see the recipe, just read more.

Poached Halibut with Fennel & Cauliflower
The World's Healthiest Foods

I am loving poached fish and this new recipe is wonderfully mild and cooling on a hot Summer's day.

Ingredients

One pound halibut steak cut into 8 to 12 pieces
1 tbs fresh lemon juice
1 cup chicken or vegetable broth
2 tbs dry white wine
1 medium sized onion cut in half and sliced medium thick
3 large carrot, sliced on diagonal
1 large head of cauliflower, cut into bite sized pieces
1 medium sized fennel bulb sliced medium thick
5 medium cloves garlic pressed or minced
salt and black pepper and lemon juice to taste
chopped fennel green tops for garnish

Directions

Slice onion and chop garlic and let sit for 5-10 minutes to bring out their hidden health-promoting properties.
Rub halibut with lemon juice and season with a little salt and pepper. Set aside.
Heat 2 tbs white wine in a large stainless steel skillet. Wet sauté onion in broth over medium heat for 5 minutes stirring frequently.
Add broth and carrots to pan. Simmer on medium heat for about 10 minutes covered.
Add cauliflower. Simmer on medium heat for 2 minutes.
Add fennel and garlic. Place halibut steaks on top and continue to cook covered for about 6 more minutes. Season with salt and pepper.
Serve halibut with vegetables and broth on rice or whole wheat cous-cous. Sprinkle with chopped fennel greens and a squeeze of lemon.

Serves 4
One serving, not including rice or couscous is about 250 calories.

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Try it! I think you will like it. This recipe is easy to make and not fishy at all. Even my girls liked it. Fish! My daughters ate fish!

Smarter Eats: Gwyneth Reminds Us to Get a Healthy Dose of D

FitSugar — Wed, 11 Nov 2009 14:30:31 -0800

Gwyneth Paltrow's dishing out some healthy advice on GOOP this week - get your daily dose of vitamin D. The super-fit star points to Dr. Frank Lipman's healthy tips for getting our fair share of the vital D, who reminds us that, especially this time of year -when we head into the colder season and see less sunlight - it's even more important to supplement our diets with the vitamin, and avoid a vitamin D deficiency.

If you're wondering why it's so important, just remember that vitamin D was first recognized for its importance in maintaining healthy calcium levels for our bones. According to Dr. Lipman, it's now becoming increasingly apparent that we've underestimated the value of the vitamin, and a lack of it has been associated with obesity, high blood pressure, heart disease, and breast cancer - to name a few.

Since we rely on the sun to generate the most reliable way of getting vitamin D, it's a good idea to up your intake of foods that can naturally deliver the goods - try fortified milk in your cereal, dried shitake mushrooms with your stir fry or salad, and wild fatty fish, like salmon and halibut. Just be aware that only 10 percent of your vitamin D intake can come from food, so to really eat smarter and healthier, it might just be a good idea to supplement with the active form of the vitamin, D3. Be sure to read all of Dr. Lipman's great tips, and until we see some sunlight this Spring, make sure you're getting your daily dose with fortified foods.

Healthy Eating Tip: Eat Two Different Fish a Week

FitSugar — Wed, 07 Oct 2009 09:00:10 -0700

Many people are worried about high mercury counts in fish, so they're swearing off seafood. The thing is, many types of fish are low in saturated fat, are an excellent source of lean protein, and are high in essential heart-healthy omega-3 fatty acids. I'm not saying that mercury is something to overlook, since this toxin can cause brain damage, and possibly cancer, but it doesn't mean you need to give up fish entirely.

It's safe to eat fish twice a week (up to 12 ounces), but you should choose two different types of fish to get a variety of nutrients. Good sources of low-mercury fish are shrimp, oysters, scallops, canned light tuna, salmon, pollock, flounder, sole, halibut, and catfish. Young children, women trying to get pregnant, those already pregnant, and nursing moms are considered "high risk," since too much mercury can affect developing brains. So for those people, the EPA recommends limiting intake of seafood that's high in mercury such as swordfish, golden bass, golden snapper, and shark.

Trying to meet your fish "quota" doesn't need to be boring. Try poached salmon with curried yogurt sauce or halibut stir-fry for dinner tonight.

What Does Your RDI Look Like: Omega-3s

FitSugar — Wed, 22 Jul 2009 13:00:53 -0700

Omega-3s fall into the category of healthy fats because they have so many benefits. These essential fatty acids reduce inflammation, stabilize your mood, lower your cholesterol, and have been found to reduce your risk of coronary heart disease. The RDI of omega-3s is 1.1 grams per day. It's easy to get your fill since omega-3s come from a variety of sources including fish, flaxseeds, walnuts, soybeans, and omega-enhanced foods. Are you getting enough? To find out, check my chart after you read more.

Food	Omega-3s (g)
3 oz. salmon	1.1
3 oz. halibut	.6
3 oz. swordfish	.97
3 oz. canned tuna	.17
1 tbsp. flaxseeds	1.8
1/8 cup walnuts	1.1
1 cup strawberries	.1
1 cup raspberries	.1
1/2 cup tofu	.23
1/2 edamame (soybeans)	2.8
1/2 cup steamed broccoli	.1
1 omega-3 enriched egg	.23

Do you think you're getting enough omega-3 fatty acids in your daily diet?

Fights the Blues With Fish

FitSugar — Tue, 09 Jun 2009 11:00:00 -0700

When thinking of food as medicine, we have gotten a little reductive. By trying to find the one active ingredient that makes a food healthy, we have forgotten about the food itself. Omega-3 fatty acids found in fish have been found to fight inflammation and reduce depression. But popping a fish oil supplement, rather than eating the fish, means you are missing out on the minerals and lean protein fish provide.

Here's another reason to add one to two servings of fish to your weekly menu. In an international breakdown of nutrition and mental health by country, researchers found that as fish consumption went up, depression rates went down. In countries where people eat the most fish - Japan, Thailand, and Hong Kong - the rates of depression were low. Conversely, countries with low fish consumption had higher rates of depression, including the US, New Zealand, and parts of Europe.The secret ingredient is the omega-3s. Rather than taking a supplement, try eating the fish for all the nutrition this lean protein can provide.

Not sure where to start when it comes to cooking with fish? For some tasty, healthy recipes featuring fish and shellfish with high amounts of omega-3s, read more.

Omega-3 fatty acids

FitSugar — Wed, 08 Oct 2008 17:35:25 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Overview

Omega-3 fatty acids are considered essential fatty acids. 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, such as salmon, tuna, and halibut, other marine life such as algae and krill, certain plants (including purslane), and nut oils. Also known as polyunsaturated fatty acids (PUFAs), omega-3 fatty acids play a crucial role in brain function as well as normal growth and development. The American Heart Association recommends eating fish (particularly fatty fish such as mackerel, lake trout, herring, sardines, albacore tuna, and salmon) at least 2 times a week. It is advised that pregnant women and mothers, nursing mothers, young children, and women who might become pregnant not eat several types of fish, including swordfish, shark, and king mackerel. These individuals should also limit consumption of other fish, including albacore tuna, salmon, and herring. They can take omega-3 fatty acids in quality dietary supplements that are certified mercury-free by a reputable third-party lab.

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 risk factors associated with chronic diseases such as heart disease, cancer, and arthritis. These essential fatty acids are highly concentrated in the brain and appear to be particularly important for cognitive (brain memory and performance) 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. Symptoms of omega-3 fatty acid deficiency include extreme tiredness (fatigue), poor memory, dry skin, heart problems, mood swings or depression, and poor circulation.

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. 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 2 - 4 times more omega-6 fatty acids than omega-3 fatty acids. The typical American diet tends to contain 14 - 25 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. It also contains another fatty acid, omega-9 fatty acids, which have been reported to help lower risks associated with cancer and 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.

Uses

Clinical studies suggest that omega-3 fatty acids may be helpful in treating a variety of health 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 high density lipoprotein (HDL or "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 eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been reported in several large clinical studies to reduce low density lipoprotein (LDL or "bad") cholesterol and triglyceride levels. Finally, walnuts (which are rich in alpha linolenic acid or ALA) have been reported to lower total cholesterol and triglycerides in individuals with high cholesterol levels.

High blood pressure

Several clinical studies suggest that diets or supplements rich in omega-3 fatty acids lower blood pressure significantly in individuals with hypertension. An analysis of 17 clinical studies using fish oil supplements found that supplementation with 3 or more grams of fish oil daily can lead to significant reductions in blood pressure in individuals with untreated hypertension.

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). Clinical 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. Clinical 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.

Strong evidence from population-based clinical 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 2 servings of fish per week can reduce the risk of stroke by as much as 50%. However, people who eat more than 3 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

Individuals with diabetes tend to have high triglyceride and low HDL levels. Omega-3 fatty acids from fish oil can help lower triglycerides and apoproteins (markers of diabetes), 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. There have been slight increases reported in fasting blood sugar levels in patients with type 2 diabetes while taking fish oil supplements.

Weight loss

Many individuals who are overweight suffer from poor blood sugar control, diabetes, and high cholesterol. Clinical studies suggest that overweight people who follow a weight loss program that includes 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 the inflammatory 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 reported 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.

An analysis was conducted of 17 randomized, controlled clinical trials assessing the pain relieving effects of omega-3 fatty acid supplementation in patients with rheumatoid arthritis or joint pain caused by inflammatory bowel disease (IBS) and painful menstruation (dysmenorrhea). The results suggest that omega-3 fatty acids are effective treatment, along with conventional therapies such as anti-inflammatory drugs, for joint pain associated with rheumatoid arthritis, inflammatory bowel disease, and dysmenorrhea.

Osteoporosis

Clinical 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 3 years than those who were given a placebo. Many of these women also experienced an increase in bone density.

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. In particular, DHA is involved in a variety of nerve cell processes.

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 clinical study of patients hospitalized for depression. In a clinical study of individuals with depression, those who ate a healthy diet consisting of fatty fish 2 - 3 times per week for 5 years experienced a significant reduction in feelings of depression and hostility.

Bipolar disorder

In a clinical study of 30 people with bipolar disorder, those who were treated with EPA and DHA (in combination with their usual mood stabilizing medications) for 4 months experienced fewer mood swings and recurrence of either depression or mania than those who received placebo. Another 4-month long clinical study treating individuals with bipolar depression and rapid cycling bipolar disorder did not find evidence of efficacy for the use of in EPA in these patients.

Schizophrenia

Preliminary clinical 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, individuals with schizophrenia may not be able to convert ALA to EPA or DHA efficiently.

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 clinical 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. Clinical studies that examine the ability of omega-3 supplements to improve symptoms of ADHD are still needed. At this point in time, eating foods high in omega-3 fatty acids is a reasonable approach for someone with ADHD. A clinical study used omega-3 and omega-6 fatty acid supplementation in 117 children with ADHD. They study found significant improvements in reading, spelling, and behavior in the children over the 3 months of therapy. Another clinical study found that omega-3 fatty acid supplementation helped to decrease physical aggression in school children with ADHD. More studies, including comparisons with drug therapies (such as stimulants), should be performed.

Eating disorders

Clinical 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 clinical study, 13 people with a particular sensitivity to the sun known as photo dermatitis 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 2 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, belching, bloating, and diarrhea).

Asthma

Clinical 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 clinical 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 clinical study comparing 350 people with macular degeneration to 500 without the eye disease 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 clinical study confirms that EPA and DHA from fish, 4 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 clinical study of nearly 200 Danish women, those with the highest dietary intake of omega-3 fatty acids had the mildest symptoms, such as hot flashes and increased sweating, 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.

Clinical studies have reported that low levels of omega-3 fatty acids in the body are a marker for an increased risk of colon cancer.

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, 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 clinical 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 clinical 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 autism, ulcers, migraine headaches, preterm labor, emphysema, psoriasis, glaucoma, Lyme disease, systemic lupus erythmatosus (lupus), irregular heart beats (arrhythmias), multiple sclerosis, and panic attacks. Omega-3 fatty acid supplementation may also help to reduce stress and the effects it has on the body.

Dietary Sources

Fish, plant, and nut oils are the primary dietary source of omega-3 fatty acids. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are found in cold-water fish such as salmon, mackerel, halibut, sardines, tuna, 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. Other sources of omega-3 fatty acids include sea life such as krill and algae.

Available Forms

In addition to the dietary sources described, EPA and DHA can be taken in the form of fish oil capsules. Flaxseed, flaxseed oil, fish and krill oils 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, lead, and cadmium.

How to Take It

Dosing for fish oil supplements should be based on the amount of EPA and DHA in the product, not on the total amount of fish oil. Supplements vary in the amounts and ratios of EPA and DHA. A common amount of omega-3 fatty acids in fish oil capsules is 0.18 grams (180 mg) of EPA and 0.12 grams (120 mg) of DHA. Five grams of fish oil contains approximately 0.17 - 0.56 grams (170 -560 mg) of EPA and 0.072 - 0.31 grams (72 - 310 mg) of DHA. Different types of fish contain variable amounts of omega-3 fatty acids, and different types of nuts or oil contain variable amounts of a-linolenic acid. Fish oils contain approximately 9 calories per gram of oil.

Children (18 years and younger)

The precise safe and effective doses of all types of omega-3 fatty acid supplements in children have not been established. Omega-3 fatty acids are used in some infant formulas, although effective doses are not clearly established. Ingestion of fresh fish should be limited in young children due to the presence of potentially harmful environmental contaminants, including mercury. Fish oil capsules should not be used in children except under the direction of a health care provider.

Adults

Individuals taking more than 3 grams daily of omega-3 fatty acids from capsules should do so only under the supervision of a health care provider due to an increase risk of bleeding.

For healthy adults with no history of heart disease: The American Heart Association (AHA) recommends eating fish at least 2 times per week.

For adults with coronary heart disease: The American Heart Association (AHA) recommends an omega-3 fatty acid supplement (as fish oils), 1 gram daily of EPA and DHA. It may take 2 - 3 weeks for benefits of fish oil supplements to be seen.

For adults with high cholesterol levels: The American Heart Association (AHA) recommends an omega-3 fatty acid supplement (as fish oils), 2 - 4 grams daily of EPA and DHA. It may take 2 - 3 weeks for benefits of fish oil supplements to be seen.

Precautions

Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable health care provider.

Omega-3 fatty acids should be used cautiously by people who bruise easily, have a bleeding disorder, or take blood-thinning medications, including warfarin (Coumadin) or clopidogrel (Plavix), 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, bloating, belching, and diarrhea. Time-release preparations may reduce these side effects, however.

People with either diabetes or schizophrenia may lack the ability to convert alpha-linolenic acid (ALA) to eicosapentaenoic acid (EPA) and docosahexaenoic acid (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. Also, individuals with type 2 diabetes may experience increases in fasting blood sugar levels while taking fish oil supplements. If you have type 2 diabetes, only use fish oil supplements under the supervision of a health care provider.

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 2 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.

Fish (and fish oil supplements) may contain potentially harmful contaminants, such as heavy metals (including mercury), dioxins, and polychlorinated biphenyls (PCBs). For sport-caught fish, the U.S. Environmental Protection Agency (EPA) recommends that intake be limited in pregnant or nursing women to a single 6-ounce meal per week, and in young children to less than 2 ounces per week. For farm-raised, imported, or marine fish, the U.S. Food and Drug Administration recommends that pregnant or nursing women and young children avoid eating types with higher levels of mercury (such as mackerel, shark, swordfish, or tilefish), and less than 12 ounces per week of other fish types. Unrefined fish oil preparations may contain pesticides.

Possible Interactions

If you are currently being treated with any of the following medications, you should not use omega-3 fatty acid supplements, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (ALA), without first talking to your health care provider.

Blood-thinning medications -- Omega-3 fatty acids may increase the effects of blood thinning medications, including aspirin, warfarin (Coumadin), and clopedigrel (Plavix). While the combination of aspirin and omega-3 fatty acids may actually be helpful under certain circumstances (such as in heart disease), they should only be taken together under the guidance and supervision of a health care provider.

Blood sugar lowering medications -- Taking omega-3 fatty acid supplements may increase fasting blood sugar levels. Use with caution if taking blood sugar lowering medications, such as glipizide (Glucotrol and Glucotrol XL), glyburide (Micronase or Diabeta), glucophage (Metformin), or insulin, as omega-3 fatty acid supplements may increase your need for the medication(s).

Cyclosporine -- Taking omega-3 fatty acids during cyclosporine (Sandimmune) 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 the drug therapy etretinate (Tegison) 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", including atorvastatin (Liptor), lovastatin (Mevacor), and simvastatin (Zocor) 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), including ibuprofen (Motrin or Advil) and naproxen (Alleve or Naprosyn). More research is needed to evaluate whether omega-3 fatty acids would have the same effects in people.

Supporting Research

Albert CM, Hennekens CH, O'Donnell CJ, et al. Fish consumption and risk of sudden cardiac death. JAMA. 1998;279(1):23-28.

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.

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.

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.

Balk EM, Lichtenstein AH, Chung M et al. Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: A systematic review. Atherosclerosis. 2006 Nov;189(1):19-30.

Baumgaertel A. Alternative and controversial treatments for attention-deficit/hyperactivity disorder. Pediatr Clin of North Am. 1999;46(5):977-992.

Bays HE. Safety considerations with omega-3 Fatty Acid therapy. Am J Cardiol. 2007;99(6A):S35-43.

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.

Berbert AA, Kondo CR, Almendra CL et al. Supplementation of fish oil and olive oil in patients with rheumatoid arthritis. Nutrition. 2005;21:131-6.

Berson EL, Rosner B, Sandberg MA, et al. Clinical trial of docosahexaenoic acid in patients with retinitis pigmentosa receiving vitamin A treatment. Arch Ophthalmol. 2004;122(9):1297-1305.

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.

Boskou, D. Olive oil. World Rev Nutr Diet. 2000;87:56-77.

Bradbury J, Myers SP, Oliver C et al. An adaptogenic role for omega-3 fatty acids in stress; a randomised placebo controlled double blind intervention study (pilot)ISRCTN22569553. Nutr J. 2004 Nov 28;3:20.

Buckley MS, Goff AD, Knapp WE, et al. Fish oil interaction with warfarin. Ann Pharmacother. 2004;38:50-2.

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.

Burr ML, Dunstan FD, George CH et al. Is fish oil good or bad for heart disease? Two trials with apparently conflicting results. J Membr Biol. 2006;206:155-63.

Calo L, Bianconi L, Colivicchi F et al. N-3 Fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a randomized, controlled trial. J Am Coll Cardiol. 2005;45:1723-8.

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.

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.

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 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.

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.

Frangou S, Lewis M, McCrone P et al. Efficacy of ethyl-eicosapentaenoic acid in bipolar depression: randomised double-blind placebo-controlled study. Br J Psychiatry. 2006;188:46-50

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.

Freund-Levi YF, Eriksdotter-Jonhagen M, Cederholm T, et al. Omega-3 fatty acid treatment in 174 patients with mild to moderate Alzheimer disease: OmegAD Study. Arch Neurol. 2006;63:1402-8.

Friedberg CE, Janssen MJ, Heine RJ, Grobbee DE. Fish oil and glycemic control in diabetes: a meta-analysis. Diabetes Care. 1998;21:494-500.

Geelen A, Brouwer IA, Schouten EG et al. Effects of n-3 fatty acids from fish on premature ventricular complexes and heart rate in humans. Am J Clin Nutr. 2005;81:416-20.

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.

Goldberg RJ, Katz J. A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain. 2007 Feb 28; [Epub ahead of print].

Hall MN, Campos H, Li H, Sesso HD, Stampfer MJ, Willett WC, Ma J. Blood levels of long-chain polyunsaturated fatty acids, aspirin, and the risk of colorectal cancer. Cancer Epidemiol Biomarkers Prev. 2007;16(2):314-21.

Harris WS. N-3 fatty acids and serum lipoproteins: human studies. Am J Clin Nutr. 1997;65(5):1645S (10).

Hibbeln JR. Fish consumption and major depression. Lancet. 1998;351(9110):1213.

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.

Hooper L, Thompson R, Harrison R et al. Omega 3 fatty acids for prevention and treatment of cardiovascular disease. Cochrane Database Syst Rev. 2004;CD003177.

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.

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.

Itomura M, Hamazaki K, Sawazaki S et al. The effect of fish oil on physical aggression in schoolchildren - a randomized, double-blind, placebo-controlled trial. J Nutr Biochem. 2005;16:163-71.

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.

Klurfeld DM, Bull AW. Fatty acids and colon cancer in experimental models. Am J Clin Nut. 1997;66(6 Suppl):1530S-1538S.

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.

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.

Laugharne JD, Mellor JE, Peet M. Fatty acids and schizophrenia. Lipids. 1996;31(Suppl):S-163-165.

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.

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.

Mozaffarian D, Geelen A, Brouwer IA et al. Effect of Fish Oil on Heart Rate in Humans. A Meta-Analysis of Randomized Controlled Trials. Circulation. 2005;112(13):1945-52.

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.

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.

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.

Romano C, Cucchiara S, Barabino A et al. Usefulness of omega-3 fatty acid supplementation in addition to mesalazine in maintaining remission in pediatric Crohn's disease: A double-blind, randomized, placebo-controlled study. World J Gastroenterol. 2006;11:7118-21.

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(:1191-1199.

Silvers KM, Woolley CC, Hamilton FC et al. Randomised double-blind placebo-controlled trial of fish oil in the treatment of depression. Prostaglandins Leukot Essent Fatty Acids. 2005;72:211-8.

Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin Nutr. 1999;70(30 Suppl):560S-569S.

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.

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.

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.

Sundstrom B, Stalnacke K, Hagfors L et al. Supplementation of omega-3 fatty acids in patients with ankylosing spondylitis. Scand J Rheumatol. 2006;35:359-62.

Terry P, Lichtenstein P, Feychting M, Ahlbom A, Wolk A. Fatty fish consumption and risk of prostate cancer. Lancet. 2001;357(9270):1764-1766.

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.

Weinstock-Guttman B, Baier M, Park Y et al. Low fat dietary intervention with omega-3 fatty acid supplementation in multiple sclerosis patients. Prostaglandins Leukot Essent Fatty Acids. 2005;73:397-404.

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.

Yuen AW, Sander JW, Fluegel D et al. Omega-3 fatty acid supplementation in patients with chronic epilepsy: A randomized trial. Epilepsy Behav. 2005;7(2):253-8.

Review Date:
5/1/2007
Reviewed By:
Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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Colorectal cancer

FitSugar — Wed, 08 Oct 2008 17:35:04 -0700

Overview

Signs and Symptoms
Causes
Risk Factors
Diagnosis
Preventive Care
Treatment
Other Considerations
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Colorectal cancer -- cancer of the colon and rectum -- is the second most commonly diagnosed cancer in American men and women. Colorectal cancer develops in the digestive system, which processes food for energy and rids the body of solid waste. Together, the colon and rectum form a muscular tube about 5 feet long known as the large intestine. The colon (the first and largest part of the large intestine) absorbs water and nutrients from food and serves as a storage place for solid waste. The waste moves from the colon into the rectum (the final 6 inches of the large intestine) where it passes out of the body through the anus. Cancers affecting either of these organs are called colorectal cancer. Most colorectal cancers arise from benign polyps (abnormal masses of tissue) that begin growing on the inner lining of the colon or rectum. These growths spread very slowly, taking from 10 - 20 years to become cancerous. Once colorectal cancer is diagnosed, the prognosis depends on how far the cancer has spread.

The American Cancer Society estimates that about 150,000 cases of colorectal cancer are diagnosed every year in the United States. Most cases of colorectal cancer occur in people older than 50 years of age. Although colorectal cancer is expected to be responsible for about 56,000 deaths this year, the death rate from this form of cancer has been dropping steadily for the past 15 years. Some researchers speculate that the lowering death rate is due to prevention and early treatment of the disease.

Signs and Symptoms

Unfortunately, most people with colorectal cancer will not begin to experience symptoms until the disease is already at a late stage. In fact, some people may experience no symptoms at all. This is the reason that screening tests, such as a colonoscopy, are so important.

In general, signs and symptoms of colorectal cancer can include the following:

Changes in bowel habits
Blood in the stool
Problems related to blood loss (anemia, weakness, fatigue, shortness of breath, pounding or racing heart, chest pain, and intolerance to exercise)
Abdominal discomfort (frequent gas, bloating, fullness, cramps, and pain)
Unexplained weight loss
Pain with defecation
Stools that are narrower than usual
Urgent desire to defecate (and the passage of little matter)

These symptoms may be caused by colorectal cancer or by other conditions such as infections, hemorrhoids, and inflammatory bowel disease. It is important to bring any of these symptoms to the attention of your health care provider to determine the cause of your symptoms.

Causes

Although more than half of all colorectal cancers occur without any clear cause, studies suggest that genetic factors may play an important role in the development of the disease. For example, many people with colorectal cancer carry specific genetic mutations (genes that normally suppress cancer growth are mutated and actually promote cancer growth) or have relatives with the condition. Those with a family history of specific genetic syndromes -- such as familial adenomatous polyposis, Lynch syndrome, juvenile polyposis, and Peutz-Jeghers syndrome -- are also at an increased risk for developing colorectal cancer. Dietary and lifestyle factors, such as smoking and high-fat intake, also influence the development of colorectal cancer. Some researchers speculate that genetic factors predispose a person to colorectal cancer, but that dietary and lifestyle factors play a strong role in determining which "at-risk" individuals go on to develop the disease.

Risk Factors

Family history of colorectal cancer or polyps in the colon
Older age (over 50 years)
Living in an industrialized country like the United States
Polyps on the inner lining of the colon or rectum
African-American descent
Diets high in meat and low in fruits and vegetables
Overweight or obesity
Regular consumption of alcohol
Smoking cigarettes regularly
Inflammatory bowel disease (such as irritable bowel syndrome, Crohn's disease, and ulcerative colitis)

Diagnosis

After obtaining a complete medical history, a health care provider will perform a physical exam and may order one or more tests to diagnose colorectal cancer. As mentioned in the Preventive Care section, standard tests used to diagnose colorectal cancer include the sigmoidoscopy, colonoscopy, and barium enema. At the time of either a sigmoidoscopy or a colonscopy, a biopsy (sample of tissue) is removed from the colon or rectum and examined under a microscope in order to detect abnormal growths. If the doctor finds cancer, a series of tests (chest x-ray, abdominal CT scan, and blood tests to check liver function) will be performed to determine if the cancer has spread and to help determine the stage (or extent) of the disease. Stages of colorectal cancer include:

Stage A: The earliest stage; cancer is found only in the innermost lining of the colon and/or rectum.
Stage B1: Involves the muscular part of the colon and/or rectum.
Stage B2: Cancer has spread to deeper layers of the wall of the colon and/or rectum.
Stage C: Cancer has spread to nearby lymph nodes but not to other parts of the body.
Stage D: Cancer has spread to other parts of the body, such as the liver and lungs.

Preventive Care

Screening

Colorectal cancer is highly preventable, even curable, when detected early. Regular screening for colorectal cancer helps detect the presence of polyps before they become cancerous. The American Cancer Society recommends the following standard screening practices for individuals who are not at high risk for colorectal cancer and who have no symptoms of the disease:

Annual digital rectal exams starting at age 40: The doctor inserts a lubricated, gloved finger into the rectum to feel for abnormal areas.
Annual fecal occult blood tests starting at age 50: Stool samples are tested in the doctor's office for the presence of hidden blood.
Visualization of the colon via one of the following:
- Sigmoidoscopy (examination of the rectum and lower colon using a lighted instrument)
- Colonoscopy (examination of the rectum and entire colon using a lighted instrument)
- Barium enema (examination using a series of x-rays that reveal barium-stained outlines of the colon and rectum) every 3 -5 years starting at age 50

Those with a family history of colorectal cancer should undergo colonoscopy every 3 - 5 years, starting at least 10 years before the age of the relative at the time of his or her diagnosis. Those with a family history of familial adenomatous polyposis (a condition causing thousands of polyps along the inner lining of the colon) or other similar genetic syndromes (listed under Causes) should start having colonoscopies at age 10.

Diet and Exercise

People may also lower their chances of developing colorectal cancer by managing the risk factors they can control, such as diet and exercise. For example, eating plenty of fruits and vegetables as well as foods rich in omega-3 fatty acids (such as salmon and halibut) and calcium (such as sea vegetables and kale) can help reduce the risk of colorectal cancer. Limiting alcohol consumption, quitting smoking, and reducing the intake of high-fat and fried foods, particularly red meats, may also protect developing colorectal cancer.

Physical activity also will decrease the risk factors associated with developing colorectal cancer. Obesity and a sedentary lifestyle increases the risk of colorectal cancer. Even small amounts of exercise on a regular basis can be helpful, and the American Cancer Society recommends at least 30 minutes of physical activity on most days.

Other Preventive Measures

Preliminary studies also suggest that aspirin may prevent tumor growth and that hormone replacement therapy (HRT) may reduce the risk of colorectal cancer in women. However, HRT may increase the chances of developing other cancers, such as breast and ovarian. It is recommended to choose diet and lifestyle changes along with dietary supplements to protect against the risk factors associated with colorectal cancer.

Treatment

Surgery to remove the tumor is the only way to cure the disease, and early detection is the best preparation for successful treatment. Depending on the stage of the cancer, surgery is generally followed with chemotherapy. If the tumor is particularly large, radiation may be necessary before or after surgery.

Certain medications or supplements may help prevent the development of polyps and/or colorectal cancer. Modifying lifestyle, particularly avoiding red meat, losing weight, quitting smoking, and increasing physical activity, may help prevent the disease -- even in individuals with a family history of the condition.

Lifestyle

An unhealthy lifestyle may increase the risk of colorectal cancer even in people who have no family history of the condition. Some experts believe that adjusting lifestyle habits may decrease the likelihood of developing colorectal cancer by as much as 70% in some individuals.

Findings from studies support the association between colorectal cancer and physical inactivity and obesity. Research continues to point to the idea that exercise and low-calorie diets can help to prevent colorectal cancer.

A large, population-based study of men and women in Hawaii found that the following lifestyle factors were linked with colorectal cancer:

Smoking
Alcohol consumption
History of diabetes
Frequent constipation
High-calorie diet
Obesity
Physical inactivity
Low vegetable fiber intake (this association is controversial)
High levels of insulin (hormone that controls blood sugar levels)
Meat consumption

Medications

After surgery, chemotherapy (the use of anticancer drugs to destroy cancer cells) may be given to kill any cancerous cells that remain in the body. Chemotherapy controls the spread of the disease and improves survival rates over time. The following chemotherapeutic medications are used alone or in combination to treat colorectal cancer:

Fluorouracil (5-FU) -- often used in combination with leucovorin for 6 months after surgery. Reduces the rate of recurrence and improves chances of survival. Common side effects include nausea, diarrhea, inflammation of the skin and lining of the mouth, and lowered white blood cell count, which increases the chance of developing an infection and anemia.
Leucovorin -- a form of folic acid often used in combination with 5-FU. Side effects are rare but can include rash, itching, and wheezing.
Levamisole -- can be used in combination with 5-FU. Potential side effects are numerous and include nausea, vomiting, diarrhea, loss of appetite, abdominal pain, lower extremity swelling, insomnia, fatigue, headache, hair loss, dizziness, muscle and joint paints, and depression.

For colorectal cancer that has metastasized, or spread, doctors generally use 5-FU in combination with other drugs. One regimen approved by the United States Food and Drug Administration for metastatic colorectal cancer is 5-FU, leucovorin, and irinotecan. With the addition of irinotecan, the progression of the disease significantly slowed and survival improved compared to the 5-FU-leucovorin combination. However, an unexpectedly high death rate in two recent studies by the National Cancer Institute has brought the addition of irinotecan into question. There are other medications currently under investigation for metastatic colon cancer.

Long-term use of aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs), and hormone replacement therapy have shown promise in the prevention and treatment of colorectal cancer.

Aspirin -- may reduce the risk of polyps and colorectal cancer by up to 44%.
NSAIDs -- reduced the number of polyps by 90% and colon tumors by 55% in animals.
Hormone-replacement therapy (HRT) -- over the past 20 years, the rate of death from colorectal cancer among women has decreased far more than the rate among men. Studies suggest that this may be due to the increasing use of hormone-replacement therapy by women after menopause. However, HRT is not without risks, and your health care provider will help you determine which treatment is best for you.

Surgery and Other Procedures

Surgery is the treatment of choice for colorectal cancer, and is best when the disease is detected at an early stage. Before becoming cancerous, polyps can be removed during a colonoscopy. Depending on the severity and location of the cancer, including whether or where it has spread, an individual may need a partial or total removal of the colon (colectomy) and rectum (rectal resection). During surgery, the surgeon also examines other abdominal organs for signs of cancer. If cancer has spread to the liver, a portion of this organ may be removed as well. After removing the tumor and nearby tissue, the surgeon reconnects the healthy portions of the colon or rectum. If the healthy portions of the colon or rectum cannot be reconnected, a temporary or permanent opening (stoma) is made through the wall of the abdomen into the colon to provide a new path for waste material to leave the body. This procedure is called a colostomy. Radiation may also be used before or during surgery (called intraoperative radiotherapy) to shrink the tumor, and it may be recommended following surgery for certain stages of colorectal cancer to reduce the risk of recurrence. Following surgery, colonoscopies are performed every 3 - 6 months for 3 years to detect recurrence.

Nutrition and Dietary Supplements

A comprehensive treatment plan for colorectal cancer may include a range of complementary and alternative therapies. Nutrients and herbs may protect against side effects from conventional therapies as well as enhance chemotherapy and support anticancer activities. Mind-body therapies such as meditation, relaxation techniques, yoga, and qi gong may reduce the effects of stress and enhance your quality of life and your response to treatment. Ask your team of health care providers about the best ways to incorporate these therapies into your overall treatment plan.

Always tell your health care provider about the herbs and supplements you are using or considering, as some supplements may interfere with conventional cancer treatments.

Following these nutritional tips may help reduce symptoms:

Try to eliminate potential food allergens, including dairy, wheat (gluten), corn, preservatives, and food additives. Your health care provider may want to test for food sensitivities.
Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers).
Eat foods high in B-vitamins and calcium, such as almonds, beans, whole grains (if no allergy), dark leafy greens (such as spinach and kale), and sea vegetables.
Avoid refined foods such as white breads, pastas, and especially sugar.
Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein. Quality protein sources, such as organic meat and eggs, whey, and vegetable protein shakes, should be used as part of balanced program aimed at gaining muscle mass and preventing wasting that can sometimes be side effects of cancer therapies.
Use healthy oils, such as olive oil or vegetable oil.
Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
Avoid coffee and other stimulants, alcohol, and tobacco.
Drink 6 - 8 glasses of filtered water daily.
Exercise at least 30 minutes daily, 5 days a week.

You may use nutritional deficiencies with the following supplements:

A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals such as magnesium, calcium, zinc, and selenium.
Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 - 3 tablespoonfuls oil daily, to help decrease inflammation and help with immunity. Cold-water fish, such as salmon or halibut, are good sources.
Vitamin C, 500 - 1,000 mg, one to three times daily, as an antioxidant and for immune support.
L-glutamine, 500 - 1,000 mg three times daily, for support of gastrointestinal health and immunity.
Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, when needed for maintenance of gastrointestinal and immune health. You should refrigerate your probiotic supplements for best results.
Grapefruit seed extract (Citrus paradisi), 100 mg capsule or 5 - 10 drops (in favorite beverage) three times daily when needed, for antibacterial, antifungal, and antiviral activity, and for immunity.
Astaxanthin, 2 - 6 mg daily, for immune and antioxidant support.
Alpha-lipoic acid, 25 - 50 mg twice daily, for antioxidant support.
Resveratrol (from red wine), 50 - 200 mg daily, to help decrease inflammation and for antioxidant effects.
Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant and immune activity.
Melatonin, 2 - 6 mg at bedtime as needed, for immune support and sleep. Higher doses may be needed in cancer. Consult your health care provider.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anticancer and immune effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
Reishi mushroom (Ganoderma lucidum) standardized extract, 150 - 300 mg two to three times daily, for anticancer and immune effects. You may also take a tincture of this mushroom extract, 30 - 60 drops two to three times a day.
Maitake mushroom (Grifola frondosa) standardized extract (D-fraction), 600 mg twice daily, for immune and anticancer effects. You may also take a tincture of this mushroom extract, 30 - 60 drops two to three times a day.
Olive leaf (Olea europaea) standardized extract, 250 - 500 mg one to three times daily, for anticancer and immune effects.
Turmeric (Curcuma longa) standardized extract, 300 mg three times a day, for pain and inflammation.
Milk thistle (Silybum marianum) seed standardized extract, 80 - 160 mg two to three times daily, for detoxification support.
Fermented wheat germ extract, 1 packet dissolved in favorite beverage once daily, for anticancer and immune effects.

Acupuncture

While acupuncture is not used as a treatment for cancer itself, evidence suggests it can be a valuable therapy for cancer-related symptoms (particularly nausea and vomiting that often accompanies chemotherapy treatment). Studies have indicatedthat acupuncture may help reduce pain and shortness of breath. Acupressure (pressing on rather than needling acupuncture points) has also proved useful in controlling breathlessness. Patients can learn this technique and use to treat themselves.

Some acupuncturists prefer to work with a patient only after the completion of conventional medical cancer therapy. Others will provide acupuncture or herbal therapy during active chemotherapy or radiation. Acupuncturists treat cancer patients based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. In many cases of cancer-related symptoms, a qi deficiency is usually detected in the spleen or kidney meridians.

Mind-Body Medicine

Relaxation techniques are beneficial for individuals undergoing surgery. In one study it was observed that patients who received standard care plus relaxation techniques in the form of guided imagery audiotapes before, during, and after surgery experienced significantly better sleep and less pain following the surgery than patients who received only standard care.

Other Considerations

Pregnancy

Colorectal cancer may be detected late in pregnant women because symptoms of the disease, such as rectal bleeding, nausea, and vomiting, resemble the symptoms of pregnancy. Pregnant women should avoid chemotherapy and radiation therapy. Surgery puts the fetus at risk, therefore folic acid and nutritional needs are usually maintained during pregnancy, and treatment is postponed until after the baby is delivered.

Prognosis and Complications

Follow-up care after treatment for colorectal cancer is very important. If the cancer returns or if new cancer develops, it should be treated as soon as possible. If left untreated, colorectal cancer can spread to the liver or lungs, or a tumor may block the colon. In some cases, individuals with colorectal cancer may need to have their entire colon or rectum removed. If the surgeon cannot reconnect healthy portions of the colon or rectum, a temporary or permanent surgical opening (stoma) is made through the wall of the abdomen into the colon to provide a new path for waste material to leave the body. After this procedure, a special bag is worn to collect body waste. Individuals who wear the bag may need counseling on how to care for the stoma as well as how to deal with the emotional difficulties associated with this procedure.

The outlook in cases of colorectal cancer depends on how deeply the tumor has penetrated into the tissue and whether the cancer has spread to lymph nodes in the abdominal region or to other areas of the body. Following are the proportions of individuals who survive at least 5 years based on the stage of their disease when it was first diagnosed:

Stage A -- more than 90%
Stages B1 and B2 -- 85%
Stage C -- 70% to 80%
Stage D -- 5%

Supporting Research

Albanes D, Malila N, Taylor PR, et al. Effects of supplemental a-tocopherol and ß-carotene on colorectal cancer: results from a controlled trial (Finland). Cancer Causes Control. 2000;11:197-205.

Alimi D, Rubino C, Leandri EP, Brule SF. Analgesic effects of auricular acupuncture for cancer pain [letter]. J Pain Symptom Manage. 2000;19(2):81-82.

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.

Baron JA, Beach M, Mandel JS, et al. Calcium supplements for the prevention of colorectal adenomas. N Eng J Med. 1999;340:101-107.

Bast A, Haenen GR. Lipoic acid: a multifunctional antioxidant. Biofactors. 2003;17(1-4):207-13.

Bauer JD, Capra S. Nutrition intervention improves outcomes in patients with cancer cachexia receiving chemotherapy -- a pilot study. Support Care Cancer. 2005;13(4):270-4.

Baur JA, Sinclair DA. Therapeutic potential of resveratrol: the in vivo evidence. Nat Rev Drug Discov. 2006;5(6):493-506.

Biasco G, Zannoni U, Paganelli GM, et al. Folic acid supplementation and cell kinetics of rectal mucosa in patients with ulcerative colitis. Cancer Epidemiol Biomarkers Prev. 1997;6:469-471.

Birdsall TC. The biological effects and clinical uses of the pineal hormone melatonin. Alt Med Rev. 1996; 1(2):94-102.

Bonithon-Kopp C, Kronborg O, Giacosa A, Rath U, Faivre J. Calcium and fibre supplementation in prevention of colorectal adenoma recurrence: a randomised intervention trial. European Cancer Prevention Organisation Study Group. Lancet. 2000;356:1300-1306.

Bushman JL. Green tea and cancer in humans: a review of the literature. Nutr Cancer. 1998;31(3):151-159.

Davies MJ, Bowey EA, Adlercreutz H, Rowland IR, Rumsby PC. Effects of soy or rye supplementation of high-fat diets on colon tumour development in azoxymethane treated rats. Carcinogenesis. 1999;20(6):927-931.

de Deckere EAM. Possible beneficial effect of fish and fish n-3 polyunsaturated fatty acids in breast and colorectal cancer. Euro J Cancer Prev. 1999;8:213-221.

Doron S, Gorbach SL. Probiotics: their role in the treatment and prevention of disease. Expert Rev Anti Infect Ther. 2006;4(2):261-75.

Douillard JY, Cunningham D, Roth AD, Navarro M, James RD, Karasek P, et al. Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial. Lancet. 2000;355:1041-1047.

Ezzo J, Berman B, Hadhazy VA, Jadad AR, Lao L, Singh BB. Is acupuncture effective for the treatment of chronic pain? A systematic review. Pain. 2000;86:217-225.

Filshie J, Penn K, Ashley S, Davis CL. Acupuncture for the relief of cancer-related breathlessness. Palliat Med. 1998;10:145-150.

Flood A, Schatzkin A. Colorectal cancer: does it matter if you eat your fruits and vegetables? J Natl Cancer Inst. 2000;92(21):1706-1707.

Giacosa A, Frascio F, Sukkar SG, Roncella S. Food intake and body composition in cancer cachexia. Nutrition. 1996;12:S20-S23.

Giardiello FM, Offerhause GJ, DuBois RN. The role of nonsteroidal anti-inflammatory drugs in colorectal cancer prevention. Eur J Cancer. 1995;31A(7-8):1071-1076.

Giovannucci E, Colditsz GA, Stampfer MJ, Willett WC. Physical activity, obesity, and risk of colorectal adenoma in women (United States). Cancer Causes Control. 1996;7:253-263.

Giovannucci E, Rimm EB, Stampfer MJ, et al. Aspirin use and the risk for colorectal cancer and adenoma in male health professionals. Ann Intern Med. 1994a;121(4):241-246.

Greenberg ER, Baron JA, Tosteson TD, et al. A clinical trial of antioxidant vitamins to prevent colorectal adenoma. N Engl J Med. 1994;331:141-147.

Holt PR. Dairy foods and prevention of colon cancer: human studies. J Am Coll Nutr. 1999;18(suppl 5):379S-391S.

Jänne PA, Mayer RJ. Chemoprevention of colorectal cancer. N Engl J Med. 2000;342(26):1960-1968.

Kawamori T, Lubet R, Steele VE, et al. Chemopreventive effect of curcumin, a naturally occurring anti-inflammatory agent, during the promotion/progression stages of colon cancer. Cancer Res. 1999;59:597-601.

Kodama N, Komuta K, Nanba H. Effect of Maitake (Grifola frondosa) D-Fraction on the activation of NK cells in cancer patients. J Med Food. 2003;6(4):371-7.

LaValle JB, Krinsky DL, Hawkins EB, et al. Natural Therapeutics Pocket Guide. Hudson, OH:LexiComp; 2000: 452-454.

La Vecchia C, Braga C, Negri E, et al. Intake of selected micronutrients and risk of colorectal cancer. Int J Cancer. 1997;73:525-530.

Le Marchand L, Wilkens LR, Hankin JH, Kolonel LN, Lyu LC. Independent and joint effects of family history and lifestyle on colorectal cancer risk: Implications for prevention. Cancer Epidemiol Biomarkers Prevent.1999;8:45-51.

Le Marchand L, Hankin JH, Wilkens LR, Kolonel LN, Englyst HN, Lyu L. Dietary fiber and colorectal cancer risk. Epidemiology. 1997a;8:658-665.

Le Marchand L, Wilkens LR, Kolonel LN, Hankin JH, Lyu LC. Associations of sedentary lifestyle, obesity, smoking, alcohol use, and diabetes with the risk of colorectal cancer. Cancer Res.1997b;57:4787-4794.

Maa SH, Gauthier D, Turner M. Acupressure as an adjunct to a pulmonary rehabilitation program. J Cardiopulm Rehabil. 1997;17(4):268-276.

Mayer RJ. Gastrointestinal tract cancer. In: Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998:571-576.

Messina M, Bennink M. Soy foods, isoflavones and risk of colonic cancer: A review of the in vitro and in vivo data. Bailliéres Clin Endocrinol Metab. 1998:12(4):707-728.

Michels KB, Giovannucci E, Joshipura KJ, et al. Prospective study of fruit and vegetable consumption and incidence of colon and rectal cancers. J Natl Cancer Inst. 2000;92:1740-1752.

Narisawa T, Fukaura Y, Hasebe M, et al. Prevention of N-methylnitrosourea-induced colon carcinogenesis in F344 rats by lycopene and tomato juice rich in lycopene. Jpn J Cancer Res. 1998;89:1003-1008.

Owen RW, Giacosa A, Hull WE, Haubner R, Spiegelhalder B, Bartsch H. The antioxidant/anticancer potential of phenolic compounds isolated from olive oil. Eur J Cancer. 2000a;36(10):1235-1247.

Pan CX, Morrison RS, Ness J, Fugh-Berman A, Leipzig RM. Complementary and alternative medicine in the management of pain, dyspnea, and nausea and vomiting near the end of life: a systematic review. J Pain Symptom Manage. 2000;20(5):374-387.

Piazza GA, Alberts DS, Hixson LJ, et al. Sulindac sulfone inhibits azoxymethane-induced colon carcinogenesis in rats without reducing prostaglandin levels. Cancer Res. 1997;57(14):2909-2915.

Potter JD. Nutrition and colorectal cancer. Cancer Causes Control. 1996;7:127-146.

Rao CV, Rivenson A, Simi B, et al. Chemoprevention of colon carcinogenesis by sulindac, a nonsteroidal anti-inflammatory agent. Cancer Res. 1995;55(7):1464-1472.

Renzi C, Peticca L, Pescatori M. The use of relaxation techniques in the perioperative management of proctological patients: preliminary results. Int J Colorectal Dis. 2000;15(5-6):313-316.

Schatzkin A, Lanza E, Corle D, et al. Lack of effect of a low-fat, high-fiber diet on the recurrence of colorectal adenomas. NEJM. 2000;342(16):1149-1155.

Shen J, Wenger N, Glaspy J, et al. Electroacupuncture for control of myeloablative chemotherapy-induced emesis. JAMA. 2000;284(21):2755-2761.

Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin Nutr. 1999;70(3 suppl):560S-569S.

Slattery ML, Benson J, Curtin K, Ma K-N, Schaeffer D, Potter JD. Carotenoids and colon cancer. Am J Clin Nutr. 2000;71:575-582.

Sung MK, Lautens M, Thompson LU. Mammalian lignans inhibit the growth of estrogen-independent human colon tumor cells. Anticancer Res. 1998;18(3A):1405-1408.

Thiagarajan D, Bennink MR, Bourquin LD, Kavas FA. Prevention of precancerous colonic lesions in rats by soy flakes, soy flour, genistein, and calcium. Am J Clin Nutr. 1998;68(suppl):1394S-1399S.

Turowski GA, Rashid Z, Hong F, Madri J, Basson MD. Glutamine modulates phenotype and stimulates proliferation in human colon cancer cell lines. Cancer Res. 1994;54:5974-5980.

Vickers AJ. Can acupuncture have specific effects on health? A systematic review of acupuncture antiemesis trials. J R Soc Med. 1996;89:303-311.

Review Date:
10/12/2006
Reviewed By:
Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

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How to Eat For Your Daily Dose of Potassium

FitSugar — Tue, 11 Nov 2008 03:00:00 -0800

Bananas are great sources of potassium, but eating one of these yellow fruits won't be enough to supply your body with the recommended daily intake (RDI) of this important mineral. Every day, you need to make sure to get 4,200 mg of potassium for digestion, to maintain healthy blood pressure, to carry out muscle contractions, and also for proper nerve, kidney, and heart functions. Since potassium is found in so many nutritious foods, you shouldn't have any problems getting your RDI. If you're not sure you're hitting the mark, I made a chart of what I ate yesterday to consume my daily potassium. To see it, read more.

Meal	Food	Potassium (mg)
Breakfast	6 oz. Stonyfield Farms low-fat vanilla yogurt	367
	1 cup of GoLean Crunch cereal	300
	1 small sliced banana	362
	6 oz. orange juice	332
Lunch	2 outer leaves of romaine lettuce, chopped	140
	8 baby carrots, sliced	190
	1/2 cup sliced cucumber	76
	1 small celery stalk, sliced	44
	1/4 medium red pepper, diced	63
	1 plum tomato, sliced	147
	1/2 avocado	487
	7 walnuts, chopped	123
	1/2 cup garbanzo beans	206
	25 raisins	24
Optional Snack (for pre-workout)	4-oz. cup of lowfat cottage cheese	109
	1/2 cup diced cantaloupe	208
Dinner	3 oz. grilled halibut	490
	2 cups spinach, steamed	335
	1 small baked sweet potato	285
	Total potassium intake	4,288 mg

It really isn't that hard to get enough potassium, as long as you include a variety of fruits, veggies, and lean protein. If you're interested in knowing what other foods contain potassium, check out this list.

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Fish Breakdown: Omegas and Mercury

FitSugar — Thu, 09 Oct 2008 03:00:00 -0700

Fish is a great source for lean protein. Fish is part of a healthy eating plan. Fish provides much lacking omega-3 fatty acids to our diets. OK, I get it. Message received. Eat fish.

The American Heart Association recommends eating fish at least twice weekly to help reach the recommendation of consuming 1.1 grams of omega-3 fats a day. Although fish is a great source of these healthy fats, you have to be careful about ingesting too much mercury, especially if you're pregnant. Expecting moms should stick to types of fish that have mercury levels of 1 part per million (ppm) or lower. The rest of us can safely consume fish with mercury levels that average 5.5 ppm. So take a look at the chart below to see where the fish you eat falls on the spectrum.

	Mercury in parts per million (ppm)	Omega-3s in grams per 3 oz. serving
Canned Tuna	.12	.17 - .24
Shrimp	below the level of detection	.29
Polluck	.06	.45
Salmon	.01	1.1 - 1.9
Cod	.11	.15 - .24
Catfish	.05	.22 - .3
Clams	below the level of detection	.25
Flounder or Sole	.05	.48
Crabs	.06	.27 - .4
Scallops	.05	.18 - .34

If you don't see your favorite seafood on the list then read more.

	Mercury in parts per million (ppm)	Omega-3s in grams per 3 oz. serving
Lobster	.31	.07 - .46
Grouper	.55	.23
Halibut	.26	.6 - 1.12
Oysters	below the level of detection	.37 - 1.14
Mahi mahi	.19	.13
Herring	.04	1.9 - 2
Shark	.99	.83
Swordfish	.97	.97
Golden bass or golden snapper	1.45	.9
King mackerel	.73	.36
Fresh or frozen tuna	.38	.21 - 1.1
Red snapper	.6	.29
Orange roughy	.54	.03

Fit's Tip: Since it may be tough to consume 1.1 grams of omega-3 fatty acids a day solely from fish, remember that flaxseeds, flaxseed oil, omega-3 enriched foods, and fish oil supplements are also great sources for this healthy fat.

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