Effects of moderate-dose omega-3 fish oil on cardiovascular risk factors and mood after ischemic stroke: a randomized, controlled trial.
OBJECTIVE
Fish-derived omega-3 fatty acids have long been associated with cardiovascular protection. In this trial, we assessed whether treatment with a guideline-recommended moderate-dose fish oil supplement could improve cardiovascular biomarkers, mood- and health-related quality of life in patients with ischemic stroke.


METHODS
Patients with CT-confirmed stroke were randomized to 3 g/day encapsulated fish oil containing approximately 1.2 g total omega-3 (0.7 g docosahexaenoic acid; 0.3 g eicosapentaenoic acid) or placebo oil (combination palm and soy) taken daily over 12 weeks. Serum triglycerides, total cholesterol and associated lipoproteins, selected inflammatory and hemostatic markers, mood, and health-related quality of life were assessed at baseline and follow-up. The primary outcome was change in triglycerides. Compliance was assessed by capsule count and serum phospholipid omega-3 levels (Australian Clinical Trials Registration: ACTRN12605000207617).


RESULTS
One hundred two patients were randomized to fish oil or placebo. Intention-to-treat and per-protocol (>85% compliance) analyses showed no significant effect of fish oil treatment on any lipid, inflammatory, hemostatic, or composite mood parameters measured. Adherence to treatment based on pill count was good (89%) reflected by increased serum docosahexanoic acid (P<0.001) and eicosapentaenoic acid (P=0.0006) in the fish oil group. Analysis of oil composition, however, showed some degradation and potentially adverse oxidation products at the end of the study.


CONCLUSIONS
There was no effect of 12 weeks of treatment with moderate-dose fish oil supplements on cardiovascular biomarkers or mood in patients with ischemic stroke. It is possible that insufficient dose, short duration of treatment, and/or oxidation of the fish oils may have influenced these outcomes.
Poppitt
Sally D
SD
Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand. s.poppitt@auckland.ac.nz
Howe
Colin A
CA
Lithander
Fiona E
FE
Silvers
Karen M
KM
Lin
Ruey-Bin
RB
Croft
John
J
Ratnasabapathy
Yogini
Y
Gibson
Robert A
RA
Anderson
Craig S
CS
D000339:Affect / Q000187:drug effects; D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000178:diet therapy* / Q000523:psychology; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D004311:Double-Blind Method; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000178:diet therapy* / Q000523:psychology; D016896:Treatment Outcome
D015525:Fatty Acids, Omega-3; D005395:Fish Oils