- Essential Fatty Acids
- Dietary Fatty Acids
- Omega-3 Fatty Acids: Fact Sheet
- Omega-3 Fatty Acids: An Essential Contribution
- Recipes for health
- Effects of stereospecific positioning of fatty acids in triacylglycerol structures in native and randomized fats: a review of their nutritional implications
Essential Fatty Acids
Fatty acids are natural components of fats and oils. their chemical structure they can be differentiated into three groups: ‘saturated’, ‘mono-unsaturated’ and ‘poly-unsaturated’ fatty acids.
Saturated fatty acids (fats) are mainly found in animal foods, such as (fatty) meat, lard, sausage, butter and cheese but even in palm kernel and coconut oil, which are used for frying. Most unsaturated fatty acids (fats) are of plant and fatty fish origin.
Foods containing unsaturated fatty acids include avocado, nuts, vegetable oils (corn, soy, and algal-oil), herring, and salmon. Meat products contain both saturated and unsaturated fats.
Of particular interest are ‘polyunsaturated fatty acids’. Within the family of polyunsaturated fatty acids (PUFAs), there are two different groups: the ‘omega-3-fatty acids ‘and ‘omega-6-fatty acids’ (1). Both are considered essential fatty acids because they cannot be synthesized by humans.
The parent fatty acid of the omega-3 series is alpha-linolenic acid (ALA).
The omega-3 long-chain polyunsaturated fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), can be synthesized from ALA, although conversion rates are very low, especially for DHA.
DHA status is not only influenced by diet but also by genetic variants, single nucleotide polymorphisms in the fatty acid desaturases (229).
The parent fatty acid of the omega-6 series is linoleic acid (LA). The omega-6 long-chain polyunsaturated fatty acid, arachidonic acid (AA), can be synthesized from LA.
Long chain polyunsaturated fatty acids (LC-PUFAs) possess a chain of 20 or more carbon molecules. The LC-PUFA of the omega-3 and omega-6 fatty acid families are considered as conditionally essential fatty acids if the endogenous production from the parent fatty acids is inefficient and insufficient to meet nutritional requirements.
It has been estimated that the ratio of omega-6 to omega-3 fatty acids in the typical Western diet is almost 10:1 due to increased use of vegetable oils rich in omega-6 fatty acids as well as reduced fish consumption (2).
A large body of scientific research suggests that increasing the relative abundance of dietary omega-3 LC-PUFAs (EPA, DHA) have a number of health benefits. However, the intake of omega-3 LC-PUFA is low and largely below recommended dietary intake.
A worldwide review of nutritional surveys showed that only 45 (representing only 18.9% of the world population) of 266 countries achieved a recommended intake of ≥ 250 mg/d (304).
Authored by Dr. Peter Engel in 2010 and revised by Dr. D. Raederstorff on 03.05.17
Omega-6 and omega-3 fatty acids are important structural components of cell membranes, affecting fluidity, flexibility, permeability and the activity of membrane-bound enzymes (3).
There is more and more data showing that increased consumption of long-chain omega-3 fatty acids – namely eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) – can result in a reduced incidence of cardiovascular disease.
Things to know about Essential Fatty Acids
- In male myocardial infarction (MI) survivors who were advised to increase their weekly intake of oily fish to 200–400 g (an amount estimated to provide an additional 500–800 mg/day of the long-chain omega-3 fatty acids EPA and DHA), total mortality and deadly (‘fatal’) MI decreased by 29% (114).
- The recommended dietary allowance (RDA) of essential fatty acids is dependent on age, gender, and other factors.
- Surveys in several European countries reported average intakes of total polyunsaturated fatty acids (PUFA) ranging from 3 –7% of the total daily energy intake (206).
- Symptoms of essential fatty acid deficiency include scaly rash, decreased juvenile growth, increased susceptibility to infection, and poor wound healing.
- Food sources of linoleic acid (LA) include vegetable oils, such as soybean, safflower, corn oil as well as nuts, seeds, and some vegetables (215).
- According to the European Food Safety Authority (EFSA), consumption of omega-3 fatty acids at observed intake levels has not been associated with adverse effects in healthy children or adults (303).
- Consult the full list of scientific references.
Dietary Fatty Acids
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2. Chait A, Brunzell JD, Denke MA, et al. Rationale of the diet-heart statement of the American Heart Association. Report of the Nutrition Committee. Circulation. 1993;88(6):3008–3029.
3. Hu , Manson JE, Willett WC. Types of dietary fat and risk of coronary heart disease: a critical review. J Am Coll Nutr. 2001;20(1):5–19.
4. Keys A. Coronary heart disease in seven countries. Circulation. 1970;41(4 suppl):1–198.
5. Kagan A, Harris BR, Winkelstein W Jr, et al. Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: demographic, physical, dietary and biochemical characteristics. J Chronic Dis. 1974;27(7):345–364.
6. Kushi LH, Lew RA, Stare FJ, et al. Diet and 20-year mortality from coronary heart disease. The Ireland-Boston Diet-Heart Study. N Engl J Med. 1985;312(13):811–818.
7. Hu , Stampfer MJ, Manson JE, et al. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med. 1997;337(21):1491–1499.
8. Artaud-Wild SM, Connor SL, Sexton G, Connor WE. Differences in coronary mortality can be explained by differences in cholesterol and saturated fat intakes in 40 countries but not in France and Finland. A paradox. Circulation. 1993;88(6):2771–2779.
9. Pietinen P, Ascherio A, Korhonen P, et al. Intake of fatty acids and risk of coronary heart disease in a cohort of Finnish men. The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Am J Epidemiol. 1997;145(10):876–887.
10. Turpeinen O, Karvonen MJ, Pekkarinen M, Miettinen M, Elosuo R, Paavilainen E. Dietary prevention of coronary heart disease: the Finnish Mental Hospital Study. Int J Epidemiol. 1979;8(2):99–118.
11. Dayton S, Pearce ML, Hashimoto S, Dixon WJ, Tomiyasu U. A controlled clinical trial of a diet high in unsaturated fat in preventing complications of atherosclerosis. Circulation. 1969;40(1 suppl 2):1–63.
12. Leren P. The Oslo diet-heart study. Eleven-year report. Circulation. 1970;42(5):935–942.
13. Frantz ID Jr, Dawson EA, Ashman PL, et al. Test of effect of lipid lowering by diet on cardiovascular risk. The Minnesota Coronary Survey. Arteriosclerosis. 1989;9(1):129–135.
14. Kris-Etherton PM. AHA science advisory: Monounsaturated fatty acids and risk of cardiovascular disease. J Nutr. 1999;129(12):2280–2284.
15. Woods RK, Thien FC, De Luca S, Abramson MJ. Dietary marine fatty acids (fish oil) for asthma in adults and children. Cochrane Database Syst Rev. 2002;(3):CD001283.
16. Dewey A, Baughan C, Dean T, Higgins B, Johnson I. Eicosapentaenoic acid (EPA, an omega-3 fatty acid from fish oils) for the treatment of cancer cachexia. Cochrane Database Syst Rev. 2007;(1):CD004597.
17. Sommerfield T, Price J, Hiatt WR. Omega-3 fatty acids for intermittent claudication. Cochrane Database Syst Rev. 2007;(4):CD003833.
18. Hooper L, Thompson RL, Harrison RA, et al. Omega 3 fatty acids for prevention and treatment of cardiovascular disease. Cochrane Database Syst Rev. 2004;(4)CD003177.
19. Turner D, Zlotkin SH, Shah PS, Griffiths AM. Omega 3 fatty acids (fish oil) for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev. 2007;(2):CD006320.
20. McKarney C, Everard M, N'Diaye T. Omega-3 fatty acids (from fish oils) for cystic fibrosis. Cochrane Database Syst Rev. 2007;(4):CD002201.
21. Lim WS, Gammack JK, Van Niekerk JK, Dangour AD. Omega 3 fatty acid for the prevention of dementia. Cochrane Database Syst Rev. 2006;(1):CD005379.
22. Hartweg J, Perera R, Montori V, Dinneen S, Neil HA, Farmer A. Omega-3 polyunsaturated fatty acids (PUFA) for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2008;(1):CD003205.
23. Lim AK, Manley KJ, Roberts MA, Fraenkel MB. Fish oil for kidney transplant recipients. Cochrane Database Syst Rev. 2007;(2):CD005282.
24. Joy CB, Mumby-Croft R, Joy LA. Polyunsaturated fatty acid supplementation for schizophrenia. Cochrane Database Syst Rev. 2006;(3):CD001257.
25. Turner D, Steinhart AH, Griffiths AM. Omega 3 fatty acids (fish oil) for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev. 2007;(3):CD006443.
26. Simopoulos AP. The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Exp Biol Med. 2008;233(6):674–688.
27. Eilander A, Hundscheid DC, Osendarp SJ, Transler C, Zock PL. Effects of n-3 long chain polyunsaturated fatty acid supplementation on visual and cognitive development throughout childhood: a review of human studies. Prostaglandins Leukot Essent Fatty Acids. 2007;76(4):189–203.
28. Astorg P. Dietary N-6 and N-3 polyunsaturated fatty acids and prostate cancer risk: a review of epidemiological and experimental evidence. Cancer Causes Control. 2004;15(4):367–386.
29. Nkondjock A, Shatenstein B, Maisonnueve P, Ghadirian P. Specific fatty acids and human colorectal cancer: an overview. Cancer Detect Prev. 2003;27(1):55–66.
30. Black HS, Rhodes LE. The potential of omega-3 fatty acids in the prevention of non-melanoma skin cancer. Cancer Detect Prev. 2006;30(3):224–232.
31. MacLean CH, Newberry SJ, Mojica WA, et al. Effects of omega-3 fatty acids on cancer risk: a systematic review [published correction in JAMA. 2006;295(16):1900]. JAMA. 2006;295(4):403–415.
32. Institute of Medicine. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. September 2002. http://www.iom.edu/Object.File/Master/4/154/MACRO8pgFINAL.pdf. Accessed March 11, 2009.
33. Grundy SM, Bilheimer D, Blackburn H, et al. Rationale of the diet-heart statement of the American Heart Association. Report of Nutrition Committee. Circulation. 1982;65(4):839A–854A.
34. U.S. Food and Drug Administration. Revealing trans fats. FDA Consumer Magazine. September-October 2003. Pubublication no. FDA05-1329C. http://www.fda.gov/FDAC/features/2003/503_fats.html. Accessed March 11, 2009.
35. Mensink RP, Katan MB. Effect of dietary trans fatty acids on high-density and low-density lipoprotein cholesterol levels in healthy subjects. N Engl J Med. 1990;323(7):439–445.
36. Zock PL, Katan MB. Hydrogenation alternatives: effects of trans fatty acids and stearic acid versus linoleic acid on serum lipids and lipoproteins in humans. J Lipid Res. 1992;33(3):399–410.
37. Judd JT, Clevidence BA, Muesing RA, Wittes J, Sunkin ME, Podczasy JJ. Dietary trans fatty acids: effects on plasma lipids and lipoproteins of healthy men and women. Am J Clin Nutr. 1994;59(4):861–868.
38. Lichtenstein AH, Ausman LM, Jalbert SM, Schaefer EJ. Effects of different forms of dietary hydrogenated fats on serum lipoprotein cholesterol levels [published correction in N Engl J Med. 1999;341(11):856]. N Engl J Med. 1999;340(25):1933–1940.
39. de Roos N, Schouten E, Katan M. Consumption of a solid fat rich in lauric acid results in a more favorable serum lipid profile in healthy men and women than consumption of a solid fat rich in trans-fatty acids. J Nutr. 2001;131(2):242–245.
40. Oomen CM, Ocké MC, Feskens EJ, van Erp-Baart MA, Kok FJ, Kromhout D. Association between trans fatty acid intake and 10-year risk of coronary heart disease in the Zutphen Elderly Study: a prospective population-based study. Lancet. 2001;357(9258):746–751.
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42. Lichtenstein Ah, Appel LJ, Brands M, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee [published corrections in Circulation. 2006;114(1):e27, and Circulation. 2006;114(23):e629]. Circulation. 2006;114(1):82–96.
Omega-3 Fatty Acids: Fact Sheet
- How They Help Your Health
- Where to Get Omega 3s
- Should You Supplement?
When it comes to fat, there's one type you don't want to cut back on: omega-3 fatty acids.
Two crucial ones — EPA and DHA — are primarily found in certain fish. ALA (alpha-linolenic acid), another omega-3 fatty acid, is found in plant sources such as nuts and seeds.
Not only does your body need these fatty acids to function, but also they deliver some big health benefits.
Blood fat (triglycerides). Fish oil supplements can lower elevated triglyceride levels. Having high levels of this blood fat puts you at risk for heart disease and stroke.
Rheumatoid arthritis. Fish oil supplements (EPA+DHA) may curb stiffness and joint pain. Omega-3 supplements also seem to boost the effectiveness of anti-inflammatory drugs.
Depression. Some researchers have found that cultures that eat foods with high levels of omega-3s have lower levels of depression. The effects of Fish oil supplements on depression has been mixed. More research is needed to see if it can make a difference.
Baby development. DHA appears to be important for visual and neurological development in infants.
Asthma. A diet high in omega-3s lowers inflammation, a key component in asthma. But more studies are needed to show if fish oil supplements improve lung function or cut the amount of medication a person needs to control the condition.
ADHD. Some studies show that fish oil can reduce the symptoms of ADHD in some children and improve their mental skills, thinking, remembering, and learning. But more research is needed in this area, and omega-3 supplements should not be used as a primary treatment.
Alzheimer's disease and dementia. Some research suggests that omega-3s may help protect against Alzheimer's disease and dementia, and have a positive effect on gradual memory loss linked to aging. But that's not certain yet.
When possible, try to get omega-3 fatty acids from foods rather than supplements. Aim to eat non-fried, oily fish high in DHA and EPA omega-3 fatty acids at least two times a week.
- Orange roughy
- Lake trout
While eating more fatty fish is a good idea, some are ly to have higher levels of mercury, polychlorinated biphenyls (PCBs), or other toxins. These include mackerel, wild swordfish, tilefish, and shark.
Fish wild trout and wild salmon are safer.
Good food sources of ALA are:
- Flaxseed and flaxseed oil
- Canola oil
- Soybean oil
- Chia seeds
While foods containing omega-3 fatty acids have health benefits, some — oils and nuts — can be high in calories. So eat them in moderation.
Fish oil has both EPA and DHA. Algae oil has DHA and may be a good option for people who don't eat fish.
Talk to your doctor about taking a supplement first. He or she may have specific recommendations, or warnings, depending on your health and the other medicines you take. There are also omega-3 prescriptions available.
Epanova, Lovaza, Omtryg, and Vascepa contain DHA/DPA and are recommended for adults with triglycerides 500 mg/dL or above.
Un fish oil supplements, these medications are approved and monitored for quality and safety by the FDA for specific use.
People with heart disease are usually advised to take 1 gram (1,000 milligrams) daily of a combination DHA /EPA from fish oil.
People with some health conditions may take doses of up to 4 grams a day — but only under a doctor's supervision.
The most common side effects from fish oil are indigestion and gas. Getting a supplement with a coating might help.
Omega-3 supplements (DHA/EPA) can make bleeding more ly. If you have a bleeding condition — or take medicines that could increase bleeding, apixaban (Eliquis), betrixaban (Bevyxxa), clopidogrel (Plavix), prasugrel (Effient), rivaroxaban (Xarelto), ticagrelor (Brilinta), warfarin (Coumadin), and some NSAIDs — talk to a doctor before using any omega-3 supplements.
American Heart Association: “Fish, Levels of Mercury and Omega-3 fatty acids.”
Ronald Glick, MD, medical director, Center for Integrative Medicine, University of Pittsburgh Medical Center.
Erminia M. Guarneri, MD, cardiologist; founder, Scripps Center for Integrative Medicine, Scripps Health, La Jolla, CA; president, American Board of Integrative Holistic Medicine; founder, Guarneri Integrative Health at Pacific Pearl La Jolla; author, The Heart Speaks.
Harvard School of Public Health.
David C. Leopold, MD, director of integrative medical education, Scripps Center for Integrative Medicine, La Jolla, CA.
Natural Medicines Comprehensive Database Monograph: “Fish oil.”
Natural Standard Patient Monograph: “Omega-3 fatty acids.”
Gail Underbakke, RD, MS, nutrition coordinator, preventative cardiology program, University of Wisconsin Hospital and Clinics.
© 2019 WebMD, LLC. All rights reserved.
Omega-3 Fatty Acids: An Essential Contribution
The human body can make most of the types of fats it needs from other fats or raw materials. That isn’t the case for omega-3 fatty acids (also called omega-3 fats and n-3 fats).
These are essential fats—the body can’t make them from scratch but must get them from food.
Foods high in Omega-3 include fish, vegetable oils, nuts (especially walnuts), flax seeds, flaxseed oil, and leafy vegetables.
What makes omega-3 fats special? They are an integral part of cell membranes throughout the body and affect the function of the cell receptors in these membranes.
They provide the starting point for making hormones that regulate blood clotting, contraction and relaxation of artery walls, and inflammation. They also bind to receptors in cells that regulate genetic function.
ly due to these effects, omega-3 fats have been shown to help prevent heart disease and stroke, may help control lupus, eczema, and rheumatoid arthritis, and may play protective roles in cancer and other conditions.
Omega-3 fats are a key family of polyunsaturated fats. There are three main omega-3s:
- Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) come mainly from fish, so they are sometimes called marine omega-3s.
- Alpha-linolenic acid (ALA), the most common omega-3 fatty acid in most Western diets, is found in vegetable oils and nuts (especially walnuts), flax seeds and flaxseed oil, leafy vegetables, and some animal fat, especially in grass-fed animals. The human body generally uses ALA for energy, and conversion into EPA and DHA is very limited.
The strongest evidence for a beneficial effect of omega-3 fats has to do with heart disease. These fats appear to help the heart beat at a steady clip and not veer into a dangerous or potentially fatal erratic rhythm.
(1) Such arrhythmias cause most of the 500,000-plus cardiac deaths that occur each year in the United States.
Omega-3 fats also lower blood pressure and heart rate, improve blood vessel function, and, at higher doses, lower triglycerides and may ease inflammation, which plays a role in the development of atherosclerosis. (1)
Several large trials have evaluated the effect of fish or fish oils on heart disease.
In the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardio (known as the GISSI Prevention Trial), heart attack survivors who took a 1-gram capsule of omega-3 fats every day for three years were less ly to have a repeat heart attack, stroke, or die of sudden death than those who took a placebo. (2) Notably, the risk of sudden cardiac death was reduced by about 50 percent. In the more recent Japan EPA Lipid Intervention Study (JELIS), participants who took EPA plus a cholesterol-lowering statin were less ly to have a major coronary event (sudden cardiac death, fatal or nonfatal heart attack, unstable angina, or a procedure to open or bypass a narrowed or blocked coronary artery) than those who took a statin alone. (3)
Most Americans take in far more of another essential fat—omega-6 fats—than they do omega-3 fats. Some experts have raised the hypothesis that this higher intake of omega-6 fats could pose problems, cardiovascular and otherwise, but this has not been supported by evidence in humans.
(4) In the Health Professionals Follow-up Study, for example, the ratio of omega-6 to omega-3 fats wasn’t linked with risk of heart disease because both of these were beneficial. (5) Many other studies and trials in humans also support cardiovascular benefits of omega-6 fats.
Although there is no question that many Americans could benefit from increasing their intake of omega-3 fats, there is evidence that omega-6 fats also positively influence cardiovascular risk factors and reduce heart disease.
Researchers are taking a hard look at a different sort of balance, this one between possible effects of marine and plant omega-3 fats on prostate cancer. Results from the Health Professionals Follow-up Study and others show that men whose diets are rich in EPA and DHA (mainly from fish and seafood) are less ly to develop advanced prostate cancer than those with low intake of EPA and DHA.
(6) At the same time, some-but not all-studies show an increase in prostate cancer and advanced prostate cancer among men with high intakes of ALA (mainly from supplements). However, this effect is inconsistent. In the very large Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, for example, there was no link between ALA intake and early, late, or advanced prostate cancer.
Recipes for health
Given the wide-ranging importance and benefits of marine omega-3 fatty acids, it is important to eat fish or other seafood one to two times per week, particularly fatty (dark meat) fish that are richer in EPA and DHA.
This is especially important for women who are pregnant or hoping to become pregnant and nursing mothers. From the third trimester until the second year of life, a developing child needs a steady supply of DHA to form the brain and other parts of the nervous system.
Many women shy away from eating fish because of concerns that mercury and other possible contaminants might harm their babies, (9) yet the evidence for harm from lack of omega-3 fats is far more consistent, and a balance of benefit vs. risk is easily obtained.
(To learn more about the controversy over contaminants in fatty fish, read Fish: Friend or Foe.)
This table lists common fish and seafood products and their omega-3 fatty acid content.
|Type of Seafood||Serving Size||Omega-3 Fatty Acids(mg/serving)|
|Catfish (farmed)||5.0 oz||253|
|Cod (Atlantic)||6.3 oz||284|
|Fish sticks (frozen)||3.2 oz||193|
|Mahi mahi||5.6 oz||221|
|Pollock (Alaskan)||2.1 oz||281|
|Salmon (wild)||6.0 oz||1,774|
|Salmon (farmed)||6.0 oz||4,504|
|Tuna (albacore)**||3.0 oz||733|
|Tuna (light, skipjack)||3.0 oz||228|
SOURCE: Mozaffarian D, Rimm EB. JAMA. 2006;296:1885-1899.
*Swordfish contains high levels of mercury, as does shark, king mackerel, and tilefish (sometimes called golden bass or golden snapper). Women who are or may become pregnant, nursing mothers, and young children should avoid these high-mercury species of fish, but can eat up to 12 ounces (two average meals) a week of a variety of fish and shellfish that are lower in mercury.
**Albacore tuna contains more mercury than canned, light tuna. Women who are or may become pregnant, nursing mothers, and young children should limit albacore tuna to one serving per week.
1. Leaf A. Prevention of sudden cardiac death by n-3 polyunsaturated fatty acids. J Cardiovasc Med. (Hagerstown). 2007; 8 Suppl 1:S27-29.
2. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico. Lancet. 1999; 354:447-55.
3. Yokoyama M, Origasa H, Matsuzaki M, et al. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet. 2007; 369:1090-98.
4. Willett WC. The role of dietary n-6 fatty acids in the prevention of cardiovascular disease. J Cardiovasc Med. (Hagerstown). 2007; 8 Suppl 1:S42-5.
5. Mozaffarian D, Ascherio A, Hu , et al. Interplay between different polyunsaturated fatty acids and risk of coronary heart disease in men. Circulation. 2005; 111:157-64.
6. Leitzmann MF, Stampfer MJ, Michaud DS, et al. Dietary intake of n-3 and n-6 fatty acids and the risk of prostate cancer. Am J Clin Nutr. 2004; 80:204-16.
7. Koralek DO, Peters U, Andriole G, et al. A prospective study of dietary alpha-linolenic acid and the risk of prostate cancer (United States). Cancer Causes Control. 2006; 17:783-91.
8. Eilander A, Hundscheid DC, Osendarp SJ, Transler C, Zock PL. Effects of n-3 long chain polyunsaturated fatty acid supplementation on visual and cognitive development throughout childhood: a review of human studies. Prostaglandins Leukot Essent Fatty Acids. 2007; 76:189-203.
9. Oken E, Kleinman KP, Berland WE, Simon SR, Rich-Edwards JW, Gillman MW. Decline in fish consumption among pregnant women after a national mercury advisory. Obstet Gynecol. 2003; 102:346-51.
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Effects of stereospecific positioning of fatty acids in triacylglycerol structures in native and randomized fats: a review of their nutritional implications
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