{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T12:28:34Z","timestamp":1789907314586,"version":"4.0.1"},"reference-count":19,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2017,8,11]],"date-time":"2017-08-11T00:00:00Z","timestamp":1502409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>We summarize the 2016 update of the 2004 Agency of Healthcare Research and Quality\u2032s evidence review of omega-3 fatty acids and cardiovascular disease (CVD). The overall findings for the effects of marine oil supplements on intermediate CVD outcomes remain largely unchanged. There is high strength of evidence, based on numerous trials, of no significant effects of marine oils on systolic or diastolic blood pressures, but there are small, yet statistically significant increases in high density lipoprotein and low density lipoprotein cholesterol concentrations. The clinical significance of these small changes, particularly in combination, is unclear. The strongest effect of marine oils is on triglyceride concentrations. Across studies, this effect was dose-dependent and related to studies\u2032 mean baseline triglyceride concentration. In observational studies, there is low strength of evidence that increased marine oil intake lowers ischemic stroke risk. Among randomized controlled trials and observational studies, there is evidence of variable strength of no association with increased marine oil intake and lower CVD event risk. Evidence regarding alpha-linolenic acid intake is sparser. There is moderate strength of evidence of no effect on blood pressure or lipoprotein concentrations and low strength of evidence of no association with coronary heart disease, atrial fibrillation and congestive heart failure.<\/jats:p>","DOI":"10.3390\/nu9080865","type":"journal-article","created":{"date-parts":[[2017,8,11]],"date-time":"2017-08-11T10:07:40Z","timestamp":1502446060000},"page":"865","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":60,"title":["Omega-3 Fatty Acids and Cardiovascular Disease: Summary of the 2016 Agency of Healthcare Research and Quality Evidence Review"],"prefix":"10.3390","volume":"9","author":[{"given":"Ethan","family":"Balk","sequence":"first","affiliation":[{"name":"Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI 02912, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1053-9478","authenticated-orcid":false,"given":"Alice","family":"Lichtenstein","sequence":"additional","affiliation":[{"name":"Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2017,8,11]]},"reference":[{"key":"ref_1","unstructured":"(2017, August 07). Scientific Report of the 2015 Dietary Guidelines Advisory Committee, Available online: http:\/\/health.gov\/dietaryguidelines\/2015-scientific-report\/pdfs\/scientific-report-of-the-2015-dietary-guidelines-advisory-committee.pdf."},{"key":"ref_2","unstructured":"Institute of Medicine (2005). Dietary Reference Intakes. Energy, Carbohydrate, Fiber, Fat Fatty Acids, Cholesterol, Protein and Amino Acids, National Academy of Sciences."},{"key":"ref_3","unstructured":"(2017, August 07). Dietary Guidelines for Americans, 2010, Available online: https:\/\/health.gov\/dietaryguidelines\/dga2010\/DietaryGuidelines2010.pdf."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3027","DOI":"10.1016\/j.jacc.2013.11.003","article-title":"2013 AHA\/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk: A Report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"63","author":"Eckel","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2542","DOI":"10.1001\/jama.2016.7491","article-title":"Dietary Intake among US Adults, 1999\u20132012","volume":"315","author":"Rehm","year":"2016","journal-title":"JAMA"},{"key":"ref_6","unstructured":"Wang, C., Chung, M., Balk, E., Kupelnick, B., DeVine, D., Lawrence, A., Lichtenstein, A., and Lau, J. (2004). Effects of Omega-3 Fatty Acids on Cardiovascular Disease, Evidence Report\/Technology Assessment No. 94 AHRQ Publication No. 04-E009-2."},{"key":"ref_7","unstructured":"Balk, E., Chung, M., Lichtenstein, A., Chew, P., Kupelnick, B., Lawrence, A., DeVine, D., and Lau, J. (2004). Effects of Omega-3 Fatty Acids on Cardiovascular Risk Factors and Intermediate Markers of Cardiovascular Disease, Evidence Report\/Technology Assessment No. 93 AHRQ Publication No. 04-E010-2."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1093\/ajcn\/84.1.5","article-title":"n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: A systematic review","volume":"84","author":"Wang","year":"2006","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.atherosclerosis.2006.02.012","article-title":"Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: A systematic review","volume":"189","author":"Balk","year":"2006","journal-title":"Atherosclerosis"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.atherosclerosis.2005.06.042","article-title":"Effects of omega-3 fatty acids on coronary restenosis, intima-media thickness, and exercise tolerance: A systematic review","volume":"184","author":"Balk","year":"2006","journal-title":"Atherosclerosis"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Centers for Disease Control and Prevention (2016). Cigarette Smoking Among Adults\u2014United States, 2005\u20132015. Morb. Mortal. Wkly. Rep., 65, 1205\u20131211.","DOI":"10.15585\/mmwr.mm6544a2"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1001\/jama.2012.39","article-title":"Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999\u20132010","volume":"307","author":"Flegal","year":"2012","journal-title":"JAMA"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Balk, E.M., Adam, G.P., Langberg, V., Halladay, C., Chung, M., Lin, L., Robertson, S., Yip, A., Steele, D., Smith, B.T., and Lau, J. (2016). Omega-3 Fatty Acids and Cardiovascular Disease: An Updated Systematic Review, Evidence Report\/Technology Assessment No. 223 AHRQ Publication No. 16-E002-EF.","DOI":"10.23970\/AHRQEPCERTA223"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.plipres.2008.03.003","article-title":"Fatty acid composition of adipose tissue and blood in humans and its use as a biomarker of dietary intake","volume":"47","author":"Hodson","year":"2008","journal-title":"Prog. Lipid Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2070S","DOI":"10.3945\/ajcn.2009.27230I","article-title":"Methods of assessment of n-3 long-chain polyunsaturated fatty acid status in humans: A systematic review","volume":"89","author":"Nissensohn","year":"2009","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S64","DOI":"10.1017\/S000711451200147X","article-title":"Dietary methods and biomarkers of omega 3 fatty acids: A systematic review","volume":"107","author":"Nissensohn","year":"2012","journal-title":"Br. J. Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.amjcard.2016.04.004","article-title":"Triglycerides and Triglyceride-Rich Lipoproteins in the Causal Pathway of Cardiovascular Disease","volume":"118","author":"Budoff","year":"2016","journal-title":"Am. J. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1161\/CIRCRESAHA.115.306249","article-title":"Triglyceride-Rich Lipoproteins and Atherosclerotic Cardiovascular Disease: New Insights from Epidemiology, Genetics, and Biology","volume":"118","author":"Nordestgaard","year":"2016","journal-title":"Circ. Res."},{"key":"ref_19","unstructured":"National Institute for Heath and Care Excellence (2017, July 27). Cardiovascular Disease: Risk Assessment and Reduction, Including Lipid Modification, 2014. Available online: https:\/\/www.nice.org.uk\/guidance\/CG181."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/9\/8\/865\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:42:08Z","timestamp":1760208128000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/9\/8\/865"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,11]]},"references-count":19,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2017,8]]}},"alternative-id":["nu9080865"],"URL":"https:\/\/doi.org\/10.3390\/nu9080865","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,11]]}}}