human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : Fish oil supplement has been proposed as a non-pharmacological strategy to correct the atherogenic lipid profile associated with type 2 diabetes mellitus . However , fish oil may have deleterious effects on lipid peroxidation and glycemic control . Design : In this study , 44 type 2 diabetic patients were r and omized to vitamin E st and ardized ( 53.6 mg/day ) supplementation ( capsules ) with 4 g daily of either fish oil ( n=23 ) or corn oil ( n=21 ) for 8 weeks preceded by a 4 week run-in period of corn oil supplementation . LDL was isolated by density gradient ultracentrifugation and oxidized in vitro with Cu2 + . As a marker of in vivo oxidation malondialdehyde concentration in LDL ( LDL-MDA ) was measured . Results : Fish oil reduced both mean lag time ( before , 57.8 ; after , 48.8 min , P<0.001 ) and mean propagation rate ( before , 0.018 ΔOD/min ; after , 0.015 ΔOD/min , P<0.001 ) , whereas corn oil had no influence on lag time and propagation rate . The changes in lag time and propagation rate differed significantly between fish oil and corn oil treatment . LDL-MDA changes differed borderline significantly between groups ( FO , 110.4 pmol/mg protein ; CO , 6.7 pmol/mg protein ; P=0.057 ) . Fish oil supplementation had no influence on glycemic control as assessed from HbA1c and fasting blood glucose . Conclusion : According to our findings , fish oil supplementation leads to increased in vivo oxidation and increased in vitro oxidation susceptibility of LDL particles . More studies are needed to clarify the clinical importance of this finding . Sponsorship : Financially supported by The Danish Heart Association and Dansk Droge A/S. Dansk Droge A/S generously provided the fish oil and corn oil capsules Restenosis after successful coronary angioplasty ( PTCA ) occurs in 25 - 35 % of all procedures . To date , most pharmacologic strategies have failed to reduce the restenosis rate significantly . However , recent studies have suggested a potential benefit of dietary supplementation with omega-3 fatty acids ( fish oil ) on restenosis following PTCA . The benefit of omega-3 polyunsaturated fatty acids on the incidence of coronary artery restenosis following elective PTCA was assessed in 212 consecutive patients ( 41 female , 171 male ) . Following a successful angioplasty , 204 patients received a dietary supplementation with either nine capsules containing fish oil ( 3.15 g omega-3 fatty acids ) or nine placebo capsules containing olive oil . Treatment was started immediately after PTCA and maintained over 4 mon . Compliance was assessed by analysis of lipid fatty acids prior to angioplasty and at 4 mon follow-up . The angiographically determined incidence of restenosis ( stenosis diameter > 50 % ) was 31.2 % per lesion in patients receiving fish oil and 33.7 % in patients receiving olive oil .  Gross progression of coronary artery disease in vessels not subjected to angioplasty was 17 % and 16 % , respectively . In conclusion , low dose fish oil supplementation begun on the day of a successful coronary angioplasty failed to demonstrate any effect on coronary artery restenosis The extent to which women of reproductive age are able to convert the n-3 fatty acid alpha-linolenic acid ( ALNA ) to eicosapentaenoic acid ( EPA ) , docosapentaenoic acid ( DPA ) and docosahexaenoic acid ( DHA ) was investigated in vivo by measuring the concentrations of labelled fatty acids in plasma for 21 d following the ingestion of [U-13C]ALNA ( 700 mg ) . [13C]ALNA excursion was greatest in cholesteryl ester ( CE ) ( 224 ( sem 70 ) micromol/l over 21 d ) compared with triacylglycerol ( 9-fold ) , non-esterified fatty acids ( 37-fold ) and phosphatidylcholine ( PC , 7-fold ) . EPA excursion was similar in both PC ( 42 ( sem 8) micromol/l ) and CE ( 42 ( sem 9 ) micromol/l ) over 21 d. In contrast both [13C]DPA and [13C]DHA were detected predominately in PC ( 18 ( sem 4 ) and 27 ( sem 7 ) micromol/l over 21 d , respectively ) . Estimated net fractional ALNA inter-conversion was EPA 21 % , DPA 6 % and DHA 9 % . Approximately 22 % of administered [13C]ALNA was recovered as 13CO2 on breath over the first 24 h of the study . These results suggest differential partitioning of ALNA , EPA and DHA between plasma lipid classes , which may facilitate targeting of individual n-3 fatty acids to specific tissues . Comparison with previous studies suggests that women may possess a greater capacity for ALNA conversion than men . Such metabolic capacity may be important for meeting the dem and s of the fetus and neonate for DHA during pregnancy and lactation . Differences in DHA status between women both in the non-pregnant state and in pregnancy may reflect variations in metabolic capacity for DHA synthesis In this long-term study , we wanted to explore the effect of dietary supplementation of seal oil ( SO ) as compared cod-liver oil ( CLO ) on subjects with moderate hypercholesterolemia . The test parameters included fatty acid composition in serum , blood lipids , platelet aggregation , and the activity of blood monocytes . After a run-in period of 6 mon , 120 clinical ly healthy hypercholesterolemic ( 7.0–9.5 mmol/L ; 270–366 mg/dL ) subjects were r and omly selected to consume either 15 mL of SO or CLO daily for 14 mon followed by a 4-mon wash-out period . A third group was not given any dietary supplement ( control ) . Consumption of marine oils ( SO and CLO ) changed the fatty acid composition of serum significantly . Maximal levels were achieved after 10 mon . No further changes were seen after 14 mon . A wash-out period of 4 mon hardly altered the level of n−3 fatty acids in serum . Addition of SO gave 30 % higher level of eicosapentaenoic acid , as compared to CLO . Subjects taking SO or CLO had lower whole-blood platelet aggregation than the control group . Neither SO nor CLO had any effects on the levels of serum total cholesterol , high-density lipoprotein cholesterol , postpr and ial triacylglycerol , apolipoproteins A1 and B100 , lipoprotein ( a ) , monocyte function expressed as monocyte-derived tissue factor expression , and tumor necrosis factor A study was performed to explore the effects of supplemental intake of various marine oils known to be part of the Eskimo diet . Healthy men and women ( 134 ) were r and omly selected to consume 15 mL/d of oil from blubber of seal , cod liver , seal/cod liver , blubber of Minke whale , or no oil for ten weeks . Total cholesterol was unchanged in the oil groups , whereas high density lipoprotein cholesterol increased 7 % in the seal/cod liver oil ( CLO ) group ( P<0.05 ) and 11 % in the whale oil group ( P<0.005 ) . Triacylglycerol was significantly reduced in the CLO group only . The concentration of prothrombin fragment 1 + 2 was reduced 25 % ( P<0.05 ) after whale oil supplementation . No change in fibrinogen or factor VIIc was detected . Tumor necrosis factor generation in lipopolysaccharide (LPS)-stimulated blood was 30 % reduced after whale oil ( P<0.05 ) , but was unaffected by intake of seal or CLO . The LPS-induced tissue factor activity in monocytes was reduced to a significant degree only in the seal/CLO group ( 34 % ) and whale oil group ( 35 % ) ( P<0.05 ) . The most dramatic change in thromboxane B2 in LPS-stimulated blood was seen after whale oil intake with 44 % reduction ( P<0.01 ) . Supplementation of a regular diet with a combination of seal oil and CLO and especially with whale oil seems to have beneficial effects on several products thought to be associated with cardiovascular and thrombotic diseases To compare the effects of highly purified ethyl ester concentrates of eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) on serum lipids , apolipoproteins , and serum phospholipid fatty acids in humans , we conducted a double-blind , placebo-controlled , parallel design intervention study . Healthy nonsmoking men ( n = 234 ) aged 36 - 56 y were r and omly assigned to dietary supplementation with 3.8 g EPA/d , 3.6 g DHA/d , or 4.0 g corn oil/d ( placebo ) for 7 wk . Serum triacylglycerols decreased 26 % ( P < 0.0001 ) in the DHA group and 21 % ( P = 0.0001 ) in the EPA group compared with the corn oil group . Although not significant , net decreases in serum triacylglycerols were consistently greater in the DHA group across all quartiles of baseline triacylglycerol concentrations . Serum high-density-lipoprotein cholesterol increased 0.06 mmol/L ( P = 0.0002 ) in the DHA group . In the EPA group , serum total cholesterol decreased 0.15 mmol/L ( P = 0.02 ) and apolipoprotein A-I decreased 0.04 g/L ( P = 0.0003 ) . In the DHA group , serum phospholipid DHA increased by 69 % and EPA increased by 29 % , indicating retroconversion of DHA to EPA . In the EPA group , serum phospholipid EPA increased by 297 % whereas DHA decreased by 15 % , suggesting that EPA is not elongated to DHA in humans . The serum phospholipid ratio of n-3 to n-6 fatty acids increased in both groups , whereas the relative changes in n-6 fatty acids suggested possible alterations in liver desaturation activity in the DHA group . We conclude that both DHA and EPA decrease serum triacylglycerols , but have differential effects on lipoprotein and fatty acid metabolism in humans BACKGROUND Results of epidemiologic studies and clinical trials indicate that moderate doses of n-3 fatty acids reduce the risk of cardiovascular disease and may improve prognosis . OBJECTIVE The objective was to evaluate the effect of a high-dose ethylester concentrate of n-3 fatty acids administered early after an acute myocardial infa rct ion ( MI ) on subsequent cardiac events and serum lipids . DESIGN Three hundred patients with acute MI were r and omly assigned to a daily dose of either 4 g highly concentrated n-3 fatty acids or corn oil , administered in a double-blind manner over 12 - 24 mo . Median follow-up time was 1.5 y. Clinical follow-up , including the drawing of blood sample s , was performed after 6 wk of treatment and later at 0.5-year intervals . RESULTS Forty-two ( 28 % ) patients in the n-3 group and 36 ( 24 % ) in the corn oil group experienced at least one cardiac event ( cardiac death , resuscitation , recurrent MI , or unstable angina ) . No significant difference in prognosis was observed between groups for single or combined cardiac events . Total cholesterol concentrations decreased in both groups , with no significant intergroup differences . On average , the monthly increase in HDL cholesterol was 1.11 % in the n-3 group and 0.55 % in the corn oil group ( P = 0.0016 ) . Triacylglycerol concentrations decreased by 1.30%/mo in the n-3 group , whereas they increased by 0.35%/mo in the corn oil group ( P < 0.0001 ) . CONCLUSION No clinical benefit of a high-dose concentrate of n-3 fatty acids compared with corn oil was found despite a favorable effect on serum lipids BACKGROUND Flaxseed oil is a rich source of 18:3n-3 ( alpha-linolenic acid , or ALA ) , which is ultimately converted to 22:6n-3 ( docosahexaenoic acid , or DHA ) , a fatty acid important for the development of the infant brain and retina . OBJECTIVE The objective of this study was to determine the effect of flaxseed oil supplementation on the breast-milk , plasma , and erythrocyte contents of DHA and other n-3 fatty acids in lactating women . DESIGN Seven women took 20 g flaxseed oil  ( 10.7 g ALA ) daily for 4 wk . Breast-milk and blood sample s were collected weekly before , during , and after supplementation and were analyzed for fatty acid composition . RESULTS Breast milk , plasma , and erythrocyte ALA increased significantly over time ( P < 0.001 ) and after 2 and 4 wk of supplementation ( 
    Output:
    
agent
Combining 21 trials evaluating lipid outcomes , fish oil consumption result ed in a summary net change in triglycerides of -27 ( 95 % CI -33 , -20)mg/dL , in HDL cholesterol of + 1.6 ( 95 % CI + 0.8 , + 2.3)mg/dL , and in LDL cholesterol of + 6 ( 95 % CI + 3 , + 8)mg/dL. There was no effect of fish oil on total cholesterol .
Across studies , higher fish oil dose and higher baseline levels were associated with greater reductions in serum triglycerides .
The evidence supports a dose-dependent beneficial effect of fish oil on serum triglycerides , particularly among people with more elevated levels .
Fish oil consumption also modestly improves HDL cholesterol , increases LDL cholesterol levels , but does not appear to adversely affect glucose homeostasis .
The evidence regarding the effects of omega-3 fatty acids on hs-CRP is inconclusive , as are data on ALA
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : Fish oil supplement has been proposed as a non-pharmacological strategy to correct the atherogenic lipid profile associated with type 2 diabetes mellitus . However , fish oil may have deleterious effects on lipid peroxidation and glycemic control . Design : In this study , 44 type 2 diabetic patients were r and omized to vitamin E st and ardized ( 53.6 mg/day ) supplementation ( capsules ) with 4 g daily of either fish oil ( n=23 ) or corn oil ( n=21 ) for 8 weeks preceded by a 4 week run-in period of corn oil supplementation . LDL was isolated by density gradient ultracentrifugation and oxidized in vitro with Cu2 + . As a marker of in vivo oxidation malondialdehyde concentration in LDL ( LDL-MDA ) was measured . Results : Fish oil reduced both mean lag time ( before , 57.8 ; after , 48.8 min , P<0.001 ) and mean propagation rate ( before , 0.018 ΔOD/min ; after , 0.015 ΔOD/min , P<0.001 ) , whereas corn oil had no influence on lag time and propagation rate . The changes in lag time and propagation rate differed significantly between fish oil and corn oil treatment . LDL-MDA changes differed borderline significantly between groups ( FO , 110.4 pmol/mg protein ; CO , 6.7 pmol/mg protein ; P=0.057 ) . Fish oil supplementation had no influence on glycemic control as assessed from HbA1c and fasting blood glucose . Conclusion : According to our findings , fish oil supplementation leads to increased in vivo oxidation and increased in vitro oxidation susceptibility of LDL particles . More studies are needed to clarify the clinical importance of this finding . Sponsorship : Financially supported by The Danish Heart Association and Dansk Droge A/S. Dansk Droge A/S generously provided the fish oil and corn oil capsules Restenosis after successful coronary angioplasty ( PTCA ) occurs in 25 - 35 % of all procedures . To date , most pharmacologic strategies have failed to reduce the restenosis rate significantly . However , recent studies have suggested a potential benefit of dietary supplementation with omega-3 fatty acids ( fish oil ) on restenosis following PTCA . The benefit of omega-3 polyunsaturated fatty acids on the incidence of coronary artery restenosis following elective PTCA was assessed in 212 consecutive patients ( 41 female , 171 male ) . Following a successful angioplasty , 204 patients received a dietary supplementation with either nine capsules containing fish oil ( 3.15 g omega-3 fatty acids ) or nine placebo capsules containing olive oil . Treatment was started immediately after PTCA and maintained over 4 mon . Compliance was assessed by analysis of lipid fatty acids prior to angioplasty and at 4 mon follow-up . The angiographically determined incidence of restenosis ( stenosis diameter > 50 % ) was 31.2 % per lesion in patients receiving fish oil and 33.7 % in patients receiving olive oil .  Gross progression of coronary artery disease in vessels not subjected to angioplasty was 17 % and 16 % , respectively . In conclusion , low dose fish oil supplementation begun on the day of a successful coronary angioplasty failed to demonstrate any effect on coronary artery restenosis The extent to which women of reproductive age are able to convert the n-3 fatty acid alpha-linolenic acid ( ALNA ) to eicosapentaenoic acid ( EPA ) , docosapentaenoic acid ( DPA ) and docosahexaenoic acid ( DHA ) was investigated in vivo by measuring the concentrations of labelled fatty acids in plasma for 21 d following the ingestion of [U-13C]ALNA ( 700 mg ) . [13C]ALNA excursion was greatest in cholesteryl ester ( CE ) ( 224 ( sem 70 ) micromol/l over 21 d ) compared with triacylglycerol ( 9-fold ) , non-esterified fatty acids ( 37-fold ) and phosphatidylcholine ( PC , 7-fold ) . EPA excursion was similar in both PC ( 42 ( sem 8) micromol/l ) and CE ( 42 ( sem 9 ) micromol/l ) over 21 d. In contrast both [13C]DPA and [13C]DHA were detected predominately in PC ( 18 ( sem 4 ) and 27 ( sem 7 ) micromol/l over 21 d , respectively ) . Estimated net fractional ALNA inter-conversion was EPA 21 % , DPA 6 % and DHA 9 % . Approximately 22 % of administered [13C]ALNA was recovered as 13CO2 on breath over the first 24 h of the study . These results suggest differential partitioning of ALNA , EPA and DHA between plasma lipid classes , which may facilitate targeting of individual n-3 fatty acids to specific tissues . Comparison with previous studies suggests that women may possess a greater capacity for ALNA conversion than men . Such metabolic capacity may be important for meeting the dem and s of the fetus and neonate for DHA during pregnancy and lactation . Differences in DHA status between women both in the non-pregnant state and in pregnancy may reflect variations in metabolic capacity for DHA synthesis In this long-term study , we wanted to explore the effect of dietary supplementation of seal oil ( SO ) as compared cod-liver oil ( CLO ) on subjects with moderate hypercholesterolemia . The test parameters included fatty acid composition in serum , blood lipids , platelet aggregation , and the activity of blood monocytes . After a run-in period of 6 mon , 120 clinical ly healthy hypercholesterolemic ( 7.0–9.5 mmol/L ; 270–366 mg/dL ) subjects were r and omly selected to consume either 15 mL of SO or CLO daily for 14 mon followed by a 4-mon wash-out period . A third group was not given any dietary supplement ( control ) . Consumption of marine oils ( SO and CLO ) changed the fatty acid composition of serum significantly . Maximal levels were achieved after 10 mon . No further changes were seen after 14 mon . A wash-out period of 4 mon hardly altered the level of n−3 fatty acids in serum . Addition of SO gave 30 % higher level of eicosapentaenoic acid , as compared to CLO . Subjects taking SO or CLO had lower whole-blood platelet aggregation than the control group . Neither SO nor CLO had any effects on the levels of serum total cholesterol , high-density lipoprotein cholesterol , postpr and ial triacylglycerol , apolipoproteins A1 and B100 , lipoprotein ( a ) , monocyte function expressed as monocyte-derived tissue factor expression , and tumor necrosis factor A study was performed to explore the effects of supplemental intake of various marine oils known to be part of the Eskimo diet . Healthy men and women ( 134 ) were r and omly selected to consume 15 mL/d of oil from blubber of seal , cod liver , seal/cod liver , blubber of Minke whale , or no oil for ten weeks . Total cholesterol was unchanged in the oil groups , whereas high density lipoprotein cholesterol increased 7 % in the seal/cod liver oil ( CLO ) group ( P<0.05 ) and 11 % in the whale oil group ( P<0.005 ) . Triacylglycerol was significantly reduced in the CLO group only . The concentration of prothrombin fragment 1 + 2 was reduced 25 % ( P<0.05 ) after whale oil supplementation . No change in fibrinogen or factor VIIc was detected . Tumor necrosis factor generation in lipopolysaccharide (LPS)-stimulated blood was 30 % reduced after whale oil ( P<0.05 ) , but was unaffected by intake of seal or CLO . The LPS-induced tissue factor activity in monocytes was reduced to a significant degree only in the seal/CLO group ( 34 % ) and whale oil group ( 35 % ) ( P<0.05 ) . The most dramatic change in thromboxane B2 in LPS-stimulated blood was seen after whale oil intake with 44 % reduction ( P<0.01 ) . Supplementation of a regular diet with a combination of seal oil and CLO and especially with whale oil seems to have beneficial effects on several products thought to be associated with cardiovascular and thrombotic diseases To compare the effects of highly purified ethyl ester concentrates of eicosapentaenoic acid ( EPA ) and docosahexaenoic acid ( DHA ) on serum lipids , apolipoproteins , and serum phospholipid fatty acids in humans , we conducted a double-blind , placebo-controlled , parallel design intervention study . Healthy nonsmoking men ( n = 234 ) aged 36 - 56 y were r and omly assigned to dietary supplementation with 3.8 g EPA/d , 3.6 g DHA/d , or 4.0 g corn oil/d ( placebo ) for 7 wk . Serum triacylglycerols decreased 26 % ( P < 0.0001 ) in the DHA group and 21 % ( P = 0.0001 ) in the EPA group compared with the corn oil group . Although not significant , net decreases in serum triacylglycerols were consistently greater in the DHA group across all quartiles of baseline triacylglycerol concentrations . Serum high-density-lipoprotein cholesterol increased 0.06 mmol/L ( P = 0.0002 ) in the DHA group . In the EPA group , serum total cholesterol decreased 0.15 mmol/L ( P = 0.02 ) and apolipoprotein A-I decreased 0.04 g/L ( P = 0.0003 ) . In the DHA group , serum phospholipid DHA increased by 69 % and EPA increased by 29 % , indicating retroconversion of DHA to EPA . In the EPA group , serum phospholipid EPA increased by 297 % whereas DHA decreased by 15 % , suggesting that EPA is not elongated to DHA in humans . The serum phospholipid ratio of n-3 to n-6 fatty acids increased in both groups , whereas the relative changes in n-6 fatty acids suggested possible alterations in liver desaturation activity in the DHA group . We conclude that both DHA and EPA decrease serum triacylglycerols , but have differential effects on lipoprotein and fatty acid metabolism in humans BACKGROUND Results of epidemiologic studies and clinical trials indicate that moderate doses of n-3 fatty acids reduce the risk of cardiovascular disease and may improve prognosis . OBJECTIVE The objective was to evaluate the effect of a high-dose ethylester concentrate of n-3 fatty acids administered early after an acute myocardial infa rct ion ( MI ) on subsequent cardiac events and serum lipids . DESIGN Three hundred patients with acute MI were r and omly assigned to a daily dose of either 4 g highly concentrated n-3 fatty acids or corn oil , administered in a double-blind manner over 12 - 24 mo . Median follow-up time was 1.5 y. Clinical follow-up , including the drawing of blood sample s , was performed after 6 wk of treatment and later at 0.5-year intervals . RESULTS Forty-two ( 28 % ) patients in the n-3 group and 36 ( 24 % ) in the corn oil group experienced at least one cardiac event ( cardiac death , resuscitation , recurrent MI , or unstable angina ) . No significant difference in prognosis was observed between groups for single or combined cardiac events . Total cholesterol concentrations decreased in both groups , with no significant intergroup differences . On average , the monthly increase in HDL cholesterol was 1.11 % in the n-3 group and 0.55 % in the corn oil group ( P = 0.0016 ) . Triacylglycerol concentrations decreased by 1.30%/mo in the n-3 group , whereas they increased by 0.35%/mo in the corn oil group ( P < 0.0001 ) . CONCLUSION No clinical benefit of a high-dose concentrate of n-3 fatty acids compared with corn oil was found despite a favorable effect on serum lipids BACKGROUND Flaxseed oil is a rich source of 18:3n-3 ( alpha-linolenic acid , or ALA ) , which is ultimately converted to 22:6n-3 ( docosahexaenoic acid , or DHA ) , a fatty acid important for the development of the infant brain and retina . OBJECTIVE The objective of this study was to determine the effect of flaxseed oil supplementation on the breast-milk , plasma , and erythrocyte contents of DHA and other n-3 fatty acids in lactating women . DESIGN Seven women took 20 g flaxseed oil  ( 10.7 g ALA ) daily for 4 wk . Breast-milk and blood sample s were collected weekly before , during , and after supplementation and were analyzed for fatty acid composition . RESULTS Breast milk , plasma , and erythrocyte ALA increased significantly over time ( P < 0.001 ) and after 2 and 4 wk of supplementation ( 
    Output:
    