Fish oil - an example of an anti-inflammatory food

With regard to anti-inflammatory effects of diet away from the gut, altering the balance of dietary poly-unsaturated fatty acids (PUFA) in favour of n-3 PUFA provides the best documented examples of effective dietary intervention. PUFA are essential macronutrients of which there are two non-interchangeable classes, n-6 and n-3. These fatty acids are metabolized to mediators that regulate cardiovascular homeostasis and inflammation. n-6 rich diets tend to be pro-inflammatory and, by comparison diets rich in n-3 PUFA are anti-inflammatory. The difference is explained by the action of n-3 PUFA as competitive inhibitors of enzymes that metabolize n-6 fats and by the lesser biological activities of most n-3 mediators, compared with their n-6 counterparts. Fish oils are a particularly rich source of desirable long chain n-3 PUFA. Fish oil has been used with benefit in the treatment of inflammatory diseases of joints and other organs and tissues. Our long-term studies in rheumatoid arthritis (RA) show that this approach, in conjunction with pharmacotherapy, can be sustained in the long term (>5 years). A potential collateral benefit is reduced risk for adverse cardiovascular events, which are increased in RA. Lack of knowledge amongst physicians of relevant biochemistry, evidence of efficacy, dose response relationships, latency in effect, availability of affordable preparations and tactics for discussing issues efficiently with patients appears to be a barrier to broader clinical use.