Table 2

Factors that affect outcomes in obesity and cardiovascular disease.

Lack to determine the composition of the background diet in terms of omega-6 and omega-3 fatty acids and inflammatory markers i.e. US, UK and Northern European countries have the highest amount of LA + AA in their diets, which competes with omega-3 PUFAs; they also have the lowest amount of vegetable and fruit intake, which are needed for optimal absorption of omega-3 PUFA from supplements
Background inflammation
Some studies are using fish and others omega-3 supplements; studies show that a continuous daily intake of omega-3 supplements leads to higher concentrations in the blood than eating fish two times/week
Variation in the dose of omega-3 fatty acids
Variation in the number of subjects
Variation in the severity of disease
Variation in the pharmacologic treatment
Genetic variants predisposing to cardiovascular disease
Dietary intake by means of questionnaires instead of actual measurements of omega-3 PUFAs in the red blood cell membrane phospholipids or plasma is a major problem that leads to conflicting results
Length of intervention
Genetic variants in the metabolism of omega-6 and omega-3 fatty acids
Low dose of EPA and DHA against a high intake of LA and AA of the background diet

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