Wikipedia - User contributions [en]

Rickson Gracie

2017-07-06T23:18:16Z

Pazemath: Rickson got promoted to 9th degree red belt.

{{Infobox martial artist
| name = Rickson Gracie
| image = rickson_gracie_20080608.jpg
| image_size =
| alt =
| caption =
| birth_name =
| birth_date = {{birth date and age|1958|11|21}}
| birth_place = [[Rio de Janeiro]], [[Brazil]]
| death_date =
| death_place =
| death_cause =
| residence =
| nationality = [[Brazilian people|Brazilian]]
| height = {{height|ft=5|in=10}}
| weight_lb = 185
| weight_class = [[Middleweight (MMA)|Middleweight (185 lb)]]
| reach_in =
| style = [[Gracie Jiu-Jitsu]], [[Judo]], [[Wrestling]], [[Sambo (martial art)|Sambo]] [https://books.google.com/books?id=5y0spT_69PoC&lpg=PA10&dq=%22Mehdi%22%20judo&pg=PA10#v=onepage&q=mehdi&f=false]
| stance =
| fighting_out_of =
| team =
| other_names =
| teacher = [[Helio Gracie]], [[Rolls Gracie]], [[Georges Mehdi]] [https://books.google.com/books?id=5y0spT_69PoC&lpg=PA10&dq=%22Mehdi%22%20judo&pg=PA10#v=onepage&q=mehdi&f=false]
| rank = {{color box|black}}{{color box|red}} 8th Degree Coral Belt in [[Brazilian Jiu-Jitsu]]''<ref>[http://instagram.com/p/dXtG5GJYC8/# Photo by krongraciejiujitsu > Rickson Gracie wearing red and black belt] URL accessed January 1, 2014.</ref> black belt in [[Judo]]{{Citation needed|date=September 2012}}
| years_active = 1980−1984, 1994−2000 ([[Mixed martial arts|MMA]])
| mma_kowin =
| mma_subwin = 11
| mma_decwin =
| mma_koloss =
| mma_subloss =
| mma_decloss =
| mma_draw =
| mma_nc =
| url =
| sherdog = 292
| footnotes =
| updated =
}}

'''Rickson Gracie''' ({{IPA-pt|ˈʁiksõ ˈɡɾejsi}}; born November 21, 1958) is a Brazilian 9th degree [[Brazilian jiu-jitsu ranking system#Red belt|red belt]] in [[Gracie Jiu-Jitsu]] and a retired [[mixed martial artist]].<ref>[http://www.rickson.com/history/rickson.htm ] {{webarchive |url=https://web.archive.org/web/20070705141236/http://www.rickson.com/history/rickson.htm |date=July 5, 2007 }}</ref><ref>{{cite web|url=http://www.budochallenge.com/ |title=Rickson Gracie's Budo Challenge |publisher=Budochallenge.com |date=1959-11-21 |accessdate=2013-09-15}}</ref><ref name="urlGracie Official Belt Ranks">{{cite web
|url=http://www.gracie.com/riofed/beltranking.html
|title=Official Federation Belt Rankings of Gracie Members Teaching in the U.S.
|publisher=Gracie USA Jiu-Jitsu
|accessdate=2010-10-16
}}</ref> He is a member of the [[Gracie family]]: the son of [[Hélio Gracie]], brother to [[Rorion Gracie|Rorion]] and [[Relson Gracie]], and half-brother to Rolker, [[Royce Gracie|Royce]], [[Robin Gracie|Robin]] and [[Royler Gracie]].<ref>{{cite web
|url=http://www.550media.com/igjjf/familytree.html
|title=Gracie Family Tree
|publisher=International Gracie Jiu-Jitsu Federation Family Tree
|accessdate=2006-04-08
|deadurl=yes
|archiveurl=https://web.archive.org/web/20090917021836/http://www.550media.com/igjjf/familytree.html
|archivedate=September 17, 2009
}}</ref> In November 2014 he became an inductee of the Legends of MMA Hall of Fame, alongside [[Big John McCarthy]], [[Pat Miletich]], and [[Fedor Emelianenko]].<ref>{{cite press release | title =Legends of MMA Hall of Fame Award Ceremony | publisher =[[Silver Legacy Reno]] | date =2014-10-20 | url =http://www.silverlegacyreno.com/press-release/Legends-of-MMA-Hall-of-Fame-Award-Ceremony/ | access-date = 2016-02-16}}</ref><ref>{{cite AV media | people = | title =Inside MMA Legends of MMA Hall of Fame Feature | medium =video | publisher =[[AXS TV Fights]] | location =[[Silver Legacy Reno]] | date =November 2014 | url = https://www.youtube.com/watch?v=7zXXestPdl8}}</ref>

==Biography==
Rickson Gracie, son of [[Helio Gracie]], received his black belt in [[Brazilian jiu-jitsu]] at age 18.{{fact|date=April 2017}} At 20, Gracie won his first victory against the famous 230-pound (104 kg) Brazilian brawler [[:pt:Rei_Zulu|Rei Zulu]] (father of [[Zuluzinho]]). With this victory, Rickson gained immediate national acclaim. Five years later Zulu requested a rematch and lost to Rickson again, in Maracanazinho before an audience of 20,000 spectators.{{fact|date=April 2017}}

Rickson also famously fought [[luta livre]] exponent Hugo Duarte on the Rio de Janeiro beach. Duarte only wanted to fight in an event, but Gracie slapped him in front of his students and challenged him again, so Hugo stepped down and faced Rickson on the sand. Gracie won after making him surrender to punches to the face.<ref name=Tadeu>[http://www.bloodyelbow.com/2013/5/8/4309600/the-riot-over-renzo-gracie-vs-eugenio-tadeu The riot over Renzo Gracie vs Eugenio Tadeu], Bloody Elbow, May 8, 2013</ref> Shortly after, maintaining that Gracie students had kicked him and thrown sand to his eyes during the fight, Duarte came to Rickson's gym and demanded a rematch. Gracie won again, causing a riot which forced neighbours to call the police. Shortly after, Rickson challenged Eugenio Tadeu, another luta livre practitioner, and the two fought to a 50 minute draw.<ref name=Tadeu/> The rivalry between Brazilian jiu-jitsu and luta livre continued without Rickson, as he left Brazil for United States after the fight.

===Vale Tudo Japan===
In 1994, Rickson was contacted by [[Erik Paulson]] to compete in [[Satoru Sayama]]'s event [[Vale Tudo Japan]]. Gracie traveled to Japan and participated in the tournament, firstly facing Daido-juku stylist Yoshinori Nishi. Gracie took him down and Nishi answered with a lockdown from [[half guard]], but the Brazilian was able to pass his guard and catch him with a [[rear naked choke]] when Nishi turned his back. He later faced much larger [[wing chun]] practitioner Dave Levicki, but he was an even easier prey once taken down, and Rickson won by TKO after a flurry of punches. Gracie then fought American [[Kickboxing|kickboxer]] Bud Smith at the finals, winning by the same method in an even minor time and getting the tournament's victory. The same year, [[pro wrestler]] [[Yoji Anjo]] came to Rickson's dojo to challenge him, after failed negotiations about Gracie wrestling for [[Union of Wrestling Force International]]. Gracie was fast in fighting him and performed abundant [[ground and pound]] on Anjo, who did not surrender, so Gracie choked him unconscious.

A year later, Gracie was invited again to the next Vale Tudo Japan. At the first round he faced pro wrestler [[Yoshihisa Yamamoto (wrestler)|Yoshihisa Yamamoto]] from [[Fighting Network Rings]], who unlike Rickson's previous opponents managed to keep him away from the mat by using the ropes and even tried a [[guillotine choke]]. However, Gracie eventually took him down and choked him. He squared against another pro wrestler in the form of [[Koichiro Kimura]], swiftly defeating him, and then met [[Shoot wrestling|shoot wrestler]] [[Yuki Nakai]] at the finals. Nakai, who was almost blind from an earlier match against [[Gerard Gordeau]], put a strong resistance against Rickson, but the Brazilian master managed to take his back and choke him for another tournament win.

===PRIDE===
In 1997, Gracie signed up to a fight against Yoji Anjo's superior [[Nobuhiko Takada]] in the [[Pride 1]] event. Before the [[Tokyo Dome]]'s 47,860 spectators, Rickson defeated the inexperienced Takada, [[Mount (grappling)|mounting]] him and locking an [[armbar]] in 4:47. Immediately after the event, Fighting Network Rings's chairman [[Akira Maeda]] challenged Gracie, but got no answer.<ref>Snowden, Jonathan. ''Total MMA: Inside Ultimate Fighting'', ECW Press, 2008</ref> Now enjoying a growing popularity in Japan, according to Gracie he was proposed to fight [[Mario Sperry]] at [[Pride 3]], but the process was stopped due to [[Carlson Gracie]]'s disavowal.<ref name=Mat2/> Pride management also offered him to take [[Royce Gracie]]'s place in his cancelled match with [[Mark Kerr (fighter)|Mark Kerr]], but he refused, citing one month to be a too short time to prepare.<ref name=Mat2/> Finally, Rickson preferred to sign up a rematch against Takada at [[1998 in Pride FC#Pride 4|Pride 4]], stating: "I feel Takada is a warrior and deserves the chance to try and redeem himself."<ref name=Mat2>[http://onthemat.com/rickson-gracie-interview-2/ Rickson Gracie interview 2], Onthemat.com</ref>

In their rematch, Takada showed improvement and was able to wrestle Rickson to neutralize his groundwork advantage, but the Brazilian master used a failed [[leglock]] attempt from the Japanese to [[Sweep (grappling)|sweep]] him and mount him. Nonetheless, Takada kept fighting under the jiu-jitsu master, dismounting him and threatening with a [[Leglock#Heel hook|heel hook]] attempt, but Gracie, who was waiting until the end of the round to prevent Takada to capitalize in case he missed his opportunity,<ref>"The first time I mounted him, about two minutes were left in the first round. I began striking him, and immediately an opportunity to attack his arm became available. I didn't take it initially because there was too much time left and I believed there was a possibility that Takada wanted me to attack his arm so he could trick me and reverse the situation to his advantage. So I waited until nearly the end of the round to prevent him from having enough time to counter. Then I ended the fight with an armbar." Rickson Gracie, ''In the ring with Takada at PRIDE IV'', Black Belt Magazine, February 1999.</ref> applied an armbar and submitted him again.

===Colosseum===
In May 2000, after Takada understudy [[Kazushi Sakuraba]] defeated [[Royler Gracie]] in the [[1999 in Pride FC#Pride 8|Pride 8]] event, he took the mic and challenged Rickson, who was in the Gracie corner, but nothing came of it.<ref>Snowden, Jonathan. ''Total MMA: Inside Ultimate Fighting'', ECW Press, 2008.</ref> Gracie preferred to face [[Pancrase]]'s retired ace [[Masakatsu Funaki]] at Colosseum event. The event almost got canceled, as Rickson demanded special rules which forbade elbows, headbutts, knee strikes and thrusts to the head or body (standing or on the ground), but the Pancrase management eventually conceded.<ref name=Colosseum>[http://www.quebrada.net/news/News20001.html Wrestling News - Colosseum]</ref>

At the event, held at the Tokyo Dome and broadcast to 30 million TV Tokyo viewers, Gracie and Funaki started the fight clinching to the corner. Masakatsu appeared to have secured a guillotine choke, but the hold was loose and Rickson managed to go to the mat. They traded kicks to no effect, until some well timed upkicks from Gracie blew out Funaki's gravely injured knee. They clinched again, but the Japanese's injury rendered him unable to wrestle Rickson correctly, and he was taken down by the Brazilian grappler, who promptly mounted him. Masakatsu looked stunned while Rickson bloodied his face with ground and pound, and finally Gracie forced his way into a rear naked choke.<ref name=Colosseum/> During the post-match interview, Gracie claimed that one of the hammerfist delivered by Funaki made him lose his eyesight for a few moments.<ref>[http://www.global-training-report.com/rickson.htm Global Training Report - Interview with Rickson Gracie]</ref>

After the Colosseum event, Gracie expressed interest on fighting judo medalist [[Naoya Ogawa]], which was signed up for the next Colosseum event. He was also proposed by Pride management a fight against Kazushi Sakuraba, who had already defeated [[Royce Gracie]] as well, but Gracie refused on the saying Sakuraba "didn't have the spirit of a warrior".<ref name=Colosseum/> Rickson further said he didn't want to fight a wrestler that was so much smaller than him.<ref name=Colosseum/> Thus, [[New Japan Pro Wrestling]] offered him to face [[Shinya Hashimoto]], or most specially [[Manabu Nakanishi]] or [[Kazuyuki Fujita]], but they were refused. The fight against Ogawa was set to the next year, with Naoya vacating his [[NWA World Heavyweight Championship]] to focus on training for the bout; however, tragedy struck when Rickson's son Rockson was found dead in January 2001. Affected by the loss, Gracie contemplated retirement, and the event fell off after some negotiations,.<ref name=Colosseum/>

===Other appearances===
In August 2002, Rickson had a special appearance in Japanese media helping out Ogawa before his bout against [[Matt Ghaffari]] at the UFO Legend event, in which he assisted.<ref name=Ichiban>[http://www.ichibanpuroresu.com/news/200208.html Ichiban Puroresu - August 2002 News Archive]</ref> After the event, Ogawa talked again about a fight against Rickson, which the Brazilian considered as possible return match. Rickson also mentioned [[Antônio Rodrigo Nogueira]] and Kazuyuki Fujita as candidates to fight him in said return.<ref name=Ichiban/> However, nothing of it came to fruition, even after UFO president Tatsuo Kawamura proposed creating an event in order to hold the match.<ref name=Ichiban2>[http://www.ichibanpuroresu.com/news/200211.html Ichiban Puroresu - November 2002 News Archive]</ref>

In 2003, [[Antonio Inoki]] offered Rickson USD$5 million for a fight against Fujita,<ref>[http://fightsport.net/?p=3210 Rickson vs Fujita], Fightsport, September 28, 2011</ref> but it had no answer.

Gracie has confirmed that he is officially retired now and his major focus is to give seminars on [[Brazilian jiu-jitsu|Jiu-Jitsu]] and to try to develop BJJ as his father saw it: not a fighting tool but a social tool, to give confidence to women, children, and physically weak individuals by giving them the ability to defend themselves.{{Citation needed|date=August 2010}}

==Films==
Gracie was the subject of the 1995 documentary, ''Choke'', by filmmaker Robert Goodman. The documentary followed Gracie and two other fighters ([[Todd Hays]] and [[Koichiro Kimura]]) as they prepared and fought in Tokyo's [[Vale Tudo Japan]] 1995. Released by [[Manga Entertainment]], the film has been distributed to 23 countries.<ref>{{cite web|url=http://www.imdb.com/title/tt0251637/|title=Choke (1999)|publisher=IMDb.com|accessdate=2013-09-16}}</ref> Rickson had a small role in ''[[The Incredible Hulk (film)|''The Incredible Hulk'']]'' as [[Bruce Banner]]'s martial arts instructor. His character is credited as an [[aikido]] instructor, despite his jiu-jitsu background. He has appeared on [[National Geographic Channel|National Geographic]]'s television programme ''[[Fight Science]]''.<ref>{{cite news|title= Martial Arts vs. Crash Test Dummies: National Geographic's FIGHT SCIENCE|work= Kung Fu Magazine|date=|url=http://ezine.kungfumagazine.com/ezine/article.php?article=675|accessdate=2010-01-29}}</ref><ref>{{cite news|title= BAS RUTTEN ON 'FIGHT SCIENCE', KIMBO & IFL|work= MMA Weekly|date=|url=http://www.mmaweekly.com/absolutenm/templates/dailynews.asp?articleid=5565&zoneid=4|accessdate=2010-01-29}}</ref>

==Controversy==
Gracie raised the ire of some in the MMA community by criticizing the abilities of top fighters. In 1996, speaking about [[Ultimate Fighting Championship]] tournament winners, he labelled [[Don Frye]] and [[Mark Coleman]] as "very weak", and said that the latter "would offer no danger".<ref name=Mat4>[http://www.onthemat.com/node/8597 Rickson Gracie interview 4], Onthemat.com</ref> He also considered [[Marco Ruas]] as "nothing special" and "basic".<ref name=Mat4/> Ruas, who was known for challenging Rickson to a fight several times in his career,<ref name=ADc/> was quoted in return as: "Talk is cheap. He has to step up in the ring and prove what he says."<ref>[http://www.reocities.com/Colosseum/field/3646/ruas.htm Marco Ruas interview], Reocities</ref>

Though he had not fought in a sanctioned MMA contest in eight years, Gracie claimed in 2008 that he could still beat the current top fighters easily. In an interview with ''Tokyo Sports'', Gracie argued that [[Fedor Emelianenko]] was a great athlete, but possessed "so-so" technical ability, and that he (Gracie) was "100% sure" that he could defeat him.<ref>[[Wrestling Observer Newsletter]], May 12, 2008</ref> Two years after, Gracie stated that he disagreed with those who view Emelianenko as "somehow special" and that he believed Emelianenko deserved to lose the decision in his fight with [[Ricardo Arona]]; described [[Brock Lesnar]] as having "zero defense from the bottom" in the fight against Carwin; and criticized [[Shane Carwin]] for what he perceived were deficiencies in Carwin's jiu-jitsu game, characterizing him as "strong as a bull but flimsy like a paper tiger."<ref>{{cite web|url=http://www.portaldovt.com.br/pvt_mag_en_09/ |title=Portal do Vale Tudo - Noticias sobre as artes marciais, novidades sobre UFC | tudo sobre o MMA | eventos de Jiu-Jitsu | lutas de Muay Thai | combates de Wrestling | Wanderlei Silva | Rodrigo Minotauro | Junior dos Santos | José Aldo | Anderson Silva | Dana White | UFC RIO |publisher=Portaldovt.com.br |date= |accessdate=2013-09-15}}</ref> Previous critical comments that Gracie made about [[Antônio Rodrigo Nogueira]] (claiming that Nogueira had "no [[Guard (grappling)|guard]]") prompted [[Wanderlei Silva]] to say that Gracie is "living in a [[fantasy world]]" and launch a new challenge to him.<ref name=ADc>{{cite web
|url=http://adcombat.com/news2005-07-07wanderlei-and-marco-ruas-challenge-rickson-gracie/
|title=Wanderlei and Marco Ruas Challenge Rickson Gracie
|format=Reprint
|publisher=AD Combat
|date=July 6, 2005
|accessdate=2016-04-30
}}</ref>

His father [[Helio Gracie]] disputed Rickson's claim to have had over 400 fights. According to Hélio, Rickson has only competed in fights that are commonly known and reported: the two against Rei Zulu and those that took place in Japan. [[Helio Gracie]] alleged that Rickson uses practice and amateur bouts to obtain a number over 400, and that if he counted his fights like Rickson does, he would have in excess of one million.
<ref>{{cite web
|url=https://www.youtube.com/watch?v=iNy1oEk47_g
|title=Helio Gracie: Rickson 400-0? I Don't Think So!
|publisher=www.youtube.com
|date=July 2, 2009
|accessdate=2014-11-12
}}</ref>

=== The [[Ron Tripp]] fight ===
At the 1993 U.S. Sambo Championships in Norman, Oklahoma, Rickson faced [[judo]] and [[sambo (martial art)|sambo]] champion Ron Tripp. Tripp threw Gracie to the canvas by [[uchi mata]] in 47 seconds, thus giving Tripp absolute victory under FIAS International Sambo rules. Rickson disputed this loss, claiming he was misinformed of the rules of the event.<ref>{{cite web
|url=http://www.onthemat.com/articles/Rickson_Gracie_Freefight_interview_10_13_2005.html
|title=Rickson Gracie interview: part one
|format=Reprint
|publisher=FreeFight magazine
|date=December 12, 2005
|accessdate=2007-07-02
}}</ref><ref>{{cite web
|title=Rickson Gracie interview: part two
|url=http://www.onthemat.com/articles/Rickson_Gracie_interview_2_10_13_2005.html
|format=Reprint
|publisher=FreeFight magazine
|date=December 12, 2005
|accessdate=2007-07-02
}}</ref>

==Personal life==
Gracie has four children; Rockson Gracie (deceased), Kauan, Kaulin and [[Kron Gracie]]. In a November 2010 Gracie Mag interview, Rickson discussed the passing of his son Rockson.<ref>{{cite web|title=Rickson speaks of hardest knockout of his life|url=http://www.graciemag.com/2010/11/rickson-speaks-of-hardest-knock-of-his-life|date=November 20, 2010|accessdate=November 20, 2016|website=''Gracie Mag''}}</ref>

==Lineage==
[[Mitsuyo Maeda|Mitsuyo "Count Koma" Maeda]] → [[Carlos Gracie]] → [[Helio Gracie]] → Rickson Gracie

==Mixed martial arts record==
{{MMArecordbox
|sub-wins=11
|sub-losses=
|ko-wins=
|ko-losses=
|dec-wins=
|dec-losses=
|draws=
|nc=
}}
{{MMA record start}}
|-
| {{yes2}}Win
|align=center| 11–0
| [[Masakatsu Funaki]]
| Technical Submission (rear naked choke)
| C2K: Colosseum
| {{dts|2000|May|26}}
|align=center| 1
|align=center| 12:49
| Japan
| Special rules: no knees or elbows to head standing up or on ground
|-
| {{yes2}}Win
|align=center| 10–0
| [[Nobuhiko Takada]]
| Submission (armbar)
| [[1998 in Pride FC#Pride 4|Pride 4]]
| {{dts|1998|October|11}}
|align=center| 1
|align=center| 9:30
| [[Tokyo]], Japan
|
|-
| {{yes2}}Win
|align=center| 9–0
| [[Nobuhiko Takada]]
| Submission (armbar)
| [[Pride 1]]
| {{dts|1997|October|11}}
|align=center| 1
|align=center| 4:47
| [[Tokyo]], Japan
|
|-
| {{yes2}}Win
|align=center| 8–0
| [[Yuki Nakai]]
| Submission (rear naked choke)
| Vale Tudo Japan 1995
| {{dts|1995|April|20}}
|align=center| 1
|align=center| 6:22
| [[Tokyo]], Japan
|
|-
| {{yes2}}Win
|align=center| 7–0
| [[Koichiro Kimura]]
| Submission (rear naked choke)
| Vale Tudo Japan 1995
| {{dts|1995|April|20}}
|align=center| 1
|align=center| 2:07
| [[Tokyo]], Japan
|
|-
| {{yes2}}Win
|align=center| 6–0
| Yoshihisa Yamamoto
| Technical Submission (rear naked choke)
| Vale Tudo Japan 1995
| {{dts|1995|April|20}}
|align=center| 3
|align=center| 3:49
| [[Tokyo]], Japan
|
|-
| {{yes2}}Win
|align=center| 5–0
| Bud Smith
| Submission (punches)
| Vale Tudo Japan 1994
| {{dts|1994|July|29}}
|align=center| 1
|align=center| 0:39
| [[Urayasu, Chiba]], Japan
|
|-
| {{yes2}}Win
|align=center| 4–0
| Dave Levicki
| Submission (punches)
| Vale Tudo Japan 1994
| {{dts|1994|July|29}}
|align=center| 1
|align=center| 2:40
| [[Urayasu, Chiba]], Japan
|
|-
| {{yes2}}Win
|align=center| 3–0
| Yoshinori Nishi
| Submission (rear naked choke)
| Vale Tudo Japan 1994
| {{dts|1994|July|29}}
|align=center| 1
|align=center| 2:58
| [[Urayasu, Chiba]], Japan
|
|-
| {{yes2}}Win
|align=center| 2–0
| Casemiro Nascimento Martins
| Submission (rear naked choke)
| ''Independent promotion''
| {{dts|1984|January|1}}
|align=center| 1
|align=center| 9:00
| [[Rio de Janeiro]], Brazil
|
|-
| {{yes2}}Win
|align=center| 1–0
| Casemiro Nascimento Martins
| Submission (rear naked choke)
| ''Independent promotion''
| {{dts|1980|April|25}}
|align=center| 1
|align=center| 11:55
| [[Brasília]], Brazil
|
{{end}}

==Submission grappling record==
{{s-start}}KO PUNCHES
|- style="text-align:center; background:#f0f0f0;"
| style="border-style:none none solid solid; "|'''Result'''
| style="border-style:none none solid solid; "|'''Opponent'''
| style="border-style:none none solid solid; "|'''Method'''
| style="border-style:none none solid solid; "|'''Event'''
| style="border-style:none none solid solid; "|'''Date'''
| style="border-style:none none solid solid; "|'''Round'''
| style="border-style:none none solid solid; "|'''Time'''
| style="border-style:none none solid solid; "|'''Notes'''
|-
|{{yes2}}Win||{{flagicon|BRA}} [[Rigan Machado]] || Submission (rear naked choke) || ''Independent promotion''|| 1986|| || ||
|-
|{{yes2}}Win||{{flagicon|BRA}} Murilo Sa || Submission (armbar) || Copa Cantao|| 1986|| || ||
|-
|{{yes2}}Win||{{flagicon|BRA}} [[Rigan Machado]] || Submission (exhaustion) || III Copa Company|| 1986|| || ||
|-
|{{yes2}}Win||{{flagicon|BRA}} Otavio Peixotinho || Submission (armbar) || LINJJI || 1984|| || ||
|-
|{{yes2}}Win||{{flagicon|BRA}} [[Sergio Penha]] || Submission (choke) || AABB || 1981|| || ||
|-
|{{yes2}}Win||{{flagicon|BRA}} [[Sergio Penha]] || Submission (armbar) || AABB || 1981|| || ||
|-
{{s-end}}

==See also==
* [[List of Brazilian Jiu-Jitsu practitioners]]

==References==
{{Reflist|30em}}

==External links==
* {{Official website|http://www.ricksongracie.com}}
* [http://www.cagefilm.com/video/1550/Rickson-Gracie-Hawai-Seminar-part-1-of-13 Rickson Gracie Seminar]
* [http://www.columbiabjj.com/ Columbia BJJ (Official Rickson Gracie Representative)]
* [http://www.axisjj.com Axis Jiu-Jitsu Academy (Rickson Gracie Japan Representative) Official website]
* [http://bjjwiki.org/Rickson_Gracie Rickson Gracie FAQ]
* {{Sherdog}}
* {{IMDb name|0333487}}
* [http://bjjwiki.org/index.php/Seminars#Rickson_Gracie_Seminars Video footages of Rickson's seminars]
* [https://www.youtube.com/user/agentmma Rare Rickson Gracie Videos]

{{Gracie family}}

{{DEFAULTSORT:Gracie, Rickson}}
[[Category:1958 births]]
[[Category:Brazilian choreographers]]
[[Category:Brazilian male judoka]]
[[Category:Brazilian male mixed martial artists]]
[[Category:Living people]]
[[Category:Middleweight mixed martial artists]]
[[Category:Sportspeople from Rio de Janeiro (city)]]
[[Category:Gracie family]]

User talk:Pazemath

2016-03-14T10:40:08Z

Pazemath: /* Comments and requests */

==Spam==
[[File:Information.svg|25px|alt=Information icon]] Hello, I'm [[User:Jytdog|Jytdog]]. I wanted to let you know that I removed one or more external links you added, because they seemed to be inappropriate for an encyclopedia. If you think I made a mistake, or if you have any questions, you can leave me a message on [[User_talk:Jytdog|my talk page]], or take a look at our [[Wikipedia:External links|guidelines]] about links. Thank you. [[Category:User talk pages with Uw-spam1 notices|{{PAGENAME}}]] [[User:Jytdog|Jytdog]] ([[User talk:Jytdog|talk]]) 19:30, 12 March 2016 (UTC)

== Conflict of interest in Wikipedia ==

Hi Pazemath I work on conflict of interest issues here in Wikipedia, along with my regular editing about health and medicine. [[Special:Contributions/Pazemath|Your edits to date]] are adding references to the youexplained.com website. I'm giving you notice of our Conflict of Interest guideline and Terms of Use, and will have some comments and requests for you below.

[[File:Information.svg|25px|alt=Information icon]] We [[Wikipedia:Welcoming committee/Welcome to Wikipedia|welcome]] your contributions, but if you have an external relationship with the people, places or things [[Special:Contributions/Pazemath|you have written about]] on Wikipedia, you may have a [[conflict of interest]] (COI). Editors with a COI may be unduly influenced by their connection to the topic. See the '''[[Wikipedia:Conflict of interest|conflict of interest guideline]]''' and [[Wikipedia:FAQ/Organizations|FAQ for organizations]] for more information. In particular, please:

*'''avoid editing or creating''' articles related to you and your circle, your organization, its competitors, projects or products;
* instead '''propose changes''' on the talk pages of affected articles (see the {{tl|request edit}} template);
* when discussing affected articles, '''disclose''' your COI (see [[Wikipedia:Conflict of interest#Declaring an interest|WP:DISCLOSE]]);
*'''avoid linking''' to the Wikipedia article or website of your organization in other articles (see [[Wikipedia:Spam|WP:SPAM]]);
*'''exercise great caution''' so that you do not violate Wikipedia's [[Wikipedia:Core content policies|content policies]].

In addition, you must disclose your employer, client, and affiliation with respect to any contribution for which you receive, or expect to receive, compensation (see [[Wikipedia:Paid-contribution disclosure|WP:PAID]]).

Please familiarize yourself with relevant policies and guidelines, especially those pertaining to [[Wikipedia:Neutral point of view|neutral point of view]], [[Wikipedia:Verifiability|sourcing]] and [[Wikipedia:Autobiography|autobiographies]]. Thank you.{{#if:| [[User:Jytdog|Jytdog]] ([[User talk:Jytdog|talk]]) 19:29, 12 March 2016 (UTC)}}[[Category:User talk pages with conflict of interest notices|{{PAGENAME}}]]

===Comments and requests===
Wikipedia is a widely-used reference work and managing conflict of interest is essential for ensuring the integrity of Wikipedia and retaining the public's trust in it. As in academia, COI is managed here in two steps - disclosure and a form of peer review. Please note that there is no bar to being part of the Wikipedia community if you want to be involved in articles where you have a conflict of interest;; there are just some things we ask you to do (and if you are paid, some things you need to do).

Disclosure is the most important, and first, step. While I am not asking you to disclose your identity (anonymity is strictly protecting by our [[WP:OUTING]] policy) would you please disclose if you have some connection with youexplained.com? You can answer how ever you wish (giving personally identifying information or not), but if there is a ''connection'', with youexplained.com, please disclose it. After you respond (and you can just reply below), perhaps we can talk a bit about editing Wikipedia, to give you some more orientation to how this place works. Please reply here - I am watching this page. Thanks! [[User:Jytdog|Jytdog]] ([[User talk:Jytdog|talk]]) 19:32, 12 March 2016 (UTC)

:Hi Jytdog. Sorry, I'm new to Wikipedia.

:I'm a medical student and I write medical-related articles among other things on my blog mentioned, youexplained.com.
:I noticed that I had written some stuff about ADHD that was relevant to some of the wikipedia pages on it, especially the Omega-3 Fish Oil connection, therefore, I decided to add my blog as a source.

:Let me know what I need to do. Thanks. — Preceding [[Wikipedia:Signatures|unsigned]] comment added by [[User:Pazemath|Pazemath]] ([[User talk:Pazemath|talk]] • [[Special:Contributions/Pazemath|contribs]]) 10:05, 13 March 2016‎ (UTC) [[User:Jytdog|Jytdog]] ([[User talk:Jytdog|talk]]) 17:43, 13 March 2016 (UTC)
::My very short answer is that you should never cite your blog in WIkipedia again. There is nothing correct about you having done that, and many things wrong with it, under Wikipedia's policies and guidelines. I will be happy to explain why, and very happy to help you get oriented, but you need to understand that this is not a conversation about whether you can cite it in the future. You can't. OK? (you are very very welcome to edit!! I just want to get clear on this thing first) [[User:Jytdog|Jytdog]] ([[User talk:Jytdog|talk]]) 17:43, 13 March 2016 (UTC)

What if someone else were to cite my blog in the future? Also, what if I wrote a peer-reviewed scientific article? I can't cite that on Wikipedia either because I wrote it?

User talk:Pazemath

2016-03-13T10:05:05Z

Pazemath: /* Comments and requests */

==Spam==
[[File:Information.svg|25px|alt=Information icon]] Hello, I'm [[User:Jytdog|Jytdog]]. I wanted to let you know that I removed one or more external links you added, because they seemed to be inappropriate for an encyclopedia. If you think I made a mistake, or if you have any questions, you can leave me a message on [[User_talk:Jytdog|my talk page]], or take a look at our [[Wikipedia:External links|guidelines]] about links. Thank you. [[Category:User talk pages with Uw-spam1 notices|{{PAGENAME}}]] [[User:Jytdog|Jytdog]] ([[User talk:Jytdog|talk]]) 19:30, 12 March 2016 (UTC)

== Conflict of interest in Wikipedia ==

Hi Pazemath I work on conflict of interest issues here in Wikipedia, along with my regular editing about health and medicine. [[Special:Contributions/Pazemath|Your edits to date]] are adding references to the youexplained.com website. I'm giving you notice of our Conflict of Interest guideline and Terms of Use, and will have some comments and requests for you below.

[[File:Information.svg|25px|alt=Information icon]] We [[Wikipedia:Welcoming committee/Welcome to Wikipedia|welcome]] your contributions, but if you have an external relationship with the people, places or things [[Special:Contributions/Pazemath|you have written about]] on Wikipedia, you may have a [[conflict of interest]] (COI). Editors with a COI may be unduly influenced by their connection to the topic. See the '''[[Wikipedia:Conflict of interest|conflict of interest guideline]]''' and [[Wikipedia:FAQ/Organizations|FAQ for organizations]] for more information. In particular, please:

*'''avoid editing or creating''' articles related to you and your circle, your organization, its competitors, projects or products;
* instead '''propose changes''' on the talk pages of affected articles (see the {{tl|request edit}} template);
* when discussing affected articles, '''disclose''' your COI (see [[Wikipedia:Conflict of interest#Declaring an interest|WP:DISCLOSE]]);
*'''avoid linking''' to the Wikipedia article or website of your organization in other articles (see [[Wikipedia:Spam|WP:SPAM]]);
*'''exercise great caution''' so that you do not violate Wikipedia's [[Wikipedia:Core content policies|content policies]].

In addition, you must disclose your employer, client, and affiliation with respect to any contribution for which you receive, or expect to receive, compensation (see [[Wikipedia:Paid-contribution disclosure|WP:PAID]]).

Please familiarize yourself with relevant policies and guidelines, especially those pertaining to [[Wikipedia:Neutral point of view|neutral point of view]], [[Wikipedia:Verifiability|sourcing]] and [[Wikipedia:Autobiography|autobiographies]]. Thank you.{{#if:| [[User:Jytdog|Jytdog]] ([[User talk:Jytdog|talk]]) 19:29, 12 March 2016 (UTC)}}[[Category:User talk pages with conflict of interest notices|{{PAGENAME}}]]

===Comments and requests===
Wikipedia is a widely-used reference work and managing conflict of interest is essential for ensuring the integrity of Wikipedia and retaining the public's trust in it. As in academia, COI is managed here in two steps - disclosure and a form of peer review. Please note that there is no bar to being part of the Wikipedia community if you want to be involved in articles where you have a conflict of interest;; there are just some things we ask you to do (and if you are paid, some things you need to do).

Disclosure is the most important, and first, step. While I am not asking you to disclose your identity (anonymity is strictly protecting by our [[WP:OUTING]] policy) would you please disclose if you have some connection with youexplained.com? You can answer how ever you wish (giving personally identifying information or not), but if there is a ''connection'', with youexplained.com, please disclose it. After you respond (and you can just reply below), perhaps we can talk a bit about editing Wikipedia, to give you some more orientation to how this place works. Please reply here - I am watching this page. Thanks! [[User:Jytdog|Jytdog]] ([[User talk:Jytdog|talk]]) 19:32, 12 March 2016 (UTC)

Hi Jytdog. Sorry, I'm new to Wikipedia.

I'm a medical student and I write medical-related articles among other things on my blog mentioned, youexplained.com.
I noticed that I had written some stuff about ADHD that was relevant to some of the wikipedia pages on it, especially the Omega-3 Fish Oil connection, therefore, I decided to add my blog as a source.

Let me know what I need to do. Thanks.

Adult attention deficit hyperactivity disorder

2016-03-12T15:07:09Z

Pazemath: Added a missing source.

{{Infobox disease
| Name = Attention deficit hyperactivity disorder
| Image= NewADHDpic.gif
| Caption= Left: brain activity in healthy subjects. Right: apparent decreased brain activity in people living with ADHD. (Zametkin et al, 1990)| alt=Image of PET brain scan showing decreased neural activity of ADHD subjects compared to control.
| DiseasesDB = 6158
| ICD10 = {{ICD10|F|90||f|90}}
| ICD9 = {{ICD9|314.00}}, {{ICD9|314.01}}
| OMIM = 143465
| MedlinePlus = 001551
| eMedicineSubj = med
| eMedicineTopic = 3103
| eMedicine_mult = {{eMedicine2|ped|177}}
| MeshID = D001289
}}
'''Adult attention deficit hyperactivity disorder''' (also referred to as '''adult ADHD''' or simply '''ADHD in adults''', formerly '''AADD''') is the [[clinical neuroscience|neurobiological]] condition of [[attention deficit hyperactivity disorder]] (ADHD) in [[adult]]s.

About one-third<ref name="Anas2001"/>{{rp|page=[http://books.google.com/books?id=0m4MbrnqEWEC&pg=PA44 44]}} to two-thirds<ref>{{cite book |last=Hechtman|first=Lily |chapter=ADHD in Adults|date=8 February 2009|title=ADHD Comorbidities: Handbook for ADHD Complications in Children and Adults|edition=1st|editor-last=Brown|editor-first=Thomas E.|publisher=American Psychiatric Publishing |location=Washington, DC|isbn=9781585628339|oclc=701833161|page=[http://books.google.com/books?id=cJyvBAAAQBAJ&pg=PA87 87]}}</ref> of children with [[symptom]]s from early childhood continue to demonstrate notable ADHD symptoms throughout life.

Three subtypes of ADHD are identified in the [[DSM-IV]] as:
* [[Attention deficit hyperactivity disorder predominantly inattentive|Predominantly Inattentive]] (ADHD-PI)
* Predominantly Hyperactive (ADHD-PH)
* Combined type (ADHD-C)
In later life, the hyperactive/impulsive subtype manifests less frequently.<ref name="Anas2001"/>{{rp|page=[http://books.google.com/books?id=0m4MbrnqEWEC&pg=PA44 44]}} The hyperactivity symptoms tend to turn more into "inner restlessness", starting in [[adolescence]] and carrying on in adulthood.<ref name="Kooij-2010"/>

Adult ADHD is typically marked by inattentiveness, difficulty getting work done, procrastination and organizational problems. Specifically, adults with ADHD present with persistent difficulties in following directions, remembering information, concentrating, organizing tasks, completing work within specified time frames and appearing timely in appointments. These difficulties affect several different areas of an ADHD adult's life, causing emotional, social, vocational, marital, legal, financial and/or academic problems.<ref name="WebMD"/><ref name="isItADHD"/><ref name="psychiatrymmc.com" /> As a result, low self-esteem is commonly developed. However, given the right guidance and coaching, these traits of ADHD could also lead to career success.<ref name="webmd.com">{{cite web |url=http://www.webmd.com/add-adhd/features/positives |title=Is There a Positive Side to Adult ADHD? |author=Eric Metcalf, MPH |publisher=WebMD, LLC |accessdate=August 17, 2015}}</ref>

Diagnosis of the condition follows after one or several [[psychiatric assessment|assessment]] interviews by a [[clinician]] including:
* examination of personal history
* observational evidence from family members or close friends
* academic reports, often going back to school years
* etc.,<ref name="Faraone"/><ref name="NASP"/>
as well as evaluation to diagnose additional possible conditions which [[Attention deficit hyperactivity disorder#Associated disorders|often coexist with ADHD]], called [[comorbidities]] or comorbid disorders.

The condition is highly [[heritable]],<ref>{{cite book |last1=Rettew|first1=David C. |last2=Hudziak|first2=James J. |chapter=Genetics of ADHD |date=2009 |title=ADHD Comorbidities: Handbook for ADHD Complications in Children and Adults |edition=1st |editor-last=Brown|editor-first=Thomas E. |publisher=American Psychiatric Publishing |location=Washington, DC |isbn=978-1-58562-158-3 |oclc=244601824 |page=[http://books.google.com/books?id=tqfHS0xfF-IC&pg=PA32 32] }}</ref> and while its exact causes are not fully known, genetic or environmental factors are understood to play a part. [[ADHD]] is a [[Mental disorders diagnosed in childhood|childhood-onset condition]], usually requiring symptoms to have been present before age 12<ref>[http://www.dsm5.org/documents/adhd%20fact%20sheet.pdf attention-deficit/hyperactivity disorder (ADHD)] by [[The American Psychiatric Association]] (2013). - [[Diagnostic and statistical manual of mental disorders]] (DSM-5), Washington, D.C.</ref> for a diagnosis. Children under [[therapy|treatment]] will migrate to adult health services if necessary as they transit into adulthood, however diagnosis of adults involves full examination of their history.

Successful treatment of ADHD is usually based on a combination of [[medication]], [[cognitive behavioral therapy]], and [[ADHD coaching|coaching]] or skills training.<ref name="skills"/>{{Unreliable medical source|sure=y|date=April 2015}} Medium-to-high intensity [[Neurobiological effects of physical exercise#Structural growth|physical exercise]], improved sleep and improved and targeted nutrition<ref name="nutrition"/>{{Unreliable medical source|sure=y|date=April 2015}} are also known to have a positive effect. Within school and work, reasonable [[special education#Accommodations|accommodations]] may be put in place to help the individual work more efficiently and productively.

==Classification==
[[File:Approximate prevalence distribution of the subtypes of adults with ADHD.PNG|thumb|Out of the 4.7% estimated adults with ADHD only 0.9% exhibit predominantly hyperactive symptoms.]]

The [[Diagnostic and Statistical Manual of Mental Disorders|DSM-IV]], or Diagnostic and Statistical Manual of Mental Disorders, 2000 edition, defines three types of ADHD:
# a [[Attention deficit hyperactivity disorder predominantly inattentive|Predominantly Inattentive]] type
# a Predominantly Hyperactive-[[Impulsivity|Impulsive]] type
# a Combined type, that displays symptoms from both types

To meet the [[diagnostic criteria]] of ADHD, an individual must display:
* at least six inattentive-type symptoms for the inattentive type
* at least six hyperactive-type symptoms for the hyperactive-impulsive type
* all of the above to have the combined type

The symptoms (see below) need to have been present since before the individual was seven years old, and must have interfered with at least two spheres of his or her [[wikt:function|functioning]] (at home and at school or work, for example) over the last six months.<ref name="neucur"/> The DSM-IV criteria for ADHD are, however, tailored towards the type of symptoms that children would show, and might therefore underestimate the prevalence of ADHD in adults.<ref name=Anas2001/>{{rp|needed=y|date=April 2015}} In 2013, the newer [[DSM-5|DSM-V]] reviewed some of these criteria, with more lenient requirements for the diagnosis, specially in adults.<ref name=cdc />
{{clear}}

==Signs and symptoms==
ADHD is a [[chronic (medicine)|chronic]] condition, beginning in early childhood and persisting throughout a person's lifetime. It is estimated that 33-66% of children with ADHD will continue to have significant ADHD-related symptoms persisting into adulthood, resulting in a significant impact on education, employment, and interpersonal relationships.<ref name="psychiatrymmc.com" /><ref name="valdizan" />

Individuals with ADHD exhibit deficiencies in [[Self control|self-regulation]] and [[Motivation#Incentive theories: intrinsic and extrinsic motivation|self-motivation]] which in turn foster problematic characteristics such as [[distraction|distractibility]], [[procrastination]], disorganization and misprioritization. They are often perceived by others as chaotic, with a tendency to need high [[stimulation]] to be less distracted and function effectively. The learning potential and overall intelligence of an adult with ADHD, however, are no different from the potential and intelligence of adults who do not have the disorder.

Whereas teachers and caregivers responsible for children are often attuned to the symptoms of ADHD, employers and others who interact with adults are far less likely to regard such behaviors as a symptom. In part, this is because symptoms do change with [[Maturity (psychological)|maturity]]; adults who have ADHD are less likely to exhibit obvious [[hyperactive]] behaviors. Instead they may report constant mental activity and inner restlessness, as their hyperactivity internalizes.<ref name="Kooij-2010" />

Symptoms of ADHD (see table below) can vary widely between individuals and throughout the lifetime of an individual. As the [[neurobiology]] of ADHD is becoming increasingly understood, it is becoming evident that difficulties exhibited by individuals with ADHD are due to problems with the parts of the brain responsible for [[executive functions]] (see below: [[#Pathophysiology|Pathophysiology]]). These result in problems with sustaining [[attention]], [[planning]], organization, prioritization, time blindness, impulse control and decision making.

The difficulties generated by these deficiencies can range from moderate to extreme, resulting in the inability to effectively structure their lives, plan daily tasks, or think of and act accordingly even when aware of potential consequences. These lead to poor performance in school and work, followed by underachievement in these areas. In young adults, poor driving record with [[traffic violation]]s<ref name="stanfordtannock2012"/> as well as histories of alcoholism or substance abuse may surface. The difficulty is often due to the ADHD person's observed behaviour (e.g. the impulsive types, who may insult their boss for instance, resulting in dismissal), despite genuinely trying to avoid these and knowing that it can get them in trouble. Often, the ADHD person will miss things that an adult of similar age and experience should catch onto or know. These lapses can lead others to label the individuals with ADHD as "lazy" or "stupid" or "inconsiderate".

As problems accumulate, a negativistic self-view becomes established and a vicious circle of failure is set up. Up to 80% of adults may have [[Attention deficit hyperactivity disorder#Associated disorders|some form]] of psychiatric [[comorbidity]]<ref name="Katragadda 2007"/> such as [[Major depressive disorder|depression]] or [[anxiety]].<ref name="psychiatrymmc.com"/> Many with ADHD also have associated [[learning disabilities]], such as [[dyslexia]], which contributes to their difficulties.<ref name="eden"/>

Studies on adults with ADHD have shown that, more than often, they experience self stigma and [[Major depressive disorder|depression]] in childhood, commonly resulting from feeling neglected and different from their peers.<ref name=McKeague>{{cite journal|last1=McKeague|first1=Lynn|last2=Hennessy|first2=Eilis|last3=O'Driscoll|first3=Claire|last4=Heary|first4=Caroline|title=Retrospective Accounts of Self-Stigma Experienced by Young People With Attention-Deficit/Hyperactivity Disorder (ADHD) or Depression|journal=Psychiatric Rehabilitation Journal|date=2015|volume=38|issue=2|pages=158–163|url=http://eds.a.ebscohost.com/eds/pdfviewer/pdfviewer?vid=7&sid=1cd532eb-a5f2-4ec0-91de-b59622e78f4a%40sessionmgr4005&hid=4211|accessdate=15 October 2015|doi=10.1037/prj0000121}}</ref> These problems may play a role to the high levels of depression, substance abuse, and relationship problems that affect adults with ADHD later in life.<ref name=Derrer>{{cite web|last1=Derrer|first1=David|title=Conditions Simular to ADHD|url=http://www.webmd.com/add-adhd/guide/adhd-conditions-similar|website=WebMD|publisher=WebMD|accessdate=16 October 2015}}</ref>

{| class="wikitable"
! '''Inattentive-type''' (ADHD-PI) !! '''Hyperactive/Impulsive-type''' (ADHD-PH)
|-
| In '''children''':
* Forgetful during daily activities
* Easily distracted by extraneous stimuli
* Losing important items (e.g. pencils, homework, toys, etc.)
* Always asking for attention, but
* Not listening and not responding to name being called out
* Unable to focus on tasks at hand, cannot sustain attention in activities
* Avoids or dislikes tasks requiring sustained mental effort
* Makes careless mistakes by failing to pay attention to details
* Difficulty organizing tasks and activities
* Fails to follow-through on complex instructions and tasks (e.g. homework, chores, etc.)
||
In '''children''':
* Squirms and fidgets (with hands and/or feet)
* Cannot sit still
* Cannot play quietly or engage in leisurely activities
* Talks excessively
* Runs and climbs excessively
* Always on the go, as if "driven by a motor"
* Cannot wait for their turn
* Blurts out answers
* Intrudes on others and interrupts conversations
|-
| In adults, these evolve into:<ref name="Katragadda 2007" />
* Avoiding tasks or jobs that require concentration
* [[Procrastination]]
* Difficulty initiating tasks
* Difficulty organizing details required for a task
* Difficulty recalling details required for a task
* Difficulty [[human multitasking|multitasking]]
* Poor time management, losing track of time
* Indecision and doubt
* Hesitation of execution
* Difficulty persevering or completing and following through on tasks
* Delayed stop and transition of concentration from one task to another
||
In adults:
* Chooses highly active, stimulating jobs
* Avoids situations with low physical activity or sedentary work
* May choose to work long hours or two jobs
* Seeks constant activity
* Easily bored
* Impatient
* Intolerant and frustrated, easily irritated
* Impulsive, snap decisions and irresponsible behaviors
* Loses temper easily, angers quickly
* The tendency to hyperfocus on particularly stimulating or emotionally engaging tasks.
|}

==Diagnosis==
The diagnosis of ADHD in adults requires retrospectively establishing whether the symptoms were also present in childhood, even if not previously recognized. As with other [[mental disorder]]s such as [[schizophrenia]] there is no objective "test" that diagnoses ADHD.<ref name="schlancet"/><ref name="nihcs"/> Rather, it is a combination of a careful history of symptoms up to early childhood, including corroborating evidence from family members, previous report cards, etc. The screening tests also seek to rule out other conditions or [[differential diagnosis|differential diagnoses]] such as [[Depression (mood)|depression]], [[anxiety]], or [[substance abuse]]. Other diseases such as [[hyperthyroidism]] may exhibit symptoms similar to those of ADHD, and it is imperative to rule these out as well. [[Asperger syndrome]], a condition on the [[autism spectrum]], is sometimes mistaken for ADHD, due to impairments in [[executive functioning]] found in some people with Asperger syndrome. However, Asperger syndrome also typically involves difficulties in social interaction, restricted and repetitive patterns of behavior and interests, and problems with [[sensory processing]], including hypersensitivity. Along with this, the quality of diagnosing an adult with ADHD can often be skewed being that the majority of adults with ADHD also have other complications, ranging from anxiety and depression to substance abuse.<ref name=Derrer />

Assessment of adult patients seeking a possible diagnosis can be better than in children due to the adult's greater ability to provide their own history, input, and insight. However, it has been noted that many individuals, particularly those with high intelligence, develop coping strategies that mask ADHD impairments and therefore they do not seek diagnosis and treatment.<ref name="neuropsychiatryreviews.com"/>{{Unreliable medical source|date=April 2015}}

Formal tests and assessment instruments such as IQ tests, standardized achievement tests, or [[neuropsychological tests]] typically are ''not helpful'' for identifying people with ADHD.<ref name="NASP" /> Furthermore, no currently available physiological or medical measure is definitive diagnostically. However, psycho-educational and medical tests are helpful in [[differential diagnosis|ruling in or out]] other conditions (e.g. learning disabilities, mental retardation, allergies) that may be associated with ADHD-like behaviors.

United States medical and mental health professionals follow the [[Diagnostic and Statistical Manual of Mental Disorders]] (DSM) of the [[American Psychiatric Association]]; the International Classification of Diseases (ICD) published by the World Health Organisation (WHO) is often used by health professionals elsewhere. Periodic updates incorporate changes in knowledge and treatments.<ref name="dsmdev"/>{{Unreliable medical source|sure=y|date=April 2015}} For example, under DSM-IV (published in 1994, with corrections and minor changes in 2000), the diagnostic criteria for ADHD in adults broadly follow the same as in children,<ref name="onset"/> but the proposed revision for the DSM-5 differentiates the presentation of ADHD for children and adults for several symptoms.<ref name="apadsm5"/>

It should be noted that every normal individual exhibits ADHD-like symptoms occasionally (when tired or stressed, for example) but for a positive diagnosis to be received, the symptoms should be present from childhood and persistently interfere with functioning in multiple spheres of an individual's life: work, school, and interpersonal relationships. The symptoms that individuals exhibit as children are still present in adulthood, but manifest differently as most adults develop compensatory mechanisms to adapt to their environment.

==Pathophysiology==
Over the last 30 years, research into ADHD has greatly accelerated.<ref name="pubtrends"/> There is no single, unified theory that explains the cause of ADHD and research is ongoing. Genetic factors are presumed important, and it has been suggested that environmental factors may affect how symptoms manifest.<ref name="Kooij-2010"/><ref name="antadv"/>

It is becoming increasingly accepted that individuals with ADHD have difficulty with "executive functioning". In higher organisms, such as humans, these functions are thought to reside in the frontal lobes. They enable recall of tasks that need accomplishing, organization to accomplish these tasks, assessment of consequences of actions, prioritization of thoughts and actions, keeping track of time, awareness of interactions with surroundings, the ability to focus despite competing stimuli, and adaptation to changing situations.

Several lines of research based on structural and/or functional imaging techniques, stimulant drugs, psychological interventions have identified alterations in the [[dopaminergic]] and [[adrenergic]] pathways of individuals with ADHD. In particular, areas of the [[prefrontal]] cortex appear to be the most affected. Dopamine and norepinephrine are [[neurotransmitters]] playing an important role in brain function. The uptake transporters for [[dopamine]]<ref name="Madras"/> and [[norepinephrine]]<ref name="Bannon"/> are overly active and clear these neurotransmitters from the synapse a lot faster than in normal individuals. This is thought to increase processing latency and [[salience (neuroscience)|salience]], and diminished [[working memory]].{{citation needed|date=July 2013}}

==Treatment==
{{See also|Attention deficit hyperactivity disorder management}}
Treatment for adult ADHD may combine medication and behavioral, cognitive, or vocational interventions. Treatment often begins with medication selected to address the symptoms of ADHD, along with any [[comorbid]] conditions that may be present. Medication alone, while effective in correcting the physiological symptoms of ADHD, will not address the paucity of skills which many adults will have failed to acquire because of their ADHD (e.g., one might regain ''ability'' to focus with medication, but skills such as organizing, prioritizing and effectively communicating have taken others time to cultivate).<ref name="Searight"/>

===Medications===
Stimulants, the first line medications in adult ADHD are typically formulated in immediate and long-acting formulations.

[[Methylphenidate]], a stimulant, with short and long-acting formulations, is often the first-line therapy and appears effective.<ref>{{cite journal|last1=Epstein|first1=T|last2=Patsopoulos|first2=NA|last3=Weiser|first3=M|title=Immediate-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults.|journal=The Cochrane database of systematic reviews|date=Sep 18, 2014|volume=9|pages=CD005041|pmid=25230710|doi=10.1002/14651858.CD005041.pub2}}</ref> In the short term, methylphenidate is well tolerated. However, long term studies have not been conducted in adults and concerns about increases in blood pressure have not been established.<ref name="Safety of therapeutic methylphenidate in adults: a systematic review of the evidence"/> Methylphenidate increases concentrations of [[dopamine]] and [[norepinephrine]] in the synaptic cleft, promoting increased neurotransmission. It acts to block the [[Norepinephrine-dopamine reuptake inhibitor|dopamine and norepinephrine reuptake transporters]], thus slowing the removal at which these [[neurotransmitters]] are cleared from the synapses.

[[Amphetamine]] and its derivatives, prototype stimulants, are likewise available in immediate and long-acting formulations. Amphetamines act by multiple mechanisms including reuptake inhibition, displacement of transmitters from vesicles, reversal of uptake transporters and reversible MAO inhibition. Thus amphetamines actively increases the release of these neurotransmitters into the [[synaptic cleft]].<ref name="junginger"/> They may have a better side-effect profile than methylphenidate [[Cardiovascular disease|cardiovascularly]] and potentially better tolerated.<ref name="kolar"/>

The non-stimulant [[atomoxetine]] (Strattera), is also an effective treatment for adult ADHD. Although atomoxetine has a half life similar to stimulants it exhibits delayed onset of therapeutic effects similar to antidepressants. Unlike the stimulants which are controlled substances, atomoxetine lacks abuse potential. It is particularly effective for those with the [[Attention deficit hyperactivity disorder predominantly inattentive|predominantly inattentive concentration]] type of attention deficit due to being primarily a [[norepinephrine reuptake inhibitor]].<ref name="atom"/> It is often prescribed in adults who cannot tolerate the side effects of amphetamines or methylphenidate. It is also approved for [[ADHD]] by the US [[Food and Drug Administration]]. A rare but potentially severe side effect includes [[liver damage]] and increased [[suicidal ideation]].<ref name="santosh"/>

[[Bupropion]] and [[desipramine]] are two antidepressants that have demonstrated some evidence of effectiveness in the management of ADHD particularly when there is comorbid [[major depression]],<ref>{{cite journal |last1=Wilens|first1=Timothy E. |last2=Morrison|first2=Nicholas R. |last3=Prince|first3=Jefferson |date=October 2011 |title=An update on the pharmacotherapy of attention-deficit/hyperactivity disorder in adults |journal=Expert Review of Neurotherapeutics |volume=11 |issue=10 |pages=1443–65 |doi=10.1586/ern.11.137 |pmid=21955201 |pmc=3229037 }}</ref> although antidepressants have lower treatment [[effect size]]s.<ref name="Antidepressants in the treatment of adult attention-deficit hyperactivity disorder: a systematic review."/>

===Psychosocial therapy===
Treatment of adult ADHD may also include forms of [[stress management]] or relaxation training.

Research has shown that, alongside medication, [[psychological intervention]]s in adults can be effective in reducing symptomatic deficiencies.<ref name="rosler"/> Emerging evidence suggests a possible role for [[cognitive behavioral therapy]] (CBT) alongside medication<ref name="antadv"/> in the treatment of adult ADHD.<ref name="KnouseLE"/>

For most adults, the psychosocial therapy is not effective.{{Citation needed|date=June 2015}} For this reason, medications are the first line of therapies. The medications that are prescribed for adults come in both stimulant and non-stimulant form. Although the drug therapies are effective for adults, the benefits should be discussed with the patient’s physician to ensure the benefits of the medications outweigh the risk. If medication is unwanted or not an option, increasing exercise and changing one’s diet may help alleviate some of the symptoms such as hyperactivity<ref>{{Cite web|url=http://www.youexplained.com/4-important-habits-for-adhd-patients/|title=4 important habits for adults and children with ADHD {{!}} You Explained|website=You Explained|language=en-GB|access-date=2016-03-12}}</ref>

==Epidemiology==
{{Main|Epidemiology of attention deficit hyperactive disorder}}
In North America and Europe, it is estimated that three to five percent of adults have ADHD, but only about ten percent of those have received a formal diagnosis.<ref name="whoprev"/>{{Primary source-inline|date=April 2015}}<ref name="kessler"/>{{Primary source-inline|date=April 2015}} It has been estimated that 5% of the global population has ADHD (including cases not yet diagnosed).<ref name="The Worldwide prevalance of ADHD"/> In the context of the [[World Health Organization]] World Mental Health Survey Initiative, researchers screened more than 11,000 people aged 18 to 44 years in ten countries in [[the Americas]], [[Europe]] and the [[Middle East]]. On this basis they estimated the adult ADHD proportion of the population to average 3.5 percent with a range of 1.2 to 7.3 percent, with a significantly lower prevalence in low-income countries (1.9%) compared to high-income countries (4.2%). The researchers concluded that adult ADHD often co-occurs with other disorders, and that it is associated with considerable role disability. Although they found that few adults are treated for ADHD itself, in many instances treatment is given for the co-occurring disorders.<ref name="fayyadcross"/>{{Primary source-inline|date=April 2015}}

== History ==
{{Main|History of attention deficit hyperactivity disorder}}
In the 1970s researchers began to realize that the condition now known as ADHD did not always disappear in adolescence, as was once thought.<ref name="pubtrends" /> The expansion of the definition for ADHD beyond only being a condition experienced by children was mainly accomplished by refocusing the diagnosis on inattention instead of [[Hyperactivity disorder|hyperactivity]].<ref>{{Cite book|title = The Medicalization of Society|last = Conrad|first = Peter|publisher = Johns Hopkins University Press|year = 2007|isbn = 978-0801885853|location = Baltimore, Maryland|pages = 66}}</ref> At about the same time, some of the symptoms were also noted in many parents of the children under treatment.{{Citation needed|date=May 2009}} The condition was formally recognized as afflicting adults in 1978, often informally called ''adult ADD'', since symptoms associated with hyperactivity are generally less pronounced.<ref name="doctorlisafairweather_dot_com" />{{Unreliable medical source|sure=y|date=April 2015}}

Early work on disorders of attention was conducted by [[Alexander Crichton]] in 1798 writing about "mental restlessness".<ref name="berrios" /> The underlying condition came to be recognized from the early 1900s by Sir [[George Frederic Still|George Still]].<ref name="lange" /><ref name="Ryan2009" /> Efficacy of medications on symptoms was discovered during the 1930s and research continued throughout the twentieth century. ADHD in adults began to be studied from the early 1970s and research has increased as worldwide interest in the condition has grown.

==Society and culture==
{{see also|Attention deficit hyperactivity disorder controversies}}
ADHD in adults, as with children, is recognized as an impairment that may constitute a disability under U.S. federal disability nondiscrimination laws, including such laws as the [[Rehabilitation Act of 1973]] and the [[ADA Amendments Act of 2008|Americans With Disabilities Act]] (ADA, 2008 revision), if the disorder substantially limits one or more of an individual's major life activities. For adults whose ADHD does constitute a disability, workplaces have a duty to provide reasonable accommodations, and educational institutions have a duty to provide appropriate academic adjustments or modifications, to help the individual work more efficiently and productively.<ref name="eoc"/><ref name="disdis"/>

In a 2004 study it was estimated that the yearly income discrepancy for adults with ADHD was $10,791 less per year than high school graduate counterparts and $4,334 lower for college graduate counterparts. The study estimates a total loss in productivity in the United States of over $77 billion USD.<ref name=AMA_Economics>{{cite web|title=Breaking News: The Social and Economic Impact of ADHD|url=http://www.ama-assn.org/ama/pub/category/12869.html|website=American Medical Association|archiveurl=http://web.archive.org/web/20041022150521/http://www.ama-assn.org/ama/pub/category/12869.html|archivedate=22 October 2004|date=7 September 2004}}</ref>{{Unreliable medical source|sure=y|date=April 2015}} By contrast, loss estimations are $58 billion for drug abuse, $85 billion for alcohol abuse and $43 billion for depression.<ref name="hw">{{cite web|last1=Reinberg|first1=Steven|title=Adult ADHD Costs Billions in Lost Income|url=http://news.healingwell.com/index.php?p=news1&id=521145|website=HealingWell|date=9 September 2004}}</ref>{{Unreliable medical source|sure=y|date=April 2015}}

==Controversy==
{{Main|Attention deficit hyperactivity disorder controversies}}
[[Attention deficit hyperactivity disorder controversies|ADHD controversies]] include concerns about its existence as a disorder, its causes, the methods by which ADHD is diagnosed and treated including the use of stimulant medications in children, possible overdiagnosis, misdiagnosis as ADHD leading to undertreatment of the real underlying disease, alleged [[Hegemony|hegemonic]] practices of the [[American Psychiatric Association]] and negative stereotypes of children diagnosed with ADHD. These controversies have surrounded the subject since at least the 1970s.<ref name=lange/><ref>{{cite journal |author=Cormier E |title=Attention deficit/hyperactivity disorder: a review and update |journal=Journal of Pediatric Nursing |volume=23 |issue=5 |pages=345–57 |date=October 2008 |pmid=18804015 |doi=10.1016/j.pedn.2008.01.003}}</ref>

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{{Research help|Med}}
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}}

==External links==
* {{cite web |title=Publications About ADHD |url=http://www.nimh.nih.gov/health/publications/adhd-listing.shtml |website=National Institute for Mental Health |location=Rockville, MD }}
* {{cite web |title=Adult ADHD (attention-deficit/hyperactivity disorder) |url=http://www.mayoclinic.org/diseases-conditions/adult-adhd/basics/definition/con-20034552 |website=[[Mayo Clinic]] |publisher=Mayo Foundation for Medical Education and Research }}
* {{cite web |title=AD/HD and Adults |url=http://www.mentalhealthamerica.net/conditions/adhd-and-adults |website=Mental Health America |location=Alexandria, VA }}
* {{cite web |title=ADDA - Attention Deficit Disorder Association |url=http://www.add.org/ |location=Wilmington, DE }}
* {{cite web |title=ADDults with ADHD |url=http://www.adultadhd.org.au/ |publisher=ADDult with ADHD (NSW) Inc. |location=Epping, {{abbr|NSW|New South Wales}} }}
* {{cite web |title=Home page |url=http://aadduk.org/ |website=AADD-UK: The site for and by adults with ADHD }}
* {{cite web |title=Living with Adult ADHD |url=http://www.additudemag.com/channel/adult-add-adhd/index.html |website=ADDitude |publisher=New Hope Media LLC |location=New York }}
* {{cite web |title=Attention Deficit Disorders Association: Southern Region |url=http://www.adda-sr.org/ |location=Houston, TX }}

{{adhd}}

{{DEFAULTSORT:Adult Attention Deficit Hyperactivity Disorder}}
[[Category:Adulthood]]
[[Category:Attention deficit hyperactivity disorder]]

[[ru:Синдром дефицита внимания и гиперактивности#СДВГ у взрослых]]

Diet and attention deficit hyperactivity disorder

2016-03-12T15:01:12Z

Pazemath: Added a source.

For some children, diet is suspected of playing a role in the multiple behavioral and cognitive symptoms of [[attention deficit hyperactivity disorder]] (ADHD).{{citation needed|date=August 2015}} Concerns have focused on food additives, blood sugar regulation, food allergies and intolerances, and vitamin, mineral and fatty acid deficiencies.

== Food coloring and additives ==
Since the 1970s and the well-publicized advocacy of [[Benjamin Feingold]], there has been public concern that food colorings may cause [[ADHD]]-like behavior in children.<ref name=FDAdyecomm>FDA. [http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/FoodAdvisoryCommittee/UCM248549.pdf Background Document for the Food Advisory Committee: Certified Color Additives in Food and Possible Association with Attention Deficit Hyperactivity Disorder in Children: March 30-31, 2011]</ref> These concerns have led the FDA and other food safety authorities to regularly review the scientific literature, and led the UK FSA to commission a study by researchers at Southampton University of the effect of a mixture of six food dyes ([[Tartrazine]], [[Allura Red]], [[Ponceau 4R]], [[Quinoline Yellow WS]], [[Sunset Yellow]] and [[Carmoisine]] (dubbed the "Southampton 6")) and [[sodium benzoate]] (a preservative) on children in the general population, who consumed them in beverages; the study published in 2007.<ref name=FDAdyecomm/><ref name=FSAguideline>Sarah Chapman of Chapman Technologies on behalf of Food Standards Agency in Scotland. March 2011 [Guidelines on approaches to the replacement of Tartrazine, Allura Red, Ponceau 4R, Quinoline Yellow, Sunset Yellow and Carmoisine in food and beverages]</ref> The study found "a possible link between the consumption of these artificial colours and a sodium benzoate preservative and increased hyperactivity" in the children;<ref name=FDAdyecomm/><ref name=FSAguideline/> the advisory committee to the FSA that evaluated the study also determined that because of study limitations, the results could not be extrapolated to the general population, and further testing was recommended".<ref name=FDAdyecomm/>

The European regulatory community, with a stronger emphasis on the [[precautionary principle]], required labelling and temporarily reduced the [[acceptable daily intake]] (ADI) for the food colorings; the UK FSA called for voluntary withdrawal of the colorings by food manufacturers.<ref name=FDAdyecomm/><ref name=FSAguideline/> However in 2009 the EFSA re-evaluated the data at hand and determined that "the available scientific evidence does not substantiate a link between the color additives and behavioral effects" for any of the dyes.<ref name=FDAdyecomm/><ref name=EFSA2009>EFSA Panel on Food Additives and Nutrient Sources added to food (ANS) [http://www.efsa.europa.eu/en/efsajournal/pub/1330.htm Scientific Opinion on the re-evaluation of Sunset Yellow FCF (E 110) as a food additive]. EFSA Journal 2009; 7(11):1330 doi:10.2903/j.efsa.2009.1330</ref><ref name=EFSA2009PR>EFSA Panel on Food Additives and Nutrient Sources added to Food (ANS) [http://www.efsa.europa.eu/en/scdocs/scdoc/1328.htm 091113 efsa.europa.eu Scientific Opinion on the re-evaluation of Ponceau 4R (E 124) as a food additive] EFSA Journal 2009; 7(11):1328</ref><ref name=EFSA2009QY>EFSA Panel on Food Additives and Nutrient Sources added to food (ANS). [http://www.efsa.europa.eu/en/efsajournal/pub/1329.htm Scientific Opinion on the re-evaluation of Quinoline Yellow (E 104) as a food additive]. EFSA Journal 2009; 7(11):1329 [40 pp.]. doi:10.2903/j.efsa.2009.1329</ref><ref name=EFSA2009Tart>{{cite journal| author= EFSA Panel on Food Additives and Nutrient Sources added to Food (ANS) |date=November 2009 | title= Scientific Opinion on the re-evaluation Tartrazine (E 102)| journal = EFSA Journal| volume= 7| issue= 11| pages= 1331–1382| doi = 10.2903/j.efsa.2009.1331| url=http://www.efsa.europa.eu/en/efsajournal/pub/1331.htm | quote = The Panel concludes that the present dataset does not give reason to revise the ADI of 7.5 mg/kg bw/day.}}</ref>

The US FDA did not make changes following the publication of the Southampton study, but following a citizen petition filed by the [[Center for Science in the Public Interest]] in 2008, requesting the FDA ban several food additives, the FDA commenced a review of the available evidence, and still made no changes.<ref name=FDAdyecomm/>

There is no evidence to support broad claims that food coloring causes [[food intolerance]] and [[ADHD]]-like behavior in children.<ref>Tomaska LD and Brooke-Taylor, S. ''Food Additives - General'' pp 449-454 in Encyclopedia of Food Safety, Vol 2: Hazards and Diseases. Eds, Motarjemi Y et al. Academic Press, 2013. ISBN 9780123786135</ref>{{rp|452}} It is possible that certain food coloring may act as a trigger in those who are genetically predisposed, but the evidence is weak.<ref name=FDAdyecomm/><ref name=Peds2012>{{cite journal |author=Millichap JG, Yee MM |title=The diet factor in attention-deficit/hyperactivity disorder|journal=Pediatrics |volume=129 |issue=2 | pages=330–337 |date=February 2012 |pmid=22232312|doi=10.1542/peds.2011-2199 |url=}}</ref>

== Sugar regulation ==
A number of studies have found that [[sucrose]] (sugar) has no effect on behavior and in particular it does not exacerbate the symptoms of children diagnosed with ADHD.<ref>{{cite journal |author=Benton D |title=Sucrose and behavioral problems |journal=Critical Reviews in Food Science and Nutrition |volume=48 |issue=5 |pages=385–401 |date=May 2008 |pmid=18464029 |doi=10.1080/10408390701407316}}</ref><ref>{{cite web |url=http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml#pub3 |title=What Causes ADHD? |work=Attention Deficit Hyperactivity Disorder |accessdate=April 22, 2010 |publisher=[[United States Department of Health and Human Services]] |year=2008}}</ref><ref name=Staudenmayer>{{cite book |title=Environmental Illness: Myth and Reality |first=Herman |last=Staudenmayer |pages=58–62 |publisher=CRC Press |year=1999 |isbn=1-56670-305-0 |quote=isbn13=978-1-56670-305-5}}</ref> One study demonstrated the impact of expectancy effects in parents' perceptions of their children's hyperactivity after consuming sugar. In this study, parents who were told their child had ingested a high concentration of sugar in drink form (even though the drink was actually flavored with aspartame), reported their child as being more active, inattentive and resistant to parental demands. This was in comparison to the group who were told (accurately) that their child had ingested no sugar.<ref>Hoover, D.W. & Milich, R. (1994). The effects of sugar ingestion expectancies on mother-child interactions, Journal of Abnormal Child Psychology, 22, 501-515.</ref>

== Omega-3 fatty acids ==
Some research suggests that children with ADHD may have low blood levels of essential [[omega-3 fatty acids]].<ref name="Young2005">{{cite journal |author=Young G, Conquer J |title=Omega-3 fatty acids and neuropsychiatric disorders |journal=Reproduction, Nutrition, Development |volume=45 |issue=1 |pages=1–28 |year=2005 |pmid=15865053 |doi=10.1051/rnd:2005001}}</ref> However, it is unknown if decreased blood levels of omega-3 fatty acids can cause or exacerbate ADHD or whether lower blood levels of omega-3 fatty acids associated with ADHD are caused by an underlying mechanism.<ref name="Young2005"/><ref name="Haag2003">{{cite journal |author=Haag M |title=Essential fatty acids and the brain |journal=Canadian Journal of Psychiatry |volume=48 |issue=3 |pages=195–203 |date=April 2003 |pmid=12728744}}</ref> Fish oils appear to reduce ADHD-related symptoms in some children<ref>{{Cite web|url=http://www.youexplained.com/4-important-habits-for-adhd-patients/|title=4 important habits for adults and children with ADHD {{!}} You Explained|website=You Explained|language=en-GB|access-date=2016-03-12}}</ref>. A double blind study has shown "medium to strong treatment effects of omega 3 fatty acids on symptoms of ADHD" after administering amounts around 1 gram for three to six months.<ref name="richardson2005">{{cite journal |author=Richardson AJ, Montgomery P |title=The Oxford-Durham study: a randomized, controlled trial of dietary supplementation with fatty acids in children with developmental coordination disorder |journal=Pediatrics |volume=115 |issue=5 |pages=1360–6 |date=May 2005 |pmid=15867048 |doi=10.1542/peds.2004-2164}}</ref> Several other studies showed similar effects, especially of Omega 3 fatty acids with Zinc and Magnesium.<ref>Huss, Michael/Andreas Volp/Manuela Stauss-Grabo, 2010: Supplementation of polyunsaturated fatty acids, magnesium and zinc in children seeking medical advice for attention-deficit/hyperactivity problems - an observational cohort study. In: Lipids in Health and Disease 9, 105. <http://www.lipidworld.com/content/9/1/105></ref><ref>N. Sinn, J. Bryan: Effect of supplementation with polyunsaturated fatty acids and micronutrients on learning and behavior problems associated with child ADHD In: J Dev Behav Pediatr 28, 2007, S. 82–91 {{doi|10.1097/01.DBP.0000267558.88457.a5}}. PMID 17435458.</ref><ref>J. Frölich, M. Döpfner: Die Behandlung von Aufmerksamkeitsdefizit-/Hyperaktivitätsstörungen mit mehrfach ungesättigten Fettsäuren – eine wirksame Behandlungsoption? In: Z Kinder Jugendpsychiatr Psychother 36, 2008, S. 109–116 {{doi|10.1024/1422-4917.36.2.109}}, PMID 18622940.</ref> A recent longitudinal study that examined the effect of omega-3 in an animal model of ADHD found gender-specific changes in all ADHD-symptoms.<ref name="Sandvik12">
{{cite journal
|author=Sandvik, T.
|title=Omega-3 polyunsaturated fatty acids induced gender-specific changes in activity, impulsiveness and attention in an animal model of Attention- Deficit/Hyperactivity Disorder.
|journal=DUO - Digital releases University of Oslo
|date=9 Sep 2012}}[http://urn.nb.no/URN:NBN:no-31905 Free full text]
</ref> Thus though it is increasingly documented in clinical studies that omega 3 fatty acids provide a safe way to treat ADHD-symptoms the mechanism of the effect may interact with several other factors such as gender.

==References==
{{Research help|Med}}
{{Reflist|3}}

[[Category:Attention deficit hyperactivity disorder]]
[[Category:Diets]]

Omega-3 fatty acid

2016-03-12T14:59:26Z

Pazemath: Added the results of a study. Accidentally removed one source (couldn't alt+Z it back).

{{merge|Fish oil|discuss=Talk:Omega-3 fatty acid#Merger proposal|date=February 2016}}
{{Fats}}
'''Omega-3 fatty acids''' — also called '''ω-3 fatty acids''' or '''''n''-3 fatty acids'''<ref>{{cite web|title=Related terms|url=http://www.mayoclinic.com/health/fish-oil/NS_patient-fishoil/DSECTION=related-terms|work=Omega-3 fatty acids, fish oil, alpha-linolenic acid|publisher=Mayo Clinic|accessdate=June 20, 2012}}</ref> — are [[polyunsaturated fatty acid]]s (PUFAs) with a [[double bond]] (C=C) at the third carbon atom from the end of the carbon chain.<ref>{{cite journal | author = Scorletti E, Byrne CD | title = Omega-3 fatty acids, hepatic lipid metabolism, and nonalcoholic fatty liver disease | journal = Annual Review of Nutrition | volume = 33 | pages = 231–48 | year = 2013 | pmid = 23862644 | doi = 10.1146/annurev-nutr-071812-161230 | issue=1}}</ref> The fatty acids have two ends, the [[carboxylic acid]] (-COOH) end, which is considered the beginning of the chain, thus "alpha", and the methyl (CH3) end, which is considered the "tail" of the chain, thus "omega". The way in which a fatty acid is named is determined by the location of the first double bond, counted from the [[methyl end]], that is, the omega (ω-) or the n- end.

The three types of omega-3 fatty acids involved in human physiology are [[α-linolenic acid|α-linolenic acid (ALA)]] (found in plant oils), [[eicosapentaenoic acid|eicosapentaenoic acid (EPA)]], and [[docosahexaenoic acid|docosahexaenoic acid (DHA)]] (both commonly found in marine oils). [[Marine algae]] and [[phytoplankton]] are primary sources of omega-3 fatty acids. Common sources of [[plant oils]] containing the omega-3 ALA fatty acid include [[walnut]], edible seeds, [[clary sage]] seed oil, [[algal oil]], [[flaxseed oil]], [[Plukenetia volubilis|Sacha Inchi]] oil, [[Echium plantagineum|''Echium'']] oil, and [[hemp oil]], while sources of animal omega-3 EPA and DHA fatty acids include [[fish oils]], [[egg oil]], squid oils, and [[krill oil]]. Dietary supplementation with omega-3 fatty acids does not appear to affect the risk of death, [[cancer]] or [[heart disease]].<ref name=JAMA2012/><ref name=Mac2006/> Furthermore, [[Fish oil|fish oil supplement]] studies have failed to support claims of preventing [[Myocardial infarction|heart attacks]] or [[stroke]]s.<ref name="NYT-20150917-cz" /><ref name="NYT-20150330" /><ref name="JAMA-201403" />

Omega-3 fatty acids are important for normal [[metabolism]].<ref name="NIH">{{cite web|url=http://ods.od.nih.gov/factsheets/Omega3FattyAcidsandHealth-HealthProfessional/|publisher=US National Institutes of Health, Office of Dietary Supplements|title=Omega-3 Fatty Acids and Health: Fact Sheet for Health Professionals|year=2005|accessdate=12 April 2014}}</ref> Mammals are unable to synthesize omega-3 fatty acids, but can obtain the shorter-chain omega-3 fatty acid ALA (18 carbons and 3 double bonds) through diet and use it to form the more important long-chain omega-3 fatty acids, EPA (20 carbons and 5 double bonds) and then from EPA, the most crucial, DHA (22 carbons and 6 double bonds).<ref name=NIH/> The ability to make the longer-chain omega-3 fatty acids from ALA may be impaired in aging.<ref>{{cite journal | author = Freemantle E, Vandal M, Tremblay-Mercier J, Tremblay S, Blachère JC, Bégin ME, Brenna JT, Windust A, Cunnane SC | title = Omega-3 fatty acids, energy substrates, and brain function during aging | journal = Prostaglandins, Leukotrienes and Essential Fatty Acids | volume = 75 | issue = 3 | pages = 213–220 | year = 2006 | pmid = 16829066| pmc = | doi = 10.1016/j.plefa.2006.05.011 }}</ref><ref>{{cite journal | author = Gao F, Taha AY, Ma K, Chang L, Kiesewetter D, Rapoport SI | title = Aging decreases rate of docosahexaenoic acid synthesis-secretion from circulating unesterified α-linolenic acid by rat liver | journal = AGE | volume = 35 | issue = 3 | pages = 597–608 | year = 2012 | pmid = 22388930 | pmc = | doi = 10.1007/s11357-012-9390-1 }}</ref> In foods exposed to air, unsaturated fatty acids are vulnerable to [[oxidation]] and [[Rancidification|rancidity]].<ref>{{cite journal | author = Chaiyasit W, Elias RJ, McClements DJ, Decker EA | title = Role of Physical Structures in Bulk Oils on Lipid Oxidation | journal = Critical Reviews in Food Science and Nutrition | volume = 47 | issue = 3 | pages = 299–317 | year = 2007 | pmid = 17453926 | pmc = | doi = 10.1080/10408390600754248 }}</ref>
{{TOC limit|3}}

==Health effects==
Supplementation does not appear to be associated with a lower risk of all-cause mortality.<ref name=JAMA2012/>

===Cancer ===
The evidence linking the consumption of fish to the risk of [[cancer]] is poor.<ref>{{cite journal | author = Sala-Vila A, Calder PC | title = Update on the relationship of fish intake with prostate, breast, and colorectal cancers | journal = Critical reviews in food science and nutrition | volume = 51 | issue = 9 | pages = 855–71 | date = October–November 2011 | pmid = 21888535 | doi = 10.1080/10408398.2010.483527 }}</ref> Supplementation with omega-3 fatty acids does not appear to affect this either.<ref name=Mac2006>{{cite journal | author = MacLean CH, Newberry SJ, Mojica WA, Khanna P, Issa AM, Suttorp MJ, Lim YW, Traina SB, Hilton L, Garland R, Morton SC | title = Effects of omega-3 fatty acids on cancer risk: a systematic review. | journal = JAMA: the Journal of the American Medical Association | volume = 295 | issue = 4 | pages = 403–15 | date = 2006-01-25 | pmid = 16434631 | doi = 10.1001/jama.295.4.403 | url = http://jama.ama-assn.org/cgi/content/short/295/4/403 | accessdate = 2006-07-07 }}</ref>

A 2006 review concluded that there was no link between omega-3 fatty acids consumption and cancer.<ref name="Mac2006"/> This is similar to the findings of a review of studies up to February 2002 that failed to find clear effects of long and shorter chain omega-3 fats on total risk of death, combined cardiovascular events and cancer.<ref name="BMJ2006">{{cite journal | author = Hooper L, Thompson RL, Harrison RA, Summerbell CD, Ness AR, Moore HJ, Worthington HV, Durrington PN, Higgins JP, Capps NE, Riemersma RA, Ebrahim SB, Davey Smith G | title = Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review | journal = BMJ | volume = 332 | issue = 7544 | pages = 752–760 | year = 2006 | pmid = 16565093 | pmc = 1420708 | doi = 10.1136/bmj.38755.366331.2F | url = http://bmj.bmjjournals.com/cgi/reprint_abr/332/7544/752/ | accessdate = 2006-07-07 }}</ref><ref>{{cite web|title=Omega-3 Fatty Acids and Health|url=http://ods.od.nih.gov/factsheets/Omega3FattyAcidsandHealth-HealthProfessional/}}</ref> In those with advanced cancer and [[cachexia]], omega-3 fatty acids supplements may be of benefit, improving appetite, weight, and [[quality of life]].<ref>{{cite journal | author = Colomer R, Moreno-Nogueira JM, García-Luna PP, García-Peris P, García-de-Lorenzo A, Zarazaga A, Quecedo L, del Llano J, Usán L, Casimiro C | title = N-3 fatty acids, cancer and cachexia: a systematic review of the literature | journal = Br. J. Nutr. | volume = 97 | issue = 5 | pages = 823–31 | date = May 2007 | pmid = 17408522 | doi = 10.1017/S000711450765795X }}</ref> There is tentative evidence that marine omega-3 polyunsaturated fatty acids reduce the risk of [[breast cancer]] but this is not conclusive.<ref>{{cite journal | author = Zheng JS, Hu XJ, Zhao YM, Yang J, Li D | title = Intake of fish and marine n-3 polyunsaturated fatty acids and risk of breast cancer: meta-analysis of data from 21 independent prospective cohort studies | journal = BMJ | volume = 346 | issue = jun27 5 | pages = f3706–f3706 | date = 27 June 2013 | pmid = 23814120 | doi = 10.1136/bmj.f3706 }}</ref><ref name=Hein2012>{{cite journal | author = Heinze VM, Actis AB | title = Dietary conjugated linoleic acid and long-chain n-3 fatty acids in mammary and prostate cancer protection: a review | journal = International journal of food sciences and nutrition | volume = 63 | issue = 1 | pages = 66–78 | date = February 2012 | pmid = 21762028 | doi = 10.3109/09637486.2011.598849 }}</ref>

The effect of consumption on [[prostate cancer]] is not conclusive.<ref name=Hein2012/> There is a decreased risk with higher blood levels of [[Docosapentaenoic acid#all-cis-7.2C10.2C13.2C16.2C19-docosapentaenoic acid .28clupanodonic acid.29|DPA]], but an increased risk of more aggressive prostate cancer with higher blood levels of combined [[Eicosapentaenoic acid|EPA]] and [[Docosahexaenoic acid|DHA]] (found in fatty fish oil).<ref>{{cite journal | author = Chua ME, Sio MC, Sorongon MC, Morales ML | title = The relevance of serum levels of long chain omega-3 polyunsaturated fatty acids and prostate cancer risk: a meta-analysis | journal = Canadian Urological Association Journal | volume = 7 | issue = 5–6 | pages = E333–E343 | date = May–June 2013 | pmid = 23766835 | pmc = 3668400 | doi = 10.5489/cuaj.1056 }}</ref>

===Cardiovascular disease===
Evidence does not support a beneficial role for omega-3 fatty acid supplementation in preventing [[cardiovascular disease]] (including [[myocardial infarction]] and [[sudden cardiac death]]) or [[stroke]].<ref name=JAMA2012>{{cite journal | author = Rizos EC, Ntzani EE, Bika E, Kostapanos MS, Elisaf MS | title = Association Between Omega-3 Fatty Acid Supplementation and Risk of Major Cardiovascular Disease Events A Systematic Review and Meta-analysis | journal = JAMA | volume = 308 | issue = 10 | pages = 1024–1033 | date = September 2012 | pmid = 22968891 | doi = 10.1001/2012.jama.11374 }}</ref><ref>{{cite journal | author = Kwak SM, Myung SK, Lee YJ, Seo HG | title = Efficacy of Omega-3 Fatty Acid Supplements (Eicosapentaenoic Acid and Docosahexaenoic Acid) in the Secondary Prevention of Cardiovascular Disease: A Meta-analysis of Randomized, Double-blind, Placebo-Controlled Trials | journal = Archives of Internal Medicine | volume = 172 | issue = 9 | pages = 686–94 | date = 2012-04-09 | pmid = 22493407 | doi = 10.1001/archinternmed.2012.262 }}</ref><ref>{{Cite journal|title = The effects of omega-3 polyunsaturated fatty acids on cardiac rhythm: a critical reassessment|url = http://www.ncbi.nlm.nih.gov/pubmed/23735203|journal = Pharmacology & Therapeutics|date = 2013-10-01|issn = 1879-016X|pmid = 23735203|pages = 53–80|volume = 140|issue = 1|doi = 10.1016/j.pharmthera.2013.05.011|first = George E.|last = Billman}}</ref> However, omega-3 fatty acid supplementation greater than one gram daily for at least a year may be protective against cardiac death, sudden death, and myocardial infarction in people who have a history of cardiovascular disease.<ref name=Casula2013>{{cite journal|author=Casula M, Soranna D, Catapano AL, Corrao G|title=Long-term effect of high dose omega-3 fatty acid supplementation for secondary prevention of cardiovascular outcomes: A meta-analysis of randomized, placebo controlled trials [corrected]|journal=Atherosclerosis Supplements|volume=14|issue=2|pages=243–51|date=August 2013|pmid=23958480|doi=10.1016/S1567-5688(13)70005-9}}</ref> No protective effect against the development of stroke or all-cause mortality was seen in this population.<ref name=Casula2013/> Eating a diet high in fish that contain long chain omega-3 fatty acids does appear to decrease the risk of [[stroke]].<ref>{{cite journal | author = Delgado-Lista J, Perez-Martinez P, Lopez-Miranda J, Perez-Jimenez F | title = Long chain omega-3 fatty acids and cardiovascular disease: a systematic review | journal = The British journal of nutrition | volume = 107 Suppl 2 | pages = S201–13 | date = June 2012 | pmid = 22591894 | doi = 10.1017/S0007114512001596 }}</ref> [[Fish oil|Fish oil supplementation]] has not been shown to benefit [[revascularization]] or [[arrhythmia|abnormal heart rhythms]] and has no effect on [[heart failure]] hospital admission rates.<ref>{{cite journal | author = Kotwal S, Jun M, Sullivan D, Perkovic V, Neal B | title = Omega 3 Fatty Acids and Cardiovascular Outcomes: Systematic Review and Meta-Analysis | journal = Circ Cardiovasc Qual Outcomes | volume = 5 | issue = 6 | pages = 808–18 | date = 18 September 2012 | pmid = 23110790 | doi = 10.1161/CIRCOUTCOMES.112.966168 }}</ref> Furthermore, [[Fish oil|fish oil supplement]] studies have failed to support claims of preventing [[Myocardial infarction|heart attacks]] or [[stroke]]s.<ref name="NYT-20150917-cz">{{cite news |last=Zimmer |first=Carl |authorlink=Carl Zimmer |title=Inuit Study Adds Twist to Omega-3 Fatty Acids’ Health Story |url=http://www.nytimes.com/2015/09/22/science/inuit-study-adds-twist-to-omega-3-fatty-acids-health-story.html |date=September 17, 2015 |work=[[New York Times]] |accessdate=October 11, 2015 }}</ref><ref name="NYT-20150330">{{cite news |last=O'Connor |first=Anahad |title=Fish Oil Claims Not Supported by Research |url=http://well.blogs.nytimes.com/2015/03/30/fish-oil-claims-not-supported-by-research/ |date=March 30, 2015 |work=[[New York Times]] |accessdate=October 11, 2015 }}</ref><ref name="JAMA-201403">{{cite journal |last1=Grey |first1=Andrew |last2=Bolland |first2=Mark |title=Clinical Trial Evidence and Use of Fish Oil Supplements |url=http://archinte.jamanetwork.com/article.aspx?articleid=1787690 |date=March 2014 |journal=[[JAMA Internal Medicine]] |volume=174 |issue=3 |pages=460–462 |doi=10.1001/jamainternmed.2013.12765 |accessdate=October 11, 2015 }}</ref>

Evidence suggests that omega-3 fatty acids modestly lower [[blood pressure]] (systolic and diastolic) in people with [[hypertension]] and in people with normal blood pressure.<ref name=Miller2014>{{cite journal|author=Miller PE, Van Elswyk M, Alexander DD|title=Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and blood pressure: a meta-analysis of randomized controlled trials|journal=American Journal of Hypertension|volume=27|issue=7|pages=885–96|date=July 2014|pmid=24610882|doi=10.1093/ajh/hpu024}}</ref> Some evidence suggests that people with certain circulatory problems, such as [[varicose veins]], may benefit from the consumption of EPA and DHA, which may stimulate [[Circulatory system|blood circulation]] and increase the breakdown of [[fibrin]], a protein involved in blood clotting and scar formation.<ref name="Morris1993">{{cite journal | author = Morris MC, Sacks F, Rosner B | title = Does fish oil lower blood pressure? A meta-analysis of controlled trials | journal = [[Circulation (journal)|Circulation]] | volume = 88 | issue = 2 | pages = 523–533 | year = 1993 | pmid = 8339414 | doi = 10.1161/01.CIR.88.2.523 | url = http://circ.ahajournals.org/cgi/reprint/88/2/523/ }}</ref><ref name="Mori1993">{{cite journal | author = Mori TA, Bao DQ, Burke V, Puddey IB, Beilin LJ | title = Docosahexaenoic acid but not eicosapentaenoic acid lowers ambulatory blood pressure and heart rate in humans | journal = Hypertension | volume = 34 | issue = 2 | pages = 253–260 | year = 1993 | pmid = 10454450 | doi = 10.1161/01.HYP.34.2.253 | url = http://hyper.ahajournals.org/cgi/reprint/34/2/253/ }}</ref>
Omega-3 fatty acids reduce [[blood]] [[triglyceride]] levels but do not significantly change the level of [[low density lipoprotein|LDL cholesterol]] or [[high density lipoprotein|HDL cholesterol]] in the blood.<ref name=Weintraub2014>{{cite journal|author=Weintraub HS|title=Overview of prescription omega-3 fatty acid products for hypertriglyceridemia|journal=Postgraduate Medicine|volume=126|issue=7|pages=7–18|date=November 2014|pmid= 25387209|doi=10.3810/pgm.2014.11.2828}}</ref><ref>{{cite journal|author=Wu L, Parhofer KG|title=Diabetic dyslipidemia|journal=Metabolism: clinical and experimental|volume=63|issue=12|pages=1469–79|date=December 2014|pmid= 25242435|doi=10.1016/j.metabol.2014.08.010}}</ref> ALA does not confer the cardiovascular health benefits of EPA and DHAs.<ref name="fishflax">{{cite journal | author = Wang C, Harris WS, Chung M, [[Alice H. Lichtenstein|Lichtenstein AH]], Balk EM, Kupelnick B, Jordan HS, Lau J | 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 | journal = The American Journal of Clinical Nutrition | volume = 84 | issue = 1 | pages = 5–17 | date = July 2006 | pmid = 16825676 }}</ref>

The effect of omega-3 polyunsaturated fatty acids on stroke is unclear, with a possible benefit in women.<ref>{{cite journal|last1=Larsson|first1=SC|title=Dietary fats and other nutrients on stroke.|journal=Current opinion in lipidology|date=February 2013|volume=24|issue=1|pages=41–8|pmid=23123763|doi=10.1097/mol.0b013e3283592eea}}</ref>

===Inflammation===
Some research suggests that the anti-inflammatory activity of long-chain omega-3 fatty acids may translate into clinical effects.<ref>{{cite journal | author = Wall R, Ross RP, Fitzgerald GF, Stanton C | title = Fatty acids from fish: the anti-inflammatory potential of long-chain omega-3 fatty acids | journal = Nutr Rev | volume = 68 | issue = 5 | pages = 280–9 | year = 2010 | pmid = 20500789 | doi = 10.1111/j.1753-4887.2010.00287.x }}</ref> A 2013 systematic review found tentative evidence of benefit.<ref name="robinson2013">{{cite journal | author = Robinson LE, Mazurak VC | title = n-3 Polyunsaturated fatty acids: Relationship to inflammation in health adults and adults exhibiting features of metabolic syndrome | journal = Lipids | volume = 48 | pages = 319–332 | year = 2013 | doi = 10.1007/s11745-013-3774-6|pmid=23456976 | issue=4}}</ref> Consumption of omega-3 fatty acids from marine sources lowers markers of inflammation in the blood such as [[C-reactive protein]], [[interleukin 6]], and [[TNF alpha]].<ref name=Li2014>{{cite journal|author=Li K1, Huang T, Zheng J, Wu K, Li D|title=Effect of marine-derived n-3 polyunsaturated fatty acids on C-reactive protein, interleukin 6 and tumor necrosis factor α: a meta-analysis|journal=PLOS ONE|volume=9|issue=2|pages=e88103|date=February 2014|pmid=24505395|pmc=3914936|doi=10.1371/journal.pone.0088103}}</ref>

For [[rheumatoid arthritis]] (RA), one systematic review found consistent, but modest, evidence for the effect of marine n-3 PUFAs on symptoms such as "joint swelling and pain, duration of morning stiffness, global assessments of pain and disease activity" as well as the use of non-steroidal anti-inflammatory drugs.<ref>{{cite journal | author = Miles EA, Calder PC | title = Influence of marine n-3 polyunsaturated fatty acids on immune function and a systematic review of their effects on clinical outcomes in rheumatoid arthritis. | journal = The British journal of nutrition | volume = 107 Suppl 2 | pages = S171–84 | date = June 2012 | pmid = 22591891 | doi = 10.1017/S0007114512001560 | issue=S2}}</ref> The [[American College of Rheumatology]] (ACR) has stated that there may be modest benefit from the use of fish oils, but that it may take months for effects to be seen, and cautions for possible gastrointestinal side effects and the possibility of the supplements containing [[mercury (element)|mercury]] or [[vitamin A]] at toxic levels. Due to the lack of regulations for safety and efficacy, the ACR does not recommend herbal supplements and feels there is an overall lack of "sound scientific evidence" for their use.<ref name=ACRCAM>{{cite web|title=Herbal Remedies, Supplements and Acupuncture for Arthritis|url=http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Herbal_Remedies,_Supplements_and_Acupuncture_for_Arthritis/|publisher=American College of Rheumatology|accessdate=14 January 2014}}</ref> The [[National Center for Complementary and Integrative Health]] has concluded that "[n]o dietary supplement has shown clear benefits for RA", but that there is preliminary evidence that fish oil may be beneficial, and called for further study.<ref name=NCCIH>{{cite web|title=Rheumatoid Arthritis and Complementary Health Approaches|url=http://nccih.nih.gov/health/RA/getthefacts.htm|publisher=National Center for Complementary and Alternative Medicine|accessdate=14 January 2014}}</ref>

===Developmental disabilities===
Although not supported by current scientific evidence as a primary treatment for [[ADHD]], [[autism spectrum|autism]], and other developmental disabilities,<ref name="levy2005">{{cite journal|year=2005|title=Novel treatments for autistic spectrum disorders|journal=Ment Retard Dev Disabil Res Rev|volume=11|issue=2|pages=131–142|doi=10.1002/mrdd.20062|pmid=15977319|author=Levy SE, Hyman SL}}</ref><ref name="richardson2006">{{cite journal | author = Richardson AJ | title = Omega-3 fatty acids in ADHD and related neurodevelopmental disorders | journal = Int Rev Psychiatry | volume = 18 | issue = 2 | pages = 155–172 | year = 2006 | pmid = 16777670 | doi = 10.1080/09540260600583031 }}</ref> omega-3 fatty acid [[Dietary supplement|supplement]]s are being given to children with these conditions. One study tests the omega-3/6 treatments against the regular medical treatment (methylphenidate) and finds that, given enough time, the omega-3/6 treatment actually levels off to only slightly lower responses than the methylphenidate treatment. The omega-3/6 treatment, however, is much more tolerable (less side-effects)<ref>{{Cite web|url=http://www.youexplained.com/4-important-habits-for-adhd-patients/|title=4 important habits for adults and children with ADHD {{!}} You Explained|website=You Explained|language=en-GB|access-date=2016-03-12}}</ref>

One meta-analysis concluded that omega-3 fatty acid supplementation demonstrated a modest effect for improving ADHD symptoms.<ref>{{cite journal|last1=Bloch|first1=Michael H.|last2=Qawasmi|first2=Ahmad|title=Omega-3 Fatty Acid Supplementation for the Treatment of Children With Attention-Deficit/Hyperactivity Disorder Symptomatology: Systematic Review and Meta-Analysis|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=50|issue=10|pages=991–1000|pmid=21961774|pmc=3625948|doi=10.1016/j.jaac.2011.06.008}}</ref> A [[Cochrane review]] of PUFA (not necessarily omega-3) supplementation found "there is little evidence that PUFA supplementation provides any benefit for the symptoms of ADHD in children and adolescents",<ref>{{cite journal | author = Gillies D, Sinn JKh, Lad SS, Leach MJ, Ross MJ | title = Polyunsaturated fatty acids (PUFA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents | journal = The Cochrane database of systematic reviews | volume = 7 | pages = CD007986 | date = July 11, 2012 | pmid = 22786509 | doi = 10.1002/14651858.CD007986.pub2 }}</ref> while a different review found "insufficient evidence to draw any conclusion about the use of PUFAs for children with specific learning disorders".<ref>{{cite journal | author = Tan ML, Ho JJ, Teh KH | title = Polyunsaturated fatty acids (PUFAs) for children with specific learning disorders | journal = The Cochrane database of systematic reviews | volume = 12 | pages = CD009398 | date = December 12, 2012 | pmid = 23235675 | doi = 10.1002/14651858.CD009398.pub2 }}</ref> Another review concluded that the evidence is inconclusive for the use of omega-3 fatty acids in behavior and non-neurodegenerative neuropsychiatric disorders such ADHD and depression.<ref>{{cite journal | author = Ortega RM, Rodríguez-Rodríguez E, López-Sobaler AM | title = Effects of omega 3 fatty acids supplementation in behavior and non-neurodegenerative neuropsychiatric disorders | journal = The British journal of nutrition | volume = 107 Suppl 2 | pages = S261–70 | date = June 2012 | pmid = 22591900 | doi = 10.1017/S000711451200164X }}</ref>

Fish oil has only a small benefit on the risk of early birth.<ref>{{cite journal | author = Secher NJ | title = Does fish oil prevent preterm birth? | journal = Journal of perinatal medicine | volume = 35 Suppl 1 | pages = S25–7 | year = 2007 | pmid = 17302537 | doi = 10.1515/JPM.2007.033 }}</ref><ref name="jensen1">{{Cite journal | last = Jensen | first = Craig L | title = Effects of n-3 fatty acids during pregnancy and lactation | journal = Am J Clin Nutr | volume = 83 | issue = 6 | pages = 1452–1457 | year = 2006 | issn = 0002-9165 | url = http://www.ajcn.org/cgi/reprint/83/6/S1452.pdf }}</ref> A 2015 meta-analysis of the effect of omega-3 supplementation during pregnancy did not demonstrate a decrease in the rate of preterm birth or improve outcomes in women with singleton pregnancies with no prior preterm births.<ref>{{Cite web| url = http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014013752| title = Omega-3 long chain polyunsaturated fatty acids to prevent preterm birth: a meta-analysis of randomized controlled trials| website = www.crd.york.ac.uk| access-date = 2016-03-01}}</ref> A systematic review and meta-analysis published the same year reached the opposite conclusion, specifically, that omega-3 fatty acids were effective in "preventing early and any preterm delivery".<ref>{{cite journal|last1=Kar|first1=S|last2=Wong|first2=M|last3=Rogozinska|first3=E|last4=Thangaratinam|first4=S|title=Effects of omega-3 fatty acids in prevention of early preterm delivery: a systematic review and meta-analysis of randomized studies.|journal=European journal of obstetrics, gynecology, and reproductive biology|date=30 November 2015|volume=198|pages=40–46|doi=10.1016/j.ejogrb.2015.11.033|pmid=26773247}}</ref>

===Mental health===
There is some evidence that omega-3 fatty acids are related to [[mental disorder|mental health]],<ref>{{cite journal | author = Perica MM, Delas I | title = Essential fatty acids and psychiatric disorders | journal = Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition | volume = 26 | issue = 4 | pages = 409–25 | date = August 2011 | pmid = 21775637 | doi = 10.1177/0884533611411306 }}</ref> including that they may tentatively be useful as an add-on for the treatment of depression associated with [[bipolar disorder]].<ref name="montgomery2008">{{cite journal | author = Montgomery P, Richardson AJ | title = Omega-3 fatty acids for bipolar disorder | journal = Cochrane database of systematic reviews (Online) | issue = 2 | pages = CD005169 | date = 2008-04-16 | pmid = 18425912 | doi = 10.1002/14651858.CD005169.pub2 | editor1-last = Montgomery | editor1-first = Paul }}</ref> Significant benefits due to EPA supplementation were only seen, however, when treating depressive symptoms and not manic symptoms suggesting a link between omega-3 and depressive mood.<ref name="montgomery2008"/> There is also preliminary evidence that [[Ethyl eicosapentaenoic acid|EPA]] supplementation is helpful in cases of [[Major depressive disorder|depression]].<ref>{{cite journal | author = Hegarty B, Parker G | title = Fish oil as a management component for mood disorders - an evolving signal | journal = Current Opinion in Psychiatry | volume = 26 | issue = 1 | pages = 33–40 | date = January 2013 | pmid = 23108232 | doi = 10.1097/YCO.0b013e32835ab4a7 }}</ref> The link between omega-3 and depression has been attributed to the fact that many of the products of the omega-3 synthesis pathway play key roles in regulating inflammation such as [[prostaglandin E3]] which have been linked to depression.<ref name="Ruxton CHS, Calder PC, Reed SC, Simpson MJA 2005 113–129">{{cite journal | author = Ruxton CHS, Calder PC, Reed SC, Simpson MJA | title = The impact of long-chain n-3 polyunsaturated fatty acids on human health | journal = Nutrition Research Reviews | volume = 18 | pages = 113–129 | year = 2005 | doi=10.1079/nrr200497 | issue=1}}</ref> This link to inflammation regulation has been supported in both in vitro <ref name="miles2003">{{cite journal | author = Miles EA, Aston L, Calder PC | title = In vitro effects of eicosanoids derived from different 20-carbon fatty acids on T helper type 1 and T helper type 2 cytokine production in human whole-blood cultures | journal = Clinical and Experimental Allergy | volume = 33 | pages = 624–632 | year = 2003 | doi = 10.1046/j.1365-2222.2003.01637.x | issue=5}}</ref> and in vivo studies as well as in meta-analysis studies.<ref name="robinson2013"/> The exact mechanism in which omega-3 acts upon the inflammatory system is still controversial as it was commonly believed to have anti-inflammatory effects.<ref>{{cite journal | author = Bucolo C, Caraci F, Drago F, Galvano F, Grosso G, Malaguarnera M, Maryentano S | title = Omega-3 fatty acids and depression: Scientific evidence and biological mechanisms | journal = Oxidative Medicine and Cellular Longevity | year = 2014 | doi = 10.1155/2014/313570 | volume=2014 | pages=1–16}}</ref>

There is, however, significant difficulty in interpreting the literature due to participant recall and systematic differences in diets.<ref>{{cite journal | author = Sanhueza C, Ryan L, Foxcroft DR | title = Diet and the risk of unipolar depression in adults: systematic review of cohort studies | journal = Journal of human nutrition and dietetics : the official journal of the British Dietetic Association | volume = 26 | issue = 1 | pages = 56–70 | date = October 18, 2012 | pmid = 23078460 | doi = 10.1111/j.1365-277X.2012.01283.x }}</ref> There is also controversy as to the efficacy of omega-3 with many meta-analysis papers finding heterogeneity among results which can be explained mostly by [[publication bias]].<ref>{{cite journal | author = Appleton KM, Rogers PJ, Ness AR | title = Updated systematic review and meta-analysis of the effects of n-3 long-chain polyunsaturated fatty acids on depressed mood | journal = American Journal of Clinical Nutrition | volume = 91 | pages = 757–770 | doi = 10.3945/ajcn.2009.28313 | year = 2010 | issue=3 | pmid=20130098}}</ref><ref name="bloch2012">{{cite journal | author = Bloch MH, Hannestad J | title = Omega-3 fatty acids for the treatment of depression: Systematic review and meta-analysis | journal = Molecular Psychiatry | volume = 17 | issue = 12 | pages = 1272–1282 | year = 2012 | doi = 10.1038/mp.2011.100 | pmid=21931319 | pmc=3625950}}</ref> A significant correlation between shorter treatment trials was associated with increased omega-3 efficacy for treating depressed symptoms further implicating bias in publication.<ref name="bloch2012"/>

There is some evidence to support the claim that omega-3 can help treat anxiety disorder symptoms as well but studies have been limited.<ref>{{cite journal | author = Ross BM | title = Omega-3 polyunsaturated fatty acids and anxiety disorders | journal = Prostaglandins, Leukotrienes and Essential Fatty Acids (PLEFA) | volume = 81 | issue = (5-6) | year = 2009 | pages = 309–312 | doi = 10.1016/j.plefa.2009.10.004 }}</ref>

Very low quality evidence finds that omega-3 fatty acids might prevent psychosis.<ref>{{cite journal|last1=Stafford|first1=MR|last2=Jackson|first2=H|last3=Mayo-Wilson|first3=E|last4=Morrison|first4=AP|last5=Kendall|first5=T|title=Early interventions to prevent psychosis: systematic review and meta-analysis.|journal=BMJ (Clinical research ed.)|date=18 January 2013|volume=346|pages=f185|pmid=23335473|doi=10.1136/bmj.f185|pmc=3548617}}</ref>

===Cognitive aging===
Epidemiological studies are inconclusive about an effect of omega-3 fatty acids on the mechanisms of [[Alzheimer's disease]].<ref>{{cite journal | author = Cederholm T, Palmblad J | title = Are omega-3 fatty acids options for prevention and treatment of cognitive decline and dementia? | journal = Current Opinion in Clinical Nutrition and Metabolic Care | volume = 13 | issue = 2 | pages = 150–155 | date = March 2010 | pmid = 20019606 | doi = 10.1097/MCO.0b013e328335c40b | url = }}</ref> There is preliminary evidence of effect on mild [[cognitive disorder|cognitive problems]], but none supporting an effect in healthy people or those with [[dementia]].<ref>{{cite journal | author = Mazereeuw G, Lanctôt KL, Chau SA, Swardfager W, Herrmann N | title = Effects of omega-3 fatty acids on cognitive performance: a meta-analysis | journal = Neurobiol Aging | volume = 33 | issue = 7 | pages = e17–29 | year = 2012 | pmid = 22305186 | doi = 10.1016/j.neurobiolaging.2011.12.014 }}</ref><ref>{{cite journal|last1=Chew|first1=EY|last2=Clemons|first2=TE|last3=Agrón|first3=E|last4=Launer|first4=LJ|last5=Grodstein|first5=F|last6=Bernstein|first6=PS|last7=Age-Related Eye Disease Study 2 (AREDS2) Research|first7=Group|title=Effect of Omega-3 Fatty Acids, Lutein/Zeaxanthin, or Other Nutrient Supplementation on Cognitive Function: The AREDS2 Randomized Clinical Trial.|journal=JAMA|date=25 August 2015|volume=314|issue=8|pages=791–801|pmid=26305649|doi=10.1001/jama.2015.9677}}</ref><ref>{{cite journal|last1=Forbes|first1=SC|last2=Holroyd-Leduc|first2=JM|last3=Poulin|first3=MJ|last4=Hogan|first4=DB|title=Effect of Nutrients, Dietary Supplements and Vitamins on Cognition: a Systematic Review and Meta-Analysis of Randomized Controlled Trials.|journal=Canadian geriatrics journal : CGJ|date=December 2015|volume=18|issue=4|pages=231–45|pmid=26740832|doi=10.5770/cgj.18.189|pmc=4696451}}</ref>

===Atopic diseases===
Results of studies investigating the role of LCPUFA supplementation and LCPUFA status in the prevention and therapy of atopic diseases (allergic rhinoconjunctivitis, atopic dermatitis and allergic asthma) are controversial; therefore, at the present stage of our knowledge we cannot state either that the nutritional intake of n-3 fatty acids has a clear preventive or therapeutic role, or that the intake of n-6 fatty acids has a promoting role in context of atopic diseases.<ref>Lohner S, Decsi T. Role of Long-Chain Polyunsaturated Fatty Acids in the Prevention and Treatment of Atopic Diseases. In: Polyunsaturated Fatty Acids: Sources, Antioxidant Properties and Health Benefits (edited by: Angel Catalá). NOVA Publishers. 2013. Chapter 11, pp. 1-24. (ISBN 978-1-62948-151-7)</ref>

==Chemistry==
[[Image:ALAnumbering.svg|360px|right|thumb|Chemical structure of alpha-linolenic acid (ALA), an essential omega-3 fatty acid, (18:3Δ9c,12c,15c, which means a chain of 18 carbons with 3 double bonds on carbons numbered 9, 12, and 15). Although chemists count from the carbonyl carbon (blue numbering), biologists count from the ''n'' (ω) carbon (red numbering). Note that, from the ''n'' end (diagram right), the first double bond appears as the third carbon-carbon bond (line segment), hence the name "''n''-3". This is explained by the fact that the ''n'' end is almost never changed during physiological transformations in the human body, as it is more energy-stable, and other compounds can be synthesized from the other carbonyl end, for example in glycerides, or from double bonds in the middle of the chain.]]
[[Image:EPAnumbering.png|360px|right|thumb|Chemical structure of [[eicosapentaenoic acid]] (EPA)]]
[[Image:DHAnumbering.png|360px|right|thumb|Chemical structure of [[docosahexaenoic acid]] (DHA)]]

Omega-3 fatty acids that are important in human physiology<ref>http://www.hsph.harvard.edu/nutritionsource/omega-3-fats/</ref> are α-linolenic acid (18:3, ''n''-3; ALA), eicosapentaenoic acid (20:5, ''n''-3; EPA), and docosahexaenoic acid (22:6, ''n''-3; DHA). These three [[polyunsaturated|polyunsaturates]] have either 3, 5, or 6 double bonds in a carbon chain of 18, 20, or 22 carbon atoms, respectively. As with most naturally-produced fatty acids, all double bonds are in the ''[[Cis-trans isomerism|cis]]''-configuration, in other words, the two hydrogen atoms are on the same side of the double bond; and the double bonds are interrupted by [[methylene bridge]]s (-{{chem|CH|2}}-), so that there are two single bonds between each pair of adjacent double bonds.

===List of omega-3 fatty acids===
This table lists several different names for the most common omega-3 fatty acids found in nature.

{| class="wikitable"
|-
! Common name
! Lipid name
! Chemical name
|-
| [[Hexadecatrienoic acid]] (HTA)
| 16:3 (''n''-3)
| ''all''-''cis''-7,10,13-hexadecatrienoic acid
|-
| [[Alpha-linolenic acid|α-Linolenic acid]] (ALA)
| 18:3 (''n''-3)
|''all''-''cis''-9,12,15-octadecatrienoic acid
|-
| [[Stearidonic acid]] (SDA)
| 18:4 (''n''-3)
|''all''-''cis''-6,9,12,15-octadecatetraenoic acid
|-
| [[Eicosatrienoic acid]] (ETE)
| 20:3 (''n''-3)
|''all''-''cis''-11,14,17-eicosatrienoic acid
|-
| [[Eicosatetraenoic acid]] (ETA)
| 20:4 (''n''-3)
|''all''-''cis''-8,11,14,17-eicosatetraenoic acid
|-
| [[Eicosapentaenoic acid]] (EPA)
| 20:5 (''n''-3)
| ''all''-''cis''-5,8,11,14,17-eicosapentaenoic acid
|-
| [[Heneicosapentaenoic acid]] (HPA)
| 21:5 (''n''-3)
| ''all-cis''-6,9,12,15,18-heneicosapentaenoic acid
|-
| [[Docosapentaenoic acid]] (DPA), Clupanodonic acid
| 22:5 (''n''-3)
| ''all''-''cis''-7,10,13,16,19-docosapentaenoic acid
|-
| [[Docosahexaenoic acid]] (DHA)
| 22:6 (''n''-3)
|''all''-''cis''-4,7,10,13,16,19-docosahexaenoic acid
|-
| [[Tetracosapentaenoic acid]]
| 24:5 (''n''-3)
|''all''-''cis''-9,12,15,18,21-tetracosapentaenoic acid
|-
| [[Tetracosahexaenoic acid]] (Nisinic acid)
| 24:6 (''n''-3)
| ''all''-''cis''-6,9,12,15,18,21-tetracosahexaenoic acid
|}

==Mechanism of action==
The 'essential' fatty acids were given their name when researchers found that they are essential to normal growth in young children and animals. The omega-3 fatty acid DHA, also known as docosahexaenoic acid, is found in high abundance in the human brain.<ref name="van WestMaes2003">{{cite journal|last1=van West|first1=Dirk|last2=Maes|first2=Michael|title=Polyunsaturated fatty acids in depression|journal=Acta Neuropsychiatrica|volume=15|issue=1|year=2003|pages=15–21|issn=0924-2708|doi=10.1034/j.1601-5215.2003.00004.x}}</ref> It is produced by a desaturation process, but humans lack the desaturase enzyme, which acts to insert double bonds at the ω6 and ω3 position.<ref name="van WestMaes2003"/> Therefore, the ω6 and ω3 polyunsaturated fatty acids cannot be synthesized and are appropriately called essential fatty acids.<ref name="van WestMaes2003"/>

In 1964, it was discovered that enzymes found in sheep tissues convert omega-6 arachidonic acid into the [[inflammation|inflammatory]] agent called [[prostaglandin]] E,2,<ref>{{cite journal|author=Bergstrom, Danielson, Klenberg, and Samuelsson |title=The Enzymatic Conversion of Essential fatty Acids into Prostaglandins |journal=The Journal of Biological Chemistry |volume=239 |issue=11 |pages=PC4006–PC4008 |date=November 1964 |url=http://www.jbc.org/content/239/11/PC4006.full.pdf}}</ref> which both causes the sensation of pain and expedites healing and immune response in traumatized and infected tissues.<ref name=Lands1992>{{cite journal | author = Lands WE | title = Biochemistry and physiology of ''n''–3 fatty acids | journal = [[FASEB Journal]] | volume = 6 | issue = 8 | pages = 2530–2536 | year = 1992 | pmid = 1592205 | url = http://www.fasebj.org/content/6/8/2530.full.pdf | publisher = [[Federation of American Societies for Experimental Biology]] | authorlink = William E.M. Lands | accessdate = 2008-03-21 }}</ref> By 1979, more of what are now known as [[eicosanoid]]s were discovered: [[thromboxane]]s, [[prostacyclin]]s, and the [[leukotriene]]s.<ref name=Lands1992/> The eicosanoids, which have important biological functions, typically have a short active lifetime in the body, starting with synthesis from fatty acids and ending with metabolism by enzymes. If the rate of synthesis exceeds the rate of metabolism, the excess eicosanoids may, however, have deleterious effects.<ref name=Lands1992/> Researchers found that certain omega-3 fatty acids are also converted into eicosanoids, but at a much slower rate. Eicosanoids made from omega-3 fatty acids are often referred to as anti-inflammatory, but in fact they are just less inflammatory than those made from omega-6 fats. If both omega-3 and omega-6 fatty acids are present, they will "compete" to be transformed,<ref name=Lands1992/> so the ratio of long-chain omega-3:omega-6 fatty acids directly affects the type of eicosanoids that are produced.<ref name=Lands1992/>

===Interconversion===

====Conversion efficiency of ALA to EPA and DHA====
Humans can convert short-chain omega-3 fatty acids to long-chain forms (EPA, DHA) with an efficiency below 5%.<ref>{{cite journal | author = Gerster H | title = Can adults adequately convert alpha-linolenic acid (18:3n-3) to eicosapentaenoic acid (20:5n-3) and docosahexaenoic acid (22:6n-3)? | journal = Int. J. Vitam. Nutr. Res. | volume = 68 | issue = 3 | pages = 159–173 | year = 1998 | pmid = 9637947 | doi = }}</ref><ref>{{cite journal | author = Brenna JT | title = Efficiency of conversion of alpha-linolenic acid to long chain n-3 fatty acids in man | journal = Current Opinion in Clinical Nutrition and Metabolic Care | volume = 5 | issue = 2 | pages = 127–132 | date = March 2002 | pmid = 11844977 | doi = 10.1097/00075197-200203000-00002 }}</ref> The omega-3 conversion efficiency is greater in women than in men, but less-studied.<ref>{{cite journal | author = Burdge GC, Calder PC | title = Conversion of alpha-linolenic acid to longer-chain polyunsaturated fatty acids in human adults | journal = Reprod. Nutr. Dev. | volume = 45 | issue = 5 | pages = 581–597 | date = September 2005 | pmid = 16188209 | doi = 10.1051/rnd:2005047 }}</ref> Higher ALA and DHA values found in plasma phospholipids of women may be due to the higher activity of desaturases, especially that of delta-6-desaturase.<ref name="pmid23327902">{{Cite journal | last1 = Lohner | first1 = S. | last2 = Fekete | first2 = K. | last3 = Marosvölgyi | first3 = T. | last4 = Decsi | first4 = T. | title = Gender differences in the long-chain polyunsaturated fatty acid status: systematic review of 51 publications. | journal = Ann Nutr Metab | volume = 62 | issue = 2 | pages = 98–112 | year = 2013 | doi = 10.1159/000345599 | PMID = 23327902 }}</ref>

These conversions occur competitively with omega-6 fatty acids, which are essential closely related chemical analogues that are derived from linoleic acid. They both utilize the same desaturase and elongase proteins in order to synthesize inflammatory regulatory proteins.<ref name="Ruxton CHS, Calder PC, Reed SC, Simpson MJA 2005 113–129"/> The products of both pathways are vital for growth making a balanced diet of omega-3 and omega-6 important to an individual’s health.<ref>{{cite journal | author = Simopoulos AP | title = The importance of the omega-3/omega-6 fatty acid ratio in cardiovascular disease and other chronic diseases | journal = Experimental Biology and Medicine | volume = 233 | issue = 6 | pages = 674–688 | year = 2001 | doi = 10.3181/0711-MR-311 | pmid=18408140}}</ref> A balanced intake ratio of 1:1 was believed to be ideal in order for proteins to be able to synthesize both pathways sufficiently, but this has been controversial as of recent research.<ref name=pmid_18196988>{{cite journal | author = Griffin BA | title = How relevant is the ratio of dietary omega-6 to omega-3 polyunsaturated fatty acids to cardiovascular disease risk? Evidence from the OPTILIP study | journal = Current Opinion in Lipidology | volume = 19 | issue = 1 | pages = 57–62 | year = 2008 | pmid = 18196988 | doi = 10.1097/MOL.0b013e3282f2e2a8 }}</ref>

The conversion of ALA to EPA and further to DHA in humans has been reported to be limited, but varies with individuals.<ref>Oregon State University Micronutrient Information Center: Essential Fatty Acids-Metabolism and Bioavailability http://lpi.oregonstate.edu/infocenter/othernuts/omega3fa/#metabolism</ref><ref name="ceol">{{cite web | title = Conversion Efficiency of ALA to DHA in Humans | url = http://dhaomega3.org/index.php?category=overview&title=Conversion-of-ALA-to-DHA | accessdate = 21 October 2007 }}</ref> Women have higher ALA conversion efficiency than men, which is presumed<ref>{{cite web | title = Women have better ALA conversion efficiency | url=http://www.dhaomega3.org/Overview/Conversion-Efficiency-of-ALA-to-DHA-in-Humans|website=DHA EPA Omega 3 Institute|accessdate=21 July 2015}}</ref> to be due to the lower rate of use of dietary ALA for beta-oxidation. This suggests that biological engineering of ALA conversion efficiency is possible. Goyens ''et al.'' argue that it is the absolute amount of ALA, rather than the ratio of omega-3 and omega-6 fatty acids, that controls the conversion efficiency.<ref name="cala">{{cite journal | author = Goyens PL, Spilker ME, Zock PL, Katan MB, Mensink RP | title = Conversion of alpha-linolenic acid in humans is influenced by the absolute amounts of alpha-linolenic acid and linoleic acid in the diet and not by their ratio | journal = American Journal of Clinical Nutrition | volume = 84 | issue = 1 | pages = 44–53 | date = 1 July 2006 | pmid = 16825680 | url = http://www.ajcn.org/cgi/content/abstract/84/1/44}}</ref>

====Omega-6 to omega-3 ratio====
{{Main|Essential fatty acid interactions}}
Human diet has changed rapidly in recent centuries resulting in a reported increased diet of omega-6 in comparison to omega-3.<ref name="def2006">{{cite journal |last1=DeFilippis|first1=Andrew P. |last2=Sperling|first2=Laurence S. |title = Understanding omega-3's |journal=American Heart Journal |volume=151 |issue=3 |pages=564–570 |date=March 2006 |doi=10.1016/j.ahj.2005.03.051 |url=http://www.biovita.fi/suomi/pdf/understanding_omega3.pdf |format=PDF |archiveurl=http://web.archive.org/web/20071022174611/www.biovita.fi/suomi/pdf/understanding_omega3.pdf |archivedate=22 October 2007 |pmid=16504616 }}</ref> The rapid evolution of human diet away from a 1:1 omega-3 and omega-6 ratio, such as during the Neolithic Agricultural Revolution, has presumably been too fast for humans to have adapted to biological profiles adept at balancing omega-3 and omega-6 ratios of 1:1.<ref name="balkom2012">{{cite journal | author = Hofmeijer-Sevink MK, Batelaan NM, van Megen HJ, Penninx BW, Cath DC, van den Hout MA, van Balkom AJ | title = Clinical relevance of comorbidity in anxiety disorders: A report from the Netherlands Study of Depression and Anxiety (NESDA) | journal = Journal of Affective Disorders| volume = 137 | issue = (1-3) | pages = 106–112 | year = 2012 | pmid=22240085 | doi = 10.1016/j.jad.2011.12.008 }}</ref> This is commonly believed to be the reason why modern diets are correlated with many inflammatory disorders.<ref name="def2006"/> While omega-3 polyunsaturated fatty acids may be beneficial in preventing heart disease in humans, the level of omega-6 polyunsaturated fatty acids (and, therefore, the ratio) does not matter.<ref name="pmid_18196988"/><ref>{{cite journal | author = Willett WC | title = The role of dietary n-6 fatty acids in the prevention of cardiovascular disease | journal = J Cardiovasc Med | volume = 8 | pages = Suppl 1:S42–5 | year = 2007 | pmid = 17876199 | doi = 10.2459/01.JCM.0000289275.72556.13 }}</ref>

Both omega-6 and omega-3 fatty acids are essential; i.e., humans must consume them in their diet. Omega-6 and omega-3 eighteen-carbon polyunsaturated fatty acids compete for the same metabolic enzymes, thus the omega-6:omega-3 ratio of ingested fatty acids has significant influence on the ratio and rate of production of eicosanoids, a group of hormones intimately involved in the body's inflammatory and homeostatic processes, which include the [[prostaglandins]], [[leukotrienes]], and [[thromboxanes]], among others. Altering this ratio can change the body's metabolic and inflammatory state.<ref name="BMJ2006"/> In general, grass-fed animals accumulate more omega-3 than do grain-fed animals, which accumulate relatively more omega-6.<ref name="Duckett Animal Finishing" /> [[Metabolites]] of omega-6 are more inflammatory (esp. arachidonic acid) than those of omega-3. This necessitates that omega-6 and omega-3 be consumed in a balanced proportion; healthy ratios of omega-6:omega-3, according to some authors, range from 1:1 to 1:4 (an individual needs more omega-3 than omega-6).<ref name="Lands2005">{{cite book|authorlink= William EM Lands | last = Lands | first = WEM |title=Fish, Omega 3 and human health | year = 2005 | publisher= [[American Oil Chemists' Society]] |isbn=978-1-893997-81-3}}</ref> Other authors believe that ratio 4:1 (when the amount of omega-6 is only 4 times greater than that of omega-3) is already healthy.<ref>{{cite journal | author = Simopoulos AP | title = The importance of the ratio of omega-6/omega-3 essential fatty acids | journal = Biomedicine & Pharmacotherapy | volume = 56 | issue = 8 | pages = 365–379 | date = October 2002 | pmid = 12442909 | doi = 10.1016/S0753-3322(02)00253-6 }}</ref><ref>{{cite journal | last1 = Daley | first1 = C. A. | author2 = Abbott, A.; Doyle, P.; Nader, G.; and Larson, S. | title = A literature review of the value-added nutrients found in grass-fed beef products | publisher = [[California State University, Chico]] (College of Agriculture) | year = 2004 | url = http://www.csuchico.edu/agr/grassfedbeef/health-benefits/index.html | accessdate = 2008-03-23 }}</ref> Studies suggest the evolutionary human diet, rich in game animals, seafood, and other sources of omega-3, may have provided such a ratio.<ref name="simopoulos2003">{{cite journal | author = Simopoulos AP | title = Importance of the ratio of omega-6/omega-3 essential fatty acids: evolutionary aspects | journal = World Review of Nutrition and Dietetics | volume = 92 | pages = 1–174 | date = September 2003 | pmid = 14579680 | doi = 10.1159/000073788 | isbn = 3-8055-7640-4 | series = World Review of Nutrition and Dietetics }}</ref><ref name="simopoulos2000">{{cite journal | author = Simopoulos AP, Leaf A, Salem N | title = Workshop Statement on the essentiality of and recommended dietary intakes for ''n''-6 and ''n''-3 fatty acids | journal = Prostaglandins Leukot Essent Fatty Acids | volume = 63 | issue = 3 | pages = 119–121 | year = 2000 | pmid = 10991764 | doi = 10.1054/plef.2000.0176 }}</ref>

Typical Western diets provide ratios of between 10:1 and 30:1 (i.e., dramatically higher levels of omega-6 than omega-3).<ref>{{cite journal | author = Hibbeln JR, Nieminen LR, Blasbalg TL, Riggs JA, Lands WE | title = Healthy intakes of n-3 and n-6 fatty acids: Estimations considering worldwide diversity | journal = The American Journal of Clinical Nutrition | volume = 83 | issue = 6 Suppl | pages = 1483S–1493S | year = 2006 | pmid = 16841858 }}</ref> The ratios of omega-6 to omega-3 fatty acids in some common vegetable oils are: [[canola]] 1:2, [[hemp oil|hemp]] 2-3:1,<ref>{{cite book |author=Martina Bavec; Franc Bavec |title=Organic Production and Use of Alternative Crops |publisher=Taylor & Francis Ltd |location=London |year=2006 |page=178 |isbn=1-4200-1742-X |url=http://books.google.com/books?id=70Ey7Kwqf3EC&pg=PA178#v=onepage&q&f=false |accessdate=2013-02-18}}</ref> [[soybean]] 7:1, [[olive]] 3–13:1, [[sunflower]] (no omega-3), [[flax]] 1:3,<ref>Erasmus, Udo, Fats and Oils. 1986. Alive books, Vancouver, ISBN 0-920470-16-5 p. 263 (round-number ratio within ranges given.)</ref> [[cottonseed]] (almost no omega-3), [[peanut]] (no omega-3), [[grapeseed oil]] (almost no omega-3) and [[corn oil]] 46:1 ratio of omega-6 to omega-3.<ref>{{cite web|title=Oil, vegetable, corn, industrial and retail, all purpose salad or cooking; USDA Nutrient Data, SR-21 |url=http://nutritiondata.self.com/facts/fats-and-oils/580/2| publisher=Conde Nast|accessdate=12 April 2014}}</ref>

==History==
Although omega-3 fatty acids have been known as essential to normal growth and health since the 1930s, awareness of their health benefits has dramatically increased since the 1980s.<ref>{{Cite journal|author=Dusheck J |title=Fish, Fatty Acids, and Physiology |journal=Science News. |volume=128 |issue=16 |pages=241–256 |date=October 1985|pmid=|doi= 10.2307/3970056|url=http://www.highbeam.com/doc/1G1-3984549.html}}</ref><ref>{{cite journal | author = Holman RT | title = The slow discovery of the importance of omega 3 essential fatty acids in human health | journal = J. Nutr. | volume = 128 | issue = 2 Suppl | pages = 427S–433S | date = February 1998 | pmid = 9478042 | doi = | url = }}</ref>

On September 8, 2004, the U.S. Food and Drug Administration gave "qualified health claim" status to EPA and DHA omega-3 fatty acids, stating, "supportive but not conclusive research shows that consumption of EPA and DHA [omega-3] fatty acids may reduce the risk of coronary heart disease".<ref name=fda2004>{{cite press release|publisher=United States Food and Drug Administration|date=September 8, 2004|url=http://www.fda.gov/SiteIndex/ucm108351.htm|title=FDA announces qualified health claims for omega-3 fatty acids|accessdate=2006-07-10}}</ref> This updated and modified their health risk advice letter of 2001 (see below). As of this writing,{{when|date=January 2015}} regulatory agencies{{who|date=December 2010}} do not accept that there is sufficient evidence for any of the suggested benefits of DHA and EPA other than for cardiovascular health.

The Canadian Food Inspection Agency has recognized the importance of DHA omega-3 and permits the following claim for DHA: "DHA, an omega-3 fatty acid, supports the normal physical development of the brain, eyes and nerves primarily in children under two year of age."<ref>Canadian Food Inspection Agency. [http://www.inspection.gc.ca/food/labelling/food-labelling-for-industry/health-claims/eng/1392834838383/1392834887794?chap=8#s16c8 Acceptable nutrient function claims]. Accessed 30 April 2015</ref>

==Dietary sources==
{| class="sortable wikitable" border=1 cellspacing=0 cellpadding=1 style="border-collapse:collapse;width:300px;float: right; margin-left: 10px;"
|+Grams of omega-3 per 3oz (85g) serving<ref name="ahao3">
{{cite web| url = http://www.americanheart.org/presenter.jhtml?identifier=3013797| title = Fish, Levels of Mercury and Omega-3 Fatty Acids| publisher = American Heart Association| accessdate = October 6, 2010}}</ref>
<ref name="KrisEtherton2002">
{{cite journal |last1=Kris-Etherton|first1=PM |last2=Harris|first2=WS |last3=Appel|first3=LJ | title=Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease |journal=Circulation |volume=106 |issue=21 |pages=2747–2757 |date=2002 |pmid=12438303 |doi=10.1161/01.CIR.0000038493.65177.94 |url=http://circ.ahajournals.org/cgi/content/full/106/21/2747 }}</ref>

!| Common name || grams omega-3
|-
| [[Flax]] || 11.4 <ref name="o3c" />
|-
| [[Hemp]] || 11.0
|-
| [[Herring]], sardines || 1.3–2
|-
| Mackerel: [[Spanish mackerel|Spanish]]/[[Atlantic mackerel|Atlantic]]/[[Pacific mackerel|Pacific]] || 1.1–1.7
|-
| [[Salmon]] || 1.1–1.9
|-
| [[Halibut]] || 0.60–1.12
|-
| Tuna || 0.21–1.1
|-
| [[Swordfish]] || 0.97
|-
| [[New Zealand green-lipped mussel|Greenshell/lipped mussels]] || 0.95<ref name="o3c">{{cite web|url=http://www.omega-3centre.com/sources_long_chain.html |title=Omega-3 Centre|accessdate=2008-07-27|work=Omega-3 sources|publisher=Omega-3 Centre|archiveurl = http://web.archive.org/web/20080718174524/http://www.omega-3centre.com/sources_long_chain.html  |archivedate = 2008-07-18}}</ref>
|-
| [[Tilefish]] || 0.9
|-
| Tuna (canned, light) || 0.17–0.24
|-
| [[Pollock]] || 0.45
|-
| [[Cod]] || 0.15–0.24
|-
| [[Catfish]] || 0.22–0.3
|-
| [[Flounder]] || 0.48
|-
| [[Grouper]] || 0.23
|-
| [[Mahi mahi]] || 0.13
|-
| [[Orange roughy]] || 0.028
|-
| [[Red snapper (fish)|Red snapper]] || 0.29
|-
| [[Shark]] || 0.83
|-
| [[King mackerel]] || 0.36
|-
| [[Blue grenadier|Hoki (blue grenadier)]] || 0.41<ref name="o3c"/>
|-
| [[Gemfish]] || 0.40<ref name="o3c"/>
|-
| [[Cod#Perciformes|Blue eye cod]] || 0.31<ref name="o3c"/>
|-
| [[Rock oyster|Sydney rock oysters]] || 0.30<ref name="o3c"/>
|-
| [[Tuna#Canned|Tuna, canned]] || 0.23<ref name="o3c"/>
|-
| [[Lutjanidae|Snapper]] || 0.22<ref name="o3c"/>
|-
| [[Egg (food)|Eggs, large regular]] || 0.109<ref name="o3c"/>
|-
| [[Strawberry]] or [[Kiwifruit]] || 0.10-0.20
|-
| [[Broccoli]] || 0.10-0.20
|-
| [[Barramundi|Barramundi, saltwater]] || 0.100<ref name="o3c"/>
|-
| [[Giant tiger prawn]] || 0.100<ref name="o3c"/>
|-
| [[Red meat|Lean red meat]] || 0.031<ref name="o3c"/>
|-
| [[Turkey (bird)|Turkey]] || 0.030<ref name="o3c"/>
|-
| [[Cereal|Cereals, rice, pasta, etc.]] || 0.00<ref name="o3c"/>
|-
| [[Fruit]] || 0.00<ref name="o3c"/>
|-
| [[Milk|Milk, regular]] || 0.00<ref name="o3c"/>
|-
| [[Bread|Bread, regular]] || 0.00<ref name="o3c"/>
|-
| [[Vegetable]]s || 0.00<ref name="o3c"/>
|}

===Daily values===
In the United States, the [[Institute of Medicine]] publishes a system of [[Dietary Reference Intake]]s, which includes Recommended Dietary Allowances (RDAs) for individual nutrients, and Acceptable Macronutrient Distribution Ranges (AMDRs) for certain groups of nutrients, such as fats. When there is insufficient evidence to determine an RDA, the institute may publish an Adequate Intake (AI) instead, which has a similar meaning, but is less certain. The AI for [[α-linolenic acid]] is 1.6 grams/day for men and 1.1 grams/day for women, while the AMDR is 0.6% to 1.2% of total energy.<ref name=IOM>{{cite book | author = Food and Nutrition Board | publisher = Institute of Medicine of the National Academies | year = 2005 | title = Dietary Reference Intakes For Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids | location = Washington, D.C. | isbn = 0-309-08537-3 | url = http://www.nal.usda.gov/fnic/DRI//DRI_Energy/energy_full_report.pdf | pages = 423; 770}}</ref>

A growing body of literature suggests that higher intakes of α-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) may afford some degree of protection against [[coronary disease]].{{citation needed|date=February 2016}} Because the physiological potency of EPA and DHA is much greater than that of ALA, it is not possible to estimate one AMDR for all omega-3 fatty acids. Approximately 10 percent of the AMDR can be consumed as EPA and/or DHA.<ref name=IOM/> There was insufficient evidence as of 2005 to set an upper tolerable limit for omega-3 fatty acids.<ref name=IOM/>

[[Heavy metal poisoning]] by the body's accumulation of traces of heavy metals, in particular [[Mercury (element)|mercury]], [[lead]], [[nickel]], [[arsenic]], and [[cadmium]], is a possible risk from consuming fish oil supplements.{{mcn|date=September 2012}} Also, other contaminants ([[PCBs]], [[furan]]s, [[Polychlorinated dibenzodioxins|dioxins]], and PBDEs) might be found, especially in less-refined fish oil supplements.{{citation needed|date=September 2012}} However, heavy metal toxicity from consuming fish oil supplements is highly unlikely, because heavy metals selectively bind with protein in the fish flesh rather than accumulate in the oil. An independent test in 2005 of 44 fish oils on the US market found all of the products passed safety standards for potential contaminants.<ref name="CL2005">{{cite web | title = Product Review: Omega-3 Fatty Acids (EPA and DHA) from Fish/Marine Oils | publisher = [[ConsumerLab.com]] | date = 2005-03-15 | url = http://www.consumerlab.com/results/omega3.asp | accessdate = 2007-08-14}}</ref>{{unreliable source?|date=September 2012}}

The FDA has advised that adults can safely consume a total of 3 grams per day of combined DHA and EPA, with no more than 2 g per day coming from dietary supplements.<ref>{{cite journal | author = Bent S, Bertoglio K, Hendren RL | title = Omega-3 fatty acids for autistic spectrum disorder: a systematic review | journal = J Autism Dev Disord | volume = 39 | issue = 8 | pages = 1145–54 | date = August 2009 | pmid = 19333748 | pmc = 2710498 | doi = 10.1007/s10803-009-0724-5 | url = }}</ref>

Throughout their history, the Council for Responsible Nutrition and the [[World Health Organization]] have published acceptability standards regarding contaminants in fish oil. The most stringent current standard is the International Fish Oils Standard.<ref>{{cite web|url=http://www.ifosprogram.com/IFOS/ConsumerReport.aspx|title=IFOS Home - The International Fish Oil Standards Program|publisher=}}</ref>{{primary source-inline|date=September 2012}} Fish oils that are [[molecular distillation|molecularly distilled]] under vacuum typically make this highest-grade, and have measurable levels of contaminants (measured parts per billion and parts per trillion).{{citation needed|date=September 2012}}

A recent trend has been to fortify food with omega-3 fatty acid supplements. Global food companies have launched omega-3 fatty acid fortified bread, mayonnaise, pizza, yogurt, orange juice, children's pasta, milk, eggs, popcorn, confections, and infant formula.{{citation needed|date=September 2012}}

The [[American Heart Association]] has set up dietary recommendations for EPA and DHA due to their cardiovascular benefits: Individuals with no history of coronary heart disease or myocardial infarction should consume oily fish or fish oils two times per week; those having been diagnosed with coronary heart disease after infarction should consume 1 g EPA and DHA per day from oily fish or supplements; those wishing to lower blood triglycerides should consume 2–4 g of EPA and DHA per day in the form of supplements.<ref name="KrisEtherton2002"/>{{update after|2012|9|19}}

===Fish===
The most widely available dietary source of EPA and DHA is [[oily fish]], such as [[salmon]], [[herring]], [[mackerel]], [[anchovies]], [[menhaden]], and [[sardine]]s. Oils from these fish have a profile of around seven times as much omega-3 as omega-6. Other oily fish, such as [[tuna]], also contain ''n''-3 in somewhat lesser amounts. Consumers of oily fish should be aware of the potential presence of [[heavy metals]] and fat-soluble pollutants like [[Polychlorinated biphenyl|PCBs]] and dioxins, which are known to [[Biomagnification|accumulate up the food chain]]. After extensive review, researchers from [[Harvard School of Public Health|Harvard's School of Public Health]] in the ''Journal of the American Medical Association'' (2006) reported that the benefits of fish intake generally far outweigh the potential risks. Although fish are a dietary source of omega-3 fatty acids, fish do not synthesize them; they obtain them from the [[algae]] ([[microalgae]] in particular) or [[plankton]] in their diets.<ref>{{Cite journal|last=Falk-Petersen |year=1998|title=Lipids and fatty acids in ice algae and phytoplankton from the Marginal Ice Zone in the Barents Sea|journal=Polar Biology|volume=20|issue=1|pages=41–47|issn=0722-4060|id={{INIST|2356641}}|doi=10.1007/s003000050274|first1=S.|display-authors=1|last2=Sargent|first2=J. R.|last3=Henderson|first3=J.|last4=Hegseth|first4=E. N.|last5=Hop|first5=H.|last6=Okolodkov|first6=Y. B.}}</ref>

====Fish oil====
{{See also|Fish oil}}

[[File:Lachsölkapsel.jpg|thumb|Fish oil capsules]]

Marine and freshwater fish oil vary in content of arachidonic acid, EPA and DHA.<ref name="pmid7666244">{{cite journal | author = Innis SM, Rioux FM, Auestad N, Ackman RG | title = Marine and freshwater fish oil varying in arachidonic, eicosapentaenoic and docosahexaenoic acids differ in their effects on organ lipids and fatty acids in growing rats. | journal = The Journal of Nutrition | volume = 125 | issue = 9 | pages = 2286–93 | date = September 1995 | pmid = 7666244 }}</ref> They also differ in their effects on organ lipids.<ref name="pmid7666244" /> Not all forms of fish oil may be equally digestible. Of four studies that compare bioavailability of the glyceryl ester form of fish oil vs. the ethyl [[ester]] form, two have concluded the natural glyceryl ester form is better, and the other two studies did not find a significant difference. No studies have shown the ethyl ester form to be superior, although it is cheaper to manufacture.<ref name="lawson1988">{{cite journal | author = Lawson LD, Hughes BG | title = Absorption of eicosapentaenoic acid and docosahexaenoic acid from fish oil triacylglycerols or fish oil ethyl esters co-ingested with a high-fat meal | journal = Biochem. Biophys. Res. Commun. | volume = 156 | issue = 2 | pages = 960–963 | year = 1988 | pmid = 2847723 | doi = 10.1016/S0006-291X(88)80937-9 }}</ref><ref name="beckermann1990">{{cite journal | author = Beckermann B, Beneke M, Seitz I | title = Comparative bioavailability of eicosapentaenoic acid and docasahexaenoic acid from triglycerides, free fatty acids and ethyl esters in volunteers | language = German | journal = Arzneimittel-Forschung | volume = 40 | issue = 6 | pages = 700–704 | year = 1990 | pmid = 2144420 }}</ref>  

===Krill===
[[Krill oil]] is a source of omega-3 fatty acids.<ref>{{cite journal|journal=Br J Nutr|year=2012|volume=107|issue=Suppl 2|pages=S23-52|doi=10.1017/S0007114512001456|pmid=22591897|title=Dietary sources of omega 3 fatty acids: public health risks and benefits|authors=Tur JA, Bibiloni MM, Sureda A, Pons A}}</ref> The effect of krill oil, at a lower dose of EPA + DHA (62.8%), was demonstrated to be similar to that of fish oil on blood lipid levels and markers of inflammation in healthy humans.<ref>{{cite journal | author = Ulven SM, Kirkhus B, Lamglait A, Basu S, Elind E, Haider T, Berge K, Vik H, Pedersen JI | title = Metabolic Effects of Krill Oil are Essentially Similar to Those of Fish Oil but at Lower Dose of EPA and DHA, in Healthy Volunteers | journal = Lipids | volume = 46 | issue = 1 | pages = 37–46 | date = January 2011 | pmid = 21042875 | pmc = 3024511 | doi = 10.1007/s11745-010-3490-4 }}</ref> While not an [[endangered species]], krill are a mainstay of the diets of many ocean-based species including whales, causing environmental and scientific concerns about their sustainability.<ref>{{cite journal|journal=Nature|volume=432|pages=100–103|issue=4 November 2004| authors=Atkinson A, Siegel V, Pakhomov E, Rothery P|title=Long-term decline in krill stock and increase in salps within the Southern Ocean|doi=10.1038/nature02996year=2004|url=http://www.nature.com/nature/journal/v432/n7013/abs/nature02996.html}}</ref><ref>{{cite web|url=http://www.stuff.co.nz/science/10093611/Malnutrition-behind-whale-strandings|title=Malnutrition behind whale strandings|author=Orr A|publisher=Stuff, Fairfax New Zealand Limited|date=2014|accessdate=8 August 2015}}</ref><ref>{{cite web|url=https://www.ccamlr.org/en/fisheries/krill-fisheries-and-sustainability|publisher=Commission for the Conservation of Antarctic Marine Living Resources, Tasmania, Australia|title=Krill fisheries and sustainability|date=2015|accessdate=8 August 2015}}</ref>

===Squid oil===
[[Squid as food|Squid]] oil (also known as calamari oil) is another source of omega-3 fatty acid.<ref>{{cite web|last=Horner|first=Hayden|title=Calamari: A source of omega-3|url=http://health365.com.au/articles/joint-health/calamari-a-source-of-omega-3|publisher=Health 365|accessdate=13 January 2014}}</ref> The editor of health365com.au considers squid environmentally friendlier than fish or krill oil, because it is prepared from the largely unused portions of squid catches.<ref>{{cite web|last=Editor|first=Health|title=Sustainability of calamari oil |url=http://health365.com.au/articles/cognitive-function/sustainability-of-calamari|publisher=Health 365|accessdate=13 January 2014}}</ref>

===Plant sources===
[[Image:Semillas de Chía.jpg|thumb|250px|[[Salvia hispanica|Chia]] is grown commercially for its seeds rich in ALA.]]
[[Image:Flax seeds.jpg|thumb|250px|[[Flax]] seeds produce [[linseed oil]] which has high ALA content]]

These tables are incomplete.

'''Table 1.''' [[alpha-linolenic acid|ALA]] content as the percentage of the seed oil.<ref name="sofadb">{{cite web| url = http://www.bfel.de/sofa| title = Seed Oil Fatty Acids - SOFA Database Retrieval}} In German. [http://translate.google.com/translate?tl=en&u=www.bfel.de/sofa Google translation]</ref>
{| class="wikitable" cellpadding="1"
|-
!|Common name||Alternative name||[[Linnaean name]]||% ALA
|-
|[[Kiwifruit seed oil]]||Chinese gooseberry||''[[Actinidia deliciosa]]''||63<ref>http://www.osel.co.nz/content/Product_Flyers/Kiwifruit.pdf</ref>
|-
|[[Perilla]]||shiso||''[[Perilla frutescens]]''||61
|-
|Chia seed ||chia sage||''[[Salvia hispanica]]''||58
|-
|[[Flax]]||linseed||''Linum usitatissimum''||53<ref name=def2006/> – 59<ref>http://www.osel.co.nz/content/Product_Flyers/FlaxSeedOil.pdf</ref>
|-
|Lingonberry||Cowberry||''[[Vaccinium vitis-idaea]]''||49
|-
|Camelina||Gold-of-pleasure||''[[Camelina sativa]]''||36
|-
|Purslane||[[Portulaca]]||''Portulaca oleracea''||35
|-
|Black raspberry|| ||''[[Rubus occidentalis]]''||33
|-
|[[Hemp]]|| ||''[[Cannabis sativa]]''||19
|-
|Canola|| || ||  9<ref name=def2006/> – 11
|}

'''Table 2.''' ALA content as the percentage of the whole food.<ref name="def2006"/><ref name="ngg">{{cite web | last = Wilkinson | first = Jennifer | title = Nut Grower's Guide: The Complete Handbook for Producers and Hobbyists | url = http://www.publish.csiro.au/samples/Nut%20Growers%20GuideSample.pdf | accessdate = 21 October 2007 |format=PDF}}</ref>
{| class="wikitable" cellpadding="1"
|-
!|Common name||[[Linnaean name]]||% ALA
|-
|Flaxseed ||''[[Linum usitatissimum]]''||18.1
|-
|Hempseed ||''[[Cannabis sativa]]''||8.7
|-
|Butternuts ||''[[Juglans cinerea]]'' ||8.7
|-
|Persian walnuts ||''[[Juglans regia]]'' ||6.3
|-
|Pecan nuts ||''[[Carya illinoinensis]]'' ||0.6
|-
|Hazel nuts ||''[[Corylus avellana]]'' ||0.1
|}
Flaxseed (or linseed) (''Linum usitatissimum'') and its oil are perhaps the most widely available [[botanical]] source of the omega-3 fatty acid ALA. [[Linseed oil|Flaxseed oil]] consists of approximately 55% ALA, which makes it six times richer than most fish oils in omega-3 fatty acids.<ref name="flaxcod">{{cite book|author=Thomas Bartram|title=Bartram's Encyclopedia of Herbal Medicine: The Definitive Guide to the Herbal Treatments of Diseases|date=September 2002|publisher=Da Capo Press|isbn=978-1-56924-550-7 | pages = 271}}</ref> A portion of this is converted by the body to EPA and DHA, though the actual converted percentage may differ between men and women.<ref>{{cite journal | author = Decsi T, Kennedy K | title = Sex-specific differences in essential fatty acid metabolism | journal = American Journal of Clinical Nutrition | volume = 94 | issue = 6_Suppl | pages = 1914S–1919S | year = 2011 | pmid = 22089435 | pmc = | doi = 10.3945/ajcn.110.000893 }}</ref>

100 g of the leaves of [[Portulaca oleracea|Purslane]] contains 300–400 mg ALA.<ref name="Simopolous1992">{{cite journal | author = Simopoulos AP, Norman HA, Gillaspy JE, Duke JA | title = Common purslane: a source of omega-3 fatty acids and antioxidants | journal = J Am Coll Nutr | volume = 11 | issue = 4 | pages = 374–382 | date = August 1992 | pmid = 1354675 | doi = 10.1080/07315724.1992.10718240 }}</ref>

In 2013 [[Rothamsted Research]] in the UK reported they had developed a genetically modified form of the plant [[Camelina]] that produced EPA and DHA. Oil from the seeds of this plant contained on average 11% EPA and 8% DHA in one development and 24% EPA in another.<ref>{{cite journal | author = Ruiz-Lopez N, Haslam RP, Napier JA, Sayanova O | title = Successful high-level accumulation of fish oil omega-3 long-chain polyunsaturated fatty acids in a transgenic oilseed crop | journal = The Plant Journal | volume = 77 | issue = 2 | pages = 198–208 | date = January 2014 | pmid = | pmc = | doi = 10.1111/tpj.12378 | url = http://onlinelibrary.wiley.com/doi/10.1111/tpj.12378/full }}</ref><ref>Coghlan, Andy (4 January 2014) "[http://www.newscientist.com/article/mg22129503.000-designer-plants-have-vital-fish-oils-in-their-seeds.html#.Us3gItIUQUo Designed plant oozes vital fish oils]" New Scientist, volume 221, issue 2950, page 12</ref>

===Eggs===
Eggs produced by hens fed a diet of greens and insects contain higher levels of omega-3 fatty acids than those produced by chickens fed corn or soybeans.<ref>{{cite web|url = http://www.medicalnewstoday.com/medicalnews.php?newsid=51575|title = How Omega-6s Usurped Omega-3s In US Diet}}</ref> In addition to feeding chickens insects and greens, fish oils may be added to their diets to increase the omega-3 fatty acid concentrations in eggs.<ref name="trebunová2007">{{cite journal | author = Trebunová A, Vasko L, Svedová M, Kastel' R, Tucková M, Mach P | title = The influence of omega-3 polyunsaturated fatty acids feeding on composition of fatty acids in fatty tissues and eggs of laying hens | journal = Deutsche Tierärztliche Wochenschrift | volume = 114 | issue = 7 | pages = 275–279 | date = July 2007 | pmid = 17724936 }}</ref>

The addition of flax and canola seeds to the diets of chickens, both good sources of alpha-linolenic acid, increases the omega-3 content of the eggs, predominantly DHA.<ref>Cherian, G. Effect of feeding full fat flax and canola seeds to laying hens on the fatty acids composition of eggs, embryos, and newly hatched chicks. http://agris.fao.org/agris-search/search/display.do?f=1991%2FUS%2FUS91146.xml%3BUS9138554</ref>

The addition of green algae or seaweed to the diets boosts the content of DHA and EPA, which are the forms of omega-3 approved by the FDA for medical claims. A common consumer complaint is "Omega-3 eggs can sometimes have a fishy taste if the hens are fed marine oils".<ref>{{cite news|url=http://www.huffingtonpost.com/2010/06/03/egg-taste-test-says-no-di_n_599286.html |title=Washington Post's Egg Taste Test Says Homegrown And Factory Eggs Taste The Same [UPDATED, POLL] |publisher=Huffingtonpost.com |date= 2010-06-03|accessdate=2011-01-03 |first=Colin |last=Sterling}}</ref>

===Meat===
Omega 3 fatty acids are formed in the chloroplasts of green leaves and algae. While seaweeds and algae are the source of omega 3 fatty acids present in fish, grass is the source of omega 3 fatty acids present in grass fed animals.<ref>{{cite journal | doi = 10.1038/187511b0 | title = Fatty Acid Composition of the Lipids of Pasture Grasses | year = 1960 | last1 = Garton | first1 = G. A. | journal = Nature | volume = 187 | issue = 4736 | pages = 511–512}}</ref> When cattle are taken off omega 3 fatty acid rich grass and shipped to a feedlot to be fattened on omega 3 fatty acid deficient grain, they begin losing their store of this beneficial fat. Each day that an animal spends in the feedlot, the amount of omega 3 fatty acids in its meat is diminished.<ref>{{cite journal | author = Duckett SK, Wagner DG, Yates LD, Dolezal HG, May SG | title = Effects of time on feed on beef nutrient composition | journal = J Anim Sci | volume = 71 | issue = 8 | pages = 2079–2088 | year = 1993 | pmid = 8376232 }}</ref>

The omega-6-to-omega-3 ratio of [[cattle feeding|grass-fed]] beef is about 2:1, making it a more useful source of omega-3 than grain-fed beef, which usually has a ratio of 4:1.<ref name="Duckett Animal Finishing" />

In a 2009 joint study by the USDA and researchers at Clemson University in South Carolina, grass-fed beef was compared with grain-finished beef. The researchers found that grass-finished beef is higher in moisture content, 42.5% lower total lipid content, 54% lower in total fatty acids, 54% higher in beta-carotene, 288% higher in vitamin E (alpha-tocopherol), higher in the B-vitamins thiamin and riboflavin, higher in the minerals calcium, magnesium, and potassium, 193% higher in total omega-3s, 117% higher in CLA (cis-9 trans-11, which is a potential cancer fighter), 90% higher in vaccenic acid (which can be transformed into CLA), lower in the saturated fats linked with heart disease, and has a healthier ratio of omega-6 to omega-3 fatty acids (1.65 vs 4.84). Protein and cholesterol content were equal.<ref name="Duckett Animal Finishing">{{cite journal | author = Duckett SK, Neel JP, Fontenot JP, Clapham WM | title = Effects of winter stocker growth rate and finishing system on: III. Tissue proximate, fatty acid, vitamin and cholesterol content | journal = Journal of Animal Science | volume = 87 | issue = 9 | pages = 2961–70 | year = 2009 | pmid = 19502506 | doi = 10.2527/jas.2009-1850 | url = http://jas.fass.org/content/early/2009/06/05/jas.2009-1850.full.pdf }}</ref>

In most countries, commercially available lamb is typically grass-fed, and thus higher in omega-3 than other grain-fed or grain-finished meat sources. In the United States, lamb is often finished (i.e., fattened before slaughter) with grain, resulting in lower omega-3.<ref>{{cite web|url=http://www.sheep101.info/labeledlamb.html|title=Specially Labeled Lamb}}</ref>

The omega-3 content of [[chicken]] meat may be enhanced by increasing the animals' dietary intake of grains high in omega-3, such as flax, chia, and canola.<ref>{{cite journal | author = Azcona, J.O., Schang, M.J., Garcia, P.T., Gallinger, C., R. Ayerza (h), and Coates, W. | year = 2008 | title = Omega-3 enriched broiler meat: The influence of dietary alpha-linolenic omega-3 fatty acid sources on growth, performance and meat fatty acid composition | journal = Canadian Journal of Animal Science | volume = 88 | pages = 257–269 | doi = 10.4141/CJAS07081 | issue = 2}}</ref>

[[Kangaroo meat]] is also a source of omega-3, with fillet and steak containing 74 mg per 100 g of raw meat.<ref>{{cite web|title=Gourment Game - Amazing Nutrition Facts|url=http://www.macromeats-gourmetgame.com.au/Nutrition/AmazingNutritionFacts.aspx}}</ref>

===Mammalian brains and eyes===

The [[Brain (food)|brains]] and eyes of mammals are extremely rich in DHA as well as other omega-3 fatty acids.<ref>{{cite web|title=DHA in Brain and Retina Structure|url=http://www.dha-in-mind.com/Portals/0/PDF%20Files/DHA_inbrain_and_retinastructure.pdf}}</ref> DHA is a major structural component of the mammalian brain, and is in fact the most abundant omega-3 fatty acid in the brain.<ref>{{cite web|title=Nutrition for the Brain|url=http://surfer.nmr.mgh.harvard.edu/ftp/articles/caudatecomm.pdf}}</ref>

===Seal oil===
Seal oil is a source of EPA, [[Docosapentaenoic acid|DPA]], and DHA. According to [[Health Canada]], it helps to support the development of the brain, eyes, and nerves in children up to 12 years of age.<ref>{{cite web|url=http://www.hc-sc.gc.ca/dhp-mps/prodnatur/applications/licen-prod/monograph/mono_seal_oil_huile_phoque-eng.php |title=Natural Health Product Monograph - Seal Oil |publisher=Health Canada |date=June 22, 2009 |accessdate=June 20, 2012}}</ref> However, like all [[Seal hunting#Products made from seals|seal products]], it is not allowed to be imported into the [[European Union]].<ref>{{cite web | last = European Parliament | authorlink = European Parliament | title = MEPs adopt strict conditions for the placing on the market of seal products in the European Union | work = Hearings | publisher = European Parliament | date = 9 November 2009 | url = http://www.europarl.europa.eu/sides/getDoc.do?pubRef=-//EP//TEXT+IM-PRESS+20090504IPR54952+0+DOC+XML+V0//EN | accessdate = 12 March 2010}}</ref>

===Other sources===
The microalgae ''[[Crypthecodinium cohnii]]'' and ''[[Schizochytrium]]'' are rich sources of DHA but not EPA, and can be produced commercially in [[bioreactor]]s. A mutant form of ''C. cohnii'' was found able to produce EPA amounting to 39% of the input biomass.<ref>{{cite journal |journal=Int J Mol Sci |title=Mutation breeding of extracellular polysaccharide-producing microalga Crypthecodinium cohnii by a novel mutagenesis with atmospheric and room temperature plasma |volume=16 |issue=4 |pages=8201–12 |doi=10.3390/ijms16048201 |author=Liu B, Sun Z, Ma X, Yang B, Jiang Y, Wei D, Chen F |date=13 April 2015 |pmid=25872142 }}</ref>

Oil from [[brown algae]] (kelp) is a source of EPA.<ref>{{cite journal | author = van Ginneken VJ, Helsper JP, de Visser W, van Keulen H, Brandenburg WA | title = Polyunsaturated fatty acids in various macroalgal species from north Atlantic and tropical seas | journal = Lipids in Health and Disease | volume = 10 | issue = 104 | pages = 104 | year = 2011 | pmid = 21696609 | pmc = 3131239 | doi = 10.1186/1476-511X-10-104 }}</ref> The alga ''[[Nannochloropsis]]'' also has high levels of EPA.<ref>{{cite journal | author = Collins ML, Lynch B, Barfield W, Bull A, Ryan AS, Astwood JD | title = Genetic and acute toxicological evaluation of an algal oil containing eicosapentaenoic acid (EPA) and palmitoleic acid | journal = Food and Chemical Toxicology | year = 2014 | pmid = 25057807 | doi = 10.1016/j.fct.2014.07.021 | volume=72 | pages=162–8}}</ref>

In 2006 the Journal of Dairy Science published a study which found that butter made from the milk of grass-fed cows contains substantially more CLA, vitamin E, beta-carotene, and omega-3 fatty acids than butter made from the milk of cows that have limited access to pasture.<ref>{{cite journal | author = Couvreur S, Hurtaud C, Lopez C, Delaby L, Peyraud JL | title = The linear relationship between the proportion of fresh grass in the cow diet, milk fatty acid composition, and butter properties | journal = Journal of Dairy Science | volume = 89 | issue = 6 | pages = 1956–69 | date = June 2006 | pmid = 16702259 | doi = 10.3168/jds.S0022-0302(06)72263-9 | url = http://www.journalofdairyscience.org/article/S0022-0302(06)72263-9/fulltext | accessdate = 16 March 2013 }}</ref>

===Risk of deficiency===
People with [[Phenylketonuria|PKU]] often have low intake of omega 3 fatty acids, because nutrients rich in omega 3 fatty acids are excluded from their diet due to high protein content.<ref name="pmid23827125">{{Cite journal | last1 = Lohner | first1 = S. | last2 = Fekete | first2 = K. | last3 = Decsi | first3 = T. | title = Lower n-3 long-chain polyunsaturated fatty acid values in patients with phenylketonuria: a systematic review and meta-analysis. | journal = Nutr Res | volume = 33 | issue = 7 | pages = 513–20 |date=Jul 2013 | doi = 10.1016/j.nutres.2013.05.003 | PMID = 23827125 }}</ref>

==References==
{{reflist|colwidth=30em}}

==Further reading==
{{Refbegin|colwidth=30em}}
* Allport, Susan. [http://worldcat.org/search?q=The+Queen+of+Fats%3A+Why+Omega-3s+Were+Removed+from+the+Western+Diet+and+What+We+Can+Do+to+Replace+Them&qt=mozilla-search ''The Queen of Fats: Why Omega-3s Were Removed from the Western Diet and What We Can Do to Replace Them'']. University of California Press, September 2006. ISBN 978-0-520-24282-1.
* Chow, Ching Kuang. [http://worldcat.org/oclc/25508943&referer=brief_results ''Fatty Acids in Foods and Their Health Implications'']. Routledge Publishing. New York. 2001.
*Clover, Charles. [http://worldcat.org/oclc/67383509&referer=brief_results ''The End of the Line: How overfishing is changing the world and what we eat'']. Ebury Press, London 2004. ISBN 0-09-189780-7
* Stoll, Andrew L. [http://worldcat.org/search?q=The+Omega-3+Connection&fq=ap%3AAndrew+L+Stoll&qt=facet_ap%3A ''The Omega-3 Connection'']. Simon & Schuster 2001. ISBN 0-684-87138-6.
{{Refend}}

==External links==

* University of Maryland Medical Center, [http://umm.edu/health/medical-reference-guide/complementary-and-alternative-medicine-guide/supplement/omega3-fatty-acids omega-3 Fatty Acids]


{{Lipids}}

{{DEFAULTSORT:Omega-3 Fatty Acid}}
[[Category:Fatty acids]]
[[Category:Biologically-based therapies]]
[[Category:Alkenoic acids]]