ORIGINAL COMMUNICATION A practical approach to increasing intakes of n-3 polyunsaturated fatty acids: use of novel foods enriched with n-3 fats RG Metcalf 1 *, MJ James 1 , E Mantzioris 1 and LG Cleland 1 1 Department of Rheumatology, Royal Adelaide Hospital, Adelaide, SA, Australia Objectives: To assess the effects of providing a wide range of foodstuffs containing n-3 polyunsaturated fatty acids (PUFA), occurring naturally or from fortification, on intake and blood and tissue proportions of n-3 PUFA. Design: Before/after dietary intervention study. Setting: Adelaide, Australia. Subjects: 16 healthy males recruited from the community. Interventions: Subjects were provided with a range of foodstuffs naturally containing n-3 PUFA (fresh fish, canned fish, flaxseed meal, canola oil) and items fortified with fish oil (margarine spread, milk, sausages, luncheon meat, french onion dip). Food choices were left to the discretion of each subject. Intake was estimated by diet diary. Blood was collected atF2, 0, 2, and 4 weeks for fatty acid analysis. Main outcome measures: Dietary intakes; plasma, platelet, and mononuclear cell phospholipid fatty acids. Results: Consumption of n-3 PUFA increased significantly: a-linolenic acid (ALA) from 1.4 to 4.1 g/day (Po0.001), eicosapentaenoic acid (EPA) from 0.03 to 0.51 g/day (Po0.001), and docosahexaenoic acid (DHA) from 0.09 to 1.01 g/day (Po0.001). Linoleic acid (LA) intake decreased from 13.1 to 9.2 g/day (Po0.001). The proportions of EPA and DHA increased significantly in all phospholipid pools examined; plasma EPA from 1.13% of total fatty acids to 3.38% (Po0.001) and DHA from 3.76 to 7.23% (Po0.001); mononuclear cell EPA from 0.40 to 1.25% (Po0.001) and DHA from 2.33 to 4.08% (Po0.001); platelet EPA from 0.41 to 1.2% (Po0.001) and DHA from 1.64 to 3.07% (Po0.001). Conclusion: Incorporating fish oil into a range of novel commercial foods provides the opportunity for wider public consumption of n-3 PUFA with their associated health benefits. Sponsorship: Dawes Scholarship, Royal Adelaide Hospital. European Journal of Clinical Nutrition (2003) 57, 1605–1612. doi:10.1038/sj.ejcn.1601731 Keywords: fish oils; fatty acids; omega-3; food; dietary fats Introduction There is a considerable body of evidence demonstrating that the regular consumption of n-3 polyunsaturated fatty acids (PUFA) as fish, fish oil, or vegetable oil, is associated with significant health benefits in cardiovascular disease (Hu et al, 2001) and rheumatoid arthritis (Cleland & James, 2000). Fish oil contains the long-chain n-3 PUFA (LC n-3 PUFA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The n-3 containing vegetable oils, primarily flax, canola, and soy, contain the shorter chain n-3 PUFA, a-linolenic acid (ALA). Increased consumption of n-3 fatty acids has been recommended by health authorities in Canada (Scientific Review Committee, 1990) and the United Kingdom (The British Nutrition Foundation, 1992), and daily intakes of about 200–400 mg of LC n-3 PUFA have been recommended in Europe and the US (de Deckere et al, 1998; Simopoulos et al, 2000). Received 24 October 2002; revised 18 December 2002; accepted 25 December 2002 *Correspondence: RG Metcalf, Department of Rheumatology, Royal Adelaide Hospital, North Tce, Adelaide, SA 5000, Australia. E-mail: robert.metcalf@adelaide.edu.au Guarantor: MJ James Contributors: RGM participated in study design, recruitment, labora- tory analyses, data collection, data analysis, writing and editing of the report. EM participated in study design and advice on study management. MJJ and LGC participated in study design, obtaining funding and editing of the report. European Journal of Clinical Nutrition (2003) 57, 1605–1612 & 2003 Nature Publishing Group All rights reserved 0954-3007/03 $25.00 www.nature.com/ejcn