Efficacy of fish oil supplementation for treatment of moderate elevation of serum cholesterol.

A study was performed to determine the efficacy and feasibility of using fish oil capsules for treatment of moderate hypercholesterolemia. Thirty-three subjects, randomized to fish or olive oil, took two 1-g capsules with each meal for 12 weeks. Each subject crossed over to the alternate treatment at 12 weeks. Patients maintained usual levels of exercise and diet for 24 weeks. Eight subjects dropped out. For the group starting fish oil (n = 13), the average baseline cholesterol level was 6.336 mmol/L (245.0 mg/dL) and was 6.341 mmol/L (245.2 mg/dL) after 12 weeks. High-density lipoprotein cholesterol (HDL-C) and calculated low-density lipoprotein cholesterol (LDL-C) baseline levels were 1.459 mmol/L (56.4 mg/dL) and 4.332 mmol/L (167.5 mg/dL); 1.474 mmol/L (57.0 mg/dL) and 4.479 mmol/L (173.2 mg/dL), respectively, after fish oil supplementation. In the group that began with olive oil (n = 12), baseline total cholesterol level was 6.274 mmol/L (242.6 mg/dL); HDL-C and calculated LDL-C baseline levels were 1.386 mmol/L (53.6 mg/dL) and 3.988 mmol/L (154.2 mg/dL). When mean baseline levels were compared with post-fish-oil values for the entire population, no significant change in total cholesterol or LDL-HDL ratio was obtained. Triglyceride responses to fish oil were variable. Values after olive oil treatment were neither significantly different from baseline nor different from fish oil. It was concluded that fish oil in manufacturer's recommended dosage does not appear to lower moderately elevated cholesterol levels.

A one-year follow-up of fatigued patients.

To better understand the complaint "fatigue" and the characteristic features of patients who present with this problem, a one-year follow-up study was performed in a county health center. One hundred-fifteen fatigued adults were identified using scores on the Rand Index of Vitality (RIV). One hundred thirty-nine patients of similar age, sex, and socioeconomic status were identified as nonfatigued. One year later, these patients were followed up with a chart review, reassessment of fatigue (by RIV score), and a telephone interview. Seventy-three (64 percent) fatigued and 72 (53 percent) nonfatigued patients provided this information. On the RIV, 31 patients moved from the fatigued group to nonfatigued, and 15 nonfatigued patients' scores changed to the fatigued category. Patients categorized as fatigued in 1984 (by RIV score) returned for office visits more often (mean of 3.85 vs 2.51, P less than .05), and developed significantly more new diagnoses (2.75 vs 1.68, P less than .05) over the follow-up year, compared with those not fatigued. Fatigued patients also had a greater proportion of diagnoses containing a psychologic component than nonfatigued patients. Persistence of fatigue over the year was significantly associated with race and education (nonwhites and those completing high school remaining fatigued). No significant association between marital status, age, sex, employment status, and either the resolution or development of fatigue over the year was found.

Demographic correlates of fatigue in a university family health centre.

To delineate the demographic correlates of the fatigued patient, 297 patients attending a family practice centre were investigated. Women were more frequently tired than were men; patients with less than a college education were over-represented, and employed persons were more robust than the unemployed. Fatigue was also associated with lack of exercise, nightly wakening and the presence of children less than six years old in the household. There were no significant relationships between fatigue and age, smoking or 'reducing' diets. The results of the study shed new light on the correlates of fatigue and confirmed some long-standing beliefs.

Fatigue of unknown aetiology--a review.

The patient complaining of fatigue presents the physician with the dilemma of distinguishing a psychological disorder from a physical illness in its early stage. Information relating this nonspecific complaint to specific diagnoses is scarce. Consequently, laboratory investigation of fatigue has been empirical. Five separate reports of patients with fatigue (n = 940) are reviewed. 'Psychologic' causes accounted for 57% of cases. Of the 36.7% of cases with 'physical' causes, infection represented the largest group followed by cardiovascular and endocrine abnormalities. In these reports, the cases of cancer and connective tissue disease was remarkably few (1% each). Duration of fatigue and patient age may be important clues to the underlying diagnosis. Appropriate laboratory investigations and suitable areas for future research are suggested.