Posts Tagged ‘omega 3 cancer nutrition’

Omega 3 and benefits to Cancer / Cardio Health

Saturday, February 18th, 2012

A recent study reported that higher intakes of the long-chain omega-3s fish oil EPA /DHA are associated with a lower risk of adenomatous polyps in women (Murff et al., 2012).

The long-chain omega-3s have been shown to reduce the effects of cancer-related cachexia (Colomer et al., 2007).

There are a multitude of studies demonstrating increased effectiveness of anticancer agents by long-chain omega-3s. One such study is Bougnoux et al., 2009.

With respect to the results from the primary analysis reported back in 2010, the most likely reason the long-chain omega-3s did not prevent major cardiovascular events in patients with pre-existing cardiovascular disease is that the dose was too low (600 mg EPA + DHA). Consider that the American Heart Association recommends 1 g/day of EPA+DHA for individuals with coronary heart disease.

Omega 3 Fish Oil EPA , DHA Marine-derived n−3 (omega-3) PUFAs may reduce risk of developing colorectal / bowel cancer 3 Cancer

Saturday, February 18th, 2012

Background: Marine-derived n−3 (omega-3) PUFAs may reduce risk of developing colorectal cancer; however, few studies have investigated the association of n−3 PUFA intakes on colorectal polyp risk.

Objective: The objective of this study was to examine the associations of dietary PUFA intake on risk of colorectal adenomatous and hyperplastic polyps.

Design: This was a colonoscopy-based case-control study that included 3166 polyp-free control subjects, 1597 adenomatous polyp cases, and 544 hyperplastic polyp cases. Dietary PUFA intake was calculated from food-frequency questionnaires and tested for association by using unconditional logistic regression. The urinary prostaglandin E2 metabolite, which is a biomarker of prostaglandin E2 production, was measured in 896 participants by using liquid chromatography and tandem mass spectrometry.

Results: n−6 PUFAs were not associated with adenomatous or hyperplastic polyps in either men or women. Marine-derived n−3 PUFAs were associated with reduced risk of colorectal adenomas in women only, with an adjusted OR of 0.67 (95% CI: 0.47, 0.97) for the highest quintile of intake compared with the lowest quintile of intake (P-trend = 0.01). Dietary intake of α-linolenic acid was associated with an increased risk of hyperplastic polyps in men (P-trend = 0.03), which was not seen in women. In women, but not in men, dietary intake of marine-derived n−3 PUFAs was negatively correlated with urinary prostaglandin E2 production (r = −0.18; P = 0.002).

Conclusion: Higher intakes of marine-derived n−3 PUFAs / omega3 from fish oil are associated with lower risk of adenomatous polyps in women, and the association may be mediated in part through a reduction in the production of prostaglandin E2. This trial was registered at clinicaltrials.gov as NCT00625066.

Dietary intake of PUFAs and colorectal polyp risk1,2,3,4
Harvey J Murff, Martha J Shrubsole, Qiuyin Cai, Walter E Smalley, Qi Dai, Ginger L Milne, Reid M Ness, and Wei Zheng

Omega-3 Essential Fatty Acid EPA May Benefit Cancer Patients Undergoing Surgery, Study by NYU Researcher Finds

Tuesday, August 16th, 2011

Omega-3 Fatty Acids May Benefit Cancer Patients Undergoing Surgery, Study by NYU Researcher Finds

research published in the Annals of Surgery points to a potentially significant advance in the treatment of patients undergoing major cancer surgery. A randomized controlled trial showed that oral nutritional supplements with omega-3 fatty acids resulted in the preservation of muscle mass in patients undergoing surgery for esophageal cancer, a procedure normally associated with significant weight loss and quality-of-life issues.

The lead investigators of the study were John V. Reynolds, professor of surgery at Trinity College Dublin, and Aoife Ryan, assistant professor of nutrition at New York University’s Steinhardt School of Culture, Education, and Human Development*.

Omega 3 fats are essential fats found naturally in oily fish. Recently food manufacturers have begun to add omega 3 to foods such as yogurt, milk, juice, eggs, and infant formula in light of a body of scientific evidence which suggests that they reduce cardiovascular disease risk, reduce blood pressure, reduce clot formations, and reduce certain types of fat in the blood.

Given these health benefits, the researchers were interested to see whether omega 3 supplements could reduce post-operative weight loss among esophageal cancer patients. Previous studies had found that nutritional supplements containing one form of omega 3 fat, eicosapentaenoic acid (EPA), significantly reduced weight loss among inoperable cancer patients. Researchers hypothesized that a nutritional supplement rich in calories and a high dose of EPA would stem the debilitating weight loss seen in patients following esophageal surgery.

In a double-blinded randomized control trial, the gold standard in medical research, patients awaiting esophagectomy surgery were randomly assigned to treatment and control groups. While both groups received a 240ml nutritional supplement twice daily starting five days before surgery (which was identical in calories, protein, micronutrients, and flavor), patients in the treatment group received an enriched formula with omega 3 (2.2 gram EPA/day).

Immediately following surgery, the supplement was given through a feeding tube for 14 days while patients recovered in hospital. Once patients could resume oral feeding, they continued drinking the supplement until 21 days post surgery.

The researchers, working at St. James Hospital and Trinity College Dublin, found that patients given the standard feed (without EPA) suffered clinically severe weight loss post-surgery which was all muscle mass, while patients in the treatment group maintained all aspects of their body composition following surgery. Omega-3 fed patients also had better immune function, lower risk of fever post op, and significantly reduced levels of inflammatory markers in their blood.

“The results are intriguing, no previous study of nutritional support in the peri-operative period has revealed such a benefit,” said Ryan.

An accompanying editorial in the journal noted that Ryan’s study “is a significant step forward” in the management of patients undergoing surgery for esophageal and perhaps other complex cancers. “[Omega 3 based nutrition] should no longer be a surgeon’s preference, but the standard of expected norm for the practice of elected complex GI cancer surgery.”

Using specialized nutritional feeds with a highly purified form of EPA, the researchers were able to administer a dose of omega 3 that was much higher than that typically found in food. They noted that treatment with omega 3 enriched supplement is only slightly more expensive than traditional nutritional therapy, and previous studies have yielded significant cost-savings in the form of fewer complications following surgery using immuno-nutrition feeds similar to this.

“Initial treatments like this may be cost-effective for our cash-strapped health care system,” said Ryan.

Commenting on the study Reynolds noted “omega 3 enriched-nutrition appears to prevent the loss of muscle mass by modulating the body’s inflammatory response following surgery. Future studies on the health benefits of EPA supplements in cancer patients should be conducted to determine whether such approaches improve quality of life, reduce complications, and improve patient outcomes, not only after surgery but also through long and complex treatment programs which may include chemotherapy and radiation therapy in addition to surgery. We can speculate moreover that the findings of the study are not unique to cancer and that potential benefits should be explored in trial in patients following major non-cancer surgery, such as liver transplantation, cardiac surgery, and neurosurgery.”

Supplementation with omega 3 fish oil increases first-line chemotherapy efficacy in patients

Thursday, July 28th, 2011

BACKGROUND:
Palliative chemotherapy is aimed at increasing survival and palliating symptoms. However, the response rate to first-line chemotherapy in patients with nonsmall cell lung cancer (NSCLC) is less than 30%. Experimental studies have shown that supplementation with omega 3  fish oil (FO) can increase chemotherapy efficacy without negatively affecting nontarget tissue. This study evaluated whether the combination of omega3 and fish oil and chemotherapy (carboplatin with vinorelbine or gemcitabine) provided a benefit over standard of care (SOC) on response rate and clinical benefit from chemotherapy in patients with advanced NSCLC.

METHODS:
Forty-six patients completed the study, n = 31 in the SOC group and n = 15 in the Omega 3 Fish oil  group (2.5 g EPA + DHA/day). Response to chemotherapy was determined by clinical examination and imaging. Response rate was defined as the sum of complete response plus partial response, and clinical benefit was defined as the sum of complete response, partial response, and stable disease divided by the number of patients. Toxicities were graded by a nurse before each chemotherapy cycle. Survival was calculated 1 year after study enrollment.

RESULTS:
Patients in the omega 3 fish oil group had an increased response rate and greater clinical benefit compared with the SOC group (60.0% vs 25.8%, P = .008; 80.0% vs 41.9%, P = .02, respectively). The incidence of dose-limiting toxicity did not differ between groups (P = .46). One-year survival tended to be greater in the FO group (60.0% vs 38.7%; P = .15).

CONCLUSIONS:
Compared with SOC, supplementation with omega 3 fish oil  results in increased chemotherapy efficacy without affecting the toxicity profile and may contribute to increased survival. Cancer 2011;. © 2011 American Cancer Society.

Copyright © 2011 American Cancer Society.

higher intakes of marine-derived omega-3 fatty acids EPA and DHA which appear to be protective in non Hodgkin’s Lymphona (NHL)

Sunday, July 17th, 2011


In this population-based study, the dietary intake of various nutrients as well as the consumption of marine-derived omega-3 fatty acids and fish consumption was compared in 591 cases of non-Hodgkin’s Lymphoma (NHL) and compared to 460 healthy controls from a Swedish population (residents aged 18-27 years). A highly-significant inverse relationship between the intake of marine-derived omega-3 fatty acids as docosahexaenoic acid (DHA) plus eicosapentaenoic acid (EPA) combined and the risk of NHL was observed. With increasing intakes of DHA/EPA (combined) of >300 mg per 1000 kcal, a 40% lower risk of NHL was indicated as compared to those consuming less than 100 mg per 1000 kcal. Interestingly, no significant relationship between the consumption of total omega-3 fatty acids (which would include DHA/EPA plus a-linolenic acid which is consumed in much higher amounts than DHA/EPA) or omega-6 fatty acids and the risk of NHL was found. In addition, the authors reported that higher consumptions of fish (including salmon, mackerel, herring, cod) were also inversely correlated in a significant manner with the risk of NHL.

(It is noteworthy that the paper reports fish consumptions in fish servings/day ranging from <1.5 up to =3.0 in the higher intake sector. Upon evaluation of this paper, the DHA/EPA Omega-3 Institute contacted the lead author regarding an apparent error and has been assured by the lead author that the reported fish servings ‘per day’ as reported should actually have been in fish servings ‘per week’.)

Non-Hodgkin’s Lymphoma (NHL) – Lymphomas are cancers of the immune system involving lymphocytes (white blood cells) which can be sub-divided into non-Hodgkin’s lymphomas (NHL) and Hodgkin’s disease. In NHL, the white blood cells can progress abnormally within the lymph nodes and can also involve other organs associated with the immune system. While it may occur at any age, deaths due to NHL occur more often amongst the elderly (over the age of 65 years). Although a relatively uncommon cancer, the incidence of NHL is increasing rapidly in North America for unknown reasons.

Dr. Holub’s Comments:

Considering the surge in the frequency of NHL in North America and elsewhere during recent years, potential dietary strategies and public health advice for reducing the development of NHL are of considerable interest. This population-based study is therefore of potential importance in this regard. The higher intakes of marine-derived omega-3 fatty acids which appear to be protective against NHL (>300 mg per 1000 kcal) would amount to approximately 650 mg of DHA/EPA (combined) per day based on a daily caloric intake of approximately 2,150 kcal per day. It is interesting to note that this intake (650 mg/day) is the recommended acceptable intake suggested at the ISSFAL workshop held in 1999 in Bethesda , Maryland by a group of scientific experts who met to evaluate omega-3 fatty acids for overall health (J. Am. Coll. Nutr. 18: 487-489, 1999).

As noted (see above), in Prof. Holub’s conversation and correspondence exchange with Dr. Ellen Chang (lead author of this new release), = 3.0 servings of fatty fish per week (and not per day as stated in the original text of the published paper) provided an approximate 50% lower observed incidence of NHL as compared to fatty fish servings of <1.5 per week.

Nutrient Intake and Risk of Non-Hodgkin’s Lymphoma

Chang, Ellen T., et al., Am J Epidemiol. 164:1222-1232 (2006).

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
North

Summary:

Omega 3 fish oil EPA linked to reduce incidence of endometriosis

Sunday, July 17th, 2011
The study — which is the largest to have investigated the link between diet and endometriosis risk and the first prospective study to identify a modifiable risk factor for the condition — found that while the total amount of fat in the diet did not matter, the type of fat did. Women who ate the highest amount of long-chain Omega-3 fatty acids were 22% less likely to be diagnosed with endometriosis than those who ate the least and that those who ate the most trans fats had a 48% increased risk, compared with those who ate the least.
The findings from 70,709 American nurses followed for 12 years, published online in Europe’s leading reproductive medicine journal Human Reproduction, not only suggest that diet may be important in the development of endometriosis, but they also provide more evidence that a low fat diet is not necessarily the healthiest and further bolster the case for eliminating trans fats from the food supply, said the study’s leader, Dr. Stacey Missmer, an assistant professor of obstetrics, gynaecology and reproductive biology at Brigham and Women’s Hospital and Harvard Medical School in Boston, Massachusetts, USA.
“Millions of women worldwide suffer from endometriosis. Many women have been searching for something they can actually do for themselves, or their daughters, to reduce the risk of developing the disease, and these findings suggest that dietary changes may be something they can do. The results need to be confirmed by further research, but this study gives us a strong indication that we’re on the right track in identifying food rich in Omega-3 oils as protective for endometriosis and trans fats as detrimental,” Dr. Missmer added.
What is endometriosis  What are symptoms of endometrioisis
Endometriosis occurs when pieces of the womb lining, or endometrium, is found outside the womb. This tissue behaves in the same way as it does in the womb — growing during the menstrual cycle in response to oestrogen in anticipation of an egg being fertilized and shedding as blood when there’s no pregnancy. However, when it grows outside the womb, it is trapped and cannot leave the body as menstruation. Some women experience no symptoms, but for many it is very incapacitating, causing severe pain. The tissue can also stick to other organs, sometimes leading to infertility. It afflicts about 10% of women. The cause is poorly understood and there is no cure. Symptoms are traditionally treated with pain medication, hormone drugs or surgery.
In the study, the researchers collected information from 1989 to 2001 on 70,709 women enrolled in the U.S. Nurses Health Study cohort. They used three food-frequency questionnaires spaced at four-year intervals to record the women’s usual dietary habits over the preceding year. They categorized consumption of the various types of dietary fat into five levels and related that information to later confirmed diagnoses of endometriosis. A total of 1,199 women were diagnosed with the disease by the end of the study. The results were adjusted to eliminate any influence on the findings from factors such as total calorie intake, body mass index, number of children borne and race.
Long-chain Omega-3 fatty acids are found mostly in oily fish. They have been linked to reduced heart disease risk. In the study, the highest contributor was mayonnaise and full-fat salad dressing, followed by fatty fish such as tuna, salmon and mackerel.
Trans fats are artificially produced through hydrogenation, which turns liquid vegetable oil into solid fat. Used in thousands of processed foods, from snacks to ready-meals, they have already been linked to increased heart disease risk. Some countries and municipalities have banned them. The major sources of trans fats in this study were fried restaurant foods, margarine and crackers.
“Women tend to go to the Internet in particular to look for something they can do. The majority of the dietary recommendations they find there are the ones prescribed for heart health, but until now, those had not been evaluated specifically for endometriosis,” Dr. Missmer said. “This gives them information that is more tailored and provides evidence for another disease where it is the type of fat in the diet, rather than the total amount, that is important.”
Besides confirming the finding, a next step could be to investigate whether dietary intervention that reduces trans fats and increases Omega-3 oils can alleviate symptoms in women who already have endometriosis, Dr. Missmer added.
The U.S. National Institutes of Health funded the study.

Omega 3 Fish Oil benefits help prevent muscle loss in breast cancer and protects immune system

Tuesday, April 12th, 2011

Fish oil supplements may help prevent muscle loss in breast cancer survivors and help them ward off other chronic diseases, new research from Australia suggests.The study suggests there are clear benefits fish oil supplementation.

Loss of muscle mass shortly after cancer treatment is a common problem for breast cancer survivors.

The problem may be partly due to the presence of chronic inflammation, which causes a breakdown in muscle tissue.

But fish oils interfere with inflammation, thereby reducing its effect.

University of Queensland researcher Cameron McDonald says exercise is effective in rebuilding lost muscle but it’s often hard to maintain over time.

He says muscle loss exposes survivors to the prospect of earlier onset, or exacerbated, obesity-related chronic diseases such as cardiovascular disease and diabetes.

“If fish oil supplementation is effective in preventing muscle loss before it occurs, or even more effective when used in conjunction with exercise, it could significantly decrease the risk of survivors developing a chronic disease,” the PhD student says.

Research is still in its early stages and clinical trials are set to start later in the year.

Omega 3 Fish Oil benefits Intensifies the positive effect of Tamoxifen

Monday, April 11th, 2011

Female mice that ingested fish oil supplements with breast cancer drug tamoxifen appeared to have slowed the proliferation of their tumors, compared to rodents given corn oil with the drug, according to researchers at Fox Chase Cancer Center.

In the controlled study, the team of scientists found that the omega-3 fatty acids found in fish oil helped to slow gene expression related to tumor growth.

“If a tumor was being treated with tamoxifen, the addition of an omega-3 fatty acid diet seemed to make the tumor, at least at the molecular level, more benign and less aggressive and responsive to tamoxifen,” said lead researcher Jose Russo, M.D. TakeOmega3 due to its unique high EPA formulation with 750mg EPA per capsule and its high purity of 85% omega3 would be the ideal omega3 supplement to take alongside Tamoxifen . TakeOmega3 offers the highest concentration currently available and it is uniquely manufactured in facilities licensed by MHRA (Medical Health & Regulatory Authority) here in UK . No other omega3 supplement currently offers these benefits .

Additionally, the healthy fats appeared to curb immune responses that result in allergies and inflammation. These negative effects have been known to alter the body’s natural defense against cancer.

Next, the researchers hope to investigate how omega-3 fatty acids in a diet can affect risk of breast cancer in women.

Authors of the study noted that an estimated 200,000 women are diagnosed with the disease each year.

Breast cancer is the second most common cancer among women, with more than 200,000 women diagnosed each year. Being exposed to estrogen over a long period of time is one factor that can increase a woman’s risk of developing the disease. One way a woman can combat this risk factor is by taking the breast cancer drug tamoxifen, which interferes with the activity of estrogen. Now, researchers at Fox Chase Cancer Center have found that omega-3 fatty acids — abundant in fish — could be a safe and beneficial booster for tamoxifen therapy.

Jose Russo, MD, director of the Breast Cancer Research Laboratory at Fox Chase, is presenting the new findings at the AACR 102nd Annual Meeting 2011 on April 6.
To investigate how fish oil intensifies the effects of tamoxifen, Russo, in collaboration with a team led by Andrea Manni, MD, from Pennsylvania State University, induced mammary tumors in rats and then divided the animals into four groups. They fed the groups either a 17 percent fish oil diet, with or without tamoxifen, or a 20 percent corn oil diet, with or without tamoxifen, for eight weeks. They then analyzed gene expression patterns in the tumors. Omega-3 fatty acids produced a greater expression of genes related to cellular specialization, or differentiation — a sign of lower cancer severity — compared to corn oil. The combination of fish oil and tamoxifen reduced the expression of genes linked to tumor growth and spreading.

“The fish oil diet also boosted the expression of genes related to immune defenses against tumors, more so than did the corn oil diet. But omega-3 fatty acids simultaneously increased the expression of genes that trigger counterproductive immune responses, such as inflammation and allergic reactions, which curtail the ability of cells to fight cancer and can even promote the migration of tumor cells.

More studies are needed to fully understand the effects of fish oil on the immune system, Russo says. Meanwhile, his team is examining whether omega-3 fatty acids can prevent breast cancer in animals and testing the influence of diet on breast cancer risk in women.

Co-authors on the study include Bidinotto, L.T.; Vanegas, J.E.; Vanden Heuvel, J.P.; Lopez, R.; Santucci-Pereira, J.; Washington, S., Xu; H., Russo I.H.; El-Bayoumy, K.; and Manni, A. from Fox Chase.

Nutrition in Cancer and the benefits of Omega 3 Take Omega3

Monday, March 21st, 2011

Recent study has shown that Omega3 specifically EPA may have a unique role in the prevention of weightloss muscle loss often associated when undergoing Chemotherapy. To date there has been no solution to this however this recent study shows the importance omega3
supplementation may play in those people undergoing treatment .TakeOmega 3 high EPA supplements may help chemotherapy patients
Omega-3 fish oil supplements high in EPA may help cancer patients to prevent the muscle loss and malnutrition which commonly accompanies chemotherapy, according to new research.

EPA rich omega-3 supplements may help chemotherapy patients, say researchers.

The study, published in Cancer found that patients supplemented with 2.2 grams of eicosapentaenoic acid per day maintained weight, muscle mass, and adipose tissue throughout approximately 10 weeks of chemotherapy despite having a mean weight loss of 6.3 percent over the previous 6 months.

In the same time, patients receiving standard treatment with no supplementation were found to loose an average of 2.3 kilograms.

“Fish oil may prevent loss of weight and muscle by interfering with some of the pathways that are altered in advanced cancer … This holds great promise because currently there is no effective treatment for cancer-related malnutrition,” said Dr. Vera Mazurak, from the University of Alberta, Canada, who led the study.

The researchers said that a nutritional intervention with two grams of fish oil (in the form of EPA) per day may provide a benefit over standard care, by allowing cancer patients to maintain weight and muscle mass during chemotherapy.

TakeOmega 3 high EPA supplements may help chemotherapy patients

Tuesday, March 8th, 2011

Omega-3  fish oil supplements  high in EPA may help cancer patients to prevent the muscle loss and malnutrition which commonly accompanies chemotherapy, according to new research.

EPA rich omega-3 supplements may help chemotherapy patients, say researchers.

The study, published in Cancer found that patients supplemented with 2.2 grams of eicosapentaenoic acid  per day maintained weight, muscle mass, and adipose tissue throughout approximately 10 weeks of chemotherapy despite having a mean weight loss of 6.3 percent over the previous 6 months.

In the same time, patients receiving standard treatment with no supplementation were found to loose an average of 2.3 kilograms.

“Fish oil may prevent loss of weight and muscle by interfering with some of the pathways that are altered in advanced cancer … This holds great promise because currently there is no effective treatment for cancer-related malnutrition,” said Dr. Vera Mazurak, from the University of Alberta, Canada, who led the study.

The researchers said that a nutritional intervention with two grams of fish oil (in the form of EPA) per day may provide a benefit over standard care, by allowing cancer patients to maintain weight and muscle mass during chemotherapy.

Omega-3 for the big C?

Chemotherapy can cause cancer patients to lose muscle mass and become malnourished, leading to fatigue, decreased quality of life, an inability to receive necessary treatments, and shorter survival.

The researchers explained that previous studies have suggested that supplementing the diet with fish oil – which contains omega-3 fatty acids such as eicosapentaenoic acid (EPA) – may help patients maintain or gain muscle mass.

To test the theory the team compared the effects of fish oil with that of standard care (with no supplementation) on weight, muscle, and fat tissue in newly referred non-small cell lung cancer patients.

Computed tomography (CT), a form of medical imaging that can precisely quantify skeletal muscle, was used by the researchers to assess the effects of EPA supplementation on skeletal muscle in patients undergoing chemotherapy.

“The efficacy of fish oil to prevent muscle loss has been the focus of several studies, but to the best of our knowledge the current study is the first to use CT images to provide a direct measurement of the effect of fish oil on skeletal muscle and adipose tissue depots,” said the researchers.

They added that the study was also unique in using an early intervention in newly referred patients –with the goal of preventing weight and muscle loss during chemotherapy.

Study details

Mazurak and her colleagues reported that 40 patients completed the study; with 16 receiving EPA fish oil supplementation (at a dose of 2.2 grams of EPA per day), and 24 patients receiving standard care.

Skeletal muscle and adipose tissue were measured using CT images, whilst blood was collected and weight was recorded at baseline and throughout chemotherapy.

The authors reported that patients receiving standard care experienced an average weight loss of 2.3 kilograms, whereas patients receiving EPA supplementation maintained their weight.

Blood analyses revealed that the patients with the largest rise in bloodstream EPA concentrations also had the greatest muscle mass gains.

Mazurak and co-workers reported that nearly 70 percent of those in the fish oil group either maintained their pre-chemotherapy muscle mass or gained mass. By comparison, less than 30 percent of the non-fish oil group maintained their original muscle mass, they added.

Fishy benefit

They research team said the results of the study indicate that supplementation with EPA fish oil reduces muscle and adipose tissue wasting in lung cancer patients, and provides a benefit over patients treated with standard care and receiving chemotherapy.

Mazurak and her colleagues noted that fish oil may be beneficial to patients with other forms of cancer and other chronic diseases that are associated with malnutrition, as well as to elderly individuals who are at risk for muscle loss. However, they noted that the results of the current study “require verification in larger randomized tria

Great Britain Flag
Made in the UK - Take Omega 3 Suspendisse lacinia ultricies justo, at ultricies nisi tempus ac. Cras sed vehicula metus. Phasellus...