A barrier to the implementation of fish oil treatment for inflammatory diseases has been the high cost and inconvenience of taking fish oil capsules in sufficient number to achieve an ahti-inflammatory effect. For example, 10 or more standard fish oil capsules daily are needed to achieve an anti-inflammatory dose. By taking fish oil on juice, an anti-inflammatory dose can be taken easily in a single swallow. The following method is recommended to avoid the taste of fish oil and to prevent “repeating” of the fish taste.

• Pour — 40ml juice into a small glass (eg. a shot’ or sherry glass)
• Pour — 30ml of juice into another small glass. Using one hand, layer the desired dose of fish oil (e.g. 15ml) onto the surface – do not stir.
• Using this hand, take up the glass with the juice and oil and swallow contents in a single gulp. Try to avoid contact of the contents with the lips (where the oil can be tasted).
• Immediately follow with juice from the other glass. Hold this glass in the other hand (to avoid smelling the fish oil) and sip slowly through the lips (to mask the taste of any oil on the lips.)
• Choose any juice, e.g. orange, tomato, vegetable and apple juice are OK. Cordial or any other strongly flavoured drink can also be used. Avoid carbonated beverages, which because of their gaseous content, cause burping and “repeating” of the fish taste.
• Take the fish oil immediately before a solid meal and without further fluid. This avoids floatingof the oil on fluid in the stomach and favours mixing of the fish oil with food and passage from the stomach into the intestine. If reflux (repeating taste) becomes a problem, split the dose before morning and evening meals. Alternatively, take the dose then lie on the left side for at least 15 minutes. In this position the oil floats into the passage from the stomach to the small intestine.
• Fish oil (obtained from the body of the fish) is preferable to cod liver oil, which can deliver undesirable amounts of vitamin A at anti-inflammatory doses.
• Bottled fish oil -should be kept refrigerated after opening, preferably on a small saucer or butter dish, as some oil may run down the side of the bottle after pouring.
• In the refrigerator, a cloud generally forms toward the bottom of the bottle, due to crystallisation of less saturated fats within the oil. These tend to settle to the bottom of the-bottle. They do not reduce the concentration of desired omega-3 fats significantly. Do not shake the bottle – some sediment can be discarded when the bottle is almost empty. To maximise use of contents, leave unrefrigerated when bottle almost spent.

Breakfast

• Add 2 tablespoons of fresh ground linseed to cut fruit and then add low fat milk. Additional cereal can be add2d according to individual preference. Ground linseed can be mixed with oats then cooked to make porridge.

Evening

• Before a meal fake the fish oil supplement by adding 10 tol5 ml oil to approximately 30 ml juice (e.g. orange, apple, tomato or vegetable juice)-allow oil to form an upper layer (do not stir). Take this in a single gulp. Avoid the lips where one would taste the fish oil. Follow immediately with Juice from a separate glass. The second glass should be drunk slowly through the lips.
• Fish oil should be kept in the refrigerator after opening. A cloud may form because some of the oil crystallizes in the cold. This is not a cause for concern. Do not shake.
• Bottled omega-3 fish oil is available through the Preventive Care Centre, Main Foyer, Royal Adelaide Hospital, North Terrace, Adelaide SA 5000. Telephone 8222 5219 or 8222 2748. Fax 8222 2752.

General

• Use canola or olive oil-based spreads, mayonnaise, salad dressing (e.g. Gold’n Canola spread).
• Eat two or more fish meals per week

• Foods that are- rich in omega-3 fats provide benefits for people who have inflammatory diseases, such as rheumatoid arthritis. Dietary omega-3 fats have also been shown to reduce risk for heart disease.
• To increase the omega-3 level in your diet, follow the guidelines listed below. Most omega-3 rich foods can be substituted for of her foods in your diet. For inflammatory diseases; fish oil supplements are needed to achieve the anti-inflammatory dose. Changing the background diet increases the effect of fish oil
• The omega-3 fats that come from fish are more effective in increasing tissue omega-3 levels than those derived from plant sources (e.g. linseed, a.k.a. flaxseed). A combination achieves the best effects.

• 1. Try to eat fish two-three times a week.
  2. When dining out, choose a fish dish from the menu.
  3. Canned salmon or sardines (but not canned tuna) makes an ideal omega-3 rich sandwich filling. (Note: Much of the omega-3 fat is removed from canned tuna during processing)
  4. Fish oil supplements are an effective -way of increasing your omega-3 intake. Bottled fish oil is an inexpensive means of achieving desired levels of dietary omega-3 fat enrichment (More than 4G of omega-3 fats are present in 15ml of fish oil) Fish oil can also be taken in capsule form. Capsules with high concentrations of omega-3 fatty acids (greater than 500mg per I G capsule) are most convenient but • most expensive. In any case, for optimal anti-inflammatory effect, the total number of capsules should be sufficient to deliver at least 3G total of omega-3 fats (e.g. 10 standard fish oil capsules, 6 Omega capsules) .

Fresh ground linseed makes a pleasant fasting breakfast cereal. Ground linseed can also be, used in baking (cakes, muffins). Linseed can be bought at most supermarkets and can be conveniently ground before use-in an inexpensive electric coffee grinder of the rotating blade-in-cup with press fop variety