COD LIVER OIL

Cod liver oil provides muliple health benefits; research finds. Cod liver oil is a good source of vitamin A, vitamin D and omega-3-fatty acids (EPA
and DHA). Vitamin A plays an important role in the healthy functioning of the immune system and to resist bacterial and viral infections. Vitamin A
is known to benefit good eyesight. Low intake of vitamin may lead to dry eyelids and poor night vision. Vitamin D helps to maintain strong and
healthy bones. Omega-3 fatty acids have anti-inflammatory properties and help relieve the symptoms of arthritis and other inflammatory
conditions.

WHAT IS COD LIVER OIL?
Cod liver oil is an oil extracted from cod livers. It was once a popular
nutrititonal supplement for children, as it provides multiple health benefits to
the young kids. Cod liver oil is made by streaming cod livers and then
decanting the cooked livers to extract the oil, while, fish oils are extracted
from the cooked whole body tissues of fatty fish. Though cod liver oil and fish
oils are similar, cod liver oil contains much more vitamins A and D per unit
weight than regular fish oil. A high quality cod liver oil is pale-yellow, thin, oily
liquid with fishy taste.

COD LIVER OIL HEALTH BENEFITS AND SIDE
EFFECTS-SCIENTIFIC EVIDENCE

WHAT ARE THE HEALTH BENEFITS OF COD LIVER OIL?

The health benefits of cod liver oil on arthritis have been demonstrated.
Cod liver oil has been demonstrated in several studies that mimic cartilage
destruction in arthritic disease. [3] Forty three patients with rheumatoid
arthritis took 1g of cod liver oil daily for 3 months. They found Improvement in
morning stiffness, painful and swollen joints. Ratings of "good" or "very good"
were awarded by 68% of the patients for cod liver oil efficacy and by 95% for
cod liver oil tolerability. Eleven patients reported non severse adverse effects
during the course of taking cod liver oil.[4]

Maternal intake of cod liver oil during pregnancy may have benefits on
newborns.
Maternal intake of cod liver oil early in pregnancy was associated with a
higher birthweight. Higher birthweight always indicates a lower risk of
diseases later in life. [5] In addition, a study has shown that taking fish oil
supplements during pregnancy may help prevent allergies in babies born to
women with a history of hay fever or asthma. In this study, the women took
four capsules a day from the 20th week of pregnancy until delivery. The
researchers found that babies' immune cells has less reaction to allergic
substances. [22]

A study shows that maternal intake of very-long-chain n-3 polyunsaturated
fatty acids (cod liver oil) during pregnancy and lactation may be favorable for
later mental development of children. [6] A study of rats has demonstrated
that fish oil supplementation during pregnancy improved cognitive
performance and maintained glucose levels into adulthood. [6]

Cod liver oil taken during pregnancy was found to assciate with reduced risk
of Type I diabetes [ a survey (85 diabetic subjects and 1,071 controls]. [7]

Cod liver oil may also have multiple benefits on young children.
The amount of vitamin D activity in a teaspoon of cod liver oil was sufficient to
prevent rickets in infants. [10] In a study, cod liver oil prevented the
development of rickets in 34 (92%) of 37 infants treated for 6 months. [11] In
another study of 65 infants, daily cod liver oil prevented the development of
rickets in 34 of 37 infants treated for 6 months. [A1]

In a study, cod liver oil together with multivitamin-mineral and selenium was
effective in chronic/recurrent sinusitis (children). [1] In this study, the cod liver
oil was well-acceptable to the children. [8] Children received 1 teaspoon of
cod liver oil per day and one half-tablet of multivitamin-mineral had a
statistically significant decrease in the mean number of clinical visits (for upper
respiratory tract} over time, while the control group had no change in this
parameter. The cod liver oil was well tolerated, per parental report, 70%of
children completed the 5-6 month course of cod liver oil. [9]

A study of 545 childhood-onset type 1 diabetes and 1668 population control
subjects in Norway shows the use of cod liver oil in the first year of life
associated with a significantly lower risk of type 1 diabetes. [12]

Researchers have shown the benefits of cod liver oil on various diseases
-cancer, diabetes mellitus, fractures,Musculoskeletal Pain, Nephrotoxicity,
Endothelium-dependent Coronary Vasodilation and cholesterol.

Cancer Vitamin D was reported to help ward off many types of cancer, such as
lymphoma, prostate, lung and skin cancers. [13]

Diabetes Mellitus Lipid disorders and increased oxidative stress may
exacerbate some complications of diabetes mellitus. Some ingredients in cod
liver oil such as antioxidants, PUFAs, EPA and DHA may help protect the cells
from the destructive effect of increased lipids and lipid peroxidation products.

Diabetic rats were divided randomly into two groups as untreated or treated
with cod liver oil for 12 weeks. Plasma glucose, triacylglycerol and cholesterol
levels were significantly elevated in the untreated rats. Cod liver oil treatment
provided a better control on lipid and glucose metabolism. Cod liver oil also
provided better weight gain in diabetic rats. [14]

Fracture Combination of vitamin D and calcium may prevent fragility fracture in
elderly. [15] Multivitamin or cod liver oil supplementation was found to be
associated with a significantly lower risk of any fracture in a study of older
women. [A2]

Musculoskeletal Pain Study of 4490 cases from the Norwegian Health Survery
demonstrated that people with mucoloskeletal pain experienced less pain if
they took cod liver oil. [16]

Nephrotoxicity In a study, cod-liver oil containing eicosapentaenoic acid
helped improvement on microvascular albumin leakage in diabetic patients
with albuminuria.[17].

Oral supplementation with fish oil prior to and during gentamicin exposure
could markedly ameliorate the drug induced nephrotoxicity. [18]

Cod liver oil was shown to protect the mice from daunomycin-induced
nephropathy by inhibiting oxidative damage. Dietary cod liver oil significantly
reduced urinary albumin excretion and ameliorated the histological changes
induced by daunomycin. Compared to soybean oil(SO)-fed mice, the increase
of tissue lipid peroxide levels was suppressed in cod liver oil-fed mice. Cod
liver oil-fed mice showed higher GSH levels than SO-fed mice throughout the
experiment. [19]

Endothelium-dependent Coronary Vasodilation In a study of a group known
to have coronary artery disease and endothelial dysfunction, dietary fish oil
supplementation enhanced endothelium-mediated vasodilator responses in
human heart transplant recipients. [20]

Cholesterol Researchers successfully decreased serum cholesterol, low
density lipoprotein cholesterol and triglycerides in18 normolipemic pigs with
cod liver oil.

B. COD LIVER OIL SIDE EFFECTS
A study shows that high doses of cod liver oil may increase blood pressure.
Otherwise, cod liver oil is safe. Cod liver oil was well-tolerated in most
studies, only a few cases of non-severse side effects have been reported [1].

Do not exceed the recommended daily dose of cod liver oil. Vitamins A and
D are fat-soluble. Intake of large amounts of vitamins A and D wil lead to toxic
levels.

Do not over-cook the cod liver oil Salmon and cod liver oils produced toxic
malonaldehyde, glyoxal and methylglyoxal when these oils were heated at 60
degrees C for 7 days. During cooking (200C 1h), salmon and cod liver oils
produced more these chemicals than vegetable oils did, probably, salmon and
cod liver oils contain more long chain PUFA such as EPA and DHA.[2]
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QUESTIONS ABOUT COD LIVER OIL
WHAT DOES A COD LIVER OIL SOFT GEL CAPSULE CONTAIN?
A. CARLSON COD LIVER OIL
From the product label of regular Carlson Cod Liver Oil, 1 serving (1 soft gel)
contains 1 g of total fat, 4 mg of cholesterol, 2000 IU of vitamin A (from cod
liver oil), 250 IU of vitamin D (from cod liver oil), 10 IU of vitamin E Natural
(d-Alpha Tocopherol), 240 mg of omega-3 fatty acids (from cod liver oil), 90 mg
of eicosapentaenoic acid, 120 mg of docosahexaenoic acid), 20 mg of ALA
(alpha-linolenic acid) and 10 mg of DPA (Docosapentaenoic acid).
B. SEVEN SEAS ONE-A-DAY Standard - COD LIVER OIL
Based on the Seven Seas' Ad (September 20, 2005), the standard strength
(525 mg) of pure cod liver oil contains 525 mg of pure cod liver oil, 120 mg of
omega 3 nutrients, 83.2 mg of which EPA and DHA, 800 ug of Vitamin A, 2.5
ug of Vitamin D, 0.33 mg of Vitamin E. Other ingredients include capsule shell
(modified maize starch, glycerol, gelling agent: carrageenan, acidity regulator:
disodium phosphate), Vitamin A (as Palmitate prep), Vitamin D3 (as D3 prep),
Vitamin E (d Alpha Tocopheryl Acetate). They recommend to take one capsule
with liquid each day.
C. NORDIC NATURALS ARCTIC COD LIVER OIL PEACH 90 SOFTGELS
(Based on the Ad, September 20 2005) The serving size for this product is
two softgels. Each container has 45 servings. Each serving contains 2 g of
total fat, 0.4 g of saturated fat, 5 mg of cholesterol, 350-780 IU of vitamin A,
2-16 IU of Vitamin D, 33 IU of Vitamin E, 280 mg of docosahexaenoic acid
(DHA), 180 mg of ecosapentaenoic acid (EPA) and 100 mg of other omega-3.
Other ingredients include gelatin, water, glycerin and natural peach essence.
They suggest to take two softgels daily with meals.
D. ICELAND HEALTH REGULAR STRENGTH OMEGA-3 - COD LIVER OIL
Based on its label, the recommended dose for adult is 3 softgels per day.
Each serving contains 5 I.U. of Vitamin E, 504 mg of omega-3 fatty acids (252
mg of Ecosapentaenoic acid (EPA), 168 mg of Eocosahexaenoic acid (DHA) and
84 mg of other omega-3 fatty acids).
E. SPECTRUM ESSENTIALS NORWEGIAN COD LIVER OIL WITH LEMON
According to its advertisement, this product is molecularly distilled. It contains
on mercury PCBs or lead. This cod liver oil product is tested by a 3rd party.
The serving size is 5 ml , containing 4.5 g of total fat, 940-2350 IU of Vitamin
A, 0-19 IU of Vitamin D, 0-1 IU of Vitamin E, 540 mg of docosahexaenoic acid,
340 mg of eicosapentaenoic acid, 300 mg of other omega-3, 120 mg of
omega-6, 1,100 mg of oleic acid. However, this product also contains 25 mg of
cholesterol.

You may say that cod liver oil is a drug!
Cod liver oil is a drug as well as food since it is recognized in the United
States Pharmacopeia (USP). According to USP XXII, cod liver oil is the partially
destearinated fixed oil obtained from fresh livers of Gadus morrhua Linne and
other species of Fam. Gadidae. Cod liver oil cotains, in each g, not less than
255 ug of vitamin A and not less than 2.125 ug of vitamin D. Cod liver oil may
be flavored by the addition of less than 1% of a suitable flavor or a mixture of
flavors.

Talk to your doctor if you take aspirin together with cod liver oil.
Cod liver oil has been demonstrated to have blood pressure lowering
activities in animal studies. [X1] In further, researchers found an increase in
the bleeding time and a decrease in platelet aggregation after supplementing
8 subjects with 40 ml/day of cod liver oil for 25 days. [X2] A 3 month-study
investigated the effects of aspirin on blood pressure in 100 untreated
hypertensive patients who received aspirin at different times of the day
according to their rest-activity cycle. The researchers found that there was no
change in blood pressure when aspirin was given on awakening. However,
they observed a high significant blood pressure reduction in the patients who
received aspirin before bedtime. [X3] Because cod liver oil and aspirin both
have blood pressure-lowering effects or other related activities, they may
interact with each other.

Studies in normal volunteers from investigators have demonstrated that
non-steroidal anti-inflammatory agents (NSAIDs) including aspirin can
significantly damage the gastroduodenal mucosa. A study of 1064 healthy
subjects has shown that the highest incidences of ulcers was found with plain
and buffered aspirin, and the lowest incidences with the lower
anti-inflammatory doses of the non-aspirin NSAIDs. [X5] Patients with
prolonged intake of aspirin at high doses are shown to have atypical, often
multiple, intractable ulcers with many complications. [X4] On the other hand, a
study has shown that a diet rich in fish oil (i.e. cod liver oil) could alter the
balance between n-6 and n-3 fatty acids in major gastric mucosal
phospholipids, markedly reduced the availability of 20:4n-6, and increased the
incidence of gastric erosions induced by restriction or emotional stress. [X6]
Because cod liver oil and aspirin both may cause undesired side effects of
gastric disturbance, some healthcare specialists do not suggest to take fish
oil and aspirin together.
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ALL RIGHTS RESERVED @ 2008 zhion . DO NOT COPY NOR TRANSFER THE CONTENT TO
OTHER WEBSITE OR OTHER TYPES OF PUBLICATIONS. THE INFORMATION ABOVE IS
FOR YOUR REFERENCE ONLY. AUTHOR DOES NOT GURANTEE ITS ACCURACY. IF YOU
HAVE ANY QUESTIONS, YOU SHOULD CONSULT WITH YOUR DOCTOR. THE BENEFITS OF
COD LIVER OIL DEMONSTRATED IN THE STUDIES MAY NOT BE APPLICABLE TO THE
PRODUCTS THAT YOU ARE TAKING.

REFERENCES
[A1] Rajakumar K et al Reemerging nutritional rickets: a historical perspective. Arch
Pediatr Adolesc Med 2005 Apr; 159(4):335-41. [A2} Barker ME et al, Serum retinoids
and beta caroteneas predictors of hip and other fractures in elderly women. J Bone
Miner Res. 2005 Jun;20(6):913-20 Epub 2005 Jan 24. [1] Effect of cod liver oil on
symptoms of rheumatoid arthritis. Adv. Ther. 2002 Mar-Apr.19(2):101-7. Study
Preparation. [2] Formation of genotoxic dicarbonyl compounds in dietary oils upon
oxidation, Lipids. 2004 May;39(5):481-6. [3] Curtis CL et al Biological basis for the
benefit of nutraceutical supplementation e.g. cod liver oil in arthritis. Drug Discov Today.
2004 April 1;9(7):336. [4] Effect of cod liver oil on symptoms of rheumatoid arthritis,
Adv Ther. 2002 Mar-Apr; 19*2):101-7.[5] Relationship between dietary intake of cod
liver oil in early pregnancy and birthweight. BJOG.2005 April; 112(4):424-9.[6] Maternal
supplementation with very-long-chain n-3 acids during pregnancy and lactation
augments children's IQ at 4 years of age. Helland et al, University of Oslo, Norway,
Pediatrics, 2003 Jan; 111(1):e39-44].[6] Differential effects of fish oil and folic acid
supplementation during pregnancy in rats on cognitive performance and serum glucose
in their offspring. Joshi et al, Agharkar Research Institute, India. Nutrition. 2004
May;20(5):465-72.][7] Use of cod liver oil during pregnancy assoicated with lower risk
of childhood-onset type 1 diabetes in the offspring. Stene et al, National Institute of
Public Health, Norway. Diabetologia 2000 Sep;43(9):1093-8.][8] Nutritional
supplements as adjunctive therapy for children with chronic/recurrent sinusitis: pilot
research. Linday et al, Iona College, USA, Int J Pediatr Otorhinolaryngol 2004
Jun;68(6):785-93 [9] Effect of daily cod liver oil and multivitamin-mineral supplement
with selenium on upper respiratory tract pediatric visits by young, inner-city, Latino
children: randomized pediatric sites. Ann Otol Rhinol Laryngol. 2004
Nov;113(11):891-901.[10] Whiting SJ et al, Dietary recommendations for vitamin D: a
critical need for functional end points to establish an estimated average requirement. J.
Nutr. 2005 Feb;135(2):304-9.[11] .Rajakumar K. et al, Reemerging nutritional rickets:
a historical perspective. Arch pediatr Adolesc med. 2005 Apri., 159(4):335-41.[12] Use
of cod liver oil during the first year of life is assoicated with lower risk of childhood-onset
type 1 diabetes: a large, population-based, case-control study. Stene et al, Ulleval
University Hospital, Norway. Am J Clin Nutr: 2004 May; 79(5):889-90; author reply
890.][13]Vitamin D has anti-cancer properties. Earthtimes.org. May 23 2005.[14] [Effect
of cod liver oil on tissue antioxidant pathways in normal and streptozotocin-diabetic
rats. Hunkar et al. Cell Biochem Funct. 2002 Dec;20(4)297-302.] [15] [Can vitamin D
supplementation reduce the risk of fracture in the elderly? A randomized controlled trial.
Meyer et al, J Bone Miner Res. 2002 Apr,17(4):709-15.[16] [Does dietary
supplementation of cod liver mitigate musculoskeletal pain? Erksen et al, University of
Oslo, Norway. Eur J Clin Nutr. 1996 Oct;50(10):689-93. [17] Long-term effect of
eicosapentaenoic acid ethyl (EPA-E) on albuminuria of non-insulin dependent diabetic
patients. Shimizu et al, Gunma University, Japan. Diabetes Res Clin Pract. 1995
Apr;28(1):35-40.][18][Effect of fish oil and sunflower oil supplementations on
gentamicin-induced nephrotoxicity in rat. Abdel-Gayoum et al, Al-Arab Medical
University, Libya, Hum Exp Toxicol. 1995 Nov;14(11):884-8]. [19] Effects of dietary
lipids on daunomycin-induced nephropathy in mice: comparison between cod liver oil
and soybean oil. Lipids 2002. April; 37(4):359-66.[20] [Fish oil improves
endothelium-dependent coronary vasodilation in heart transplant recipients.
Fleischhauer et al, Stanford University, California. J Am Coll Cardiol. 1993 Mar
15;21(4):992-9].[21] [Cod liver oil alters platelet-arterial wall response to injury in pigs.
Lam et al, Mayo Clinic, Minn. Circ Res. 1992 Oct,71(4):769-7 [22] J Allergy Cli Imm
Dec., 2003;112(6):1178-84. RECOMMENDED RESEARCH ARTICLES [1] Relationship
between dietary intake of cod liver oil in early pregnancy and birthweight. Olafsdottir AS
et al, BJOG. 2005 Apr;112(4):424-9. [2] On call I was impressed by your July 2004
article on fish oil, and I'm thinking of taking it. I remember that my mother gave me a
spoonful of cod liver oil every day. Would it be a good thing for me to have today?
Simon HB. Harv Mens Health Watch. 2005 Jan;9(6):8. [3] Cod and the consumptive:
abrief history of cod-liver oil in the treatment of pulmonary tuberculosis. Grad R. ,
Pharm. Hist. 2004; 46(3):106-20. [5] Effect of daily cod liver oil and a
multivitamin-mineral supplement with selenium on upper respiratory tract pediatric visits
by young, inner-city, Latino children: randomized pediatric sites. Linday LA et al, Ann
Otol Rhinol Laryngol. 2004 Nov;113(11):891-901. [6] Polychlorinated biphenyls,
hexachlorobenzene, hexachlorocyclohexane isomers, and pesticide organochlorine
residues in cod-liver oil dietary supplements. Storelli MM et al, J. Food Prot. 2004
Aug;67(8):1767-91. [7] Predictors for cod-liver oil supplement use--the Norwegian
Women and Cancer Study. Brustad M. et al, Eur J Clin Nutr. 2004 jan;58(1):128-36.[X1]
Ziemlanski S et al, Effect of dietary fats on experimental hypertension. Ann Nutr Metab.
1985;29(4):223-31. [X2] Lorenz R et al, Platelet function, thromboxane formation and
blood pressure control during supplementation of the Western diet with cod liver oil.
Circulation. 1983 Mar;67(3):504-11. [X3] Hermida RC et al, Administration
time-dependent effects of aspirin on blood pressure in untreated hypertensive patients.
Hypertension. 2003 Jun;41(6):1259-67. Epub 2003 May 5. [X4] Hirschowitz BI et al,
Atypical and aggressive upper gastrointestinal ulceration associated with aspirin abuse.
J Clin Gastroenterol. 2002 May-Jun;34(5):523-8. [X5] Lanza FL A review of gastric ulcer
and gastroduodenal injury in normal volunteers receiving aspirin and other
non-steroidal anti-inflammatory drugs. Scand J Gastroenterol Suppl. 1989;163:24-31.
[X7] Olafsson SO Dietary cod liver oil decreases arachidonic acid in rat gastric mucosa
and increases stress-induced gastric erosions. Lipids. 2000 Jun;35(6):601-5.

BENEFITS OF COD LIVER OIL
SIDE EFFECTS July, 2008

"I remember
that my mother
gave me a
spoonful of cod
liver oil every
day. Would it be
a good thing for
me to have
today?"
-Harv Mens Health
Watch 2005 Jan;9(6):8

"In the old time, I
hated to take (a
spoonful of) cod
liver oil,
because of its
fishy smell.
Nowaday, we
have cod liver
oil capsules to
mask its
unpleasant
smell."
-Zhion December
23, 2005

"Fish oil versus cod
liver oil: is vitamin D a
reason to go back to the
future?"
-Ross CM J Am Board
Fam Pract. 2005
Sep-Oct;18(5):445-6

A recent study
conducted by
researchers
from University
of Sheffield, UK,
further confirms
the potential
health benefits
of cod liver oil
on elderly
women.

Barker ME et al
examined serum retinol,
retinyl palmitate, and
beta-carotene as
predictors of incident
hip and other fractures
in a large case-control
design study of 2606
British women over the
age of 75 years
(including 312 incident
osteoporotic fractures
and 92 incident hip
fractures). They
concluded that
multivitamin or cod
liver oil
supplementation was
associated with a
significantly lower risk of
any fracture.

Reference Serum
retinoids and
beta-carotene as
predictors of hip and
other fractures in
elderly women. J Bone
Miner Res. 2005
Jun;20(6):913-20. Epub
2005 Jan 24.