a net increase and others a net decrease. None of the studies investigated specify the effect of increased seafood consumption on factor VIII levels (Balk et al., 2004) (see Appendix Table B-2f).

Platelet Aggregation

Platelet aggregation is a very complex measurement, depending on the aggregating agent, the dose of the agent, and the measurement metric used. As a result, findings of studies on the effects of EPA/DHA on platelet aggregation are inconsistent and difficult to interpret (Balk et al., 2004). Agren et al. (1997) examined the effects of a seafood-based diet, fish-oil supplementation, and algal DHA oil on platelet aggregation and showed that collagen aggregation was reduced more in subjects on both the seafood diet and fish-oil supplementation regimens, but not the algal DHA oil treatment, compared to the controls (p<0.05). No significant association was found for EPA/DHA impairment of platelet aggregation, although algal DHA oil is less potent than either fish oil or seafood (which are sources of both EPA and DHA) (see Appendix Table B-2f).

Indicators of Glucose Tolerance in Diabetes

Although EPA/DHA consumption has been shown to improve lipid profiles and other indicators of cardiovascular risk in those with type II diabetes, there is currently no evidence that intakes of 2–4 g/day of EPA/ DHA can improve glycemic control (Grundt et al., 1995; Sirtori et al., 1998; Kesavulu et al., 2002). Consistent with this finding, a review (Balk et al., 2004) concluded that there was no clear evidence that EPA/DHA had an effect on moderating glucose tolerance or hemoglobin A1c levels, fasting blood sugar, and fasting insulin levels (see Appendix Table B-2g).

Allergy and Asthma

The Nurses’ Health Study’s prospective cohort was evaluated by Troisi et al. (1995) for a possible association of risk for adult-onset asthma and frequency of intake of various types of food. A semi-quantitative food frequency questionnaire was employed to index food intake over the previous year (e.g., “dark meat” seafood vs. other seafood). Over 1200 cases of adult-onset asthma were identified. Data from this study showed that the 6-year risk of adult-onset asthma was unrelated to the frequency of intake of dark meat seafood, tuna, or shrimp. This nonsignificant association was maintained when results were adjusted for age and smoking status, and also when other factors (body mass index, residential area, number of physician visits, and energy intake) were adjusted for (see Appendix Table B-2h; see also Schachter et al., 2004, AHRQ Report No. 91).

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