Abstract
Epidemiological studies suggest that Eskimos have a low incidence of atherosclerosis and other degenerative diseases, including stone disease1-4. This immunity which the Inuit shares with the Japanese of Okinawa island has been attributed to their fish-rich diet with its high concentration of eicosapentaenoic acid (EPA)5. EPA is the precursor poly-unsaturated fatty acid for the Ω-3 series of prostaglandins. High concentrations in the diet will act as a replacement for and competitive inhibitor of arachidonic acid, the precursor of the Ω-6 series of pro-aggregatory and pro-inflammatory dienoic metabolites. In a preliminary experimental and open clinical study, fish oil (EPA) inhibited experimental nephrocalcinosis and reduced urinary calcium and oxalate excretion in hypercalciuric recurrent stone formers. Recent studies have shown that the beneficial effects of Ω-3 fatty acids (EPA) can be potentiated in the presence of evening primrose oil containing γ-linolenic acid (GLA), a precursor poly-unsaturated fatty acid of the monoenoic metabolites (ie, PGE1). GLA has also been reported to inhibit formation of 2-series prostaglandins from arachidonic acid. To study the influence of fish oil and evening primrose oil on urinary solute excretion a double-blind, placebo-controlled study was performed in 40 recurrent idiopathic stone formers.
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