Cod liver oil
Cod liver oil is a nutritional supplement derived from liver of cod fish (Gadidae).  As with most fish oils, it has high levels of the omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Cod liver oil also contains vitamin A and vitamin D. It has historically been taken because of its vitamin A and vitamin D content. It was once commonly given to children, because vitamin D has been shown to prevent rickets and other symptoms of vitamin D deficiency.
Cod liver oil was traditionally manufactured by filling a wooden barrel with fresh cod livers and seawater and allowing the mixture to ferment for up to a year before removing the oil. Modern cod liver oil is made by cooking the whole cod body tissues during the manufacture of fish meal.
Though similar in composition to fish oil, cod liver oil has higher concentrations of vitamins A and D. According to the United States Department of Agriculture, a tablespoon (4 drams or 15 ml) of cod liver oil contains 4080 μg of retinol (vitamin A) and 34 μg of vitamin D. The Dietary Reference Intake of vitamin A is 900 μg per day for adult men and 700 μg per day for women, while that for vitamin D is 15 μg per day. The "tolerable upper intake levels" are 3000 μg/day and 100 μg/day respectively, so people consuming cod liver oil as a source of omega-3 fatty acids should pay attention to how much vitamin A and vitamin D this adds to their diet.
Rich in omega-3 fatty acids, cod liver oil may be beneficial in secondary prophylaxis after a heart attack. Diets supplemented with cod liver oil have also been demonstrated to have beneficial effects on psoriasis.
Potential adverse effects
Per tablespoon (13.6 g), cod liver oil contains 136% of the established daily Tolerable Upper Intake Level (UL) for Preformed Vitamin A (Retinol). Vitamin A accumulates in the liver, and can reach harmful levels sufficient to cause hypervitaminosis A. Pregnant women may want to consider consulting a doctor when taking cod liver oil because of the high amount of natural forms of vitamin A such as retinol. A toxic dose of retinol (vitamin A) is around 25 000 IU/kg (see Retinol#Retinoid overdose (toxicity)), or the equivalent of about 1.25 kg of cod liver oil for a 50 kg person.
The risks of fatty acid oxidation, hypervitaminosis, and exposure to environmental toxins are reduced when purification processes are applied to produce refined fish oil products.
A high intake of cod liver oil by pregnant women is associated with a nearly fivefold increased risk of gestational hypertension. The study noted that "possibly, the amount of n-3 LCPUFA may have positive effects up to a certain level, while becoming detrimental in high doses."
- "REPORT OF THE TWENTY FORTH SESSION OF THE CODEX COMMITTEE ON FATS AND OILS" (PDF). Report of the Twenty Forth Session of the CODEX Committee on Fats and Oils. JOINT FAO/WHO FOOD STANDARDS PROGRAMME CODEX ALIMENTARIUS COMMISSION. Retrieved 8 December 2015.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
- Rajakumar, K. "Vitamin D, Cod-Liver Oil, Sunlight, and Rickets: A Historical Perspective. 2003". Pediatrics. 112 (2): 132–135.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
- David Wetzel (28 February 2006). "Cod Liver Oil Manufacturing". The Weston A. Price Foundation. Archived from the original on 11 March 2012. Unknown parameter
|deadurl=ignored (help)<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
- Paul Lips (8 May 2003). "Hypervitaminosis A and fractures". N Engl J Med. 348 (4): 1927–1928. doi:10.1056/NEJMe020167. PMID 12540650. Retrieved 6 March 2008.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
- Haddad J.G. (30 April 1992). "Vitamin D — Solar Rays, the Milky Way, or Both?". The New England Journal of Medicine. Retrieved 29 January 2012.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
- von Schacky, C (2000). "n-3 Fatty acids and the prevention of coronary atherosclerosis". Am J Clin Nutr. 71 ((1 Suppl)): 224S–7S. PMID 10617975.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
- Wolters, M. (2005). "Diet and psoriasis: experimental data and clinical evidence". British Journal of Dermatology. 153 (4): 706–14. doi:10.1111/j.1365-2133.2005.06781.x. PMID 16181450.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
- National Nutrient Database for Standard Reference "USDA Nutrition Facts: Fish oil, cod liver" USDA
- Jane Higdon, Ph.D. of the Linus Pauling Institute "Linus Pauling Institute Micronutirent Center" Oregon State University
- Myhre AM, Carlsen MH, Bøhn SK, Wold HL, Laake P, Blomhoff R (December 2003). "Water-miscible, emulsified, and solid forms of retinol supplements are more toxic than oil-based preparations". Am. J. Clin. Nutr. 78 (6): 1152–9. PMID 14668278.CS1 maint: multiple names: authors list (link)<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
- Bays H E (19 March 2007). "Safety Considerations with Omega-3 Fatty Acid Therapy". The American Journal of Cardiology. 99. (Supplement 1) (6): S35–S43. doi:10.1016/j.amjcard.2006.11.020. PMID 17368277.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
- Olafsdottir AS, Skuladottir GV, Thorsdottir I, Hauksson A, Thorgeirsdottir H, Steingrimsdottir L (March 2006). "Relationship between high consumption of marine fatty acids in early pregnancy and hypertensive disorders in pregnancy". BJOG. 113 (3): 301–9. doi:10.1111/j.1471-0528.2006.00826.x. PMID 16487202.CS1 maint: multiple names: authors list (link)<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
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