Essential fatty acids cannot be made by the body and thus need to be consumed in the diet. Omega-3 fatty acids such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) and omega-6 fatty acids such as gamma-linolenic acid (GLA) are often taken as supplements because of their strong anti-inflammatory action. EPA and DHA are present in high amounts in fish oils and produce anti-inflammatory and antithrombotic effects. Specifically, EPA has cardioprotective effects, such as decreasing triglycerides and increasing high-density lipoprotein (HDL).60 As previously mentioned, women with PCOS often have hyperlipidemia with elevated triglyceride levels and low HDL levels. EPA and DHA decrease inflammatory ei-cosanoids by competing with arachidonic acid (AA) in the lipo-oxygenase and cyclooxygenase pathways. GLA is commonly found in borage (Borago officinalis) seed oil, evening primrose (Oenothera spp.) oil, and black currant (Ribes nigrum) oil. GLA metabolites decrease the inflammatory response by inhibiting the production of inflammatory leukotrienes from AA.61
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