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DOES THIS SUPPLEMENT WORK AS WELL AS A $1500/MONTH DRUG?  This is not the first time that we have seen that essential fatty acids are quite potent at suppressing inflammation.  In this particular study (an animal study) we see that alpha linolenic acid (the same fats found in flaxseed, walnuts, chia, salba…) helps to suppress TNF-alpha expression, which is the same target of the very expensive class of drugs that block the action of TNF-alpha (Remicade, Humira, Enbrel).  This is not to suggest that one replaces the other, but it again shows that essential fatty acids being stripped from our heavily processed diets may have a strong tendency to shift our bodies towards inflammation.

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How Much Fish Oil Dosage Should You Be Taking?

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You’re aware that fish oils play a role in health.  But, there is serious disconnect between how much fish oil you should take and the fish oil dosage you are taking.

First, a little background.

When we talk about “fish oils” we are really referring to two types of fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).  These are called fish oils because we get them from fatty fish that got these fats in the first place from eating a plant based diet made up of seaweed and algae.

Another common type of omega 3 fatty acid is alpha linolenic acid (ALA), which is the principal form of fatty acids in plants such as walnuts, flaxseed and chia seeds.

This blog post is not going to go into the hundreds of benefits of omega 3 fatty acids.  Rather, I need to discuss dosages.  I do not believe I have ever had a patient come in who was taking the right amount of omega 3 fatty acids for their specific scenario.

As an example, I had a new patient this week who was a 51 year old diabetic female on 2 different diabetic drugs as well as insulin.  Pretty much the only supplement she was taking was fish oil.  Her dosage?  1 tablet.

Keep in mind that most fish oil supplements are in a one gram dose.  This is NOT 1 gram of omega 3 fatty acids, but rather the total weight of the little capsule.  Manufacturers usually use glycerin to make up the difference.  Do the math to make sure you know what dosage of omega-3 fatty acids you are taking.

Which brings us to the point of this blog post.  Therapeutic dosages of fish oil is almost always higher than what people are taking.  In general, it STARTS at 3,000 mg (3 grams).

This particular article confirms the appropriate dosages.  Researchers looked at the ability of 3.36 grams (3360 mg) of essential fatty acids to cut down on inflammation created by visceral fat cells.

Overall, the results were positive (as expected), but the take home message here is that the dosages used in clinical studies are much higher than what patients are generally using.

If you are using fish oils supplements, what dosages are you taking?

 

MONOUNSATURATED FATTY ACIDS POSITIVELY EFFECTS CHRONIC DISEASE – (10-23-06)

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Omega 3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary and secondary-prevention studies

Sometimes I think we get to a point where additional studies seem to be a waste of resources and we ought to just accept a fact and move on (i.e. breast feeding is good for babies, cigarette smoking is bad for us…). We are definitely there with fish oil. And of course, adding in omega 3 and monounsaturated fatty acids into your diet as much as possible is going to be a good thing on almost every chronic disease because they have an anti-inflammatory action.

This review does not find the same benefits from ALA (found in higher levels in flax), but we have always known the human conversion from ALA to EPA is pretty low. But, in ALA’s defense, we have see positive effects of this fatty acid on other aspects of our health as well.

Read entire article here

ESTIMATED CONVERSION OF A-LINOLENIC ACID – (05-18-09)

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Estimated conversion of a-linolenic acid to long chain n-3 polyunsaturated fatty acids is greater than expected in non fish-eating vegetarians and non fish-eating meat-eaters than in fish-eaters

There has also been discussion about just how much ALA from plant sources gets converted to DHA/EPA. The concerns have been that ALA intake is not enough to keep elevated levels of DHA/EPA without additional supplementation.

Two comments here…first, the conversion seems to be greater than originally thought in several studies, including this one. Second, ALA has it’s own benefits in clinical studies on cancer risk and CVD. The bottom line is that I feel we should get a strong balance of plant based and fish based EFAs. Of course, we could then point out that the ultimate origin of fish based EFAs is algae.

Read entire article here

WHICH FAT FROM THE SEA WILL KEEP YOU SMARTER?

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WHICH FAT FROM THE SEA WILL KEEP YOU SMARTER?  In this trial of omega 3 fatty acids (ALA, EPA, DHA) and cognitive function in middle aged (35-54) individuals, higher levels of DHA, the higher the levels of DHA, the better the mental performance.  The ultimate source of DHA is primarily algae (hence finding it in “fish oils”–the fish eat the algae).  It is extremely high in mother’s milk vs cow’s milk (30x higher), and infant formulas are only now starting to add it in.

Overall, a diet higher in DHA (mostly from cold water, wild caught fish, unless you actually like to gnaw on algae..) will be protective to the brain from the womb to the grave.  Unfortunately, the standard American diet is almost completely devoid of omega 3 fatty acids.  As an FYI–if you don’t have a Costco membership, get one.  They have all kinds of cost-efficient, wild caught frozen seafood.

AM I TAKING ENOUGH FISH OILS?

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Typically, the answer is a pretty strong no.  The research on the benefits of healthy fats are all over the board, and this particular study is no exception.  Ever since fats were demonized in the early 90s as a result of the USDA’s food guide pyramid (remember–the one with “fats and oils-use sparingly” at the top while refined carbs were proudly displayed across the bottom?) nutritional experts were warning about the detrimental effects from the lowered intake of omega 3 fatty acids.  They predicted increased rates of cancer, diabetes, heart disease and obesity.  And sure enough, we have seen increased risks of cancer, diabetes, heart disease and obesity (among other chronic diseases).

The most common of the omega 3s are ALA, DHA and EPA.  Each have health benefits of their own.  ALA is principally derived from plant sources such as flax seed, nuts and seeds (pumpkin is high in ALA).  The “fish oils” are DHA and EPA.  Their ultimate source is DHA in algae.  The vegetarian fish eat the algae, leading to higher levels of DHA in the fish.  Salmon is a great example.  These fish are then in turn eaten by large fish like halibut.  The vegetarian fish like salmon, tilapia and trout are the better sources for the omega 3 fatty acids because the mercury content is lower.  But NEVER eat farm raised–farm raised are fed corn (an omega 6 fatty acid), are high in pesticides and are dyed with a dye to give the “natural” color (wild caught salmon’s pink color is from the carotenoids in their diet).

From a supplement standpoint, it is rare that patients taking fish oils are taking decent dosages.  This particular study, which shows strong benefit in those with chronic heart failure, found most benefit from 4 GRAMS per day.  Not four capsules, but 4 grams.  In many cases, the capsules will contain anywhere from 300 mg to 740 mg, depending on strength.  Do the math–this could mean up to 13 capsules per day if it is the cheaper, less strength, supplements.

http://www.sciencedirect.com/science/article/pii/S0002870311001645