I was dismayed recently when I read about a large clinical trial in Italy which showed no benefit to the risk of heart disease from supplementing 1 gram per day of Omega 3 (fish oil), published in the New England Journal of Medicine May 9 (1). They took 12,500 high-risk patients, many of whom had diabetes and/or high cholesterol, and randomized them to receive either 1 gram of fish oil or a placebo, and followed them for 5 years. The endpoint was death from heart disease, or hospitalization for heart disease. The conclusion: absolutely no difference between the two groups.
This contrasts sharply with the study I read a few weeks earlier coming out of Harvard and published in the Annals of Internal Medicine in April (2). They followed a group of 2600 older adults for 16 years, and found the quartile with the highest blood levels of Omega 3 had a 35% lower risk of death from heart disease, a 28% lower risk of death from all causes, and lived more than 2 years longer on average than those with the lowest Omega 3 levels!
Are you confused yet? Well, the key is to make sure you have adequate blood levels of Omega 3. We know that chronic inflammation is the underlying cause of most of the diseases we associate with aging, including heart disease. A substance called Nuclear Factor Kappa Beta (NFKB) is responsible for turning on inflammatory enzymes, and the EPA in Omega 3 helps reduce the level of NFKB. (Note: so does vitamin D!!). The arachidonic acid (AA) in Omega 6 (animal fats) turns on NFKB. An excellent way to measure your inflammation and therefore risk for disease is to measure the ratio of AA to EPA. This can be done with a simple blood test through our office. The ratio should be less than 5:1, but the typical North American has a ratio of greater than 20:1 because we tend to eat way more animals than we do fish.
Additional benefits of fish oil are the protective effects on the brain. The April 1st issue of the American Journal of Physiology (3) published a double-blind trial showing a significant reduction in the response to mental stress in men and women given a supplement of fish oil. A study out of England published in March in the Journal of Clinical Nutrition (4) showed a protective effect on memory and reaction times in younger adults age 18-45 with fish oil supplementation compared to placebo.
I continue to take 3000mg of Omega 3 fish oils daily.
Partnering with you in wellness,
Dr. Grant Pagdin, MD
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2. Mozaffarian D, Lemaitre RN, King IB, Song X, Huang H, Sacks FM, Rimm EB, Wang M, Siscovick DS. “Plasma Phospholipid Long-Chain [omega]-3 Fatty Acids and Total and Cause-Specific Mortality in Older Adults: A Cohort Study.” Ann Intern Med. 2013 Apr 2;158(7):515-25.
3. Jason R. Carter, Christopher E. Schwartz, Huan Yang, and Michael J. Joyner: “Fish oil and neurovascular reactivity to mental stress in humans”
Am J Physiol Regul Integr Comp Physiol April 1, 2013 304:R523-R530; published ahead of print February 13, 2013, doi:10.1152/ajpregu.00031.2013
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