Expert advice on fish oil

Most of us are deficient in Omega-3s

While most Americans eat way too much saturated fat and the omega-6 oils found in meats and most vegetable oils, they suffer a relative deficiency of the omega-3 oils -- a situation that is associated with an increased risk for heart disease and about 60 other conditions including cancer, arthritis, stroke, high blood pressure, skin diseases, and diabetes.

Particularly important to good health are the longer chain omega-3 fatty acids such as eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA) found in fish, especially cold-water fish such as salmon, mackerel, herring, and halibut as well as fish oil supplements.

Reduce your risk of heart disease 47%

It is now estimated that individuals with higher dietary intake of EPA and DHA reduce their risk of heart disease by roughly 47% compared to those individuals who do not eat fish.(1-3)

In addition to heart disease, scientists now know that fish oil consumption can lower the risk for many cancers (particularly breast, prostate, colon, and lung cancer) and many other chronic diseases including Alzheimer's disease, asthma, depression, diabetes, high blood pressure, macular degeneration, multiple sclerosis, and rheumatoid arthritis.(4,5)

More heart health benefits of omega-3s

Even the U.S. government has acknowledged the importance of the omega-3 fatty acids for heart health. Specifically, a detailed evaluation of the scientific evidence by the United States Agency for Healthcare Research and Quality concluded that the long chain omega-3 fatty acids, either from fish consumption or supplementation, significantly reduce the risk of heart attacks and strokes. The review also found other evidence indicating that fish oil supplementation can help lower high blood pressure slightly, reduce risk of coronary artery re-blockage after angioplasty, increase exercise capability among patients with clogged arteries, and reduce the risk of irregular heart beats -- particularly in individuals with a recent heart attack.(6)

Protect your heart — 1,000 mg EPA/DHA daily

When researchers measured the level of the long chain omega-3 fatty acids EPA and DHA within red blood cells, they found that they had discovered one of the most significant predictors of heart disease.(7) This laboratory value was termed the Omega-3 Index. An Omega-3 Index of =8% was associated with the greatest protection, whereas an index of =4% was associated with the least. The Omega-3 Index was shown to be a better predictor of coronary artery disease compared to other well-established markers such as total, LDL, or HDL cholesterol; C-reactive protein; and homocysteine.

Researchers subsequently determined that the amount of EPA and DHA required to achieve or surpass the =8% Omega-3 Index target was a combined total of 1,000 mg of EPA and DHA daily. This amount is found in 3-4 "regular" fish oil softgels or 2 "concentrated" fish oil softgels.

Omega-3 fatty acids and the brain

The importance of omega-3 fatty acids to brain function relates to their role in the phospholipid composition of nerve cell membranes. A relative deficiency of omega-3 fatty acids in cellular membranes substantially impairs cell membrane function and has been implicated in depression, attention deficit disorder, and other psychological disturbances.

Fish oils effective in major depression

Fish oils concentrated for EPA and DHA have previously been shown to have positive effects for patients with schizophrenia in several studies as well as in bipolar disorder (manic depression). In a recent study, 28 patients with major depression were given a hefty dosage of omega-3 fatty acids (4,400 mg EPA/2,200 mg DHA) or placebo, on the top of their usual treatment, for 8 weeks. Evaluation of the subjects with the Hamilton Rating Scale for Depression showed that those taking the fish oils had a significantly improved score compared to the placebo group. These exciting results suggested that continued use may produce even greater benefit as there was a continued downward trend with time on the symptoms of depression.(8)

Fish oils in borderline personality disorder

In another recent study, fish oil was shown to be very effective in improving borderline personality disorder (BPD) -- a pervasive pattern of instability of interpersonal relationships, self-image, and mood, and marked impulsivity beginning by early adulthood. In the study, 30 women with BPD were given either 1,000 mg of EPA or a placebo for 8 weeks. Detailed analyses using sophisticated measures found EPA to be superior to a placebo in diminishing aggression as well as the severity of depressive symptoms.(9) If fish oil can help BPD (and I believe that it does), it would be a godsend to many.

Fish oils can make kids smarter

Did you know that breastfed infants are smarter and have higher IQs than formula fed infants? According to a large amount of research, the availability of DHA to the developing brain is one of the key reasons why they"re smarter. EPA and DHA are critical for proper brain development -- especially during the fetal and infant stage. A recent study tested the hypothesis that supplementing the mother"s diet during pregnancy and lactation with DHA and EPA could make their child smarter. In the study, a total of 341 pregnant women were supplemented with either omega-3 fatty acids (1,200 mg DHA, 800 mg EPA) or corn oil from 18 weeks of pregnancy through completion of lactation, and the children were examined at 4 years of age with an intelligence test. All of the children were breastfed exclusively for the first three months. Results indicated that the group getting the DHA and EPA scored considerably higher on the Mental Processing Composite tests at 4 years of age as compared with children whose mothers had taken corn oil.(10)

Think about the ramifications of helping children get a head start in life. Sadly, low levels of DHA during fetal and infant brain development may be one of the reasons why we are seeing so many children with attention deficit disorder, depression, obsessive compulsive disorder, and other psychological illnesses.

Supplements — better than eating fish?

Based upon the research looking at the amount of fish required to offer protection against heart disease, it appears that having fish several times a week will provide distinct health benefits. That translates to approximately 14 to 28 ounces of fish per week or roughly 1,000 mg of the EPA/DHA omega-3 fatty acids per day.

However, recent reports on the problems with contaminants in salmon and other fish have led to modifications in the amount of fish that should be consumed. For example, based upon the results of a recent study on the level of contaminants in salmon (particularly farmed salmon), the recommendation on safe levels of consumption per month aimed at avoiding any significant increase in cancer risks was roughly one portion per month for farmed salmon and no more than one or two portions per week for wild Alaskan salmon.(11,12)

The bottom line is that the best manner in which to achieve optimal levels of EPA and DHA is through the use of high quality fish oil. It simply eliminates the risk of ingesting unwanted toxic contaminants.

Higher quality products source their oil from small fish like sardine, mackerel, and anchovy which are low in the food chain. Levels of contaminants tend to rise in species that are higher in the food chain such as tuna or cod. High grade fish oils also go through a distillation process (either molecular or steam) in order to concentrate and purify the oil to ensure it"s virtually free from lipid peroxides, heavy metals, environmental contaminants, and other harmful compounds.

A "regular" fish oil softgel contains 300 mg of EPA/DHA (180 mg EPA and 120 mg DHA), while the "concentrated" fish oil softgels typically contain 600 mg of EPA/DHA.

For prevention, the recommended daily dosage is roughly 1,000 mg of EPA and DHA combined. The actual number of pills that you take is determined by the concentration of EPA/DHA (i.e., 2 softgels for the higher concentrated fish oils, 4 softgels for the lower). Higher dosages (e.g., 3,000 mg of EPA and DHA) have been used in therapeutic applications including lowering triglycerides, boosting mood, and reducing inflammation.

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