A recent study published in the journal Diabetes Care has found that low doses of the omega-3 fatty acids eicosapentaenoic acid (EPA), docosaheaxaenoic acid (DHA), and alpha-linolenic acid (ALA) reduced the risk of heart arrhythmia-related events in diabetic patients who had previously suffered a heart attack.

1,014 diabetic patients, aged 60 to 80 years old, were randomized into four groups and consumed margarine that contained either 223 mg EPA and 149 mg DHA, 1.9 g ALA, both EPA/DHA and ALA, or no omega-3 fatty acids every day for 40 months. The group that consumed the margarine with EPA/DHA and ALA experienced an 84 percent lower risk of arrhythmia-related events and a 72 percent lower risk of arrhythmia-related events and fatal coronary events when compared to the group consuming the plain margarine. Heart arrhythmia is an irregular heartbeat, and can lead to cardiac arrest.

The authors of the study suggest a few possible reasons why these omega-3s might be helpful in diabetics with heart disease. One, they might play a role in regulating insulin sensitivity, an important factor in diabetes. Two, they may help to lower blood sugar levels. And three, their anti-inflammatory properties may help to reverse insulin resistance. All these factors can lead to heart disease if unaddressed.

More studies will be done to determine the precise role each omega-3 plays in heart arrhythmia and heart disease, but this study adds to the thousands of studies illustrating the heart-healthy benefits of omega-3 oils.

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Renew You Challenge

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Fish has long been known as “brain food” because it contains the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), both brain-healthy nutrients that must be obtained from the diet. Certain fish contain more heart-healthy omega-3s than others. Be sure you’re eating the right kind. Cold-water oily fish, like salmon, mackerel, sardines, and tuna contain high amounts of omega-3s.

A recent study from the University of Pittsburg found that people who eat baked or broiled fish at least once a week are at decreased risk of developing Alzheimer’s disease or mild cognitive impairment (less-severe memory loss that may lead to Alzheimer’s). The decreased risk was associated with increases in grey matter in certain areas of the brain associated with memory—the hippocampus, posterior cingulate, and the orbital frontal cortex.

A previous study, presented at the American Heart Association’s Scientific Sessions in 2009 found that eating baked or boiled fish gave better heart-healthy omega-3 benefits than eating fried, salted or dried fish. So how you cook the fish makes a difference.

One thing I always caution, however, is to be careful of the mercury content of certain fish. Take for example albacore tuna—yes, it contains a lot of omega-3s, but it’s also high in mercury. Not the best option, especially on a regular basis! Sardines and salmon tend to be some of the best sources of omega-3s low in mercury.

If you want to be sure to get the heart healthy omega-3s, but don’t want to eat so much fish, or risk consuming too much mercury, take a high-quality, purified, concentrated fish oil supplement. Look for the International Fish Oils Standard (IFOS) icon to be sure the product is certified to exceed world standards for fish oil purity.

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Fish high in omega-3 oils provide a rich source of the fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). DHA is a physiologically-essential nutrient in the brain and retina where it is found in high concentrations. For this reason fish oil rich in DHA is particularly beneficial for the eyes and brain. EPA is especially helpful for reducing inflammation. Together, EPA and DHA have been found to be helpful in a host of health conditions.

Recently, a couple studies have been published highlighting the visual benefits of fish oil. In one study involving 38,022 women, regular consumption of the omega-3 fatty acids EPA and DHA found in fish was associated with lower risk of developing age-related macular degeneration, which is a condition in older people that gradually destroys central sharp vision. Women who regularly consumed fish had a 42 percent lower risk.

The second study evaluated the way that omega-3 fatty acids work. The study found an effect that promotes healthy blood vessel growth while inhibiting abnormal blood vessel growth. Both retinopathy and macular degeneration involve abnormal blood vessel growth. Researchers isolated the compound which exhibited this effect—a metabolite of the omega-3 DHA.

Currently, an ongoing study through the National Eye Institute is underway looking at the benefits of fish oil supplements in people with age-related macular degeneration, and another study in Sweden is investigating the effects of omega-3 supplementation in premature infants who are deficient in omega-3 to determine if the supplement reduces the development of retinopathy. If so, this will lead to more studies.

The science behind EPA and DHA from fish oil span a wide range of health conditions, which highlights the importance of these oils for the body’s optimal function.

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The benefits of omega-3 oils from fish were first noticed in Inuit populations of Greenland. Researchers noticed that these people consumed high amounts of fat, yet did not develop heart disease or experience heart attacks like people in the Western world. Thus began studies of the Inuit diet in which beneficial omega-3 fatty acids from fish—EPA and DHA—were found to be the heart-protective components.

Many thousands of studies later, the benefits of omega-3 fish oil are still being found in many different areas of health. In a new study of Yup’ik Eskimos in Alaska, researchers evaluated the effects of a high-fat fish-based diet on disease markers in obese Eskimos. The rate of obesity in these people is similar to that in the lower US—the difference is the source of dietary fat. In the US, saturated and trans fats are high in the diet, and healthy polyunsaturated fats, like omega-3s, are low.  

In obese Yup’ik Eskimos with the highest blood levels of EPA and DHA, blood triglyceride and C-reactive protein (a measure of overall inflammation) were the same as normal weight people. In those Eskimos with the lowest EPA and DHA levels, however, blood triglyceride and CRP levels were high. High triglycerides and CRP levels are risk factors for the development of cardiovascular disease and possibly diabetes.

Results of this study suggest that omega-3 fatty acids EPA and DHA found in fish may have health protecting effects even in obese people. More studies are needed to confirm these results, but this study is promising.

Now, don’t get carried away and think you can eat all the fatty foods you want and just pop a fish oil supplement. Instead choose healthy fats as part of your diet with plenty of fish on the menu, and supplement that with omega-3s from fish oil to be sure you’re getting enough of these great fats. Just be sure to look for a fish oil that meets International Fish Oil Standards (IFOS—look for the IFOS seal on the bottle).

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Anxiety, or worry, is experienced by just about everyone at some point. Some people have anxiety disorders, which are more serious conditions, but it’s safe to say that most people experience at least occasional anxiety. That’s why a new study on omega-3s found in fish oil is so exciting. It’s the first study to look at the effects of fish oil on anxiety in a healthy population—meaning, in people who don’t already have an anxiety disorder. It’s already known that fish oil can be helpful for those people. But what about people who only experience anxiety here and there?

The researchers took a group of medical students and gave them omega-3 supplements for three months. The supplements contained 2,085 mg of EPA and 348 mg of DHA. Another group got a placebo. After three months, the group taking the fish oil showed a 20 percent reduction in anxiety scores and a 14 percent reduction in the production of the inflammatory marker interleukin-6 (IL-6) over the placebo group.

IL-6 is an inflammatory cytokine. Depression and anxiety are both known to involve the production of inflammatory cytokines. This is one of the gut-brain connections, actually, since the inflammation can originate in the gut. Omega-3s were able to reduce these inflammatory compounds, highlighting just one way they may be helping mood disorders like depression and anxiety.

This week, if you tend to get anxious about things, even if occasionally, and you’re not taking fish oil, you might want to reconsider. The studies on fish oil are hard to ignore.

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Renew You Challenge

Let’s start this week off right!

Weekly challenge (I mean opportunity!) to help set you off on the right foot and in the right direction for bringing health to your week. You could even add it to your calendar. Join us!

Many people are familiar with the term “omega-3.” And many people also know that good sources of omega-3 are fish and flaxseeds. But did you know that these two sources contain different types of omega-3? That’s right. Flaxseed contains the omega-3 called alpha-linolenic acid (ALA) and fish contains two different types of omega-3: docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).

ALA actually converts into EPA, which then can convert into DHA (and vice versa). These conversions, however, occur on a very limited basis. ALA only converts to EPA at a rate of between 8 and 20 percent, and only converts to DHA (by way of EPA) at a rate of between 0.5 and 9 percent. Many people take omega-3 in the ALA form, like flaxseed oil, thinking that they are getting all the benefits of omega-3s, but they’re not getting the whole story. Certainly ALA is a beneficial omega-3. I don’t refute that. But most of the benefits of ALA are thought to be due to its eventual conversion into EPA and DHA—especially when it comes to heart health.

A recent study published in the American Journal of Clinical Nutrition highlights this point. Data based on 3,277 healthy Danish adults found that a higher intake of ALA over 23 years was not associated with a reduction in risk of ischemic heart disease—the most common form of heart disease, and the most common cause of death in the U.S. But intake of other long-chain omega-3s—like EPA and DHA—was associated with a reduced risk.

The researchers found that intakes ranging from 0.45 to 11.2 grams per day were associated with a 38 percent reduced risk of ischemic heart disease for women. This is a large range, certainly, and higher doses of EPA and DHA should only be taken under the consult of a doctor. But the American Heart Association does recommend that people consume the equivalent of 500 mg per day of EPA and DHA (not ALA) if they are healthy and want to maintain heart health; 1 gram per day if they have coronary heart disease; and 2 to 4 grams per day if they have high triglycerides.

This week, if you are taking an omega-3 supplement, take a look at the label and see how much EPA and DHA you are getting. This is what you should be looking for in a high-quality omega-3.

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The science behind omega-3s—especially EPA ad DHA, the omega-3s found in fish—is particularly strong for cardiovascular benefits. In fact, the American Heart Association recommends that healthy adults consume the equivalent of 500 mg daily of EPA and DHA; that people with heart disease consume 1,000 mg of EPA and DHA daily; and that patients who need to lower triglyceride levels consume 2 to 4 grams of EPA and DHA daily.

The reasons why fish oil is so heart healthy are many. In addition to helping lower triglyceride levels, omega-3s from fish oil have also been found to reduce blood clots and improve blood pressure, heart rate and vascular function. On top of that, a recent meta-analysis (a study which compiles data across many studies—in this case 10 randomized, controlled, human clinical trials) found that omega-3 intake was effective in reducing arterial stiffness, also known as hardening of the arteries.

Arterial stiffness is associated with an increased risk of cardiovascular events like heart attack and stroke. It is the result of atherosclerosis, the buildup of plaque in the artery wall, and is more common with age. “Reduction in arterial stiffness by omega-3 may account for some of its purported cardio-protective effects,” stated researchers.

Fish oil supplements are not all created equal. The most beneficial omega-3s found in fish oil are EPA and DHA. Be sure you are getting the most of your fish oil—read the label and add up the amounts of EPA + DHA. That’s what you’re looking for when it comes to a good fish oil supplement.

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The development of allergies in infants is influenced by different factors. A too-clean environment is one factor. Lack of breastfeeding is another factor. Diet, both of the infant and the mother, is yet another factor. In a recent study, mothers’ diets during pregnancy were evaluated for a link to the development of allergies in infants.

Researchers found that if the mother’s diet contained omega-3 polyunsaturated fatty acids (PUFAs) like those found in fish, walnuts and flaxseed, the babys’ guts developed differently. The PUFAs help to improve how gut immune cells respond to gut bacteria and other foreign substances in the gut. This highlights the complementary action of omega-3s with gut bacteria. The result? A reduction in the risk of allergy development in children.

Studies have shown that fish oil and walnut oil supplementation during pregnancy help reduce allergy risk in their children, and now this new study shows why. “The end result is that the baby’s immune system may develop and mature faster—leading to better immune function and less likelihood of suffering allergies,” stated Dr. Gaelle Boudry one of the study’s researchers.

It is well known that omega-3 fish oil—particularly DHA—is important for brain development of the fetus during pregnancy. This new study adds to the understanding of the benefits of omega-3s. This week, if you or someone you know is pregnant, be sure you’re getting enough omega-3s. A concentrated, purified fish oil supplement is a great way to get your omega-3s, just be sure to clear it with your doctor.

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According to the Centers for Disease Control (CDC) 12 percent of children aged 2 to 19 years are obese—triple the number it was in 1980. This increase is attributed, in part, to the Standard American Diet (SAD), a poor diet high in refined carbohydrates, bad fats, and sugar, and low in high-fiber foods like whole grains and fruits and vegetables.

A recent study takes a look at fat intake of pregnant women and fat accumulation in their children by age 3. Specifically, the study looked at the status of two types of polyunsaturated fatty acids (PUFAs)—omega-6 and omega-3. These fats are both essential to the diet. The Standard American Diet is very high in the omega-6 fatty acids, found in vegetable oils and grains like corn. Omega-3 fatty acids, however, are not consumed in adequate amounts, creating an imbalance in the ratio of omega-6 to omega-3s.

Omega-3 fatty acids, especially docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) found primarily in fish, promote optimal development of the fetal brain and immune system. Many women in the U.S. do not consume enough of these beneficial omega-3s. In a study published in the American Journal of Clinical Nutrition, researchers assessed mid-pregnancy intake of omega-3 and omega-6 fatty acids and tested plasma fatty acid levels of the mother and umbilical cord fatty acid levels of the infant to determine omega-3 status. At age 3, body mass index (BMI) and skin fold measurement were taken to determine obesity in the children.

The odds of obesity in 3-year-olds were two to four times higher when cord blood had a high ratio of omega-6 to omega-3 fatty acids. When maternal intake of omega-3s was higher, or when the omega 3/6 ratio was closer to recommended levels, the odds of childhood obesity were lower.

It has long been known that omega-3s, especially DHA, are necessary for brain development of the fetus and infants. The study also found that only three percent of mothers consumed the recommended 200 mg of DHA per day in the last month of pregnancy, when DHA is most rapidly transferred from the mother to fetus. This study is building the evidence that omega-3 fatty acids provide a variety of benefits for infants and children that go beyond brain and eye development.

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The immune system is a complex organization of coordinated responses to “foreign” invaders in the body. Foreign invaders include microbes—bacteria, fungus, parasites and viruses—as well as toxins and even food. As a matter of fact, one major role of the immune system is to not respond to food. As is seen with food allergies, however, the immune system is not always successful at this. Food allergies involve an overactive immune response to certain foods, which would normally be recognized as harmless. 

The immune system is comprised of two main branches: the innate immune system and the adaptive immune system. The innate immune system, also known as cell-mediated immunity, involves an immediate non-specific immune response, often against pathogens. The adaptive immune system, also called humoral immunity, involves a delayed, specific, organized response involving the production of antibodies that later recognize invading microbes so that a more effective immune response can be mounted. The innate immune system involves the production of cells called T helper 1 (Th1) cells, and adaptive immunity involves the production T helper 2 (Th2) cells. T helper cells are lymphocytes, a type of white blood cell. They are like the messengers of the immune system, sending signals that stimulate various immune responses.

Th1 and Th2 responses are joined by another type of T helper cell known as Th17. Th17 and Th1 responses are both associated with over-active immune responses, as is seen in autoimmune conditions, in which the body mistakenly attacks its own tissues. Both these responses produce inflammation by way of cytokines, the immune equivalent of hormones. These three types of T helper cells are all regulated and balanced by cells known as T regulatory cells, or Tregs.¹

Are you confused yet? Think of all these T cells as a four-way seesaw.  Th1 and Th17 are on two prongs of one end, and Th2 and Tregs are on two prongs of the other. When all is well, this seesaw is in balance, like a harmonized symphony responding appropriately to that which the body comes into contact.  If out of balance, you may see higher levels of Th1 and Th17, an indication of underlying autoimmunity as is seen with type 1 diabetes, celiac disease, rheumatoid arthritis, psoriasis, multiple sclerosis and systemic lupus erythematous. In contrast, higher levels of Th2 and Tregs are characteristic of allergic conditions like asthma, food allergies and hay fever, and with immune suppression.

How can we balance immunity? Well, probiotics are one solution. Since over 70 percent of the immune system is in the gut, probiotics are in the right terrain for immune system communication. Probiotics help balance immune response.  Gut bacteria essentially “prime” the immune system,² educating it so that it responds appropriately to what passes through the digestive tract—and to what may ultimately pass through the small intestine and into the body.

Omega-3 fatty acids also affect immunity, largely by helping to balance the inflammatory response—an important aspect of immunity. You see, inflammation is a necessary physiologic occurrence.  But too much inflammation spells trouble.  The omega-3 fatty acids EPA and DHA found in fish oil help to quell inflammation at the right time.  They help stimulate the production of resolvins, chemicals knows to help “resolve” inflammation—or end it at the appropriate time.³ 

Further, the proper digestion of food is necessary so the immune system doesn’t have to work too hard.  When food is not broken down properly, undigested food particles can aggravate the gut, causing inflammation and even leaking through a permeable intestine (also known as leaky gut) and entering circulation where yet more inflammation is triggered, in a downward spiral of excess inflammation (which is at the basis of most, if not all, chronic disease).

Also important is regular bowel elimination, which can be attained by the consumption of dietary fiber—at least 35 grams per day. A diet rich in fruits, vegetables and whole grains is essential, and a fiber supplement can help reach 35 grams, which can be difficult to obtain through diet alone.

In essence, the HOPE Formula—High-fiber, Omega Oils, Probiotics and digestive Enzymes—can help improve digestive health and improve immune balance. Brenda and I have been recommending this formula for years for many good reasons. With the HOPE Formula, there is hope that your health will improve. 

References

1. Cooke A, “Th17 cells in inflammatory conditions.” Rev Diabet Stud. 2006 Summer;3(2):72-5.
2. Round JL and Mazmanian Sk, “The gut microbiota shapes intestinal immune responses during health and disease.” Nat Rev Immunol. 2009 May;9(5):313-23.
3. Serhan CN and Savil J, “Resolution of inflammation: the beginning programs the end.” Nat Immunol. 2005 Dec;6(12):1191-7.

Leonard Smith, M.D.

Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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