Autoimmune disease involves a process whereby the immune system mistakes part of the body as a foreign invader, and mounts an attack against it, damaging tissue. The most common autoimmune diseases include type 1 diabetes, rheumatoid arthritis, multiple sclerosis, celiac disease, psoriasis, lupus, and Grave’s and Hashimoto’s diseases.

Prevalence of autoimmune disease is on the rise. The National Institutes of Health (NIH) estimates as many as 23.5 million Americans may be afflicted with at least one autoimmune condition, up from 8.5 million in 1996. But even this estimate is low, since those numbers only consider 24 autoimmune conditions, when these illnesses actually number over 80.

Though genes do play a role in autoimmune diseases (they tend to run in families), environmental triggers are also involved and contribute to the increase in prevalence rates, according to Fred Miller, director of the Environmental Autoimmunity Group at the National Institutes of Environmental Health Sciences. “Our gene sequences aren’t changing fast enough to account for the increases,” Miller says. “Yet our environment is—we’ve got 80,000 chemicals approved for use in commerce, but we know very little about their immune effects. Our lifestyles are also different than they were a few decades ago, and we’re eating more processed food.”

Environmental triggers of autoimmunity include: chemicals, infections, stress, hormones, drugs, diet, weight gain and behavior. Of these, chemicals are particularly concerning due to their prevalence in the environment and to the lack of safety testing and regulation. The following toxins have been linked to autoimmunity: polyaromatic hydrocarbons (found in air pollution), heavy metals (lead and mercury), trichloroethylene (an industrial solvent that contaminates our water and air) and asbestos (found in building materials of older buildings).

Studying the link between environmental toxins and any illness is difficult, but because there are so many autoimmune disease, and because each one has different features, studying the link between chemicals and each illness is particularly difficult. Scientists are calling for better ways to link autoimmune diseases together, as occurs with cancer, to increase funding and understanding of what factors trigger this complex of diseases.

In the meantime, reducing toxin exposure, following a healthy diet, and supporting the seven channels of elimination—colon, liver, lungs, lymph, kidneys, skin and blood—with regular internal cleansing is recommended to help reduce toxic burden.

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A recent study published in the journal PLoS Biology has found that Candida albicans forms two distinct biofilm types according to what form the Candida is in—the sexual or asexual form.¹ A biofilm is a protective polysaccharide matrix in which microbial populations exist and are able to hide from the immune system and antimicrobials. As it turns out, when Candida is in an asexual form, it produces a biofilm that is impermeable to antifungals, antibodies and white blood cells. This asexual form makes up the majority—about 90 percent—of Candida cells in the body. The other ten percent are sexually reproducing Candida cells that form a similar looking biofilm that behaves differently and is susceptible to antifungals and to the immune system.

Biofilms are formed by more than just Candida, however. The National Institutes of Health (NIH) estimates that nearly 80 percent of chronic microbial infections are due to biofilms.² Dr. Maria Usman, MD has developed, and is refining, a Biofilm Protocol for use in children with gut disorders on the autism spectrum.³ She is seeing some success with this protocol, though it must be tailored to the individual and can cause a “die-off” reaction, also known as the Herxheimer reaction. (When microbes are killed they give off microbial toxins that can cause sickness-like symptoms that can make the patient feel worse before getting better.)

Another approach that can help get Candida and gut issues under control is the 4R Model.⁴ The Institute of Functional Medicine promotes this model as the best way to evaluate and treat patients with gastrointestinal complaints. The 4R model asks four main questions:

REMOVE—What may need to be removed? This may be pathogenic or potentially pathogenic organisms like Candida, bacteria or parasites. It can also be foods or toxins to which the person is sensitive or allergic.

REPLACE—What may need to be replaced? In this step, the use of digestive enzymes and HCl should be considered to ensure that they body is properly absorbing necessary nutrients.

REINOCULATE—What may the body need to be reinoculated with? This considers intestinal microbes and uses probiotics and prebiotics to reestablish intestinal balance.

REPAIR—What may be needed to repair a healthy mucosal layer? The use of certain nutrients, such as L-glutamine, to repair the mucosal layer are useful here. 

One probiotic—the probiotic yeast Saccharomyces boulardii—may be particularly helpful for those with Candida problems. Candida often occurs in people who have been treated with antibiotics. Antibiotics target bacteria, both good and bad, but do not affect Candida because it is a yeast, leaving no competition for Candida. This is where S. boulardii can be helpful, because it is not killed by antibiotics like other probiotic bacteria. Futher, S. boulardii has also been shown to inhibit Candida albicans.⁵ S. boulardii produces capric acid, and both have been shown to downregulate (reduce) the expression of genes associated with Candida virulence. Thus, the capric acid secreted by S. boulardii inhibits C. albicans hyphal formation, adhesion properties and biofilm formation.⁶ Probiotic bacteria have also been found to be helpful for Candida by helping to reduce and inhibit Candida, and by stimulating immune response against Candida.⁷ 

Bringing the gut back into balance takes a multipronged approach.  The 4R program can help address the multiple issues that arise when faced with digestive conditions like Candida overgrowth. 

1. Song Y, et al., “Alternative mating type configurations of Candida albicans result in alternative biofilms regulated by different pathways.” PLoS Biology. Aug 2011;9(8): e1001117.
2.  http://grants.nih.gov/grants/guide/pa-files/PA-03-047.html
3. http://www.autismpedia.org/wiki/index.php?title=Protocols/Usman
4. Jones DS (editor), Textbook of Functional Medicine, The Institute for Functional Medicine, 2005, p. 462-8.
5. Krasowska A, et al., “The antagonistic effect of Saccharomyces boulardii on Candida albicans filamentation, adhesion and biofilm formation.”FEMS Yeast Res. 2009 Dec;9(8):1312-21.
6. Murzyn A, et al., “Capric acid secreted by S. boulardii inhibits C. albicans filamentous growth, adhesion and biofilm formation.” PLoS One. 2010 Aug 10;5(8):e12050.
7. Wagner RD, et al., “Biotherapeutic effects of probiotic cacteria on candidiasis in immunodeficient mice.” Infect and Immun. 1997 Oct; p. 4165-72.

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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A recent study published in the journal Environmental Health Perspectives and based on the National Health and Nutrition Examination Survey (NHANES) investigated the exposure of pregnant women to 163 chemicals, revealing, “ubiquitous exposure to multiple chemicals during a sensitive period of development.” The study found that pregnant women were even exposed to chemicals banned decades ago, and some of the chemicals analyzed were found in 99 – 100 percent of the women.

Health effects were not assessed in this study, but many of the chemicals found are known to have detrimental consequences on health. In another case study of one women with particularly high levels of bisphenol A (BPA) during her 27^th week of pregnancy, the infant experienced neurobehavioral abnormalities at his one-month study visit. Researchers of this study were able to trace her abnormally high BPA exposure to the high consumption of canned foods, heating of plastic food containers, and use of plastic cups. The week of her highest recorded BPA level, she consumed canned ravioli each day. It is known that acidic foods can bring out more BPA from can lining, and canned tomato foods have been found to be higher in BPA.

BPA and phthalate exposure can be reduced by purchasing fresh unpackaged foods and avoiding plastic food packaging, storage containers and utensils. In one study, again published in Environmental Health Perspectives, consuming fresh foods prepared and consumed without the use of plastic was associated with a 66 percent reduction in the amount of BPA in urine.

We can’t eliminate all toxins, but there are small things we can do try to reduce them. Replace your plastic Tupperware with glass containers. Don’t use plastic wrap and try to prepare as much food as you can from fresh, unpackaged foods. And never heat food or drink in plastic. Do what you can and know that you are at least doing something. Spread the word—pass this information on.

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I often blog about the widespread negative effects of chemicals and pesticides. We live in a toxic soup, and the more people realize that, the more likely they will be to make changes. Ultimately, the more natural products and services you buy, the more those products and businesses will appear until one day (in my perfect world) we will be able to live without all these toxins!

Take a couple of recent studies (out of many) on pesticide exposure—as it turns out, prenatal exposure to pesticides is linked to lower IQ in children at age 7. And people exposed to pesticides near the workplace are at increased risk for developing Parkinson’s disease. Everywhere I look is another study to add to the mounds of evidence that the toxins we are regularly exposed to in everyday life are destroying us. Literally.

In the prenatal pesticide exposure study published in the journal Environmental Health Perspectives, for every ten-fold increase in organophosphate pesticides detected during pregnancy, the child experienced a 5.5 point decrease in IQ score by age 7. The study found a correlation with prenatal exposure specifically, suggesting that there is a critical time period to which the baby in womb is susceptible.

In the Parkinson’s study, researchers found that exposure to the three commonly sprayed crop pesticides—ziram, maneb and paraquat—while at work was associated with a three-fold increase in risk of later developing Parksinson’s disease. Working near a field (not necessarily in direct contact with the pesticides, as they tend to drift up to several hundred meters from the fields) was enough to increase risk.

These are two small—yet significant—reasons to try to eat organic when possible, and to support your seven channels of elimination—colon, liver, lungs, lymph, kidneys, skin and blood—with regular cleansing and detoxification.

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A recent study to be published in the journal Pediatrics found that the prevalence of food allergy in children is higher than previously thought.¹ It turns out that 8 percent of children—that’s about 1 in every 13 children—are affected by food allergy. Food allergies and sensitivities are far-reaching problems contributing to many autoimmune conditions like type 1 diabetes, arthritis and psoriasis, and to neuro-inflammatory conditions like autism and attention-deficit/hyperactivity disorder (ADHD).^2-5

Food allergies and sensitivities are essentially the result of a breakdown in gut mucosal immune regulation in response to food antigens that pass through the gut. The gut-associated lymphoid tissue (GALT) makes up about 80 percent of the body’s immune system, and it resides in and around the gut. The job of the immune system in the gut is to respond to foreign invaders, like pathogens, by destroying them. At the same time, it must also not respond to the large amount of food that passes through the gut every day—this is known as oral tolerance.

When it comes to food allergies and sensitivities, building and maintaining a healthy gut lining is key. The HOPE Formula can help you to achieve this with High fiber, Omega oils, Probiotics and digestive Enzymes.   

If you have the right bacterial balance, as can be achieved with probiotics, the gut lining will be minimally inflamed and therefore minimal leakage of microbial toxins will be available to activate the GALT. The beneficial bacteria also create more of an immune tolerance with the epithelial cells that line the intestine—especially the mucosal-associated lymphocytes that are part of the epithelial lining.⁶

The right balance of soluble fiber and insoluble fiber can also minimize allergies—the soluble fiber by producing beneficial short chain fatty acids, especially butyrate, which is the primary fuel of the colonocytes; and insoluble fiber by diluting out any toxins associated with allergens that are exposed to the intestinal lining. In addition, it holds water and bulks the stools to promote better and quicker elimination, thus reducing the time of exposure to allergens.

The essential omega-3 and omega-6 oils in the right ratio promote immune balance in the gut lining and gut-associated immune system. Most people consume too many omega-6 oils and too few anti-inflammatory omega-3 oils. Omega-3 supplements can help reverse this imbalance. Digestive enzymes help by effectively breaking down proteins, fats, and carbs into less-antigenic food particles so that the intestinal (epithelial) lining does not react in an allergic, immunologic manner.  

HOPE should be a foundational health concept to help eliminate and/or prevent food allergies, especially when combined with avoidance of known allergenic foods and a rotation diet that avoids repetition of any given sensitive food for at least 3 to 4 days before eating it again. 

1. Gupta RS, et al., “The prevalence, severity, and distribution of childhood food allergy in the United States.” Pediatrics. 2011 Jun 20. [Epub ahead of print]
2. Wasmuth HE and Kolb H, “Cow’s milk and immune-mediated diabetes.” Proc Nutr Soc. 2000 Nov;59(4):573-9.
3. Hvatum M, et al., “The gut-joint axis: cross reactive food antibodies in rheumatoid arthritis.” Gut. 2006 Sep;55(9):1240-7.
4. Abenavoli M, et al., “Celiac disease and skin: psoriasis association.” World J Gastroenterol. 2007 Apr 14;13(14):2138-9.
5. Curtis LT and Patel K, “Nutritional and environmental approaches to preventing and treating autism and attention deficit hyperactivity disorder (ADHD): a review.” J Altern Complement Med. 2008 Jan-Feb;14(1):79-85.
6. Savilahti E, et al., “Pre and probiotics in the prevention and treatment of food allergy.” Curr Opin Allergy Clin Immunol. 2008 Jun;8(3):243-8.

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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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! 

Flame retardants are just about everywhere. They are especially concentrated in the home due to their presence on such items as upholstery, carpets, bedding, electronics and clothing, like children’s pajamas. 

Say what? Yes, they put these horrible chemicals on children’s pajamas. Luckily, you might be able to check the tags to be sure you are buying pajamas that do not contain these toxins. The tight-fitting pajamas are allowed to be sold without flame retardants, thankfully.

Many other baby items may be covered with the chemicals—car seats, changing pads, portable cribs, nursing pillows, the list goes on. A recent article in USA today reported on a study that found flame retardants in 80 percent of baby products tested. Children already have the highest levels of these chemicals in their bodies because they are always crawling around on the floor (where the chemicals settle in dust).  

Products containing fire retardants are not required to be labeled, but you can look for companies that choose to not use flame retardants. The article listed four brands claiming their products meet safety standards without chemical flame retardants—BabyLuxe Organic, Baby Bjorn, Orbit Baby and Boppy.  If you can, choosing products without these toxins is best, though at this point, we can’t avoid them all.

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 Constipation is a common childhood condition, unfortunately. Even worse is the mainstream definition of constipation—less than three bowel movements per week. Say what! If you or little Johnny are only pooping three times a week, we’ve got a problem. Regular elimination helps remove toxins from the system. And the longer feces sit in the colon the more toxic it gets!

A recent study evaluated the effect of the probiotic Bifidobacterium breve in children with constipation. Twenty children between the ages of 3 and 16 took the probiotic daily for a 4-week period. Bowel movement frequency and stool consistency improved significantly in these children. That means their constipation improved. The results of this pilot trial are promising, and will lead to a larger randomized controlled trial.  

Bifidobacteria are the most prevalent probiotic bacteria in the large intestine, or colon, of children. Normal bifidobacteria colonization occurs when babies are born vaginally, and is improved during breastfeeding. Antibiotic treatment can interfere with colonization, especially during the first months and years of life. Maintaining a healthy balance of bifidobacteria is associated with intestinal health, which is the foundation of total body health.

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Brenda and I have been talking for years about the toxic soup that we all live in. It’s in our food, in the water, in the air and in our own bodies. It’s impossible to completely avoid toxins, and that’s a problem, especially in light of the scientific evidence that shows environmental toxins are destroying our health.

Many recent studies have looked at air pollution and its many harmful effects. It has been known for some time that exposure to air pollution is associated with health conditions like asthma, cardiovascular disease and attention deficit hyperactivity disorder (ADHD). In fact, polluted air can even create serious ventricular arrhythmias.¹ Also, the incidence of heart attacks in rush hour traffic in the United Kingdom are thought to be due to the polluted air. In support of this is a quote from the August 2005 Environmental Health Perspectives (EHP) referring to particle laden dirty air, “Ultrafine particles < 0.1 µm (UFPs) dominate particle number concentrations and surface area, and are therefore capable of carrying large concentrations of adsorbed or condensed toxic air pollutants. It is likely that redox-active components in UFPs from fossil fuel combustion reach cardiovascular target sites. High UFP exposures may lead to systemic inflammation through oxidative stress responses to reactive oxygen species and thereby promote the progression of atherosclerosis, and precipitate acute cardiovascular responses ranging from increased blood pressure to myocardial infarction.”²

The studies on this topic keep rolling in. The latest issue of EHP published a study on the link between prenatal exposure to air pollutants and subsequent behavioral problems in children.³ Children with the highest levels of pollution exposure had more attention problems, anxiety and depression at age 5 to 7 than those children with the least exposure. It is also known that exposure to organophosphate pesticides found on foods is linked to ADHD symptoms, by the way. And we wonder why ADHD is on the rise.

Other new studies continue to support just how air pollution affects health. One study in animals found that chronic inhalation of polluted air triggered inflammation that spread throughout the body.⁴ To quote one of the researchers, “Our main hypothesis is that particulate matter stimulates inflammation in the lung, and products of that inflammation spill over into the body’s circulation, traveling to fat tissue to promote inflammation and causing vascular dysfunction.”

This comes as no surprise to me. Inflammation is involved in most every disease, and certainly plays a role in all chronic diseases. Inflammation can be triggered by a number of factors—toxins, stress, illness, digestive imbalance—and it can travel throughout the body causing disease.

Another recent study, again published in EHP, found that short term exposure to air pollution damaged areas of the brain associated with memory loss and Alzheimer’s disease in mice.⁴ Guess what the study found? The brains affected by air pollution showed signs of inflammation associated with premature aging and Alzheimer’s disease.

Finally, the New England Journal of Medicine showed that reductions in air pollution accounted for as much as 15% of the overall increase in life expectancy in the areas that were studied!⁶

It’s difficult to know just how to avoid all this pollution, but there are things we can do to reduce toxicity. First, use high efficiency particulate air filters (HEPA filters) throughout your house (or at least your bedroom), and in your car cabin. According to Carla Kalogeridis at the Filter Manufacturers Council, only 40 percent of North American vehicles have cabin air filters despite the ongoing concern of consumers regarding cabin air quality.⁷ Others say as many as 80% or more now have cabin filters. I couldn’t find a clear answer from the www.epa.gov site, but did find where they recommended a portable cabin filter.⁸ In any case if you have a cabin filter they generally need to be replaced annually or every 15,000 miles. The filters can be easily bought from the dealers or online⁹ with instructions on how to change them at home.

If you can avoid daily bumper-to-bumper traffic jams, that’s a good start, and if you can’t it would be very wise to change your cabin air filter. If your vehicle doesn’t have one there are portables available.⁸ Eating a healthy diet high in fruits and vegetables, whole grains, healthy fats and lean proteins will help your body get many nutrients and fiber it needs. Reduce inflammation with omega-3 oils, and quell gut inflammation with probiotics. And support the body’s seven channels of elimination: colon, liver, lungs, lymph, kidneys, skin and blood with nutrients that promote the healthy function of these channels, plus periodic colon hydrotherapy, and infrared sauna. Lastly, find stress-reducing activities including exercise and meditation to round out a healthy lifestyle. All of the above strategies will help to keep your detoxification pathways open.

1. M.S. Link and D.W. Dockery, “Air pollution and the triggering of cardiac arrhythmias.” Curr Opin Cardiol. 2010 Jan;25(1):16-22.
2. R.J. Delfino, et al., “Potential role of ultrafine particles in associations between airborne particle mass and cardiovascular health.” Environ Health Perspect. 2005 Aug;113(8):934-46.
3. F.P. Perera, et al., “PAH/Aromatic DNA Adducts in Cord Blood and Behavior Scores in New York City Children.” Environ Health Perspect. 2011 Apr 4.
4. T. Kampfrath, et al., “Chronic Fine Particulate Matter Exposure Induces Systemic Vascular Dysfunction via NADPH Oxidase and TLR4 Pathways.” Circ Res. 2011 Mar 18;108(6):716-26.
5. T.E. Morgan, et al., “Glutamatergic neurons in rodent models respond to nanoscale particulate urban air pollutants in vivo and in vitro.” Environ Health Perspect. 2011 Apr 4.
6. C.A. Cope, et al., “Fine-particulate air pollution and life expectancy in the United States.” N Engl J Med. 2009 Jan 22;360(4):376-86.
7. http://www.ehow.com/about_6404803_hepa-cabin-filter_.html#ixzz1JnfTQzQA
8. http://www.epa.gov/nhsrc/pubs/TISPortableMotorVehicleCabinAirPurifier.pdf
9. www.filters-now.com

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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We hear about toxins all around us—in the air, in the water, in the food, in our homes—but what about toxicity that comes from within? Think about your digestion. When you eat a big cheeseburger and fries with a milkshake, or a number of other foods found in the Standard American Diet (SAD), digestion slows. Tick. Tock. You may not actually pass that food out of your system for days.

What happens during all that time? Well, the bun breaks down into sugar almost immediately, causing a blood sugar spike followed by an energy crash. The protein portion from the wheat found in bread may not break down completely, possibly triggering a reaction in your gut known as gluten sensitivity, which you may or may not feel. The fries also break down into sugar, and fat—a lot of fat. Also released from the fries is acrylamide, a compound thought to be carcinogenic, formed when starches are fried at high heat. If you don’t produce enough of the digestive enzyme lactase, the milk sugar lactose in the milkshake will not break down, resulting in gas and bloating when bacteria ferment the lactose in your gut. Now for the meat, which breaks down slowly and possibly incompletely depending on your system. Meat cooked at high temperatures contains the cancer-causing heterocyclic amines. Further, when meat is broken down by gut bacteria, more toxic compounds are formed.

As all of these harmful toxins are released in the gut some of them get absorbed into the bloodstream. First stop? The liver. Metabolically, the liver works harder than any other organ in the body. That’s a good thing because it has a lot of toxins to process. In today’s world more toxins than ever are processed in the liver. Often, not all toxins can be detoxified, so some are stored in the liver, in fat cells, or are released back into the bloodstream. Those toxins that are able to be processed by the liver are sent with bile to the gallbladder and then released into the small intestine to be excreted with a bowel movement.

If your intestinal transit is slow, however, with food sitting in the intestines for long periods of time, these toxins can be reabsorbed back into the bloodstream to the liver once again (a process known as enterohepatic circulation). It’s a vicious cycle, and highlights the importance of regular bowel elimination. Do you experience 2-3 bowel movements daily? Or even one daily? You need to be eliminating either 2-3 times daily, or once daily in large quantity. This is the first step to reducing toxicity.

Consuming a high fiber diet (at least 35 grams daily) or taking a fiber supplement if you can’t get it all from food, supporting gut microbial balance with probiotics, lubricating the bowel with anti-inflammatory omega-3 oils and increasing food digestion with digestive enzymes can help to achieve digestive regularity. For some people who are very constipated, an herbal laxative formula can help jumpstart elimination.

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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Here is your newest 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!

With the new release of the Dietary Guidelines for Americans comes the recommendation to eat more fish. This is not surprising, as it reflects the recommendations by the American Heart Association. Americans consume about 3 ½ ounces of seafood each week, but are encouraged to more than double that to 8 ounces.

Why the recommendation? Because research shows it reduces the risk of cardiovascular disease and stroke. Fish is rich in nutrients, especially omega-3 fatty acids thought to be the main contributor to heart health. Just how much fish to consume has been debated due to the presence of toxins—especially methyl mercury—in certain fish. However, the dietary guidelines say the health benefits of eating a variety of seafood outweigh the risks associated with methyl mercury.

Any more than two servings of fish per week (and it depends on the fish—some are much higher in mercury than others), and you’re better off with a fish oil supplement that has been purified to meet purity standards set by International Fish Oil Standards (IFOS). IFOS standards meet or exceed world standards for purity, potency and freshness of fish oil.

This week, try to eat at least two servings of fish high in omega-3s, like salmon, sardines, anchovies, herring or light canned tuna (not albacore). Can’t stand to eat that much fish, or want to get even more heart healthy omega-3s? Look for a fish oil that is tested by IFOS. Look for the IFOS seal on the box.

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