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DHA May Help the Brain By Improving Blood Flow, Reducing Plaque Aggregation, & Reducing Inflammation
Fotuhi, M. et al. Nature Clinical Practice. Neurology. 5(3):140-152, March 2009. "Fish consumption, long-chain omega-3 fatty acids and risk of cognitive decline or Alzheimer disease: a complex association." Click on drawing to enlarge.
"Omega-3's in the brain do three things:
- They reduce inflammation
- They increase blood flow
- They're important for improving the structure & integrity of the brain's cellular membranes, and they reduce proteins associated with Alzheimer's disease.
I think the best source [of omega-3's], in my opinion, is algal DHA, which is where fish get their omega-3's. Algal is the most pure form, and algal DHA is a supplement that people can take.
[I] personally prefer DHA because it has been associated with reduced blood pressure, better HDL, better brain function. And I have seen in some studies that there is plenty [of] compelling evidence that I would take it myself.
My wife & I take 900 mg of algal DHA.
And, you know, we're talking about children with ADHD. I give it to my two daughters, who are five and seven--100 mg each. It's like a dessert after dinner. We have our little DHA supplement. They have smaller amounts, obviously, than I do."
Dr. Majid Fotuhi chair of the Neurology Institute for Brain Health and Fitness, and assistant professor of neurology at Johns Hopkins University School of Medicine, interviewed on Diane Rehm's NPR 10/3/12 radio show, "Assessing the Health Benefits of Omega-3's". Click here for the transcript
Oh, baby! Omega 3's are back in the news again! Big time.
But, if you only looked at the three "big news" articles highlighted below, you may have decided to throw your hands up in the air & just quit worrying about this whole omega-3 business altogether. One week they're good. The next week they're not.
Not so fast!
As always--there's more to the story. Right?
It's high time to do a little omega-3 recap & pitch the benefits, in spite of these recent nay-saying studies.
- JAMA meta-analysis, September 12, 2012: The latest meta-analysis of 20 clinical trials, involving 70,000 people concluded that supplementing with omega-3's won't reduce deaths from heart disease, sudden death, myocardial infarction or strokes. This study has been criticized by many because it combined different trials, using different doses & sources of omega-3s; and most of the subjects already had heart disease & were on serious heart medications. Hey, it's a supplement, a food, not a miracle worker.
- Archives of Internal Medicine meta-analysis, May 14, 2012: Insufficient evidence that omega-3's can prevent a second cardiovascular event in people with a history of heart disease. Hey, it's a supplement, a food, not a miracle worker.
- New England Journal of Medicine double-blind study, July 26, 2012: 1 gram of fish oil didn't reduce the risk of cardiovascular events in diabetics. Hey, it's a supplement, a food, not a miracle worker.
Bottom line: Omega-3's don't have super powers. They can't make up for years of eating a high-fat Western diet that's high in saturated fats, sugar, & omega-6's. They can't make up for diabetes, a previous heart attack, being overweight, & sitting most of the day.
Prescribing omega-3 supplements without first measuring an individual's baseline level of omega-3 or their ratio of omega-6's to omega-3's is like giving someone a baby aspirin for a migraine---or a prescription pain pill for a hangnail. It's dancing in the dark.
But, you probably knew all that.
Omega-3's are essential fatty acids. We need them. We can't manufacture them in our bodies. They curb inflammation. They've shown benefits to the brain, blood pressure, the cardiovascular system, vision, mood, and learning. But, more on that later.
BIG POINT TO REMEMBER: The more grain-fed animals, fried foods, seed oils (like corn, soy & safflower), nuts & seeds, junk & snack food you're eating--the more inflammatory omega-6's you'll have stored in your body--and the more omega-3's you will need to consume. If you eat less of the omega-6's, you'll need less omega-3's. It's that simple. Omega-3 & omega-6's compete for the same enzymes & position in our cells. Susan Allport does a nice job explaining this:
"[W]hen a person on the normal American diet has plenty of extra fat around, let's say, 20 pounds, a huge amount of that is going to be these omega-6's.
And when they go on fish oil, [they're] not going to see that fish oil showing up in their membranes for a long time, because it's competing with those stored omega-6's."
-Susan Allport, journalist & author of "The Queen of Fats", interviewed on Diane Rehm's NPR 10/3/12 radio show, "Assessing the Health Benefits of Omega-3's". Click here for the transcript-
"..if you understand that food energy causes transient inflammatory insults and omega-6s amplify that into chronic injury and omega-3s moderate it, then you can tell people that the take home message is:
- Eat more omega-3s
- Eat less omega-6s
- Eat fewer calories per meal and stop smoking. That's it."
-William Lands, PhD., a pioneer in the study of lipids, omega-3 fatty acids, and the effects of diet on disease, University of Michigan & NIH-
Before You Toss the Chia & Flax, Ditch Your Omega-3 Supplements, or Lose Confidence in Salmon - Give a Listen to Dr. Melina Jampolis
Dr. Melina Jampolis is one of the few physician nutrition specialists in the country.
She's not happy with the quality & conclusions of the latest JAMA study that minimizes the benefits of omega-3's. Jampolis looked over all the 20 clinical trials in the JAMA meta-analysis & strongly disputes the authors' conclusions.
Don't miss her short rebuttal of the September JAMA omega-3 meta-analysis.
Click Here for the Jampolis video if you don't see it on your screen
It's Been an Omega-3 Kind of Week
Here's what I've been reading this week to help me get a handle on the benefits (or the hype) of omega-3's.
- "Assessing the Health Benefits of Omega-3"--Diane Rehm's October 3, 2012 NPR broadcast. Rehm interviews four experts: Dr. Majid Fotuhi, chair of the Neurology Institute for Brain Health and Fitness, and assistant professor of neurology at Johns Hopkins University School of Medicine (my personal fave--showing my omega-3 biases, here); Paul Coates, director of the Office of Dietary Supplements at National Institutes of Health; Thomas Sherman, associate professor of pharmacology at Georgetown University Medical Center; and Susan Allport, journalist and author of "The Queen of Fats". Fascinating discussion--that confirmed my own admitted bias towards the importance of DHA for brain health--and the superiority of taking an algal supplement.
- Can Omega-3's Slow Aging? Hot-Off-The-Press Ohio State University research, "Omega-3 supplements may slow a biological effect of aging." In Dr. Janice Kiecolt-Glaser's study, published in Brain, Behavior, & Immunity, 106 healthy-but-overweight-50-somethings supplemented with 2 different doses of high-quality omega-3's for 4 months, lowered their inflammation levels by 15%, increased their telomere length (a biomarker of aging), & improved their omega-6 to omega-3 ratios. The lower their ratios--the greater the increase in telomere length. Translation: Longer telomeres=longer healthier life--or at least that's the theory. Kiecolt-Glaser says that while the U.S. average ratio of omega-6's to omega-3's is 15-to-1, a ratio of 4-to-1 or even 2-to-1 would be ideal. Read more about omega-3's, slowing down aging, & telomeres below.
- "Questioning the Superpowers of Omega-3 in Diets", Melinda Beck in the October 1, 2012 Wall Street Journal. Mostly good, but some questionable misinformation. Beck examines the benefits of omega-3's in light of three recent studies that questioned their benefit in reducing deaths or cardiovascular events in people who had previous heart attacks or were at high risk for having one. Beck, also takes a look at some of the recent omega-3 research & offers "a tantalizing mix of healing possibilities".
- Supplementing with algal DHA improves learning & memory function only in healthy middle-aged individuals. It will not benefit or reverse dementia, cognitive dysfunction, or Alzheimer's. Adults 55+: The Memory Improvement with Docosahexaenoic Acid (DHA) Study, or MIDAS, was the first large, randomized, double-blind and placebo-controlled study demonstrating the benefits of algal DHA in maintaining and improving brain health in older adults. The study indicated that the use of DHA improves learning and memory recall in healthy older adults with mild memory complaints. 485 healthy individuals ≥55 participated in the trial for 24 weeks, in 19 U.S. clinical sites. This is the study that turned Dr. Majid Fotuhi into an algal DHA booster.
My Omega-3 Adventures - It's All About the Brain
Look, I'm serious about getting my daily supply of omega-3's.
I don't leave my "getting enough" up to chance. Honestly, if you are eating a plant-based diet, like I am, you might not be getting enough omega-3's. You have to be methodical about it. Eat enough chia, hemp seed, or flax. Greens help--but, they don't provide a significant amount. Consider taking an algal omega-3 supplement. Think about getting your blood levels tested. I did. That's why I now take an algal DHA supplement.
Credit: Dr. Joanne L. Mumola Williams' blog, Foods for Long Life
It's a complicated process--and it's a good bet that you'll need a whole lot less of the omega-3's if you're plant-based & have ditched oils.
But, bottom line, our bodies aren't so efficient at converting the plant-versions of omega-3's (ALA)--like chia, flax, greens, & walnuts--into DHA or EPA, the long-chain most benefiical omega-3's.
And, even if you're eating enough very expensive wild salmon (the farmed won't quite do the job--it's grain-fed & high in omega-6's according to Thomas Sherman, professor of pharmacology at Georgetown Medical Center) to boost your levels, your likely taking in more mercury, toxins, heavy metals, pesticides, & PCB's than you should.
According to fish expert, Paul Greenberg, the only really safe source of salmon right now is from Bristol Bay, Alaska, and those fisheries are now being threatened by copper mines that want to operate in that region--threatening to pollute those safe waters.
Here's what I'm taking to boost my omega-3's:
I add 1 1/2 tablespoons of chia to my morning oatmeal--about 3 grams of omega-3 ALA. Nothing wrong with flax--I just like the taste & texture of chia better.
On most days I also take an algal DHA/EPA (omega-3) supplement--320 mg DHA/130 mg EPA. I'm currently taking Ovega Algal Supplement--which is recommended by ConsumerLabs, the independent lab that tests supplements. I've also taken Spectrum's Agal DHA.
Just by eating plant-based & no-added-oil I drastically lower the amount of omega-3's (in a supplement) I need to take--because I've cut out the biggest sources of omega-6's that compete for "cell-space" with omega-3's. No need for those mega-prescription-strength fish oil capsules. I'm not eating the typical omega-6 heavy Western diet.
Credit: Dr. Joanne L. Mumola Williams' blog, Foods for Long Life
Sure, I know there's a whole laundry list of omega-3 benefits. But, honestly, the only benefit that I can physically point to, is that I'm now free from joint aches, pains, & stiffness. That wasn't always the case. And maybe those omega-3's are part of the reason I'm almost always in a good mood.
But, here's the REAL REASON, I'm religious about getting omega-3's into my diet.
It's all about keeping my brain in working order.
Read on. This study got my attention last year.
Low Levels of Omega-3 Fatty Acids May Cause Memory Problems
ST. PAUL, Minn. – A diet lacking in omega-3 fatty acids, nutrients commonly found in fish, may cause your brain to age faster and lose some of its memory and thinking abilities, according to a study published in the February 28, 2012, print issue of Neurology®, the medical journal of the American Academy of Neurology. Omega-3 fatty acids include the nutrients called docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA).
“People with lower blood levels of omega-3 fatty acids had lower brain volumes that were equivalent to about two years of structural brain aging,” said study author Zaldy S. Tan, MD, MPH, of the Easton Center for Alzheimer’s Disease Research and the Division of Geriatrics, University of California at Los Angeles.
For the study, 1,575 people with an average age of 67 and free of dementia underwent MRI brain scans. They were also given tests that measured mental function, body mass and the omega-3 fatty acid levels in their red blood cells.
The researchers found that people whose DHA levels were among the bottom 25 percent of the participants had lower brain volume compared to people who had higher DHA levels. Similarly, participants with levels of all omega-3 fatty acids in the bottom 25 percent also scored lower on tests of visual memory and executive function, such as problem solving and multi-tasking and abstract thinking.
The study was supported by the Framingham Heart Study’s National Heart, Lung, and Blood Institute and the National Institute on Aging.
Tan, ZS et al. "Red Blood Cell Omega-3 Fatty Acid Levels & Markers of Accelerated Brain Aging," Neurology 2012 Feb. 28; 78(9):658-64.
The "Best Brains" in the Neurology Study Had a DHA/EPA Level of 6.5%
When my omega-3 levels were tested last March as part of a pilot omega-3 study, --without taking any kind of a supplement--& only using chia--my DHA/EPA levels were similar to the 75% "healthy brain" levels in the Neurology study--at 6.6%. Pretty darn good. Check out the chart below.
But, l'm still shooting to get that level up to the "low heart disease risk level" of 8%. For comparison--the omega-3 levels of most Americans are at 4 to 5%. And, honestly, my DHA levels could stand for a bit of a boost.
Although my omega 6 to omega 3 ratio of 5.8:1 was a lot better than the US average which ranges from 8.11:1 to 17:1---getting down to a ratio of 4:1 is my goal.
I hope to get retested after sticking to a daily algal supplement for 3 months. Stay tuned.
The Neurology Study's DHA+EPA Omega-3 Index Levels
Ditch the Sugar & Go for the Omega-3s
Like I said--it's been quite a week for omega-3 studies, and here's another one to help convince you that the 3's are good for the brain.
Ditch the sugar/fructose & eat a diet sufficient in omega-3's for
brain health!! It worked for rats trying to find their way through a maze--maybe it will help us find our keys or glasses. (And check out the Rat Race video at the bottom of this post. See if that doesn't convince you.)
All the rats in this study were first trained to get through the Barnes Maze, before they started on their special diets.
After just six weeks on the four respective diets,
the rats on a high-fructose and omega-3 deficient diet (RED) took 6 times as
long to get through the maze compared to rats on a diet sufficient in
omega-3 and without fructose (GREEN).
This study was led by my fave UCLA brain/food researcher, Dr. Fernando Gomez-Pinilla, "'Metabolic syndrome' in the brain: deficiency in omega-3 fatty acid exacerbates dysfunctions in insulin receptor signalling and cognition" Journal of Physiology 2012 May 1;590(Pt 10):2485-99. For a copy of the article, click here.
Key Points in the article:
•We provide novel evidence for the effects of metabolic dysfunctions on brain function using the rat model of metabolic syndrome induced by high fructose intake.
•We describe that the deleterious consequences of unhealthy dietary habits can be partially counteracted by dietary supplementation of n-3 fatty acid.
•High sugar consumption impaired cognitive abilities and disrupted insulin signalling by engaging molecules associated with energy metabolism and synaptic plasticity; in turn, the presence of docosahexaenoic acid (DHA), an n-3 fatty acid, restored metabolic homeostasis.
•These findings expand the concept of metabolic syndrome affecting the brain and provide the mechanistic evidence of how dietary habits can interact to regulate brain functions, which can further alter lifelong susceptibility to the metabolic disorders.
Rats on Diets - A Little Sugar (Fru) - And a Side of Omega-3's
What's Up With Telomeres & Aging? The Studies Keep Showing an Omega-3 Connection
Ohio State University's Research is Just the Latest
Originally posted on January 23, 2010
A New Role for Omega-3? Lengthening Our Telomeres--A Key Marker for Aging, Longer Life, and Health. From JAMA & UCSF
"The main result of our study is that patients with high levels of Omega-3 fish oil in the blood appear to have a slowing of the biological aging process over five years as measured by the change in telomere length. It's also the first study that shows that a dietary factor may be able to slow down telomere shortening."
-Ramin Farzaneh-Far, M.D., of the University of California at San Francisco, lead author of "Association of Marine Omega-3 Fatty Acid Levels with Telomeric Aging in Patients with Coronary Heart Disease" JAMA 2010;303(3):250-257.
This week's big medical news story appeared in JAMA and it is one more reason why you want to be sure to get your Omega-3s everyday--while lowering your intake of the Omega-6s.
We already knew that the Omega-3s were amazing.
- They're anti-inflammatory and anti-clotting
- They prevent age-related cognitive decline
- They lower triglycerides
- They lower blood pressure
- They slow age-related macular degeneration
- They keep blood vessels flexible
- They lower depression
- They decrease joint stiffness in rheumatoid and osteo-arthritis
- They're necessary for fetal and infant brain development
So What Did The JAMA Heart And Soul Study Tell Us That We Didn't Already Know?
The UCSF researchers followed 608 outpatients with stable coronary artery disease for 5-8 years. At the start of the study they measured everyone's levels of Omega-3's and the length of their leukocyte telomeres--which is a marker of aging. Remember though--this was an observational study, not a gold-standard double-blind randomized controlled study.
Here's how the lead researcher Dr. Ramin Farzaneh-Far explains the results:
"The main result from our study is that patients with high levels of Omega-3's fish oil in the blood appear to have a slowing of the biological aging process over five years as measured by the change in telomere length."
"Patients with the highest levels of Omega-3 fish oils were found to display the slowest decrease in telomere length, whereas those with the lowest levels of Omega-3 fish oils in the blood had the fastest rate of telomere shortening, suggesting that these patients were aging faster than those with the higher fish oil levels in their blood."
"By measuring telomere length at two different times we are able to see the speed at which the telomeres are shortening and that gives us some indication of how rapidly the biological aging process is taking place in these patients."
What Are Telomeres And How Exactly Do They Affect The Aging Process?
PLASTIC TIPS ON SHOELACES—that’s the analogy often used to
describe telomeres. They are the red caps sitting on the ends of these blue chromosomes.
Just like plastic shoelace tips that keep the laces from fraying--the telomeres protect valuable genetic material needed for our cells to divide properly, and to repair worn-out cells.
They are also strong markers for aging (see the graph below and get depressed). Not only do they shorten as we age, over time the telomeres can become damaged and shorten because of inflammation, smoking, obesity, or lack of exercise.
Emmuanel Skorkalakes, of the Wistar Institue in Philadelphia, explains,
"When the telomeres become short, then you start cutting into actual chromosomes where there are genes essential for our body. To prevent the fraying DNA in all those aging cells from seeding maliganant tumors, the body turns them dormant. Your body shuts down more and more cells every day and you become old."
This week's JAMA study is just one more bit of evidence that shows how our lifestyle choices can affect telomere length--and promote healthy aging.
- A 2008 twin study published in the Archives of Internal Medicine compared the telomere length of exercising twins versus couch-potato twins. After only 12 months, the telomere's of the exercising showed the equivalent of being 10 years younger than their couch-potato siblings. Click here to read about the study.
- A 2008 study led by Dr. Dean Ornish followed a group of men with early prostate cancer who made these lifestyle changes: increased their fruit & vegetable consumption; limited their fat consumption to 10%; lowered their consumption of refined sugar; took vitamin supplements & fish oil; exercised for 30 minutes a day; and either meditated or did yoga for stress relief. After only 3 months, 24 out of 30 men showed significant increases in their telomerase levels. Click here to read about the study.
- A number of studies have also shown how stress can accelerate telomere shrinking, especially in caregivers of chronically ill children and the spouses of Alzheimer's patients. One study even suggested that you can accelerate your biological age by as much as 17 years if you're exposed to what you perceive as high psychological stress!
All About Omega-3's. Does It Really Have To Be Fish Oil?
Yes, the JAMA study used Omega-3 fish oil, but Omega-3s really originate in green leafy plants--not in fish.
MUST READ ARTICLE ALERT! REALLY. Susan Allport is a medical journalist/researcher who is an expert in "all things Omega-3". She has written a brilliant article in the September 2009 issue of Prevention, "The Vanishing Youth Nutrient" that does an excellent job of explaining why we need Omega-3s in our diet, why so many physicians equate Omega-3 with fish, and why Omega-3 is sorely lacking in our diets. Click here for the article.
- We can only obtain the Omega-3s through our diet.
- They are essential to the healthy development of our brains--and they are found in the highest concentrations in our most active tissues: brains, eyes, hearts, the tails of sperm.
- The metabolism of every species on the planet is a function of the amount of Omega-3s in its tissues, according the Dr. Tony Hulbert of the University of Wollongong in Australia. Think: Omega-3=growth, activity, energy. Omega-6=hibernation, fat storage, belly fat. Athletes take note: high concentrations of omega-3s in muscle cells lead to improved athletic performance.
- Research from the 1980s showed fish-eating populations of Greenland and Japan had the lowest rates of heart disease. That's why the Omega-3s became associated with fish--instead of with green plants. And that's why the American Heart Association recommends fish or fish oil as our main source of Omega-3s. Big Problem: Fish are not a sustainable source of Omega-3s--there are simply not enough fish in the world's oceans.
- Big Point: "Omega-3s are found in the green leaves of plants. Fish are full of omega-3s because they eat phytoplankton (the microscopic green plants of the ocean) and seaweed. They are what turn sunlight into sugars, the basis of life on Earth."
- You can get all your Omega-3s from green leafy vegetables, legumes, flax seeds, chia seeds (they have the highest level of any plant-click here to read more), or walnuts, grass-fed animals and their milk, or eggs, wild cold-water fish like salmon, highly purified fish oil supplements, or algae-sourced Omega-3 supplements.
- Big Point: If you cut back on vegetable oils, processed foods, trans-fats, corn-fed meat, chicken and milk you will actually lower the amount of Omega-3s you need in your diet to balance the negative effects of the inflammatory, fat-promoting Omega-6s we are getting in our Western Diet.
- The ratio of Omega 6's to 3's should be between 4:1 and 2:1, or ideally 1:1.
Currently, for most Americans, the range for the ratio is anywhere between 8:1 and 17:1, in favor of
heart-disease-causing Omega 6's.
Why Is Our Diet So High in Omega-6s, And So Low In Healthy Omega 3's?
- Omega-6 fats come from the seeds of plants. We need them--but we need far less of them than we are consuming--and we need them in just the right ratio to Omega-3s. They promote blood clotting, inflammation, and cause us to "pack on the pounds". Just like corn-fed beef. Grass-fed or plant-fed animals and humans are naturally lower in fat!
- Big Point: Omega-6s and Omega-3s are in constant competition to enter our cells. Eat too many Omega-6s in the form of meat, oil, or processed food--and you'll be seriously deficient in Omega-3s. Eat less Omega-6s, and your body won't need as many Omega-3s to function properly.
- Omega-3s began to disappear from our food supply when previously grass-fed animals began eating corn and soybeans, which are high in Omega-6s. The factory-farm and feedlots replaced the family farm, and grass-fed meat, milk, and eggs became history. Click here to read about King Corn's effect on our health.
- With farm subsidies for corn and soybeans, companies like Archer Daniels Midland figured out how to extract oil from these and other seed plants--giving us even more Omega-6s in our diet.
- The AHA and other health agencies encouraged us to use oil and margarine because they assumed these cholesterol-free oils were good for the heart. Wrong!
- "Food chemists discovered that rancidity in packaged food was caused by the oxidation of some minor but pesky fats: the Omega-3s." So they removed them and extended the shelf-life of packaged food.
- Fewer and fewer of us are eating enough green leafy vegetables, fish, or flax to even put a dent into the "out-of-whack" Omega-6 to Omega 3 ratio.
If you need any more convincing on the wonders of Omega-3, watch Allport's brief video, The Rat Race, comparing rats fed on diets rich in Omega-3s with those fed on diets deficient in Omega-3s.
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