My Amateur Spin on Putting the Diet Puzzle Pieces Together - The Omega-6 and Omega-3 Face-Off in Health & Disease

"..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.

"Curiosity is the beginning of learning and understanding.  Keep on keepin' on."

-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-

Click here if you received this post via email to get all the links and a video.

The more I think about it, diets are a little like religion.  Everyone thinks that theirs is the perfect one.   But there are many paths to the same destination. 

The Dalai Lama says, "The ultimate authority must always rest with the individual's own reason and critical analysis."   

And who am I to argue with the Dalai Lama.  I'm using my own (perhaps limited) reasoning and critical analysis skills (?) to traverse this diet jungle.

For 2 1/2 years I've been tweaking my diet.  I'm now ready for a little more fine-tuning & experimentation.  Anyone want to venture a guess where this is going?

• Dr. Colin Campbell's China Study motivated me to "mostly" ditch meat, chicken, fish, and dairy for 2 1/2 years.   Without even knowing it at the time--I was completely eliminating all long-chain omega-6s--the most inflammatory of the fatty acids.  Guess what?  These only come from animal products.  Who knew?
• Dr. Caldwell Esselstyn's Prevent and Reverse Heart Disease "challenge" got me to ditch all oils, nuts, and avocados, and to substantially increase my intake of greens, beans, vegetables, and fruit over the past 9 weeks.  Without knowing it at the time--I was drastically cutting out the biggest suppliers of the short chain omega-6s--the vegetable oils (yes, olive oil, too), Earth Balance margarine, the nuts, the fake soy products, most tofus & other soy delights, and even my beloved avocados.  Who knew?
• Evelyn Tribole, Susan Allport, Dr. Artemis Simopoulos, and Dr. William Lands have taught me the importance of substantially lowering the omega-6s in my diet, and increasing the omega-3s.  Down with fats & nuts.  Up with  greens, beans, berries, flax, chia---and maybe some reconsideration of wild cold-water fish--and a teaspoon or spritz or 2 of canola oil every now & then?  Turns out, wild salmon (canned included) and canola do not impair vascular function or nitric oxide production--and salmon actually improves it.
• Dr. Robert Vogel and Dr. Lawrence Rudel--two physician researchers well-respected by Dr. Caldwell Esselstyn--led me to reconsider adding wild salmon back into my diet.  Their recent research points to the superiority of the kind of omega-3s (EPA & DHA) found in cold-water fish over the less-dependable plant-based omega-3s found in flax, chia, & greens.  OK, sure, I agree--algal omega-3 sources are just as good--but they are harder to find & they lack EPA.

From Vogel:  "In general, endothelium dependent vasodilation is reduced to the greatest extent by saturated fatty acids, especially of the long-chain variety  (omega-6s found in animal products). The oxidation of cooking oil, which occurs during its reuse, also increases its adverse effect. At the other end of the saturation spectrum, highly unsaturated omega-3 fatty acids, such as DHA & EPA (six double bonds), found in fish oil, do not impair endothelial function when ingested in a single meal and improve endothelial function when given chronically.  Concordant with these observations is the finding that fatty acids inhibit inflammatory markers proportional to how many double bonds they contain.  Vogel, RA.  Eur Heart J  27:13-14, 2006,  "Eating: vascular biology & atherosclerosis.  A lot to chew on."

From Vogel's classic article:   "The postprandial effects of components of the Mediterranean diet on endothelial function."  J Am Coll Cardiol  36(5):1455-60, Nov. 1, 2000.   Conclusions:  "In terms of their effects on postprandial (after a meal) endothelial function, the beneficial components of the Mediterranean and Lyon Diet Heart Study diets appear to be the antioxidant-rich foods—vegetables, fruits, and their derivatives such as (balsamic) vinegar, and omega-3-rich fish and canola oils—not olive oil.  Canola oil may share some of the unique vasoprotective properties of other omega-3-rich oils, such as fish oil. Dietary fruits, vegetables, and their products appear to provide some protection against the direct impairment in endothelial function produced by high-fat foods, including olive oil."  Note: Vogel used canned salmon in his tests.

From Lawrence Rudel's hot-off-the-press article, "Dietary n-3 LCPUFA from fish oil but not alpha-linolenic acid-derived LCPUFA confers atheroprotection in mice"  51:1897-1905, August 21, 2010.  "Indeed, the paradox of the data presented here is that dietary ALA (the plant-based omega-3) does not provide a similar atheroprotection in spite of significant conversion into EPA and DHA over the course of atherosclerosis development."

This article certainly got my attention.  All the mice were able to convert ALA flax oil into EPA just perfectly, something humans can't always do reliably.  But, the big surprise was that the EPA they were able to convert from flax oil, even at high-doses, didn't protect the mice from atherosclerosis--while the fish-oil did.  And a couple months ago, Dr. Christopher Gardner of Stanford also found out that even in high-doses, flax oil didn't lower triglycerides (in human subjects) anywhere near as well as fish-oil did! 

This gives me one more good reason to reconsider adding wild salmon, and/or fish oil back into my diet.         

• Although omega-3 expert Dr. William Lands is certain that when one lowers their omega-6s substantially--by cutting out the worst offenders, like vegetable oils, nuts, fried foods, junk snack food, and grain-fed animal products--that the plant-based omega-3s will adequately convert to the inflammation-suppressing-disease-preventing EPA & DHA--but, I'm ready to give that delicious super-EPA/DHA wild salmon a try.  I like the insurance.  And I like wild salmon.

• Turns out, coho salmon and canned salmon are very lean, low in saturated fat, high in EPA & DHA , and have almost non-existent levels of toxins.  Unlike fish oil capsules, they're whole foods, so they also contain substantial amounts of D3, and a new-to-me-superstar anti-oxidant called astaxanthin. This beta-carotene is what gives wild salmon it's red-orange pigment. Farm-raised salmon has red dye.
• According to Brenda Davis, RD, the blood & tissue levels of EPA & DHA in vegetarians are about half of those of non-vegetarians.  Sometimes flax, bean, berries & greens might not be enough.  The only way to really know if your body has converted plant-based ALA into the workhorse omega-3s known as EPA/DHA is by having a HUFA finger prick test--and these are presently not widely available--or inexpensive. 

Here's what Davis  has to say about vegetarian's and omega 3s:  "When fish is eliminated from the diet, few direct sources of highly unsaturated omega-3 fatty acids remain.  Therefore, vegetarians predominately rely on the conversion of the essential fatty acid alpha-linolenic acid (ALA) from plants to supply EPA & DHA. 

Unfortunately, this process is commonly inefficient, as enzymes necessary for this conversion are easily disrupted.  High intakes of omega-6 fatty acids can have a profound effect on omega-3 fatty acid conversion, reducing it by as much as 40-50% (or more).  Conversion enzymes may not function as well in people with diabetes, metabolic syndrome, hypertension, or certain metabolic disorders."   

The best advice is to minimize the omega-6's, and maximize the omega-3's, if you want the most efficient conversion of plant-sourced omega-3s into EPA/DHA.  Recommendations for healthy vegetarians are to keep their ratios at 2:1 to 4:1, for optimal conversion of flax (and other ALA sources) into EPA & DHA.  Recent research, however, now recommends keeping that ratio to 1:1, but that's very difficult to do.

To read more on the Vegetarian's Challenge--Optimizing Essential Fatty Acid Status, by Brenda Davis, RD, click here. 

First Things First.  Why Should We Care About Increasing Our Omega-3s, and Lowering Our Omega-6s?

Two words:  Inflammation & disease.  Excess omega-6s (and excess calories) contribute to excess inflammation, which leads to--or plays a role in the following disease states:

• Blood vessel damage (omega-3s keep the blood vessels elastic & flexible)
• Heart attacks
• Strokes
• Blood clot formation (omega-3s keep the blood flowing smoothly)
• Abnormal heart rhythms (omega-3s help maintain a steady and slower heart beat)
• Asthma
• Arthritis--osteo & rheumatoid (omega-3s act as pain relievers by curbing inflammation)
• Bone Loss (omega-3s help increase calcium absorption & bone formation)  New to me.
• Cancers (particularly colorectal cancer & breast cancer)
• Bipolar disease
• Depression
• Mood disorders (omega-3s help make & regulate key chemicals that affect mood)
• Learning disorders  (omega-3s are necessary for brain development & brain cell communication)
• Vision disorders (omega-3s are critical for vision)
• Inflammatory bowel disorders
• Autoimmune diseases
• Omega-3s slow biological aging--and lengthen telomeres
  

Increasing omega-3s can contribute to the prevention or management of all of these.

For details on the effect of omega-3 to omega-6 ratios on specific diseases, read:  Omega-6/Omega-3 Essential Fatty Acid Ratio:  The Scientific Evidence.  edited by Artemis Simopoulos & Leslie G. Cleland.  New York: Karger, 2003.  (World Reviiew of Nutrition and DIetetics.  vol. 92)  

For an easy-to-read understanding of how the omega-3s & omega-6s affect disease & health, read Evelyn Tribole's The Ultimate Omega-3 Diet

"Meeting" Evelyn Tribole, Susan Allport, and Dr. William Lands

Susan Allport:  About two years ago I was "introduced" to Susan Allport, the science writer who wrote the eye-opening, Queen of Fats.  After reading one of my blog posts, she emailed me a diet-changing video, called, The Rat Race.  It would convince anyone to pump up their intake of omega-3, particularly the DHAs! 

It shows Dr. Norman Salem's rats in a maze experiment--a rat fed a diet rich in omega-3s is pitted against a rat fed a diet deficient in omega 3's.  If you've been reading this blog regularly, Susan Allport might sound familiar--I recently wrote about her month-long diet experiment eating foods high in omega-6s.  The subtle changes she experienced convinced her that even one month on a high omega-6 diet was bad for her health: weight gain, belly fat, and fatigue.  I know I've posted this video before--but it's a favorite of mine.

Evelyn Tribole:  Also, about two years ago, I received an email from California author, dietitian, and private practitioner, Evelyn Tribole.  Her 2007 book, The Ultimate Omega-3 Diet  further opened my eyes to the importance of lowering my intake of omega-6s, and increasing my intake of omega-3s.  I highly recommend her book, and her blog, Omega-6 Commentary & News.  Here's a good introduction by Tribole about how omega-6s negatively affect our health.

Dr. William Lands:  Both Susan & Evelyn had sought out Dr. William Lands when they wrote their books.  If you want to know all about how important omega-3s are to growth, development, and disease prevention--Lands is the man you seek out.

On July 8th of this year I was pleasantly surprised to receive an email from Dr. Lands.  Turns out, he cc'd me, when he wrote a response to one of my blog readers--who had written him with questions after watching Bill's NIH lecture after I recommended it on my blog.  (if you can follow that connection)  Here's a link to Lands' lecture. 

And for the past 6 weeks I've had a back and forth mini-dialogue with Dr. Lands all about balancing omega-3s & 6s on a vegan no-oil diet.   I wanted to know what he thought about a vegan diet that nixed oils, nuts, & avocados.  Would he consider this to be an excellent model for curbing omega-6s and disease-prevention?  Would it provide sufficient omega-3s?  Needless to say, I was honored that he took the time to answer my questions, and I was enlightened by what I learned.  And no, he didn't give me a straight-forward answer to either of those questions.  He said you just have to "run the numbers" on his KIM2 software or by using a too-complicated-for-me mathematical formula--or measure your HUFAs (highly unsaturated fatty acids) via a finger prick test. 

• "The tissue is the issue."  It's all about how much omega-3 & omega-6 is saturated in your tissues.  The closer the ratio of omega-3s to omega-6s gets to 1:1 the lower the risk you have for a whole host of inflammatory diseases:  heart disease, stroke, autoimmune diseases, arthritis, psychiatric diseases, depression, asthma, eczema, and the list goes on.  Most Americans are at a 17:1 ratio.  But even when you start to get to a ratio of 4:1 you would see impressive improvements in disease prevention. 
• Omega-6s are rampant in our Western diet, and they compete for the same enzymes in our cells as do the omega-3s.  Since most of us eat far too few omega-3s, guess which omegas end up saturating our tissues?  The inflammatory omega-6s.  No use popping omega-3 pills if you aren't also lowering your omega-6 intake.
• Lower the intake of omega-6s & the body can properly convert plant-based omega-3s, into the powerful inflammation-suppressing-disease-preventing EPA & DHA.  According to Dr. Lands, "As you add more and more omega-6, the omega-3 is not very effective.  So do not be surprised, dear children, that there are a lot of articles in the literature saying that the short chain omega-3 (those are the plant version omega-3s found in greens, flax, chia, fruits, & most beans) are not very effective, because (these studies) are all done in the presence of a substantial excess of omega-6 (on people whose tissues are loaded with omega-6s).  The paradox is that, conversion is not effective when it's in the presence of omega-6, but by itself it's quite effective.
• "This puts together everything I've told you.  Let's lower the omega-6s.  You're eating like 17,000 milligrams a day.  What would happen if you just made it 4,000?  Now you're at a level where you have the protection that you want.  You can prevent disease.  It's as simple as that."
• Dr. Lands wouldn't tell me what he eats, even though nosy me asked.  He answered my question about diet with, "Never mind the diet details, my HUFA (hormone precursors) have about a 60% omega-3 to 40% omega-6 ratio.  That's pretty amazing, if you ask me.

He just turned 80 years old.  He's incredibly active, writing, researching, & lecturing.  One of the lipid researchers at my hospital tells me that he is the picture of health, fit, slim, an dedicated exerciser, and a role model.  I asked him if he knew what Bill ate.  He told me Lands eats a whole lot of fish!

• Lands covers all the bases, when it comes to diet.  Sure it's important to kick up the omega-3s, and lower the omega-6s substantially, but that's not enough for Dr. Lands.   We also wants us to eat less calories at every meal--to decrease the damage of oxidative stress.   And exercise is a crucial component to the whole package. 

Here's my summary of Lands' recommendations:

1.  Exercise
2.  Small, more frequent meals--less oxidative stress
3.  Less calories
4.  Emphasize beans, greens, squash, other veggies, fruit, wild fish, flax, seafood.
5.  Watch out for the "not-so-healthy" foods masquerading as good: like garbanzos, tofu, corn, hummus, nuts, peanut butter.  Who knew?
6.  Ditch the omega-6 oils/mayo, fast food, & junk food!

What foods are highest in omega-6s? Eat Less of These.

• Soybean, corn, cottonseed, safflower, sunflower, grapeseed, sesame, and peanut oils.  Even olive oil and walnut oil have substantial amounts of omega-6s.
• All nuts and seeds are high in omega-6s.  Peanuts & peanut butter are especially high.  Walnuts have the lowest amount with a 4:1 ratio of 6s to 3s.
• Margarines, mayonnaise (most are made with soybean or safflower oil, & eggs), and salad dressings (check the oil used--canola is rarely used)
• Grain-fed meat, poultry, fish, and eggs.
• French fries, fast-food restaurant fare, fried foods (beware the deep fat fryer that reuses oil), all processed snack/junk foods made with oils or sat fat, cakes, cookies, muffins, or crackers.  Read labels.  Unless you've made it yourself, it's probably suspect.
• Soybean & peanut based foods.  Yes, that includes edamame, soy burgers & hotdogs, & even regular tofu. Soy is over 40% fat.  (This made me think about that 2000 study correlating high tofu consumption with cognitive impairment.  Hmm.)
• An easy way to check the omega-6 & omega-3 content of most foods is through Nutrition Data. Look in the top right-hand corner search box.  Unfortunately, there isn't data on all foods, and the only way to know their omega content is through laboratory testing. 

Surprising sources of omega-6s. Even "healthy plant-based fare" may be high in omega-6s.  And fat-free doesn't me omega-6-free.   Who knew?

• Peanut butter, nuts, & seeds.  Walnuts are the lowest of the lot.
• Garbanzo beans aka chick peas have the highest amount of omega-6s of the beans.  1 cup=1178 mg of omega-6s, 45 mg of omega-3s.
• Fava beans  (an ingredient in falafel--it's moderate in n-6, but very low in n-3)
• Tahini
• Hummus (It has two offenders: garbanzo beans & tahini)
• Most processed faux meat soy products--oil + soy=oy!
• Most tofu, tempeh, edamame, & other soy products  (NaSoya low-fat firm tofu has far less omega-6.  Mori-Nu low-fat brands haven't yet been analyzed, nor has Soy Boy Low-fat Tempeh)
• Most whole grain products are higher in omega-6s (than beans, fruits & veggies) including:  quinoa, brown rice, corn, whole grain breads, & oatmeal.
• Avocados

But Don't Avoid Healthy Foods Just Because They Have Omega-6s. They're Still Important Foods--and we also need Omega-6s.

We need the omega-6s, too.  Just not as much as we're currently eating.  Be aware of the omega-6 content of the food you are eating, and balance them with a higher intake of omega-3s.  Cutting out oils, nuts, processed junk & fast food makes a huge dent in omega-6 intake.

What Else Can I Do to Kick Up My Omega-3 status?

• Eat lots & lots of fruits & vegetables  (greens & beans rock!)
• Reduce saturated fat
• Eliminate trans-fatty acids
• Eliminate hydrogenated or partially hydrogenated oils
• Maintain a healthy weight by getting enough exercise, and not taking in more calories than you need
• Try to eat a source of omega-3s at every meal--this could be greens or beans.
• If you absolutely must use an oil, stick to canola for cooking, and if you use flax oil, make sure that it's fresh & refrigerated--and use it "raw", not for cooking.
• Be aware that grain-fed animal products (meat, poultry, eggs, & dairy) are also high in omega-6s & this is the most damaging & inflammatory kind, arachidonic acid.

What's a good way to compare the omega-3 & omega-6 content of everyday foods?

• Get a copy of Evelyn Tribole's "The Ultimate Omega-3 Diet"
• Be sure to take a look at Dr. Bill Lands' recent handout that was distributed at the Morgan County, WV County Fair in August 2010.  It has excellent comparative charts of the omegas for all the food groups, sample menus from real people, demonstrating the best to the worst, in terms of reducing the risk for inflammation, depression & heart attacks.  It's also filled with sage advice on reducing the future risks of disease & provides an excellent overview of how our diet affects our health.  A critique of all the popular diet books is also included.  There's a lot of info packed into this excellent handout!
• Check out the omega-3 & omega-6 content of individual foods through the Nutrition Data website, I find it easier to understand that the USDA nutritional data database. 

Omega Definitions

1.  Short-chain omega-3 is the plant-based ALA (alpha linolenic acid) that needs to be converted in the body to make long-chain omega3 EPA and DHA--the inflammation-suppressing powerhouses.   This conversion is not always so reliable--and no one can guarantee how well it's working for you.

2.  Short-chain omega-6 can come from plants or animals.  It is easily converted into the most inflammatory-disease-producing fatty acid, arachidonic acid.  Not fair--plant-based omega-3 converts unreliably & short-chain omega-6 conversion in dependable!  The long-chain omega-6s come only from animal products, and they are a direct source of the inflammatory-disease-producing arachidonic acid.

3.  Omega-3s & Omega-6s "compete for enzymes and positions in cell membranes.  A high omega-6 to omega-3 ratio has been linked to many human diseases.  ... omega-6s are preferred in food processing: because omega-3s are easily oxidized, manufacturers remove them when possible to reduce rancidity and increase shelf life ...."  Susan Allport, The Queen of Fats.

I've tried hard to make sure that this information is correct--but, hey, I'm just a librarian, not a lipid researcher or a dietitian.  I'm certain I'll hear if I've misrepresented anything here--and I'll gladly make corrections on anything when it's fact-based & referenced to reliable sources.  I felt like I was writing a term paper as I put together this one.  Now for some lunch, & "La dolcezza di non fare niente!"  The Sweetness of Doing Nothing.

Comments

[JK]

I'm right here with you on your spin for the diet. I have added fish (wild salmon) and flax fed chicken eggs back to my diet.

In your post, you said, "Turns out, coho salmon and canned salmon are very lean, low in saturated fat, high in EPA & DHA , and have almost non-existent levels of toxins." Can you tell me more or point me to some references? I wan to read more!

Thanks for all you do! Here's to health. xoxo

[Karen]

Thank you for sharing your knowledge and insights. I found your site after I started my own Dr. Esselstyn book inspired eating changes. It has been a little over 7 weeks for me this go around (did a few weeks in January). It has been very successful in improving how I feel and my weight. I am finding it fascinating to learn more and more about the complexities of nutrition optimization. I enjoy and respect your evidence based approach. As always in life, the more I learn...the more I can learn.

[Alex]

Why not just eat some grass-fed beef and get ideal ratios of Omega 3 along with some CLA?

[Healthy Librarian]

Hi Alex,

I'm not fond of beef, but even if I was, the omega-3s in cold-water salmon far exceed those of grass-fed beef. Grass fed beef also has a less-healthy ratio of omega-3s to omega-6s, and this is long-chain omega-6, the most inflammatory type.
Finally, all the positive research I'm writing about is about fish oil, and cold-water fish. No one, that I am aware of is recommending grass-fed beef over cold-water fish in the medical literature. Sure, it would be a better alternative to grain-fed beef--but not to fish oil.

1 lean grass-fed beef steak

Total Omega-3 fatty acids
44.9 mg

Total Omega-6 fatty acids
171 mg

6 ounces of Coho Wild Salmon

2,235 mg of omega-3 fatty acids (1844 mg EPA +DHA)

Vitamin D3
about 747 IUs

Astaxanthin (a carotene-type anti-oxidant)
about 4 mg

[OL]

Yet another wonderful post. I think you did a very good job of clarifying everything so that I can really understand it. Since I started reading your blog in the fall of 2009, I have really changed my diet and I am feeling better and better. (I still eat a few nuts, avocados, small portions of organic chicken, occasional organic grassfed beef and lots of wild salmon, lots of greens, beans, some fruit, no sweets and no added oils). My blood tests, blood pressure etc. are excellent. I have passed on the link to friends of mine and now they are also changing their diets and experiencing benefits. You lay out the science so clearly and convincingly. We often comment about how great this blog and how grateful we are to you. Thank you.

[MK]

LOVE this post. Thank you for sharing your insights, info, links and videos. Most of us have quite a bit of room for body, mind and soul improvement. Happy Healthy Long Life is a favorite place for me to go for inspiration and motivation. My profound thanks to you.

[[email protected]]

thank you for all the information you've shared!

[Gael in Vermont]

This WAS like writing a term paper! You are so dedicated and we all cannot thank you enough for helping us find the right path through the maze of nutritional information. Adding in some cold-water salmon will also help me with maintaining a better B12 balance since strict vegans need to supplement. Any thoughts on that? Were you taking a B12 previously?

[Healthy Librarian]

JK:

First got the nutrition & safety info on Coho from Dr. Robert Vogel's book, The Pritikin Edge. Since he's the man who did all the research on the negative effects of various food on the endothelial lining of blood vessels--and their effect on nitric oxide production--if he says wild salmon is OK--I'm all ears.

Then got more detailed nutrition info from Vital Choices website--purveyor's of healthy fish. They're in the business to sell fish--so keep that in mind. But, the nutritional info on various kinds of salmon is readily available on the USDA nutrition site, too.
Here's the Vital Choice link comparing the toxin/mercury levels of fish. http://www.vitalchoice.com/uploads/Merc%20Comp%204_06.pdf

The smaller the fish, the lower the toxins. Vogel, says wild & canned salmon are exceeding low to non-existent.

Also, coincidentally, I just received a research article all about the high anti-oxidant properties of astaxanthin--ordered for one of our physicians. First I'd ever heard of it--and then a few days later I'm reading that it's in wild salmon. Monterey Bay Aquarium's (check on the web) Seafood Watch lists Wild Salmon as tops for environmentally friendly fishing & sustainability.

This is from Vital Choices:

About Silver (Coho) salmon
Wild Alaskan Silver Salmon is substantially leaner than Sockeye or King Salmon, yet is prized for its moist, delicate texture.

While leaner than Sockeye or King,
our Wild Alaskan Silver (Coho) salmon
offers abundant omega-3s and vitamin D.

Often overshadowed by better-known Sockeye and King, Silver salmon finds favor with many connoisseurs.

In addition to ample protein and fewer calories, Silver Salmon provides three beneficial natural food factors in abundance ... amounts are per 6 oz portion, and will vary annually and by harvest location:

* Omega-3s – About 2,223 mg, or four to seven times more than many fish oil capsules.
* Vitamin D3 – About 747 IU -- in the optimal D3 form -- which is much more than most other whole or fortified foods and nearly double the US RDA of 400 IU. (Most experts now advise adults to consume 1,000-2,000 IU every day.)
* Astaxanthin – About 4 mg. This red-orange pigment is a carotene-type antioxidant that, in test tube experiments, measures 100-500 times more powerful than vitamin E.

Thanks to everyone for your appreciation & kind words about this post--both on & off the blog.

Gael,

Re B12--I take a sub-lingual for better absorption (bypasses digestive system) of 1000 micrograms--very inexpensive. I asked Dr. Esselstyn about this--and he received this recommendation from an expert in vitamin b research. It's methylcobalamin--tastes great, and I just keep the bottle in my purse so I won't forget.

[Maria]

Thank you so much for the fascinating information. Just when I think I have pretty good knowledge on good eating habits, you give me more information to learn and new habits to adopt. I am happy to be your student. Keep the healthy information flowing.

I always look forward to your posts!

[Hank]

Also, any chance you can get this one, and tell us what the "other" dietary factors hinted at by their results are?

http://www.ncbi.nlm.nih.gov/pubmed/20396634

[Hank]

> fish

Unfortunately, it's awful hard to find fish nowadays, if you want to buy from sustainable sources so you can still find the fish again later.

The Marine Stewardship Council appears to have sold out to the people stripmining the ocean, and has been busted by scientists:

http://www.seaturtles.org/article.php?id=1779
http://www.sciencedaily.com/releases/2010/09/100901132159.htm

[Pam]

Well, I'm discouraged -- and confused. I finally figured out how to do sample menus in Kim2, and it appears that as a vegan, I just can't get to the "very low risk" category in Bill Lands' Morgan Fair handout (around 9 - 25% Omega 6 in the precursors). Even if I ate NO grains along with no nuts or avocado, I can't get below about 35%. To get to his lowest risk category, you *have* to add fish.

But this is where I'm confused -- aren't we aiming for a 1:1 ratio as ideal? In which case, wouldn't anything under 50% Omega 6 in the precursors be very low risk? I've missed something somewhere ...

Thank you for this blog; I saw it referred to on the McDougall board and have been following it with fascination since.

Pam

[Healthy Librarian]

Hi Pam,

I'm not an expert at this at all, but I spent a fair amount of time trying to understand it. The long-chain 3s are of course the best--and the highest source is going to be in fish. But, they are also in algal sources, so that is certainly an option--and eventually, they will be more widely available, because they are the most sustainable source in the long-term. I take an algal form of DHA, but it's only about 125 mg. of n-3 per capsule. About 4 times a week take purified fish oil capsules that are 1200 mg of n-3 for the standard serving size of 3 capsules. Remember, the more you lower your intake of omega-6, the less n-3 you need. If you are eating lots of corn or garbanzos--just eat more foods higher in n-3 that day--like chia.

You didn't say if you are using flax meal or chia---they are tremendous sources of ALA, the short chain omega-3s. The body still has to convert these into the long-chain, and according to Lands, the more you lower your intake of the omega-6s, the higher the conversion rate of the ALAs. Chia is fantastic in water, and it's so easy to sprinkle on cereal or on anything else, & it has 2740 mg of n-3 in a TBS, at least in the Salba brand. I still use flax meal in cereal, but I like chia better--there's no bitter taste & it doesn't need refrigeration.

Vegetable oils are a huge source of omega-6s, except for canola oil. So keep that in mind. Beans (except soy), vegetables, & most fruits are pretty much perfectly balanced foods. And flax oil is a huge source of plant-based ALAs--you can't use it for cooking, though.

If you're doing all of this, and are really interested in increasing the omega-3s, I'd say email Dr. Lands-and ask the real expert. Also, in the final analysis, the only way you will really know how efficiently your body is converting the plant-based ALAs is by having a blood test. That info is in my post. Lands' mission is to convince health care systems to make these tests widely available--just like cholesterol tests--and he believes they are a much more accurate marker of health (physical & mental).

Hope this helps. Oops, last point, don't worry about getting to 1:1, if you got to 4:1 you'd make a huge difference.

[mark]

Very nice blog. It seems your are doing everything Dr Essselstyn recommends except Fish. You are more in line with Dr Ornish.

I have no scientific proof but my gut feeling tells me that nature is very smart, it is quite the intelligent design if you look around and think about various things such as nature provided Zero calorie drink water, it provides low calorie foods without cholesterol/high amount of fat etc.

If six billion people on planet had to pop 3-4 fish oil pills per day, I don't think it is self sustaining. I can't not imagine the number of fish would have to be killed. Why would nature do that?

I'm all ears.

[Healthy Librarian]

Mark, you're right. Fish oil isn't sustainable for 6 billion people--and the same goes for 2-3 servings of fish a week. My omega-3 expert tells me that algal-produced omega-3s are sustainable, can be processed inexpensively, and are just as good as fish oil. Only a blood test (pretty costly) would tell us how well our plant-based omega-3s are converting to long-chain omega-3s, and if one's omega-6 to omega-3 ratios are in a good range--without fish, fish oil, or algal oil.

[mark]

HL,

Can you please list some of the algal produced omega3s? Also does it contain just DHA OR EPA and DHA. Request you to consider writing a blog dedicated to ALL ABOUT omega3s in layman's terms. Thanks

[Rob]

For someone who wants to minimize cardiovascular risk, does Dr. Esselstyn still recommend to avoid eating any fish at all? Or has this research changed his views at all?