Fish Oils: The Essential Nutrients

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Fish Oils: The Essential NutrientsWith complete references for researchers

by Hans R. Larsen, MSc ChE

There are good fats and there are bad fats. Artificially produced trans-fatty

acids are bad in any amount and saturated fats from animal products should be

kept to a minimum. The best fats or oils rather, since they are liquid at room

temperature, are those that contain the essential fatty acids so named because

without them we die. Essential fatty acids are polyunsaturated and grouped into

two families, the omega-6 EFAs and the omega-3 EFAs.

Seemingly minor differences in their molecular structure make the two EFA

families act very differently in the body. While the metabolic products of

omega-6 acids promote inflammation, blood clotting, and tumor growth, the

omega-3 acids act entirely opposite. Although we do need both omega-3s and

omega-6s it is becoming increasingly clear that an excess of omega-6 fatty acids

can have dire consequences. Many scientists believe that a major reason for the

high incidence of heart disease, hypertension, diabetes, obesity, premature

aging, and some forms of cancer is the profound imbalance between our intake of

omega-6 and omega-3 fatty acids. Our ancestors evolved on a diet with a ratio of

omega-6 to omega-3 of about 1:1. A massive change in dietary habits over the

last few centuries has changed this ratio to something closer to 20:1 and this

spells trouble. [1-3]

Sources and requirements

The main sources of omega-6 fatty acids are vegetable oils such as corn oil and

soy oil that contain a high proportion of linoleic acid. Omega-3 acids are found

in flaxseed oil, walnut oil, and marine plankton and fatty fish. The main

component of flaxseed and walnut oils is alpha-linolenic acid while the

predominant fatty acids found in fatty fish and fish oils are eicosapentaenoic

acid (EPA) and docosahexaenoic acid (DHA). The most beneficial and active of

these fatty acids are EPA and DHA. Alpha-linolenic acid can be converted to EPA

and DHA in the body, but the conversion is quite inefficient especially in older

people. [1, 2]

Scientists were first alerted to the many benefits of EPA and DHA in the early

1970s when Danish physicians observed that Greenland Eskimos had an

exceptionally low incidence of heart disease and arthritis despite the fact that

they consumed a high-fat diet. Intensive research soon discovered that two of

the fats (oils) they consumed in large quantities, EPA and DHA, were actually

highly beneficial. More recent research has established that fish oils (EPA and

DHA) play a crucial role in the prevention of atherosclerosis, heart attack,

depression, and cancer. Clinical trials have shown that fish oil supplementation

is effective in the treatment of many disorders including rheumatoid arthritis,

diabetes, ulcerative colitis, and Raynaud's disease. [1-5]

Recognizing the unique benefits of EPA and DHA and the serious consequences of a

deficiency the US National Institutes of Health recently published Recommended

Daily Intakes of fatty acids. They recommend a total daily intake of 650 mg of

EPA and DHA, 2.22 g/day of alpha-linolenic acid and 4.44 g/day of linoleic acid.

Saturated fat intake should not exceed 8 per cent of total calorie intake or

about 18 g/day.

Good for the brain and children too

The human brain is one of the largest " consumers " of DHA. A normal adult human

brain contains more than 20 grams of DHA. Low DHA levels have been linked to low

brain serotonin levels which again are connected to an increased tendency to

depression, suicide, and violence. A high intake of fish has been linked to a

significant decrease in age-related memory loss and cognitive function

impairment and a lower risk of developing Alzheimer's disease. A recent study

found that Alzheimer's patients given an omega-3-rich supplement experienced a

significant improvement in their quality of life.[6-9]

Several studies have established a clear association between low levels of

omega-3 fatty acids and depression. Other studies have shown that countries with

a high level of fish consumption have fewer cases of depression. Researchers at

Harvard Medical School have successfully used fish oil supplementation to treat

bipolar disorder (manic-depressive illness) and British researchers report

encouraging results in the treatment of schizophrenia. [10-15]

An adequate intake of DHA and EPA is particularly important during pregnancy and

lactation. During this time the mother must supply all the baby's needs for DHA

and EPA because it is unable to synthesize these essential fatty acids itself.

DHA makes up 15 to 20% of the cerebral cortex and 30 to 60% of the retina so it

is absolutely necessary for normal development of the fetus and baby. There is

some evidence that an insufficient intake of omega-3 fatty acids may increase

the risk of premature birth and an abnormally low birth weight. There is also

emerging evidence that low levels of omega-3 acids are associated with

hyperactivity in children. [1, 3, 16- 22]

The constant drain on a mother's DHA reserves can easily lead to a deficiency

and some researchers believe that preeclampsia (pregnancy-related high blood

pressure) and postpartum depression could be linked to a DHA deficiency. Experts

recommend that women get at least 500-600 mg of DHA every day during pregnancy

and lactation. The easiest way to ensure this intake is to take a good fish oil

supplement daily. [17-19]

Researchers at the University of Sydney have found that children who regularly

eat fresh, oily fish have a four times lower risk of developing asthma than do

children who rarely eat such fish. They speculate that EPA present in the fish

may prevent the development of asthma or reduce its severity by reducing airway

inflammation and responsiveness. Researchers at the University of Wyoming have

found that supplementation with 3.3 grams/day of fish oil markedly reduces

breathing difficulties and other symptoms in asthma patients. Other research has

found fish oil to be beneficial in the treatment of other lung diseases such as

cystic fibrosis and emphysema. [23- 29]

The heart's best friend

An enormous amount of medical literature testifies to the fact that fish oils

prevent and may help to ameliorate or reverse atherosclerosis, angina, heart

attack, congestive heart failure, arrhythmias, stroke, and peripheral vascular

disease. Fish oils help maintain the elasticity of artery walls, prevent blood

clotting, reduce blood pressure and stabilize heart rhythm. [1-4, 30-33]

Danish researchers have concluded that fish oil supplementation may help prevent

arrhythmias and sudden cardiac death in healthy men. An Italian study of 11,000

heart attack survivors found that patients supplementing with fish oils markedly

reduced their risk of another heart attack, a stroke or death. A group of German

researchers found that fish oil supplementation for 2 years caused regression of

atherosclerotic deposits and American medical researchers report that men who

consume fish once or more every week have a 50% lower risk of dying from a

sudden cardiac event than do men who eat fish less than once a month. [34-40]

Greek researchers report that fish oil supplementation (10 grams/day) reduces

the number of attacks by 41% in men suffering from angina. Norwegian medical

doctors have found that fish oil supplementation reduces the severity of a heart

attack and Indian researchers report that supplementation started immediately

after a heart attack reduces future complications. Bypass surgery and

angioplasty patients reportedly also benefit from fish oils and clinical trials

have shown that fish oils are safe for heart disease patients. The evidence is

indeed overwhelming. An adequate daily intake (about 1 gram) of EPA and DHA is

essential to maintain a healthy heart. Fish oils are especially important for

diabetics who have an increased risk of heart disease. [41- 49]

Researchers at the University of Cincinnati have found that supplementing with

as little as 2 grams/day of fish oil (410 mg of EPA plus 285 mg of DHA) can

lower diastolic pressure by 4.4 mm Hg and systolic pressure by 6.5 mm Hg in

people with elevated blood pressure. Enough to avoid taking drugs in cases of

borderline hypertension. Several other clinical trials have confirmed that fish

oils are indeed effective in lowering high blood pressure and that they may work

even better if combined with a program of salt restriction. [50-55]

Reduces pain and helps prevent cancer

Fish oils are particularly effective in reducing inflammation and can be of

great benefit to people suffering from rheumatoid arthritis or ulcerative

colitis. Daily supplementation with as little as 2.7 grams of EPA and 1.8 grams

of DHA can markedly reduce the number of tender joints and increase the time

before fatigue sets in. Some studies have also noted a decrease in morning

stiffness and at least two clinical trials concluded that arthritis patients who

took fish oils could eliminate or sharply reduce their use of NSAIDs and other

arthritis drugs. [56-61]

Patients with ulcerative colitis have abnormally low blood levels of EPA.

Clinical trials have shown that supplementation with fish oil (2.7 grams of EPA

and 1.8 grams of DHA daily) can reduce the severity of the condition by more

than 50% and enable many patients to discontinue anti-inflammatory medication

and steroids. [62-64]

There is now also considerable evidence that fish oil consumption can delay or

reduce tumor development in breast cancer. Studies have also shown that a high

blood level of omega-3 fatty acids combined with a low level of omega-6 acids

reduces the risk of developing breast cancer. Daily supplementation with as

little as 2.5 grams of fish oils has been found effective in preventing the

progression from benign polyps to colon cancer and Korean researchers recently

reported that prostate cancer patients have low blood levels of omega-3 fatty

acids. Greek researchers report that fish oil supplementation improves survival

and quality of life in terminally ill cancer patients. [65-73]

Safe and easily available

It is estimated that 85% or more of people in the Western world are deficient in

omega-3 fatty acids and most get far too much of the omega-6 fatty acids.

Vegetarian diets, for example, tend to be very high in omega-6.

The recommended daily intake of EPA plus DHA is about 650 mg rising to 1000

mg/day during pregnancy and lactation. Clinical trials have used anywhere from 1

g/day to 10 g/day, but little additional benefit has been observed at levels

above 5 g/day of EPA and DHA combined. The benefits of therapeutic

supplementation may become evident in a few weeks when blood parameters

(triglycerides, fibrinogen) are involved, but may take 3 months or longer to

materialize in degenerative diseases like atherosclerosis and rheumatoid

arthritis. [74, 75]

The processing and packaging of the fish oil are crucial in determining its

quality. Low quality oils may be quite unstable and contain significant amounts

of mercury, pesticides, and undesirable oxidation products. High quality oils

are stabilized with adequate amounts of vitamin E and are packaged in individual

foil pouches or other packaging impervious to light and oxygen. Some very recent

research carried out at the University of Minnesota found that emulsified fish

oils are much better absorbed than the straight oils in gelatin capsules. [76]

Cod liver oils and fish oils are not the same. Cod liver oil is extracted from

cod liver and is an excellent source of vitamins A and D. Fish oils are

extracted from the tissues (flesh) of fatty fish like salmon and herring and are

good sources of EPA and DHA. Fish oils contain very little vitamin A and D, but

cod liver oil does contain EPA and DHA. However, you would probably exceed the

recommended daily intake of vitamins A and D if you were to try to obtain

therapeutic amounts of EPA and DHA from cod liver oil.

Supplementing with fish oils has been found to be entirely safe even for periods

as long as 7 years and no significant adverse effects have been reported in

hundreds of clinical trials using as much as 18 grams/day of fish oils. Fish oil

supplementation does, however, lower blood concentrations of vitamin E so it is

a good idea to take extra vitamin E when adding fish oils to your diet. A

clinical trial carried out by the US Department of Agriculture found that taking

200 mg/day of synthetic vitamin E (equivalent to about 100 IU of natural

alpha-tocopherol) is sufficient to completely counteract this effect of fish oil

supplementation. [74, 75, 77, 78]

*****

 

 

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First published in International Health News Issue 103, July 2000

 

 

 

 

 

 

 

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