How much fish oil is enough?

9. August 2008 William Davis (7)

This post just furthers this line of thinking out loud: How much fish oil is "enough"?

Observations over the last 30 years followed this path: If a little bit of omega-3 fatty acids from fish are beneficial in reducing cardiovascular events, and a moderate intake is even better, is even more better? When have we reached a plateau? When do adverse effects outweigh the benefits?

Some insight can be gained through studies that examined blood levels of omega-3s. Let's take a look at some data from 2002, a comparison of men dying from heart disease vs. controls in the Physicians' Health Study, Blood Levels of Long-Chain n–3 Fatty Acids and the Risk of Sudden Death.

This is a table that shows the blood levels of various fatty acids Group with sudden death vs Control Group:




Several observations jump out:

--The total omega-3 blood content differed significantly, 4.82 vs 5.24% ("Total long-chain n-3 polyunsaturated")
--Total omega-6 content did not differ
--Arachidonic acid (AA) content did not differ
--Linolenic acid content did not differ (i.e., plant sourced omega-3)

The fact that neither omega-6 nor arachidonic acid content differed counters the argument that Simopoulos has made that the omega-6 to omega-3 ratio (intake, not blood levels) is what counts. It also argues against the EPA to AA ratio (and similar manipulations) that some have argued is important. In this study, only the omega-3 level itself made a difference; no ratio was necessary to distinguish sudden death victims vs controls.

Further, quartiles of omega-3 blood levels showed graded reductions of risk:




An omega-3 blood level of 6.87% conferred greatest risk reduction. Depending on the model of statistical analysis, risk reductions of up to 81-90% were observed. Wow.

Taken at face value, this study would argue that:

--An omega-3 fatty acid blood level of 6.87% (or greater?) is ideal
--The omega-3 fatty acid blood level stands alone as a predictor without resorting to any further manipulation of numbers, such as relating EPA and/or DHA to AA levels.

Of course, this is just one study, though an important one. It is also not a study based on any intervention, just an observational effort. But it does add to our understanding.


We will develop these issues further in our upcoming Track Your Plaque Webinar on Wednesday, August 20th, 2008.
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Comments (7) -

  • Anonymous

    8/9/2008 5:50:00 PM |

    I get the pharma grade fish oil pill called Lavasa.


    These are really expensive and can one buy similar good fish oil pills over the counter.  I take 4 per day?

    Thanks

  • Anonymous

    8/9/2008 6:34:00 PM |

    So to get a level of 6.8%, how many mg must you consume in a day?

  • AJL

    8/9/2008 7:05:00 PM |

    Great info!

    Is there a lab blood test (low cost) to have one's own DHA/EPA level tested to confirm the level is optimal?

  • M. Levin

    8/11/2008 2:39:00 PM |

    A couple of observations.

    One is that trans fats do not appear to be associated with sudden cardiac arrest. This does not say that they aren't associated with heart disease or that they are healthy.

    The other is that the Cordain et. al estimate of 21% of calories from fat (from primitive man) has been challenged by various sources as being too low based on observations of various recent primitive native cultures, especially based on observations that the parts of the animal that contained the most saturated fat were preferentially consumed. I've included a few references. Other can be found on the net. The point is that this is not established fact, but a guess or a scientific hypothesis.


    from Michael Eades Protein Power Blog  January 30, 2008

    ....Loren Cordain’s seminal paper (http://www.ajcn.org/cgi/content/full/71/3/682) on the plant/animal subsistence ratios of hunter/gatherers, ......
    ... Loren emailed me when I sent him this paper

    Nowhere in that paper do we give the numbers he quoted. We provided these ranges of macronutrient estimations are being most likely (protein 19-35% energy, carb 22-40% energy, and fat (28-58% energy).

    Other references

    http://www.westonaprice.org/traditional_diets/caveman_cuisine.

    https://westonaprice.org/traditional_diets/native_americans.html

  • Tom

    8/11/2008 8:33:00 PM |

    Interesting topic. A couple of years ago a Dr. Leaf of Harvard Medical School made a statement that for those of us with angina fish oil could be deadly.
    I wonder if this idea has been disproven or is it still valid ?

  • Peter Silverman

    8/15/2008 3:02:00 PM |

    Scientists have shown that zero percent of cave men ate food from factories and feed lots.

  • buy jeans

    11/3/2010 8:46:40 PM |

    Of course, this is just one study, though an important one. It is also not a study based on any intervention, just an observational effort. But it does add to our understanding.

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Cheerios: Prescription required?

Cheerios: Prescription required?

13. May 2009 William Davis (15)
Followers of The Heart Scan Blog know my feelings about Cheerios:


Can you say "sugar"?

Cheerios and heart health


There's an interesting tussle going on between the makers of Cheerios, General Mills, and the FDA.

The FDA says that the Cheerios' package claims of:

• "you can Lower Your Cholesterol 4% in 6 weeks"
• "Did you know that in just 6 weeks Cheerios can reduce bad cholesterol by an average of 4 percent? Cheerios is ... clinically proven to lower cholesterol. A clinical study showed that eating two 1 1/2 cup servings daily of Cheerios cereal reduced bad cholesterol when eaten as part of a diet low in saturated fat and cholesterol."

constitute a medical claim, i.e., trying to promote Cheerios as a drug.

I'm glad that the FDA has come down on General Mills. But I find this entire episode laughable: The debate is over the purported health benefits of what I would regard as pure junk food, no better in my view than claiming that a cupcake has health benefits, or a carton of ice cream.

In my experience, Cheerios does not 1) reduce risk for heart disease, nor 2) reduce cholesterol.

It does, however, cause blood sugar to skyrocket and increase the small type of LDL--you know, the type that causes heart disease.
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Comments (15) -

  • Stephan

    5/13/2009 8:49:00 PM |

    I would say that Cheerios are neither food nor drug.  I bet they make great compost though.

  • Gayle

    5/14/2009 2:38:00 AM |

    I agree with Stephen.  Doc wanted my cholesterol down, so I did the low fat diet which included Cheerios.  Cholesterol came down 20 points.  Doc was elated but wanted it lower , so I really hit the Cheerios.  Cholesterol went up 120 points and my triglycerides were up 300 points to 450.  Doc was not happy but probably was elated that he had a reason to hand me the Lipitor prescription.  I refused because I thought my numbers were due to a bad test, after a lot of research,  I now eat  low carb.  Cholesterol total now in the 180 range and triglycerides are around 80.  Fasting blood sugar has now dropped about 10 points, its now under 100.  Dr Davis, thanks for a wonderful informative Blog.

    Gayle

  • SueD

    5/14/2009 2:40:00 AM |

    Does anyone have a link to the "clinical study" that purports to support the claims made by Cheerios?  I certainly can't find it on their website.

  • Ellen

    5/14/2009 9:31:00 AM |

    Where did General Mills ever get the idea that there was something in Cheerios that would lower cholesterol?  Fiber?  I don't get what they're latching onto that's supposedly healthy about cheerios?

  • Susan

    5/14/2009 3:19:00 PM |

    Sue, if you go back to Dr. Davis's blog entry for Monday, April 21, 2008, you'll find out more. I dug around a little and left a comment about the origins of the study and the companies behind the journal that published it.

  • ecrunner

    5/14/2009 4:34:00 PM |

    Opinions on Cheerios aside, when something like this happens it makes me realize how vulnerable we are to advertising. It seems like the general population should know enough about cholesterol and their health that a cereal should not have this kind of influence. It can be as simple as reading a couple of knowledgeable health sources and watching what you eat.

  • Anonymous

    5/14/2009 4:49:00 PM |

    The report on CBS re Cheerios vs FDA presented a doctor who said that it was scientifically proved that Cheerios lowers cholesterol ... a blatant piece of irresponsible ignorance or wanton lying ... you pick!

  • SueD

    5/15/2009 3:57:00 PM |

    @Susan,
    Sorry, I should have checked the link to the April 2008 post before I asked!

    But it appears that the "study" itself isn't available for review.  What a surprise!

  • Trinkwasser

    5/16/2009 1:11:00 PM |

    It's entirely plausible that eating Cheerios works better than eating even worse crap.

    In exactly the same way that eating Whole Grains is marginally better than eating highly refined grains.

    Then the message gets perverted by advertising executives from something being slightly less bad to actually being good.

    I wouldn't even put them in the compost, can you imagine worms with bad lipids?

  • Anna

    5/18/2009 3:30:00 PM |

    Yeah, I feed my compost worms far better than Cheerios, though I did unintentionally kill a whole bin full not long ago with very fermented steel cut oats.

  • Trinkwasser

    5/22/2009 12:44:56 PM |

    Don't worry, if they were fermented enough the worms died happy (grins)

    One of my bins is currently offline, bumble bees are nesting in it. I'd sooner eat them than Cheerios

  • Amanda

    8/25/2009 7:55:53 PM |

    The Food and Drug Administration says in a warning letter to General Mills that language on the Cheerios box suggests the cereal is designed to prevent or treat heart disease.

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    11/3/2010 3:17:28 PM |

    I'm glad that the FDA has come down on General Mills. But I find this entire episode laughable: The debate is over the purported health benefits of what I would regard as pure junk food, no better in my view than claiming that a cupcake has health benefits, or a carton of ice cream.

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