Have you ever used a DexCom 7, like Tim Ferriss did for the 4 Hour Body book?

There is evidence that alcohol decreases the blood glucose rise, which may explain in part why moderate drinkers have lower risk of heart attacks. Have you found this to be true?

With all respects, Doctor Davis, but I am at a loss to understand your reasoning behind the suggestion of constructing a 2-hour curve with readings taken every 15 minutes. Invariably after eating, blood glucose level will rise and then fall over the two-hour period. I can control the severity of the "spike" by the type of food I consume. After eating however, I cannot control the shape of the curve without the intervention of medication or physical exercise. This is known. So what additional practical information is provided me from this exercise?
My regards, StanO

Hi! These are my readings using a 1-low carb meal-day approach during months.

day   hour mg/dL
02/15 11:17 74
02/15 12:57 83
02/15 13:53 79
exercise lifting weights
02/15 15:11 93
end of exercise
02/15 15:46 75
02/15 16:22 86
02/15 16:49 83
meal time

As you can see these are my pre-meal levels in a low carb diet, one meal a day approach eating nuts, yogurt, liver, meat, fish, especial atkins bread, butter, chicken, eggs etc..

Next day I change my normal low carb meal for a high carb meal (pasta with a bit of meat) with my morning sugar in these same levels. Lets the party begin.

02/16 13:20 finish pasta festival
02/16 13:29 114
02/16 13:42 103
02/16 13:57 125
02/16 14:06 127
02/16 14:12 137
02/16 14:23 119
02/16 14:36 126
02/16 14:48 130
02/16 15:03 123
02/16 15:15 106
02/16 15:30 112
02/16 15:46 111
02/16 16:11 107
02/16 16:22 105
02/16 16:47 114
02/16 17:21 121
02/16 17:32 120
02/16 18:07 113
02/16 18:21 125
02/16 18:50 110
02/16 19:42 114
02/16 20:21 130
02/16 21:29 112
02/16 23:37 119
time to bed. I also feel like shit.

Next day, do you think the party is over?

02/17 07:20 121 (no)
02/17 12:15  71 (finally, nearly 24 hours of high sugar levels!)
02/17 13:00  84
02/17 14:50  81
02/17 15:57  71
02/17 16:30  end meal (with a bit of wheat bread)
02/17 16:48  99
02/17 17:08 111
02/17 17:27  94
02/17 17:47  82
02/17 18:18  87
02/17 18:42  73
02/17 20:09  78
exercise (please, do not ask what type of exercise and how I can manage to check my sugar in that situation
02/17 21:31  98
02/17 22:01  97
end of exercise
02/17 23:15  88
02/17 00:38  83

Next day

02/18 09:18 79
02/18 10:36 81
02/18 11:38 85
exercise (ski, more aerobic so my sugar levels do not increase to much. Cannot use the sticks due to low temp)
02/18 18:00 80
low carb meal using  whole grain special atkins bread
02/18 18:31 85
02/18 18:47 98
02/18 19:08 90
02/18 19:30 88
02/18 19:45 93
02/18 20:20 87
02/18 20:40 80
exercise
02/18 21:12 92
02/18 21:58 94
02/18 22:26 91
end of exercise
02/18 23:39 88
02/18 01:17 88
exercise
02/18 02:20 93
end of exercise

Next day similar to my first set of data.

"I am at a loss to understand your reasoning behind the suggestion of constructing a 2-hour curve"

Varies so much per person and meal composition.  Some people will get peak even longer than two hours w/ something like pizza that has lot of heavy grease as well as the carbs.  Or if they have any gastroparesis  issues

Hi, Eric--

Sorry, but I don't know what DexCom 7 is. Can you tell me anything about it?


Hi, Kurt--

The effects of alcohol and alcoholic beverages are complex. The blood sugar effect is only a small part of the equation. Among the most consistent effects are reduced blood sugar with red wine, increased blood sugar with beer.

Hi, Anonymous--

Impressive effort!

Incredibly, just about any primary care doc would declare your values "normal," since you don't "need" medication.

You've found the secret: Carbohydrates screw up health galore.

I almost had a wheat relapse today, but what I realized is that I wanted the butter. So, I ate a small bite of organic butter.

Carbohydrates don't screw up health in most people, but they have to be managed properly. Anonymous's glucose spike occurred because he/she surprised the body with a heavier carb load than it was adapted to. It takes a week or so for the body to upregulate insulin sensitivity and glycogen storage ability. Until that upregulation occurs, high carb intake will indeed cause glucose spikes.

Here's my own anecdote. After switching to a paleo diet for a week, I then switched back to high-carb. Upon eating 200g (dry) of cooked oats, my glucose shot up to 195 mg/dL. A week later, I was able to eat the same 200g (dry) of cooked oats and glucose remained below 120 mg/dL. What happened is that my ability to process glucose downregulated when I switched to paleo, then upregulated after I switched back to high-carb. Both the down and upregulation take a few days. It is probably inadvisable to constantly switch between paleo and high-carb. If you plan to eat high-carb, then do so consistently, so that the body is always prepared for high glucose loads.

My recent VAP blood tests, taken after resuming my usual high-carb regimen, show HDL=66 mg/dL, LDL=61, VLDL=12, Trig=45, Lp(a)=15, HDL-2=23 (most protective HDL greater than Lp(a), thus counteracting the latter), and type A LDL pattern (mostly large buoyant LDL). CRP was .16mg/L, which is very low. Laboratory measurement of fasting glucose was 85 mg/dL, versus 84 for Reli-On Confirm home glucose testing device measured that same morning (the Reli-On device thus appears to be accurate). These results hardly suggest that a high-carb diet necessarily screws up health.

There is also plenty of other evidence that carbs are not unhealthy for people who are lean, get daily exercise, don't have an underlying illness, and eat mostly unrefined carbs. All sorts of primitive peoples (Kitavans, Tarahumara indians, Bantus,  traditional mediterranean people's, etc) eat high-carb diets and have very low incidence of diabetes, heart disease and other chronic illnesses due to diet (they may have chronic illnesses due to parasites).

Depression a variable: Japan 2010 journal "Anti- Aging" showed affect on blood glucose in 5 hour glucose(75 grams) tolerance test on a clinic's depressed in-patient (woman age 36). The articles authors conclude a "very low saccharide diet" is better for the brain, which runs fine on ketones.

Fasting blood sugar = 74
30 min post glucose = 97
1  hour  "    "     = 78
   (coincides with insulin peak)
2 hour post glucose = 54
   (27% below fasting blood    
    sugar)
3 hour post glucose = 99
   (insulin less than 1/2 of
    30 min. insulin & 1/3 of
     2 hour insulin)
4 hour post glucose = 75
5 hour "     "       = 80

I have a big question here.
I persoanlly have my peak at 30 minutes. So my question is:
Is it a BG of 140-160 after 30 minutes if after 60 minutes it is under 100 too bad?

@Might-o'chondri-AL: Can't understand the logic of low-carb for depressed people. High-carb boosts serotonin. The only reason I could think of prescribing low-carb for a depressed person is because they are overweight, and the excess weight is partly responsible for the depression (inability to move about and exercise due to morbid obesity, for example).

revelo, thanks for some sanity.  Reading these blog posts and most of the comments that follow is depressing.  They would have everyone believe that their inability to handle carbs is representative of normal, healthy, individuals.

Maybe they need to get healthy, and then they can actually eat whole-food sources of carbs and stop being so scared and go and live life.

Hi Revelo,
I've got nothing against carbs & am still learning (I eat carbs); your blood profile seems excellent enough to trade for.My thinking on your approach is: that you may find, like me in my 20/30/40s + years, care free
carbohydrates are fine and by
the time hit 60 there's the unforseen to adjust to. The famous quote is: "Old age ain't for sissys."
  
So, back to Japan ....
Psychiatric clinic tested 2,000;
detailed one to show how variable blood sugar/insulin expression is in depression. They claim to have got her off meds and adressed low neuro-transmitters of depression; which clinically they say (depression) is common in metabolic syndrome.

Their flow chart for seratonin is dietary amino acid L-tryptophan as substrate with folic acid, iron, niacin and enzyme tryptophan hydroxylase; yields, 5-HTP with vitamin B6 and enzyme 5-HTP decarboxylase; yields seratonin (which in it's own right is the substrate for
magnesium and SAMe to make into melatonin). I'll skip their GABA and dopamine flow charts.

This was a geriatric symposium paper, so focus was on brain down the line. Their pitch was for preventing cognitive decline;
and that ketones protect the brain from Alzheimers and Parkinsons - just as ketones diets do help in
epilesy and other mental disorders.

They specify that in the brain beta-hydroxy-butyrate (ketone) ups utilization of circulating oxygen more, decreases CO2 in tissues from glucose "burning", and ketones make ATP more efficiently too. As for the mitochondria, they continue to get their essential glucose molecules from gluco-neogenesis.

My impression is they're showing that in geriatrics the potential
accumulation of what Doc's blog
warned about, namely  A.G.E.s
(advanced glycation endproducts)is a risk factor for Alzheimers, etc. The authors conclusion was the central nervous system used ketones just fine;and carbohydrates were not required for old people to have good levels of circulating blood sugar.





sowed data for 1 depressed lady

Dr Davis: Two comments were made asking for your reasoning behind the suggestion for construction of a 2 hr curve. To me the comments are politely made. They are appropriate in my opinion and they deserve a response. It is obvious that you chose deliberately to ignore them.

Your commentary is followed and I expect influences countless readers; some possibly obsessively, ie healthy individual who performed more the 75 glucose checks over a few days time.

With your efforts to maintain this blog come added responsibilities to its readers which you currently are ignoring.

Shame on you.

Anonymous: Your response to this blog is somewhat emotional and critical. Perhaps you could be open to the idea that some people can consume a high, unrefined carbo diet and be healthy; others will suffer adverse effects on a high carbo diet and need a more protein based or mixed diet. For those individuals that are carbo sensitive, there is good dietary advise on the blog. I do not currently test my blood sugar. I do not want to become myopic about health; however,I don't judge others on this blog who want to pursue this strategy even if they are not insulin resistant, diabetic or pre-diabetic. Moreover, I may have to resort to using a monitor in the future. The blood sugar data from another "anonymous" is very interesting and certainly provides real data for determining his or her dietary choices. Please keep an open mind and avoid insulting comments like "shame on you" which add nothing to the dicussion and are meant to insult not to educate or enlighten others.

DexCom 7 is a "continuous" bg monitor for home use. http://www.dexcom.com/products

I have been eating Dr Fuhrman's diet and lately, typical meal contains 3-4 cups chopped leafy greens, 2/3 cups cooked beans, about 2/3 oz raw seeds/nuts, 200 grams starchy root veg, one piece of fruit (most often an apple).  Peak postprandial sugars for me come very close to one hour after end of meal and are in low 120's to high hundred teens, back to fasting by 90-120 minutes Usually 90 minutes).

why do you think that post meal levels of 120 or 140 are "normal"? Simply because are the levels that people get when eat a lot of carbs in a meal.

You body do not like this levels, that is why it try to put them down using insulin. Why is your body doing that if they are "normal levels"?

If you check my levels in the 4 reply you could find that when you do not eat for longs periods of time your body try keep your sugar between 70 and 90. If you are relaxed the level could be in the 70 zone and if you do some exercise it will go to 90 zone. Why your body do no increase it to "normal levels" of 120-140? Probably because this levels are not "normal".

So you have a high carb meal. Your body react to it trying to keep your sugar down, why?. Yes... your body is stupid and doesn't have a degree in nutrition so cannot understand the science behind this "normal levels".

When you body finally got the 85 level your dietitian says that you need to have another high carb meal. So your levels return to 120-140, and you ignorant body starts to reduce this "normal level" to 70-85. When you got that level is time to have another high carb meal, and your ignorant body returns to do the same trick.

Years of doing that and your body cannot maintain the true normal levels your doctor says that you need to do some exercise to well... reduce sugar levels! and of course still doing 5-6 small high carb meals a day.

So now you need to run the New York City Marathon to get rid of all that carbs in all that meals your are eating during the day.

Of course you need increase the carbs in these meals to have energy to do all that exercises. In one of those healthy marathons you also take a high carb drink to... well... you know.

It doesn't work, you end eating more than before because your body needs more energy to run all that healthy marathons and you are all the day hungry.

Later your unscientific and stupid  pancreas collapse and your doctor says that you need to maintain your 34646464 high carbs meals a day, but take some insulin to help your body to reduce all the sugars YOU ARE EATING EVERY 3 HOURS.

Probably our pancreas simply commit suicide because is not able to understand our rock solid science.

Can someone explain to a non-scientist what "up-regulate" and "down-regulate" mean?  Peter

A couple of people have asked why construct your own glucose curve so I thought I'd throw out my thoughts on it.  Every person's glucose will peak at different points either due to slower stomach emptying or a slower absorbed carb or whatever. I have read that many people will peak at 75 minutes.  So if you are trying to get a real idea as to how your body reacts to glucose/insulin then you need to test frequently to find YOUR personal peak.  Then you will know when to test when you try new foods.  Is that others understanding too?
Char

This blog post is so full of Fear, Uncertainty, and Doubt.  People asking questions due to being scared by Dr. Davis' suggestion of "constructing your glucose curve", so they ask him questions in the comments, like what their "glucose curve" should look like.  People thinking now they better be jabbing themselves 15 times after a meal.  Thinking about a meal for hours after a meal.  Guilt for eating that meal.

So Dr. Davis' response?  IGNORE THEM and put up a new blog post with MORE scare-mongering:


Now you should fear the banana!
http://www.heartscanblog.org/2011/02/american-heart-association-diet-makes.html

"Would you like a banana?"


What a joke.  Show us a single person who got fat off of bananas OR potatoes, or any whole food carbs.

Hi Peter,
Up-regulate is an action on a gene that makes it do more of what it's capable of doing. And down-regulate is when a gene is being acted on in a way that it will do less of what it's capable of doing.

A gene can be overactive or underactive. Depending on the dynamic, of how a specific gene ideally should be doing, regulation up or down is desired.

Here is giving nice tips. Thanks for its. I the way you explain us.

Hey there Dr Davis,

Created my own glucose curve as part of my own research and actually got a bit of a scare!

I was doing a high carb meal to try and demonstrate an early carb spike then drop.

While I didn't get the response I was looking for I got something a bit scarier. A fasting glucose indicitive of pre-diabetes reading instead. I am amazed how one bad meal was able to send my sugar awol over night.

Back onto low carbs for me.

Thanks for helping open my eyes to my potential diabetes.

Dr George

Cool.

But reading your ad page, it isn't clear to me.  Does this kit measure the abundance of all the ω-3 and ω-6 (including the n-18 linoleic / linolenic acids)?  Or is it specific to the long chain (EPA+DHA / AA)?

One thing that seems to be left out of this analysis: omega-3 to omega-6 RATIO. There is some evidence that the ratio is what is important, and biochemically it makes some sense. The PUFAs compete for the enzymes in the eicosanoid pathways, determining relative strength of the inflammatory response. Nowadays, the typical developed-world diet contains far more vegetable oil (rich in omega-6) than people are adapted to. To keep the ratio favorable would require far more omega-3 than a traditional Inuit would need to achieve the same effect on chronic inflammation. To my patients, I stress the importance of limiting use/consumption of vegetable oils as much as seeking extra fish oil.

And by-the-by, there may be a trade-off for the Inuits' lower risk of heart disease - I can't cite a source at the moment, but do you recall hearing that their risk of hemorrhagic stroke is/was higher? The speculation being that the less-active omega-3-based thromboxanes permitted more bleeding to occur. Don't misunderstand me, I'm a big proponent of omega-3 supplementation (I take 6+ grams of fish oil daily myself). But I'm thinking that there must be an optimal ratio/dose, leading to a "trough" in mortality.

Red-

The omega-3s measured are EPA and DHA.


Antidrugrep--

Interesting name!

To my knowledge, the question has been raised but not confirmed. However, there is prolongation of a measure called "bleeding time" in some Inuit groups, though not all.

I've had this test done using the home kit. My test measured RBC levels of EPA, DHA, ALA, 4 monounsaturates, 7 omega-6s, 4 saturated fats and 3 trans fats.  It also shows Omega-6/Omega-3 ratio and AA/EPA ratio.

For what it's worth, I was taking 1,600 mg of total EPA/DHA and my Omega-3 index was only 7.3%.  I've upped my intake to 2,000 mg EPA/DHA daily to try and get it over 8%.

Awesome post Dr. Davis!!!


antidrugrep -- I concur! that wins for  name of the year! *haa*

For 24 mos I took high dose omega-3 4-8 grams daily (SUPER EPA by Now -- I have no finanacial afflilation with them). For my ENTIRE life I consumed a LOT of omega-6
--cooked with gallons of canola oil (dep on the brand may be 20-30% omega-6 LA)
--ate fast food
--ate margarine in the 1970-1990s
--ate restaurant food and still do (it's ALL n-6 PUFAs and worse trans-fat unless you are in NYC)


Omega-6 stays in our cell membranes for up to 18-24 mos (or longer). On the hand omega-3s (flaxseed, EPA DHA) are used up and depleted very quickly for cellular processes, cemm membrane structure/ compositon, nerve conduction, heart rate regulation, and in the control of cardiac and mitochondrial energetics.

A few years ago, the ratio of n-6:n-3 in the U.S. was estimated to be 30:1 however I believe it is somehow far worse. The AHA recommendations will push it even further up (subequently raising cancer and CAD rates).

You bring up an excellent point -- I believe the Inuit experience hemorrhagic strokes if the ratio is below 1.0 (n-6:n-3). This low ratio would be  VERY hard to establish consuming modern foods. All industrial lot cheese, milk, dairy, eggs,  beef, pork, chicken of CHOCK FULL of n-6.  

This low ratio is difficult as well to achieve when inflammation is present
--heart disease (post-cabg, PTCA, MI, revasc)
--subclinical heart disease
--food allergies (gluten, A1 casein, dairy,e tc)
--hypertension, diabetes, Metabolic Syndrome, hyperinsulinemia, obesity, asthma, chronic kidney disease (Cr > 1.0-1.2), low HDL/high sdLDL, etc
--chronic pain syndromes, fibromyalgia, LBP, migraines, etc
--mental illness (SAD, depression, schizo, bipolar which occurs freq in inflammed or CAD patients)

-G

I'm just not sure, if high N-3 doses are necessary for otherwise healthy people.
The JELIS study suggests that there is no significant benefit in primary prevention from 1800mg EPA in a Japanese population (high background consumption of fish), while there were significantly more side-effects.
The study looked somewhat stronger when it comes to secondary prevention, but, again, only soft endpoints were affected (if I recall correctly).

Due to the small rate of eventes, the study apparently lacked power to detect changes in some of the sub-groups, but it really did not look that impressive for primary prevention...

Hi, Kis--

I believe that JELIS showed a 19% (relative reduction) in cardiovascular events in a primary prevention population when 1800 mg EPA was added to the already substantial omega-3 intake of the nearly 19,000 Japanese participants.

I might add that in JELIS study the japanese used EPA ethyl ester, which has a bit different pharmacological profile thaan common EPA.

For example, EPA ethyl ester (E-EPA) may cross blood-brain barrier more easily than common EPA.

http://www.ncbi.nlm.nih.gov/pubmed/19442696

The test looks kind of pricey. If I take the test once as a baseline then when should I take it again after making a change in my omega-3 intake? 6 months? 6 weeks? A year?

I don't mean to hijack the topic but can someone tell me what the difference is between omega-3 and ethyl ester based omega-3?

Hey Kismet,

One thing about the Jelis study that shouldn't be overlooked is the fact they used EPA only.

If I remember my Pubmed studies correctly, DHA tends to be the Omega 3 that increases HDL, and decreases trigs more than EPA does.

And fish (real fish) usually have a higher DHA/EPA ratio than fish oil capsules do. I sometimes wonder if a higher DHA ratio or DHA alone may be a better therapy for heart people.

As for forms, I'm not sure if ethyl ester matters... maybe? Perhaps it absorbs less than the trigylercide form does, but most studies tend to use ethyl esters anyway. Populations studies excluded, of course, as they just eat fish.

I just don't understand the utility of taking a test.  Why?  Just to look at a number?  Similiar tests have been available for a number of years, are not reimbersible by insurance, and may be of questionable accuracy.  
To me, both limiting omega 6's and increasing DHA/EPA is a slam dunk.  Of course it should be done and there is no way that any of us will get anywhere near the Intuit's 1:1 ratio.  Anyway, hemorrhaggic strokes, even if you were to double your risk, would still be a rare event especially compared to an MI or thrombotic stroke.  
Too much fish oil?  Your pocketbook may limit you, your rosacea may limit you, diarrhea/ GI side effects may limit you, but not a blood test.
Too little Omega 6?  I guess Borage Oil is ok for a transfat but I wouldn't pay money for it. And the food industry's Omega 6 PUFA's,.....well you know.

It's all a bit confusing.  We're told that nuts are associated with improved heart health, yet nuts are chalk full of Omega-6.  (Even walnuts, the nut with the most Omega-3, is still 4 to 1 Omega 6.)

I thought you would be interested in my article on omega-3s in Prevention Magazine: http://health.msn.com/nutrition/articlepage.aspx?cp-documentid=100245164

doc-
Outstanding piece and blog. I've been a fan of your work for a long time, keep it up!!

Hi, Robb--

Good to see you here!

You are doing absolutely fabulous work on your blog.

Anyone interested in an exceptionally insightful discussion of the role of diet, exercise, and supplements would benefit from reading Robb's wonderful blog: Robb Wolf: Intermittent Fasting, Fitness, Paleo & CrossFit Nutrition
at http://robbwolf.com.

Hi, Boris--

My understanding is that the ethyl ester form is simply a modification to allow more omega-3s to be contained within a smaller volume. While prescription Lovaza uses the ethyl ester form, so do some quality retail brands, such as Costco's enteric-coated ethyl ester fish oil.

Costco's Kirkland enteric-coated ethyl ester failed a Consumer Labs test, just in case people didn't know. The enteric coating didn't work right and released the oil too soon. The actual fish oil in the capsule is fine, or should be  (Meg-3, which it uses, is considered pretty good). But if anyone is taking it solely because of the enteric coating, and are getting fishy burps, perhaps it isn't working correctly.

http://www.healthnews.com/natural-health/vitamins-supplements/consumerlab-finds-fifty-fish-oil-supplements-free-contaminants-1553.html

You can find the same Meg-3 from Jarrow pretty cheap, although it's not enteric coated and capsules are somewhat large.

Speaking of Enteric coating, Nordic Naturals posted that the coating is a cover-up for cheap quality.

http://www.nordicnaturals.com/en/General_Public/FAQs/264/#19

What do you think?

Nordic Naturals has a history of lying to consumers to promote their own product.  For example, right now they promote their fish oil concentrates as being in a "natural triglyceride form".  The truth is that their concentrates are reconstituted triglycerides that were once ethyl esters.  ALthough still healthy to consume, they are anything but natural form.  Furthermore, there will always be a small fraction of residual ethyl esters left in a triglyceride concentrate because the transesterification process is never 100%.

It's interesting to hear that Nordic Naturals may not be the most honest business out there. Do you have any proof of that? It's not that I don't believe you. I just want to read more about it. All I can find are articles like this:

http://www.reuters.com/article/pressRelease/idUS123643+11-Feb-2009+PRN20090211

That one says Nordic Naturals became the official omega-3 supplement of the American Pregnancy Association.

Nice post! Base from the previous posts, it's not only how high the Omega-3 but the ratio between Omega-3 and Omega-6. I'm not the expert here but I found a FOOD that has the perfect ratio of Omega-3 and Omega-6. You check it out here http://tinyurl.com/ykvj3uw

Dr B.G. (or anyone),
Why are restaurant foods full of Omega-6? And how is NYC different?

Rick,

Back in 2006 NYC banned transfats from restaurants:
http://www.nytimes.com/2006/09/27/nyregion/27fat.html?ex=1317009600&en=e20e688e95d428bd&ei=5090&partner=rssuserland&emc=rss

The article cites Americans consume 5800 mg of transfats daily. OMG. Transfats are worse than omega-6, they are artificially hydrogenated omega-6 which biologically stay in our lipid bilayers (the coating of EVERY CELL OF YOUR BODY), visceral fat depots (eg, our meno-pots and beer bellies), subcutaneous fat stores (under our skin), and in our brains -- where fat comprises 60% of this very important master controller... Trans fats wreak havoc b/c our bodies don't know how to dispose, metabolize or eliminate these synthetically derived oils. That is why there is a HIGH HIGH incidence of heart disease and transfats. All progressive cities and states should follow suit with New York City. Otherwise the food expenses for a transfat ban are being shifted to disability, mortality, and health care dollars!

-G

Doc,

I'd love to know your thoughts on the ratios of DHA to EPA. I notice that NOW brands now makes a DHA-weighted supplement that is enteric coated and free of additives.

What ratio of DHA to EPA do you recommend, and what sort of literature/studies have you found discussing the differences between them?

Even if you take fish oil supplements, it is hard to know just how much you’ve increased blood levels. It is now possible to measure the amount of omega-3 fatty acids in your bloodstream, a value called the omega-3 index. Too little and you might still be at high risk for cardiovascular events.