Your Lifestyle Is Your Medicine
“Your Life Style Is Your Medicine” is a podcast that focuses on how a person's lifestyle can be the key to health and happiness. Routed in the principles of lifestyle medicine, Ed Paget, osteopath, and exercise scientist, interviews area-specific experts on how lifestyle impacts well-being, focusing on purpose, physical activity, nutrition, sleep, and stress, which could lead to a longer, happier life. Edward now runs immersive lifestyle medicine retreats, with the purpose of helping others take back control of their lives to live longer and healthier.
Your Lifestyle Is Your Medicine
Episode 46: Unraveling the Mysteries of Omega-3s with Dr. Bill Harris: From Health Benefits to Future Innovations
Join us as Dr. Bill Harris, a distinguished researcher with over 40 years of expertise in the omega-3 field, unravels the mysteries of fatty acids and their vital role in our health. Together, we shed light on the complex landscape of fats, including triglycerides, saturated, and unsaturated fats, and particularly focus on the essential nature of omega-3 and omega-6 polyunsaturated fats. Dr. Harris shares his personal journey into this fascinating field, offering insights into the molecular structure and distinctive characteristics of omega-3 fatty acids.
Discover the profound health benefits that omega-3s, especially those derived from fish oils, can provide in promoting long-term well-being. We tackle misconceptions about supplements, such as blood thinning fears, and emphasize the non-threatening nature of typical doses. Learn how a diet rich in omega-3s is linked to a reduced risk of heart disease, diabetes, and certain cancers, highlighting their significance as essential nutrients. We also address the challenges in distinguishing the benefits of omega-3s from other healthy lifestyle factors, underscoring the need for comprehensive research to fully understand their impact.
Explore the potential of omega-3s across different life stages, from pregnancy to old age, and their role in mitigating risks of autoimmune diseases and cognitive decline. Dr. Harris introduces the Omega-3 Index, a groundbreaking tool for assessing heart disease risk, and shares practical advice on supplementation, including the importance of testing. As we look to the future, the conversation shifts to innovative sources of omega-3s, such as genetically modified seed oils, which promise a sustainable alternative to traditional fish-based options. This episode is a treasure trove of information for anyone eager to enhance their health using the power of omega-3 fatty acids.
If you have higher levels of omega-3 in your diet all your life, then you have better health outcomes toward the end.
Speaker 2:Welcome to the your Lifestyle is your Medicine podcast, where we do deep dives into topics of mind, body and spirit. Through these conversations, you'll hear practical advice and effective strategies to improve your health and ultimately add healthspan to your lifespan. I'm Ed Padgett. I'm an osteopath and exercise physiologist with a special interest in longevity. Now today's guest is Dr Bill Harris.
Speaker 2:Now Dr Harris has been a leading researcher in the omega 3 fatty acid field for over 40 years. He has published in excess of 300 scientific papers on fatty acids and health, and the vast majority of those have been, in particular, on omega-3. He's been on the faculty of three medical schools the University of Kansas, missouri and South Dakota and has received five NIH grants to study omega-3s. He was the co-author on three AHA statements on fatty acid and heart disease and the co-inventor of the Omega-3 Index and other Omega-3 blood tests. He's also the founder of OmegaQuant Analytics, which we'll be getting into in more detail later in the show. Dr Harris has been ranked among the top 2% of scientists worldwide based on the impact of his research. So, dr Harris, welcome to the show.
Speaker 1:Thank you, Ed Appreciate your having me on.
Speaker 2:Oh, appreciate you being here. Thank you very much. I thought we could just start by giving our listeners just a sort of a 10,000 foot overview of where fats fit into the whole kind of subject of nutrition, and then dial it down into your specialist subject. Can you do that for us?
Speaker 1:Sure, sure, I mean, we think about nutrition, we think about food and then we think about nutrients in food. Three major, what we call the macronutrients, which are protein, fat, carbohydrate and water, I suppose, would be there too. So those are the big, the big guys. Of course, fats is the one I'm interested in particularly so. If we drill down out of fats, there are a variety of kinds of fat in our diet. The one that's most common in our diet is what we call triglycerides, which would, if you picture butter, you picture butter, you picture lard, you picture a bottle of vegetable oil. That's essentially 100% triglyceride. The other kinds of fats would be like cholesterol, would be another fat, but we're not going to talk about cholesterol. So we have fats, triglycerides, which we typically say fats and oils. Fats and oils. Well, a fat is typically a triglyceride-based product that's solid at room temperature, like butter, and an oil is a triglyceride fat that's liquid at room temperature. So it's kind of an arbitrary. Of course it depends on how warm your room is, right, of course, but in the end the hard fats are what we call saturated fats and the liquid ones are typically called unsaturated fats. And you know, saturated with what? Well, saturated with hydrogen atoms is what the chemically. So, if a molecule is saturated, has all the hydrogen atoms it can hold. It has no double bonds in it. In chemistry we have single bonds, double bonds, triple bonds. So if you have any double bonds in your fat molecule, you have an unsaturated fatty acid. If you have more than one, you have a polyunsaturated fatty acid, meaning there's two double bonds at least. So the omega-3 and the omega-6 fatty acids fall into that polyunsaturated fatty acid subset and those are really the two what we call essential fatty acids, because the what we call monounsaturated fatty acids, like what you get in olive oil or canola, are in the saturated fatty acids from animal product beef, tallow, things like that. Those are not essential. You don't have to eat them. You can make them in your body from carbohydrates. But you can't make the polyunsaturated essential fatty acids, the omega-3s and omega-6s, unsaturated essential fatty acids the omega-3s and omega-6s, and so I'm by far the biggest.
Speaker 1:The most common polyunsaturated fat in our diet is the omega-6 fatty acid called linoleic acid. It's 18 carbons long, it's got two double bonds in it and it's an omega-6 configuration of the omega six configuration of the omega. You know where's that come from? Uh, the omega three, omega six, omega nine, yada, yada. Uh, that all comes from looking at the chemistry of the molecule, structure of the molecule.
Speaker 1:And every fatty acid, kind of by its name, has a fat group, a fatty group and a acid group group, a fatty group and an acid group on it. Chemically and in normal chemistry we count the, the acid group, as the active group, the important part. So we start, we call that that carbon atom, at that end the alpha carbon of the molecule. And then, since fatty acid chains can be somewhere between 2 and 30 carbons long, we always say the last carbon is the omega carbon. So we have the first one and the last one and the last one is the omega. So if you count back three positions, three carbon atoms, if there's a double bond there it's an omega minus 3 fatty acid, and if it's an omega 6, you, you got to count back six carbons to get the first double bond. Well, that's so, you know? So what? Well, it makes a lot of difference in biochemistry where that double bond is, as it turns out. But that's the two big families. So we're not really going to talk much about the omega six family today.
Speaker 1:I don't think I've gotten into the omega-3 family. I got into it basically almost 44 years ago now, as it turns out when I was assigned by my. I got a PhD in nutrition and needed to do a postdoc postdoctoral fellowship, which is like a residency in medicine and I picked working with a guy who was very interested in the effects of different dietary fats on cholesterol levels, dr Bill Connor, portland Oregon. And when I got there in 78, he said well, let's, I'm wondering what fish oil does to your cholesterol level. I'm wondering what fish oil does to your cholesterol level. Okay, hadn't crossed my mind.
Speaker 2:Why did that topic come up? Because around that time there was some studies on vegetable oils versus animal fats, raising or lowering cholesterol. Is that right? That's true. That's exactly right Is that the genesis of this.
Speaker 1:That was somewhat of the puzzle at the time. We knew that animal fats, which are solid, raise cholesterol. We knew that vegetable fats, vegetable oils, seed oils literally speaking, these are not vegetable. These are not coming from tomatoes or cucumbers, this is from corn, soybean, primarily soybean. Seed oils are all liquid at room temperature. So what we didn't know was well, is it the liquidness or the plantness of these oils that makes them lower cholesterol? Was it the hardness of the solid or the fact that it came from an animal that made cholesterol levels go up? So we just so bill connor said well, you know, fish is an animal, but it's got liquid, liquid fat, so we'll sell.
Speaker 1:That question turned out it's the liquidness that's important, not the, not the source, not the, uh, animal or vegetable source. So that's what prompted it. So he assigned me to do this as my project and spent quite a while doing it. It was a metabolic ward study, meaning that we recruited healthy, normal volunteers from around the medical center and we fed them all their food for essentially three months one month of almost the only, virtually the only fat in the diet was salmon oil. One month where virtually only the the only oil was like soybean oil. And then one month where it was only animal fat, and then we just looked to see what happened to their cholesterol levels okay, these are the same.
Speaker 2:The same group had all three different diets.
Speaker 1:Yeah mixed them up right, different sequence, you know. So it's a big, big project. Um, and we? You know what do we find? Well, we found that the two liquid oils lowered cholesterol relative to the saturated fat, the animal fat oil. From that we concluded that fish oil lowered cholesterol, which in hindsight was not really right, because the vegetable oil and the fish oil lowered cholesterol, but it really wasn't that they were lowering it so much as that. The animal fat diet, the saturated fat diet, raised it. So you could replace saturated fat with cardboard, you know, and your cholesterol level would go down. So it's not that so much these oils were actively lowering. It was more that it's what you took out of the diet that made the difference.
Speaker 1:So it was not very interesting exactly, but we discovered that triglyceride levels went down, the other two blood fats, cholesterol and triglycerides and the triglyceride level dropped on the fish oil diet but not on the vegetable oil diet. So there's something unique about fish oils on triglycerides, about fish oils on triglycerides. So we started digging into that, and triglycerides are not as clearly associated with heart disease as cholesterol is. But it's not nothing either. They do play a role, and so we spent many years exploring what's the mechanism of that effect? What's the effect of fish oils on LDL, the bad particles, vldl kind of okay particles, hdl good particles. So that's kind of where it all began and around that time the studies from the Greenland Eskimos had come out. We didn't really realize they were published before we started our study, but we didn't cross our radar.
Speaker 1:Before PubMed Before well, yes, before PubMed, it was back to indexed medicus in those days, the big book you get, you know. Yeah, that's a long time ago, but when we realized what had happened with the Eskimos where it looked like lot of omega-3, as it turned out, had less heart attacks because they weren't having blood clots that clotted up their coronary artery- Was there a negative effect with the bleeding, a negative health effect with?
Speaker 1:that or not On them. I mean they were consuming like 10 grams a day of EPA, dha I mean huge way beyond anything anybody does and you know that had a blood thinning effect. It's very hard to know. They have a very different diet, so there's so many different factors, but one of them would be that, and so fish oils at that point kind of got a rat for causing bleeding. Well, it turns out not anything like the doses anybody uses, it doesn't. It's actually better for reduced bleeding, but maybe we can talk about that. In any event, we went down those two roads. We went down the blood lipid road, we went down the platelet aggregation road and we rode those ponies for quite a while.
Speaker 2:Okay. So then, looking back on the 40 years of research that you've done and other groups have done, what are the health benefits of supplementing or eating more fish which we can talk about the quantities of that later for someone who is relatively healthy? So if I was trying to convince well, I don't try and convince anybody of anything, but if someone asked me, you know, should I be taking these? What would I say for the benefits of a healthy person taking fish oils?
Speaker 1:Yeah, and it's hard to know. I mean, it's not hard to know, but in the world of nutrition, people are familiar with things like vitamin C, which is an essential nutrient, like we think the omega-3s are. But with vitamin C, if you don't have any in your diet, you'll probably, in a couple of months, you're dead. You're just flat out dead, and it's uh the same for some of the b vitamins. There's a very clear deficiency syndrome. It's called scurvy. You know killed more people at sea than all the wars put together. It was a terrible disease in the uh 18th, 19th century. Um, until they figured out, you know, eat a lime that's that my british namesakes, the limeys they're the limeys, that's right and
Speaker 1:they're well deserved. Um, so the omega-3s don't have that kind of if you're not eating, it's not like your teeth are falling out or you know. Uh, so we have to look. But we know they're important for health. It's one thing to be essential for life in the short run, it's another to be a nutrient that's helpful for optimal health, and that's kind of where the omega threes are there in that long term. If you're higher, have higher levels of omega three in your diet all your life, then you have better health outcomes toward the end.
Speaker 1:And how do we know that? Well, the way we do it is we do studies in large populations of people where we measure their blood levels of omega-3, which is better than just asking them how much fish you eat. So we really get a very clear look at the body's status of omega-3s. And we ask the question take a group of 100,000 people and you know the omega-3 level of everybody. And then you divide them into and these are people in their 40s, 50s. You know the omega-3 level of everybody. And then you divide them into and these are people in their 40s 50s. You know. We divide them into 20%, 20%, 20%, quintiles, and then we based on their omega-3 levels. And then we ask okay, over the next 20 years, who's having what diseases? Who's developing heart disease? Who's dying? Who's got diabetes? Who's developing heart failure? Pick your disease, you know who's dying from cancer? And so we look back and we find invariably the people that have the highest omega-3 levels are the ones that, over time, have the best health outcomes, whether it's diabetes, heart disease, death from cancer, death from other causes, uh, dementia, you know big, big stuff. So it's that's how I know these are good for you, because we have evidence in humans measuring blood levels that higher blood levels are always linked to better outcomes.
Speaker 1:Now there you know, there have been some randomized studies where you actually placebo versus fish oil, studies, where you actually placebo versus fish oil, and in the early days, in the 1990s, they most of those studies and into the early 2000s, most of those studies were favorable. They actually showed in the standard medical drug model of it you know, divide people by random in two groups, give one of them fish oil, give one of a placebo and watch over the next three or four years what happens. And when they were doing those studies they found benefits of omega-3, reduced risk for things as time has gone on medical care. Background care has improved a lot. Drugs have improved, treatments for acute myocardial infarction have improved tremendously, and so some studies that came on later that layered omega-3 on top of modern medical therapy didn't find any benefit. And so people say, oh, omega-3s don't work. Well, that's not true. You're testing it in the wrong setting. The setting is lifetime. That's really. It's a nutrient, it's not a drug, and it needs to be seen as a nutrient.
Speaker 2:Yeah, and so those studies you did and other groups did, do they sort of correct for other lifestyle factors, because if a person is eating fish, and maybe they're doing that for health reasons, they may also have a healthy lifestyle. Or did this protection still happen with people who, let's say, smoked or were overweight and that kind of thing?
Speaker 1:Yeah, it's a great question. It's something that always comes up with that kind of study design because you can't control everything. Plus you can't do a randomized trial for 20 years, so you can't ask the question the way you'd really want to. So you have to say we don't know for lifestyle factors Everything we can. You know like 10 or 20 different factors. We put them in the statistical model so we're controlling for them. Presumably that means you're, regardless of whether you're an exerciser or not, regardless of whether you're a smoker or not, the omega-3s always come out better. So that is when you control for those things.
Speaker 1:Interesting papers recently come out looking at very large populations and their use of multivitamins. So someone who's a multivitamin user would be a healthy user. It's a person who's concerned about their health. So if we think this idea that people who are just healthy users just have a healthier lifestyle, it's very intangible and you can't put your finger on it exactly. But those kinds of people, they just do better, they just well turns out. The people who are multivitamin users versus non-users don't live any longer. There's no mortality benefit for being a multivitamin user and so when I see that, I say, okay, antivitamin user. And so when I see that, I say okay, then that excuse, for why is it that people who take omega-3 or have higher omega-3 levels have lower risk for total mortality, greater longevity? Is it because they're a healthy user? Well, I don't think so, because here's a group that's a healthy user and they didn't get that benefit. So why do we think the omega-3 benefit is explained by that? I think that's been helpful actually to see these studies on multivitamins come out, because I can say, okay, it ain't that.
Speaker 1:But when you mentioned smoking, it just reminded me of one of the studies we did in the Framingham study, which is again what's called a prospective cohort, a group of people healthy people that get recruited. You measure everything top to bottom at the beginning of the study and then you just watch these people over time, see what happens to them, and then you just watch these people over time, see what happens to them. And Framingham study is the one of. Framingham is a suburb of Boston and that's probably the most famous of the original observational studies in heart disease. And we've worked with that group for a long time and we measured the omega-3 index and measured their blood omega-3 levels and then followed them out for 10 or 12 years to see what would happen.
Speaker 1:And we were looking really at total mortality, meaning dead from any cause, who died, who didn't, and so you've got a window of time. People are roughly 65 years old when the blood samples were drawn, roughly 65 years old when the blood samples were drawn. We're now looking over the next 10 years, say between 65 and 75, and who dies in that window as a function of their omega-3 levels? Well, the higher the omega-3, the lower their risk for dying. We said, well, how about smoking? Does that affect your risk for dying over 10 years? Well, yeah, that shouldn't be a surprise to anybody.
Speaker 1:It turned out that when we looked at the kind of the combination of omega-3 levels having a high omega-3 versus a low, being a smoker, non-smoker, kind of look at the intersection of those variables, the people who died the most, who were most likely to die over the period of the study, like 50-50 chance of living were the smokers, who had low omega-3. And, of course, the people who had the least chance of dying, like a 15% risk instead of a 50% risk, were the people who had the highest omega-3s and were not smokers and the other ones you know, the low omega-3, non-smoker, the high omega-3, smoker. They were kind of in the middle. Their death rate was certainly not as bad as the smokers and the omega-3, but it wasn't as good as the people who were non-smoking. So having a high omega-3 is protective in the same sense of being non-smoker, and I always want to clarify that.
Speaker 1:This doesn't mean obviously keep on smoking but take your omega-3s. Right, you know, eat fish and have a cigarette. No, I'm not trying to say that. I'm just trying to give people a perspective on if you think smoking is a risk factor for bad outcomes cancer, cardiovascular disease well then you should also understand that omega-3s are just about as powerful a predictor. So attend to it. So can you tell that to a 25-year-old guy and change his life? That's a tough job. You've got to do that, but most people don't have that long vision. But if I'd had that vision, I mean, what I try to do with my kids and grandkids is get them to take omega-3 all the time. It's just going to be better for them across the board.
Speaker 2:Okay, well, let's talk about that a little bit. I would call different groups of people. We can divide them into different populations. So for the average healthy person, I think you've put forward a really nice case to say if we want to add a long healthy life to a long life, reduce your chance of dying and dementia and so on, then omega-ol is going to be part of that. What about specific groups of people? Are there any studies where they've just looked at omega-3 supplementation or fish increase in diabetics or people with depression, dementia or cardiovascular disease?
Speaker 1:Certainly have. You can almost ask has omega-3 been studied in? Fill out the blank and the answer is going to be yes, because there are. I think omega-3 fatty acids are like the fourth most studied molecules in biology or medicine. So there's so many papers Somebody studied, you know, because they've had an effect on so many things, because they've had an effect on so many things. People with heart disease, certainly we know that giving high omega-3, well, again, some of these trials were very favorable where they gave high omega-3 to people with known disease. Some of them were neutral. There had been no negative study, meaning where omega-3 cause more heart damage or anything like that. So it's either you can't detect an effect or there's a beneficial effect. So to me, that's a good reason to take the chance. Beneficial in diabetes as well, for reducing risk for diabetic complications. For reducing risk for diabetic complications, it's been used as a treatment in a way in depression, okay, and
Speaker 1:how effective is that? Well, it's not as effective as the standard pharmaceuticals, but it kind of depends on the EPA DHA mixture. It turns out, although we expect it, because the brain is virtually the only omega-3 in your brain is DHA, and it's a major fatty acid in the brain we assume that DHA is the important one for mental health, and it turns out that at least some of these studies that have looked at the effects of omega-3 on depression depression symptoms it's the products that were richer in EPA than DHA that seemed to work, whereas the DHA ones didn't work. So you know, we learn all kinds of things we didn't expect when you do studies. You didn't know.
Speaker 2:Any theories on why that is?
Speaker 1:People suggest, even though the EPA doesn't get into the brain. The EPA is an anti-inflammatory molecule and systemically and there's a lot of blood that flows through the brain, of course it's just not part of the meat of the brain, so it's not like omega-3s or EPA is not being present in the above the neck. It certainly is, and it's probably some kind of an anti-inflammatory effect, although DHA has anti-inflammatory effects too. So it's a little hard to understand why EPA alone would do that, and we really need better trials to directly compare EPA to DHA in depression.
Speaker 2:And so let's have a look at this anti-inflammatory effect for a little bit, because a lot of those disease populations we can trace it back to inflammation and this seems to be a trend in medicine at the moment that they're looking at inflammation being one of the root causes for many, many different diseases. And if omega oils help with inflammation, then we could look at successful outcomes in many different disease populations. How does it affect inflammation in the body?
Speaker 1:Well, and you're absolutely right At its core. It seems like many diseases are, at least have, an inflammatory component, if not being driven by it, and so that's probably why the omega-3s are effective everywhere. Why, what do the omega-3s do? A variety of things. For one thing, they tend to be anti-inflammatory because some of the molecules that, so the omega-3s not only do things by themselves, because they get incorporated into membranes of cells and kind of improve the functioning of the membrane.
Speaker 1:People don't really appreciate how important a membrane is around a cell. What gets in and what gets out is all depending on what the composition of the membrane is, how efficient it is. So the EPA and DHA become incorporated in membranes and they change the properties and have good effects. That way they can quiet down. So say there's some kind of an insult, a signal, an infection signal that comes to a cell and says there's an infection out here. We need to make some anti-inflammatory molecules to control it. The receptor on the cell membrane that gets that message is sort of down, quieted down in a way. It doesn't receive the message and transmit it so strongly as a membrane that doesn't have the omega-3s in it. So the signal to over-inflame is blocked simply, by the way, the changes in the membrane.
Speaker 1:In addition, the omega-3s they serve as a substrate, as the starting material for the synthesis of other molecules which also have powerful anti-what they call pro-resolving mediators. That is to say, when you have a cut, for example, that's going to be an infection, it's going to be an insult. You need to have an inflammatory response to heal that cut. But you don't want that inflammatory response to go on for years. You want it to be done. You know, come and go.
Speaker 1:Well, it turns out that the omega-3s are very active in the act, actively shutting down an inflammatory response, not not just letting it drift off unabated. The omega-3s, if they're there, some of the molecules, what they call protectants and resolvents are actively shutting down the inflammation. So that's another part of how they do it. They also, you know, part of this thing is keeping the blood flowing well and the blood thinning effect of omega-3. It's not dangerous but it's helpful actually, and that's part of the overall health Because, you know, obviously the blood flows everywhere and if you have good blood flow and you're're delivering good nutrients, you're going to be healthier that's one of the tenants of osteopathy, uh, the, the doctor who put it together back in the 1860s, he, he said, you know, if the, if the blood is flowing, then you've got health.
Speaker 2:And that was one of the, the main things. And quick aside, but a story about him, for my listeners mainly uh, he was a civil war doctor in the us and, um, you know, they were just packing off limbs when, when cannonballs hit them and that kind of stuff. And but he, he would, he would check for the pulse in the distal part of the injury and if it was there he would leave whatever limit was and no antibiotics and and so on. So he would actually pack everything in moss, build crates around legs and pour water in at the top and then drain it off the bottom, keep it cool. And he checked the pulse. As long as the pulse was there, he saved people's limbs and that was his sort of light bulb moment on. The phrase he used was that the artery rules supreme.
Speaker 2:If the artery is working then then then you got health.
Speaker 1:And that's pretty cool. Yeah, really reminds me of a famous movie called Dances with Wolves. Oh yeah.
Speaker 2:Remember that one.
Speaker 1:Kevin Costner is about to have his legs sawn off in an army hospital in the Civil War. And forget it. I'm just going to put my boot back on and yeah, I remember that scene and right out. And if they want to put my boot back on and write out, and if they want to shoot me, shoot me. Turns out anyway. Yeah, that's. That's a very interesting story. I didn't know that's part of the roots of osteopathy.
Speaker 2:OK, so I've actually heard you talk about in your research and and on other podcasts about those special populations and on other podcasts about those special populations. But something just came to me then with allergies or things or even autoimmune problems like asthma, allergic responses to things. Has that been tested with Omegarol?
Speaker 1:Yeah, that's one of the things that's actually been tested in a randomized trial in a big one. There was a big study done several years ago called vital v-i-t-a-l, which was a vitamin d and omega-3 trial, primarily looking at development of heart disease and cancer, and they gave one capsule a day of omega-3 in this study but it had 25,000 people in it. So it's a big study. So 840 milligrams of omega-3. So not a big dose. So I'm not holding my breath. You know that anything is going to happen and you know writ large. They said the study was neutral. It's certainly many different cardiovascular outcomes that were benefited by even that low dose of omega-3.
Speaker 1:But there were many sub-studies to this and once you've got 25,000 people, you, you know, get as much information as you can. So one of the questions they studied was autoimmune disease and a whole. You know, put them all in one bucket because there's so many different kinds. So the idea was well, yes or no, did you develop an autoimmune or not? And the omega-3 group it got just the omega-3s had a statistically significant like 20% over the five-year period lower risk of developing autoimmune diseases. So that's pretty good evidence that there's something there and would fit with this whole idea of blocking this inflammation writ large problem in the body.
Speaker 2:Okay, so that's special populations sort of discussed. What about age and different genders? So women versus men, young versus old? Can you give us some guidelines around that?
Speaker 1:Sure, I mean, let's start early pregnancy and in pregnancy, one of the early observations of the Omega three in the Omega three field was that it looked like women who were eating a lot of Omega three seemed to give birth to heavier babies. Women who were eating a lot of omega-3s seemed to give birth to heavier babies. It's kind of a hmm, hmm, what's that about? And then they looked a little closer and they found that well, it's not just that the babies were heavier, it's just that the gestation was a little longer, so they stayed in the oven a little bit longer, so that explains why they're a little bit bigger. So if you stay in utero a little longer, that also implies that you're less likely to have premature birth, and so that hypothesis that omega-3s will reduce risk for premature birth has been studied a lot. I think there's some 70 different studies and a big meta-analysis, a pooling of lots of different studies. It was published a couple of years ago and said something like you know, there's a for women who are given omega-3 supplements during pregnancy. There's like a 10% 11% reduction in risk for what's just called preterm birth and there's a 40% reduction in what's called early preterm birth, which is like before 34 weeks. So 34 to 37 weeks is preterm, before 34 is early preterm and there was a big impact on early preterm birth by giving omega-3 supplements. So this is one of the clearest benefits we've seen in the world of pregnancy. There are also benefits to the baby and the mom after baby's born, and having milk that's rich in omega-3 is helpful for the baby.
Speaker 1:But for that one outcome of, of course, premature birth is a big deal. There's a lot of expenses involved and a lot of downstream pain and disability that can come from premature birth, a lot of resources spent on it. So that in itself is worth focusing on, and some, you know, major expert committees have said you know, look, pregnant women need to have actually they need to have an omega-3 level. That's a certain level. If it's above a certain level, then giving supplements isn't going to help, because they're okay, they got enough. But if they're below that level, then we have evidence that giving omega-3 supplements will reduce their risk for preterm birth. So it's a real call for measuring omega-3 status in pregnant women and then, depending on the outcome, really pushing them to take supplement omega-3 supplements or eat more fish, which is another thing we can talk about or maybe not.
Speaker 2:Okay, well, we'll talk about the fish and we'll talk about how to test it shortly, but I want to ask you this question because it's been on my mind for a while and I don't know whether it's an old wives tale or not, and I think you can clear this up for me. Someone once told me that the mother will give their omega-3s to the developing baby. That makes sense, so that it comes through the female diet, but if they are not supplementing or eating fish, they will be stripped out of the female body. Is that, does that make sense? Okay?
Speaker 1:At large, that's true Right.
Speaker 2:Then if that woman does not bring her omega levels back up and gets pregnant again, then she's going to have low omega-3 levels and the baby and so on and so on, with multiple pregnancies potentially leading to premature birth in later pregnancies.
Speaker 1:Theoretically, yes, yeah, it's certainly true that baby takes from mom. Yeah, it's certainly true that baby takes from mom, and if mom's stories are not good, mom will suffer the consequences. And I'm not sure anybody's looked at multiple pregnancies and multiple cycles of that and whether it is a downward spiral or between pregnancies. Mom eats enough omega-3 to get back up to speed again or her body will make more omega-3 from the plant, the alpha-linolenic acid, which is most people eat plenty of. Uh, it's part of the part of our diets and you can make omega-3 from, and when women are certainly premenopausal, women can make omega-3 from it. And when women are certainly premenopausal, women do make omega-3 long chain EPA DHA better than men do, and it's because of estrogen. It will stimulate those enzymes so there can be a rebound after the delivery. But it's a good question you've asked. Has anybody really looked at kid number two, kid number three, kid number four?
Speaker 2:But so testing in between pregnancies could be something that women should do just to make sure that they're in the best shape for the next pregnancy. Absolutely, yeah, okay, all right, let's talk about. Oh well, we've got one in the spectrum there. What about elderly people?
Speaker 1:Yeah, and we're very focused on elderly people. We're very concerned about dementia, alzheimer's disease, and we've got increasing evidence that a higher omega-3, I mean once you've got Alzheimer's disease, there is no point taking omega-3. I mean it's not going to reverse it, so let's put that away. I mean it's not going to reverse it, so let's put that away. When you have mild cognitive impairment, it's kind of on the way.
Speaker 1:There is some evidence that actually taking B vitamins and omega-3 is the best combination. Some studies have suggested that if you're too low in your B vitamins because you have a high homocysteine level, giving omega-3 isn't going to help. Vice versa, if you're low in omega-3, giving the B vitamins to lower homocysteine is not going to help. But when they're both up B vitamins and omega-3, that's where you get the best cognitive benefit. It's maybe a slowing of loss. That's kind of the best we can hope for. But you know, again, it's what's your omega-3 is your mega-3 level high when you're in your 30s and your 40s and your 50s? That's what's going to be. It's almost like bone health. You know you want to have the most bone density when you, you know, hit 20 because it's just going to go downhill from there, so build it up while you can, and same story generally with omega-3 okay, so let's, let's get into how we test it then, because am I understanding this correctly that you, your team and you personally were one of the first people to start testing it?
Speaker 1:we were one of the first, I think, that really focused on it. It was used in research uh, the group in italy and milan that, I think, did the first that I'm aware of dried blood spot testing of omega-3. And it was, you know. But omega-3 levels weren't really considered a risk factor or a marker that anybody wanted to measure. I think we were the ones that kind of brought that to light, starting in 2004. So it was 20 years ago. So it was 20 years ago.
Speaker 1:A colleague, dr Von Schacke, in Munich. He and I wrote a paper proposing that a low omega-3 index we called it, which was red blood cell EPA, dha, content, was not only a marker of fish intake, it was a risk factor for heart disease, meaning you could modify it and it would lower the. You could raise it and lower the risk for heart disease, meaning you could modify it and it would lower the diff. You can raise it and lower the risk for the disease. And it's also part of we know the biochemical mechanisms by which that happens. So I think we put that on the map. The omega-3 index and that's been very satisfying to see that being picked up more and more Formed a company to sell that test to clinicians for use in their patients. For consumers, you just order it themselves. It's not something that you need to have a doctor involved with. It's to manage your omega-3 status and we use it a lot with researchers around the world using this test.
Speaker 1:We've seen situations where in a randomized trial of omega-3, placebo group omega-3 group, you look at what the outcome is say it's heart failure and you find out oh yeah, it didn't really work. No real difference. But if you measure, you ask the question well, in the people whose omega-3 levels went up by X percent, was there a benefit in those people compared to those people who had no rise in omega-3? Either they didn't take it, which can happen, they didn't take enough. Something blocked its absorption. They just have a genetic predisposition to a low level.
Speaker 1:Whatever, the people that had the biggest rise in omega-3 saw a benefit in heart failure, but the people who didn't get the, regardless of how they were assigned to different groups. So it's really important in some of these randomized trials to measure omega-3 levels and then ask the question secondarily, after you ask the standard. You know placebo active did people who achieved a certain omega-3 level benefit? And we've seen that happen a couple three times recently where no effect in the original study but secondary analysis based on omega-3 index. Yeah, that works, so it's an encouragement that means something to get that omega-3 index up.
Speaker 2:Okay, and how does it work the test?
Speaker 1:Typically people will go to the OmegaQuant website. People will go to the OmegaQuant website. That's the company that we started some 12, 13 years ago, omegaquant Analytics. Go to the end. You can order online a dried blood spot kit to be mailed to your home. You open it up, you wash your finger with alcohol, you poke your finger and put a drop of blood on a piece of filter paper that's been pretreated with a preservative to keep the fatty acids protected while they're in transit and then in about I think we say three to five days after receipt in the laboratory.
Speaker 1:You'll go to your portal into OmegaGlant where you set your account up and you'll get your result PDF of your Omega-3 index and it'll range from somewhere in 2%, which is terrible. Under 4% is not good, but we've seen people as low as 2. And over 8% Omega-3 index, which is EPA plus DHA as a percent of the total fatty acids in the red cell. If you're over 8%, that's great. We've seen people up into 12, 15%. I don't know that they need to be up there. Not sure that's giving them any additional benefit over being at eight. There's not much study up in that world, but that's the way it works. So the test is like in the US. It's like 50 bucks, something like that.
Speaker 2:Okay, if someone's listening to this and they're not in the US and they wanted to sort of make sure that they're getting a good test, that maybe did not make a quant anything, they should look for.
Speaker 1:Well, I think it's really. I mentioned that antioxidant pretreatment that we put on our cards. We discovered many years ago that if you don't pretreat the standard you know filter paper and you put a drop on it and you just and you don't throw it in the freezer immediately if you want to leave it out for four or five days, which is what happens when you mail it the EPA and DHA levels go, they start to break down, they get oxidized, and so if you're not protecting your paper with some kind of an anti-coagulant or antioxidant, I think you're going to get an incorrect omega-3 index, because it will look lower than it really is, and that's a problem.
Speaker 2:That's something people could look into and just check with the lab whether they're pre-treating their their sure their blotting paper, whatever it's called right there blood spot, dry blood spot car. Okay, and so what's the average um index for the average american? If, if, eight is good, what? Where does the average person sit?
Speaker 1:about five, five and a half. It's sort of we US studies. That's kind of where it comes out, not under 4%. The groups that are under 4%, which is what we think. The bad place particularly is three groups of people that we've seen. Young Palestinians just happened to do a study there, us military deployed in Iraq and vegans are all down like that 3.5% level, which is not good. So we're particularly interested in because of the interest in vegan diets. There may be some long-term adverse effects of those diets vis-a-vis omega-3 status if you don't take a supplement to get your omega-3 levels up.
Speaker 2:Okay, so I'm going to bring some of this together. We've got omega oils, mega fatty acids, being essential ie. Our body does not produce it. We have to have it from our diet. We can test to see where we are on this on the index and if it's low, we can take some different foods to bring it up. But vegans, for example military as well, like you say are low in the index because they're not getting it from their foods. So let's talk about how we can get it from foods and what would be vegan-friendly options if they don't want to eat fish Standard way that most of the people get it from foods and what would be vegan friendly?
Speaker 1:um, options if they don't eat fish. Standard way that most of the people get it in their diets is through fish uh, certain, and not just any fish. You know, it's ocean going fish typically, and they are an ocean going fish because they are in a ecosystem where the omega-3 fatty acids are originally synthesized by phytoplankton. We call them microalgae, not seaweed. We're talking about single-celled organisms that actually synthesize EPA and DHA and sunlight and carbon dioxide and amazing stuff, and then the little fish eat that and the big fish eat the little fish, and and so we salmon, mackerel, herring, tuna, sardines um, good sources of omega-3 because they're it's oily fish. The oil will have omega-3.
Speaker 1:Some fish are very low fat tilapia. I don't know you couldn't find one molecule omega-3 in a tilapia. It's not there, um, and cod is not a great one either. Cod liver is great, but cod is not cod flesh. So those fish is where you get them typically, and most of the fish oil capsules come from sardines and anchovies caught off the coast of Peru, which is where they really seem to hang out.
Speaker 1:There are, of course, companies that harvest krill, which is a very tiny crustacean around the South Pole, and they're good sources of omega-3. It's more of a complicated process to get the oil out of krill than it is from fish, and so fish oils they have EPA and DHA, and particularly those sardines and anchovies are small fish. They don't accumulate any pollutants like big, long-lived fish can, and so they're a good source. And almost virtually all the whether it's supplements or pharmaceutical omega-3 products start from that raw fish oil that's caught out of out of peru, um, and chile now too, um, and so the a vegan can get. You know, can a vegan get an omega-3 that's not from an animal? Yes, you can get it from these microalgae. There are companies that are extracting oil from microalgae and packaging it as a vegan-friendly omega-3 product. So it's out there and available.
Speaker 2:Okay, and what would someone need to supplement, or what doses would they need to supplement with to bring up their omega index from, let's say, four the average to eight?
Speaker 1:Yeah. So if you're at four, which is a bad spot, to go to eight roughly, you need about 1500 milligrams of EPA and DHA per day. You need to look at the label and see how much EPA and DHA you're getting. If it's a triglyceride-based oil, if it's an ethyl ester-based oil, you need more. It's not absorbed as well, and so you might need two thousand what's an ethyl ester based off?
Speaker 1:the fall. The pharmaceutical omega-3 products lovesa, vasipa are ethyl esters, meaning that they they take the EPA and DHA. They they out of regular fish oil. They chop off the glycerol part from the triglyceride and just have the fatty acid. Then they hook the fatty acid to another alcohol, in this case ethanol, and you produce an ethyl ester. So it's just the fatty acid. So you can point the point of it is you can you can pack a lot of those epa and DHA molecules into a pill If you don't have to have the other. A triglyceride has got two other fatty acids and a glycerol. If you throw that away, there's more room in the pill for EPA and DHA. So it's a way of concentrating the omega-3 content. So those are ethyl esters and some supplements are ethyl ester form, it should say on the label, and some will be a triglyceride form and that's probably the better absorbed of the triglyceride forms.
Speaker 2:All right, and in the spectrum of supplements, someone goes into a health food store and they see these ones for 20 bucks and they see other ones for 80 bucks. Is there a huge difference in quality between those two things, or what is the difference?
Speaker 1:between the prices. Yeah, you really ought to look at the price per gram of EPA and DHA, because these cheap ones are going to have lower. One capsule might have 25% omega-3 and 75% other fatty acids. That's why it's cheap. Another capsule might have 75% EPA and DHA per capsule, and it takes a lot more processing to get that, so that's worth the price. So, instead of taking maybe 10 pills a day, you only take two or three pills a day, and so that's worth the extra price. Two or three pills a day, and so that's worth the extra price. As far as products that have virtually the same amount of omega-3 and some cost 30 bucks and some cost 60, some of that is, I think, hype, some marketing hype about uber, uber purity, and you know I don't get too worried about oxidation in fish oil products. I don't think that's a big deal. You know, don't store them in the sunshine on an open plate. Keep them in an opaque bottle in the cupboard or refrigerator. You don't have to freeze them.
Speaker 2:Refrigerator is fine, they'll be fine, and so I'm not too concerned about that okay, that is a concern from some people who have uh spoken to, about uh, omega-ol. They sort of say well, you know there's two, two concerns. One is they is the potential contaminants in the mercury coming from fish and that kind of stuff, and the other one is this oxidation and you seem to sort of not worry about that. What was that?
Speaker 1:I don't worry about, and I don't worry about the contaminants either, because the the number of steps they go through to purify just to get the crappy taste out of them, get rid of all all kinds I mean, there's virtually no mercury in them anyway. Mercury would be in the protein of the fish, not the oil. So it's when they separate the oil the mercury is fundamentally gone. Um, and you know we could have a long talk about mercury, because I think that's also a way overblown concern.
Speaker 2:But mercury, mercury and fish. Okay, we want fish. Yes, yeah, okay all right and then with the um, the oxidization, I've seen some companies talk about putting in uh, olive oil with it and other companies talk about little essential oils from citrus fruit and that kind of thing. Does that make a difference or not?
Speaker 1:I don't think we know. I haven't seen any evidence that it makes a difference. I think there are people can take and kind of be. Theoretically this ought to be good. But you know, has anybody really ever tested the effects of those different oils on the omega-3 index for one thing or any important medical outcome? No, I think it's somewhat marketing. I don't really care what the other components of the oil are. I want to get the most omega-3 I can per capsule.
Speaker 2:Okay. So let's say someone's found their good quality capsule. It's concentrated, or maybe they're taking you know. You see, on the back it says take three capsules three times a day. And I always wonder why they say that. It's probably because I'm looking at the cheap ones.
Speaker 1:Because you're looking at the cheap ones right, that explains it.
Speaker 2:That would explain it. So let's say they take these for a few months, would they see a change in their omega index or what would be the correct time to get retested?
Speaker 1:I think, because the omega-3 index is a metric measured in red blood cells. Your whole population of red blood cells is refreshed every about four months. So we say three to four months after you change your intake, test again, because you should be at a new, pretty much a new steady state by then and you know waiting. But then you know, don't start to test yourself today. You find out you're low, start taking fish soil pills and three weeks later test again. You're not, you're going to be just on the way up. You're not going to be. You don't know where you're going to end up. So wait till three or four months okay, bill.
Speaker 2:Um, I've got to bring this to a, but I just want to see if you can let us know what's exciting happening in the world of research with omega-olars at the moment. What's next? Is there something coming down the pipeline that we should perhaps have a hint about?
Speaker 1:Well, I think one of the big developments is going to be the way we source omega-3, because right now we get it from fish. It's the way we source omega-3 because right now we get it from fish. You know there's a growing effort, of course, to get it from microalgae that's grown in big incubator tanks in Texas. You know you can do it anywhere and that's a reasonable source. We'd like to get to the point we don't have to kill any fish to get our omega-3.
Speaker 1:Another source that's going to come online in time is genetically modified seed oils like soybean oil, corn oil, a variety of oils that already have some omega-3 in them.
Speaker 1:They have some of the enzymatic machinery to make omega-3, but they don't make EPA and DHA. They make ALA omega-3, but they don't make EPA and DHA. They make ALA. So scientists have been able to insert certain genes into soybean oil so that it makes sort of the next step up toward EPA and DHA, and others have actually put the genes or the enzymes in to make EPA and DHA on something that has roots. So those products if we eventually get to where those things are economical, we'll be able to harvest omega-3 out of a field in Kansas and concentrate them down and put them in capsules and give them to people, and I think that's going to be an exciting time when we don't really have to get it from fish anymore. Health-wise, I mean, I just think that the connection between omega-3 and healthy aging is really going to be very important, and people need to know that they need to start early. Once that horse is out of the barn, it's hard to put it back in.
Speaker 2:Okay, how can people find out more about you and find out more about the tests?
Speaker 1:I probably go to the company website is omegaquantcom O-M-E-G-A, then quant like quantity omegaquantcom, and there's always an about page there or something. I also have what we call the Fatty Acid Research Institute, which is really where I work, mostly because I'm more interested in the research side than the business side, frankly, and so Fatty Acid Research Institute search for that and it talks about me and all of our other scientists there and the kind of work we're doing.
Speaker 2:Perfect and as of now I think I checked recently the blood test in 2024 is about 50 bucks. Is that right?
Speaker 1:It's about right With the omega-3 index, right.
Speaker 2:Well, thank you very much for coming on the show. Really appreciate your insights and your thoughts.
Speaker 1:You're welcome. Thank you, Ed. Good to meet you and nice to chat. Nice to chat too.