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Fish Oil Update: Part 2
An interview with Garry F. Gordon, M.D., D.O., M.D.(H)
By Richard A. Passwater, Ph.D.
Let’s continue our chat with Dr. Garry Gordon that we started last month. We had been discussing the importance of proper blood viscosity and some of the studies on fish oil and heart health benefits. Now, let’s talk about fish oil basics and some additional studies on the benefits of fish oil to health.
Garry F. Gordon, M.D., D.O., M.D.(H), received his doctorate of osteopathy in 1958 from the Chicago College of Osteopathy in Illinois. He received his honorary M.D. degree from the University of California Irvine in 1962 and completed his radiology residency from Mt. Zion in San Francisco, CA in 1964. For many years, he was the medical director of Mineral Lab in Hayward, CA, a leading laboratory for trace mineral analysis worldwide.
Dr. Gordon is co-founder of the American College for Advancement in Medicine (ACAM). He is founder/president of the International College of Advanced Longevity (ICALM) and a board member of the International Oxidative Medicine Association (IOMA). In addition, he is associated with the Gordon Research Institute, located in Payson, AZ.
Dr. Gordon’s book, The Omega-3 Miracle - The Icelandic Longevity Secret (written with Herb Joiner-Bey, Freedom Press, 2005) is a best-seller.
Passwater: We have been chatting about fish oils. Let’s clarify what we mean here when we say “fish oil.” We are not talking about cod-liver oil or eating fried bass. Please clarify what fish we are including in our classification of “fish oil.”
Gordon: This comes from “Omega-3 fatty acids are linked to healthy hearts but their benefits may stretch beyond,” Times staff writer, October 4, 2004:
* Atlantic salmon, sardines, Pacific mackerel, Atlantic mackerel, king salmon, dog fish, albacore tuna, sockeye, and Cisco, Atlantic herring, Pacific herring, American heel, rainbow trout, lake trout, anchovy, Coho salmon, pink salmon, blue fin tuna, Pacific oysters, Atlantic halibut, sable fish.
Fish oil means oil derived from fish in contradiction to vegetable oils. There is confusion in that many people thought that cod-liver oil could produce all of these benefits, but I find they really require the 1,000 mg dietary supplement capsules of omega-3 oils containing specifically docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), once or twice a day
Passwater: We have mentioned your book, The Omega-3 Miracle – The Icelandic Longevity Secret, a few times already. What exactly are omega-3 fats, and why are they important?
Gordon: I was first taught about the importance of these essential fats in a conference in which Dr. Donald O. Rudin, M.D. from the Massachusetts General Hospital, Department of Pharmacology Harvard Medical School and Dr. David Horrobin presented a two-day conference on the importance of these fats in our diet. Yes, without question, Dr. Rudin convinced me in that meeting and in his book, The Omega-3 Phenomena, that omega-3 fats are essential. I have subsequently become even more convinced that the omega-3 fats found in fish oil, EPA, and DHA are absolutely essential for human health.
Many are confused about this. Many hope that a strict vegetarian diet would be adequate to keep maximum health and that they should be able to convert the ALA, which, as the precursor of n-3 fatty acids (such as found in flax oil), should be an adequate substitute for fish oil. We find that all too many of us do not have efficient conversion to deal with the huge need that we all now have for omega-3 fatty acids to try to neutralize the tremendous overconsumption in our diet of omega-6 fatty acids. This excess intake of omega 6 has caused virtually everyone today to have a relative omega-3 deficiency.
Passwater: There had been so much talk of fats being bad for us, and then came the low-carb fad and the realization that some fats are beneficial. What are dietary essential fats, and are omega-3 fats dietary essential?
Gordon: Yes, it was ironic. We all were busily telling everyone that fats in our diet were killing us. Yet, here I was, spending my time and money to attend a conference all the way across the country, to learn about the essential nature of fats and the importance of these fats for optimal health.
Essential fats are those that are necessary for optimal health. These include omega-3 and certain omega-6 fats. These essential fatty acids are the major building blocks of cellular membranes surrounding every cell in the body. They must be consumed as a regular part of our diet for us to thrive. It has now been clearly documented that both omega-6 and omega-3 fatty acids are necessary for optimal health.
The difference between omega-6 and omega-3 is the first double bond: in the omega-6 class, this begins at the sixth carbon atom from the end of the chain. Omega-3 fats have their first double bond at the third carbon position. This one difference, and the absence of only two hydrogen atoms, is what makes the omega-3 fatty acids unique and essential for optimal health. These fats are not made in the human body; they are synthesized in the chloroplast of plants, particularly the chloroplasts in marine and fresh water algae. They produce high quantities of long-chain omega-3 fatty acids. These two essential fats compete with each other in the body, and it appears likely that this understanding led to consensus at one NIH conference that these two fats need to be in roughly equal amounts in our diet. Unfortunately, that is not the case in the American diet today. We find that many individuals are consuming 20 times more of the omega-6 than they consume of omega- 3 oils.
Passwater: Why are the fish oil fats—EPA and DHA—better for us than the Omega-3 fats, say from flax?
Gordon: Flax seed provides the omega-3 fatty acid called ALA (alpha-linolenic acid). This is believed to be the parent compound of all omega-3s. However, coldwater fish provide two other kinds, EPA and DHA. Unfortunately, the conversion of ALA in the human body is hampered by environmental influences, genetics and various dietary practices. It is these various influences that prevent flax seed oil from meeting our omega-3 and omega-6 needs that causes fish oil fats to be better for us than the other omega-3 fats such as those from flax seed oil.
Passwater: What are the advantages of taking fish oil supplements over just relying on only including more fish in our diets?
Gordon: One of the advantages is that the fish oil supplements can be processed in such a way as to eliminate the dioxins, PCBs and heavy metals that are such a concern in the fish that we eat today. The more advanced processing techniques available today allow us to standardize the dose so that there should not be any question that you are getting the intended dose of say 300 mg of EPA and 200 mg of DHA that I believe is the minimum that everyone needs to consume on a daily basis today. My recommendation is 1,000 mg in softgel capsules containing 600 mg of omega-3 fatty acids per capsule, with 300 of those being EPA, 200 being DHA, and 100 mg coming from other omega-3 fatty acids. People should be taking two of these capsules a day, with adjustments being made for weight.
In other word, an individual might need to have two-to-three grams a day if he or she weighs 180 or so pounds; whereas people weighing only 80 to 90 pounds should do very well with only one a day. However, this is somewhat tied to genetics, health history, health problems that the patient may have and consumption of the competing forms of inexpensive dangerous fats from the trans fats to the excessive consumption of corn or other oils in our diet. These conditions can increase the need so that reputable researchers such as Andrew L. Stoll, director of the Psycho Pharmacology Research Lab in McLean Hospital Faculty, Harvard Medical School, finds that in treating some of his patients, loading doses of 12 and even 16 grams are necessary for several months before he begins to see benefits in his psychiatric practice.
Passwater: How much fish oil should people take as a supplement?
Gordon: Let me repeat part of what I just said: a dose of 1 to 2 grams a day, 1,000-to 2,000 mg daily, of total omega-3 fatty acids (EPA plus DHA) is probably adequate. Dr. Stoll’s bipolar disorder study utilized 9.6 grams a day, including 6.2 grams of EPA and 3.4 of DHA. Usually he finds 2 to 5 grams of omega-3 per day is adequate. Some doctors helping patients get off NSAIDs have been known to load with as much as 15 and 20 grams a day for a couple of months. The Greenland Eskimo diet contains 14 grams per day. Of the side effects, some may include a potentially increased tendency toward bleeding, particularly for patients who are also taking high doses of aspirin or related drugs and/or anti-clotting agents. However, my work has been to explain to people the limitations of those various anti-clotting drugs and to have my patients choose to utilize natural products instead of drugs for the anti-clotting/anti-platelet activity that natural products can provide far more safely and even more effectively than any commonly used drugs for these purposes.
Passwater: After my chat with Dr. Gordon, and while this column was being prepared for printing, an “incorrect” report was widely circulated in the media that needs comment. It’s hard to “un-ring” a bell, but I’ll report the truth here. The researchers misrepresented by the media have tried to correct the facts. The report was a meta-analysis of previous studies with fish oils. Here is what the researchers published:
“We did not report that ‘long chain omega-3 does not offer any protection from heart disease’, that ‘omega-3 fats have no effect on total mortality, combined cardiovascular events, or cancer’ or that omega 3 fats are of ‘no benefit’—this is not what we found, or what we reported (despite our being misquoted in much of the press).”
Hooper L, Riemersma R, Durrington P, et. al. Authors’ reply - omega 3s and health. BMJ.com April 7, 2006.
Why this study was misreported is hard to understand, but, unfortunately, the media spin is what will live on and be quoted by many future reports.
In March, an observational study involving more than 30,000 people was reported at the 55th annual meeting of the American College of Cardiology in Atlanta (Abstract 914-206) by Dr. Vinod Raxwal and colleagues at the University of Kansas Medical Center in Kansas City. This study found that the risk of mortality was significantly reduced for those who had been taking fish oil supplements. The study found that if people were not taking fish oil supplements, they had a 2.96 times risk of dying compared with people who were taking the fish oil.
Dr. Raxwal and colleagues reported that 2,870 patients taking fish oil supplements were followed from 1998 through April 2005 along with 27,811 patients who were not taking fish oil supplements. The study found that 115 people who were taking fish oil supplements had died compared with 3,120 patients who had not been taking the capsules. Thus, about 11% of the patients not taking the fish oil supplements died compared with 4% of those who were taking the fish oil supplements. That is a statistically significant difference (p=.01). The study also examined patients who did not have coronary artery disease and compared them with patients who had coronary artery disease and found virtually the same relationship. Those who were not taking the supplements died at a greater rate than those taking omega-3 fatty acids. About 30% of those not taking fish oil supplements had died compared to about 17% of those patients who were on fish oils. That difference was also statistically significant (p=.01)
In April, another report confirmed the benefit of fish oil on heart health. This time the media reported, “Omega 3s could cut risk of second heart attack.”
The researchers stated that their study “explored possible mechanisms by which recommended intakes of omega-3 fatty acids may decrease the risk for sudden cardiac death in patients with documented coronary heart disease. The cardioprotective effects of omega-3 fatty acids have been documented in epidemiologic and randomized controlled trials.”
“Our study documents an improved post-exercise heart rate with omega-3 supplementation,” said Dr. James O’Keefe from the Mid America Heart Institute and the University of Missouri.
The randomized, double-blind, placebo-controlled crossover trial, published in The American Journal of Cardiology (Am. J. Cardiol. 2006 Apr 15;97(8):1127-30), looked at the effects of a daily supplement of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) on the heart rate, heart rate variability, and heart rate recovery after exercise of men who had suffered a heart attack before the start of the clinical study.
After four months of supplementation of placebo or omega-3, the researchers reported: “Our principal findings were that omega-3 fatty acids significantly decreased heart rate at rest and accelerated the return to a normal heart rate after standing and exercise…”
After omega-3 supplementation, the researchers reported a 19% decrease in HR one minute after exercising.
“The decrease in HR was accompanied by appropriate increases in stroke volume and ejection times,” remarked Dr. O’Keefe. The published study concluded “These changes are consistent with an increase in vagal activity and may in part explain the observed decrease in risk for sudden cardiac death seen with omega-3 fatty acid supplementation.”
A report published in the July, 2006 issue of the American Journal of Clinical Nutrition confirmed a correlation between a higher intake of omega-3 fatty acids mainly from fish and a reduction in C-reactive protein (CRP), a marker
of inflammation that has been demonstrated to be an independent risk factor for heart attack and stroke.
Also in July, researchers at Children’s Hospital Boston reported that fish oils could help greatly lower the risk of liver damage in infants who have to receive prolonged intravenous feeding. (July Pediatrics).
And in late July, Dr. R. Metcalf of Royal Adelaide Hospital, Adelaide, South Australia reported at the ISSFAL meeting in Cairns, Australia, that patients with heart disease receiving fish oil supplements (900 mg of omega-3 fatty acids as DHA + EPA) each day for at least four weeks, or placebo, were subjected to arrhythmia testing by electrical impulses to induce sustained ventricular arrhythmias. After fish oil supplementation, 75% of the patients were either no longer inducible or required extra stimulation to induce the arrhythmia as compared to only 14% in the control group.
Most recently, two new studies have given one more reason to eat a diet rich in fish: prevention of age-related macular degeneration, the leading cause of blindness in old age.
Readers may want to periodically check www.dhaomega3.org for ongoing references.
Dr. Gordon, thanks for sharing this information with us. I want to chat with you about your exciting new research with RNA in the near future, as well as your research on menopause. Let’s get together again soon. WF
Leaf, A. and Weber, PC. “Cardiovascular Effects of Omega 3 Fatty Acids”, NJM 1988; 318:549-557
De Caterina, R., et al. “Anti-arrhythmic effects of Omega-3 fatty acids: from epidemiology to bedside”, American Heart Journal, Sept 2003; 164:420-430
Marchioli, R., et al, “Early protection against sudden death by polyunsaturated fatty acids after myocardial infarction” Circulation 2002;105(16):1897-1903
Albert, C.M., Campos, H., et al, “Blood levels of long-chain Omega 3 fatty acids and the risk of sudden death”, NEJM, 2002;346(15):1113-1118
© 2006 Whole Foods Magazine and Richard A. Passwater, Ph.D.
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