Friday, 23 January 2015

Omega 3

In the UK we are always being encouraged to consume more oily fish, and current recommendations are two portions per week.  But why? The reason is to increase our intake of the essential fatty acid, Omega 3.  The term essential is thrown out there all too often.  I seem to always be inundated with buzzfeed articles citing essential things to do before I’m 30, essential life hacks, essential albums to listen to and so on.  When the term essential is used in nutritional science it means just that essential.  The body needs omega 3 fatty acids and is unable to produce them. We actually lack the de-saturase enzymes required for their production, therefore we must consume them in the diet.

So what is Omega 3?  Omega 3 is a polyunsaturated fatty acid, it has a double bond at the third from last carbon molecule in the chain.  Omega 3 fatty acids come in three main forms: alpha linolenic acid, eicosapentaenoic acid and docosahexaenoic acid which are abbreviated to ALA, EPA and DHA.  EPA & DHA serve a number of purposes in the human body.  I’m going to attempt to explain the functions and benefits of consuming enough of these awesome fats.  After explaining these mechanisms I will look at some of the benefits of omega 3 consumption, omega 3 rich foods, some easy and tasty recipes to get those foods into your diet and I’ll point you in the direction of some local producers in the Berwick and Eyemouth area.

EPA – Along with a derivative of omega 6 (arachidonic acid) EPA is converted into a family of molecules called eicosanoids.  These eicosanoids have a very complex role in the human body mostly as messengers for the central nervous system as well as playing a role in the immune system more specifically the pathways of inflammation. Generally speaking the eicosanoids produced from arachidonic acid (omega 6) are pro-inflammatory.  Eicosanoids derived from omega 3 fatty acids help to decrease inflammation by decreasing the production of pro inflammatory compounds.  This brings me nicely onto the omega 3 to omega 6 ratio.  This is something that anyone who is familiar with the paleo diet, or any diet that has a focus on health fat consumption may have come across.

The UK, and the west in general, consumes large amounts of omega 6 and not enough omega 3.  On average it’s around 15:1 in favour of omega 6.  What we should be consuming is a ratio of 4:1 in favour of omega 3.  The reason for this is our consumption of oils from corn, soy, and sunflower, also a lot of omega 3 sources also contain omega 6 eg. flaxseed and nuts.  Now this does not mean omega 6 is bad or we should avoid it completely, it’s an essential fatty acid and we do need it, just not in the quantity that most of us consume it.  So why is this ratio important?  What is actually going on in the body?  It’s simply a case of input effecting output.  Picture a coffee shop, the baristas are your body’s enzymes.  They could spend their time making coffee or doing dishes.  Now if a bus stops outside and everyone pours in the sheer number of customers mean the baristas will focus their attention on making coffee.  As a result fewer dishes will be cleaned.  So more coffee is being made but fewer dishes are being cleaned, creating an imbalance in output (I currently work in a coffee shop the struggle is real).  A similar scenario is going on in the body, both omega 6 and omega 3 use the same pathways to convert to eicosanoids. If we consume too much omega 6 more enzymes will be used up converting them to pro-inflammatory molecules, and less will be available to convert EPA.  Alternatively if we consume adequate amounts of omega 3, fewer enzymes will be available to convert omega 6 to pro-inflammatory eicosanoids, thus reducing inflammation. This is concept is called competitive inhibition. 

DHA – Brain and nervous tissue membranes fats have a high proportion of DHA.  In fact one third of fats in the brain are DHA.  Photoreceptors in the retina of the eye also contain a high amount of DHA.  DHA is involved in multiple brain functions including cell membrane fluidity, receptor affinity, and modulation of signal transduction molecules.  Like EPA, DHA is also converted into another group of molecules, these are called docosanoids. These docosanoids have been found to be both protective of the brain as well as being anti-inflammatory.

Now I’ve talked about some of science behind omega 3 consumption let’s explore the real world applications.  How can omega 3 consumption be protective and potentially therapeutic?  The National Centre for Health Statistics has shown that omega 3 is one of the top dietary factors influencing early mortality.   

Studies into omega 3 first started back in 1970 based on what was at the time some interesting anecdotal evidence.  Inuit’s eat a high fat diet mostly consisting of fish and other marine animals.  They also had low rates of heart attacks.  Anecdotal evidence is generally frowned upon in the scientific community.  There’s no numbers to crunch, no accounting for cofounding variables, no placebo or control group, no graphs drawn.  So researchers began looking into this population and why they appeared to have better heart health compared to the rest of the western world.  Now there are over 4500 published studies into omega 3 and human health.

I have already talked about the anti-inflammatory properties of omega 3 but how does this apply to health and disease.  Inflammation is responsible for a plethora of diseases including rheumatoid arthritis, atherosclerosis, asthma, inflammatory bowel disease, depression, Crohn’s disease, ulcerative colitis, psoriasis, lupus erythematosus, multiple sclerosis, migraine headaches, and diabetes.  There are a number of really credible review articles looking into some of these conditions, and going to touch on some of them.

Heart Disease – This is the biggie really, the latest statistic I can find are from 2010, where just over 179,000 people died in the UK as a result of heart disease.  Bare in mind this is just the number of people who died.  It doesn’t account for the people who have a heart attack or a stroke whose quality of life ordinarily takes a turn for the worse as a result.  A lot of the proposed mechanisms, for the protective role of omega 3 against heart disease, are tied into the anti-inflammatory action I have mentioned.  Regular omega 3 consumption, has been shown to reduce cardiovascular incidence, cardiovascular death, heart failure and stroke.   

Brain Development, Function and Disease
As I have mentioned there is a lot of DHA in the brain and it is particularly important during brain development.  The DHA required for brain development comes from the mother.  The greatest demand for DHA comes in the final trimester of pregnancy where the brain quadruples in size.  It is also supplied through the mother’s breast milk once the baby is born.  Lack of DHA in this critical time of development can permanently impair learning ability and also eye function.  There are also strong correlations between DHA intake and child birth weights and head circumference.  Current recommendations for DHA during pregnancy are 200-300mg.  Beware when considering supplements as some contain high levels of vitamin A which can be harmful during pregnancy.

As medicine improves in the UK so does the average age and this is fantastic people are living longer.  Unfortunately there is a trade-off.  Degenerative diseases can be a real issue as we get older.   Unfortunately this is a very complex issue and there is no one solution there are a ton of contributing factors.  It is an area I am very interested in and something I may explore in my masters dissertation.  Omega 3 and DHA has been shown to reduce amyloid beta plaques.  Amyloid beta plaques are a hallmark of Alzheimer's disease.  Furthermore intake of 900mg per day of DHA improved learning and memory function.

Rheumatoid Arthritis – having worked for a health a supplement shop, I have to say one of the most common problems I encountered was that of arthritis.  Luckily it’s not something I had come across much in my family. I have now seen the crippling pain it can cause and how that affects the quality of life of the sufferer. 

Rheumatoid arthritis is an auto-immune condition causing massive amounts of pain and inflammation in the joints.  The cause of this inflammation is the pro-inflammatory cytokines TNF-alpha and IL-1.  Cytokines are messengers and in the case of rheumatoid arthritis they cause chronic inflammation.  The synthesis of both TNF-alpha and IL-1 beta are dramatically reduced in humans supplementing with omega-3 fatty acids from fish oil. In a study, humans supplementing 9 grams of fish oil daily for four weeks displayed a 74% reduction in TNF-alpha and 80% decrease in IL-1 beta synthesis.

Food Sources – Marines sources of omega 3 are top dogs, as they are conveniently already in EPA and DHA form.  There are plant sources of Omega 3 but they typically in alpha linolenic form and require your body to then convert that into EPA and DHA, thus is much less efficient (sorry vegetarians and vegans).  Oily fish such as: mackerel, herring, salmon, anchovies and sardines are fantastic sources.  Plant sources include flaxseed (linseed), hemp and some nuts.

Supplements – Let’s talk supplements.  I am a massive supporter of whole foods first, nutrient dense, unrefined whole foods should be everyone’s priority.  When you eat a whole food you get a ton of benefits you wouldn’t otherwise get in a supplement.  With fish you will be getting loads of protein, B vitamins, magnesium, potassium and selenium, not just the omega 3.  Also substituting more fish in your diet will generally cause a reduction in less healthy fats.  However I am not averse to supplementing some nutrients, omega 3 is one along with vitamin D but that’s a whole other blog post.  A simple Google search will reveal the sheer volume of fish oil supplements on the market, and it can be really confusing.  The key things to look for in a supplement are:  is it already in EPA and DHA form (this should be the case for any fish based supplement), does the packaging state how much EPA and DHA there is per capsule, if so how much is in there, is it an ethyl-ester fish oil and does it contain vitamin E (I will explain these final two now).

It’s unfortunate but we humans insist on using the ocean as a dumping ground for a plethora of crap.  The result of this, lots of pollution this pollution enters the food chain and when we consume fish that can enters us!  As long as you’re not large quantities of fish this won’t be too much of an issue but when taking concentrated supplements it is a concern. If you want to delve into this topic a bit more give this article a read from the scientific advisory committee on nutrition 
or this more recent summary from the UK FSA 

Supplement companies usually use a process called molecular distillation to remove these toxins the main one being mercury.  Unfortunately this means breaking the fish oil down from its original triglyceride form.  Now breaking it down is easy put putting it back together is a bit more complex.  Most opt to reattach the fatty acids to an ethanol back bone as opposed to its original glycerol backbone.  This process allows supplements to be more concentrated, therefore more EPA and DHA per capsule.  This sounds brilliant but unfortunately the ethyl-ester form is less bioavailable, the body doesn’t recognise it as well.  So the fish oil has concentrated levels of EPA and DHA, but is less absorbable. Most of the literature I’m reading suggests that, the difference between the EPA and DHA absorbed in the two different types is fairly minimal especially over a long period of time.  Also most studies on the health benefits are conducted using ethyl ester supplements.  From this I would conclude if money is no object go for triglyceride form, but don’t feel bad about going for the ethyl ester supplements.

This brings me onto krill oil.  Now krill oil has less EPA and DHA compared to ethyl-ester fish oil but is very bioavailable.  It also does not typically require distillation as it is very low on the food chain and thus has lower levels of toxins.  It also contains the antioxidant astaxanthin.  This does however come with an increased price tag but if money is no object I would go for krill oil.

Finally for you veges and vegans you can now get supplements made from algae that will give you omega 3 already in EPA and DHA form.  As far as I’m aware this is the only way for you guys to get EPA and DHA directly from your diet.

Earlier I mentioned vitamin E.  It is not an essential ingredient in omega 3 supplements, but it is a nice thing to have in there.  Vitamin E is one of the antioxidant vitamins.  Omega 3 fatty acids are very susceptible to oxidative damage, this is called lipid peroxidation and causes the supplements to become rancid.  By adding vitamin E into the supplements it helps to prevent this process from occurring.  This prevents the supplements from losing their nutritional value over time and increases their efficiency.  The recommended ratio of vitamin E to omega-3 intake is 0.6 mg of vitamin E or every gram of omega-3 fatty acid.

How much Omega 3 should I have?
This very much depends on who you talk to.  Over the course of writing this post I have seen a huge variance in the amounts given in the scientific literature.  Currently the UK is trying to get everyone to consume two portions of oily fish per week.  In America women are recommended to consume 1.1g per day and men 1.6g per day.  Personally I take 3x1000mg capsules of fish oil per day providing 540mg of EPA and 360mg of DHA (This is ethyl ester fish oil).  Due to my research into the benefits of krill oil I will probably invest, next time I shop.  I will take one krill oil capsule either in place of one fish oil or in addition.  Or I may seek out a triglyceride form fish oil supplement.

Recipes - I really love my food I enjoy cooking or at least attempting to cook.  So let me share with you some recipes, that I really enjoy. 

Indonesian Fried Rice with Mackerel

These are just three recipes out of thousands that can be found on the bbc website or anywhere online.  No matter what kind of food you’re into there will be something for everyone.

I’m a real believer in local produce and supporting local business.  It’s something I am trying to do more myself and that I would like to include in these posts when I can.  Here is some info on where you can get some really good quality fish and seafood, in your local area to meet all your omega 3 needs.  Please if anyone knows anymore just pop a comment on and I will add them to the list.

Berwick Shellfish Co. - Dock Road, Tweedmouth, Berwick-upon-Tweed TD15 2BE 01289 30437

D R Collin and Son - 34 Harbour Road, Eyemouth TD14 5H 01890 752018

J. Waddell and Son - Masons Wynd, Eyemouth TD14 5HG 01890 750392

I had a bit of a trip round Berwick and Eyemouth taking some photos of suppliers here is a few snaps.  
The trip kind of inspired me to some time walking along the coast.  Its something I never really appreciated
growing up around the area, but definitely something I am going to continue to do.  I know its very clique but
its really relaxing and a great way to start of a busy day, spending some time by the sea. 

Conclusion - I’ve talked about a few conditions here and how omega 3 can possibly help them.  I am not saying omega 3 is some magic cure, and there certainly are some studies that are less conclusive out there.  It has so many potential benefits and is so important for so many bodily functions.  On top of this there is little to no side effects of intake of omega 3, as long as you stick to recommended doses.  I really can’t stress enough how important it is to get enough through your diet and if you need to supplementation.

Sunrise on Spittal Beach, I've had worse mornings.

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