Accurate Education – Omega-3 Supplements (quick review)

Nutrition and Diet:

Omega-3 Supplements – A Quick Review

To achieve the high blood levels recommended to obtain the therapeutic benefits that omega-3 fatty acids may provide, it is often difficult or not possible to achieve those blood levels with an individuals normal diet. In these cases, one can turn to omega-3 supplements to provide the additional amounts of omega-3 fatty acids to reach once therapeutic goal.

For an in-depth review of omega-3 fatty acids, please see:

Omega-3 Fatty Acids

 

Also See:

• An Anti-Inflammatory Diet
• Nutrition: Amino Acids
• Nutrition: Carbohydrates
• Dietary Fiber

 

See also:

• Diet & Diets
• Diet & Fasting
• Diet & Pain
• Diet & Fibromyalgia
• Integrative, Complimentary and Alternative Medicine
• Supplements

 

Key to Links:

• Grey text – handout
• Red text – another page on this website
• Blue text – Journal publication

Definitions and Terms Related to Pain

 

 

A  Brief Review of Omega-3 Fatty Acids

Chronic pain is driven by two conditions, systemic inflammation and oxidative stress. As a reminder, systemic inflammation is what it sounds like – it is widespread inflammation that affects the nervous system in the form of neuro-inflammation, the joints as in arthritis, and inflammatory processes that affect the organs, including the liver, pancreas and the heart and blood vessels.

Oxidative stress, a term unfamiliar to many, is the condition which dietary nutrients known as antioxidants are needed to fight. Oxidative stress is a condition in which compounds called free radicals that are found in our environment and in our bodies that are created as a result of inflammation and from metabolic processes. Free radicals are highly reactive and they damage tissues, including our organs and blood vessels.

The anti-inflammatory diet (AID) is a diet that stresses foods that suppress inflammation and avoids foods that promote inflammation. It also includes foods high in antioxidants to protect our tissues from oxidation. Therefore, the anti-inflammatory diet is essentially a diet directed at maintaining health – simply put, a healthy diet particularly important for patients with chronic pain and chronic inflammation and oxidative stress.

Omega-3 fatty acids are probably the most important compounds found in foods that reduce inflammation. However, only some omega-3 fatty acids provide the most benefit. These are the omega-3 fatty acids found in a small number of marine-based foods, Docosaexaenoic acid (DHA) and Eicosapentaenoic acid (EPA). These are the most important omega-3 fatty acids involved in physiological functions and the only omega-3’s that research has demonstrated the most potential for health benefits. The omega-3 fatty acids, mostly alpha-linoleic acid (ALA), that are found in plant food products such as nuts and seeds, are healthful and help reduce inflammation but they do not have the greater benefits compared to DHA and EPA.

These two fatty acids, DHA and EPA, when ingested in high amounts, have been shown to reduce the joint pain of arthritis and the severity of chronic pain including headaches. They also likely reduce the risk of transitioning from acute to chronic pain as seen in traumatic injuries, including nerve injuries and they reduce the risk of having a heart attack or stroke.

To gain these benefits, however, a significantly higher intake of DHA and EPA then usually found in an otherwise healthy anti-inflammatory diet is required. One could argue that at the level of intake recommended, one is actually ingesting pharmacologic doses of DHA and EPA in what could be considered a therapeutic diet rather than simply a healthy diet. In this case, a therapeutic diet directed at the conditions noted above.

In order to gain these benefits, it is recommended that one ingest 2000-3000 mg/day (EPA+DHA). Blood tests can determine levels consistent with gaining these benefits and can be used to guide dietary intake.

The best way to gain these blood levels from dietary intake is to eat DHA and EPA omega 3-rich marine-based foods, approximately 5 servings/week:

• Salmon, sardines, fresh anchovies, mackerel, pickled herring
• Fresh and frozen tuna, not canned (limited to 5-6 oz/week due to mercury)
• Oysters & Mussels, Crawfish tails (1/2 – 1 lb)

 

A  Brief Review of Omega-3 Supplements

When unable to maintain high enough levels of omega-3 fatty acids in one’s diet, one can take omega-3 supplements in the form of either  fish oil or krill oil capsules.

When purchasing an Omega-3, Fish or Krill Oil supplement, pay careful attention to identify the total amount of EPA + DHA per serving (not the total Omega-3 fatty acid amount).

EPA+DHA Dosing:

To determine what dose of “EPA + DHA” one needs to raise one’s blood level to recommended amount, the dosing can be guided by estimated intake based on the amount of omega-3 rich foods, one eats, or, preferably, based on a blood level. The blood tests available include “Omega-Check” or “Omega-Index”  but depends on what lab one uses. Quest diagnostics uses the Omega-Check.

There is preliminary research that suggests that the ratio of EPA to DHA may impact the therapeutic benefit of omega-3 fatty acids. Currently research suggest that an EPA ratio of equal or greater amounts of EPA compared with DHA may be the best choice for cardiovascular and or inflammatory conditions. For conditions, focusing on nerve health, such as peripheral neuropathy and brain injury ratios of DHA greater than EPA are suggested.

 

To reach the recommended blood level:

1. Based on Diet

EPA+DHA intakes to reach the recommended level Omega-Check of 5.5% (or Omega-Index of 8%):

1.  Very low dietary intake of omega-rich foods (<3 servings/week):

• • Consume 3–4 gm/day (EPA+DHA) for12-16 weeks to correct deficiency.
  • EPA:DHA ratio 1:1 or  2:1 for inflammatory pain  OR 1:2 for neuropathic/nerve pain

2. Low to moderate dietary intake of omega-rich foods (3-4 servings/week):

• • Consume 2 gm/day (EPA+DHA) for12-16 weeks to correct deficiency.
  • EPA:DHA ratio 1:1 or 2:1 for inflammatory pain OR 1:2 for neuropathic/central pain

2. Based on Blood Level

1. Omega-Check of <3.8% (or Omega-3 of <4%):

• • Consume 3–4 gm/day (EPA+DHA) for12-16 weeks to correct deficiency.
  • EPA:DHA ratio: 1:1 or  2:1 for inflammatory pain; OR 1:2 for neuropathic/nerve pain)

2. Omega-Check of 3.8-5.4% (or Omega-3 Index of 4-8%):

• • Consume 2 gm/day (EPA+DHA) for12-16 weeks to correct deficiency.
  • (EPA:DHA ratio:  1:1 or 2:1 for inflammatory pain; OR 1:2 for neuropathic/nerve pain)

Caveats:

• • It may require >12-16 weeks to reach Omega-Check of 5.5% (or Omega-Index of 8%)
  • A dose of 1 gram/day EPA+DHA lowers serum triglycerides by about 7-10% in 2-3 weeks
  • The research supporting the recommendations above was directed towards improving O3i rather than maintaining healthy levels, so the appropriate dose for maintenance is an area for future research.

 

For maintenance of blood levels:

When Omega-Check reaches ≥5.5% (or Omega-3 Index reaches ≥8%):

Maintenance dose: 1,000-1,500 mg/day (EPA+DHA) to sustain levels (may vary by body weight)

 

Recommended brands:

• Lovaza (EPA-465mg / DHA-375mg) /capsule Rx: #120 tabs.
• Nature Made Minis (EPA-680mg / DHA-250mg) Target: $12/30 days.
• Ocean Blue 2100 (EPA-1350mg / DHA-600mg / DPA-150mg) Rodriguez: $46/60 days
• Thorne Advanced DHA (EPA-200mg / DHA-650mg) DSS: $22/30 days.

 

 

Subsequent Maintenance of Omega-3 Levels

The doses advised above are directed at raising one to recommended blood levels which is likely to be achieved in about 3 months. Subsequently one should not require these high levels to be maintained  but it is unclear. After 3 months at these higher doses it may be best recommended to follow the usual daily guidelines, but at the higher range. Most expert guidelines recommend a total intake of EPA + DHA ranging from 500 mg to 1,800 mg (0.5 to 1.8 gm) per day (either as fatty fish or supplements) should be ingested to significantly reduce the number of deaths from heart disease.

 

• Ultimately, one’s choice of fish consumption, fortified foods, or dietary supplements will depend on their baseline O3i, their food tolerance, and availability.
• The research supporting the recommendations above was directed towards improving O3i rather than maintaining healthy levels, so the appropriate dose for maintenance is an area for future research.

Omega-3 Dietary Supplement Productss

Because the only practical way to obtain recommended amounts of EPA and DHA in one’s diet is by eating fish,  dietary supplements provide the only alternative source for those who do not eat enough fish. There are many different dietary supplement formulations of Omega-3s available. Formulations of omega-3 dietary supplements vary widely, so it is important to check product labels to determine the types and amounts of omega-3s in them. Omega-3 dietary supplements can be fish oil-based or plant-based (vegan). In some cases, fortified foods (above) may offer additional options for supplementing one’s diet.

Omega-3 dietary supplements vary in omega-3s chemical composition; a recent review identified the most common are triglycerides (TAG) or ethyl esters (EE).  Supplements composed of TAG are more bioavailable and thus more effective than other formulas so lower doses can be employed.

The review found the lowest supplement intervention dose was formulated to supply only 100 mg/day EPA + DHA, while the highest was formulated to supply 4,400 mg/day EPA + DHA. Research suggests that 3000 mg per day of omega 3s helps to reduce pain, especially in rheumatoid arthritis. When using fish oil supplements it is recommended by some to ensure that the ratio of EPA/DHA is ≥1.5 while some research noted above suggests DHA may be more advantageous.

 

Krill Oil

Krill oil contains omega-3s primarily as phospholipids. Some studies suggest that these phospholipids have somewhat higher bioavailability than the omega-3s in fish oil, whereas other studies do not.

 

Plant-based Omega-3 Supplements

Plant-based sources of omega-3s are made from algal oil (derived from algae). Algal oil is a good direct source of DHA and in some cases, EPA. It provides the same benefits as fish oil but is a better choice for those choosing to follow a plant-based diet or for those who can’t tolerate the taste or after-effects of fish oil. Plant-based sources of omega-3s usually provide doses around 100–300 mg of DHA and some contain EPA as well. These supplements typically contain omega-3s in the triglyceride form (TAG) . According to a small study, the bioavailability of DHA from algal oil is equivalent to that from cooked salmon.

While certain types of seaweed and algae contain small amounts of omega-3s, the amounts may vary and not all types are good sources. So, if opting for vegetarian Omega 3 supplements, check for the amounts and sources.

 

Cautions and Concerns Regarding Fish Oil Supplements

Adverse Effects of Omega-3 Fatty Acid Supplements

Studies with omega-3 fatty acid supplements have reported no serious adverse reactions. The more common adverse effects of fish oil supplements, particularly in higher dosages, include nausea, fishy belching, indigestion, heartburn or reflux and loose stools. One study reported that gas and bloating were are more frequent with krill oil supplementation than with fish oil supplementation. Taking fish oil in smaller, divided doses, just before a meal may reduce reflux from fish oil supplements.

Misleading Labeling

It should be noted that a commercial “1000 mg” fish oil capsules will usually contain between only 300 mg and 400 mg, maybe up to 600 mg of omega-3 fats (EPA + DHA).

Mercury

Although seafood contains varying amounts of mercury, omega-3 supplements generally have not been found to contain mercury because it is removed during processing and purification. That being said, one should check the label before purchasing – Look for “molecularly distilled”  (mercury-free) brands.

Vitamins A and D

Some cod or other fish liver oils may contain high amounts of vitamins A and D, so be cautious if supplementing with these vitamins also.

Fishy Body Odor

Taking high doses of fish oil supplements can sometimes cause the skin, breath, vaginal fluids and/or urine to have a fishy smell. 

Trimethylamine (TMA): Trimethylamine is the compound that causes the fishy smell. It is a breakdown product of omega-3 fatty acids and can build up in the body when ingesting high doses of fish oil.  Rarely, an individual may have a genetic condition where they are unable to properly metabolize TMA so it builds up in the body, leading to a persistent fishy odor in body fluids. 

This genetic condition is called Trimethylaminuria (TMAU), also known as fish odor syndrome. It is a rare metabolic disorder with an estimated prevalence that may vary depending on ethnicity, but is between 1 in 200,000 and 1 in 1 million people. Genetic testing can confirm if an individual has this condition.

While there is no cure, symptoms can be managed through a combination of dietary modifications, medications, and behavioral changes.

• • Avoiding certain foods: The main goal is to reduce the levels of TMA by avoiding foods high in TMA and its precursors, such as choline, carnitine. These include seafood, eggs, liver, kidney, beans, peas, peanuts, cabbage, broccoli and cauliflower.
  • Antibiotics: in some cases, short courses of low dose antibiotics like neomycin, metronidazole, or amoxicillin may be prescribed to reduce the gut bacteria that produce TMA.
  • Washing with acidic soaps: Using soaps and shampoos with a pH of 5.5-6.5 can help remove traces of TMA from the skin and hair. 

High Dose Cautions Regarding Fish Oil Supplementation

Unless prescribed by your physician, it may be best not to exceed more than a total of 3 grams per day of EPA and DHA omega-3 fatty acids, with no more than 2 grams per day from a dietary supplement.

• Such high doses may suppress the immune system so such high doses should be avoided by immunocompromised individuals.
• Fish oil may have a blood-thinning effect, especially at doses above 3 grams of EPA + DHA per day and particularly for those on blood thinning medication. Lower doses (less than 1 gram of omega-3 fatty acids, including EPA + DHA, per day) do not appear to have this concern.
• Fish oil may lower blood pressure. so blood pressure should be monitored by those taking medication for their high blood pressure.
• High doses of fish oil from supplements may increase the risk of atrial fibrillation or atrial flutter, particularly in people with heart disease.

Selecting A Fish Oil Supplement

• Triglyceride forms may allow better absorption than the ethyl ester form
• Softgels are generally the least expensive way to get good-quality EPA and DHA.
• To reduce the chance of fishy burps after taking fish oil, select a capsule or softgel that is enteric-coated which is designed to release the oil in the small intestine rather than in the stomach.
• Consider OmegaVia, a small, enteric-coated softgel, with 1,040 mg of EPA and DHA (triglyceride form
• Consider choosing a fish oil supplement that also contains additional anti-inflammatory compounds like as curcumin, a dietary supplement with excellent research supporting its anti-inflammatory benefits such as Bio-Avail Omega+ (Adapt Naturals) or Ultimate Omega + Curcumin (Nordic Naturals) or others.
• Consider reading www.consumerlab.com, an excellent source for supplement product reviews, including fish oils
• Consider viewing  The Dietary Supplement Label Database from the National Institutes of Health that contains label information from many dietary supplements on the market that contain omega-3s.
• Healthline: 12 Best Fish Oil Supplements for 2025, According to Experts

 

Combination Supplements with Fish Oil

Some formulations include fish oil, krill oil, or cod liver oil and some are vegetarian only products that contain algal oil made from microalgae. Some formulations also include other nutriceutical compounds in addition to omega-3s including vitamin A and vitamin D (cod liver oil) as well as curcumin and black seed oil.

 

Fish Oil and Curcumin with Black Seed Oil (Bio-Avail Omega+).

The benefits of supplementing with fish oil has been made above, including it’s cardiovascular benefits that  are well known, there is growing evidence for its cerebrovascular benefits as well. There is an argument for selecting fish oil supplements that include other nutriceuticals with known anti-inflammatory benefits.

Curcumin, the active compound found in turmeric, is also a well known supplement with powerful anti-inflammatory benefits. A recent study evaluating supplementation with fish oil ((2000 mg/dDHA+ 400 mg/dEPA), and curcumin (160 mg/day) demonstrated that curcumin supplementation significantly improved performance related to immediate recall assessing verbal memory in overweight or obese males, middle-aged and older.

Black seed oil, also known as black cumin (Nigella sativa L.), has been shown to have many medicinal benefits, including antioxidant, anti-inflammatory, immunomodulatory, anti-cancer, neuroprotective, anti-hypertensive,, anti-diabetic properties as well as protective properties for heart, stomach, kidneys and liver. 

 

Omega-6 Fatty Acids

 

Omega-7 Fatty Acids

Omega-7s are a class of unsaturated fatty acids including palmitoleic acid, vaccenic acid and margaroleic acid. Palmitoleic acid is the most common omega-7s and is found in eggs, salmon, anchovy, sardines, macadamia nuts, olive oil and cod liver oil. It is also synthesized in the body by the liver. Palmitoleic acid is not the same as palmitic acid, a saturated fatty acid found in many of the same foods as palmitoleic acid.

Some fish and marine oil supplements may contain palmitoleic acid but, in general, the higher the concentration a fish oil is in EPA and/or DHA, the lower the concentration of omega-7 fatty acids will be. Products made from algae oil contain virtually no omega-7s, although it is abundant in the sea buckthorn.

Preliminary evidence suggests that palmitoleic acid, may reduce inflammation and improve cholesterol levels. Herring contains, by far, the highest amounts of omega-7s (over 1,000 mg per serving), followed by sardines (578 mg to 748 mg per serving), while sockeye salmon products generally contain 201 mg to 255 mg per serving. Pink salmon and most tuna contain lower amounts, or are not detectable.

 

Omega-9 Fatty Acids

(Mono-unsaturated fats i.e. Oleic Acid)

Omega-9 fats are mono-unsaturated (MUFAs) and they are nonessential, meaning that your body can produce them, so there are no specific intake recommendations for omega-9. Although omega-9 MUFAs aren’t strictly “essential,” the body does not always manufacture enough omega-9 to meet requirements. so consequently they may be considered as “partially essential” fatty acids. MUFAs represent a healthier alternative to saturated animal fats and have several health benefits, including anti-inflammatory and anti-breast cancer properties.

Research indicates that people who eat high mono-unsaturated fat diets have less inflammation and better insulin sensitivity than those who eat diets high in saturated fat.  Additionally, studies demonstrate that they may act synergistically with omega-3 fatty acids to enhance the anti-inflammatory benefits each of these provide on their own. This synergy has been demonstrated in the treatment of arthritis.  See:  CAM Tx osteoarthritis. 

Oleic acid is tthe most common mono-unsaturated fatty acid in the diet and has received the most attention in research. One of the best sources of oleic acid is olive oil. It is the oleic acid in olive oil that provides much of the health benefits relative to the Mediterranean diet, which includes significant amounts of olive oil. Note that while extra virgin olive oil is the least processed form and retains more antioxidants, the oleic acid content remains consistent between the two.

Here are the amounts of omega-9s in 100 grams of the following common foods:

• Olive oil: 83 grams 
• Cashew nut oil: 73 grams
• Almond oil: 70 grams
• Avocado oil: 60 grams
• Canola oil: 60 grams
• Peanut oil: 47 grams
• Sesame oil: 40 grams
• Pumpkin seed oil: 33 grams
• Flaxseed oil: 18 grams
• Avocado: 10 grams
• Macadamia nuts: 60 grams
• Hazel nuts: 40-60 grams
• Pecans: 47 grams
• Almonds: 30 grams
• Pistachios: 24 grams
• Cashews: 24 grams
• Walnuts: 9 grams

 

 

 

Types of Fat:

Saturated, Polyunsaturated, Mono-unsaturated and Trans Fats

The Nutrition Facts label on each bottle of oil lists the content of four different types of fat: saturated, polyunsaturated, monounsaturated and trans fats.  Because of the links between saturated fats and heart disease and stroke, the American Heart Association recommends that most saturated fat in the diet be replaced with mono- and polyunsaturated fat and that trans fats be avoided altogether.

Saturated Fat

Saturated fat can come from meat, lard, and dairy, as well as some plant sources like coconut and palm. Saturated fat is solid at room temperature. Recent research is showing a role for saturated fat in a healthy lifestyle, but it should still be used sparingly because of its link to poor health.  It is recommended to limit or avoid animal-based saturated fats completely.

Polyunsaturated Fat

Polyunsaturated fat tends to be higher in omega-6 than omega-3 fatty acids, which is linked to inflammation in the body. Healthier polyunsaturated oil choices contain more omega-3s and less omega-6s. Polyunsaturated oil is less stable than monounsaturated or saturated fat. Polyunsaturated fat can degrade in the body, leading to oxidation and cell damage. These types of fat are not typically used for cooking — especially not at higher temperatures.

Mono-unsaturated Fat

(i.e: Omega-9 Fatty Acids)

Oil that’s high in monounsaturated fatty acids is a staple of the Mediterranean diet, which has been shown to reduce arthritis pain, chronic pain and extend length and quality of life. Mono-unsaturated fats usually solidify when refrigerated. Oils high in mono-unsaturated fats include avocado, sunflower, safflower and peanut oils.  See: Omega-9 Fatty Acids

Trans fats

Trans fats are unsaturated fatty acids found in both natural and industrial sources. They can be harmful to your health and increase the risk of heart disease and death. Trans fats can be found in many commercial foods, including baked goods, fried foods, frozen pizza, microwave popcorn, and margarine. Eggs are low in both saturated and trans fats and commercial peanut butters do not contain trans fats.
.

• • Trans fats in fried foods
    Even though restaurants and bakeries have reduced or eliminated the use of trans fats, trans fats can still develop during the frying process. 
  • FDA regulations
    In 2015, the FDA banned the use of partially hydrogenated oils (PHOs) in the United States. PHOs are oils that are turned into solid fats, like shortening or margarine. The FDA also requires that trans fats be listed on Nutrition Facts labels.
  • World Health Organization (WHO) goals
    The WHO has set a goal to eliminate industrially produced trans fats by the end of 2023. As of the end of 2021, 40 countries had implemented policies to eliminate industrial trans fats.

Cooking Oils

The choice of what oil to cook with is important relative to health considerations, as some oils are definitively more healthy than others. The Nutrition Facts label on each bottle of oil lists the content of three different types of fat: saturated, polyunsaturated, and monounsaturated. Some of each kind are beneficial in the diet, but because of the links between saturated fats and trans fats with heart disease and stroke, the American Heart Association recommends that most saturated fat in the diet be replaced with mono- and polyunsaturated fat and that trans fats be eliminated.

Most cooking oils contains about 120 calories and 14 grams of fat per tablespoon.

Choosing a Cooking Oil

When choosing a cooking oil from a health perspective, the most important consideration in choosing a cooking oil is the content of its fats. As noted above,  monounsaturated and polyunsaturated fats are emphasized.

One should also be aware of an oil’s smoke point, which is the temperature at which an oil begins to smoke and burn. Smoke points of oils typically range from 225 – 510 degrees Fahrenheit. When oil is overheated, its taste and nutritional value may be altered. When it starts to burn and smoke, it releases toxic free radicals into the food and toxic compounds into the air in the kitchen.

Always look for organic oils and avoid dangerous, “partially hydrogenated” (trans) fats. Many conventional cooking oils are extracted from plants with industrial chemicals such as hexane. Cold-pressed oil, extracted mechanically from the plant or seed using pressure, is typically healthier. Some oils are refined so they can better withstand heat, but refinement reduces nutritional value. Some experts recommend avoiding genetically modified oils (GMO-free) – See below.

 

The Healthiest Cooking Oils

Most cooking oils contain all three types of fat, or at least two, but sometimes people classify them by the type they contain the most of. Here are some recommended oils:

 

Extra Virgin Olive Oil

Extra virgin olive oil (EVOO) comes from olives with a rich, distinctive flavor and contains mostly monounsaturated fat. “Extra virgin” means it’s an unrefined oil in a natural state, not treated with chemicals or heated. EVOO and a relatively low smoke point of 375 degrees Fahrenheit so, while one can cook with EVOO on the stovetop, other oils may be a better choice for frying or high-heat cooking. Extra virgin olive oil contains the highest amount of health-protecting monounsaturated fatty acids of any oil, along with vitamins A, D, E, K, and beta-carotene and is rich in polyphenolst.

Refined olive oil is lower quality and loses some of its antioxidants and other nutrients in processing, so stick with EVOO.

Best Uses: EVOO is great for sautéing garlic and other veggies at low heat, and it makes a delicious oil and vinegar dressing for salads. You can also use it in recipes such as pesto and ratatouille.

 

Avocado Oil

Avocado oil is a monounsaturated fat extracted from the fruit of the avocado tree. It has a mild, buttery taste and a smoke point of 520 degrees Fahrenheit. One study showed that avocado oil helped reduce LDL (bad) cholesterol and triglyceride levels while increasing HDL (good) cholesterol in people with high cholesterol.

Best Uses: Because of its very high smoke point, it is good for highest-heat cooking and frying but can also be used cold in dips or recipes. The low-carbohydrate FODMAP diet, which helps reduce symptoms of irritable bowel syndrome (IBS), makes extensive use of avocado oil.

 

Grape Seed Oil

Organic grape seed oil is a healthy cooking oil, high in vitamin E and antioxidants and is known to deter harmful organisms. Cold-pressed or expeller-pressed is the best choices because other options involve chemical processing which introduces harmful polyaromatic hydrocarbons into the oil. Don’t confuse it with rapeseed, a similarly named oil that comes from another plant entirely, but is not a healthy option.

Best Uses: Grape seed oil has a smoke point of 390 to 420 degrees, so one can use it for sauteeing and other high-heat cooking, but it also works well in a homemade salad dressing recipe.

 

Flaxseed Oil

Flaxseed oil comes from the seeds of the flax plant. It is a neutral-tasting oil with a very low smoke point of only 225 degrees Fahrenheit, which means one should not use it for high-temperature cooking. Flaxseed oil has the highest alpha-linolenic acid (ALA) omega-3 content of all oils, plus some fiber. Studies have shown the omega-3s in flaxseed oil are associated with nearly a 10 percent lower risk of fatal heart attacks.

Best Uses: Use at room temperature in recipes for dips and dressings. Add a teaspoon to a fruit smoothie to boost your nutrition without changing its flavor. Many people take flaxseed oil as a supplement.

 

Sesame Oil

Made from sesame seeds, this oil has equal amounts of polyunsaturated and monounsaturated fats. Its nutty, fragrant flavor best complements South Asian, Middle Eastern, and African cuisine. It has a smoke point of 350 (unrefined) or 450 (refined) degrees Fahrenheit. Sesame oil has an extremely high antioxidant capacity, making it good at fighting free radicals. Although it has anti-inflammatory properties, it’s also higher omega-6 content than some other oils, so use it in moderation.

Best Uses: With its distinctive taste, a little sesame oil goes a long way. It can be a good oil for high temperature cooking and for people who are allergic to peanuts.

 

Walnut Oil

Pressed from walnuts, this oil has a rich, nutty taste. Its smoke point is 320 degrees Fahrenheit. It’s high in the essential fatty acid ALA and contains an antioxidant called ellagic acid, which research suggests may be an important nutrient in the fight against cancer.  Walnut oil is a good source of  other important nutrients including B vitamins, vitamin E, selenium, iron, and calcium.

Best Uses: Walnut oil’s flavor and texture make it good for low heat uses such as baking, marinades, dressings, or atop whole-grain pasta.

 

Coconut Oil  – Encouraged or Avoided?

An integral part of tropical cuisine, coconut oil is extracted from coconut flesh. One can buy unrefined extra virgin coconut oil or refined coconut oil for a more neutral flavor. Its smoke point is 350 (unrefined) and 450 (refined) degrees Fahrenheit. Unlike olive oil, the terms “virgin” and “extra virgin” are not regulated and should be considered interchangeable.

Coconut oil is 92 percent saturated fat, The predominant type is lauric acid (47%), with myristic and palmitic acids present in smaller amounts, which have been shown to raise harmful LDL levels. Coconut oil raises “bad” LDL cholesterol more than unsaturated oils but less than butter.

Researchers have concluded that because of coconut oil’s effects on raising blood cholesterol including harmful LDL and in some cases triglycerides, and because its cholesterol-raising effects were comparable to other saturated fats, coconut oil should not be viewed as a heart-healthy food and should be limited in the diet. (Source)

 

Coconut  MCT Oil vs Coconut Oil

Many of the health claims for coconut oil refer to research that used a special formulation of coconut oil made of 100% medium-chain triglycerides (MCTs), not the commercial coconut oil most available on supermarket shelves. MCTs have a shorter chemical structure than other fats, and so are quickly absorbed and used by the body. After digestion, MCTs travel to the liver where they are immediately used for energy. The theory is that this quickly absorbed form promotes satiety and prevents fat storage.

Coconut oil however contains mostly lauric acid, which is not an MCT. Lauric acid is absorbed more slowly and metabolized like other long-chain fatty acids. So, the health benefits reported from a specially constructed MCT coconut oil that contains medium-chain triglycerides other than lauric acid cannot be applied directly to commercial coconut oils.

Best Uses: Coconut oil is extremely versatile. When making Thai or Indian food, use the unrefined oil which retains the coconut flavor more than refined coconut oil. One can use coconut oil for frying, sautéing, baking, to grease pans or add it to coffee.

 

When to Limit or Avoid a Cooking Oil 

The arguments against using specific cooking oils are based largely on their fat profiles (monounsaturated fats  preferred over saturated fats and to some degree polyunsaturated fats and mostly to avoid trans fats). Additional arguments against some oils are the presence of genetically modified (GM) compounds and the potential for an oil to be contaminated with toxic solvents such as hexane during processing.

 

Genetically Modified (GM) Foods

Genetic modification alters the genetic machinery of living organisms including animals, plants and microorganisms. Combining genes from different organisms is known as recombinant DNA technology and the resulting organism is said to be ‘Genetically Modified (GM)’, ‘genetically engineered’ or ‘transgenic’.

There a variety of motivations for genetic modification including enhancing resistance to viruses, pests and inclement weather environments as well as improving the taste or nutritional values of a food. The principal transgenic crops grown commercially are herbicide and insecticide resistant soybeans, corn, cotton and canola. GM foods are often reported to be higher in nutrients and contain more minerals and vitamins than those found in traditional foods and they often taste better. GM foods can have increased shelf lives with less concerns for spoiling quickly. Some transgenic foods now available in the market include cotton, soybean, canola, potatoes, eggplant, strawberries, corn, tomatoes, lettuce, cantaloupe, and carrots.

The technology of gene manipulation raises questions as to the risks of “tampering with Mother Nature.” The biggest threat of GM foods is that they can have harmful effects on health and on the environment. Since not much is known about their long term effects, many people prefer to simply avoid GM foods.

Health risks associated with GM foods are concerned with toxins, allergens, or genetic hazards. With regards to genetic hazards, it is not the transferred gene itself that necessarily poses a health risk, it is the expression of the gene and the affects of the gene product. Fore example, new proteins can be synthesized that may produce unpredictable allergenic effects.

Early research suggested that GM foods could have toxic effects on the liver, pancreas, kidneys or reproductive organs and that they may alter hematological, biochemical, and immunologic parameters. However, many years of research with animals and clinical trials are still required for this assessment. For now, the decision to ingest GM foods remains controversial and left to the individual.

 

Cooking Oils to Limit or Avoid

Based on potential health risks, including the presence of GM foods, the following oils should be avoided or limited in their use:

Soybean Oil

Soybean oil is is too high in omega- 6 fatty acids, which increases the risk of obesity, inflammation, cardiovascular disease, cancer, and autoimmune diseases. Unless organic, it also comes from GM soybeans and is extracted with the neurotoxin hexane, a toxic chemical solvent that may end up in the final product. GMO soybean oil is commonly found in packaged foods, so read product labels.

Corn Oil

More than 50% of corn oil is polyunsaturated fat, and it also contains a high proportion of omega-6 fatty acids. Most corn oil is extracted with hexane, a toxic chemical solvent that may end up in the final product and most corn oil comes from genetically modified corn.

Canola Oil

Although it is polyunsaturated, most canola oil is genetically modified. Canola is also heavily processed and extracted with hexane, which may contaminate the cooking oil. High heat is used during canola oil processing, which turns polyunsaturated fats rancid — or into dangerous trans fats. One study found that 0.5 to 4 percent of the oil in soybean and canola oil being sold had turned to trans fats.

Palm Oil

Palm oil may have more grams of fat per serving than other oils (22 grams vs. 14 grams), and it also consists almost entirely of saturated fat. Like soybean oil, palm oil is found extensively in packaged foods.

Cottonseed Oil

Made from seeds of the cotton plant, which aren’t edible, this polyunsaturated oil can contain residue of chemical fertilizers and pesticides used to grow the cotton. More than half of the fatty acids it contains are omega-6, and it’s higher in saturated fat than most polyunsaturated oils.

Peanut Oil

Peanuts often contain aflatoxins, substances responsible for severe allergic reactions in some people. The oil contains high levels of omega-6 fatty acids, which contributes to inflammation in the body. While peanut oil is high in healthy monounsaturated fats, it is also his in unhealthy saturated fats, making its fat profile less healthy than other oils like olive and avocado oils.  Peanut oil is also prone to oxidation, which means the fat goes bad on the shelf — often without one realizing it. Peanut oil also has been linked to high rates of atherosclerosis (hardening of the arteries), possibly due to its high levels of lectins.

Crisco

Crisco shortening is gluten free and contains ALA omega-3 fatty acid, but no EPA or DHA. It is used for baking and frying, substituting for butter or margarine. While the latest version of Crisco is considered less harmful than older versions due to the removal of trans fats, it is still a processed fat that is high in saturated fat and should be avoided or consumed in very limited amounts.

Crisco contains the following (unrecommended) oils:

Crisco shortening contains the following nutrients per tablespoon: 

 

“Vegetable Oil”

Products are sometimes simply labeled as “vegetable oil” and generally contain a mixture of different cheaper but unrecommended oils, usually soybean, canola, corn, cottonseed and other oils that are high in omega-6 fatty acids. While it may be cheaper, avoid anything labeled only as “vegetable oil” because it is, inevitably, also processed with toxic solvents like hexane and is simply not the healthiest choice.

 

Points to Remember

The best cooking oils are fresh, organic, and cold-pressed. They’re rich in omega-3 fatty acids and stand up to the level of heat you plan to use. Olive and avocado oil, with the most monounsaturated fat, are the most healthful choices. Sesame and walnut oil are also excellent choices for cooking. Flaxseed oil, which is high in omega-3 fatty acids, is a good option for low-temperature uses, like salad dressing.

Coconut oil contains mostly saturated fat so its use should be limited, but coconut MCT oil, if available, may offer unique advantages.

Stay clear of hydrogenated oils (usually found in margarine and packaged foods) because they contain dangerous trans fats.  Avoid soybean, corn, palm kernel, cottonseed, canola, and grapeseed oil as they  are extracted with harsh chemical solvents (hexane). Additionally, they likely contain GM compounds.

 

 

 

Purchasing Supplements

To purchase supplements reviewed on this web site or discussed with Dr. Ehlenberger, a discount can be applied to usual commercial pricing by purchasing from Accurate Clinic’s online Supplement Store after acquiring the discount code from Accurate Clinic. Please note that Dr. Ehlenberger does not receive any financial rewards from sales through this store, it has been set up as a means to allow purchase of quality supplements more accessible and more affordable for his patients.

Accurate Clinic’s Supplement Store or, call Toll-Free: 877-846-7122 (Option 1)

 

Handouts

• A Brief Review of Omega-3 Fatty Acids

Resources:

Online Resources for Nutritional Information

MyFoodData.com

MyFoodData.com provides nutrition data tools and articles to empower you to create a better diet. All data is sourced from the USDA Food Data Central.This site includes many tools related to nutrition including one that allows you to look up any food for a nutritional analysis, including commercial products,

 The Nutrition Source

www.Nutrition.gov
Nutrition.gov provides easy access to vetted food and nutrition information from across the federal government. It serves as a gateway to reliable information on nutrition, healthy eating, physical activity, and food safety for consumers. Since dietary needs change throughout the lifespan, specialized nutrition information is provided about infants, children, teens, adult women and men, and seniors. Users can find practical information on healthy eating, dietary supplements, fitness and how to keep food safe. The site is kept fresh with the latest news and features links to interesting sites.

 

 National Association to Advance Fat Acceptance
Founded in 1969, the National Association to Advance Fat Acceptance (NAAFA) is a non-profit, all volunteer, civil rights organization dedicated to protecting the rights and improving the quality of life for fat people. NAAFA works to eliminate discrimination based on body size and provide fat people with the tools for self-empowerment through advocacy, public education, and support.

 

Journals & Newsletters

 

Books

“Dopamine for Dinner”

by Joan Borsten, 2014
Available online at Amazon.com: Kindle subscriber: free;  Kindle book: $9.95  Paperback: $149.00

 

“Dopamine for Dinner,” is the first Malibu Beach Recovery Diet Cookbook, based on their famous low-glycemic diet. The recipes developed by four accomplished chefs are both pleasant eating as well as healthy. Based on the use of low glycemic index foods, the recipes emphasize nutritious eating in a manner that promotes maintaining high brain levels of dopamine and serotonin as a means of supporting healthy brain chemistry.

 

Educational Resources:

Genetically Modified Food

• Genetically Engineered Crops- Experiences and Prospects – 2016
• Genetically modified foods- safety, risks and public concerns—a review – 2012

 

Misc.

1. Simopoulos AP. The importance of the ratio of omega 6/omega 3 essential fatty acids. Biomed Pharmacother. 2002 Oct;56(8):365-379.
2. LeGendre O, et al. (-)-Oleocanthal rapidly and selectively induces cancer cell death via lysosomal membrane permeabilization. Mol Cell Oncol. 2015 Jan; 2(4):e1006077.
3. Carvajal-Zarrabal O, et al. Effect of dietary intake of avocado oil and olive oil on biochemical markers of liver function in sucrose-fed rats. Biomed Res Int. 2014;2014:595479.
4. Unlu NZ, et al. Carotenoid absorption from salad and salsa by humans is enhanced by the addition of avocado or avocado oil. J Nutr. 2005 Mar;135(3):431-436.
5. Irandoost P, et al. Does grape seed oil improve inflammation and insulin resistance in overweight or obese women?. Int J Food Sci Nutr. 2013 Sep;64(6):706-710
6. Del Gobbo LC, et al. ω-3 ω-3 polyunsaturated fatty acid biomarkers and coronary heart disease pooling project of 19 cohort studies. JAMA Intern Med. 2016 Aug; 176(8):1155-66.
7. Carvalho M, et al. Human cancer cell antiproliferative and antioxidant activities of Juglans regia L. Food ChemToxicol. 2010 Jan; 48(1):441-447.
8. Deol P, et al. Soybean oil is more obesogenic and diabetogenic than coconut oil and fructose in mouse: Potential role for the liver. PLOS One. 2015 June.
9. O’Keefe S, et al. Levels of trans geometrical isomers of essential fatty acids in some unhydrogenated U. S. vegetable oils. J Food Lipid. 1(3):165-176.
10. Kritchevsky D, et al. Lectin may contribute to the atherogenicity of peanut oil. Lipids. 1998 Aug;33(8):821-3.

Emphasis on Education

 

Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.

 

For medical-legal reasons, access to these links is limited to patients enrolled in an Accurate Clinic medical program.

 

Should you wish more information regarding any of the subjects listed – or not listed –  here, please contact Dr. Ehlenberger. He has literally thousands of published articles to share on hundreds of topics associated with pain management, weight loss, nutrition, addiction recovery and emergency medicine. It would take years for you to read them, as it did him.

 

For more information, please contact Accurate Clinic.

 

Supplements recommended by Dr. Ehlenberger may be purchased commercially online

Please read about our statement regarding the sale of products recommended by Dr. Ehlenberger.

 

 

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