Accurate Education – Omega Fatty Acids

An Anti-Inflammatory Diet:

Omega Fatty Acids

An anti-inflammatory diet is encouraged as a remedy to battle chronic low grade inflammation throughout the body (“systemic inflammation” ), a condition that contributes to chronic pain, cardiovascular diseases, mental health and certain cancers.

Understanding the role of dietary fats and oils, especially omega fatty acids, is an important aspect of maintaining an anti-inflammatory diet. This section is not meant to be exhaustive, but rather a reference for confirming recommended foods.

Included are links that serve as more in depth resources of information for those who want to pursue greater knowledge of a subject.

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
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Definitions and Terms Related to Pain

 

Page links:

• Omega-3 Fatty Acids
• Dietary Needs
• Omega-3 index (O3i)
• Improving an Individual’s Omega-3 Intake
• Food sources of omega-3 fatty acids
• Recommendations for Dietary Intake of Omega-3 Fatty Acids
• Omega-3 Dietary Supplements
• Omega-6 Fatty Acids
• Types of Fat: Saturated, Polyunsaturated, Monounsaturated and Trans
• Cooking Oils

• References & Resources

 

Brief Summary of Omega Fatty Acids

LOC: High

• Omega fatty acids are essential for human health and cannot be synthesized by the body, so they must be ingested in food.
• Omega-3 fatty acids are divided into three different types: Eicosapentaenoic acid (EPA), docosa-hexaenoic acid (DHA), and alpha-linolenic acid (ALA). The EPA and DHA are present in fish and can be used by the body without been changed. ALA, which is present in large quantities in plants, nuts and seeds, must be converted to EPA and DHA.

Benefits:

Omega-3 fatty acids are anti-inflammatory and counter the processes of many chronic diseases:

 Pain

• • Helps reduce joint pain
  • May assist in reducing transition of acute to chronic pain
  • May help suppress evolution of central sensitization that magnifies chronic pain

Arthritis

• • Helps reduce inflammation and joint pain (in osteoarthritis and rheumatoid arthritis) with high dose
  • Improvement in morning stiffness

Cardiovascular Disease

• • Diets rich in Omega-3 fatty acids reduce risk of developing diabetes type 2 and heart disease
  • Evidence suggests EPA alone in a highly-purified, high-dose form (iicosapent ethyl (IPE)), improves cardiovascular outcomes among patients with elevated triglycerides  Current guidelines endorse the use of IPE in statin-treated patients at high cardiovascular risk who have triglycerides >135 mg/dl.

Daily Intake:

Although the ideal amount for average daily intake is not firmly established and opinions vary, most expert guidelines recommend total intakes of EPA + DHA ranging from at least 0.5 to 1.8 g per day.

• But, higher intake (>2.7 gm/day of EPA and DHA) may be recommended based on individual lab testing (O3 index)
• A minimum of 3 months of treatment may be necessary to improve levels and joint pain

Best food sources of EPA + DHA 

• Cold-water, oily fish like salmon and tuna, oysters as well as fish oil supplements. EPA & DHA can also be obtained from non-animal sources, such as microalgae

 

Fats and Oils in Food

It’s important to learn a bit about fats and oils because of the different health implications associated with the types and amounts of them in one’s diet.

Fats are important for energy, they help with nutrient absorption, energy storage, and controlling inflammation. Fatty acids are the building blocks of fats. Fats can then be categorized as saturated, polyunsaturated, mono-unsaturated and Trans fats.

Fatty Acids 

Essential fatty acids are fatty acids that the body can’t produce on its own yet they are vital to many bodily functions. acids: There are two categories of essential fatty acids Omega-3 and Omega-6, both are polyunsaturated fatty acids (PUFAs).

 

Omega-3 and Omega-6 Fatty Acids

Omega-3 and omega-6 fatty acids are necessary because they make compounds called eicosanoids, which are important hormones that control the immune system, nervous system, and other hormones. However, the eicosanoids from omega-3 and omega-6 fatty acids act differently and can produce opposing effects.  As such, a proper dietary balance of them is important.

Some researchers propose that the relative intakes of omega-3s and omega-6s (the omega 3:6 ratio) may have important implications for the pathogenesis of many chronic diseases, such as cardiovascular disease (CVD) and cancer. But the optimal omega 3:6 ratio—if any—has not been definitively identified. Some experts recommend that one should consume one omega-3 for every two omega-6s (a 1:2 ratio) for optimal benefits, but most people ingest about 16 times as many omega-6s than omega-3s.

Others researchers have concluded that such ratios are too non-specific and are insensitive to individual fatty acid levels. Most experts do agree that raising EPA and DHA blood levels is far more important than lowering linoleic acid or arachidonic acid levels.

What is becoming clear with recent research is that the higher ratio of Omega -3 to Omega-6 dietary intake is associated with less pain in many conditions including fibromyalgia, low back pain and sciatica, TMJ syndromes, abdominal and pelvic pain,

Omega -3 fatty acids are important for:

• • • Heart health – Reduce risk for cardiovascular disease.
    • Skin health – Maintain the integrity of skin cell membranes and cell hydration.
    • Brain health – Improve cognitive function.
    • Reducing inflammation
    • Easing Joint and muscle pain
    • Bone health
    • Maintaining the reproductive system
    • Regulating metabolism. 

 

Omega-3 Fatty Acids

High consumption of omega-3 fatty acids has been associated with improved cardiovascular health, decreased anxiety and depression, as well as reduced rates of cancer, Alzheimer’s Disease, type 1 Diabetes, multiple sclerosis, and total mortality.

There are three important types of omega-3 fatty acids which are essential for your body: 

• • Alpha-linolenic acid (ALA)
  • Docosa-hexaenoic acid (DHA)
  • Eicosapentaenoic acid (EPA)

 

Dietary intake of EPA and DHA is emphasized because they provide greater health benefits compared to ALA for improving cardiovascular health and supporting vision, while all three lower inflammation. ALA is present in plant oils whereas EPA and DHA are present only in fish and krill (small, shrimp-like crustaceans).  Therefore, consuming EPA and DHA directly from fish or krill oils and/or dietary supplements is the only practical way to maintain recommended levels of these fatty acids in the body.

Actually, EPA and DHA are originally synthesized by microalgae that are ingested by fish and krill and subsequently accumulate in their tissues.  As such, when it comes to whether farmed fish provide less or more EPA and DHA than wild fish, it depends on the farmed fish’s diet.

Alpha-linolenic Acid (ALA)

Alpha-linolenic acid (ALA) is an essential omega-3 fatty acid found in plants such as flaxseed, walnuts, chia seeds, hemp, and many vegetable oils, including canola and soybean oils.  The body can convert ALA into eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are the other essential omega-3 fatty acids found almost exclusively in fish.  However, while EPA and DHA can be used directly by the body, ALA must be converted by the liver into EPA and then to DHA. This conversion is very limited, with rates of less than 15%.

ALA is a precursor to important anti-inflammatory compounds produced by the body that help modulate inflammatory responses and reduce inflammation in joints and tissues, so it is important to include ALA-rich foods in one’s diet. ALA may also contribute to lower blood triglyceride levels, and reduce the risk of heart disease.

Benefits of ALA

• • ALA has anti-inflammatory benefits
  • ALA has cardiovascular-protective,, anti-cancer, neuro-protective, and anti-osteoporotic effects
  • ALA may help reduce total cholesterol, LDL cholesterol, triglycerides, and blood pressure
  • ALA may help reduce the risk of diabetes
  • ALA may help counteract cognitive impairment 

 

Eicosapentaenoic acid (EPA)

Eicosapentaenoic acid (EPA)  has anti-inflammatory and anti-oxidative properties. It can help lower the risk of heart disease, high blood pressure and high triglycerides. Appropriate dietary intake of EPA is a very important aspect of maintaining an anti-inflammatory diet.

EPA is also available as a prescription drug to reduce triglyceride levels and as a supplement, it is commonly used for heart disease, depression, and preventing heart attack.

Beneficial roles for omega-3 fatty acids

Osteoarthritis (OA)

A 2024 study demonstrates that the consumption of omega-3 fatty acids significantly reduces the risk of all-cause mortality in patients with OA. This effect is likely due to the anti-inflammatory, antioxidant, gut microbiota regulatory, and immune-modulating properties of omega-3 fatty acids.

 

Mitigating central sensitization

Omega-3 fatty acids have a potential role in mitigating central sensitization, a process associated with chronic pain in which the central nervous system  (CNS – brain and spinal cord) becomes hypersensitive to pain signals. By exerting anti-inflammatory effects and modifying nerve activity within the CNS,  omega-3 fatty acids may reduce the severity and magnification of pain perception in conditions associated with central sensitization.

Reduces Chronic Inflammation and Oxidative Stress

Aging is the most significant risk factor for chronic pain syndromes such as arthritis. During aging, cells produce various inflammatory factors (chemokines and and other factors) that lead to chronic, systemic inflammation. This chronic inflammation accelerates aging and increases mortality risk by causing oxidative damage (oxidative stress), DNA telomere attrition, loss of protein balance, and stem cell depletion. Omega-3 fatty acids can effectively stabilize these inflammatory responses and reduce the risk of systemic inflammation by inhibiting inflammation-related activity, disrupting the production of pro-inflammatory mediators and enhancing mitochondrial antioxidant capacity that reduces oxidative stress and inflammation.

 

Improvement of the Gut Microbiota

Disruption of the gut microbiota (dysbiosis) is an important factor in the development of arthritis by inducing immune activity and activating the “gut-joint axis,” that worsens progression of arthritis and other chronic pain conditions. Omega-3 fatty acids can improve gut dysbiosis by regulating the gut microbiota and restoring the healthy a healthy bacterial balance (including the ratio of Bacteroidetes to Firmicutes bacteria), which reduce intestinal inflammation by increasing short-chain fatty acid synthesis.

 

Cardiovascular disease 

Research suggests EPA alone (in the highly-purified, high-dose form of icosapent ethyl – IPE), improves cardiovascular outcomes among patients with elevated triglycerides at high cardiovascular risk. Current guidelines endorse the use of IPE in statin-treated patients at high cardiovascular risk who have triglycerides >135 mg/dl.

 

Omegas-3 Dietary Needs

Omega-3 index (O3i) – Assessing an Individual’s Omega-3 Intake

In order to determine the status of an individual’s intake of omega-3s, specifically EPA and DHA, one can measure their omega-3 index (O3i) (defined as the ratio of EPA and DHA to total fatty acids measured in erythrocyte (red blood cell) membranes), which is indicative of overall omega-3 status. The O3i was first validated as a risk factor for cardiovascular disease in 2004 and remains a generally accepted measure for determining omega-3 status.

O3i has been shown to reflect tissue omega-3 distribution and is more representative of long-term omega-3 dietary intake than other assessment methods. It can be measured via a quick and non-invasive blood test. Non-fasting blood samples are unlikely to bias findings because erythrocytes are insensitive to fasting status.

Some studies look at blood levels of PUFA to assess diet. Comparing measuring blood levels of PUFA to erythrocyte membrane levels, erythrocyte testing has lower within-person variability than blood, they have a much longer half-life and they are less affected by any recent dietary ingestion of fatty acids  in the previous 24 hours.

Individuals with O3i >8% have a lower risk of cardiovascular disease vs. those with <4%. Further evidence supports health benefits for maintaining O3i >8%.

 

Population Analysis

A 2023 scoping review article concluded that the majority of the population does not consume adequate omega-3 fatty acids, leading to global deficiencies and subsequent increased risk of cardiovascular disease among other chronic ailments. The majority of the world population has O3i levels well below the recommended target of ≥8% with most mean baseline O3i ranging from 3 to 6%, suggesting that most individuals would benefit from improved omega intake.

Population studies suggest that even those who consume fish regularly have a low O3i. The Food and Drug Administration (FDA) has established a Daily Value (DV) of 65 gm for total fat intake but not for omega-3s. Dietary Guidelines for Americans (DGA) and the American Heart Association recommend consuming two servings of fish per week (3.5–4-oz per serving), to reach an intake of 250 mg/day of EPA and DHA. However, his targeted daily dose is lower than other expert recommendations.

The majority of the American population consumes approximately half of the recommended 7–8 oz. fish per week. NHANES data have estimated the mean fish intake among adults to be 4 oz. per week and only 1 oz. per week if limiting intake to oily fish high in omega-3. This amount of fish intake translates to dietary omega-3 to be far short of the recommended 250 mg/day, with an estimated mean consumption of 63 mg/day DHA (72 mg/day when including supplements) and 23 mg/day EPA (41 mg/day when including supplements). 

Recommendations for Dietary Intake of Omega-3 Fatty Acids 

Although the ideal amount of omega-3 fatty acids for one’s diet is not firmly established, in the absence of O3i measurements, most expert guidelines recommend a total intake of EPA + DHA ranging from 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.

• But, higher intake (>2.7 gm/day of EPA + DHA) may be recommended based on individual lab testing (O3 index)
• A minimum of 3 months of treatment may be necessary to improve levels 

Improving an Individual’s Omega-3 Intake.

Since few individuals meet the recommended amount of fish intake or meet the target O3i of 8%, improving O3i by recommending an increase intake of fish alone is neither realistic nor sustainable. Only two means of achieving healthier omega-3 intake are available if an individual’s intake  of food sources is insufficient: fortifying foods with omega-3s and/or encouraging dietary supplements of omega-3s.

 

Food sources of omega-3 fatty acids

This table provides the amounts of omega-3 fatty acids in grams per serving:

See: Food Sources of Omega 3 Fatty Acids

 

Plant-based food sources of ALA

Plant-based foods may contain large quantities of ALA but they have little to no EPA and DHA. Because ALA allows only limited conversion to EPA and DHA, plant sources of omega-3s are insufficient to provide recommended amounts of these omega-3s.

Plant-based foods that contain large quantities of ALA include:

• • Chia seeds
  • Flaxseed seeds and oil (linseed)
  • Walnuts
  • Hemp seeds, and oil
  • Soybeans
  • Canola oil

 

Seafood and fish sources of EPA and DHA

The omega-3 (EPA and DHA) content of fish varies widely. Cold-water fatty fish contain the highest amounts of omega-3s, whereas fish with a lower fat content—such as bass, tilapia, and cod—as well as shellfish, contain significantly lower levels than oily fish.

Fish with the highest content of EPA and DHA include:

• • Salmon
  • Tuna
  • Mackerel,
  • Herring
  • Anchovies
  • Sardines
  • Oysters

The omega-3 content of fish also depends on the composition of the food that the fish consumes. Farmed fish such as salmon may have higher levels of EPA and DHA than wild-caught fish, but it depends on the food they are fed.

See: Omega-3 Fatty Acid Content of Fish and Seafood

 

Salmon vs Salmon

While all salmon is highly nutritious, some salmon have a slightly better profile of omega-3 fatty acids (noted here, per 100 gms or 3.5 oz): :

• • Atlantic Salmon (Wild): ALA (0.2), EPA (0.3 gm), DHA (0.9 gm), Total: 1.4 gm
  • Atlantic Salmon (Farm): May be higher or lower c/w Wild, depending on diet
  • Sockeye Salmon: ALA (0.1), EPA (0.5 gm), DHA (0.7 gm), Total: 1.3 gm
  • Chinook Salmon: ALA (0.1), EPA (0.8 gm), DHA (0.6 gm), Total: 1.5 gm
  • Chum Salmon: ALA (0.1), EPA (0.4 gm), DHA (0.6 gm), Total: 1.1 gm
  • Coho Salmon: ALA (0.2), EPA (0.3 gm), DHA (0.5 gm), Total: 1 gm

 

Tuna vs Salmon

Tuna and salmon are both highly nutritious sources of fish. 

Tuna and salmon are both highly nutritious fatty fish and they have plenty of similarities. Both are high in omega-3 fatty acids (though wild and farmed salmon both outrank tuna, with over 1.5 gm of these fats per serving versus tuna’s 1,000 to 1,500 mg). Neither salmon nor tuna contains any carbohydrates, which means they have no fiber or sugar. Their sodium content is also nearly identical at a low 37 mg per serving for salmon and 38 gm for tuna and both provide plenty of protein.

Despite their similarities, these fish differ in significant ways. Ounce for ounce, salmon contains about one-third more calories than tuna because it has more fat content,  at 5 gm per serving versus 1 gm per serving in tuna (but remember, dietary fat can be beneficial. Fat helps to promote feeling full and they help with absorption of fat-soluble vitamins. 

Salmon has more vitamin D and vitamin B12 than tuna, while tuna has more niacin (the high amounts of niacin in tuna can lower cholesterol) and selenium than salmon. Tuna is among the highest dietary sources of the important mineral, selenium. Selenium is a trace mineral that provides a number of health benefits.  It is an antioxidant which protects against DNA damage by free radicals and it plays a role in cancer prevention. Selenium also plays an essential role in thyroid health.

The nutrition information for 3 ounces (85g) of yellowfin tuna and 3 ounces (85 gm) of wild Atlantic Salmon is provided here.

Note, however, that not all tuna is the same. The amount of omega-3s in raw tuna varies by type, but tuna is generally a good source of these fatty acids (noted here, per 100 gms or 3.5 oz):  

• • Albacore tuna: ALA (0.2), EPA (0.3 gm), DHA (1.0 gm), Total: 1.5 gm
  • Bluefin tuna: ALA (0), EPA (0.4 gm), DHA (1.2 gm), Total: 1.6 gm
  • Skipjack tuna: ALA (0), EPA (0.1 gm), DHA (0.3 gm), Total: 0.4 gm

 

Tuna Salad

For those who prefer their tuna in the form of tuna salad, the nutritional content will vary, of course, based on the type of tuna used. They all have some omega-3, but our likely to have less fish oil and therefore less omega-3 than one would get with the type of tuna used in restaurants and for sushi. Or if one’s source is Subway, here is. nutritional analysis for a Subway tuna sub on white bread with lettuce and tomato – (USDA FoodData Central Food Details0.

Tuna Used in Sushi

Given that sushi and sometimes sashimi are quite popular and excellent sources of omega-3 fatty acids, it seems appropriate to provide a little additional information for those interested in sushi. While there are around 15 species of tuna worldwide, five different types of tuna are most commonly used in sushi and sashimi and each type differs significantly in terms of taste, texture and color. 

1. 1. Bluefin Tuna (Southern, Pacific and Atlantic),
   2. Bigeye Tuna
   3. Yellowfin Tuna
   4. Skipjack
   5. Albacore

 

Bluefin Tuna

The largest of the tuna varieties is the Bluefin Tuna, which can reach more than six feet in length and weigh 500 lbs or more. Atlantic, Pacific and Southern are the three species of Bluefin Tuna.

The Southern Bluefin Tuna is the most renowned and the first choice for high-end restaurants, particularly those serving Japanese cuisine. There three premium cuts of the Southern Bluefin Tuna are known by the traditional Japanese terms otoro, chutoro and akami.

• • Otoro is from the belly, or underside, of the fish and has the highest fat content — otoro translates to ‘big fat’. Because of this fattiness, the otoro falls apart easily and can quite literally melt in your mouth. Because of its flavor and texture, It is the most sought after and the most expensive part of the fish.
  • Chutoro and otoro are both cuts of tuna belly, but otoro is significantly fattier, while chutoro is a middle ground between the fatty belly and leaner meat, This makes otoro richer and more decadent in taste, but also typically more expensive than chutoro
  • Akami is the largest part of the fish, covering the top loin, shoulder and tail. It is meatier in texture and brighter in colour. It is the most frequently used part of the fish because of its abundance.

 

Ahi Tuna

Bigeye Tuna and Yellowfin Tuna are the two varieties known as ‘ahi.’ Smaller than the bluefin and with a deep pink color, they are classifies as ‘sashimi grade’ and ‘other.’

Bigeye Tuna is the type of tuna you will find in sushi and sashimi offerings in supermarkets, inexpensive restaurants and sushi-train bars.

Yellowfin Tuna, however, is most commonly used for canned products. Unlike its fatty relatives, yellowfin tuna has a low-fat content and a light and refreshing taste.

Albacore and Skipjack Tuna

On the smaller side,, the Albacore and Skipjack tuna species are most commonly used for canned products.

Skipjack Tuna, often called ‘light chunk,’ is the most abundant and widely fished of the tuna varieties. It is relatively small by comparison and is generally canned as tuna chunks and flakes, in brine or oil.

Albacore Tuna is another commonly canned tuna with a firmer texture and milder flavor than the Skipjack variety. Due to their lighter-coloured flesh, they sometime go by the name of ‘white tuna.’ Albacore potentially has some of the highest levels of mercury. Review the label on any canned product of albacore regarding mercury. but some brands promote mercury levels to be extremely low.

 

Other Food Sources of Omega-3

Beef is very low in omega-3, but beef from grass-fed cows contains somewhat higher levels of omega-3, mainly as ALA, than that from grain-fed cows.

Some foods, such as certain brands of eggs, yogurt, juices, milk, and soy beverages, are fortified with DHA and other omega-3s. Since 2002, manufacturers have added DHA and arachidonic acid (the two most prevalent PUFAs in the brain) to most infant formulas. 

 

Foods Fortified with Omega-3s

Some food is available that is fortified with omega-3s and research shows that fortified foods may significantly improve O3i by 1–2% with lower doses than dietary supplements. Nevertheless,  it is unlikely that fortified foods will provide enough EPA and DHA to raise O3i to >8%, so it is recommended that one still obtain the bulk of their omega-3s by ingesting natural foods and/or supplements rich in  omega-3s.

Some brands of the following foods are fortified with omega-3s: 

 

Supplementing Dietary Omega-3

Despite the definitive need, surveys indicate that only 7.8% of U.S. adults and 1.1% of U.S. children use supplements containing fish oil, omega-3s, and/or DHA or EPA. Generally, it may require up to 12 weeks or more of taking omega-3 supplements to be effective in raising O3i to recommended levels of >8%. Dietary supplements vary in chemical composition but 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.

Recent research suggests that DHA is more effective at raising O3i than EPA, compared to studies which supplemented equal or greater amounts of EPA vs DHA. This is because DHA is more efficiently incorporated into erythrocyte membranes. EPA and DHA both improve the O3i to a greater extent than ALA and other omega 3s such as SDA (from soybeans), which both show minimal effect on O3i.

 

Recommended omega-3 supplement doses to raise O3i to recommended levels of >8%:

(1). Those individuals with unknown O3i levels but poor dietary intake of fish: Consume at least 2,250 mg/day of EPA and DHA (as TAGs) or 2,250–3,250 mg/day (EE’s) for at least 12 weeks to reach 8%.

(2). Those individuals with unknown O3i levels but dietary intake of fish low to moderate: Consume at least 1,000–1,500 mg/day EPA and DHA (as TAGs) for at least 12 weeks to improve levels. Those with baseline O3i <4% will likely need longer time periods of supplementation and/or higher doses.

(3). Those individuals with an O3i of 2–4%: Consume 1,500–2,250 mg/day of EPA and DHA (as TAG’s) or 2,250–3,250 mg/day (EE’s) to reach 8%.

(4). Those individuals with an O3i of 4 to 6%: Consume 1,000–1,500 mg/day of EPA and DHA (as TAG’s) or 1,500–2,250 mg/day (as EE’s).

 

• 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 Supplements

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.

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) or curcumin, and black seed oil (Bio-Avail Omega+).

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.

 

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.

 

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, and loose stools. 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.

The Dietary Supplement Label Database (http://www.dsld.nlm.nih.gov/dsld/) from the National Institutes of Health contains label information from many dietary supplements on the market that contain omega-3s.

 

Omega-6 Fatty Acids

Types of Fat: Saturated, Polyunsaturated, Monounsaturated and Trans

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

Oil that’s high in monounsaturated fatty acids is a staple of the Mediterranean diet, which has been shown to extend length and quality of life. Monounsaturated fats tend to be higher in omega-3s than other types of oil and usually solidify when refrigerated. Oils high in monounsaturated fats include avocado, sunflower, safflower and peanut oils.

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)

 

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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