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The Realities of Diet and Dosage With Omega-3 Supplementation

What the media and ivory-tower doctors often ignore.

 

chart showing american men and women fish consumption in the US to AHA guidelines. Only 18% of men and 15% of women meet guidelinesResearch published in the mid-1980s began to awaken the scientific community to the health benefits of omega-3 fatty acids, and for more than 16 years Americans have been admonished to eat three servings of non-fried, fatty fish a week. Has this message been heard and adopted? The answer is a clear and resounding no. This is especially true for those living in the Midwest and other non-coastal areas.
Midwestern adults (at the 50th percentile of consumption) eat less than ½ of a serving of fish a week, or 20% of the recommended amount. Women, on average, consume about 20% less than men, so their deficit is even more severe. In total, approximately 96% of midwestern adults consume less than the recommended amount of fatty fish per week. While those in coastal areas consume at a higher rate, they still fall well below the recommended intake.
My wife, Joan O'Keefe, RD, and I always advise our patients to get their nutrients from whole foods whenever possible, but for many of them getting all of the necessary omega-3 fatty acids through diet alone is too much of a struggle. Many people may not have the knowledge and skills needed to select, prepare and eat the kinds of fish needed to provide the proper amounts of EPA and DHA.
The Reality of the American Diet
Do you really think the average American knows that canned pink salmon has 1 gram of EPA+DHA while Atlantic salmon has almost double the amount at 1.8 grams? Would they know that chunk light tuna has .5 grams of EPA+DHA, while albacore has nearly triple the total at 1.3 grams?
Do they know that while tilapia and orange roughy are fish, they contain very little omega-3 fatty acids? When they prepare it, will it be fried or sautéed in butter? Even educated health care professionals often don’t get the needed omega-3 through diet. Take Anne, a physical therapist at a Kansas City area hospital. While she recognizes the value of omega-3 fatty acids, in her words, “I can’t stand the taste of fish, even salmon. It’s the texture – yuck! Because I don’t eat it, my family doesn’t get it either.”
While compliance with the guidelines is poor, it is important to remember that these are recommended amounts for the average American with no specific deficiencies or health conditions. For those who suffer from conditions which can benefit from higher levels of omega-3 fatty acids, ensuring adequate daily intake is even more critical.
Dramatic Research Study Results
chart showing participants taking 1 gram of omega-3 lowered risk of heart attack, stroke and cardiovascular death eventsWhile the role of omega-3 fatty acids in heart health has been studied for many years, some headlines questioned their value. However, recently released studies back up our opinion that dosage and timing matter. The VITAL study examined the benefits of large doses of highly refined omega-3 and measured for a variety of cardiovascular events. Unfortunately, many in the media focused on the result that supplementation did not reduce the total number of events to a significant degree. What they failed to notice when reading the study report was the finding that while stroke risk was not reduced, the risk of heart attacks was reduced by 28% and the risk of fatal heart attacks was reduced by 50%.
Likewise, the REDUCE-IT study utilized a significantly larger dosage and controlled for specific conditions, namely high triglycerides and utilization with a statin drug. The REDUCE-IT study showed a 25% reduction across all of the measured cardiovascular events.
So no, omega-3 supplementation isn’t a magic pill that solves all problems, but it has demonstrated significant benefits to heart health. The takeaway: Dosage, diet, lifestyle, other treatments, genetics and existing conditions all matter. If we can’t people to eat the fatty fish their body needs, let’s try to find a practical method for seeing they don’t miss out on the benefits of essential omega-3 fatty acids.
Why Cardiotabs Omega-3?
At Cardiotabs the most important factors we focus on relate to the quality of the product we deliver. Joan and I spend many long hours examining all of the latest research on the various forms of omega-3 and the optimal ratio of essential EPA and DHA. We travel the world to ensure our suppliers are as committed as we are to quality and sustainability. After all, our professional reputations as a cardiologist and dietitian are on the line every time someone buys a bottle of Cardiotabs Omega-3.
At Cardiotabs, all products are formulated to meet the highest quality standards and to 1) directly support the health of the heart and the cardiovascular system OR 2) directly support the health of another organ or bodily function AND eliminate or minimize
negative effects on heart health.
In Good Health,
James O'Keefe, MD

References:

  1. Maes M, Christophe A, Delanghe J, Altamura C, Neels H, Meltzer HY. Lowered omega3 polyunsaturated fatty acids in serum phospholipids and cholesteryl esters of depressed patients. Psychiatry Res. 1999;85:275-91.
  2. Estimated Fish Consumption Rates for the U.S. Population and Selected Subpopulations (NHANES 2003-2010), April 2014, EPA-820-R-14-002 https://www.epa.gov/sites/production/files/2015-01/documents/fish-consumption-rates-2014.pdf accessed 3/4/2019
  3. Nutritional composition references
    1. Exler, J. (1987) Composition of Foods: Finfish and Shellfish Products. Agriculture handbook No. 8-15. Washington, DC: USDA
    2. Nettleton JA. (1995) Omega-3 Fatty Acid and Health. Chapman & Hall, 115 Fifth Ave., New York, NY 10003, pp. 21-30.
    3. Spiller GA. (1996) Lipid in Human Nutrition Handbook, Manuals, etc. CRS Press, Inc., 2000 Corporate Blvd., NW., Boca Raton, FL 33431, P54
    4. Wang YJ, Miller LA, Ferren M, Addis PB (1990) Omega-3 fatty acid in Lake Superior fish. Journal of Food Science Vol. 55(1): 71-73.
  4. https://www.vitalstudy.org/findings.html, accessed 3/4/19
  5. George Leef, MD; Zackary Goff, MD; Roger S. Blumenthal, MD, FACC; Seth Shay Martin, MD, MHS, FACC, EPA Rises From a Dead Sea of Omega-3: The Landmark REDUCE-IT Trial, https://www.acc.org/latest-in-cardiology/articles/2018/11/28/06/11/epa-rises-from-a-dead-sea-of-omega-3, accessed 3/4/2019

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