The Omega-3 Index

The Omega-3 Index measures the concentration of two specific omega-3, Eicosapentaenoic Acid (EPA) & Docosahexaenoic Acid (DHA), as a percent of total fatty acids in red blood cell membranes. In recent years, a significant body of research has been published showing that the Omega 3 Index is a very strong predictor of heart disease risk, and especially the risk of dying from a sudden heart attack which contributes to over half of heart disease related deaths. The studies have shown that an Omega 3 Index of 8% or greater is desirable for its cardio-protective benefits.

Unfortunately, studies also suggest that the average Omega 3 Index score in America is only 4% to 5%, placing millions at risk. In SA limited testing of subjects has shown only 15% of subjects has an Omega-3 Index >9%.

The Omega 3 Index: The New Measure of Heart Health

In the Physicians’ Health Study, which involved nearly 15,000 healthy male physicians, there was a greater than 90% reduction in risk of dying from a sudden heart attack for the one-quarter of individuals with the highest  Omega-3 Index compared to those with the lowest levels.  This predictive value was far greater than total cholesterol which showed a 35% reduction in relative risk for those with the lowest cholesterol levels.

The Omega-3 Index appears to be an independent risk factor and not influenced by other heart disease risk factors like cholesterol or blood pressure. All risk factors including the Omega-3 Index should ideally be addressed as part of an overall heart health risk reduction strategy. 

In the Physician’s Health Study a multivariable-adjusted relative risk for sudden cardiac death by quartile of the Omega-3 Index compared with other, more traditional circulating cardiovascular risk factors (C-reactive protein CRP; Homocysteine Hcy; total cholesterol TC; LDL; HDL triglycerides). The quartiles at presumed highest risk (black bars) are set at a relative risk of 1.0. Each subsequent lighter bar represents the risk at each decreasing (or, for HDL and Omega-3 Index, increasing) quartile.

Omega 3 Test: Omega 3 Index and Biological Aging

Recent anti-aging research suggests that a high Omega-3 Index may protect against the biological aging process.  In a study among coronary heart disease patients published by the Journal of the American Medical Association, a high Omega-3 Index was associated with up to a 65% reduction in the rate at which an individual’s cells age as measured by the rate of telomere shortening, a new marker of biological aging.  In this study, patients with the fastest aging cells had an Omega-3 Index of 3.1% whereas those with the slowest aging cells had an Omega-3 Index of 8.7%.

Omega 6 to Omega 3 Ratio and Whole Body Inflammation

A consequence of the dramatic changes to our food supply over the past 50 years is that typical American diets are very high in omega-6 and low in omega-3, leading to high omega 6: omega-3 ratios.  The Omega 3 home blood test kit is unique because it also provides information on the omega-6: omega-3 ratio, a measure associated with whole body inflammation.  We are now aware of the relationship between systemic and whole body inflammation and many of our largest and fastest growing health conditions including obesity, diabetes, cardiovascular disease, arthritis, allergies, asthma, cancer and many others. 

Together with theOmega-3 Index and Omega-6: Omega-3 ratio, the third very important measure is a comparison of your highly unsaturated omega-3 levels to your highly unsaturated omega-6 levels.  In fact, some leading scientists believe that this is the most important of the three because it considers the key anti-inflammatory omega-3 like EPA & DHA and the most active inflammation promoting omega-6 like Arachidonic Acid (AA).

The Omega 3 Index Home Blood Test Kit and Your Personal Nutrition

Even those taking steps to increase their consumption of omega 3s may not be getting enough.  The body’s response to omega-3 in the diet is influenced by many factors including genetics, age, sex, weight, smoking, medications, and medical conditions, as well as the source and quality of omega-3 and how they are consumed. 

Until recently we had no accurate measure of these biological parameters but fortunately the technology has been developed to accurately analyse red blood cell (RBC) membranes for EPA and DHA levels and other lipid fractions including omega-6, saturated and trans fats. 

This test may well revolutionise our approach to RISK STRATIFICATION for definitive measure of cellular incorporation of omega-3 into cell membranes will modify our approach to prevention of these important disease states.

I believe documenting your Omega-3 Index will profoundly affect your future risk and if applied early in life we should be able to age appropriately without chronic debilitating disease.

Blessings

Cardiologydoc

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“I am the Alpha and the Omega” says the Lord God

“Who is, and who was, and who is to come, the Almighty.” (Revelation 1:8)

You will agree God is incredible through His two great teachings: Nature and the Bible.

We have been blessed with an increbible chemical called Omega 3 fats as a natural anti ageing and anti inflammatory agent.

Researchers at the University of California, San Francisco reveal in the January 20, 2010 issue of the Journal of the American Medical Association (JAMA) that heart disease patients who have higher levels of omega-3 fatty acids experience a lower rate of reduction in telomere length over time. Telomeres, which are protective DNA sequences at the ends of chromosomes, shorten with the age of the cell, and their length is a marker of biological aging.

Multiple epidemiologic studies, including several large randomized controlled trials, have demonstrated higher survival rates among individuals with high dietary intake of marine omega-3 fatty acids and established cardiovascular disease. On this basis, the American Heart Association recommends increased oily fish intake and the use of omega-3 fatty acid supplements for the primary and secondary prevention of coronary heart disease. The mechanisms underlying this protective effect are poorly understood but are thought to include anti-inflammatory, anti platelet, antihypertensive, antiarrhythmic, and triglyceride-lowering effects.

Patients whose levels of EPA and DHA were among the top 25 percent of participants had the slowest rate of telomere shortening over the 5 year period, while those whose levels were lowest had rates that were the fastest. The authors noted that “Each 1-standard deviation increase in DHA + EPA levels was associated with a 32 percent reduction in the odds of telomere shortening.”

Because increased oxidative stress has been identified as a factor in telomere shortening and aging, the ability of omega-3 fatty acids to help reduce oxidative stress as previously determined by lower levels of F2-isoprostanes and higher levels of the body’s antioxidant enzymes in response to supplementation could explain the benefit observed in the current research. Additionally, the authors speculate that omega-3 fatty acids could enhance the activity of telomerase (the enzyme that helps maintain telomere length) in healthy tissue, while suppressing it in cancer cells.

“In this longitudinal study, we observed that baseline levels of marine omega-3 fatty acids were associated with decelerated telomere attrition over 5 years,” the authors conclude. “These findings raise the possibility that omega-3 fatty acids may protect against cellular aging in patients with coronary heart disease.”

Omega-3 fatty acids                                          

Overview:

Omega-3 fatty acids are essential fatty acids necessary for human health. By being essential the body can’t make them so you have to get them through food.

Omega-3 fatty acids are found in fish, such as salmon, tuna, and sardine, other seafood including algae and krill, some plants, and nut oils. Also known as polyunsaturated fatty acids (PUFAs), omega-3 fatty acids play a crucial role in brain function, as well as normal growth and development. They have also become popular because they may reduce the risk of heart disease and the American Heart Association recommends eating fish (particularly fatty fish such as mackerel, lake trout, herring, sardines, albacore tuna, and salmon) at least 2-3 times a week.

Research shows that omega-3 fatty acids reduce inflammation (God’s natural anti-inflammatory agent) and may help lower risk of chronic diseases such as heart disease, cancer, and arthritis. Omega-3 fatty acids are highly concentrated in the brain and appear to be important for cognitive (brain memory and performance) and behavioural function. In fact, infants who do not get enough omega-3 fatty acids from their mothers during pregnancy are at risk for developing vision and nerve problems. Symptoms of omega-3 fatty acid deficiency include fatigue, poor memory, dry skin, heart problems, mood swings or depression, and poor circulation.

It is important to have the proper ratio of omega-3 and omega-6 (another essential fatty acid) in the diet. Omega-3 fatty acids help reduce inflammation, and most omega-6 fatty acids tend to promote inflammation. The typical American diet tends to contain 14 – 25 times more omega-6 fatty acids than omega-3 fatty acids, which many nutritionally oriented physicians consider to be way too high on the omega-6 side. The correct ratio of omega-3: omega-6 is 1:5 so to correct the current 1:25 ratio we need to reduce omega-6 intake and drastically increase omega-3 intake.

The Mediterranean diet or Paleolithic style diets (low carbohydrate), provides a healthier balance between omega-3 and omega-6 fatty acids. Many studies have shown that people who follow this diet are less likely to develop heart disease.

The Mediterranean diet emphasizes foods rich in omega-3 fatty acids, including whole grains, fresh fruits and vegetables, fish, olive oil, garlic, as well as moderate wine consumption.

Modified low carbohydrate diets like “Eco-Atkins” with 60% of daily calories from healthy fatty acids including omega-3 fats; 30% of calories from protein and 10% calories from carbohydrate are ideal for the individuals with “carbohydrate intolerance” or insulin resistance, obesity, with the metabolic syndrome.

Uses of Omega-3:

Clinical evidence is strongest for heart disease and problems that contribute to heart disease, but omega-3 fatty acids may also be used for:

High cholesterol

People who follow a Mediterranean style diets and Paleolithic style diets tend to have higher HDL (protective good cholesterol), which help promote heart health. Inuit Eskimos, who get high amounts of omega-3 fatty acids from eating fatty fish, also tend to have increased HDL cholesterol and decreased triglycerides (a different fat in the blood). Several studies have shown that fish oil supplements reduce triglyceride levels. Finally, walnuts (which are rich in alpha linolenic acid or ANA, which converts to omega-3s in the body) have been reported to lower total cholesterol and triglycerides in people with high cholesterol levels.

High blood pressure

Several clinical studies suggest that diets rich in omega-3 fatty acids lower blood pressure in people with hypertension. An analysis of 17 clinical studies using fish oil supplements found that taking 3 or more grams of fish oil daily may reduce blood pressure in people with untreated hypertension. Doses this high, however, should only be taken under the direction of a physician.

Heart disease

The role of omega-3 fatty acids in cardiovascular disease is well established. One of the best ways to help prevent heart disease is to eat a diet low in saturated fat and to eat foods that are rich in monounsaturated and polyunsaturated fats (including omega-3 fatty acids). Clinical evidence suggests that EPA and DHA (eicosapentaenoic acid and docosahexaenoic acid, the 2 omega-3 fatty acids found in fish oil) help reduce risk factors for heart disease, including high cholesterol and high blood pressure. Fish oil has been shown to lower levels of triglycerides (fats in the blood), and to lower the risk of death, heart attack, stroke, and abnormal heart rhythms in people who have already had a heart attack. Fish oil also appears to help prevent and treat atherosclerosis (hardening of the arteries) by reducing the inflammatory cytokine content of plaque and reducing coagulation (blood clots), which can progressively clog arteries.

Large population studies suggest that getting omega-3 fatty acids in the diet, primarily from fish, helps protect against stroke. Eating at least 2 servings of fish per week can reduce the risk of stroke by as much as 50%. However, high doses of fish oil and omega-3 fatty acids may increase the risk of bleeding. People who eat more than 3 grams of omega-3 fatty acids per day (equivalent to 3 servings of fish per day) may have higher risk for hemorrhagic stroke, a potentially fatal type of stroke in which an artery in the brain leaks or ruptures.

Diabetes

People with diabetes often have high triglyceride and low HDL levels. Omega-3 fatty acids from fish oil can help lower triglycerides and raise HDL, so eating foods or taking fish oil supplements may help people with diabetes. Another type of omega-3 fatty acid, ALA (from flaxseed, for example) may not have the same benefit as fish oil. Some people with diabetes can’t efficiently convert ANA to a form of omega-3 fatty acids that the body can use.

Other benefits of Omega-3:

  • Rheumatoid Arthritis: Most clinical studies examining omega-3 fatty acid supplements for arthritis have focused on rheumatoid arthritis (RA), an autoimmune disease that causes inflammation in the joints. A number of small studies have found that fish oil helps reduce symptoms of RA, including joint pain and morning stiffness.). However, unlike prescription medications, fish oil does not appear to slow progression of RA, only to treat the symptoms. Joint damage still occurs.
  • Systemic lupus erythematosus: Several small studies suggest that EPA and fish oil may help reduce symptoms of lupus, an autoimmune condition characterized by fatigue and joint pain.
  • Osteoporosis: Some studies suggest that omega-3 fatty acids may help increase levels of calcium in the body and improve bone strength, although not all results were positive. Some studies also suggest that people who don’ t get enough of some essential fatty acids (particularly EPA and gamma-linolenic acid [GLA], an omega-6 fatty acid) are more likely to have bone loss than those with normal levels of these fatty acids. In a study of women over 65 with osteoporosis, those who took EPA and GLA supplements had less bone loss over 3 years than those who took placebo. Many of these women also experienced an increase in bone density.
  • Depression & Bipolar disorder. Studies have found mixed results as to whether taking omega-3 fatty acids can help depression symptoms. Several studies have found that people who took omega-3 fatty acids in addition to prescription antidepressants had a greater improvement in symptoms than those who took antidepressants alone. Other studies show that omega-3 fatty acid intake helps protect against postpartum depression, among other benefits. However, other studies have found no benefit. In a clinical study of 30 people with bipolar disorder, those who took fish oil in addition to standard prescription treatments for bipolar disorder for 4 months experienced fewer mood swings and relapse than those who received placebo
  • Attention deficit/hyperactivity disorder (ADHD): Children with attention deficit/hyperactivity disorder (ADHD) may have low levels of certain essential fatty acids (including EPA and DHA). In a clinical study of nearly 100 boys, those with lower levels of omega-3 fatty acids had more learning and behavioural problems (such as temper tantrums and sleep disturbances) than boys with normal omega-3 fatty acid levels.
  • Cognitive decline: A number of studies show that reduced intake of omega-3 fatty acids is associated with increased risk of age related cognitive decline or dementia, including Alzheimer’s disease. Scientists believe the omega-3 fatty acid DHA is protective against Alzheimer’s disease and dementia.
  • Skin disorders: In one clinical study, people with sun sensitivity known as photo dermatitis showed less sensitivity to UV rays after taking fish oil supplements. However, topical sunscreens are much better at protecting the skin from damaging effects of the sun than omega-3 fatty acids. In another study of 40 people with psoriasis, those who took EPA with their prescription medications did better than those treated with the medications alone. However, a larger study of people with psoriasis found no benefit from fish oil.
  • Inflammatory bowel disease (IBD): Some studies suggest that omega-3 fatty acids may help when added to medication, such as sulfasalazine (a standard medication for IBD). Fish oil supplements can however cause side effects that are similar to symptoms of IBD (such as flatulence, belching, bloating, and diarrhoea).
  • Macular Degeneration: A questionnaire given to more than 3,000 people over the age of 49 found that those who ate more fish were less likely to have macular degeneration (a serious age related eye condition that can progress to blindness) than those who ate less fish. Similarly, a clinical study comparing 350 people with macular degeneration to 500 without the eye disease found that those with a healthy dietary balance of omega-3 and omega-6 fatty acids and more fish in their diets were less likely to have macular degeneration.
  • Colon; Prostate & Breast cancer: Eating foods rich in omega-3 fatty acids seems to reduce the risk of colorectal cancer. For example, Eskimos, who tend to have a high fat diet, but eat significant amounts of fish rich in omega-3 fatty acids, have a low rate of colorectal cancer. Animal studies and laboratory studies have found that omega-3 fatty acids prevent worsening of colon cancer. Preliminary studies suggest that taking fish oil daily may help slow the progression of colon cancer in people with early stages of the disease.

Dietary Sources:

Fish, plant, and nut oils are the primary dietary source of omega-3 fatty acids. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are found in cold water fish such as salmon, mackerel, sardines, tuna, and herring. ALA is found in flaxseeds, flaxseed oil, canola (rapeseed) oil, soybeans, soybean oil, pumpkin seeds, pumpkin seed oil, purslane, perilla seed oil, walnuts, and walnut oil. The health effects of omega-3 fatty acids come mostly from EPA and DHA. ALA from flax and other vegetarian sources needs to be converted in the body to EPA and DHA. Many people do not make these conversions very effectively, however. This remains an ongoing debate in the nutrition community; fish and sea vegetable sources of EPA and DHA versus vegetarian sources of ALA. Other sources of omega-3 fatty acids include sea life such as krill and algae.

Available Forms:

Both EPA and DHA can be taken in the form of fish oil capsules. Flaxseed, flaxseed oil, fish, and krill oils should be kept refrigerated.

Whole flaxseeds must be ground within 24 hours of use, so the ingredients stay active. Flaxseeds are also available in ground form in a special mylar package so the components in the flaxseeds stay active.

Be sure to buy omega-3 fatty acid supplements made by established companies who certify that their products are free of heavy metals such as mercury, lead, and cadmium.

How to Take It:

Dosing for fish oil supplements should be based on the amount of EPA and DHA, not on the total amount of fish oil. Supplements vary in the amounts and ratios of EPA and DHA. A common amount of omega-3 fatty acids in fish oil capsules is 0.18 grams (180 mg) of EPA and 0.12 grams (120 mg) of DHA. Different types of fish contain variable amounts of omega-3 fatty acids, and different types of nuts or oil contain variable amounts of ALA. Fish oils contain approximately 9 calories per gram of oil.

Children (18 years and younger)

There is no established dose for children. Omega-3 fatty acids are used in some infant formulas. Fish oil capsules should not be used in children except under the direction of a health care provider. Children should avoid eating fish that may be high in mercury, such as shark, swordfish, king mackerel, and tilefish. (See Precautions section.)

Adults

Do not take more than 3 grams daily of omega-3 fatty acids from capsules without the supervision of a health care provider, due to an increased risk of bleeding.

  • For healthy adults with no history of heart disease: The American Heart Association (AHA) recommends eating fish at least 2-3 times per week.
  • For adults with coronary heart disease: The AHA recommends an omega-3 fatty acid supplement (as fish oils), 1 gram daily of EPA and DHA. It may take 2 – 3 weeks for benefits of fish oil supplements to be seen. Supplements should be taken under the direction of a physician.
  • For adults with high cholesterol levels: The AHA recommends an omega-3 fatty acid supplement (as fish oils), 2 – 4 grams daily of EPA and DHA. It may take 2 – 3 weeks for benefits of fish oil supplements to be seen. Supplements should be taken under the direction of a physician.
  • For adults with high blood pressure, scientists generally recommend 3 – 4 grams per day, but you should only take under the supervision of a health care provider.

Precautions:

Because of the potential for side effects and interactions with medications, you should only take dietary supplements only under the supervision of a knowledgeable health care provider.

Omega-3 fatty acids should be used cautiously by people who bruise easily, have a bleeding disorder, or take blood thinning medications including warfarin (Coumadin), clopidogrel (Plavix), or aspirin. High doses of omega-3 fatty acids may increase the risk of bleeding, even in people without a history of bleeding disorders and even in those who are not taking other medications.

Fish oil can cause gas, bloating, belching, and diarrhoea.

Some fish may contain potentially harmful contaminants, such as heavy metals (including mercury), dioxins, and polychlorinated biphenyls (PCBs). For sport caught fish, the U.S. Environmental Protection Agency (EPA) recommends that pregnant or nursing women eat no more than a single 6 ounce meal per week, and young children less than 2 ounces per week. For farm raised, imported, or marine fish, the U.S. Food and Drug Administration recommends that pregnant or nursing women and young children avoid eating types with higher levels of mercury (such as mackerel, shark, swordfish, or tilefish), and eat up to 12 ounces per week of other fish types.

Buy fish oil from a reputable source that tests to make sure there is no mercury or pesticide residues in its products.

Possible Interactions:

If you are currently being treated with any of the following medications, you should not use omega-3 fatty acid supplements, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (ALA), without first talking to your health care provider.

Blood thinning medications — Omega-3 fatty acids may increase the effects of blood thinning medications, including aspirin, warfarin (Coumadin), and clopidogrel (Plavix). Taking aspirin and omega-3 fatty acids may be helpful in some circumstances (such as in heart disease), but they should only be taken together under the supervision of a health care provider.

Diabetes medications — Taking omega-3 fatty acid supplements may increase fasting blood sugar levels. Use with caution if taking medications to lower blood sugar, such as glipizide (Glucotrol and Glucotrol XL), glyburide (Micronase or Diabeta), glucophage (Metformin), or insulin. Your doctor may need to increase your medication dose. These drugs include:

  • Glipizide (Glucotrol and Glucotrol XL)
  • Glyburide (Micronase or Diabeta)
  • Metformin (Glucophage)
  • Insulin

Cyclosporine — Cyclosporine is a medication given to people with organ transplants. Taking omega-3 fatty acids during cyclosporine (Sandimmune) therapy may reduce toxic side effects, such as high blood pressure and kidney damage, associated with this medication.

Etretinate and topical steroids — Adding omega-3 fatty acids (specifically EPA) to the drug therapy etretinate (Tegison) and topical corticosteroids may improve symptoms of psoriasis.

Cholesterol-lowering medications — Following dietary guidelines, including increasing the amount of omega-3 fatty acids in your diet and reducing the omega-6 to omega-3 ratio, may help a group of cholesterol lowering medications known as statins to work more effectively. These medications include:

  • Rosuvastatin (Crestor)
  • Atorvastatin (Liptor)
  • Lovastatin (Mevacor)
  • Simvastatin (Zocor)

God is AMAZING. Why do you enjoy good health?  Why does God permit it? The answer is that he wants you to turn to Him and acknowledge his goodness and accept the riches he has for you.

Genesis 1

26 Then God said, “Let us make mankind in our image, in our likeness, so that they may rule over the fish in the sea and the birds in the sky, over the livestock and all the wild animals, and over all the creatures that move along the ground.”

29 Then God said, “I give you every seed-bearing plant on the face of the whole earth and every tree that has fruit with seed in it. They will be yours for food. 30 And to all the beasts of the earth and all the birds in the sky and all the creatures that move along the ground-everything that has the breath of life in it-I give every green plant for food.” And it was so.

15 The LORD God took the man and put him in the Garden of Eden to work it and take care of it. 16 And the LORD God commanded the man, “You are free to eat from any tree in the garden; 17 but you must not eat from the tree of the knowledge of good and evil, for when you eat from it you will certainly die.”

Leviticus 26

3 “‘If you follow my decrees and are careful to obey my commands, 4 I will send you rain in its season, and the ground will yield its crops and the trees their fruit. 5 Your threshing will continue until grape harvest and the grape harvest will continue until planting, and you will eat all the food you want and live in safety in your land.

14 “‘But if you will not listen to me and carry out all these commands, 15 and if you reject my decrees and abhor my laws and fail to carry out all my commands and so violate my covenant, 16 then I will do this to you: I will bring on you sudden terror, wasting diseases and fever that will destroy your sight and sap your strength. You will plant seed in vain, because your enemies will eat it.

Deuteronomy 7:15

The LORD will keep you free from every disease.

Deuteronomy 11

13 So if you faithfully obey the commands I am giving you today-to love the LORD your God and to serve him with all your heart and with all your soul- 14 then I will send rain on your land in its season, both autumn and spring rains, so that you may gather in your grain, new wine and olive oil. 15 I will provide grass in the fields for your cattle, and you will eat and be satisfied.

1 Corinthians 6

12 “I have the right to do anything,” you say-but not everything is beneficial. “I have the right to do anything”- but I will not be mastered by anything. 13 You say, “Food for the stomach and the stomach for food, and God will destroy them both.” The body, however, is not meant for sexual immorality but for the Lord, and the Lord for the body. 14 By his power God raised the Lord from the dead, and he will raise us also. 15 Do you not know that your bodies are members of Christ himself?

19 Do you not know that your bodies are temples of the Holy Spirit, who is in you, whom you have received from God? You are not your own; 20 you were bought at a price. Therefore honour God with your bodies.

Philippines 2:15-16

Then you will shine among them like stars in the sky 16 as you hold firmly to the word of life. And then I will be able to boast on the day of Christ that I did not run or labour in vain.

1 Timothy 2

6 If you point these things out to the brothers and sisters, you will be a good minister of Christ Jesus, nourished on the truths of the faith and of the good teaching that you have followed. 7 Have nothing to do with godless myths and old wives’ tales; rather, train yourself to be godly. 8 For physical training is of some value, but godliness has value for all things, holding promise for both the present life and the life to come. 9 This is a trustworthy saying that deserves full acceptance. 10 That is why we labor and strive, because we have put our hope in the living God, who is the Savior of all people, and especially of those who believe.

God Bless

Cardiology doc