The Reversal on Fish Oil

Is Fish Oil Just Snake Oil?
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Are the purported benefits of fish oil supplementation for the prevention and treatment of heart disease just a “fish tale“? Thanks to recommendations from organizations such as the American Heart Association that individuals at high risk for heart disease ask their physicians about fish oil supplementation, fish oil has grown into a multibillion dollar industry. We now consume over 100,000 tons of fish oil every year.

But what does the science say? A systematic review and meta-analysis published in the Journal of the American Medical Association, highlighted in my video Is Fish Oil Just Snake Oil? looked at all the best “randomized clinical trials evaluating the effects of omega-3’s on lifespan, cardiac death, sudden death, heart attack, and stroke.” The studies told the subjects to either eat more oily fish or to take fish oil capsules. What did the study find? Overall, the researchers found no protective benefit for all-cause mortality, heart disease mortality, sudden cardiac death, heart attack, or stroke.

What about for those who already had a heart attack and are trying to prevent another? Still no benefit. Where did we even get this idea that omega 3’s were good for the heart? If we look at some of the older studies, the results seemed promising. For example, there was the famous DART trial back in the 80s involving 2,000 men. Those advised to eat fatty fish had a 29% reduction in mortality. Pretty impressive—no wonder it got a lot of attention. But people seemed to have forgotten the sequel, the DART-2 trial. The same group of researchers, and an even bigger study (3,000 men). In DART-2 “those advised to eat oily fish and particularly those supplied with fish oil capsules had a higher risk of cardiac death.”

Put all the studies together, and there’s no justification for the use of omega 3s as a structured intervention in everyday clinical practice or for guidelines supporting more dietary omega-3’s. So what should doctors say when their patients follow the American Heart Association advice to ask them about fish oil supplements? Given this and other negative meta-analyses, “our job as doctors should be to stop highly marketed fish oil supplementation in all of our patients.”

I’ve previously discussed fish oil supplements in the context of risks versus purported cardiovascular benefits:

But if the benefits aren’t there, then all one is left with are concerns over the industrial pollutants that concentrate in the fish fat (even in distilled fish oil, see Is Distilled Fish Oil Toxin-Free?).

These same contaminants are found in the fish themselves. This raises concern for adults (Fish Fog), children (Nerves of Mercury), and pregnant moms:

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my videos for free by clicking here and watch my full 2012 – 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Jo Christian Oterhals / Flickr

  • Theodore

    Why are there no comments on this article yet ?

    • Normand

      What about the Omega 3using microalgea oil with DHA and EPA?
      Are they a waste of time as well?

      • Joseph Gonzales R.D.

        Not entirely. The microalgae DHA-based seems to have comparable efficacies to that of fish oil. Plus, you avoid potential contaminants that Dr. Greger is talking about in fish oil. Dr. Greger recommends Omega-3 Fatty Acids 250 mg daily of pollutant free (yeast- or algae-derived) long-chain omega-3’s (EPA/DHA). More attention should be paid to this type of nutrient if balance of fats are off (omega-3 to the omega 6 ratio) in the diet, or folks are not consuming foods rich in omega-3 fats. More on Dr Greger’s nutrient recommendation.

        • Alex

          The Fish/Snake Oil video (3 Feb 2014) cites several papers particularly from 2012 which found no benefit (even harm) from n3 with respect to all-cause mortality, cardiac death, sudden death, myocardial infarction, and stroke. However, the linked Doughman et al paper from 2007 claims n3 provides “health benefits and as natural medicine in several major diseases.” What benefits and major diseases are they referring to? They bullet five discussion points of which #3: “possible protective mechanisms of EPA/DHA in major diseases such as
          coronary heart disease, atherosclerosis, cancer and type 2 diabetes”

          I don’t see compelling evidence stating that “fish oil: bad” but “algae oil: good”.

        • Ella

          Great article, I really dislike fish oil, if not for the nasty contaminants but also because it’s such an unsustainable source. I am however, a believer in Omega-3, and started taking this microalgae supplement a few months ago: http://www.ora.organic/products/omega-3 – so far so good, but I’d love a professional opinion on it. Thoughts?

    • Joseph Gonzales R.D.

      I see some! Forgive any delays, Theodore. Sometimes my posts may be later generated. I am starting to see more!

    • I’ll comment. My biggest concern about relying on epidemiological studies is this: Do we know enough yet to design the studies correctly? Omega 3s are extremely heat sensitive. The oils can go rancid easily–and the fats in the fish may get oxidized or not, depending on how you cook it. So unless we’re comparing raw apples with raw apples, we’ll be spending a lot of research time and money coming up with what could likely be meaningless results.

    • sf_jeff

      If you look in the address bar you can see the release date of the article.

  • Arjan den Hollander.

    I postponed dealing with the “other than saturated” fat issue for a long time because of all the confusionist talk, settled for a lets sit this one out and then act. :)
    However I’ve come around so many articles claiming benefit for ADHD or other less than optimal functioning brain afflictions, that I’ve settled on some 3’s. There was one study that mentioned that even if fed a diet extremely high in 3’s, people with certain sensitivities in the end always end up with very high 6 vs 3 in their profiles.
    I don’t understand how that comes to be, maybe the 3’s get selectively burnt off or something?
    The thing is that if those inevitable low 3’s if, end up causing me symptoms, I’d rather keep using some support than have none.

    This site is very good at pointing average Joe too a better diet, but not all of us are average Joe’s.
    Since we have a nutrition director now I’d like to ask what the fatty acid advice would be for people with ADHD/Autism Spectrum Disorders.

    • Joseph Gonzales R.D.

      Hi Arjan den Hollander,

      Can you give me a background of the studies you are referring to? I am not too familiar with ADHD and essential fats. Off the top of my head I would not think the amounts would differ. Have you seen Dr. Greger’s videos on ADHD and food dyes? or Cow’s milk and autism? A assume so since you are an above average joe! Send me some of the study links and lets see what they say about fat. thanks!

      • Arjan den Hollander.

        Hi,

        I’d be a below average Joe if anything but no I cannot give you “the” study, the internet is abuzz with them and I’ve categorized the lot as just noise, the amount of noise made me think I might be in the vulnerable category though.

        The balance became taking them will likely not harm me too much, severe deficits if they occur likely will, so I settled on a fish first or some oils every now and then.

        That sentiment still stands for me, as it will for a lot of people google fish oil and ADHD :
        About 696,000 results (0.60 seconds)

        Internet abuzz is no understatement as you can see.

        I haven’t used milk in a year, only WFPB. And at this time haven’t eaten anything animal based for 6 weeks.
        Never really been a candy (color) or artificial sugar person, not a big refined sugar consumer either for that matter.

        • Hello The minimum people should consume daily is 2 tablespoons of ground flax seeds to meet the minimum 4000mg Omega3 daily requirement to live. No personal advice is permitted in this forum, but since you insist: You are doing fine with with 15g walnuts and 15g of flax. Greger, McDougall, Barnard and others low fat vegans will flip and call that a high fat diet, that’s why Gonzalez didn’t answer you yet. If you want to hit 50g daily, I would tell you to add cacao to the ground flax seeds and walnuts and wet the mixture with raw organic coconut oil, add raisins, craisins or banana for delicious chocolate pudding.

          • Arjan den Hollander.

            Hi, thanks for your reply. If I add this all up I end up getting 15% of my energy intake from fats.
            The Swank people themselves set the value at 40 -50 gr. I’m 95 Kg@ 1.86 body fat about 15%,
            I’m not very active overall but I do as much short moderate bursts of activity as my personal weaknesses allow me to do, I try never to stall for more than 30 – 45 min.

            In what universe is 15% fat much? I need to go even lower?

          • Arjan den Hollander.

            Hi, thanks for your reply. If I add this all up I end up getting 15% of my energy intake from fats, I eat a lot.
            The Swank people themselves set the value at 40 -50 gr. I’m 95 Kg@ 1.86 body fat about </=15%,
            I'm not highly active overall but I do as much short moderate bursts of activity as my personal weaknesses allow me to do, I try never to stall for more than 30 – 45 min. Given what I eat I suspect I burn at least 3000 but probably 3500 calories a day.

            In what universe is 15% fat much? I need to go even lower? The 15 gr flax and walnuts are non negotiable,
            400 grams (dry weight) of rice/oats/quinoa packs 15 grams of fat all in itself.

            Oh and cacao for me cannot be more than a few fresh ground nibs through my 1 cup of coffee a day.
            I get very more more vulnerable to mania, especially if I combine it with physical activity or fun reads/shows/good humor. Sounds jummy though :)

          • The flax seeds and walnuts are great sources of omega3. If we don’t eat animal products or any other oils except a little unadulterated extra virgin olive oil or a little raw organic coconut oil we can get adequate omega3 from flax seeds, walnuts and greens. Ground flax seeds can be mixed into anything. Ground flax seeds with tomato sauce is a ground beef substitute, a meat sauce substitute that people cannot tell the difference when served with whole grains and beans. I eat as much avocado, seeds and walnuts as you, I am into good fat. I don’t believe Dean Ornish never eats avocado, walnuts and flax seeds. I always wonder whether low fat vegans really avoid these good helpful fats. I await their response to this conversation.

          • marysaunders

            I especially appreciate advice on how to prepare things and what combinations to do for flavor and function.

          • Personal advice is encouraged on the forum! And just for the record I don’t consider myself a “low fat vegan.” But your thoughts and feedback are always welcome, Rivka, as are everyone else’s. Thanks so much for everyone’s participation and for making NutritionFacts.org a thiving community of ideas!

          • Arjan den Hollander.

            Could it be that switching to a WFPBD should come with a cautionary warning when on medications?
            Dr. Greger, would you care to comment on tbatts666 and me in this topic?
            http://nutritionfacts.org/video/testing-your-diet-with-pee-purple-cabbage/

          • Proper nutrition is important and as you point out in previous post there is variation in populations. So one size doesn’t fit all. When one is on medications it is always best to work with your prescribing professional when making lifestyle changes. The problem is that my industry is much better about getting folks onto meds than discussing the potential problems and lifestyle alternatives. Psychiatric medicines pose many challenges due to lack of data on long term effects and withdrawal problems. I recommend that those interested in these areas… psychiatric illness and psychiatric medications read Robert Whitaker’s, Anatomy of an Epidemic, and Breggin’s, Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Families. After reading these books and working with patients I have found that all these medications should come with warnings on long term (i.e. over 4-6 weeks) usage of these medications regardless of diet. In my experience adjusting psychiatric medications needs to be done with the guidance of a knowledgeable practitioner with support from patient and their support network.

          • marysaunders

            It can also be very helpful to get connected to peer-support groups. Re-Thinking Psychiatry has been great for me in Portland, Oregon, as has Heaving Voices Networks. Icarus responded with a volunteer visitor for a family member who was inpatient. Researching the work of Open Dialogue has also been helpful. It isn’t just diet that needs attention in these difficult times. I am an exercise instructor, and I am well aware one can over-dose on exercise, as it can trigger endorphins and other endogenous biochemicals that are addictive. This process in a reason anorexia is so difficult to treat for conventional medicine. The interaction of exercise and endocrine function is not as well understood as it should be, though some coaches know to counsel injured athletes that they may suffer withdrawal syndromes if they cannot get the workouts they are used to.

          • Charzie

            Yeah, try to find one of those, especially on a limited income! Trying to get off Celexa after many years turned into a nightmare and the only “advice” I can get is keep taking it, other than the million plus suggestions online!

          • Peanut Butter Sandwich

            survivingantidepressants.org is an online community with lots of support for those looking to get off antidepressants.

          • Arjan den Hollander.

            But since urinary PH is inherently changes with switching too a WFPBD and this clearly influences metabolism of these stimulants, I am openly requesting Nutritonfacts.org puts up a cautionary addendum on all topics ADHD/stimulants/high fiber vegan/wfpb.

            https://www.youtube.com/watch?v=RybNI0KB1bg
            They might end up getting forced into taking full doses while the dose which is based on the old diet.

          • GuestVegan

            So, Dr Greger, does this mean you support her recommendation to eat coconut oil and her other tips?

          • You use the words may and might in every fact in your book. You also use the words may and might in tweets and in the first three words of your email newsletter subject where these qualifying words don’t belong at all. You MichaelGregerMD may be able to get over with giving direct advice but a dietician, a nutritionist, a pharmacist can’t. Non profits can’t get donations to give health advice. It can be a thriving community of ideas that is applicable as general knowledge and individuals can decide for themselves. Don’t use the words “advice” or “counseling” You can tell what the science says and you can qualify with “may” and “might”
            Before AsktheDietician gives advice, if you don’t believe me, Ask the Lawyer.
            So 2 tablespoons ground flax seeds daily is what? Low fat? high fat? adequate good fat? You have no comment or complaint about 2 tablespoons ground flax seeds daily; it must be adequate good fat, not too much, not too little!

          • AnnaleighBelle

            I’m not sure you’ve actually read or viewed many of the videos on this forum, Rivka. Dr. Greger promote flax and walnuts and other nut consumption. If anything, consumption of oils (a refined food) is downplayed.

          • I viewed the videos. He is very conservative with nuts and seeds portions. Low fat high fat very subjective unless there is some science we haven’t heard yet. He is scared of too much fat and so are all the researchers.

          • Alex

            In the last few days we learned from the Med Diet videos that 30g of nuts daily (and veggies) provided stat sig benefit (particularly walnuts although several other nuts also produced negative hazard risk from all causes). Dr Greger since at least 2011 has recommended “250 mg daily of pollutant free (yeast- or algae-derived) long-chain omega-3’s (EPA/DHA)”.

            Animal fats, saturated fats, cholesterol, and transfats are to be avoided (ideally 0 g). Unsaturated fats should be consumed in moderation (I don’t recall upper or lower limit recommendations).

            Last month we learned in “Flax seeds for hypertension” that we want SBP < 115 mmHg, that SBP may be "the single most important determinant for death in the world today" and that 30 g of ground flax seed daily sig reduced SBP by about 10-15mmHg. If our blood pressure is above 115, we may want to consider the following daily:

            * 250 mg yeast of algae EPA+DHA
            * 30 g walnuts or other nuts (3.6 g ALA, 11.5 g LA)
            * 30 g ground flax seeds (about 7 g ALA)

            Which is roughly a 1:1 ratio of omega-6 to omega-3 and 200 kcal (or 10% of a typical daily diet) from these essential fatty acids.

          • Stephen Albers

            My experience is that this regimen is not effective for most people because of the low or non-existent conversion rate of short chain Omegas to their long chain equivalents. Realize that humans have NO NEED for the short chain Omegas found in the plant foods you cite. Humans require only long chain Omegas which they normally get from fish and minimally might get from plant foods.

            There is only one way to determine whether the individual is getting enough LONG CHAIN omegas in the optimal 1:1 ratio and that is through serum testing which is accurate mature technology available from several labs in the USA. My experience has been that EVERYONE blindly consuming Omega 3 plant foods is being mislead which shows up when they get tested. Most plant sources of Omega 3s are a waste of time for most people.

          • Take some enzymes or leafy greens with ground flax seeds if you can’t convert the fats to active DHA and EPA. The fish are Fukushima-ed and toxic from everything else, we have to make the plant sources work.

          • Stephen Albers

            Rita,

            Your suggestions may prove helpful. But my overriding point is that nearly all vegans who eat plant sources of Omega 3s are terribly deficient in their ratio. In fact, my experience with several runner friends is that, with all the chia, flax, walnuts, etc they consume, they have the same terrible ratio as SAD dieters – about 1/14. It is a rude awakening to find this out. Assuming consuming these foods will optimize or even improve one’s ratio is the height of folly. Responses to different regimens varies considerably with the individual. The only way to determine a personal ratio is with lab testing.

          • Rivka,
            What enzymes are you suggesting–digestive enzymes? And how do leafy greens help convert ALA to long chain 3s?

          • sf_jeff

            Are you talking about leafy greens as a source or as a catalyst of some sort?

          • Joseph Gonzales R.D.

            Hey Stephen, Can you clarity what short chained omegas you are referring to? Humans do have a need for ALA (omega 3) and LA (omega 6). These are the essential fatty acids our body’s can only obtain from foods. I agree with you that the conversion rates vary widely and it is clear we do need sufficient EPA and DHA. I am glad you are finding testing that works for you.

          • Stephen Albers

            Dear Dr Gonzales,

            Thanks for requesting clarification. I welcome the opportunity to discuss the Omega 3/6 ratio issue with an aggressive health professional like you. I’ve been researching it for about 2 years through reading the literature and personal testing.

            In all my reading, there has been universal agreement that optimizing the LONG CHAIN Omega 3/6 ratio has a strong protective effect for chronic disease in the general public. Beyond that is where I have detected problems.

            My tentative conclusion is that the public is being seriously mislead by ubiquitous ineffective Omega dietary advice. My perspective comes from the aviation and fleet maintenance industries where oil sample analysis is highly accurate at detecting anomalous wear patterns that predict equipment failure long before it occurs. In a like manner, serum gas spectroscopy testing is mature reasonably priced technology that can map out every fatty acid in a serum sample. So computing the Omega 3/6 ratio for this technology is a slam dunk. Not just “for me”, testing is the only method anyone should use to determine their Omega status. Popular advice is the equivalent of pouring oil in your engine by guessing rather than using a dipstick – not a good idea.

            My present suspicion is that nearly everyone following a plant-based diet with foods high in SHORT CHAIN omega 3s like flax and walnuts is no better than average for their LONG CHAIN Omega 3/6 ratio which is 1/14 and that is TERRIBLE. It gets worse. The ratio is only part of the issue. The LEVEL of Omega 3s is also very important. Without the proper level, not enough Omega 3s get into cells no matter what the ratio is. Testing can determine the level too.

            Have YOU had your serum Omega status tested recently and, if so, what is it? There are a number of labs doing this testing. I can make a recommendation if you like. Why not invite Dr Greger to test too if he has not done so and publish the results.

            In summary, my position is, it is inaccurate and irresponsible to recommend dietary sources of SHORT CHAIN Omega fatty acids like flax and walnuts the way so many popular articles do because it misleads the public into thinking that somehow optimizes their LONG CHAIN Omega 3/6 ratio. NOT TRUE. Dr Greger’s recommendation for algae base supplementation, while “functionally equivalent” to the LONG CHAIN Omegas from fish, will likely turn out to be woefully inadequate for optimization for most people. The ONLY way to determine the individual ratio is through testing. Everyone’s motto should be: DON’T GUESS. TEST!

            I can speak further on the subject of optimization – another knotty subject – once you guys have published your ratios.

            An excellent National Institutes of Health lecture by Dr William Lands is available here:

            https://youtu.be/kivrYNjiXk8

            Stephen Albers

          • jj

            Be sure to listen to parts 3 and 4 of this video by Dr. Landis. That gives a much clearer picture.

          • Joseph Gonzales R.D.

            You are welcome! Anyone is always free to share their ideas or research here! That is the point of our website!

          • Stephen Albers

            Dr Gonzales,

            One of the researchers I contacted had developed an equation for estimating the proper dosage of EPA/DHA needed to reach a particular serum ratio. After confirming that a salmon regimen would drastically lower my ratio from 1/14 to 1/2, I began a new regimen based solely on Dr Greger’s recommended Algae based supplement with an amount based on the equation. The researcher called the EPA/DHA Golden Algae source “functionally equivalent” to fish sources. He also said that nutrition research into the millions of different algae strains is just beginning and stressed that algae are one of the oldest known life forms on this planet. It will take about 60 days for me to receive test results from this plant-based supplementation regimen.

          • sf_jeff

            So just to be sure, are you talking about long chain Omega 3’s for brain health or for heart/artery health? Are you suggesting that the longevity studies for the Mediterranean diets were based on the effects of long chain ratios?

          • Jeff,

            Thanks for your question. Keep in mind I’m a consumer, not a medical expert. But, based on my considerable reading, the body has NO NEED for short chain EFAs except for converting them to long chain EFAs which the body uses. By supplementing with LONG CHAIN EFAs (EPA/DHA) the need for short chain EFAs from flax, hemp, chia, walnuts, etc disappears. Since short chain EFAs are poorly converted to long chain EFAs in everyone and not converted at all in some people, focusing on them is not appropriate. The focus for all health benefits should be on long chain EFAs which are obtainable from fish or vegan source golden algae supplements. The amount of supplementation should be adjusted to obtain the desired ratio as revealed by serum TESTING.

          • sf_jeff

            I am not a doctor either, but my understanding is that Omega 3s also help reduce the amount of AA that is made out of Omega 6s because uptake of omega 3 aids with release of excess omega 6. I think that AA promotes inflammation.

          • Kim

            Didn’t read this whole comment thread, but just wanted to point out that eating lots of flax, chia, walnuts, etc. isn’t the only way to get a good omega-3/omega-6 ratio on a vegan diet. For those of us who eat higher-carb and eat lots of greens, plugging your food into a site like Cron-o-Meter shows that you actually get the optimal ratio easily. Emily of Bite Size Vegan eats a high-carb, low-fat mostly raw diet with lots of greens and she’s had her levels checked as you recommend and her tests came back perfect.

            The issue with most vegans isn’t the lack of short-chain omega 3s in the diet, it’s eating way too many omega-6s, just like most SAD eaters.

          • GuestVegan

            Why do people continue to suggest to others to eat coconut oil when Dr. Greger keeps warning against it bcuz of the high saturated fat content. Plus, consuming high n~6 will block n~3 eaten at the same time. And, plant based n~3 doesn’t convert efficiently. So, while I am not a doctor and wouldn’t presume to give out advice, I can say that I think what you’re recommending is incorrect information.

          • Mangalore Cafe

            Good question, I found a flaw in the study that @Michael_Greger_MD:disqus refers to as the basis for his “coconut oil is bad for you” video. This featured in his Nutrition DVD more than 5 years ago as far as I can remember. The study was giving margarine to all 3 groups (safflower, butter and coconut) which we all know does raise your cholesterol, and the coconut group received an extra serving of Hydrogenated coconut cream. We all know that is transfat, you can take any healthy oil and hydrogenate it and i will be bad for you.
            Apart from margarine(for what reason they were giving this beats me, well the only reason I see it so skew the results to show coconut is bad) the other two groups were given NON-hydrogenated servings of Safflower oil and Butter, Only Coconut group was given oil and hydrogenated cream.
            I read the paper that Dr Greger provides with his DVD. When I argued about this with a “blind follower”(no issues with DR Greger this guy kept saying that he cannot be wrong when Dr Greger was humble enough to admit otherwise) of Dr. Greger. he refused to accept and then said you can contact Dr Greger he will respond. Cut a long story short I told him to contact Dr Greger and He did and Dr Greger RESPONDED(I hear he always does so Kudos to him) and he admitted “the cohorts were wrong” in that study.
            So I don’t understand why Dr Greger still carries this study that he admitted was wrong.
            If Coconut or coconut oil was bad for you entire South India would have been extinct

          • Alex

            “If Coconut or coconut oil was bad for you entire South India would have been extinct”

            By the same logic, “If saturated fat, cholesterol, or transfat was bad for you, the entire modern world would have been extinct.” Indeed, we’re headed in that direction.

          • Mangalore Cafe

            How long has the modern world been consuming transfats? Sorry your point is devoid of Logic Please don’t try to argue if you have not idea what is the consumption of coconut in South india. They have been consuming coconut for thousands of years. Transfats consumption has only become mainstream in the 1960 it was only invented in 1890 as far as I remember.
            Everything is coconut. All 3 meals coconut chutney and everything cooked in coconut oil and deserts made from coconut. Infact most vegetarians at one point(before the formation of the Dairy Industry that resulted in Cold Chain Supply) were vegan they were using only coconut milk.

            We sure can see the modern world riddled with diseases. In South India only in the last few decades diseases have increased.
            We never get to hear that those in South India were living comfortable till 100 til the last generation.
            My own great Grandmother lived to be 104 years and 99 she travelled alone 1500 km to reach my Grandmas house in Bombay where she died.

            I am curious why did you only choose to address this because it seemed easy to argue ;-).
            Lets address the facts that why trans fat was fed to the coconut group double than the other two groups and why @Michael_Greger_MD:disqus after admitting the studies were wrong is still carrying this on his website.
            Here is a lot of research done on coconut oil that is peer reviewed But in India
            http://coconutboard.nic.in/cnoqulty.htm
            At the bottom of each of the pages you will find the research papers

          • Alex

            I don’t appreciate the personal attack. I am not obligated to engage and address all of your points. I only countered your absurd hyperbole with another hyperbole. Extinction requires 100% fatality. So, it matters not if a population has lived for thousands of years or one generation. Saturated fat does not lead to extinction but is implicated in sub-optimal health.

            Whether coconut oil has other great benefits or whether there are cofounding problems with other sources of saturated fat (such as cholesterol and proteins in dairy) is an interesting discussion for which I have little to contribute. I will allow those more knowledgable to jump in. Until then, I remain sceptical of pro-coconut research put forth by the Coconut Board of India.

          • Mangalore Cafe

            Wow you sure are a #TROLL then. You are the one attacking me for a casual statement. It was Hyperbole I never meant or even imagined that they could go extinct. And you had to #troll me for that.
            You are the only one attacking here.
            The coconut Board is only listing down research done by Research centers in india. They do not do any inhouse research. You are being cynical. You did not even bother to check where the studies are from.
            Stop Trolling if you don’t have time to even read the links go back under your bridge

          • Joseph Gonzales R.D.

            Thanks for your post! Please send me the links you are referring to, or any reference that you feel is incorrect and we’ll take a look! It is because of folks like you we’re able to alter our information and stay current on the science.

            Thanks so much!
            Joseph

          • Mangalore Cafe

            This is the study on Nutritionfacts.org that says coconut oil is no better than butter when it comes to cholesterol. http://nutritionfacts.org/video/does-coconut-oil-clog-arteries/ Someone has posted a link here. I have read this study in the 2007 nutrition DVD of @Michael_Greger_MD:disqus
            As he attaches all the pdfs of the studies I found this flaw. here is the study http://www.ncbi.nlm.nih.gov/pubmed/9756121
            My friend even wrote to Dr Greger more than 5 years ago and Dr Greger admitted it was a mistake. Back then this website did not exist(rather it was not the same website) but when This website was started in this Avatar that study was included.
            We can clearly see in the study that that the groups(the full study was in Dr Gregers DVD) that all 3 groups were given margarine Which we know raises Cholesterol. But the Coconut group was also given Hydrogenated Coconut cream. This is why the Coconut group did just a little better than the butter group
            Obviously if you gave it two servings of hydrogenated fat it still was not the worst.
            I don’t know why you guys keep demonizing Coconut oil based on these flawed studies.

          • Joseph Gonzales R.D.

            Thanks for reposting your questions and finding that study. From what I see not all of the citations from this video involves studies that only used hydrogenated coconut oil. One study that Dr. Greger profiles in the video you linked actually mentions some of your concerns regarding other studies that use hydrogenated oil in the introduction section. If interested you can read here.

            I don’t think Dr. Greger is saying that coconut oil be shunned completely. I took this straight from the transcripts.

            “Walt Willett’s recommendation from Harvard, if you are going to use it use it sparingly. Now look, if you’re eating so healthy that your LDL cholesterol is under 60 or 70, then I don’t see coconut oil as a problem. Unlike saturated animal fats, coconut oil doesn’t cause that spike inflammation immediately after consumption of animal foods, which makes sense because as you’ll remember it may be the dead bacterial endotoxins in animal products ferried into the body by saturated fat that are to blame. ”

            I hope that helps a bit. Please keep us posted should another study arise, just post it on the website for discussion.

            Thanks,
            Joseph

          • Mangalore Cafe

            I think its giving out the wrong message to include a flawed study or rather a study that was aimed at demonizing coconut oil by whatever industry.
            here are some more studies conducted in India http://coconutboard.nic.in/cnoqulty.htm
            At the bottom you can see the studies especially in South India coconut oil has been consumed as a staple for thousands of years.
            No way coconut can be called unhealthy unless you are talking about oil which in case every oil is unhealthy. There is not need to pick on coconut oil.
            I think you should make a video on your views @disqus_wnYOIlS4ks:disqus which is very true.
            I just find it sad to see today coconut oil being demonized and an oil that was not even edible once is being touted as a healthy oil(I am speaking about Canola which is nothing rapeseed oil which was used as an industrial oil. It has high Ueric acid and was actually used to adulterate its cousin Mustard oil in India and had caused deaths)
            Whats even more appalling that many people believe that coconut oil(along with cashews) contain cholesterol its all a result of these fraudulent studies conducted by the “hydrogenated fat industry” few decades ago so they could replace the coconut oil in the food/baking industry with margarine.

          • Joseph Gonzales R.D.

            I’ll update the info on coconut oil in a Q&A. Please check back within a week to see my response here.

            Thanks for the follow-up. I think flawed study or not it was still published and I don’t feel we’re giving our the “wrong” information when Dr. Greger is simply relaying information from the studies. As I mentioned, the researchers themselves in one study we reference are asking the same questions you are regarding studies using hydrogenated oil.

          • Mangalore Cafe

            Thanks

            About the part where you say “simply relaying information on studies”, It would be very “wrong” if you started to “relay” information on the deliberately fraudulent studies sponsored by GMO.
            Then what about the scores of peer reviewed studies that are against a plant based diet or promote meat/eggs/dairy?
            So you see you cannot “simply relay” information, we trust you guys who are the expert to even verify these studies. Because since the last few decades there are enough studies that promote a meat based diet that we can relay. If you get my drift?

          • GuestVegan
  • rjs

    Should DHA still be recommended for pregnant women?

    • Joseph Gonzales R.D.

      According to the Institutes of Medicine, pregnant women need 1.4g/day of a-linolenic acid (ALA), an essential omega-3 fatty acid that elongates and “breaks” into DHA and EPA. It is unclear how well ALA can convert into DHA and EPA, which is why some take extra precautions about supplementing DHA.

      • I recall some research showing women of childbearing age are better at converting ALA to long chain 3s than men or older women (I think). Have you read that research, Dr. G?

        • Joseph Gonzales R.D.

          I have only seen this study on women converting ALA better than men. If you find other please post! And please forgive my delay I know you asked other important questions that I will answer in due time!

          Thanks for you patience,
          Joseph

  • Tom

    My Dr suggested I stop taking fish oil supplements for a different reason: he said there were links to prostate cancer in men. Anyone else been advised of the same thing?

    • Joseph Gonzales R.D.

      The research is mixed. Some do say omega-3’s/fish oil may be risky and increase prostate cancer risk I feel Dr. describes many reasons to avoid it from this blog regardless of it’s impact on prostate cancer.

      • Alex

        Armchair theory

        Facts: Whole food selenium reduces prostate cancer risk (supplement selenium increases risk). Selenium neutralizes mercury. Mercury is dangerously abundant in fish and fish oils.

        Thus (again armchair hypothesis): Mercury in fish oil *causes* prostate cancer.

        • Mangalore Cafe

          The only armchair theory is yours :-P>…They conducted a study that passed a peer review.

          • Alex

            Where, what results?

      • Alex

        Hi Joseph. Do you have access to the SELECT paper to which you linked? Does the paper mention the source of omega-3 and selenium? Other studies have shown that selenium (from for example Brazil nuts) correlates to lower cancer risk and other studies correlate concentrated supplemental selenium to cancer. Likewise, did SELECT participants received isolated omega-3, or was it from fish, algae, or plant source?

        • Joseph Gonzales R.D.

          The paper is free and you can download from the link above. It doesn’t mention sources of the foods, the researchers used dietary questionnaires and measured blood levels of different omega-3s.

  • mvdz66

    So then is there any benefit to taking the algal omega 3’s?

    • Joseph Gonzales R.D.

      Sure there could be. They are effective, but the question is do you need them or not? Some folks choose to take as safety measure. Please see my comment below, Dr. Greger gives tips on this. thanks!

  • Enthusiast

    So, no fish oil… Still flax seeds for omega-3? I assume the science hasn’t reversed the position on needing omega-3s, just the need to supplement them in non-whole food form?

    • peterpan

      wish this was clearer in the article. here, dr. greger questions the benefits of omega 3 in relationship to CHD (in addition to expounded upon the danger from a fish source.) previously, we’ve been shown that plant based sources of omega 3 cut risks of CHD in addition to providing numerous other health benefits.

      • Joseph Gonzales R.D.

        It may be clearer in the flax seed videos all over the website. Sorry about any confusion in this article.

        • Alex

          It seems to me the findings in the videos have changed over time. We had for years understood n3 to be good for the heart. We understood that DHA and EPA were specifically good for the brain and heart. Less clear are the direct benefits of ALA and conversion. We know fish oil is loaded with toxins (unchanged or worsening). Now we learn that there is no heart benefit from fish oil (reversal of understanding). It is unclear whether there is any heart benefit to n3 in general sans fish.

          I will say however, that hypertension is obviously heart related. So, while there may not have been a study directly comparing fish oil, flax ALA, algae DHA+EPA, it does seem reasonable to assume there’s something fishy about the fish. That’s vaguely implied by Dr Greger’s videos but not spelled out (I assume because the evidence is weak). It’s also not clear if the benefits of flax have anything to do with ALA or rather the high fiber, lignans, and other nutrients.

    • Joseph Gonzales R.D.

      YES!!!! That is what I am talking about!!!! “Enthusiast” ;) (pun intended) . But seriously, you are spot on.

  • Steve Campo

    As always, thank you for the truth.

  • Glen Foss

    You rock, Dr. G.

  • Robert Haile

    My triglycerides were 2,000 30 years ago. I was 71 inches tall and 158 pounds, as well as being very fit. I was placed in lipid studies and ultimately received maximum dose statins, developing myopathy and a high CPK. Despite intense exercise and statins with progressive elimination of meat, my triglycerides only decreased to 500 with an LDL of 18.. I have always loved vegetables and fruit. I switched to Zetia with some improvement , but when I added Lovaza, my triglycerides dropped to 140, HDL 41, and LDL of 56. The trouble with trials is that they do not address atypical patients such as myself. I eat a mostly vegetarian diet with no red meat, milk products or eggs. Occasionally I have a flavouring of free range self fed Costa Rican chicken, as did some heathy Chinese in the China Study. I surf, run, play tennis , walk my dogs and do not own a car. Where I live in Costa Rica is a Blue Zone(Guanacaste) with high levels of magnesium, calcium, and other minerals in the water. Do you have alternatives for extremely high triglycerides, with milky plasma & urine, and additional risk of pancreatitis? Thank you.

    • Joseph Gonzales R.D.

      Good question. Not sure about “alternatives” other than trying to control blood fats thru strict dietary intervention?

    • Jen Drost, PA-C, NF Volunteer

      Hi Robert! Sheesh, sorry to hear you’ve been having to deal with that! Agree with Joseph (isn’t NF lucky to have him? :) diet may be your best answer. (Also, remember any kind of processed sugar-including alcohol-can elevate triglycerides.) Additionally, high triglycerides can also sometimes be caused by a slow thyroid or by liver problems. Might be worth having your doc check those out. And if you’re not already, don’t forget to eat 2 TB of ground flax per day! Pura vida & hope this helps!

  • Phil

    I eat nothing from out of the Pacific ocean or from the far east though I do sprinkle a TBSP of organic flax seed on my organic oats every day. As for heart, circulation & BP issues….pure organic cayenne pepper in a lil water has kept me off of filling a second prescription for BP meds and allowed me (yes, without Drs. blessing) to take less meds than prescribed….and maintain my BP now at 110/68. Ask , No print out and take this info to your doctor for his evaluation & opinion…

    • brit

      Phil which form of cayenne pepper do you use? I have a tincture that I can put a few drops into the water but not sure how much to use. I do know however that cayenne capsules can cause extreme heartburn :( Please tell me dose and frequency that you take your cayenne. Thanks brit

  • Mark Smith, DC

    Thanks for your newsletters and videos.
    As for EPA and DHA, can you comment on the literature about their usefulness regarding brain health, ADHD, lowering of inflammatory markers, and lowering of triglycerides?
    It is easy to understand that eating the standard American diet (SAD) leads to an imbalance of Omega 6 to 3 ratios, and that a largely plant based diet may correct that, so is there any place in nutrition to supplement with non-contaminated omega-3’s considering many people eat less than an optimal food plan?

    • Joseph Gonzales R.D.

      There surely could be, and Dr. Greger has that recommendation for optimal nutritional. Please see me comment at the very end of this thread.

      Thanks,
      Joseph

  • Narsing Kusma

    You people are discussing about health issues, I like it. But do you people know that you are ignoring/neglecting many important factors?
    Really, you people are ignoring /neglecting many important factors which you people should not ignore while discussing any of the health related issues such as on this platform. That is, while discussing any of the health issues(esp about etiology, effects of some nutrients,….) you people shouldn’t ignore these important factors. So my advice is first of all, discover those important factors.

    • Hmm. You mention the phrase “important factors” no less than 4 times in your comment but do not explain further. With 1500+ videos on all sorts of health topics, which “important factors” do you believe Dr. Greger is ignoring/neglecting?

      • Narsing Kusma

        The important factors you are ignoring/neglecting while discussing health issues :
        As example, I will mention few of them :
        1)Many people have bad habits such as cigarette smoking, alcohol consumption,… Also many people consume other narcotics/substances which are harmful to health. Also it is possible that some people do take drugs to enhance sex performance, but do not disclose that they are taking these drugs.
        These are just some examples. All these are to be investigated and studied ( all their effects on All THE ASPECTS of health) in details before coming to some conclusion. At least, by research scientists and other related people.
        2)It may happen that a person may be contaminated with poisonous substances incidentally or thru some other routes(Toxicology). These are just some examples. All these are to be investigated and studied(all their effects on ALL THE ASPECTS of health) in details before coming to some conclusion. At least, by research scientists and other related people.

        3) It may also happen that the place/environment where the person is living/working is not good, and causes some sort of harmful effects on the health of the person. All these are to be investigated and studied(all their effects on ALL THE ASPECTS of health) in details before coming to some conclusion. At least, by research scientists and other related people.

        In my earlier comment, I many times mentioned “you people” because not only you but almost all the research scientists and other related people ignore/neglect these important factors and come to conclusions regarding the etiology of the diseases. This is wrong, wrong, wrong.

        Also at this point of time, I want to mention one important aspect as follows:
        THE HEALTH STATUS OF A PERSON (healthy or diseased. If diseased, suffering from which disease/diseases) DEPENDS ON THE FOLLOWING THREE FACTORS:
        1)What he/she eats: here every that thing comes which enters the person’s body thru any of the routes(oral, injectables, breathing,…)
        2)What he/she does: here all the actions/work/…done by person comes
        3)What he/she thinks:

        Noted down, yet I am unable to find the fourth factor. You may think of Genetic diseases/factors. But let me tell you, if we study and investigate the reasons/causes/etiology behind these genetic diseases in details, then again you will come across the above three factors (That is, these genetic diseases are due to the above three factors, anyone, anytwo or all the factors mentioned above). So, no need to mention genetic factors separately.
        Here what I meant to say is that at least research scientists and related people should consider the above three factors while investigating and studying the etiology of diseases/disease.

        Also noted, in treatment of Disease, like you I don’t believe in medicines prescribed by doctors. Instead I believe in nutritions/nutrients/nutritional medicines. Noted, once I frequently used to got ill (fever, headache and other symptoms of infections ). Upon the requests of the doctor, I used to do malaria, typhoid tests. Most of the times, they come positive and the doctor used to give me antibiotics/antimicrobials as per the pathological test reports. But again after 15-30 days, again malaria or typhoid. This happened many years. Then lastly, my Doctor, Dr. Z. A. Dhange, M.S. (general), prescribed me the following medicines :
        Syp. Elixir Neogadine, two times a day before lunch and before dinner, 30 days {iodised peptone 0.322 mg(equivalent to 33 mcg of iodine), manganese chloride 6.67 mg, manganese sulphate 1.33 mg, sodium metavanadate 0.22 mg, zinc sulphate 10.71 mg, pyridoxine hydrochloride 0.25 mg, cyanocobalamin 0.167 mcg, nicotinamide 3.33 mg/15 mL.
        Tab. Ferium 100mg, after lunch, 30 days. {Iron (|||) hydroxide polymaltose complex}
        Tab.Folvite 5mg, half a tablet, three times a day, 30 days. {Folic acid}
        Cap. Omeprazole, before lunch and before dinner, 30 days.
        Antipyretic/pain killer tablet

        Noted this time, he has not prescribed any antimicrobial, as usual.
        But even after two whole days no change in symptoms/signs. Noted every that time when he prescribed antimicrobials, within one or two days, I feel better and many symptoms/signs have been vanished off. But this time (no antimicrobial), this is not the case. I got angry with my doctor thinking that how infection will be cured without the use of antimicrobials. No change in symptoms /signs even on 4th and 5th day. But anyhow I sticked to the prescription. Ha, after taking antipyretic/pain killer, I felt better to some extent, but only for few hours. But on the sixth day, surprisingly I felt totally better. Not only this, the infection has been vanished off completely. Not only this, now even after so many years, I hardly got infection (malaria, typhoid, ….. ). Then, many things/conclusions came in my mind. Noted, I did Diploma in Pharmacy and M.Sc. (Biochemistry ). Also I have a great passion in medical field(esp. Analysis type). I do study as and when I get time.

        • These “important factors” are called confounders in scientific research, and in good studies scientists do their best to account for them.

          It is true that no study is perfect. All have flaws. However…

          Dr. Greger is not a scientist. He is merely reporting the science as he sees it. He leaves the adjustments for the researchers doing the research.

          • Narsing Kusma

            Thanks for your reply, Sir. But let me tell you that Scientists are not doing their best.
            Reasons:
            1) These scientists are not enough for these tasks
            Or
            2)They researched studies is not being made applicable to bear good fruits.

          • Narsing Kusma

            Thanks for your reply, Sir. But let me tell you that Scientists are not doing their best.
            Reasons :
            1 ) These scientists are not enough for these tasks.
            Or
            2 ) Their researched studies is not being made applicable to bear good fruits.
            In medical science, many, many things related to diseases remained unanswered even today. If these scientists and related people would have done their best, as far as those ” important factors ” are considered, so many things would not have remained unanswered.
            And my advice to them ( scientists and other related people ) is : Please don’t neglect these important factors. Go deep and deep. Also, let me tell you that crime is related to diseases to some extent, ie, if dreadful diseases are vanished off, crime will also decrease to much/some extent, and that too automatically. And in such situations, police,politics, people, ….are grateful to these people(scientists and related people).

          • Narsing Kusma

            Thanks for your reply, Sir. But let me tell you that Scientists are not doing their best.
            Reasons :
            1 ) These scientists are not enough for these tasks.
            Or
            2 ) Their researched studies is not being made applicable to bear good fruits.
            In medical science, many, many things related to diseases remained unanswered even today. If these scientists and related people would have done their best, as far as those ” important factors ” are considered, so many things would not have remained unanswered.
            And my advice to them ( scientists and other related people ) is : Please don’t neglect these important factors. Go deep and deep. Also, let me tell you that crime is related to diseases to some extent, ie, if dreadful diseases are vanished off, crime will also decrease to much/some extent, and that too automatically. And in such situations, police,politics, people, ….are grateful to these people(scientists and related people). I know initially you will not accept this point ( crime reduction ), but it is Truth.

          • Narsing Kusma

            Thanks for your reply, Sir. But let me tell you that Scientists are not doing their best.
            Reasons :
            1 ) These scientists are not enough for these tasks.
            Or
            2 ) Their researched studies is not being made applicable to bear good fruits.
            In medical science, many, many things related to diseases remained unanswered even today. If these scientists and related people would have done their best, as far as those ” important factors ” are considered, so many things would not have remained unanswered.
            And my advice to them ( scientists and other related people ) is : Please don’t neglect these important factors. Go deep and deep. Also, let me tell you that crime is related to diseases to some extent, ie, if dreadful diseases are vanished off, crime will also decrease to much/some extent, and that too automatically. And in such situations, police,politics, people, ….are grateful to these people(scientists and related people). I know, you people don’t believe this (automatic crime reduction) initially, but it is the Truth. If you people don’t believe this, you people can do a lot of research on this matter (automatic crime reduction due to decrease in dreadful diseases) (but for this you people also have to research/understand what compels some people to go in the wrong path and do crime. And let me tell you if crime has to be vanished off, then this( what compels some people to go in the wrong path and do crime) has to be investigated/researched/understood thoroughly, among others. May be some people go in the wrong path and do crime due to greed and/or bad intentions but this is not the case with most/many many of the criminals, I think.

    • thorn324

      If your (not entirely clear) observations apply solely to what you perceive from this particular page of blog + comments, you might benefit from & be more satisfied by reading & listening to at least several other of Dr. Greger’s instructive blogs & videos. (I might also add, since it is also unclear if English is your native tongue, that referring to those whom you address as “you people”–and doing so repeatedly–comes across as rude at best and belligerent at worst.)

      • Narsing Kusma

        The important factors you are ignoring/neglecting while discussing health issues :
        As example, I will mention few of them :
        1)Many people have bad habits such as cigarette smoking, alcohol consumption,… Also many people consume other narcotics/substances which are harmful to health. Also it is possible that some people do take drugs to enhance sex performance, but do not disclose that they are taking these drugs.
        These are just some examples. All these are to be investigated and studied ( all their effects on All THE ASPECTS of health) in details before coming to some conclusion. At least, by research scientists and other related people.
        2)It may happen that a person may be contaminated with poisonous substances incidentally or thru some other routes(Toxicology). These are just some examples. All these are to be investigated and studied(all their effects on ALL THE ASPECTS of health) in details before coming to some conclusion. At least, by research scientists and other related people.

        3) It may also happen that the place/environment where the person is living/working is not good, and causes some sort of harmful effects on the health of the person. All these are to be investigated and studied(all their effects on ALL THE ASPECTS of health) in details before coming to some conclusion. At least, by research scientists and other related people.

        In my earlier comment, I many times mentioned “you people” because not only you but almost all the research scientists and other related people ignore/neglect these important factors and come to conclusions regarding the etiology of the diseases. This is wrong, wrong, wrong.

        Also at this point of time, I want to mention one important aspect as follows:
        THE HEALTH STATUS OF A PERSON (healthy or diseased. If diseased, suffering from which disease/diseases) DEPENDS ON THE FOLLOWING THREE FACTORS:
        1)What he/she eats: here every that thing comes which enters the person’s body thru any of the routes(oral, injectables, breathing,…)
        2)What he/she does: here all the actions/work/…done by person comes
        3)What he/she thinks:

        Noted down, yet I am unable to find the fourth factor. You may think of Genetic diseases/factors. But let me tell you, if we study and investigate the reasons/causes/etiology behind these genetic diseases in details, then again you will come across the above three factors (That is, these genetic diseases are due to the above three factors, anyone, anytwo or all the factors mentioned above). So, no need to mention genetic factors separately.
        Here what I meant to say is that at least research scientists and related people should consider the above three factors while investigating and studying the etiology of diseases/disease.

        Also noted, in treatment of Disease, like you I don’t believe in medicines prescribed by doctors. Instead I believe in nutritions/nutrients/nutritional medicines. Noted, once I frequently used to got ill (fever, headache and other symptoms of infections ). Upon the requests of the doctor, I used to do malaria, typhoid tests. Most of the times, they come positive and the doctor used to give me antibiotics/antimicrobials as per the pathological test reports. But again after 15-30 days, again malaria or typhoid. This happened many years. Then lastly, my Doctor, Dr. Z. A. Dhange, M.S. (general), prescribed me the following medicines :
        Syp. Elixir Neogadine, two times a day before lunch and before dinner, 30 days {iodised peptone 0.322 mg(equivalent to 33 mcg of iodine), manganese chloride 6.67 mg, manganese sulphate 1.33 mg, sodium metavanadate 0.22 mg, zinc sulphate 10.71 mg, pyridoxine hydrochloride 0.25 mg, cyanocobalamin 0.167 mcg, nicotinamide 3.33 mg/15 mL.
        Tab. Ferium 100mg, after lunch, 30 days. {Iron (|||) hydroxide polymaltose complex}
        Tab.Folvite 5mg, half a tablet, three times a day, 30 days. {Folic acid}
        Cap. Omeprazole, before lunch and before dinner, 30 days.
        Antipyretic/pain killer tablet

        Noted this time, he has not prescribed any antimicrobial, as usual.
        But even after two whole days no change in symptoms/signs. Noted every that time when he prescribed antimicrobials, within one or two days, I feel better and many symptoms/signs have been vanished off. But this time (no antimicrobial), this is not the case. I got angry with my doctor thinking that how infection will be cured without the use of antimicrobials. No change in symptoms /signs even on 4th and 5th day. But anyhow I sticked to the prescription. Ha, after taking antipyretic/pain killer, I felt better to some extent, but only for few hours. But on the sixth day, surprisingly I felt totally better. Not only this, the infection has been vanished off completely. Not only this, now even after so many years, I hardly got infection (malaria, typhoid, ….. ). Then, many things/conclusions came in my mind. Noted, I did Diploma in Pharmacy and M.Sc. (Biochemistry ). Also I have a great passion in medical field(esp. Analysis type). I do study as and when I get time.

      • Guest

        again malaria or typhoid. This happened many years. Then lastly, my Doctor, Dr. Z. A. Dhange, M.S. (general), prescribed me the following medicines :
        Syp. Elixir Neogadine, two times a day before lunch and before dinner, 30 days {iodised peptone 0.322 mg(equivalent to 33 mcg of iodine), manganese chloride 6.67 mg, manganese sulphate 1.33 mg, sodium metavanadate 0.22 mg, zinc sulphate 10.71 mg, pyridoxine hydrochloride 0.25 mg, cyanocobalamin 0.167 mcg, nicotinamide 3.33 mg/15 mL.
        Tab. Ferium 100mg, after lunch, 30 days. {Iron (|||) hydroxide polymaltose complex}
        Tab.Folvite 5mg, half a tablet, three times a day, 30 days. {Folic acid}
        Cap. Omeprazole, before lunch and before dinner, 30 days.
        Antipyretic/pain killer tablet

        Noted this time, he has not prescribed any antimicrobial, as usual.
        But even after two whole days no change in symptoms/signs. Noted every that time when he prescribed antimicrobials, within one or two days, I feel better and many symptoms/signs have been vanished off. But this time (no antimicrobial), this is not the case. I got angry with my doctor thinking that how infection will be cured without the use of antimicrobials. No change in symptoms /signs even on 4th and 5th day. But anyhow I sticked to the prescription. Ha, after taking antipyretic/pain killer, I felt better to some extent, but only for few hours. But on the sixth day, surprisingly I felt totally better. Not only this, the infection has been vanished off completely. Not only this, now even after so many years, I hardly got infection (malaria, typhoid, ….. ). Then, many things/conclusions came in my mind. Noted, I did Diploma in Pharmacy and M.Sc. (Biochemistry ). Also I have a great passion in medical field(esp. Analysis type). I do study as and when I get time.

  • statins

    Correct me if I’m wrong but weren’t the majority of the people in Dart-2 on statins and other meds? If so, then it is unlikely that Omega-3s would make a difference. If true then this doesn’t disprove the value of Omega-3s for the rare unmedicated human being.

    • dirkhofman

      That is my understanding from this article: http://jama.jamanetwork.com/article.aspx?articleid=1357266

    • Joseph Gonzales R.D.

      Looking at the Dart-2 study, subjects were treated for Angina, but it makes no mention of satins.

      • peseta11

        I notice in dirkhofman’s posted metastudy that its authors were careful to distinguish, twice, “statin-era” studies from the older ones. Clearly, widespread statin use makes many studies less useful, until they correct for that possible confounder..

  • Julie

    Well omega 3’s may not be good at preventing heart attacks, but for women I’ll tell you one thing they’re good at: preventing menstrual cramps. When I take 850 mg of algae omega 3’s daily I never get cramps. Although I faithfully take a heaping TB of ground flax daily, for the last 2 weeks I haven’t taken my algae omega due to a delay receiving my online order. The result? I got a terrible sleep last night due to cramps–OUCH!

  • Rph1978

    The DART and DART2 trials had subjects consume oily fish rather than just fish oil supplements. Is that a fair conclusion against the use of fish oil capsules?
    Fish oil supplements have been associated with a reduction in cognitive decline. http://www.ncbi.nlm.nih.gov/pubmed/24954371

    • Joseph Gonzales R.D.

      Hi Rph1978. The DART-2 study participants ate both oily fish and fish oil supplements finding, “Men advised to eat oily fish, and particularly those supplied with fish oil capsules, had a higher risk of cardiac death.” So both sources seem to be problematic if this study holds true. I think Dr. Greger makes good points by looking at 10 other links beyond fish and cardiac health in his blog. Re: cognitive decline – thanks for the study you listed. Looks like folks with a certain allele-type had benefit, and folks with normal cognitive function, too. Not sure this study alone on cognition is enough to warrant fish oil supplements.

  • Raymond Colon

    One thing that I think causes bad results in studies that look at products like fish oil, herbs, and similar is the quality of the product used. I did a report a little bit ago on the efficacy of Echinacea on cold and flu and most studies showed benefits and the ones that did not were using preparations of Echinacea that were of low quality, inadequate dose, or/and used the wrong parts in the preparation. Back on subject, could that be the case here? Could these studies be looking at inferior fish oils? I work at a health food store in north Florida and we only offer fish oils that have very strict processes as far as purity source and overall quality.

    • Joseph Gonzales R.D.

      Interesting take, Raymond Colon. I feel with any study it’s important to know the quality of food or supplements taken, which researchers cannot always take into account. You are onto something there! One thing I may point to is this link discussing studies on supposedly “high quality” fish oil. Perhaps there are other methods I am unaware of regarding regulatory testing but it appears even “quality” fish oils still pose a risk.

    • Alex

      The vast majority of random samples of oils on shelves and immediately after leaving factories were rancid and toxic. There might be ‘higher quality’ oils, but how would you rate them? I personally visited a highly regarded factory in Iceland and while they have lots of lovely literature and claim to take numerous periodic tests, I found no convincing numbers, just a lot of eloquent hand-waving.

  • Laurili

    Dr. Gregor, I watched one of your hour-long lectures about mortality from all causes and the upshot was that the reason that meat eaters and vegetarians had comparable death rate was because the B12 and omega-3’s that meat eaters got balanced out all the other health benefits that the vegetarians got from not eating animal products. So are you still in favor of omega-3’s, just not from animal sources?

    • Joseph Gonzales R.D.

      Good question, Laurili! Others have been asking about this so I’ll point you to Dr. Greger’s recommendations. Please click this link and check out my comment about this, here.

      • JosephOlstad

        Do those of us who are low fat vegans who don’t consume any oil or margarine at all need to worry about the omega 6:omega 3 ratio because our intake of omega six is so low. In other words, adopting the strategy of lowering omega 6 INSTEAD of increasing or supplementing with omega 3 in order to arrive at a proper ratio (walnuts, flax, and avocado occasionally consumed). This seems intuitively better because it uses food and/or its restriction instead of supplementation. Is this a correct strategy or am I missing something?

    • Joseph Gonzales R.D.

      And to answer your question, yes! whole plant-sources of omega-3s are packed with ALA and essential fats.

  • guest

    The negative studies were all done in omnivores, as veganism is rare in the general population. We don’t know the effect of DHA deficiency in long-term vegans, but studies suggest that levels are very low over time in veganism. To err on the side of caution, it is wise to recommend replacement of DHA (since conversion from EPA is very low).

    • Boris

      I don’t know which studies you are referring to but here’s one that shows the conversion rate in vegetarians and vegans increases to accommodate the need for DHA. Also notice the part about vegans having the highest level of DHA (286.4 micromoles) in the blood, even higher than that of fish eaters.

      http://www.nutraingredients-usa.com/Research/Omega-3-ALA-intakes-enough-for-EPA-DPA-levels-for-non-fish-eaters

      It is just one study but it does make sense from an evolutionary stand point. Not all regions of the world could have provided ample sources of DHA for the millions of years of our evolution.

    • Alex

      I’m no paleo-dieter, but their basic thesis interests me. If ancient humans did not adequately produce a particular essential nutrient ourselves, we’d need to get it from the environment. From where would ancient humans have obtained EPA and DHA? Should we assume that all humans ate fish or algae? Or did we obtain EPA and DHA from higher quality free range animal flesh? I’m sceptical.

  • VeganBlitz

    I recently started taking vegan Omega 3 (EPA-DHA) in the hope of lowering my triglycerides. Am I wasting my time/money?

    • Joseph Gonzales R.D.

      Not sure, VeganBlitz. Many ways to try and help lower tryiglycerides. Some studies do support your theory, http://www.ncbi.nlm.nih.gov/pubmed/25480558, but I would certainly discuss with doctor.

      • Caroline

        I heard a high consumption of fish oil could lower triglycerides. My level is really low, so I stopped taking them. I’m curious how to get them higher. Any thoughts?

    • ron

      It is my understanding that only fish oil provides EPA-DHA.

      • Kim Churchman

        DHA is cheaply processed from plants, namely, microscopic algae which are plants. No need to strip out the oceans. Algae grown in vats inside a building.

        • laguna

          Why is the retail price several times what fish oil is if they are ‘cheaply made’?

          • Kim Churchman

            Not in my experience. My WalMart has mine at $10/month. Good luck –

    • Kim Churchman

      I have found that sugar and oil drive triglycerides. Cut those out and your numbers will be good. Or so it was for me.

  • Judy

    What about fish oil for eye health or skin- should we still avoid it because it increases cardiac risks?

    • dirkhofman

      It doesn’t, or at least it’s not clear at all that it does. Worth a read: http://jama.jamanetwork.com/article.aspx?articleid=1357266

    • Joseph Gonzales R.D.

      Not sure, Judy. Haven’t seen the research. Good question though! I feel many foods and dietary patterns help protect the skin, eyes, other organs. One post I found on skin health.

      Best wishes,
      Joseph

    • Eat 2 tablespoons ground flax seeds daily to consume 4000mg Omega3.

  • dirkhofman

    On reading other sources (JAMA, 2013) it is suggested that the reason there is no statistically significant benefit in the latest studies is that the studies couldn’t be controlled for statin drugs, which even out the results. Any answer to that finding? The recommendation continues to be eating some forms of fatty fish a couple of times a week. I really enjoy the articles here but I really wish they were a bit less biased and more inclusive of research which might suggest other than a completely meat-free diet. It makes me lose confidence in the credibility here, which is a shame. Not the only example I’ve found since following this site.

    • Joseph Gonzales R.D.

      Thanks for your feedback. It is important to be transparent. NutritionFacts does not suggesting a meat-free diet, or any “diet” for that matter. Do you mind forwarding reference that counter this blog? I feel this is the point of the comment section, to explore the research. Happy to correspond and discuss other areas of the site you find bias.

      Sincerely,
      Joseph

      • dirkhofman

        Sure, here’s the study. http://jama.jamanetwork.com/article.aspx?articleid=1357266

        I am surprised to hear NutritionFacts is not suggesting a meat-free diet. Almost every article or video I read/see suggests this. With data in most cases, but they do suggest it. Which is fine, I would just like there to be a more not “balanced” but widely informed view. If the widely informed view leads to one diet or another, all the better. Not looking for “balance” for it’s own sake. Thanks for the response Joseph!

        • Joseph Gonzales R.D.

          Thank for the study. What I gathered from the conclusion was omega-3 supplementation didn’t associate with less disease risk. Not sure how this study counters the blog post? You make a great point about balancing the studies. Our hope is folks can decide what foods to eat and what “diet” works best for them based the research. If there are ever any studies you feel we’re leaving out please simply post them :)

  • barbarabrussels

    Just to clear things up, the omega 3 to 6 ratio is still important, right?

  • Steve

    Interesting post – thanks. No change in all-cause mortality is a little surprising given the role of n3 vs n6 fatty acids in inflammation. Does this mean…
    1) That anti-inflammatory benefits of omega 3s are equally dubious or
    2) Inflammation doesn’t have a significant role in disease after all?

    • Joseph Gonzales R.D.

      Hi Steve. Omega-3’s play a role on inflammation and they are essential to consume in the diet, so I would say they do play a significant role on health and disease. It just appears fish oil research is too controversial and they should not be touted by doctors for all patients, as they typically are.

  • David Johnson

    There are reasons to consider consuming DHA/EPA other than heart health, namely, to help protect against neurological problems including dementia, macular degeneration, etc. I am not sure if Dr. Gregor has addressed this issue but sure would appreciate it if he were to. I have read studies showing that vegans have very low serum levels of DHA, which I find worrisome. Hence I supplement with an algae oil (Ovega 3).

    • Joseph Gonzales R.D.

      Great question, Mr. Johnson. Here is a study looking at DHA/EPA levels in both fish and non-fish eaters. Researchers found “Total n-3 PUFA intakes in non-fish-eaters were 57-80% of those in fish-eaters, but status differences were considerably smaller [corrected]. The estimated product-precursor ratio [corrected] was greater in women than in men and greater in non-fish-eaters than in fish-eaters.” And to conclude: “Substantial differences in intakes and in sources of n-3 PUFAs existed between the dietary-habit groups, but the differences in status were smaller than expected, possibly because the product-precursor ratio [corrected] was greater in non-fish-eaters than in fish-eaters, potentially indicating increased estimated conversion of ALA”

      It appears vegans have a high product-precurser ratio, (women even better than men) making their conversation of ALA to EPA/DHA acceptable.

      I am uncertain all studies make this claim. So you are thinking right, if vegan, not bad idea to consider algae omega-3 supplement as a safety blanket, especially for men.

      • David Johnson

        Joseph: Thanks for your response. I think this is perhaps an underappreciated issue. I would point out that the quality of this study has been questioned in the following comments:

        http://ajcn.nutrition.org/content/93/5/1154.1.long

        But independently, it seems to me the real issue is tissue level of DHA/EPA (where blood serum levels are often taken as a proxy; I have no idea if this is a good assumption). It is difficult for non-experts (like me) to obtain the relevant literature and have confidence in evaluating what we do read (so thanks for Dr. Gregor for being a great guide!). Jack Norris provides a detailed overview along with references that is fairly recent (April 2014), which might be of help to those interested in this topic:

        http://www.veganhealth.org/articles/omega3#n3intake

        His conclusion (same as that of Dr. Fuhrman) is that vegans/vegetarians cannot get sufficient DHA (in particular) and EPA from relying on ALA conversion, and should supplement. So as you said at the end, it is something that one should consider, and I would add “very carefully”.

        • Joseph Gonzales R.D.

          Thanks for mentioning Jack’s work. I was writing about some of the studies he references. Here is what i drafted that discusses this further and can link back to the site. Hope this helps:


          ​Dr. Greger discusses, How do you achieve a good omega 3 to omega 6 fatty acid ratio? Very complicated research. Some concerns may exist taking high doses of ALA (think flaxseed oil) and eye issues. Other studies show ALA can help boost levels of DHA over time. Older vegan men can have very little DHA in their blood. It’s unclear how blood levels of DHA translate to disease risk. The bottom line: there is not enough research to show these supplements (either ALA from flax oil or DHA/EPA from microalgae/yeast) are 100% necessary. It depends on age and gender. For example, pregnant women run more risks if they fail to supplement. DHA is so crucial in childhood brain development that pregnant and lactating women should take a supplement. Advice needs to be individualized and best to discuss this with your doctor. Because of all the interest in this topic I am considering posting a separate Q&A. Until then, Dr. Greger has general information and guidelines about omega-3’s. As a precaution, and especially if you following a vegan, taking a vegetarian-based DHA/EPA supplement may be a good idea. I appreciate everyone’s feedback on such a wide ranging topic!

      • david

        I understand that long chain omega 3’s are very unstable and are rapidly oxidized bringing into question the value of supplemental omega 3’s regardless of derivation.

  • Susan

    we have algae omega: Algae- Based Omega 3 EPA and DHA 2 capsules have 570 mg of total Omega 3’s. EPA 180 mg, DHA 320 mg, and other Omega 3’s 70 mg. Is this good or bad?

  • charles grashow

    https://docs.google.com/file/d/0Bx5wFjZiRSvRZ0JOWTBTcXdoU0U/edit

    Effect of a Combined Therapeutic Approach of Intensive Lipid Management, Omega-3 Fatty Acid Supplementation, and Increased Serum 25 (OH) Vitamin D on Coronary Calcium Scores in Asymptomatic Adults

    William Davis, MD, FACC, Susie Rockway, PhD, CNS, and Mary Kwasny, ScD

  • ambrosephill

    If the benefits of Omega 3 fish oils is untrue how do we know if Omega 3 from plant base diet is also a lie, who to trust?

    • Joseph Gonzales R.D.

      Huge difference between fish oils and omega-3’s from whole-foods. Great question though. Here is one paper looking at a high-fat (includes nuts) and lower carbohydrate vegan diet, showing cardiac benefits.

      • peterpan

        more conflicting info. this doesn’t jive with with Ornish’s work.

        • Joseph Gonzales R.D.

          Peterpan, good call! it doesn’t match other intervention studies that have been conducted on lower-fat diets, as you mention, Dean Ornish. It is not to say previous studies on lower-fat diets were incorrect in their findings (finding are findings), but perhaps that fat intake is not the whole story? Maybe it depends on type of fat, how much, and what other foods are eating in the diet? I am not sure, but let’s follow these types of intervention trials and see what comes out next.

  • vegank

    I also wonder about the change in quality like oxidization of these omega 3 /DHA oils , even if we choose the algae based DHA capsules.

    • Joseph Gonzales R.D.

      Good point. This is why I am big on whole-foods! The algae-DHA appears to be effective. The microalgae DHA-based seems to have comparable efficacies to that of fish oil. Plus, you avoid potential contaminants that Dr. Greger is talking about in fish oil.

      • vegank

        Thanks ! This has prompted me to look for more whole food /plant based source of DHA.
        Are there any food or beverages that may interrupt the absorption of plant based DHA?

        • Joseph Gonzales R.D.

          Not that I am aware of. ​Dr. Greger discusses how to achieve a good omega 3 to omega 6 fatty acid ratio, which may help. Omega-6’s will compete with omega-3’s for elongation of fatty acids, but taking it straight I am not sure. I would expect the DHA to work effectively.

      • You don’t have to worry about oxidation when cooking whole foods? Is that correct? My nutritionist says that omega 3s are extremely sensitive to heat–even more so than 6s–and suggests using dietary anti-oxidants (in marinades, for example) to help protect against oxidation.

        • Joseph Gonzales R.D.

          Thanks for the correction! I meant to elaborate saying whole foods sources do not appear to be as volatile as ALA- rich oils, like flax oil. You can still cook ground flax for up to an hour without losing the benefits.

          • That’s great to know about cooking flax.

            Is algae-based oil as volatile as fish oil? (That may have been a & a-ed already–asked and answered.)

          • Joseph Gonzales R.D.

            Hi Harriet. It may be I am not sure? At any rate I do think it would be less risky than fish oil if one were taking it. I posted more about the algae oils here not sure if I let you know yet forgive my delay I know you’ve been patient :-) I appreciate your posts.

            Thanks for your questions!
            Joseph

          • And thanks for your responses. Correct me if I’m wrong, but it seems that the website might need two people to fill your shoes. Answering all these questions is a lot of work.

          • Joseph Gonzales R.D.

            :-) Yes, try 3 or 4! Just jokes. This is an exciting challenge and I am blessed with the opportunity. I have so many new posts coming soon! Check back on my page Ask the Dietitian for more info as I compile all the best questions from our members. Thanks Harriet Sugar Miller!

  • Galvanni

    I’m discouraged by this. I’ve been taking distilled fish oil every day just to keep the Omega 3:6 ratio in check. Now I guess I have to find an Algal solution. And what’s to say they are contaminating the Algae from the water source used to grow it?

    • vegank

      Aren’t they cultivated in vats?

  • Schalk Neethling

    What about evening primrose oil? I am currently taking a supplement that is a combination of epa + dha fish oil concentrate and primrose oil. Is there real benefit from either or should I just toss the bottle now ;)

    • Joseph Gonzales R.D.

      Hi, Schalk Neething. Good question. Not sure about primrose oil I haven’t read anything ground breaking. It’s touted for high levels of Gamma-linolenic acid (GLA).

  • Kim Churchman

    Could have mentioned the overfishing madness when algae-sourced Omega 3s will serve nicely for better benefit.

  • Russell

    Setting aside the pollutant issue, if that’s possible, I’ve read from other sources that we should we be taking Fish oil to help prevent cognitive decline? What do you think?

    • Joseph Gonzales R.D.

      Hi, Russell. I mentioned cognitive decline in a below comment. Click here . See if that helps?

  • Joi Gleason, RD

    I wonder if you have seen the paper by Superko, et al. Circulation 2013;;128:2154-2161 regarding the variability of individual blood response to omega 3 supplementation? From this paper the authors refute the JAMA meta-analysis……”conclusions regarding the benefit of omega-3 fatty acids, based on studies that did not assess blood levels, may be confusing and misleading because of the inclusion of subjects who did not achieve a therapeutic blood level. For example, in the JELIS investigation, the risk of major coronary events was significantly decreased in the group with high (>150 μg/mL) on-treatment plasma EPA levels, but ≈39% of subjects did not achieve that level despite1800 mg/d EPA supplementation.”

    There is genetic variability in the response to supplementation. Measuring blood levels would provide beneficial information about the dosage required to optimally reduce cardiovascular risk.

    • Joseph Gonzales R.D.

      Thanks for this! I read it. I think that is a great point about measuring blood values vs amounts the amount of essential fats we obtain from foods or supplements. Seems like a better indicator to measure blood, doesn’t it? I also have the question “what about actual levels in tissues?” how do we know the blood fats are being absorbed by the tissues that use these fats? At any rate, this is important to understand the different methodology in these studies. if anyone can lend more info here I am sure we could all learn more. One thing to note, higher blood levels of omega-3’s are not always associated with positive results. This study found prostate cancer patients with higher blood levels of omega-3 have been shown to have higher risks of prostate cancer. Even the researchers were shocked of this finding. It did not change recommendations for essential fats and prostate cancer, but interesting findings nonetheless.

  • vegank

    I am more concerned about strokes than heart disease since a number of relatives have succumbed to it in the past, although they were in their 90s. This is also to do with DHA if I remember correctly.

    • Charzie

      Purslane is also a common “weed” than can be found just about anywhere. I love to forage not only to supplement my diet with superior nutritious “real” plants that haven’t been altered and hybridized, but for the exercise and satisfaction of identifying viable alternatives to our “typical” veggies. I’ve had both the wild and domesticated versions of purslane, and though the domesticated variety is bigger and fatter than it’s wild relative, I vastly prefer the wild variety.
      A great website for anyone who is interested is http://www.eattheweeds.com/ He also has a bunch of videos on Youtube. Fun stuff! I had to learn all over again after moving from CT to FL, but it’s always rewarding! You’d be surprised how many edibles you can find even in your own neighborhood if you are adventurous!

      • vegank

        it’s interesting how we could be missing out on all the EPA/DHA and immune boosting nutrients by throwing away these “weeds”. Apparently purslane is quite invasive though , so some people might want to grow them in a pot unless the wild varieties are available somewhere.

        • Charzie

          Purslane used to “volunteer” in my garden in CT, which most people would have tossed out with the other “weeds”, but it is so small and low growing, it never truly became a pest, especially once it became a “crop”…I actually wished for more! LOL. There was also wild amaranth, disrespectfully known as “pigweed”. an amazing, delicious, nutritious, multi-purpose plant of which you can eat the young greens or wait for the seedhead… yep, the same family as the amaranth seed you purchase, growing FREE and freely almost everywhere! Along with that there is chenopodium, also known as lambs quarters, goosefoot, and a slew of other local names, another very desirable and nutritious green related to quinoa, and the seeds again are a valuable crop! Of course it isn’t the same as going to the store and buying produce ready to cook or eat, but a wonderful free alternate that gets us back to our literal “roots”, with new eyes, healthy exercise, amazing nutrition, free of charge, and for me, a kind of primal satisfaction lacking in modern life!
          There is “magic” in these wild plants because they are the medicines we evolved with, ignored out of ignorance and disrespected because we didn’t cultivate them…”WEED” is such a relative moniker, as it really only refers to a plant growing where it wasn’t planted intentionally, but so many of these are real food that has so many more nutrients than domesticated varieties because nature has created it, and man has not messed with it…only their relatives, bred to specific ends. There is a world of nutrition and new flavors out there we ignore simply because we call them weeds. Of course they are not all edible or even taste good, so it does take knowledge to correctly identify them and know the specifics. Even our tomatoes and potatoes will sicken us if we eat the leafy parts…they belong to the same family as “deadly nightshade”!
          Here in FL there is a ubiquitous wild cactus in the opuntia family, that like many “weeds”, is not only edible, but has medicinal properties…a chemical structure similar to glucophage, the anti-diabetic medicine, with a similar effect. The young, flat pads are known as nopales, a traditional food used by natives of the Americas through history, and also the source of the “cactus pear” or “prickly pear”. These are just of few of the more common ones, but there is a whole new world of them to learn if you are so inclined, even if just a handful of the more common ones. They are so much more than “weeds”!!! (Can you tell I’m enthusiastic about the topic? LOL!)

          • vegank

            Thanks ! You got me curious about edible weeds now. I realized now that I shouldn’t be “weeding out” the violets in my flower-bed which I nearly did.
            If anyone is interested in Purslane , go to the SuperfoodEvolution-channel on Youtube titled “Wild purslane plant, A common “weed” or Edible super green?”.
            It lists ways of identifying Purslane weeds, the nutritional value, and how to use them.
            However they also warn that the roots are inedible, and people sensitive to Oxalates or kidney stones shouldn’t eat it raw but need to steam it.
            I’ll try growing them , collecting seeds from the pods and keep cultivating like micro -greens because I am unsure about the effect of traffic fumes and spraying around my place.

          • Charzie

            Good for you! It amazes me how much more nutrition these wild edibles contain than the “normal” produce that’s been hybridized! Some of them border on medicinal herbs because of issues of concentration of particular components and/or flavor, and are used in moderation or for teas/tisanes, etc., but the more research that is done, the more amazing they prove to be…they truly are medicine!
            Because of their tenacity to survive they are branded weeds and people spend a fortune trying to get rid of them when we could be reaping the benefits of consuming them instead! I get a sort of perverse kick out of so many weeds increasing tolerance to Glyphosate, the killer herbicide sprayed on crops and in GMO’s. As with the abuse of antibiotics, (a much more serious issue) mother nature tries to strike a balance, something much of mankind seems intent on dominating or destroying, in so many ways.

          • vegank

            you make a good point there, when you think about it there must be a scientific reason why these so-called common weeds are “tenacious survivors”, and by consuming them we also derive whatever benefit they have. Some apparently regulate blood sugar as well, or give us an energy boost. I don’t have enough knowledge to tell if any one of them are toxic so I need to learn a little more. It seems like we’re now realizing the value of the knowledge our grandparents and great grandparents had (I wish I listened to them !).

  • NHindie

    ProOmega fish oil from Nordic Naturals was recommended by my ophthamologist for chronic dry eye. Do you know of scientific evidence that this helps? Nordic Naturals states that it is third party tested for environmental toxins but maybe I should switch to the yeast or microalgae omega 3s. Your thoughts are appreciated!

    • Jen Drost, PA-C, NF Volunteer

      Hi NHindie, Great question! Hope you don’t mind if I jump in…My aunt’s eye doc also recommended Nordic Naturals, but even though she got some relief of dry eye (about 30%), she said she was self conscious that her breath smelled fishy all the time! :( Also, I was concerned about it as I remembered a Consumer Reports article a few years back questioning the freshness and possible preservatives NN uses in their fish oil. SO my aunt switched to a microalgae Omega 3 and had a 100% improvement in her dry eye-in less than 2 weeks! So you would know quickly if it’s going to work for you. Here’s a piece Dr. G. did awhile back about plant-based versus fish-based Omega 3’s

      • NHindie

        Hi Jen and thanks so much for your comments! Do you know what brand of microalgae omega 3 your aunt is using and also whether the brand used is important? Sincerely, Diane

        • Jen Drost, PA-C, NF Volunteer

          I don’t know off the top of my head but can find out! But better yet, Dr. G. mentions some possibilities here. I’ll get back with you when I find out which one she’s using :)

          • NHindie

            Awesome! Thanks for that and for the links. Much appreciated!!

        • Joseph Gonzales R.D.

          Hey NHindie,

          There are many to choose from. This is a old video talking about a few brands. Any should suffice. Dr. Greger recomends any one that offers 250 mg daily of pollutant free (yeast- or algae-derived) long-chain omega-3’s (EPA/DHA)

          Hope our answers help!

          Joseph

          • NHindie

            Hi Joseph,
            Welcome aboard! I love NutritionFacts.org and have shared videos from the site with many of my friends and family. I truly appreciate you and Jen getting back to me and on a weekend too!
            Based on all the great input I’m looking forward to making a switch from the fish to the yeast or algae-derived long chain omega-3s.
            Sincerely,
            Diane

  • Lisa

    This reminds me of the continued onslaught of Statin drugs still being prescribed to so many; yet heart disease remains the number one killer in Americans especially women. Fish oil I have read many studies especially how the processes come together in creating the product as a whole. Just to create fish oil there are many steps and the end result does indeed leave questions to me on the safety and actual product itself. It all comes down to our diet. We are what we eat, plain and simple. Inflammation and oxidation is the culprit to many diseases especially cancers and heart disease. Gods pharmacy is abundant. It’s there for anyone that chooses to seek alternative therapies, and not just a synthetic drug. Terry talks Naturally is a great website for many topics and other resources. I am 52 and take no prescriptions. It is my desire and lifetime goal not to fall in the death trap of the vicious cycle of RX drugs.

  • Jerry Amos

    Nerve and brain cell walls are made up of fat. A diet high in Omega 6 results in hard sticky brain cell walls which are prone to MS – see “Overcoming MS” by R. George Jelinek.
    Omega 3 cell walls are soft and flexible, not sticky, and are very beneficial for MS treatment.
    Plant sources of Omega 3, such as walnuts, chia, flax are very inefficiently absorbed as sources of EPA and DHA.
    As an 80 year old, blood tests show very high levels of SHBG binding globulin which pushes my free testosterone down below acceptable range. Walnuts, chia, flax raise SHBG which I certainly don’t want. So we do look for DHA about 100mg and somewhat less EPA in diet, currently from fish oil pills. We just ordered algae with claimed 100 mg DHA plus EPA.

  • James

    I take Omega3 supplements for brain health as well as heart health. I’ve read medical study reports that Omega3 improves brain function in older adults. Has Dr Greger researched brain health and Omega3s?

  • Geo.

    Do these results mean there is no benefit from eating ground flaxseed?

    • Joseph Gonzales R.D.

      Hi Geo,

      I don’t think so. Most of these studies were looking at fatty acid supplements, not flaxseed. We still see such wonderful benefits regarding flax seeds! Please see my other comments within this thread re: flaxseed. Thanks, Joseph

  • guest

    A 2014 meta-analysis showed that marine-derived omega-3 polyunsaturated fatty acids supplementation had a significant lowering effect on CRP, IL-6 and TNF-α levels.

    http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0088103

    That surely has to count for something when we are talking about preventing chronic low-grade inflammation and related diseases. I have not seen this study referenced anywhere on nutrtionfacts.org.

    Please can this be looked into for future NutritionFacts research?

    • Joseph Gonzales R.D.

      Thanks for this. This study found “The effect of marine-derived n-3 PUFAs from dietary intake was only assessed in subjects with chronic non-autoimmune disease, and a significant lowering effect was observed on IL-6, but not on CRP and TNF-α.” This is valuable and meta-analyses are important as they take into consideration a lot of research at once. So I agree with you, and they certainly count for something. I don’t doubt these findings. I still have concern with potential toxins found in marine oils, as Dr. Greger addresses in this blog. Maybe a question could be, “how could we see the same effects of lowering inflammatory compounds by choosing toxin-free PUFAs”, or “what is the effect of diet on these same markers?”, or “what randomized control trials focus on these inflammatory markers “

  • I just found this study on algal oil based omega3s: http://www.ncbi.nlm.nih.gov/pubmed/24261532

  • guest

    As a side note, there has also been a recent study into the bioavailability of fish oil powder, being shown to be comparable to that of traditional fish oil.

    http://www.nature.com/ejcn/journal/v69/n3/full/ejcn2014250a.html

  • Mangalore Cafe

    My theory on these studies. Why Fish and Fish oil was found to have benefits in the past? Only because it was in comparison to a meat and dairy diet. Fish is anywhere from 60% to 90% water. It is so light and is filling. So studies that showed health benefits from consuming fish and fish products was simply due to a reduction in consumption of meat/Dairy/Eggs that the fish replaced.
    But when you compare it with a vegetarian or a very healthy vegan diet fish consumption will show no additional health benefits.
    So there is no controversy or some mysterious factor
    Fish oil and fish products was promoted by the fish industry. Fish oil is the waste of the fish industry. What better way to sell their waste turn into the “health product”.

    • Thanks, that’s an interesting take on it for sure

  • sf_jeff

    Do Omega 9s help the body rid itself of excess omega 6s, and if so, are Omega 9s plus DHA supplementation (for neurology support) as helpful as Omega 3’s?

    • Joseph Gonzales R.D.

      HI sf_jeff. I am not sure. I only know omega 3’s are the only fats that are essential. The body can make omega-9 so supplementing seems off.

  • Alex

    What do you make of this? Does the USDA have access to different or only older studies?

    Page 20 Line 282 (UDSA: Science Report 2015 Diet Guidelines) “Regarding contaminants, for the majority of wild caught and farmed species, neither the risks of mercury nor organic pollutants outweigh the health benefits of seafood consumption.” ( http://health.gov/dietaryguidelines/2015-scientific-report/PDFs/Scientific-Report-of-the-2015-Dietary-Guidelines-Advisory-Committee.pdf )

    • Joseph Gonzales R.D.

      Hi Alex. Many reports like to claim there are more health benefits than risks. I think it depends on so many factors. As you know there are many resources here on fish it is up the consumer to weigh the benefits and risks. Thanks for sharing the report.

  • Josefreak Salem

    Fish oil also raises uric acid levels, which can lead to kidney stones, gout, etc.

    • Gio850

      What is your reference for this claim?

  • Greg N

    A March 30, 2015 New York Times report states that research does not support any benefits from fish oil supplements. The article is here: http://mobile.nytimes.com/blogs/well/2015/03/30/fish-oil-claims-not-supported-by-research/

    Is this the same study?

    • Joseph Gonzales R.D.

      Hi Greg N. I’m not sure looks like a JAMA 2014 article in the times report. At any rate it may be similar to the 2012 JAMA article that Dr. Greger cites. Not sure if that is helpful.

  • Christian

    You need omega 3’s 6’s and 9’s not just omega 3’s

  • Chay

    This just shows that media can overshadow the truth by highlighting only one result of a study. I always believed that fish oil was highly beneficial and almost an essential for optimum health. Thank you for showing us the truth.

  • Lizzy

    Fish oil is quite popular among my friends, I can’t wait to show them is article.

    • Lizzy

      *This

    • Joseph Gonzales R.D.

      Thanks Lizzy! I highly recommend checking out the videos that Dr. Greger hyperlinks and checking out the Doctor’s Note in each video, as they link to more and more research about fish oil. I think their are safer alternatives, like golden algae. If curious about how much Dr. Greger recommends see his Optimal Nutrition Recommendations. Thanks again, Lizzy we love when articles are shared!

      Best,
      Joseph

  • Sam

    What fish is fish oil made from?

    • Joseph Gonzales R.D.

      They vary. All kinds of fish! Check the bottle as again they really do all vary and some have mixtures.

  • Surfer2u2015

    Great information as always. I have a question: Has anyone looked at the product below? It is the highest potency I found on the market and the best price per content. Please click the tabs to see the ingredients, etc. My questions are these on all these supplements:

    Do we have to be concerned with oxidation of the omega-3 fatty acids in the algae based supplements? I have not found any studies or independent testing to answer my question, so I thought I would pose it to the group to see if anyone knows anything, or can answer my question related to the oxidative state of the final products, including the one below from opti3omega. I also asked the opti3omega manufacturer the same question and if I received a reply, I will post it here for everyone to benefit (if anyone else is interested in this topic). The reason I bring this up is Dr. Greger, if I’m understanding correctly, indicates bodily systemic oxidative stress is induced from the oxidation of fish oils. Does the same concern translate to the algae based supplements too? Lastly, what about all the other ingredients added (see the ingredient tab at the link below to see what I am talking about for the opti3omega product). Are these things helpful, harmful, neutral; or does the benefit of the long-chain omega-3 fatty acids trump any concerns about the additives? I also ask this because the six brands featured inDr. Greger’s video (link below) also contain similar additives. It would be nice to have development of a truly “clean” plant based, long-chain omega-3 supplement. The closest I found as far as additive free is at another link below for the unique brand (pretty “clean” in comparison), but my question remains regarding the oxidative states of the oil in these supplements. Lastly, the mg of DHA per mg oil for the Diva, opti3omega, and nuique respectively are the following in case anyone is interested:
    0.24
    0.60
    0.55
    So the potency of the opti3omaga was the best and the best price on a cost basis, while the next most potent was the cleanest as far as additives go.
    http://nutritionfacts.org/video/algae-based-dha-vs-flax-2/
    http://opti3omega.com/opti3.html
    http://www.nuique.com/omega-3-dha-375mg/

    • Joseph Gonzales R.D.

      There could be a concern with oxidation, like as we see in flax oil. Dr. Greger address the shelf-life of oils in this video. Thanks for sharing those links I had not heard of some of those brands. Still, the studies show these algae oils are effective. Perhaps we could ask the companies themselves about shelf life and ways to measure oxidation? Maybe this could be a NutritionFacts Research Fund project in the future?

      • Surfer2u2015

        Thanks. I did write to the opt-3mega company and their reply was that their oil was not oxidized, but no analyses of final product was sent to support their claim. I could write back if anyone is interested to see if they do testing on a per batch basis, and more importantly, will share their analyses as proof of their claim…

  • Surfer2u2015

    Again, any comments/thoughts on additives?

  • Surfer2u2015

    What about oxidation? Is no one else interested regarding oxidation state of the supplements?

    • Joseph Gonzales R.D.

      My thoughts below…

  • walterbyrd

    I know that flax meal is inefficient at converting omega-3 to DHA and EHA. But, what if I just took more of it? Instead of a few grams of algae omega-3, take a tablespoon for flax meal?

    Might be cheaper, plus flax meal has protein and fiber. Also makes smoothies thicker.

    • Nice thought. But not a panacea. It is now known that conversion of SHORT to LONG chain fatty acids is not only very inefficient as you point out (typically about 3%), it is also variable from one person to the next. And, even worse, some people do not convert at all. That is why standardized supplementation advice is wrong. The only way to determine Omega 3/6 statusis by serum testing.

    • Joseph Gonzales R.D.

      You only need so much alpha-linolenic acid (ALA – mother chain of omega-3’s). Adequate intake is 1.6g/d for adult men and 1.1g/d for adult women. That is not much. I’d ask your doctor what they recommend. Dr. Greger has Optimal Nutrition Recommendations that includes information about DHA. Lastly, dietitian Ginny Messina gives her thoughts on supplementing EPA/DHA​. You have to find what’s best for you! It also depends on your overall diet, as Dr. Greger discusses, achieving a good omega 3 to omega 6 fatty acid ratio.

  • Lila

    I wonder whether the fish oil used in the study was low quality stinky fish oil covered by capsules, masquerading the quality, thereby affecting study results? I am enrolled in a voluntary Vitamin D study and they ask for the brand and type of Vitamin D supplement used( i.e. liquid or capsule). Quality and absorbability of supplements are often overlooked factors.

    • Joseph Gonzales R.D.

      That is a good question. All studies are available in our “sources cited” section they might have more information about specific brands. I might add that even some fish oil brands that claim to molecularly distill to remove PCBs and other contaminants have still been found to contain toxins. When looking at children’s fish oil supplements PCB’s were found.

  • Gio850

    I’m new here, and a new vegan. I saw Dr. Greger’s video on Youtube titled “40 year vegan dies” which suggested DHA may extend the life of vegans. But this article on the “reversal on fish oil” is newer. Should I hold off on the DHA? and should the youtube video “40 year vegan dies” be taken down?

  • dietisthekeydotcom

    Hi I want to send in some info that might make a good video how do I do that