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Fish Consumption and Suicide

Depression is a serious and common mental disorder responsible for the majority of suicides. As I’ve covered in Antioxidants & Depression, intake of fruits, vegetables, and naturally occurring antioxidants has been found to be protectively associated with depression. Therefore, researchers have considered that “it may be possible to prevent depression or to lessen its negative effects through dietary intervention.”

But not so fast. Cross-sectional studies are snapshots in time; so, we don’t know “whether a poor dietary pattern precedes the development of depression or if depression causes poor dietary intake.” Depression and even treatments for depression can affect appetite and dietary intake. Maybe people who feel crappier just eat crappier, instead of the other way around.

What we need is a prospective study (a study performed over time) where we start out with people who are not depressed and follow them for several years. In 2012, we got just such a study, which ran over six years. As you’ll see in my video Fish Consumption and Suicide, those with higher carotenoid levels in their bloodstream, which is considered a good indicator of fruit and vegetable intake, had a 28% lower risk of becoming depressed within that time. The researchers conclude that having low blood levels of those healthy phytonutrients may predict the development of new depressive symptoms. What about suicide?

Worldwide, a million people kill themselves every year. Of all European countries, Greece appears to have the lowest rates of suicide. It may be the balmy weather, but it may also have something to do with their diet. Ten thousand people were followed for years, and those following a more Mediterranean diet pattern were less likely to be diagnosed with depression. What was it about the diet that was protective? It wasn’t the red wine or fish; it was the fruit, nuts, beans, and effectively higher plant to animal fat ratio that appeared protective. Conversely, significant adverse trends were observed for dairy and meat consumption.

A similar protective dietary pattern was found in Japan. A high intake of vegetables, fruits, mushrooms, and soy products was associated with a decreased prevalence of depressive symptoms. The healthy dietary pattern was not characterized by a high intake of seafood. Similar results were found in a study of 100,000 Japanese men and women followed for up to 10 years. There was no evidence of a protective role of higher fish consumption or the long-chain omega 3s EPA and DHA against suicide. In fact, they found a significantly increased risk of suicide among male nondrinkers with high seafood omega 3 intake. This may have been by chance, but a similar result was found in the Mediterranean. High baseline fish consumption with an increase in consumption were associated with an increased risk of mental disorders.

One possible explanation could be the mercury content of fish. Could an accumulation of mercury compounds in the body increase the risk of depression? We know that mercury in fish can cause neurological damage, associated with increased risk of Alzheimer’s disease, memory loss, and autism, but also depression. Therefore, “the increased risk of suicide among persons with a high fish intake might also be attributable to the harmful effects of mercury in fish.”

Large Harvard University cohort studies found similar results. Hundreds of thousands were followed for up to 20 years, and no evidence was found that taking fish oil or eating fish lowered risk of suicide. There was even a trend towards higher suicide mortality.

What about fish consumption for the treatment of depression? When we put together all the trials done to date, neither the EPA nor DHA long-chain omega-3s appears more effective than sugar pills. We used to think omega-3 supplementation was useful, but several recent studies have tipped the balance the other way. It seems that “[n]early all of the treatment efficacy observed in the published literature may be attributable to publication bias,” meaning the trials that showed no benefit tended not to get published at all. So, all doctors saw were a bunch of positive studies, but only because a bunch of the negative ones were buried.

This reminds me of my Is Fish Oil Just Snake Oil? video. Just like we thought omega-3 supplementation could help with mood, we also thought it could help with heart health, but the balance of evidence has decidedly shifted. I still recommend the consumption of pollutant-free sources of preformed long-chain omega 3s for cognitive health and explain my rationale in Should We Take DHA Supplements to Boost Brain Function? and Should Vegans Take DHA to Preserve Brain Function?


For more on the neurotoxic nature of mercury-contaminated seafood, see:

What can we do to help our mood? See:

What about antidepressant drugs? Sometimes they can be absolutely life-saving, but other times they may actually do more harm than good. See my controversial video Do Antidepressant Drugs Really Work?.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Discuss

Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.


76 responses to “Fish Consumption and Suicide

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  1. A recent study pointed (1) out that vegetarian men were at risk for depression, because of B12 deficiency…

    Surely the addictive foods (Yale Food Addictive Scale) like processed foods an dairies may also be a cause.

    But in some countries, the overall atmosphere against plant-based diets in mainstream media, justifying by all sort of propaganda the killing of billions of animals and products that are bad for the health may also be a pressure on the mood of people eating healthy.

    (1) Vegetarian diets and depressive symptoms among men
    http://www.jad-journal.com/article/S0165-0327(16)32391-6/fulltext




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      1. Really? The ncbi study had 10 males and 10 females. The psych today article didn’t even cite a study. But you say it’s B12 deficiency & low fat.




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        1. No need to reply to the saturated fat buffoon backed up by streams of unrelated links. No point in even reading their comments in the first place.




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      2. I had a look at the PsychologyToday article that Jerry cited.
        I wouldn’t normally waste my time on pop psychology magazines which appear willing to print any old rubbish as long as it generates catchy headlines. However, I was lingering over a cup of coffee so why not?
        This article Jerry cited is particularly bad. As another poster has already commented, it provides no citations or sources for the claims and statements it makes. Most egregiously, it vaguely refers to unnamed studies that show that people with the lowest cholesterol levels have increased risk for suicide. It then makes a huge leap and assumes that those people had low cholesterol because they ate a low fat and low cholesterol diet. Sure, some people have low cholesterol because they eat a healthy diet. But I suspect that the great majority of people in the US and other Western countries, have low cholesterol for other reasons. These reasons include
        1. ALCOHOLISM ” Decreased low-density lipoprotein (LDL) cholesterol in chronic alcoholics is well known.”
        http://onlinelibrary.wiley.com/doi/10.1111/j.1530-0277.2001.tb02315.x/abstract;jsessionid=3F486E4FA729E8B8F5A869B21DA86F52.f03t03
        .2. DEMENTIA “Cholesterol levels in men with dementia and, in particular, those with Alzheimer disease had declined at least 15 years before the diagnosis and remained lower than cholesterol levels in men without dementia throughout that period.”
        https://www.ncbi.nlm.nih.gov/pubmed/17210816
        3. CANCERS ” Falling TC level was accompanied by a subsequent increased risk of death caused by some cancers (hemopoietic, esophageal, and prostate), noncardiovascular noncancer causes (particularly liver disease), and all causes. The risk-factor–adjusted rate of all-cause mortality was 30% higher (relative risk, 1.30; 95% CI, 1.06 to 1.59) among persons with a decline from middle (180 to 239 mg/dL) to low (<180 mg/dL) TC than in persons remaining at a stable middle level. By contrast, there was no significant increase in all-cause mortality risk among cohort men with stable low TC levels. "
        http://circ.ahajournals.org/content/92/9/2396.full
        4. INFECTIOUS AND OTHER INFLAMMATORY DISEASES "Patients with a variety of different infections (gram positive bacterial, gram negative bacterial, viral, tuberculosis) have similar alterations in plasma lipid levels. Specifically, total cholesterol, LDL cholesterol, and HDL cholesterol levels are decreased"
        https://www.ncbi.nlm.nih.gov/books/NBK326741/
        5. TRAUMA "Hypocholesterolemia is an important observation following trauma. In a study of critically ill trauma patients, mean cholesterol levels were significantly lower (119 ± 44 mg/dl) than expected values (201 ± 17 mg/dl). In patients who died, final cholesterol levels fell by 33% versus a 28% increase in survivors. Cholesterol levels were also adversely affected by infection or organ system dysfunction."

        The author of the PsychologyToday simply assumed that in Western countries, everybody has low cholesterol because they eat a low fat low cholesterol diet. Such people are in fact likely to be only a tiny minority of people with low cholesterol. In fact, most people with declining or low cholesterol are likely to have a serious disease or suffered trauma of some sort. It is hardly surprising that such people might consequently be depressed and more prone to suicide.
        These things have been known for a long time but self-styled cholesterol and saturated fat sceptics never mention them. Instead,they prefer to claim that low cholesterol and low fat diets cause the low cholesterol associated with illnesses and suicide when it's well known that illnesses and traumas cause cholesterol to decline. Frankly, this seems like either deliberately deceptive behaviour or appalling ignorance on the part of people who like to present themselves as cholesterol and saturated fat experts who know so much more about these things than the global scientific and medical communities.




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        1. I have to delete the other links to get it posted hopefully.

          https://draxe.com/glutathione/

          In a different subject, about your statement that vegans can convert ALA to DHA better than meat eaters, and taking DHA supplement will decrease the conversion, it is so incorrect and so laughable that I don’t want to bother to comment about it. And also if I comment too much then I get complained for posting too much. I cannot win with you guys.




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          1. Insert http://www. in front of the following url and change dot to “.” because I cannot post otherwise.

            immunehealthscience(dot)com/glutathione-foods.html

            immunehealthscience(dot)com/cysteine.html




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      3. Jerry

        I have received email notifications of a number of new posts by you but when I went to the NF website, those posts weren’t there. Looking for those posts has wasted a fair bit of my time. I suspect that most of those missing posts contained personal attacks and comments which breached comment etiquette and the moderators were obliged to delete them. Such comments are not a problem for me personally but the comment etiquette does ensure that discussions here remain fairly civil.

        In order to avoid wasting your time and my time in future (because I am sure you do invest a fair bit of time composing those posts), can I suggest we confine comments to the issue at hand, discuss only relevant evidence and conform to the comment etiquette?

        However, I have to respond to one of your missing posts – well, I assume it is missing because I can’t find it. You wrote “In a different subject, about your statement that vegans can convert ALA to DHA better than meat eaters, and taking DHA supplement will decrease the conversion, it is so incorrect and so laughable that I don’t want to bother to comment about it.”

        You don’t want to comment about it but you did anyway? Also, you have completely misrepresented what I wrote. I referred to a study which showed that non fish eaters (both meat-eating non fish eaters and vegetarian non fish eaters) have higher conversion rates than fish eaters. As for suggesting that taking DHA supplements might decrease conversion, I put this out as a possibility based on the findings from this study not as a statement of absolute fact. But please tell me where is your evidence that taking DHA supplements does not decrease ALA conversion rates? You seem so certain of this that surely you have some evidence to share with us?




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        1. Jerry Oh, you also provided a link to a website operated by a “Dr Axe”. Apparently, he is a chiropractor and naturopath – not a medical doctor . According to RationalWiki, he is also a creationist which perhaps says something about his attitude towards science and evidence.
          https://rationalwiki.org/wiki/Joshua_Lee_Axe%5D

          Why on Earth would anyone cite internet marketers like Axe as authorities on health issues and yet resolutelyn ignore the evidence posted on well-regarded and well-credentialled science sites operated by the likes of the WHO, the US national institutes of health, the UK NICE and institutions like Harvard? It makes no sense to me.




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          1. For some reason I could not get that link to work. Here’s the one I found:
            https://rationalwiki.org/wiki/Joshua_Lee_Axe#I_wanna_get_off_Dr._Axe.27s_wild_ride

            I noticed that “Dr.” Axe does not say where his nutrition certification is from. People should be aware that certifying so-called clinical nutritionists is a well known scam industry. For example, one person got his cat certified via the American Association of Nutritional Consultants (AANC).

            Cf.
            https://www.theguardian.com/science/2004/sep/30/badscience.research

            “In fact, I know you get a certificate, because I’m holding it in my hand right now. It’s in the name of my cat, Henrietta. I got it in return for $60, and it’s a particular honour since dear, sweet, little Hettie died about a year ago.”

            So who knows what kind of certification “Dr.” Axe has.




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          2. Please be careful not to bash creationist because they choose to believe in a different theory than yours. Adventist are creationist and contribute quite a bit to science. In fact Dr. Greger continually uses their findings from their AHS-2 studies to support his messages.




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    1. I think that it is worth noting that the actual study itself notes that reverse causation is a possible explanation for this finding ….. ie mental and physical health issues may have led people to adopt a low fat vegetarian diet for therapeutic reasons.
      http://www.jad-journal.com/article/S0165-0327(16)32391-6/fulltext

      This explanation s a very real possibility because similar research which found a link between vegetarian diets and mental health problems also found that adoption of vegetarian diets tended to follow not precede diagnoses of mental health problems.
      “on average the start of a vegetarian diet follows the onset of mental disorder.”
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466124/

      Strangely, the saturated fat apologists and anti-vegetarians never seem to mention this fact even when they trumpet other findings from the very same studies. Curious indeed.




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    2. Also, there’s a difference between vegetarian and vegan. Had I not learned, from these wonderful videoes and website, how crucial a vegan diet can be, and were I just a plain vegetarian, I would be eating tons of eggs and cheese, a diet that probably is as harmful as consuming fish and/or animal products.




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    1. Hello Greg, sorry but your link “https://mobile.nytimes.com/2017/06/21/well/live/fish-as-medicine-for-rheumatoid-arthritis.html” leads me only to a new Your Times article but not to a study – it’s the ame in Germany, journalists claim there is a study and the study say this or this but not leads to the study beyourself. That’s bullshit but no proof – sorry for my rude words.
      Don’t be a fool and belief such things – ask alsways for the source and read the original, then you can belief it or not.
      Most of the time I ask some papers in Germany for the sources I didn’t get any answer or only the answer: “Look at the internet by your self.” Not helpful at all.
      So I decided to hear to Dr. Greger more then to news papers and there stupid journalists ;-)




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    2. Indeed… might these be the same doctors that in the 50’s and 60’s recommended smoking Kent cigarettes because of their ‘micronite’ filters?




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  2. These studies MAY be telling us that the brain’s requirement for long-chain omega-3 fatty acids is more easily satisfied than we used to think. In other words, that although a certain minimum intake of fish/fish oils is important (I’ve read these are critical for the existence of neurotransmitter receptors) higher intakes are counterproductive due to mercury, PCBs, etc. Also, if we were relying on the anti-inflammatory benefits of omega-3 fats, perhaps we SHOULD be relying on a WFPB diet for the bulk of anti-inflammatory effects of healthy eating (I think this is a foregone conclusion at this time) and strive to rely on our omega-3 intakes to a far less degree.




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    1. Yes, I think you are correct. EPA/DHA is overrated in my opinion. At best the most recent study results are a mixed bag delineating no clear benefit.

      I think EPA/DHA is the new protein. We’ve invented this mythology around it that says it’s difficult to get enough of. Years later we will probably look just as foolish as we did recommending obscene amounts of protein.

      Ann Crile Esselstyn famously eats absolutely no flax and takes no EPA/DHA supplements, and yet her omega 3 levels are above average. She attributes her high levels to daily hearty green consumption.

      There is a publicly available test you can take to get your levels checked. It’s under $100, but I think it’s a waste of time and money. Generally speaking if someone is telling you to take an omega 3 supplement it’s because they sell it themselves or receive a referral commission for pushing it.




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      1. People vary in their ability to convert ALA to EPA. Women, as I recall, typically are better converters than men. Finally, is “above average” really adequate? If the comparison population is very low overall, then perhaps not. Personally I supplement with algal DHA/EPA but I have to admit this area is quite murky. I don’t think anyone should be overly confident they know the answer, or at least the answer for everyone.




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        1. I think an “above average” level in someone who takes no supplements shows that the whole debate over adequate levels is complete nonsense.

          Taking preform supplements decreases your body’s ability to convert ALA to long chains, so you may be doing more harm than good right now and definitely later on if you eventually decide to quit taking the supplements. Who knows how long it will take to recover your ability to convert to long chains after flooding your body with amounts that are nearly impossible to get in nature.

          These pills are just an uncertain and unproven insurance policy that anxious superfood buyers seek out. If the evidence were really there, then we would see recommendations from all the top plant-based doctors, rather than just the handful who make money off it and who happen to be very closely associated with each other.

          Dr. Greger pushes the pills. But where on earth can I buy them? If only there were someone closely associated with Dr. Greger who made these pills available to the general public out of the goodness of his heart!

          Maybe if I just go to the “Supporters” page and look for his friend and associate, Dr. Joel Fuhrman. Ah, yes, here is a direct link to Joel Fuhrman’s website on the supporters page:

          NutritionFacts Supporters

          In case the link above gets changed, here’s the archived link

          And just a few clicks later:

          Dr. Fuhrman’s Smart Nutrition. Superior Health. DHA+EPA Purity

          Thank goodness! Smart, superior, pure! That’s the kind of supplement I want!

          As Joel Fuhrman ominously informs us on his website, “Eating well may not be enough.” And Dr. Greger agrees! How odd that he is so perfectly aligned with one of his biggest financial supporters.

          Eating well may not be enough!

          So buy his pills! It’s only $46.73 for a 60 day supply. That’s only $280.38 per year. What a bargain!

          I’m so glad there’s a place where I can buy this essential nutrient that Dr. Greger recommends! And it costs less than $300 per year. I’d be a fool not to buy it.

          Isn’t it fantastic that NutritionFacts.org is an unbiased source of information that has no ties to the food or supplement industry? I’m sure it’s just a coincidence that one of Dr. Greger’s biggest financial supporters sells the very supplements that Dr. Greger himself recommends.




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          1. Wow, if you believe what you said about Dr. Greger and Dr. Fuhrman why would you come to this site at all? There are arguments on the other side, which I won’t attempt to repeat as Dr. Greger and Dr. Fuhrman have addressed them in various places, including references.

            The experience of one person does not show much. One can, though, have one’s blood tested, but of course, that’s another expense.

            If you were to eat 2-3 servings of fatty fish per week, you would easily get the amount of DHA/EPA recommended by Dr. Greger and Dr. Fuhrman.




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            1. I respect and consistently read Dr. Fuhrman, Dr. Greger, John Douillard, and Walt Willett, but I don’t think any of them are saints. They are hard working, smart, but biased scientists who are trying their best to help us. They are human so they will have biases. I read all of them carefully, but I have a bit of skepticism even on my favorite health authorities. I think that’s a positive, because ultimately we have to help ourselves. We all have different bodies and we have to learn what we need, not what 400 million other people need.
              John S
              PDX OR




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              1. You raised a good point John. At the end of the day, we individually, are the best judge on what works & doesnt as we have different physiology. I heartily appreciate everything that Dr. Greger is doing to share with us for free, the latest in science

                Sent from my Samsung Galaxy smartphone.




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          2. Dr. Greger has NEVER pushed those supplements…only suggested non-fish oil ones if YOU feel you want them. Dr. GREGER does not take them himself. Not sure where you got your incorrect info from.




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          3. Gosh. It’s a conspiracy then?

            The US National Academy of Medicine has established RDIs, AIs and EARs for all sorts of nutrients including omega 3s Dr Greger recommends people get their omega 3s from algal oils if they don’t get adequate levels from whole foods. This means the National Academy of Medicine must be part of a plot to boost Fuhrman’s sales, too. Makes sense – in the end, all these things are Gubbermint conspiracies in furtherance of the NWO agenda. That must be why Dr Greger travels everywhere in one of those mysterious, unmarked black helicopters …..

            I knew it all along of course You see, 2+2 really do make 5 after all. It is a plot by maths teachers everywhere to make us falsely believe that 2+2=4.

            Mark my words, these things are linked. They are all part of the same NWO agenda ….




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          4. “only $46.73 for a 60 day supply” Interesting that this is almost the same price as I paid on Amazon.com for a home blood test kit for long chain omega-3s. I refused to take supplements before taking this test to see if they’re a waste of money or not. I suspected that they are since people have successfully lived since the beginning of the human race without taking pills.Turns out that in my case, I have plenty of the long chained omega-3s in my blood just from eating a couple of tablespoons of flax seeds a day. I understand that some people may not convert ALA as easily as I do, so I suggest that they get the test too. It might just save you the $280 a year.




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            1. Interesting. Living in a nanny state or perhaps it’s really one that protects the financial interests of the medical community (NY), that test, like other consumer-ordered blood tests, is unavailable to me. But I did discover one can get a test kit mailed to NY from Florida and get the results mailed back for $150..




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          5. Hey Mark. Are you trying to raise a red flag here? I can pick some sense of sarcasm along the way. Or are u truly endorsing Dr Greger? Sorry if i cant read you well. So, just had to ask. Thanks.  Nanette

            Sent from my Samsung Galaxy smartphone.




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        2. I agree. It is worth noting that non fish eaters apparently have a higher ALA conversion rate than fish eaters.
          “the precursor-product ratio was greater in non-fish-eaters than in fish-eaters, potentially indicating increased estimated conversion of ALA.”
          http://ajcn.nutrition.org/content/92/5/1040.long

          Of course, those of us who take DHA/EPA supplements may also have lower conversion rates as a consequence.




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          1. The point about conversion rates is well taken but I am wondering whether that isn’t also true for those who eat fish. In any event, for those interested in details, here’s a link to the Linus Pauling Institute’s rather complete seeming article on essential fatty acids, importance of sufficient DHA/EPA, conversion rates, status of studies, etc.

            http://lpi.oregonstate.edu/mic/other-nutrients/essential-fatty-acids#metabolism-bioavailability

            Here are a few germane snippets:

            Gender-based conversion rate Differences:

            “The capacity to generate DHA from ALA is higher in women than men. Studies of ALA metabolism in healthy young men indicate that approximately 8% of dietary ALA is converted to EPA and 0-4% is converted to DHA (6). In healthy young women, approximately 21% of dietary ALA is converted to EPA and 9% is converted to DHA (7). The better conversion efficiency of young women compared to men appears to be related to the effects of estrogen (8, 9). Although ALA is considered the essential omega-3 fatty acid because it cannot be synthesized by humans, evidence that human conversion of EPA and, particularly, DHA is relatively inefficient suggests that EPA and DHA ***may be considered conditionally essential nutrients***.

            In addition to gender differences, genetic variability in enzymes involved in fatty acid metabolism influences one’s ability to generate long-chain polyunsaturated fatty acids (LC-PUFA). ”

            ==> Notice that in general healthy woman convert ALA to EPA better than healthy men do by a factor of ~2.5 (~21% to ~8%) . Notice too how low the conversion to DHA can be in men (0 – 4%). For women the rate is on average ~9%, again a very large difference.
            _________________________

            Genetic Differences:

            “Two key enzymes in fatty acid metabolism are delta-6 desaturase (FADS2) and delta-5 desaturase (FADS1) (see Figure 3 above) (10). Two common haplotypes (a cluster of polymorphisms) in the FADS genes differ dramatically in their ability to generate LC-PUFA: haplotype D is associated with increased FADS activity (both FADS1 and FADS2) and is more efficient in converting fatty acid precursors (LA and ALA) to LC-PUFA (EPA, GLA, DHA, and AA) (11). These FADS polymorphisms are relatively common in the population and may explain up to 30% of the variability in blood levels of omega-3 and omega-6 fatty acids among individuals (3).”

            ==> Note the polymorphisms are “relatively common”, so one should not blithely ignore this possibility. Aside: I do not think genetic variation is discussed enough in some of these disussions.
            _____________________________________________________________________
            NB: “conditionally essential nutrient” means “although not strictly considered a nutrient due to endogenous synthesis, certain conditions (e.g., stress, aging) may result in the demand exceeding the body’s capacity for synthesis, rendering a conditionally essential nutrient.”

            Lastly, the article points out that “LA and ALA compete for the same elongase and desaturase enzymes in the synthesis of longer polyunsaturated fatty acids, such as AA and EPA.”

            ==> So those wishing to rely solely on ALA need to be very careful about their LA:ALA ratio.




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            1. Thnk you for the response and the link to the LPI article. I have always found LPI’s summaries and analyses to be very helpful. I must spend more time on the LPI site – it is a goldmine.




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      2. I think that omitting all the oils and junk food that are heavy, heavy, heavy bearers of omega 6 has a lot to do with our not really needing so much omega 3. It’s about balance, and most Americans have their omega 6:3 ratios way off the charts.




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  3. Avoiding all oils, I stopped taking fish oil supplements, and haven’t tasted the Wild Alaskan Wood Smoked Salmon for months. Verboten.

    Could some WAWSS be eaten occasionally, like once in five or six weeks? Miss it.




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    1. It takes your body one year to clear half the mercury from one serving of fish. Also, ALS is clearly caused by seafood consumption:

      Fishing for Answers

      Diet and ALS

      Commercial fishing is also destroying our planet:

      Comfortably Unaware: The Relationship Between Your Food And Our Future

      And fish are intelligent living beings that can think, experience emotional distress, and feel pain:

      What a Fish Knows

      If you are comfortable with the risks and can still sleep at night despite knowing you are party to so much death and destruction, then you should absolutely eat fish!




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      1. Don’t leave out the damaging fish farms and their terrible products. They are the water – both fresh and salt – equivalent of filthy feedlots full of beef, chickens, pigs, and lambs.




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    2. Catbird,

      I don’t profess to suggest an absolute in one’s diet, period. (pun intended)

      Find some small salmon (if you have access to the coast it’s fairly easy). Where I live they even test some of the fish for mercury levels and constantly find it to be very low. You can also purchase the least affected, Alaskan wild salmon.

      Is the smoked approach the best well…..not really from a chemical point of view but as I said…. if it makes you happy and your intake is as low as you’re suggesting….. go for it and add loads of veggies at the same meal. !

      Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com




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    1. Paul,

      That depends on whom you ask…… and I’d like to reframe the question to a high intake of mercury or other accumulated toxins in the fish you eat. It’s different if your consumption is lower on the food chain, smaller fish such as sardines vs salmon.

      To explore the question further…. the American Heart Association suggests 2 servings (3.5 oz) per week and the EPA/FDA suggest a similar amount dependent on the type of fish.

      By extrapolation more than this amount is considered a high intake…..but remember it’s all about the consistency, body tolerance and toxicity load.

      Dr. Alan Kadish moderator for Dr. Greger http://www.Centerofhealth.com




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  4. Fish and fish oil are obsolete. The new thing is algae EPA/DHA from plants. It is tasteless but it oxidizes fast, so it is best to explode the capsule in the mouth. Also too much omega 3 is bad but it is hard to get rid of myths.




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  5. I recall from memory a formal study that suggested that either 0 weekly servings of fish or more than 3 servings of fish were correlated positively with depression. With shame, I admit that I neither saved the file nor can find the title of that study. I currently regard fish as a controversial food, although some types of fish like Alaskan sockeye and sardines are certainly better than swordfish and tuna. It seems clear that too much fish is certainly not a good idea.

    From a meta-analytical study I did save, Molecular Mechanisms of Depression by Lang and Borgwardt, they found a few nutrients that seem useful for fighting depression: EPA, folate, quercetin, B6, B12, a particular selenium compound, and chromium. Note that chromium is abundant in broccoli. Broccoli is generally regarded as the key to transcending your mortality and achieving godhood. Whether or not you eat a little fish is probably not as important an issue as the question of whether or not you eat lots of broccoli.




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  6. “””The researchers conclude that having low blood levels of those healthy phytonutrients may predict the development of new depressive symptoms. “””

    I think you mean high, not low




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  7. I am at work when I see the title of this blog and I almost fell off my chair laughing, I mean worrying. I think we need to alert the European and Japanese and Korean to not eat too much fish or they will go and kill themselves. I am afraid that in the next 10 years, 95% of people will kill themselves and we will only have vegans left on this earth.

    I don’t know if it is fake news or not but NPR and a number of news outlet reported that a village in Italian has a lot of people living more than 100 years old and they are obese, smokers and don’t exercise. Apparently they eat anchovies and that’s what keep them going without killing themselves.

    http://www.npr.org/2016/03/30/472442367/in-one-italian-village-nearly-300-residents-are-over-100-years-old




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    1. People are still trying to discover the magic pill by imitation. Life expectancy is believed a combination of many factors. They could have eaten a cricket a day, or maybe smoke cigars instead of cigarettes. It does not matter, you would still have the rest of the equation left to figure out. So, why not start smoking to live longer? Why do you think people clinch to the anchovies theory?




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  8. “Greece appears to have the lowest rates of suicide. It may be the balmy weather, but it may also have something to do with their diet. Ten thousand people were followed for years, and those following a more Mediterranean diet pattern were less likely to be diagnosed with depression. ”

    Perhaps it has to do with the fact the Greeks don’t pay their taxes!
    Has anyone considered the fact that the Greeks do not work nearly the numbers of hours as Americans do. Furthermore, Greeks to not have the level of mad. consumerism / materialism that Americans have. Job dissatisfaction, over working, must have something to do with depression , discouragement, feelings of being overwhelmed and sadly suicide rates. Additionally, Greeks are very family and community oriented where as many Americans admit to being isolated in without a friend in the world. Spending hours reading about other peoples lives and staying in other peoples newsfeed is not the same as having legitimate relationships and a strong sense of community and social network.
    While I agree that food has a big play on disposition and over all health ….it is not the cure-all everything that plagues humanity .




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  9. So this is what are said in the blog:

    It is observed that the Greek eat a lot of fish but do not have high suicide rate. Oh because they eat a lot of fruits and vegetables too and that negates the effects from eating fish.

    On the other hand, the Japanese eat a lot of fish and have high suicide rate. Is it because they don’t eat fruits and vegetables? I thought the people on this board say that they only eat plant foods and munch on sweet potatoes. And the Japanese has a lot of DHA/EPA but that does not help on their suicide rate and therefore DHA/EPA oil is junk.

    Hmm, what a scientific conclusion.

    But is it the reason that the Japanese has high suicide rate because they are living in a more stressful society due to work while the Greek has less because they are more laid back?

    And without any study, I can tell that fish oil or any healthy diet won’t stop people from killing themselves if they are stressful. What a discovery.




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  10. Hi, thank you for the wonderful work you do. After watching the omega 3 / DHA videos, I have a question on algae supplement dosage.

    Should we take 250 mg of algae oil, or 250 mg of DHA (e.g. there is a 625 mg algae oil capsule with 250 mg of DHA)?

    Also, is there any info on the ratio of DHA to EPA for health? Supplements vary a lot.

    Thank you!




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  11. Txs Dr Greger as always for these informative brief. I just need to better understand the decision process that u use to in cases where research generate conflicting results; one says its good, the other says its not. How do you decide now which one to share n promote.

    Kudos again to your commitment to making our world healthier

    Nanette




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  12. Hello Nanette! From what I’ve gathered, Dr. Greger goes with the preponderance of evidence- what does the vast majority of research suggest? If it’s close or a contentious subject he’ll evaluate which studies were performed the most effectively and meticulously with the largest number of subjects.




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  13. When it comes to studies that compare things and statistics about depression and suicide, I just do not pay attention. “Depression” itself can be categorized is many ways. Then there are the people that are extremely depressed but they never tell anyone. Then there are the places that over-diagnose people with depression. Suicide is also a thing that cannot have a number put on it. What about those people that attempted suicide, but didn’t die. What statistic do they go under?




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    1. Hey Wendy, thanks for writing. Those individuals go under the category of “ever attempted suicide” when researchers are doing work in this field.




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  14. The oceans are getting more and more polluted, mercury, arsenic, plastic, …
    Fish don’t make Omega 3 oil. It’s in their diet of algae, the original source of Omega oils.
    We get Omega 3 from algae grown in drinking water purity.

    We have seen statistics such as very large Seventh Day Adventist statistics who have several groups, vegetarian, vegetarian + fish, nonvegetarian. In the reports the lowest rate of cancer & mortality was the group that were vegetarians plus fish. I don’t know what plant foods or what fish.

    There is a smaller group on island where 100 people were over 100 out of a population of 300. They were reported to eat lots of anchovies, note very low on the food chain.

    We do have one foot stuck in the bad old days to the tune of 2 eggs a week because my wife has favorite recipes including eggs. There was data showing 1 egg a week no adverse effect, 1 egg a day increased mortality – the worst group was diabetic doctors who doubled their death rate on 1 egg a day.

    Well in the old days before all this nutrition info was available I did 2 eggs + 1 strip of thick bacon a day, hamburger with onion tomato on a hard roll for lunch, and meat in supper. I’m 82 been on mostly plant food diet since The China Study came out, and just recovering from colon cancer…..yes we do have Dr. Weber’s book on How Not To Die but it wasn’t published when I was 20 back in 1955….




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    1. Thanks for your post Jerry.

      Yes, the Adventist health study did find that people who ate a diet consisting of plant based foods and fish had the lowest mortality risk rates … 81% of that of meat eaters. In contrast, strict vegetarians (who for some reason are called vegans in this study) had a relative (to meat eaters) mortality of 85%. These figures are based on results for both men and women.

      However, if you drill down and look at the results for males and females separately, things become more nuanced. Among men, so-called “vegans” had the lowest relative mortality risk of any cohort at 72% of the rate of male meat eaters. Male fish eaters also did well but had a slightly higher mortality risk at 73%. Based on these figures, if you are male, I can see no compelling reason to eat fish.

      If you are a woman, the situation is more challenging. Perhaps oestrogen and androgen levels ave something to do with the different results for men and women. It has been speculated that these may account for the significant difference between male and female mortality rates generally and cardiovascular disease risk. it is not impossible that such factors may interact in complex ways with the effect of different nutrients on mortality risk. If you are female, then, pollution-free fish consumption a few times a week may be a reasonable choice on health grounds. However, for ethical and environmental reasons, a completely vegetarian diet with algal DHA supplements and a good “vegan” women’s multi may be a better option. The choice for us males though is much easier.

      If you are interested, the relative figures for men and women are shown in table 4 of the study.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4191896/




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  15. Regarding the linked videos and the Omega 3 aspects, The Doc mentions Pollutant free sources, And Algae gets a mention but so does Yeast. So is nutritional yeast also a viable option ? It would be a far easier to get a hold of and less expensive I would have thought. And of course Flax meal etc ?




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    1. I don’t see any literature showing that nutritional yeast is a viable Omega 3 source. Your best bet will be chia, flax and walnuts.

      Dr. Ben




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  16. I don’t know about fish and and suicide. I can tell you 12 years ago I suffered with very dry eyes,
    constantly using eye drops. After visiting my eye doctor he told me to take 1000 mg/300 mg of Omega 3 every morning. (purified to eliminate mercury). Within 2 week the difference in my eyes was amazing. I rarely need eye drops. In fact they become out dated I use them so little. This is before I lived a plant based food life for the past year.




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      1. 1000 mg of fish oil provide 300 mg of Omega-3.(a total Omega 3 fatty acids of EPA, DHA and other fatty acids.) The product I use is Nature Bounty.
        The information is on the label. I take 1 a day and have not had dry eyes in 12 years.This was on the recommendation of my eye doctor.




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      2. Thanks for writing, Gengogakusha. Fish oil capsules are typically 1 gram (1,000 mg) in weight and contain roughly 300 mg of the active ingredients (EPA and DHA). Some products vary and provide only DHA, which can be converted in the body back to EPA. I hope this helps!




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