Should We Take DHA Supplements to Boost Brain Function?

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Do DHA Supplements Improve Brain Function?

The concept of vitamins was first described by none other than Dr. Funk. In his landmark paper in 1912, he discussed the notion that there were complex compounds our body couldn’t make from scratch, so we had to get them from our diet. By the mid-20th century, all the vitamins had been discovered and isolated, but it wasn’t until the 1960s that we realized that certain fats were essential, too.

In 1929, the necessity for fat was definitively settled… “in the diet (of the rat),” but when one of the researchers tried a 99 percent fat-free diet on himself for six months, ironically, he felt better. His high blood pressure went away, he felt more energetic, and his migraines disappeared. This one-man experiment “fortif[ied] the medical profession’s doubt that essential fatty acids had any relevance to humans,” until TPN—Total Parenteral Nutrition, meaning feeding someone exclusively through an IV—was developed in the 1960s. TPN was initially developed for babies born without working intestines. Because we didn’t think humans needed fat, “the first preparations were fat free, and they rapidly induced severe EFA [essential fatty acid] deficiencies, ultimately convincing the medical community” that some fats are indeed essential. They started out using safflower oil, but, as they discovered in a young girl given the oil after an abdominal gunshot wound, we don’t just need fat—we need specific fats like omega-3s. So, when they switched from safflower oil to soybean oil, she was restored to normal.

The fact it took so long and under such extreme circumstances to demonstrate the essential nature of omega-3s illustrates how hard it is to develop overt omega-3 deficiency. Of course, the amount required to avoid deficiency is not necessarily the optimal amount for health. The vitamin C in a spoonful of orange juice would be enough to avoid scurvy (the overt vitamin C deficiency disease), but no one considers that enough vitamin C for optimal health.

As I discuss in my video Should We Take DHA Supplements to Boost Brain Function?, what would optimal omega-3 status look like? Well, doubt has been cast on its role in heart health (see Is Fish Oil Just Snake Oil?), which appears to have been based on a faulty premise in the first place (see Omega-3s and the Eskimo Fish Tale), so taking extra omega-3s for our heart might not make any sense (see Should We Take EPA and DHA Omega-3 for Our Heart?). But what about for our baby’s brain (see Should Pregnant and Breastfeeding Women Take DHA?)? Extra DHA may not help pregnant or breast-feeding fish-eaters, but those who want to avoid the contaminants in fishes can take supplements of pollutant-free algae oil to get the best of both worlds for their babies (see Should Vegan Women Supplement with DHA During Pregnancy?). What about adults? There doesn’t appear to be any apparent psychological (see Fish Consumption and Suicide) or neurological (see Is Fish “Brain Food” for Older Adults?) benefit of DHA supplementation for the general public, but what about in those who don’t eat fish?

The famous Alpha Omega Trial randomized thousands of people over three years to get either long-chain omega-3s from fish, short-chain omega-3s from plants, or placebo. The result? The study found no significant benefits for any kind of omega-3 supplementation on global cognitive decline. However, most of the subjects were eating fish, thereby already getting pre-formed DHA in their diets. General population studies like this, that find no benefit, can’t fully inform us about the role of DHA in brain health. It would be akin to giving half these people oranges, finding no difference in scurvy rates (zero in both groups), and concluding vitamin C plays no role in scurvy.

In 2013, for the first time, DHA supplementation was found to improve memory and reaction time among young adults who rarely ate fish. Previous randomized, controlled trials failed to find such a benefit among18- to 45-year-olds, but they only lasted a few months at most, whereas the 2013 study lasted for six months. If all the studies showed either no effect or a positive effect, one might give it a try. But in one of those shorter trials, DHA supplementation didn’t just fail to show benefit—it appeared to make things worse. After 50 days, those who consumed the DHA had worse memory than those taking the placebo. So, out of the six randomized controlled trials for DHA supplementation, four showed nothing, one showed a benefit, and one showed a harm. If it were just about boosting brain function in the short term, I’d err on the side of caution and spend my money elsewhere.

What about the long term though? See Should Vegans Take DHA to Preserve Brain Function?.

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:



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.

208 responses to “Do DHA Supplements Improve Brain Function?

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  1. What about EDTA? I keep getting literature from the Journal of New Medical Discoveries about EDTA (latest Advanced EDTA Mega Plus) for cardiovascular support.

    1. Some of the potential side effects of EDTA are kidney damage, kidney failure, anemia, blood clot in a vein, Insulin shock, Irregular heart beats, diarrhea, vomiting, lower levels of magnesium and potassium in the blood, abnormal levels of calcium in the blood, joint pain, plus other symptoms.

    2. EDTA is a chelating agent which means it BINDS essential minerals such as iron, magnesium, calcium, etc in your blood. why would you take it and what are the claimed benefits?

    1. Yes, he ended on a confusing line, but the video linked confirms that he IS saying to take 250 mg of Vegan sourced Omega 3 per day.

      Based on the long-term studies, particularly this one:

      “[D]ouble-blind randomized interventional study” providing evidence, for the first time, that extra long-chain omega-3s “exert positive effects on brain functions in healthy older adults…” A significant improvement in executive function after six and a half months of supplementation, and significantly less brain shrinkage compared to placebo.”

        1. Lida,

          Science is pretty contradictory, but he does recommend Plant-Based DHA.

          He doesn’t recommend fish oil because of how many of them test for toxins.

          He has a video on that and, those toxins in supplements and fish may well be why there have been studies with negative results..

        2. How large, and can you tell whether they help?

          I have chronic dry eye syndrome and take about 800 mg/d combined DHA/EPA but it is not clear to me it helps. Perhaps the dose is too low. (I’ve been putting off cataract removal out of concern it would exacerbate the problem.)

          1. Make sure to watch Dr. Greger’s video to slow the progression of your cataracts.

            Eventually, there will be other ways to deal with cataracts.

            There is an eye drop, which is already approved for dogs, which works in 6 weeks. It works because of it dealing with misfolded proteins – yes, the infamous beta-amyloid from Alzheimer’s is supposedly also involved in cataracts.


            I am trying PEMF and Nattokinase / Serrapeptase and diet, of course.


            Getting enough Vitamin C and Lutein from foods, in particular.

              1. Thanks Marilyn. I have dry eye disease too so this is interesting..

                However, the analysis notes

                ‘he mean follow-up period ranged from 1 to 12months; 14 studies used only omega-3 FAs as dietarysupplementation,17–21,23–27,29–31,33whereas the 3 remaining studies used a combination of omega-3 and omega-6FAs.22,28,32 The sources included fish oil, krill oil, seabuckthorn oil, flaxseed oil, borage oil, and black currant seedoil. The placebo included olive oil, sunflower oil, corn oil,wheat germ oil, safflower oil, and medium-chain triglycer-ides. The EPA daily dose ranged from 127.5 to 2000 mg,whereas the DHA daily dose ranged from 99 to 1000 mg. One of the studies compared 3 interventions: fish oil (EPA 1000mg + DHA 500 mg), krill oil (EPA 945 mg + DHA 510 mg),and placebo’

                So, no clear dosage pointers there …. but an implication perhaps that higher doses than the 250mg daily recommended for brain health might be beneficial. However, from memory, I think the FDA cautions that no more than 3 grammes per day should be taken while the European food safety authority states that up to 5 grammes per day is safe. There may be an increased risk of bleeding/haemorrhagic stroke with high doses.

                The other point to be considered is the ever present possibility that the placebos used were not inert and may have had a negative effect. This would have presented the intervention in a positive light even if it did nothing. .

      1. Brain shrinkage may induce lower levels of DHA in the brain, and not lower levels of DHA may induce brain shrinkage… Those hypothesis are not ironed out by the studies.

  2. I really appreciate the sentence “I’d err on the side of caution and spend my money elsewhere.” So many expensive supplements/superfoods/general consumables are promoted (elsewhere) as if one’s life depended on them. But the reality is most people just trying to stretch their budget to cover copays, health insurance premiums, mortgage or rent, gas, food, insurance, etc. and spending hundreds of dollars on these things per month just not sustainable. I prefer to spend my money on the highest quality real whole foods and support small local farms and if I have some leftover in my budget to donate to worthy causes trying to protect our air, water, soil.

    1. Laughing,

      Yes, he has our minds go straight to spending our money elsewhere, but there was a bait and switch of the last video where he recommends plant-based Omega 3’s, based on brain studies.

      Dr. Greger, we are mentally now spending our money elsewhere.

      That is teasing us.

      1. I agree. He really plays a bit of a game with us on the title of these videos. Really unnecessary and honestly insulting. We don’t need click bait and inconclusive videos. As a fan of this site I would hope for better titles and conclusions that we can recommend to others. If there are no conclusions then we need not watch a confusing video.

        1. I think it is useful to see here a discussion of some possibilities/hypotheses touted on the internet as justifications for people to buy supplements.

          As for ‘bait and switch’, he isn’t selling supplements so I am not convinced that that is a fair description.

        2. Agree they’re annoying but also bad for learning and health results as it’s a tumble down the dark rabbit hole to link from blog or video to the next link to the next link in the endless series of numerous more linked resources each with Its own links.

          It’s easy to miss the recommendation or miss a related recommendation. It’s happened before

          Please just give it to us straight – the latest recommendation and other related things to know eg if recommending turmeric also mention taking black pepper with it and doses

          1. I have to disagree.

            My interest is in what the research shows rather than in obtaining very detailed dietary recommendations.which may only apply in specific circumstances. The information provided here is intended to help us make decisions, not to tell us what to do.

            In any case, there may be legal, ethical or professional prohibitions against providing ‘medical’ advice to people who are not registered patients of Dr Greger.

        3. But when the science is inconclusive we have to decide for ourselves…thats one of Gregors key messages. We have to weight up the risks for ourselves, and there are risks on either side.

        1. I stopped taking DHA after watching Jeff Nelson’s series of videos and cut down in my fat intake at the same time. I feel better, but don’t know which of the two is the cause. By cutting down on fat, I mean cutting down on tofu, soy milk, and nuts and seeds. I still have 1 tbsp of flax seed daily.

          1. Liisa,

            What were your symptoms?

            I ask because my brain improved more with avocado and nuts and soy than anything.

            But I am reversing serious brain-damage and I was using the individual videos.

            I have watched many videos by Jeff, but I am probably more influenced by things like the Global Burden of Disease Risk and the studies with the Adventist vegans where the vegans who even within that group, the vegans who ate nuts lived longer than the vegans who didn’t eat nuts.

            For the brain health, I am more focused on the fact that there was less brain loss if Omega 3’s are kept at a sufficient level. I am not testing every year, but the supplementing slowed the loss of brain matter and I had such bad brain problems that I can’t afford to lose anymore brain matter.

            I am having strong improvements and have continued to improve.

            Lowering the fats do help with weight loss, but I intentionally take soy because of being post-menopausal.

            So I guess I would like to hear what your logic is.

            1. The thing that scares me is if we guess wrong and the studies where if you don’t produce enough Omega 3 are right, then you lose brain structure and volume more.

              I do know that there are other mechanisms and that starting to eat WFPB by age 50 can improve things by 90%, so WFPB is the biggest factor, but Jeff is against supplementing even if people are symptomatically deficient.

              I personally had challenged him on that in the past and, since that time, he came out and said it using the Okinawans anecdotally that because some of them are symptomatically deficient, that must mean it is okay.

              Reading that once women lose estrogen, they lose estrogen’s protective mechanism of increasing the levels of Omega 3 in the brain, I just do feel like I would rather waste money than risk losing more brain matter.

              1. Deb, I don’t understand why anyone would listen to Jeff Nelson (I assume that’s who you mean). As I think you know from previous posts about him, he has no medical credentials, let alone clinical experience (he was a film producer, as I recall). His views are not worth discussing, in my view.

                1. he has no medical credentials, let alone clinical experience (he was a film producer, as I recall). His views are not worth discussing, in my view.
                  gengo, I think your bias against non-credentialed individuals is unwarranted. Having someone from the “outside” having eyes on a subject often can solve for x when others remain unable to.

                  I remember reading some years ago about an Australian layman who solved one of those unsolvable physics problems for all the physicists (or maybe it was a mathematics problem… it’s been awhile) of the time. They of coursed dismissed his work until finally, someone realized he got it right and had to acknowledge his accomplishment.

                  Your statement suggests we discount what someone like Deb says as she has no formal training in nutrition that I know of.

                  Yet, because of the fact the world’s knowledge is available to anyone with a smart phone or Internet connection, she has become quite knowledgeable… as you yourself have become. ‘-)

                  1. Lonie, Well, of course, I think my bias is wise and so warranted, especially in applied fields like medicine and nutrition, where the consequences of bad advice can be serious. There are many untrained people hoping to build a following by promoting themselves as health gurus on the internet/youtube.
                    Caveat emptor. I acknowledge that of course, it is possible for some gifted amateur to make a significant contribution to any field, but the odds are much lower, and if it’s an area I am currently not on top of (like quantum gravity :-), I am unlikely to be able to spot the rare, important contribution among all the mediocre, misleading or possibly damaging material. So, why bother when there are so many exceptionally well-trained, highly educated professionals to learn from? In every case, if some claim effects my life, I do the best I can to investigate it in the course of making up my own mind. As far as this forum goes, I enjoy the interactions and have learned a lot from various contributors, in one case something very significant (possibly critical over the long term) for my wife’s future health (but I checked out what I was told very carefully).
                    Overall, I enjoy the interactions and see no essential conflict with my general bias. I even appreciate and have learned from some of your posts :-)

                    By the way, the example you gave was in mathematics: Austrian sci fi writer, Greg Egan, partially solved an outstanding, so-called superpermutation problem. I found that interesting.


                    Peace and cheers!

                    1. ‘Why do I discover these After publishing a note?’

                      Take comfort from the fact that you have a long way to go before you drop down to my level!

                    2. Lonie, Well, of course, I think my bias is wise and so warranted, especially in applied fields like medicine and nutrition, where the consequences of bad advice can be serious. There are many untrained people hoping to build a following by promoting themselves as health gurus on the internet/youtube.
                      Caveat emptor. I acknowledge that of course, it is possible for some gifted amateur to make a significant contribution to any field, but the odds are much lower, and if it’s an area I am currently not on top of (like quantum gravity :-), I am unlikely to be able to spot the rare, important contribution among all the mediocre, misleading or possibly damaging material. So, why bother when there are so many exceptionally well-trained, highly educated professionals to learn from?
                      To your point that there are many setting themselves up as Internet gurus etc., I think it is wrong to discourage people from reading what these groups offer.

                      Your own reply to Deb about the warm wet compresses to the eyes to ameliorate Dry Eye Syndrome (top shelf, by the way ‘-) shows you engage in what seems to have been an old wives tale.

                      I’m just sayin’ that by discouraging someone from reading popular remedy sites you may have caused them to miss something that might have made their lives better.

                      I believe most people are well enough informed to choose wisely what advice is worth following. In my own experience I have followed both good and bad advice. Eventually I realize the bad advice and drop it but in the meantime, I’ve benefited greatly from the good advice I kept.

                      But even for those who are not yet well enough informed and end up following advice that simply isn’t useful… well, they may at least be getting a placebo effect. ‘-)

                      I know, I know… you are probably thinking “but what about the harmful advice out there that may be life-threatening?!”

                      Well, I think you are right to discourage following those professinal pharmaceutical/medical doctor sites that may be life threatening. ‘-)

            2. I am still overweight and I lost some weight when eliminating fats. That, and I just feel better which I can’t explain! I was and am still wfpb.

              1. Yes, lowering fat can help with weight loss, but there are things for instance like the fact that Omega 3’s are involved in lowering Homocysteine


                And the fact that 1/3 of an ounce of nuts improved brain function in a study shared here recently, like we need to understand the logic from both sides and strike a balance.

                Dr Fuhrman was talking about how his vegan and near vegan mentors tested seriously low in DHA and ended up getting Parkinson’s.

                I am also lowering fat to lose more weight, but my brain improvements involved eating the healthy fats.

                1. I haven’t figured how to achieve that balance yet, but vegans can have higher or lower Homocysteine than everybody else depending on whether they do supplement B12 and Omega 3.

                2. Yes but Fuhrman’s argument is based on anecdotes.

                  Also, ‘vegans’ aren’t the same thing as WFPB dieters. What is more, many of them were Natural Hygienists who have some peculiar beliefs and practices. Further, I seriously doubt if they used supplements such as B12 and omega 3 for brain health (I believe it would be contrary to Natural Hygiene principles).

                  1. Tom,

                    Yes, his argument is anecdotal, and I do know that vegan is not necessarily the same as WFPB, but his change in position was not based on any old vegans. It was based on his highly-educated, clean-eating mentors and, yes, they probably didn’t supplement and he tested their levels and they were so low in DHA and that is what convinced him that supplementing was important.

                    He does read the studies, but he also leans on his clinical experience and seeing vegans with serious brain problems.

                    I felt that his response was sincere. People accuse him of being a slick salesman and I do not know him personally and my father was a salesman and Dr. Fuhrman may be one, but that is not all that he is. He also has an emotional side and I do believe that seeing his own mentors get Parkinson’s changed his viewpoint on supplementing.

                    1. Deb and Fumbles, And of course Dr. Fuhrman knows very well that his clinical observations are not conclusive. Here is what he said on the issue in his last rebuttal to Jeff Nelson, who has tried hard to smear him.


                      “ To be specific with one of the main issues here, I have reported that I have encountered some vegans, not supplementing with DHA, who have become demented, due to what I believe was from DHA deficiency. I also have encountered a few who developed Parkinson’s disease and some with low levels who have developed depression. Finding a limited number of these people does not demonstrate how rare or how prevalent this problem is. Nor does it mean for sure that the low DHA levels was the cause of their dementia or other problems. Therefore, I was instrumental in funding a study through the NRF of 166 un-supplemented vegans to ascertain the answer. That study, published in a peer reviewed journal, showed insufficiencies in about half and severe deficiencies in about a quarter.
                      These severe deficiencies were consistent with other studies that demonstrate brain shrinkage with aging with this level of deficiency.
                      Sure, more studies are always better, but we have to make a decision on the data we have and err on the side of caution.

                      Here’s his earlier response to Nelson, for those interested.

                    2. Thanks Gengo.

                      But isn’t that the point? They didn’t supplement with DHA (as we are advised to do here).and some WFPB dieters (unlike ‘vegans’) include oily fish in their diet which will provide DHA/EPA. In other words what happens with ‘vegans’ and/or Natural Hygienists isn’t necessarilyn a good guide to what happens with WFPB dieters who follow Dr G’s recommendations.

                      Of course, we may just be talking at cross purposes here ………..

                3. Deb, Not to mention that nuts are not particularly fattening because the fat is not well absorbed. Nuts get a bad rap.


                  “The calorie counts shown on food labels are computed from how much heat can be produced by the food in a laboratory. However, this method of measuring calories is meaningless for foods that are poorly absorbed. The number of calories listed on the label can be much higher than those a person actually absorbs; many of the potential calories pass through, undigested, in the person’s stool. This explains why blood fat levels are lower than expected after a person eats nuts. Another study showed that roasting almonds does not increase the absorption of fat over that absorbed from raw almonds (Br J Nutr, 2014 Nov 14;112(9):1521-9). Some of the fat that has passed through the upper intestines is absorbed after the nuts reach the colon, where bacteria ferment the cell walls to release some of the fat (*Am J Clin Nutr*, 2004 Sep;80(3):604-13)”

                  1. Gengo,

                    Intellectually, I totally agree with you, but I am heading toward 2 years on WFPB and I haven’t lost weight. I also haven’t gained weight.

                    I don’t know how much of it was the nuts and avocado, but I listened to Chef AJ say that she couldn’t lose weight even on one ounce of nuts and I seem to have the same problem.

                    The nuts may be a scapegoat. It might be the no-oil hummus or the beans or mushrooms or the no-oil ginger miso salad dressing or the Wasa rye crisps.

                    I do not understand the logic for how to lose weight on WFPB. That is the truth.

                    This morning I was up a pound and a half, but I was relieved, because yesterday, I had been down 8 tenths of a pound, but when I stepped on the scale last night, I was up 5 pounds, so my day and night swing is still there.

                    Anyway, I didn’t gain weight eating nuts. But I also haven’t really lost weight trying to do WFPB.

                    1. Deb, That’s mysterious and no doubt frustrating. People can certainly differ significantly in how they respond to food. I have the opposite problem.
                      Seemingly no matter how much I eat, including 25% fat from nuts (no oil) on a 100% WFPB diet, I remain slightly underweight (and despite regular, fairly vigorous weight training). Perhaps as I’ve read, it comes down to differences in gut microbiomes, not to simply “calories in” or calories from fat.

                    2. Deb

                      Your weight is going to vary during the day – depending on what you have eaten and drunk. And whether you have been to the toilet. That’s perectly norml.

                      Some people have lost a couple of pounds just by defecating once …. see Jenkins’ study on the effects if a very high fibre diet. On the other hand, just drinking four 8oz glasses of water will increase your weight by a couple pounds.

                      Weigh yourself at the same time once a week, after going to the toilet and before eating breakfast …. to get a better indication of how your weight is trending.

                  2. I got skinny on lower fat wfpb then gained by eating more, with more wholegrain carbs and beans (a few nuts and regular avocado but not a lot)

                    1. By the way, some of the fat from nuts is absorbed, so it’s not the case those wishing to lose weight or who are inactive people do not have to be moderate in their consumption.

              2. I understand that when dietary fat is restricted, the body releases fat from ‘adipose tissue’ to ensure adequate amounts of circulating fats. So, short term results of fat restriction may not be a good guide to the long term effects.

                On the other hand, people on the traditional Okinawan diet only consumed about 6% of total calories as fat and certainly didn’t seem to be at a mortaity disadvantage even compared to mainland Japanese who consumed 8% of calories as fat.

                However, despite their low fat consumption, they weren’t noted for high rates of Parkinson’s or other neurological diseases to my knowledge. About 20% of Okinawans, though, were reported to have nutritional deficiency symptoms. Mind you,. one of those symptoms was Bradycardia (something I appeared to have when I had an ECG a year or so ago). Bradycardia is usually defined as a resting heart rate of under 60 beats per minute. Athletes and physically active people often have Bradycardia.and the Okinawans were reported to be physically active. Also, there is a suggestion that if it is not caused by a pathological condition, it may even be beneficial:

                ‘Compared with 45 beats/min, the risk of all-cause mortality increased significantly with increasing resting heart rate in a linear relation, but a significantly increased risk of cardiovascular mortality was observed at 90 beats/min. Substantial heterogeneity and publication bias were detected.’

                Some nutritional deficiencies may be worth having it seems.

                1. Thank you for your post, Tom. I appreciate it! I typically seem to have a pulse in the 60’s. I have attributed that to being fairly active although not what I’d call athletic. I jog/run and walk on alternate days in addition to caregiving–which requires quite a bit of extra running around…. : )

                2. Fumbles,
                  I admit the Okinawans remain a bit of a mystery to me given how low in fat their traditional diet was. However, at least they did get DHA and EPA from the fish and I suppose, from the pigs they ate. Also their n6:n3 ratio was reasonable. So perhaps the kinds of fat and their ratios played a significant positive role in their longevity despite the extremely low quantities.

                  One reason I hesitate to draw general conclusions from the Okinawan statistics is that they are a small, genetically homogeneous population, and it is possible other populations would react differently to their traditional diet. I have never seen this issue discussed. Have you?

                  1. Not really but migration studies generally suggest that this is unlikely to be an issue. Most human cultures appear to have evolved on traditional high carb diets so I can’t imagine that Okinawans are special in that respect. Their experience might not be relevant to small etnic groups like Eskimoes and Masaai, who appear to have some genetic adaptations to high fat diets, true. However, for most of us, our civilisations/cultures largely developed on grain or tuber based diets and, except for the rich, I suspect that fat wasn’t plentiful in our ancestors’ diets either.

                    That said, there have been some studies that link Okinawans’ longevity with their genes so you certainly have a point.

                    However, Wilcox seems to attribute the benefits of the OD largely to calorie restriction, social connectedness and physical activity rather than to the diet itself. Or at least, that’s the impression I get. So fat consumption levels might not even be the issue there especially since neither DHA nor EPA are essential and the body can manufacture them.

                    Some people too have suggested that it is the saturated-unsaturated fat and/or the omega3-omega 6 ratio that is important rather than the amounts of fat that are important. In particular Simopoulis

                    However, the point I was trying to make was that low fat diets don’t necessarly lead to neurological problems. And that Fuhrman’s examples were a peculiar bunch who weren’t necessarily eating a WFPB diet like the Okinawans or people following Dr G’s optimal diet suggestions. They were instead Natural Hygienists and ‘vegans’ or ‘near vegans’.

                    I too hesitate to draw general conclusions from the Okinawan study and the Adventist study …. but that is because they were observational studies. However, where people are drawing conclusions based on other observations, like Fuhrman, I think it is fair to mention them where they appear to contradict those latter observations.

                    1. Thanks for the detailed reply and that interesting link.

                      >>>However, the point I was trying to make was that low fat diets don’t necessarly lead to neurological problems.

                      Definitely relevant to raise the Okinawan case. Overall I think we agree. My main point was simply that given the uncertainties, it seems wise to me to be ‘safe rather than sorry’ and follow the Greger/Fuhrman advice (or eat small amount of oily fish, which is not an option for me).

                3. I am consistently between 45 and 50 heart beats per minute and have been for the past decade, but I am an enthusiastic exerciser. Doctors raise their eyebrows and ask “is this normal?”

                  1. Barb, In my case, my waking RHR is between 43-48, sleeping it drops to 39-40 (I know from both a sleep test and wearing an O2 Vibe, which also records oxygen levels). However, my cardiologist has never expressed concern since it seems to be from years of aerobic and other exercise (several hours per day) and I have no evidence of an underlying cause (but I did have a procedure to correct an atrial flutter issue 5 years ago).

            3. That’s good news Deb Was avocado (& raw nuts?) the only difference that tested so well for you? Marked test difference?

        2. Barb,

          The only problem with that one is that they are saying to eat fish twice per week instead of taking the supplements.

          The last line is from someone who didn’t want to eat fish and they said,

          “But Dr Carrie Ruxton, from the industry-funded Health and Food Supplements Information Service (HSIS), said: “While I would prefer people to follow the government’s advice and eat more fish, this isn’t the reality and a daily omega-3 supplement – whether from fish oil or algae – can bridge the gap.”

          1. Yes of course, an industry rep! Can’t have pill sales lagging!

            If I remember correctly, Jeff said that although there is evidence that the okinawans were deficient in some nutrients, they were still one of the longest living people. I am paraphrasing, but i can find it.

            I would think that people have to read the study reviews and make the best decision they can for themselves. We get omega 3’s from various sources, including greens (as I understand it) and we sure get enough of those. In the studies I read today, I saw it repeated a few times that omega 3 deficiency is rare.

  3. Still eating my small tin of herring filets, just in case they have some undiscovered benefit. I have cut down from once a day to ~ once per week. Still doing the addition of balsamic vinegar, hemp protein, turmeric liquid, and piperine but also adding guacamole salsa.

    Eating this with ~ 10 Greek Kalamata Olives makes for a nice small meal. Not sure what the calorie count is but I feel as though I’m doing something akin to calorie restriction as this is normally my main meal (or only meal plus some healthy snacks.)

    But even if this is in some ways unhealthy, I feel I do enough other healthy things to more than cancel out any bad actors from the fish.

    After all, if our anti-oxidants don’t have anything to scavenge from oxidation, what happens then?

      1. Thanks Deb,

        In re: your ongoing chase for weight loss, I may have something for you later on.

        My neighbor is also battling her weight. I’ve ordered a whole body vibrator platform (to battle inflammation through the combining of the layered gut bacteria into a formation that increases Butyrate)… that also may help with weight loss.

        She’s gonna try mine out this weekend when she brings the kids over to play with Momma Cat’s four new babies.

        If she buys into this concept, I’ll let you know her results.

        1. That is cool, Lonie!

          I looked into those when my step-mother had a stroke.

          Things like that can increase neuroplasticity.

          I ended up choosing PEMF and LLLT and infrared light panels, but it was on my list of gadgets.

          I can’t remember why I didn’t choose it.

        2. Lonie, this article from Harvard gives a fuller perspective on the topic of fish /fish products
          They say 90% of the PCB’s, dioxins, pesticides etc in our food supply is non-seafood eg. meat, poultry, dairy, vegetables. They also point out the distinct health advantages.

          I am not promoting fish eating, though I cook it on occasion for pets. I just think that the point should be made that there are some health advantages to consuming fish (whether we care to eat it is another matter), and that there are a number of third-party tested contaminate-free fish oils on the market which are more reasonably priced than vegan options.

          As Fumbles pointed out a couple of times, there are heart-health benefits to taking fish oils or eating fish when it comes to secondary prevention. Dr Ornish recommends at least 2 grams of fish oil daily to his people.

          1. Barb, good link. I trust Harvard to put out good information and they have apparently weighed in on the positives vs the negatives of fish consumption to arrive at a generally regarded as safe conclusion.

            As a result I think I’ll occasionally up my herring filet fish consumption up to twice per week or more.

            Some have brought up that one reason not to eat fish is because of the plastics from the ocean that fish mistake as food.

            I’ve recently read (sorry no link) that those plastics are almost totally trapped in the fish’s gut and as long as you don’t eat the whole fish (read: sardines) you shouldn’t add to the plastics you already have inside you.

  4. another with faulty misleading premises. additionally ignores the numerous of studies showing benefits and/or long term harm from insufficient Omega 3 intake.

    1. Care to post some of these studies then?

      Remember, this is about omega supplementation for short term brain function – not long term nor whether there are benefits in other areas.

      And just what faulty misleading premises are you talking about anyway?

      You also ignore the fact that Dr Greger recommends that people take a daily omega 3 supplement.

  5. OK, even after reading all of the comments, I am confused by what the final recommendation is. You say that “if it were just about boosting brain function in the short term…”

    Well, is it or isn’t it “just about boosting brain function”? I have been taking plant-based DHA because You had recommended it, but after reading this blog post, I’m confused. Like everyone else, I’m happy to save my money on supplements, but if this is indeed a helpful benefit for someone who has been vegan for 30 years, then I will certainly continue to take it.

    But the blog is not clear, the way I read it.

    1. Odd. I thought that the last line of the blog was perfectly clear

      ‘ …What about the long term though? See Should Vegans Take DHA to Preserve Brain Function?.’…………..

  6. Think “what is the most current thinking.” Seeing that this blog is most current I would say spend your money elsewhere.

    But we are also assuming we are getting our essential fatty acids from food sources.

      1. “So, out of the six randomized controlled trials for DHA supplementation, four showed nothing, one showed a benefit, and one showed a harm.”

        1. WFPBRunner,

          Yes, but I believe the harm is based on toxins and heavy metals and microplastics in fish and fish oils. He has a lot of videos on that.

          He does still recommend vegans take 250 mg Plant-Based Omega 3’s.

          The logic for that is in the final link.

          1. Interesting interpretation Deb. That last video is 3 years old. This blog is his current message based on studies done.

            Don’t suppose they are gonna hurt you right? Only one study showed harm.

            Obviously more data needed.

            1. WFPBRunner,

              This blog was based on those videos and the video I am talking about is also linked.

              The thing is there are different mechanisms.

              They used to think fish oil helped with cardiovascular problems, but that is what it doesn’t help with and if you take fish oil or eat fish, you risk the fact that the oceans are contaminated and the PCB’s in the supplements and fish and other toxins in the supplements and fish and the microplastics in the fish are what cause harm.

              The Algae oil is not harvested from the polluted oceans.

              That is still on his recommendation and that is based on cerebrovascular studies and it only helps people when they are low in Omega 3’s and that happens as people get older and they stop converting ALA as well and women lose Estrogen and Estrogen increases available Omega 3’s in the body so that process stops at menopause and people lose a teaspoon of brain matter per year and taking the Plant-Based Omega 3 slows that process down.

              1. Deb

                The argument is that omega 3 oil doesn;t help with the primary prevention of cardiovascular disease in the general population.

                Secodary prevention and people with particular risk factors may be a dfferent matter.

                  1. Yes, I take a daily algal oil supplement as per Dr G’s suggestion


                    Another reason is that there are some studies which associate higher plasma omega 3 levels with lower overall mortality risk

                    ‘According to the study, which was funded by the National Institutes of Health (NIH), a higher Omega-3 Index was associated with a lower risk for total CVD events, total coronary heart disease events, and total strokes. The category most strongly associated with the Omega-3 Index was non-CV, non-cancer deaths – deaths from all other causes. This would suggest a wide spectrum of beneficial actions of EPA and DHA in the body that are not just linked with one pathological process (like plaque build up in arteries).
                    The link between higher omega-3 blood levels and lower risk for death has been reported in at least three other studies…’

                    Of course, there is the possibility that PUFA levels may just be a marker for fish consumption in the population as a whole (I don’t eat fish BTW but it needs to be said)

                    1. That’s fair enough but as Marro acknowledges the issue is is ‘far from settled.’

                      However, there is no evidence of harm from taking small amounts of DHA/EPA supplements to my knowledge and, as Dr G’s video shows, improving blood PUFA levels may be beneficial.

                      I was also a bit taken aback when he mentioned Christopher Ramsden approvingly. This is the guy who argues that LA vegetable oils are worse than saturated fats based on (reworked) stats from the old Minnesota and Sydney studies. Yet fails to adequately acknowledge that the dangers of trans fats weren’t really known in the 1960s and 1970s, which is why the studies didn’t even measure them and the spreads etc used in those studies contained significant amounts of trans fats (hydrogenated omega 6 fats in this instance). It’s litttle surprise that interventions supplying trans fats in place of saturated fats faild to show a benefit. He neverthelss argues that they show that omega 6 fats deliver adverse health effects. That seems positively disingenuous to me.

        2. WFPBRunner,

          Most of these studies are not long enough to reach a firm conclusion. A three-year period is far too short since cognitive issues typically do not reveal themselves until one is fairly old. Most people have enough “reserve” to keep them functioning cognitively at a ‘normal’ level for many decades.

      2. His advice for people to take 250 mg Plant-Based DHA does have more recent studies.

        That is the final video link at the bottom and that is what his current recommendation to supplement Plant-Based DHA is based on.

        In the video, you can see how the 250 mg was chosen.

        1. The way these blog posts are created, they seem to be taken verbatim from previous video transcripts. So the video may be several years old and surpassed by more recent videos, especially when they are in a series.

          I have learned to re-watch all the related videos so I get the latest info from the most recent video.

          And I do take the 250 mg Algae Omega 3’s.

          1. Not everyone has time for that. Each latest topic update should summarise the best recommendations. We dont benefit from deep details to so many prior studies that ultimately don’t help the final recommendation. Sure add them as an aside, but make them less prominent. It’s getting annoying, confusing and time sucking

    1. ‘But we are also assuming we are getting our essential fatty acids from food sources.’

      DHA and EPA are not essential fatty acids. ALA is (so is LA).

  7. Doing research on cytochrome c oxidase, I recently read that cytochrome c oxidase it is a respiratory enzyme that interacts directly with oxygen and catalyzes the last step in oxidative phosphorylation. The last step is where a lot of damaging free radical get generated when oxygen interacts with unsaturated fats. And the most unsaturated fats are the omaga 3’s. Got this info from “Cancer-The Metabolic Disease Unraveled” Gives convincing data explaining why most oils-liquid at room temperature(with the exception of extra virgin olive oil) should be avoided.

    1. Thanks for sharing that, Wayne!

      Yes, the doctors do not recommend oil, and I will say they also do not recommend olive oil.

      Dr. Greger did a series where they did the Mediterranean diet and gave half the people nuts and the other half olive oil and there was a significant improvement with the nut eaters.

      I think the video was named something about improving the Mediterranean diet.

    2. It’s probably tosh, Wayne. It’s something that saturated fat apologists have been claiming for years despite the fact that actual evidence shows that unhydrogenated liquid fats reduce cardiovascular disease whereas hard fats appear to increase it

      There are all sorts of sensational books out there which seem very plausible at first to us laypeople. The author of this one has written a number of other books describing similarly miraculous medcall cures All equally improbable, unfortunately. great stories though..

      Frankly, I’d stick with reports by panels of expert scientists for information on fats and human health rather than relying on the claims of authors who make their living selling sensational books. Or websites run by opinionated cranks like the WPF.. .

    1. Doreen, this is going to sound flippant but that’s not my intention.

      My own personal experience has been that if I sit in front of a fan’s air stream, my eyes water. Otherwise they do not.

      But I guess if you just aren’t making enough tears you can’t trick your eyes into watering.

        1. Interesting… and I noticed that prevention is to NOT have a fan blowing toward your face.

          But I’ve gotten my little one-room portable refrigerated air conditioner hooked up and working so I’m not using the fan other than when I’m out of the room. Reason I turn it on then is because it has an ionizing function and I’ve found that seems to clear up any excessive watering in my eyes.

          Lately I haven’t been dealing with any excessive watering as a natural state. Hardly any sleep needed to washed from my eyes each morning. No idea what I may have done differently but eyes seem to be performing well.

          (Interesting aside about the portable air conditioner… it produces water at a rate of from 2 to 3 gallons per day. This helps offset the cost of RO water from the city to run through my distiller in the winter time. I don’t dare drink it without further distillation as it goes through a plastic tank and who knows what may build up in that.)

      1. Deb,
        A very common problem for people with dry eye syndrome is their Meibomian glands do not secrete enough oily meibum, which prevents evaporation.of the eye’s tear film. Warm, wet compresses to open up those glands can be a big help. Drinking more water might not help unless one is truly dehydrated.

        Aside: drinking excessive water on a very low WFPB diet can result in hyponatremia (too little sodium in the blood) which can be serious, even deadly. Dr. Fuhrman says that those on his diet typically need only about 4 cups a day.

    2. Doreen,

      Here are sentences from Dr. Greger’s blog on the subject.

      A plant-based diet may actually be the best thing for patients with dry eye disease, those who wear contact lenses, and those who wish to maximize their tear secretions. People with dry eyes should be advised to lower protein, total fat, and cholesterol intake, and do the following:

      increase complex carbohydrates;
      increase vitamin A content (by eating red, orange, yellow, and dark green leafy vegetables);
      increase zinc and folate intake (by eating whole grains, beans, and raw vegetables, especially spinach);
      ensure sufficient vitamin B6 and potassium intake (by eating nuts, bananas, and beans);
      ensure sufficient vitamin C intake (by eating citrus);
      eliminate alcohol and caffeine;
      reduce sugar and salt intake; and
      consume six to eight glasses of water per day.

      1. It’s worth noting perhaps that we may consume significant amounts of water via boiled oats/potatoes/rice/beans etc and via tea/coffee consumption. Drinking so many actual glasses of water may not be required to achieve adequate hydration..

  8. Laughing

    I am going to take my Algae-based Omega 3 now.

    Dr. Greger, you put the final video link under the line so people don’t even see it.

    1. I wonder about the psychology of you doing it that way.

      Do you have an internal mental conflict within yourself?

      Are you mentally going back and forth between the study where there was harm and all of the studies where it was useless and is that causing you to hide the brain study a little bit?

      I am wondering because you chose this part of the story for the Flashback Friday and for this and in both cases, you linked the brain study, but in this one, it was even one stage removed, rather than made more prominent.

      I am not trying to psychoanalyze it, but it just seems like it is more important for vegans to know to take it for their brains versus knowing that it doesn’t work for heart health.

      Is it because of the conflicts out there in the WFPB community?

      Or is it just the process of how the videos become blogs?

      Dr Ornish said that he is the type of friend who just tells the truth.

      This would have been stronger and less confusing if you added the brain-health Omega 3’s in at the end and left the spend your money elsewhere sentences out.

      1. The way these blog posts are created, they seem to be taken verbatim from previous video transcripts. So the video may be several years old and surpassed by more recent videos, especially when they are in a series.

        I have learned to re-watch all the related videos so I get the latest info from the most recent video.

        And I do take the 250 mg Algae Omega 3’s.

        1. Yes, his blog has a final link below the solid line and I am posting most of that video transcript here, for people who are confused.

          About half of the dry weight of our brain is fat. Lower levels of the long-chain omega-3 fat DHA in some areas of Alzheimer’s brains got people thinking that maybe DHA was protective. Since the level of DHA in the brain tends to correlate with the level of DHA in the blood, one can do cross-sectional studies of dementia and pre-dementia patients, and they do tend to have lower levels of both long-chain omega-3s EPA and DHA circulating in their bloodstream. Now, this doesn’t necessarily mean that lower omega-3 levels cause cognitive impairment. It was just a snapshot in time; so, you don’t know which came first. Maybe the dementia led to a dietary deficiency, rather than a dietary deficiency leading to dementia.

          What you want is to measure long-chain omega-3 levels at the beginning and then follow people over time. And indeed, there may be a slower rate of cognitive decline in those that start out with higher levels. And, you can actually see the difference on MRI. Thousands of older men and women had their levels checked, and were scanned, and then re-scanned, and the brains of those with higher levels looked noticeably healthier five years later.

          The size of our brain actually shrinks as we get older, starting around age 20. Between ages 16 and 80, our brain loses about 1% of its volume every two to three years, such that by the time we’re in our 70s, our brain has lost 26% of its size, and ends up smaller than that of two- to three-year old children.

          As we age, our ability to make the long chain omega-3s, like DHA, from the short chain omega-3s in plant foods, such as flaxseeds, chia seeds, walnuts, and greens, may decline. And so, researchers compared DHA levels to brain volumes in the Framingham study, and lower DHA levels were associated with smaller brain volumes.

          But this was just from a snapshot in time, until this study was published. Higher EPA and DHA levels correlated with larger brain volume eight years later. While normal aging results in overall brain shrinkage, having lower long-chain omega-3s may signal increased risk. The only thing one would need now, to prove cause and effect, is a randomized, controlled trial showing we can actually slow brain loss by giving people extra long-chain omega-3s. But the trials to date showed no cognitive benefits from supplementation, until now.

          “[D]ouble-blind randomized interventional study” providing evidence, for the first time, that extra long-chain omega-3s “exert positive effects on brain functions in healthy older adults…” A significant improvement in executive function after six and a half months of supplementation, and significantly less brain shrinkage compared to placebo. This kind of gray matter shrinkage in the placebo might be considered just normal brain aging, but it was significantly slowed in the supplementation group. They also described changes in the white matter of the brain, increased fractional anisotropy, and decreases in mean and radial diffusivity—terms I’ve never heard of, but evidently, they imply greater structural integrity.

          So, having sufficient long-chain omega-3s—EPA and DHA—may be important for preserving brain function and structure. So, the next question becomes what’s sufficient, and how do you get there? The Framingham study found what appears to be a threshold value around an omega-3 index of 4.4, which is a measure of our EPA and DHA levels. Having more or much more than 4.4 didn’t seem to matter. But having less was associated with accelerated brain loss, equivalent to like an extra two years of brain aging. That comes out to be about a teaspoon less brain matter. So, it’s probably good to have an omega-3 index over 4.4.

          The problem is that people who don’t eat fishes may be under 4.4. Nearly two-thirds of vegans may fall below 4, suggesting a substantial number of vegans have an omega-3 status associated with accelerated brain aging. The average American just exceeds the threshold, at about 4.5. Though if you age and gender match for the vegans, ironically, the omnivores did just as bad. There’s not a lot of long-chains in Big Macs, either. But, having a nutrient status no worse than those eating a Standard American Diet is not saying much.

          All we need now is a study that gives those with such low levels some pollutant-free EPA and DHA, and see how much it takes to push people past the threshold. And, here we go. They took those eating vegan with levels under 4, gave them algae-derived EPA and DHA, and about 250mg a day took them from an average of 3.1 over the line to 4.8 within four months.

          And so, that’s why I recommend everyone eat a plant-based diet, along with contaminant-free EPA and DHA, to get the best of both worlds—omega-3 levels associated with brain preservation, while minimizing exposure to toxic pollutants.

          1. The most important sentences to me are:

            1) Nearly two-thirds of vegans may fall below 4, suggesting a substantial number of vegans have an omega-3 status associated with accelerated brain aging.

            2) They took those eating vegan with levels under 4, gave them algae-derived EPA and DHA, and about 250mg a day took them from an average of 3.1 over the line to 4.8 within four months

            3) A significant improvement in executive function after six and a half months of supplementation, and significantly less brain shrinkage compared to placebo.

          2. I really like this explanation. My Omega-3 level I tested with Cleveland heart labs is 3.7 and I eat 2 tablespoons of flaxseeds and 2 tablespoons of nuts/seeds daily.
            WFPB for 8 years. I am started taking 250 mg algae oil every other day since the Omega check. Cleveland heart labs did indicate excess DHA increases LDL so I am reluctant to take it every day.

      1. Though, honestly, looking at the studies, even that has mixed results in studies.


        Numerous randomized trials and observational studies have examined the relationship between DHA and cognitive decline or dementia. Despite the number of high-quality studies, the evidence is rated low because of inconsistent results. Our search identified:

        • 4 meta-analyses of randomized clinical trials in the elderly or people with mild cognitive impairment
        • 2 meta-analyses or systematic reviews of observational studies
        • 2 randomized controlled trials in elderly patients
        • Numerous preclinical studies that established a compelling biological rationale for potential benefit


        In one study, they showed that DHA alone resulted in less cognitive decline but only in people who had low levels of DHA at the start of the trial, which may explain why DHA (or DHA with EPA) have not slowed cognitive decline or improved cognition in other trials.

        But, as Dr. Greger showed in his Vegan brain health video, most vegans are low.

        That is why you supplement.

        Two factors that I have seen are that being post-menopausal and having the APOE4 allele can change how the body and brain processes long-chain omega-3 fatty acids such as DHA, those are factors why it can be more important for post-menopausal women to supplement.

        I think.

        That is my take on it based on what I have read, but I haven’t seen any doctors focusing on post-menopausal women. I just know that Estrogen is protective against Alzheimer’s and one of the mechanisms may be how it helps increase the Omega 3’s.

        1. ab,

          Different risk factors and different sources of Omega 3.

          Many supplements and fish sources have toxins and heavy metals, which are bad.

          The benefits end is for the brain and that is because you lose structure of the brain over the years and it is later in life. Estrogen decreases in women and suddenly they have less Omega 3 because Estrogen was protective over Omega 3.

          People get older and they start converting less ALA to Omega 3 – that is a long term issue, which comes with aging.

          It only helps people who are low in Omega 3. It isn’t something where higher doses help better, so when they are younger and converting ALA better or have things like Estrogen maximizing their Omega 3’s, that would be where you might not see the benefits until their system changed. Plus, they get older and gain weight and stop eating nuts and seeds and suddenly they have less ALA available.

          Does that make sense to you?

          1. I am overcoming brain problems and tend to think circles around everything, so if that wasn’t clear, maybe a moderator can help.

            I just thought of another way to explain the long-term benefits.

            Dr. Greger explained in the brain video that the brain shrinks about 1 teaspoon-full per year and the brain has a lot of DHA and taking the supplements doesn’t help through the mechanism of cardiovascular, it helps through the long-term benefit of slowing the loss of brain matter.

            1. The mechanisms for helping the heart which do work are diets like Dr. Ornish’s diet.

              Lowering saturated fats and oils and cholesterol and sugar and processed food and refined carbs.

              I say that because that way of improving cardiovascular conditions DOES also improve Cerebrovascular symptoms.

              But you have to understand mechanisms.

              Intaking fish from polluted waters and fish oils, which often test with the same pollution, is not helpful.

              But being low in Omega 3 is ALSO not helpful. You need food sources of ALA, like flaxseeds and nuts, and as you get older and can’t convert it as well, taking Algae-based Omega 3 works by the mechanism of slowing the shrinking of the brain.

              The thing is, if you are worried about brain health, Omega 3 alone is not enough. You need to eat a diet which doesn’t block your arteries, because blood flow to the brain is important and you need to eat your foods with folate and supplement B12 because Homocysteine levels are important and you need to learn where aluminum is entering your brain – through things like baked goods and sliced cheese and aluminum pans and aluminum foils and aluminum in personal care products, and you need to keep your blood sugar in check – by lowering saturated fats and refined carbs and simple sugars, etc.

              It is a list of mechanisms and Omega 3 is one.

    1. No contradiction.

      This blog discusses studies of the short term effects of supplementation whereas the video you reference goes on to describe the results of long term studies. In short, no benefits seen in short term studies but benefits have been seen in long term studies.

  9. I just got through looking at a email sent to me today by B. Sears, MD selling a squid DHA with Krill Oil DHA with Astraxanthin for 49 bucks/mo; he sites studies showing 200% increase in brain function in adults; not sure if he referenced it. Sounds like the study he quoted was new, however

    1. The problem with fish oil is that most test toxic.

      There is a benefit of DHA over time, but it is only a benefit if people are low in it.

  10. I agree that fish oil supplements usually are a waste of money. My diet is more than 96% whole plant with rare fish. I have a tablespoon of ground flax and a tablespoon of ground chia daily. But my triglycerides were > 2,000 with fatty white plasma and urine. Nothing worked and my arteries became stiff with multiple drug resistant severe hypertension. 4 grams of fish oil and zetia daily have brought the triglycerides to just above normal and my hypertension is still an issue but stable despite no salt, regular daily exercise, and a strict diet. No sleep apnea, etc. I think there are genetic variations that require exceptional care. I’d love to hear your thoughts on severe hypertriglyceridemia. Thank you.

    1. Robert and that is an excellent post, because things like hypertension decrease the conversion of ALA to Omega 3 by up to 50%, so people looking for a “one size fits all answer” may not know risk factors like that.

      1. I found an interesting sentence on T. Colin Campbell’s site:

        Randomized control trials show that triglycerides may either increase or decrease when switching to a plant-based diet; by less than 25 in either the up or down direction.

        That is interesting.

        He talked about avoiding alcohol, staying off things like fruit juice and smoothies, keeping saturated fats low, and not being sedentary.

        Dr Greger adds in his blog transcript on the topic:

        Regular consumption of fiber may help lower triglycerides. All whole plant foods contain fiber, but flax seeds, leafy greens, beans and whole grains are particularly rich sources. Beans and other legumes appear to be particularly effective at lowering triglyceride levels, though whether this is due to their fiber content or to specific phytonutrients has not yet been determined.

        Decreasing stress through regular exercise and meditation and decreasing the intake of saturated fat, cholesterol, and processed sugars are lifestyle interventions that may help lower triglyceride levels.

      2. I am going to tell you that looking on Colin’s page, he somehow treats it without omega 3’s, and he says not to take them for it. I don’t understand his logic yet.

        There has to be a logic, but I did find studies that it does lower it.

        And I also have read that people with blood pressure have trouble converting ALA.

        I am going to try to learn it from his side, too.

        1. I don’t know whether Colin thinks that the Omega 3 isn’t good at treating it or if he is anti Omega 3 and knows people could use it for that and he doesn’t want them to do it that way.

          I don’t know if he is highly anti-fat maybe or something.

    2. Robert, thank you for reminding people that there is such a .thing as genetic differences. Most of the patients sent to me are not ‘average’. That is why they are not responding to the usual prescriptions. They are always surprised when I ask about ethnicity. But different groups of people did have different diets, and they adapted to that diet. We can now test for certain genes that reveal some of those differences.

  11. Can you comment on the rates of ALA conversion to EPA and DHA, respectively?
    For a vegan looking to maximize the amount of both (ideally obtain at least 1200-1500 mg/day), what are the best sources/ are there strategies or methods your would recommend?
    On another note, I know not to heat or cook with flax oil or fish oil because it will oxidize the omega 3 fatty acids. However, people grill salmon and bake with flax all the time… what gives?

    1. Dr Greger said this in a blog:

      According to two of the most credible nutrition authorities, the World Health Organization and the European Food Safety Authority, we should get at least a half a percent of our calories from the short-chain omega-3 ALA. That’s easy: My Daily Dozen recommendation for one tablespoon of ground flaxseeds takes care of that.

      6 walnuts = 1 tablespoon of ground flaxseed if that is easier.

      For the supplement end, Dr. Greger used the Framingham study and another study, which I forgot the name, but they took those eating vegan with levels under 4, gave them algae-derived EPA and DHA, and about 250mg a day took them from an average of 3.1 over the line to 4.8 within four months.

    1. Damian,

      He still does recommend vegans to take it for brain health. Not for heart health.

      It only helps if you are low, so if you test high enough, you don’t need it, but if you are low, taking it can slow the degeneration of the brain and can lower homocysteine and both of those are what harms vegan brains. I don’t know if you are vegan, but vegans can have the highest homocysteine levels or the lowest and Omega 3 and B12 and eating your folate is how you get lower levels.

      1. Thanks Deb,

        Are you sure he still recommends it for brain health because his last line in regards to brain health seems to be a No. “four showed nothing, one showed a benefit, and one showed a harm. If it were just about boosting brain function in the short term, I’d err on the side of caution and spend my money elsewhere.” I didn’t know you could test for it, so thanks for the tip. Yes I’m vegan and my homocystine is a little higher than I think it should be, about 10-12, nothing bad but I note vegans are usually low around 5-6. I always take B12 and I eat tons of spinach a day, so I’m thinking the reason with me is my MTHFR gene defect, I’ve started on Active B12 with L-5-MTHF from seeking health which contains the active form of B9 (Folate).

        1. The one thing I am going to say is that a few of us have ended up insufficient with B-12 supplementing with the Methyl form.

          I ended up symptomatic and it went away when I changed B12.

          I say that because Methyl B12 isn’t shelf-stable and that is what most people use nowadays.

          Last I looked at PubMed, they said that if you are using a version other than Cyano, take more than one form together. They sell Methyl with Adenosyl or Hydroxo with Adenosyl, etc.

          I have interacted with enough people who have had problems while supplementing Methyl B12 that I just want you to have that on your radar.

          1. Thanks very much, I used to take 2000mg of cyano a week (I know 2500 is better). With the methly form I take 1000 a day sublingual as I did hear Dr Greger mention that. In fact Dr Greger recommended 2000mg a day if taking methly. The new Active B12 and B9 I mentioned above has methylcobalamin and adenosylcobalamin with an 80/20 split. I haven’t started taking it yet.

            1. Damian,

              Can you share the brand? I currently take Thorne Methyl-Guard (0.8 mg Folate, 0.8mg Methyl and 13 mg B6) to help with lowering homocysteine. I occasionally will take some Adenosyl/Hydroxy B12 or Cyanocobalamin as well.

              Sent from michael’s mobile

        2. He should not be so ambiguous, after dragging us through various studies with differing results, he leaves everyone confused what the recommendation is

          This whole presentation style is bad for adult learning. Is the intention for people to remember what good health habits to follow? Our brains tend to remember the 1sr thing we thought was the answer even if we quickly realised we’d jumped to the wrong conclusion, we still remember that

          1. It all seems pretty clear to me and i don’t see any ambiguity. We just have to read all of it since the last line of the blog post is “What about the long term though? See Should Vegans Take DHA to Preserve Brain Function?”

            What’s ambiguous about that?

            And the link to his recommendations is pinned to the site front page.

    1. Kate, I have done that same process, and it is frustrating.

      A lot of them have Carrageenan.

      I have been looking at Nested Naturals. It is GMP and it doesn’t have Carrageenan.

      It has hypromellose and candelilla wax and water.

      I looked up candelilla wax. It seems benign so far.

      It has 200 DHA and 100 EPA.

      I haven’t tried it yet, and some people talked about it having a taste.

      I have been using the brands at Vitamin Shoppe, and those do not have a taste, but they do have the stupid fillers.

      A lot of them have Carrageenan and sorbitol.

      I did see one on Amazon with just sorbitol and I haven’t looked that up.

      Mostly, you want GMP. Look for that.

      You want lab-tested and GMP whenever you order any supplement, particularly on-line.

      1. Deb, The Deva algal DHA/EPA also has no carrageenan or other objectionable ingredients, and the caps are vegan. Interestingly, it also has a taste, almost fishy. When I asked them about this, they replied that it is actually the algae that naturally has that taste and had nothing to do with rancidity. I think other brands add ingredients to cover up the natural taste and any rancidity.

    2. Consumerlabs tested the Deva Omega 3 – DHA and gave it top marks for value. But it is almost totally DHA. They also approved Ovega 3 Plant-based Omega. This contains EPA also but is significantly more expensive.

      However, you have to be a member to view the test results.

    1. It’s very expensive.

      I split my time between Australia and the Philippines, and usually buy my supplements from

      What supplier do you use in the UK.? Last time I looked, they tended to have a limited range of choices compared to the big US sites.

      1. Sorry but I have just noticed that the link you (Damian) supplied took me to the website and quoted a price in Australian dollars (and included free delivery). If you are buying direct from the UK, it may be cheaper.

  12. Then should us WFPB actually eat some fatty fish? A whole food improvement on 250 mg of DHA supplements daily (despite fish also being a cancer etc risk like meat?)? Which is the lesser evil?

        1. Gengogakusha and WFPB enthusiast, thank you for your comments! I value your input, and unfortunately my link didn’t post.

          If you have time, please check out table 4. The whole article is interesting but there you might notice what caught my attention
          years ago when Dr Greger talked about it in videos. As far as ischemic heart disease and cardiovascular disease, pesco vegetarians did anout the same as vegans roughly, but but markedly better where women are concerned. Check it out!

          I have heard the argument that the vegans were eating junk but I don’t buy it. The Adventists as a whole are well educated and their beliefs center on good self care. They have had educators like Dr Hans Diehl of CHIP program fame touting the value of whole plant foods for decades. Also, throughout the different tables please note the larger response of men to the vegan diet vs the women. It was noticed by the researchers. Anyway, for the level of serious disease we have in this household, I can not ignore things like this. Again, thank you for your comments

          1. Yes I was just talking overall results, (most benefit for males). Eggs and dairy carry high disease burdens, pity they were included in the pesce results

            That Harvard link did put the toxin load into perspective, thanks. Is it reliable or are big fish behind it? :O Then I remembered apparently radiation has spread everywhere and it’s hard to forget feeling revolted by what Dr Greger said about impacts from spread of diseases in seafood (warming waters). I don’t want to listen to that again

            A comparison noted the advents ate healthy foods overall, especially the more veg they were (the veg groups also slept more, less TV anf alcohol). It was a British study where the vegans (veg more for political or animal justice reasons) didn’t eat as much fibre or vitamin C and didn’t have the health benefits of the advents (vegan for health reasons).

          2. Thanks for the link, Barb. I had run across that study/table some time ago but forgot about it. I agree trying to pin differences in results on eating junk food in this case is suspect. The gender differences are a real mystery.

            The one thing I am convinced of though is that, as Dr. Greger and Dr.
            Fuhrman recommends, it is wise to include reasonable amounts of nuts/seeds in one’s diet. Adventist study results among others support that conclusion.

            1. Here’s a link to the conclusions about eating nuts among the Adventists.


              “In the following statistics, the percentages mentioned represent the groups eating nuts five or more times a week, as compared to those who ate nuts less than once a week. In the first example, the two sexes were evaluated separately and results compared. Men who ate nuts more than five times a week enjoyed a 40 percent risk and women a 52 percent risk, as compared to those who ate nuts less than once a week. Those less than 80 years old who ate nuts more than five times a week showed 47 percent the risk, and those more than 80 years old who ate nuts frequently had a relative risk of 45 percent compared to those individuals who ate nuts infrequently.”

              1. Thank you too gengogakusha! It’s amazing how powerful each element of the puzzle can be. So as slim vegetarian, avid exercising, normotensive, never-ever smokers, consuming whole wheat bread and nuts puts us in good stead. I will share a link I have had for years for a brief interview with the ‘boss’ Dr Hans Diehl. I was surprised to find that our daily menu for past decades was almost identical to the meals he enjoys.

            1. Yes Fumbles, that’s what we were discussing. And not by a small margin either.. it’s something I can’t easily dismiss.
              I have come across other types of studies in recent months where I noticed gender differences, but Dr Greger rarely mentions it.

              1. Barb

                Yes, some people have suggested that oestrogen may be the key factor here in explaing sex differences in the Adventist mortality results. It’s possible too that male vegans were particularly health conscious and exercised more which might explain their superior results vis-a-vis male pescatarians ….. but that’s just speculation on my part.

                Fortunately, as a man and non-fish eater, (for ethical reasons) I can take some comfort from the Adventist mortality study results for male ‘vegans’. The situation is much more difficult for women.

                On the plus side. a WFPB diet can include small amounts of animal food including – fish. What is more, mainstream dietary recommendations usually include two servings of oily fish per week. We also have to recognise I think that these can help people meet their B12, selenium, zinc, iodine, vitamin D etc needs as well as offering PUFAs. That is consistent with the Adventist results. [ Flying off into the wild blue yonder, the Aquatic Ape hypothesis even hints that we may have some adaptations to seafood consumption.]

                Not eating fish means we have to plan well to address those particular nutrient needs. Even more so, if we are averse to taking supplements.

                1. Your input is greatly appreciated Fumbles! Since you began the wfpb experience, you too must have received positive feedback from doctors on your bloodwork etc. For people in my situation, with my family history and personal history, the odds were not in my favor of living to this point. The fact that my bloodwork (other than cholesterol) comes back “perfect,” consistently, is a little reassuring to me, and really surprising to doctors. I have no doubt that eating wfpb puts us in good stead with most conditions life throws at us. I am also indebted to the contributions of NF forum participants like yourself who share their knowledge so generously. Thank you!

      1. Thanks very much for borh Barb. That advent study, as Dr Greger said before, found thst the vegans did the best (high fibre etc) followed by the pesce and octo lacto who were similar . But they considered pesce to also be octo.lacto which would introduce extra health risks

      2. Barb,

        The vegan males did the best.

        The fish eating women.

        Though Brenda Davis said that all of the groups of the Adventist’s ate such healthy food that there was very little difference between the diets.

        It wasn’t people eating fish every day.

        1. The pescatarians held a distinct advantage over the vegan females in the study Deb. It showed actual risk in being vegan as far as heart related issues. I supplied the link above. Check out Table 4

    1. My opinion – it’s a gray zone. No one really knows. I don’t eat fish but my wife eats sardines sometimes and I am reluctant to try to persuade her not to. Also Barb raised a very important point in her last post re: gender differences in the Adventist studies – women vegans fared much worse than pesco-veg. in the categories of ischemic heart disease and somewhat worse in cardiovascular disease. See her note and link. Men vegans did much better in those categories, skewing the overall statistics. It seems no one really knows why. Speculations are easy, but actionable information is elusive here.

      1. Yes. Now yourself or Barb will hopefully give me a reality check to stop feeling sickened :/ after Dr Gregor drew links between human disease effects and the spread of diseases in seafood. It’s hard to put it out of mind so I don’t want to look back at his video that I wish I hadn’t seen

        1. WFPB enthusiast, Fumbles or gengogakusha or others would offer advice but I am practical about these issues. First, don’t eat things that make you queasy no matter what the science says… just not a healthy habit.
          If I was a guy, I would be sticking closely to the wfpb pattern with the possible exception of two things. If I had to eat out on a special occasion, I would go for the cold water fish and salad/veggies. Also, if a friend or relative brought us a nice fish or fresh oysters etc, I would gratefully accept.
          As a woman I will continue to enjoy wfpb eating for the diverse benefits it provides (animals, planet, weight, health) and will consider adding a small amount of fish occasionally at the suggestion of my physicians.

          1. Thanks Barb. It was just Dr Gregers scary video I mentioned that revolted me :( even if the disease connection he mentioned was tentative, he said it was growing of course. Drama

            I’m reading other papers on the benefits and minimal risks, no mention of that stuff

            Also fish have lifestyles too. Although we all die somehow

          2. ‘If I was a guy, I would be sticking closely to the wfpb pattern’

            I’d still argue that a WFPB diet is not synonymous with a WFP diet – and that a WFP diet is merely a subset of WFPB diets. But then, I’m a broken record on this and various other points.

        2. Rob, I would respectfully suggest to you to read “The World Peace Diet” by Will Tuttle in the section about fish. You should be able to get a copy from your library. When I was contemplating fish consumption for health, that did it for me. I will not eat fish.

  13. Hey, Dr. Gregor. I found the following line very interesting: “…it appeared to make things worse. After 50 days, those who consumed the DHA had worse memory than those taking the placebo.” In 2015, I took CVS’ algae-based DHA supplant daily, as directed (

    In the first few weeks, I noticed a better state of mood throughout my days; however, shortly after a few months, my short-term and long-term memory became almost non-existent. It was a shock to me, because my memory was very sharp. I literally asked my peers “what just happened right now?” for a span of a few months. Up until the DHA supplements, I was a top student and remembered names and phone numbers with no struggle. I consulted with a psychiatrist, and he clueless as what happened.

    To diagnose if it was anything from my diet, I stopped taking the supplements, and my memory slowly recovered (it took 4 years to recover to—an estimate of—90%. I refuse to take any supplement now before there’s any research that shows side effects.

    1. Anon,

      May I ask if you are a male or female and your age?

      That is interesting to me.

      I had a mental breakdown years ago and have been recovering eating WFPB and supplementing.

      I do supplement Omega 3 and my memory is improving, so I am going through opposite but I am interested.

      Women talk about it near menopause related to lowering of estrogen. Women’s brains switch to keto and I have spoken to many women who do have cognitive problems during the transition.

      If you are a woman, I will look up Estrogen and DHA and things like that.

      1. I ended up reading the negative result study and it was with young women. College age.

        The positive 13 year study was with elderly people.

        I paused at the control capsule. Maize and soya oil.

        Gotta look up soya oil.

        Could they have chosen something better somehow?

  14. This article leaves me totally confused. I just want a simple yes or no. Should I keep taking DHA/EPA as recommended by Dr. Greger earlier?

    1. Read the last line of the blog post and click on the link there to get the answer

      ‘What about the long term though? See Should Vegans Take DHA to Preserve Brain Function?.’

      1. Mr. Fumblefingers,
        The blog say “don’t waste your money” and the link says “And so, that’s why I recommend everyone eat a plant-based diet, along with contaminant-free EPA and DHA, to get the best of both worlds—omega-3 levels associated with brain preservation, while minimizing exposure to toxic pollutants.”
        So which is it?????

        1. Perhaps I am missing something but I’m confused by your question since the answer seems crystal clear to me – take an algal EPA/DHA supplement (ie contaminant-free EPA and DHA). After al, he states

          ”that’s why I recommend everyone eat a plant-based diet, along with contaminant-free EPA and DHA’

          1. Just to add, the blog is about short term effects – none observed – whereas the video is about the long term effects of supplementation which show significant benefits

            As he says, it it were ONLY about short term effects, then don’t waste your money. But it isn’t just about short term effects for most of us. That’s the difference between the blog post and the video link.

    2. Joan,

      How old are you?

      The short-term study was on college-age students.

      The 13-year study where it showed long-term benefits was on elderly people.

      Before menopause, Estrogen is protective over a woman’s brain.

      After menopause, that protection is gone and suddenly, the shrinking of the brain increases along with the loss of brain matter and vasculature and there is also an increase of Homocysteine.

      Omega 3 helps with lowering Homocysteine, among other things.

      The truth is the science is mixed enough that probably nobody knows fully, but the long-term study, the people with higher Omega 3’s lost less brain matter over the course of 13 years.

      If you choose not to take Omega 3 and you are in the at-risk age-range, there is a point where the brain shrinkage can’t be reversed.

      What I will say is that you can take a memory test on-line and do your own study on yourself.

      I have something called a brain gauge and I can see which parts of my brain was damaged and that it is slowly healing, but there is one part of my brain, which isn’t healing at all and it is sometimes hard to get it back.

  15. I don’t know about this. Professor Arnold Ehret (Rational Fasting) showed that fasting and ridding the body of stored mucus and then existing on fruit only elevated brain function to a level that’s unheard of. We place too much emphasis on nutritive values of food and not enough on excreting the junk we’ve already accumulated. Is there something to be said about the rancidiy of the combinations of different substances we continually shove into the 98.6 degree cauldron that’s our stomach? Could the toxins that result from this actually be poisoning our system and making our brains sick?

    1. Ehret was a crackpot. Why would you take any notice of the claims of some crank who died in 922?

      As Wikipedia observes

      ‘His ideas about diet and disease have no scientific basis and have been criticized by medical experts as dangerous’

  16. Now I’m confused. This post says don’t bother to supplement, but the one I received today (and just read) says supplementing is probably a good idea in those who don’t eat fish (vegans). Or have I lost the plot (I do supplement with algae based, so shouldn’t have…)?

    1. Dr. Greger does recommend supplementing.

      This blog was the results of short-term studies on cardiac function, which weren’t all that promising.

      The next blog entry was based on the long-term studies on BRAIN structure and function and THOSE tip the scales toward supplementing.

      The science is conflicted and that isn’t Dr. Greger’s fault. He is showing both sides of the argument.

      For brain health, supplementing is a good idea.

    2. Dr G’s recommendation is to supplememt for long term brain health (2nd post). The 1st post observed that there is no known short term benefit.
      This is not inconsistent since it can take decades before any cognitive deficit would be noticeable.

      1. Thanks for the clarification.
        So not too late to take it mid to late 60s? If it is too late might as well save the money. Planning to live into our 90s. That’s decades. (But who knows?)

        1. >> So not too late to take it mid to late 60s? If it is too late might as well save the money. Planning to live into our 90s. That’s decades. (But who knows?) I would assume not but no one knows for sure. I’m being cautious and supplement. (I’m 72 and tell my doctor I plan to live till 102; next year it’;; be 103.)

  17. I know I said this before but….I am 74 and taking the supplement. Started 3 years ago. I also plan to live into my 90s but my mother (who lived to be 100) had Dementia so to me it is worth it to continue with the supplement. Who knows what else it might help and I haven’t heard of any downsides. I am WFPB so I take the algae supplement.

  18. I don’t know if it is just me but, it seems more and more to be the case that, should you be able to find sustainably sourced, “organic/free-range” fish, it might be a good idea to add this to one’s diet say twice a week.

    Of course, the fish should then not be dipped in egg and breadcrumbs and deep-fried ;) What are people’s thoughts around this? Could it be that a complete optimal diet is a wholefood, plant-based diet that includes fish?

    1. Hello Schalk,

      While fish may have been a part of a healthy diet centuries ago, unfortunately our waters are just far too polluted. Even organic fish will be subjected to PCBs and mercury, and surprisingly, freshwater fish tend to have higher mercury levels than saltwater fish. The 2 healthiest dietary groups in most large studies are those on strictly plant-based diets and those who are on plant-based diets plus some fish, but we now have access to algae-sourced supplements to provide us with DHA without any of the contaminants. Ultimately it’s up to the individual to make their decision, but for these reasons, I believe avoiding fish as much as possible is the healthier choice.

      I hope this helps,
      Dr. Matt, Health Support

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