Omega 3s, Prostate Cancer, and Atrial Fibrillation

Omega 3s, Prostate Cancer, and Atrial Fibrillation
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Fish and fish oil consumption do not appear to protect against heart disease, arrhythmias, or sudden death, but why would they increase cancer risk?

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2013 was a bad year for fish oil. Claims were crushed that the long chain omega-3s in fish oil, EPA, and DHA would stop the progression of heart disease. And then, DHA was associated with increased risk of prostate cancer and monumentally failed to treat macular degeneration. This over-the-top rhetoric sounded a little suspicious, and indeed, the paper was retracted because the author sells some rival supplement that he failed to disclose. But, he does have a point.

I covered the fish oil failure for heart disease. What about the increased cancer risk? Men with the highest circulating levels in their blood of the long chain omega-3 fat DHA were found to be at higher risk for prostate cancer.  Though, a subsequent compilation of all such studies suggested EPA, the other major long chain omega-3 in fish and fish oil, may be more closely associated with increased cancer risk. Either way, these long chain omega-3s have been promoted for prevention of heart disease and cancer.

But now, we know that not only does there appear to be no benefit for death, heart attack, or stroke, but there may be an elevation in cancer risk. The general recommendations to increase the intake of these fats should consider its potential risks.

How could eating more fish or fish oil increase cancer risk? Well, there are some industrial pollutants, like PCBs, linked to increased prostate cancer risk, and the primary source of exposure in the general population is believed to be through diet: from fish, meat, and dairy products. If you do a supermarket survey, the PCBs, shown in white here, are highest in freshwater fish, and lowest in vegans—cannibals take note! No, that’s just how they label the market basket of plant foods, though vegans have been tested, and they were found to be significantly less polluted, including the PCB linked to prostate cancer.

But, this study was done in North America where people don’t eat a lot of fish. And indeed, even the group with the highest DHA levels weren’t that high. And so, maybe the confounding factor was meat consumption in general, not just fish. And, lower meat consumption may be a reason for the lower rates of prostate cancer in the lower DHA group, as the consumption of well-done meat is associated with an increased risk of prostate cancer, and intake should be restricted.

We also used to think omega-3s could protect us from arrhythmias (abnormal heart rhythms), like atrial fibrillation. Millions suffer from the condition, which causes an irregular heartbeat and a higher risk of stroke and death, but fish and fish oil consumption does not appear effective for preventing it or treating it.

Other arrhythmias can be life-threatening and cause sudden death. Despite initial encouraging results, in more recent studies, fish and fish oil consumption have not only failed to reduce sudden cardiac death with omega-3s, but actually increased mortality in cardiac patients. For example, men with heart disease, advised to eat more oily fish, or supplied with fish oil capsules, were found to have a higher risk of cardiac death—maybe because of the contaminants in fish, such as mercury?

In either case, given the inconsistent benefits and the potential adverse effects, omega-3s must be prescribed with caution, and generalized recommendations to increase fish intake or to take fish oil capsules need to be reconsidered.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to Survivor via Pixabay.

2013 was a bad year for fish oil. Claims were crushed that the long chain omega-3s in fish oil, EPA, and DHA would stop the progression of heart disease. And then, DHA was associated with increased risk of prostate cancer and monumentally failed to treat macular degeneration. This over-the-top rhetoric sounded a little suspicious, and indeed, the paper was retracted because the author sells some rival supplement that he failed to disclose. But, he does have a point.

I covered the fish oil failure for heart disease. What about the increased cancer risk? Men with the highest circulating levels in their blood of the long chain omega-3 fat DHA were found to be at higher risk for prostate cancer.  Though, a subsequent compilation of all such studies suggested EPA, the other major long chain omega-3 in fish and fish oil, may be more closely associated with increased cancer risk. Either way, these long chain omega-3s have been promoted for prevention of heart disease and cancer.

But now, we know that not only does there appear to be no benefit for death, heart attack, or stroke, but there may be an elevation in cancer risk. The general recommendations to increase the intake of these fats should consider its potential risks.

How could eating more fish or fish oil increase cancer risk? Well, there are some industrial pollutants, like PCBs, linked to increased prostate cancer risk, and the primary source of exposure in the general population is believed to be through diet: from fish, meat, and dairy products. If you do a supermarket survey, the PCBs, shown in white here, are highest in freshwater fish, and lowest in vegans—cannibals take note! No, that’s just how they label the market basket of plant foods, though vegans have been tested, and they were found to be significantly less polluted, including the PCB linked to prostate cancer.

But, this study was done in North America where people don’t eat a lot of fish. And indeed, even the group with the highest DHA levels weren’t that high. And so, maybe the confounding factor was meat consumption in general, not just fish. And, lower meat consumption may be a reason for the lower rates of prostate cancer in the lower DHA group, as the consumption of well-done meat is associated with an increased risk of prostate cancer, and intake should be restricted.

We also used to think omega-3s could protect us from arrhythmias (abnormal heart rhythms), like atrial fibrillation. Millions suffer from the condition, which causes an irregular heartbeat and a higher risk of stroke and death, but fish and fish oil consumption does not appear effective for preventing it or treating it.

Other arrhythmias can be life-threatening and cause sudden death. Despite initial encouraging results, in more recent studies, fish and fish oil consumption have not only failed to reduce sudden cardiac death with omega-3s, but actually increased mortality in cardiac patients. For example, men with heart disease, advised to eat more oily fish, or supplied with fish oil capsules, were found to have a higher risk of cardiac death—maybe because of the contaminants in fish, such as mercury?

In either case, given the inconsistent benefits and the potential adverse effects, omega-3s must be prescribed with caution, and generalized recommendations to increase fish intake or to take fish oil capsules need to be reconsidered.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

Images thanks to Survivor via Pixabay.

Doctor's Note

Fish oil doesn’t help with heart disease?! I was as surprised as you. See: Is Fish Oil Just Snake Oil?

In terms of PCB contamination, see Food Sources of PCB Chemical Pollutants and PCBs in Children’s Fish Oil Supplements. Our oceans and waterways have become humanity’s sewer—everything eventually flows into the sea. For discussion of all the other industrial contaminants that build up in the aquatic food chain, see:

For ways to decrease the risk of prostate cancer and slow its progression, see:

If you haven’t yet, you can subscribe to my videos for free by clicking here.

180 responses to “Omega 3s, Prostate Cancer, and Atrial Fibrillation

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        1. Omega 3 ratio to omega 6 is this still correct as explained by Dr.Greger in the above youtube link for the prevention of heart attack heart ? Thank you Dr. Greger for all your work.




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          1. Hello

            What I am saying is, Do we need to be sure to get Omega-3 from flax seed if “Fish and fish oil consumption do not appear to protect against heart disease, arrhythmias, or sudden death,”
            The above Quote, seems to state that Omega-3 from fish oil does not protect a 40 year old Vegan from a heart attack.
            I am 65 year old, been a Vegan for 5 years, grew up as a Vegetarian till I was 16, But ate the SAD diet after leaving home.




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      1. How well does your human body convert the omega 3s in plants into the long chain 3s that the fish and microalgae supplements provide? What factors does it depend on? I understand that hemp’s omega 3s are in a form that may be more readily converted than the form in most other plant foods. Are you addressing those issues, Dr. G?




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        1. Because omega 3s are also very susceptible to oxidation from heat (and even light), I’m wondering whether studies of Japanese men, who often eat fish raw, show the same results as studies of western men. What do studies from Japan show about fish and prostate cancer? Might cooking methods also be a confounding factor?




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      1. Joseph, I tried to post a question on “Ask the dietitian” but could not find an active link. My question concerns amla. I have found that a little cooking of the fresh amla actually gives it a pretty good taste. Mixed with beans greens mushrooms flax and spices it helps make for a super healthy breakfast. I know that dried is still super strong in phyto nutrients but what about cooked?




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        1. I am not sure if cooking would deactivate any compounds in the amla. It’s unlikely. I searched a bit, and what do you know, I was wrong. It looks like cooking amla can ruin some of the vitamin C, but it doesn’t say much about other components in amla.




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          1. Phenol Explorer can be helpful (sometimes) for finding out the polyphenols in various plants and how cooking affects them. Here’s a link showing the polyphenols in gooseberries. http://phenol-explorer.eu/contents/food/91 Unfortunately, the researchers haven’t posted any info yet on how cooking affects those polyphenols. But note that many of the polyphenols are anthocyanins, and berry researcher Dr. Mary Ann Lila cautions that anthocyanins are quite heat-sensitive. http://zesterdaily.com/cooking/tips-picking-unseasonal-berries/ Until the research is certain, perhaps the most useful strategy is to hedge your bets by combining some raw with the cooked.




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    1. Good catch Chris. However this article and the one on NPR did downplay just what the report said. I heard an interview with the head of the WHO and he recited all the carcinogens in read meat after noting the nitrosamines in all processed meat. He said there is no safe level of consumption of bacon and processed meat. The BBC says an occasional bacon sandwich is OK. The head of WHO on the other hand emphasized that there is no safe lower intake and that red meat is still carcinogenic.

      Specifically he noted the heterocyclic amines and polycyclic aromatic hydrocarbons in all meat that everyone should be concerned with.

      I haven’t read the actual report yet but I’m thinking tobacco company tactics.




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  1. I think a meal or two of oily fish per week keeps skin on back of my hands supple, rather than cracking painfully during cold, dry winter weather. Has anyone else noticed this? Manitoba winters were most memorable, but hands will crack in Ontario and Michigan when temperatures drop.




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        1. There’s a sign beside the fresh fish at my local Costco that warns that fish consumption should be limited.

          Reading through the recommendations, you are right! They say you should limit it to twice a week or once a week or less depending on the type of fish consumed. My bad!

          It’s actually the only meat I’ve eaten in the past year and that is about once every six months. I do this because my family still eats meat and it’s the only thing I will prepare for them for holidays when they come over.

          Here is a video on the subject from this website: http://nutritionfacts.org/video/nerves-of-mercury/

          Here is the EPA website and its recommendations: http://water.epa.gov/scitech/swguidance/fishshellfish/outreach/advice_index.cfm

          Here is another webpage from the EPA site offers specific info on fish from lakes and streams: http://www2.epa.gov/fish-tech

          Also remember that farmed fish contains dioxins: http://nutritionfacts.org/video/dioxins-in-u-s-farm-raised-catfish/

          You can also find a lot of articles on the NIH website. http://search.nih.gov/search?utf8=%E2%9C%93&affiliate=nih&query=fish+consumption+advisories




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  2. How about soy and the prevention of prostate cancer? Based on the Adventist Health Study showing men who drank more than one cup of soymilk per day had a reduced chance of prostate cancer, my husband is considering upping his soymilk intake. However, there’s also information that soy contributes to health problems like thyroid disease and intestinal permeability. Recommendations?




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    1. I think it’s important to choose whole food sources of soy. This includes edamame, tofu, miso, and tempeh. Some groups like the American Institute for Cancer Research consider soymilk a whole soy food. Where we run into trouble is the soy isoflavone pills and soy protein powders. One major concern with dairy milk is the hormones. By choosing soymilk and other plant milks you can bypass the animal protein and hormones found in cow’s milk. Dr. Greger has a video explaining how swapping soy protein for dairy protein may help lower body weight. I think the only time soy can disrupt thyroid disorders is when iodine is lacking in the diet. Dr. Greger covers this nicely in his Q&A: Can Soy Suppress the Thyroid. If someone is on medication for a thyroid disease they shouldn’t eat soy like an hour before or after taking it, but they can certainly still eat soy if they wish.




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      1. Dr. Greger once stated that the maximum daily safe levels of soy are 3-5 servings. This is a bit confusing as a serving of Tofurky sausage (100 grams) has 29 grams of protein and 280 calories (almost identical to a Cup of soy beans, actually), a serving of Woodstock Tofu (79 grams) has 8 grams of protein and 90 calories, and a Boca Burger (71 grams) with the dreaded soy isolate has 17 grams of protein and 90 calories. So… three to five Tofurky sausages a day sounds a bit high. How does he measure “a serving”? Is it based on total protein content, or something else?




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        1. It gets harder when we consider faux meats. I’d say a serving is whatever is on the package. So like one sausage, 3-4 slices of the faux deli meat, etc.

          Typically one serving of soy is the equivalent of 1 cup of fortified soymilk, a 1/2 cup of tofu, or a 1/2 cup of cooked soybeans.

          I hope that helps a bit.




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          1. Well, since Dr. Greger based his recommendations on a very specific unit of measurement from peer-reviewed studies, it would of course be best to know precisely what that was… otherwise, we are doing little more than guessing. Any chance you could ask him? Some of us are very reliant on soy products and it would be a shame if we were accidentally eating double his recommendations due to a misunderstanding.




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            1. It does seem to get confusing when talking about faux soy meats and products. I am not sure this will help but the USDA has a reference for the isoflavanone content of foods per 100 gm servings http://www.ars.usda.gov/SP2UserFiles/Place/80400525/Data/isoflav/Isoflav_R2.pdf and http://www.ars.usda.gov/SP2UserFiles/Place/80400525/Data/isoflav/Isoflav_R2.pdf. and Dr greger talks about soy protective effects here – http://nutritionfacts.org/video/breast-cancer-survival-and-soy. 100 gms of Extra firm tofu has about 23 mg of isoflavonones. Dried frozed tofu has 83 mg.(too much?) I think 20-40 mg of isoflavonoes may be a good range to get per day.




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              1. Dara, I appreciate your thoughts on this, but surely there must have been a specific amount of protein or something else that Dr. Greger used to make his determinations on the daily serving maximum. I just don’t think this should involve conjecture and guesswork on our part if Dr. Greger already has the information and has based a whole video on it. I’m just hoping Joe Gonzales would be willing to find it for us, as it would be most helpful!




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                1. Russell, . Unfortunately there is a conundrum of eating a whole food plant based diet. On the one hand we are eating plants as a strategy, on the other hand we want to look at what we are doing and confirm we are targeting precise and healthy intake of nutrients. There will always be an important interplay between these two important notions. I certainly hope Joe Gonzales responds to your request.




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                  1. Dara, you are so right! I learned my lesson the hard way two years ago when I went fully vegan and developed a host of health issues including muscle pulls all over my body, low energy and fatigue, etc. Had to stop weight lifting and running due to so many weird musculoskeletal injuries. A year later, I found cronometer.com due to the great people on this site, and found my protein was at only 25 grams/day, got tested and was found to be anemic, low potassium, low calcium, etc. Quickly modified my diet, and fortunately my body is almost 100% normal again. My lesson is that plants alone without appropriate oversight and balance can cause a lot of problems. So… that’s one reason I’ve been asking this question of Joe. It would be great to nail down the exact amounts of soy that would be excessive, based on the true definition used in the studies of what constitutes “a serving”. I remain a committed vegan, but I now recognize the dangers of not doing it correctly.




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                    1. >> My lesson is that plants alone without appropriate oversight and balance can cause a lot of problems.

                      I think this is an important statement for vegetarians/vegans to acknowledge and deal with, but instead so often they get defensive and feel challenged.

                      I know it would be monotonous, but I wish someone would come out with some daily eating suggestions that would cover all the nutrition someone would need from plant sources.

                      Just one menu would be nice to get an idea of how much, how varied, how expensive and how long it would take to shop for and cook. Just start with one day, that would minimize cost and time and build from there.

                      For example, just for the mineral potassium getting like, I think it is over 4 grams of the stuff daily is a major problem on any diet that I can see. And how do we actually know what is really in the food that we buy as opposed to some test foods that experimenters analyze?




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          2. I am also puzzled by what determines a serving of soy – is it the protein content? According to Chronometer, four servings of cooked soybeans will yield 57 grams of protein, while four servings of soy milk yields 36 grams. How do we know if we’re getting too much?




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          3. Joe, I apologize if I’m being pushy, but just wondering if you think Dr. Greger would be willing to provide us this information? It sure would help take the mystery out of the discussion! Thanks much.




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            1. Oh no you are fine. I see what you are saying. Dr. Greger says that the soy protein analogs tend to have more concentrated protein. He prefer folks choose whole soy foods (tofu, edamame, tempeh). In his video on soy where he says 3-5 servings he indeed means a “serving” but it’s not clear how a serving is defined. Every study that measures soy varies and some researchers will look at isoflavone levels or total soy protein. The USDA bases servings on ounce equivalents . All I was trying to get at was that the soy-based meats are a little harder to determine what constitutes a serving. That is why I suggested looking at the package to see what each company lists. Looking at Dr. David Jenkin’s work, soy protein analogs (like hot dogs, veggie burgers, and soy deli slices) were given at around 43 grams per day. That is not far off from the 3-5 servings of soy recommended.




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              1. Thanks. So, according to the USDA, men need about 6 ounce-equivalents a day, and their examples illustrate that this would mean three soy burger patties/day. As you noted, Jenkins’ work uses 43 grams of soy to demonstrate that one can effectively lower cholesterol similarly to statins. But neither source addresses concerns over high IGF-1, which Dr. Greger did, with his recommendation to keep soy intake below 3-5 servings/day. So… again I find myself wondering what Dr. Greger means. Was he referring to a specific measure of total soy protein, or isoflavones? If he’s not willing or too busy to provide that information, I guess the fallback is for those of us who are concerned about this to do IGF-1 testing on an individual basis and try to stay under carnivore levels.




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                1. He is reading the studies just like we are, so referring to the science (especially the studies he lists in his soy video where he gives the 3-5 servings/day) is the best bet. If you have read thru them and still need clarification I am happy to bug him again. When I wrote my paper, I found studies that took into account isoflavone intake and also total protein intake. Applying the precautionary principle to nutrition and cancer. It just varies per study.




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    1. Oh I loves me some fish sauce! Good thing it doesn’t take much. Fish sauce has been named here in a video or two in a negative light, but I don’t think my extremely small volume of consumption could ever cause a problem.




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  3. Looks like the video is only working on Firefox and IE – Come on Greger, sort this out, it’s not as if you’re busy trying to save the world….




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    1. Haha! He’s been on the phone with AT&T all morning! No, in truth, we’re aware of the problem and sorting out. It’s viewable from IE or Safari.




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  4. As I understand from the video, fish oil is bad not because of the DHA and EPA but because of the contaminants. I take algal DHA daily, which is supposedly free of contaminants, so it’s presumably alright? Human breast milk contains DHA, which wouldn’t be the case, if DHA were bad.




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  5. Dang. I just started taking Krill Oil supplements based largely on recommendations that I attributed (perhaps incorrectly) to Joel Fuhrman — also a very well-respected promoter of a plant-based diet.

    So, did I misinterpret his recommendations?




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      1. You could bypass the industrial fish ideology as the fish get the oil from plants (algae). Why not get it straight from the plants? Look for algae derived dha-epa products or flax seeds, walnuts, etc.




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    1. Krill oil, like fish oil, comes from open ocean harvest. And so they are exposed to the same environmental toxin load as fish. Krill is lower on the food chain and so it is possible that the amount of these toxins in the refined oil is less than fish oil. However, there is no need to consume either. Algae oil come from algae grown in closed system tanks and are thus never exposed to environmental toxins. The DHA and EPA from these algae are chemically identical to that in krill and fish oil, so if you are going to continue with DHA and EPA suppliments, there is no reason to not switch to algae oil and many to switch.




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      1. Hello. Dr. Mercola is a vegetable juicer. He is not, I guess, a smoothie person. I am also more interested in Vegetable Juicing that fruit smoothies. Vegetable juice people are, I guess, more interested in vitamins than other vegans. I drink tea all day. Is that a further distinction? I enjoy Dr. Mercola’s coverage of vitamins, though he not support our diet. Dr. Weil and Dr. Mercola have excellent coverage of vitamins. Could you imagine if the standard treatment for any disease would include a Whole Food Plant Based diet addition, a vitamin, and a herbal supplement? Do you take Vegan DHA and EPA? I did and would like to refresh my supply I took it everyday just like Dr. Greger said. I don’t know if it made me smarter, I think so…




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  6. What to do if a congenital hypertriglceridemia of > 2,000 resistant to diet, exercise, and statins but 164 on(prescription: Lovaza) fish oil and Zetia? ( When first detected I was 157 lbs., 5′ 10″, ran >100 miles/week and vegetarian.)




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    1. Dr. Greger has a video on Amla and Triglycerides. “Boosted their good cholesterol, and cut their triglycerides in half!” Amla Versus Diabetes. http://nutritionfacts.org/video/amla-versus-diabetes/ I am glad your Triglycerides are well controlled on your medication. I think you have a real medical mystery as to why they are so high. You must be the exact case that would stump the plant based diet. You would perplex modern medicine and confuse a dietician. I am sorry you are made to take fish oil pills and medicine you don’t want. I also had high triglycerides until I started taking high dose Niacin (two grams a day). Thank you for your post. Is mercury of concern to you? Perhaps sunflower seeds and kale would help remove some of the heavy metals.




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    2. If it is was that high on a vegetarian diet, try a plant focused diet with some (non-processed) meat. Or alternatively a high fibre, lowish carb diet. You may be surprised. Interested to see what your triglyceride levels would be then. As far as I know, no know harmful effects above levels of 1000-1200.




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      1. Pancreatitis, pancreatic cysts, pancreatic failure can occur with very high triglycercerides, not only causing severe morbidity, but severe pain, and some reports of death. Very high triglycerides is a very dangerous condition.




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  7. Docyor, you say fish oi tablets l should be prescribed with caution. Are there situations where it would be appropriate to prescribe it? My doctor has prescribed it and I would like to understand circumstances where it IS. appropriate so I can have an informed discussion.




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      1. Thank you . I have not seen these algae based DHA in Walmart where my pharmacy is. Perhaps I am not looking for the right thing? Do I need to go to some specialized store? Is there a brand name you recommend?

        Also your post seems to imply that fish oil tablets are never appropriate – a tad different from – prescribe with caution. Did I understand you correctly?




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  8. Is there any update on the supposed prevention of Parkinsons by supplementing with DHA? I thought I read that men in particular have trouble using food sources alone to get adequate blood levels.




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  9. Fish oil shows no benefit in later studies because the sample groups have heart disease already, are on statins and other so called wonders of medicine. It’s too late for them. The question or study should be are they beneficial for healthy people. Most evidence says yes plus quality fish oil doesn’t contain toxins.




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    1. Following your own pattern of reasoning, people that benefited from fish oil did so because of an unhealthy/unbalanced diet. Address the cause and leave the oil on the shelf. It would fix so many other things that it would not fit on commercials like those of fishy oils. Once you are free of problems you don’t need the companies to save you with their products.




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  10. Is it the fish that’s bad or the Omega 3’s? Usually the videos make a clear distinction between animal and plant foods but here you end with ‘omega 3’s must be prescribed with caution’.

    A walnut is basically shaped like a heart – it’s GOTTA be good for it! (#logic)




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    1. In this case it seems like both fish and fish oil may be poor choices. When he mentions omega-3’s in the article he is referring to fish oil. Walnuts are different ball game :-) A+ for good logic, S Slavin. Thanks for your note.




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    2. Oil is not a natural food. It is a man made food created through a complex process and causing havoc. You never see the fish it came from. In contrast, a walnut is natural food and you can see it and taste it. There is no grinder or hidden surprises.




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      1. Agreed, but the video also says fish itself, which is naturally oily, is not good – although perhaps its the contaminants and not the oils itself.




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        1. There are a lot of things going on. Some people kill bears to extract the gall bladder juice. They are only interested in the economical gains and belief it is their right to cause harm. The bear is left dead because of an ideology dumb. Concentrated sources of animal protein actually cause problems and shift the balance of bacteria to gram negative which release toxic substances among other things. Fix the ideology.




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    1. I’ll add it to the list! I send Dr. Greger all inquiries like this so really it’s everyone who asks questions and visits the site who gives him video ammunition :-) Thanks, Acreech.




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    2. If you are taking about the THRIVE study they are garbage. The Pharmacy companies with NIH took a large group of people, medicated them and selected from them a group with perfect blood lipids, and then put this group of people with perfect blood lipids on a mixture of medicine, with one group on Niacin and a statin. The group on Niacin and a Statin had 10 point higher HDL. The study was stopped when there was no benefit found. Why would you put people with perfect blood lipids on statins? Why would you try to say that HDL doesn’t matter now just to sell Statins? Why, of why, should we care so much about NIH and pharmacy money when Niacin reduces Lipoprotein (A) and Statins do not and there still was the possibility that in this very study Niacin reduces heart attacks? Dr. Greger says he likes to stay away from Industry bias. This study was designed to fall, is bad medicine, represents corporate greed, and is as flawed and spun as could be, it was funded by the drug companies. Niacin could add many years to your life.




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    1. Can you try on a different browser? Our team is eagerly looking into the problem. I know it’s not the same but the transcripts are still viewable.




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  11. The video mentions the cancer risk from meat. Today we are hearing about a WHO study of 800 studies that says processed meat is a carcinogen ( esp. bowel cancer) and red meat is a probable carcinogen. And yet recent videos here seem to suggest that chicken is a greater risk (AGEs for instance). So why the traditional demonization of red meat in particular?




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    1. flaxseed has become a new staple of my diet. very beneficial and tasty and easy to incorporate via sprinkling over, baking in, straight up…




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    1. Ugh so sorry we are tackling this currently. Reading the transcripts can bypass any fuzziness but I know all will be back in order soon. Thanks for your patience.




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  12. Is PCB concentration something that will decrease when you stop eating fish, diary, etc? I used to eat a lot of fish, but in the form of sushi 20-30 years ago, but over time as the issue of contamination in fish came up I gave it up both for health but also because the oceans are being severely over-fished. So if I had PCB’s or other toxins from eating fish at that time would it necessarily decrease or go away?

    My eye doctor of all people suggested I take fish oil regularly, but I never saw the need for that and it makes me wonder where medical advice like that comes from. If doctors are going to pile risk and expenses on people like that, I don’t see what good they are in some cases. This was the same eye doctor who had two practices and got my prescription wrong for some very expensive special glasses. You don’t always get what you pay for, or anything at all from the medical industry.




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      1. I did not buy into my eye doctors talk about fish oil for my eyes. In fact I thought it as silly without any explanation as to why. He said he could tell from my eyes, which I had heard before that I had some BP problems or beginning type-2 diabetes, but other subsequent doctors have said no, with no prompting, and after I specifically asked. You never know what a doctor’s priorities or thoughts are. They think ( present company excepted, of course ) that they are smart enough to ignore anything a patient says and decide for themselves what is going on without having to make a case or argument. I can understand they don’t want to engage in arguments or alienate patients, it is a business and political decision, so one ends up just having to make the best guess on can about parsing and sorting out information and priorities. I have moved the needle way over to the WFPB diet, but I don’t know that the last little bit is going to make a difference or might let me miss out on some nutrition there is in some animal products. I know that is fighting words for some here and maybe in the future might see things different.

        I know in general the less animal products I eat the lighter and more awake I feel, so I let that guide me and program my body. It is useless to try to fight your body about what it thinks it wants or needs … you body will win out eventually. I think one needs to find a way to reprogram their body, and that is the hardest thing to really do … no good technology or pill for that, that I know of. ;-)

        By the way, you know that the general rule for half-life is like 5 to 6 half-lives is generally regarded as gone at least in engineering …reduced to 3% of max, … so that is a bit of a long time … another 40 years. Why we need to put this stuff in our environment is beyond me. The greed impulse is just as dangerous or more than being carnivore.




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  13. This has possibly been addressed elsewhere but I must wonder about the Asian population. They consume fish the way Americans consume ice cream, cheeseburgers and pizza; however, they have among the lowest prostate cancer risk on the planet. This has perplexed me ever since I have been hearing about these study results and I cannot seem to get a clear explanation. Any ideas are welcome.




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      1. So, it isn’t the kung fu? Just kidding. Indeed, they do consume more of a plant based diet, especially the Chinese; however, even in the case of Japanese, who consume massive amounts of fish (even more than Chinese), they have a remarkably low incidence of prostate cancer and prostate disease in general. I’ve been trying to put my finger on this button for a long time. I believe you have hit on the right idea. They each actually consume waaay more green tea than westerners. A known and powerful prostate cancer fighter. Also, they often ferment soy products. This makes a big difference from what I’m understanding.




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    1. One speculation about the Japanese diet and their low incidence of prostate cancer is connected to their much higher intake of iodine. This would come from sea vegetables and fish. I would be interested in seeing more about what the research says.




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      1. After taking a very quick look at some research on iodine Japanese diet, I see that the main source of iodine and of dietary fiber in their diet is edible seaweed. They do have much lower rates of breast and prostate cancer and longer lives as well. And yes too much iodine can be a problem in some people with thyroid issues. There is also some research about breathing in iodine gas near the ocean. Check out the links next to this article.

        http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3204293/




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  14. Dr. Oz is pushing the paleo diet as we speak. Why do I bother watching that show? :-( I’ll bet he’d never interview Dr. G. or Garth Davis, M.D., who wrote “Proteinaholic: How Our Obsession with Meat is Killing Us and What We Can Do About It.”




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  15. Theoretically, its not ω3 intake per se that should benefit inflammatory disorders like cardiovascular disease, but lowering the plasma ratio of arachidonic acid (AA) to eicosapentaenoic acid (EPA). Our bodies produce signalling eicosanoids from the pool of these two fatty acids, and the AA derived eicosanoids are more inflammatory than the EPA derived ones. Typical plasma AA:EPA ratios in plasma in those consuming Western diets range from 7 to 40, and over 100 in vegetarian men. In other words, intakes of arachidonic acid (most from animal products) and its metabolic precursor linoleic acid (high in vegetable oils) are so high in Western and vegetarian diets that the proportion of AA is 85-99+% of eicosanoid precursors.

    Fish oil supplementation can reduce the AA:EPA ratio, but even a high 3 g / d of EPA+DHA from fish oil (6 high potency capsules/d) only reduced the proportion of AA from 97% to 80% of eicosanoid precursors in plasma. Even high EPA supplementation in the denominator only budges the AA proportion slightly, so it seems we should pay much more attention to reducing dietary AA and linoleic acid contributing to the numerator.

    More to say here, alas delayed for work and errands.




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      1. It my understanding 3/6 ratio is a myth. The are both healthy especially when from whole foods. Conversion in the body to tightly regulated to control inflammatory AA. The problem is not high Omega 6 but people get way to little long chain Omega 3. Had the blood test to see Omega index. The only thing that moved the needle is more Omega 3 not less Omega 6.




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    1. And one could get a lot more linoleic acid from plant oils, like peanut oil, soy oil, and sunflower oil, than from fish oil. Even most nuts have a lot of linoleic acid.




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      1. I’m not going to use internet exploder – I use Chrome and haven’t ever had trouble with videos here before. Something is wrong with the video!




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  16. Dr. Greger points out the dangers of fish and fish oil. Just like Jacob, Will and Heather, sorry to be impatient, but hope Dr. Greger soon addresses, ” What about plant-based omega 3 or plant-based EPA/DHA supplements? Any update on those options?” In the past Dr. Greger espoused the benefits of plant based omega3s such as those from ground flax sees. We later learned that the ALA in flax seeds does not easily convert to EPA and DHA the active form of Omega threes,especially in older men.like me. In one of Dr. Greger’s 1 hour videos, if I recall correctly, Dr Greger pointed out that plant based omega threes, along with supplemental B12 is the reason that whole food, plant based vegans have better health and longer longevity than people whose diet includes meat and dairy. Are there any change to those recommendations?




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  17. I’d like to see Dr. Gregor address the role of DHA in neurological/brain health, if he hasn’t (if he has please give me a pointer :). Vegans typically have very low blood serum levels of DHA, men more than women. As a male vegan, I find this a serious concern and so use an algal DHA/EPA supplement. I am also at rather high risk for prostate cancer so found the claim of a positive association also of concern. But my understanding is that the study making the claim based on the SELECT data flawed in many ways and have discounted it. So I was disappointed to see it mentioned in the video without also pointing out the flaws in the study. Why mention bad studies (if it is not bad, I’d like to learn why). It seems to me there are a lot of variables that need to be sorted out before one could decide what action to take.




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  18. In fair balance, the GISSI trial showed a decrease in sudden death when given 1000 mg of Fish Oil per day. Mechanism was thought to be due to prevention of VENTRICULAR dysrhythmias.




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  19. I’ve been attributing my most excellent HDL levels (81) to my weekly fish but would like to reduce my consumption or eliminate it. Can I still maintain my HDL with flax, beans and other veggies?




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  20. According the the numbers provided by (http://www.whfoods.com) Brussel sprouts, cauliflower and broccoli have 0.27, 0.21 and 0.19 grams respectively of Omega-3 fatty acids (ALA) per one cup cooked serving without the bioaccumulated environmental pollutants found in fish, dairy, eggs and meat. That is a significant amount of health promoting PUFA from low fat food sources. Throw in some ground flax seeds and/or walnuts, and your body will synthesize all of the EPA and DHA you need, no flesh required.




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    1. I noticed this phrase in your post Joe:
      >> without the bioaccumulated environmental pollutants found in fish, dairy, eggs and meat.

      It makes me wonder if this whole nutrition milieu could also be framed as a continuing pollution of Earth’s environment with all kinds of different toxic pollutions. I look at the biological environment as putting a protective wrapper around the geological environment protecting the higher level forms like life from reactive chemicals and toxins. Ever since humans started doing “unnatural” things we have been creating things that never had a place in the world up until today when we dump so many pollutants into the environment where does it all go? Could the reason animal products are so toxic be that they are the high-level warning system for life? Sicknesses and deficits in the plant and animal environment can be creating both plants and animals that we think are normal but are they really. For example, I can put a cutting of bamboo in a glass of water and it will grow and grow … but what is it growing on, how nutritious would that be for something eats bamboo, whatever that is? And then what would be missing in the organisms higher on the food chain that eats the creature that eats the bamboo?




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      1. Humans create and are indiscriminately releasing many novel molecules into the environment, many of which are toxic. Some decompose into other toxic compounds; while others decompose into benign forms; while still others are persistent. Whatever form they take, they eventually find their way into the ground water, aquifers, rivers and oceans where they are incorporated into the tissues of plants and animals. The amounts of these chemicals found in various species depends on their relative position on the food chain.
        I would imagine that eating untainted animal products would be considerably healthier, although not entirely healthy due to saturated fat levels verses plant based foods, but where is one to find such meat, fish, dairy or poultry?
        As for bamboo grown hydroponically, it still needs to be fertilized. It cannot live exclusively on sunlight & water and thrive.




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  21. I stopped recommending Omega 3’s when the article from The Journal of Family Practice came out with new recommendations to STOP recommending omega 3 supplants in their article in 2013 “Should you still recommend omega-3 supplements?”
    Strength of recommendation ‘A’ Based on a meta-analysis of randomized controlled trials. “stop recommending omega-3 fatty acid supplements for cardiovascular protection. They have no significant impact on all cause mortality, acute myocardial infarction, sudden death, or stroke.” I don’t know if you came across this article in you lit search.
    As always thanks for that nice piece :)




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    1. Stroke?

      In this study, scientists took animals and pre-treated them with various nutrients and drugs. Then they mimicked the damage by inducing a stroke. This gave them an idea of which nutrients and/or drugs are protective. One nutrient stood head and shoulders above the rest in this area. That nutrient was coenzyme Q10.

      No other study on any other substance done to date has ever seen the remarkable results they obtained for animals using CoQ10. The researchers demonstrated CoQ10’s brain-protective effect both before and after a stroke. They’ve studied the effects of CoQ10 on stroke victims since 1972. And they’ve studied how well it works in dogs, rats, and gerbils. In all of their studies, CoQ10 was the only agent that gave complete protection. It was over two times more effective than the next best agent (naloxone). Some of the animals they treated before the stroke – and some after (within 12 hours). And CoQ10 worked in both cases, though it’s more effective if you take it before and after.

      Steve Kroening

      -NO LINK-




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  22. Dr. Greger, It seems pretty clear that fish oil poses potential risks. But parts of your transcript above,and I quoted a couple of those sentences, leave me wondering just how helpful plant based omega 3s are? Here are a couple of your quotes from the above review ” Either way, these long chain omega 3’s have been promoted for prevention of heart disease and cancer, but now that we know that not only does there appears to be no benefit for death, heart attack, or stroke, but there may be an elevation in cancer risk. The general recommendations to increase the intake of these fats should consider its potential risks.”……” In either case, given the inconsistent benefits and the potential adverse effects, omega 3’s must be prescribed with caution and generalized recommendations to increase fish intake or to take fish oil capsules need to be reconsidered.”

    Dr Robert Osteld, vegan cardiologist in NY, said in 2012, “While plant-based diets can provide omega-3 fatty acids aplenty in the form of ALA , this is not the active form that the body utilizes. The body must first convert the ALA into the biologically-3 fats EPA and DHA. Women and younger adults tend to convert more efficiently and are at lower risk for an omega-3 active forms of omega-3 deficiency. Older men such as myself ( I am 63) , are at higher risk for poor conversion and absorption of the omega-3 fats.” if one takes a vegan omega 3 supplement, he recommends vegan omega 3 supplements containing at least 200 mg of DHA.

    So the question I have, considering the latest research, is just how valuable omega 3s are from plant based food sources, such as ground flax seeds, for males and females of various age groups, and what quantity is helpful? Sloan Kettering is opposed to ground flax for estrogen positive women who have had breast cancer, due to the phyto-estrogens in flax seeds. So when are ground flax seeds helpful and harmful?

    When are vegan omega 3 supplements preferable and in what quantity? Dr..Ostfeld in 2012 said to look for supplements at least 200mga of DHA.

    So, in summary, what is the value and risks in plant based omega 3s, and plant based omega 3 supplements? Thank you.

    .




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  23. Dr. Greger, It seems pretty clear that fish oil poses potential risks. But parts of your transcript above,and I quoted a couple of those
    sentences, leave me wondering just how helpful plant based omega 3s are?

    Here are a couple of your quotes from the transcript: ” Either way, these long chain omega 3’s have been promoted for prevention of heart disease and cancer, but now that we know that not only does there appears to be no benefit for death, heart attack, or stroke, but there may be an elevation in cancer risk. The general recommendations to increase the intake of these fats should consider its potential risks.”……” In either case, given the inconsistent benefits and the potential adverse effects, omega 3’s must be prescribed with caution and generalized recommendations to increase fish intake or to take fish oil capsules need to be reconsidered.”

    Dr Robert Osteld, vegan cardiologist in NY, said in 2012, “While plant-based diets can provide omega-3 fatty acids aplenty in the form of ALA , this is not the active form that the body utilizes. The body must first convert the ALA into the biologically-3 fats EPA and DHA. Women and younger adults tend to convert more efficiently and are at lower risk for an omega-3 active forms of omega-3 deficiency. Older men such as myself ( I am 63) , are
    at higher risk for poor conversion and absorption of the omega-3 fats.” if one takes a vegan omega 3 supplement, he recommends vegan omega 3
    supplements containing at least 200 mg of DHA.

    So the question I have, considering the latest research, is just how valuable omega 3s are from plant based food sources, such as ground flax seeds, for males and females of various age groups, and what quantity is helpful? Sloan Kettering is opposed to ground flax for estrogen positive women who have had breast cancer, due to the phyto-estrogens in flax seeds. So when are ground flax seeds helpful and harmful?

    When are vegan omega 3 supplements preferable and in what quantity? Dr..Ostfeld in 2012 said to look for supplements at least 200mga of DHA.

    So, in summary, what are the benefits and risks of plant based omega 3s foods, and plant based omega 3 supplements? Thank you.

    .




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  24. Dr Greger,
    Are there any instances of contamination from any source in vegetables? I have been following you for a couple of years and note that there is continual malignment if animal food products but I can’t remember seeing any warnings about vegetables (unprocessed).




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    1. Truthseeker: You got a good reply from Tom. Here’s a similar reply with a site-specific slant.

      I imagine you can find “instances” of just about any food having been contaminated contaminated at one point or another. There can be all sorts of one-off outbreaks of something. We can learn about those instances in the news. What we need to know from NutritionFacts to protect our health is if there are certain foods that are systematically contaminated. (Hence the information NutritionFacts has on animal products.)

      *And* we need to have such information about contamination put into perspective for us so that we can properly weigh the risks. In my opinion, Dr. Greger does that too. I can think of several instances where Dr. Greger has reported on plant contamination. Here is an example:
      “More than a dozen deaths have been reported in the national outbreak of listeriosis linked to cantaloupes from a farm in Colorado, making it the third deadliest recorded Listeria outbreak in U.S. history, after a 1985 outbreak linked to cheese, and a 1998 outbreak linked to Sara Lee deli meat and hot dogs.”
      http://nutritionfacts.org/2011/09/30/cantaloupe-and-listeria-an-estimated-85-of-cases-are-from-deli-meats-not-melons/

      The article then goes on to explain where this type of problem comes from. That puts the problem into perspective for us. In my opinion, that’s what we need from a source like NutritionFacts.

      If memory serves, this site also has videos of contamination in sea vegetables. Though I haven’t looked just now. And I think I remember an article about contamination in some plant, but then compared it to the vast greater number of the same contamination from eggs making people sick. That’s an important perspective since we have to eat something…

      Here’s my point: It would be false equivalency if Dr. Greger gave equal weight on this site to animal and plant problems if such problems are not equal in real life. Seeking truth is great. I also seek Truth. No one and no site is perfect, but I don’t see how this site is failing in this particular topic. What do you think?




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    1. Just bought some whole flax seeds from Whole Foods – they are insanely easy to grind yourself (anything like a coffee grinder or a Nutri Bullet type of machine grind them in literally 2 seconds) and are great additions to things like oatmeal and baking.

      According to the Whole Foods package, 2 packages have about 5,000mg of Omega 3, although I never quite understand the conversion process of ALA to DHA/EPA – and I’m pretty sure plant foods are ALA.




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  25. So just so I’m clear; throw out the ultimate omega supplement I’m taking? Even though it’s GMO free, mercury free and cholesterol free?




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    1. Same question if anybody can answer, I’ve seen fish oils touting “third party testing” and fancy methods for removing mercury and other contaminants. Is there any research on confirmed non contaminated fish oil in comparison to, say, algae oil? I don’t see why would they be different.




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  26. Dr G. Usually studies that test fish oil use 1-2mls as a dose. 15 mls is an anti-inflammatory dose and from memory 8 mls is a cardaic dose which has been shown to be effective. What doses are the studies referring to when you say not effective.




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  27. Since the brain is made up of fat, it was suggested that I take fish oil with EPA and DHA included to aid in memory loss. Carlson makes a liquid for those of us unable to swallow large pills. Suggestions for senior citizens.




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    1. sherl0cke: This site gives shares all sorts of scientific evidence *not* to take fish oil. However, if you want to take a vegan/algae derived DHA and EPA pill, there are several on the market and these oils that come from sterile grown algae will not have the serious problems that come from fish oil.
      http://nutritionfacts.org/topics/fish-oil/

      The main problem for some people, such as yourself, for those pills is the size. My mother can’t swallow pills and she wants to take algae based DHA/EPA pills. So, what she does is get a pill with a soft gel outer shell. She hold the gel in her hand and carefully cuts a slit with a small paring knife. then she puts it to her mouth and squeezes out the oil while sucking with her mouth. Another option might be to squeeze the oil into something, like a smoothie, where you will be unlikely to notice it.

      This particular pill/oil doesn’t taste bad, because the oil has been given a lemon flavor. Would you like me to find out which brand it is?

      Another option to consider is getting 1 to 2 tablespoons of ground flaxseed in your diet each day. *If* you eat a whole plant food based diet, there is some good reason to believe that your body is able to convert the ALA in the flaxseed to the omega 3s that your body needs just fine.




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    1. http://www.ijcem.com/files/ijcem0055258.pdf Previous reports have suggested a potential association of fish consumption and the risk
      of prostate cancer. Since the associations between different studies were controversial, therefore a meta-analysis to re-assess the relationship between fish consumption and prostate cancer risk. The Conclusion?: They found that the highest fish consumption had no significant association on the risk of prostate cancer. Eating a lot of oily fish or taking potent fish oil supplements was associated with a 43% increased risk of prostate cancer, according to a Fred Hutchinson Cancer Research Center study published online in the Journal of the National Cancer Institute. The researchers also discovered a 71% increased risk of aggressive prostate cancer among those consuming fish oil or large amounts of oily fish. I think the health benefits of the omega-3 fatty acids contained in fish outweigh the risks of consuming this food by far. I believe solid research is being dismissed inappropriately. I believe the takeaway is to eat small amounts of low on the food chain fish like sardines as in only 2 times per week, avoid omega supplements, and be vegan. I believe it is better to be otherwise vegan and eat fish in this manner than to be vegan and not eat small amounts of oily low on the food chain fish. The overwhelming science appears to say so.




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      1. As a side note Omega-3 fish oil supplements may slightly lower the risk of dying after heart failure or a recent heart attack, but they don’t prevent heart disease, says an advisory issued Monday by the American Heart Association. Most studies conclude that after adjustment for a large panel of covariates, fish intake ≥4 times per week was associated with 40% reduced risk of composite CHD and stroke (HR = 0.60; 95%CI 0.40-0.90), and with 40% lower risk of CHD (HR = 0.60; 95%CI 0.38-0.94) as compared with subjects in the lowest category of intake (<2 times/week). A similar trend of protection was found for stroke risk although results were not significant (HR = 0.62; 95%CI 0.26-1.51). When fish types were considered, protection against the composite outcome and CHD was confined to fatty fish intake.




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  28. My MD based on “Health Diagnostic Laboratories, Inc” measurement of the HS-Omega-3 index = 3.4%. This test based on RBC EPA + DHA. Optimal is > 8%. He put me on Krill Oil (Pure Encapsulations) at 3 x/day 1000 mg krill oil caps. 7 months later the same test showed 3.7 and he increased dose to 4x/day 1000 mg krill oil caps. Is this a useful therapy given the negative you just presented?




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  29. i have a question about omega 3… this vegan DHA from algae in my country is SO EXPENSIVE, i can’t afford it AT ALL. i consume 3 tbsp of flax seed daily and have a healthy whole food vegan diet (lots of greens, beans, etc)….it must be enough for my brain health right? i can’t see how its sustainable for other countries other than US to buy this supplements…




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  30. really unclear, and probably equally confusing as it is helpful, as to whether or not omega 3’s are problematic (heart issues), regardless of their sourcing, or if omega 3 specifically sourced from fish oil.fish is the culprit (including toxins) while omega 3 from flax remains a healthful choice




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  31. Hi I’m wondering about the dangers of fish I switched to to a primary plant based diet. But I was advised to eat fish as well. In small amounts. I’m also very big into weight lifting so I’m concerned about not getting amino acids. I’m 28 and I’m trying to make healthy choices. Any info is great. I’m kinda sad that most of the food information that I’ve gotten most of life has been totally wrong. Is there any studies to indicate how long it takes to begin to see the benefits of a plant based diet. Weeks months years? Thanks




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    1. David: Good for you for taking your health into your hands! As you explore this site, you will find evidence that some benefits of switching to eating a whole plant food diet start showing themselves very quickly, even a couple of weeks. Other benefits take longer to appear.

      Of course, the benefits you get will be proportional to the amount of whole plant foods you are really eating. And it is important to note that there are no guarantees. Eating whole plants greatly lowers your risk of the major diseases of our time–just like refraining from smoking greatly lowers a person’s risk of lung cancer. But some people get lung cancer even if they never smoke. There are no guarantees. But there is great hope and power in eating healthy.

      Your concern about getting proper nutrients for weight lifting is shared by many. Here are two pages that I think will really help you. It really worth it to take some time to go through these pages.
      http://michaelbluejay.com/veg/protein-strength.html
      http://michaelbluejay.com/veg/protein.html
      Take a look and let me know what you think. Also, I have a ton more information about athletes, including body builders, who are excelling and making world records while eating vegan. Let me know if you want that information.

      Hope that helps!
      PS: I have some links to some great resources if you would like any advice on *how* to eat health–ie, the practical details. Personally, I would refrain from eating any fish, even in small amounts. Here is the topic page for Fish from NutritionFacts:
      http://nutritionfacts.org/topics/fish/




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        1. David: Dr. Greger has videos showing that it is never too late! Of course, the sooner the better in terms of increasing one’s chances of preventing or reversing disease. So, it’s great that you are starting when you are. Best of luck to you.




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    1. Ryo,

      yes, there are animal sources of omega 3, mainly fish and grass-fed beef. But you probably already know that we wouldn’t recommend to get your omega 3 from meat, do you?

      Moderator Adam P.




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  32. Dear Dr. Greger,

    The first study mentioned in the video “Why Fish Oil Fails: A Comprehensive 21st Century Lipids-Based Physiologic Analysis” has been retracted.

    The description of the video or the video itself should likely reflect this fact.




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