Should We Take DHA Supplements to Boost Brain Function?

Should We Take DHA Supplements to Boost Brain Function?
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Overt omega-3 deficiency is rare, but do short-term experiments on cognitive function suggest there might be an optimal DHA dose?

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The concept of vitamins was first described by none other than Dr. Funk, in his landmark paper in 1912: the concept that there were complex compounds that our body couldn’t make from scratch, and so had to get from our diet. By the mid-twentieth century, all of the vitamins had been discovered and isolated.

But it wasn’t until the 60s 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% fat-free diet on himself for six months, ironically, he felt better. His high blood pressure went away; he felt more energetic; his migraines disappeared. This one-man experiment fortified the medical profession’s doubt that essential fatty acids had any relevance to human nutrition, until TPN was developed in the 60s—Total Parenteral Nutrition, meaning feeding someone exclusively through an IV: initially developed for babies born without working intestines.

But, the first preparations were fat-free, because we didn’t think humans needed fat. And so, they rapidly induced severe 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 they were giving it to after an abdominal gunshot wound, we don’t just need fat, but specific fats, like omega-3s. And so, when they switched to soybean oil instead, she was restored to normal.

The fact that 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. A spoonful of orange juice worth of vitamin C would be enough to avoid scurvy (the overt vitamin C deficiency disease). But no one considers that enough vitamin C for optimum health.

What would optimal omega-3 status look like? Well, doubt has been cast on its role in heart health—which appears to be based on a faulty premise in the first place. And so, taking extra omega-3s for our heart might not make any sense.

But what about for our baby’s brain? 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.

But what about adults? No apparent psychological or neurological benefit of DHA supplementation for the general public. But what about in those who don’t eat fishes?

Take the famous Alpha Omega Trial, with thousands of people randomized for over three years to get either long-chain omega-3s from fishes, short-chain omega-3s from plants, or placebo. And, they found no significant benefits for any kind of omega-3 supplementation on global cognitive decline. But, most were eating fishes; already getting preformed DHA in their diet.

And so, general population studies like this, that found no benefit, can’t fully inform us about the role of DHA in brain health—any more than giving half of these people oranges, finding no difference in scurvy rates (zero in both groups), and concluding that 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 fishes. Previous randomized, controlled trials failed to find such a benefit among, like, 18- to 45-year olds. But they all only lasted a few months at most, whereas the 2013 study lasted six months. So, if all the studies either showed 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, four showed nothing; one showed a benefit; one showed a harm.

So, if it was just about boosting brain function in the short-term, I’d err on the side of caution, and spend my money elsewhere.

But what about preserving brain function over the long run? I’ll address that, next.

Please consider volunteering to help out on the site.

Image thanks to dierk schaefer via flickr

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The concept of vitamins was first described by none other than Dr. Funk, in his landmark paper in 1912: the concept that there were complex compounds that our body couldn’t make from scratch, and so had to get from our diet. By the mid-twentieth century, all of the vitamins had been discovered and isolated.

But it wasn’t until the 60s 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% fat-free diet on himself for six months, ironically, he felt better. His high blood pressure went away; he felt more energetic; his migraines disappeared. This one-man experiment fortified the medical profession’s doubt that essential fatty acids had any relevance to human nutrition, until TPN was developed in the 60s—Total Parenteral Nutrition, meaning feeding someone exclusively through an IV: initially developed for babies born without working intestines.

But, the first preparations were fat-free, because we didn’t think humans needed fat. And so, they rapidly induced severe 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 they were giving it to after an abdominal gunshot wound, we don’t just need fat, but specific fats, like omega-3s. And so, when they switched to soybean oil instead, she was restored to normal.

The fact that 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. A spoonful of orange juice worth of vitamin C would be enough to avoid scurvy (the overt vitamin C deficiency disease). But no one considers that enough vitamin C for optimum health.

What would optimal omega-3 status look like? Well, doubt has been cast on its role in heart health—which appears to be based on a faulty premise in the first place. And so, taking extra omega-3s for our heart might not make any sense.

But what about for our baby’s brain? 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.

But what about adults? No apparent psychological or neurological benefit of DHA supplementation for the general public. But what about in those who don’t eat fishes?

Take the famous Alpha Omega Trial, with thousands of people randomized for over three years to get either long-chain omega-3s from fishes, short-chain omega-3s from plants, or placebo. And, they found no significant benefits for any kind of omega-3 supplementation on global cognitive decline. But, most were eating fishes; already getting preformed DHA in their diet.

And so, general population studies like this, that found no benefit, can’t fully inform us about the role of DHA in brain health—any more than giving half of these people oranges, finding no difference in scurvy rates (zero in both groups), and concluding that 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 fishes. Previous randomized, controlled trials failed to find such a benefit among, like, 18- to 45-year olds. But they all only lasted a few months at most, whereas the 2013 study lasted six months. So, if all the studies either showed 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, four showed nothing; one showed a benefit; one showed a harm.

So, if it was just about boosting brain function in the short-term, I’d err on the side of caution, and spend my money elsewhere.

But what about preserving brain function over the long run? I’ll address that, next.

Please consider volunteering to help out on the site.

Image thanks to dierk schaefer via flickr

Doctor's Note

Here is my coverage of the omega-3 heart story:

Then, I had two videos on DHA supplementation in pregnancy: Should Pregnant and Breastfeeding Women Take DHA? and Should Vegan Women Supplement with DHA During Pregnancy?

And then finally, cognitive health, which started with Should We Take DHA Supplements to Boost Brain Function? Stay tuned for the thrilling conclusion in Should Vegans Take DHA to Preserve Brain Function?

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

204 responses to “Should We Take DHA Supplements to Boost Brain Function?

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  1. What about EPA? Some are claiming that EPA needs to be higher than DHA, as far as mood and depression. And there are companies starting to skew their supplements to contain this EPA to DHA ratio in favor of EPA.

    Also, do humans have an easier time getting EPA from plant sources than they do getting DHA from plant sources, as far as conversions and all that? I’ve had a difficult time understanding how we can get our EPA (not DHA) on a vegan diet.




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        1. Yes. At the end of the “Should we take EPA and DHA omega 3 for our heart?” video Dr. Greger concludes, “But, recently, it was demonstrated that these long-chain omega-3s don’t seem to help with preventing or treating heart disease after all. And since that’s the main reason we thought people should get that extra 250mg of preformed EPA and DHA, why do I still recommend following the guidelines? Because the recommendations were not just based on heart health, but brain health as well. To be continued…”
          I bet your question will be thoroughly answered in the next video, “Should Vegans Take DHA to Preserve Brain Function?”.




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  2. Hi NF Staff!

    I have a question (i was told to place them here).

    Sometimes when i eat fruit i get a minor allergic(?) reaction. A banana for example will give me an itchy throat and berries will give me itchy skin.

    I’m curious as to whether it is still beneficial for me to eat the fruit despite the reaction to it.

    My body doesn’t seem to get on with fruit in general so its not as if i can avoid certain types.

    Thank you!




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    1. Hi Steveooooo. Does this allergic reaction occur when you eat ORGANIC fruit? I’m asking because I know someone who is severely allergic to the pesticides on fruit. He can eat organic, no problem.




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        1. Depends where you shop! If most of YOUR so called organic fruit is from sewer markets, sorry, super markets, then what do you expect? All the organic fruit I consume has no pesticides or other toxin sprayed on it. Likewise for my vegetables. So if you support toxic conglomerates and cartels, that’s your fault; but don’t go suggesting that organic isn’t the most healthy way to eat. It simply depends on which grower you support.




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          1. No. Organic growers also use pesticides. Organic does not mean, nor has it ever meant, the plants are grown without pesticides. Any organic grower (such as myself) will explain that organic means grown without SYNTHETIC pesticides. We still use neem, spinosad, etc. which are natural pesticides.
            You have to use some sort of pesticide or you won’t have any crops left to harvest. Julot had it right.




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            1. I grow a lot of fruit without pesticides and I have too much fruit to eat. So I think to say that you won’t have any crops left to harvest is incorrect. Try permaculture techniques.
              John S




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            2. What a load of rubbish. Just because you use pesticides doesn’t mean that others, who, unlike yourself, grow plenty of crops without using pesticides. You, yourself, might have to use pesticides to grow crops but the two independent farms I use do not and that is fact whether you like it or not.




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            3. Like John, I also grow my own produce without using pesticides (natural or otherwise). My garden have a balanced ecosystem and so I don’t really have any plagues, plus approaching permaculture helps. If you have problems with your crop, well, that’s a pity, but to say that ALL organic growers use pesticides is simply saying too much. Most? I don’t know, maybe.




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        2. That exactly is the reason why the people of Germany stand against there own Government an the US-Industry with there idea for the TTIP oder (Canada) CETA contract – in Germany, at the moment, it is forbidden to use any pesticides if you sell your products with a good organic label. I don’t speak about the EU-Organic-Label because that is grape…
          Despite this facts – to eat animal products is much more danger because in this are the bad ones of pesticide residues, hormone residues, antibiotic residues and the bad fats.
          And another thought should be remembered the most problems occur with so called monocultures there is no different between organic farms or others – the are both fragile to pests. Therefor und the intelligent organic farmer so called useful plant communities – like corn, beans and pumpkins on one and the same field. Or like me, I grow flowers between cale to prevent the cale for the cabbage with butterfly – because the flowers attract bees and the song of the bees sound to the larvae of this butterfly like wasps. Waps eating larvae – and so they gone to other plants. ;-)




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        3. In my local farmer’s market I can speak directly with the farmers. I typically buy “no spray” fruits and vegetables, and they are often priced the same as other fruits and vegetables. They are not certified organic, but at least I know that they haven’t been sprayed. This is a practical solution to this dilemma. All you have to do is ask the farmer what products he has that have not been sprayed.




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    2. Steveooooo: I’m not an expert, but I have some thoughts for you.
      .
      First, I agree with Julie that you might try organic fruits from various sources (farmer’s markets, people’s back yards, etc) to see if the problem is less the fruit itself and more what might be on the fruit. Maybe you could even work with an allergy expert to help you try to pin down what exactly is happening.
      .
      Second, do you have the same problem with foods that are really fruits, but are treated like vegetables? For example, tomatoes and bell peppers. If you can eat foods like tomatoes and bell peppers without problems, maybe that is a way to get fruits in your diet. Along these lines, maybe you are sensitive to the fruits you have tried, but there are a bazillion and one types of fruits out there. I would suggest seeing if you can find at least one or two types of berries that your body is OK with. Eating some fruit types is better than eating no fruit, especially if you can eat some berries.
      .
      Finally, I’ll repeat again that I am not an expert. Also note that Dr. Greger does highly recommend fruit consumption. Having said that, my personal opinion is that you should not eat a food (or even a food group as important as fruit) that appears to be causing a bad reaction. Is the rest of your diet a whole plant food diet consisting of lots of intact grains, beans, veggies? Does it also include some nuts/seeds, mushrooms, and a B12 supplement? Do you skip over the meat, dairy, eggs, and plant junk food? Then you are (in my opinion) doing a million times better than the average person and probably do not need to worry if you are unable to fruit. (Though again, I’m not an expert and could be totally wrong…)




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      1. #Steveooooo
        I agree with Thea and Cathleen. But allow me to direct your attentiveness to the this important word from Thea: “… Is …your diet a whole plant food diet consisting of lots of intact grains, beans veggies?…”
        Because my experiences from my own praxis as a natural doctor is, that some patients develop an “allergy” with some fruits or vegetables because there remaining unhealthy diet. For example, one of my patient had a allergy agains nearly all nuts, oranges, apples, cherries, plums, tomatoes, bell pepper and much more, despite (he was thinking) his main food was meat, pizza, McDonalds, and other junk food combined with a lot of sugar and soft drinks every day. His condition was really bad at this time, to much weight, short of focus, no sports – a real couch potato. To make a long story short, after he was able to eat more healthy, at the beginning without the “allergy-fruits and vegetables” of course, only once per week meat and a softdrink, no cow products at all and only once per month McDonald – the allergy slowly disappeared. Now, one year later he is in a better state and he feels by him self that he feels sick after McDonalds… (now he is eating a more plant-based-diet, is doing some sport activities per week and drinking mostly water).
        What I like to underline with this example is – that sometimes the body showed a strange reaction to a (actually) good thing we will do, so that we get the impression of this is not a good idea but it is only a “deputy reaction”, maybe the subconscious developed it as an excuse for not eating good things. (Look, I like to eat healthy, like you told me but my body don’t like it… what can I do???) ;-)




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        1. Thanks for the insight Steffen. I suspect that it is my relapses that could be triggering all of this then. I’ll have to keep reminding myself that its good!! :p




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      2. Hi Thea. I have not noticed the issue with tomatoes and bell peppers so i will continue to munch on those and search out other fruit as you suggest.

        My diet has been 95.435 (i joke i joke) % plant based for the last 2 years but i have had periods of “relapse”…

        Thanks for your reply.




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    3. Hi Steveooo-
      Thea gave you a great answer below. I just wanted to briefly add (as a physician) that I really don’t think you should eat anything that has given you an itchy throat in the past, at least not without an Allergist’s ok. Allergic reactions like that can get worse with repeat exposure. Have you had any formal allergy testing? Might help you safely determine what fruits are safe to eat. In the meantime, stick with the other healthy foods Thea discussed below. Good luck!




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      1. Hi Cathleen,

        I have had testing in the past but they didn’t seem to find anything conclusive. The tests showed a low level positive to latex (0.48iu/ml) but nothing showed up when they deliberately tested against foods that caused me a problem.

        As you say i will avoid fruits that do cause me issues and consume others that dont. I just wasn’t sure if i was good to consume them even if the reaction was little but now i know :)




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    4. Hi Steveo,
      Bananas are high in histamine, so perhaps that is why you have a small allergic reaction. Also high in histamine – tomatoes, spinach, strawberries and avocados. I have issues/problems with histamine and must stay away from these foods.




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    1. Just as an FYI, his videos are made weeks in advance prior to being posted for us. I receive the DVDs and can view the series well in advance of it being made public here.




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    2. ProteinDeficient: I’m not quite sure about the details of your question. Maybe this will help:
      .
      An “essential fat” is one that humans have to get from our diet. The two essential fats are omega 3 and omega 6. An oil is a pure, extracted fat. Normally we don’t want to be consuming junk food like oils. However, if we decide that there is a benefit to consuming pre-formed DHA/EPA from algae, then by necessity, that supplement would come in the form of an oil/fat. Because oil/fat is what omega 3 *is*. (At least, that’s my understanding.)
      .
      Note that our need for omega 3 is *very* small. So, any such supplement will be a small amount also. Cooking/food oils are generally bad for a number of reasons, one of which is the effect on the lining of our blood vessels. But I don’t think a small, medicinal amount of omega 3 oils is likely to harm our blood vessels.




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      1. This is my issue. Too many studies done with supplements and not done with wholefoods. Hasn’t the science already established that reductionist attitudes towards these things doesn’t work??? So why does anyone think that eating pure flax oil will do them any good, or algae extract?

        I have yet to see any science showing me i need extracted junk food to be healthy.

        There is no need to be consuming extracts when you can dump whole flax seeds into your morning smoothie and munch on some walnuts later in the day. I will bet my last penny that a wholefood approach to a good omega 3:6 ratio will show a perfectly good level of EPA and DHA conversion within the body. You can’t expect the body to work perfectly if you’re going to pour in stuff it never evolved to consume. We evolved to consume seeds and nuts for our omega 3’s and to convert all we need to EPA and DHA from them. Not to take supplements to line the pockets of corporate snake oil sellers.




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        1. Growing_Young: I can understand why you think the way you do. It makes a certain amount of intuitive sense and I agree with some of your points. However, note that we are not talking about eating flax oil. We are talking about an algae oil/extract, which is a very important, key difference. (You do not want to confuse the two in your communications.)
          .
          Also note that not all the studies are done on supplements and that arguments about how we evolved don’t always translate into the unnatural world that we live in today. As I’m sure you know, the foods we ate as we evolved a long time ago (we are always evolving) have changed. And conditions such as dirty water have been changed so that we have to do things (like supplement with B12) that we did not have to do in our species’ infancy.
          .
          You claim, “We evolved to consume seeds and nuts for our omega 3’s and to convert all we need to EPA and DHA from them.” This sounds to me more like an opinion than something our scientists have determined to be true… Personally, given the ratios of omega 3 to 6 in most nuts/seeds, I doubt it. I think (as just a guess) that humans historically (way back) got most of our omega 3 from greens.
          .
          Dr. Greger is generally pretty careful about making supplement recommendations. So, I say let’s wait and see where Dr. Greger goes with this series. Perhaps the evidence is compelling. Perhaps not. We shall see.




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          1. Hi Thea, you say that we’re not talking about eating flax oil, but we are. All too often the use of extracted oils is recommended to be consumed for the ALA, and extracted oils have been used in many studies to determine efficacy of conversion rates to EPA and DHA, and health benefits/problems thereby caused without any regard to other areas of diet. These studies, in turn, are then used by people/corporations to promote the consumption of algae extract and fish oils, etc.. for EPA and DHA with claims that you can’t convert enough from ALA so you need to take EPA and DHA supplements.

            I enjoyed your anecdote about B12 availability, it you live in and eat food from a sterilised area you will need to supplement B12. Likewise, if you don’t get enough sunshine you’ll need to supplement D. These are perfectly rational and sensible points, but i have yet to see any such argument toward ALA from wholefoods and it’s conversion rates into EPA and DHA being affected by our environment in any such manner. Neither B12 or D defiencies are evolutionary, they are specifically environmental and you have given no pointers as to why you believe that EPA./DHA conversion is affected by environment in any way.

            The underlying theme on NF towards this issue is that we should take supplements until we have proof that they’re either unnecessary or harmful. It’s like the people who run around telling everyone that protein deficiency is bad for your health so you best make sure you eat plenty of protein – and we can see the health damage that has caused.

            No one has any idea what the human body does when it is flooded with too much EPA and DHA. Whatever you say about it being my opinions, it is a fact – to all but the insane – that our bodies did not evolve with us supplementing EPA and DHA extracted from any source. If you have any evidence of human beings getting exogenous EPA and DHA on the plains of Africa 100,000 – 200,000 years ago, then please present it.

            Take vitamin A. It’s toxic when we have too much. But the converted stuff our bodies make from wholefood plant carotene isn’t – and we can convert as much as we need from that.

            Take cholesterol. It’s worse than toxic when we have too much. But our livers make the perfect amount for our own health supplies if we eat the correct whole plant foods.

            But here we have NF’s publicly doubting the body’s ability to convert EPA and DHA from whole plant foods and telling people that it’s best to supplement until we know more???? Surely the side of caution is to not supplement until you realise you actually have a deficiency????

            If someone actually has a deficiency then fair enough, find out what they’re eating and fix it, and maybe give them some exogenous supplementation to bring their levels up to normal – but what is normal? You don’t know, no one seems to know.

            I’m not going to pay for any corporate snake oil unless someone shows me a much better reason than Michael has come up with so far with this. The Science is all over the place on this topic and to err on the side of taking a supplement when you have no deficiency is wrong.




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            1. Growing_Young: You are miss-characterizing this site when you write, “The underlying theme on NF towards this issue is that we should take supplements until we have proof that they’re either unnecessary or harmful.” That is the very opposite of what happens on this site. For any supplement Dr. Greger recommends, Dr. Greger presents positive evidence which he finds very compelling that the supplementation is important for optimal health. Take a look around…
              .
              As I mentioned a couple of times, the evidence supporting the recommendation for needing pre-formed DHA/EPA is coming up. So, it’s hard to talk about/make claims about the evidence at this point. Also, Dr. Greger does not use as strong a language for recommending DHA/EPA than he does for B12 and D. People can look at the evidence regarding the DHA/EPA supplementation when it comes out and decide for themselves what they want to do.
              .
              As of this moment, I’m not convinced of the need to supplement with DHA/EPA, but I don’t find your arguments compelling either. Arguments about evolution come across as pretty weak most of the time. Maybe the land of the human birthplace included streams containing fish, which supplied DHA/EPA. (While I don’t subscribe to this theory, there are experts who believe that eating fish is what made us human/allowed us to get our big brains.) Maybe we have evolved to be less able to meet our DHA/EPA needs over the years. Maybe… I could come up with all sorts of plausible theories. The question is: does the evidence show harm if we do not consume preformed DHA/EPA? (Forget conversion rates. Think of that question.) My point about the B12 and D stories is that there are all sorts of changes over time which may indicate a need to do things differently now compared to our ancestors. The evidence should help us figure out whether that is true or not.
              .
              Here’s how I think your evolution argument particularly fails: We have a hint from these videos that the recommendation for DHA/EPA comes from the impact of preformed DHA/EPA on long term brain health. When we evolved, we just had to get a few years past child bearing age. This site is concerned with a lot more than than. We are talking here now about optimum health over many more decades than what it takes to push out a kid and get them to independence. As Dr. Greger explained, it’s really hard to get omega 3 deficiency. So, it’s easy to imagine that we evolved to get enough omega 3 from greens (and the occasional nut when we could find it and break it open) in order to survive to the next generation. But what if we want to have a really healthy brain when we are 98?

              .

              Maybe “long term” means something different in the upcoming video. I don’t know. The evolution argument just doesn’t seem to be relevant to this discussion–depending on the evidence. Let’s see what we learn in the upcoming video(s).




              1
              1. I’m not mischaracterising this site. As you quote me… ‘The underlying theme on NF towards this issue…’ and this issue being that of EPA/DHA supplementation, which you then muddy by stating ‘ For any supplement Dr. Greger recommends’.

                You are twisting this. I’m not referring to… ‘any supplement Dr Greger recommends’. I’m referring specifically to EPA/DHA. And all i’ve seen so far is a recommendation to supplement until further science has revealed not to. I’ve seen no scientific evidence on this site that i need to supplement EPA and DHA, just unscientific speculation – which i would like to add i find completely out of character with this site – so please don’t accuse me of mischaracterising this site, i’m not, just this one single recommendation. If you think the science is there, don’t just say, ‘take a look around’, point me to the evidence. It’s a very large site and i’m not trawling it for 3 years to find the piece of evidence that you say you know exists and you can point me to in minutes.

                I’m not interested in what you know is coming, i’m interested in what is published and recommended now. That’s what we’re discussing.

                You then go back to your thing with B12 and D….

                You state…. ‘My point about the B12 and D stories is that there are all sorts of
                changes over time which may indicate a need to do things differently now
                compared to our ancestors.’

                B12 and D has nothing whatsoever to do with changes over time. Why do you keep twisting this??? B12 and D deficiencies are purely down to environment. IT HAS NOTHING TO DO WITH TIME!!!!!!! Why do you keep insisting it is a time thing? Show any science that shows we need to supplement with B12 or D because we have evolved a need to. There isn’t any science in that regard. We only need to supplement these if we live in an environment that doesn’t provide them.

                But you keep implying that we have evolved (over time) a need to supplement EPA and DHA. Please present evidence to support this. That’s all i ask. There is, as far as i’m aware, not evolutionary need that has developed over the last 200,000 years for us to supplement any nutrient.

                Anyway, look forward to the next videos and continuing our chat. Peace and beans. xx




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                1. Growing_Young: I don’t think you are understanding what I’m saying. I don’t think there is anywhere to go with this conversation as neither of us wants me to repeat myself. We shall see if you think the upcoming videos are compelling or not.




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          2. Thea: I don’t think it’s feasible that humans historically got most of their n-3s from greens. For most greens, you’d have to eat massive amounts to get even a half gram of n-3, in the form of ALA. With low elongase conversion rates, the amount of DHA you’d end up with would be next to none. Insects are a good source (https://www.sciencedaily.com/releases/2016/01/160111122520.htm) and I don’t think it’s a coincidence that other primates eat bugs. As we discussed in another thread, the odds are good that humans did too, and we have direct evidence of bone marrow consumption pretty much wherever stone tools are found (cracked-open bones). Bone marrow also has n-3. For people who don’t want to eat bugs or marrow (or brains, or fish, and so on), it makes sense to me to get some pre-formed DHA, rather than depend on either the tiny amounts in greens or, as you point out, the n-6 overloads in most nuts and seeds.




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            1. Todd: You could be right. I think it’s possible we got omega 3 from both greens and bugs.
              .
              My thinking on the greens is related to a chart I once saw about the amount of omega 3 in greens. Say a serving has .1 grams. If you ate 9 servings (something I think our ancestors likely did), that gets you close to the daily limit. I know you are then concerned about the conversion rate, but I’m aware of one study showing our bodies get better at converting when we don’t have a lot of preformed DHA coming in. It may have been enough to meet basic survival needs. Now add in a few random bugs…
              .
              I’m not arguing this strongly. And it is almost irrelevant to the main points I was trying to make above. In talking about the greens, I was trying to show that there are alternatives to the nut theory of evolution that was presented. You have provided yet one more alternative theory (and maybe even a better one). The real point of my posts were that the amount of omega 3 needed to meet basic survival needs may not be the same thing as the amount needed for optimum health, especially in our modern world where things are so different. It may be that in our modern world, the healthiest way to meet our optimum health needs is to just take the algae-based DHA supplement. I don’t know yet.
              .
              It will be really interesting to see where this series of videos ends up. Thank you for your thoughts.




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              1. Thea: The conversion rate is part of my concern, yes, but there are other reasons to doubt that our ancestors–at least anatomically modern humans of the past 200,000 years or so–were eating greens in those quantities. Greens have extremely low caloric density, but they take time to gather and to eat. Some animals, such as gorillas, get by that way, supplemented by bugs, especially found while grooming. Chimps get about 6% of calories from insects.

                We know that a lot of n-3 fat ends up in brains, in addition to their role in prostaglandin synthesis. As humans evolved bigger brains, it makes sense that their n-3 requirements also increased. The Aiello-Wheeler hypothesis claims that since brains and guts are both metabolically “expensive” tissues, as one gets larger, the other is likely to get shorter, over evolutionary time. This does seem to fit the human evolutionary path (although the thesis remains controversial).

                I think there’s still a lot we don’t know about what “n-3 deficiency” looks like, so I’m inclined to agree that we should consider the possibility that those of us not eating bugs, brains, fish, or marrow should consider replacing the DHA from these sources.




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    3. Dr Greger answered this question in a recent youtube interview. i’m sorry i can’t remember which one so i can’t provide the link. His opinion is that the tiny amounts of oil in supplements is pretty much harmless, as opposed to consuming spoonfuls of oil with your meals.




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      1. Plus, there’s a big difference between a tiny amount of algae oil and a tiny amount of something like safflower oil. Even a tiny bit of safflower will throw your omega 3/6 ratio out of balance whereas the opposite is true with algae oil. That’s why if I must have a little oil on food I make sure it’s coconut or canola, neither will screw up the balance.




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  3. I have reduced my supplements to just D3 and B12. I hope that the next video definitively answers the question of whether for modern plant eaters DHA is also a “missing piece” that needs supplementation.

    I consume lots of ALA (DHA precursor) and very limited Omega-6 fats. My thinking has been that, even with an inefficient conversion rate, DHA will be sufficient if ALA is plentiful.




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    1. Me too; I’m taking very few supplements these days, but I do take one kelp tablet, along with D3 each day and B12 three times a week- since my blood tests showed too much B12 in my system if I take it (1000 mcg) every day. Kelp tablets are dirt cheap and mine contain 225 mcg of iodine, neither too little or too much. Since I don’t use salt and don’t care for sea vegetables, I think this is a good option.




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      1. I’m uncomfortable with kelp these days, since our oceans have become the ultimate toxic dumping grounds, and especially since Fukushima. I do occasionally eat some dulse, which I’m pretty sure comes from eastern Canada.

        Also, my doctor, who is alternative, wants my B12 levels much higher than the range shown on the tests as normal. I don’t think you can overdose on B12, as your body excretes any excess.




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        1. What is your B12 number in the blood test? The reference range on my test is 150-900. Mine is 301 I am 82 and my HGB is a little low at 12.5, so I am taking Ferrous Sulphate 325 mg for 2 months.




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          1. I’ve been looking over my test results from last March and I think my lab, True Health Diagnostics, uses a different scale for measuring B12. Here’s what mine says: B12 (pg/mL) High Risk Range 400. When I asked about it, since mine is 1387, she told me they like to see it at about 2,000.




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    2. I’m on the same thought supplement regime as you are. I can’t find anywhere that shows that if you’re getting enough 3 and minimal 6’s you won’t be making all the EPA and DHA you need.

      Like you, i supplement D and B12 and that’s it. Not having a problem with my memory, no cognitive decline, health is great, fitness getting better. In my 50’s and feeling better than ever, so if someone has any science to back up me needing to supplement with EPA and DHA please show it. Like where were we getting it from on the African plains 200,000 years ago?




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      1. Naturalistic fallacy. Just because our ancestors didn’t take algae capsules 200,000 years ago, that doesn’t mean that we cannot benefit from them now.




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        1. As i stated… ‘if someone has any science to back up me needing to supplement with EPA and DHA please show it.’

          I don’t see any science in your answer. Just another corporate supplement shill spouting fantasies on behalf of your masters to boost their profits.

          You say ‘naturalistic fallacy’ where’s the fallacy? Obviously our ancestors were getting EPA and DHA from somewhere, and it wasn’t from a corporate supplement.

          You state…. ‘that doesn’t mean that we cannot benefit from them now’

          Show how algae capsules would benefit me now. Put up some science that shows unequivocally that i would benefit from taking algae supplements, and show me how exactly i would benefit.




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    3. One study showed that women converted 21 percent of ALA to EPA and 9
      percent to DHA, whereas men converted 8 percent of ALA to EPA and 0
      percent for DHA. http://www.ncbi.nlm.nih.gov/pubmed/12323085

      In addition, studies have shown that the delta-5 and delta-6 conversion enzymes don’t
      function as well in people with diabetes, metabolic syndrome,
      hypertension, or certain metabolic disorders. http://www.ncbi.nlm.nih.gov/pubmed/16892270 and https://lipidworld.biomedcentral.com/articles/10.1186/1476-511X-9-130.

      Therefore, it is insufficient to reply on ALA and its conversion.




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      1. Jason Huang: Your conclusion does not follow from your data. You need to put it into context. It doesn’t matter if someone converts only say 8 percent or 21 percent ALA if enough ALA is converted to meet our needs. Our omega 3 needs are very small. Below is more information for anyone who is interested.
        .
        For anyone who has read Dr. Greger’s book How Not To Die, we know that Dr. Greger thinks that there is enough evidence to suggest there may be benefits for fish-abstainers to take an algae-based DHA supplement. But this recommendation came with the word “consider” – ie, we might consider taking an algae-based DHA supplement. This is not the same type of recommendation for say B12, which we absolutely need to be concerned with.
        .
        Here is some information about how our bodies convert ALA and putting that information into context.
        ——————
        1) The bodies of vegan people do a better job of converting ALA to DHA. So, the question is, even if the conversation rate is low, can our bodies convert enough to make us healthy? We don’t need very much: 1.1 g for women and 1.6 g for men – which is about 1/4 to 1/3 teaspoon.
        2) Studies of vegan people show DHA levels to be high compared to other groups. Other studies show vegan bodies to be relatively low, but in those cases there is no apparent harm from those levels. So, the problem may be in the assumption that the DHA levels are low.

        *********************
        In regards to ALA conversions, This recent study showed that the conversion rate in Vegans is 2x that of a fish-eater.

        “Comparison of the PLLC n23 PUFAs:DALA ratio between dietary-habit groups showed that it was 209% higher in vegan men and 184% higher in vegan women than in fish-eaters, was 14% higher in vegetarian men and 6% higher in vegetarian women than in fish-eaters, and was 17% and 18% higher in male and female meat-eaters, respectively, than in fish-eaters This suggests that the statistically estimated conversion may be higher in non-fish-eaters than in fish-eaters.”
        http://www.ncbi.nlm.nih.gov/pubmed/20861171

        *****************************
        In addition, another study showed that despise this “theoretical” low conversion rate, there is no evidence of any harm so, the problem may not be in the conversion rate, but in the assumption that it is low.

        Prostaglandins Leukot Essent Fatty Acids. 2009 Jun 3.

        “There is no evidence of adverse effects on health or cognitive function with lower DHA intake in vegetarians.

        In the absence of convincing evidence for the deleterious effects resulting from the lack of DHA from the diet of vegetarians, it must be concluded that needs for omega-3 fatty acids can be met by dietary ALA. ”

        They also noted the importance of limiting excess omega 6’s, especially in vegans/vegetarians.

        **************************
        American Journal of Clinical Nutrition. November 2010, Vol 92, Number 5, Pages 1040-1051. The vegans in the study actually had highest levels of DHA (which most sources say it’s harder for the body to convert ALA into DHA, than it is to convert ALA into EPA) compared to the fish eaters, non-fish-eating meat-eaters, and vegetarians. This was despite the fact that they consumed less omega 3s. (Stephanie also found an article that summarizes the study: http://www.nutraingredients-usa.com/Research/Omega-3-ALA-intakes-enough-for-EPA-DPA-levels-for-non-fish-eaters?utm_source=copyright&utm_medium=OnSite&utm_campaign=copyright




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        1. There are some portion of people who cannot convert ALA to DHA due to genetic or current health conditions.
          Vegan people do not supplementing algae. They are at risk of B12 deficiency in long runs.




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          1. Jason Huang: re: “There are some portion of people who cannot convert ALA to DHA due to genetic…” The last time I asked someone to back up this claim with a study, they were not able to do so. It may be true, but I have yet to see the evidence.

            As for some health condition preventing the conversion, I have no trouble believing that. But that’s a different issue all together. People with various health conditions often have to do things differently compared to the general public.




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  4. According to this study,
    http://www.nutraingredients-usa.com/Research/Dietary-ALA-sufficient-to-raise-omega-3-levels-says-study
    it isn’t necessary to supplement with DHA or EPA if you take 2.4 grams of flax seed oil- the equivalent of a rounded teaspoon of flax seed. Because the ratio of omega 6 to omega 3 oils is also important, I take 2.5 Tablespoons of flax seed for every 1/4 cup of nuts I eat in order to keep this ratio down to about 2 to 1.




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    1. I agree, i put 1 tsp of whole flax seed and 1 tsp chia seed into every smoothie, and also add 1oz walnuts to every salad. Mostly all i eat is smoothies and salads, so that’s a lot of 3 to 6 ratio. Feeling awesome. Ooh yeah! :-D




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      1. When you say “whole flax seed” do you mean whole as in, not ground? My understanding is that flax seed is mostly passed through your digestive system unless it is ground first.




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        1. You put whole flax seed into your smoothie mix and turn the blender on. You’ll digest it :-D

          I don’t recommend anyone buy ground seeds, always buy whole and grind them as you use them. As soon as a seed is ground it is dead and life is falling away, and it is decomposing. If you are adding to a smoothie then add whole seeds and allow them to puree into the smoothie.

          If you’re adding to other things, you can roughly crush in a mortar whatever you need. Just keep the seed whole and full of life until you need them.




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            1. What are you talking about? My common, cheapo, 600watt blender has no problems dealing with flax seeds in smoothies.

              You need to stop listening to all the Vitamix marketing hype – common blenders are just as good, if not better. You can now buy more powerful blenders than a Vitamix for less than 20% of the price.




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    2. The linked article says, “A new clinical trial by researchers from the University of North Dakota and the University of Manitoba found that flax oil, rich in alpha-linolenic acid (ALA), could increase red blood cell levels of eicosapentaenoic acid (EPA) and docosapentaenoic acid (DPA), but not docosahexaenoic acid (DHA).[emphasis added]”

      Meanwhile, I’m adding flaxmeal — ground flax seeds — to my oatmeal. I believe that whole flax seeds are not digested.




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  5. Once again i am bemused and puzzled at how Dr Greger ‘s articles contrast with those of Mr Mercola! It is almost as if a silent cold war is going on between the two and i am lost at deciding who to trust in the end…the confidence both put with their assertions is just something…




    0
    1. The difference is that Dr. Greger does his homework, considering the broad sweep of available research before drawing conclusions while Dr. Mercola cherry picks a few studies to support is bias and desire to continue eating animal products. In effect, Mercola discounts the scientific literature in favor of his taste buds.




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        1. Thanks all very much for your replies!!i begin to see a little clearer now through that tunnel of darkness lol and although in effect Mercola explains rightfully i would think that only DHA supplementation from krill oil is really effective i feel like he does tend to cherry pick towards meat-eating supporting literature..
          To be followed then :-)




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          1. Mercola is a phony. He rarely has any reliable sources to back up his claims . For example look at his article on the superiority of grass fed beef, the entire article reads as a advertisement for a particualr brand of grass fed beef at outrageous prices. And not one source listed to back up his claims on potential health benefits, nor does he even say if beef is healthy in the first place. And did you read his disclaimer. Eye opening.

            http://products.mercola.com/grass-fed-beef/




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            1. Thanks very much Aaron also for this reply!one thing i ‘ve noticed: many people who transition from being meat-eater to a WPFB diet are not doing any proper detox for their emonctory nor taking for exemple adaptogenic supplements to support their endocrine system.I personally believe those two being two cornerstones for proper health on top of whatever your diet is meat-eater, vegan etc…




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              1. I transitioned without any sort of “detox” routine and felt physically BETTER in just two or three days. I yet eat some AP on weekends, but if I’m not careful and eat too much-it makes me feel BAD and gain weight. Our bodies know how to detoxify given the chance. Mine does anyway.




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    2. I am a MD, by early decision in my life, having Louis Pasteur and Dr Schweitzer as ideal model, Pr. Dausset ( Nobel price 1980) taught me immunology and observation. I realized early, the complexity of immunogenetics and the competition working in the body to chose the “right” nutriments to maintain a healthy life and to repair any harm when it is time. Dr. Greger is bringing information from decent studies, some times i comment because I have some sources to support a comment, Dr Mercola, is a chiropractor, if I am well informed, he is more selling products asked from customers to be healthier. The concept to be healthy from a lifestyle is not accepted. The deny of most of chronic diseases is leading to increase the risks as customers do not accept the cause. Dr Greger informs Dr Mercola sells.




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      1. I followed Dr. Mercola’s posts for over 10 years and most of the time, his advice pans out for my health, no I don’t eat butter, but other advice, for example against mercury in dental fillings and no vaccination against a swine flu panic, worked for me.

        By the way, Dr. Mercola is DO osteopathic physician
        a medical doctor with additional studies, so his and Dr. Greger’s credentials are most equal.

        And as far as selling, you can buy products his advocates elsewhere, he doesn’t sell a secret patented supplement formula. His and Life Extension Foundation’s recommendations are similar.

        DHA Supports Brain Development and Protects Neurological Function
        http://www.lifeextension.com/magazine/2008/1/report_dhafishoil/Page-01




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        1. Yes Dr Mercola keeps always common sense face to any health panic. He is delivering good information in general and I send many acquaintances to his website where you can found good products , never harmful. He is more commercial than Dr Greger I will say?




          0
        2. Dr. G doesn’t sell or promote products. Dr. Mercola does. Personally, that makes all the difference in the world to me. I think that’s why doctors like Mercola & Oz end up on sites like quackwatch.




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          1. Quackwatch is a quack! DOn’t trust quackwatch. They will tell people never to take herbs or vegetables and only trust chemotherapy. Check out quackpot watch. Barrett is a con man.
            Mercola spends most of his time telling people to exercise, get more sleep, eat vegetables, mushrooms and fruit and eat less food. Most of what he says agrees with most of what Dr. G says. If most people followed either one exactly, they would be 10 times healthier than the SAD diet most use. Dr. Joel Fuhrman also sells things. Are you putting him down? I don’t buy any doctor’s advice 100%. I follow Dr. G more than anyone else, but he is a good doctor, not a holy man. More nutrition doctors agree with Mercola than Greger, and most of them like Dr. Katz say, “Let’s find what we can agree on.” The rest is details for your individual body. Some people love to argue and put down others. I just want to figure out how to be healthy.




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            1. Hi John, I’m not putting anyone down. Nor am I fan or user of quackwatch or other sites like it, but I do know they’re out there & unfortunately people do refer to them. I don’t think doctors like Mercola or Oz are quacks. I think doctors like Fuhrman, Oz, Katz etc., have done a lot to help promote better health for millions of people. But unfortunately any doctor that promotes or sells products pretty much ends up on some of these quack sites because they tend to throw the baby out with the bath water, so to speak. Like it or not, it’s often the commercial component that fans the flames for these sites. That’s why I appreciate Dr. G’s non-commercial approach so much. For me, it eliminates any questions. And that’s not to say that I think Dr. Mercola is a charlatan because he sells or promotes products. It’s just that there are too many unknown variables, in my opinion, regarding some of the product that are out there.
              I’m merely expressing my opinion and giving the reason behind my personal preference. Other people have their criteria and experiences, and I respect that.




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    3. Mercola keeps interests high for his followers with about 234000 visitors per day while nutritionfacts has about 59000 per day. If each visit is a vote mercola wins . Just from myself and a few people I know advice from nutrition fact is a life changing , life saving experience .




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    4. Dr Mercola advocates homeopathy and appears to be against all vaccines. I also seem to remember that some years ago, he also sold “tachyon energy” products.

      This demonstrates to me that he is not committed to evidence-based medicine. He may be correct on a number of issues but how can anyone be confident that he is? His views do not seem to consistently stem from a serious consideration of all the available evidence.




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  6. It is hard to make a cost benefit analysis here. Fish oil supplements are expensive and their quality is often is often questionable. I have seen videos on how they produce the product. (they use a lot of sardines, which they put in a food processor). Off course, with enough money you can buy better products like algae omega 3 etc. However, I wonder, for most people, say the average joe and jane consumer, do the benefits outweigh the risks? (poising from PCBs etc)




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  7. It seems to me that in a previous video, Dr. G covered the point that although we can convert short-chain n-3 fats (ALA) to long-chain (EPA and DHA), the conversion is very inefficient, and gets worse with age (like a lot of things, alas). Back in around 1988 it was discovered that the n-3 and n-6 fats play a role in directing our systems into and out of inflammatory states, via substances called eicosanoids (prostaglandins). This was part of the basis of Barry Sears’s “Zone” diet, in fact, and he later began to favor fairly massive n-3 supplementation. I haven’t kept up with his writing so I don’t know where he stands now.

    Also, in another video from 2003 in London (https://www.youtube.com/watch?v=q7KeRwdIH04), Dr. G discusses populaiton studies showing that health and longevity outcomes for plant-eaters were no better than, or even worse than, those for omnivores. These studies are obviously a challenge to his overall view of things (and these same studies are often cited by critics of vegetarianism as a refutation of health claims often made by vegetarians and vegans. In that video, Dr. G conjectures that n-3 deficiency may be the cause of the unexpected results (Unexpected because so many studies show so many specific health benefits of plant-based diets, so you’d expect population studies to reflect this). I’ll be interested to learn whether his view of this has changed.




    0
    1. I ordered the Dr. Sears blood test kit to test my Omega 3 to Omega 6 ratio. I am almost 100 percent plant based for almost 11 years, mostly whole foods and minimal oils. I was shocked that my omega 3 to 6 ratio was 1:16. Very bad. My omega 6 were not bad, they were in range because I eat so little processed foods or oils, mainly cook my own foods. However my omega 3 were so low, that the ratio was bad. I should note that I eat 2 tablespoons ground flax seeds or ground chia seeds every day, and that did not have enough effect to get my omega 3’s up. I started supplementing with algae based omega 3 DHA supplements, and within 6 months got the ratio down to 1:3. Perhaps if you eat no oil at all and have a 100 percent perfect diet you don’t need to supplement, but for most people trying to eat vegan, they may be walking around with more inflammation than they want, in spite of trying to eat a healthy diet.




      0
      1. Thank you for sharing that. It’s consistent with what Robin Jeep reported below about Dr. Fuhrman’s experience with his patients. Actual measurements should always trump theoretical positions. Some have the position that a WFPB diet that includes plenty of short-chain n-3 SHOULD be good enough, based on the (possibly mistaken) theory that a diet just like this is natural/ancestral/ethical/whatever. It’s no different, really, from the view often expressed in paleo circles that saturated fat is beneficial because it’s natural/ancestral/etc. It’s fine to hold such views tentatively, as working hypotheses, but when actual observational evidence comes in, they should be discarded. Otherwise, you get into the “you’re not doing it right” cycle, you start adding more flax seeds, chia seeds, and whatnot.

        If we need, for optimum health, some pre-formed long-chain n-3 fat, specifically DHA, then the most pressing question is how much and what’s the best way to get it. The question of why we were deficient when we were doing all the “right things” is entirely secondary, though interesting.




        0
        1. I started with taking 2 algae based omega 3 tablets per day along with 2 tablespoons of either flax or chia seeds daily. That got me down to a better ratio. I now have upped it to 3 tablets per day (about 600 mg of DHA per day). I recommend anyone eating a plant based diet to get tested. The test was only $75 dollars. A test kit is sent to you and you do a simple finger prick and mail it back in. I got my results in a week.




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      2. Sandy, did you have your CRP tested? I would think that would be a more important marker of systemic inflammation that omega 3 to 6 ratio. I eat as Dr. Greger recommends including flax seeds but take no DHA supplements and the last time my CRP was tested, it was barely detectable- showing very low body-wide inflammation.




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    2. Todd: I have a problem with “gets worse with age”. It might be more appropriate to say “changes with age”. Testosterone and estrogen production decrease with age, and our immediate conclusion was that we should supplement. I’m not saying that they are equivalent cases, but it points to a popular mindset of panic concerning what might be normal aging.




      0
      1. That’s a good point. Not all change with age is deterioration. Then again, the change may itself be caused by decades of dietary or other abuse, and may not be age-related at all. Strange things happen to systems pushed out of equilibrium.




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    3. I love how much better Dr. G sounds and looks in 2016 then when this video was shot 13 years ago… Very cool. May we all do as well on our WFPBD’s.




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  8. “Omega-3 fatty acids are clinically shown to improve cardiovascular conditions such as coronary heart disease, hyperlipidemia and hypertension, and, according to limited evidence, enhance cognition, reduce anxiety, improve athletic performance and decrease risk of certain cancers. Clinical research supporting the latter effects is promising, but not conclusive; additional research is required before any conclusions can be drawn.”

    So, the above, false? Comments welcomed, thanks in advance.




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  9. Joel Fuhrman told me that50% of his vegan patients he tested showed a DHA deficiency even when they omega-3 rich foods. For some reason they weren’t converting it. That’s why he recommends algae DHA/EPA. Dr. Greger, what say you?




    0
    1. There is no recommended dietary allowance for DHA or EPA, but only for the plant-based fatty acids, LA and ALA. So, how can someone be deficient in DHA? If a person has a normal constitution, I trust that he or she will convert ALA to whatever amount of DHA or EPA that they need, which may be a minuscule amount after childhood and the full formation of their nervous system.




      0
  10. In the Adventist Health Study 2 the adjusted hazard ratio (HR) for all-cause mortality was best for “pesco-vegetarians”, even better than for “vegans”. http://www.ncbi.nlm.nih.gov/pubmed/23836264. I am therefore hoping, that this study will be commented at nutrtionfacts.org. Maybe, the omega 3s in fish are important here – and could i get the same effect without fish (algae derived, flax seed)?




    0
    1. For all cause mortality there was a big difference between men and women. The hazard ratio for male pesco-vegetarians and vegans was about the same (HR = .73 pesco vs .72 vegan). However female pesco-vegetarians did live longer than female vegans (HR = .88 pesco vs .97 vegan).




      0
      1. Hi Julie, thanks for your comment. Anyway, the vegan-vegetarian group has an advantage compared to the omnivores. I did not yet get deep into the study. But i find it interesting to see in the summary advantages for pesco-vegetarians; i didnt find, wether pesco-vegetarian in the study means people eating egg and dairy and fish, would make more sense if it means vegans, who sometimes eat fish. My hope is, that Dr. Greger sometimes talks about this theme. As a MD i recommend my patients eating more plants, but should i recommend plants and a bit of fish (at least for the women)? Up to now, i stay with plants, flax seeds, and algae derived omega 3s.




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        1. Yes, I found this study interesting, too. The pesco-vegetarians in the study did consume milk, eggs and fish. I know, doesn’t make a lot of sense. I think that grouping people into such broad categories can be problematic. What foods did everybody eat? Here’s an awesome table summarizing the AH-1 cancer findings that tells us which specific foods were associated with decreased risk of various cancers. http://publichealth.llu.edu/sites/publichealth.llu.edu/files/docs/sph-cancer-findings.pdf




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      1. Sandy: The sceptic in me thinks: Of course your DHA plasma levels are going to go up if you supplement, because you are just putting more DHA into the bloodstream. This does not mean that it is actually being utilized at a greater rate. In the case of ALA conversion, only what is needed is converted, so perhaps less is present in the plasma. In other words, plasma levels are only a very gross measure of PUFA metabolism.

        I would be interested in what your symptoms were, and whether they improved with Algal DHA.




        0
        1. I really did not have any symptoms to begin with. But I am a 11 year cancer survivor, so I want to make sure I don’t have inflammation in my body. I look at taking the supplements the same as eating a piece of fish a few times per week without the toxins.




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    2. If you read the full study, you will find that yes for both sexes combined the HR for all-cause mortality was lowest for “pesco-vegetarians” at .81. However, in males, those eating a completely vegetarian diet (called “vegan” in this study) had the lowest HR – at .72. “Pesco-vegetarians were the second lowest at .73.

      The picture among women was rather different. There, women “pesco-vegetarians” were lowest at .88. In fact, among women, “lacto-ovo” and “semi-vegetarians” also had a lower HR than “vegans” who came in at .97.

      I do not know why there was this sex difference. The figures are set out in Table 4.

      http://archinte.jamanetwork.com/article.aspx?articleid=1710093




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  11. As a scientist I must point out that the point “1 for, 4 neutral, 1 against” by itself is a bit weak. The 1 for can be super weak with 3 guys sometimes taking a bit of EPA, and the 1 against can be a hyper-powerful interventional trial with long term followup etc. Can anyone compare?




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  12. Dr. Greger. In nature some trees seem to have indefinite life spans. Whales, turtles and sharks can live hundreds of years. If humans eat the diet they evolved to eat and avoid accidents and otherwise remain active, socially connected, and healthy, could our life spans be similarly lengthened? What’s the real limit on human longevity?




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    1. We did not evolve to eat any particular diet. This is an idea promoted by paleo diet advocates but it dos not hold much water. Humans have adaptation that allow us to eat and benefit from a range foods. Adaptations usually involve trade-offs however.

      Our evolutionary history is very long and has included a great many dietary patterns. Even during the “paleo” period, alone many different diets would have been eaten around the globe. These would have altered as people migrated to new regions and climate fluctuations and other environmental changes affected the availability of local food resources. Evolution is really about the survival and reproduction of the species. Being able to eat a very wide range of foods, including animal foods for example, has allowed humans to survive and reproduce in most environments. That does not mean that eating a wide range of foods or any particular range of foods is a diet which necessarily promotes healthy longevity in individuals.

      Even if one accepted the contention that a species has evolved to eat a particular diet, it would not follow that that diet will promote health and longevity in individual members of that species. However, you will find plenty of paleo diet proponents who believe that it does.

      ” ….. eating some ancestral diet on its own will not make us healthy. Our ancestors did not eat diets perfectly in tune with their body. Rather, they took the best advantage of the foods around them they could in light of their bodies which, like ours, were whittled by evolution out of more ancient forms and so flawed, complicated, and filled with tradeoffs.”
      http://www.skepticalraptor.com/skepticalraptorblog.php/ancestors-eat-paleolithi-diet/

      Dr G has a number of videos on paleo diet claims
      http://nutritionfacts.org/?fwp_search=paleo&fwp_content_type=video




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      1. Evolution is a very subtle concept that is often over-simplified, even by the highly educated. A red flag should go up when anyone says “We evolved to…”

        I like the example of sickle-cell anaemia, which is a trait that emerged in a subset of humans because it happened to bestow resistance to malaria. Evolution, in practice, has this kind of blind, amoral quality, with trade-offs and ambiguity. All creatures incorporate a hodgepodge of arbitrary features each of which, historically, conferred some survival advantage, but which may be irrelevant now or may even work against survival in a radically different environment.




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    1. There have been some studies noting that krill oil is ineffective. Mercola sells it, so you need to be cautious there. I don’t have the studies here, but I remember reading about them.




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    2. There is a 2015 study on bioavailabilty compared to fish oil. However, only 15 subjects were studied.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4374210/

      Also in 2015, there was a review of both human and animal studies, which you may find helpful
      ttps://www.dovepress.com/comparison-of-bioavailability-of-krill-oil-versus-fish-oil-and-health–peer-reviewed-fulltext-article-VHRM

      Krill oil may improve cognitive function and symptoms of depression – at least in rats.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3618203/

      However, it is worth noting that both krill and fish oils contain persistent organic pollutants.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4179167/

      Algal oils appear to increase plasma DHA levels (but do not contain such pollutants)
      http://link.springer.com/article/10.1007/s11745-007-3098-5
      https://www.ncbi.nlm.nih.gov/pubmed/24261532




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        1. Thanks Darryl – very interesting reads.

          There may still be a Goldilocks dosage level at which benefits outweigh disadvantages, of course.

          However, there is also the fact that many commercially sold oils including algal oils may be oxidised and therefore possibly harmful on balance.
          https://www.ncbi.nlm.nih.gov/pubmed/11902962
          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681158/
          https://www.hindawi.com/journals/bmri/2013/464921/
          http://www.nature.com/articles/srep07928




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    3. Hi George, krill oil generally contains less EPA and DHA per gram than a fish oil supplement. However, krill oil does contain astaxanthin (a potent antioxidant) and phospholipids (that help your body absorb the oil). If your healthcare provider recommended a certain dose of EPA or DHA you want to read your product labels to see how many krill oil pills that would require– it is usually much more than a standard fish oil supplement. Either way, quality matters so always select a product that you know the source and the ingredients. Hope this helps.




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  13. Yesterday, Mercola had a new newsletter on DHA and omega 3’s. He interviews a woman in the video who is an ex-vegan. She talks about how being on a vegan diet helps a person initially, because they lose weight, and their blood pressure goes down. But, she said that long term being on a vegan diet can have negative neurological consequences for “some” people, not all people, but “some” people. In the comment section of the Mercola newsletter, there were other people who tried the vegan diet for a year or more and had the same complaint of having “brain fog”, being tired, and jut not having enough energy. But, then there were long term vegans who commented that their health has been excellent and have had no problems. The people that had problems with the vegan diet have switched to eating Pacific Alaskan salmon just once a week, and they report that it has really helped them to overcome the brain fog, and now their energy is back to normal. I wonder if that is because they are getting DHA and omega 3’s that they were not getting on their vegan diet. Anyhow, since I have energy problems, I am going to start to eat wild caught Pacific Alaskan salmon just once a week. By the way, gorillas do not eat meat, ( maybe a few insects ), but they seem to be getting plenty of omega 3’s from their plants to build huge strong bodies. I think everyone needs to find what works for them….and it probably isn’t a cookie cutter one size fits all solution. By the way, I bet getting omega 3’s from wild caught Alaskan salmon is a lot better than getting omega 3’s from Mercola’s krill oil supplements. In other words “real fish” is better than any supplement.




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    1. John Axsom: If you believe that you need more omega 3 to fix a problem, eating salmon is one option. As you know, what you get with that salmon (even wild caught) is all the negatives like contaminants, animal protein, cholesterol, saturated fat, etc. In light of the negatives, I’m curious why you would choose salmon over an algae-derived omega 3 pill as your first attempt to fix your problem. I’m not trying to convince you to chose a different path. I’m just wondering what your reasoning is. I can’t think of a down-side health-wise to trying the supplement first.
      .
      I have one thought for you regarding being tired: I’m curious if you think you are getting enough calories. A couple people have reported on this site that when they started eating more calorie dense plant foods, it fixed their energy problems. They had simply not been getting enough calories with the plants they were eating. They could have eaten a fat-laden animal food like salmon and gotten better and concluded that they needed salmon. But what they really needed was just more calories. That issue may not apply to you. I’m just raising it as a possibility in case it would be helpful.
      .
      Good luck. I hope you cure your problem.




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      1. One thing about feeling tired most people miss is doing regular detox and mandatory endocrine support with adaptogenic herbs.I don’t believe so much in that omega 3 hype.In case you really think its the problem go for HAWAIAN SPIRULINA tablets/powder…




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    2. It is important to remember that Dr G does not recommend “vegan” diets as such. There are many kinds of so-called vegan diets – even a college beer and chips diet would count as one, as would many other junk food diets. “Vegan” diets cover a multitude of sins, we might say.

      He recommends well-planned whole food plant based dots, and supplements.where appropriate, to achieve optimal health.
      http://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/




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    3. John, please let me know how this works out for you (simply respond to my post here and I will get an update in my inbox that you replied). Very much appreciated if you do. I have witnessed first-hand a positive effect from eating the wild-salmon as far as energy, mood, mental functioning, and ability to focus. I wonder if it has to do with digestion, as salmon contains B12, D, DHA/EPA, selenium, and iodine, all in one complete package, and vegan supplements are basically “man-made” attempts at duplicating nature, and maybe man has not been able to perfect this yet for all.




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    4. I had just the opposite experience. Before going vegan, I got my meat consumption down to eating just one tin of sardines a week and at the same time, was eating whole natural vegan food the rest of the time, but I experienced no improvements in my health. It was only when I removed that one tin of sardines and made no other changes that I started loosing weight, had better energy, less pain, slept better and had better memory (and other health benefits as well). That was 15 years ago and I’ve felt just fine since then. My doctor is impressed with my health since I’m 65 years old and have the appearance of a much younger man. If these vegans you describe had problems, perhaps it was because they were on the junk-food version of the vegan diet or didn’t use flax, vitamin D or B-12 or follow some other recommendation.




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  14. I hope that Dr Greger does not lead us toward having heart or cognitive diseases down the line if he is wrong. 10 years ago, he made a video warning that vegans run into the risks of dying early, or have heart diseases or cognitive issues if they don’t take Vitamin B-12, D, Omega-3 and Zinc supplements. Now he says that vegans can get it all from our plant food diet and supplements are not needed. I understand that sciences can discover new things but not in such a drastic way. What happens if 10 year from now Dr Greger will say that oops, based on new evidences then Omega-3 and Vitamin B-12, D are needed?

    Dr Fuhman who is vegan said that many of his elderly vegan patients have cognitive problems and they test low on Omega-3. So who is right? Dr Greger or Fuhman?

    I hope that we don’t end up like this couple down the line.

    http://www.cnn.com/2016/09/20/health/cnnphotos-alzheimers-couple/




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    1. Freestyle1: You wrote, “Now he says that vegans can get it all from our plant food diet and supplements are not needed.” I have never known Dr. Greger to say this, and I have been following him for 6 years. In all that time, Dr. Greger has produced multiple videos discussing the vital importance of taking for example a B12 supplement. Here are Dr. Greger’s optimum nutrition recommendations: http://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/ You will note on that page references to B12, D, Omega 3, iodine, etc as nutrients of concern. Dr. Greger’s new book, How Not To Die includes specific recommendations for B12, an algae-derived omega 3 supplement, and D supplement.
      .
      The information on the page I linked to above is nothing new and nothing that has gone away as near as I can tell. (Ie, your characterization of Dr. Greger “flip flopping” is not something I have ever seen on this topic.) Where is your evidence that Dr. Greger says we do not need a B12 supplement? Or that he does not recommend an omega 3 supplement? Etc. It sounds to me like Dr. Greger and Dr. Fuhrman are pretty much on the same page on this topic. Why are you claiming otherwise?
      .
      When you say, “I hope that we don’t end up like this couple…” are you saying that you follow the Daily Dozen and Dr. Greger’s other recommendations regarding what you eat and supplement?




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      1. I am talking about this particular video where Dr Greger said that Omega-3 supplementation is not needed, but perhaps needed… see my next video.

        And yes I eat the daily dozen.




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        1. Freestyle1: Saying that omega-3 supplementation is not needed for say heart health is not the same as saying omega 3 is not needed for something else. This video is part of a series, as you are aware. Since Dr. Greger’s book and recommendations on this site both recommend omega-3 supplementation as the bottom line, we know that the series will eventually get to the evidence which Dr. Greger thinks is compelling enough to recommend omega-3 supplementation.
          I hope the link I provided above is helpful in terms of pointing you to all the recommended supplements and nutrients of concern that Dr. Greger points out.




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          1. So 10 years ago, Dr Greger said that lack of Omega-3 will cause heart diseases and shorten life. 10 years later, Dr Greger says that Omega-3 supplementation is not needed to prevent heart diseases. So how can in 10 years, sciences have changed drastically from one extreme to another? It’s not like saying lack of Omega-3 will make you gain weight or look older but shorter life and heart diseases are pretty extreme, don’t you think so? And what will happen to those people who listened to Dr Greger advise and took algae or fish oil for the last 10 years? Do they stop taking now?




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            1. Freestyle1: I don’t get where you are coming from. Stop taking fish oil? Absolutely. I don’t remember Dr. Greger ever recommending fish oil. You can learn more about the problems of fish oil on this site. (Start with the topic page.) Did he really recommend fish oil on that old talk?
              .
              Stop taking DHA/EPA in the form of an algae oil extract? Yes or No. Depending on whether you think the upcoming video is compelling. See my previous posts. Depending on what your overall diet is . Depending on your medical situation. Depending on what you believe about evolution and what you believe about that story’s relevance to today. Depending on…
              .
              Note: I *think* I know which old Dr. Greger talk you are talking about. It’s been several years since I watched that talk myself, but I seem to remember that Dr. Greger’s conclusion in that video was more about the ratio of omega 3 to omega 6 than a great push to supplement omega 3. Now we are talking about something a little different as I see it. Now we are seeing that supplementing with omega 3 (without regard to other factors such as ratios) may not help with heart health, but that doesn’t mean that it still isn’t important to get those ratios of omega 3 to 6 correct—which can be done without supplementation. (In other words, the talk from 10 years ago may still be correct. I don’t know.)
              .
              I also seem to remember (perhaps incorrectly) that the old talk was more about Dr. Greger’s theories. I don’t remember that talk standing up to the same level of evidence standards that today’s videos on NutritionFacts must meet. Dr. Greger wanted to explain why a 40 year old vegan would get a heart attack. He came up with some theories. But I don’t remember that he had the level of studies we have today to verify those theories. Surely you are not arguing that if Dr. Greger doesn’t know the absolute truth about absolutely everything at this very moment, he has nothing relevant to say? Happily we do know what will prevent heart attacks, and this site has a lot of information on that topic for anyone who is interested. So, we don’t have to worry that supplementing with omega 3 may not help with heart health.
              .
              There’s a lot I don’t know. What I do know is that while the big picture of nutrition has been unchanged over decades, new information will tweak some fine details. At any one point in time, Dr. Greger will (rightly) present the best available information we have. Sometimes, pieces will change. Happily for this piece: While omega 3 supplementation may not be helpful for heart health, it looks like we will be learning about another reason that supplementing with pre-formed DHA/EPA algae-based oils is health promoting. So, if someone started taking that algae DHA 10 years ago, they are *golden.* I’m envious. It sounds like they may be ahead of the game.
              .
              We shall know more when the next video in the series comes out. At that time we will each be able to weigh the evidence Dr. Greger has for us.




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                1. Freestyle1: 2 tablespoons of flaxseed. Now that sounds right! FYI: Dr. Greger now recommends 1 tablespoon, but I don’t think that’s because 2 will hurt. Just that when you balance out all your calories, you may only need 1.
                  .
                  I don’t remember Dr. Greger saying “or you will die of heard disease at age 40”. The point of that talk was that disease *risk* might go up if his theories were correct. And if his theories were correct, that could explain some of the data he was seeing. As for whether he has changed his mind, I would refer you to my previous posts for my opinion on the matter.




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    2. Funny thing is if any of Dr. Fuhrman’s vegan patients test low for Omega-3, it’s probably as a result of following his diet long-term. He’s the only plant-based doc I’m aware of that promotes eating significant quantities of all kinds of nuts and seeds, which are the food sources with the highest Omega-6 content. Most studies that have looked into ALA to Omega-3 conversion found a significant correlation with the n3:n6 ratio, the higher the Omega-6 content of the diet, the poorer the conversion rate.




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  15. Hi George, krill oil contains less EPA and DHA per gram than fish oil but does contain the powerful antioxidant astaxanthin and phospholipids for better absorption. It really depends on what your healthcare provider is looking to support. If it’s higher amounts of EPA, for example, you would need to take 3-5 x the amount of krill oil pills as you would fish oil to get the same amount. BOth have their benefits as long as it comes from a pure, uncontaminated source. Hope this helps.




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  16. Dear Dr. Greger and the Nutrition Facts staff,
    Can you do a post on longevity showing what the maximum human lifespan is given proper nutrition and lifestyle? It seems that many organisms are capable of extremely long life such as trees, sharks, turtles, and whales. It’s well known that certain animals lifespans are shortened in captivity. Perhaps modern lifestyles are like living in captivity and we’ve shortened our lives. In How Not to Die, you wrote that everyone dies of some disease. Perhaps, with a whole food, plant-based diet and exercise, humans can live much longer. Please advise.
    Thanks,
    Peter




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    1. Hi Peter, that sounds like a great idea. I will pass it on to Dr. Gregar’s research team. I don’t know how much research they will find on diet and longevity. Certainly Dr. Gregar has mentioned that the famed Okinowan’s have lost their longevity advantage to a large degree due to adopting the modern high fat and animal based diet.




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      1. Great. Some sharks live 500 years it seems. Many whales live 200 years. Orcas in captivity l live a few decades at most. Wonder if other wild animals, living in accord with their evolutionary history, might live longer. I heard great apes live 80 years. Maybe some live longer. Biblical life spans were 500 years, but those were fanciful, or were they? Doesn’t seem like we really need to wear out our bodies, if we eat right and avoid accidents. Would love to see what the research says. If there is any. Might be good to explore what “natural causes” really are. There’s also the subject of “biological age” – whereby older athletes appear much younger in terms of cardiovascular health. Hope they explore it. and Thanks!




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    2. It turns out Dr. Gregar already found a lot of research showing the longevity effects of Low Fat, Wholefood, Plant based Nutrition. Although the total lifespan achievable may not be easily quantifiable, there are many videos showing the positive effects of such foods on longevity. A few are… http://nutritionfacts.org/video/fruits-veggies-and-longevity-how-many-minutes-per-mouthful/
      and http://nutritionfacts.org/video/slowing-metabolism-nitrate-rich-vegetables/
      In fact, if you enter “Longevity” into the search bar at the top of each page on nutritionfacts.org, you will get 135 videos on the subject!




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    3. Studies have been done on how much life extension might be expected if we eliminated some major causes of death. Eliminating cardiovascular disease (32% of deaths in the US) would increase average male lifespans by 4 years. Eliminating cancer (23% of deaths) would add 3.8 years. Respiratory diseases (6%), 0.4 years. Eliminating all other causes of death, leaving just those three, would add 1.9 years. The problem is there are some fundamental systemic collapses in aging (from cell senescence to the immune system) such that without any of the big killers, most of us would live to around 90, have swift declines, and promptly die of pneumonia or septicemia. For lifespan extension of more than about a decade in humans, its not enough to eliminate the current major causes of death, some modulation of more fundamental aging processes is required.

      Experimental gerontologists have found dietary interventions, like protein restriction, or restriction of specific amino acids like methionine or tryptophan, that extend mammalian lifespans by about 20-30%. These may presently contribute to greater longevity in vegetarians. Total calorie restriction achieves mammalian lifespan gains of around 40%, and that may contribute to greater longevity in regular fasters and ascetics. The likely mechanisms are pretty well understood, through targeting nutrient sensing hubs like mTOR and shifting cells from anabolic to catabolic states with more autophagy, which clears out damaged proteins and mitochondria. The problem is that there are many other hallmarks of aging, and were we to “solve” one pathway, the others would become more prominent, just as is the case with aging related chronic diseases. The situation is not unlike the legend of the boy and the dike.




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  17. I’m really interested in how and land-based animals that appear to get very ill indeed on animal foods (at least in our later years) how did we get to need all this dha and epa to build our brains? I see greens and bugs cited in various discussions here. But what about shellfish? As they are lower down the foodchain they may cause fewer problems with concentrations of POPs for instance. They area also down there with bugs, worms, snails, grubs etc as the types of “animal foods” that even “plant eating animals’ eat regularly (often by accident). So Dr Greger if you are reading this – Hi! And: please can we look at some evidence on shellfish specifically?




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    1. I read that shellfish filters out the toxins from polluted water and therefore has no toxins, even if raised in farms.

      Depending on what you define by life, shellfish has the lowest “intelligence” because it does not have a brain. Actually most animals die a very horrific death in nature either through starvation or being eaten alive by bigger animals and … plants like you said.




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    1. Freestyle1: I don’t know how valid your links are. Dr. Greger has never said that omega 3s are not a vital essential fatty acid. The question we are all pondering is whether active supplementation of pre-formed DHA/EPA confers benefits. Dr. Greger found that the balance of evidence shows that taking supplements of DHA/EPA may not confer benefits for say the heart.
      .
      I randomly picked one of your links to look at: https://www.ncbi.nlm.nih.gov/pubmed/21684546 From what I can tell of the abstract, all it says is that if you already have a heart problem, your DHA/EPA levels will be lower. The researchers looked at “patients suspected of having coronary artery disease who underwent coronary angiography”. The finding in the people they looked at was, “Patients with acute coronary syndrome had significantly lower levels of ω3 PUFAs (especially of EPA and DPA) than those without it.”
      .
      I’m sure you have heard that association does not equal causation. For all we know, people with low DHA/EPA in their blood got low EPA/DHA because they had worse diets. The finding does not necessarily mean that the people got heart disease because of lower DHA/EPA. And we have no idea from this study if DHA/EPA supplementation would have provided any benefit.
      .
      That’s why the studies that Dr. Greger provides are so much more compelling and tells us something of actionable value. If I recall correctly, the studies highlighted on NutritionFacts tells us what happens when people supplement with DHA/EPA. Does the balance of evidence say that doing so confers heart benefits? According to one person, no.




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      1. There is no source of Omega-3 in foods that can be can be converted to DHA/EPA unless you eat seafood, period. ALA in fax seed cannot be converted into DHA/EPA efficiently. So without eating seafood, the only thing left to do is to take a supplement, as fish oil or algae oil.

        Now studies after studies have demonstrated the benefits of DHA and EPA. They don’t do studies for nothing if this association does not equate causation. If you use the same argument then I can say that smoking does not cause cancer just because most people who die of lung cancer smoke.

        Dr Furhman who is vegan, advocates Omega-3 supplementation and he sells an algae oil supplement. You can say that he has a conflict of interest if you want.

        I suspect that the main reason why Dr Greger now says that we don’t need Omega-3 supplementation is because 10 years ago, he said that vegans can eat flax seed to prevent early death from heart disease. Then he found out that ALA from flax seed is poorly converted to DHA and EPA. So what is left for vegans now is to take algae oil supplement which is very expensive. So now he says that vegans don’t need to take Omega-3 supplement.




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        1. Freestyle1: You wrote, “I suspect that the main reason why Dr Greger now says that we don’t need Omega-3 supplementation…” As I’m pretty sure I explained before, Dr. Greger *does* recommend omega-3 supplementation. Please be very clear about that as we don’t want to misquote anyone…

          You wrote, “They don’t do studies for nothing if this association does not equate causation.” Actually they do. This is done for a variety of purposes. But if you want to assume a clean motive and talk about basic science, then this is part of the basic scientific process. First you figure out if there is an association. That gives you a clue to whether there is something more worth investigating. Then you try to figure out if causation is involved. Looking at associations without knowing causation is just part of the process.

          Sure, at some point, we can learn that an association was indicative of causation. But as I said above, we already know this is not likely true. We have studies showing that DHA supplementation does not help with heart disease. That tells us that the association between DHA levels in our blood and heart disease are not likely a situation of cause and effect. It could be a situation of reverse causation as we get with the whole cholesterol question. Or maybe all we can say is that DHA supplementation does not fix a heart disease problem.

          Yes, Dr. Furhman has a conflict of interest. That doesn’t mean that Dr. Furhman, along with Dr. Greger, are not both right about the advisability of supplementing with DHA/EPA. It just means that Dr. Furhman’s recommendation has to be taken with a whole lot more investigation and caution.

          You wrote, “There is no source of Omega-3 in foods that can be converted to DHA/EPA unless you eat seafood, period.” This is incorrect on a couple of levels. Level 1: fat from the flesh of fish does not need to be converted to DHA/EPA, because it already contains DHA/EPA. https://health.gov/DietaryGuidelines/dga2005/report/HTML/table_g2_adda2.htm

          Level 2: while the conversion is not efficient, our bodies do convert omega 3 ALA from plant foods to DHA/EPA. The question is, does our bodies convert enough? We will find out more tomorrow. For now, note that our needs for DHA/EPA are very small. So, small conversions may be plenty. And take note of the following:

          1) The bodies of vegan people do a better job of converting ALA to DHA. So, the question is, even if the conversation rate is low, can our bodies convert enough to make us healthy? We don’t need very much:
          2) Studies of vegan people show DHA levels to be high compared to other groups. Other studies show vegan bodies to be relatively low, but in those cases there is no apparent harm from those levels. So, the problem may be in the assumption that the DHA levels are low.

          *********************
          In regards to ALA conversions, This recent study showed that the conversion rate in Vegans is 2x that of a fish-eater.

          “Comparison of the PLLC n23 PUFAs:DALA ratio between dietary-habit groups showed that it was 209% higher in vegan men and 184% higher in vegan women than in fish-eaters, was 14% higher in vegetarian men and 6% higher in vegetarian women than in fish-eaters, and was 17% and 18% higher in male and female meat-eaters, respectively, than in fish-eaters This suggests that the statistically estimated conversion may be higher in non-fish-eaters than in fish-eaters.”
          http://www.ncbi.nlm.nih.gov/pubmed/20861171

          *****************************
          In addition, another study showed that despise this “theoretical” low conversion rate, there is no evidence of any harm so, the problem may not be in the conversion rate, but in the assumption that it is low.

          Prostaglandins Leukot Essent Fatty Acids. 2009 Jun 3.

          “There is no evidence of adverse effects on health or cognitive function with lower DHA intake in vegetarians.

          In the absence of convincing evidence for the deleterious effects resulting from the lack of DHA from the diet of vegetarians, it must be concluded that needs for omega-3 fatty acids can be met by dietary ALA. ”

          They also noted the importance of limiting excess omega 6’s, especially in vegans/vegetarians.

          **************************
          American Journal of Clinical Nutrition. November 2010, Vol 92, Number 5, Pages 1040-1051. The vegans in the study actually had highest levels of DHA (which most sources say it’s harder for the body to convert ALA into DHA, than it is to convert ALA into EPA) compared to the fish eaters, non-fish-eating meat-eaters, and vegetarians. This was despite the fact that they consumed less omega 3s. (Stephanie also found an article that summarizes the study: http://www.nutraingredients-usa.com/Research/Omega-3-ALA-intakes-enough-for-EPA-DPA-levels-for-non-fish-eaters?utm_source=copyright&utm_medium=OnSite&utm_campaign=copyright




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            1. Freestyle1: You do not seem to understand what a conflict of interest is. We can’t go anywhere in this conversation until you understand the term.




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  18. I have a very sound question and would really appreciate if an expert answers it:

    In all human history, most mothers did not access to fish and of course flax & chia seeds etc. and by some miracle they were able to convert 1mg (averaging) ALA to DHA such that their babies have developed A BRAIN from scratch without problem (and in some cases lots of babies and lots of brains)! Corporate financed studies are not enough to change this fact. Now, they say we need to take the pill. And I have a counter argument for this presumably brain shrinkage as we age: People clog their arteries with crappy diet and their brain can’t get enough oxygen & glucose, and hinder DHA production which occurs naturally in our body. Maybe that’s why they lose their brains! Just show me an evidence that a person who eats WFPB may benefit from DHA supplementation. I would rather buy and eat walnuts instead of investing tons in pills.




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    1. I agree 100% ! It goes against evolution and WFPB diet. Unless Drs. can show modern life has made it harder for us to have access to certain chemicals that were available long time ago (like for example B12 and Vitamin D deficiency due to modern sanitized life and lack of access to direct Sun light).




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  19. I used to subscribe to the Harvard Heart Health Newsletter. Twenty or so years ago, it included an article about a study done at Harvard to see if salmon oil supplementation would prevent second heart attack. It did. I can’t recall the stats, but they were highly positive. A footnote mentioned that an unexpected side effect was also discovered: those taking salmon oil who had irregular heartbeat had fewer episodes of irregularities. As I have this tendency, I started taking salmon oil daily. My incidences were cut at least in half if not more. I continue to take a 1000mg twice a day with continuing success.




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    1. Dear Claudia,

      I am not sure of which publication you are referring to but it seems like the benefit might be related to the omega-3 EPA DHA. For a contamination free alternative, I’d suggest a microalgae based oil.

      Hope this answer helps.




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  20. I’m a Vegan. I take D3.B12.KI,Folacin,VIt.C. Should I take DHA/EPA ( algae derived) This video gives essentially a different opinion than the “Should vegans supplement with DHA/EPA”, video. What ( other than the ones listed) supplements should I be taking?
    Thanks




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    1. Dear Fab,

      If you are taking a B12 & microalgae omega-3 supplement whilst having a diversified diet with a variety of plant food you should be covered. D3 will have to judged on your geographical location and baseline levels.

      Hope this answer helps.




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  21. I’ve been looking for a good vegan DHA supplement. I can’t find any that don’t contain Tocopherols or vitamin E. I’ve read vitamin E supplements are linked to increased mortality. So, is it still better to take a DHA supplement that contains vitamin E? The labels do not say the amount of vitamin E.




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    1. TT: My *guess* is that the small amount of vitamin E in a DHA pill would provide the function of helping to preserve the liquid and that the amount would be a trivial amount compared to an actual vitamin E supplement. But that’s just my guess.




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  22. Hello Everyone,

    First of all apologize me in advance for the little bit silly questions and also for that I think I know the answers in 90% but still, I would like to ask for your opinions in the following issue: for my optimal Omega 3 – Omega 6 ratio during a day I always eat 20gr of walnuts/pecans/almonds/peanuts for breakfast. Then for lunch I am having 30gr of flaxseeds/chia seeds and finally for diner 10gr of flaxseeds/chia seeds also.

    So my questions are the following:

    1. Does it necessary to have the good O3:O6 ratio during every meal we have or do we have to look the whole day for that? I mean for breakfast my O6 intake is much more than the O3 but after that with my lunch and diner (flaxseeds/chia seeds) I end up with a good O3:O6 ratio. Also I don’t know maybe it is better to start the day with the “good ones” so I mean with the O3s than for lunch the O6 intake and finally end the day with a slightly amount of O3 again. Or it does not matter at all?

    2. What if our O3:O6 ratio is actually better than 1:1 (in the direction of O3 of course)?

    I am sorry again for the little dumby questions but I am curious about your opinions.

    So thank You very much for your kind replies and helps in advance. Also I wish You a beautiful day : )

    Best regards,
    Zsolt




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    1. Very thoughtful question! You are doing a great job of boosting your omega 3 plant sources with the walnuts, flaxseed and chia seeds which will help to move your omega 3 to omega 6 ratio in the right direction. With most nutrients, best to reflect on the whole day, not individual meals. I’m not aware of any studies looking at what you’ve asked in this regard, though. To your second question, because omega 6 fats are so widely spread in our food supply (ie. poultry, nuts, seeds, eggs, most vegetable oils), it would be a challenge I think to tip the scale in favour of a better than 1:1 omega 3:6 ratio. You can read Dr. Greger’s blog on this topic here: http://nutritionfacts.org/questions/what-would-you-suggest-as-an-ideal-omega-369/




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  23. WFPBrunner: Woo hoo! That’s pretty cool about the trans fat number. And that you got your cholesterol number back in check is also exciting. Good For You!!!
    .
    Thanks for sharing. :-)




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    1. Hi Ron, Yes. There are a number of labs around the country that offer this testing. Quest diagnostics a major national lab offers a test named Omega 3 and 6 Fatty Acids that provides a measurement of percentages of EPA, DHA and Arachidonic Acid in the blood. This test also provide some ratios of these fatty acids and a risk index. There are several other specialty labs around the country that offer similar tests such as Boston Heart labs and Cleveland Clinic but it’s likely that your primary physician would be most able to order it through Quest labs.




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  24. We have an algae based epa/dha oil available here in NS from Accenta. They want us to take more than the 250 mg suggested in Michael’s video. So, what is the shelf life once opened, of these oils and refrigerated?




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  25. Dr. Greger please comment on SN-1 vs SN-2 and its importance to DHA absorption — seems like mother’s milk gives a clue here that it is important during those times when we need large amounts to support massive brain growth… but, what does the mature brain need and how important is the SN-1 vs SN-2 position.




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  26. I used to subscribe to the Harvard Heart Health Newsletter. Twenty or so years ago, it included an article about a study done at Harvard to see if salmon oil supplementation would prevent second heart attack. It did. I can’t recall the stats, but they were highly positive. A footnote mentioned that an unexpected side effect was also discovered: those taking salmon oil who had irregular heartbeat had fewer episodes of irregularities. As I have this tendency, I started taking salmon oil daily. My incidences were cut at least in half if not more. I continue to take a 1000mg twice a day with continuing success.




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  27. So 250 mg of clean pollutant free algae is recommended? Over flax oil? Does anyone have any pollutant free brands they trust? I’ve been so confused about ala conversion. I’ve been taking flax capsules and my dr told me I need 9000 mg of ala to convert into 2000 mg of omega 3. Now I’m learning that omega 6s block the conversion of ala and lessen that percentage even more. Do omega 6s also block conversion with the algae?




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