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Fish oil catching on

Capsules or liquid every day keeps heart disease away, experts say

Saturday, February 20, 2010
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Kailyn Cavanaugh, a dietician at Ellis Hospital, eyes a spoonful of fish oil capsules.
Photographer: Peter R. Barber
Kailyn Cavanaugh, a dietician at Ellis Hospital, eyes a spoonful of fish oil capsules.

Kailyn Cavanaugh is ordering big helpings of omega-3 fatty acids. For everyone.

The registered dietician at Ellis Hospital hopes people get their omegas — which promote healthy cardiovascular activity — by eating wild salmon, tuna, herring and halibut.

But Cavanaugh knows about finicky eaters, folks who don’t like fish on their dinner plates. So she hopes fish oil capsules or liquid are part of their daily diet — especially if they have pre-existing heart conditions.

Doctors and dieticians have long been promoting fish oil, which contains eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which they say benefit both the heart and brain. Members of the medical community are always willing to promote the gold-colored oil as insurance against bad things that can happen to a body.

“Fish oil should be taken for several reasons,” said Dr. Joseph C. Maroon, a neurosurgeon at the University of Pittsburgh whose book “Fish Oil: The Natural Anti-Inflammatory” was published in 2006. “Number one, it’s an essential fatty acid that you have to get by diet. And number two, the National Geographic survey last year did a survey of streams in the United States and found that in over half the cases, the fish in the streams throughout the United States had mercury levels higher than permitted.”

Many grades of fish oil are purified of contaminants, including mercury, and labeled “mercury free.” The oils come in capsules, which generally require a handful to get the proper amount, and liquid form that puts one spoonful-sized serving on a person’s morning or evening schedule.

Maroon is an advocate for fish oil because he said people cannot get enough omega-3 fatty acids from just flaxseed oil and walnuts. “It’s not converted to the EPA and DHA as much,” Maroon said. “The best way to get adequate amounts assuredly is with fish oil capsules or liquid.”

Daily doses from the sea can accomplish much.

Prevents Inflammation

“The major diseases of aging are due to inflammations,” Maroon said. “This includes arthritis, Alzheimer’s disease, cancer and most importantly coronary artery disease and stroke. All of these are diseases caused by inflammation. Fish oil, being a natural anti-inflammatory, can be protective against all of these conditions.”

Americans are not helping themselves with diets full of fast foods deep-fried in partially hydrogenated oil; packaged frozen foods; and sweets like doughnuts and cookies. “The most common cause for inflammatory conditions is the Western diet full of trans fats, sugars and vegetable oils, and all leading to obesity,” Maroon said.

Reeling in people to try fish oil is not a new move by the medical community. Encyclopedic sources say cod liver oil, a source of vitamins A and D, has been used as a folk remedy by the Dutch for centuries. Fishermen rubbed the oil onto aching joints and irritated skin. During the mid-19th century, it was introduced into scientific medicine. It has long been used to prevent rickets in children and for other nutritional purposes, but may be more widely remembered as the medicine with the strong aroma and taste that mothers endorsed and kids despised.

Fish oil began picking up followers about 20 years ago, Maroon said, “but medically speaking, within the past five

years the medical establishment has become aware of how powerful the health benefits are.”

Elizabeth Somer, an Oregon-based registered dietician and author of 2009’s “Eat Your Way to Happiness” is also on the bandwagon.

Two servings per week

“We’ve known for years, since the 1980s, that the omega-3s in fish oil were critical for lowering heart disease risk,” she said. “That’s so well-substantiated that the American Heart Association even recommends that people get at least two servings of fatty fish a week — wild salmon, mackerel, herring, sardines, things like that. But in the last 10 years, the research has exploded into whole other areas. We have substantial research now that shows omega-3s lower the risk for depression. Even the American Psychiatric Association in 2006 included in their recommendations that anyone battling depression, no matter what their therapy was — medication or psychotherapy or whatever — should be taking omega-3s because the research is so strong. And there’s also some pretty good preliminary evidence that omega-3s lower the risk for things like dementia, possibly even Alzheimer’s down the road, and that’s just the tip of the iceberg. I think we’re going to be finding more and more in the future.”

She said children used to hear it from their mothers all the time: fish was brain food; prospective smart children swallowed spoonfuls of cod liver oil.

“We’ve had this wives’ tale for years, and now we have actually found there’s a scientific basis for it,” Somer said.

“Your brain is about 60 percent fat, and one of the predominant fats in the brain are omega-3s,” she added. “Your body doesn’t make it, you have to get it from the diet. If you don’t get it from the diet, the brain cells that really depend on that very fluid flexible fat, has to build its membranes out of something more rigid. So it makes sense these guys are really important in brain function. The more you consume, the more get imbedded in your brain cells, the more fluid the brain cells become.”

Somer, while doing research for her 2001 book “The Origin Diet,” said the American diet wasn’t always such a wreck.

“We average 100 milligrams of omega-3s,” she said. “Our ancestors ate grams, they ate lots of omega-3s. They were eating wild game, which is extremely lean ... very low saturated fat content and a relatively higher content of omega-3s. If they were eating eggs, eggs would have had a higher content of omega-3s.”

Fish not steak

Others in the nutritional know say people should not think they’re helping diet and health by ingesting fish oil after ingesting a big sirloin steak. Eating a smaller piece of wild salmon instead of steak provides fatty acids, but part of the fish dinner benefit is it becomes an alternate protein source — and replaces cardiovascular-unfriendly red meat for an evening.

“Fish oil should really be seen as an added benefit to your diet, not an excuse for eating poorly,” Cavanaugh said.

She would like to see more people reap the omega-3 benefits through several helpings of fish each week.

“You absorb more of the benefits, the omega-3 fatty acids, through the fish itself,” Cavanaugh said. “We absorb more nutrition through food than food supplements.”

She recommends salmon, tuna, herring and halibut. The American Heart Association advises people to stay away from golden bass, golden snapper, shark, swordfish and king mackerel because of their high mercury contents.

Cavanaugh said vegetarians can get their omega-3s through algae capsules.

People may have to do some math when they begin their fish oil regimens. Maroon said that a person who buys a bottle of 1,000-miligram capsules is not getting 1,000 milligrams of EPA and DHA.

“The minimum amount recommended is 650 milligrams of EPA-DHA,” Maroon said. “That’s not 1,000 milligrams of fish oil. The EPA-DHA content is the critical part, ideally you want 1.2 grams of EPA-DHA.”

People can find the numbers on the supplement facts printed on each bottle. For the 1,000-milligram capsules, the EPA-DHA total is 300 milligrams. “You need four of those a day,” Maroon said.

The doctor also said consumers must pay attention to the expiration dates on their bottles of fish oil. The oil can be refrigerated to prevent rancidity.

“You have to be careful with the shelf life of fish oil,” he said. “The problem with fish oil is it becomes rancid, and when it gets rancid, it’s worse for you because it releases chemicals that can actually damage your body, free radicals that can be harmful. Fish oil is rancid if you burp it up and it smells like fish.”

Check with doctor

Somer has heard from some people who complain that even newly purchased fish oil causes digestive annoyances.

“Some complain they repeat on you, they make you burp,” she said. “If you put them in the freezer and take them when they’re frozen, that cuts down the burping.”

Cavanaugh suggests checking with personal physicians before starting fish oil regimens. “Under a physician’s care is the best way to know you are taking the correct amount of fish oil,” she said. The Internet’s WebMD site agrees. “Fish oils can affect the blood’s ability to clot,” the Web doctors advise, “and taking too much could be dangerous for people already on blood-thinning drugs.”

Cavanaugh wants people to start that regimen — getting fatty acid benefits from fish from the dinner plate or capsule bottle.

“I think there’s been too much out in the public about the fears of eating too much fish due to mercury and PCBs and all the negative side effects,” Cavanaugh said, “and I know a lot of people will approach me, especially pregnant women and children, about the risk of eating fish. But truly the benefits outweigh the risk. You can eat up to 12 ounces of fish in a week and be within the safety limits. A serving size is 3 ounces, so up to four times a week.”

 
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