KNOW YOUR OMEGA-3 STATUS
By Dr. Alby Ford
Everybody has checked their cholesterol levels at some time or another. But have you ever checked your Omega-3 Index? The Omega-3 Index is an important measure of heart health. In recent studies, individuals with a low Omega-3 Index were up to ten times more likely to die from a sudden heart attack (also known as sudden cardiac death (SCD) compared to those with a high Omega-3 Index. Dr. Bernadine Healy, Cardiologist and health editor of US News and World Report had the following to say: “Before long, your personal Omega-3 Index could be the new cholesterol test – the number you want to brag about”.
How important is it to have a high Omega-3 Index?
Omega-3 fatty acids protect your cardiovascular system. In the Physicians Health Study, which involved nearly 15,000 healthy male doctors, there was a greater than 90% reduction in risk of dying from sudden heart attack for one quarter of individuals with the highest Omega-3 Index compared to those with the lowest levels. (Elber et.al. New England Journal of Medicine 2002). Based on this and other studies, the Omega-3 Index appears to be an independent risk factor and not influenced by other heart disease risk factors like cholesterol or blood pressure.
How do Omega-3 fatty acids work in our bodies?
They operate via several pathways all beginning with the incorporation of EPA and DHA into cell membranes. From here, these omega-3 fatty acids alter membrane physical characteristics and the activity of membrane-bound proteins, and once released by intracellular phospholipases, can interact with ion channels, be converted into a wide variety of bioactive eicosanoids and serve as ligands for several nuclear transcription factors, thereby altering gene expression.
As much as blood levels are a strong reflection of dietary intake, it is proposed that the Omega-3 Index be considered a marker, if not a risk factor for coronary heart disease, especially sudden cardiac death.
The most pronounced data on omega-3 status have been reported for sudden cardiac death. Sudden cardiac death occurs 20 times more frequently in Western countries in comparison to Japan. In Japan, the average Omega-3 Index is 10%, whereas the Omega-3 Index of Western countries is as low as 5%. Sudden cardiac death in Japan is rare and consequently, in a large randomized intervention study showed that individual risk for non-fatal cardiovascular events can be reduced by adjusting the Omega-3 Index to be greater than 8%. (Yokoyama et.al. 2007)
Persons frequently ingesting omega-3 fatty acids have a 33% lower risk to develop congestive heart failure, as compared to persons never ingesting fish or omega-3 fatty acids. (Levitan et.al. 2009). A large randomized intervention study has demonstrated that 500mg EPA & DHA per day, reduces mortality and morbidity in patients with congestive cardiac failure. (Gissi et.al. 2008).
It is also important to know your omega-3 to omega-6 ratio. In our modern society everyone is getting in too much omega-6 fatty acids and too little omega-3 oils. Remember, that omega-6 fatty acids are pro-inflammatory which can cause whole body inflammation. Whole body inflammation is responsible for many of our largest and fastest growing health conditions including, obesity, diabetes, cardiovascular diseases, arthritis, cancer and many others.
Omega-3 fatty acids protects us against biological aging
Longevity and healthy aging is based on increasing evidence that associates part of our chromosomes (telomeres) with cellular and biological aging. In 2009 the Nobel Prize for Medicine was awarded for the discovery of telomeres and its connection to biological aging. Telomeres are protective caps of DNA at the tips of a chromosome that get shorter the more times the human cell divides. Over time telomeres can get damaged and shortened due to inflammation, smoking, obesity and lack of exercise. When the telomere is too short, the cell can no longer divide and will become inactive and die.
In recent omega-3 studies, patients with a high Omega-3 Index were shown to have a slowing of the biological aging process as measured by telomere length. The Omega-3 aging study was published in the Journal of the Medical Association in 2010, which was conducted among patients with coronary heart disease over a 5 year period.
Omega-3 fatty acids in pregnancy and lactation
The placenta provides 50 – 60 mg/day DHA to the foetus. This provision is regulated by proteins in the placenta that try to adjust the growing foetus to an Omega-3 Index of 10%. Endogenous stores are thus depleted in mothers with low levels. The motherly levels should be at 10% at all times during pregnancy and lactation.
Premature birth – a Cochrane meta-analysis, covering 6 randomized intervention studies (2783 pregnancies), demonstrated that premature birth was less frequent in women starting omega-3 fatty acids before week 34. This was also found in a more recent randomized multi-centre study in 961 women with pregnancies with elevated risk (premature birth, intrauterine growth retardation, pregnancy induced hypertension in a previous pregnancy) taking 2000mg per day starting at week 20, reduced the risk substantially.
Duration of pregnancy – In a systematic analysis of randomized studies, covering 1278 newborns, supplementing EPA and DHA prolonged pregnancy by 1.57 days and the head circumference was 0.26 cm larger. In the Cochrane analysis mentioned, omega-3 fatty acids prolonged pregnancy by 2.6 days and increased birth weight slightly. DHA is an important structural fatty acid for brain and eye, among other tissues. Therefore foetus and baby depend on a sufficient supply.
Post-partum depression – In nations where mothers consume large amounts of fish and/or omega-3 oils, post-partum depression is very rare.
Brain development – Parameters assessing visual information processing, like visual acuity or stereo-tactic vision, develop better in children with higher levels of EPA and DHA, similar to parameters of speech development. Attention spans are longer and distractibility is less. Better eye-hand coordination was seen in 2 year olds from mothers supplementing 2000 mg omega-3 per day starting at week 20.
Lactation – Breastfeeding transports EPA and DHA from mother to child. The content of breast milk can be enriched dose-dependently by supplementing the mother with these omega-3 fatty acids. Randomized studies demonstrate a positive effect of high levels of omega-3 in terms of visual acuity and psychomotor development in comparison with placebo.
Omega-3 fatty acids in Neurology and Psychiatry.
Docosahexaenoic acid (DHA) and to a lesser degree eicosapentaenoic acid (EPA), but not alpha-linolenic acid, modulates brain function. They modulate dopaminergic function, intracellular messenger systems, adjust hormonal systems, increase dendritic arborisaton and the formation of synapses.
Stroke – Ischaemic stroke is less frequent by some 30% in persons with a high Omega-3 Index. However, there does not seem to be an association between omega-3 oils and haemorrhagic stroke.
Cognitive deficits – Higher levels of DHA and EPA are associated with a lower risk for cognitive deficit and dementia. A first intervention study in patients with Alzheimer’s disease showed very promising results.
Major and Bipolar depression – Low consumption of omega-3 increases the risk for depression and future suicide attempts. Intervention studies with doses between 1-3 grams per day had promising results regarding depressive symptoms.
Schizophrenia – Levels of omega-3 fatty acids are lower in schizophrenic patients than healthy controls.
Borderline personalities – Data from intervention studies demonstrated that high levels of omega-3 fatty acids reduced hostility and aggression.
ADHA (attention deficit hyperkinetic disorder) – In children and adults with this disorder, lower levels of omega-3 fatty acids were found.
The Omega-3 Index Blood Test
The Omega-3 Index measures the concentration of the two specific omega-3’s namely EPA and DHA as a percentage of total fatty acids in red blood cell membranes. Studies have shown that an Omega-3 Index of 8% or greater is desirable for its cardio-protective benefits.
It also measures the major dietary saturated fatty acids (the very bad fats) as well as the Omega 6 to Omega 3 ratio. A lower ratio of omega-6/omega-3 fatty acids is more desirable in reducing the risk of many of the chronic diseases of high prevalence in Western societies, as well as in the developing countries, that are being exported to the rest of the world. (Biomed Pharmacotherapy 2002). Saturated fatty acids are associated with insulin resistance and glucose intolerance and are a significant risk factor for Type II diabetes.
Finally, it also measures the Arachidonic acid to EPA ratio, referred to as the Silent inflammation profile. Silent inflammation is the first sign that the body is out of balance and you are no longer well. You cannot feel it, but it is affecting your heart, your brain, and your immune system.
The Omega 3 Index test costs R875 and the blood (one drop) sample is sent to the USA for analysis.
High quality Omega-3 capsules are available from the practice (also imported from the USA) at a very reasonable cost.
For the above, please contact the practice.
Remember the old adage: “Prevention is better and cheaper than cure”.
Reference: The Omega 3 miracle – Dr G. Gordon MD. DO