fish oils

[dhflp]

Dr. Barry Sears (#New York Times bestselling author of the zone) in one of his books writes the following "THE PRIMARY PREDICTOR OF HEART DISEASE IS HIGH LEVELS OF INSULIN.Heart disease is the number one killer of both men and women in America.However,the best predictor of heart disease is not high cholestrol,not high blood pressure,but elevated levels of insulin." He also writes "If the ratio of triglycerides to HDL is less than 2, you've got a rough indicator that you're relatively healthy.Ideal state of wellness: TG/HDL 1,Fasting Insulin(uU/ml) 5, AA/EPA 1.5. Recommendations for Taking Pharmaceutical-Grade Fish Oils.Mainenance 1 teaspoon,Improved cardiovascular health 1 to 2 teaspoons, enhancement of brain function 2 to 3 teaspoons." 1.What's your opinion on taking (liquid) fish oils supplements and how may teaspoons should middle age men be taking for raising HDL,lowering TG and in general for prevention of heart disease?2.Which fish oils (name brands) are the best to take daily and what do you think about Carlsons fish oils in regards to potency,purity(mercury,lead,PCB)? 3.Is it healthy to have fasting insulin level in the range of 2.5 to 5.0 uU/ml for middle age men and is insulin the primary predictor of heart disease as Dr.Barry Sears writes in his book?If no what are the primary predictors of heart disease? 4. Which of these two lipids test results is better for average healthy middle age men to have:TC 135,TG 158,HDL 35,LDL 68 or TC 155,TG 83, HDL 44, LDL 94 for prevention of heart disease and why? 5. Is TG/HDL ratio better predictor of heart disease than TC/HDL?T

[CCF-M.D.-MJM]

Hi dhfp,

These are very difficult questions that I am not sure there is a clear answer to yet.    Dr. Sears' book is very popular but I have not read it nor do I recommend that patients take fish oils supplements.  I have read that if you are going to take them, you should take pharmaceutical grade fish oils.  I am not familiar with brands.


1.What's your opinion on taking (liquid) fish oils supplements and how may teaspoons should middle age men be taking for raising HDL,lowering TG and in general for prevention of heart disease?

The recommendations I have seen are to have 2-3 servings of a fatty fish like salmon per week.  I do not recommend taking fish oils daily.

2.Which fish oils (name brands) are the best to take daily and what do you think about Carlsons fish oils in regards to potency,purity(mercury,lead,PCB)?

I am not familiar with brands.

3.Is it healthy to have fasting insulin level in the range of 2.5 to 5.0 uU/ml for middle age men and is insulin the primary predictor of heart disease as Dr.Barry Sears writes in his book?

I do not check insulin levels on screening for cardiovascular risk. However, other predictors that we look for (weight, blood sugar, and cholesterol especially triglycerides) are indirect measure of blood insulin levels.  I am not sure what the healthy insulin range is and I don't think there are any ACC guidelines to for checking them.

If no what are the primary predictors of heart disease?

age, cholesterol (high ldl, low hdl) diabetes, family history, smoking

non traditional: serum inflammation (hsCRP), HPa, (insulin?)

4. Which of these two lipids test results is better for average healthy middle age men to have:TC 135,TG 158,HDL 35,LDL 68 or TC 155,TG 83, HDL 44, LDL 94 for prevention of heart disease and why?

I think the question you are asking is it better to have a low LDL or a higher HDL.   The real answer is both.  Statistically, I am not sure which profile is better.  The recommendation for LDL is based on your LDL level and your risk factors.  HDL is desireable to have above 40-45, usually the higher the better.  I would focus more on this than individual panels.

5. Is TG/HDL ratio better predictor of heart disease than TC/HDL?

I think you are overly concerned with statistics here. I don't know which is the better predictor.  The goal in my practice to decrease the LDL and trigs, and try to increase the HDL.  I do not make medication adjustments based on ratios.

I approach these questions in a different way than I thik you want to know them and am not sure how to advise you differently. I hope this helps.

[stlcard1521]

"What's your opinion on taking (liquid) fish oils supplements and how may teaspoons should middle age men be taking for raising HDL,lowering TG and in general for prevention of heart disease?"

Depends on the concentration of the stuff. Diffrent products have diffrent concentrations. Might be 1 tsp for one brand and 2 tsps for another. You should probably talk to a doctor or pharmacist about that if youre dead set on using fish oil. Niacin is probably a more tried and proven non prescription medication, but youre supposed to use it under supervision of your doctor because it causes liver problems/failure in a small number of users (you should probably talk to your personal physician to make sure youre OK with the fish oil too if you havent already, because it makes you bleed easier)


The doc is right; don't get too concerned with statistics, because theyre just that, statistics. Just live a healthy lifestyle instead of worrying about which lipid profile will theoretically make you 0.43128152% less likely to have heart attack and you'll lower the odds of having one. Quit using tobacco if you do, excercise regularly or atleast stay active, keep your blood pressure and weight in check, and try to eat a reasonably healthy diet. There is no magic indicator as to whether or not you'll have a heart attack, so dont get too concerned with the details. Check the american heart association's website if you want more tips on improving CV health, its a decent resource.


Note: I'm not a doctor

[LynnSB]

Here's the American Heart Association's position statement on fish oil and eating fish: http://www.americanheart.org/presenter.jhtml?identifier=3006624

there's a ton of data out there in the literature - try a google search on the subject.

Dr. Andrew Weil recommends fish oil. see his comments here:http://www.drweil.com/u/Article/A116/

Unfortunately fish oil supplements can be contaminated with mercury and other things you don't want to take --- my own research makes me very comfortable taking Vital Choice, www.vitalchoice.com ( recommended by Dr. Weil and many other docs).. just my opinion.

Lynn

[Gaspipe]

I have not read this book but have read others like it. One precaution ..many if not most times these "authoritative" books are based on the authors empirical data or more simply his or her personal experiences. They are not the result of long term controlled studies that have been given critical review by experts in the area of study. Bottom line.. take it all with a grain of salt and remember these people are trying to sell books,

[dhflp]

Are Dr.Weil supplements sold in liquid form and how many EPA,DHA and other Omega 3 Fatty Acids mg are there in one teaspoonful?What's the price?Thank you

[netrox]

Fish oil supplements, even cheap ones, are proven to be safe and free of toxins. There is NO need to worry as long as they're from well known health companies like Kirkland (costco), nature made, jarrows, etc.

I agree with the doctor - I don't recommend taking it everyday.

There is no evidence that fish oil will help your PVC's. In fact, one study found that people who had history of deadly arrythmias (with no heart disease) developed more fatal arrythmias on fish oil supplement than those on soybean oil. In other words, fish oil may be proarrhythmic in patients who have no heart disease.  

http://jama.ama-assn.org/cgi/content/abstract/293/23/2884

Why does it contradict the older studies? It doesn't. Fish oil is effective for those who had a HEART ATTACK. My best theory is when the heart tissue is damaged, the tissue releases free omega-3 fatty acids into the blood which stablizes the heartbeat. When you have arrhythmia without heart disease, the tissue doesn't get damaged at all. The omega-3 acids are simply residing in tissues and the tissues can get too "slippery" and set off VT or VF.

But mind you, you STILL need omega-3 in your diet. It can provide protection in CASE you have a heart attack and it also keeps your brain healthy. Fish oil is the best source. It's just that it's no longer recommended that you take it on a daily basis.

-jeff

[Dasobel]

Not a doc, but--

Just to add some context, the JAMA article suggesting proarrhythmic effects from fish oil is rather complicated.  The patients receiving fish oil did not have coronary artery disease, but did have a long history of serious SVT and had implanted defibrillators.  They DID NOT subsequently have a higher incidence of fatal arrhythmia, but rather their defibrillators were activated sooner for the first time than other subjects receiving placebos. That doesn't mean they would have died from the event that prompted the defibrillator to activate.  

In addition, as many physicians pointed out in letters to the JAMA after the article's publication, these individuals might not be expected to respond positively to fish oil since their arrhythnmias did not stem from sodium or calcium channels prompting extra electrical activity--  which is what fatty acides in heart cells seem to block.  Many people with non-ischemic hearts DO have these calcium channel, etc., problems as the prime source of their arrhythmia, so fatty acids presumably would be beneficial for them , as so many studies have indicated.  

For the class of patients in the JAMA study, fish oils did not help, and may have even hurt.  The prophylactic benefit of fatty acids is overwhelmingly documented, though; not just for pateints with ischemic heart disease, but for general populations.  Indeed, interest in fish oils began with research into why populations like the Japanese and Icelanders have such low incidence of CAD and sudden cardiac arrest.

Just some additional thoughts on the "fish oil wars"....

[dhflp]

There is no Carlson fish oil on INFOS lab testing site,but there is Dr.Weil,Dr.Sears(Zone), nordic naturals.Do you know why since I heard that Carlsons are also very good?

[LynnSB]

I’m a science/medical journalist, not a doctor, but I peruse and study the medical literature   daily. I can tell you that taking one study out of context – as not only the public but many in the media (who opt for sensationalist headlines and  sometimes seem incapable of understanding the science) do too frequently -- means little. The  trial  you refer to tested the effects of omega-3 fish oil supplements on heart patients with an implantable cardioverter defibrillator (ICD). It hardly should be taken as the “Bible” on the effects of omega-3 supplementation with fish oil on others! As I’ve noted in another post some months ago,  the European “SOFA” trial also concluded fish oil  results in  little or no benefit in  people at risk of sudden death who have ICDs.  Both of these studies focused on people with extremely serious heart problems ( in all likelihood with major electro-physiological damage to their heart) who, at their “late stage of the game”, so to speak, were least likely to benefit for a nutritional intervention such as omega-3 supplementation.

The overwhelming body of evidence from laboratory, animal, epidemiological, and clinical studies indicates that fish oil reduces the incidence of irregular heart beats and also reduces rates of sudden cardiac death itself.  For example, a  very large  European study  published three years ago (called GSSI-Prevention), studied 11,323 cardiac patients randomly assigned to receive omega-3 fish oil supplements vitamin E (300 mg per day), both, or no treatment (control), in addition to medication if needed  and lifestyle changes.  The researchers concluded:  “The early effect of low-dose [omega-3 supplements] on total mortality and sudden death supports the hypothesis of an anti-arrhythmic effect of this drug.  Such a result is consistent with the wealth of evidence coming from laboratory experiments on isolated myocytes [heart-muscle cells], animal models, and epidemiological and clinical studies."

More studies  supporting the efficacy of Omega-3s in supporting heart health have been published; more are in the works. The AHA has NOT reversed its position stated here  on the value of Omega-3s (  http://www.americanheart.org/presenter.jhtml?identifier=3006624 ) .

[netrox]

Like you, I read those studies but from what I find, the protective effects of omega-3 acids appear when the heart tissues are damaged. When scientists induced PHYSICAL DAMAGE to heart tissues in animals, it can cause lethal arrhythmia but animals taking omega 3 acids were protected. I haven't find any studies that show omega-3 acid protection against arrhythmia when its cause is NOT caused by tissue damage.

Because of all the studies I've come across, I've concluded that the omega-3 acids seem to work ONLY if the tissues are damaged (which helps release fatty acids in tissues). When a person has arrhythmia due to electrical problems, I am not convinced omega-3 acids offer any protection. Arrhythmia not caused by CAD does not cause the heart tissue to be damaged so omega-3 acids don't do anything for it. If you have arrythmia that is clearly caused by CAD, then omega-3 acids offer that significant protection.

I do take fish oil every other day BTW.

[dhflp]

There is typo,should be IFOS instead INFOS.If Dr.Sears fish oils are so good why nobody sells them,but instead one has to order them directly from him at a high price?Spring Vally fish oils are cheap but what is interesting about them is the following advertisment "FISH OIL is to your HEART what CALCIUM is to your BONES."

[rabbit35]

Most Dr.s that I know do not know anything about nutrition because it is not in the medical school's curriculum. Dr. CCF you sound like you don't know anything about nutrition.

[dvd123]

As with BP the lower (insulin)the better.Good insulin level is 5,however the best level is 2-3 uU/ml,while high risk for diabetes is above 10.Men who have TC 135 (without cholestrol lowering drugs)and fasting(8hour)insulin level 2-3 don't get heart attacks. Does anyone know what the average mercury levels are in folks who take fish oil daily?

[jasonz85]

while surfing the net, I stumbled upon this site
http://fishoil.atspace.com
it states down lots of benefits of eating fish oil
is it really that great?
anyone eating fish oil now for such benefits? care to give me your feedback? thinking of buying it now... a tempting man... fish oil can really helps with fass loss, more fit and also prevent heart attack? so good?

[colas1976]

For all that are interested in FISH OIL, Omega-3, EPA and DHA consumption....there is a prescription strength, purer form of fish oil out there called OMACOR.  It was approved by the FDA in November and is available by presciption only.

[sirunning]

I am a 46 year old male who has struggled with high cholesterol since I first was tested 20 years ago. My levels have always been in the 260 to 295 range. I also was diagnosed with SVT last year but that is unrelated to this post.

I have tried different approaches to lowering my cholesterol over the years; diet change, garlic, fish oil, and flax seed oil, among others; but I was never able to significantly lower my numbers. I have tried Lipitor twice for a short period of time and it worked, but I am not comfortable taking statins due to the possible side effects.

I am writing now because I believe that I have found a way to lower my cholesterol using a natural product that has been studied extensively, though not necessarily in this country, has been found to be safe, and is as at least as effective as the current crop of pharmacueticals that are on the market today.

The product is Policosanol. It can be purchased at any health food store, is relatively inexpensive.... and it works!!!

On 11/19/05 my lipid profile was:

Total Cholesterol - 294
Triglycerides - 116
HDL - 49
LDL - 222
HDL/CHOL Ratio - 6.00
TG/HDL Ratio - 2.36

I took 20 mg of Policosanol (derived from sugar cane, not beeswax) each evening after dinner, along with 3 - 800 mg fish oil supplements, for three months, with no other diet changes. I had another blood test on 2/17/06 and the results were:

Total Cholesterol - 221
Triglycerides - 61
HDL - 56
LDL - 153
HDL/CHOL Ratio - 3.90
TG/HDL Ratio - 1.09

After reading many studies on the internet which have shown similar results, and reviewing my results, I am convinced that this is the supplement/treatment that I have been looking for.

Go to Google or Yahoo, do a search on policosanol and read the studies. It is effective, it is natural, and there are no side effects. I can't wait for my next test in three months.

Rich

[sptpr]

I take fish oils, coenzyme q-10 and hawthorn everyday.  I purchased them through Dr. Julian Whitaker and Dr. Stephen Sinatra who are both well known cardiologists and huge proponents of natural remedies.  They have well documented cases of people being "cured" or experiencing significant improvement when taking natural supplements that offer the same benefit as drugs.  I wouldn't just buy any old supplement off the market.  I have read alot about both of these doctors who have been around for 30+ years and still actively treat patients along with selling supplements.