People with high oxidized LDL are 4-times more likely to have heart attacks than those with low oxidized LDL.
Does this affect you? (It does.)

Cholesterol particles are part of the ‘gunk’ that blocks clogged arteries.

And vegetable oils contain no cholesterol. They actually lower cholesterol.

These are reasons why vegetable oil has been promoted as a ‘healthy’ alternative to cholesterol-containing animal fats.

The popularity of vegetable seed oils

Our food supply is drowning in vegetable oils. They’re cheap. They’re from vegetables. They sound healthy. What’s not to like?

You’d think that with all that vegetable goodness, clogged arteries would be a thing of the past. But it’s not.

In the last few years, I’ve beat up on Omega-6-rich vegetable oils at every chance I get. Here and here. But that’s mostly because Omega-6 can increase inflammation. But getting the right balance of Omega-3 and 6 with fish and fish oil can offset some of that risk.

Vegetable seed oil consumption (lbs/year)

If all you’re after is a ‘healthy’ ratio between Omega-3 and 6, well, then you can out-drown vegetable oils with fish oil. Right? Technically, yes. But there is a deadly flaw in this thinking.

There is a problem with excess Omega-6 that Omega-3 cannot cure. Actually, excess Omega-3 is just as much to blame. Are you listening fish-oil-glugging Crossfitters?

It has to do with your LDL cholesterol. Most of us know LDL as the ‘bad’ cholesterol, playing Joker to HDL’s Batman. But this aint the movies – it’s an over-simplified and inaccurate view of the situation because LDL is critical for healing and immune functions.

Omega-6, LDL and atherosclerosis

LDL particles get blamed because of their role in atherosclerosis. It’s not because too much LDL ‘clogs up your pipes,’ like a highway with too many cars. That too is an over-simplified and inaccurate notion. It’s a much more complicated and layered situation.

There are people with very high LDL who never get heart attacks. And those with low LDL that do. Yet, most cardiologists agree that LDL particle size and number should be watched.

Something happens to the LDL that causes it to ‘go rogue.’ And that something is oxidation.

You can leave a stick of butter or tub of coconut oil at room temperature and they won’t go rancid. The fats in these are ‘saturated’ and so they are inert – don’t go rancid.

Do the same with vegetable oil, flaxseed oil or Canola…and you have a stinky mess in a few weeks. Same with fish oil. Why? Because vegetable oils and fish oil have delicate polyunsaturated fats that can oxidize or go rancid when exposed to oxygen.

And that is a problem.

The problem with Oxidized LDL

The fats you eat end up on the outer membrane of each of your cells. So if you eat a lot of Omega-6-rich vegetable seed oils, your cell membranes will have a lot of Omega-6 fats.

Similarly, the membranes of the LDL particles will also contain high levels of Omega-6 fats. After all, you are what you eat.

The Omega-6 from those super-sized french fries ends up on your LDL particle. And it goes rancid while attached to the cell membrane of your LDL. It ‘rots on the vine’ so to speak.

In effect, your LDL particles become rancid.

Damaged. Oxidized.

It’s called Oxidized LDL (oxLDL). There are other reasons why LDL oxidizes but this one’s a biggie.

When the Omega-6 fats in your LDL cell membrane oxidizes, your immune system recognizes it as a threat to your arteries and blood vessels. And the clean-up process forms a plaque to protect you from harm. When these plaques fall apart after years of build up, inflammation and oxidation, you have the recipe for a heart attack.

The tipping point…

Seed oil driven oxLDL started when we began switching to vegetable oils from fear of animal fat and cholesterol (see graph above.) It started when we went low-fat and whole grain. When we went vegan. And when we stopped eating butter and started eating margarine, fast food and take-out.

I still remember my mom switching from butter to I Cant Believe Our Lifespan is so Short.

We thought we were doing the right things. But all of these things increase your Omega-6 load.

Remember that Time magazine cover with the sad bacon face? I do – I was in high school. I switched to soy sausages and low-fat milk on my frosted flakes. (Good Lord! What was I thinking?!)

While your great-grandmother had LDL particles too, hers had a lot of stable saturated and monounsaturated fats from eating butter, lard and tallow. Your LDL, on the other hand, contain delicate polyunsaturated fats from vegetable oils.

There is a difference. Your LDL is more likely to oxidize than Great-grandma Eunice’s.

The cardinal rule of Omegas

Our bodies are built to run on small quantities of Omega-3 and Omega-6. Both are essential, but in small quantities. Without either, you die. But the cardinal rule of Omegas 3 and 6 is small quantities.

Eat a Mickey Ds french fry? Oops! Your need for counter-balancing Omega-3s just went up. You’d better eat some salmon or a fish oil supplement. OK – technically, you’re ‘balanced.’ But your just broke the cardinal rule and entered a biological rabbit hole.

If you want out of the rabbit hole, the only solution is to cut out the Omega-6.

We’re in the middle of a never-before-conducted human experiment of cooking everything with vegetable oils. And we need to stop and think about the effects of eating incredibly artificial amounts of Omega-6.

Why you should care about oxidized LDL

People with high oxidized LDL (or oxLDL) are four times more likely to have heart attacks than those with low oxLDL.

You may gain comfort in knowing that vegetable oils reduce cholesterol, but it also oxidizes what’s left and possibly increases death rates from cardiovascular and coronary artery diseases. What’s the point? (I consider low cholesterol a bad thing, but more on that another day.)

OxLDL is involved in the early stages of heart disease and artery damage.

OxLDL is a much better predictor of heart disease than LDL and HDL. Certainly better than total cholesterol. LDL is a toss up – with it, you can predict heart disease half the time.

But with oxLDL, you can predict heart disease with 82% accuracy.

Small dense LDL, the kind that goes up with low-fat/high-carb diets, are particularly vulnerable to becoming oxidized and causing blocked arteries. Another reason to cut down on sugar and refined carbs.

Your body’s defense: natural, built-in antioxidants

Your liver expects some LDL oxidation, so it packs all LDL with CoQ10 for antioxidant protection. But that statin drug you’ve been taking for cholesterol reduction…well, it wipes out your CoQ10 production.

Oops!

So…you’re gulping down Omega-6 fats…and your cholesterol meds have wiped out the only protection your body can offer you.

Nice going!

Doctors are still quick to prescribe statin drugs for lowering cholesterol, without much discussion about the risk of excess vegetable oils or oxLDL.

In some people, this added risk from statins is worth it. Is it for you? Ask your doctor. For me, no.

In the next installment, we’ll take a look at some of the factors that increase LDL oxidation and steps you can take to protect yourself. Hint: you can’t take a pill to reverse oxLDL. Sorry.

About the Author: Vin Kutty, M.S., is OmegaVia’s Scientific Advisor and Chief Blogger. He is a nutritionist, author, and Omega-3 expert with over 20 years of experience.

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Oxidized LDL is a much better predictor of ‘cardiovascular events’ than anything on your regular cholesterol panel. Tests for oxidized LDL are not easily available, but there are some things you can do to shift the odds in your favor.

Factors that affect LDL oxidation

1. The type of fats found in your LDL cell membranes

As we discussed in the last blog, the types of fat you eat determine how delicate your LDL cell membranes are. If you eat a lot of easily-oxidized Omega-3s and Omega-6s, you will have more LDL oxidation.

 Percentage of ‘delicate’ Polyunsaturated Fats in Common Cooking Fats and Oils

I’m not asking you to stop eating fish or fish oil supplements.

Eat fish a few times a week or take fish oil supplements when you can’t eat seafood. The key point that I want you to notice in the chart above is that the oils you were told are ‘healthy’ (because they lower cholesterol) are the ones most likely to oxidize your LDL.

Duck fat and avocado oil are my unofficial cut off points. I avoid everything above it. This is the #1 reason why I avoid eating out. If I must, I order a salad with olive oil on the side.

Sit down and clutch your pearls, Agnes!

I cook generously with beef tallow, butter and coconut oil. I mail order beef tallow rendered from grass-fed cattle, my absolute favorite.

I do not fear saturated fats but you are welcome to. That they are harmful is, uh, a ‘faith-based initiative‘ and has been proven false over and over. Here. Here. Here. Here. Here. Here. Here. Here. Here. None of these references are light-weight blogs like this – they are published studies.

Your body is built to thrive on normal levels of both Omega-3 and Omega-6. Your body is built to function despite some levels of oxidation. Not the 20-fold increase in oxidation burden we are subjecting our bodies to…and that dramatic increase oxidation comes almost exclusively from Omega-6, linoleic acid, in the form of vegetable cooking oils.

The level of pro-inflammatory and easily oxidized Omega-6 fat (Linoleic Acid) in subcutaneous body fat stores has increased 200% in the last half century. Adapted from: Whole Health Source blog by Dr. Stephan Guyenet.
 
As an aside, when three generations of mice were given a similar, increasing levels of Omega-6, each generation got fatter, slower and dumber. This could never apply to us. Of course. Never.

2. Toxins

Toxins (think cigarettes, alcohol, BPA in plastics, most things in the cleaning and cosmetics aisles), free radicals etc. will consume the built-in antioxidants in the LDL – CoQ10 and Vitamin E. Once the antioxidants are exhausted, the LDL is exposed and vulnerable to oxidation.

3. Antioxidants

Your liver bundles LDL with CoQ10 and Vitamin E. Statin drugs for cholesterol reduction wipe out CoQ10 along with the cholesterol. And 90% of us don’t get enough Vitamin E from foods. Together, this also increases vulnerability to LDL oxidation.

There is some evidence (at least in mice) that a combination of CoQ10 and Vitamin E helps prevent atherosclerosis, but Vitamin E by itself appears to not have much effect.

4. Duration of circulation

How long the LDL particle stays around in the body also determines LDL oxidation. The longer it is in circulation, the more likely it is to get oxidized. LDL particle density influences this. 

Small, dense LDL particles (the bane of soda-guzzlin’ insulin resistant folk) have slightly higher ‘hang time’ in the body and are more likely to get oxidized. Go Cola!

5. Leaky gut

In short, gluten in wheat makes intestines porous, hence the term ‘leaky’ gut. Infections, stress and toxins can also cause leaky gut, but wheat is the champ.

With a leaky gut, partially digested food and bacteria from food waste enter your blood stream. Bacterial cell wall components also oxidize LDL and are taken up by white blood cells and turn into foam cells which turns into plaque in your arteries. (Whew! So don’t eat wheat. Better yet, do some yoga while not eating wheat.)

6. Nutrient deficiencies

Not enough Zinc and copper will make it hard for your body to make enzymes that remove oxidizing substances from your body. When that happens, again, LDL gets oxidized. (Eat liver, nuts, shellfish, sesame seeds, oysters and beef.)

7. Glucose

How much sugar, carbs and grains (yes, even ‘healthy’ whole grains) you eat affects LDL oxidation. Sugar binds to LDL and speeds up oxidation.

8. Hypothyroidism

Low thyroid levels reduce LDL receptor activity, which causes LDL to remain in circulation and allows greater exposure to oxidants. Low thyroid due to diet-induced autoimmune hypothyroidism (see #5, Hashimoto‘s), iodine deficiency, goitrogen activity from excessive soy, millet, raw cruciferous vegetables, pollution etc.

Notice that most of the factors listed above are diet-related.

Not surprisingly, Big Pharma and medical establishment react with a yawn and continue to pump us full of statins.

But, oh, never mind that…

• Most people who take statins don’t live longer or have significantly fewer heart attacks.
• Or that people with the lowest LDL are at 350% greater risk of Parkinson’s.
• Or that people in this study with the highest cholesterol levels had a 48% reduction in death.
• Or that eating saturated fat is not associated with heart disease or stroke.
• Or that the old data used to scare people about animal fats shows nothing scary when reanalyzed in 2013.
• Or that only 25% of people who get heart attacks have high cholesterol.

Turns out eggs and butter were only deadly during the Reagan and Clinton eras.

I could go on…this statin horse is far from dead.

There are no Rx drugs to reduce oxLDL

When diet is the best prevention tool for any illness, you won’t hear much about it. Because apparently you don’t want to. Can’t blame big pharma for everything. Sometimes you gotta look in the mirror.

Still, your great-grandmother probably didn’t have a terrible oxLDL problem. But you do. See graph above.

Our bodies are meant to operate quite nicely on fats found in olive oil, butter and yes, even lard and tallow. Human breast milk is rich in cholesterol and saturated fat – almost two third of the calories of breast milk comes from saturated fats.

Lard vs Olive Oil

Would you believe me if I told you that do-no-wrong olive oil is very similar to kill-you-dead lard? They both are mostly oleic acid. Yup – the #1 fat in both lard and olive oil are the same. Years of brain-washing from the media might make you avoid lard, tallow or butter, but they all contain fats that don’t oxidize easily. Go ahead, ask a teenager if he/she even knows what tallow is.

In my house, people get in trouble for throwing away bacon fat. Kids eat fruits, eggs and bacon for breakfast. And daddy gets to make scrambled eggs in bacon fat. Yum.

Either way, you won’t see a bottle of Canola within a mile of my kitchen.

What now? More lard and less Lipitor?

Them’re fightin’ words to many of you out there. I’m just pointing out evidence that made me scratch my head (and alter my diet.)

But what you do is up to you and your doctor. Don’t wing it! I see three different integrative/functional MDs.

Based on what causes increased oxLDL production, it seems to me (and my doctors) that reducing Omega-6-rich vegetable oils and replacing them with coconut oil or one of the animal fats makes sense. Along with making sure you’re not taking anything to nuke your CoQ10 levels.

Cutting out wheat and sugar seems prudent regardless.

About the Author: Vin Kutty, M.S., is OmegaVia’s Scientific Advisor and Chief Blogger. He is a nutritionist, author, and Omega-3 expert with over 20 years of experience.

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Nope. That was not a typo. That was Omega-7 with a SEVEN.

You’ll be hearing more about it.

You’ve obviously heard about Omega-3s. And probably Omega-6s and 9s. Omega-6s are essential but cause inflammation in excess. Omega-9s are found in olive oil and bacon fat. Omega-9s are not essential because your body can make it as needed.

So what is Omega-7?

The Omega-7 or Palmitoleic Acid (POA) is a mono-unsaturated fat found in nature.

It’s early days for Omega-7. The science has progressed from mouse studies to human studies.

And the results are head-turning. Enough so that I’ve begun taking it every day. More on that below.

POA is found naturally in macadamia nuts and sea buckthorn fruit. It is also found in fish like anchovies.

Is Omega-7 found in regular fish oil?

Sadly, Omega-7 (POA) is not found in most fish oils. Products like New Chapter’s Wholemega have tiny amounts of Omega-7 (POA) listed on the product label.

The reason Omega-7 is absent from most fish oil supplements is that it is removed during the Omega-3 concentration process. The part of the fish oil that contains Omega-7 is discarded or sold as bio-diesel.

This could be one reason why studies find that eating fish is better than taking fish oil supplements.

So what can Omega-7 do for you?

Source: Martinez, L. Purified Omega-7 in the reduction of hs-CRP: a double-blind, randomized, placebo-controlled study. Proprietary Research Report, 2013.

For me, the eye-opener was its effect on CRP.

Why you should care about CRP

C-Reactive Protein or CRP is a simple and inexpensive test that your doctor can order for you. It measures systemic inflammation.

Big deal, you might say. But high CRP is a strong risk factor for heart and artery disease. Possibly because CRP is an indicator of arterial inflammation and arterial tissue injury – the location where cholesterol starts clogging arteries. This was pointed out as far back as 2002.

CRP is not just a marker of poor heart health – it a culprit as well. It actually causes harm by being pro-inflammatory and pro-atherogenic. CRP gets deposited into plaque. (In other words, when you reduce CRP, you’re not just sweeping the symptom under the rug without addressing the true issue.)

CRP is a better predictor of cardiovascular events than LDL ‘bad’ cholesterol. After all, half the people who have heart attacks have normal LDL levels.

High sensitivity CRP is almost 10X better at predicting future heart ‘events’ than your Total Cholesterol number.

Interesting how scientific journals describe heart attacks as ‘events.’

Some lab, like Shiel, consider a combination of CRP, HDL ‘good’ cholesterol and Oxidized LDL level to be the best predictor of your heart’s future.

Shiel claims that combing these three markers will give you a 30-fold better ability to predict heart disease when compared to Total Cholesterol figures.

Statin drugs and CRP

Cholesterol-lowering statin drugs also lower CRP by 25% or so. The same group of researchers from Harvard found that patients on statins with the lowest CRP had fewer cardiovascular ‘events’ regardless of having reached a low LDL cholesterol target point. They hypothesize that reduced inflammation rather than reduced LDL may be the true mechanism behind statin’s risk reduction.

What should your CRP level be?

It is generally accepted that a CRP level of 1 or less is considered low risk. 1 to 3 translates to medium risk and anything higher than 3 is high risk.

CRP levels can spike if you catch a cold or flu, but in the absence of an infection, it could mean other inflammatory conditions like arthritis or autoimmune disease.

If you have a cold, wait about three weeks before getting your CRP tested.

Plant sources of Omega-7: risky for some

Both Macadamia nuts and Sea Buckthorn contain Omega-7 Palmitoleic Acid. However, both also contain Palmitic Acid (PA).

Palmitic Acid may be harmful to pancreatic beta cells, where insulin is produced – diabetics and pre-diabetics need to pay attention. Purified Omega-7, on the other hand, can help with insulin resistance.

Small amounts of Palmitic Acid is probably fine for young, metabolically healthy individuals. Sadly, most Americans over the age of forty are probably pre-diabetics with compromised pancreatic beta-cells…they just don’t know it.

The pioneers of Omega-7 research at the Cleveland Clinic feel so strongly against Palmitic Acid that they insist that all Omega-7 products should have less than 5% Palmitic Acid.

The World Health Organization issued a notice that said there is ‘convincing evidence’ that PA is harmful for cardiovascular health, grouping it along with risk factor like alcohol, trans fats, obesity and high sodium intake.

 Purified Omega-7 – where to buy

The term ‘Purified Omega-7′ was coined by the folks at Cleveland Clinic to indicate Palmitoleic Acid that has been purified of Palmitic Acid.

One way to make sure you get the right Omega-7 is to look for Provinal brand Omega-7.

Purified Omega-7 products are available online, on Amazon.com. Look for Innovix Labs or Cardia7 brands – they are comparable products that contain the same ingredient in equal amounts. (Disclosure: Innovix Labs brand is owned by OmegaVia’s parent company, Innovix Pharma. Inc.)

Should you stop Omega-3 and switch to Omega-7?

No. Omega-7 cannot replace Omega-3.

If you’re on Omega-3, don’t quit. Omega-3 is necessary for several essential functions.

A personal note…

Back in my low-fat, whole grain days, my triglyceride was at an astronomical 600 + and my CRP was also too high, between 3 and 4.

I eliminated sugar, wheat (gluten), most grains and Omega-6-rich seed oils (all highly inflammatory) from my diet about 5 or 6 years ago. My triglycerides dropped to about 100 and my CRP came down to 1.5 and there is stayed for 5 years. Several minor chronic issues disappeared – like the annoying Restless Leg Syndrome that kept me up at night.

But my high-ish CRP still bugged me. I just could not get it below 1.5.

Earlier this summer, I saw pre-clinical study results of Omega-7′s effect on CRP. That was a small study that came before the study whose results are shown above. It showed a whopping 63% drop in CRP in metabolically imperfect population.

I was skeptical but I was given a few free sample bottles of the Purified Omega-7.

After two months, my CRP was down to 0.5! It’s never been that low, despite my near-perfect diet. My doctor was amazed – as often happens, we made the other patients wait and talked about the science behind Omega-7. My CRP drop was the same as the drop noted in the pre-clinical trial, possibly suggesting that the efficacy of Omega-7 in lowering CRP may be greatest in those with high CRP.

I was so impressed that we’ve now launched an Omega-7 product under the Innovix Labs brand, available on Amazon.com.

Bottom-line

All this goes to show that inflammation may be one of the most important things you need to watch – mostly thru diet, lifestyle and a little help from supplements.

Dr. Mike Roizen, co-author, along with Dr. Mehmet Oz, of the popular “YOU” series of health books, on Omega-7 and its benefits:

About the Author: Vin Kutty, M.S., is OmegaVia’s Scientific Advisor and Chief Blogger. He is a nutritionist, author, and Omega-3 expert with over 20 years of experience.

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A quick departure from Omega-3 and fish oil to talk about something just as important…

While playing in the backyard few years ago, my daughter picked up a roly-poly pill bug. She quickly ate half of it and offered me the other half.

We’d been trying to teach her to share.

‘Aye-aye-ugh…thank you, sweetie,’ I replied, trying to hide my horror. The suburban father in me was disgusted. But the geek in me was quite pleased about the introduction of new probiotic strains into her gut.

How was I going to explain it to my wife? This, a day after the same child was caught swirling her hands in the toilet bowl. The kid was under my watch during both incidents.

This brings me to why I don’t regularly take probiotic supplements. Yes, sometimes, this blog strays from talking about Omega-3 and fish oil supplements.

It’s not because I don’t think probiotics are not important. Quite the opposite. It is desperately important.

The importance of a healthy gut flora

I don’t consistently take a fancy probiotic supplement from the bug refrigerator at Whole Foods. We’ll soon get to the reasons why…

But there’s more to it than eating a cup of Activia and hoping you’ll poop regularly. If you take probiotics just for being regular or to boost immunity (whatever that means!), you’re missing the big picture.

There is a flood of new research proving that your ‘microbiome’ or the trillions of bacteria that live in your gut have an effect on not just your gut health, but also:

• inflammation
• diabetes
• weight
• LDL cholesterol
• autoimmunity and even your mood.

These critters control us more than we ever thought possible.

The problem with probiotic supplements

There are over a thousand species or strains of bacteria in a healthy gut.

‘Potent’ probiotic supplements have, what, a dozen species? What about the other 99% of species?

I’m guessing that if you took every probiotic supplement known to mankind, that you’ll get to about 50 different species. That’s great…what about the other 95%?

Most probiotic supplements (Lactobacillus or Bifidobacteria) are dairy-based or derived. They’re great for digesting milk. But beyond that, their benefits are limited.

Exceptions are products like CardioViva, a Lactobacillus shown to help your heart, and products like Align or Culturelle. These are single proprietary strains used for very specific health goals, with a lot of research behind them. This is where the future of probiotic supplementation is going. There are proprietary (or patented) bugs for colic, mood,  weight loss etc..

The bugs in a healthy gut are mostly soil-based. Soil-based is a nice way to say dirt. In this list of top gut bacteria, Lactobacillus and Bifidobacteria are nowhere to be seen.

My point is: the number and variety of healthy bacteria in your gut are extremely important. Supplements, as always, come up short.

Don’t just take a Lactobacillus or Bifidobacteria pill and call it a day. Sure, it’s nice, but you haven’t altered your health much.

If you really want to improve your health and have a thriving gut population of probiotics, you will need to change not just your probiotic supplement, but also your diet, lifestyle and your attitude towards dirt.

The two key things about your gut flora are:

1. The number of healthy microbes in your gut
2. The variety of healthy microbes in your gut

But before we jump in, while you read all this, keep in mind that we’ve just emerged from the dark ages of probiotics. There has only been focused research on this for a couple of decades. And US consumers have only been aware of it for a decade or so.

What we know about the benefits of having a healthy gut microbiome is miniscule. I suspect it will be a fairly common occurrence in our great-grandchildren’s time to get poop transplants. Fecal banks. Seriously. Take a little poop from a healthy person and delicately welcome it into ones hind quarters to make an unhealthy person whole. Sound crazy? It’s already being done. It’s been effective and safe. (Update: fecal banks already exist! OpenBiome)

Want to lose weight? Skinny and obese people have different sets of bugs in their gut. Can transferring bacteria from a skinny person’s colon into an obese person (fecal transplant) make them skinny? Poop pills are not science fiction. It’s also already been done. And proven to help irritable bowel syndrome and colitis.

The point I’m trying to make (besides using shock to expand our view of the role of probiotics) is that we’re at the leading edge of this probiotic revolution. There are brave pill poppers out there, yet there is a lot we don’t understand.

Back to discussing the key factors in probiotics:

The number of Probiotic Bacteria

No, I’m not talking about the bug count on the bottles.

10 years ago, it was impressive to have 1 million acidophilus bugs per pill. Then the cool kids started selling 1 billion. Then 10 billion. Now 100 billion doesn’t get much attention.

This is a marketing rat race and it’s mostly bullshit.

Formulas with a dozen or more species are not necessarily better. Some species inhibit eatch other. None of the major brands of probiotics on the market have studies how their species interact and which one’s left standing.

Whether you’re welcoming these bugs into a place that’s hospitable to them and whether you eat foods they need is what matters.

It’s easy for the 100 billion to become 10 billion while the bottle is on the shelf. And then for it to become 1 million after the bugs have been thrashed by your stomach acid. So don’t fall for the numbers nonsense.

A healthy gut has hundreds of trillions of thriving bacteria. One pill isn’t going to do a damn thing to the total number. If you look at your body as a total number of cells. We are outnumbered. There are more bacterial cells in your body than human cells. You’re 5% human and 95% bacteria. You’re a giant lump of bacteria wearing a human suit. Sorry – I calls it as I reads it.

What affects the number of bacteria in your gut?

Antibiotic overuse and a diet low in soluble fiber are the two main reasons for reduced gut flora.

Antibiotic overuse. Sure, they save lives. But rampant and often unnecessary antibiotic use is the #1 killer of healthy gut microbiomes. Antibiotics are indiscriminate, killing both good and bad bacteria.

This becomes a vicious cycle because a compromised bacterial community allows you to get infected by antibiotic-requiring harmful bacteria. And yes, they are a community. Good guys join hands and fight the bad guys. Example: think of a probiotic-compromised child born via C-section and exclusively bottle fed. He or she invariably gets an ear infection and gets regular doses of antibiotics. It could take the child several years (if ever!) to recuperate a full gut flora.

We worry about creating resistant bacteria with excess antibiotic use. But the bigger risk may be that we’re permanently altering our protective gut flora with each antibiotic treatment.

One course of a gut-blastin’ antibiotic like Cipro can wipe out a third of your bacterial community.

If you have to take antibiotics, make sure you take a variety of probiotics (separate the dosing) to keep side effects to a minimum.  I take this yeast product.

Diet. Gut bacteria use soluble fiber in your diet as a food source. This is the kind of fiber that you really want, not the physically abrasive insoluble kind marketed on breakfast cereal boxes that does very little besides increase stool volume.

Soluble fiber is found in veggies, fruits and beans. They’re also found in unrefined grains, but you get more bad than good with grains. Since most of us don’t eat enough veggies, we starve our gut bacteria. Same goes for the extreme low-carb folks who eat nothing but animal protein and fats – you may be skinny and non-diabetic for the first time in a decade, but your gut flora is starving.

We’ll get to specific foods for your gut later.

What affects the variety of bacteria in your gut?

The variety and diversity of your gut flora is key. Having the right type of friendly bacteria is important not just because of the push and pull of friend versus foe, but because good bacteria secrete butyrates and other fatty acids that keep your colon healthy.

People with IBS have 25% fewer types of bacteria in their gut. We’re talking variety, not total numbers. They’re missing 250 of the 1000 or so types of bacteria. Turns out that folks with colitis and Cronh’s have similar limited bacterial ‘signatures.’

Antibiotic use. Besides cutting down the number of friendly flora, antibiotics wipe out, sometimes permanently, many species of bacteria.

Dirt-phobia and germophobia. This is a big one. I know people who douse their children with antibacterial hand sanitizing goop every few hours. It’s done with good intentions but if only they knew the harm they’re inflicting.

Toddlers and preschoolers need to get grubby and dirty. They check to see if everything is al dente. This is the natural process of gut colonization.

Of course, never to leave a fear untapped, marketers have taken germophobia to new heights. Heck, they sell Triclosan-laced antibacterial toothpaste and kitchenware! I give up.

Exposure to nature. Children living on farms have far less allergies and asthma than city kids. Children exposed to dirt (and the organisms within) and farm animals during their early years even get some immunity from Type 1 Diabetes.

A century or two ago, most of us lived on farms and rural areas full of dirt and bacteria. Showers were scarce and everyone may have walked around with clothespins on their noses but allergies, Crohn’s and type 1 diabestes were rare.

Nature is where we get a lot of our good bacteria – soil based organisms or SBOs – it’s cleaner sounding than saying ‘Bugs From Dirt.’

A ‘soil-based’ bacteria commonly found on fruits and vegetables, Mycobacterium vaccae, has been shown to improve cognitive function and diminish anxiety-like behavior…at least in animals.

I know some people who eat their backyard veggies ‘lightly washed,’ just to get some bugs. For the less daring (nutty?), I suggest a product called Prescript-Assist, a supplement of soil based bacteria. In my opinion, this product stands head and shoulders above the probiotic supplement fray. I occasionally take it and even sprinkle it over my kids’ dinners. Even it contains only about 29 species.

Our manicured and sterile suburbs and homes in middle-class and upper middle-class America are dangerously empty of dirt.

So munch away, my dear, on roly polies. We won’t tell mommy.

If you’re lucky, you may still have the bacteria that your mother gave you during childbirth and breast feeding. Or the bugs that you swallowed from your own roly-poly-eatin’ days.

Other factors like high-sugar diets, chronic stress and early childhood conditions like C-section birth and bottle feeding also affect the variety gut flora.

If probiotics are so great, why not supplement?

There is nothing wrong with supplementing with probiotic pills. Many of the bugs in probiotic supplements are transient – they are gone from your body in a few weeks. While they do a lot of good during their stay, supplements are simply inadequate.

I’m constantly trying to increase the variety and quantity of my gut flora. And supplements are inefficient and limited at both. I use supplements as part of a ‘recolonization program,’ especially if I’m forced to take an antibiotic. I recently had to take Cipro after picking up a charming respiratory tract infection while camping in the Amazon jungle.

My gut recolonization plan:

1. Take Prescript Assist and about a dozen different brands of supplements. Once I’ve reintroduced these bugs to my gut, I don’t take the pills anymore.
2. Fermented foods. Fermentation often takes place in low-oxygen environments like our gut. These anaerobic bugs are not often found in supplements. I consume several different types of sauerkraut, kimchi, kefir, kombucha. I love this Hot Pink Jalapeno Garlic Kraut. I make yogurt at home – the stuff in grocery stores don’t interest me because they’re sweetened, too low in fat, underfermented and too high in lactose.
3. Soluble fiber and Resistant starch. I gradually increase the prebiotic content in my diet by eating more soluble fiber and resistant starch. These are what gut flora thrive on. A little bit of prebiotics can make a huge difference in the number and the ratio of good vs bad bacteria in your gut. You could try prebiotic supplements (fertilizers for probiotics) like Inulin FOS or Arabinogalactan, oligofructose etc., in very small doses at first. I don’t take prebiotic supplements, I prefer food. Raw onions, garlic, leeks and jerusalem artichokes are good sources of prebiotics.

Don’t fall for products that claim to be both pre and pro-biotic. This is like a shampoo with a built-in conditioner. For prebiotics to work, you need teaspoon quantities of it. Fairy-dusting is a marketing gimmick.

The real reasons I don’t take probiotic supplements…

…are that I’ve replaced probiotic supplements with fermented foods and soluble fiber. This is a far healthier, cheaper and tastier approach to maintaining gut health.

After all, what’s the point of taking probiotic pills if you’re not feeding your gut flora with the right kinds of food? Think of them as a pet you have to feed.

Fido or Bifido – both need to be fed.

Care and Feeding of Bowel Bugs

Start eating foods rich in soluble fiber: brussel sprouts, avocado, yams, potatoes, oranges, sweet potato, asparagus, nuts, apples, turnips, plantains, taro, and broccoli.

You can get soluble fiber from beans, but make sure the beans are soaked overnight before you cook them.

Here is an easy way to cheat: this unmodified raw potato starch is full of resistant starch, a type of fiber that you won’t digest, but will make your gut flora very happy. Start with just half teaspoon a day and work up to a couple of tablespoons per day…or else you’ll end up with what my roly-poly eater calls butt-burps.

The cell lining of your colon is built to thrive on the butyrates secreted by probiotics. Any left over butyrates help reduce inflammation in the gut – hope Crohn’s and IBD folks are reading.

Oh, and if you want find out what’s in your gut, check out the American Gut Project.

‘Bottom’-line:

Eating fermented foods and following up by feeding your gut bacteria soluble fiber from foods are far more effective, cheaper and fun than taking probiotic supplements.

Source: Benjamin Arthur (NPR)

About the Author: Vin Kutty, M.S., is OmegaVia’s Scientific Advisor and Chief Blogger. He is a nutritionist, author, and Omega-3 expert with over 20 years of experience.

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What can Omega-3 do for your kids?

Omega-3 from fish oil has been strongly associated with:

• birth weight
• reduced pre-term births
• improved brain function
• eye development
• reading ability
• IQ and behavior/ADHD.

‘Less bed-time resistance’

Yesss!

Fewer waking episodes and an hour of extra sleep, says a new study.

Things to remember:

• Moms need extra Omega-3 before pregnancy and especially during the last trimester and breast feeding.
• Make sure formula is fortified with Omega-3. Once you move to milk, make sure it is organic, full-fat and preferably grass-fed.
• Once they’re eating solid foods, get them used to eating wild salmon instead of supplements. Keep trying. Get clever.
• Omega-3 gummies are sugary junk. There’s very little Omega-3 and lot of sugar and other useless stuff.
• Omega-3 smoothies are great options for picky eaters.
• Flavored liquid fish oils and flavored gelatin capsules are effective but not for picky eaters.
• Plant-based Omega-3 (Flax, Chia) are not useful.

DHA is the key Omega-3 for infants but as the brain growth slows at about age 3, the need for DHA decreases. After 3, kids need a balance of both EPA and DHA.

How much Omega-3 does your child need?

• Aim for 5 mg of DHA per pound of body weight for infants 6 to 24 months of age.
• Kids 2 to 4 need 150 mg per day of combined DHA and EPA.
• Kids 4 to 6 need 200 mg per day.
• Kids 6 to 10 need 250 mg per day.
• Teenagers may take up to 1000 mg per day.

These are very conservative levels suggested by the World Health Organization. US Institute of Medicine recommends numbers that are about twice as high. Wild salmon eaten two or three times a week can easily meet these needs.

FACT: American kids 1-5 years of age get a shockingly low 20 mg DHA per day.

Still, very few families seem to get enough Omega-3 from actual seafood. Possibly because of the cost or available seafood is no longer fresh and stinks up the house when cooked.

Lack of cooking skills is another – this is why I have my foodie friend on speaker phone when we get the salmon out.

Omega-3 Product Options For Your Kids

 Coromega Kids Omega-3 Squeeze Orange

Cost: $14.99 for 30 packets (serving = 1 packet)
Fish oil: 2000 mg
Omega-3: 650 mg
EPA: 350 mg
DHA: 230 mg

Ingredients: egg yolk, ascorbic acid, natural orange flavor, natural pineapple flavor, stevia, vegetable oil, sodium ascorbate, d-alpha tocopherol, citric acid, potassium sorbate, sodium benzoate, beta carotene, xanthan gum, menthol, cholecalciferol.

My comments: Coromega has been the go-to product for people who can’t handle pills or gulping plain fish oil by the spoonful. There is a solid dose of Omega-3 in each packet. I’m not happy about the preservatives and the gums. Otherwise, this is a very versatile form of Omega-3 for the whole family. The extra Vitamin D3 is sort of a bonus (like the dealer throwing in floor mats with your new car) – but for D3 to be properly used, you need Vitamins A and K2.

What my 3-year-old twins said: a spoonful by itself did not go over well. They looked at me with a ‘how could you?’ face and ran away. But when mixed with fruit sauce or smoothie, it was barely noticed.

Smarty Pants Kids Complete

Cost: $ $16.49/120 gummies
GOTCHA WARNING: 4 gummy serving!!

1 gummy provides:
Fish oil: 75 mg
Omega-3: 25 mg
EPA: 14 mg
DHA: 7 mg

Ingredients: Organic cane sugar, organic tapioca syrup, gelatin, pectin, citric acid, natural flavors, colors from black carrot juice, annatto and turmeric.

My comments: these are popular and yummy. But a serving size is four gummies and that adds up to a lot of unwanted sugar and processed ingredients and very little Omega-3. It’s the gummy curse. No gummy that tastes good has enough Omega-3. The packaging is clever, cute and whispers all the right things. The product ultimately leaves out the most important thing (to me at least!) – enough Omega-3.

What my 3-year-old twins said: they wanted more. (Of course, they did! It’s a candy with a halo.)

Nordic Natural Omega-3 Gummies

Cost: $22.95 for 60 gummies
Gotcha alert: 2 gummy serving!

1 gummy provides:
Omega-3: 41 mg
EPA + DHA: 34 mg

Ingredients: organic tapioca syrup, organic sugar, porcine gelatin, pectin, citric acid, natural flavor, natural color, sodium citrate.

My comments: I like this product a bit more than most Omega gummies. I generally like most product made by Nordic Naturals because the ingredients are safe and inoffensive. There is a combined EPA + DHA number instead of separating them out – I don’t like that. With young kids, I’m interested in DHA and I’d like to know amount of DHA. I still hesitate recommending this product, not because of the missing DHA number, but because it’s good-for-you candy. That’s as good a gummy gets.

(If you opt for Omega gummies, do not buy Lil Critters or VitaFusion – they inflate their Omega-3 numbers with ALA (plant) Omega-3, which are not as effective as EPA and DHA Omega-3 from fish oil. This is a deceptive practice.)

What my 3-year-old twins said: ‘Can I have more?’

 Barleans Kid’s Omega Swirl

Cost: 8 oz bottle, $11.69

1 teaspoon serving:
Omega-3: 513 mg
EPA: 180 mg
DHA: 180 mg

Ingredients: water, xylitol, glycerine, gum arabic, natural flavors, citric acid, xanthan gum, guar gum, turmeric, sorbic acid, d-alpha tocopherol, ascorbyl palmitate.

My comments: This is a good dose of Omega-3. These smoothie type products are great for kids. If you can get it new and fresh, then your kids will probably like it. Mine did. But I’ve also received a stinky bottle from Amazon.com. The problem is that ‘smoothie’ Omega-3s have water in them and no matter how much you try to keep the product chilled or away from oxygen, there will always be some oxygen in the water. And that oxygen will react with the Omega-3 causing rancidity. The shelf-life for smoothie Omegas is only about 6 months at best and the product may spend the best weeks of its life getting transported to a store near you.

Oh – note the mish-mosh of preservatives, gums and sugar alcohols. I gave it to my kids just to hear their opinion. You may or may not want to give some of these ingredients to your kids.

What my 3-year-old twins said: They didn’t say anything. They didn’t dislike it and would probably be happy to have another spoonful if I offered more.

Omega Fusion Shots

Cost: $16.95 for a 12-pack

Serving size: one 2-oz shot
Omega-3: 250 mg
EPA + DHA: 250 mg?

Ingredients: water, natural and artificial flavors, citric acid, calcium disodium EDTA, gum acacia, sucralose, potassium benzoate, potassium sorbate, ascorbic acid.

My comments: This is a new option – I tasted a fresh bottle at a show and it was fine but I have not offered it to my kids. 250 mg is a solid dose of Omega-3, so you may want to look into it.

But the preservatives and artificial sweeteners are not what I’d give my kids.

Nordic Naturals Baby’s DHA

Cost: $13.56 for 2 oz. bottle
Serving size gotcha: 5 ml serving! Dropper provided is for 1 ml.

Serving size: 1 dropper (1 ml)
Omega-3: 210 mg
EPA: 70 mg
DHA: 97 mg

Ingredients: cod liver oil, rosemary extract, d-alpha tocopherol (Vit E), cholecalciferol (Vit D3) in olive oil.

My comments: this was the very first baby DHA product that I purchased after my twins were born. The idea was to put a dropper of it into their milk. We tried it once and tossed the bottle – it was off-the-charts rancid. This is rare for Nordic Naturals, as they usually don’t sell stinky stuff. The whole house stunk and the stench was hard to get off the bottles.

What my 3-year-old twins said: of course, they were too young to comment, but they flatly refused the bottle with 1 ml of the product mixed in with 8 oz of milk. Imagine if I’d given the kids 5 ml like the label suggests.

Nordic Naturals Omega-3 Fishies

Cost: $21.25 for 36 servings

Serving size: 1 fishie
Omega-3: 300 mg
EPA: 150 mg
DHA: 100 mg

Ingredients: fish oil, xylitol, purified water, sorbitol, gelatin, natural tutti frutti flavor, citric acid, trisodium citrate, paprika extract, canola oil.

My comments: These are NOT gummies. This is a high-tech candy with a meaningful dosage of Omega-3 in each tasty fish-shaped gelatinous fishy thingie. They’re expensive, your fingers get a little oily when you eat them and have some less-than-ideal ingredients like sugar alcohols and canola oil (definitely not non-GMO), but despite all of that, this is my favorite product of the bunch. There is water in the formula, so I expect the shelf-life to be shorter than promised.

This product is definitely worth trying.

What my 3-year-old twins said: they will happily eat it.

Nordic Naturals Omega Boost

Cost: $18.99 for 6 oz. bottle.

Serving size: 1 teaspoon (5 ml) – roughly 30 servings per bottle.
Omega-3: 525 mg
EPA: 270 mg
DHA: 165 mg

Ingredients: water, fish oil, xylitol, glycerol, natural mango flavor, gum arabic, citric acid, rosemary extract, guar gum, sorbic acid, xanthan gum, d-alpha-tocopherol, natural vanillin crystals, vegetable juice color, turmeric extract, mixed tocopherols.

My comments: This is a comparable product to Barleans Swirl. It has a laundry list of ingredients necessary to make fish oil taste acceptable to picky kids. Turning fish oil into an emulsion smoothie, to make it taste decent and not go rancid overnight is not easy. So the food scientists who concocted this brew must have felt like they needed all the other ingredients. It’s the price you pay for taste.

Besides that, I thought it tasted pretty good and there is a solid dose of Omega-3 per teaspoon. Between Barleans Kids’ Swirl and this, I’d go with this.

What my 3-year-old twins said: when I gave them the smoothie by itself, one of them wanted more and the other ran away. So, 50/50. Your mileage may vary. I then tried adding a teaspoon to a freshly made blueberry, banana, coconut milk smoothie – they picked up the taste right away and would not have the smoothie, which they otherwise love. May be I should have added it to something unfamiliar.

NatureMade Fish Oil Pearls

Cost: $11.99 for 90 pearl-sized pills

Serving size hype alert: bottle label is for 3 pearls, not one. Each pill does NOT have 500 mg of Omega-3.
Omega-3 per pill: 183 mg
DHA per pill: 92 mg
EPA per pill: 76 mg

Ingredients: fish oil, gelatin, glycerin, water, tocopherol.

My comments: These ‘pearls’ have a kid-friendly size. It may work very well for older kids who can manage to swallow pills. May not work so well for toddlers. My kids are more likely to play with these things or stomp on them than swallow them as instructed, so I haven’t offered. They’re small enough that I can swallow these by the handful. Worth a try.

L’il Critters Omega-3 DHA

Cost: $7.99 for 120 gummies

Serving size gotcha: label is based on 2 gummies

Omega-3 per gummy: 50 mg
DHA per gummy: 16 mg
EPA per gummy: ?
ALA per gummy: 34 mg

Ingredients: Glucose Syrup, Sugar, Gelatin, Natural Flavors, Soy Lecithin, Citric Acid, Carrot and Blueberry Juices (Color), Black Carrot Juice Extract (Color), Turmeric (Cucuma Longa) (Color), Lactic Acid, Fumaric Acid.

My comments: the first two ingredients are glucose and sugar. That’s all I need to know. But the real gotcha here is that the Omega-3 number is fluffed up with ALA Omega-3 from Flax. ALA Omega-3 is very poorly absorbed by the body and it is fairly useless as is because it needs to be converted by the body to EPA and DHA. Granted kids do this better than adults, but hardly any of the ALA is converted to essential DHA. So most of the Omega-3 in this product is not usable. We don’t know how much EPA is present, but each sugary gummy has just 16 mg of DHA.

What my 3-year-old twins said: I’m not giving this to my children, no matter how many truckloads of it they sell at Costco. The wild alaskan salmon that Costco has in the summer…now that I’ll give to my kids.

 What I give my kids

We do our best to get Omega-3 through diet.

The best ways are:

1. Eggs, especially from chicken raised outdoors in pastures. Chicken are DHA concentrating machines! They pack all the DHA into the yolks. Eggs are near-perfect foods for kids (who’re not sensitive or allergic to it!) and contain several nutrients shown to help with attention and behavior.
2. Grass-fed beef has much higher levels of Omega-3 than standard grain-fed beef.
3. Seafood, obviously.  (Introducing salmon as ‘pink chicken’ seemed to go over well. Halibut is ‘white chicken.’) Vital Choice has salmon burger patties – not cheap, but great quality. Kids will need repeated exposure to accept new stuff. They may even need to see you and/or siblings eat salmon before they’ll try it.
4. Dairy from grass-fed cows have much higher levels of Omega-3.

You’ll have to get clever. 2-year-olds are fairly easy to fool – we sold them kale chips as ‘green bacon.’ Score!

Finally, it’s good to remember that health starts in the kitchen and not the medicine cabinet because no supplement or drug can outrun a bad diet.

Your Turn…

If you know any tricks or have tried any products that I’ve not listed above, post a comment below.

About the Author: Vin Kutty, M.S., is OmegaVia’s Scientific Advisor and Chief Blogger. He is a nutritionist, author, and Omega-3 expert with over 20 years of experience.

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7 reasons why recent news on fish oil has been negative

Lately, there’s been nothing but bad news about fish oil.

Is the jig up? Time to go back to selling snake oil and used cars?

Not so fast, Cletus.

At last check, there were over 22,000 separate published studies on fish oil, most of it published in the last decade.

If there is such an explosive increase in scientific proof in support of fish oil’s benefits, then what gives?

Here are a few reasons reasons why:

1. Fear sells. Information doesn’t.

Survival is a very primal human instinct. And fear relates to our survival. TV producers aren’t trying to scare you. They’re just doing what works.

If CNN’s top health report was ‘Yet another study validates EPA Omega-3′s effect on inflammation,’ you’d switch to the Kardashian Channel. That’s what sells. Not judging. Here are some cat videos.

Heck, even science-savvy Ira Flatow on NPR’s Science Friday, seemingly sat there filing his nails allowing scaremongering to go unquestioned.

Just last week, we got what may possibly be the best news on fish oil in a long time – a review of 70 studies showed that fish oil reduces blood pressure. A brilliant piece of science commissioned by the equally brilliant people at GOED. The cricket-chirping silence from the media was noted by the savvier-than-Flatow Stephen Daniells in this piece.

2. The cocktail effect

Ever try speaking softly in a crowded sports bar? It doesn’t work. Similar situation with heart meds and Omega-3 studies.

Patients in many fish oil studies are also taking mega-cocktails of several different powerful cardiovascular drugs. This is called combination therapy, a throw-everything-at-the-wall approach.

Back in the 80s and 90s, when virtually every study on fish oil was positive, people weren’t exposed to aggressive background medical treatment. Back then, many of these drugs weren’t even around. So, in a polypill world, it is almost impossible for fish oil or even a new, powerful stand-alone drug to provide enough benefit to rise above the noise.

Six recent trials showed little or no benefit to taking Omega-3 and all of them had very high background medical treatment with statins, antihypertensives and anticoagulants.

This is a huge problem but it does not mean that Omega-3 is ineffective.

 3. People are aware of (and consuming) Omega-3

People have begun eating Omega-3 fortified foods.

There is Omega-3 in milk, eggs, orange juice, bread, yogurt and anything else that marketers can sprinkle a little Omega-3 into.

If you’re already getting Omega-3 from several sources in your diet, it becomes difficult to show benefit with a little more added Omega-3. ‘High background fish and fish oil supplement‘ use among study participants has been noted by several researchers.

William Harris, a professor of medicine at the Sanford School of Medicine at the University of South Dakota says that as more people consume fish and other products with omega-3 in it, the harder it is to show a benefit because there is no true placebo group.

4. High Omega-6 consumption

Omega-6 and Omega-3 fats have opposing ying-yang effects in your body.

Our natural (and ideal) ratio between these two groups of fatty acids is roughly 1 to 1. But even 2 or 3 times as much Omega-6 is fine. But modern diets are as much as 15 or 20 times in favor of Omega-6.

This extreme imbalance may be part of the reason why we need more Omega-3 ying to balance the Omega-6 yang.

Most Omega-3 benefits often trace back to moderating inflammation. And Omega-6 is a precursor for several pro-inflammatory compounds. The anti-inflammatory effects of low or moderate levels of Omega-3 are likely to be drowned out due to the unnaturally high levels of Omega-6 in our diet…again, not unlike speaking softly in a loud sports bar.

Given that our Omega-6 consumption has dramatically increased since the 1970s, isn’t it logical to assume that you’d need higher amount of Omega-3 to notice a health benefit?

There is proof that reducing Omega-6 makes Omega-3 more bio-available.

Some researchers have started accounting for high dietary Omega-6 intake. But most have not.

5. Omega-3 Dosage is too low

If you want to show an effect, you may need to take higher doses. Simple concept.

But not all studies use effective doses. It does not mean Omega-3 is a dud. It just means that at that low dosage, the study showed no statistical benefit.

Dr. Barry Sears of Zone Diet fame has beat this point to death. Or has he?

 6. Global warming kills pirates – confusing correlation and causation

This is a pet peeve. I could rant for days.

Correlation means two things are somehow associated but one does not necessarily cause the other. Like ice cream causes drowning. Or global warming kills pirates.

This should be a litmus test for all graduate students defending their thesis: can you kill pirates by cranking up your thermostat?  (Instead, they asked me about standard deviation and secondary differential equations…pshaw! Thanks, Dr. Cornell!)

Last year’s charmingly flawed ‘fish oil supplements cause prostate cancer‘ study confused correlation with causation.

Theodore Brasky, the lead author of the study, I’m told, keeps his office at a toasty 110 degrees. When faced with a room full of scientists, he offered a plausible explanation that supplement users are more likely to visit their doctors and therefore more likely to be diagnosed earlier with prostate cancer.

At the same conference, when Dr. Dominik Alexander, an epidemiologist, reviewed the same data from the prostate cancer study. He described prostate cancer risk from fish oil consumption as ‘Not much. No increased risk. No decreased risk. Nothing much is going on. A non-statistically-significant finding.‘

Not the message we heard on TV last year, which by the way, caused 12 million people to stop taking fish oil supplements.

7. Scientific sloppiness

Lots of ways to screw up scientific research, but here are some very common ones seen in Omega-3 studies:

1. Treatment duration is too short. This is often the case with studies that look at DHA’s effect on brain health.
2. Poorly defined end points. In earlier Omega-3 studies, death of patient was often the study end point. In all of the recent recent studies, ‘non-fatal events‘ became the study end point due to, well, people not dying. Some called it quits early because people were not dying as expected. Those stubborn patients…how dare they!
3. Too few subjects. This causes ‘insufficient power’ for the number crunching to yield results. This does not mean that fish oil did not work, but rather a failure to detect a benefit due to too few people/subjects.
4. How Omega-3 is measured. Omega-3 levels is plasma tends to rise and fall depending on your last meal. The level of Omega-3 incorporated into your red blood cells membrane may be more reliable. The least reliable is asking people what they ate the previous day (food frequency questionnaires) and extrapolating that into a conclusion.
5. Lousy placebo. What makes a good placebo against fish oil? Vegetable oil? Margarine? Olive oil? Nope, nope and nope. Yet, studies use these regularly.
6. Confusing primary and secondary prevention. I’ll excuse the media for not getting this, but not scientists.
   • Primary prevention is preventing a disease before you get it.
   • Secondary is treating it after you get the disease. Example: may be fish oil or eating fish won’t do a damn thing for Alzheimer’s after you get it…but, may be, watching you diet and eating fish in your youth and middle age helps. You’d need a 50-year study to prove this (see point 1).

Here is a link to A Rough Guide to Spotting Bad Science.

Omega-3 is not magic. It is entirely possible that even massive amounts of Omega-3 will not reverse advanced Alzheimer’s. We just don’t know. But I do know that giving fish oil to Alzheimer’s patients for a few months and expressing outrage at the lack of results isn’t accomplishing much.

For a more technical review of some of these points, see Dr. Harry Rice’s lecture here.

A special case of sloppiness…

This recent study in the Annals of Internal Medicine (a prestigious journal), despite its Cambridge/Harvard authors, simply screwed up.  But the authors issued a reluctant correction, possibly due to pressure from other scientists.

The original version of the study (that the media frenzied on) said that fish oil did not work. An ‘Oops! Never-mind-us-but-fish-oil-does-work’ version came a couple of weeks later. The correction, of course, was ignored by the press.

Original version: “We saw statistically nonsignificant associations in prospective studies of coronary disease that involved assessment of dietary intake of long-chain omega-3…” Translation: fish oil does not work.

Mea culpa version: “Dietary long-chain omega-3 polyunsaturated fatty acids was associated with lower risk of coronary disease” Translation: Well…looks like EPA and DHA helps your heart, after all.

 Ignoring the obvious

Omega-3 EPA and DHA are essential nutrients. Let’s not forget that.

It doesn’t matter what the TV says. You still need Omega-3 to stay alive. And hopefully you get it from fresh fish rather than supplements or plants.

About the Author: Vin Kutty, M.S., is OmegaVia’s Scientific Advisor and Chief Blogger. He is a nutritionist, author, and Omega-3 expert with a statistically significant amount of experience.

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We receive a lot of inquiries about how to use Omega-3 for brain injury recovery.

I need to be upfront about a few things:

1. We don’t know with certainty whether fish oil can heal brain injuries. But we know that fish oil should be part of the nutritional foundation for improving recovery.
2. Don’t do this on your own. Work with your doctor. This is outside the scope of most people’s self-medication skills.
3. If you think you or someone you know has suffered from brain injury, get medical help immediately.

A very short history of use

Omega-3′s potential for healing brain injury was first investigated in the Sago mine collapse in 2006.

Randy McCloy was the only survivor of the collapse.

When the rescuers found him in the rubble, he had brain, heart, liver and kidney failure. He was barely clinging to life. After he was transported to West Virginia School of Medicine, the hospital neurosurgeons tube-feed him very large doses of fish oil.

 Randy has since made a remarkable recovery.

“I certainly think it played a big role,” said Dr. Julian Bailes, then Chair of the Department of Neurosurgery. “How can he rebuild his brain, if he doesn’t have the substrate to do it?”

Dr. Barry Sears of ‘Zone Diet’ fame was a consultant for Randy’s treatment and has been at the forefront of this new therapy.

Omega-3 and the brain

The brain, after all, is 60% fat and a big chunk of it is Omega-3.

• The cell walls of neurons are largely Omega-3
• Omega-3s keep brain cells alive (neuro-protection)
• Omega-3s reduce inflammation in the brain
• Omega-3s promote synaptogenesis – growth and branching of brain cells

In the news again…

Fish oil and brain injury was, once again, in the news: teenager Grant Virgin was struck by a hit-and-run driver and taken to a trauma center.

Doctors were preparing family members for the worst. (Because modern medicine does not have a treatment for brain trauma.)

Grant’s family contacted Dr. Barry Sears. When the boy’s doctors dismissed fish oil as untested and unproven, the family began sneaking a few grams of fish oil into his feeding tube.

Two months later, when he was moved from ICU to a rehabilitation center, his parents told the doctors at the new facility that their son was receiving 20 grams (20,000 mg) of fish oil per day, a far bigger amount than what they had been sneaking into the feeding tube.

Forty eight hours after the near-comatose boy had begun taking the mega dose, he asked a nurse for a cell phone to call his mom. He’s since made an impressive recovery.

Watch a video about this here. Part 2.

For another similar story about a teenager and fish oil, read Bobby Ghassemi’s story here.

Many questions with few answers

• Did the fish oil have anything to do with the recovery?
• Can Omega-3 help older injury victims?
• Are there risks that we’re unaware of?
• Would Grant Virgin have recovered sooner if he’d been given the 20 gram dose immediately after injury?
• Is there a therapeutic window that closes after a period of time?

We don’t know all the answers.

What we do know is:

1. DHA is a building block of your brain. If your brain is built with DHA, it simply makes sense that you will need a lot of it to repair damaged brains.
2. Injury causes inflammation and swelling. Sadly, the skull prevents swelling and this in itself can be extremely dangerous. It is not uncommon for army physicians treating soldiers with brain trauma to remove portions of the skull to allow the brain to swell.

EPA in fish oil reduces inflammation. DHA reduces inflammation too, but in slightly different ways than EPA.

Drugs vs Fish Oil

Certainly, there are powerful pharmaceutical anti-inflammatories. But many of these have strong side effects and may not cross the blood-brain barrier efficiently in those with injuries to put out inflammation where it is needed most. Omega-3s don’t have these issues. Please work with your doctors on this!

It is also possible that Resolvins, a metabolite of EPA Omega-3 is highly effective in reducing inflammation in the brain.

The initial mechanical damage from the trauma is not the only risk associated with brain injury. There are several post-injury developments that occur that also need watching – there is a secondary, cascading, domino-effect from the injury that happens over the next few days, weeks or months.

It’s this secondary effect that Omega-3 may help with.

Dr. Michael Lewis, whom I met briefly earlier this year, is a retired army colonel. He directs the non-profit Brain Health Education and Research Institute in Potomac, Maryland. He, along with Drs Barry Sears, Joe Hibbeln and Julian Bales are the handful of leading authorities in this field.

“If you have a brick wall and it gets damaged, wouldn’t you want to use bricks to repair that wall?” asks Dr. Lewis describing his simple approach.

He receives so many requests for help from families of brain injury victims that he has set up a website with a clear protocol for healing brain injuries with Omega-3.

Dr. Sears has done something similar. I suggest you read both because Dr. Sears offers more detailed product selection insight.

Dr. Sears’ approach:

1. Choose high purity fish oil with less than 5 ppb PCBs. The industry maximum of 90 parts per billion is like setting the limbo pole 10 feet off the ground. How do you tell if your fish oil has less than 5 ppb of PCB? Go to IFOS Consumer Reports. There are several very good brands you can choose from.
2. The fish oil must contain both EPA and DHA. A minimum of 60% total Omega-3 is a must.
3. Use 10,000 to 15,000 mg of total EPA + DHA per day to ‘put out the fire in the brain before you can rebuild it.’
4. Prefers 2:1 ratio of EPA to DHA.
5. Track your AA/EPA ratio with a simple finger-stick blood test.

Dr. Lewis’ approach:

1. Begin with molecular distilled, pharmaceutical grade supplement. May be capsules or liquid.
2. Begin taking Omega-3 as soon as possible after the injury.
3. Take 3000 mg of EPA + DHA three times a day for 7 days.
4. Reduce dosage to 3000 mg EPA + DHA twice a day for week 2.
5. Continue a lower dose maintenance dose.

See Dr. Michael Lewis’ detailed protocol here.

Note that none of these methods have been approved by the FDA. The US FDA considers Omega-3 to be GRAS (Generally Recognized as Safe) and considers doses up to 3 grams of EPA + DHA to be without adverse events. EU’s upper limit is 5 grams per day. When using higher amounts of EPA and DHA, it is important that you do so only under the supervision of your doctor.

Case studies: how much Omega-3 did they use?

Patient Bobby Ghassemi was given a higher dose than described above – almost 20,000 mg of EPA + DHA per day. And he stayed at that dose for a year without any documented side effects.

Grant Virgin was eventually moved to 20,000 mg per day of fish oil per day, a lower Omega-3 dose than what Bobby was given.

The risks associated with such mega doses of Omega-3 have not been studied. There may be increase risk of bleeding, but this risk has been shown to be unfounded when used at levels suggested by FDA and EU.

Then what?

Dr. Lewis: ‘Every individual is different. Patients typically notice results within the first week, often in the first several days.’

Dr. Sears: ‘Each case is different. Based on my experience if you are using the correct amount of omega-3 fatty acids, you should see the beginnings of a response within 60 days. In Grant’s case, it was two days.’

Which fish oil should you use?

Well, if you are going to add Omega-3 to a feeding tube, then buy liquid fish oil.

Do not buy capsules and squeeze the oil out.

Try liquid fish oils from Nordic Naturals, Dr. Sears’ Zone, Barleans or Carlsons. Most liquid fish oils have more EPA than DHA – this is fine. But if you are looking for equal parts EPA and DHA, look into Salmon oil. VitalChoice has a good liquid salmon oil.

If the person can swallow capsules, your options are wide open. Reduce the number of pills by buying products with at least 1000 mg of Omega-3 per pill. This allows you to take just 3 pills three times a day if you’re following Dr. Lewis’ approach or 4-5 pills three times a day with the Sears approach. Check IFOS Consumer Reports for brands.

Do not use DHA-only or EPA-only formulas. You need both fatty acids.

What else can you do?

Most experts agree that you should reduce your Omega-6 load. But this can’t be done quickly.

How much Omega-3 you need depends on how much Omega-6 and its byproducts you have in your body. This is why the Sears approach relies heavily on Arachidonic Acid (AA) to EPA ratio – AA is a byproduct of Omega-6. The higher your AA/EPA ratio, the more likely that inflammation on the cell membrane covering each brain neuron will increase.

The average AA/EPA ratio for Americans is about 20. It needs to be close to 5.

It’s too late to worry about Omega-6 after a brain injury, so the higher this ratio the more fish oil you will need to reduce inflammation.

How to reduce Omega-6 levels:

• Eliminate all processed foods
• Eliminate all fast foods (they’re cooked in high Omega-6 soybean oil)
• Eliminate foods cooked outside the home (see above)
• Change your cooking oil to coconut oil or butter
• Eliminate all sources of vegetable seed oils
• Reduce seeds and poultry consumption.

A modified Paleo diet with lots of fresh vegetables, wild seafood, grass-fed meats and fruits is very good for reducing your AA/EPA ratio to healthy levels.

“There are no magic pills; there are no magic cures for TBI (Traumatic Brain Injury),” states Dr. Lewis. “There will never be a cure for TBI.”

However, providing your brain with all the nutrients it needs to heal itself may give you better odds at regaining your old life.

What about you?

Do you know anyone who’s suffered from brain injury or trauma? What was their medical experience? Did their doctor suggest more Omega-3?

Additional reading:

You may need to pay to access some of these papers

• Practical hints for helping to manage brain trauma. Dr. Barry Sears.
• Roberts L, Bailes J, Dedhia H, Zikos A, Singh A, McDowell D, Failinger C, Biundo R, Petrick J, and Carpenter J. “Surviving a mine explosion.” J Am Coll Surg 207:276-283 (2008)
• Sears B, Bailes J, and Asselin B. “Therapeutic use of high-dose omega-3 fatty acids to treat comatose patients with severe brain injury.” PhamaNutrition 1: 86-89 (2013)
• Lewis, Michael. Omega-3 long-chain fatty acids and their use in traumatic brain injury and concussions. Inform January 2014, Vol. 25 (1) • 61
•  Goldstein, J., No Stone Unturned: A Father’s Memoir of His Son’s Encounter with Traumati c Brain Injury, Potomac Books, Dulles, Virginia, USA, 2012, p. 242.
• Lewis, M., P. Ghassemi, and J. Hibbeln, Therapeutic use of omega-3 fatt y acids in severe head trauma, Am. J. Emerg. Med. 31:5–8 (2013).
• Lewis, M.D., and J. Bailes, Neuroprotection for the warrior: dietary supplementation with omega-3 fatty acids, Mil. Med. 176:1120–1127 (2011).

About the Author: Vin Kutty, M.S., is OmegaVia’s Scientific Advisor and Chief Blogger. He is a nutritionist, author, and Omega-3 expert with 20 years of experience.

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A little worried about your heart? You’re not alone.

Here are a four tests that you (and your doctor) ought to be looking at during your next physical.

1. Omega-3 Index
2. CRP (C-Reactive Protein)
3. Insulin
4. Triglyceride/HDL ratio

1. Omega-3 Index

I’ll have more to say to about this in a future blog, but whether you’re taking fish oil or not, you still need to know your Omega-3 index.

Why you should care: it’s a good marker of heart disease. Several studies have linked a 70 to 90% drop in risk for cardiac events in people with the highest Omega-3 index.

It’s new, so it’s often called an ‘emerging risk factor.’

If you eat a healthy amount of Omega-3, the cell membranes of your red blood cells become enriched with Omega-3. This changes the flexibility and function of your cells.

You can measure the percent of Omega-3 in the red blood cell membrane with a simple finger prick test. You dab the drop of blood onto the test blotter and send it off in the mail. The results will be mailed back.

Acceptable Omega-3 Levels:

• Lower risk = 8% or higher
• Medium risk = 4 to 8%
• Higher risk = under 4%

The real gems in the results may be the level of Omega-6 Arachidonic Acid (AA/EPA ratio) in your cell membranes and your Omega-6 to 3 ratio. These are factors most Americans need to lower.

It is easy to boost your Omega-3 index quickly by eating fish or taking fish oil supplements. But the equally important job of decreasing Omega-6 is a very slow process and requires eliminating vegetable seed oils and reducing nuts, seeds and poultry.

You can get your Omega-3 index measured for anywhere from $30 to $99.

2. CRP (C-Reactive Protein)

C-Reactive Protein is an indicator of inflammation. CRP is released from the liver in response to inflammation.

Why you should care: it is a good predictor of future cardiac events in people who are currently healthy.

We didn’t know the predictive ability of CRP until 1997. CRP does not point to the presence of a specific disease, but inflammation is closely tied to several diseases.

Chronic inflammation of cardiac tissues and endothelium are hallmarks of heart disease. The scar tissue from this inflammation is one of the early drivers of plaque build up.

People with high CRP are up to 4 times more likely to have cardiac events and at 4 to 6 times greater risk of developing diabetes.

It’s actually a much better predictor of heart attack and stroke than LDL ‘bad’ Cholesterol.

Acceptable CRP Levels:

• Lower risk: less than 1.0 mg/L
• Average risk: 1.0 to 3.0 mg/L
• Higher risk: above 3.0 mg/L
• Above 10 mg/mL usually indicates acute inflammation

It’s important to order the High-sensitivity CRP or hs-CRP test. The regular CRP test measures down to 3 mg/L whereas hs-CRP measures down to 0.3 mg/L, allowing you to detect low levels of chronic inflammation.

There are no drugs approved for lowering CRP, but some statins lower it. Several other Rx drugs lower it too, but all have significant side effects.

I’d pass on the Rx drugs. High CRP is a bright neon sign over your head saying ‘Time for lifestyle change.’

Diet and lifestyle factors like exercise, eating an anti-inflammatory diet (Zone, Paleo etc.), healing your gut, lowering sugar/Omega-6 and getting adequate levels of magnesium, Omega-7, Vitamin C, fiber (vegetables) and even turmeric can lower CRP. Using all the techniques above, I managed to get my CRP down from almost 4 to under 0.3.

Talk to your doctor about adding this test to your panel and techniques for lowering it.

3. Insulin

Insulin is the hormone that manages your blood sugar levels and your fat metabolism.

Insulin spikes and falls based on what you eat.

Your blood has very little capacity to contain sugar. So, if you drink a glass of soda or orange juice, you’ve consumed way more sugar than what your body was built for. Excess blood sugar can give you a mild case of coma or death. To keep you from going into coma, your pancreas cranks out insulin.

Insulin then lowers your blood sugar back to safe levels. The down side? The sugar gets packed away as fat. Every time you drink a glass of orange juice, your body shifts silently to ‘Defcon 5′ and back without you knowing it.

Why you should  care: 8 out of 10 people with heart attacks also have high insulin. High insulin is a hallmark of metabolic syndrome.

A diet high in sugar and refined carbohydrates will keep your insulin levels high. This leads to weight gain, high triglycerides, low HDL and small/dense variety of LDL cholesterol.

In people prone to the problem, a diet that’s consistently high in insulin-elevating sugars and carbs will lead to insulin resistance. Insulin resistance is a condition where the body ‘gives up’ and stops responding to higher and higher levels of insulin produced by the pancreas.

Like CRP, high post-prandial (after a meal) insulin levels can predict your likelihood of developing insulin resistance, pre-diabetes and diabetes. It’s easier to get your fasting insulin measured and that’s very useful too.

Measuring your fasting insulin along with your regular lipid panel is easy and your doctor ought to test it.

Acceptable Fasting Insulin Levels: Aim for 4 uIU/ml or lower. The average American is above 8.

Reducing sugar, juice, soda, grains and refined carb consumption is the best way to prevent high insulin levels. The diabetes drug metformin can reduce it. And, yes, exercise has a positive impact.

The good news: if you’re still young and/or undamaged from years of unlimited carb-feasting, going on a restricted diet like the paleo diet may drop your insulin levels quickly. In pigs, it dropped in as little as 10 days. A few people I know fit the description, so thought I’d share.

Low-carb diets have also been shown to bring high insulin under control.

Carnitine, alpha-lipoic acid, CoQ10, magnesium and EPA Omega-3 can all slightly improve insulin sensitivity.

I was able to drop my sky-high insulin level down to the normal range by going on a low-carb, high-veggie paleo type diet. I also take most of the supplements listed above, except carnitine. If I go on vacation and eat gelato every day (Pshaw – who would do such a thing?!), my insulin (and love handles) return. Quickly. And then I look like this guy.

4. Triglyceride (TG)/HDL Ratio

Ok – this is not an actual test. Your regular lipid panel already has your Triglyceride (TG) and HDL numbers.

By dividing the Triglyceride number by the HDL you get a ratio that is very informative.

Why you should care: People with the highest TG/HDL levels are 16 times more likely to suffer a heart attack.

Calculating this ratio is a simple trick to measure your risk for insulin resistance, metabolic syndrome, pre-diabetes, LDL particle size and, of course, heart disease.

High triglyceride and low HDL levels are independently good at predicting atherosclerosis. When you combine these two readily available data points, you are looking into your future with a telescope.

Small dense LDL particles are more dangerous than large ones. Measuring LDL particle density is somewhat expensive, but your TG/HDL ratio is also a poor man’s LDL density predictor. If your ratio is above 3.8, you have an 80% chance of having the more dangerous small, dense LDL. And with a ratio of less than 3.8, you have 80% likelihood of having the large, less dangerous LDL.

Acceptable TG/HDL Levels:

If your TG/HDL ratio is less than 1, you are at lower risk.
1 to 3 represents medium risk.
3 or higher may mean that you are at high risk and insulin resistant.

This ratio cuts through the confusion about ‘cholesterol numbers.’

We’ve only known about this since the turn of the century, so most doctors and lab tests don’t focus on it, even though it may be the strongest predictor of heart attack on your lipid panel.

Is it hard to get this ratio down? Yes. Mine was a sky-high 17 a few years ago. I got it down to 2.5. I’ve written about my struggles and eventual success in getting my triglyceride levels down, here and here. Simply put, it involves reducing or cutting out sugar, sodas, juices, fruits and grains.

Omega-3 from supplements or drugs like Lovaza and Vascepa help reduce triglyceride. So can Metformin.

A low-fat, high whole-grain diet will almost certainly not work. In fact, that’s what got my ratio up to 17.

Smoking, trans fats, Omega-6 fats and fructose can all decrease HDL.

Low-carb diets are more effective than low-fat diet at getting this ratio down.

Raising HDL is harder and slower – increasing exercise, not sitting a lot, increasing healthy fats all help. Advanced HDL-boosting techniques like ketogenic diets and intermittent fasting can also help, but it will require the assistance of a professional nutritionist.

Besides these four measures, homocysteine, apoB, ferritin, coronary calcium score, and oxLDL are also good predictors of heart health. More on those another day.

About the Author: Vin Kutty, MS, is co-founder of Innovix Pharma. He is a nutritionist, author, and Omega-3 expert with 20 years of experience.

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Regular Fish Oil – what’s in it?

‘Regular’ fish oil is sold in most grocery, drug and warehouse stores. They are inexpensive – you can get several hundred pills for $15.

These oils are usually made from Sardines and Anchovies caught in the Pacific ocean, off the coast of Peru and Chile. The data for the chart above is from Sardine oil.

They contain a blend of Omega-3, Omega-6, saturated, monounsaturated and even some natural trans fats. (No, these trans fats have not been shown to be harmful.) These oils also contain some cholesterol.

Since most people use the terms ‘fish oil’ and ‘Omega-3′ interchangeably and take fish oil for its Omega-3 content, it may be surprising to see that only 20-30% of the oil is actually Omega-3.

Now you know what the other 70% is.

Pharmaceutical Grade Fish Oil

Regular fish oil is the starting raw material used to make Pharmaceutical grade fish oils. Low-Omega-3 oil is concentrated using molecular distillation to provide a product that is mostly Omega-3 and very little of anything else.

The ‘other 70%’ is removed.

In other words, more of what you want and less of what you don’t.

The only downside with pharmaceutical grade fish oil is that the naturally present Vitamins A and D are removed. With fat/sun-phobia still raging, people have become Vitamin A and D deficient. If you want your fish oil to contain Vitamins A and D, they’re not in regular fish oil either. You’ll need to take unrefined salmon, pollock or cod liver oils.

Fish Oil and Environmental Contamination

Unlike less concentrated oils, ‘pharma grade’ oils have less mercury and PCB contamination.

When IFOS compared fish oils with less than 50% Omega-3 vs fish oil with more than 50% Omega-3 for environmental contamination, both groups passed the test, but they found almost 80% more PCBs in the lower concentration oils.

The lower concentration oils had 3X as much mercury as well. If IFOS had sorted their oils into four groups – 30% Omega-3 oils, 50%, 70% and 85%+, I suspect that they would have found bigger differences between the lowest and highest Omega-3 groups.

 ‘Pharmaceutical grade’ is not a regulated term

The term ‘Pharmaceutical Grade’ does not have an official FDA definition. It was coined by Dr. Barry Sears of Zone Diet fame. It used to mean that the oil had 50 or 60% Omega-3, which was a lot back in the 90s. Nowadays, it’s used to refer to oils that are about 85% Omega-3 or higher.

The data for the charts above and the table below is from an analysis of a recent lot of OmegaVia (Lot# UC130542) tested at IFOS.

These numbers will vary slightly from year to year, between products and types of fish.

• Sardine and Anchovy have very high levels of Omega-3 with a 3:2 ratio of EPA and DHA.
• Salmon oil tends to be a little lower in Omega-3. Salmon oil is made from ‘offal’ or parts of the fish that’s not a filet. The muscle meat of filets is not where most of the Omega-3 are stored.
• Tuna oil is high in DHA and is usually made from Tuna eyes. Eyes are full of DHA. Our ancestors were onto something with their  fish head and eye ball soups.
• Pollock and Whiting oil often have a 2:1 ratio of EPA and DHA. These Alaskan fish are processed similar to Salmon.

Detailed fatty acid profile comparison:

Your turn…

Do you take pharma grade fish oil?
Do you think it’s worth the added cost?

Let us know in the comments section.

About the Author: Vin Kutty, MS, is co-founder of Innovix Pharma. He is a nutritionist, author, and Omega-3 expert with 20 years of experience.

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We’ve made some upgrades to OmegaVia.

It still has the same amount of Omega-3. Same EPA to DHA ratio. And the same price.

Here are some of the upgrades:

1. POTENCY: Now concentrated with heat-free Supercritical CO2.
2. PURITY: Additional step for cholesterol and impurity reduction.
3. PEACE OF MIND: Certified third-party radiation tested.
4. OIL SOURCE: Now made from wild, small, algae-eating fish – Sardine, Anchovy, Mackerel and Menhaden.
5. FRESHNESS: Soy-free sunflower antioxidants + Rosemary extract. Most fish oils contain soy-derived preservatives. OmegaVia is completely soy-free and GMO-free.

1. SUPERCRITICAL CARBON DIOXIDE (CO2) EXTRACTION

This, in my very biased opinion, is the biggest and best of the improvements.

Supercritical CO2 Extraction is a purification and concentration technology. It is fairly new to fish oil products and it is better than molecular distillation.

Almost all fish oils these days are molecularly distilled. Molecular distillation is cheap and effective in concentrating fish oils, but it has one major disadvantage – heat.

Heat, light and oxygen are harmful to Omega-3 fats because it increases rancidity and aging.

When making a pharmaceutical grade fish oil using molecular distillation, there is no choice but to expose the delicate Omega-3s to high heat during the repeated molecular distillation process. The higher the concentration of Omega-3, the more times the oil is subjected to high-temperature distillation.

With this CO2 technology, however, we can make highly concentrated and pure fish oils without the heat. While regular pharma-grade fish oils have to be heated to over 350 degrees F to get its high potency, the new OmegaVia is just as potent as the old, but is made at just above room temperature. Compared to CO2 technology, molecular distillation applies up to 350% more heat to the oil.

Compared to CO2 technology, molecular distillation is aggressive and has the potential to generate unwanted isomers (residues) due to repeated and prolonged exposure to heat. However, not all molecular distillation produces isomers or residues. If done correctly, we can avoid heat damage with molecular distillation. But we now have a new technology that completely avoids that heat – so why take any chances when we now have a better alternative.

With this CO2 technology, low concentration or crude fish oil is mixed with liquid CO2. The Omega-3s dissolve into the liquid CO2 and are easily separated and concentrated from the other fats and cholesterol. The CO2 is recycled, making it environmentally sustainable too.

Krill oil is also made in a similar way, but instead of CO2, krill oil is concentrated using acetone (nail polish remover) or isopropanol (rubbing alcohol.) CO2 extraction does not use any of these toxic solvents.

Why aren’t more fish oils concentrated using this CO2 technology?

Cost. It is expensive compared to molecular distillation. Brands like Minami Nutrition, Real Dose and RenewLife offer fish oils made with this technology…so you can compare. OmegaVia’s price will remain the same.

Molecular distillation was a good technology. This is better. So we traded up.

2. CHOLESTEROL REDUCTION USING CO2 CHROMATOGRAPHY

Cholesterol is a concern for many people.

In addition to the CO2 Extraction mentioned above, we use an additional step called CO2 Supercritical Chromatography to further concentrate and purify the pre-concentrated oil. This ensures removal of remaining traces of cholesterol (not that the previous formula had any.)

This also removes additional contaminants. This additional step is not used by molecular distilled fish oils, even the leading brands.

This additional step produces an oil that is remarkably low in environmental contaminants. This type of chromatography can be used to make oil that is 99% EPA or 99% DHA. This technology is used to make OmegaVia EPA 500.

The only other brand that uses both CO2 extraction and CO2 chromatography is Minami Nutrition. Compare products and prices here.

3. RADIATION TESTING

Ever since the Japanese Fukushima nuclear tragedy, we’ve been getting questions from many of you about the safety of fish oil.

Does fish oil contain harmful levels of radiation? No. Not at all. More here and here.

Still, many have expressed concerns. To put this concern to rest, all future OmegaVia products will be tested by a third-party lab for radiation. All OmegaVia IFOS tests will contain these test results.

• FDA limit: < (less than) 1200 bq/Kg
• IFOS limit: < 50 bq/Kg
• Actual level in OmegaVia: < 2 bq/Kg

Sometimes it’s just good to know.

4. FISH OIL MADE FROM SARDINE, ANCHOVY, MACKEREL AND MENHADEN

Most of you are familiar with Sardines, Anchovies and Mackerel.

But Menhaden? Yes, Menhaden. It’s a small, bait-sized algae-eating fish like the others. It’s sustainably harvested off the US east coast.

Sardines, Anchovies and Mackerels are wild caught off the coast of Peru and Chile in the icy currents flowing up from the Antarctic. These are short-lived (less time to accumulate pollution) algae-eating fish that produce very clean oil.

Why the switch from Pollock and Whiting to these fish? Pollock and Whiting are slightly larger fish and have the potential to contain more environmental toxins. The key word here is potential. Even though the fish meat may have some pollutants, the processing of the oil removes virtually all of it. Sardines, Anchovies etc. are smaller, vegetarian (algae-eating) fish that naturally contain fewer pollutants that we don’t have to rely on molecular distillation to remove it. You could almost say these smaller fish come pre-purified.

5. 100% SOY-FREE ANTIOXIDANT + ROSEMARY EXTRACT

Over the last couple of years, OmegaVia has been transitioning away from soy-derived ingredients. The natural preservative Vitamin E (tocopherols) used to come from soybeans. Even though soy tocopherols are allergen-free, many of you objected to this due to GMO-concerns and health reasons.

So now, the the tocopherols come from non-GMO sunflower. Sunflower tocopherols have a unique ‘fingerprint’ of 4 natural forms of Vitamin E that are handled better by your body. Each OmegaVia capsule contains 2-3 IU of sunflower Vitamin E.

For additional protection against rancidity, OmegaVia now contains Rosemary extract, a powerful yet natural preservative.

Do you have any questions about OmegaVia?
Please post your questions in the comments section.

About the Author: Vin Kutty, MS, is co-founder of Innovix Pharma. He is a nutritionist, author, and Omega-3 expert with 20 years of experience.

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Omega-6 is the villain around these parts.

Why? Because excess Omega-6 can lead to inflammation.

It’s not is black and white as ‘Omega-3 good; Omega-6 baaad!‘ That’s an over-simplified view of a blog focused on the wonders of Omega-3.

Health matters are never that simple. Inflammation, after all, is a natural repair process.

Excess Omega-6 is just one of the reasons behind chronic, low-level inflammation. Other reasons include excess blood glucose, poor probiotic status, obesity, lack of sleep, gluten consumption etc.

For now, let’s focus on how to reduce Omega-6 fats.

The Omega-3 and Omega-6 Balance

Omega-3s and 6s have opposing functions in the body. Think ying-yang. How much Omega-3 or fish oil you need depends on how much Omega-6 you get in your diet.

Omega-3 are anti-inflammatory fats. And Omega-6 are largely pro-inflammatory. For eons, our ancestors ate a roughly 1 to 1 ratio of these two fats. This is ideal.

But things haven’t been ideal for a few decades.

We’ve been eating almost 20 times as much Omega-6 as Omega-3. Part of our myopic love for Omega-6-rich vegetable oils is that it reduces cholesterol. In 1969, the Los Angeles Veterans Trial studied the replacement of dietary saturated fats with Omega-6-rich fats. The group on the high Omega-6 diet had lower cholesterol and fewer deaths from cardiovascular causes. But they started dying of cancer at alarming rates.

Oops!

No one issued a memo. It was the dawn of cholesterol-phobia and the study was quietly forgotten.

Arachidonic Acid – a major source of inflammation

The Omega-6 in our diet is mostly Linoleic Acid (LA). This Omega-6 can get converted to Arachidonic Acid (AA) depending on what else you eat.

AA has a big impact on inflammation and your overall health because it breaks down into several inflammatory compounds. To some degree, you can prevent AA from being converted to inflammatory compounds by taking EPA Omega-3. This is because both Omega-3 and Omega-6 use the same metabolic path.

In other words, we’re all drowning in Omega-6. So out-drown the Omega-6 with Omega-3. When this conversion path is hogged by Omega-6, you can elbow in with some Omega-3 of your own.

Measuring the ratio of AA to EPA is very revealing about your level of inflammation. Japanese have a ratio of about 1.7 and Greenland Inuit are at 0.14. Ideally you want this ratio to be 1.5 to 3.  The average American omnivore is about 11. Adults with ADHD have a ratio of about 15. And people with depression have been shown to be as high as 30. Find out your ratio here. Or here.

In a self-experiment, scientific writer and the author of The Queen of Fats,  Susan Allport embarked on a high-Omega-6 diet for one month. She worked closely with researchers to get blood tested through this experiment. Within a month, her AA/EPA ratio went from about 3 to 9.

Using EPA to reduce Arachidonic Acid

To reduce your inflammation or AA/EPA ratio, you will need to do the following:

1. Reduce intake of AA and fats that convert to AA
2. Increase EPA Omega-3

But to get down to the 1:1 Omega-3 to Omega-6 ratio of our ancestors by using just EPA, you’ll need an awful lot of EPA. You’d have to consume amounts of Omega-3 never before done in human history. That’s a nutritional experiment I’d like to skip due to the potential for increased LDL oxidation.

You are most at risk if you eat a standard American diet AND you do not eat seafood or take Omega-3 supplements.

Where does our dietary Omega-6 come from?

And, more importantly, how can you reduce the amount of Omega-6 in your body?

The average American man eats about 17,000 mg of Omega-6 (Linoleic Acid) daily.

And most of it comes from vegetable seed oils:

• Soy
• Corn
• Canola
• Safflower
• Sunflower
• Peanut
• Grape seed
• Cottonseed
• Sesame

Some of it also comes from shortening and margarine.

Is this a problem? It’s unprecedented…that’s for sure. Omega-6 fats make up 7-10% of our calories. It mostly comes from soybean oil, a ‘food’ that did not exist on the planet until the 1950s. In my opinion, yes, this is a problem given that for all of human history, we got about 2% of our calories from Omega-6.

But the severity of the problem depends on your diet – what else are you eating besides Omega-6?

Steps to Reducing your Omega-6 Load

Step 1. Stop cooking with seed oils.
Step 2. Cut out restaurant-cooked or store-bought fried foods:

• french fries
• chips
• packaged baked goods
• virtually all junk foods

Step 3. Go easy on poultry and chicken dark meat.
Step 4. Eat home-cooked foods. Restaurants rely heavily soybean oil.

A visit to McDonald’s

McDonald’s uses a vegetable oil that’s a blend of Soy and Canola.

McDonald’s medium fries contain 16 grams of total fat. Assuming their oil blend is about 40% Omega-6 Linoleic acid, you get a whopping 6,400 mg of Omega-6. That’s just from the fries!

About 0.5% of all LA is converted to AA. More if your diet is low in Omega-3 and high in insulin-spiking sugar and refined carbs. McDonald’s fries are both, low Omega-3 and high in carbs. If the fries were rich in magnesium, zinc, Vit C, B3 and B6, less of the LA would be converted to AA…but no such luck with fries, so even more of the LA gets converted to inflammatory AA.

Also, when AA is consumed by fish-eating populations or when taken with Omega-3, the harm appears to be moderated.

Let’s say you eat a fish sandwich at McDonald’s – both Omega-6 LA from your french fries and Omega-3 EPA from the fish will have to compete for the same enzyme to get converted to AA. This enzyme is called delta-6-desaturase. (For the geeks amongst us: D-6-D is the rate-limiting enzyme in the LA to AA pathway.) Just the mere presence of EPA reduces the conversion of LA into potentially harmful AA.

There is a push-pull battle. The Coke and the fries push towards greater AA production. The Omega-3, minerals, vitamins (found in seafood, veggies, nuts, meats and tubers) pull you away from AA production. Ahem – paleo, anyone?

The Risk with Restaurants

You might think you left shortening or margarine behind back in the 90s. Think again. Restaurants, even fancy ones, use them liberally. This Zagat-rated fancy place had cooked my salmon in margarine.

What should you cook with?

• Olive oil. I use Bertolli Extra Light. I’m having this oil analyzed at UC Davis to find out its exact Omega-6 content. I’ll share results here when I have it. Use caution with blended mainstream olive oils – this stuff is expensive and ripe for adulteration.
• Butter, preferably grass-fed. I use Kerry Gold when my local farmer gal runs out.
• Expeller pressed coconut oil. The organic, extra virgin stuff that everyone’s going nuts over makes your food and the house smell like Almond Joy and it doesn’t hold up to heat very well. Look for Expeller pressed coconut oil – it has low-odor and much higher smoking point.
• Beef tallow, if you dare. I get mine from US Wellness.

What about chicken? Well, pass on the deep-fried thighs from KFC and deep-fried mystery nuggets. White meat cooked at home is OK.

What about nuts? Nuts should be a part of everyone’s diet – they’re packed with nutrients. Minerals, vitamins and prebiotics. Yes, they’re rich in Omega-6 but you have to look at the big picture. Eat no more than a handful per day. But if you buy those giant tub-o-nuts from Costco, well, just a handful is kinda hard.

What about eggs and meats? Eggs yolks and red meat have some built-in Arachidonic Acid and cholesterol. And this has been used as an argument for going vegan. Egg yolks are one of the most nutrient dense foods on the planet. Remember, eggs contribute just 1% of your Omega-6 intake. You could reduce egg consumption if you absolutely must, but don’t eliminate it from your diet. Instead, tackle the elephant on your plate – seed oils.

The bottom-line is that you cannot supplement your way out of an inflammatory condition with just Omega-3 pills.

Your multi-pronged approach should be: reduce Omega-6, reduce insulin-spiking foods, eat a whole food nutrient dense diet that provides plenty of magnesium, zinc, Vitamin C, B3, and B6, heal your gut, and fix your sleep issues.

But start with reducing Omega-6 back to ancestral human levels.

Do you have any questions about reducing Omega-6?
Please post your questions in the comments section.

About the Author: Vin Kutty, MS, is co-founder of Innovix Pharma. He is a nutritionist, author, and Omega-3 expert with 20 years of experience.

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Everyone agrees olive oil is good for you. But can you use if it you’re trying to lower your Omega-6 intake?

We put a popular olive oil to test.

In the last post, How to Reduce Omega-6, I suggested using olive oil instead of other vegetable seed oils.

Coconut oil and butter are both lower in Omega-6 than olive oil, but for those still worried about saturated fats, olive oil is a great compromise.

After all, who doesn’t love olive oil.

A survey of nearly 800 members of the American Dietetic Association (dietitians) showed that 95% of them chose olive oil as their #1 oil pick. **

Potential issues with Olive Oil

Despite universal acceptance, there are some minor issues with using olive oil:

1. Olive oil, especially extra virgin, has a strong flavor that overpowers other subtle flavors.
2. There isn’t enough olive oil to go around – so there is increasing talk of adulteration.

I buy two types of olive oils:

• Extra virgin oil for dipping and pouring over salads.
• A Light oil for high-heat cooking – something that replaces soybean or canola but with a lot less Omega-6. A working oil with a slightly higher smoke point than regular olive oil.

And in both cases, my primary reason for using olive oil is that it is low in Omega-6. Not flavor. Not price. Not smoke point.

Above all, it has to be low in Omega-6.

(Ahem – why not use coconut or butter if you’re so paranoid about Omega-6,  you say. I do! We go through pounds of both. And some beef tallow, cocoa butter, and ghee too. But people are still afraid of saturated fats after decades of misinformation. Hence olive oil.)

Now back to my two issues with olive oil – overpowering taste and risk of adulteration.

Extra Light Olive Oil – What is it?

Olive oils marketed as ‘Light’ or ‘Extra Light’ have a less bold flavor but the same amount of calories.

Light and Extra Light olive oils do not have intrusive flavors.

But what am I really getting with these ‘Light’ oils? Anything Light or Lite arouses suspicion.

Olive oil snobs would never be caught buying this stuff. But our family goes through quite a bit of it and I was worried about my kids eating ‘olive oil’ that was diluted with corn oil or canola.

Adulteration is a problem with olive oils. Only 10% of the oils produced strictly qualify as ‘extra virgin,’ yet 50% of all products pass themselves off as extra virgin. You can’t judge a bottle by its label. USA does not belong to International Olive Oil Council, so regulations are also, well, light.

So what was I cooking with? How much Omega-6 was I eating?

I wanted the exact fatty acid composition.

Instead of asking the manufacturer and possibly getting a coined answer, I decided to test it and find out for myself.

(I completely understand if you share similar cynicism towards peddlers of fish oil. I get it.)

University of California, Davis – Olive Center

I sent a bottle of Bertolli Extra Light Olive Oil to University of California, Davis – Olive Center.  They have an olive oil testing center. And for just about $200, you too can have your olive oil tested.

Here are the results.

Primary ingredients of my Extra Light olive oil. It is mostly Omega-9 oleic acid. It also has about 6 to 7% Omega-6. This makes olive oil a good choice for replacing Omega-6-rich seed oils.

The first thing I looked for in the result was the percent of linoleic acid. This is the key Omega-6 fat found in all seed oils. Olive oil usually contains 5 to 10% linoleic acid. Soybean/corn oils can be as high as 60% linoleic acid. So if there was any adulteration, you’d see a spike in the linoleic acid level.

Anything higher than 10% and I was going to blow a gasket.

But fortunately, the result came back at 6.74%.

Gaskets intact.

Another thing I looked at was the oleic acid content. It was 77%. Again, all-kosher.

Typical Olive Oil Fatty Acid Levels (USDA limits)

Oleic acid (Omega-9: Monounsaturated or MUFA) = 55 to 83%
Linoleic acid (Omega-6: Polyunsaturated or PUFA) = 3.5 to 21%
Palmitic acid (Saturated or SA) = 7.5 to 20%
Stearic acid (Saturated or SA) = 0.5 – 5%

I think the USDA limits are wide. As a chemist, I could easily blend soybean oil with a good quality olive oil and still be within the USDA upper limit of 21% for Omega-6. I’m sure that happens. And you’d never know.

Oleic acid is the most prevalent fat in olive oil. In addition to having low Omega-6, high oleic acid is a big draw for me. Oleic acid is far more resistant to oxidation or rancidity than Omega-3 and 6.

Oleic also is neutral in its effect on blood lipids like cholesterol. For the small percent of people who respond to saturated fats with an increase in LDL cholesterol, olive oil is a great alternative.

(Never mind that after all these years of hemming and hawing, eggs, a rich source of saturated fats and cholesterol have never been proven to increase heart disease. As Tom Petty put it, you believe what you want to believe.)

I will continue to eat grass-fed butter, coconut oil, tallow, bacon, liver, and red meat. Not because I want to thumb the eye of conventional wisdom, but because science has never conclusively proven harm associated with it.

Still, based on the results of this test, I will also continue to use my Extra Light olive oil. Am I positive that it’s unadulterated? No. But it’s low in Omega-6 and that’s what I care about in a cooking oil. I’ll probably get it tested again next year. Just in case.

Your turn…

Do you use olive oil? Butter? Lard? Do you use olive oil for high heat cooking? Share your thoughts in the comments section below.

** Of course, the dietitians shot themselves in the foot by picking Omega-6-rich Canola as #2 and lumped butter in the same category as hydrogenated fats. The American Dietetic Association is yet another organization that’s behind the curve on science and needs to take a long hard look at its own recommendations.

About the Author: Vin Kutty, MS, is co-founder of Innovix Pharma. He is a nutritionist, author, and Omega-3 expert with 20 years of experience.

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Sometimes even so-called ‘Burp-free’ fish oil pills cause burping. This is usually caused by low stomach acid.

‘Your product said BURP-FREE! Yet I keep burping fish! You’re a bunch of liars!’

Fishy burps.

It’s the #1 reason why people stop taking fish oil supplements.

According to GOED,

• 1 in 5 adults get fishy burps
• 11% won’t take it because of fishy burps
• 32 million adults will not believe a ‘No Fishy Burps’ label claim

Two people could take the same fish oil supplement. But one might burp in disgust while the other smells like a rose.

Burping does not necessarily mean the oil is bad. Nor is burping harmful in anyway.

Let’s assume you’re a burper. What can you do to prevent it?

There are lots of tricks – freezing the pills before taking it, taking it just before falling asleep, taking it with a meal etc. None of these tricks work well.

What works better is taking an enteric coated pill.

Enteric coating works. Most of the time anyway.

20% of you will burp if you take a regular (non-enteric) fish oil. With enteric coated pills, the number is under 5%. Shouldn’t it be zero? It should…but it isn’t.

How Enteric Coating Works
(and why it sometimes fails)

Enteric coating is sprayed onto the outside of the pill. The coating will stay intact and prevent the pill from dissolving in the acidic environment of your stomach.

Once the pill has moved past the stomach and into the small intestine, the surrounding environment is no longer acidic. It is neutral. In non-acidic environments, the enteric coating dissolves and the fish oil is released into the intestine for absorption.

Since the pill dissolves in the intestines and not the stomach, you will not experience fishy burps. Well, you shouldn’t. The reason that enteric coating works is due to the highly acidic nature of the stomach.

There are two reasons why enteric coating of fish oil supplements fail:

1. The coating is chipped or cracked
2. Your stomach is not as acidic as it should be

Since enteric coating is sprayed onto the surface of the capsule, it is technically possible that the coating could chip or crack, like the paint on a wall. But this is so rare that it virtually never happens.

More often than not, it’s the stomach acidity that’s at the root of the problem.

Let me explain: acidity or pH is measured on a scale from 0 to 14. Zero is extremely acidic and 14 is extremely alkaline. 7 is neutral.

• Hydrochloric acid is near 0
• Battery acid is near 1
• Coca Cola is about 2
• Vinegar and Lemon juice is about 3
• Wine is about 4
• Coffee is about 5
• Rain water is about 6
• Pure water has a pH of 7
• Seawater is about 8
• Baking soda is about 9
• Antacids are about 10
• Milk of magnesia is about 11
• Bleach and oven cleaners are about 13
• Sodium Hydroxide (household lye) is about 14

A healthy stomach is at about 1 or 2…in the same ballpark as battery acid. This is normal and healthy.

Your stomach produces hydrochloric acid in small quantities to kill germs and to prepare proteins, some vitamins and minerals for digestion.

The pH scale. Enteric coated fish oil pills are tested twice. The first test shows whether pills holds up to stomach acid and the second test shows that it dissolves quickly at neutral pH of the intestine.

Here’s the surprise – many people don’t produce enough stomach acid.

There are several reasons for this:

• age
• stress
• poor thyroid function
• nutritional imbalances
• H. pylori infection due to gut microbiota imbalance
• Pernicious anemia
• long-term use of heartburn medications, etc.

This condition is called hypochlorhydria. Instead of pH being at 1.2, their stomach pH drifts up to 4 or 5 or even above 7.

Most people ironically consider this ‘too much acid,’ and begin taking antacids like Tums, Rolaids or stronger heartburn meds like Omeprazole. The problem is not always too much acid and these products don’t address the root cause of the issues. But that’s a rant for another day.

How does low stomach acid affect enteric coated fish oil pills?

Enteric coated fish oil pills will work perfectly well at pH of 1, 2 or 3. But at pH of 5 or 6, it won’t work. pH of 6 is getting close to being neutral and the enteric coating starts to dissolve.

If you have a low-acid stomach, the enteric coated pill ‘thinks’ it’s in the intestine and promptly dissolves.

If you burp up fish oil after taking an enteric coated product, your stomach acid production is compromised. The burping window is 2-3 hours.

This is a very simple test for hypochlorhydria.

Doctors should be using enteric coated fish oil pills to test their patients’ stomach acid production. It is a simple, cheap and safe test. The only downside is that if your stomach isn’t acidic enough, you may burp for about 3 hours.

People with this condition may not know that they have low stomach acid. We know. We hear from customers who have this issue.

Our customer service folks are not doctors. They are neither qualified nor authorized to diagnose you with hypochlorhydria. But we keep detailed notes of angry calls from burpers. We’ve noticed trends and have learned a thing or two about stomach acid.

Temporary cures

If you take OmegaVia and experienced burping, you may want to do a small, self-experiment: take your OmegaVia with something acidic.

Your choices are:

1. Orange juice (pH of 3.5) but you will have to drink 6 to 8 oz every hour for 3 hours. If you burp when you take the pills with water and don’t burp with orange juice, you may have stomach acid issues. Coca-Cola will work better. But both beverages are harmful if consumed regularly.
2. Powdered ascorbic acid. This is Vitamin C. Mix half a teaspoon into 8 oz of water and sip a few ounces every hour for three hours. Too much Vit C can cause stomach distress.
3. Apple cider vinegar. Same process as Ascorbic acid, but skip this if you’re sensitive to yeast.
4. Betaine hydrochloride – this may require assistance from a doctor or a professional. Take 1 Betaine pill a few minutes before your enteric coated fish oil pill. Take one every hour for three hours. This may be your best bet in the long run.

With all of these acidifying agents, you will be able to keep the enteric coating intact in the stomach, so you don’t burp up fish oil. But don’t do this on a daily basis. That’s overlooking the real problem.

The Elephant in the Stomach

Removing the inconvenience and nuisance of a fishy burp is minor compared to addressing the key issue: decreased stomach acid.

I strongly suggest you go to a functional medicine doctor to get to the root of this problem because fishy burps are the least of your problems. There are several health issues associated with low stomach acidity. Find the root cause and fix it.

Low stomach acid can cause several nutrient deficiencies. Another issue is that a healthy stomach is a very hostile place for most bacteria. With a low-acid stomach, bacteria from the mouth, intestines and elsewhere can easily colonize the stomach. A low-acid stomach is also unable to reliably kill pathogens like Salmonella.

If you go to a general practitioner, he or she may simply send you home with an antacid, which fixes nothing. Go to a functional medicine MD.

Once the problem is truly addressed, you will not only not burp up ‘burp-free’ fish oil pills, but you’ll feel a lot better a lot healthier.

 Your turn…

• Do you get fishy burps without enteric coating?
• More importantly, do you get fishy burps even with enteric coating?

About the Author: Vin Kutty, MS, is co-founder of Innovix Pharma. He is a nutritionist, author, and Omega-3 expert with 20 years of experience.

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Twelve million Americans, mostly young women and middle-aged men, stopped taking fish oil supplements last year due to the alarming headlines linking fish oil and prostate cancer.

Good news: even ultra-high doses of Omega-3 do not promote prostate cancer, says Europe’s top food safety agency.

Yet, last year, 12 million of you stopped taking fish oil…and for no good reason.

Why? Because of a study that said fish oil could cause prostate cancer.

The authors of that study have now published a new study that says ‘there was no strong evidence’ that fish oil caused prostate cancer.

‘No strong evidence’ that fish oil causes prostate cancer

The Journal of the National Cancer Institute published a study in September 2014 that, in effect, said that it was a wash. There was no cause and effect between fish oil fatty acids and prostate cancer.

Theodore Brasky and Alan Kristal, who were all over TV and radio telling us that fish oil causes cancer, are also coauthors of this new paper.

Their words, then and now:

(Keep in mind that the original study participants were not required to take or avoid fish oil supplements.)

2013: “We’ve shown once again that use of nutritional supplements may be harmful. The data doesn’t support the use of Omega-3 fatty acids for anything. There is no good data. People like to believe that the supplements they take improves their health. It’s all frankly just not true. I honestly can’t say there is any condition where taking supplements makes sense. The best advice I could ever give to people is to just stop taking supplements.”

2014: “There was no strong evidence that circulating fatty acids are important predictors of prostate cancer risk.”

This is what I had to say about it in 2013:

‘The media circus around this study plays along with this researcher’s irresponsibility and personal bias. I think the authors are aware that their data does not support these statements. It’s not ignorance. It’s just career advancement. This kind of media attention brings funding and ensures job promotions, tenureship and all-around back-slapping.

And the media? Well, fear-mongering sells. And in a facts-be-damned media circus, it’s always the supplement that gets taken out back and shot.’

The original study was not about fish oil supplements. But virtually every interview about it became about fish oil supplements.

After I published the above statement, I briefly met with Theodore Brasky, one of the authors, in February 2014. He looked uncomfortable and publicly distanced himself from co-author Alan Kristal. Yet, he continued to dig in and stand by his original unsupported statements, even though many of his more informed peers had openly criticized the study and the author’s choice of words.

This is what I have to say now:
The media should have covered this new study with as much attention as they did the sky-is-falling headline last year.

But sensationalism sells. Good news does not. (We just survived a million negative ads from the mid-term elections. I can’t remember a single positive, informative political ad. It’s what sells and it’s what gets remembered.)

So, what gives? Is the new study wrong? Or just more compatible with my preexisting bias? I don’t think the new study is wrong – it is probably a fair assessment. Science often takes a fire-aim-fire route to understanding. That was never the issue.

The issue was (and remains) the unfair coverage of health matters in the media and scientists who get caught up in the giddiness and end up making self-serving (rather than factual) statements.

12 million quitters

But what about the 12 million people who quit taking fish oil because they were afraid of prostate cancer? Most of those who quit were middle aged men and young women – two groups who critically need Omega-3 for different reasons.

Young women need large quantities of Omega-3 for pregnancy. Inadequate Omega-3 during pregnancy has serious consequences to both the mother and child.

Middle aged men are the ones most aggressively treated for heart health.

I doubt these 12 million people switched from taking fish oil supplements to eating salmon three times a week. Who is going to tell them that the media circus that made them quit fish oil is now officially inaccurate?

Do Brasky et al. owe anything to those 12 million people?

Science is a series of understandings, re-understandings and better-understandings. But that’s not what happened with Brasky et al. Their data and the author’s public interpretation of it were worlds apart.

The new paper undoes some of the scientific damage, but not the public health damage, which remains a shameful chapter in Omega-3 history.

Incident #2: a head-shaker and a head-slapper

Oh, the next little incident would be really funny, if it wasn’t so sad.

Journal of Lipids published this ‘review article’ in January 2014. It was retracted in November 2014. It’s open access and still available for reading. Click on the image above.

It involves Brian Peskin.

The Journal of Lipids retracted his paper titled ‘Why Fish Oil Fails: A Comprehensive 21st Century Lipids-Based Physiologic Analysis’

If you read a lot of scientific papers, that title should have made flashing red lights come on in your head.

It is rare for a journal to retract a published paper

When a retraction happens, it is usually because there was a major mistake. In this case, Peskin did not disclose a conflict of interest.

Peskin swims against the tide with his pro-Omega-6, anti-EPA/DHA stance. For reasons not fully explained in his retracted paper, he worships Omega-6 and denounces fish oil. He sells products that are largely seed oils, rich in Omega-6 and ALA Omega-3, some of which he claims are cures for cancer.

That this business interest was not revealed by Peskin to Journal of Lipids may not be surprising, but that the editors of the journal overlooked the contents of the paper is disturbing and very puzzling.

Journal of Lipids is not exactly Annals of Internal Medicine or New England Journal of Medicine.

Journal of Lipids is a you-pay-we-publish establishment. While that alone does not nod to unethical behavior, the peer-review editors were clearly asleep at the wheel in this instance.

Here’s a list of doozies:

The unnecessary big words. The mind-numbing details about nothing that lead to nowhere. The interwoven fabric of fact and hope. Just the right amount of science to dazzle and impress average Joes all across America. (You know, kinda like this blog.) The repeated references to the now-kaput Brasky paper (see above). The out-of-place aspirational marketing language in a science journal. Citing old college text books.

The esteemed Dr. Michael Crawford sits on this journal’s editorial board. There is no chance that Dr. Crawford would have allowed the publication of this paper had he reviewed the manuscript.

The journal’s editorial process did not vet the author’s credentials or history. A quick Google search reveals that Peskin has paid $100,000 to the state of Texas for misrepresenting his credentials and making fraudulent medical claims.

So, how did the paper get retracted?

Well, a Canadian medical student, Ian Garber, found his ‘pseudoscience sense tingle,’ when he read the paper. He contacted the journal and the editors finally (and quickly) did their jobs. Almost as if it was the first time they were reading the paper.

The conflict of interest non-disclosure made it very easy for them to retract and blame-shift.

So what does all this mean to your health?

1. It means that people will continue to promote their agendas, to publish papers, and to sell products, even if there is scant proof to support their positions.
2. Question everything. Read a lot, not just one self-proclaimed expert. Yes, including the mindless rambling on these pages.
3. Your health really is in your own hands.

And finally, know that you can never outrun disease, poor diet, and lack of exercise by taking supplements.

About the Author: Vin Kutty, MS, is co-founder of Innovix Pharma. He is a nutritionist, author, and Omega-3 expert with 20 years of experience.

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Eggs are one of the most nutrient-dense foods. Along with liver, they’re nature’s multivitamin. Yet, most cardiologists are nervous about yolks.

Paleo is all the rage.

Should you join the bandwagon?

Absolutely!

But most cardiologists think it is nuts to warm up to eggs, butter or lard.

Most people have several incorrect assumptions about the Paleo diet. It is almost always misinterpreted.

Paleo should be an inspiration to eat and live in a simpler, cleaner, ancestral way. A rough guide. A template. That’s it.

It is not a low-carb carnivorous diet. It’s not Atkins with a spit shine. Technically, even vegans could be Paleo if they ate just fruits, vegetables and nuts.

True Paleolithic diets are almost never replicated because it would require eating bugs, grubs, reptiles and the like. But that’s not the point.

The point I’m trying to make is that you don’t have to go that far back in human history to find the ideal nutritional template. Eating the way people did even 100 years ago will have tremendous positive effects on your health.

My 30 Year Study

I’ve been quietly conducting an informal study/survey for the past 30+ years.

It involves talking to two groups of people about diet.

The first group: elderly people from remote and rural parts of the world

I asked them these questions:

1. What did you eat as a child?
2. What do you recall your grandparents or great-grandparents eating?
3. Do your grandchildren still eat the same foods? If not, how is their diet different today?

Second group: cardiologists from all over the world

These are interventional cardiologists – the people trained to do bypass surgeries and put in stents. Cardio plumbers. To this group, I asked the following question: what dietary advice do you give your patients?

This survey wasn’t meant to be a secret. Initially, it was mostly to satisfy my curiosity. It’s where my love for off-the-beaten-path travel and interests in nutrition, anthropology and geopolitics met.

I traveled a lot as a child – with and without my parents. I spent 1980 in Nigeria and that was a springboard to my globetrotting. It seemed quite normal that I, a mere teenager, found myself traveling alone in Spain or Ghana. (Yes, my parents were concerned and no, they weren’t hippies.)

Everywhere I went, I noticed that the illnesses that people complained about were different.

My neighbors in Chicago seemed to be dealing with completely different health issues than the people I met in the Niger river delta of West Africa. The issues were chronic diseases in modern societies and infectious diseases in rural and forest societies. I just assumed that was a cultural and genetic difference.

The older I got, the more I started to suspect that diet had something to do with this.

As the 80s and 90s rolled on by, America was gripped in fat-phobia. By the time I graduated from Purdue Univ. (Indiana) in 1990, I was eating fat-free everything. So were most of my peers. Yet the student body was literally getting bigger.

Why were we getting fatter? Why wasn’t heart disease over?

Strangely, people I met in rural parts of the world – Chiang Mai (Thailand), Zaragoza (Spain), and Beni (Bolivia), who weren’t on fat-free diets – were all thin and relatively healthy.

I found the diet in Basque and Catalonia regions of Spain to be particularly high in fat, with their cheeses, hams, cream, rabbit, and octopus specialties. Yet nobody in the rural areas was fat.

The city folk in Barcelona and Madrid were, however, starting to look soft and unhealthy like my neighbors in America.

The same for the gauchos in rural Artigas (Uruguay) versus the office workers in capital city, Montevideo.

Urban teenagers in Brazilian shopping malls were almost always heavier and had more acne than the indigenous rural tribes kids in the Amazon. The teenagers growing up deep in the Amazon jungle had insect bites but never any acne.

Apparently acne doesn’t have to be a rite of passage. I’d like to have known that at fifteen.

This got me thinking. Rural, working class, or forest-dwelling, hunter-gatherer people seem to eat a more conservative or ancestral diet than their city brethren.

Was there something in the way rural people ate that made them healthier?

My gut said ‘yes.’ So I kept asking questions till I felt I had some answers.

And I have some answers.

I hope to keep expanding this blog over the years. But I’ll share the punch line with you here.

Here is what all cardiologists the world over said:

‘Eat a low-fat diet.’

That’s it. Simple.

Every single cardiologist said the same thing. They all wanted me to avoid fat like it was poison. Many of them expanded on it and said that I’d be better off avoiding meat as well.

I met with cardiologists in Brazil, Nigeria, Spain, USA, Uruguay, Singapore, Korea, and India.

Universal egg avoidance

We usually met over breakfast and you’d be surprised how many of them left the eggs on their plates untouched. Many of them ate the egg white and left the yolk alone.

This often led to my eating their yolks (if I knew them well enough) and them thinking I was crazy. They all had the same puzzled, patronizing look when I ate their yolks or poured a generous amount of cream into my coffee. One advised me to stop embracing American counter-culture. And another said, ‘But…you’re a scientist! Why would you eat the yolks?’

But that’s exactly my point. I am a scientist. If the evidence against egg yolks was convincing (or even present), I’d eliminate it from my diet right now.

But there hasn’t been a single published scientific paper that conclusively proves eating egg yolks causes any disease. Yet there are dozens upon dozens of papers proving egg yolks are one of the richest and densest source of nutrients available to humans. It contains essential nutrients that most city dwellers are deficient in – choline, Vitamins A, and K2 come to mind.

But that’s just pesky science.

My goal wasn’t to change the minds of a few cardiologists – the point of this decades-long survey was to hear confirmation of what they thought. And now I know.

It’s as if cardiologists the world over were reading from the same notes. Notes disseminated by the US government and American Heart Association back in the 1970s.

‘Animal fat contains cholesterol and cholesterol is involved in atherosclerosis,’ summed up their collective view on butter, red meat, cream, lard, and certainly egg yolks. Egg whites got a reluctant approval. Some of them avoided egg whites too.

These foods rest on the Paleo altar thanks to their nutrient density and millennia of use. But it’s easy to see how the Paleo diet can be viewed as part of counter-culture. Sure, there are folks who’ve had enough of ‘low-fat’ and choose to defiantly wrap their middle fingers with bacon.

A New Breed of Cardiologists

There is something else you need to know: these opinions are from interventional cardiologists. They receive virtually no training in nutrition or food biochemistry. Everything they know about nutrition is from what they’ve heard from TV, news, pharmaceutical reps, and reading.

Interventional cardiologists are not paid for preventing heart disease. They’re paid for roto-rootering you. They send you back out into the world, nutritionally naked and with a zipper on your chest. That’s what they do. And they do it well.

Preventive cardiology is different. It is an emerging field. So is functional cardiology. Cardiologists in this new branch of science are cut from a different cloth. And you will often hear them discussing healthy fats, refined grain and sugar avoidance, inflammation, etc.

Outside wealthy, westernized nations, preventive cardiology is almost unheard of. I’ve only spoken to a couple of preventive cardiologists and don’t yet have a grasp on how they collectively feel about diet. But so far, they seem more informed and fat-friendly.

This brings me to the diets of rural, ancestral, or forest-dwelling peoples. What can these people teach us? More in Part 2 of this series.

About the Author: Vin Kutty, MS, is co-founder of Innovix Pharma. He is a nutritionist, author, and Omega-3 expert with 20 years of experience.

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Restaurante Botin in Madrid is the oldest restaurant in the world, established in 1725. The menu seems to have changed little since, offering mostly fish, vegetables and meats. Ancestral European cuisine is simple, healthy, and delicious.

In Part 1, we discussed the universal fear cardiologists have for eggs and butter.

Yet, traditional societies that do not avoid fat have low levels of obesity and heart disease.

During the past 30 years, I’ve frequently traveled to remote corners of the world where traditional diets are the norm. Some rural Europeans eat a lot of meat and fat. The indigenous tribes of the Amazon hardly eat green vegetables. Peoples of south Asia eat a lot of saturated fat from coconut. West African fishing villages eat mostly, well, fish, palm oil and root vegetables.

None of them give a damn about carbs or fat content. You’d think they’d all be dead, on their backs with limbs in the air. Except they’re not. They’re thriving!

At first, I was unable to see any connective threads between people living in the middle of the Amazon and those living on Indonesian islands or a fishing village in West Africa.

Oh, but there are strong connective threads! Every single rural or ancestral society that I’ve become familiar with shares habits and traits with all the others.

On the flip side, there are many clear and obvious dietary and lifestyle habits that we (urban and ‘modern’ people) have moved away from.

Is modern living making us sick?

I believe this shift away from an ancestral way of living is dangerous. I’m not talking about lifespan. I’m talking about quality of life after middle-age.

I believe our modern diet and lifestyle is making the last third to quarter of our lives miserable. Misery prolonged still more by advanced medicine.

We weren’t meant to spend the last decades of our life fighting chronic diseases.

From what I’ve seen, death seems very different in ancestral/traditional societies. They live comfortably into their 80s. And end of life is swift, with very little prolonged agony.

Is there something to learn from ancestral societies?

So, what are the dietary and lifestyle threads that connect rural and ancestral societies?

I’ve noticed three:

1. An absence of fat-phobia
2. Reliance on non-grain sources of starch
3. A constant and close association with nature

AN ABSENCE OF FAT-PHOBIA

This observation is much more than just eating more butter. It’s about how ancestral cultures:

i. Cook and eat the entire animal/fish/bird

You don’t have to go to a remote jungle to observe this.

Any rural market in Mexico or China will have virtually every single body part of a cow or pig for sale.

When was the last time you went to a dinner party where someone loudly slurped the marrow from a bone?

When was the last time you saw fish heads or chicken feet in an American grocery chain? Heck, forget chicken feet – how about liver?

Wings good. Feet bad. When it comes to chicken, that’s how we roll.
So billions of chicken feet are exported to Asia, where there is no ick-factor to overcome. Chicken feet aren’t nutritional powerhouses, but it’s emblematic of how we now dismiss many traditional foods.

When was the last time you made fish soup with a whole fish, head to tail?

At a business lunch recently, I asked a few of my colleagues what they thought of these now-foreign foods. All of them stopped eating. And talking.

American grocery chains sell muscle meats. Muscle, while still nutritious, is very low in the amino acid glycine. And glycine is essential for making your body’s master detoxifier and antioxidant, glutathione.

If you don’t eat skin, cartilage or a soup or broth made with the entire animal, you are likely deficient in glycine and subsequently glutathione. If you’re a poor soul with MTHFR issues, like 1 in 6 Americans, this is a recipe for misery.

ii. Get vitamins A and K2 from animal fats

I realized about 10 years ago that I was following the well-worn steps of Weston Price, a genius who’d figured all this out almost 100 years ago. He was brilliant and absolutely correct about the importance of fat-soluble vitamins.

Vitamin A

The FDA permits beta-carotene in foods and multivitamins to be measured as Vitamin A.

This is a big mistake.

Beta-carotene is a PRECURSOR to Vitamin A. It’s not Vitamin A. Many people don’t convert beta-carotene to Vitamin A.

Preformed Vitamin A comes from animal fats and organs – stuff that we think of as dangerous or gross.

Vitamin K2

Vitamin K2 is found exclusively in fermented foods and fats of animals that have recently grazed on growing, green grass.

When was the last time you ate Natto, sauerkraut, or grass-fed butter?

Want your kids to have perfect teeth? Travel back in time when you were 5 weeks pregnant, and then stuff yourself with foods rich in Vitamin A, D and K2. Weeks 5 through 11 are critical for proper development of chompers and bone geometry. ‘Bone geometry’ is a nice way of saying good looking. Heck, even their adult teeth are formed during that time.

But it’s not too late. Don’t let that missed opportunity stop you from stuffing them with butter, liver and eggs now. Switch from cheeze to cheese.

Not enough K2 = smaller jaw bones = crowded teeth = expensive and awkward braces for every teenager.

Adults need K2 to keep calcium in their bones and out of arteries, and to prevent heel spurs and kidney stones. K2 keeps calcium from misbehaving. A, D3 and K2 work together in keeping  you healthy. Animal fats are the richest source of all these nutrients.

If you’re afraid of ancestral foods like animal fats, you must accept that your calcium will misbehave.

Modern fats and oils

Modern vegetable seed oils are everywhere. Even in remote corners of the world.

Of all the places I visit, the Amazon jungle, its indigenous peoples and the nature surrounding them fascinate me the most. I’ve gone there almost every year since 1996.

The indigenous tribes there don’t use much fat or oils to cook. But when they do, they prefer fat rendered from turtles or Tambaqui. Turtles can no longer be legally hunted, so that’s off the table. Tambaqui (Colossoma macropomum) is a seed-and-fruit eating cousin of the Piranha.

Of the thousands of different fishes in the Amazon, Tambaqui rests near the top of the culinary hierarchy. It’s what you whip out when the in-laws come over for dinner for the first time.

Tambaqui is a fruit and seed-eating cousin of the Piranha. It is rich in Omega-3 fats and consumed frequently by rural people of the Amazon. Tambaqui and Manioc (also known as Cassava, Tapioca, or Yucca) is a typical breakfast for many Amazonian residents. And about as healthy as a meal can get.

Tambaqui is a rich source of all essential Omega-3s and Omega-6s, especially during the dry season.

Turtle fat is no longer a part of Amazonian diet. Over a century ago, turtles were so abundant that turtle fat from the Amazon lit thousands of lamps across Europe. When I was in the Amazon two months ago, I think I saw two tiny turtles in 10 days.

Sadly, no one seems to render Tambaqui fat anymore either. Why bother when traders from the city bring in cheap soybean oil upriver to every remote corner of the Amazon. And soybean oil never seems to go rotten in the jungle heat. What’s not to like?

This gradual switch from traditional fats that contain Vitamins A, D3 and K2 to virtually nutrient-free industrial seed oils has been going on in every single country and traditional culture I’ve studied.

People in West Africa and Indonesia who used to consume large amounts of red palm oil (rich in healthy tocotrieneols) have switched to Omega-6-rich seed oils.

Little balls of Gari dipped in red palm oil. Yum! Brings back memories of my youth in Nigeria. Today I see this food combo as a friendly starch eaten with a nutrient rich fat. But back then, it was a lot less complicated. It was just tasty food.

Vegetarians across northern India who for millennia got their Vitamins A and K2 from ghee have been cholesterol-spooked into nutrient-free seed oils. In south India, people have switched from Omega-6-free coconut oil to Omega-6-rich seed oils.

In every one of these places, fat-soluble vitamin deficiency is rampant. Children frequently suffer from Vit A deficiency induced night blindness.

Can Paleo diet help you?

A little, maybe.

Paleo puts sugar, grains, and processed vegetable oils as its top NO-NOs. Many followers of the Paleo diet have switched from seed oils to low-Omega-6 oils like butter, coconut oil, and olive oil.

This is definitely a step in the right direction. But coconut oil and olive oil have no Vitamins A or K2.

And strict followers of Paleo avoid dairy too. So they’ve sworn off Vitamin A and K2 rich foods like grass-fed heavy cream, cheese, and butter. Avoiding dairy is not a bad idea, but do so only after you’ve included other rich sources of fat-soluble vitamins into your diet. Think liver and fermented foods.

Ancestral diets were right and healthy. Because they didn’t toss the nutrient-dense organs. Because they consumed fats rich in Vitamin A, D3, K2 and E.

This isn’t the only healthy thing our ancestors did. They ate non-grain starches, they were active, and were very connected to nature and each other. Mostly, they ate food…real food. Not food-like products.

More on all that later.

About the Author: Vin Kutty, MS, is co-founder of Innovix Pharma. He is a nutritionist, author, and Omega-3 expert with 20 years of experience.

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There is a misperception that the Paleo diet is about gorging on meat. And avoiding all carbs.

There is nothing wrong with eating a little meat, especially organ meats. As we saw in Part 2, animal fats are a rich source of Vitamins A and K2. But eating meat three times a day doesn’t make you Paleo.

Starchy boiled palm fruit called ‘Pupunha’ is part of a traditional breakfast for people living along Amazonian rivers.

Also, unless you’re pre/diabetic, have high triglyceride/metabolic syndrome, or trying to lose weight to fit into a wedding dress, there is no need to go low-carb. Cutting back on carbs, especially the good kind can be a bad idea.

Grains – carbs at a cost

Most people think of whole grains as a good for you.

Grains kill you very slowly.

There is absolutely nothing essential in grains that you can’t get from fruits and vegetables.

Grains contain phytic acid, which reduces absorption of calcium, magnesium and several other essential minerals.

You already know about gluten. No need to beat that ex horse.

But there are other possibly scarier proteins in wheat like gliadin, glutenin, and germ agglutinin that enter your gut wearing brass knuckles.

Some traditional cultures seem to have figured out ways of reducing the full brunt of these toxins by soaking, sprouting, and fermenting grains and legumes. This is still not ideal, but it helps a little.

The pacifist vegetarian Jain tribes of northern India are expert legume sprouters. They were also huge consumers of butter oil /ghee and home-fermented yogurt. Urban Jains have dropped ghee and embraced wheat in a big way…and seem to be paying for it.

Gut-Friendly Starches

The truly healthy ancestral cultures, however, seem to get their carbs from roots and tubers.

Paleo folks are familiar with Staffan Lindberg’s study of the residents of Kitava, a small island in Papua New Guinea. The locals are remarkably free of modern diseases and they mostly eat root vegetables (yam, sweet potato, taro and tapioca), fruits, coconuts and fish. There is no heart disease, diabetes, hypertension, obesity or dementia. Sudden death appears to come only by way of drowning or falling from coconut trees.

Low-carb Paleo folks have often dismissed the starchy, high-tuber consumption of Kitavans.

Taro (Colocasia esculenta) is a safe starch that’s still widely consumed.

Looking at my notes, I found something remarkable. Three different cultures I’ve studied have a virtually identical diet to the Kitavans.

•    Indigenous tribes in northern Amazon (Brazil)
•    The Igbo people of the Niger delta (West Africa)
•    The Malayalees of south Kerala (India)

Ancestral Northern Amazonian Diet

Manioc and freshwater fish make up most of their diet. Manioc (also known as Cassava or Tapioca) is a starchy tuber. The skin of the tuber contains some cyanide, so it needs to be peeled, soaked and processed carefully.

It’s not uncommon to see sunken canoes in the shallows of rivers, filled with peeled tubers. After a couple of days of soaking, the cyanide will leach out and you’re left with a very safe and gut-friendly starch.

Palm fruits are also a rich source of starch and several other nutrients.

Leafy vegetables, worshipped by westerners, are not a big part of the diet. Cucumbers, peppers, cilantro, and pumpkin are consumed. Legumes are consumed two or three times a year.

Dairy, wheat, and grains are not consumed. Meats like beef and chicken are eaten very rarely…but when they do, they leave no part of the animal to waste. Raw Brazil nuts, a nutritional powerhouse, are used to make ‘milk’ – crushed or blended with some water. The soft nut is also scraped and used like butter on top of manioc flour pancakes – a delicacy that I miss every single day when I’m not in the jungle.

There are lots of seasonal fruits in the jungle, some of which, like Acai and Cupuacu are eaten almost daily. Camu camu fruit, available freely along any river, is unbelievably high in Vitamin C.

Jamelao fruit, or ‘Purple olive’ is high in phenolics and vitamins.

Ancestral diet of the Niger Delta

Yam forms the basis of this diet. Cassava, taro and plantains are consumed in large quantites.

Yam and cassava in many different forms are eaten with a fish or goat soup of stew. Those living along the waterways eat fish on a daily basis.  Garri, cooked tapioca flour, is the common man’s food.

Freshly dug up cassava root is also known as arrowroot, tapioca, manioc, and yuca. The powdery extract is called tapioca and the flaky fermented kind is garri. Eating it as is can be deadly, but proper processing removes the toxins.

The Igbo people eat a little more meat (bush meat – small antelopes, monkeys, etc.) than the Kitavans. Traditionally, the Igbo used red palm oil as their primary cooking oil.

Bitterleaf (similar to spinach) and Breadfruit are common vegetables.
Today, rice, vegetable seed oils and chicken have replaced a lot of the traditional foods.

Traditional diet of the south Kerala fishing villages

A fishing village near Bekal Fort, Kerala, India. Spiced sardines fried in coconut oil is a staple. Virtually every tree in the background is a coconut palm.

Clearly, they have access to fish and coconuts. Tapioca, yam and several types of root vegetables are cooked with coconut oil.

Tapioca, fish, and coconut form the basis of at least two meals every day.

Several leafy vegetables and plantains are consumed almost every day. Turmeric is used daily.

Elephant foot yam (Amorphophallus sp.) is another starchy tuber. The plant also has a short-lived high-protein flower that is a delicacy, but past its prime, the flower smells so offensive and corpse-like that it has to be buried.

Of the three non-Kitavan diets described here, this was the one most like Kitavan. And it’s also the diet that’s worsened the most in the last 50-100 years. Rice has almost completely replaced root vegetables. And Omega-6-rich seed oils have replaced coconut oil.

Frequent and excessive (almost candy like!) antibiotic abuse appears to have wiped out many of the probiotic organisms needed to digest prebiotic soluble fibers in tubers. I’ve never seen people complain so much about digestive distress after eating root vegetables. Not surprising. But they haven’t made the connection yet.

Many middle-class people from Kerala now hold traditional root vegetables in disdain.

According to a doctor employed at a free government hospital, when the volume of patients gets overwhelming, nurses are instructed to send everyone home, after distributing free antibiotics to all in the waiting room.

Words fail my outrage.

Common dietary threads

The main dietary thread that connects all these cultures is consumption of friendly starches in the form of roots, tubers and plantains.

The following commonalities are secondary:
•    Daily or near-daily fish consumption
•    Minimal (but adequate) local leafy vegetables
•    Seasonal fruit consumption
•    Reliance on saturated fats

The secondary points are nothing new to followers of the Paleo diet. But the heavy reliance on roots and tubers may be novel to many.

There is a very important reason why I think this is crucial: tubers are full of prebiotic fibers.

No, not the insoluble, bark-like roughage marketed in boxed breakfast cereals.  That’s not the kind of fiber you really want.

You want the soluble kind that humans cannot digest, but the bacteria in your intestines love.

There are several kinds of prebiotic fibers in tubers, plantains, vegetables, fruits and nuts. Each kind of prebiotic fiber sustains a different community of probiotic flora in different sections of your gut.

Amazonian fruits are also very high in polyphenols, yet another class of prebiotic.

Without these fibers, these bacteria either starve or die.

As if that weren’t enough, we squirt anti-bacterial potions into every possible orifice. Triclosan and Listerine and Summer’s Eve! Oh my!

I’m surprised there isn’t a product to sterilize belly buttons.

We’re waging chemical warfare against ourselves.

Why should we care?

We should care because the last decade has opened scientists’ eyes about the far-reaching health effects our bowel bugs can have.

Each of us has a probiotic fingerprint that’s established by age 3.

There is mounting evidence that several ‘health states’ like obesity, rheumatoid arthritis, diabetes, and celiac each have unique probiotic fingerprints.

The question to answer now is whether the disease caused the compromised fingerprint or vice versa? And even more importantly, will reverting to a more ideal microbiome fix the health problem? I don’t have the answer, but a lot of things are pointing to a preceding probiotic compromise.

The prebiotic and soluble fiber-heavy diets of these cultures suggest that our ancestors had figured out over eons that such a diet made them thrive.

I just happened to stumble across these findings when I was entering notes into my computer after my recent trip to the Amazon. But I’m far from alone in coming to this conclusion. Paul Jaminet and Shou-Ching Jaminet, Ph.Ds have wonderfully articulated all this in their book, Perfect Health Diet. Possibly the best health related book I’ve ever read.

Don’t look to supplements for a complete cure

I’d guess that only 5% of the species in our guts are available as supplements. One course of antibiotics can permanently alter your microbial fingerprint.

Same goes for prebiotic fiber supplements – we are just starting to understand the fiber needs of each bacterial community.

Other factors…

They were also in constant contact with nature. They were all, in effect, organic farmers, exposed to dirt and animals at all times. Washing hands after each activity was not the norm. They were covered with bacteria. (Hey new mom – how quickly can you draw that portable Purell bottle from your purse?)

They walked. A lot. Usually in the sun, soaking up Vitamin D3. Most adults probably walked 5 miles a day.

They were also intensely connected to their communities. Our understanding of the influence of social structure on human health is in its infancy. I look forward to learning more.

There’s a lot more to Paleo diet than just eating more meat.

Looking backwards to a simpler, more ancestral way of eating and living will help you in ways modern medicine cannot.

Some people call it Paleo. I call it eating real food – stuff that was alive a few days ago. And while you’re out shopping for real food, pick up a new root vegetable you’ve never tried before. Or maybe a plantain.

About the Author: Vin Kutty, MS, is co-founder of Innovix Pharma. He is a nutritionist, author, and Omega-3 expert with 20 years of experience.

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Krill oil supplements are supposed to be protected from rancidity by the natural antioxidant astaxanthin…but astaxanthin is very sensitive and quickly degrades to almost nothing. This leaves krill oil exposed to oxidation and rancidity.

Nutritional misinformation (intentional or not) is very common on the internet. Here are two examples, with a focus on krill oil.

I got several emails about the Dean Ornish piece in the NY Times where he once again blames all our ill health on fat and meat.

(No, Ornish did not talk about krill oil, but misinformation is misinformation, whether it’s about meat or krill oil.)

As always, I am amused and annoyed by poorly supported science pieces. (Perhaps some of you reading this find that ironic…?) Most people will take Ornish at this word. Even scientists with PubMed access may not look up the references to fact-check thoroughly. If you did that, you’d be amused and annoyed too.

This is too big a subject to tackle here and now, but I’ll say this: Ornish’s intervention works because it is multi-pronged: besides avoiding meat, they tell people to strictly avoid sugar, flour, processed foods, Omega-6-rich vegetable oils, and eat a lot of vegetables and some fish oil, manage stress, exercise and get supportive counseling. And you blame just meat and fat for all you ailments?!

I think patients who follow Ornish’s protocol notice improvements DESPITE meat avoidance, not BECAUSE of it.

I would alter his protocol by replacing some of the cruciferous veggies with probiotic-friendly root veggies and tubers, adding pastured eggs, lots of seafood, occasional liver, grass-fed butter and yes, some red meat. If you took the ancestral people I talk about in this recent previous blog and hypothetically put them on the Ornish diet, I’m guessing they’d develop several modern diseases.

But your average Homer Simpson will thrive on an Ornish diet…initially at least. Bill Clinton, anyone?

An annoyed Dr. Michael Eades points out some of the major flaws with the Ornish approach here.

A krill oil video

In the same vein as the Ornish piece, I saw a video about why krill oil is better than fish oil. Also by someone apparently widely followed.

See the video for yourself here:  It’s called Battle of the Omega-3 Fatty Acids: Krill Oil vs Fish Oil.

Like the Ornish piece, the disturbing thing here is how smoothly facts and almost-facts are weaved together. I’ll try to sort them for you.

Here are questionable facts from the video above:

• There is a rumor going around that fish oil actually thins your blood and so does krill oil. And it does.
• When I take too much krill or too much fish oil, I actually get nose bleeds because they thin your blood so effectively.
•  Fish oil tends to be less stable than krill oil because krill oil contains astaxanthin.

These krill oil claims are not new. They originated from marketing departments of the first krill oil manufacturers. Even Dr. Mercola holds some of these (perhaps convenient) beliefs too. Unlike Ornish, the nutritional arrows of Mercola and Asprey mostly point in the right direction. That’s the surprising bit.

Let’s look at the disputed (boldface or is it bald-face?) sentences in more detail.

“There is a rumor going around that fish oil actually thins your blood and so does krill oil. And it does. When I take too much krill or too much fish oil, I actually get nose bleeds because they thin your blood so effectively.”

Well, this is kind of a half-truth. So I half object.

Yes, in extremely high doses, fish oil can cause some blood thinning. In this instance, we don’t know how much ‘too much’ refers to. If you are a ‘bio-hacker,’ your variables are multiple. Blaming it all on Omega-3 may be just convenient and semi-supported.

If you look at the science (and this has been pretty well studied) the reality is somewhat different. Fish oil does not appear to cause increased bleeding even when combined with anticoagulant drugs like warfarin or coumadin.

Of course, as our mothers told us, we’re all unique little snowflakes. For every person who does not notice increased bleeding, there may be one who does. More on this subject in an older blog.

“Fish oil tends to be less stable than krill oil because krill oil contains astaxanthin.”

This is the over-simplified claim that requires debunking. Science is rarely simple enough to fit on a bumper sticker.

There is no direct evidence to support this statement. All Omega-3 fatty acids and Omega-3 containing oils will oxidize. The molecule form (ethyl ester, free fatty acid, triglyceride, or phospholipid etc.) of the Omega-3 fat influences oxidation. Phospholipids are more prone to oxidation than triglycerides. And krill Omega-3 is in phospholipid form. This suggests the exact opposite, that krill oil will oxidize faster.

In the video’s defense, people think krill oil is more stable because of:

1. Astaxanthin. Krill contains some astaxanthin. But astaxanthin is notoriously delicate and it degrades very quickly. Milligram quantities quickly become micrograms. In the early days of krill oil, companies used to list astaxanthin levels on their labels. Now, few of them do. Why? Astaxanthin degrades quickly. Barely measurable. This means there is some antioxidant protection provided by astaxanthin when the product is very fresh, but hardly any after a while on the shelves.
2. Minimal burping involved with krill oil. This is because there is an emulsifying effect provided by the phospholipids in krill oil, so krill oil blends with whatever you’ve eaten and does not float on top of your meal like fish oil might. This makes you not notice the rancidity if/when you burp. More importantly, there is far less Omega-3 in krill oil. Less Omega-3 = less rancidity to be noticed. This does not mean the oil is not rancid. It means you notice less of the rancidity.

So is fish oil less stable?

That depends on many internal and external factors:

• degree of unsaturation of fatty acids (no difference between fish and krill)
• how much oxygen the oil has been exposed to
• light exposure
• heat exposure
• UV exposure
• exposure to metals
• excessive handling of the oils
• the antioxidant blend used to protect the Omega-3.

All this has very little to do with whether it is from fish or krill.

Buckle up. It’s going to get a little geeky for a couple of paragraphs.

EPA and DHA, regardless of origin, will oxidize because of the bisallylic carbons between the double bonds. These carbons have low activation energy for hydrogen loss and have a tendency towards free radical formation.

Fish or krill does not matter.

EPA has four bisallylic carbons and DHA five. This is because DHA is a longer molecule and has the potential to oxidize faster/more. Less useful plant Omegas have only 2. Saturated (animal, coconut) and monounsaturated (olive, lard) fats have none, making them much safer from an oxidative stress perspective.

Different oxidation byproducts develop depending on the position of the carbon undergoing oxidation.

As a consumer, you may go to IFOS Consumer Reports and check your product’s rancidity/freshness level.

Acid Value, Peroxide Value, Anisidine Value and TOTOX

You will find Acid value, Peroxide value, Anisidine value and TOTOX listed there.

Example of IFOS freshness or stability analysis.

Some of these markers are more useful than others.

Acid value is a measure of the amount of fatty acids present in free fatty acid form. In fish and krill oils, Omega-3 is bound to ethyl ester, triglyceride or phospholipid form. When a fatty acid is cleaved, you have free fatty acids. A high measure does not mean the product is rancid – it could mean that some of the Omega-3 is in the free fatty acid form.

The new triglyceride-lowering fish oil drug, Epanova, is mostly free fatty acids. Looking at its acid value will give you a falsely disturbing number. Our EPA 500 tends to have higher free fatty acid levels. All krill oils have high free fatty acid levels.

The first products of lipid oxidation are measured by Peroxide value (PV). It is considered a leading indicator. The PV of an abused or air-exposed oil will rise over a few months. Then, a cascade of reactions that first produced peroxides isomerizes to conjugated dienes and trienes. These are measured as Anisidine value (AV). For example, EPA produces F3-isoprostanes and DHA produces F4-neuroprostanes.

After a few more months, PV drops off and Anisidine value (AV) begins to climb.

PV tends to increase and then fall while AV will tend to rise steadily over time. So if you look at a super rancid krill oil’s PV without sniffing it or looking at the AV, you might falsely believe that astaxanthin is doing a good job protecting it. Not so.

TOTOX, like your LDL Cholesterol, is a calculated value.

(2 × PV) + AV = TOTOX.

Generally, any product with a TOTOX higher than 20 should be considered slightly rancid, even though the industry cut off is 26.

Then there’s that sneaky trick, steam deodorization. Here, a somewhat stinky oil is exposed to steam and most of the more polar oxidation compounds are partitioned out with the steam, leaving behind much cleaner oil. It’s a sneaky way to get old oil to resemble new.

Recently a study revealed that several fish oil supplements marketed in New Zealand were severely oxidized. As a consumer, there is no way to tell how rancid your product is without third-party testing services like IFOS.

Of course, nothing beats sniffing and tasting the oil!

My point in going through this detail (besides dredging up the subject of my grad school thesis from 25 years ago and feeling like a geezer) is that it doesn’t matter, not one tiny bit, whether EPA and DHA come from fish or krill. In the absence of astaxanthin, krill oil will oxidize just the same. And astaxanthin is virtually absent in most products.

Krill oil has another issue: it goes from red to brown over time. This is from non-enzymatic browning of the amino acids present and can result in the formation of pyrroles and other volatile (read stinky) compounds.

IKOS…to the rescue?

The good folks at IFOS (International Fish Oil Standards) have also begun a krill oil testing program called IKOS – the only one of its kind. IKOS is certainly a step in the right direction, nudging krill oil companies to step into the light. But their test results show that peroxide values are certainly not low – they are all over the map.

The IKOS program is not without its flaws:

• Anisidine and TOTOX values are disappointingly absent
• Even though IKOS tests for astaxanthin level, a true astaxanthin level should be measured at the end of the product’s life, not when it’s freshly bottled
• Non-enzymatic browning is not measured
• Traces of solvents used to extract and concentrate krill oil is not measured or declared. Typically used solvents are acetone and isopropanol.

It’s been two years since IKOS launched and yet only three (of hundreds?) brands have had the courage to step up.

Bottom-line:

Fish and krill oils are both unstable and need to be protected with ultimate care. This means never exposing the oil to air/oxygen and minimizing heat and light.

My beef with krill oil is mostly with the marketing and hype associated with its sale. Krill is primarily a phospholipid supplement…with a tiny little bit of Omega-3 and astaxanthin (if fresh.) Fish oil is just plain Omega-3 and nothing else.

They are not interchangeable in any way. They work differently. They absorb differently and they influence gene expression differently.

Don’t take krill oil because fish oil is ‘less stable.’ Take krill because it is a good source of much needed phospholipids.

Phospholipids are an essential class of fats that helps cell membranes function properly. Want more phospholipids? Eat egg yolks. Or if Ornish has you scared of yolks, supplement with phosphatidylserine or phosphatidylcholine. Or krill.

About the Author: Vin Kutty, MS, is co-founder of Innovix Pharma. He is a nutritionist, author, and Omega-3 expert with 20 years of experience.

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We posted a couple of blogs about Vitamin K2 two years ago. A lot’s happened in our understanding of Vitamin K2 since then. This is an update.

In that blog, we struggled to find a good product to recommend. That got me thinking about what an ideal Vitamin K2 product should look like.

I spent a year gathering and reading all the research. And another year finding the right ingredients to make a product based on that research.

Summary:

1. You need BOTH MK-4 and MK-7 forms of Vitamin K2. MK-4 may be more important.
2. The shape of the K2 molecule makes a difference (CIS form or TRANS form)
3. It’s not critical to have Vitamin K1 in K2 formulas

You need both MK-4 and MK-7

These are very different molecules with different structures and different functions.

• MK-4 is the only K2 in the brain, where it seems to concentrate. MK-7 seems to be absent in the brain. MK-4 activates proteins involved in maintaining structure of brain cell membranes. These proteins are called Vitamin K Dependent Proteins (VKDP). Scientists have identified 15 VKDP proteins so far. MK-4 also manages inflammation and oxidative stress in the brain.
• Pregnant women need MK-4 because MK-7 does not cross the placenta. MK-4 does. Pregnant women given supplements of MK-7 did not pass on MK-7 to the fetus. This means that pregnant women and developing fetus must have MK-4. MK-7 is also noticeably absent in the cord blood and fetus. Again, we don’t know why this is the case.
• MK-4 and MK-7 are transported in the body by different lipoproteins. MK-4 is transported by HDL and LDL whereas MK-7 is transported around the body by VLDL.
• Human breast milk contains MK-4. It does not contain MK-7.
• Some cellular functions must have MK-4. And MK-7 does things MK-4 cannot.
• Consuming large quantities of MK-7 was extremely rare until the Japanese started fermenting soybeans (Natto) around 1000 AD. Until then, most of our K2 came in the form of MK-4 with a smattering of other MK forms. Until recently, most healthy traditional cultures got their K2 in the MK-4 form.
• High dose MK-4 is used in Japan as a prescription drug for osteoporosis. Most of the studies showing lowered fracture risk used MK-4, not MK-7.

Based on all of the above, you could make a compelling argument that MK-4 is more important than MK-7.

Our understanding of these various forms of K2 is still in its infancy. The longer K2 molecules like MK-8 – 14 may also be essential in trace levels. Some of them have been associated with heart health, but once again, we simply don’t know enough to say what each of these molecules do.

It may take another generation of research for us to accept that K2 is really K Complex. Like B Complex.

Watch out for self-serving anti-MK-4 marketing messages

Marketers and manufacturers of MK-7 say it’s better than MK-4.

(Of course, they do!)

Plasma half-life. They keep repeating the fact that MK-7 has a much longer plasma half-life than MK-4. This is true – but it’s a crappy argument. MK-4 is rapidly soaked up by many organs and tissues, so it will be quickly removed from the blood.

Think about it this way: throw a fistful of $100 bills into the air at a football game. You won’t see any bills on the stadium floor after a few seconds. Does that mean no one has money?

A short plasma half-life his does NOT make MK-4 useless, redundant or any less beneficial to your health. The plasma half life does not make a molecule more or less influential in the body. MK-4 is stored in the brain, pancreas, salivary glands, and arteries. This stored MK-4 cannot be measured and has specific biological activities in these tissues (beside Gla-protein formation.) This stored tissue pool of MK-4 may be present much longer.

There are no studies that compare the effects of MK-4 to MK-7.

Synthetic vs Natural. You will hear that MK-4 is synthetic and that MK-7 is not. Neither MK-4 nor MK-7, in my opinion, is natural.

They are both ‘made from natural sources‘ like leaves, petals, and legumes. But both nutrients undergo lots of fermentation, purification, extraction, and precipitation that it’s really not right to call either of these ingredients ‘Natural.’ If you want natural, eat Natto or fatty goose liver.

Importance of MK-4 during pregnancy and in prenatal vitamins

Given what I stated about the need for MK-4 during pregnancy, you’d think that all prenatal vitamins would have MK-4.

They don’t.

Some prenatals have MK-7, which only benefits the mother. Ideally, they all should have MK-4. In a perfect world, you should all be getting K2 from real food.

(Oh, please, please read this book: Vitamin K2 and the Calcium Paradox by Dr. Kate Rhéaume-Bleue. If not for you, certainly for your kids.)

I don’t know a single prenatal vitamin that contains MK-4. I don’t know a single OB/GYN who suggests K2-rich foods (let alone MK-4) to their patients. I find this disturbing since weeks 5-12 of pregnancy are critical for the baby’s teeth development. Both sets of teeth, your ‘baby teeth’ and adult teeth are formed in utero during weeks 5 – 12. Proper bone, jaw, skull, dental development is impossible without adequate MK-4.

Pregnant women may be able to partially convert relatively abundant K1 to MK-4. This may be an evolutionary advantage in women of reproductive age, much like their ability to convert ALA Omega-3 to EPA Omega-3 better than the rest of us.

As far as we know, there is little or no role for MK-7 in fetal development. The human body is ultra-efficient. There is very little duplication of function. It is naive to think that all we need is MK-7. The evidence that MK-4 and MK-7 do different things, and that BOTH are essential is very compelling.

Not all MKs found as supplements

We may still not be off the hook by taking an MK4 + MK-7 supplement. The other MK forms are not available in supplement form and can only come from fermented foods and fats of animals that have recently grazed on rapidly growing green grass. Why ‘recently’, ‘rapidly growing’, and ‘green grass’? Because they contain the most chlorophyll. Chlorophyll in green grass is processed by probiotic bacteria in the ruminating guts of grazing animals into MK forms.

So cows eating dead hay may not produce K2 rich dairy products. We won’t bother talking about cows fed corn and soy.

The shape of the MK-7 molecule makes a difference

This is a somewhat new realization. No one is talking about it because it is inconvenient.

You may have heard that there is a difference in absorption or biological effect between CoQ10 (Ubiquinone vs Ubiquinol) or Omega-3 (Ethyl ester vs triglyceride vs phospholipid) forms. There is truth behind these notions.

The situation with Vitamin K2 is somewhat similar.

There are two forms of MK-7. Cis MK-7 and Trans MK-7.

MK-7 is always found in the trans form in nature and in foods. Cis form of MK-7 is not found in nature and may not provide the same benefit.

If you look at the structure, it becomes clear why.

Vitamin K2 MK-7 in nature and in food is always in the trans form. The cis form of MK-7 is L-shaped as opposed to the generally straight, elongated shape of trans MK-7. The unique shape of these molecules dictates what they do in the body. Like a lock and key, Vitamin K2 and their receptors work when the body is provided with trans MK-7.

If you get your K2 from foods, then great – this does not apply to you. But if you get it from supplements, listen up.

Most MK-7 found in supplements are a blend of Cis and Trans.

Example: if a label says 100 mcg (microgram) of MK-7, you’d expect most of it to be absorbed or bioavailable. Not so. In most cases, it is impossible to tell how much of the 100 mcg is in the biologically active and beneficial trans form. Most of it is probably in the trans form. But K2 supplements analyzed at the University of Oslo suggests that some products contain only about 15% of MK-7 in the trans form.

So this hypothetical product may be providing you just 15 mcg of trans MK-7 and 85 mcg cis MK-7, instead of the 100 mcg of usable K2 as claimed by the label.

This is a bit of a bummer. Because most of the manufacturers of K2 products don’t even bother to check how much cis and trans is present in their product. It has simply not dawned on the industry’s collective conscience. (But it may…if you ask them to test and share the results.)

MK-7 molecular structure of various sources per unpublished data from University of Oslo/KappaBio:

Are Natto-based K2 products all-trans?

Products that claim to be all trans because they are made from Natto, are, well, hoping it is all trans.

Natto-based K2 supplements on the market have very little to do with the dish Natto. They use a similar (or the same) bacteria for fermentation, but every thing else is different. Instead of soybeans, they start with soy protein concentrates. The soy protein fermentation process includes complicated manufacturing steps and the use of solvents. During this process, small deviations can influence the molecule structure and…voila! Cis MK-7.

There is one lab here in California and another in Norway that can test for the presence of cis MK-7. When I asked them about it, they said there isn’t any demand for this test. (For chemistry geeks: use HPLC/UV reverse-phase C30 column at 270 nm to sort out stereoisomers.)

It’s not critical to have Vitamin K1 in K2 formulas

Vitamin K1 has been repeatedly shown to offer no benefit to your heart.

Vitamin K2, on the other hand, has been repeatedly shown to improve heart health.

Vitamin K1 is essential for proper blood coagulation. K1 has little or no role in proper calcium deposition.

Most adults are not K1 deficient. Even consuming very small amounts of green leafy vegetables or vegetable oils can provide you with ample K1. It’s even found in fast food and soybean oil.

Better yet, your body can recycle K1. You rarely, if ever, become deficient. So no need to supplement. If you supplement with K1, serum levels reach a plateau at 200 mcg. Doses of 1000 mcg per day may even contribute to periodontal disease.

Vitamin K1 and K2 negate the effect of drugs like Coumadin or Warfarin. Actually the truth is the reverse. These anticoagulant drugs stop K1 recycling and so keep the blood very thin. Taking these drugs keep you in an artificially K1 and K2 deficient state. So if you’re taking these drugs, supplementing with K1 or K2 makes the drug ineffective.

Anticoagulant drugs also take out some K2. There is evidence that people on anticoagulant drugs quickly develop arterial calcium deposits.

Regardless, if your doctor deems it important for you to be on these drugs, adding K1 (or K2) to the mix warrants a discussion with your doctor.

I regularly talk about the need to avoid vegetable seed oils and processed foods. Here is another reason: soybean and canola oils contain K1. When these oils are hydrogenated for use in processed foods, K1 gets converted to DHP (dihydrophylloquinone), a substance of questionable impact. Yet another reason to go back to traditional fats like grass-fed butter.

All said, having K1 in your K2 supplement is not critical because it increases risk a little without adding much in the way of benefits.

Ideal dosage

MK-7 has never been consumed in high doses in human history, unless you lived in eastern Japan and eat Natto. Japanese 230 mcg of MK-7 per day due to Natto consumption. No other culture consumes that much MK-7. So a dose of 100 mcg seems more than adequate.

We consumed MK-4 regularly when we were hunter gatherers or even a century ago when we were not disgusted by the concept of eating animal organs. Such a traditional diet would not have given you much more than 500 to 1000 mcg MK-4 per day.

Some Japanese studies have used 45,000 mcg (45 mg) daily dosage without major side effects. 45,000 mcg per day is an extreme dose without basis in human diet. 45,000 mcg is about 50X what you might be able to get from eating K2-rich foods. Anything higher than 1000 mcg per day is well outside your body’s operating parameters. Supplements based on these Japanese pharmaceutical protocols should be taken with caution.

16,000 postmenopausal Dutch women averaged 29 mcg of K2 per day. Americans probably get far less than that.

Products worth considering

Thorne Vitamin K2 Liquid (MK-4). This may be a bit pricey upfront, but it is a liquid MK-4 and each drop contains 1000 mcg of MK-4. One bottle may last you a year. Their dosage is based on Japanese osteoporosis studies and is extreme. I think one drop a day is about all you’d need. This is what I gave my kids when they were too young to swallow pills or eat solid foods.

If you want a standalone MK-7 (not sure why you would), there are plenty of options online – Nutrigold and Jarrow are trustworthy.

InnovixLabs Full Spectrum Vitamin K2 contains both MK-4 and MK-7 forms of Vitamin K2. Available on Amazon.

Based on the research I’ve done, we formulated InnovixLabs Full Spectrum Vitamin K2 with 500 mcg of MK-4 and 100 mcg of MK-7. Both forms in one pill. The size/shape of the pill was described as ‘adorable’ by my wife.

I prefer to get my nutrients from foods and not supplements, leaning on supplement when I’m traveling, busy, or sick.

If you want to get your K2 from foods, the most palatable options are grass-fed butter, European hard cheeses, and poultry. Natto is for the brave – it has been described as a sticky, stretchy blend between gummy bears and snot.

It doesn’t help that Americans, fearing cholesterol, have cut down on red meat, eggs, and butter by about 20% in the last few decades. Specifically, we eat 40% less K2-rich animal fats and a 177% more K2-free vegetable oils. This misguided diet shift may have actually worsened the state of all our arteries and our bones.

Note that the food options below are mostly MK-4, as that’s what’s in most foods:

 Bottom-line:

1. Look for products that contain both MK-4 and MK-7.
2. Find out if the K2 is in the trans form.
3. All other factors are secondary to the two above.

About the Author: Vin Kutty, MS, is co-founder of Innovix Pharma. He is a nutritionist, author, and Omega-3 expert with 20 years of experience.

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Multis are gateway supplements.

They’re often the first step in people’s health enlightenment. Along with a gym membership, maybe. Or a Fitbit.

But there are a lot of people for whom a multivitamin is it. No other supplements, diet change or exercise. That’s all they’re willing to do. They couldn’t quit smoking, so they’ll take a multi instead. Or their spouse is on them to get healthy.

So they buy a giant bottle of multi at Costco. Centrum. One-A-Day.  Or (ha!) an ‘adult gummy.’

Good for them. You’re not them.

But seriously, if you’re taking an adult gummy vitamin, stop it. Just stop it.

The one pill that has it all?

You want a good multi so you don’t have to take so many pills. You may even take an Omega-3. You may be considering taking Vitamin D3 or a probiotic.

This is when the hunt for a good multi heats up.

I get a lot of questions about which multi to choose. But I don’t like multis and I don’t take one.

Why I don’t take multivitamins

Several reasons:

1. Multis usually have the wrong TYPE of nutrients
2. Multis usually have too little of some and too much of other nutrients, contributing to nutrient imbalance
3. Multis are never complete or comprehensive
4. ‘100% Daily Values of everything’ can give you a false sense of dietary accomplishment
5. You can still have several deficiencies after taking a daily multi

Here’s what I mean:

1. Vitamin A

Many multis have beta-carotene as a Vitamin A source. Beta-carotene is not Vitamin A but a precursor to it. Some people convert it to Vitamin A and some don’t.

You need the retinol form of Vitamin A, not the carotenoid forms.

Severe Vitamin A deficiency is rare in America, but it is very common in developing countries and causes night blindness. Just because things aren’t that bad here does not mean things are peachy.

Since we stopped eating egg yolks, butter, liver, and animal fats in the 70s and 80s, we have collectively been consuming a lot less retinol Vitamin A.

Mass market multis are hopeless sources of Vitamin A. Eat the foods listed above. If you don’t eat liver, take 10,000 IU of preformed Vitamin A from a product like this.

10,000 IU is not too much assuming you get plenty of sun exposure or take Vitamin D3 too. Keep in mind that disease-free cultures like pre-westernized Inuits used to consume between 30,000 and 40,000 IU of retinol Vitamin A daily. People are unnecessarily worried about Vitamin A toxicity…something that happens usually when you’re Vitamin D deficient. If you have enough Vitamin D, the toxicity level of Vitamin A is about 200,000 IU per day.

What I do for the kids: we blend in grass-fed beef or bison liver with hamburger meat. No one’s the wiser. I also get them this liver + beef snack from Epic.  It’s actually pretty good.

2. Folic acid

Multis have folic acid. Multis should have FOLATE, the metabolic active form of folic acid.

We were all told that pregnant women need folic acid.

Never mind that you need FOLATE, not folic acid. And that you need it 3 months BEFORE pregnancy as much as you need it for 3 months after conception. So starting with folic acid during your second trimester is missing the boat.

Folic acid in multis is synthetic and needs to go through five different enzymatic conversions before it becomes folate. This conversion declines as we age.

Even if you’re not pregnant, folic acid must be converted to folate before it can reduce homocysteine, a risk factor for heart disease. There are implications for mood disorders too, as folate is required in processing brain neurotransmitters.

The folic acid in your multi may not be doing much for you.

My source.

3. Vitamin D

Most multis have very low levels of D3. Some even have the poorly-absorbed D2 form.

Get your blood level tested and supplement to get up to optimal levels.

Most people need between 2000 and 5000 IU of D3 per day along with Vitamin A (see above.) Unless you’re getting a lot of full body summertime sun exposure and eating a lot of seafood, you’re going to need supplementation. Following the FDA’s 100% Daily Value (600 IU per day) is virtually guaranteed to keep you deficient.

If you’re dark skinned or pregnant, you will need more than what most multis or prenatals provide.

Taking Vitamin D without A and K2 is a bad idea.

My preferred source.

4. Vitamin K2

Most multi buyers haven’t even heard of Vitamin K2. Your body needs K2 to figure out  what to do with calcium. K2 keeps calcium in your bones and teeth instead of in your arteries.

Vitamin K2 is absent in most multis. Some ‘health food’ multi brands now have K2 in the MK-7 form. That’s nice, but what you really need is MK-4.

Want K2? Eat dairy fat from cows that recently ate rapidly growing green grass. Or eat european hard cheeses and pastured egg yolks.

If you’re pregnant, MK-4 is essential and MK-7 may be useless for the baby’s development. Strangely, I’ve yet to see a prenatal that contains MK-4 form of K2. It is critical for the baby’s bone and skull development. And virtually every pregnant mother is deficient.

In retrospect, I’m really glad my vegetarian wife developed a pregnancy craving for meat and european hard cheeses.

Most multis have K1, a nutrient that is almost impossible to become deficient in because it is recycled by the body. It does not help that the FDA and the Institute of Medicine are decades behind and have not established a formal daily value for K2.

You need between 500 – 1000 mcg of K2 daily, most of it in the MK-4 form and some in the MK-7 form.

This is a good liquid form for kids.
Our sister brand (InnovixLabs) makes this.

There is a trend here that some of you may have noticed. Three of the 4 nutrients discussed so far are fat-soluble vitamins. Nutrients that we all began going deficient in when we started avoiding fats and meats.

5. Magnesium

None of the mass market multis have enough magnesium.

Centrum has 50 mg (13%) of Daily Value as magnesium oxide. Perfect example of wrong quantity and wrong type.

One A Day has 140 mg (35%) as magnesium oxide.

You need 400 to 600 mg of magnesium daily. Very few of us get this much magnesium in our diet, even with a near-perfect diet. Our soils are depleted from intensive agriculture. Our bodies burn through magnesium due to high-stress lifestyles.

No wonder we are cranky, sleepless, and anxious. This is one nutrient that I think all of us need to supplement.

Magnesium oxide is close to useless. You might as well swallow a pebble. Sadly, it is found in all the biggest-selling multis and magnesium supplements.

Magnesium citrate is a little better. But you’re best served by far better absorbed forms like glycinate, malate, threonate, lysinate.

All the well-absorbed forms are fluffy and light – so you’ll need a lot pills to get 600 mg a day.

A few options:
Powdered magnesium glycinate – nice to blend into your smoothie or beverage for kids.

Capsule form with malate and glycinate forms

A few more reasons:

The FDA has known how critical choline is, especially during pregnancy. They’ve had the data for 20 years. But have done nothing with it.

In the meantime, 90% of pregnant women are deficient in choline.

Where do you get choline? Yup – meats, egg yolks, and animal products. All things the government told us to avoid.

Then there’s Vitamin E. Vitamin E is actually a complex of 4 tocopherols and 4 tocotrieneols. What you find in multis is the synthetic version of one of the tocopherols. I’ve yet to see a multi with all eight Es. In the meantime, try this.

Most multis have B12 in the cyanocobalamin form. It should be in the methylcobalamin form.

These are some (but not all) of the reasons why I don’t take a multivitamin.

There are other reasons, but I think you get the drift.

Oh, but the multi I get at Whole Foods has food-based synergistic cofactors!

Sure.

Some are a little better. I’ll give you that. Some of them have B12 as methylcobalamin. Some throw in the wrong kind of K2. They have natural Vit E.

But for the most part, health food multis make you feel special by throwing in ‘proprietary blends’ of antioxidants or fruit and veggies extracts or intangible mumbo jumbo blends. The purpose of these blends is to separate one product from another on the shelf.

Holier-than-thou health food store multis also have long lists of things they do not contain, starting with gluten. Not having gluten is great. But the internet has made false demons out of things like magnesium stearate and ascorbyl palmitate. Mag stearate phobia is not based on science, but fools fan the fears.

Look to whole, nutrient-dense foods for nutrition

Take another look at egg yolks and liver. They’re natures multivitamins. If you’re not OK with liver and organ meats, you need supplements.

Go back to colorful berries. Fresh seafood and leafy greens. Locally grown fruits and nuts. Go back to butter.

Maybe, just maybe, eat your liver and eggs in the midday sun in the backyard. Naked. You make Vitamin D for free and the neighbors move out in a hurry. It’s a win-win. I know. Brilliant.

About the Author: Vin Kutty, MS, is co-founder of Innovix Pharma. He is a nutritionist, author, and Omega-3 expert with 20 years of experience.

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