August 2020

Home » Archives for August 2020

Benefits of Omega-3 Fatty Acids: What Does the Latest Research Indicate?

   August 07, 2020      

 

 Omega-3 fatty acids fall under the category of polyunsaturated fats. Polyunsaturated means it remains liquid at room temperature. These fats are primarily marine and plant-based. On the other hand, the saturated fats are solid at room temperature, primarily coming from an animal source.

There are 3 types of omega-3 fatty acids: Alpha-lenoic acid (ALA), Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA). Out of these, ALA is an essential nutrient, which must be taken from the diet. ALA then breaks down into EPA and DHA. However, this conversion rate is quite low and therefore, it is recommended to incorporate EPA and DHA from diet and supplements.

 

To be discussed in this article:

  • Benefits of omega-3 fatty acids in heart health

  • Benefits of omega-3 fatty acids in brain health

  • Benefits of omega-3 fatty acids in eye health

  • Benefits of omega-3 fatty acids in prenatal health 

  • How to get the adequate amounts of omega-3 fatty acids

 

Benefits of Omega-3 Fatty Acid in Heart Health:

Regular intake of omega-3 fatty acids is directly linked with significant reduction in coronary heart disease and sudden cardiac arrest. It also helps lower triglyceride levels by maintaining healthy blood vessels with adequate blood pressure control. 

  • A Study of Cardiovascular Events in Diabetes: 1 gram per day of omega-3 fatty acids lead to a 18% reduction in risk of heart-related deaths.
  • Reduction of Cardiovascular Events with EPA- Intervention Trial: 4 gram per day of EPA combined with statin medication lead to a 25% decrease of cardiac-related events. 
  • Vitamin D and Omega-3 Trial: 1 gram per day of omega-3 fatty acid supplement reduced the risk of heart attacks by 28%.

 

Benefits of Omega-3 Fatty Acids in Brain Health:

DHA is found in a high concentration in brain tissue. Adequate omega-3 fatty acid supplement improves cognition and memory and reduces cognitive decline with increasing age. There is a growing body of research in psychology that supports the benefits of omega-3s in mental health conditions like Attention-Deficit Hyperactive Disorder (ADHD), Major Depressive Disorder (MDD), Bipolar Disorder, Schizophrenia and Anxiety Disorders. 

  • International Society for Nutritional Psychiatry Research: Omega-3 fatty acids can be combined with the regular medical treatment of MDD, as they have been proven to be both safe and effective in reducing the severity of MDD when taken with regular antidepressants. The most effective EPA to DHA ratio in this case is >2:1. 
  • Use of Omega-3s in traumatic brain injury: single dose of 3000mg of EPA+DHA given 3 times a day for the first week, for a maximum of 9000mg per day. For the second week, one dose 2 times per day for a maximum of 6000mg per day. Beyond that, one dose daily for maintenance, for a maximum of 3000mg per day. 

 

Benefits of Omega-3 Fatty Acids in Eye Health:

 Just like in the brain, DHA is highly concentrated in the eye tissue, especially in the retina. DHA plays a critical role in the development of eyes during pregnancy. Deficiency of omega-3s can be associated with dry eyes, and age-related vision problems, called macular degeneration.

 

Benefits of Omega-3 Fatty Acids in Prenatal Health:

Omega-3 fatty acids play a vital role in the development of a fetus brain and eyes. Brain development is linked with an increase in functionality of the brain parts that are involved in handling attention and physical movements. The development of the eyes is linked with an increase in visual acuity and increased functionality of photo-receptors, or the ability to see in minimal light and differentiate between specific colours. 

  • American Academy of Pediatrics: Omega-3 supplement should begin while the mother is pregnant and should continue for the child's first 2 years of life (1000 days) as the effects of omega-3s are crucial for the neurodevelopment and long-term mental health of the child. 
  • Effects of Omega-3 fatty acid on pregnancy: A study has shown that an adequate omega-3 fatty acid supplement in pregnancy leads to a massive 42% risk reduction of preterm birth before 34 weeks, 11% risk reduction of preterm birth before 37 weeks and a 10% risk reduction of a baby born with low birth weight (less than 5.5lbs).

 

How to Get the "Super Nutrient" Omega-3 Fatty Acids:

While the daily recommendation is 250mg of EPA+DHA, new research is beginning to show that we might need more than that. It has been concluded that while the general population is taking adequate amounts of ALA in their diets, the level of EPA and DHA is very, very low (the good stuff that we actually need!).

  • Start with knowing your needs of omega-3s: A simple blood test can be easily carried out at home, similar to diabetics checking blood sugar levels at home on a strip. This sample can then be sent to the lab to measure the level of omega-3 fatty acids in your body: low level corresponds to anything below 4%, intermediate is between 4-8%, and a desirable level of omega-3s should be between 8-12%.
  • 8 ounces of seafood per week (2-3 servings per week) provides an average of 250mg EPA+DHA per day. Include fatty fish like salmon and herring.
  • When you are grocery shopping, look for food items that are especially fortified with omega-3 fatty acids.
  • Omega-3 fatty acid supplements: fish oil gels, flavoured gummies, liquid syrup, like cod liver oil, that can be given to children. Check the supplement label for the serving size and the amount of EPA+DHA present (listed separately). As a general rule, the sum of EPA+DHA should equal to at least 900mg.
  • Options of vegetarians/vegans: marine microalgae, chia seeds, flax seeds, walnuts, soy beans are some of the options. 
It is best to take omega-3 fatty acids from multiple resources for a more balanced nutrition. 

 

Omega-3 fatty acids sit at the top of the list of those nutrients that have gained immense popularity in recent times and rightfully so, as more emerging research data support the benefits on fetus development, heart health, brain health and eye health, covering all age groups of the population, beginning from pregnancy. What is your requirement of omega-3 fatty acid intake? And how do you make sure you are getting enough of that good stuff? Leave your comments below and let me know!


References:

 1. Essential fatty acids. Oregon State University,Linus Pauling Institute, Micronutrient Information Center website.https://lpi.oregonstate.edu/mic/other-nutrients/essential-fatty-acids. Updated May 2019.

 2.Fatty acids and cholesterol subcommittee. US Department of Agriculture, Nutrition Evidence Systematic Review website. https://nesr.usda.gov/fatty-acids-and-cholesterol-subcommittee.

3.EslickGD, Howe PR, Smith C, Priest R, Bensoussan A. Benefits of fish oil supplementation in hyperlipidemia: a systematic review and meta-analysis. Int J Cardiol. 2009;136(1):4-16. 

4.Nestel P, Shige H, Pomeroy S, Cehun M, Abbey M, Raederstorff D. The n-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid increase systemic arterial compliance in humans. Am J Clin Nutr. 2002;76(2):326-330. 

5.Miller PE, Van Elswyk M, Alexander DD. Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and blood pressure: a meta-analysis of randomized controlled trials. Am J Hypertens. 2014;27(7):885-896. 

6.Bowman L, Mafham M, Wallendszus K, et al.; ASCEND Study Collaborative Group. Effects of n-3 fatty acid supplements in diabetes mellitus. N Engl J Med. 2018;379(16):1540-1550. 

7.Bhatt DL, Steg PG, Miller M, et al. Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia. N Engl J Med. 2019;380(1):11-22.

 8.Manson JE, Cook NR, Lee IM, et al. Marine n-3 fatty acids and prevention of cardiovasculardisease and cancer. N Engl J Med. 2019;380(1):23-32. 

9.Chang JP, Su KP, Mondelli V, Pariante CM.Omega-3 polyunsaturated fatty acids in youths with attention deficit hyperactivity disorder: a systematic review and meta-analysis of clinical trials and biological studies.Neuropsychopharmacology. 2018;43(3):534-545. 

10.Lin PY, Huang SY, Su KP.A meta-analytic review of polyunsaturated fatty acid compositions in patients with depression.Biol Psychiatry. 2010;68(2):140-147. 

11.McNamaraRK,WelgeJA.Meta-analysis of erythrocyte polyunsaturated fatty acids biostatus in bipolar disorder.Bipolar Disord. 2016;18(3):300-306.

12.van der Kamp WJ, Klomp DW, Kahn RS, Luijten PR, Hulshoff Pol HE.A meta-analysis of the polyunsaturated fatty acid composition of erythrocyte membranes in schizophrenia.Schizophr Res. 2012;141(2-3):153-161. 

13.Gupta A Summerville G, Senter C.Treatment of acute sports-related concussion.Curr Rev Musculoskelet Med. 2019;12(2):117-123. 

14.Guu TW, Mischoulon D, Sarris J, et al.InternationalSociety for Nutritional Psychiatry Research practice guidelines for omega-3 fatty acids in the treatment of major depressive disorder.Psychother Psychosom. 2019;88(5):263-273.

15.Omega-3 protocol for brain health. Brain Health Education and Research Institutewebsite.http://www.brainhealtheducation.org/omega-3-protocol/. 

16.Schwarzenberg SJ, Georgieff MK; Committee on Nutrition. Advocacy for improving nutrition in the first 1000 days to support childhood development and adult health. Pediatrics.2018;141(2):e20173716. 

17.AbdelhamidAS, BrownTJ, BrainardJS, et al. Omega‐3 fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev.2020;3:CD003177. 

18.Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes forenergy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids.https://www.nal.usda.gov/sites/default/files/fnic_uploads/energy_full_report.pdf. Published 2005. 

19.US Department of Health and Human Services. 2015–2020 Dietary Guidelines for Americans. 8th Edition. https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/table-of-contents/.Published January 7, 2016. 

20.US Department of Agriculture, Agricultural Research Service. What We Eat in America, NHANES 2015-2016: table 1. Nutrient intakes from food and beverages: mean amounts consumed per individual, by gender and age, in the United States,2015-2016. https://www.ars.usda.gov/ARSUserFiles/80400530/pdf/1516/Table_1_NIN_GEN_15.pdf.

21.Hu Y, Hu FB,Manson JE. Marine omega-3 supplementation and cardiovascular disease: an updated meta-analysis of 13 randomized controlled trials involving 127477 participants. J Am Heart Assoc. 2019;8(19):e013543.  

22.Makrides M, Best K, Yelland L,et al.A randomized trial of prenatal n-3 fatty acid supplementation and preterm delivery.N Engl J Med.2019;381(11):1035-1045. 

23.Simmonds LA, Sullivan TR, Skubisz M,et al. Omega-3 fatty acid supplementation in pregnancy-baseline omega-3 status and early preterm birth: exploratory analysis of a randomized controlled trial [published online February 8, 2020]. BJOG.doi:10.1111/1471‐0528.16168.


 

   5 Comments

at August 07, 2020 5 Comments

Polycystic Ovary Syndrome Part II: Nutritional Strategies of Management

   August 03, 2020      

Dietary management of Polycystic Ovary Syndrome (PCOS) should focus on weight loss and modification in insulin levels.

In this article:

  • Ketogenic diets and insulin management

  • Mediterranean diet and risk reduction of metabolic syndrome and type 2 diabetes

  • Polyphenols and their role in blood sugar levels

  • Curcumin and its properties

  • Role of omega-3 fatty acids

  • Coenzyme Q10 health benefits

  • Most powerful antioxidants

  • Relationship between gut health and PCOS



Ketogenic Diets

Insulin signalling is key in the management of insulin resistance that gives rise to metabolic syndrome and type 2 diabetes. Research has shown that low-carb ketogenic diets have resulted in greater improvement of blood sugar levels in obese patients with type 2 diabetes. Additional benefits of these diets include better hormonal control, significant weight loss and improvement of fatty liver disease.

Mediterranean Diet

Mediterranean diet is composed of cereals, nuts, legumes, vegetables, fruits with significant use of extra virgin olive oil. This food composition enhances the intake of complex carbs like fiber & whole grains, minerals like selenium, iron, potassium, magnesium & calcium, vegetable proteins & polyphenols, which are micronutrients present in plant-based foods. All these together lead to better control of blood sugar levels & aim at reducing the blood pressure. The unsaturated fatty acids of healthy oils and polyphenols together work to increase HDL (good cholesterol) and decrease chronic inflammation. These effects lead to lower cholesterol and triglyceride levels and reduced fat storage, which significantly reduces the risk of metabolic syndrome and type 2 diabetes.

Polyphenols:

A research study comprising of 1133 subjects has shown that the consumption of green tea lead to decreased fasting glucose and HbA1c levels. Eleven other studies on 388 subjects have concluded that the consumption of resveratrol (plant-based polyphenol that is a strong antioxidant) significantly reduced fasting glucose, insulin, HbA1c levels in the diabetic population.
(Read the effects of green tea on sleep and stress: What is the Relationship Between Sleep, Stress and Nutrition?)

Curcumin:

Curcumin has long been known for its strong anti-inflammatory and antioxidant properties and has been widely practiced since ancient times in Indian Ayurvedic medicine. Turmeric contains roughly 10% curcuminoids that are a potent combination of curcumin, demethoxycurcumin, bis-demethoxycurcumin.In a 30-day research trial, daily supplementation with 400mg curcumin in healthy individuals lead to reduced brain aging, lowered triglyceride levels, reduced stress levels, improved liver function and an increase in antioxidant enzymes.

Omega-3 Fatty Acids:

Two comprehensive studies have shown that taking 1200-1500mg of omega-3 fatty acids over the period of 2-6 months significantly reduced free testosterone levels and lead to a better hormonal control of PCOS in obese and non-obese women. Long-term effects included lower insulin resistance, blood glucose and triglyceride levels. Other equally significant benefits of omega-3 fatty acids are: improved symptoms of chronic depression, lower inflammatory markers in blood, low cortisol (stress hormone) levels and increased brain function.

Coenzyme Q10 (CoQ10):

 In a clinical trial conducted on 60 women with PCOS that were given 100mg CoQ10 for 12 weeks, it was concluded that CoQ10 supplementation significantly reduced blood glucose levels with well-controlled insulin levels and reduced cholesterol levels with enhanced heart health.

Strong antioxidants to include in diet:

  • Vitamins A, C, D, E
  • Alpha-lipoic acid
  • Polyphenols
  • Selenium
  • Copper
  • Magnesium
  • Zinc
Antioxidants stabilize free radicals and essentially stop their damaging effects on cells and their metabolic activities. They further support detoxification, reduce fatigue and tiredness, boost mental health and are very important elements for proper functioning of the nervous system.

Gut Health:

In humans, around 90% of gut bacteria are represented by two major strains: Firmicutes (60-80%) and Bacteriodetes (15-30%). In obese women with PCOS, this ratio is imbalanced with a reduced microbial diversity. This imbalance and compromised gut health is linked with increased risk of type 2 diabetes in PCOS. Other risk factors include inflammatory bowel disease, irritable bowel syndrome, celiac disease, colorectal cancer, gut-brain axis disorders like depression, anxiety, chronic pain, fatigue, and compromised immune system (gut houses around 80% of the total immune system). In order to improve gut health, it is recommended to: increase fiber content in diet, which is naturally fermented in the gut that strengthens and diversifies gut bacteria; increase natural prebiotic intake in forms of cereals, fruits and vegetables; incorporate fermented foods like sauerkraut, kimchi, yogurt, kefir.


The nutritional strategies mentioned above are interventions that can be used in combination to synergistically enhance the health benefits while significantly reducing the health risk factors and hormonal disturbances associated with PCOS. Targeting multiple health factors with the combination of diverse nutrients mentioned above eases the challenging task of clinical management of PCOS.

Leave your thoughts and concerns in the comment section below and connect with me.




References:
1. DiSilvestro et al. Diverse effects of a low dose supplement of lipidated currcumin in healthy middle aged people. Nutr J. 2012. 11(79). doi: 10.1186/1475-2891-11-79.
2. Gholnari et al. The effects of coenzyme Q10 supplementation on glucose metabolism, lipid profiles, inflammation, and oxidative stress in patients with diabetic nephropathy: A randomized, double-blind, placebo-controlled trial. J Am Coll Nutr. 2018. 37(3):188-193.
3. Gokalp et al. Efficacy of omega-3 in the treatment of polycystic ovary syndrome. Journal of Obstetrics and Gynecology 2012. 33:289-291.
4. Liu et al. Effect of green tea on glucose control and insulin sensitivity: a meta-analysis of 17 randomized  controlled trials. Am J Clin Nutr. 2013. 98(2):340-348.
5. Liu et al. Effect of resveratrol on glucose control and insulin sensitivity: a meta-analysis of 11 randomized  controlled trials. Al J Clin Nutr. 2014. 99(6):1510-1519.
6. Mohammadi et al. Effects of omega-3 fatty acids supplementation on serum adiponectin levels and some metabolic risk factors in women with polycystic ovary syndrome. Asia Pac J Clin Nutr 2012. 21(4): 511-518.
7. Salas-Salvado et al. Protective Effects of the Mediterranean Diet on Type  Diabetes and Metabolic Syndrome. The Journal of Nutrition 2016. 146(4): 920S-927S.
8. Dr. Nina Bailey, PhD. Igennus Healthcare Nutrition.

   /

   13 Comments

at August 03, 2020 13 Comments