Introduction
In the last year, several landmark studies have once again highlighted the importance of the longer chain omega-3 fatty acids such as eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA) found in fish. The reason why these fatty substances are so important revolve around their role in cellular membranes. A diet that is deficient in omega-3 fatty acids, particularly EPA and DHA, results in altered cell membranes. Without a healthy membrane, cells lose their ability to hold water, vital nutrients, and electrolytes. They also lose their ability to communicate with other cells and be controlled by regulating hormones. They simply do not function properly. Cell membrane dysfunction is a critical factor in the development of virtually every chronic disease, especially cancer, diabetes, arthritis, and heart disease. Not surprisingly, long-chain omega-3 fatty acids have shown tremendous protective effects against all of these diseases.

Some conditions benefited more by long-chain omega-3 fatty acids than flaxseed oil:

• Aging (are you over 50?)
• Allergies
• Arthritis
• Asthma
• Attention deficit disorder
• Autoimmune diseases (e.g., rheumatoid arthritis, lupus, MS, etc.)
• Cancer (prevention and treatment adjunct)
• Depression
• Diabetes
• Eczema
• Elevated cholesterol or triglyceride levels
• Heart disease (prevention and treatment)
• Inflammatory conditions (e.g., ulcerative colitis, Crohn's disease)
• Menopause
• Pregnancy
• Psoriasis

Fish Oils vs. Flaxseed Oil
Although the body can convert alpha-linolenic acid, a short-chain omega-3 fatty acid, from flaxseed oil, it is much more efficient to get EPA and DHA from fish oils. Furthermore, there is evidence that many people, particularly many men, have a difficult time converting alpha-linolenic acid to EPA and DHA. Also, the long-chain omega-3 fatty acids, but not alpha-linolenic acid the chief component of, are also transformed into regulatory compounds known as prostaglandins. These compounds carry out many important tasks in the body. They regulate inflammation, pain, and swelling; they play a role in maintaining blood pressure; and they regulate heart, digestive, and kidney function. Prostaglandins also participate in the response to allergies, help control transmission of signals along the nerves, and help regulate the production of steroids and other hormones. Through their effects on prostaglandins and related compounds, long-chain omega-3 fatty acids can mediate many physiological processes making them useful in virtually every disease state as well.

My opinion on the superiority of longer-chain omega-3 fatty acids over alpha-linolenic acid is not new. I have always held that if manufacturers could solve some of the problems with commercial sources of EPA and DHA that I would wholeheartedly recommend them over flaxseed oil. The reason that I favored flaxseed oil over fish oils in some of my books (e.g., Encyclopedia of Natural Medicine) was because at the time the books were written there were MAJOR problems with fish oil supplements. These problems still persist in that most encapsulated fish oil products have been shown to contain very high levels of lipid peroxides, harmful contaminants, and heavy metals. Furthermore, because of the relatively low concentration of EPA and DHA in these products in order to produce therapeutic benefits people would have to consume 10 or more 1,000 mg capsules daily. Because of these factors, it simply made more sense to recommend flaxseed oil. However, a new development has changed my perspective a bit although I still think it makes great sense to utilize flaxseed oil on a daily basis as well.

New Developments
The ability to produce a highly concentrated form of long-chain omega-3 fatty acids that is free from lipid peroxides, heavy metals, environmental contaminants, and other harmful compounds. These "pharmaceutical grade" marine lipid concentrates are so superior to earlier fish oil products that they are literally revolutionizing nutritional medicine. RxOmega-3 Factors from Natural Factors is an example of this revolutionary new source of long-chain fatty acids. The key features of this product over regular fish oil products include:

• More than twice the level of EPA and DHA per capsule than most brands.
• Each capsule provides 600 mg of long-chain omega-3 fatty acids (400 mg EPA/200 mg DHA)*
• Quality control steps to insure the product is free from lipid peroxides, heavy metals, environmental contaminants, and other harmful compounds.
• Ratio of omega-3 fatty acids to arachidonic acid > 50:1
• Contains the optimal amount of natural vitamin E as a preservative.

Fish oil, mercury, and heart disease
Two highly publicized studies in 2002 demonstrated quite conclusively that fish consumption can reduce heart disease. The first article, published in the JAMA (Journal of the American Medical Association) showed that there was a clear relationship between dietary intake of fish and omega-3 fatty acids and the likelihood of developing coronary heart disease - the higher the omega-3 fatty acid intake, the lower the likelihood of coronary heart disease. This relationship was even stronger for coronary deaths. The second article, published in the New England Journal of Medicine, looked at omega-3 fatty acid levels in blood as opposed to diet. The investigators found a striking relationship between the blood level of omega-3 fatty acids present and the follow-up likelihood of dying from coronary heart disease.

The Latest Study
While fish oils may protect against heart disease, the latest study raises an important question - Is the benefit of eating fish counteracted by a higher intake of mercury? Mercury has been known to increase the risk of cardiovascular disease. Because fish intake is a major source of exposure to mercury, the mercury content of fish may counteract the beneficial effects of its n-3 fatty acids. Results from another study published in the New England Journal of Medicine show that while higher body levels of fish oils were associated with a decreased risk for heart attacks, the higher the body mercury level the greater risk of a heart attack, Researchers concluded that the high mercury content of fish may diminish the protective effect of fish intake against heart disease.

The Solution
Using a pharmaceutical grade fish oil supplement is the perfect solution to people wanting the health benefits of fish oils without the mercury and other contaminants found in fish. It is estimated that the use of fish oil supplements may reduce overall cardiovascular mortality by as much as 45%. This effect is not related to a change in blood cholesterol levels. The favorable effect is seen very rapidly, usually by three months into the study. In contrast, cholesterol-lowering drugs do not usually show benefit until after a year or more of therapy. As compared to drug therapy, omega-3 fatty acids provide remarkable benefits, are entirely safe, and are inexpensive.

My Recommendations
For general health, take 200 to 400 mg of EPA and 100 to 200 mg of DHA daily. It is best to take the supplements at the beginning of the meal. For therapeutic indications the dosage is to triple this dosage.

 

Key References:

• Hu FB, Bronner L, Willett WC, et al. Fish and omega-3 fatty acid intake and risk of coronary heart disease in women. JAMA 2002;287:1815-21.
• Albert CM, Campos H, Stampfer MJ, et al. Blood levels of long-chain n-3 fatty acids and the risk of sudden death. N Engl J Med 2002;346:1113-8.
• Guallar E, Sanz-Gallardo MI, van't Veer P, Bode P, et al. Mercury, fish oils, and the risk of myocardial infarction. N Engl J Med 2002;347:1747-54.
• Bucher HC, Hengstler P, Schindler C, Meier G. N-3 polyunsaturated fatty acids in coronary heart disease: a meta-analysis of randomized controlled trials. Am J Med 2002;112:298-304.

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Michael T. Murray, N.D., is widely regarded as one of world's leading authorities on natural medicine. A prolific author, Dr. Murray has written over 20 books on health and nutrition including the best-selling Encyclopedia of Natural Medicine and his latest book The Encyclopedia of Healing Foods. Dr. Murray is also Director of Product Development and Education for Natural Factors one of the leading manufacturers of natural products.