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I Take Your Omega-3…But My Triglycerides Still Went Up!

“I take 3,000 mg of your Omega-3 and I’m eating a healthier diet…but my Triglycerides are up! What the heck?!”

I get this question quite often.

On the surface it makes no sense.

fish oil, triglycerides and grains
Image: Hannah Chapman

As a general rule, every 1000 mg of Omega-3 will reduce your triglycerides by 5 to 10%.

So if you’re taking 3,000 mg of Omega-3 per day, you should notice at least a 15-20% reduction in blood triglycerides.

Yet, your doctor’s office calls with news that your triglycerides have actually gone up. You may have even gained a couple of pounds.

Frustration is a normal and acceptable response to this development.

I understand. The same thing has happened to me.

Here’s the good news:
it has nothing to do with the Omega-3. You’re not immune to the benefits of Omega-3.

Omega-3 has a very ‘linear response’ on everyone’s plasma triglyceride levels. You’re not an exception.

Forget the fish oil. It’s not the problem.

The problem is that ‘healthier’ diet you’re on.

When people decide to take charge of their health, they usually do these four things:

  1. cut out fatty foods
  2. exercise more
  3. eat more fruits and vegetables
  4. increase whole grain consumption

Three of the four changes above can increase triglycerides.

Surprised?

Let’s look at cutting out fats from the diet.

Before: Whole milk. After: skim milk
Before: regular ice cream. After: fat-free yogurt
Before: bacon. After: dry toast
Before: scrambled eggs. After: oatmeal
Before: coffee with cream. After: orange juice.

Look familiar?

In every one of these scenarios, people are doing what they’e told. They are following the healthy-eating guidelines we’ve subconsciously picked up from years of reading and watching pundits on TV. May be you’ve been watching Dr. Oz.

You’re doing what you were told.

If you want to lose weight or be healthy, you’re supposed to worship at the Altar of Fat-Free.

But what have you really done? Let’s look at each of the Before & After scenarios.

Before & After: The ‘After’ is rarely Better!

Milk. Most of the calories of regular whole milk comes from its fat. Only 30% comes from sugar. But almost 60% of the calories of skim milk comes from its lactose, milk sugar. Result: more calories from sugar and carbohydrates.

fish oil, carbohydrates and triglycerides

What do these changes do to your Triglycerides?

In each of these ‘healthy’ changes, there is a big jump in carbohydrate and sugar calories.

It doesn’t matter if your toast or oatmeal is considered ‘whole grain.’ (I call whole grains the ‘filtered-cigarettes of nutrition.’ Yes, they are better than refined grains. They are lesser-evil foods, cleverly exploited by food marketers.)

What matters is that carbohydrates are starches and your body ultimately uses enzymes to break it down to sugar.

Your body has a very limited capacity to store sugar. But it can store virtually unlimited amounts of fat.

When your body gets a wallop of carbs, a series of things happen…

First, blood sugar rises.

Second is an insulin spike.

Insulin takes the sugar and packs it away as much as possible in various cells in your body. But like I said, only in very limited amounts. Cells reach their sugar storage capacity quickly.

So then what?

Well, off to the liver, the sugars go. In the liver, sugars are converted into fats.

It does not matter if you ate whiter-than-white Wonder Bread or if you ate organic, stone-ground, 7-grain whole bread from a health food store that looks and tastes like the oak tree outside my window.

They all end up getting sent to the Principal’s office – the liver. And a nifty process called de novo lipogensis occurs.

This is fat production. Mostly the saturated kind.

Triglycerides are fats.

And…ta-daa…that is why your triglycerides went up after you started on your ‘healthy’ diet.

It’s not your fault. At least it WASN’T your fault. You were only doing what you thought was best.

So why is everyone telling you to eat more ‘healthy’ whole grains?

Most doctors, dietitians, The Dr. Oz Show, experts on ‘The Biggest Loser,’ all tell you to eat a low-fat diet high in whole grains.

Even organizations like the American Heart Association, American Diabetic Association tell you to do the same thing.

Hmm. Makes you wonder, doesn’t it?

The answer is that these organizations are extremely conservative. They are clinging to unproven dogma that was believed to be correct back in the 1980s, when these organizations told Americans to cut out fat and eat more whole grains.

For heaven’s sake, the FDA, the nation’s, ultimate health authority, repeats the same tired diet advice.

They’re wrong.

Excess carbs + Bad genes = Insulin Resistance

We’ll talk about insulin resistance in another blog. But insulin resistance is a huge problem and is associated with obesity, diabetes, blood pressure, high triglycerides, low HDL, high LDL particles, increased risk of heart disease, dementia, alzherimer’s and the list goes on.

The science I just explained above it not new. It’s old stuff. You don’t have go digging in obscure medical journals. It’s right there for you to see in most nutrition and medical text books.

Nothing I’ve stated above is mysterious or controversial.

A diet high in carbs will increase your triglyceride levels. Period.

That’s not my opinion. It’s a fact.

Want to reduce your triglycerides?

  • Ditch your donut.
  • Cut out fruit juices.
  • Cut out cereal.
  • Cut out pasta.

Go back to eating eggs. Go back to eating seafoods, grass-fed meats, nuts and lots of green leafy vegetables. Eat healthy fats like Omega-3. Eat more healthy oils like olive oil, coconut oil and yes, (gasp!) even pastured butter.

It’s OK to be shocked.

I followed my own advice and dropped my triglycerides from about 800 to about 100.

So, yeah, your triglycerides dropped a lot after taking fish oil. But that ‘healthy’ diet with lots of whole grains pushed it back up higher than it originally was.

The triglycerides that were removed by all that Omega-3…well, were easily replaced (and then some!) by a bowl of ‘healthy’ oatmeal in the morning.

Think twice if you see the words ‘Healthy Whole Grains’ on a box of breakfast cereal.

Just because it looks and tastes like a tree bark doesn’t make it good for you!


Author Vin Kutty is an expert on fish oil About the Author: Vin Kutty 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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Filed under: Heart Health, Triglycerides by Omegavia
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Fish Oil & Depression – Karen’s Story – Part 1

By Kathy Mankofsky, RD, LD.

Karen prefers to ‘fight through’ her depression.

It wasn’t working. At all.
fish oil depression
Image: Patrice Dufour

She was able to maintain a household with children, hold down a job and still keep things going.

But barely.

She was lethargic, moody, and tired. Everything seemed sour.

She was never happy or cheerful and stopped wanting to do things with friends.

On antidepressants: ‘I just felt numb’

She stopped taking antidepressants a long time ago.

She’d tried it twice.

“I didn’t like the side effects on the drugs. It gave me an uncontrollable appetite and I gained a bunch of weight. On the antidepressant, I just felt numb,” she said.

And while antidepressants got rid of her depression, she said that she felt flat, apathetic and generally didn’t care about anything. She said the antidepressant made her feel very ‘zombie-like.’

Karen said it was like she was out of a bad mood, but nothing seemed to matter anymore. She never really felt happy or joyous.

So she quit taking antidepressants.

Does Nature have an answer?

I’d just read ‘The Natural Way To Beat Depression The Groundbreaking Discovery Of EPA To Change Your Life’ By Basant Puri & Hilary Boyd.
The Natural Way to Beat Depression - EPA Omega-3 by Puri and Boyd
So I told her how EPA Omega-3 fish oil could improve her mood.

She said, “Great Kathy, I am already taking that stuff! I take one capsule per day. And it’s not doing a damn thing!”

“Well, you are taking it…just not enough,” I replied.

So I told Karen about some of the current research on EPA Omega-3 and depression and, in my opinion, how much Omega-3 fish oil to take to help improve her mood.

Karen didn’t believe that fish oil helped her

After about a month, I called to check in on her. She’d been taking more fish oil as I’d recommended.

She said, “You know, now that you mention it, I am feeling much better.”

I asked, “Do you think it was the fish oil that helped?”

Being a skeptic, she said, “Well, I am not sure, but I don’t think so.” Then we both burst out laughing.

She told me she was so used to ‘fighting through’ the depression on her own. And that the good mood sometimes slowly crept up on her.

Karen’s depression returned

A few months later, she called me and said, “Kathy, I am sooo miserable and depressed again.”

The joy had once again, vanished. Nothing seemed to matter anymore. It was a struggle for her to keep her mood under control.

The depression was back.

She’d stopped taking fish oil after her last recovery. She didn’t think the Omega-3 had anything to do with her mood anyway, so she didn’t bother replacing the empty bottle of fish oil.

But I could tell she was somewhat open to the possibility that Omega-3 could work.

Sure enough, when Karen went back on the fish oil, at my urging, she started feeling much better.

This is where I ought to have a bunch of disclaimers. [Editor: you certainly do!] This is just Karen’s experience. This is not scientific proof – it’s an anecdote. Her story and my part in it.

Disclaimer:

If you are taking a prescription medicine for depression…
Do not stop taking your current medication without consulting your doctor.
Do not change dosage of medication without medical supervision.
Do not self-diagnose or make medical decisions without your doctor.
Omega 3 may be taken in addition to prescription medicines for depression and it may have an additive benefit.

Depression can be caused by reasons other than Omega-3 or nutritional deficiency. If this is your case, Omega-3 may not help you.

On-again, off-again…

Karen went on and off the Omega-3 fish oil several times. Every time she stayed on the fish oil for several weeks, she would feel better.

She would care about things again. The depressive symptoms would go away.

And every time she went off, the depression would come back in full force.

She finally started believing me that her diet and Omega-3 deficiency had something to do with it.

Karen admitted, “I just can’t believe that something as simple as fish oil would help me so much!”

The Usual Dose

As a licensed dietitian, I see a lot of people who take Omega-3 supplements. Like Karen, the typical person I work with usually takes 1 fish oil capsule per day. This is about 300 mg of omega-3.

One fish oil capsule is not enough!

You may not feel any improvement when taking fish oil because you are not taking a high enough dose.

So, most people never feel the benefits of Omega-3!

Weak Fish Oil

If you are taking regular fish oil that has 300 mg Omega-3 per pill, you would have to take about 7 pills to get 2,000 mg Omega-3, which is what I tell people to take for noticing mood benefits.

And how many of you are taking 7 pills? NONE, I BET!

So no wonder you are not getting the health benefits of Omega-3!

If you find an Omega-3 product that is more concentrated, you can take fewer pills. This is commonly referred to as ‘pharmaceutical grade fish oil.’

Proper Dosage for Mood Benefits

It is important to take 1000-2000 mg of EPA Omega-3 to achieve noticeable mood benefits.

If your Omega-3 stores have been depleted, it can take 1-2 months to build stores back up to a healthy level.

It is the EPA Omega-3 in fish oil that has been repeatedly shown in studies to help with mood.

Studies show that a formulation needs to have over 60% EPA Omega-3 and under 40% DHA Omega-3 to be effective for depression.

Where’s the proof?

So that’s Karen’s experience. Is it backed up by science? Where’s the proof?

In Part 2, we’ll look at what the studies say about fish oil and depression.

Suggested Reading & References:

All of these books are great!

But if you want just one, I suggest ‘The Natural Way To Beat Depression The Groundbreaking Discovery Of EPA To Change Your Life’ By Basant Puri and Hilary Boyd.

Books:

  1. Ilardi, Stephen S. The Depression Cure, Cambridge, MA. Da Capo Press, 2009.
  2. Servan-Schreiber, David. The Instinct to Heal. Curing Depression, Anxiety, & Stress Without Drugs & Without Talk Therapy, USA, Holtzbrink,2004.
  3. Stoll, Andrew L. The Omega 3 Connection: The Groundbreaking Anti-depression Diet and Brain Program, New York, Simon & Schuster, 2001.
  4. Puri, Basant K and Boyd, Hilary. The Natural Way to Beat Depression The groundbreaking discovery of EPA to change your life. London, Hodder & Stroughton, 2004.
  5. Hyman, Mark. The Ultramind Solution: Fix Your Broken Brain, New York, Schribner, A division of Simon & Schuster, Inc., 2009.
  6. Murphee, Rodger. Treating and Beating Anxiety and Depression with Orthomolecular Medicine, Birmingham, Alabama, Harrison & Hamptom, 2005.
  7. Schmidt. Michael A., Brain Building Nutrition, Frog, Ltd, Berkeley CA, 2007.
  8. Tribole, Evelyn. The Ultimate Omega-3 Diet, New York, McGraw Hill, 2007.

Journals:

  1. Lesperance, et al, ‘The efficacy of Omega-3 supplementation for Major Depression: A Randomized Controlled Trial.’ J Clin Psychiatry 2010; 72(8) 1054-1062.
  2. Treating Depression With Omega-3: Encouraging Results from Largest Clinical Study” Science Daily, June 30, 2010.
  3. Lin, et al. A meta-analytic review of double-blind, placebo-controlled trials of antidepressant efficacy of omega-3 fatty acids. J Clin Psychiatry, July 2007; 68 (7) 1056-61
  4. Lin, et al. A meta-analytic review of polyunsaturated fatty acid compositions in patients with depression. Biol Psychiatry 2010 Jul 15;68 (2): 140-7
DISCLAIMER: This website is for your education and general health information only. The ideas and suggestions contained on this website are not to be used as a substitute for medical advice, diagnosis or treatment from your doctor for any health condition or problem. Users of this website should not rely on information provided on this website for their own health problems. Any questions regarding your own health should be addressed to your own physician.

Fish Oil Labels About the Author: Kathy Mankofsky RD, LD is a registered and licensed dietitian. She has studied Omega-3s extensively. She lives in St. Louis, Missouri.

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Filed under: Fish Oil & Depression, Fish Oil Benefits, Omega-3 Fatty Acids by Omegavia
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Why Enteric Coating on Fish Oil Pills Fail

They usually dont. But when they do…
You’re popping too many antacids.
You’re taking heartburn meds.


Ok, a little more detail…

Good news: there’s usually nothing wrong with the fish oil pill
Bad news: it’s usually because of what you ate

I know, not what you wanted to hear.

enteric coated fish oil supplement
If you’ve been reading this blog for a while, you know that things aren’t quite that simple.

To get to the bottom of it, let’s quickly take a look at what enteric coating is.

What is Enteric Coated Fish Oil?

Enteric coating is a sprayed-on layer on the outside of the fish oil pill’s gelatin shell. It’s sprayed onto the capsules in a drum sprayer.

Think cement mixer. Except, there is a nozzle that sprays the enteric coating material onto thousands of shiny fish oil pills. When all is said and done, the clear pill becomes frosty or translucent.

There are a few types of enteric coating materials used to coat fish oil pills. The most popular enteric coating material is methacrylic acid copolymer. It’s been used for decades and works very well. But as you probably guessed, it’s synthetic. And people don’t like putting methacrylic-anything in their bodies.

So we use a natural, plant-based cellulose coating to coat OmegaVia. Works pretty well. But it’s a little tricker and a lot more expensive – that’s OK, we don’t mind.

The purpose of enteric coating:

  1. Prevent fishy burping and repeating. This is the #1 complaint people have about fish oil and the #1 reason why people stop taking Omega-3 supplements.
  2. Reduce potential damage to Omega-3 by stomach acids. In studies conducted on people with Crohn’s Disease, only enteric coated fish oil provided relief. Regular, non-enteric coated Omega-3 did not. Don’t want to get side-tracked about Omega-3 absorption here…

The Science Behind Enteric Coated Fish Oil

Enteric coated fish oil in New England Journal of MedicineThe New England Journal of Medicine published a paper that proved that patients needed only one-third the amount of fish oil if it was enteric coated. Delivering omega-3 intact to the intestines instead of the stomach, allowed 3X as much Omega-3 to be absorbed into the phospholipid membrane. The study was done on patients with Crohn’s disease but the take away message about absorption can be applied to healthy populations as well.

Another paper compared studies that used enteric coated fish oil capsules – three studies used enteric coated capsules with positive results and one used ordinary gelatin capsules (no advantage).

How Enteric Coating Works

The material used to enteric coat fish oil supplements is acid-resistant. In plain English, that means the capsule will not dissolve in an acid environment. Like your stomach.

Stomach acid is much more powerful than lime juice. The acid helps with digestion and with disinfecting food.

A regular fish oil pill that is NOT enteric coated will dissolve in the stomach in about 15 to 20 minutes. Once the pill dissolves, the oil can rise to the surface and possibly cause burping.

Since enteric coating will not dissolve in acidic environments, it stays put. It will not dissolve in the stomach. If it doesn’t dissolve, you cannot burp up oil or possibly damage the Omega-3.

Enteric coated pills will simply move along untouched past the stomach to the small intestine.

The duodenum or small intestine is not acidic. It is neutral. Stomach acids are neutralized at the entrance of the small intestines.

In the ‘safe’ environment of the small intestines, the enteric coating quickly dissolves. Within minutes.

At this point, the oil is too far down the gullet for you to burp it up.

Neat trick!

We test it too.

How Enteric Coating is Tested

The new lot of OmegaVia being manufactured and bottled just got tested. In two steps.

Step 1: We put the pills in ‘Gastric fluid,’ a solution that imitates the acidity of the stomach. We then stir it for 2 hours. It should not dissolve. And it doesn’t.

Step 2: We take those pills and put them in a solution charmingly called ‘intestinal fluid.’ Not unlike the goo that splatters at the end of space alien movies. This fluid mimics the environment in the small intestines or duodenum. The pills always fall apart in this space-alien-goo within minutes.

This is proof that the enteric coating works.

Weasel Alert!

Sometimes, enteric coating is used to cover up old, rancid fish oil. Yes – gasp! – there are weasels out there.

That’s not why we enteric coat our fish oil. It’s just our formula. We enteric coat. Always. Even if the oil smells fresh like a spring meadow!

Three Reasons Why Enteric Coatings Fail

  1. Lousy paint job. Like your walls or your car, enteric coating is spray-painted onto the capsules. It’s a science and an art. Sometimes, there can be a chip or a crack in the enteric coating. This makes the coating useless. Fortunately, this does not happen 99.9% of the time.
    End result: burping.
  2. Antacids. Think TUMS, Mylanta, Maalox, or Alka-Seltzer. Products like these may provide relief. But it also makes the stomach more like the small intestines. So what happens when you take enteric coated fish oil with TUMS? The enteric coating ‘thinks’ it has reached your small intestines and it dissolves. But it’s not! It’s still in the stomach.
    End result: burping.
  3. Heartburn medications. There is a class of drugs called Proton Pump Inhibitors (keeping with the space alien theme today.) Think Prilosec, Prevacid and Nexium. These drugs reduce acid production in the stomach. They may temporarily make life more bearable. But like TUMS, it makes your stomach less acidic.
    End result: enteric coating dissolves too soon and you may burp up fish oil.

What are your options?

If you take antacids… you can change your fish oil dosage time to a few hours before or after taking the antacid. This should return the stomach acidity to a more natural state. So you may avoid burping.

If you take heartburn meds…unlike Antacids, some heartburn pills can keep working for 24 hours. Then most people hurry up and take the next dose. So there is never a time when your stomach is as acidic as it should be. So if you take Prilosec every day, enteric coating may not work as intended.

Not everyone taking Prilosec will burp up fish oil. Most don’t. This is just an explanation why a simple and safe technology sometimes stops working. It’s not the end of the world. Your Omega-3s will still get absorbed.

A (much rarer) slightly more awkward problem

Some people, well, pass enteric coated fish oils right through their digestive system.

Yup, out the other end.

Why does this happen? More like, how the heck could that happen?!

Simple. It’s the reverse of antacids and heartburn meds. Your intestines are too acidic.

How might that happen? Too much apple cider vinegar.

Vinegar is acidic. And if excess apple cider vinegar is consumed, it may overwhelm the small intestine’s ability to neutralize the flood of acid.
End result: pill leaves your body without dissolving.

A hormone called Secretin controls the acidity in the duodenum. In some people, secretin production may be limited.

If something is amiss with your secretin secretion, then, well, cutting out apple cider vinegar may not be enough. Time to make an appointment with your gastroenterologist and/or your endocrinologist.

A bigger issue: if your entire digestive system is so acidic that enteric coated pills are passing right through, your colonies of probiotic bacteria (and you, their host) may be in serious trouble. Probiotic bacteria in your gut are associated with everything from immune response to your mood.

So these are the technical reasons why enteric coating may fail. Most people do fine with non-enteric coated pills.

If you have a good quality product, whether you have this coating may not matter that much.

DISCLAIMER: This website is for your education and general health information only. The ideas and suggestions contained on this website are not to be used as a substitute for medical advice, diagnosis or treatment from your doctor for any health condition or problem. Users of this website should not rely on information provided on this website for their own health problems. Any questions regarding your own health should be addressed to your own physician.

Author Vin Kutty is an expert on fish oil About the Author: Vin Kutty 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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Filed under: Choosing the Best Fish Oil, Fish Oil Pills, Fish Oil Technology by Omegavia
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Cholesterol: When to Panic

This is part 2. See part 1 – Fish Oil & Cholesterol.

Controlling Cholesterol with Diet

Trying to reduce your cholesterol by avoiding eggs and meat is useless.

Here’s why:

Most – about 80% – of the cholesterol in your body is produced by your liver and other cells in your body. And for good reason. Every cell in your body has and needs cholesterol. There are hundreds of bodily tasks for cholesterol.
fish oil_egg_cholesterol

Image: Mariola Streim

If you remove all cholesterol from your body, you will die.

Period.

So it would be foolish of your body to depend on your diet for all its cholesterol needs. And your body knows it. This is why your liver is in charge.

Your diet only controls the remaining 20% or less of the cholesterol coursing through your body.

Most of the cholesterol found in foods are in the esterified form. Your body will not readily absorb esterified cholestserol. It simply gets excreted.

(Tech talk: Your body already produces gobs of ready-to-absorb free cholesterol that it can use at will – why wait for a lipase enzyme to deesterify the cholesterol that came into your body from eating eggs or bacon? There is no need! It just gets excreted.)

All those egg yolks and bacon that you’ve been avoiding? Avoid it for reasons other than cholesterol!

All your dieting and cutting out meat or going vegan can at best reduce your cholesterol by about 20%. And that too, only temporarily.

If your body senses that you’re not feeding it enough cholesterol, it will automatically increase liver’s cholesterol production. And vice versa, if you’re eating a lot of cholesterol, the liver will take it easy on cranking out cholesterol.

So if you quit eating meat and become a vegan, to reduce cholesterol, it may work. Temporarily. After all, cholesterol is only found in animal products. But after a couple of months, your cholesterol numbers will start creeping up again even on a vegan diet.

cholesterol and archives of internal medicine

A recent study published by Harvard researchers, followed over 121,000 people over several years. A tiny nugget of data buried in the study showed that:

  • people eating the least amount of red meat had the highest cholesterol
  • and those who ate the most red meat had the lowest cholesterol

That’s an important finding!

But not a single TV show talked about this.

Just sayin…

When to Panic?

What if your total cholesterol is 200? Is it time to panic?

Should you panic at 250? 300?

You should never panic about cholesterol.

What you shouldn’t do is start preemptively taking cholesterol-lowering statin medications to pound and pummel your cholesterol number into double digits.

It’s easy to following this logic:

a) if cholesterol is dangerous
b) and your cholesterol is going up gradually
c) you should simply nip it in the bud before it gunks up your arteries

Right?

Wrong.

A cholesterol number close to ZERO is not good. Or perfect.

Having too little cholesterol may be even more dangerous than having too much.

Panicky patients and enabling doctors preemptively popping statin drugs like candy is dangerous. There was a doctor in the UK who called for addition of statin drugs into tap water. Never mind that his name is Dr. John Reckless.

For most people, a total cholesterol somewhere between 200 and 250 is nothing to be worried about, especially if you’re female and getting older.

Your total cholesterol number is not very revealing. Still, I am NOT asking you to ignore your cholesterol number!

It’s one of your body’s check engine lights

A cholesterol number of 250 or 300 means it is time to open the hood and give the engine a thorough inspection.

Blindly reducing your cholesterol number with statin drugs is like unplugging that check engine light.

Sure, that annoying red light is no longer there when you start your car in the morning, but the reason why that red light went on still remains.

It’s up to you whether you want to ignore the real problem under the hood.

This is why I called hasty, chop-chop statin therapy ‘lazy medicine’ in a recent blog about Fish Oil & Red Yeast Rice.

Before I get drowned in hate mail, let me make the following statements very clear:

  1. If you’re on statin therapy, talk to your doctor. DO NOT self-diagnose and stop taking prescription medications without talking to your doctor – that can be dangerous. (No, our legal dept. didn’t make me say that. I meant it.)
  2. If you have a genetic condition called familial hypercholesterolemia, you probably ought to be on statins.
  3. If you have heart disease or have had a heart attack, you probably ought to be on statins.
  4. If your doctor did an NMR Lipoprotein analysis and told you that your LDL particle number is too high – listen to your doctor! – and take the Zetia or Niaspan or whatever he/she prescribed!

What if you don’t fall into the above categories? Well, then, it is time to look under the hood.

If the only solutions your doctor knows for high cholesterol are to:

  1. immediately put you on statins
  2. tell you to exercise and cut fat from your diet

Ding-ding-ding! It’s time to look for another doctor.

Some doctors – a sad commentary – will prescribe statin drugs even if the patient does not absolutely need it, to reduce the risk of negligent malpractice lawsuit. Sigh.

But the good ones who have the time to practice good medicine, without being harassed by insurance companies, know that high cholesterol often is just a symptom of metabolic disorder.

High cholesterol could be caused by:

  1. thyroid imbalance (usual culprit)
  2. infections
  3. inflammation
  4. nutritional imbalance

Most allopathic doctors rarely focus on inflammation or nutritional deficiencies – that’s a whole another rant/blog.

(Tech talk: a really impressive doctor would probably do an NMR Lipoprotein analysis on you. This will give you an idea of how many LDL particles you have. Under 1000 is ideal. It is these LDL particles that deposit cholesterol into artery walls  – atherosclerosis – and THAT IS NOT GOOD)

Remember: cholesterol in your diet is OK. Cholesterol in your artery is NOT OK.

But for many people, understanding thyroid imbalances and fixing it through medication or even iodine supplementation could fix the problem. DO NOT do this without your doctor’s help! Your thyroid is not a do-it-yourself project! Don’t even think about it.

Speaking of inflammation, what’s one of the key causes of inflammation? Yup, too much Omega-6 from vegetable oil consumption. I can never beat that dead horse enough.

The solution to most metabolic disorders:

…is not found in a pill. Wish it was!

The solution is a simple, whole foods diet exclusively of non-starchy vegetables, Omega-3 rich seafood, grass-fed meats, fruits, nuts and pastured eggs, all cooked in low-Omega-6 fats – olive oil, coconut oil or pastured butter.

Note the absence of sugars, grains and Omega-6-rich seed-based vegetable oils!

Popping a bunch of fish oil supplements will not correct metabolic disorders. Wish it did!

Sure, EPA Omega-3 is one of the most potent anti-inflammatories. But high dose Omega-3 supplementation only gets you half way there…what’s required is cutting out Omega-6, sugar and flour.

Mainstream medicine is changing…slowly

Dr. Dwight Lundell, cardiologist, explains all this a bit more thoroughly…
Fish oil quote

The only accepted therapy was prescribing medications to lower cholesterol and a diet that severely restricted fat intake.

It Is Not Working!

These recommendations are no longer scientifically or morally defensible. The discovery a few years ago that inflammation in the artery wall is the real cause of heart disease is slowly leading to a paradigm shift in how heart disease and other chronic ailments will be treated.

What are the biggest culprits of chronic inflammation? Quite simply, they are the overload of simple, highly processed carbohydrates (sugar, flour and all the products made from them) and the excess consumption of omega-6 vegetable oils like soybean, corn and sunflower that are found in many processed foods.

- Dr. Dwight Lundell, Cardiologist

fish oil quote

BBC Video: Statins – use them or lose them?

So should you ignore your high cholesterol?

No. Don’t ignore it.

High cholesterol just means it’s time for you and your doctor to take a better look under the hood.

DISCLAIMER: This website is for your education and general health information only. The ideas and suggestions contained on this website are not to be used as a substitute for medical advice, diagnosis or treatment from your doctor for any health condition or problem. Users of this website should not rely on information provided on this website for their own health problems. Any questions regarding your own health should be addressed to your own physician.

Author Vin Kutty is an expert on fish oil About the Author: Vin Kutty is OmegaVia’s Scientific Advisor and Chief Blogger. He is a nutritionist, author, and Omega-3 expert with over 20 years of experience. Email him.

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Fish Oil & Cholesterol

Fish Oil & Cholesterol

The following frustrating conversation happens at least twice a week at our office.

Caller on phone: “Does your fish oil reduce cholesterol?”

Me: “No…it does not. Fish oil reduces triglycerides but it doesn’t reduce cholesterol significantly…”

Caller: “I need a fish oil brand that reduces my cholesterol. Oh well, I’ll keep looking for one that does.” Click.

This is frustrating on several levels. Not because they didn’t buy our product, but because of the decades of misinformation and fears that led to this discourse.

These callers usually have tried taking cholesterol-lowering statin drugs after their doctors put them on it. But the statin side effects were so severe that they’ve quit taking it and are looking for other options.

I can sense the concern and even desperation in their voices. I don’t blame them!

They have high cholesterol. But their doctor’s fix – statin drugs – caused them severe muscle pains and mental fog.

Thanks to doctors and drug companies, cholesterol scares the bejessus out of people. Every 10 years or so, the ‘normal’ cholesterol range keeps getting reduced.

So I don’t blame the callers’ fear and concern.

They’ve heard good things about fish oil so they begin looking into it. That’s when they call us.

Fish oil doesn’t decrease cholesterol!

At least not dramatically. Like your Lipitor would.

If anyone’s told you otherwise, you’ve been misled.

Sorry.

I see it all the time. Just last week, I read a press release about a medical doctor launching his own brand of pharmaceutical grade fish oil.

The product’s web site and the product label prominently claimed their product would “lower LDL (bad) cholesterol and increase HDL (good) cholesterol.”

Whoa, Doc!

Fish oil cholesterol_International Journal of Cardiology

What the science says…

An analysis of 47 clinical trials showed that taking fish oils (about 3,000 mg of Omega-3 per day) showed the following results:

  1. Significant reduction of triglcyerides.
  2. No change in total cholesterol.
  3. Very slight increases in HDL and LDL cholesterol.
  4. And how much the triglycerides went down was dependent on how much EPA and DHA were consumed.

Published in the International Journal of Cardiology.

Some people notice a slight lowering of cholesterol after they start taking fish oil or krill oil.

Sure, Omega-3 tends to straighten things out in your metabolism a little bit. You might see a temporary 5 to 10% reduction if you’re lucky.

More often than not, the reduction is correlation and not causation.

Correlation, not causation

In other words, one does not cause the other, but the two are related. (Think ice cream and drowning. A few decades ago, some poindexter figured out that whenever ice cream sales went up, there was increased drowning in pools. He concluded that some protein in ice cream caused people to pass out while swimming. Folks panicked! Well, turns out that people eat ice cream when it’s hot and also go swimming when it’s hot. It was the hot weather-related swimming. Ice cream had nothing to do with it!)

Anyway, when people start taking fish oil, they’re generally concerned about health. They cut out junk food, sodas and cookies. This change in diet and lifestyle is the likely cause of lower cholesterol.

DHA Omega-3 increases both HDL and LDL

As a matter of fact, there is some research that shows that high DHA Omega-3 consumption can actually INCREASE your LDL cholesterol by about 10 to 15%. This is why the new triglyceride lowering drugs made from fish oil, like Amarin’s AMR-101, is all EPA. These new triglyceride-lowering drugs (not yet on the market) contain little or no DHA.

People are scared of LDL cholesterol.

Prescription Lovaza comes with a warning that it could increase LDL cholesterol.

So should you stop taking fish oil because of DHA? Good God, no!

LDL cholesterol is not all bad!

LDL has very important repair functions in your body and it is critical in maintaining your immunity. Simply calling LDL “bad” is silly. And avoiding DHA because it can raise LDL a tiny bit is even sillier.

The point I’m making is that fish oil may not reduce your cholesterol. But that is absolutely no reason not to take fish oil!

You take Omega-3 to:

  1. Help your body function well.
  2. Offset the inflammation caused by too much Omega-6 from vegetable oils.

The fact that it does not reduce cholesterol SHOULD NOT be a reason not to take Omega-3 supplements or eat fish.

Omega-3 reduces risk of death from cardiovascular causes by between 30 to 50%.

The Italian GISSI study says taking just 850 mg of EPA DHA Omega-3 per day showed a dramatic reduction of sudden death.

This risk reduction isn’t from cholesterol reduction.

The risk reduction comes from:

  • reduction in triglycerides
  • reduction in inflammation
  • providing antiarrhythmic properties
  • improved endothelial function

Keeping with the fish theme here, not taking fish oil because it does not reduce cholesterol is like judging a fish by its ability to climb a tree.

I think Einstein put it a little more eloquently…

einstein quote

Parting shot…this is comedy with an important message:

DISCLAIMER: This website is for your education and general health information only. The ideas and suggestions contained on this website are not to be used as a substitute for medical advice, diagnosis or treatment from your doctor for any health condition or problem. Users of this website should not rely on information provided on this website for their own health problems. Any questions regarding your own health should be addressed to your own physician.

Author Vin Kutty is an expert on fish oil About the Author: Vin Kutty is OmegaVia’s Scientific Advisor and Chief Blogger. He is a nutritionist, author, and Omega-3 expert with over 20 years of experience. Email him.

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Fish Oil & Red Yeast Rice: a Good Combo?

Red Yeast Rice and Fish Oil - a good combo?

Should you take Red Yeast Rice along with your fish oil supplement?

That’s a frequent question in my inbox.

My answer: No.

Why?

Here’s the short version:

If the Red Yeast Rice works, it’s illegal. If it’s legal, it won’t work.

And the long version:

Many people turn to Red Yeast Rice because they’ve heard it reduces cholesterol. (Yes, it can.)

Traditional Chinese Red Yeast Rice is a reddish rice that’s fermented with a special kind of mold. The finished product, Red Yeast Rice, contains a substance called Monacolin.

Monacolin is virtually the same as Lovastatin or the active ingredient in Mevacor, Lipitor and several other groups of cholesterol-lowering drugs called statins, at least from a chemical structure point of view. Your body won’t know the difference.

Red Yeast Rice was likely the inspiration for the original statin drug patent.

If you’re taking Red Yeast Rice, because it’s natural and works differently than Lipitor, you’re mistaken.

Monacolin from Red Yeast Rice and Lipitor do the exact same thing to your body.

They both block an enzyme called HMG-CoA reductase, which is involved in cholesterol synthesis in the body.

They both reduce cholesterol.

Red Yeast Rice Side Effects vs Statins

Since Red Yeast Rice and statins do the exact same thing to your body, it’s not surprising that they both have the same dangerous side effects of muscle cramping, CoQ10 depletion and brain-fog to list a few.

Except, with a statin drug, you know what you’re getting. With Red Yeast Rice, you’re, well, gambling.

A Side Story: The Original Inconvenient Truth

When Merck invented the original statin drug, Mevacor, they applied for a patent. Obviously! After all, they were about to make billions of dollars.
Statin drugs and CoQ10 depletion
Merck knew that their statin drug reduced cholesterol, but they also knew that it wiped out most of the essential CoQ10 in your body. And wiping out CoQ10 causes painful leg cramps and several serious side effects.

That’s why their original patent was for a mixture of statins and CoQ10. But CoQ10 by itself was available as a supplement and hence not patentable. Also, CoQ10 was extremely expensive. The bean counters at Merck decided that they’d pass on the CoQ10. And they sold their statin without any CoQ10.

It’s been 30 years and most doctors do not know this little fact. But Merck sat on the patent, so other drug companies could not mix their statins with CoQ10. That was 30 years ago and the situation has changed very little today.

During the 1990s, Red Yeast Rice supplements became very popular. They were cheap. They reduced cholesterol. And you didn’t have to see your doctor for it. People were happy and sales exploded.

Merck was losing sales to a cheap dietary supplement.

Not surprisingly, the Red Yeast Rice party came to a swift end when the FDA and Merck decided that Red Yeast Rice supplements with measurable amounts of Monacolin were infringing on Merck’s patent.

Never mind that Red Yeast Rice has been used regularly in Chinese cooking for centuries.

The small dietary supplement companies earnestly peddling Red Yeast Rice didn’t stand a chance against Merck and the Feds.

The party was over.

A NEW LAW: any Red Yeast Rice supplement with appreciable quantities of Monacolin was a drug. An unauthorized drug.

And if you were caught selling Red Yeast Rice, first you’d get a nasty letter from the FDA, asking you to stop. And the punishment for ignoring the Feds? Well, you can imagine.

For about a half dozen years, dietary supplement companies would not even think about selling Red Yeast Rice.

They were powerless against the FDA and Merck.

But things changed around 2004…

Scrutinizing the FDA regulations, supplement marketers found out that if you sold Red Yeast Rice WITHOUT any Monacolin, it wasn’t breaking the law.

Sure enough, the FDA looked the other way when these ‘dummy Red Yeast Rice’ products began flooding local drug stores.

Neither the FDA (nor Merck) cared.

They knew the truth…that without Monacolin, Red Yeast Rice was just colored rice powder.

But the consumers who were used to buying cheap and effective Red Yeast Rice were glad that after many years, their favorite cholesterol-killer was back!

People started buying the ‘toothless’ Red Yeast Rice.

But nothing happened.

Cholesterol wasn’t dropping.

Red Yeast Rice Rebirth

Emboldened by their sales and FDA nonchalance, supplement companies (some of them) slowly started sneaking small amount of Monacolin-rich Red Yeast Rice into their formulas.

Thanks to word of mouth, the brands that were ‘adulterating’ the toothless Red Yeast Rice with some Monacolin, started noticing brisk sales.

No one in the supplement industry talked about this. But it was all around us. We all knew where to get the good stuff. It was all from China.

‘Gimme the good stuff,’ was all you had to say. Nothing written and nothing promised. You paid a little more for the Monacolin-spiked stuff.

It was everywhere. (It is everywhere.)

The FDA finally started cracking down on these spiked brands. Most quickly went back to selling useless Red Yeast Rice.

Today’s Reality

Today’s Red Yeast Rice supplements fall into two categories:

  1. If a Red Yeast Rice supplement is legal, it has little or no Monacolin and it will not reduce your cholesterol.
  2. If your Red Yeast Rice has been reducing your cholesterol, know that you are buying a product that the FDA considers illegal.

A recent ConsumerLab.com test of several brands found that some had Monacolins and others didn’t. And you can’t tell by reading the label.

If you call your favorite Red Yeast Rice dealer, uh…brand and ask them if their product contains Monacolins, you can almost hear them squirm in their chairs while they try to get you off the phone quickly.

A couple of other cautions

  1. ConsumerLab.com found a naturally occurring toxin (nephrotoxin) called Citrinin in several brands. Goes with the territory.
  2. All of it comes from China and all the baggage that China entails.

So that’s the long story of why you shouldn’t take Red Yeast Rice along with your fish oil – if the Red Yeast Rice works, it’s illegal. If it’s legal, it won’t work.

All this trouble for reducing cholesterol?!

I don’t get it. Total cholesterol is not a very revealing marker of your heart health or your overall health.

Cholesterol itself is not bad! Your body needs it. It’s present in every cell.

If your total cholesterol is higher than, say 250, it means that your doctor needs to open the hood and start poking around for irregularities.

Popping handfuls of Red Yeast Rice pills if your cholesterol is approaching 200 and calling it a day is dangerous. If your doctor does it, it’s lazy medicine. Why? Because it’s glossing over something more fundamental like poor diet.

You’re better off cutting back on soda, juice and processed foods made with flour. These spike your blood glucose and insulin levels.

You’re better off avoiding Omega-6 rich seed oils like corn, soybean, sunflower oils. These spike inflammation.

Eat more seafood and veggies.

DISCLAIMER: This website is for your education and general health information only. The ideas and suggestions contained on this website are not to be used as a substitute for medical advice, diagnosis or treatment from your doctor for any health condition or problem. Users of this website should not rely on information provided on this website for their own health problems. Any questions regarding your own health should be addressed to your own physician.

Author Vin Kutty is an expert on fish oil About the Author: Vin Kutty is OmegaVia’s Scientific Advisor and Chief Blogger. He is a nutritionist, author, and Omega-3 expert with over 20 years of experience. Email him.

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Fish Oil Forms: EE vs TG – Part 2

In Part 1, we reviewed the scientific evidence of the difference in absorption between EE fish oil and its TG cousin. TG came out slightly ahead.

But…are there any problems with TG fish oil?

Let’s look at some facts:

  1. True TG fish oil is low in Omega-3, usually 20-30% Omega-3 or less.
  2. At that concentration, you’ll have to take almost a dozen pills a day to get enough Omega-3 for reducing your blood triglycerides.
  3. Concentrated TG fish oil (also called rTG) supplements are not exactly natural and are very expensive.
  4. Almost all the scientific research to date (more than 18,000 scientific papers) has been performed using EE form of fish oil and NOT the TG form.
  5. Prescription Omega-3 like Lovaza, Omacor, AMR-101 and Epadel are all EE forms.

Besides the increased cost and large number of pills required, there are no valid reasons to avoid TG fish oil. If you’re on a tight budget and need 4,000 mg of Omega-3 per day, rTG fish oil may cause some financial difficulty.

OmegaVia uses EE form of fish oil.

Internet and Emails as a Scare Tactic!

A lot of internet marketing and advertising chatter will have you believe that EE fish oil is pure poison! One drop and you’ll fall flat on your back. Time to meet your maker!

Not so fast, Skippy!

Moderation and common sense does not get much attention these days.

There are a lot of people (and brands) on the internet spreading fear about EE fish oil. I think this is predatory and self-serving.

SCARE TACTIC #1: Your kids will get intoxicated!

One of the points used to stir up fake-fear is alcohol.

When a molecule of EE fish oil is metabolized by your body, a molecule of alcohol is released. A teeny, tiny bit.

A daily dose of EE fish oil has about as much alcohol as a glass of orange juice. Yes, all fruits and juices have a tiny bit of alcohol in it. Nothing to worry about – your body is built for and perfectly capable of handling fruits as well as EE fish oil.

But if you believed everything you read, you’d think that little children all over the country are passing out drunk from taking a little EE fish oil!

SCARE TACTIC #2: Styrofoam Cup Parlor Trick

This is my favorite!

There is a YouTube video of someone putting ethyl ester oil in a styrofoam cup. The oil, naturally, melts through the cup. The demonstrator looks up at the camera is mock shock!

It makes for great entertainment, but the only thing it proves is what they taught me in Chemistry 101, that compounds with similar polarity attract and often dissolve each other. Unless your digestive system is composed of polystyrene, there is absolutely nothing to fear! Until then, the styrofoam cup video is a great parlor trick.

Ironically, in Asia, where they sell mostly low-potency oils, they use reverse-styrofoam-melting-trick…in other words, their advertisers are telling people that good and strong fish oils SHOULD dissolve styrofoam cups and one SHOULD ONLY BUY oils that do so.

I got this email from a customer in Malaysia, just 2 days ago:

“We see lots of demonstrations using polystyrene food box. One will cut the fish oil capsule into half letting the oil drip onto the box. Oil that ‘burns’ a hole through the box is claimed to be of the highest purity. What do you make of such claim? Is there any scientific truth there?”

These demonstrators do not understand chemistry and are hoping you’ve forgotten it since high school. If I were really cynical, I’d say they know their chemistry, but are sure you don’t!

SCARE TACTIC #3: Yikes! EE fish oil is banned in some countries!

Easy there, Skippy! Not so fast!

Japan and some EU countries distinguish over-the-counter supplements and pharma drugs. Supplements are TG fish oils. And pharmaceutical drugs are EE fish oils.

Simple rule. Keeps the kids from fighting.

Japan has had a high-EPA prescription fish oil drug in EE form for two decades. It’s sold as Epadel.

US regulations allow for EE fish oil to be sold as BOTH prescription Lovaza and OTC supplements.

Why all the scare tactics?

Profit.

And the competition is stiff.

Using fear as a selling tool is an age-old trick. Politicians do it every day! Need I say more?

Why do we use EE fish oil?

Simple. It allows for ultra-concentration of Omega-3.

TG fish oils contain 20-30% Omega-3 and cannot be concentrated.

If you want pharmaceutical grade or prescription strength fish oil, you need to concentrate the oil to 80 or 90% Omega-3. EE fish oil can be concentrated to pharmaceutical strength. TG fish oil cannot.

This concentration allows you to take fewer pills and yet get all the desired benefits of fish oil.

After all, what’s the point in taking fish oil if there isn’t enough Omega-3 in it?

Omega-3 delivered to your body in either form, EE or TG, eventually ends up in your cell membranes, where they go about doing the wonderful things they do.

EE still does the job – pancreatic lipase hydrolyses EE to a slightly less degree than TG. And at a slightly slower rate. You won’t feel the difference.

What’s rTG Fish Oil? Even more science!

Some companies now go a step further…

They start with 30% Omega-3 TG fish oil. Then convert it to 60 or 70% Omega-3 as EE fish oil. Remember, you can only concentrate fish oil in the EE form.

And then, enzymes are used to re-esterify the Omega-3 fatty acids back into the TG form. This process is called enzymatic glycerolysis. These oils are called rTG in the fish oil industry.

It’s a fancy way of getting high concentration, yet be able to say that the oil is in its ‘natural triglyceride’ form.

Is rTG Fish Oil Really ‘Natural’?

rTG is super-natural. Or nature-identical. But not natural. rTG is like those audio speakers people put in their back yards that look like rocks. Skippy tells me they are rocks.

Enzymatic glycerolysis does not produce a pure triglyceride (three glycerol molecules) product. It’s often half triglycerides and the rest of the oil is a mix of mono and di-glycerides. It’s a super-natural mix unlike what’s found in fish. Dyerberg et al. suggest this may be why it is slightly better absorbed.

Nordic Naturals uses a clever way of increasing the triglyceride content to 93%. It’s a great laboratory achievement by a pioneering company and it deserves attention and respect. But don’t confuse that with 93% Omega-3! 93% triglycerides does NOT mean it is 93% Omega-3!

Whatever the glyceride combination, rTG is perfectly fine to take and it’s very well absorbed.

This additional enzymatic step is expensive, but is it worth it?

Personally, I think it is fascinating chemistry. But it’s a lot of chemical intervention and cost for a minor benefit.

Is rTG better than TG?

Yes. A little.

A recent 2-week study by Dyerberg et al., did something, ummm…interesting, in my opinion – they indexed the results. Instead of comparing all fish oil results to placebo, they compared EE and rTG to regular fish oil. While this might seem harmless on the surface, it exaggerates the facts. It makes the difference between TG and EE APPEAR bigger.

Some call it funny math.

I’m not the only one who found this a little odd…

fish oil EE vs TG

“How they reported the results was instead of comparing the results to placebo, they took the position of comparing the other forms to regular fish oil and cod liver oil, “as if” regular fish oil and cod liver oil were “the standard” by which to compare the others. With this approach, the re-esterified TG concentrate form improved blood levels better than regular fish oil and cod liver oil, and the result of consuming the EE concentrate on blood levels was less than regular fish oil and cod liver oil.”

- Gretchen Vannice, MS, RD – Omega-3 Dietitian in Comments on recent studies comparing TG and EE forms of fish oil

fish oil EE vs TG quote

Like I said, funny math. Using this funny math, rTG is 70% better than EE. I’ve seen websites that claim 120-something percent better. Skippy strikes again!

Funny Math & TV Commercials

Tangentially, this funny math is used to market cholesterol (statin) drugs. If people on placebo had a 1% decrease in cardiac events and people on stains had a 1.5% decrease, that HALF PERCENT difference will be conveniently interpreted as (1.5-1/1.5) = 33%.

Before you know it, there is a TV ad that says statin drugs reduce your risk of cardiac events by 33%.

Very clever!

This has actually happened!

The Neubronner study was longer, more robust and much more conclusive in comparing the Omega-3 Index (see Part 1) of TG vs EE.

At the end of their study, they got the participant’s Omega-3 Index up from 7 to 12.2 for the EE group and 13.2 for the TG group. That about 15% difference. Let’s be generous and say 20%. Super generous = 25%. That’s still far from the 70% that marketers of TG oils like to claim.

Regardless, if you can get your Omega-3 Index above 12, you should be jumping up and down! And EE fish oil clearly did so in this very well designed study. Nuff said.

Cost difference between EE and TG (or rTG)?

A big cost difference.

Concentrated TG oils (rTG) are very expensive.

If you buy fish oil by the truckload, like we do, there is roughly 40% premium for TG oils. That usually translates to twice the cost for you, the consumer.

There are very few well-known TG fish oil brands. Nordic Naturals Ultimate Omega and Minami Nutrition MorO-3 come to mind. Both are excellent products. I recommend them without hesitation.

They are both rTG products, which are usually about 60% Omega-3 potency. The following is a comparison of these two products with a couple of other mid-grade fish oils.

Cost of 1000 mg Omega-3
Fish oil cost EE vs TG

As a comparison, OmegaVia costs about as much as the GNC Triple Strength Fish Oil.

The bottom-line remains…

Are you willing to pay almost twice as much for far less than twice as much absorption?

Once you dispense with the shady marketing, you are left with two slightly different products that give you the same health benefits. Generally speaking, the strongest EE oils contain 20 to 30% more Omega-3 than the strongest TG oils. This makes the absorption claims somewhat of a wash.

Unless major new clinical evidence changes the scientific landscape, it’s a no-brainer to me.

I’m sticking with EE fish oil.

And I eat salmon frequently and avoid Omega-6-rich vegetable seed oils.

 

DISCLAIMER: This website is for your education and general health information only. The ideas and suggestions contained on this website are not to be used as a substitute for medical advice, diagnosis or treatment from your doctor for any health condition or problem. Users of this website should not rely on information provided on this website for their own health problems. Any questions regarding your own health should be addressed to your own physician.

Author Vin Kutty is an expert on fish oil About the Author: Vin Kutty is OmegaVia’s Scientific Advisor and Chief Blogger. He is a nutritionist, author, and Omega-3 expert with over 20 years of experience. Email him.

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Fish Oil Forms: EE vs. TG Oils – Part 1

Ethyl ester versus Triglyceride form of Omega-3 fish oil

Is one better than the other? Or is it just nerdy hair-splitting?

I’ve had a few questions in my inbox about the difference between different types of fish oils.

No, I don’t mean Cod liver oil vs Salmon oil.

We’re talking molecular structure of the Omega-3 fatty acids.

We’ve talked quite a bit about the Phospholipid (PL) form of Omega-3 found in krill oil.

Ethyl Ester (EE) form and Triglcyeride (TG) form are the most common types of fish oils.

The TG form is naturally found in fish. But it can’t be concentrated. To produce a concentrated pharmaceutical grade fish oil, it is necessary to convert the TG form into EE.

Almost all the pharmaceutical grade oils and prescription Lovaza are in the EE form.

The science suggests that the PL form is likely the best absorbed of the bunch.

PL Omega-3 found in krill makes a lot of sense theoretically because that’s how Omega-3 is stored in our body. But krill oil is a very weak source of Omega-3. And it cannot be concentrated without destroying the PL-Omega-3 bond. If you heat krill oil, you destroy most of what’s good about it.

That’s why krill oil is concentrated (somewhat) using solvents like hexane or alcohol.

Still, there are slight differences in absorption between EE and TG forms of fish oil. Don’t think of this as two losers fighting for second place.

So…between TG and EE, which is better?

TG is a little better, in my opinion. But not much.

Scientific opinions vary.

See table below:

The Science Behind EE vs TG Absorption

Research Results are Mixed

STUDY

AUTHORS

RESULT

#1 Luley et al. No difference between EE and TG.
#2 Nordoy et al No difference between EE and TG.
#3 Krokan et al No difference between EE and TG.
#4 Hansen et al No difference between EE and TG.
#5 Harris et al No difference between ME and TG. But both reduced blood triglyceride equally well.
#6 Reis et al No clear difference.
#7 El Boustani et al TG was slightly better.
#8 Lawson & Hughes TG was slightly better.
#9 Dyerberg et al TG was better.
#10 Neubronner et al TG was better.

There’s one common element in all the studies where the researchers found no clear difference between EE and TG: study participants took the pills with their meals.

Specifically, the fish oil pills were taken in the presence of some dietary fat.

So if you take EE fish oil with your meals, you will dramatically increase its absorption, to the point that there is virtually no difference between the two forms.

This study showed that eating fish was the best way to get Omega-3 but there was a 3-fold increase in absorption of Omega-3 if fish oil pills were taken along with food.

OmegaVia uses EE fish oil.

This is why our dosage directions clearly say: BEST IF CONSUMED WITH A MEAL.

If taken on an empty stomach, TG is slightly better absorbed.
If taken with a full meal, TG and EE forms are almost equally well absorbed and the above advantage virtually vanishes.

Also, there are no reliable studies where EE dramatically outperformed TG.

Other than that, the differences are minor:

  • TG tastes better than EE, if you want to drink liquid fish oil by the spoonful.
  • TG is the natural form Omega-3, as it is found in fish.
  • TG is slightly more resistant to rancidity.

These are clear benefits if you take liquid fish oil.

The Omega-3 Index

Of the list of studies in the table above, the best designed and most recent is the one by Neubronner et al.

Unlike the other studies, these scientists decided to measure the Omega-3 Index.

I’ll write more about Omega-3 Index at a later date, but in a nutshell, it measures the actual percent of Omega-3 that becomes a part of your red blood cell membranes.

An Omega-3 Index of 8 and above is considered low risk for disease. 4 to 8 is intermediate risk. Below 4 is high risk.

  • Japanese are almost at 9. Not bad!
  • Germans are at 6. So-so.
  • Americans are, ahem, at 4.

In the study, BOTH EE and TG forms of fish oil were well absorbed and BOTH increased Omega-3 Index quickly and significantly after taking about 1,700 mg of Omega-3 per day.

The TG form did a slightly better job than EE form. See below.

Omega-3 Index comparison of EE vs TG fish oil. Adapted from Neubronner et al.
Adapted from Neubronner et al. Enhanced increase of omega-3 index in response to long-term n-3 fatty acid supplementation from triacylglycerides versus ethyl esters Eur J Clin Nutr 65 (2010) 247-254.

Both TG and EE forms of fish oil quickly got the participants from below an index of 8 to well above it. And it looks like it took less than 3 months to do so.

There was a 15% difference in Omega-3 index between TG and EE fish oils at the end of 6 months.

This tells me that the ‘biological outcome’ (translated to English, that means ‘the benefits to your health’) is virtually the same.

In the authors words, the EE fish oil ‘highly exceeded’ the goal of getting the participants above an Omega-3 index of 8. They reached a very healthy index of 12.2.

Next…

  • Is that 15% worth the extra cost of TG fish oil?
  • Is all this just nerds splitting hairs?
  • Is there any truth behind the internet fear-mongering?

Find out in Part 2.

 

DISCLAIMER: This website is for your education and general health information only. The ideas and suggestions contained on this website are not to be used as a substitute for medical advice, diagnosis or treatment from your doctor for any health condition or problem. Users of this website should not rely on information provided on this website for their own health problems. Any questions regarding your own health should be addressed to your own physician.

Author Vin Kutty is an expert on fish oil About the Author: Vin Kutty is OmegaVia’s Scientific Advisor and Chief Blogger. He is a nutritionist, author, and Omega-3 expert with over 20 years of experience. Email him.

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Is Your Fish Oil Made in China? Part 3

fish oil made in china
See Part 1 and Part 2.

In Part 2, we talked about the likelihood of your Omega-3 supplement being made in China or containing Chinese fish oil.

So what if it really was made in China?

What’s the problem with ‘Made in China’?

Well, the problem is that there is no permanent transparency in China.

Some Chinese plants are open to audits. And many US auditors visit these companies regularly.

But there are no true and lasting controls.

Some Chinese manufacturers produce excellent products. And some don’t. It’s the latter that worry me.
GOED Global Organization for EPA DHA Omega-3
Most North American and European fish oil refiners belong to GOED, the Global Organization for EPA and DHA Omega 3, a non-profit trade group.

  • GOED membership requires some transparency and quality compliance.
  • GOED members must commit to following a code of ethics and business practices.
  • Most importantly, GOED’s monograph serves as an unofficial quality guideline for the fish oil industry.

Until very recently, GOED had no Chinese members.

You only need to look at the drug recalls during the last 5 years to get an idea of what scares me.

The 2007 Melamine pet food scare followed by the 2008 Heparin disaster that killed 149 people, were on newspaper front pages. When the FDA inspected the offending plants, they found several serious issues.

More recently, counterfeit Viagra that had drywall ingredients mixed in. (No jokes, please!)

And that’s just for pharmaceutical drugs that legally require more monitoring that a dietary supplement like fish oil.

Only 12% of Chinese plants inspected by 2010

FDA Inspection of fish oil facilities in China
The FDA says that it does not have the funds nor bear the responsibility to inspect on a regular basis, overseas manufacturers of active pharmaceutical ingredients. A GAO report released in October 2010 states that the FDA had inspected only 12% of hundreds of Chinese pharmaceutical plants that produce ingredients for the US market.

That’s just for pharmaceutical drugs, not dietary supplement manufacturers.

Monitoring all foreign fish oil manufacturing is unreasonable and simply can’t be a high priority for the FDA.

The Beauty of Cheap

As Americans, we expect a Chinese screwdriver or pen to be cheap.

We expect it to break.

We toss it and buy a new one.

That’s the beauty of cheap.

A leaky pen or broken screwdriver never hurts your health.

The point of all this is to demand transparency! If you choose to buy a discount fish oil for any reason, that’s fine. But you deserve the right to know what you’re getting for your money.

If you can’t get transparency from the Chinese, well, fine. You should expect demand it from your American supplier!

  • When it comes to something you ingest, something you put in your body to improve your health, don’t you want better control over it?
  • Don’t you want to know where it’s from and what’s in it?
  • When you ask questions, don’t you want real answers?

It’s OK to expect all of that!

Enter Branded Fish Oils!

Manufacturers of high quality fish oils like Ocean Nutrition, EPAX, Organic Technologies and Croda have begun branding their oils.

Think ‘Intel Inside.’

Ocean Nutrition’s oil is called MEG-3.
Croda’s oil is called PureMax.
Organic Tech’s is called AlaskOmega.
EPAX’s oil is called, well, EPAX.

You may not know these names or their brands. Yet. But these brands are made proudly in places like Norway, Canada or…Ohio. Yes, Ohio!

They have their own logos.

AlaskOmega Fish Oil
EPAX Fish Oil Made in Norway
meg-3 fish oil logo

Some fish oil products have started putting these fishy logos on their products. Look for it. At least it tells you that the oils were made to exacting and third-party validated standards.

Think Dell computer with that tiny Intel logo. Same thing.

If there’s no fancy logo…

…call the company that makes your fish oil pills and just ask.

Some will tell you the straight up truth. They may even show you proof of where it’s made.

Others may give you a coined answer like “Our product is sourced from various locations and it passes all mandated quality specifications.” That’s when you hang up the phone and keep looking for a better fish oil supplement.

EPA DHA Fish Oil Ohio Plate

DISCLAIMER: This website is for your education and general health information only. The ideas and suggestions contained on this website are not to be used as a substitute for medical advice, diagnosis or treatment from your doctor for any health condition or problem. Users of this website should not rely on information provided on this website for their own health problems. Any questions regarding your own health should be addressed to your own physician.

Author Vin Kutty is an expert on fish oil About the Author: Vin Kutty is OmegaVia’s Scientific Advisor and Chief Blogger. He is a nutritionist, author, and Omega-3 expert with over 20 years of experience. Email him.

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Is Your Fish Oil Made in China? Part 2

3 Ways to Tell!

chinese fish oil quote - Kansas City Star

See Part 1 here.

So what’s in your fish oil?

Is it made with Chinese fish oil?

And why does the bottle not say ‘Made in China’ if the fish oil pills were made in China?

It’s easy for supplement companies to find loopholes in labeling rules. And most do. In all my years in the dietary supplement industry, I have never heard of any supplement company getting in trouble for country-of-origin issues.

80 year old regulations

The laws governing country-of-origin declaration is 80 years old. It was put in place when Herbert Hoover was in the White House and when China was a poor farming society.

Things have changed.

Regardless, the law says where ever the products underwent ‘substantial transformation’ is the country of origin.

That’s a loophole big enough to drive a Hummer through.

Theoretically, if the pills inside the bottle cost $2, and the packaging costs $3, then wherever the bottle was packaged is where there was a ‘substantial transformation’ in value.

Chinese-made pills that are bottled and sniffed for quality in America = MADE IN AMERICA.

Interestingly, US Customs and Border Protection, not the FDA, is responsible for country-of-origin oversight. (Note to Feds: please don’t come a knockin’ – my cleaning lady is a US Citizen, I swear!)

A LOT of the fish oil pills sold in American drug stores, grocery stores and department stores are Chinese.

It’s very hard to say exactly what percent of the American fish oil supply is Chinese, but my guess is about a quarter to a third.

Kansas City Star Report

In a brilliant piece by Kansas City Star news paper (November 7, 2010. Industry groups consider pushing for country-of-origin labels on fish oil bottles, where I’m quoted), investigative reporter Steve Everly dug up all import records of fish oil capsules and found that about 20% of American fish oil products came from China.

And none of it was labeled as being from China.

At a recent industry trade show, a Chinese fish oil vendor tried to convince me to convert OmegaVia to their oil. Shockingly, he volunteered that two pharmaceutical grade fish oil brands that I’ve frequently recommended to customers use their oil! Say it aint so!

What about mixing-n-matching?

There is ABSOLUTELY NOTHING stopping a manufacturer from blending high-quality Canadian or Norwegian oil with barely-passing Chinese oil to ‘bump up the specs’ of the finished product.

It happens every day.

And it works like a charm.

Mix a few drums of expensive Norwegian oil with a lot of Chinese stuff…and you still get to market the product as ‘Made with Norwegian Fish Oil.’

Chinese oils could be 30% cheaper.

Fish Oil and Big-box Retailers

There are products sold at big retailers that could have Canadian oil in one lot and Chinese oil in another. As long as the ‘label claims’ (amount of EPA and DHA) and contaminant levels pass, everything is approved and shipped out.

In this case, it is not done to improve profits – when a retailer sells 10 million fish oil capsules every week, the manufacturer that supplies the retailer cannot be picky about where the oil comes from. It is a logistical nightmare to keep a large retailer stocked and supplied with such large volumes of fish oil, so some manufacturers buy oil or finished pills from anywhere they can.

If you buy a brand of fish oil at a very large retailer and decide to call the customer service number to figure out the country of origin of the oil, you will likely waste your time. It is unlikely that the customer service rep will know this information or be able to retrieve it easily.

3 ways to tell if your fish oil may be from China

  1. If you comparison shop based on price, and always pick the cheapest one, you’re likely buying Chinese fish oil.
  2. If you buy at retailers known for low prices, you’re increasing your odds of getting Chinese fish oil.
  3. If you buy private label (store brand) fish oil, chances are high that you have Chinese fish oil.

Chinese ingredients are cheap. Sometimes they are of very high quality and other times, well, you’ve heard about the recalls.

Using Chinese oil reduces cost. And increases profit.

That’s irresistible to any corporation that has shareholders to please.

So far, there’s been little or no harm done.

No major fish oil recalls.
No mercury poisoning.
No complaints of oxidized oil.

In Part 3, we will review what industry groups are doing to bring clarity to fish oil labels and some other tricks to figure out where your fish oil is from.

DISCLAIMER: This website is for your education and general health information only. The ideas and suggestions contained on this website are not to be used as a substitute for medical advice, diagnosis or treatment from your doctor for any health condition or problem. Users of this website should not rely on information provided on this website for their own health problems. Any questions regarding your own health should be addressed to your own physician.

Author Vin Kutty is an expert on fish oil About the Author: Vin Kutty is OmegaVia’s Scientific Advisor and Chief Blogger. He is a nutritionist, author, and Omega-3 expert with over 20 years of experience. Email him.

pharmaceutical grade fish oil

Filed under: Choosing the Best Fish Oil, Fish Oil Purity & Safety, Fish Oil Quality, Fish Oil Safety by Omegavia
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