Liz - On the topic of Omega 3 Essential Fatty Acids... following are clips from past posts gleaned from my notes when I attended a seminar segment presented by Barry Sears, PhD... who hardly can be classified as a "so-called nutrition doctor" ...
see his Bio and CV at these weblinks
Bio [
www.drsears.com]
CV [
www.drsears.com]
But first… read this recent response by Mark Hyman, MD to the report you are probably referencing:
Can Fish Oil Cause Prostate Cancer?
by Mark Hyman, MD
Whenever a newly published health study challenges current thinking, you can bet it won’t be long before the news media starts ratcheting up the drama and jumping to conclusions. This is true of a recent study called “Plasma Phospholipid Fatty Acids and Prostate Cancer Risk in the SELECT Trial,” published in the July 2013 issue of the Journal of the National Cancer Institute. This study suggests a higher risk of prostate cancer among men who eat omega-3 fatty acids, such as those found in fatty fish like sardines and salmon or in fish oil supplements.
Because I encourage my patients and readers to get plenty of omega-3s, I want to respond to these reports and offer my answer to the question they’ve raised: can fish oil cause prostate cancer? But first, let’s examine the findings.
What the Study Found
The study, which was conducted at the Fred Hutchinson Cancer Research Center in Seattle, WA, claims a link between increased blood levels of omega-3 fatty acids and increased incidence of prostate cancer. The highest blood plasma levels of these polyunsaturated fatty acids, specifically EPA, DHA and DPA, were associated with the highest risk. The research also showed that higher levels of linoleic acid (or omega-6 fatty acids, which most Americans eat too much of) were actually associated with a lowered risk. This would suggest that the more fish or fish oil a man included in his diet, the greater the chances he would develop prostate cancer. It would also mean that increasing his omega-6 fatty acid intake would be a good idea.
So, have I led you astray by telling you to eat your fatty fish and limit your intake of processed vegetable oils that contain omega-6 fatty acids? Should I warn you against taking fish oil and instead tell you to eat more cottonseed and sunflower seed oils? Let’s look at the facts and decide.
A Closer Look at the Study
This study used what is called a retrospective case controlled cohort design. Simply put, to make their conclusions, researchers from the Fred Hutchinson Cancer Research Center used data from a previous study conducted in 2011 called the SELECT (Selenium and Vitamin E Cancer Prevention Trial). It’s important to note that the original SELECT study did not have the same objective as this current one. It wasn’t designed to determine whether fish oil led to prostate cancer. The fact that both studies didn’t have the same goal calls into question whether the old data is even relevant to the new study.
What we can be sure of is that association does not prove cause and effect. If this had been an intervention design study, where half the participants got fish oil and half didn’t and they were followed for 20 years to see if they got prostate cancer, then you can say pretty definitively that they are connected. Bottom line, this type of study does not prove cause and effect. If I did a study on sunrise and humans waking up, I would find 100% correlation, but that doesn’t mean that the sun came up because you woke up. Correlation, yes; causation, no.
Another problem with the study is that the researchers did not address whether the men who were studied got their omega-3 fatty acids from eating fatty fish or from taking supplements. Also, there was no regard for their health status before starting the study. Did they start using fish oil as a therapy once diagnosed with prostate cancer or had they been taking it all along?
And what about the myriad other factors that can lead to the onset and progression of cancer, such as how lifestyle affects genetics? Smoking, nutrition, exercise, environmental toxicity, stress: none of these things were taken into account. It is too simplistic to reduce a disease as complex as cancer down to one trigger. In fact, perhaps we should be asking if these men were exposed to toxins and heavy metals from eating mercury-containing fish, which can cause cancer. Or did the men smoke or drink to excess? Was there a history of cancer in the family? What was their personal health history prior to diagnosis? Were they overweight or obese, and did they have other symptoms of diabesity?
Another major flaw with this study’s design involves the way the researchers got their data. They analyzed blood plasma instead of red blood cells. And they did so with one single blood draw! The conclusions would have been stronger and more reliable had they used red blood cell samples, because those provide a more accurate assessment over the long term (plasma tends to provide only a short-term picture). Because the research was based only on samples of a single blood draw, the red blood cell analysis would have given a better picture of long-term omega-3 intake (a couple months of eating salmon, for example, instead of what happens in the body after a single meal). That’s why I suggest people use the omega-3 index test, which measures levels from within the red blood cells.
Consider the Japanese
If it is true that taking fish oil or raising your blood levels of omega-3 phospholipids increases risk for prostate cancer, then why hasn’t this been a problem for Japanese men? They certainly eat their fair share of fatty fish and have done so for generations! The Japanese (and other fish-loving cultures) have been studied many times to test this hypothesis, and guess what? Males in Japan, while having some of the highest levels of EPA and DHA, also have some of the lowest rates of prostate cancer. Only in the most recent studies have Japanese men been shown to have an increase in prostate cancer. Could it be that, as the Japanese begin to abandon their traditional diet of fish, seaweed, and other sea vegetables for the typical SAD (standard American diet, high in saturated fat and linoleic fatty acids), their risk of prostate cancer rises?
It seems that for every claim against fish and fish oil, there are several studies that confirm their benefits. One study, Consumption of Fish Products Across the Lifespan and Prostate Cancer Risk, showed that high blood plasma phospholipids was protective against prostate cancer when fish oil was consumed. Another study showed that omega-3 fatty acids protect against death caused by prostate cancer. And what about the effect of fish oils on the outcome of prostate cancer in men with elevated PSA levels? Again, the literature shows that EPA and DHA have no negative effect.
Personalized Medicine
It’s important to stop and remember that each person has a unique inner ecology and external environment. Contributing factors, such as exposure to environmental toxicity, poor nutrition, and other lifestyle variables, as well as genetics, all play a role in the development of cancer. It’s a complicated disease, and it would be a good idea to pause and look at the whole picture before drawing any major conclusions.
The simple fact is that countless studies have proven the health benefits of eating a diet rich in antioxidants and fiber from fruits and vegetables. And just as we all know that eating your veggies is good for your health, we are now beginning to prove similar health benefits from including healthy fats in your diet. (For more information on how to increase your intake of healthy fats, please see my discussion here). We also know that limiting omega-6 fatty acids and increasing omega-3 fatty acids has been shown to reduce the risk of diabesity in Western cultures.
So, before we toss good medicine aside, we need to examine carefully the factors that contribute to imbalances in the body. We need to assess what we do know and keep asking questions about what we don’t.
We know that a whole foods-based diet, rich in fresh, nutrient-dense fruits and vegetables, healthy fats, and lean protein, does make a positive difference in health outcomes. We know that high-quality, purified fish oils are best. We know that a balanced and varied diet is key for maintaining good health. And we know that moderation is the key to a healthy and sensible relationship to food. Any diet or program promoting an extreme is not realistic, sustainable, or even remotely healthy. Remember, the “dose makes the poison,” so just the right amount—and not too much—will allow you to reap the intended benefits. In the case of fish oil, 1-2 grams daily is appropriate for most people, though some of you may need more. I strongly suggest you work with a trained functional medicine practitioner to help you determine the appropriate doses you need, not only for fish oil but for all supplements. My nutrition coaches are here to help you transform general guidelines into personalized solutions.
So, where do I stand on whether fish oil causes prostate cancer? I’ll be eating sardines in my salad for lunch tomorrow, and I’ll be taking my daily fish oil supplement with my dinner tonight. And I hope you will be too!
Now, I’d like to hear from you…
Have you been swayed by recent reports to feel that omega-3s can cause prostate cancer?
Will you limit the amount of omega-6 fatty acids you consume?
What are some of your favorite ways to include fatty fish in your diet?
To your good health!
Mark Hyman, MD
About Mark Hyman, MD
Mark Hyman, MD, believes that we all deserve a life of vitality—and that we have the potential to create it for ourselves. That’s why he is dedicated to tackling the root causes of chronic disease by harnessing the power of Functional Medicine to transform healthcare. He is a practicing family physician, an eight-time #1 New York Times bestselling author, and an internationally recognized leader, speaker, educator, and advocate in his field. He is the Director of the Cleveland Clinic Center for Functional Medicine. He is also the founder and medical director of The UltraWellness Center, chairman of the board of the Institute for Functional Medicine, a medical editor of The Huffington Post, and has been a regular medical contributor on many television shows including CBS This Morning, the Today Show, CNN, The View, the Katie Couric show and The Dr. Oz Show.
Source: [
drhyman.com]
=====
Following are clips from past posts from the Sears’ presentation….
Omega 3's are important for the antiinflammatory properties and to help maintain the integrity (flexibility) of the outer cell wall or envelope.
In the book by Omega 3 expert, Barry Sears, PhD - The Anti-Inflammatory Diet... there are references to dosages indicating with the supervision of a physician, doses of 9 grams a day help with psychological disorders. A minimum is 2 grams a day - 4 grams is better and if you are treating damaged cell walls, then 6 grams a day for 3 - 4 months is appropriate.
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From a 2011 post:
Jackie
Re: Omega-6/Omega-3 ratio
Josiah - the preference is to have much more Omega 3's than 6. So, that typically means supplementing. Lots of opinions out there on this topic but every seminar I've attended emphasizes the n3's.
Barry Sears, PhD is well known for his research into healthy fats. His Zone books are memorable. The Antiinflammatory Zone was out about the time I attended an Anti-Aging convention where he spoke... this was in 2004... following are my notes which may help you sort this out because he gives the reasons why the 3's are healthy and too many 6's are not.
There may be refinements to this thinking some seven years later, but the majority of it is the basic science behind the Omega 3 story. I hope it is useful. (I can post the Sinatra notes, Fire in the Heart, if that's of interest because he goes into more detail.)
Jackie
Ready for another segment?
This is from the A4M convention this section was on Treating the Difficult Patient
There was one group of presenters talking on Inflammation. I sat in on Barry Sears, PhD ( of "The Zone" fame) and the last portion of Stephen Sinatra, MD. Dr. Sinatra gave an abbreviated version the handout Ive reproduced for you here. Its like a mini book
loaded with nuggets of importance and was originally presented at another conference. I was elated to find it in my handouts.
Thought you like to print it for reading at quite times over the holidays. Food for thought, for sure. Motivation for making new resolutions for the coming year.
Happy Reading! Jackie
Dr. Sears talk was Does Silent Inflammation Make Medicine an Art instead of a Science? Dr. Sinatra covers this in detail below so I’ll only give you some nuggets from Dr. Sears and leave the rest to your reading.
Dr. Sears New Book - " The Anti Inflammatory Zone" is one to consider owning.
He emphasized that testing for the ratio of Arachidonic Acid (AA) and EPA is the most precise marker of Silent Inflammation (SI) it is a predictor decades before diseases manifest. Early detection and prevention.
For inflammation as in the case of NSAIDS using the correct dosage is critical. He says that as many people die from side effects of NSAIDS as from AIDS.
We must practice dietary endocrinology Glucagon is the Mobilizing Hormone; Eicosanoids are master hormones. Anti-inflammatory diets control Eicosanoids.
Everyone should be checked for fasting Insulin. Average is 10 and idea is less than 5. If elevated, people have a 5-fold increase of likelihood of dying from heart disease.
We must lose fat. Fat cells generate inflammation. Obesity has produced an epidemic of inflammation.
Pediatric concerns indicate higher BMIs and equivalent higher CRP (inflammation marker)
Elevated insulin increases hunger.
The best diet is a balanced diet (Dr. Sinatra discusses below) because too much protein increases ketosis which increases cortisol which increases insulin.
The brain needs adequate blood glucose and if you don’t put complex carbs in the diet, the body breaks down muscle to get glucose.
He said the Zone Diet to control insulin is easy. Cut back on grains and starches. Look at your plate. the low-fat protein portion should be no bigger than the size of your palm and no thicker. The rest of the plate should be filled with veggies and fruits and a small quantity of monosaturated fat..
Insulin and EPA - EPA is an inhibitor.
We need to avoid making Acharadonic Acid this is most toxic. Inhibit Cox enzymes with high dose EPA fish oils.
[aside:
1. Omega-3 fatty acids reduce inflammation, omega-6 increase inflammation.
2. Omega-3 fatty acids are antithrombotic, omega-6 increase blood clotting.
3. Omega-3 are non-immunoreactive, omega-6 are immunoreactive.
Flaxseed oil contains alpha-linolenic acid but no EPA and DHA.
Fish oil contains primarily EPA and DHA ]
He says fish oils act the same as statins.
One of the most well known studies, the GISSI-3 {Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardio (GISSI)-Prevenzione}, in which 11,324 people were given 1gram of omega-3 fatty acids or control for 24 months. This large study showed that persons given omega-3 fatty acid supplements had a 45% decrease in risk of sudden cardiac death and a 20% reduction in all-cause mortality.
[GISSI-Prevenzione Investigators. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 1999;354:447-55. ] [www.ajcn.org]
Fish oil crosses the Blood Brain Barrier.
In Bipolar cases people given 9 grams fish oil a day showed 500% improvement. This is close to a medical miracle. In the Omega 3s the EPA is anti-inflammatory and the DHA supports the brain.
He says use fish oil rather than eating fish. All fish are contaminated they eat from the "sewer of the sea".
Daily Dosing: Total EPA/DHA Omega 3 Fish oil.
2.5 grams for Wellness Omega 3 and a TBS of cod liver oil
5 gms daily to improve heart function and if diabetic
7.5 grams to reduce pain and inflammation
10 - 25 grams for neurological diseases.
Fish oil has no impact on Coumadin. He says studies up to 16 grams a day show anti-clotting action the same as 1 aspirin a day.
We must test for AA/EPA ratio. which should be 1.5 and 3 respectively.
Called Isolated Plasma Phospholipids.
To use fish oils in elevated doses, it is important to do testing. This is not a guessing game. It will take 7 - 14 days to make a biochemical difference and this is a lifetime commitment the taking of Omega 3 fish oils.
Borage oil is a toxic nutrient as it goes right to AA - the very thing we are trying to avoid.
Lancet Eskimos haemorrhagic stroke study[journals.cambridge.org]
End of Sears notes