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After recounting four fish stories that prompted my interest in omega-3s, I take you inside the biochemistry of omega-3 fats to help you appreciate how this marvelous molecule is made and why it behaves so beautifully in your body and brain. I also clear up the standard consumer confusion about fats, explain why and how to give yourself an oil change, and point out that the key to good health is not necessarily a low-fat diet but rather a right-fat diet.
The following stories tell about my search for a lifesaving nutrient and how discovering it enriched my health.
My passion for omega-3 research began with the birth of our eighth child. The story begins in 1991 with the pregnant teenage daughter of a close friend. Like many pregnant teens, she was struggling with the realization that she did not have the maturity to raise her child. Yet, giving her child up for adoption was an even more upsetting alternative—choosing strange parents from a stack of résumés, perhaps never seeing her child again, and always wondering if she’d made the right decision.
Sensing her struggle, my wife, Martha, and I offered to raise her child in open adoption, where she could choose to be involved on her own terms. She was overjoyed, as were her parents, and she thrived throughout the rest of her pregnancy.
Around that time studies had started to show what breast-feeding mothers had suspected all along: children who are breast-fed grow up to be smarter and healthier. We felt that just because Lauren was adopted, she shouldn’t be deprived. We began searching for the formula closest to mother’s milk.
After looking into the nutritional content of all the infant formulas, I discovered that every formula, especially those made in the United States, was missing vital brain-building omega-3 fats. The brain is 60 percent fat, and one of the top omega-3 fats in the brain is DHA. Hmm! Growing brains need special fats, yet infant formulas contained none. What’s wrong with this cerebral picture? In the end, the only choice was to find a way to give Lauren breast milk. We concluded that the best alternative to her mother’s milk was another mother’s milk.
When I made my case to one of the largest formula sellers in the United States, I presented a slide show of what I thought was compelling proof for why omega-3 DHA, the smartest fat in the brain, must be added to infant formulas. To my amazement and disappointment, the head number cruncher said, “It would not be profitable for us to add DHA to our formula at this time because it would cost the consumer thirty-five cents more a can.” Shocked, I pleaded, “I don’t know a parent in the world who would not pay thirty-five cents more a day for their baby to grow a better brain!” I lost my case.
One of the joys of being a pediatrician is what I call the helper’s high, the feeling that someone’s life will be better because of something you said or did. Vowing to get formula companies to upgrade their offerings, I teamed up with doctors and scientists who taught me about brain-building fats, and continued crusading.
Finally, in 2001, the FDA and the infant formula companies could no longer ignore the science, and today nearly all companies add omega-3 fats to their infant formulas.
Growing up Roman Catholic, I ate fish once a week. I thought I had to if I wanted to go to heaven. Yet what I ate were fish sticks and breaded fish sandwiches. Real seafood was not at the top of my list until April 1997, when I was diagnosed with colon cancer. Following major surgery, chemotherapy, and radiation therapy, I studied the data on survivors of major illnesses and life-changing events. Survivors had one thing in common: they made a project out of their problem. So that’s what I did. Because my problem was in my gut, I began to search for the healthiest foods. Why not make a project out of healthy aging at the same time I was searching for the perfect health food? I found that the food that was ranked as the best health food also got top marks for healthy aging—seafood. In fact, the same fats that were crucial for baby brains were also important for senior brains and bodies. From head to toe—brain, eyes, heart, gut, muscles, joints, and skin—seafood was the best food to help prevent all the ailments I didn’t want to get.
One of the earliest studies I discovered showed that cultures that eat more seafood have less cancer, especially colon cancer. In fact, these cultures have a lower incidence of just about every ailment of aging, like cardiovascular disease and many of the -itis illnesses, such as arthritis, bronchitis, and dermatitis. There was even emerging research suggesting these neuroprotective fats might delay Alzheimer’s disease, or what I call cognitivitis. In my life before cancer I was a hearty carnivore, habitually devouring grilled steaks. “Burn a big one” was my eating-out meat order. In my postcancer life I became a healthier kind of foodie, a seafood lover.
In order to learn more about omega-3 fats, I followed the advice I gave young medical students: “Surround yourself with wise mentors and have the wisdom and humility to learn from them.”
In June 2006 I had the opportunity to spend a week fishing in Norway with a Danish doctor, Jørn Dyerberg, who is deservedly known as the father of omega-3s. After hearing of his thirty-plus years of research, I came home not only motivated to eat more fish with my family but also to share this research with my readers and patients.
As a medical resident in 1970, Dr. Dyerberg was intrigued by this paradox: Inuits ate a high-fat, high-cholesterol diet but enjoyed a low incidence of cardiovascular disease. That didn’t fit with the conventional wisdom of the time, “Fat is bad for the heart.” So Dr. Dyerberg traveled to Greenland to study the Inuits in the hope of finding a clue to this medical puzzle. While traveling through the Inuit villages he observed that the natives had frequent nosebleeds. Many people have nosebleeds in the winter. Must be the dry air in those igloos, he reasoned. Not so fast!
“Their nuisance nosebleeds seemed to take longer to stop than I remember occurring back home,” he told me. When Dr. Dyerberg took blood samples from the Inuits, the tests revealed their bleeding times (the time it takes for blood to clot) were longer than the average bleeding times of Europeans. Could a high omega-fat diet cause thinner blood, he wondered? Many people on high-fat Western diets were dying of diseases related to blood that clotted too fast—at that time called the thick blood syndrome.
Dr. Dyerberg continued to try to piece together the puzzle of longer bleeding times and lower incidence of heart disease. Could it be that when blood is slower to clot, arteries don’t get plugged? Intrigued, he collected more blood samples from the Inuits and then, back at home, compared them with similar blood samples from the Danes. Here’s what he found:
Thinner blood, slower to clot
High blood level of omega-3 fats
Lower blood level of heart-unhealthy sticky fats
Very low rates of cardiovascular disease
A diet with much more omega-3 fat than omega-6 fat
Blood with balanced omega-3 and omega-6 fats
Thicker blood, quicker to clot
Low blood level of omega-3 fats
Higher blood level of heart-unhealthy sticky fats
High rates of cardiovascular disease
A diet with much more omega-6 fat than omega-3 fat
Blood with too much omega-6 fat and too little omega-3 fat
Dr. Dyerberg realized that compared to the Danes, the Inuits ate more omega-3s (found in fish oils) and less of their cousins, the omega-6s (found in factory-processed foods). Could there be a cause-and-effect relation here? Thirty years and over twenty thousand scientific articles later, the medical community had proved that one simple oil change could lower the rate of heart disease throughout the world.
Coincidentally, Dr. Dyerberg studied with Professor John Vane, who won the Nobel Prize for figuring out that aspirin worked by blocking the production of biochemicals that inflame the tissues. It’s interesting that Dr. Dyerberg had a theory, later proven, that fish oil could have a similar therapeutic effect by a similar mechanism.
Dr. Dyerberg believed, and subsequent research confirmed, that the high doses of EPA in the Inuit diet lowered the risk of coronary artery thrombosis by shifting the tendency for blood’s clotting too fast to clotting just right. When Inuits started eating like Americans, their blood began overclotting, and their rates of dying from cardiovascular disease became similar to the American rates. It’s alarming that the relation between higher dietary proportions of omega-3s and lower incidence of heart disease was known in 1970, but as of 2012 the United States still does not have an official government Recommended Daily Intake (RDI) for omega-3s.
A year after our 2006 fishing trip and twice again in 2011, I had the pleasure of hosting Dr. Dyerberg at our home for the traditional Sears salmon-at-sunset dinner, where we caught up on the latest in omega-3 research and more fish stories. At one of our dinners I asked him to tell me more about his challenges in getting his discovery accepted by his medical colleagues.
When he studied blood platelets—those blood cells that bunch up and stick together—the Inuits’ platelets contained a much higher proportion of omega-3s compared to the Danes’, and their bleeding times were nearly twice as long. Dr. Dyerberg believed that the high proportion of omega-3 EPA fat in the Inuit diet shifted the blood to a slower-to-clot state and that the difference could help explain why the Inuits suffered fewer heart attacks.
Dr. Dyerberg went on to publish more than three hundred scientific articles on the health benefits of omega-3 fats. But these good fats had a public relations problem. The information about the good they do for bodies and brains lay hidden in journals that were not found in supermarkets. Finally, in the late 1990s, the popularity of omega-3 fats soared as top doctors began prescribing them as “medicine.” All those -ologists started to use omega-3 EPA/DHA fats and saw that they were good. The cardiologists saw how much they helped hearts stay healthy. Ophthalmologists saw that they were good for the eyes. Neurologists saw how they built smarter brains. Gastroenterologists saw they were good for the gut. Rheumatologists found that they helped alleviate arthritis, and dermatologists discovered that omega-3 EPA/DHA improved the skin. The list of medical problems alleviated by eating more omega-3 EPA/DHA is even longer.
Much of this book was written under the influence of the omega-3 effect during my four lecture tours of Japan, the country with one of the highest per capita rates of seafood consumption and healthiest longevity. In Kyoto, Japan, in 2001 I was invited to speak about family health issues. Before the talk our host announced, “We will take you and Mrs. Sears out for a medicine meal.” While I seldom eat a big lunch before giving a talk, it would have been rude to refuse. At the restaurant we were served a traditional meal, consisting of fifteen strange-looking small dishes, which our interpreter translated as “seafood and edible sea plants.” Our host announced, “It’s a Japanese tradition to feed visiting professors this medicine meal before their lecture. We find they give a better talk.”
About an hour after my omega-3 overload, I felt the first effect—satisfied but not uncomfortably full. My lecture was in a hall adjacent to a famous Buddhist temple. After being escorted to the stage by the resident monk, I was amazed by the words that came out of my mouth. I experienced a level of alertness and eloquence that took me by surprise. Afterward Martha said, “That was your best talk yet.” Those good gut feelings, together with a high cerebral alertness and mental peace, lasted several more hours. On three subsequent visits to Japan, I experienced similar omega-3 effects after prelecture medicine meals.
Want your body to be in biochemical balance?
Want your brain to be smarter?
Want to feel happier?
Want your vision to be sharper?
Want your heart to be stronger?
Want your skin to feel smoother?
Want your pregnancy to be healthier?
Want your breast milk to be more nourishing?
Want your children to grow smarter and healthier?
Want your loved ones to live longer?
If you want any or all of these health perks, you want the omega-3 effect.
This chapter explains what omega-3s are and why they are so good for you.
Imagine you gather a group of people together to form a health club. In this club are people who already have ailments and want to reduce medication dependence. Also in the club are people who are well but don’t want to wait until they get sick before they take care of themselves. They simply want to make their brains smarter and their bodies stronger, and to feel better and happier. Last, there are young parents or parents-to-be who plan ahead and want to give their children the best intellectual and physical start in life.
All of you decide to find the Top Doc in the world to give you the best science-based medicine to heal your hurts, prevent illnesses, and help your families thrive. I love that term thrive. It means being the healthiest you can be emotionally, intellectually, and physically.
You charter a plane and fly across the world to make an appointment with the Top Doc in preventive medicine. You enter the office and tell Top Doc why you’re there and what you want. Top Doc hears your request and pleasantly surprises you: “I’ve got just the right medicine that all of you have come searching for.”
You’re all imagining what this marvelous medicine could be. To add to your surprise, you don’t see Top Doc reaching for a prescription pad. Instead, she reaches into a drawer and hands you a fish. She reaches into another drawer and hands you a bottle of fish oil.
Top Doc’s “prescriptions” receive mixed reactions. Most are amazed, some are confused, some even incredulous. Some wonder why they traveled all this way to get a fish and a bottle of fish oil.
To calm their anxiety, Top Doc says, “I sense your confusion. When you came here you gave me a list of your ailments and your wishes, and challenged me to help heal your hurts. Some of you have early Alzheimer’s disease. Others suffer from poor vision. Many of you have arthritis or some other -itis. Many have cardiovascular disease. A few have diabetes. Many of you have mood disorders. And I see there are a few expectant and new moms here who simply want to raise smarter and healthier babies. You asked me for the most scientifically researched, safest medicine for all these needs, and that’s what I’m giving you. My medicine is certainly not instead of the prescription drugs your own doctor recommends, but it also is very well researched.”
Sensing the sincerity in this doctor’s voice, the eager crowd upgrades their impressions from “something is fishy here” to “I’m glad we consulted this Top Doc!”
Sound farfetched? Here are quotes from some of the Top Docs whose advice I trust:
—Mehmet Oz, MD
As a doctor, I believe omega-3s are one of the rare magic bullets in medicine.
—Surgeon General Richard Carmona, at a Nutrition for Warfighters Conference
Because of omega-3 deficiency in our troops they are at increased risk of physical and psychological illnesses. We want our troops to benefit from this new omega-3 science.
Because more misinformation is circulated about fats (also called lipids) than about any other nutrient, here’s a slim course on fat terms you should know. If your brain could vote, it would pick fats as the most important nutrient. The heart would second that.
Unsaturated Fats. On the fat molecules are empty areas; let’s call them parking spaces. When there is plenty of room to park, these fats are called unsaturated. If lots of spaces are unfilled, the fat is called a highly unsaturated fatty acid (HUFA). HUFAs are the healthiest fats because they are liquid, smooth, soft, and flexible. In fact, because they are so flexible, they become liquid and are called oils, namely, the omega oils.
Biochemically speaking, these parking spaces are called double bonds. These double bonds are the usual areas that other chemicals attach to, either naturally or put there by food chemists. If oxygen attaches to these double bonds (“oxidize”), they spoil or turn rancid. Think of fish exposed to air. If they are zapped with hydrogen molecules (e.g., trans fats or hydrogenated oils), they get stiff but don’t spoil. If they stay the way nature intended (neither oxidized nor hydrogenated), they remain healthfully soft, elastic, flexible, and adaptable.
Saturated Fats. Along come cars (hydrogen molecules) that fill some or all of the parking spaces. The more parking spots that are filled, the more saturated the parking lot fat molecule becomes. Because these parking spots are filled, the molecule becomes stiff. Like HUFAs, these saturated fats are healthy building blocks for tissues that require some stiffness, such as the myelin of the brain. As long as the HUFAs and saturated fats are eaten in the right proportions, the tissue is healthy.
Hydrogenated Fats. Along comes an unscrupulous builder who decides to change the normal configuration of the parking spaces from natural to unnatural (resulting in trans fats, meaning the molecule is chemically crossed up), and the parking spaces are zapped with hydrogen cars (hydrogenated fats). This chemical mischief makes the fat molecule so stiff and sticky that other cars (e.g., oxygen) won’t park there. So the parking lot stays the same (hydrogenated fat sits on the shelf and doesn’t spoil for years).
Tissues love HUFAs because they act like a multipurpose building material, changing shape to become whatever growing and healing tissue needs.
Let me introduce you to the omega-3 fish oil medicines. I use the term medicine to mean any chemical, food, herb, or spice that helps your body heal and be healthier. This could be a prescription pill or a nutrient in food. Remember, one of the most famous medical doctors, Hippocrates, called food “medicine.” My favorite medicine is omega-3 fish oil. And the good health omega-3s give you I call the omega-3 effect. Omega-3s are the safest, most healing and health-producing medicines that I prescribe.
You can tell a lot about how fats will behave in your body by how they appear in food. Some fats are stiff, like lard and the marbling in steak. When you eat them, they behave the same way in your body, making your arteries stiff. Older folks (and even kids) get hardening of the arteries after years of eating stiff fats. What makes omega-3s so healthful is that these fats act as fluidly in your body as fish swim in the sea. Omega-3s keep your tissues soft and smooth.
A fat molecule is like a necklace. Each bead on the necklace is a carbon atom. There are also flexible areas on the molecule called double bonds, which bend like hinges. In general, the longer the necklace, and the more carbon atoms and hinges the molecule has, the more flexible and healthful is the effect of the fat in the body.
A necklace whose beads are held together by string is softer and more flexible than a necklace made of wire, which is stiffer and can’t bend as well. Fat molecules whose hinges bend easily are called unsaturated. Fat molecules with stiff hinges are called saturated because hydrogen atoms fill up (saturate) the double bonds, making them stiffer. Some saturated fats have no hinges at all.
Omega-3 EPA/DHA (“the tall guys”) have more carbon atoms (20–22 atoms) and more hinges (5–6 double bonds) than fats like ALA (the “short guys”), with 18 carbon atoms and 3 hinges.
Remember, health and wellness means having soft and smooth tissues. Illness is usually caused by stiff and sticky tissues. This is why, when doctors talk about the biochemical basis of disease, they say, “The tissue is the issue.”
In the body omega-3s are known as quick-change artists. They can change shape and quickly become whatever your tissue needs them to be for growth, function, and repair. The flexible hinges on omega-3 molecules help them assume all kinds of unusual shapes and wriggle into whatever part of the tissue needs more omega-3s.
Omega-3s are so named because omega is the last letter of the Greek alphabet, and most of these fats’ healthful qualities are at the tail end of the molecule. The 3 refers to a soft spot (double bond) like a hinge, on the third carbon atom from the end. This hinge makes the molecule soft and flexible.
More omegas will probably be discovered in the future, but the following ones are the most popular omegas that you should know about now.
Found in plants like salad greens and in seeds like flax and canola, ALA is the most abundant omega-3 fat in nature. It is a “short guy” in that it has only 18 carbon atoms and 3 hinges. Since, for tissue health, the body and brain prefer “tall guys” (like the omegas EPA and DHA), the body must use enzymes to convert ALA to EPA and DHA. Enzymes are the body’s micromechanics that convert ALA into EPA and DHA, fashioning them into the tissue the body needs to grow and repair. Conversions like these are very inefficient. Only 1–4 percent of the omega-3 ALA oils you eat may be converted to EPA and even less to DHA. People vary in how well their individual biochemistry can convert ALA into EPA and DHA. (See more about ALA conversion in flax oil, page 164.)
This “tall guy” omega-3 molecule, found mainly in seafood, has 20 carbon atoms and 5 double bonds. (Its name, of Greek origin, reflects this: eicosa, 20; penta, 5; enoic, refers to double bond.) Like other omega-3s, EPA has its first hinge third from the end of the molecule. It has more hinges and carbon atoms than ALA and is therefore more flexible.
Also found mainly in seafood, this “tall guy” omega-3 has 22 carbon atoms and 6 double bonds (docosa, 22; hexa, 6). Like EPA, it is a HUFA, or highly unsaturated fat.
Most of us need to eat more of these three amigos, ALA, EPA, and DHA.
Excerpted from The Omega-3 Effect by William Sears Copyright © 2012 by William Sears. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Meet the Experts xi
Introduction: Fishing for the Omega-3 Effect 3
Part I What You Need to Know about 0mega-3s: Science Made Simple 7
Chapter 1 Four Fish Stories 9
Out of the Mouths of Babes
Cancer Caused Me to Care
Inuits Don't Get Heart Disease
My Medicine Meal
Chapter 2 What Are 0mega-3s and Why Are They So Healthy? 18
Let Omega-3s Be Your Medicine
Know Your Omegas
Omegas Are Membrane Molecules
The Differences in Fats
Give Yourself an Oil Change
Understanding Omega Balance
The Omega-6 Bully Effect
Omega Questions You May Have
Part II The Head-to-Toe Healing Effects of 0mega-3s 39
Chapter 3 How 0mega-3s Help Your Heart 41
How the Omega-3 Effect Cares for Your Heart
Meet Dr. NO
Keep Your Pharmacy Open
The Tale of Two Fats
Heart Health Questions You May Have
Chapter 4 How 0mega-3s Build Smarter Brains and Better Moods 62
Omega-3s Are Smart Fats
Omegas Build Better Brain Cells
Omega-3s Are Membrane Molecules
Omega-3s Make Myelin Work Better
Omega-3s Feed Brain Messengers
Omega-3s Improve Vision: Seafood Is See Food
Omega-3s Are Mood Mellowers
Eat More Omega-3s, Handle Stress Better
An Upset Immune System May Cause an Upset Mind
Omega-3s Help Prevent Alzheimer's Disease
Neurological Questions You May Have
Chapter 5 How 0mega-3s Help Childhood Ds 85
To Read, Write, Spell, and Behave Better, Go Fish!
How Omega-3s Help Learning and Behavior
Fish Stories of School Success
Omega-3 Questions You May Have
Chapter 6 Enjoy the Omega-3 Effect during Pregnancy and Your Child's Infancy 98
Omega-3s Promote Healthy Pregnancies
Omega-3s Make New Moms Happier
Omega-3s Make Baby Brains Brighter
Omega-3s Make "Smart" Breast Milk
Common Questions Pregnant Mothers Have
Chapter 7 How Omega-3s Help -itis Illnesses 110
Are You an iBod?
The Concept of Inflammatory Balance
Omega-3s Are Natural Anti-inflammatories
HowOmega-3s Balance Inflammation
Omega-3s Help Build Healthier Skin
Inflammation Questions You May Have
Chapter 8 How Omega-3s Help You Lose Weight 124
What Fats Make You Fat?
Eat More Fish, Get Less Fat and Less Sick
Seafood Is More Filling, Less Fattening
Weight Loss Questions You May Have
Chapter 9 How Omega-3s Help Keep You Young 131
Why We Age: Science Made Simple
For Longevity, Go Fish!
Healthy Aging Questions You May Have
Chapter 10 How Omega-3s Help You Heal 139
Traumatized Tissues Healed Faster
Brain Surgery Healed Faster
Brain Trauma Healed Faster
Omega-3s: Nutritional Armor for the Military
Medical Questions You May Have
Part III Selecting Fish Oil Supplements and Enjoying Safe Seafood 149
Chapter 11 Getting the Most Omega-3 Effect out of Omega-3 Supplements 151
How Much Omega-3 Should Healthy People Eat?
How Much Omega-3 for Various Illnesses?
Dosage-Selecting Questions You May Have
Chapter 12 Selecting and Preparing Safe Seafood 173
Farmed Fish Can Also Be Health
Serving Safe Fish to Kids
Seafood Questions You May Have
Appendix A What Science Says about Omega-3 EPA/DHA's Healthful Effects 197
Appendix B Helpful Chart for Selecting Safe Seafood 199
Appendix C Average Nutrient Profile of Salmon 202
Omega-3 Resources 204
Posted August 29, 2012