Copyright 2001 Krispin Sullivan, CN Updated: April 07, 2016
Omega-6: Any of the fatty acids in the omega-6 family, short or long-chain. Also designated as n-6. These fats are polyunsaturates with multiple double bonds beginning on carbon 6.
Linoleic Acid: Short-chain omega-6 fatty acid also designated by LA. Can be converted into arachidonic acid.
Arachidonic acid: Long-chain essential omega-6 designated AA
Docosapentanoic Acid: Long-chain omega-6 designated DPA (displaces DHA in the brain- not a good thing)
Omega-3: Any of the fatty acids in the omega-3 family, short or long-chain. Also designated by n-3. These fats are polyunsaturated with multiple double bonds beginning on carbon 3.
Linolenic Acid: Short-chain omega-3 fatty acid designated by ALA or LNA or alpha linolenic acid. Can be converted into EPA and DHA.
Eicosapentanoic Acid: Long-chain essential omega-3 designated EPA
Docosahexaenoic Acid: Long-chain essential omega-3 designated DHA. The most important fatty acid for brain function.
Monounsaturated Fatty Acids: Fats containing one double bond on carbon 9. Designated omega-9 or n-9 or oleic acid.
Saturated fats: Fats with no double bonds. They can be short or long-chained. They are ubiquitous (in all life). Several are critically important to health and may be anti-viral and anti-bacterial. Natural saturated fats are stable to heat and light and safe for higher heat cooking. They do not oxidize readily.
Trans-fats: Trans-fatty acids are created when seed and grain oils are processed such as in the making of margarine and the hydrogenated fats used in most processed foods. Trans-fats also occur in vegetable and grain oils when they are heated.
Seed and grain oils: Corn, soy, safflower, sunflower, sesame, cottonseed, canola, walnut, peanut, flax,
Fruit oils: Olive, avocado.
Fatty acids play critical roles in human health and disease. Cell membranes (all cells) are composed of a double layer of fats. Your brain is about 60% fat. The fats you eat strongly influence the ability of your cell membranes, especially brain and nerve cells, to function.
Cholesterol is an alcohol, not a fat. Natural saturated fats are found in all foods to some degree. Saturation of a fat may be natural or from processing as is done to make margarine solid. Naturally occurring saturated fats are not associated with disease unless they are imbalanced by inadequate intake of the polyunsaturate essential fatty acids, especially the omega-3 fats.
Omega-3 fatty acids, DHA and EPA, are essential to brain and nerve function. In cell membranes they enhance cell response (to insulin, neurotransmitters and other messengers), and facilitate repair when cells are damaged. Omega-6 fats contribute to membrane resistance, altering mood, insulin response, learning and cell repair in a negative way.
There is a chart located on the end of this report showing the list of fat types and other charts showing fat types in foods. You may use this as a reference guide.
Some anthropologists believe the human brain would not have developed as it did without access to high levels of DHA found in fish and shellfish and to a lesser degree in wild game. Just two generations of high omega-6 and low omega-3 can lead to profound alterations in brain size and brain function in animals and probably in man. Other anthropologists believe that the human brain formed as it is today, large in proportion to body size, and that its capacity is being diminished as the diet becomes deficient in omega-3 fats. A relative omega-3 fatty acid deficiency can be created by an overabundance of omega-6 fats; a lack of omega-3 fats; alcohol consumption; or the consumption of trans-fats. All of these conditions have been dramatically increasing in occurrence in the US over the past 50 years.
Breast milk contains DHA and EPA, equivalent to amounts present in the mother's diet (what mom eats is critical). Formula contains no omega-3. Raising children on formula or mother's milk deficient in omega-3 fatty acids contributes to impaired visual development, poor spatial development, slower learning, decreased comprehension and early allergies and asthma.
A building body of research is showing the critical importance, to our current health and our children's health, of reducing the amount of omega-6 fats in the American diet while increasing intake of omega-3 fatty acids. I have suggested the use of butter, coconut and olive oil for many years and this recommendation continues. An additional change in fat intake should include identification and elimination of all added omega-6 fats while omega-3 fats need to be sought out and their intake substantially increased. To do this you will need to avoid as much as possible all vegetable seed oils. Do not use sunflower, corn, soy, safflower, canola, or products that contain these oils. That is, no hydrogenated or partially hydrogenated fats, no margarine, no vegetable oil of any kind, no shortening.
Acceptable oils are extra virgin olive oil and avocado oil in moderate quantities. Interestingly these are fruit oils. High oleic (omega-9) safflower or sunflower oils are also acceptable. Natural (non-hydrogenated) saturated fats are NOT a problem. Use butter, coconut oil, palm oil and non-hydrogenated lard as desired, also in moderate amounts.
Fats in natural foods are never composed of a single type of fatty acid. Coconut oil has polyunsaturated fats and olive oil has saturated fat. In nature fats are always mixed. Even fish oil contains saturated fat and cholesterol.
Do not worry about naturally occurring cholesterol in fish, eggs or lean meats. Do not worry about total fat intake as long as it is from actual food, whole-fat milk, real butter, the fat naturally found on wild caught fish, free range poultry and grass fed beef or pastured pork. The change to concentrate on is reducing ADDED FAT, eliminating as much omega-6 added fat as possible. Do your best to avoid all obvious omega-6 fats. If you suffer from elevated cholesterol it is even more important that you increase your omega-3 fats and avoid omega-6. Keep your total fat grams, from food and added, to about 30% of total calories.
Between 1903 and 1998 added fats rose from 34 pounds per person per year, mostly butter and lard, to more than 66 pounds per person per year. All of the fat increase was in the form of omega-6 as salad dressing, margarine, shortening and hydrogenated fat added to processed foods and candies. See the charts that follow.
The ratio of omega-6 to omega-3 in the U.S. diet is somewhere between 25-50:1. The ideal ratio is somewhere between 4:1-1:1.
To correct this imbalance you will need to avoid added omega-6 fats and add fatty fish 3 or 4 days a week, minimum, making sure to eat the skin and fat under the skin. Remember, the fish should not be cooked with an omega-6 fat (vegetable oil or margarine) nor dipped in mayonnaise, also an omega-6. The one exception is Saffola Mayonnaise, high oleic containing mostly omega-9 fatty acids.
If you are not eating fatty fish such as mackerel, sardines, salmon, daily, including the skin and fat under the skin, you will need to use fish oil supplements to equal 10-15 grams of fish fat containing 3-5 grams of combined DHA-EPA per day (equivalent to about 1-2 tbsps. of fish oil).
Fish oil can be taken with or without food. Many clients find that there is less reflux when taken on an empty stomach. If you have a sensitive stomach do not take all of your fish oil at once. Split your daily amount into two or three doses. Do not take any after 5 PM if you find the fish oil very energizing as it may disrupt your sleep. If digestive upset occurs stop until things normalize and increase slowly or stick with a lower dose. If you use the soft gels, keeping them in the freezer will keep your oil fresher AND it seems to prevent gastric distress.
The maintenance dose of fish oil is 2,000-3,000 mg of combined DHA-EPA depending on diet, genetics and body size. 3 grams of combined DHA-EPA is found in 10 of the Costco Fish Oil or 4 of the Now Foods Ultra Omega-3.
The best source of omega-3 fish oil I have found is the Kirkland Signature Omega-3 Fish Oil Concentrate 1,000 mg from Price-Costco. It is the freshest (due to high product turnover), good quality, free of heavy metals and contaminants and a great price, 400 soft gels for $11.50, a 40 day supply (10 a day to get 3,000 mg EPA/DHA). Each soft gel contains 300 mg of omega-3 fatty acids per each 1,000 mg soft gel. Now Foods Ultra Omega-3 contains 750 mg of combined EPA/DHA per softgel. Taking 4 softgels a day will provide 3,000 mg combined EPA/DHA and cost about $17 a month.
Mercury toxicity is not a consideration with fish oil. Mercury is WATER soluble, not fat soluble. Low fat tuna and the flesh (not fat) of other large fish contain the highest levels of mercury. Other toxins can be present in fish oils. Reputable manufacturers should be willing to provide safety standards/testing. Due to the way fish oil is processed many contaminates are removed and taking fish oil is safer than eating large amounts of fish. Farmed fish have the lowest levels of omega-3 and highest levels of ALL contaminants.
Omega-3 and 6 fats move into cell membranes, particularly the membranes of nerve and epithelial cells. Epithelial cells compose skin, the lining of the arteries and lungs, the linings of the ducts in the breast and testes. The preferential fat for these brain and epithelial cell membranes is omega-3 but n-3 will be replaced by n-6, if n-3 is not available. Cells where omega-3 is displaced by omega-6 are less able to repair themselves and may become hyperplasic.
The brain and nerves so need omega-3 that they will rob it from every other cell to maintain optimum brain levels. Some of the brain and nerve conditions associated with high omega-6 and/or low omega-3 include, alcoholism, depression, manic depression, memory loss, impaired night vision, anxiety, insomnia, dementia, Multiple Sclerosis, Alzheimer's, Parkinson's, ADD, ADHD, dyslexia, stress induced hostility and schizophrenia.
In the following graph of US per capita fat consumption 1909-1998 it is clear that both our overall intake of fats and intake of omega-6 fats has dramatically increased. From this data it seems prudent to reduce omega-6 fats.
There is no indication our intake of natural saturated fats has increased over this period of time as is suggested to be the commonly accepted 'cause' of degenerative diseases. What has increased is our intake of processed omega-6 fats.
The following paper was presented in 2000 at the National Institute of Health is Washington, DC. The BOLD text is my emphasis. Keywords in understanding fats- Linoleate is omega-6, linolenate is omega-3 as is DHA and EPA and oleic is omega-9. Linoleate, DHA, EPA and linolenate are all polyunsaturated fats. Oleic omega-9 is monounsaturated fat.
Mizuhoku, Nagoya 467-8603, Japan
Excessive linoleic acid (omega-6) intake and relative n-3 deficiency syndrome
Animal experiments and epidemiological studies have revealed that excessive intake of linoleic acid (omega-6) (LA, n-6) is a major risk factor for cancers of western type, allergic hyper-reactivity, coronary heart disease ( CHD) and cerebrovascular disease (CVD) (1). Although epidemiological studies performed in the USA failed to reveal a positive correlation between LA intake and breast cancer mortality, this is probably because the proximate marker for breast cancer is the proportion of n-6 eicosanoid precursors in phospholipids, which is saturated both in the high and low LA intake groups in the USA. Empirical equations presented by Lands indicate that both increasing the intake of n-3 fatty acids and decreasing that of n-6 fatty acids are necessary for effectively decreasing the n-6 eicosanoid precursors in phospholipids and thereby decreasing cancer mortality. On the other hand, high n-6/n-3 ratio but not hypercholesterolemia has been proved clinically to be a major risk factor for thrombotic diseases. Over-production of inflammatory lipid mediators of n-6 series has been shown to be a major cause for the rapid increase in allergic hyper-reactive patients in Japan.
President's Summary 1997 from the Japan Society for Lipid Nutrition
After discussion through several annual meetings of the Japan Society for Lipid Nutrition, Presidents Summary 1997 was published (in Japanese) as a review article (J. Lipid Nutr. 6:5-42, 1997), in which 20% as total fat energy was recommended for those with moderate physical activity. For healthy populations, saturated plus monounsaturated : n-6 : n-3 = 2.5 : 0.8 : 0.2 (n-6/n-3 4) was recommended.
For the primary and secondary prevention of those diseases described above, an n-6/n-3 ratio of 2 was recommended. The latter value was based on: 1) even the n-6/n-3 ratio of Danes was 3 in a well known epidemiology of Greenland natives; 2) the ratio of current Japanese is 4 but the incidence of cancers of western type has been increasing rapidly, and the ratio of 4 or above cannot be recommended; 3) animal experiments have shown the effectiveness of decreasing n-6/n-3 ratio to below 2 for the suppression of carcinogenesis and metastasis; and 4) the safety of n-6/n-3 ratio of 1 has been established in animal experiments and in a retrospective study on hunters and gatherers foods.
In order to meet the recommendations described above, vegetable oils with n-6/n-3 ratios of 2 or below and those with very low n-6 fatty acid contents (e.g., high-oleic type) are useful. However, there was another criterion to be considered; the presence of minor components, which affect animal physiology seriously.
Survival time-shortening and renal injury induced by some vegetable oils and partially hydrogenated oils in SHRSP rats
Using soybean oil as a control, some oils were found to prolong the mean survival time of SHRSP rats by ca 10% (e.g., DHA-rich fish oil, perilla seed oil, flaxseed oil) while some others shortened it dose-dependently by ca 40% (double-low rapeseed oil, evening primrose oil, high-oleate safflower oil, high-oleate sunflower oil, olive oil and partially hydrogenated rapeseed and soybean oil). When the rapeseed oil was lipase-treated, the resulting free fatty acid fraction was almost free of such activity, indicating that the survival-time shortening activity is due to minor components other than fatty acids in these oils. Free fatty acid fraction from partially-hydrogenated soybean oil exhibited a survival time between those of the original oil and soybean oil. It should be emphasized that lard and sesame oil were relatively safe for the SHRSP rats.
Those oils with survival-time shortening activity were found to cause renal injury; lesions in blood vessels, accelerated proteinuria, decreased platelet count and elevated gene expression for TGF7, fibronectin and renin.
Choice of n-3, monounsaturated and trans-fatty acid-enriched oils
In order to decrease the n-6/n-3 ratio of our current foods to 2 or below, the intake of high-n3 linolenate oils such as perilla seed oil and flaxseed oil as well as seafood and vegetables should be increased.
High-linoleate (omega-6) oils are inappropriate for human use as foods. For deep-frying and preservation purpose, high-oleate vegetable oils are useful but all the high-oleate vegetable oils and hydrogenated vegetable oils we have examined so far exhibited the survival time-shortening activity, and I cannot recommend people to have these oils in large quantities. Instead, lard was safe for this animal model, and could be used in quantities not to induce obesity; animal fats as well as a high-LA vegetable oil intake caused insulin resistance in a NIDDM model of rats.
Okuyama, H., Kobayashi, T., and Watanabe, S. (1997) Dietary fatty acids: The n-6/n-3 balance and chronic, elderly diseases. Excess linoleic acid (omega-6) and relative n-3 deficiency syndrome seen in Japan. Prog. Lipid Res. 35: 409-457.
HDL has long been known as the good cholesterol, protecting against heart disease and atherosclerosis. It was recently discovered that HDL has powerful antioxidant properties similar to vitamin C, vitamin E, and coenzyme Q-10. An HDL associated enzyme, lecithin-cholesterol acyltransferase , which forms part of HDL, is a powerful antioxidant enzyme that blocks the oxidization of LDL cholesterol. Cholesterol is beneficial and without harm if it is not first oxidized. Vohl MC, Neville TA, Kumarathasan R, Braschi S, Sparks DL: A novel lecithin-cholesterol acyltransferase antioxidant activity prevents the formation of oxidized lipids during lipoprotein oxidation. Biochemistry; 1999 May 11;38(19):5976-81
Oleic acid is an omega-9 such as found in olive oil and avocado oil. Some sunflower and safflower oils are bred to be high in this fat, safe for cooking and mayonnaise. Look for the words High Oleic on the bottle and a high number for omega-9 on the label.Essential Fatty Acids Explained
Many people find it difficult to believe that fat can be essential to your health, but it's true. Fatty acids are the "building blocks" of fat. Some of these fats are called "essential" because your body needs them, yet cannot make them; you must eat them.
Essential fatty acids (EFAs) are all polyunsaturated fats. The two types of essential fatty acids are omega-3 fatty acids and omega-6 fatty acids. These come in short and long chain configurations. The short-chain omega-3 is alpha-linolenic acid (LNA or ALA). Its elongated (made longer) derivatives include: eicosapentaeonic acid (EPA), docosahexaenoic acid (DHA) and a few others, less well known and less studied.
The main short-chain omega-6 is linoleic acid (LA). Like LNA, it also has elongated derivatives, the main being arachidonic acid, necessary for prostaglandin formation and brain function.
The very long-chain omega-3 EFAs are connected with brain and visual development in infants. Deficiencies in adults can lead to impaired mental processes, including learning disorders, dementias and other neuronal diseases, impaired vision, and depression. Studies suggest that prolonged deficiencies might lead to retinal and macular damage. In pregnant women low levels of the elongated omega-3 can actually reduce brain size in offspring.
How much of these essential fatty acids do you need? There is no RDA yet, but many sources agree that Americans do not get nearly enough omega-3. Even worse we get too much omega-6, which displaces omega-3 in cell membranes and neural circuits.
Researchers involved in the Workshop on the Essentiality of and Recommended Dietary Intakes for Omega-6 and Omega-3 Fatty Acids suggest "adequate intakes" of each:
The problem with these numbers is that a diet containing nuts and seeds or meat or even milk and eggs as a protein source has at least 12 grams of omega-6. That would mean that a minimum (not optimal) of omega-3 would be 1.95 grams which is the amount in about 6 ounces of fatty fish daily (more would be needed if lean fish is used) however, even that does not work if you are eating farmed fish as farmed fish is high in omega-3 but equally high in omega-6, canceling the much of the benefit to balance ratios.
Sources looking at the dietary ratio of omega-6 to omega-3 fatty acids suggest that in early human history the ratio was about 1:1. Currently most Americans eat a dietary ratio that falls between 20:1 and 50:1. The optimal ratio is most likely between 4:1 and 1:1. For most Americans this means greatly reducing the omega-6 fatty acids they consume and increasing the amount of omega-3 fatty acids.
Please note that this has nothing to do with rancid fats, trans-fats or hydrogenated fats. These damaged fats are not good for you but neither are the 'cold pressed' so called healthy vegetable oils like canola, soy, safflower, sunflower or corn oils. Even flax has a significant amount of omega-6 and should be avoided. If you are vegan or vegetarian use perilla oil instead and avoid so called 'essential fat' supplements that contain omega-6 and omega-9 in addition to omega-3. You can get all you need of n6 and n9 from food.
The best source of omega-3 fatty acids is cold-water (the colder the better) fish, which is high in both EPA and DHA. You may need as little as three servings a week of very fatty fish (make sure to eat the skin and surrounding fat) or 8 or more ounces daily to meet your genetic need. If fish are not your thing you can use fish oil capsules. A standard fish oil concentrate soft gel weighing 1000 mg contains about 300 milligrams of omega-3. The suggested dose is 300 mg of total (EPA+DHA) omega-3 for each 10 pounds of body weight during the first three months or so. After this time reduce the dose to 1/2-2/3 of original dose, that would be 300 mg total combined DHA-EPA omega-3 for each 15-20 lbs. of body weight. Maintenance for most persons would be between 1,500-3,000 mg of combined EPA and DHA
Important: Fish oils produce free radicals in your body. You must be sure to get enough antioxidants, particularly vitamin E and vitamin K, when you increase your fish or fish oil intake. About 1 mg. of vitamin K and 100 IU of vitamin E daily will suffice. Amounts greater than this are not needed. Both vitamins are fat soluble so must be taken with a meal containing fat OR with your dose of fish oil.
You may be tempted to eat foods or use supplements that contain LNA (alpha-linolenic acid- short chain omega-3) rather than EPA and DHA from fish or fish oil (particularly if you're a vegetarian), but you should be aware that it may not be very useful to you, as many of us convert it to EPA and DHA very inefficiently. This impaired conversion is further reduced in aging. In many studies even large doses of ALA (flax or perilla) did not raise membrane DHA. Flaxseed, perilla oil and walnuts are common sources of LNA. Recent studies suggest high amounts of ALA may be associated with prostate cancer.
You may try adding perilla oil (lower in omega-6) and buying the 'algae' DHA such as Neuromins from Solgar or Nature's Way, which contain 100 mg of DHA per each soft gel. To match the fish oil program you would need 3 or more tbsps. of perilla oil daily plus about 5-15 per day of the Neuromins providing 500-1,500 mg of DHA.A sampling of foods high in DHA and EPA (combined):
Most of us get our omega-6 fatty acids from vegetable oils including foods made from vegetable oils, like margarine, Crisco and mayonnaise. The popular evening primrose and borage supplements are also high in omega-6. As you can see from the chart below, simply changing the type of oil you use could greatly reduce your intake of LA. Also pay special attention to the difference between wild and farmed salmon as to omega-6 content. This pattern of higher omega-6 in farmed animals is repeated in wild compared to domestic game and grass-fed compared to grain-fed beef, poultry and pork. Organic dairy, meat and poultry are products from animals fed grain so omega-6 is still high.Vitamin E and K, Anti-oxidants Extraordinaire, Needed to Protect Omega-3
A typical breakfast in Tokyo, Japan contains natto, fish, rice and pickles. Natto is high in vitamin K. The fish, consumed flesh, bones and skin, contains vitamin K, vitamin D, omega-3, minerals and amino acids. The pickle improves digestion. In all traditional cultures the daily diet contains protein, dark greens and some fermented food from natto to yogurt to fermented cabbage. This wide variety assures adequate nutrition from fresh whole foods. Without this natural balance nutritional deficiencies are inevitable.
Vitamin K is a fat-soluble vitamin found in dark green leafy foods and naturally fermented foods. The symbol K is used for potassium on the periodic chart. We are not talking about potassium here, but a fat soluble vitamin. Vitamin K1 is phylloquinone, found in plants. Vitamin K2, menaquinone, is found in animals and made in the human gut by 'good' bacteria. Antibiotics destroy our ability to make K in the gut. Probiotics like acidophilus restore gut K production. There is increasing evidence that natural gut production is not enough to support artery and bone health. Dietary sources are critical.
Vitamin K reverses postmenopausal bone loss by keeping calcium in the bone where it belongs, working better than Fosamax. Low levels of vitamin K lead to under-carboxylated calcium forming plaque in the arteries in heart disease. K is necessary for the formation of osteocalcin a bone builder. It is intimately related to the functions and actions of vitamin D. Vitamin K is an effective anti-oxidant in the cell membrane and necessary for normal blood clotting.
Large doses of the naturally occurring K1 and K2, up to 45 mg daily, have been given with few side effects. Normal, traditional dietary doses (1-5 mg) of vitamin K as found in naturally fermented foods, dark green leafy vegetables, seaweeds and animal livers, do not 'over' coagulate the blood. Adequate vitamin K normalizes fragile membranes. It has proven useful preventing or correcting easy bruising, varicose veins and 'spider' veins. Vitamin K within physiological amounts does not make blood thicker or 'stickier'. K toxicity has occurred in infants given vitamin K3 (not a natural form of K) by injection. In research only the analog 'man-made' K3 has shown toxicity.
If you are on a blood thinning medication, such as Coumadin or aspirin or other non-steroidal anti-inflammatory, you must discuss vitamin K supplementation with your physician. Recent research suggests Coumadin may, by way of reducing vitamin K, induce arterial calcification. Some researchers are now suggesting a vitamin K supplement for Coumadin users.
Med Res Rev. 2001 Jul;21(4):274-301.
Arterial calcification: a review of mechanisms, animal models, and the prospects for therapy.
Wallin R, Wajih N, Greenwood GT, Sane DC.
Section of Rheumatology, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
The causes of arterial calcification are beginning to be elucidated. Macrophages, mast cells, and smooth muscle cells are the primary cells implicated in this process. The roles of a variety of bone-related proteins including bone morphogenetic protein-2 (BMP-2), matrix Gla protein (MGP), osteoprotegerin (OPG), osteopontin, and osteonectin in regulating arterial calcification are reviewed. Animals lacking MGP, OPG, smad6, carbonic anhydrase isoenzyme II, fibrillin-1, and klotho gene product develop varying extents of arterial calcification. Hyperlipidemia, vitamin D, nicotine, and warfarin, alone or in various combinations, produce arterial calcification in animal models. MGP has recently been discovered to be an inhibitor of bone morphogenetic protein-2, the principal osteogenic growth factor. Many of the forces that induce arterial calcification may act by disrupting the essential post-translational modification of MGP, allowing BMP-2 to induce mineralization. MGP requires gamma-carboxylation before it is functional, and this process uses vitamin K as an essential cofactor. Vitamin K deficiency, drugs that act as vitamin K antagonists, and oxidant stress are forces that could prevent the formation of GLA residues on MGP. The potential role of arterial apoptosis in calcification is discussed. Potential therapeutic options to limit the rate of arterial calcification are summarized. Copyright 2001 John Wiley & Sons, Inc.
PMID: 11410932 [PubMed - indexed for MEDLINE]
Curr Opin Nephrol Hypertens. 2002 Jul;11(4):437-43.
Erratum in: Curr Opin Nephrol Hypertens. 2003 Mar;12(2):221.
Novel mechanisms in accelerated vascular calcification in renal disease patients.
Demer LL, Tintut Y, Parhami F.
Departments of Medicine and Physiology, UCLA School of Medicine, Los Angeles, California, USA. firstname.lastname@example.org
PURPOSE OF REVIEW: Vascular calcification occurs more often and earlier in patients with end-stage renal disease than in normal controls. It is a regulated biological process following many of the cellular and molecular programs in osteogenesis. This review summarizes some of the regulatory mechanisms that may explain its severity in renal patients. RECENT FINDINGS: A subpopulation of cells from arteries and cardiac valves produce a mineralizing matrix and undergo osteoblastic differentiation. Osteogenic differentiation regulators are found in calcified but not normal arteries. Phosphate levels have dramatic effects on vascular calcification in vitro, through a sodium phosphate transporter signaling molecular changes. Atherogenic oxidized lipids promote osteoblastic differentiation of vascular cells and inhibit bone mineralization. In uremic patients, the severity of dyslipidemia corresponds with the progression of vascular calcification. Oxidative stress and inflammatory mediators may underlie the effects of oxidized lipids. In dialysis patients, the degree of cardiac valvular calcification corresponds with levels of C-reactive protein. Genetic factors may also contribute. Polymorphisms of the inflammatory adhesion molecule, E-selectin, associate with coronary calcification in young women. Mice deficient in matrix GLA protein, which inhibits bone morphogenetic protein activity, develop complete ossification of the aorta, presumably as a result of unopposed osteogenic activity on vascular mesenchyme. Since matrix GLA protein function requires gamma-carboxylation of its glutamate residues by a vitamin K dependent carboxylase, warfarin treatment may affect vascular calcification by blocking vitamin K and hence matrix GLA protein activity. SUMMARY: These findings indicate that vascular calcification is regulated both positively and negatively by a wide variety of mechanisms affecting patients with renal disease.
Research demonstrates a high intake of fat, whether omega-3, omega-6, omega-9, or saturated fat, increases the need for vitamins E and K. The traditional diet would provide extra nutrients as a natural component of the fatty food. Food processing and storage change the availability of these natural components. In animals given diets high in omega-3, omega-6, omega-9 or saturated fat liver content of vitamin K was reduced to 1/5 of controls (normal chow diet). The tendency of blood to coagulate more slowly or a reduction in blood platelets is often a side effect of using omega-3 fatty acids and may occur when eating a diet high in fatty fish. Normalizing levels of vitamin K with high vitamin K foods or a vitamin K supplement reverses both of these tendencies.
In the US vitamin E supplementation is common. Most health food store multiples contain 200-400 IU per daily dose. Higher levels of E have a reverse effect. In fact, high levels of E actually reduce levels of vitamin K, not a good idea for postmenopausal women needing to keep or rebuild bone or heart patients using omega-3 and vitamin K to prevent or reverse arteriosclerosis.
Finding vitamin K is much harder, whether in foods or in a supplement. The DRI is 90 mcg. but just 1 mg (1,000 mcg, more than 10 times the DRI) has reversed bone loss in post-menopausal women, reducing urinary calcium loss by 25% within a few days of starting supplementation. 10 mg (10,000 mcg) of vitamin K daily has been used by our space program to prevent bone loss in astronauts during weightlessness.
A study published April 2001 in Kardiologie correlated low levels of vitamin K to under-carboxylated MGP (a protein that reflect artery health). The conclusion? Low levels of K allow calcium to leave the bone, not be delivered to the bone and promote the deposition of calcium in soft tissues. The study determined the lowest level of vitamin K to reach sufficiency is 900 mcg, just under 1 mg.
Vitamin K works with vitamin D (both are equally important) to prevent bone loss and build new bone. It also influences blood sugar levels and adult onset diabetes. Low vitamin K contributes to post meal hyperinsulinemia (high insulin) and insulin resistance.
We do make some vitamin K in our guts if we have normal bowel flora (the 'good' gut bugs, they make the K for us) and normal bowel function. Constipation, diarrhea, IBS or Crohn's would all indicate a problem with vitamin K, either making it or absorbing it. Dietary fiber (soluble fiber) helps the 'good' gut bacteria thrive so soluble fibers, found in high fiber foods like berries, figs and some legumes, will increase vitamin K if the gut bugs are right.
Vitamin K is found in very dark green leafy vegetables like chard, spinach, bok choy and seaweeds such as dulse. It is also found in cod liver oil, beef and poultry livers.
Vitamin K 1.5 mg containing 67% vitamin K2 and 33% vitamin K1 (product #CP1091) is available from Complementary Prescriptions or call 1-888-401-1105. Use my PIN number 230288, to register or at checkout. This product currently comes closest to the type and amount of vitamin K found in ancestral diets. Make sure you get the right product. Make sure not to get the 15 milligram product, it is provided for persons with cancer and is too high a dose for daily use.
The only other K supplement coming close to ideal is the Life Extension Super K with Advanced K2. Dose is one per day taken with a fatty meal. High doses of vitamin K equaling 10 mg or more show no specific benefit in research and some harm is always possible with long term use of excessive doses of any supplement.
To be absorbed vitamin K, in a supplement or food, must be consumed with fat. Fat-free veggies for dinner, no K absorbed, but with a little added butter or olive oil on your greens the K is very well absorbed. Wrapping sushi in seaweed gives a meal high in vitamin K and omega-3, both well absorbed. This rule regarding the need for fats to absorb is also true of 'green drinks'. Unless you add fat to your drink or have some with it (not later) the important fat-soluble nutrients will pass you right by.
Vitamins A, D and E also need fat for absorption. Since they are usually found in a fat containing supplement (cod liver oil) or in fats found in animal or poultry livers, butter, full-fat dairy and such, absorption is usually not a problem. Our modified 'low-fat' or 'no fat' diets are un-natural and rob us of the very important fat-soluble vitamins, A, D, E and K. Absorption of calcium, A and D from non-fat milk is poor.
If you have difficulty digesting fats it is important to address this problem ASAP. Health and longevity require adequate A, D, E and K and without good fat digestion you will not get what you need, from supplements or from food.
Essential and non-essential fats carry these vitamins and alter them for cellular function. Using a water based or 'dry' fat-soluble won't alter the way fat-soluble vitamins act once they are absorbed. You still need the good fats and must be able to digest them to get them 'in'.
If you have had your gallbladder removed you no longer concentrate bile. You may need to take lecithin, about 3-4 triple strength soft gels or 1 teaspoon of the granules, or a concentrated fat-digesting enzyme (lipase) or concentrated pancreatin or ox bile at every meal, especially meals containing your fat-soluble vitamins and omega-3 oils.
If you have difficulty digesting fats but still have your gallbladder using the lecithin or lipase or pancreatin along with 500 mg of taurine with each meal for a few weeks while getting the fat-soluble vitamins and omega-3 fats will most likely correct the problem. Use the digestive aids temporarily and see how you improve.
Nature's Sources AbsorbAid powder is an excellent digestive aid. Be careful to follow instructions. Powder mixes more freely with your food. Capsules or tablets (unless they are chewable) are not the best choice. My favorite lecithin granules are the Fearn brand. Use as much as you need to emulsify the fats. You can tell because the fats won't reflux and your digestion will proceed normally.
Avoid high Short 6 and get Long 3. Use only oils in bold. Use Olive, Butter and Coconut for cooking.
Note Regarding Fish Oil Brands, Efficacy and Safety
Some clinicians have suggested that only a particular brand or source of fish oil, usually one they are selling, is safe. They have reasons, often ones that appear to make sense, however, there is no evidence that fish oil from any of the major, reputable, companies is harmful or damaged. The best buy is without a doubt Costco Kirkland Fish Oil Concentrate 1,000 mg at 400 soft gels for about $11.50. They are able to offer this price because of high turnover, that is, volume sales allows for a deep discount. Now Foods also offers a regular and extra strength (called Ultra Omega-3, fewer soft gels to take) fish oil at reasonable cost.
Recently a popular web based doctor strongly criticized use of Costco Kirkland fish oil. He admits the brand tested well, fresh and low in any toxic elements but found that another brand, which he now sells, raised his cholesterol (genetically too low) and the Costco brand didn't. From this and other anecdotal evidence he concluded the Costco brand was in some way 'damaged', his "educated' guess". If you use a particular source and you get results, have more energy, improved vision, experience improved memory, continue using your source, whatever it may be.
While krill oil does provide omega-3 like all of the core elements on this site NUMBERS COUNT. We need, as humans, a particular amount of EPA and DHA and this amount should not be considered unimportant. Krill oil does not contain significant amounts of EPA and DHA and many soft gels would need to be taken to equal amounts recommended. Save your money. Buy reasonably priced fish oil, keep it in the refrigerator or freezer, and use it daily.
As to efficacy and safety I refer you to:
Measurement of Mercury Levels in Concentrated Over-the-Counter Fish Oil Preparations
Is Fish Oil Healthier Than Fish?
Stacy E. Foran, MD, PhD; James G. Flood, PhD; Kent B. Lewandrowski, MD
c Context.-Fish consumption has been associated with a decreased risk of coronary artery disease. Recent studies have illustrated that the high mercury content in cold-water fish may negate the cardiovascular benefits of fish meals. Fish oils have similar antiatherogenic properties to fish, and similar studies should be performed to determine the level of mercury in fish oils. Objective.-To determine the concentration of mercury in 5 over-the-counter brands of fish oil.
Results.-The levels of mercury in the 5 different brands of fish oil ranged from nondetectable (,6 mg/L) to negligible (10-12 mg/L). The mercury content of fish oil was similar to the basal concentration normally found in human blood.
Conclusions.-Fish are rich in omega-3 fatty acids, and their consumption is recommended to decrease the risk of coronary artery disease. However, fish such as swordfish and shark are also a source of exposure to the heavy metal toxin, mercury. The fish oil brands examined in this manuscript have negligible amounts of mercury and may provide a safer alternative to fish consumption. ( Arch Pathol Lab Med. 2003;127:1603-1605)
Measurement of Organochlorines in Commercial Over-the-Counter Fish Oil Preparations
Implications for Dietary and Therapeutic Recommendations for Omega-3 Fatty Acids and a Review of the Literature
Stacy Foran Melanson, MD, PhD; Elizabeth Lee Lewandrowski, PhD; James G. Flood, PhD; Kent B. Lewandrowski, MD
c Context.-The consumption of fish high in omega-3 fatty acids is advocated by the American Heart Association to decrease the risk of coronary artery disease. However, fish contain environmental toxins such as mercury, polychlorinated biphenyls, and organochlorine pesticides, which may negate the beneficial cardiovascular effects of fish meals. Toxin levels vary depending on both the fish source and the specific toxin, and neither farm-raised nor wild fish are toxin free. Fish oil supplements also prevent the progression of coronary artery disease and reduce cardiovascular mortality. However, only sparse data exist on the level of toxins in fish oil. In a previous study we showed that the amount of mercury in 5 over-the-counter brands of fish oil was negligible.
Objective.-To determine the concentrations of polychlorinated biphenyls and other organochlorines in 5 over-the-counter preparations of fish oil.
Design.-The contents of 5 commercial fish oil brands were sent for organochlorine analysis. Results.-The levels of polychlorinated biphenyls and organochlorines were all below the detectable limit.
Conclusions.-Fish oil supplements are more healthful than the consumption of fish high in organochlorines. Fish oils provide the benefits of omega-3 fatty acids without the risk of toxicity. In addition, fish oil supplements have been helpful in a variety of diseases, including bipolar disorder and depression. ( Arch Pathol Lab Med. 2005;129:74-77)
Unless the 'expert' can show you data, hard data, not produced by them or offered second hand, but from an independent reliable testing or research source, to prove the 'danger' of some particular brand of fish oil please consider the above and this:
An affordable, fresh, clean source of the all important omega-3 fatty acids is better than an unaffordable source. It should not cost a fortune to maximize your health.
EPA and DHA do different things in our bodies. They are not interchangeable. EPA is anti-inflammatory, DHA is important for brain and nerve function. Both are important. Different omega-3 sources contain different balances between these two omega-3 fats. If you decide to take fish oil take a balance of both EPA and DHA. Typical fish oils contain slightly more EPA (anti-inflammatory) than DHA (for nerves and cell) Always count the combined number of these two for total essential omega-3 per soft gel. A good daily dose is about 3,000 mg combined EPA and DHA for adults.
Remember when reading labels to make sure the number you are using is per each. Many labels give the number for 2 or some other serving size and you will need to take that into consideration when running the numbers.
For obese persons the upper limit is probably 4,000-6,000 mg of combine EPA-DHA no matter your weight. Higher doses of fish oil may cause digestive distress and show no more benefit than somewhat lower doses This calculates to about 11/2 tbsps. of the Carlson's liquid, 20 of the Costco brand (lots of 'pills' but also less expensive, the down side is more potential for digestive problems), 8 of the Now Foods Ultra Omega-3. Maintenance after 8-10 weeks of repletion would be 3,000 mg combined EPA/DHA..
Often within the 'health food' community I get the feeling from advertising promotion (by book sellers, alternative physicians, health food store personnel and others) that we will surely perish unless we spend large sums of money to purchase every new 'discovery' in a bottle. Health still comes from regular exercise, good food, good friends and joy in life. These things will never be bottled.
Liquid or Soft Gels? While fish oil, as oil, is certainly more natural than soft gels, soft gels protect the oil from rancidity (destruction by oxygen). However fresh the fish oil may be when purchased, once your bottle is opened the process of destruction by oxygen progresses rapidly. Liquid oils are more exposed to this destruction. Unless you intend to finish the entire bottle of liquid fish oil within a week or 10 days (the liquid oil not the oil in soft gels), consider the soft gels as a safer source.
After opening your bottle of fish oil you may want to store the oil or the oil in soft gels in your freezer to help either stay fresh longer. Health From the Sun offers Ultra Omega-3 Fish Oil that contains 1350 mg combined EPA-DHA per teaspoon. Just one-two teaspoons a day would provide the maintenance dose for most adults. Again, if using oil not in soft gels, keep it in the freezer, it won't freeze.
Fatty acids found in fats are critical to the health of all cells. Every cell membrane is composed of fatty acids and the human nervous system including the human brain is composed of numerous lipids making up between 60 and 70% of the total weight. These lipids are composed of dietary essential fats, both saturated and unsaturated. What fats you consume are critical to both your vitality and your longevity.
Fat is not the enemy but too much or the wrong types of fats will make you miserable (increase pain and inflammation, cause depression, contribute to obesity) and shorten your life. Check you refrigerator and your cabinets and toss out 'bad fats' and foods containing 'bad fats'. Stock up on the good fats and make sure to keep them fresh. You will appreciate the worth of your efforts within weeks. Omega-3 fatty acids will replace in brain cells in just 4 weeks, improving mood and even enhancing your color vision. A reduction in omega-6 fats while increasing omega-3 fatty acids will improve muscle strength, reduce muscle and joint pain, and shorten exercise recovery time in just 3 months.
Last modified on: 07 April, 2016
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