Friday, October 17, 2008

Toxic Fat News

“Toxic Fat,” the latest book by my friend and colleague Dr. Sears explains the role of inflammation in obesity and chronic disease.

If almost by serendipity, the October, 2008 issue of Cancer Journal has a major article linking omega-6 fatty acids to breast cancer.

For years it was though that eating grilled meats was a potential causative factor because meat produces heterocyclic amines that had been demonstrated to cause cancer in rats.

This new article studied women for 10 years and found that consumption of heterocyclic amines was not associated with the development of breast cancer.

What researchers did find was that a diet rich in omega-6 fats (but low in heterocyclic amines) was strongly associated with increased breast cancer.

The answer is quite clear. Those women with low intakes of heterocyclic amines had been previously shown to have high levels of insulin. When excess insulin is combined with high levels of omega-6 fats, the result is the production of increased arachidonic acid.

This is the toxic fat that is the driving force of increased cancer.

Be Well!

Saturday, October 11, 2008

Diabetes, Heart Disease and Sea Vegetables.

Diabetes, Heart Disease, Obesity and Sea Vegatables originally published by Well Being Journal, Vol.13, #3, May-June 2004.

What's the hoopla with "healing" lopps?

Originally posted Wednesday, February 28, 2007 on www.AskDrD.com
Ionized wrist bracelets are popular over-the-counter alternative treatments for pain.
Originally "developed" by Dr. Manuel Porto in 1973, only 4 million bracelets have been sold worldwide to counteract the damaging effects of positive ions.

Negative ions are generally abundant in nature through plants, waterfalls, rain storms and forests—all of which might offer a natural good feeling.

These ions, unfortunately, might be depleted in urban areas as a result of modern technology, pollution and the greenhouse effects.

The human body is exposed to positive ions from electronic equipment, cell phones, electrical wiring, and machinery encountered in everyday modern life
Physical stress and exposure to Ultraviolet (UV) Rays may also elevate the positive ion levels within the body.

Research suggests that excessive positive ion levels might be associated with chronic fatigue syndrome (CFS) lack of concentration, muscle and joint aches, and feeling of nausea, etc.

Contrary to my opinions in the initial (2006) report on the subject, further review of relevant literature and research clearly demonstrate that there is no clear and/or convincing evidence as to the effectiveness of the ionized bracelets and the mechanisms of their action remains in dispute.

In 2002, the Scientific Assembly of the American Association of Family Physicians (AAFP) was presented with an original prospective study by Robert Bratton, MD, from the Mayo Clinic in Jacksonville, Florida on the effect of ionized wrist bracelets on musculoskeletal pain.

Patients were then randomized to receive either ionized bracelets, or placebo bracelets that exactly matched the appearance of the ionized bracelets.

Patients were reporting pain at baseline and while wearing the bracelet for up to 4 weeks. At the outset of the study, 80% of subjects believed that the ionized bracelets would help pain.
After the 4 week trial, both groups did report significant reductions in pain from baseline at all study points, despite the fact that there was no significant difference in the pain scores.
These findings echoed those of a 2002 prospective trial of magnetized bracelets for carpal tunnel syndrome pain. (Carter R, Hall T, Aspy CB, Mold J.

The effectiveness of magnet therapy for treatment of wrist pain attributed to carpal tunnel syndrome. J Fam Pract. 2002;51:38-40.)

Two years later (Dec.17,2004), Medscape Medical News reported that magnetic bracelets may reduce the pain associated with osteoarthritis of the hip and knee, suggest the results of a multicenter, randomized, placebo-controlled study published in the December issue of the British Medical Journal (BMJ. 2004;329:1450-1454) and sponsored by the Netherlands Heart Foundation and the Netherlands Organization for Scientific Research.

Investigators from the Peninsula Medical School evaluated the effects of bracelet therapy in 194 patients aged 45 to 80 years with osteoarthritis of the hip and knee.

Comparative analysis showed greater reduction of pain in the standard magnet group as compared with placebo.

Unfortunately, the study does not resolve the extent to which the effect of magnetic bracelets is specific or due to placebo.

Also, in 2004, there was a British study (Harlow T, Greaves C, White A, et al. Randomized controlled trial of magnetic bracelets for relieving pain in osteoarthritis of the hip and knee. BMJ 2004; 329:1450-1454) devoted to the effects of magnetic bracelets on knee pain in patients with osteoarthritis.

The study "documented" the specific therapeutic effects of the bracelets evident by the reduction of pain, stiffness and improvement in the functioning score.

Unfortunately, again and again, the investigators were not able to conclude if their data was due to specific effects on bracelets, a placebo, or both. (!)

To address the issues of bracelet-induced v. placebo effect a definitive study was conducted by the University of British Columbia, Vancouver, D.C. , Canada in 2005 and reported in the Journal of Evidence-based Nursing (Evid Based Nurs. 2005; 8(3):89 (ISSN: 1367-6539).

It "suggested" that patients who wore bracelets reported reduced pain from osteoarthritis of the hip or knee compared with patients wearing placebo bracelets.

There is a working "hypothesis" that thee positive metallic ions could, possibly, increase the level of allergen-mediated mast cell activation, which might be one of the mechanisms mediating exacerbation of allergen-driven asthma symptoms by air pollution, as well as chronic fatigue, nausea, headaches, general malaise, and, probably, recent stock market declines.(?)

However, there is no clear & convincing evidence of such correlation.

Further, a recent study from the University of Kentucky (Brain Behav Immun. 2005; 19(3):195-200 (ISSN: 0889-1591) was dedicated to the effects of "dispositional optimism"."

"Dispositional optimism" is defined by "...generalized positive expectations for the future, on physical health showed that it is more likely to be a positive consequence of optimists' greater engagement during difficult stressors...”

Fortunately for health consumers, US Government disagrees with presented "evidence", and is pursuing manufacturers of different magnetic/ionized bracelets with "dispositional pessimism":
In 2000, the Consumer Justice Center sued QT, Inc., and its owners for false advertising.The suit was settled with a nondisclosure agreement.

However, it is safe to assume that the settlement agreement included payment and a pledge to stop making most of the claims that the suit challenged.

A class-action suit is pending, and a false advertising suit is pending against the marketers of a similar device called the Balance Bracelet.In June 2003, the FTC charged QT, Inc, Q-Ray Company, Bio-Metal, Inc., and their principals, Que Te (Andrew) Park and Jung Joo Park, with false advertising, and the federal district court in Chicago issued a temporary restraining order freezing their assets and prohibiting further use of misleading claims.

In May 2004, the FTC filed a similar suit against Balance Bracelet marketers Media Maverick, Inc., of San Luis Obispo, California, and its officers Mark Jones and Charles Cody.

Among other things, the company's Web site had claimed:"...The Balance Bracelet is designed to aid the body in helping itself through electro-polarization. This helps the body return to its normal ionic balance. The Balance Bracelet acts on the body absorbing the static electricity that causes changes in different parts of the body..."

In September 2006, the Chicago court sided with the FTC and ordered Que Te Park and his companies to turn over $22.5 million in net profits and provide up to $64.5 million more in refunds to consumers who had bought the bracelets.

During the trial, Park testified that he "...could not define the term "ionization" but picked it because it was simple and easy to remember...”

The court concluded that his testimony on ionization was "contradictory and full of obfuscation" and that "he is a clever marketer but a poor witness."Park also acknowledged that QT had at least a 25% refund rate from dissatisfied customers (more than 100,000 people).

The FTC has set up a hotline number, 202-326-2063, for consumers with questions about the court’s opinion and order.

The bottom line:

Armed with the "scientific" evidence above, my natural "dispositional optimism" (probably a placebo effect!?), and my deep appreciation of its artistic (and conversation starting) value, I will continue to wear my "negative ionic" pink-on-pink wristbands.

Be well!

--
This article is to be used for education and general discussion purposes only. It does not constitute medical opinion and should not be used for or relied upon as medical advice. Publication of this newsletter does not create physician-patient relationship between the reader and the author. The article does not contain comprehensive description of the subject issues discussed. It is based on present medical knowledge which is subject to change and is unclear in numerous respects. Statements regarding the bio-efficacy of any and all bracelets (ionic, magnetic, decorative), and/or wristbands have not been evaluated by the FDA. They are not intended to diagnose, treat, cure or prevent any disease. The issues discussed can not be resolved without specific analysis of the specific circumstances of each person. The readers should consult with their individual health care/wellness professional to resolve their individual situation.

Why can(?) anal sex kill

First posted Saturday, March 3, 2007 on www.AskDrD.com

An "authoritative" website, capable of inducing a mental image, claims" "...It’s important to remember that HIV can be transmitted through anal sex, especially anal intercourse.

In fact, the risk of HIV transmission is greater than it is in vaginal intercourse because the lining of the rectum tears more easily than the vagina. The resulting skin breaks and bleeding increase the possibility of the transmission of bodily fluids containing the virus that causes AIDS.

Such a conclusion can be reached only by a militantly ignorant author.

Review of the foundational (written by yours truly in 1996), and current literature on the subject begs to disagree.

My, then revolutionary, theories of 13 years ago were noticed, (after years of ridiculing) and acknowledged by the only organization that really counts:
"... In fact, unprotected (without a condom) anal sex (intercourse) is considered to be very risky behavior.

It is possible for either sex partner to become infected with HIV during anal sex. HIV can be found in the blood, semen, pre-seminal fluid, or vaginal fluid of a person infected with the virus.

In general, the person receiving the semen is at greater risk of getting HIV because the lining of the rectum is thin and may allow the virus to enter the body during anal sex.

However, a person who inserts his penis into an infected partner also is at risk because HIV can enter through the urethra (the opening at the tip of the penis) or through small cuts, abrasions, or open sores on the penis..."

But some advice never changes, whether practiced or not:

"...If people choose to have anal sex, they should use a latex condom. Most of the time, condoms work well.

However, condoms are more likely to break during anal sex than during vaginal sex.

Thus, even with a condom, anal sex can be risky.

A person should use generous amounts of water-based lubricant in addition to the condom to reduce the chances of the condom breaking..."

The only practical way not to get infected during sex, is to avoid having it all together.

Be Well!

My sincere thanks to the Editorial and Publishing leadership of the US Pharmacist Journal for their foresight in March of 1996 (eleven years ago!) to take on an unpopular, but an important issue; and to Birdie for being my creative inspiration.

***This article is to be used for education and general discussion purposes only. It does not constitute medical opinion and should not be used for or relied upon as medical advice. Publication of this article does not create physician-patient relationship between the reader and the author. Dr.Dorodny assumes no responsibility and/or liability for any and all actions and/or inactions by any person(s) as a result of this article. The article does not contain comprehensive description of the subject issues discussed. It is based on present medical knowledge which is subject to change and is unclear in numerous respects. The issued discussed in this article are not intended to diagnose, treat, cure or prevent any disease. The issues discussed can not be resolved without specific analysis of the specific circumstances of each person. The readers should consult with their individual health care/wellness professional to resolve their individual situation.

Friday, October 10, 2008

Who can you trust on quality of health care!?

Communication from Dr. Jack Lewin, CEO, American College of Cardiology.

Doctors or patient-advocacy groups should be the ones to set standards for measuring and reporting health care quality, according to a survey from the American College of Cardiology.

The ACC released its survey results along with a new campaign to set
standards for quality in health care reform at a news briefing in Washington.

Eighty-six percent of the respondents said they would most trust physicians or
patient advocates to set quality standards.


“As the survey results indicated, the American public believes that physicians
must play a lead role in identifying the problems plaguing our health care system and in developing the solutions,” said Rep. Lois Capps (D-Calif.), who joined Rep. Joe Barton (R-Texas), ranking member of the House Energy and Commerce Committee, and ACC officials at the briefing.


Barton said crafting a health care reform bill that providers will support is a
challenge, especially on the issue of transparency. Most health care bills that have a transparency component often have to be pulled, mainly because “providers are opposed to the bill. They’re that afraid of it.”


Increased transparency, however, was one of the principles the ACC set forth in its new quality campaign, along with payment incentives for quality care and other initiatives.

The online survey was conducted Sept. 4-10 and polled a nationally representative sample of 1,003 adults who were likely to vote in the upcoming
elections.


Be Well!

Should you give (or take) a hoot?

Originally published on August 5, 2006

There has always been a demand for “quick-fix”, “no-pain” weight loss pills.After the ban on the herb ephedra, the market was particularly ripe for the next new "weight loss solution", preferably one that didn't have the same stimulating side effects as ephedra.

Hoodia gordonii is also called hoodia, xhooba, khoba, Ghaap, hoodia cactus, and South African desert cactus hoodia is a cactus-like plant that's causing a stir for its ability to suppress appetite and promote weight loss.


Hoodia is commercially available in capsule, liquid extract, spray, patch or tea form in health food stores and on the Internet.

Hoodia gordonii can be found in the semi-deserts of South Africa. It grows in clumps of green upright stems and is actually a succulent, not a cactus. It takes about 5 years before hoodia's pale purple flowers appear and the cactus can be harvested.

Although there are 20 types of hoodia, only the hoodia gordonii variety is believed to contain the natural appetite suppressant.Although hoodia was "discovered" relatively recently (2005 by CBS 60 minutes), the San Bushmen of the Kalahari Desert have been eating it for a very long time.

The Bushmen, who live off the land, would cut off part of the hoodia stem and eat it to ward off hunger and thirst during nomadic hunting trips. They’ve, reportedly, also used hoodia for severe abdominal cramps, hemorrhoids, tuberculosis, indigestion, hypertension and diabetes.

In a 2004 study (Brain Res. 2004; 1020(1-2):1-11 (ISSN: 0006-8993) conducted at the Brown Medical School, Providence, RI a steroidal glycoside with anorectic activity in animals, termed P57AS3 (P57), was isolated from Hoodia gordonii and found to have homologies to the steroidal core of cardiac glycosides.

Intracerebroventricular, (seriously!) (i.c.v.) injections of the purified P57AS3 demonstrated that the compound has a likely central (CNS) mechanism of action.The studies demonstrated that the compound increases the content of ATP by 50-150% in hypothalamic neurons.

In addition, third ventricle (i.c.v.) administration of P57, which reduces subsequent 24-h food intake by 40-60%, also increases ATP content in hypothalamus.

With growing evidence of metabolic or nutrient-sensing by the hypothalamus, ATP may be a common currency of energy sensing, which in turn may trigger the appropriate neural, endocrine and appetitive responses as similar to other fundamental hypothalamic homeostatic centers for temperature and osmolarity.

In layman terms, the chemical constituents in hoodia might work within the satiety center by releasing a chemical compound similar to glucose, but are up to 100,000 times more powerful.

However, it is just a theory, for now.The hypothalamus receives this signal as an indication that enough food has been consumed and this in turn stunts the appetite.

This pure organic hoodia gordinii contains a molecule that, possibly, effects, fools the brain into believing you are full, and can even stop the brain from thinking about food-got to love this proposition!(?)

However, there is no clear and/or convincing evidence of any medicinal effects of hoodia.

Scientists at the Council for Scientific and Industrial Research (CSIR), South Africa’s national laboratory, began studying hoodia and the initial results were promising -- lab animals lost weight after taking hoodia.

Later, the South African scientists, working in conjunction with a British company named Phytopharm, isolated the active ingredient in hoodia, a steroidal glycoside, which they named p57.Phytopharm has spent more than $20 million on hoodia research.

The company completed a double-blind, placebo-controlled clinical study in overweight, but otherwise healthy volunteers using the P57 extract from hoodia gordonii.The participants were split into two groups, one received the P57 and the other received a placebo. Each group was told to continue their normal diet and exercise.

The results of the study were as follows: When comparing the hoodia group to the Placebo group, the hoodia group had a statistically significant reduction in caloric intake, had a statistically significant reduction in body fat and had no adverse side effects--if it sounds to good to be true, it probably isn't!

The South African government has strictly regulated the exportation of hoodia to the rest of the world. A Convention of International Trade in Endangered Species of Wild Fauna and Flora (C.I.T.I.E.S.) certificate is required to legally export hoodia gordonii from South Africa.

C.I.T.I.E.S. is an international agreement between countries design to protect and regulate international trade of wild animals and plants. Hoodia gordonii is one of those plants protected by C.I.T.I.E.S.The demand for real hoodia is great, but the supply isn't.

Until very recently, hoodia gordonii was only found in the wild in South Africa. Hoodia is difficult to grow.It requires 4-5 years to mature and temperatures in the range of 122F. The supply is scarce, which keeps costs high. (in the range of $115-160 per lb for the un-concentrated raw material).

Due to the high demand and relatively short supply, about 60% of so-called hoodia products on the market are in fact counterfeit.Reputable manufacturers make their authentication documents available for consumer inspection on-line.

There are three different ways of processing hoodia. Knowing these different ways of making hoodia products is very important: Most of the hoodia capsule products are made from powder out of hoodia plants.The whole hoodia plant is ground into a powder. Products using this method claim that since Bushmen, alegedly, ate the whole hoodia plant, it's therefore the most effective way.

However, the Bushmen actually(?) peeled away the hoodia skin and discarded it; they didn't actually eat the entire hoodia plant. This is the cheapest type of hoodia to manufacture, and most likely, the least effective.

Hoodia extract products discard the fiber and skin, that just takes up room and provides little to no positive effect. This processing method extracts and concentrates the active ingredients.

These products usually come in 20:1 or 10:1 potency levels. 20:1 means that 1 g of this extract was made by using 20 g of the whole plant and 10:1 means that 10 g of the whole plant were used to make 1 g of their extract.

The NEW Institute has conducted an "anecdotal" clinical" study with a number of informed willing patients and myself.

The bottom line: unless you are a South African lab animal or Bushmen, stick to moderation, healthy diet and exercise.

Be well!

***This article is to be used for education and general discussion purposes only. It does not constitute medical opinion and should not be used for or relied upon as medical advice. Publication of this newsletter does not create physician-patient relationship between the reader and the author. The article does not contain comprehensive description of the subject issues discussed. It is based on present medical knowledge which is subject to change and is unclear in numerous respects. Statements regarding the bio-efficacy of the nutritional supplements have not been evaluated by the FDA. They are not intended to diagnose, treat, cure or prevent any disease. The issues discussed can not be resolved without specific analysis of the specific circumstances of each person. The readers should consult with their individual health care/wellness professional to resolve their individual situation. Regrettably, the author of this article will be unable to respond to individual questions, but will address issues of interest to the majority of our membership and the general public.

Tuesday, October 7, 2008

Freshly"" Frozen Sushi!

Originally posted on Friday, March 2, 2007

"Freshly" Frozen Sushi!-a fascinating expose of the "fresh sushi " myth appeared in the April 8, 2004 edition of New York Times, by Julia Moskin.

Consumers have a right to know and make choices based on informed decisions--here is our take on the issue:

The general sushi/sashimi eating public creates and propagates urban legends based upon particular chef’s “being in the know” for access to "just come out of the ocean" fish and other seafood and spending his/her early morning hours perusing local “fresh” fish markets.

This sushi eating public might not realize that fresh frozen seafood for sushi or sashimi consumption and is also commonly used in sushi restaurants, whether its referred to as: "fresh-frozen, freshly-cooled, previously frozen and thawed, re-freshed, flash-chilled"-- take your pick-its all frozen!

Most would be even more surprised to learn that if the sushi has not been frozen, it is illegal to serve it in the United States.The Japanese Restaurants Association of Southern California is not in a hurry to advertise as to why most seafood are “always in season (freezer?)”.

Some, actually, take pride in the fact that they do not use mictowaves to thaw the fish slated for sushi!

Shipping seafood from overseas by airplane would make the cost of most products impractical. Shipping high quality seafood by ship, in a frozen state, allows for a reasonable price for the consumer.

Many seafood items from around the world are prepared specifically for sushi or sashimi and are only imported in a frozen state.

I wonder how many fine “fresh” sushi restaurants tell customers upfront that they may be eating fish that has been in deep freeze for up to two years!

Modern fishing trawlers are virtual fishing factories at sea-seafood they harvest is cleaned, processed and flash frozen aboard ship within hours.

Many fish and shellfish (with the exception of tuna) that is suitable for eating raw must be must be frozen for seven days at negative 4 degrees Fahrenheit flash frozen within hours of harvest, and than must be kept for 15 hours at negative 31 degrees., or frozen for seven days at negative 4 degrees Fahrenheit.

But tuna is often frozen, too, not necessarily to make it safe, but because global consumption of sushi continues to rise.

Frozen fish usually costs about half as much wholesale as fresh. And some cuts, like the prized fatty toro, are practically unavailable fresh.A

At 76 degrees below zero, one can feel one’s hair follicles freeze. A 20-pound chunk of premium bluefin tuna is rock hard and cold enough to burn a blister on one’s finger.

But all it takes is a band saw, 10 minutes and a bowl of warm water to produce deep red, dewy slices of the finest sushi money can buy, the same toro served big cities sushi shrines.

There is only one question one should ask about "fresh" seafood: how long it traveled to distributors, whether it was kept cold enough in route to maintain its flavor and safety, or how long it has been on ice?.

Many fish and shellfish are "flash frozen" within hours of harvest. It might take several days for the same seafood to make it to your local seafood dealer as "fresh".

Fish from most supermarkets are up to weeks old, and not always properly taken care of, which is why they are not usually safe to eat raw.

It is important to remember that it will only be safe to eat raw for up to 2 days if properly stored.For safety reasons raw seafood is not recommended for people with poor immune systems.

Also, all freshwater fish which includes our salmon must be frozen to kill possible parasites, bacteria and viruses.

A parasite is a living organism dependent on a host for which it takes nourishment. It grows naturally in many animals and can be transmitted to humans and cause illness.

One of the major human health hazards of consuming uncooked, undercooked or unfrozen seafood are the parasites, particularly, nematodes, or roundworms, tapeworms and flukes.

Parasites occur in mackerel, squid, cod, haddock, fluke, pacific salmon, herring, flounder, monkfish, anchovy, and tuna.Within one to six hours after the ingestion of infected larvae, violent abdominal pain, nausea, and vomiting may occur.

Bacteria and viruses that cause disease do not normally occur in the part of the fish that is eaten, the intact muscle.However, fish fillets and steaks can become contaminated by improper handling, storage, or preparation.

There are many different types of bacteria, but one in particular is associated with the rice used to make sushi.

Bacillus cereus is a spore forming bacterium commonly found in soil, dust, and raw foods which when ingested can cause profuse watery diarrhea, abdominal pain, vomiting, and nausea.Another bacteria associated with seafood is Yersinia enterocolitica.

These bacteria are transmitted to humans by cross-contamination from raw to cooked seafood, the consumption of raw seafood, and temperature abuse.

When bacteria are ingested it causes diarrhea, vomiting, abdominal pain, and fever. Vibrio spp. is a bacterium that is commonly found in oysters and other shellfish (lobster, shrimp, clams and mussels.

Having placed all of relevant rules and regulations on the books, the FDA does not enforce the frozen-fish rule, leaving that to local health officials.

The agency says sushi fish can be frozen either by the producer, the wholesaler/distributor, or by the restaurant, and each party likes to believe that the other is taking care of it.

This uncontrolled “cross-reliance” can result in either “fresh” fish frozen and re-frozen 3-5 times, or simply unsafe for raw consumption by the general public resulting in food-borne illnesses and deaths.

Be Well!

This article is to be used for education and general discussion purposes only. It does not constitute medical opinion and should not be used for or relied upon as medical advice. Publication of this article does not create physician-patient relationship between the reader and the author. Dr.Dorodny assumes no responsibility and/or liability for any and all actions and/or inactions by any person(s) as a result of this article. The article does not contain comprehensive description of the subject issues discussed. It is based on present medical knowledge which is subject to change and is unclear in numerous respects. The issued discussed in this article are not intended to diagnose, treat, cure or prevent any disease. The issues discussed can not be resolved without specific analysis of the specific circumstances of each person. The readers should consult with their individual health care/wellness professional to resolve their individual situation.

Sunday, October 5, 2008

Fish Oil v Fish

From www.AskDrD.com, posted May 9, 2006


"A new tuna warning for pregnant women” article in the Health section of the June 12, 2006 issue of the Los Angeles Times stirred quite a controversy in the health and wellness community.

As a result, the NEW™ Institute in Malibu, California has received a number of inquiries. The original article (May 9, 2006) was published in response to legitimate concerns of the general public caused by mass media desire to cause a sensation, rather than provide useful information.

Fish oil supplementation has waxed and waned in popularity over the past decade.In the late 1990s when large clinical trials such as the GISSI study were published supporting the cardiovascular benefits of omega-3 fatty acids, fish oil became one of the most sought after supplements.

Hence, most health and wellness experts recommend consumption of fish and shellfish to meet some of the human bodies’ requirement for fish oil.However, due to fish oil's less than desirable taste characteristics, it was not well tolerated by even its most ardent supporters.

Improved molecular distillation processing has helped to enhance fish oil's purity and flavor and there are now even more studies to support the benefits of fish oil supplementation that reach beyond heart health.Some of the these studies were presented at the Omega-3 Fatty Acids: Recommendations for Therapeutics and Prevention Symposium, Institute of Human Nutrition, Columbia University College of Physicians and Surgeons, New York in October of 2005.

Recent studies by Craig L Jensen, M.D. (that included outcome measurements of gestational length and birth weight, preeclampsia, recurrent miscarriages, and maternal depression) have found positive associations between fish intake and gestational length and birth weight.

In a randomized multi-center trial, supplementation of 2.7g EPA and DHA from 20 weeks gestation or 6.1 g EPA and DHA from 33 weeks gestation reduced risk of preterm delivery.Preeclampsia is a common problem during pregnancy, especially as maternal age increases.

Observational data of potential effects of n-3 fatty acids on preeclampsia and related conditions show benefit.Additionally, the potential effects of n-3 fatty acids and recurrent miscarriages are promising.

Pilot study supplemented fish oil in patients with persistent anti-phospholipid syndrome associated recurrent miscarriages and found over a 3-year period, 86% of the patients had well babies.

Clinical depression has been associated with low levels of n-3 fatty acids, particularly DHA. A large, multi-country observational study of postpartum depression found a negative correlation between seafood consumption and/or breast milk DHA concentrations and postpartum depression.

Maternal DHA levels decline during pregnancy (as well as postpartum) as DHA is transferred to the fetus or newborn to aid in neural development.

Studies by Susan E. Carlson, M.D. clearly demonstrated that there is definitive evidence that DHA is essential in cognitive and visual development of a fetus/child because DHA is concentrated in the brain and retina.

Dr. Carlson discussed the positive long-term effects of early DHA supplementation related to higher Bayley Psychomotor Developmental Index (PDI) (gold standard for neurological development, measures body control, coordination and fine motor skills) in scores at 30 months, higher IQ at 4 years, higher MFFT (Matching Familiar Figures Test) score and speed at 6 years, and lower diastolic and mean blood pressure at 6 years of age.

However, the specific benefits of adequate DHA intake during periods of rapid brain development may not be measurable until older ages. Infant development studies often compare formula to human milk.

Human milk levels vary and the United States is considered an "at risk population" for low DHA levels, because US women consume lower levels of DHA compared to intake in other countries.
Human milk DHA content varies primarily as a result of mother's dietary intake differences.

The highest levels of DHA in human milk are found in the Japanese and marine China female populations.The United States has some of the lowest levels of DHA in human milk. In the United States, DHA was added to infant formula in 2002.

To reach worldwide median human milk DHA consumption levels, formula should contain 0.3% to 0.4 % DHA and women who are considering getting pregnant, who are pregnant and are breastfeeding should consider supplementation -- current recommendations are 300 mg/day.

Epidemiologic studies in the United States report 500 mg/day of n-3 fatty acids can decrease CHD (coronary heart disease) risk and mitigate many risks of pregnancy as well as to contribute to the fetal and neonatal cognitive development.The average American diet only provides 100 mg EPA and DHA per day.

This is 5 times less than the amount observed for cardiovascular benefit and also 5 times less than the WHO's current dietary recommendation for EPA and DHA. Not only are consistent recommendations needed, strategies to increase intakes are also necessary.
Some recommendations are to increase fish intake, while others recommend specific amounts of EPA and DHA either as supplemental or marine sources.

Since March 2004, the Food and Drug Administration and the Environmental Protection Agency have recommended women who are pregnant, nursing or planning to become pregnant should eat no more than 6 ounces of albacore tune a week; and recommends up to 12 ounces (the amount of fish in two meals) per week of fish and shellfish low in mercury, such as shrimp, salmon, light tuna and catfish for general population.

Current prudent recommendations for consumption of fish (other than tuna) high in n-3 fatty acid contents are anchovies, mackerel, salmon, sardines, sea bass, swordfish, and trout.Some of these fish also need to be consumed in limited amounts because of mercury and other toxins. Swordfish, king mackerel, shark, and tilefish should be limited to 7 oz/week; red snapper should be limited to 14 oz/week; while salmon, catfish, and mahi-mahi have no restrictions.

Water sources have differing toxic levels of mercury, PCBs, digoxins, and others that may alter these general suggestions.However, Consumer Reports magazine published by Consumers Union recently said that 6% of canned tuna tested by the FDA “contained at least as much of the metal—in some cases more than twice as much—as the average albacore”.

It further recommends that women who are pregnant, nursing or planning to become pregnant eat neither “fresh”, nor canned tuna.

Again, this a “knee-jerk” overreacting by an ill qualified layman organization that creates panic, without informing the general population of the fact, that nutritional benefits of fish oil in seafood (especially in general population) easily outweigh the risk of trace amounts of contaminants.

Clearly, the general public often receives conflicting, and frequently contradicting, recommendations from mass media, Governmental and private sources--not only are consistent recommendations needed (please see above), but strategies to increase intakes are also necessary.

An effort by Kris-Etherton to substitute fish oil with walnut, flaxseed, soybean, and canola oil can contribute to meet LNA (pre-cursor of EPA and DHA) failed, despite the results from the landmark Lyon Diet Heart Study.

A Mediterranean style diet could provide approximately 0.6% to 1% energy or 2 g LNA, no more than 7 g per day LA, be rich in oleic acid, poor in saturated fat, and low in n-6 fatty acid sources.

The American diet, unfortunately, does not mimic these fatty acid intakes and is very high in n-6 fatty acid intake, which hinders the ability for LNA to be converted to EPA and DHA.

Having understood the critical importance of EPA and DHA for healthy childbearing and proper cognitive development of fetuses, infants, children and adults, and following the recent recommendation of the Consumer Reports, where should a pregnant and/or breastfeeding women to turn to?

Nutritional supplements of the health food grade fish oil, even in rather lower doses recommended by most of the over-the-counter manufacturers (700-1500 mg/day) generally provide a proper level of protection for pregnancy and child development.

Levels of in-organic (Dioxins, Mercury, etc), as well as microbial contamination of those supplements could be as high as in the fish it’s made from. However, in the recommended doses the possible side effects of contaminants are, probably, negligible.

The commercial grade fish oil is affordable and easily available.


Pharmaceutical grade (PG) oil is produced through 8-stage purification process followed by concentration with resulting no trans fats, and higher levels of EPA and DHA and low contaminants levels.

Some PG fish oil products contains 100 times less PCB's than health food grade fish oil, has twice the EPA and DHA as found in health-food grade fish oil.

Further, most people will not experience mild gastric problems often found with high doses of health-food grade fish oil.

The supply of this type of pharmaceutical grade fish oil is very limited since it takes 100 kg. of health-food grade fish oil to make just 1 kg. of pharmaceutical grade fish oil!

One teaspoon of the liquid OmegaRxTM contains 1.8 grams of EPA and 0.9 grams of DHA.

Such quality of fish oil is usually not available in health food stores because the supply of this type of pharmaceutical grade fish oil is very limited since it takes 100 kg. of health-food grade fish oil to make just 1 kg. of pharmaceutical grade fish oil!

And that is why one teaspoon of the liquid OmegaRxTM may contain 1.8 grams of EPA and 0.9 grams of DHA.

Although pharmaceutical-grade fish oil costs 10-20 times more than health-food grade, responsible manufacturers keep their price per gram of EPA and DHA as low as possible as shown below:


Product Grade: Price PerGram ofEPA & DHA


Lowest grade health food grade $0.30
Molecular distilled health food grade $0.54
OmegaRxTM Pharmaceutical grade capsules $0.56
OmegaRxTM Pharmaceutical grade liquid oil $0.49

All & all, pharmaceutical grade fish oil offers significant advantages and wellness benefits than the health food grade one, a
nd, yes, higher concentration requires a lesser number of capsules to swallow!

Happy fishing and/or fish oiling.

Be Well!

***This article is to be used for education and general discussion purposes only. It does not constitute medical opinion and should not be used for or relied upon as medical advice. Publication of this newsletter does not create physician-patient relationship between the reader and the author. The article does not contain comprehensive description of the subject issues discussed. It is based on present medical knowledge which is subject to change and is unclear in numerous respects. Statements regarding the bio-efficacy of the nutritional supplements have not been evaluated by the FDA. They are not intended to diagnose, treat, cure or prevent any disease. The issues discussed can not be resolved without specific analysis of the specific circumstances of each person. The readers should consult with their individual health care/wellness professional to resolve their individual situation.