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, and, 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.

From Mangled Care to Direct Health CarING©

The process of health carING© is almost insurmountable in its multifaceted complexity, thus according to the rules of non-linear dynamics it simply can not be “managed”.

What can be managed, meaning rationed, are the ever-rising costs of such carING©.

“Managed care” is a primary oxymoron by default; in its present form is best described as mangled care.

When originally introduced to our naive country and promoted by then ,and still, misguided and ill qualified Mrs. Clinton and her Jackson Hole Task Force, mangled care was, defined as:

" A prepaid risk-based system of integrated health care delivery, having appropriate capabilities to improve quality of care and manage utilization and cost of a given population.” (Thomas Morrow, MD., at NMHCC/IT Fall 1998, Los Angeles, CA)

These for-profit extremely profitable mangled care companies have embraced, and function under divergent and practically mutually exclusive core values.

On one hand, these companies are obligated to provide rather than ration health care services.

On the other, their entire existence hinges on their obligation and ability to generate consistent profits for their executives and shareholders.

More often than not, provision of appropriate health carING© and profit margins of mangled care companies come into direct conflict.

This conflict fuels a “double explosion” of the system: while availability and quality of health services goes down; costs of services to purchasers and profits of mangled care companies go up.

This abominable situation creates significant financial “counter-incentives” to provision of appropriate, accessible, affordable health carING© which can be gauged by the divergence coefficient.

Such counter-incentives further negatively effect already financially squeezed powerless and frequently frustrated health providers.

In addition to divergent and conflicting core values, double explosion, financial counter-incentives and overall patient and provider frustration there is, what I coined, business disconnect.

Entire purpose for insurance, companies, HMOs and other "mangled" health care organizations existence is to grab as many pennies from consumer’s health care dollar as they are allowed to by the workers.

Business disconnects exist due to interlined logistical, financial, physical and ethical aspects of mangled health care:

•The recipient usually does not request, does not order, or pay for the service.

•The payor never requests, does not receive, nor order the service.

•The orderer does not pay, nor receive the service.

In order to achieve their business objectives, here are some of the strategies used:

•If someone is already paying a lot, let him or her continue.

•Even if a lot of people complain about managed care quality, it won’t contain cost.

•Never provide coverage unless the treatment is unpleasant.

•Quality is being in a waiting room with people who earn more money than you do.

Please visit www.workingamerica.org/healthcarehustle maintained by AFL-CIO for real life stories.

Despite such an unorthodox business model, they do grab a sizable chunk: 17 cents out of every healthcare dollar without actually working, being sick, or providing services.

Here are three of many “secrets” in health carING © that health insurance companies do not want health consumers to know:

• Health consumers can request and receive health carING© from doctors, nurses,

pharmacists, hospitals, labs, pharmaceutical companies, and others without mangled care.

• Doctors, nurses, pharmacists, hospitals, labs, pharmaceutical companies, and others can

provide health carING© without mangled care.

• Healthcare consumers can pay for health carING© without mangled care companies.

Only complete elimination of mangled care as the middle man, can generate enough money to provide appropriate, accessible and affordable health carING©.

Patient-driven health care model promoted by mangled care must give way to direct health consumer-administered health carING ©.

I, for one, am willing to make a difference and show the way.

We are making a difference (MAD), you decide!

Milestone achievement by the NEW™ Institute is a victory for health consumers.

Yesterday, September 23 2008 FDA finally launched a long awaited crackdown against companies marketing prescription medications without government approval.

The NEW™ Institute involvement with the skin cream containing papain, derived from the tropical papaya plant, provided evidence that manufacturers were selling it without federal validation of their safety and efficacy.

The cream is being touted by about a dozen of manufacturers for treatment of chronic (non-healing) skin ulcers from diabetes and other causes.

As of today, there is no single approved version of such cream in a "business" worth about $50 million a year.

The adverse reporting noted that frequently the cream was of no help to patients and caused life-threatening allergiс reactions.

Companies making this unapproved cream have till November 24 to file for FDA approval or cease production in lieu of FDA seizures and other legal actions.

Be Well!

Prof V.S. Dorodny to re-enter clinical practice

Having dedicated most of my professional activities since 2006 to pursuit of Academic and Research endeavors, I am happy to announce that I will be returning to Clinical Practice before the end of 2008.

A dully licensed California Physician & Surgeon with over 30 years of traditional medical experience, I am also a Naturopathic Doctor with over 10 years of experience of convergent, and, frequently, symbiotic approach to the management of all chronic and multi-systemic disease states.

My areas of expertise encompass traditional medical practice and naturopathy with a focus on nutrition, botanical medicine, homeopathy, hydrotherapy, physical manipulation, pharmacology and psychology.

Naturopathy is a philosophy which encompasses a view of life, a model for living a full life. The word naturopathy is a Latin-Greek hybrid which can be defined as 'being close to or benefiting from nature.'" - Stewart Mitchell, Naturopathy: Understanding the Healing Power of Nature.

Naturopathic Medicine is the practice of assisting in the health of patients through the application of natural remedies. Most naturopaths consider their care complementary, not supplementary, to the care a traditional medical professional.

However, the field and its practitioners remain mostly unregulated even in a progressive State of California with only few, at least for know, that can formally called themselves Doctors of Naturopathy. (N.D.)

There are tens of thousands of natural bio-active food supplements and preparations that are being marketed to the general public. Clearly, there is an expressed need for an orderly, studied and unbiased assessment of the benefits and risks of this burgeoning marketplace.

The recent (2007) shutdown by the FTC/FDA of the $250-million-a-year liquid vitamin manufacturer SeaSilver sent shock waves through the booming food supplement market.

While there are a number of lessons to be learned by long overdue and clearly warranted enforcement action, the most important message is probably this: A whole lot of people spent a great deal of money on a product which, as far as regulators were concerned, was marketed in wholly inappropriate and perhaps misleading fashion.

When family health and well-being are at stake, we all want the best information available. We all want the correct information.

We want unbiased information. The National Institute of Health (NIH), the Food and Drug Administration (FDA), and other agencies that we traditionally rely upon to serve as vanguards of medical authenticity are experiencing funding and manpower shortages, as well as conflicts of interest.

While these agencies are without doubt the most capable sources of evaluating legitimate health-benefit claims, they are buried by the sheer volume of their mandates, and have difficulty coping.

Having served as a Consumer Representative on the FDA’s general Scientific Advisory Board (1998-2002), the need was clear.

In July 2003, the FDA set forth the conditions under which it will exercise enforcement discretion for qualified health claims: "…when it determines, based on the totality of publicly available scientific evidence (including evidence from well-designed studies conducted in a manner which is consistent with generally recognized scientific procedures and principles), that there is significant scientific agreement, among experts qualified by scientific training and experience to evaluate such claims, that the claim is supported by such evidence".

To provide a repository for scientific data about naturopathic supplements that empowers health consumers and providers to make good, safe decisions; and serves as an additional resource for the regulatory community, I founded the Naturopathic Evidence-based Wellness Institute (NEW™) in May of 2003 in Malibu, California.

Finally, the NEW™ Institute provides an authoritative resource for the manufacturers of food supplements to educate their markets about the true benefits of their products through compelling and compliant advertising and marketing.

Over the past 2 years we were inundated by requests for information, consultation and direct care. Responding to the needs of health care consumers I will be announcing the new physical location and contact information in mid-October 2008

Be Well!

Lethal Injection Deemed Constitutional

WASHINGTON--The Supreme Court on Wednesday rejected a challenge to the lethal three-drug cocktail used in most U.S. executions during the past 30 years.

By a 7-2 vote, the high court rejected a challenge by two Kentucky death row inmates who argued the current lethal injection method violated the constitutional ban on cruel and unusual punishment by inflicting needless pain and suffering.

"We too agree that petitioners have not carried their burden of showing that the risk of pain from maladministration of a concededly humane lethal injection protocol, and the failure to adopt untried and untested alternatives constitute cruel and unusual punishment," Chief Justice John Roberts wrote in the court's main opinion.

Death penalty opponents argued the condemned prisoner can suffer excruciating pain, without being able to cry out, if given too small a dose of the anesthetic.

States began using the three-drug lethal injection method in 1978 as an alternative to the historic methods of execution -- electrocution, the gas chamber, hanging and shooting.
But in recent years there have been botched lethal injection executions in Florida and California, in which inmates took up to 30 minutes to die.

Executions in the United States last year fell to a 13-year low of 42, and have been temporarily halted since the court agreed in late September to decide the case. The ruling clears the way for executions to resume.

Justices Ruth Bader Ginsburg and David Souter dissented.

Sen. Obama supports Eugenics

On 3/23/2007 Sen. Barack Obama without much fanfare introduced Senate bill S.976 with a stated purpose “to secure the promise of personalized medicine for all Americans by expanding and accelerating genomics research and initiatives to improve the accuracy of disease diagnosis, increase the safety of drugs, and identify novel treatments”.

“Genomics and Personalized Medicine Act of 2007” among its key provisions will:

· establish the Genomics and Personalized Medicine Interagency Working Group (IWG) to facilitate collaboration, coordination, and integration of activities among federal agencies relating to genomic research and initiatives;

· establish a national biobanking distributed database for the collection and integration of genomic data and associated environmental and clinical health information;

· establish a grant program for academic medical centers and other entities to develop or expand biobanking initiatives;

· improve genetics and genomics training for diagnosis, treatment, and counseling of adults and children for both rare and common disorders;

Eugenics is a social philosophy which advocates the improvement of human hereditary traits through various forms of intervention. Throughout history, eugenics has been regarded by its various advocates as a social ­responsibility, an altruistic stance of a society meant to create healthier and more intelligent people, to save resources, and to lessen human suffering.

Earlier proposed means of achieving these goals focused on selective breeding, while modern ones focus on prenatal testing and screening, genetic counseling, birth control, in vitro fertilization, and genetic engineering.

Enter “humanitarian eugenics” that strives ""to leave a genuine legacy of love to future generations: good health, high intelligence, and noble character. It advocates measures to improve the innate quality of humankind which are entirely voluntary".

Opponents argue that eugenics is immoral. Historically, a minority of eugenics advocates have used it as justification for state-sponsored discrimination; forced sterilization of persons deemed genetically defective, and the killing of institutionalized populations. Eugenics was also used to rationalize certain aspects of the Holocaust.

Sen. Obama’s introduction of the Bill, coupled with availability of over the counter genetic testing in fact, advocates and promotes eugenics by creating a national genetic bank leading to definitive identification of “less-than-perfect” (LTP) Americans possibly in violation of the Americans with Disabilities Act.

Since there are no clear laws or guidelines as to the ownership, storage, analysis, release, exchange and application of such information, Sen. Obama’s Bill simply invites abuses by individuals, companies and the State.

Outfits such as Future Generation and Eugenics Watch claim that :“Selection must not be left to chance for chance is cruel, capricious and, all too often, expensive but must instead be led by the kindly elite - Harvard professors, British aristocrats, Serbian psychiatrists, Aryans and so on. But death control, which has been the main method used by natural selection or chance, for termination of useless populations, must be replaced by birth control which is cheaper, and, as Charles Darwin pointed out in The Descent of Man, more effective”.

Sen. Obama obviously agrees, but prefers new massive Government bureaucracies described in his eugenics-enabling Bill to control the “selection” process and to legitimize "humane"or “positive” Governmental discrimination and eugenics.

We are making a difference (MAD), you decide!

Dr.D.

Genome Unleashed

An expert on confidentiality and security of health information, co-author of HIPAA of 1996 and a former co-Editor of "Information Security" Journal I am compelled to sound off.

For "only" $1,000. web-based startup “23andMe” offers a person an “unguided” tour of geneology offering predictions of its genetic future as well as its ancestral past. Similarly, "Navigenics" will match your genes to current medical research calculating your risk for a number of diseases.

“23andMe” was funded personally by the co-founder of Google, Sergei Brin (later repaid by Google!?) who's also married to the co-founder of 23andMe Anne Wojcicki.

Google's investment in the company is driven by its desire to obtain, control, and sell valuable information without owners’ knowledge and/or consent.

Given that the vast majority of patients are unable to comprehend the results and will have to rely on the very same companies to “translate” them, most physicians are currently untrained for genomic medicine and are ill equiped to assist patients wielding printouts indicating “variations” in a particular gene possibly leading to successful claims of medical malpractice.

Issues of genomic information ownership and release create new fertile ground for litigation.
Who owns the genomic test results? Is it the patient, testing lab, Google, patient employer, insurance company, lending institution, state and/or federal government?

Fortunately for the genomic industry, Food & Drug Administration which strictly regulates diagnostic testing for diseases, has been “slow to respond” to business practices of these companies and its consequences!

An individual can finally make a quick life-changing decision (even deadly one) based on the results of a genetic test. Armed with individuals genomic information employers can deny employment and/or promotion'; insurance companies can and will deny coverage; banks will deny loans under the justification of unreasonable business risk?

We are Making a Difference (MAD), you decide.

Dr.D.