<p>In this episode, Bill Harris, Ph.D. in human nutrition and expert on omega-3 fatty acids, sets the table by clearly defining the families of fatty acids (saturated, monounsaturated, polyunsaturated) before diving into the current landscape of polyunsaturated fat (omega-6 and omega-3) with a particular focus on EPA and DHA (the two main elements of fish oil supplements). Bill gives a historical overview, updates us on the latest science related to the health benefits, and provides plenty of insights as to how we should think about increasing our EPA and DHA intake.</p> <p><span style="color: #2b2e2f;">We discuss:</span><span style="color: #333333;"><br /> <br /></span></p> <ul> <li><span style="color: #2b2e2f;">Bill's long history of studying fatty acids [6:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">Defining the fatty acids—SFA, MUFA, PUFA, omega-3, omega-6, and more [9:45];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">What is the significance of fatty acids? Why should we care? [19:45];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">History of fat phobia, saturated fat, and does PUFA reduce cholesterol? [23:45];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">Breaking down the conversion process of omega-6 and omega-3 fatty acids including how we get to EPA and DHA [28:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">Takeaway from Bill's 1980 study looking at how salmon oil affected cholesterol and triglyceride levels [36:15];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">History of our understanding of omega-3 and its effect on LDL cholesterol [45:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">Prescribed fish oil drugs vs. OTC supplements—Differences and recommended brands [52:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">Health benefits of EPA [57:45];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">Potential benefits of ALA and how it compares to taking EPA and DHA directly [1:12:45];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">Health benefits of DHA [1:17:15];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">Cell membrane omega-3 index—What is it, the role of genetics, how to increase it, and a recommended target [1:19:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">Is EPA or DHA neuroprotective? Can it help with depression? [1:23:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">Recommended fish to eat for EPA and DHA - Any mercury concerns? [1:25:45];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">Can omega-3 mitigate risks associated with smoking? [1:29:15];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">The problem with the omega-6 to omega-3 ratio [1:30:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">The problem with labeling any kind of fatty acid as "bad" [1:36:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">Why increasing EPA and DHA intake matters more than reducing omega-6 intake [1:38:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">Important takeaway from the VITAL study [1:46:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">Importance of testing your omega-3 index [1:53:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">Exciting study coming out soon, and why you need to take your fish oil with food [1:57:15]; and</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #2b2e2f;">More.</span><span style="color: #333333;"><br /></span></li> </ul> <p><span style="color: #2b2e2f;">Learn more: <a href="https://peterattiamd.com/">https://peterattiamd.com/</a><br /> <br /> Show notes page for this episode: <a href="https://peterattiamd.com/billharris">https://peterattiamd.com/billharris</a><br /> <br /> Subscribe to receive exclusive subscriber-only content: <a href="https://peterattiamd.com/subscribe/">https://peterattiamd.com/subscribe/</a><br /> <br /> Sign up to receive Peter's email newsletter: <a href="https://peterattiamd.com/newsletter/">https://peterattiamd.com/newsletter/</a><br /> <br /> Connect with Peter on <a href="http://Facebook.com/PeterAttiaMD"><u>Faceboo</u></a><u>k</u> | <a href="http://Twitter.com/PeterAttiaMD"><u>Twitter</u></a> | <a href="http://Instagram.com/PeterAttiaMD"><u>Instagram</u></a>.<br /></span></p>
Actionable Insights
1. Health Target: Aim for 8-12% Omega-3 Index
Strive to achieve an omega-3 index (red cell EPA + DHA) between 8% and 12%, as this range is considered healthy, compared to the average American’s 4-5%.
2. Health Monitoring: Measure Blood Omega-3 Levels
Assess omega-3 status (e.g., red cell EPA DHA) as regularly and importantly as cholesterol, as low omega-3 levels have significant health implications.
3. Dietary Protocol: Consume Both EPA and DHA
For overall health and any medical condition, aim to consume both EPA and DHA, as they naturally occur together in fish and are both beneficial.
4. Dietary Protocol: Prioritize Oily Fish
To maximize EPA and DHA intake through food while minimizing mercury concerns, prioritize oily fish such as salmon, sardines, herring, and mackerel.
5. Dietary Flexibility: Fish or Supplements for Omega-3s
While consuming fish is preferred, obtaining EPA and DHA through supplements (either EPA-only or EPA+DHA) is an effective alternative, considering personal preferences, cost, and ecological factors.
6. Supplement Protocol: Take Ethyl Ester Omega-3s with Food
To ensure optimal absorption of ethyl ester forms of omega-3 supplements (like Vascepa and Lovaza), always take them with food, as absorption is significantly reduced on an empty stomach.
7. Health Protocol: Re-test Omega-3 After Four Months
After making changes to omega-3 intake (diet or supplements), wait approximately four months before re-testing blood levels to allow for the red blood cell turnover and reach a new steady state.
8. Health Monitoring: Focus on Omega-3 Index
Concentrate on raising the absolute levels of EPA and DHA (Omega-3 Index) if they are low, rather than getting distracted by omega-6 to omega-3 or AA to EPA ratios, as increasing EPA/DHA addresses the core issue.
9. Health Protocol: Increase EPA/DHA to Lower AA
If the goal is to lower arachidonic acid (AA) levels, the most effective strategy is to increase EPA and DHA intake, typically through fish oil supplementation.
10. Dietary Focus: Focus on Increasing EPA/DHA
Instead of overly focusing on reducing omega-6 fatty acids, prioritize increasing EPA and DHA intake in the diet, as the primary problem is a lack of these beneficial omega-3s.
11. Dietary Principle: Fish Benefits Outweigh Mercury
The health benefits derived from consuming fish, including its omega-3 content, generally far outweigh the potential downsides of small amounts of mercury.
12. Dietary Strategy: Replace Saturated with Unsaturated Fats
If reducing saturated fat intake, replace it with monounsaturated and polyunsaturated fats rather than carbohydrates or other macronutrients to avoid potential health problems.
13. Decision-Making: Evaluate Interventions by Safety, Cost
When evaluating interventions with even a hint of benefit, especially those that are extremely safe, cheap, and have no drug interactions, consider adopting them.
14. Depression: Use EPA-Rich Omega-3s
For potential effects on depressive symptoms, choose omega-3 supplements that are richer in EPA than DHA.
15. Dietary: Avoid High-Mercury Fish (Pregnancy)
Pregnant and lactating women should avoid high-mercury fish like tilefish, swordfish, king mackerel, and shark due to potential adverse effects on neurodevelopment.
16. Supplement Choice: Reputable Omega-3 Supplements are Quality
High-quality omega-3 dietary supplements from reputable companies are generally comparable in quality to FDA-approved pharmaceutical-grade products.
17. Health Monitoring: Prefer Red Cell Omega-3 Test
Opt for a red blood cell omega-3 test over a plasma test for a more stable, long-term marker of omega-3 status.
18. Health Monitoring: Access Omega-3 Index Test Directly
Individuals can order a finger-stick omega-3 index test directly from OmegaQuant’s website for $50 to assess their red blood cell EPA and DHA levels at home.
19. Supplement Protocol: Take Omega-3s with Dinner
If practicing intermittent fasting or not eating breakfast, take omega-3 supplements at night, as close to dinner as possible, to ensure they are consumed with food for better absorption.
20. Mental Model: Body’s Buffering Capacity
Recognize that the body has a significant buffering capacity in cell membrane composition, meaning dietary changes may not drastically alter tissue levels of certain fats as much as one might expect.
When evaluating health information, prioritize sources that are transparent about financial incentives, as direct payment for recommendations can compromise trustworthiness.
22. Deconstruct Complex Terms
Overcome intimidation by complex terminology by breaking down terms and understanding their underlying meaning or context to make learning easier.
23. Utilize Visual Aids for Complex Topics
For technically dense subjects like fatty acid chemistry, refer to diagrams and figures in show notes to better understand the material.
24. Reference Studies for Deep Understanding
When discussing scientific subject matter, consult the referenced studies to gain a deeper, evidence-based understanding.
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