Omega-3 Q&A with Bill Harris

Sure. I my degree is in nutrition from about nineteen seventy-eight and I've been studying omega three fatty acids and health and then fatty acids in general. really since that time, about forty five years. I've spent my first half of my career was studying really the effects of giving fish oil

To people on their blood lipid levels, cholesterol, triglycerides, different lipoproteins, that was and the effects on bleeding, on platelet function, on those sorts of things. That was about 20, 25 years, and then about twenty-five years ago, we developed the omega-3 index blood test for omega-3 status. And then using that, I got interested in more the epidemiology.

of health looking at relationships between blood omega three levels and risk for a variety of diseases. and that's what I've been doing really for since then.

Yeah, the omega 3 index is a blood test. can be done on a dried blood spot and sent through the mail, or it can be done with a tube of blood. But we measure the omega 3 cont the EPA and DHA content of red blood cell membranes. That's our that's what the test is. It's much if your listeners are familiar with a hemoglobin A1C type test for people with diabetes or prediabetes.

it's a very stable long-term marker of omega-3 status like the A1C is for glucose. And it's also it's good because it's a tissue. The red blood cells are tissues, not plasma. And like all other cells in the body, the omega-3s find their way into the membranes. And so we like to use the red blood cell EPA DHA membrane fatty acid levels as a we we call that the omega-3 index.

yeah, deficiency interesting word. we we think a healthy target is over eight percent. eight percent of the so eight eight percent of the fatty acids in a red cell as EPA plus DHA. That's kind of the goal. we think under four percent is probably the place you really don't want to be, and then s then four to eight is kind of intermediate. eight to twelve is what we call our our green zone, our happy zone. Americans are

in the low four percent. the we just there was just a paper published it was a national federally funded survey of the omega-3 index of Americans and it was four point two five percent on average for adults which is dancing around the low end. a similar survey was done in Canada a few years ago about four point five percent. Never been done in England per se.

In fact, it's never been done anywhere else besides the US and Canada a as a formal national survey. But that's kind of probably where people are in the West generally.

y right. if you're starting around there we're th we think roughly fifteen hundred milligrams a day of EPA and DHA on average. we get a person from four percent to eight percent. That's based on studies we published. it would probably take in the neighborhood of three to four months to reach a new stable, steady state, to get all those red cells up to date on omega three.

Combine.

Yeah. So you might take two or three pills depending on what you're taking, right?

Not that we know of. populations like the Japanese and the Koreans have omega three index levels in the eight to ten, maybe even twelve percent level, which is high, very high. It's certainly for Americans and and most of us in the West, that's that's a h very high level. And there's no downside. They these people live longer, they have their lower risk for heart disease.

so we we haven't seen any downside for having higher levels. I mean, there's a point, which we don't really know where it is, because again you can't do studies when you haven't got many people up there. But there's got to be a a point beyond which there is no point in going any higher. but we don't I I would say that's probably around twelve percent. Not that it's damaging, not that it's harmful, it's just that there's you know, why do it? Why go f even higher, right?

Not for the most part. yeah, we th there is some evidence that for treating depression, products that are richer in EPA it might be better, but that really hasn't shown up in other disease outcomes. I w I t always recommend people take both of them, not worry much about the ratio. I wouldn't get excited about it. As long as you get you're getting something like you know, forty percent, sixty percent, fifty fifty,

Somewhere in there. N not ninety ten, you know. let's that's the way it is in fish. I mean, let's look to nature and that's where you see it.

it improves it. If particularly if it's a I mean there are different forms, we probably will get into this later, but there are different forms of omega-3 chemical forms. The most the natural form is the triglyceride form, which is an oil, it's standard fish oil, like vegetable oil, I mean there's triglyceride is a common dietary fat form. That's well absorbed. phospholipid forms like from krill oil, they're well absorbed, but if it the the ethyl ester form, which is a

a form that the pharmaceutical products are typically come in are not as well absorbed and they they definitely benefit from having a f fatty meal when you take your omega threes.

Well t t to me a capsule is a soft gel. So that to me that's the same thing. but yeah, a a powdered pill, you can't put omega threes in that kind of form. They they're they're lipids. they have to be liquid.

Yeah.

I I think they've w worked very hard to do their best to make fish oil products good and and and healthy. I that's industry wide standard. there really isn't any governmental organization that could set a standard that would that one would have to legally follow. So the industry has for for years tried to say if you're gonna be a member, if you're gonna you know

put the Go Ed logo on your bottle, for example. I'm not s I think they do that. y you've got to meet these standards.

No, I don't I don't think we can say that w we haven't got any evidence that it causes harm. I mean there was an interesting study done some years ago in Norway l w looking at this oxidation question and how harmful is it. And so these researchers did some pretty amazing things to me. they took raw f or fish oil that they're going to put in a capsule and they put it in a beaker on the

Desktop and just bubbled oxygen through it, which is way more oxidation than anything's ever going to happen just naturally. They forced it and they did this for you know like a day. Crazy oxidation. Then they put those pills, that oil into capsules. And then they did a randomized study of the unoxidized oil and the oxidized oil. They gave it to volunteers for eight weeks, I think. And then they measured.

blood levels of oxidation products of lipids and just inflammatory markers. They didn't find anything. I it's like the body can handle this. either they're it just never absorbed any adverse products or the it just I mean who knows if you do that for years yeah who but by and large, I mean that study kind of convinced me that

There are a lot of things in life to worry about besides the o level of oxidation. Now that one product you showed and you you s shared with me earlier, I appreciate that. yeah, that's that's a real outlier. It was I don't know what happened to that, but even if you're taking that, I mean I would think you get some pretty nasty burps, fishy burps from that kind of product, and you might just throw it away after that. sh but as far as doing physical harm, I don't think we really have evidence that it does.

Yeah.

Right. tell me about it. Right.

Mm-hmm.

I'm not absolutely sure. Certainly if a if a capsule in that bottle broke open. definitely. You definitely I'm you you would definitely smell that. If it's and none of the capsules have opened, I don't know that you would smell it. I'm not sure because the the encapsulation is is pretty intense. I mean it it's hard to oxygen can't get in.

I'm not sure how odors can get out, but maybe they could.

That's a that's that's a good question. it it will probably be different. You know, th th the the simple everybody's different d doesn't really help explain anything. it it will depend on of course, like you mentioned earlier, what you what do you take it with. it will depend on what your and what your starting omega three level is. I think your presumption is that people are taking exactly the same amount of omega three. I mean

From food and and capsules. Yeah, we did a study, golly, some years ago where we gave people, I think, eighteen hundred milligrams a day of EPA DHA, six capsules a day is what it took, for about five months, which is plenty of time to get stables. And some people's omega-3 index went up by five, six, seven units, which is great. Some only went up one or two units. And

It was an a remarkable spread to me. I mean that's I would have thought it would be a little tighter than that. but it was a randomized study, so everybody had, you know, kind of started out in the same place. Each group did. so I mean to me that just underscores the importance of testing.

And so yeah. And I didn't I didn't address your why why question. I a and I guess the easy answer is we don't know why. it it it could be absorption, it could be red blood cell tur or fatty acid turnover, that is to say, you maybe burning fatty acids instead of incorporating them in membranes, and that's just your own genetics might determine that. So a lot of stuff between the mouth and the blood.

Exactly.

certainly possible. I guess the question is even in that I mean again you sent me I think eight data data from eight samples that you had tested and one of them was crazy off the scale. What I don't remember seeing on that chart was the alg the level of EPA and DHA actually much lower than it should have been, or these oxidization was.

Okay. So I mean that that's an interesting point because when we talk about oxidation, you can get it it doesn't take many molecules of EPA and DHA to get whacked by oxygen to raise oxidation levels and but the actual mass of omega three there, you know, say it's supposed to be three hundred milligrams per pill, and maybe it five milligrams of that three hundred get

really badly oxidized and smell and and raise the total and all this stuff. You still got 295 milligrams of omega 3s. I you know it's it's the issue is how much EPA and DHA is actually being absorbed. not so much because I don't think it doesn't take much to of a degradation to really cause a stink.

Yeah. first of all, don't believe what you see on the front of the bottle, because the important information is on the the the nutrition facts panel or the ingredients panel on the on the back side of the product. And I assume you've got these in the UK, we certainly have it here. And and you look for first of all, it will tell you the whole point is to tell you how much of fat, protein, carbohydrate, and omega 3 is there.

And look for the serving size first. Because they will say a serving is one capsule, a serving is two capsules or three capsules, whatever they want to call a serving. And then all the numbers below that will tell you how much EPA and DHA is per serving. And so if you find a product that has two capsules, has a total of 500 milligrams EPA and DHA per serving.

Then you know each capsule is 250 milligrams. so you really gotta do a little bit of math to figure out how much omega-3 you're getting per capsule. So, yeah, and to your point, how do you know a good one? The it to some extent it goes with the price. The more exp the more concentrated the product, I mean the more omega-3 per pill, which means more concentrated,

the manufacturers had to go through more steps to purify and concentrate. So it's going to cost more. So there is a rough the more it costs in general, the more likely it's going to be a highly concentrated and cleaner, quote quote, because the more you concentrate, the more you remove other stuff. And that just so you pay for that.

You mean it like in a fish oil capsule? Yes. Yeah. There are what are they? Right. the kind of standard or original omega 3 concentrate was called Maxepa. It's it's about thirty percent EPA plus DHA, roughly. meaning that it's seventy percent other stuff. And the other stuff is really nothing

it's very garden variety fatty acids that you get in other foods you're ch you're eating. Nothing weird or unique that's makes up the difference in fatty acids. Excuse me. like you know, palmitic acid, oleic acid, these are very common fatty acids, some of which you you can make anyway and you're I don't even need to eat. Not not beneficial, really, not harmful.

To me, they're just kind of neutral.

Yeah.

Interesting. I mean i I I generally think about expiration dates, I don't pay a lot of attention to them on on any any foods. I I just, you know, s don't I I guess I've had enough foods that are supposed to be expired that just taste fine. you know, and so I don't I don't worry a lot about it. the the basis for putting an expiration date

on a product I'm not sure is chemically determined or it's just they just don't they just want you to buy more product. Yeah. so yeah, I mean you have you have an interesting example in in the eight that you did, that was close to expiration and it should have been. So I mean there is a case where it makes sense to pay attention to the expiration date. yeah.

You still have the bottles?

Yeah.

Yeah, sure, sure. Yeah, but that's that's a good idea. And don't put it in the fridge. You know, just just leave it out and see how it goes.

Should. I mean every everything slows down cool temperatures. So yeah. And and they're almost all of them come in yeah, they they all come in colored bottles, so the light can't r really get in and and create oxidation. So that's pretty standard green or brown or plastic. Yeah, right.

Well, one capsule a day would not do much. that's where you have to look at the dose. So that's roughly two two hundred and ninety milligrams, something like that. It's a combined EPA plus D, something like that. Yeah, there then you if if if you wanted to aim for f fifteen hundred, you'd need to take, you know, three to five, six, seven, a lot of those things. yeah.

And then and then you're getting that's for those other fats you were talking about. You're really just adding calories to your diet. that's not necessary. That's why I like a c more concentrated product.

Right, right.

It's fine. It's the same chemistry, the same EPA and DHA. They just and that's really where fish ultimately get their EPA and DHA is up the the marine food chain from these single celled algal organisms that make EPA and DHA. And then again, they fish don't really make the omega 3s any more than we do.

They have to eat it. So it it starts there with algae. Algae's just more expensive.

That's all. But it's good.

Yes. That's that's correct. So right, and that's probably gonna make the algal products a little more attractive in the next year or two. the the Peruvian fishery is g they're very careful to maintain it and they have warmer waters there, the fish are going deeper into the ocean and harder to catch and so they're the the Peruvians are into I mean most of the fish oil we get

comes from Peru. That's just where they catch it. And it goes all over the world. And so they're they're very careful about putting up with the down down years to make it up in the up years.

Right. Right.

I th I I f I've ha been on a c a crusade, I guess you'd say, to try to stamp that thing out to because I think it's a very con confusing metric. it it's number one, you don't even know what you're applying. I mean if you're talking about a fish oil or a food or your total diet or your whole blood or what w what race are you talking about? Number one and number two, it doesn't it doesn't

differentiate between the omega all the different omega-3 fatty acids, just pools them all together and sort of assume they're all doing the same thing. And for the omega-6, the same. It just pools all of them and says they all act the same way. And we know that's absolutely not true. So putting a total omega-3 and a total omega-6 together e i e it doesn't tell you anything. Thirdly, you get you can have a high level of omega 3 and a high level omega six.

And a low omega-3 and omega and have the same ratio. So how helpful is that? I mean, it doesn't really tell you what to do about it. And it also implies that the omega-6 fatty acids, really the ones we primarily eat, which is linoleic acid, an essential fatty acid, it implies that that's a bad player. There's this idea that the omega-6 are bad, omega-3 are good. Well, omega-3 are good, but the omega-6s are not.

Bad. Linoleic acid, we've done several studies looking at blood levels of linoleic acid, again, which is the omega-6. That's 90% of the omega-6 we eat is linoleic acid. And we've looked at again blood levels in large populations, UK Biobank, for example, a something near and dear to you. We've seen that.

The people who have the highest level of linoleic acid in their blood, w when the study started, which is somewhere about fifteen years, twenty years ago, we we look at who's living the longest. And we found that the people who had the highest linoleic acid levels, presumably because they're eating more linolac acid, that's the only way you can't make it, so you we gotta eat it. They were the ones that live

Live the longest, had the l the lowest risk of death during the study follow-up period of time. People had the highest risk of death are the ones that had the lowest levels of linoleic acid. So it's studies like that, and we've seen that for we've seen that for dementia as well, high linoleic, lower risk for dementia over time. And we've seen that for diabetes, seen that for heart disease. to me it's that's really interesting data and and

People who are saying we gotta avoid omega-6, we gotta reduce the omega-6, to me the the onus is on them to explain why having a high linoleic acid links to better health outcomes and why they think we ought to reduce it. Because to me it looks like you're just gonna make worse health outc outcomes if you do that. So anyway, that's that's a a little bit of a tirade. I just don't like the omega-6 omega-3 ratio. I mean, that's why we picked

EPA and DHA, the omega 3 index, that the problem in America and the West is the lack of EPA and DHA. It's not the presence of the omega 6s. It's the la and people get distracted when you think about this ratio. I can fix my ratio if I just eat less omega 6. Well, that's not the thing to do. You need to eat more EPA and DHA. And not ALA, the plant omega 3. That's not going to do it for you.

that's part of the other confusion of the ratio. You think you can just eat plant omega three and you'll fix your ratio, but that's not helping you.

Well they're linoleic acid, yeah. They're found in i in the U I mean they come originally in in soy in vegetable oils, soybean oil, cotton seagull. And then th those oils get used in hundreds of different products, I think. there's when you look at the kinds of foods, you know, salad dressings, but then like chicken dishes or carascor casseroles or

But it's in lots and lots of different kinds of foods. A little bit here, a little bit there. So it's what you don't want to do is just intentionally avoid them. Avoid the omega sixes. That's what I think people this is what I think the problem with the seed oil thing is. It's it's the the omega six part of the seed oil is not the problem.

Exactly. It could be certainly the the the company it keeps could certainly be part of the problem.

Mm-hmm.

Right, right. Fair enough.

Mm-hmm. That'd be fun.

what you mean the the lab in Poland doesn't do the ma omega six products?

Or I mean

Well, pretty minor. I mean if you certainly stored it cold, if you it froze it, you know, a and then send it from frozen, they'd thought out that that shouldn't that'd be okay. I mean, I wouldn't object to that. I mean it it'll be a lot easier. Yeah.

Right, right. I mean you can go to a fast food place and get a sample of their French fries, you know, and that but I don't know if they'll be able to tell you. You d y yeah, and then you gotta ask I d I they probably couldn't tell you. How long has this oil been boiling? Well, we change it every X hours, you know. It's hard to it's hard to put your finger on that unless you can do it yourself in a lab. But yeah, just cooking some chicken. So it's a great idea.

I don't cook much, to tell you the truth.

I'm yeah, I'm living the dream. I I w we have olive oil, we use coconut oil to make granola. We use just vegetable soybean oil, which is fundamentally the vegetable for some frying. We don't do a lot of that. I I don't worry a lot about it.

Yeah, sure. Cool.

Yeah, actually we have a lab in Sterling, Scotland. that the Omega three index can be pr I assume if you look for Omega three indexed maybe UK you'll find either that or just the omega look for omega quant is the name of the laboratory. So omega q an t dot com. and I th I suspect if you Google that or go to that from the UK it would take you

to the the lab of the Sterling. I'm not sure. But anyway.

Right. Right.

Sure. That'd be that'd be cool.

Well that that happens. Yeah. So so test yourself before you start, you know, don't too many people I'll I'll test myself, but wait a minute, I gotta I gotta get my levels back up again before I test. That's not the point. See where you're at. Right, exactly.