Tag Archives: LDL

Fish Oil Supplements

We are often told that we should eat oily fish or take a fish oil supplement, but why? When? Which one do you choose?

Why do you need fish oil?

Although maligned by the weight loss industry, dietary fats exist for a reason. They are present in plant and animal tissue because they perform vital functions for those organisms and, when we consume them, they do the same for us. The body needs to ingest or synthesise a ready supply to maintain health. Some lipids are even essential because they cannot be manufactured by the body and must be obtained through diet. There are many different forms of lipids, one of the most crucial subsets are the essential fatty acids (EFAs), omega-3 and omega-6.

Some anthropologists believe consumption of omega-3 fats lead to profound changes in the human brain. We probably evolved on a 1:1 ratio of omega 3:6 in our diets (1). Post agricultural and industrial revolutions, this has dramatically switched in favour of omega-6 and is now closer to 16:1. Balancing omega-3 and 6 fats is crucial for the management of many chronic diseases. Oils from cold water fish such as salmon, sardines, trout and mackerel have been the subject of thousands of research papers, showing efficacy for a number of conditions. They provide a rich source of the active omega-3 fats, eicosapentanoic acid (EPA) and docosahexaenoic acid (DHA). Vegetarian sources of omega-3 require further conversion in order to metabolise EPA and DHA.

The most obvious way to tackle the shortfall in dietary omega-3 is to consume more oily fish. Individual taste is often a barrier. Furthermore, the beneficial long chain omega-3 fats can be damaged by cooking and the larger fish such as salmon can contain high levels of heavy metals and other contaminants. Therefore fish oil supplementation presents a practical way to increase omega-3 intake, but not all fish oil products are created equally.

When choosing a product it is important to be sure that it has been produced with due regard to environmental impact, has an exemplary quality profile and is effective.

How much do you need?
The omega-3 essential fats, EPA and DHA, are mostly found in oily fish such as sardines and anchovies

To maintain healthy levels of essential fats, the government recommends that we all eat at least two portions of oily fish each week but this can be difficult to achieve through diet alone, especially if you don’t like to eat fish! A good quality fish oil supplement can be a great option to ensure levels are high enough to maintain good health.

How do you know if a supplement is good quality?

Here are a few tips when looking for a good quality fish oil supplement:

  • Look for a fish oil supplement that is produced from small fish such as anchovies and sardines as the levels of essential fats within these fish are naturally more concentrated. You will therefore get better quality oil.
  • Look at where the fish are sourced. Small fish sourced from areas such as the clear pacific waters will drastically minimise the level of pollutants. This will mean you will get cleaner, more pure oil.
  • Look for oil that has had minimal processing. Fatty acids are delicate and can become damaged when put through aggressive production methods. If minimal heat and chemicals are used, the oil will be closer to its natural form.
  • Look for variety. If fish oil is pure and clean, then it can be made into capsules and liquids that have very little fishy aftertaste. Some fish oils can even be mixed with fruit bases so that adults and children can enjoy taking a daily supplement.

References:

1. Simopoulos AP Evolutionary aspects of diet, the omega 6/omega 3 ratio and genetic variation: nutritional implications for chronic diseases. Biomedicine and Pharmacotherapy 60 (2006) 502-507.

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The role of omega-3 in heart health

Deaths caused by cardiovascular disease are generally premature and could easily, in some cases, be prevented by making lifestyle changes that include adopting a healthy lifestyle and increasing physical activity.

The role of lipid lowering (cholesterol and triglyceride) in reducing the risk of mortality and morbidity from cardiovascular disease is well documented. The cardiovascular benefits of omega-3, certainly in terms of cholesterol and triglyceride management, are probably the most researched of all the dietary nutrients known to influence cardiovascular disease risk. With the recent approval of the use of pure eicosapentaenoic acid (EPA) as a prescription treatment for hypertriglyceridemia [1] and with overwhelming evidence for EPA’s role over docosahexaenoic acid (DHA) in cholesterol management, [2] consumers should be aware of the differential effects of the two main omega-3s, EPA and DHA, on cardiovascular disease risk factors and why they should choose isolated EPA over generic fish oil.

EPA and lipid management

Whilst fish oil provides a convenient dietary intervention for maintaining heart health, the differential effects of the two main long-chain omega-3s, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on cardiovascular disease risk factors means that not all fish oil products are equal in their action.

Firstly, generic oils generally contain around 30% total omega-3 and are therefore not considered viable as a therapeutic. For example, the optimal triglyceride-lowering doses of omega-3 are 3-4g/day, with little evidence to support lipid-altering efficacy in doses of less than 1g/day. [3] In addition to providing a soluble means for transporting cholesterol and triglycerides through the blood, lipoproteins have cell-targeting signals that direct the lipids they carry to certain tissues.

Pharmepa Step 1: Restore (E-EPA 90) contains the purest ethyl-EPA concentrate available without prescription

Whilst high density lipoproteins (HDL) correlate with better health outcomes, effectively clearing cholesterol from the system, low density lipoproteins (LDL) are, in contrast, considered the cholesterol ‘bad boy’ and are responsible for the detrimental effects associated with total cholesterol.

Both EPA and DHA decrease triglyceride levels, and whilst EPA lowers LDL levels, DHA appears to increase LDL levels [4, 5]. Given that products that contain a mixture of EPA and DHA may increase LDL levels, the benefits of a pure EPA product understandably extend to both cholesterol and triglyceride management. Indeed, the cholesterol-lowering ability of pure EPA at a dose of 1.8 grams in a study of approximately 19,000 statin-treated patients with hypercholesterolaemia was shown to reduce the 5-year cumulative risk of major coronary events by 19%. Igennus’ Pharmepa Step 1: Restore (E-EPA 90) contains the purest ethyl-EPA concentrate available (90%) without prescription, delivers 1g pure EPA in just two easy-to-swallow capsules, and is ideal for those individuals wanting to manage cholesterol and triglyceride levels.

AA to EPA ratio and cardiovascular health

In addition to altering lipid metabolism, omega-3 may also improve cardiovascular health by inhibiting inflammatory products derived from the key pro-inflammatory fatty acid arachidonic acid (AA). AA and EPA are converted through phospholipase A2, cyclooxygenase (COX) and lipooxygenase (LOX) to prostaglandins, thromboxanes and leukotrienes, as well as various hydroxyl-fatty acids, and the AA to EPA ratio provides an established risk factor for numerous inflammatory-related conditions, including poor cardiovascular health. Indeed, inflammation is an important process in the development of cardiovascular disease; chronic inflammation, characterised by elevated plasma levels of inflammatory markers such as C-reactive protein (CRP) and IL-6, are commonly found in subjects at high cardiovascular risk, including type2 diabetics and patients with coronary heart disease. [6] Supplementing with EPA, in addition to triglyceride and cholesterol improvement, increases EPA blood levels, improves the AA to EPA ratio (which directly correlates with changes in improved LDL levels) and reduces cardiovascular related inflammation. [7]

In summary, EPA, unlike DHA, lowers levels of triglyceride, lowers ‘bad’ cholesterol and increases ‘good’ cholesterol, whilst reducing inflammation via management of the AA to EPA ratio. By providing pure isolated EPA at the concentrations required for therapeutic outcomes, Igennus’ Pharmepa range of EPA products are ideal health supplements for managing optimal heart health by managing lipid levels and modulating dysregulated inflammation. The prescription-strength ethyl-EPA Pharmepa Restore & MaintainTM  protocol is an innovative two-step treatment programme formulated to re-establish a healthy inflammatory status within the body. Step 1 counteracts an unhealthy AA to EPA ratio – the direct measure of inflammatory status, and step 2 ensures long-term balance for optimal cardiovascular health benefits.

References

1.  Ballantyne CM, Braeckman RA, Soni PN: Icosapent ethyl for the treatment of hypertriglyceridemia. Expert opinion on pharmacotherapy 2013, 14:1409-1416.

2. Yokoyama M, Origasa H, Matsuzaki M, Matsuzawa Y, Saito Y, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Itakura H, et al: Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 2007, 369:1090-1098.

3. Pirillo A, Catapano AL: Omega-3 polyunsaturated fatty acids in the treatment of hypertriglyceridaemia. International journal of cardiology 2013.

4. Itakura H, Yokoyama M, Matsuzaki M, Saito Y, Origasa H, Ishikawa Y, Oikawa S, Sasaki J, Hishida H, Kita T, et al: The change in low-density lipoprotein cholesterol concentration is positively related to plasma docosahexaenoic acid but not eicosapentaenoic acid. Journal of atherosclerosis and thrombosis 2012, 19:673-679.

5. Cottin SC, Sanders TA, Hall WL: The differential effects of EPA and DHA on cardiovascular risk factors. The Proceedings of the Nutrition Society 2011, 70:215-231.

6. Brevetti G, Giugliano G, Brevetti L, Hiatt WR: Inflammation in peripheral artery disease. Circulation 2010, 122:1862-1875.

7. Tani S, Nagao K, Matsumoto M, Hirayama A: Highly Purified Eicosapentaenoic Acid May Increase Low-Density Lipoprotein Particle Size by Improving Triglyceride Metabolism in Patients With Hypertriglyceridemia. Circulation journal : official journal of the Japanese Circulation Society 2013.

 

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