Monday, September 8, 2008

A Practical Approach to Omega Fats

Hunter-gatherers and healthy non-industrial cultures didn't know what omega-6 and omega-3 fats were. They didn't balance nutrients precisely; they stayed healthy by eating foods that they knew were available and nourishing. Therefore, I don't think it's necessary to bean count omega fats, and I don't think there's likely to be a single ideal ratio of n-6 to n-3. However, I do think there's evidence for an optimal range. To find out what it is, let's look at what's been done by healthy cultures in the past:
  • Hunter-gatherers living mostly on land animals: 2:1
  • Pacific islanders getting most of their fat from coconut and fish: 1:2 or less
  • Inuit and other Pacific coast Americans: 1:4 or less
  • Dairy-based cultures: 1:1
  • Cultures eating fish and grains: 1:2 or less
It looks like a healthy ratio is between 2:1 and 1:4 n-6 to n-3. Some of these cultures ate a good amount of n-3 polyunsaturated fat, but none of them ate much n-6. There are three basic patterns that I've seen: 1) low fat with low total n-6 and n-3, and a ratio of less than 2:1; 2) high fat with low total n-6 and n-3 and a ratio of 2:1 or less; 3) high fat with low n-6 and high n-3, and a low carbohydrate intake.

I think there's a simple way to interpret all this. Number one, don't eat vegetable oils high in n-6 fats. They are mostly industrial creations that have never supported human health. Number two, find a source of n-3 fats that can approximately balance your n-6 intake. In practical terms, this means minimizing sources of n-6 and eating modest amounts of n-3 to balance it. Some foods are naturally balanced, such as grass-fed dairy and pastured lamb. Others, like coconut oil, have so little n-6 it doesn't take much n-3 to create a proper balance.

Animal sources of n-3 are the best because they provide pre-formed long-chain fats like DHA, which some people have difficulty producing themselves. I don't trust flax because paleolithic humans wouldn't have eaten anything like it, and it's full of phytoestrogens. Fish oil and cod liver oil can be a convenient source of n-3; take them in doses of one teaspoon or less. As usual, whole foods are probably better than isolated oils. Weston Price noted that cultures throughout the world went to great lengths to obtain fresh and dried marine foods. Choose shellfish and wild fish that are low on the food chain so they aren't excessively polluted.

I don't think adding gobs of fish oil on top of the standard American diet to correct a poor n-6:n-3 ratio is optimal. It may be better than no fish oil, but it's probably not the best approach. I just read a study, hot off the presses, that examines this very issue in young pigs. Pigs are similar to humans in many ways, including aspects of their fat metabolism. They were fed three diets: a "deficient" diet containing some n-6 but very little n-3; a "contemporary" diet containing a lot of n-6 and some n-3; an "evolutionary" diet containing a modest, balanced amount of n-6 and n-3; and a "supplemented" diet, which is the contemporary diet plus DHA and arachidonic acid (AA).

Using the evolutionary diet as a benchmark, none of the other diets were able to achieve the same fatty acid profile in the young pigs' brains, blood, liver or heart. They also showed that neurons in culture require DHA for proper development, and excess n-6 interferes with the process.

With that said, here are a few graphs of the proportion of n-6 in common foods. These numbers all come from nutrition data. They reflect the percentage n-6 out of the total fat content. First, animal fats:


Except salmon oil, these are traditional fats suitable for cooking. Except schmaltz (chicken fat), they are relatively low in n-6. Next, vegetable oils:


These range from very low in n-6 to very high. Most of the modern, industrially processed oils are on the right, while most traditional oils are on the left. I don't recommend using anything to the right of olive oil on a regular basis. "HO" sunflower oil is high-oleic, which mealns it has been bred for a high monounsaturated fat content at the expense of n-6. Here are the meats and eggs:

n-3 eggs are from hens fed flax or seaweed, while the other bar refers to conventional eggs.

A few of these foods are good sources of n-3. At the top of the list is fish oil, followed by n-3 eggs, grass-fed butter, and the fat of grass-fed ruminants. It is possible to keep a good balance without seafood, it just requires keeping n-6 fats to an absolute minimum. It's also possible to overdo n-3 fats. The traditional Inuit, despite their excellent health overall, did not clot well. They commonly developed nosebleeds that would last for three days, for example. This is thought to be due to the effect of n-3 on blood clotting. But keep in mind that their n-3 intake was so high it would be difficult to achieve today without drinking wine glasses full of fish oil.

Freezing

Its so cold in this house. My fingertips are blue.

Yesterday I went for another fill. I had 0.3mls put in. This takes me to 6.3ml in my band.

I cant say that I feel a whole lot different, but I am not sure...

This is such a surreal thing. I know what 'way to tight' feels like. I know what 'oh so slack' feels like. What I have now is I think different to a few days ago... but I'm not sure.

Hmmm. I will monitor it for a few days and see.

Today's intake:
Breakfast
1 wholemeal pitta with cheese and onion sandwich filler
Lunch
1 bowl tomato soup and 2 slices bread and butter
Dinner
spaghetti carbonara and a green salad.
Snack
Vanilla fromage frais.

I have not been hungry between meals. I feel full and satisfied, but able to complete my meal. I have not been sick.

Hopefully this is it. I am slightly panicky that my band is broken... not because I actually think it is, but because in some strange sense I felt that when I was choking on every meal at least I knew the band was there, whereas now I am eating, albeit gingerly, adequate amounts. I am worried that something will go wrong, I guess because I have put on weight. I have put on 8 pounds in the last 4 weeks. 2 pounds a week since I had my really restrictive fill taken out. That's stressed me out a hell of a lot.

I just hope being back to work, coupled with 0.3ml will sort me out for a while. I don't think I can face another drive to London this month!

Saturday, September 6, 2008

Omega Fats and Cardiovascular Disease

I noticed something strange when I was poring over data about the Inuit last month. Modern Inuit who have adopted Western food habits get fat, they get diabetes... but they don't get heart attacks. This was a paradox to me at the time, because heart disease mortality typically comes along with the cluster of modern, non-communicable diseases I call the "diseases of civilization".

One of the interesting things about the modern Inuit diet is it's most often a combination of Western and traditional foods. For example, they typically use white flour and sugar, but continue to eat seal oil and fish. Both seal oil and fish are a concentrated source of long-chain omega-3 (n-3) fatty acids.The 'paradox' makes much more sense to me now that I've seen
this:

It's from the same paper as the graphs in the last post. Note that it doesn't take much n-3 to get you to the asymptote. Here's another one that might interest you:

The finding in this graph is supported by the Lyon diet heart study, which I'll describe below. One more graph from a presentation by Dr. Lands, since I began by talking about the Inuit:


Cardiovascular disease mortality tracks well with the n-6 content of blood plasma, both across populations and within them. You can see modern Quebec Inuit have the same low rate of CVD mortality as the Japanese. The five red triangles are from
MRFIT, a large American intervention trial. They represent the study participants divided into five groups based on their plasma n-6. Note that the average percentage of n-6 fatty acids is very high, even though the trial occurred in the 1970s! Since n-3 and n-6 fats compete for space in human tissue, it makes sense that the Inuit are protected from CVD by their high n-3 intake.

Now for a little mechanism. Dr. Lands' hypothesis is that a high n-6 intake promotes a general state of inflammation in the body. The term 'inflammation' refers to the chronic activation of the innate immune system. The reason is that n-3 and n-6 fats are precursors to longer-chain signaling molecules called eicosanoids. In a nutshell, eicosanoids produced from n-6 fatty acids are more inflammatory and promote thrombosis (clotting) more than those produced from n-3 fatty acids. Dr. Lands is in a position to know this, since he was one of the main researchers involved in discovering these mechanisms. He points out that taking aspirin to 'thin' the blood and reduce inflammation (by inhibiting inflammatory eicosanoids) basically puts a band-aid over the problem caused by excess n-6 fats to begin with.


The
Lyon Diet Heart Study assessed the effect of n-3 fat supplementation on CVD risk. The four-year intervention involved a number of diet changes designed to mimic the American Heart Association's concept of a "Mediterranean diet". The participants were counseled to eat a special margarine that was high in n-3 from alpha-linolenic acid. Overall PUFA intake decreased, mostly due to n-6 reduction, and n-3 intake increased relative to controls. The intervention caused a 70% reduction in cardiac mortality and a large reduction in all-cause mortality, a smashing success by any measure.

In a large five-year intervention trial in Japan,
JELIS, patients who took EPA (a long-chain n-3 fatty acid) plus statins had 19% fewer cardiac events than patients taking statins alone. I don't know why you would give EPA by itself when it occurs with DHA and alpha-linolenic acid in nature, but it did nevertheless have a significant effect. Keep in mind that this trial was in Japan, where they already have a much better n-6/n-3 ratio than in Western nations.

In my opinion, what all the data
(including a lot that I haven't included) point to is that a good n-6 to n-3 ratio is a basic necessity for vibrant health and proper development. In the next post, I'll talk about practical considerations for achieving a good ratio.

Thursday, September 4, 2008

Omega-3 Fats and Brain Development

Another interesting study that Dr. Hibbeln sent me is about the link between maternal seafood consumption and neurodevelopmental outcomes in children. The study is about as powerful as epidemiology gets, with an enrollment of 11,875 mothers.

The bottom line is short and sweet: compared to the children of mothers who ate 340 grams or more of fish per week, children whose mothers ate very little fish had an increased risk of low verbal intelligence, poor social behavior, poor motor skills, poor communication skills, and poor social development. These associations remained after adjusting for 28 potential confounders, including social status, level of education, stressful life events, smoking, alcohol, and several others.

In support of this association, in another study the four-year-old children of mothers who were given DHA and arachidonic acid supplements had higher IQs than those given "placebo" (corn oil). There have been a number of trials of varying quality that have shown varying results with n-3 supplementation, so I'll leave you to decide what you think of this. A 2007 review I found on n-3 supplementation and brain development states that "the evidence for potential benefits of LCPUFA [long-chain polyunsaturated fatty acid] supplementation is promising but yet inconclusive".

I do think it's interesting to note that the brain has the highest concentration of long-chain n-3 fats of any organ, and eating n-3 fats in the form of fish, fish oil or cod liver oil increases the amount in tissues. Eating too much n-6 depletes the brain of DHA and adversely affects neuron development in piglets. n-3 deficiency affects the release of serotonin (a neurotransmitter) in rat brains.

Put it all together, including the data from the last two posts, and I think there's sound evidence that a good balance of n-3 to n-6 fatty acids is important for optimal brain function and perhaps development.

DishNetwork & DirectTV Suffer Service Standards

Hello Neighbors!Normally I do not use this space to voice my concerns or complaints about commerce.However: I am fed up! I am exasperated with "customer support" and "call centers" to be exact. Where o'where has the service gone?We have recently been Dish Network customers: disappointed by their highly inferior customer service and disinterest in customer satisfaction. Calls for help are put on

Wednesday, September 3, 2008

Ok, I have chilled a little

Right, maybe I was so damn moody because I got the dreaded curse again. What is with that? I wish I could take a pill and it would just go away forever. I hate it. Its like every week! It seems I just start to forget about the last awful episode and feel a bit better again and then WHAM! The painters are in again. Its not fair. I wish I was a man!

Anyway, like I said, I have actually chilled a little today. There is little point trying to punish myself when most of the weight gain could possibly (here's hoping) be down to the curse.

So today I did some shopping and went to the cinema and saw Get Smart... kinda funny in places, but not as good as it could have been. Quite tragically cheesy. Had lots of familiar faces in it though... some bloke from WWF or Gladiators or something, the guy from Evan almighty, and what looked like Warf from Star trek, and also a bloke I am SURE has been on James bond.

anyway, that's it really. Oh, and an Albanian guy has looked around the room... GULP.

Fat and f*&%ed off

I am serious annoyed.

This morning, after a drink and fully dressed I weigh 16 stone 3.

THAT SUCKS BIG TIME

I have already booked another fill for Sunday, but got I am depressed.

I have decided that I have to take 1 day at a time. Stick to healthy eating each day and not look too far ahead. If I think to myself in 1 week I hope to lose 2 pounds... etc then things seem to go rubbish.

I am gonna just try to eat day by day and not worry about stuff.

I was 15 stone 7 a while ago... this feels like crap. REAL crap. Just shows how much restriction the band can give you because I have put on 9 pounds since being unfilled 3 and a half weeks ago. OH MY GOODNESS!!! That is horrendous.

I am listening to Nirvana's unplugged album that I got for our anniversary on Saturday. Its wicked, but is sadly not lifting my mood much! All that angst and stuff

What is with those lyrics man...

Underneath the bridge
tarp has sprung a leak
the animals are trapped
they've all become my pets
feed em up with grass
and the drippings from the ceiling
Its ok to eat fish
'cos they don't have any feelings.

What a load of TRIPE. I used to think it was all so full of meaning, but its just a pile of crap.

RARRRRRRRRR

I have just printed off all my pupils contracts for this year and put my prices up by a poxy 25p. like that's gonna help! that's like an extra £8 a week. WOOOoooooooo!

I feel miserable.

I hate being fat