INTRODUCTION
In November of 1998, I began studying and writing about essential fatty acids (EFAs) as they relate to brain function and development in children, and sustaining a healthy brain as people age. Initially I recommended consumption of fish, flaxseeds and supplements containing flax, borage, and primrose oils to supply your body with EFAs. Since then, more research (and clinical experience with my patients) has led to changes and improvements in my recommendations. In my office I am now treating many children who unfortunately have a myriad of learning and behavior disabilities, including ADD, AD/HD, OCD (obsessive compulsive disorder), PDD (pervasive developmental disorder), ODD (oppositional defiant disorder), GAD, NLD, DCD, DDS, SID, Asperger’s syndrome, Autism, Tourette’s syndrome, bipolar disorder, dyslexia, dyspraxia, and depression. Please see my ADD and AD/HD section of the website for more information about the treatment program. I do not recommend the intake of fish regularly, due to global contamination with mercury and other toxins. In addition, one would have to eat a substantial amount of fish to replenish brain and body stores of two critical omega-3 EFAs, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), which many of us are lacking. EPA and DHA are the essential fatty acids critical for proper nervous system growth and health. Another important fatty acid, AA (arachidonic acid, omega-6) is present in animal foods and is over-consumed in the typical American diet. Many people take supplements that contain ALA (alpha-linolenic acid), which comes from flax and other oils. However, the conversion of ALA to DHA and EPA is inefficient in humans. If you are interested in increasing EPA and DHA levels in your body, in breast milk, and in your children, I recommend taking a purified fish oil supplement. High quality fish oils can be filtered and purified to remove mercury and other toxins, and you can get a concentrated, convenient dose of EPA and DHA without having to eat a lot of fish. I also recommend taking a liquid rather than a gel cap, and many oils are pleasantly flavored. In my experience, most children and adults tolerate the flavored liquids well. If you can’t take a liquid, many tasty chewable and non-chewable capsules are available to deliver the critical EPA and DHA. Remember, I always recommend that moms and dads “to be” get their EPA and DHA levels up well before having children. This means cleaning up your diet (more on that later), and taking a fish oil supplement regularly before conception, ideally, a year before. Pregnant and nursing moms should continue fish oil supplements. Of course, breast-feeding is critical for healthy development of a baby’s brain. In my opinion, formulas that are fortified with essential fatty acids are inferior to human breast milk, especially if a nursing mother continues with a healthy diet and fish oil supplementation. Also, please tell your doctor you are taking fish oil, and if you are taking blood thinner medication, you must talk to your doctor before taking fish oil.
SOME FATS ARE HEALTHY
Although many commonly consumed fats are unhealthy, not all fats are evil. EPA and DHA (and to a smaller extent, ALA and AA) are essential for healthy nerve cell membranes, myelin (nerve insulation), neurotransmitters (message chemicals), and mitochondria (the energy producing workhorses of cells). These EFAs are crucial for proper brain growth and development, and to maintain a healthy brain throughout your life. Brain tissue is 60% fat; therefore essential fats play an important role in your mental, physical, and emotional health. One-third of fat intake needs to be polyunsaturated, derived directly from diet. Retinal (eye) neurons require higher concentrations of unsaturated fatty acids (FAs); this is why eye function is particularly sensitive to deficiencies of FAs. FAs in the cell membranes also become messengers in times of crisis (trauma, virus, bacteria, free radical, toxin) and are transferred into highly active hormone-like substances, called prostaglandins (PG). FAs are precursors of prostaglandins. Worthy of note is PGE2, which is highly inflammatory, and is derived from processed, packaged foods, too much animal meat and dairy products, and refined carbohydrates. Although needed, elevated PGE2 causes too much inflammation, an overactive immune system, and mood and behavior problems. The typical western diet includes a large amount of foods that enhance PGE2. Increased inflammation is receiving more attention as undesirable inflammation may lead to a whole host of health problems, including chronic pain, MS, fibromyalgia, atopic diseases in children (allergies, asthma, ear infections, skin problems), and all forms of arthritis (osteo, gout, rheumatoid, psoriatic), among others. PGE3 is mildly anti-inflammatory and immune enhancing, and inhibits the activity of PGE2. PGE3 is derived from EPA and DHA. Therefore, EPA and DHA from fish oil fight inflammation.
OMEGA-6:OMEGA-3 RATIO
Certain FAs are of the omega-6 variety, and others are omega-3. The omega-6 to omega-3 fatty acid ratio is receiving more attention. Your goal omega-6:omega-3 ratio is 1:1. Current western diets have unhealthy ratios of 30:1 omega-6 to omega-3, and breast milk has shown to be as bad as 45:1. Over the past 75 years, several factors have decreased our omega-3 intake by 80%, and have contributed to the unhealthy omega-6 to omega-3 ratios commonly seen. Some factors include increased intake of warm weather oils, including corn, sesame, safflower, and sunflower oils, which are deficient in omega-3. Commercial hydrogenation of oils and a 2,500% increase in trans-fatty acid intake (processed food) has compounded these problems. Modern milling practices to make processed food has stripped cereal germ from grains, and a 250% increased intake of sugar (especially in children) has interfered with enzymes of FA synthesis. There has also been an increased saturated fat intake from animal meats and dairy products, with a decreased intake of fish. Unfortunately fish are contaminated with mercury and other hazards, so fish oil is the preferred source of EPA and DHA.
Although arachidonic acid (AA) is an omega-6 fatty acid and is important, it is already over-consumed. Increased intake of AA increases PGE2 levels, which increases systemic inflammation and the consequences mentioned above. AA consumption should be decreased by decreasing foods that contain AA, including beef, dairy products, pork, chicken, turkey, seaweed, squid, and processed food. Decreasing these foods will also improve the omega-6:omega-3 ratio.
BREAST MILK, COW’S MILK, and FORMULA
Human breast milk is always a healthier choice than cow’s milk or formula, as human breast milk provides brain-enhancing EPA and DHA, particularly if a lactating woman is taking fish oil supplements. Breast milk has other contents (antibodies, etc.), critical for a healthy baby, which will never be found in formula. Although the human breast milk omega-6:omega-3 ratio has worsened over the years, it can be improved with proper intake of omega-3 foods and supplements (especially if taken before pregnancy and breast-feeding begins). Cow’s milk contains saturated fat and is devoid of brain-fats, and should be limited or eliminated, in my opinion. Low fat dairy products are not good alternatives as they have undesirable protein levels and are contributors to osteoporosis, and many people are sensitive or allergic to dairy foods (plus they still lack brain fats). For years I have recommended elimination of dairy products in patients that suffer with allergies, seasonal allergies, chronic sinus infections, eczema and other skin problems, ADD, AD/HD and other learning and behavior problems, ear infections, asthma, lupus, rheumatoid, gout, psoriasis, and other autoimmune diseases. People who take my advice often enjoy wonderful improvements in their health (see the newsletters and testimonials elsewhere on my website). I recommend complete avoidance of dairy products in children and adults that seem to be sensitive (although I realize very few of you will take my advice). Of course, this should be done only with the advice of your healthcare practitioner (but remember some healthcare practitioners think this advice is ridiculous-let your results speak for themselves).
CONSEQUENCES OF LOW OMEGA-3 FATS
A deficiency in EFAs, and unfavorable omega-6:omega-3 ratios may cause conditions such as: multiple sclerosis (MS), ADD, AD/HD, OCD, ODD, PDD, GAD, NLD, DCD, DDS, SID, Asperger’s syndrome, Autism, Tourette’s syndrome, bipolar disorder, dyslexia, dyspraxia, dementias such as Alzheimer’s disease, Parkinson’s disease, age-related cognitive decline, vision problems, chronic fatigue/immune deficiency syndromes, PMS, post-partum depression, skin problems, mood disorders, depression, stress, cerebral palsy, schizophrenia, Crohn’s Disease/digestive problems, developmental delays, seizures, stroke, memory problems, migraines, aggression, tinnitus, neuropathy, high cholesterol, high blood pressure, macular degeneration, diabetes, diabetic neuropathy, and chronic pain, among others. These conditions may improve with fish oil supplements and improvements in diet. I do not think people should only take fish oil and expect miracles. In my opinion, fish oil should be taken with improvements in diet (see the nutrition section of my website for healthy food intake recommendations). I recommend you significantly increase your intake of fresh, good quality vegetables and fruit, and take antioxidant supplements to further aid and protect fish oil. Soy products, specifically whole soybeans and tempeh, may be added to the diet (if one is not sensitive to soy) to increase the intake of two important phospholipids phosphatidylserine (PS) and phosphatidylcholine (PC) (a.k.a. lecithin). These substances can also be found in supplements.
FISH and OMEGA-3 FOODS
Fish that contain the highest levels of EPA and DHA are (non-farmed, non-Atlantic, only wild caught) salmon, mackerel, herring, sardines, and anchovies. Other plant foods contain omega-3 fats, but not EPA and DHA, which are only found in fish. Algae (a plant source) has DHA, but we cannot consume enough algae to be effective. I have been taking fish oil daily for 10 years and occasionally eat the fish listed above. I prefer sardines as they are low on the food chain, and canned wild Alaskan salmon. Foods which contain omega-3 fats can help improve the omega-6:omega-3 ratio. For those that are able to “afford” the calories, the healthiest nuts include walnuts, almonds, macadamias, brazils, cashews, filberts, pecans, and pinenuts. Other foods which contain healthier fat include millet, oats, rice, rye, sorghum, wheat, flaxseed, olive, sesame seed, and avocado. If you have weight issues, some of these higher calorie foods may need to be limited. Work with your physician or other healthcare practitioner familiar with healthy food intake and healthy weight loss (in comparison to unhealthy weight loss such as drugs, supplements, surgeries, and fad diets).
Regarding cooking and baking, I believe the only oil that should exist in your household is olive oil. It should never be heated to the smoking point, and should be used sparingly (try sautéing with less oil and some water). I recommend complete elimination of all other oils, including sunflower, safflower, corn, canola, and vegetable oils, shortening, and margarine (organic butter is a much better choice). One of my patients is a professional pastry chef, and she has been able to successfully substitute olive oil for shortening and margarine in most recipes, to the delight of her clients. If you still decide to consume canola, flaxseed, borage, and primrose oils, never use them in cooking. Never use fish oil in cooking, either. If needed, you may mix fish oil in smoothies. Never heat any food with fish oil. Fish oil supplements should always be refrigerated, as these fats are sensitive to heat. Read my newsletter “all about fish oil” on this website.
ANTIOXIDANTS and FREE RADICALS
When consumption of FAs increases, antioxidants should be increased to prevent rancidity of FA’s by free radicals. Increased vitamins A, C, E (d-alpha-tocopherol and other mixed tocopherols), B-2, B-6, folic acid, B-12, zinc, magnesium, selenium, coenzyme Q-10, Alpha-Lipoic acid, and Glutathione are recommended. The Nutri-West supplement company has a supplement which contains most of these antioxidants, designed by Dr. Dan Murphy, DC, DABCO, and Dr. Harold McCoy, DC, DACS. It is called “complete omega-3 cofactors,” and I recommend taking this with fish oil. You can read the ingredients and levels of the cofactors on nutri-west.com, but unfortunately the supplement is only available through doctor’s offices.
Foods rich in antioxidants include various vegetables and fruit: carrots, broccoli, spinach, garlic, beets, sweet potatoes, red, green, bell, and hot peppers, alfalfa sprouts, kale, mango, nuts, cantaloupe, orange, grapefruit, cauliflower, yellow squash, tomato, and wheat germ. You should increase your intake of these foods with fish oil. Try to eat a variety of fresh, good quality vegetables and fruits every day. It will take work, and you will need to lead by example to get your children to follow along.
Substances that increase free radicals which can increase rancidity of FAs include: alcohol, drugs (prescription, non-prescription, recreational), spinal misalignments and subluxations, bacteria, viruses, toxic metals, decreased oxygen intake, smoking, stress, food allergens, and poor nutrition, especially processed food. The brain and nervous system are especially prone to free radical damage. Substances that can inhibit digestion and absorption of FAs are antacids, antibiotics, fungi, inadequate chewing, parasites, yeast, anti-inflammatory drugs, and sugar.
FATS and FOODS TO AVOID
Fats to reduce and avoid include saturated fats, hydrogenated fats, and trans-fats. These fats are unfortunately found in foods that taste good: beef, chicken, pork, dairy products, and commercially produced eggs. If you are an egg consumer, you should only consume range-fed, organic, omega-3 eggs. The omega-6:omega-3 ratio of commercial eggs is unhealthy and unfavorable; the omega-6:omega-3 ratio of range-fed eggs can actually be healthy (although, as Dr. Andrew Weil states, eggs should not be eaten with reckless abandon). Trans-fatty acids and hydrogenated fats are commercially altered fats and oils, commonly listed in ingredient lists as “hydrogenated or partially hydrogenated soybean, safflower, sunflower, or corn oil.” To reduce your trans-fat intake, avoid deep fried anything including french fries, fish, veggies, cheese, and chicken; potato, corn, and tortilla chips (unless baked with no oil or fat); shortening; margarine; doughnuts; cookies; cake; most salad dressings; candy; mayonnaise; junk food; cheese balls; certain types of bread, rolls, and crackers. Read ingredient labels as all packaged foods must be considered suspect. If you see any hydrogenated or partially hydrogenated fats or oils, don’t buy it. In other words, processed food is bad. Is this new news?
If an omega-3 FA deficiency exists, the body will replace the missing omega-3 with saturated, hydrogenated, and trans-fats. These bad fats make nerve cells “stiff,” and they cannot function properly, and do not work efficiently with neurotransmitters. Serotonin and dopamine cannot do their job due to these stiff membranes, with a variety of consequences. Drugs commonly prescribed for conditions relating to serotonin and dopamine dysfunction do not address the cause of the problems. Only a healthy diet, fish oil, and motion activities such as chiropractic, general physical exercise, PT, OT, massage, and rehab can address the causes. Trans-fatty acids can be passed via breast milk; therefore, trans-fat intake should be limited/eliminated especially before and during conception, pregnancy, and lactation. Both mom and dad should supplement with fish oil before conception, and continue to avoid bad fats. Trans-fats should be avoided to help prevent, or to help improve, cases of Parkinson’s disease, dementias such as Alzheimer’s disease and age-related cognitive decline, ALS, and MS. In my opinion, these disorders are not mainly caused by faulty genes; rather, they are caused by poor diet, especially the standard American diet as described, along with a lack of exercise.
Consider a consultation with a health professional knowledgeable in FA nutrition before you alter your diet and begin taking supplements. Also consider keeping a health journal and make daily entries of changes you have made and results you have experienced. Repeat blood tests should be performed to evaluate specific conditions. Blood tests for omega-6:omega-3 ratios are available (metametrix.com). Although taking fish oil supplements and consuming foods that contain healthy fats and antioxidants are generally safe, if someone experiences problems they should discontinue use and consult a health professional knowledgeable in FA nutrition. Consult your medical doctor if you are on blood-thinning drugs before taking fish oil. Remember to be patient, as improvements may take 6 months to a year in some cases, although some notice measurable changes in days or weeks. updated 2009
FISH OIL DOSAGE
Dr. Joseph Mercola (www.mercola.com) recommends one teaspoon for every 50 pounds of body weight daily. Using a teaspoon of Carlson Lab’s Fish Oil as a reference, a 150 lb. person would take 3 teaspoons (a tablespoon), which is about 3,900 mg (3.9 grams) of EPA and DHA combined. I agree this is a good dose to take, which is about a tablespoon a day for an average adult. Children may take less, but in many cases I have children with learning and behavior disorders on adult doses.
Dr. Dan Murphy, DC recommends 5,000 mg (5 grams) of EPA and DHA combined for adults that have Mild Traumatic Brain Injury (MTBI), resulting from injuries such as whiplash. Dr. Murphy developed his recommendations based on current research.
I vary my recommendations depending on the individual. Again, fish oil, especially higher doses, should be taken under the advice of your health care practitioner. With some conditions such as Multiple Sclerosis, I have seen favorable results with doses of 10,000 mg (10 grams). Again, I don’t recommend this for everyone, but for brief periods of time, for 3-6 months or more, higher doses may be useful. After higher doses are taken, one may be able to lower the dose to a maintenance level (see above). Young, healthy children may take lower doses. Consult with a practitioner knowledgeable about FA nutrition.
With nervous system conditions and health issues as previously described, fish oil and dietary changes should be used in conjunction with chiropractic care for optimum results. Please refer to other articles on my website for explanations how chiropractic care may assist the health of your nervous system. Consult with a chiropractor for evaluation and treatment recommendations, and some chiropractors are knowledgeable in FA nutrition. Chiropractic may be very effective in helping people become well, especially in conjunction with the dietary changes and fish oil/antioxidant supplementation described in this newsletter.
FISH OIL BRANDS
Carlson Labs: www.carlsonlabs.com
Nordic Naturals: www.nordicnaturals.com
Nutri-West: www.nutri-west.com (available through doctor’s offices)
I prefer liquid fish oil to gel caps. Liquid fish oil is more cost effective per dose. Gelatin capsules are convenient for travel. There are many other good quality brands available, but read labels carefully. Labels should contain language such as “non-detectable levels of mercury, PCB’s, and other heavy metals.” Less expensive brands may not mention this. Read the back label carefully, to see how much EPA and DHA you are getting per serving. Although the front label of a bottle may read “1,000 mg,” the concentration of EPA and DHA may be much lower. Locate the milligrams of EPA and DHA on the back label, add the EPA and DHA milligrams together, and compare the amount to the recommendations in this newsletter to determine how much you should take.
References:
Melillo, Robert, D.C., and Gerry Leisman. Neurobehavioral Disorders of Childhood. New York: Kluwer Academic/Plenum Publishers, 2004.
Schmidt, Michael, D.C. Smart Fats. Frog, Ltd., 1997, and Brain-Building Nutrition, 2001.
Stordy, B. Jacqueline, Ph. D. The LCP Solution. The Remarkable Nutritional Treatment for ADHD, Dyslexia, and Dyspraxia. New York: The Ballantine Publishing Group, 2000.
Dr. Joseph Mercola, via information on his website, www.mercola.com.
Special thanks to Dr. Dan Murphy, D.C., referencing his class and e-mail group notes. Dr. Murphy has been my primary source of information. He has recommended and referenced volumes of research articles and books on essential fatty acids and nervous system health, anti-inflammatory diet recommendations, and other health topics to tens of thousands of practicing doctors of chiropractic and other health professionals via his lectures.