Omega 3s and Fatty Liver Disease

Whilst most people in the UK are familiar with alcohol-related liver disease as a result of heavy drinking, which is on the rise, many of us are unaware of the problems associated with another form of liver disease, non-alcoholic fatty liver disease (NAFLD) – also known as non-alcoholic steatohepatitis (NASH). A recent review of four human studies by a group based at the University of Edinburgh found that long-chain omega-3 fatty acids not only improve liver health and function, but also increase insulin sensitivity in people suffering from fatty liver disease.

I’ve recently published an article on Omega 3s and fatty liver disease and the study led by Dr Gail Masterton and I would be very interested to hear your feed back!

The mood food connection

Each year on 10th October, the Mental Health Foundation marks the day by raising awareness about mental health and well-being. Whilst we would probably all consider ourselves as reasonably tolerant and open minded, there is still quite a significant stigma about depression. If we haven’t experienced depression directly, it’s highly probable that we know someone, perhaps a friend, relative or workmate, who suffers. Mental Health Statistics report that 1 in 4 British adults experience at least one diagnosable mental health problem in any one year and 1 in 6 of us experiences this at any given time. In 2001 the World Health Organisation (WHO) estimated that approximately 450 million people worldwide have a mental health problem, of which 154 million are affected by depression.One of the major side effects of depression is that the way we think about food changes and this can influence how we eat – both the types of food and how often. Because food can directly influence our mood, our diet is even more fundamental when we’re feeling low.

The Glycemic Index

The brain needs energy supplied at an even rate in order to function optimally. Sudden peaks in blood sugar will adversely affect behaviour, anxiety, depression, and fatigue, so it is particularly important for people with depression to keep their blood glucose levels even. Although commonly known for its diabetes and weight loss benefits, the glycemic index (most commonly referred to as GI index), which ranks carbohydrates according to their effect on blood glucose levels, is a good guide to informing us which foods to include as part of a healthy diet, and indeed which foods to limit.

While all carbohydrate foods are eventually broken down into glucose, quick-release simple carbohydrates (such as high sugar foods, glucose and fructose) are broken down more quickly into glucose than complex carbohydrates (such as wholemeal grains), releasing glucose rapidly into the bloodstream. Repeated ‘spikes’ of glucose can decrease insulin sensitivity, increasing the risk of type 2 diabetes, as well as promoting oxidative stress in the veins and arteries – a cause of coronary heart disease. After the highs come the energy-sapping blood sugar lows and, frequently, strong urges to reach for another sugary carbohydrate snack to perk us up. Indeed individuals who suffer from atypical depression (a subtype of depression) often overeat and report an almost irresistible craving for carbohydrates.

White sugar and other refined carbohydrates, such as those found in processed white bread and white pasta, white rice and most convenience foods, supply few nutrients to the body but use up important B vitamins, which are essential for our nervous and immune systems, as well as healthy digestion. Avoiding refined foods and sugar, as well as consuming foods with a low GI value, will help to keep blood sugar levels even. Perhaps a more accurate reference guide to prevent blood sugar spikes is the Glycemic Load(GL) ranking system, which is based on a food’s GI value and average portion size. For example, whilst an apple is not low GI, it has a low GL and will barely influence blood sugar levels.

Micronutrient deficiencies

It is extemely common for depression sufferers to have low levels of B vitamins and essential minerals such as zinc, selenium and magnesium. These water-soluble vitamins and minerals must be consumed daily to avoid depletion. Deficiency can, in turn, hinder the body’s ability to utilise specific omega-3 fatty acids, which are known to lift our mood by elevating serotonin and regulating levels of this important neurotransmitter.

EPA, a long-chain omega-3 fatty acid found in fish oil, not only influences serotonin and dopamine in the brain, but is also converted to powerful anti-inlammatories via a series of enzyme-mediated steps. It is these enzymes that rely on the presence of B vitamins and essential minerals in order to function, without which the body’s production of natural anti-inflammatories is minimal, and can even result in the production of inflammatory substances. Combining a good nutritional vitamin and mineral supplement with 1 gram EPA daily (or 4 capsules Vegepa) can help to balance serotonin levels and alleviate the symptoms of depression.

Carbohydrate cravings are also linked with low levels of chromium, which helps to regulate blood sugar levels and reduce cravings. This is because for blood sugar to provide energy, it must be escorted into each of our cells where the energy conversion takes place. Insulin then ‘unlocks’ the cell, allowing glucose to pass in. But there is a missing link. Insulin doesn’t work properly unless biologically active chromium is present as a cofactor (much like a catalyst).

With many modern food processing methods, up to 80% of chromium is lost – particularly with whole wheat and raw sugar when they are processed to white flour and refined sugar. If we regularly opt for these refined foods over their healthy wholegrain relatives, chromium levels within the body can easily become depleted.

Whilst it is likely a low priority during episodes of low mood to concentrate on our eating habits, following a few general guidelines can help to restore healthy brain chemistry and minimise sugar-induced mood swings.

– Avoid processed foods.

– Keep red meat to a minimum or eat organic (red meat is high in inflammatory omega-6 unless animals are fed on natural grass).

– Drink plenty of water, as the brain needs to be hydrated to function at its best.

– Don’t forget your ‘five a day’. Make sure you get plenty of vitamins and minerals by eating a wide variety of fresh fruit and vegetables. If you eat them raw they’ll supply even more nutrients.

– Eat two portions of oily fish weekly to top up on omega-3, containing the natural antidepressant EPA, or take 2 capsules of Vegepa morning and night.

If you found this article interesting, you might like to read more about anti depression foods.

DHA, Fish and Alzheimer’s: Press Misinformation

The general public are reliant on the media for their most recent update on “what to eat and what not to eat” and so it’s terribly important that studies are reported objectively and fairly – and, of course, that we are given the whole picture. It is not a very new concept that eating fish such as salmon, sardines and mackerel may offer an element of protection against developing dementia and indeed the media has reported on a number of studies showing that people who consume a significant amount of oily fish or fish oil are less likely to develop Alzheimer’s disease. This week’s headline, “Fish may not be Alzheimer’s answer” suggests, however, that Alzheimer’s patients may not benefit from eating fish, despite this “brain food” reputation.

Our understanding of the significant health benefits associated with fish oil supplementation has come a long, long way since scientists’ original discovery, back in the 1950s, that cod liver oil was a rich source of fatty acids. Researchers have since then progressed far beyond the basic understanding that fish oil is a promoter of general good health, and moved onto the next phase of innovation – investigating which particular elements within this oil are biologically active and whether a physical deficiency in this bioactive element results in some degree of physical deterioration. Indeed, fish oil contains two major fatty acids EPA and DHA and it is only really in recent years that these important fatty acids have been investigated individually rather than dumping them in the same boat with the generic label of omega-3.

DHA is the most abundant omega-3 fatty acid in cell membranes, present in all organs and most abundant in the brain and retina. In contrast, EPA is present in minute quantities. It could be easily assumed that DHA is the more dominant of the two fatty acids and put all of our focus here. However whilst DHA has a primarily structural role, EPA plays an important functional role. In actual fact whist EPA and DHA are both considered to be important regulators of immunity, platelet aggregation and inflammation, their influencing bi-products arise from very different pathways and it is therefore not surprising that their mechanism of action will differ.

So what is my problem with the latest headline? Well what’s very misleading with this is the loose use of the word “fish”. The study didn’t even have a vague whiff of fish about it but was conducted using a DHA supplement and a dummy placebo. The importance of this is that the information put forward to eager ears gives the impression that all that mackerel eating is a waste of time. But hear me out. This study took but one of the major fatty acids associated with fish oil, showed no benefit, but happily used the word fish to summarise the findings. If we recall, fish oil contains two important fatty acids, DHA and EPA. It is becoming increasingly clear that the marked differences between the effects of EPA and DHA mean that we can no longer generalise the effects of ‘fish oil’ as a reservoir of omega-3. EPA not only plays a major role in cell signalling but also contributes to the compaction and stabilisation of neurones. Indeed previous studies have shown that high plasma EPA concentration may decrease the risk of dementia and that EPA can actually reduce the atrophy associated with the shrinking brain. I’m not objecting to their findings that DHA is not the fatty acid which plays a role in dementia, rather it’s the fact that the message implies that it we should now question or even rule out the protective role of fish altogether. But when we dig deeper and unravel the scientific evidence and put that on our plates to eat, we see that things are a little more convoluted than we initially thought – well, if you read the recent headlines, that is. Just because the bigwigs are now telling us that DHA won’t save our brains (this week at least) it doesn’t mean that we should now disregard our efforts to include fish as part of our diets in our bid to prevent age-related mental decline. I, for one, shall be continuing to get my twice weekly portions in and I hope you will too. Do remember that once again, it’s not black or white, to fish or not to fish.

Statins – Should all over 50s get anti-cholesterol drugs?

Today’s Daily Mail headline announced the question “should all over 50s get anti-cholesterol drugs?” Normally statins are only prescribed to people who are considered to be at significant risk of a heart attack or stroke. In fact, it seems that these drugs can cut the risk of heart attack by 30% even in healthy people. So what are statins exactly? These are drugs that are known as HMG-CoA reductase inhibitors. HMG-CoA is an enzyme that is involved in the production of cholesterol in the liver. Ruducing or inhibiting the function of this enzyme therefore prevents cholesterol production. Statins (usually synthetic) are similar to HMG-CoA and mimic the actions of this enzyme but prevent the pathway progressing to the production of cholesterol and more than six million adults in the UK use them.

So far so good, until I open up the paper to page two where I am met with the words “although side effects are rare, they can include muscle pain and damage to the liver and kidneys.” I guess this is what infuriates me. With the majority of pharmaceuticals there will be the downside list of side effects or contraindications that steal some of the glamour from a treatment programme. Take NSAIDs, for example; these are common over-the-counter anti-inflammatory drugs, like Ibubrofen.

Whilst one of the most common over-the-counter drugs and used by millions, NSAIDs are associated with several side effects, of which many are probably not known by the common user. Whilst the frequency of side effects varies among NSAIDs, the most common side effects are nausea, vomiting, diarrhoea, constipation, rash, dizziness and headache (interesting that we often take them when we have a headache!). NSAIDs may also cause fluid retention, leading to oedema. The most serious side effects are kidney failure, liver failure, ulcers, an increased risk of heart attack and prolonged bleeding after an injury or surgery.

So why is it that if there is a natural alternative which we can take for both of these drugs and without the associated side effects, that we are not advised? Let me speak firstly about cholesterol. In the 1970s Danish researchers discovered that in spite of their high-cholesterol, high-fat, diet Greenland Eskimos had an astonishingly low incidence of cardiovascular disease (as well as arthritis and other chronic inflammatory diseases). When analysing blood samples it was discovered that they had low levels of LDL (bad cholesterol) and low levels of VLDL (triglyceride), but high levels of HDL (good cholesterol). It appeared that their high intake of omega-3 was responsible for this low risk of heart disease. Since this research emerged, much focus has been centred on the role of omega-3 fatty acids and, more recently, specifically the role of EPA in lowering cholesterol levels. EPA reduces cholesterol production by inhibiting the activity of another enzyme called acyl-CoA but without the side effects associated with statins. EPA also acts as an anti-inflammatory in a similar mechanism to that of NSAIDs, but again without the side effects. So my message today is to boost your EPA levels on a long-term basis and you may well lower the possibilities of having to resort to pharmaceuticals with all sorts of side effects.

Increase your fish intake and adopt a more Eskimo-like diet! For those who don’t like fish, you can opt for a high-EPA supplement. Purified fish oils actually are a useful alternative to oily fish consumption and, unlike most oily fish, are contamination-free.

Peripheral Neuropathy in Diabetics; what steps can we take to avoid it?

You might already be aware that of the many deteriorative conditions related to diabetes; ‘peripheral neuropathy’ is perhaps the most common, with an estimated 60-70% of diabetics reportedly experiencing symptoms. ‘Neuropathy’ describes damage, whether moderate or severe, to the peripheral nervous system (the ‘external’ portion of the nervous system, situated beyond the brain and spinal cord), which transmits information directly from the brain and spinal cord to the rest of the body.

Our nervous system acts very similarly to an electrical cable; with the nerve’s ‘impulse’ adopting the role of the electrical wire itself, and the ‘myelin sheath’ (the ‘skin’ of the nerve), mimicking the insulation surrounding the wire. If the wire becomes damaged, then the nerve signal will not travel efficiently along the wire, nor will it transmit the intended messages as instantaneously. This delay results inevitably in the ‘classic’ symptoms of neuropathy; namely; tingling, numbness, ‘burning’ and pain.

A causative link has been drawn between neuropathy and deficiencies of long-chain polyunsaturated fatty acids within the body. Indeed, insulin itself plays a pivotal role in the metabolism of EFAs (essential fatty acids), by alerting the genes necessary for enzyme-conversion to begin the process of converting short-chain fatty acids into a bio-available (i.e. usable by the body) long-chain fatty acid.

Where insulin is absent, or enzyme-activity impeded, the enzymes needed to create specific fatty acids cannot be produced and a deficiency results. Of the myelin layer which protects our vulnerable nerves, an estimated 75 % is composed exclusively of EFA’s (these are termed ‘essential’ because the body cannot generate them independently, but must instead source them externally from the diet). Depletion of this fatty, insulatory layer, leads to severe nerve damage (Neuropathy).

Nutrition, as all Diabetics are painfully aware, is central to the manufacture of insulin and for creating the right ‘biological environment’ to encourage enzyme conversions to take place. By boosting or supplementing our dietary levels of long-chain fatty acids we can essentially sidestep the risk that the enzyme-mediated conversions will fail to progress past the initial hurdle.

Fatty acid supplementation nourishes the myelin sheath, and prevents further degeneration of inter-cellular communication; it reduces the risk of developing Neuropathy, and actually reinvigorates nerve endings to overcome numbness and the likelihood of eventual tissue loss. However, EPA, a specific omega-3 fatty acid found in fish oil that appears to have significant beneficial effects on diabetic neuropathy and serum lipids as well as other diabetic complications such as nephropathy (kidney damage) and macroangiopathy (damage to the blood vessels). EPA plays a role in the compaction, stabilization, and maintenance of myelin sheaths by regulating the production of proteolipid protein or PLP. PLP is literally the ‘glue’ that hold in place the sheets of protective fats that cover the nerve axon. Loss of PLP is associated with many conditions that have nerve damage including Multiple sclerosis, Alzheimer’s disease and Huntington chorea.

OmegaForce is a patented formulation of omega-3 and 6 long-chain fatty acids with a multitude of health-enhancing properties, including anti-inflammatory and pain-relieving actions. For more information on the relationship between EPA deficiency and the pathogenesis of Diabetic Neuropathy, please go to www.igennus.com

Omega-3 fish oil supplements reduce cardiovascular disease in diabetics

According to a new study from Tehran University of Medical Sciences in Iran, daily intake of omega-3 fatty acids may reduce levels of a trigger substance linked to heart disease in diabetics.

Results published in the peer-reviewed journal Nutrition, Metabolism and Cardiovascular Disease suggest that high doses of omega-3 fish oil daily (3 grams per day) cut levels of the amino acid homocysteine by 22%, compared with less than 1% in the placebo group.

81 diabetics took part in this randomised, double-blind placebo-controlled trial, which lasted two months with participants randomly assigned to either receive 3 grams of omega-3 or a sunflower oil placebo daily.

Previous research has linked increased levels of homocysteine with an increased risk of cardiovascular disease. By lowering levels of this amino acid in the blood, scientists believe it is possible to reduce their heart disease risk, providing support for the inclusion of omega-3s as part of the diabetic diet. Evidence is not yet conclusive however, and further research needs to be conducted before firm conclusions may be drawn.

The number of diabetics diagnosed with the disease soared by 70,000 in the UK between 2006-7, according to a report by the Information Centre for Health and Social Care.
According to their report, people affected by diabetes in the UK has climbed to 3.7 per cent, with a record number of 1,986,200 people diagnosed with the condition; a further 750,000 people are likely to have diabetes and not be aware of it. These figures paint a worrying picture for the health of the nation.

The Chief Executive of Diabetes UK, Douglas Smallwood, commented: “These figures are truly alarming as diabetes is a serious condition, which can lead to blindness, kidney failure, heart disease, stroke and nerve damage that can cause amputation . We need to do all we can to raise awareness of the condition and to encourage people to follow a healthy diet, and pursue an active lifestyle to help them reduce their risk of developing diabetes.”

When you consider that the impact of our 24/7 culture is that we tend to drive to work, drink a little too much, eat too few freshly prepared meals (not to mention that most of us are probably short on dietary fibre) you can appreciate why diabetes is becoming a real problem.

This is not to say that there’s nothing we can do about it, however. Simple changes to our diet and lifestyle and dramatically decrease our chance of developing diabetes and, if you’re affected already, it is definitely possible to influence the likelihood of associated health problems as the condition advances. As a nutrition scientist I would advise a diet with increased fibre, whole grains, few sugars, as well as cutting out the bad fats – this is actually a good approach for anyone.

I’d also add to the diet highly concentrated omega-3 fish oil containing pure EPA, an active component of fish oil which is especially beneficial for reducing the risk of complications in the cardiovascular system. OmegaForce is ideal in this respect, as it combines with pure EPA the omega-6 GLA (highly anti-inflammatory) with the omega-9 oleic acid from olive oil, its benefits associated with the healthy Mediterranean diet.

For more information about omega-3 fatty acids and how they can be included as part of the diet, click here.

A Natural Science-based Solution for Depression

Isn’t it strange that whilst we would probably all consider ourselves as reasonably tolerant and open minded that there is still such a huge stigma when we think about depression. If we haven’t experienced depression directly it’s highly probable that we know someone, be they a friend, relative or workmate, who suffers. I have a friend myself who was diagnosed with major depression just under a year ago. Slowly she has become quite reclusive mostly because, she tells me, she’s ashamed and embarrassed. She talks about her black days. Days with no focus, and with very little meaning or purpose. “They come less often”, she had said to me, “but nevertheless they still come. You just learn to deal with it Nina, It’s like there’s a wall between you and the world but someone’s turned the lights off too. So what’s the point of living in isolated darkness? Oh and there’s pain too. Just to top it. Immense and unbearable pain. So there we have it. Pain, darkness and isolation that is the be-all and end-all of your life.”

I didn’t really know what to say to that. Who would? She’s been taking Prozac for the last 6 months and she tells me that whilst she sees a difference she feels sick most of the time. That’s not unusual though, because that’s the trouble with most anti-depressants – the side effects. And so we got talking and I asked what was it she did with her time, did she go out, what did she eat? “I can’t be bothered” was the main theme of her answers. Not because she was lazy, there was just a lack of motivation. She’d got into a negative pattern of not going out or doing much more than watching T.V. But it was her eating patterns that really made me think. She didn’t cook at all. Everything she ate (if and when she ate) came out of a packet. Her whole diet was pretty appalling really and she seemed to have very little understanding that the food we eat really can affect our mood. So I found myself asking more and more questions. One of them was “do you ever eat fish?” The answer was a straight no, well not since it was forced on her as a child (at this point she actually laughed). So we sat and talked about changes she could make and how certain foods could help. I told her how omega-3 from fish oils can benefit people with depression. In fact the American Psychiatric Association actually recommends treatment with at least 1 gram daily of fish oil for depression, as an addition to standard treatment. We don’t get offered that here. In fact there are probably very few GPs in the UK who know about the benefits of fish oils as an alternative or as an add-on, even though more and more trials are showing that EPA (the active omega-3 in fish oil) has a distinct anti-depressant role. If you compare EPA with Prozac, just 1gram daily can equal the benefits of a standard 20 mg Prozac dose and there are no side effects!

“But be fussy” I said. “Not all fish oils are the same, don’t go for cheap like most people do. There’s meaning to the saying that ‘you get what you pay for’. Interestingly, as the link between fish and depression risk strengthens, with it comes products formulated specifically to help. Remember that it’s EPA that you need to look for on the product label, and if you combine this with a good source of gamma linolenic (GLA) then you’re laughing, literally.

Recommended reading material:

An eminent psychiatrist and researcher, Professor Basant Puri, proposes an alternative option to conventional treatments for depression, arguing that standard treatments often fail to address the underlying biochemical factors. I thoroughly recommend his book The Natural Way to Beat Depression – The Groundbreaking Discovery of EPA to Change Your Lifea well-written, concise and informative read for anyone affected by this debilitating condition.

A diet rich in fish oils could extend your life, research shows

Researchers from Norway and France found that elderly people who consume plenty of omega-3 acids, found in oily fish such as salmon, not only performed better in cognitive function tests than those who do not, but also demonstrated greater longevity than those who don’t regularly consume fish.

Norwegian researchers studied 254 frail, elderly patients and measured their dietary intakes of omega-3 fatty acids using plasma phospholipid concentrations of EPA. Patients’ omega-3 consumption was analysed and they were asked to return for further analysis after a period of three years. The results later showed that those tested with the lowest plasma phospholipid EPA levels were approximately 40 per cent more likely to die.

The French researchers observed 1214 healthy participants over a period of four years, 65 of which developed dementia. The results showed that only those with higher blood levels of EPA were linked with the reduced risk (31 per cent) of contracting dementia.

The omega-3 fatty acid EPA (eicosapentaenoic acid), which occurs naturally in oily fish such as salmon, mackerel and tuna, is responsible for a range of health benefits, from combating heart disease to boosting intelligence.
Despite this, most people eat just a fifth of the amount recommended for good health. The fact of the matter is that most people do not consume enough oily fish to reap the benefits of fatty acids, so supplementation with fish oils is a more viable option for many.
Vegepa is a patented formulation of completely natural long-chain omega fatty acids. It contains a unique ratio of ultra-pure EPA (the omega-3 eicosapentaenoic acid) and cold-pressed, non-raffinated, virgin evening primrose oil (containing the omega-6 gamma-linolenic acid). As such, Vegepa combines the benefits that both these natural substances bring to the body.

Fatty acids play an important part in the functioning of every living cell in the body. Specifically they may help the body in several ways including: improving the circulatory system, aiding concentration, maintaining a well-balanced state of mind and keeping joints in good condition.

The EPA in Vegepa is derived from fish oil – the highest yielding source of long-chain omega-3 fats. This fatty acid forms a vital part of the diet as it enables the body to produce many substances that are necessary for health and well-being.

The evening primrose oil (EPO) in Vegepa is derived from the cold pressing of evening primrose seeds. When EPO is unprocessed and unrefined it is a rich source of botanical triterpenes hormone-like substances, which play an important role in immune function. Just two capsules daily provide 560 mg EPA and 200 mg organic EPO, and help to reverse fatty acid deficiencies by nourishing the brain’s phospholipids. Vegepa is available from all good health food shops, or online at www.igennus.com

The Alzheimer’s Society provides a national help line on 0845 3000 336 and website www.alzheimers.org.uk.

Omega-3 boosts sight

According to the data pooled from nine previously conducted studies, published in the June issue of Archives of Opthalmology, [i] the most marked benefits relate to more advanced AMD, although increasing one’s intake of omega-3 is associated with a lower risk of both early and late onset of AMD.

AMD is the prime cause of blindness over the age of 55 in the West, according to AMD Alliance International. Its incidence is not insignificant, with 25-30 million people affected worldwide. Scientists are predicting these figures to increase as the unhealthy generation of baby boomers gets older.

AMD is a degenerative disease of the retina, causing loss of central vision which leaves sufferers with only peripheral vision. Early detection is crucial as it can enable effective treatment to be prescribed before the condition worsens.

This recent study is welcome news because it suggests that we can and should take a proactive approach to our health. Long-chain omega-3 fatty acids form building blocks in the layer of nerve cells in the retina, therefore playing an important part in maintaining healthy eyesight. According to the lead author of the study, “a diet rich in omega-3 fatty acids and fish, as a proxy for long-chain omega-3 fatty acid intake, has therefore been hypothesised as a means to prevent AMD”.

Additionally, the outer photoreceptor (cell segments of the outer retina) are constantly shred in the normal visual cycle and deficiencies of omega-3 fatty acids may initiate AMD. The researchers have also highlighted the protective effect of long-chain omega-3 fatty acids against oxygenic, inflammatory and age-associated pathology of the vascular and neural retina, all of which are thought to affect the onset of AMD. All the more reason, we believe, to ensure that your diet is rich in the important bioavailable fatty acids.

[i]: Chong, E.W.-T., Kreis, A.J., Wong, T.Y. ,. Simpson, J.A, Guymer, R.H. “Dietary -3 Fatty Acid and Fish Intake in the Primary Prevention of Age-Related Macular Degeneration – A Systematic Review and Meta-analysis” Archives of Ophthalmology, Vol.126:6 pp. 826-833

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