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Medical Forum / General / Nutrition / January 2007

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Flax vs Fish

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Bob Arnold - 10 Jan 2007 14:24 GMT
The following paragraph is from a white paper on the importance of
Omega-3 Fatty Acids for heart health from the Council for Responsible
Nutrition.

http://www.crnusa.org/about_specialty_o3.html

"The parent fatty acid for both classes is the 18-carbon fatty acid,
called linoleic acid (LA) for the omega-6 series and alpha-linolenic
acid (ALA) for the omega- 3 series. These are the two ³essential² fatty
acids, in nutritional terms, because they cannot be made by the body
but must be obtained from food sources. These can be elongated by
human, animal and marine life metabolism to produce longer-chain fatty
acids such as arachidonic acid (ARA) in the omega-6 series or EPA and
DHA in the omega-3 series (Figure 1). The Institute of Medicine states
³ALA is not known to have any specific functions other than to serve as
a precursor for synthesis of EPA and DHA.² (IOM 2002). However, the
conversion of ALA to EPA and DHA occurs only at a very low rate (Emken
1994, Pawlosky 2001). Such conversion will not be sufficient to produce
the levels of EPA and DHA believed to have heart health benefits. The
optimal approach to ensuring optimum intakes of omega-3 fatty acids for
heart health is to directly increase consumption of EPA and DHA via
frequent fish consumption or supplementation. Note however, that women
of childbearing age should follow FDA guidelines on fish consumption to
limit exposure to environmental contaminants.
Enrico C - 10 Jan 2007 18:32 GMT
> The following paragraph is from a white paper on the importance of
> Omega-3 Fatty Acids for heart health from the Council for Responsible
> Nutrition.
>
> http://www.crnusa.org/about_specialty_o3.html

About CRN

The Council for Responsible Nutrition (CRN), founded in 1973, is a
Washington-based trade association representing ingredient suppliers and
manufacturers in the dietary supplement industry [...]
http://www.crnusa.org/who_about.html
spamfree@spam.heaven - 10 Jan 2007 20:42 GMT
>> The following paragraph is from a white paper on the importance of
>> Omega-3 Fatty Acids for heart health from the Council for Responsible
[quoted text clipped - 8 lines]
>manufacturers in the dietary supplement industry [...]
>http://www.crnusa.org/who_about.html

Just curious though, is what was quoted by the original poster pretty
right? Or is there some correction needed?     jack
monty1945@lycos.com - 10 Jan 2007 22:28 GMT
If you want to see my research into this issue, including a great deal
of source citation, go to my free web site.  You will see an essay on
fish oil specifically.  You can ask questions in the nutrition forum -
there is already a thread on fish oil.

http://groups.msn.com/TheScientificDebateForum-
spamfree@spam.heaven - 13 Jan 2007 03:03 GMT
>If you want to see my research into this issue, including a great deal
>of source citation, go to my free web site.  You will see an essay on
>fish oil specifically.  You can ask questions in the nutrition forum -
>there is already a thread on fish oil.
>
>http://groups.msn.com/TheScientificDebateForum-

But is what was quoted by the original poster pretty
right? Or is there some correction needed?   jack
Enrico C - 10 Jan 2007 23:54 GMT
>>> The following paragraph is from a white paper on the importance of
>>> Omega-3 Fatty Acids for heart health from the Council for Responsible
[quoted text clipped - 8 lines]
>>manufacturers in the dietary supplement industry [...]
>>http://www.crnusa.org/who_about.html

> Just curious though, is what was quoted by the original poster pretty
> right? Or is there some correction needed?     jack

Let's see...

http://www.crnusa.org/about_specialty_o3.html
[...]
>>> conversion of ALA to EPA and DHA occurs only at a very low rate (Emken
>>> 1994, Pawlosky 2001).

"very low" sounds negative. Why don't they just report the conversion
rate?

>>> Such conversion will not be sufficient to produce the levels of EPA and
>>> DHA believed to have heart health benefits.

Hmmm... I guess that's controversial.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ctPlus&list_uids=16365063&query_hl=2&itool=pubmed_docsum

J Nutr. 2006 Jan;136(1):83-7.  
Flaxseed oil increases the plasma concentrations of cardioprotective (n-3)
fatty acids in humans.Harper CR, Edwards MJ, DeFilipis AP, Jacobson TA.
Department of Medicine, Office of Health Promotion and Disease Prevention,
Emory University, Atlanta, GA, USA. charper@emory.edu

Alpha-linolenic acid (ALA) is a major dietary (n-3) fatty acid. ALA is
converted to longer-chain (n-3) PUFA, such as eicosapentaenoic acid (EPA)
and possibly docosahexaenoic acid (DHA). EPA and DHA are fish-based (n-3)
fatty acids that have proven cardioprotective properties. We studied the
effect of daily supplementation with 3 g of ALA on the plasma concentration
of long-chain (n-3) fatty acids in a predominantly African-American
population with chronic illness. In a randomized, double-blind trial, 56
participants were given 3 g ALA/d from flaxseed oil capsules (n = 31) or
olive oil placebo capsules (n = 25). Plasma EPA levels at 12 wk in the
flaxseed oil group increased by 60%, from 24.09 +/- 16.71 to 38.56 +/-
28.92 micromol/L (P = 0.004), whereas no change occurred in the olive oil
group. Plasma docosapentaenoic acid (DPA) levels in the flaxseed oil group
increased by 25% from 19.94 +/- 9.22 to 27.03 +/- 17.17 micromol/L (P =
0.03) with no change in the olive oil group. Plasma DHA levels did not
change in either group. This study demonstrates the efficacy of the
conversion of ALA to EPA and DPA in a minority population with chronic
disease. ALA may be an alternative to fish oil; however, additional
clinical trials with ALA are warranted.

PMID: 16365063 [PubMed - indexed for MEDLINE]

>>> The optimal approach to ensuring optimum intakes of omega-3 fatty acids
>>> for heart health is to directly increase consumption of EPA and DHA
>>> via frequent fish consumption or supplementation.

I gather that the current official recommendations do not suggest
supplementation.

http://www.issfal.org.uk/lipid-matters/issfal-policy-statements/issfal-policy-st
atement-3-12.html

[...]
| Based on large prospective population studies and well-controlled
| case-control studies, an intake of about 500 mg of EPA+DHA per day would
| be expected to significantly reduce risk for death from CHD in healthy
| adults.  This intake is both safe and achievable by diet alone, even for
| pregnant and lactating women for whom mercury intake can be an issue.

>>> Note however, that women of childbearing age should follow FDA
>>> guidelines on fish consumption to limit exposure to environmental
>>> contaminants.

Again:

www.issfal.org.uk/welcome/PolicyStatement3.asp  
[...]
| This intake is both safe and achievable by diet alone, even for
| pregnant and lactating women for whom mercury intake can be an issue.

BTW, they warn about contaminats in fish, what about contaminants in cheap
oil pills?

Bottom line: don't ask the innkeeper if the wine is good ;-)
(Italian saying).
Ron Peterson - 11 Jan 2007 04:54 GMT
> BTW, they warn about contaminats in fish, what about contaminants in cheap
> oil pills?

IIRC, there isn't a problem with contaminants in the oil pills,
especially if they have been doubly distilled. Fish oil capsules aren't
cheap which is one good reason to look at ALA for providing some of the
omega 3 fatty acids.

Signature

  Ron

Enrico C - 11 Jan 2007 12:28 GMT
> IIRC, there isn't a problem with contaminants in the oil pills,

I find some conflicting information...

*All* oil pills are safe...?

http://www.usatoday.com/news/health/2004-12-15-fish-oil-usat_x.htm
| 12/15/2004 6:34 PM
|
[quoted text clipped - 9 lines]
| found that of 41 fish oil supplements tested, none were contaminated
| with mercury or PCBs.
[...]

... or they are not? (not all of them, at least)

http://www.nutraingredients.com/news/ng.asp?n=50678-higher-levels-of
| Higher levels of contaminants in fish oils, finds study
| 7/03/2004 - Levels of chemicals commonly used in flame retardants have
[quoted text clipped - 4 lines]
| The researchers suggest that consumers should switch to vegetable
| oil-based products.
[...]
| Writing in the April 7 edition of the Journal of Agricultural and Food
| Chemistry, the researchers describe an analysis of 21 fish and vegetable
| oil dietary supplements available in the UK. Levels of polybrominated
| diphenyl ethers (PBDEs) ranged from about 15-34 nanograms per gram of
| fat, while the range was 0-13 only four years ago.
[...]

or is it the case that not all fish oil pills were made equal? :-)

http://www.nutraingredients.com/news/ng.asp?n=50678-higher-levels-of
[...]
| But supplements based on vegetable oil and whole body fish oil showed
| little or no contamination
[...]
| Pronova sources its crude oil from the eastern Pacific waters where the
| concentration of such pollutants is lower than elsewere. It also uses
| molecular distillation to remove such contaminants.

> especially if they have been doubly distilled.

Ok. But then, why doesn't the CRN white paper tell consumers to look for
double distilled oil pills?

Signature

Enrico C

My new email address: http://www.x-privat.org/sigmail/sig-5ace6.png

Ron Peterson - 11 Jan 2007 16:07 GMT
> > IIRC, there isn't a problem with contaminants in the oil pills,

> I find some conflicting information...

> *All* oil pills are safe...?

They can be safer than eating the fish.

> or is it the case that not all fish oil pills were made equal? :-)

Some are going to be better than others and since one DHA supplement
isn't derived from fish, they may be safer yet.

> > especially if they have been doubly distilled.

> Ok. But then, why doesn't the CRN white paper tell consumers to look for
> double distilled oil pills?

CRN is a vendor organization and isn't about to recommend one vendor
over another. The consumer has to weigh the cost versus the
effectiveness.

Signature

   Ron

Enrico C - 11 Jan 2007 16:33 GMT
[...]

>>> especially if they have been doubly distilled.

>> Ok. But then, why doesn't the CRN white paper tell consumers to look for
>> double distilled oil pills?

> CRN is a vendor organization

That was precisely my point.

> and isn't about to recommend one vendor
> over another. The consumer has to weigh the cost versus the
> effectiveness.

Yet, they warn consumers about the dangers in other products (some fish)
;-)
DZ - 11 Jan 2007 05:03 GMT
>>>> Such conversion will not be sufficient to produce the levels of EPA and
>>>> DHA believed to have heart health benefits.
>
> Hmmm... I guess that's controversial.

No notable conversion to DHA has been detected in the study quoted
below, confirming that flax seed oil is not good a substitute for fish
oil.

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ctPlus&list_uids=16365063

> J Nutr. 2006 Jan;136(1):83-7.  
[quoted text clipped - 23 lines]
>
> PMID: 16365063 [PubMed - indexed for MEDLINE]
Enrico C - 11 Jan 2007 12:44 GMT
>>>>> Such conversion will not be sufficient to produce the levels of EPA and
>>>>> DHA believed to have heart health benefits.
[quoted text clipped - 3 lines]
> No notable conversion to DHA has been detected in the study quoted
> below,

True.

> confirming that flax seed oil is not good a substitute for fish
> oil.

That may well be, but it's not what those researchers think.

"ALA may be an alternative to fish oil; however, additional
clinical trials with ALA are warranted."
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ctPlus&list_uids=16365063


In the full text they expand on that.

http://jn.nutrition.org/cgi/content/full/136/1/83
[...]
"The results suggest that a significant increase in plasma EPA levels can
be obtained with a relatively low daily dose of ALA (3 g/d).  Individuals
consuming a reasonable diet can obtain 2–3 g of ALA without having to
resort to dietary supplements (20). This can be achieved by consuming
ALA-rich nuts, cereals, oils, and fortified breads. As "

[...]

"The Lyon Diet Heart Study is the only clinical trial completed with ALA
supplementation designed to analyze hard cardiac endpoints in which the
investigators reported plasma fatty acid levels (25). In the Lyon Study,
ALA supplementation in the form of canola-enriched margarine was given to
patients recently recovering from a myocardial infarction (MI); the ALA
group experienced a 65% relative risk reduction in cardiac death and
nonfatal MI (P = 0.001). Coinciding with this large reduction in cardiac
events, participants in the ALA arm of the Lyon study demonstrated a 35%
increase in EPA levels (expressed as a percentage of total fatty acids).
The results from the Lyon Diet Heart Study suggest that the increases in
plasma EPA levels demonstrated in our trial may be clinically relevant. The
Lyon Diet Heart Study is limited, however, by the fact that multiple
changes in the diet were made in the experimental group including increased
intake of nuts, fruits, and fish as well as favorable changes in saturated,
monounsaturated, and (n-6) fatty acids. "

"Several key questions remain unanswered concerning ALA supplementation:
Will dietary supplementation with ALA result in cardiovascular benefit
similar to that seen with EPA and DHA? If increasing consumption of ALA
results in reduced cardiac risk, is it because of its conversion to EPA or
another mechanism unrelated to EPA (i.e., improvements in endothelial
function, inflammation, lipid changes, or antiarrhythmic effect)? The
answers to these questions may have important clinical and public health
implications because many people do not consume fish or do not have access
to fish rich in EPA."

"The FORCE trial demonstrates the feasibility of increasing EPA levels by
supplementing the diet with ALA in a high risk population and underscores
the need for a larger more definitive clinical trial with coronary
endpoints to determine whether ALA is indeed cardioprotective."

===================

My point is: I am not saying they are right, I am only saying there are
different takes on the topic.
DZ - 11 Jan 2007 15:36 GMT
>>>>>> Such conversion will not be sufficient to produce the levels of EPA and
>>>>>> DHA believed to have heart health benefits.
[quoted text clipped - 13 lines]
> "ALA may be an alternative to fish oil; however, additional
> clinical trials with ALA are warranted."

They say this in the context of cardiovascular benefits only. DHA
remains an essential FA, and the text does not imply that ALA is a
viable substitute for fish oil in this regard.
Enrico C - 11 Jan 2007 16:26 GMT
>> That may well be, but it's not what those researchers think.
>>
[quoted text clipped - 4 lines]
> remains an essential FA, and the text does not imply that ALA is a
> viable substitute for fish oil in this regard.

Agreed. But the statement in the CNR paper was just about "heart health
benefits".

"Such conversion will not be sufficient to produce
the levels of EPA and DHA believed to have heart health benefits."
DZ - 12 Jan 2007 01:49 GMT
>>> That may well be, but it's not what those researchers think.
>>>
[quoted text clipped - 10 lines]
> "Such conversion will not be sufficient to produce
> the levels of EPA and DHA believed to have heart health benefits."

Well, they should have asked me to write that paragraph :-)
spamfree@spam.heaven - 13 Jan 2007 03:03 GMT
<good stuff snipped>

>Bottom line: don't ask the innkeeper if the wine is good ;-)
>(Italian saying).

Thanks Enrico

jack
 
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