Omega-3 fatty acids: are supplements truly necessary for optimal brain health?

Greater intake of long-chain omega-3 fatty acids (EPA and DHA) is associated with decreased risk of brain disorders (such as Alzheimer’s disease) and cardiovascular disease.1-3 DHA is a crucial factor in early brain development because it is a major constituent of cell membranes in the brain, retina, and nervous system. There is significant evidence in the fossil record that a increase in DHA availability in the diet of early humans was responsible for the expansion of the brain into the large, complex organ it has now become.4,5 DHA requirements are the greatest in the developing brain during the last trimester of pregnancy and the first two years of life. During early life, a baby’s only source of this building block of brain and eye tissue is its mother’s milk.6,7 Several studies have documented improved cognitive scores in breastfed infants compared to formula-fed infants, prompting supplementation of infant formula with DHA in the U.S.8 But what if the “normal” amount of DHA in American women’s breast milk is still not enough? What if the developing brain requires more DHA for optimal cognitive development?

A recent study compared the fatty acid content of breast milk in American women in Cincinnati to that of Tsimane women of Bolivia. Tsimane women eat a traditional diet of primarily locally grown plant foods, wild-caught animals, and freshwater fish. The results of the study showed that the DHA concentration of Tsimane mothers’ milk was 400% higher than that of Cincinnati mothers, their concentration of linoleic acid (an omega-6 fatty acid abundant in oils) was 84% lower, and their concentration of trans fat was 260% lower than in Cincinnati mothers.9,10 In a previous analysis, pooling data from 84 studies of breast milk DHA concentrations in many different countries, the U.S. concentrations fell below the worldwide average. The areas with the highest breast milk DHA concentrations were coastal or island nations, suggesting that breast milk DHA concentration is closely linked to the consumption of fish.11

Our modern eating habits have transformed the fatty acid distribution of our diet.12 One of the study’s authors, Steven Gaulin, a professor of anthropology at the University of California at Santa Barbara, noted "The American diet is eroding one of the most important benefits breast milk can provide –– fats that are critical to infant brain development. It's not surprising that, among developed nations, American children are last on international tests of math and science."9

What is the “normal” DHA of content of human breast milk – or rather, the amount that will ideally support brain development in infants? We don’t know for sure. However, these huge differences between a traditional diet and a modern diet, and the high DHA concentrations in high fish-consuming countries indicate that the DHA intake of Americans may be sub-optimal for supporting brain health. The American diet is low in DHA, and high in vegetable oils and trans fats, which limit the elongation of ALA from plant foods into DHA and EPA, and displaces omega-3 fats from cell membranes.4,13 Factory-farmed meats, oils and trans fats are not the appropriate fatty fuel to grow a baby’s brain.

Does this mean that we should eat fish? From the evidence we have now, if you eat with a modern diet (even without oils) and you don’t eat fish regularly, it is almost impossible to have adequate DHA stores, especially for pregnant and nursing women.

Avoiding oils and eating plenty of hemp, chia, flax, walnuts, and leafy greens is likely still not enough, since the conversion rate of ALA (short-chain omega-3) in these foods to DHA (long-chain omega-3) is very low. Large increases in ALA intake have been shown to produce only very slight increases in long-chain omega-3 blood levels. Plus, much of the ALA we consume is burned for energy, not converted to DHA or EPA.14,15

However, modern fish is a heavily polluted food that I do not recommend eating regularly. The DHA in fish may benefit the brain, but the fatty tissues of fish is highly contaminated with mercury, and other pollutants, which could be toxic to the brain and may also contribute to cardiovascular disease.16,17 In addition to the potential effects of mercury on human health, huge declines in wild fish populations have been reported since the 1950s, and populations continue to decline as the purported benefits of fish consumption on heart and brain health increase the demand for fish and fish oils.18 Fish is not an ideal source of DHA; fortunately DHA derived from lab-grown algae is available as a supplement.

One can't really be sure they have ideal levels of omega-3 anymore without supplements. If you eat enough fish to idealize your omega-3 ratio, you get too much mercury, dioxin, and other pollutants. I think it is sensible and conservative to err on the side of caution and eat a diet that contains ALA from flax, chia, walnuts and leafy greens, not merely because of their ALA content, but also for their anti-inflammatory and anti-cancer effects. Then adding a supplement of a clean algae-derived DHA is a wise insurance policy. Significant evidence suggests that a comparatively small amount of DHA and EPA can add health protection without the potential drawbacks of high dose fish oil capsules.19-21

 

 References:

1. Yurko-Mauro K. Cognitive and cardiovascular benefits of docosahexaenoic acid in aging and cognitive decline. Curr Alzheimer Res 2010;7:190-196.
2. Yurko-Mauro K, McCarthy D, Rom D, et al. Beneficial effects of docosahexaenoic acid on cognition in age-related cognitive decline. Alzheimers Dement 2010.
3. Kris-Etherton PM, Harris WS, Appel LJ. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation 2002;106:2747-2757.
4. Crawford MA, Broadhurst CL. The role of docosahexaenoic and the marine food web as determinants of evolution and hominid brain development: the challenge for human sustainability. Nutr Health 2012;21:17-39.
5. Bradbury J. Docosahexaenoic acid (DHA): an ancient nutrient for the modern human brain. Nutrients 2011;3:529-554.
6. Ryan AS, Astwood JD, Gautier S, et al. Effects of long-chain polyunsaturated fatty acid supplementation on neurodevelopment in childhood: a review of human studies. Prostaglandins Leukot Essent Fatty Acids 2010;82:305-314.
7. Kidd PM. Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids. Altern Med Rev 2007;12:207-227.
8. Hoffman DR, Boettcher JA, Diersen-Schade DA. Toward optimizing vision and cognition in term infants by dietary docosahexaenoic and arachidonic acid supplementation: a review of randomized controlled trials. Prostaglandins Leukot Essent Fatty Acids 2009;81:151-158.
9. UCSB anthropologists finds high levels of omega-3 fatty acids in breast milk of Amerindian women. 2012. EurekAlert! http://www.eurekalert.org/pub_releases/2012-06/uoc--uaf060812.php. Accessed August 15, 2012.
10. Martin MA, Lassek WD, Gaulin SJ, et al. Fatty acid composition in the mature milk of Bolivian forager-horticulturalists: controlled comparisons with a US sample. Matern Child Nutr 2012;8:404-418.
11. Brenna JT, Varamini B, Jensen RG, et al. Docosahexaenoic and arachidonic acid concentrations in human breast milk worldwide. Am J Clin Nutr 2007;85:1457-1464.
12. Blasbalg TL, Hibbeln JR, Ramsden CE, et al. Changes in consumption of omega-3 and omega-6 fatty acids in the United States during the 20th century. Am J Clin Nutr 2011.
13. Harnack K, Andersen G, Somoza V. Quantitation of alpha-linolenic acid elongation to eicosapentaenoic and docosahexaenoic acid as affected by the ratio of n6/n3 fatty acids. Nutr Metab 2009;6:8.
14. Arterburn LM, Hall EB, Oken H. Distribution, interconversion, and dose response of n-3 fatty acids in humans. Am J Clin Nutr 2006;83:1467S-1476S.
15. Fokkema MR, Brouwer DA, Hasperhoven MB, et al. Short-term supplementation of low-dose gamma-linolenic acid (GLA), alpha-linolenic acid (ALA), or GLA plus ALA does not augment LCP omega 3 status of Dutch vegans to an appreciable extent. Prostaglandins Leukot Essent Fatty Acids 2000;63:287-292.
16. Rice GE, Hammitt JK, Evans JS. A probabilistic characterization of the health benefits of reducing methyl mercury intake in the United States. Environmental science & technology 2010;44:5216-5224.
17. Virtanen JK, Rissanen TH, Voutilainen S, et al. Mercury as a risk factor for cardiovascular diseases. The Journal of nutritional biochemistry 2007;18:75-85.
18. Myers RA, Worm B. Rapid worldwide depletion of predatory fish communities. Nature 2003;423:280-283.
19. Musa-Veloso K, Binns MA, Kocenas A, et al: Impact of low v. moderate intakes of long-chain n-3 fatty acids on risk of coronary heart disease. Br J Nutr 2011.
20. Thies F, Nebe-von-Caron G, Powell JR, et al. Dietary supplementation with eicosapentaenoic acid, but not with other long-chain n-3 or n-6 polyunsaturated fatty acids, decreases natural killer cell activity in healthy subjects aged >55 y. Am J Clin Nutr. 2001 Mar;73(3):539-48.
21. Linus Pauling Institute: Essential Fatty Acids. http://lpi.oregonstate.edu/infocenter/othernuts/omega3fa/


 

Obesity during pregnancy puts the child in danger

Over 50% of women of childbearing age in the U.S. are either overweight or obese. In the U.K., the percentage of obese pregnant women has doubled in the past 19 years, from 7.6% to 15.6%.1 Obesity is closely linked to diabetes, heart disease, and cancer, and evidence is now mounting that excess maternal weight can have dangerous effects on fetal development.2

Obesity contributes to infertility, making it more difficult to become pregnant. Obese women who do become pregnant are at risk for serious complications such as pre-eclampsia and gestational diabetes, and are more likely to require Caesarian section and labor induction.

The pregnancy of an obese women itself is at risk – obese women are more likely to experience early miscarriage or spontaneous intrauterine demise.3

The children of obese women are at increased risk of excessive birth weight, neural tube defects, and congenital heart disease.

Maternal overeating during pregnancy is even thought to produce adaptive cues that may predispose the developing fetus to obesity during childhood or adulthood.4

This is a serious issue that needs to be brought to women’s attention. All women want to have healthy pregnancies and to give their babies the healthiest possible start. Achieving a healthy weight prior to becoming pregnant can help to prevent devastating complications for mother and baby. Obesity is not benign, and it is not just a cosmetic issue – it is a serious health hazard, especially during pregnancy.

 

References:

1. Heslehurst N, Rankin J, Wilkinson JR, et al. A nationally representative study of maternal obesity in England, UK: trends in incidence and demographic inequalities in 619,323 births, 1989–2007. International Journal of Obesity (2010) 34, 420–428

2. Wiley-Blackwell (2010, January 26). Pregnant women who are overweight put their infants at risk, study finds. ScienceDaily. Retrieved March 23, 2010, from http://www.sciencedaily.com /releases/2010/01/100120121558.htm

Walters MR, Taylor JS. Maternal obesity: consequences and prevention strategies. Nurs Womens Health. 2009 Dec;13(6):486-94; quiz 495.

3. Satpathy HK, Fleming A, Frey D. Maternal obesity and pregnancy. Postgrad Med. 2008 Sep 15;120(3):E01-9.

4. Wax JR. Risks and management of obesity in pregnancy: current controversies. Curr Opin Obstet Gynecol. 2009 Apr;21(2):117-23.

USDA/Agricultural Research Service (2010, March 15). Baby's obesity risk: What's the mother's influence?. ScienceDaily. Retrieved March 17, 2010, from http://www.sciencedaily.com/releases/2010/03/100315125551.htm

Conventional prenatal vitamins may do more harm than good

It is imperative for me to make women aware that they may be endangering their health and the health of their unborn children by using conventional supplements.

Nearly all multivitamins and prenatal vitamins contain folic acid.

Unlike most physicians, I do not recommend folic acid supplementation for pregnant women.  Folic acid supplementation can damage the health of women and their children.

Folic acid is the synthetic form of folate, a member of the family of B vitamins that is involved in regulating DNA synthesis and gene expression. Because of these crucial functions, folate plays an important role in fetal development - folate is essential during pregnancy, especially early on in pregnancy, for the prevention of neural tube defects. Folate is abundant in green vegetables like spinach, collards, bok choy, artichokes, and broccoli.

The Standard American Diet (SAD) is so nutritionally inadequate that the U.S. government and most physicians encourage women to take folic acid supplements, assuming that they do not eat green vegetables and are folate deficient.

Taking synthetic folic acid is not the same as getting natural folate from vegetables.

Scientific studies have revealed the dangers to women and their children involved in taking folic acid supplements:

  • Women who followed the typical recommendations to take folic acid during pregnancy and were followed by researchers for thirty years were twice as likely to die from breast cancer.1   Another study following women for ten years concluded that those who took multivitamins containing folic acid increased their breast cancer risk by 20-30%.2   Folic acid in supplement form may contribute to producing a cancer-promoting environment in the body – in addition to breast cancer, synthetic folic acid has been linked to dramatic increases in prostate and colorectal cancers, as well as overall cancer incidence.3
  • Folic acid supplementation by pregnant women has been associated with incidence of childhood asthma, infant respiratory tract infections, and cardiac birth defects.4

However, food folate is associated with benefits for both women and children:

  • Women with lower levels of food folate intake are more likely to be diagnosed with breast cancer.5
  • The children of women who consumed more food folate during pregnancy were less likely to develop ADHD.6
  • Several studies have made connections between vegetable intake during pregnancy and lower risks of childhood cancers.7

This is too important an issue to ignore, and women are simply not told the facts here.

I needed to take action and supply a prenatal and other supplements that did not contain folic acid as well as other supplemental ingredients with documented risk. 

 My Gentle Prenatal contains the same carefully designed combination of vitamins and minerals present in my original multivitamin and mineral, Gentle Care Formula, but has been uniquely tailored to the needs of child-bearing and pregnant women. 

Read more about my Gentle Prenatal

 

 

 

References:

 [1] Charles D et al. Taking folate in pregnancy and risk of maternal breast cancer. BMJ 2004;329:1375-6

[2] Stolzenberg-Solomon RZ et al. Folate intake, alcohol use, and postmenopausal breast cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Am J Clin Nutr. 2006 Apr;83(4):895-904.

[3] Fife, J et al. Folic Acid Supplementation and Colorectal Cancer Risk; A Meta-analysis. Colorectal Dis. 2009 Oct 27. [Epub ahead of print]

Hirsch S et al. Colon cancer in Chile before and after the start of the flour fortification program with folic acid. Eur J Gastroenterol Hepatol. 2009 Apr;21(4):436-9.

http://www.medscape.com/viewarticle/591111

Figueiredo JC et al. Folic acid and risk of prostate cancer: results from a randomized clinical trial. J Natl Cancer Inst. 2009 Mar 18;101(6):432-5. Epub 2009 Mar 10.

Ebbing M et al. Cancer Incidence and Mortality After Treatment With Folic Acid and Vitamin B12. JAMA. 2009;302(19):2119-2126

[4]   Whitrow MJ. Effect of Supplemental Folic Acid in Pregnancy on Childhood Asthma: A Prospective Birth Cohort Study. Am J Epidemiol. 2009 Oct 30. [Epub ahead of print]

Haberg SE, London SJ, Stigum H, Nafstad P, Nystad W. Folic acid supplements in pregnancy and early childhood respiratory health. Arch Dis Child. 2009 Mar;94(3):180-4. Epub 2008 Dec 3.

Källén B. Congenital malformations in infants whose mothers reported the use of folic acid in early pregnancy in Sweden. A prospective population study. Congenit Anom (Kyoto). 2007 Dec;47(4):119-24.

[5] Sellers TA et al. Dietary folate intake, alcohol, and risk of breast cancer in a prospective study of postmenopausal women. Epidemiology. 2001 Jul;12(4):420-8.

Kim YI. Does a high folate intake increase the risk of breast cancer? Nutr Rev. 2006 Oct;64(10 Pt 1):468-75.

[6] Wiley-Blackwell (2009, October 28). Attention-deficit/hyperactivity Problems Associated With Low Folate Levels In Pregnant Women. ScienceDaily. Retrieved February 5, 2010, from http://www.sciencedaily.com /releases/2009/10/091028134631.htm

[7] Kwan ML et al. Maternal diet and risk of childhood acute lymphoblastic leukemia. Public Health Rep. 2009 Jul-Aug;124(4):503-14.

Tower RL et al. The epidemiology of childhood leukemia with a focus on birth weight and diet. Crit Rev Clin Lab Sci. 2007;44(3):203-42.

Petridou E et al. Maternal diet and acute lymphoblastic leukemia in young children.Cancer Epidemiol Biomarkers Prev. 2005 Aug;14(8):1935-9.

Jensen CD et al. Maternal dietary risk factors in childhood acute lymphoblastic leukemia (United States).Cancer Causes Control. 2004 Aug;15(6):559-70.

Huncharek M et al. A meta-analysis of maternal cured meat consumption during pregnancy and the risk of childhood brain tumors. Neuroepidemiology. 2004 Jan-Apr;23(1-2):78-84.

 

 

 

Antibiotic overuse is a danger to public health, and especially dangerous for pregnant women

 The European Center for Disease Prevention and Control (ECDC) is warning the public that antibiotic overuse has the potential to cripple the entire modern medical system.1

Despite public awareness campaigns about responsible use of antibiotics, antibiotics continue to be prescribed for colds, flu, sinusitis and bronchitis. Medical authorities continually warn doctors that antibiotics should NOT be prescribed for routine bronchitis and sinusitis. The scientific studies show that they do not improve outcome.  These are infections that, except in rare instances, are caused by viruses, not bacteria. Plus, these infections resolve by strengthening the immune system with excellent nutrition, not weakening it and creating more serious future infections that can develop as a result of antibiotic use

As inappropriate use of antibiotics continues, more and more resistant microbes will spread, and antibiotics will consequently become less effective. Drug-resistant bacteria emerge from mutations – microbes are constantly mutating, and these mutations eventually cause resistance to antibiotics.

Drug-resistant infections kill about 19,000 people each year in the U.S., and are a significant cost to the healthcare system.1 Drug-resistant bacteria have the potential to compromise our ability to perform procedures for which antibiotics are crucial.

"If this wave of antibiotic resistance gets over us, we will not be able to do organ transplants, hip replacements, cancer chemotherapy, intensive care and neonatal care for premature babies."

- Dominique Monnet, ECDC scientific advice unit1

The dangers of antibiotic overuse extend further than infection alone – all drugs have side effects, and antibiotics are especially toxic, and their side-effects are significant. . Antibiotics kill bacteria indiscriminately – therefore they disrupt our microbial balance, killing the beneficial flora that aid in digestion and absorption of nutrients and keep other microbes at bay. Children who are prescribed more antibiotics in the first year of life are more likely to be diagnosed with asthma and allergies during childhood.3  Antibiotic use has even been linked to a higher incidence of breast cancer.4   

Antibiotics are one of the most common medications taken by pregnant women, and a new study has made connections between antibiotics use during pregnancy and incidence of birth defects. Sulfonamides and nitrofurantoins were each associated with several birth defects – women who took these classes of antibiotics while pregnant were 2-4 times as likely to give birth to a baby with a heart defect. The more commonly used penicillins, eythromycins, and cephalosporins were each associated with at least one birth defect.2  

Antibiotics are not harmless medications and should be reserved for severe (and carefully documented) bacterial infections - infections that would seriously threaten the health of the patient if left untreated. We have powerful immune systems which, when supported by excellent nutrition, will clear the more moderate infections without help from drugs. 

 

References:

  1. http://www.reuters.com/article/healthNews/idUSTRE5A927820091110
  2. Crider KS et al. Antibacterial medication use during pregnancy and risk of birth defects: National Birth Defects Prevention Study. Arch Pediatr Adolesc Med. 2009 Nov;163(11):978-85.
  3. Foliaki S et al. Antibiotic use in infancy and symptoms of asthma, rhinoconjunctivitis, and eczema in children 6 and 7 years old: International Study of Asthma and Allergies in Childhood Phase III. J Allergy Clin Immunol. 2009 Nov;124(5):982-9.
  4. Velicer CM et al. Antibiotic Use in Relation to the Risk of Breast Cancer. JAMA. 2004;291:827-835.