While a lot of pregnant women knows the importance of increasing their intake of Omega-3, it is important that we keep ourselves informed with the various kind of seafood that can contain high levels of mercury. High levels of mercury is not good for the nerves, brain and heart and might cause harm in the fetus.
Some types of fish contain much more mercury, on average, than others. However, mercury levels can vary between populations of the same species depending on where they reside and migrate.
Alzheimer's Disease is the number one cause of dementia (70% of cases). Causes include cardiovascular events whereby there is reduced blood flow to the brain, aging, genetics, etc. Risk factors include older age, family history, having Apolipoprotein E (ApoE), abnormal MRI, history of cardiovascular disease.
Associated with multiple changes including:
- Cognitive Differences ( difficulty finding words, disorientation, forgetfulness etc)
- A reduction in Daily Functioning ( getting lost, neglecting self care)
- Personality Changes ( social withdrawal, disinterest, easy frustration)
- Problem Behaviors ( obsessive/compulsive behavior, nightime restlessness)
- Mental Health Issues ( depression, paranoia, abnormal beliefs, anxiety etc)
To slow the disease:
1. Vitamin E (as dl-alpha-tocopheryl acetate) 1000IU twice a day
Based on a large clinical trial published in Journal of the American Medical Association (JAMA), a 5 year study with more than 600 participants showed that the Vitamin E group, taking 2000IU of Vitamin E per day, experienced significant delay of more than 6 months in progression of the disease (1). On top of that caregiver time also decreased by 2 hours each day which means better quality of life for both the patient and the caregiver.
2. Panax Ginseng or Korean Red Ginseng
The primary active ingredients in ginseng are ginsenosides and there are 7 main ones found in dietary supplements namely Rb1, Rb2, Rc, Rd, Re, Rf and Rg1. Some of them have been shown in laboratories to be able to reduce levels of a compound called amyloid beta peptide which is found in brains of Alzheimer's patients. Moreover it also improves blood flow.
3. Omega-3 Supplements
May improve the appetite and weight gain in Alzheimer's patients. They might even help with reducing depressive symptoms.
4. Lifestyle Changes
This includes finding the right protein, fat, and carb balance. Studies have shown that diet high in lean protein and healthy fats may protect against mild cognitive impairment. On top of that, more exercise not just physically but also mentally are really important. Play more crossword puzzles and reading will reduce the risk of AD. Lastly, make sure to take time to de-stress as chronic stress can increase the amount of stress steroids in your body and this can block brain activities as well as increase risk of AD.
It is important to remember in Alzheimer that heart healthy = brain healthy so prevention is extremely important.
1. Dysken MW, Sano M, Asthana S, et al. Effect of Vitamin E and Memantine on Functional Decline in Alzheimer Disease: The TEAM-AD VA Cooperative Randomized Trial. JAMA.2014;311(1):33-44. doi:10.1001/jama.2013.282834.
I am a medical doctor and a researcher hence I believe in evidence based medicine. I was very shocked to find this article recently (by accident) titled " A Nutritional-Toxicological Assessment of Antarctic Krill Oil versus Fish Oil Dietary Supplements ". This article was published in 2014 in Nutrients Journal by researchers from Griffith University and CSIRO Food and Nutrition in Tasmania. This research is also funded by ARC Discovery Grant DP666891.
So here comes the shocking part. They actually tested multiple readily available fish oils on the market and found that the DHA content in particularly 2 products fell below (~10%–30%) the manufacturer specifications namely Nature’s Way Kidsmart (133 mg specified vs. 95 mg observed) and Blackmores Pregnancy and Breastfeeding Gold (125 mg specified vs. 85 mg observed).
When I shared this piece of article with my friends they asked me how could the manufacturers be so misleading and why is this even allowed? To be absolutely honest, I am not here to judge or comment on different brands but merely sharing what I found published in the medical research world.
The next table below is where the researchers did an analysis of the contamination level of all the products. Even though they found that none of the products analysed in the current study (at their highest recommended dosage) came close to fulfilling tolerable daily intake (TDI) levels for any single analyte, they have listed the top five products with the greatest contaminant burden for five key compound groups, plus TEQ values, ranking them from 1–5 with the sample containing the highest concentrations receiving a score of 5.
Bioceuticals Omegasure liquid fish oil and Blackmores 1000 mg both carried a cumulative score of 16, Blackmores Pregnancy and Breastfeeding Gold formula and Nature’s Own 1000 mg each received a score of 12.
According to the researchers, Blackmore’s Pregnancy and Breastfeeding Gold formula incorporates tuna oil, sourced from northern hemisphere oceans, thereby likely contributing to the higher contaminant burdens found in this formulation, despite its lower oil content.
This again highlights that translational research is very important. What is translational research? In a medical research context, it aims to "translate" findings in fundamental research into medical practice and meaningful health outcomes. It is very common in medical research where great amount of research work and funding has been put in but there is lack of dissemination of information to the public. This is a gap that needs to be bridged and my blog is all about this. In regards to this article, it was an accidental find for me, to better educate myself (and definitely to warn all my pregnant friends to not take the particular product mentioned) and the public.
The researchers in the article has concluded that ongoing monitoring of the pollutant content of fish and krill oil products will become increasingly important as food authorities seek
regulatory overview of this rapidly expanding industry.
Make sure you know what you are taking and whether you are really paying for the quality.
Bengtson Nash SM, Schlabach M, Nichols PD. A Nutritional-Toxicological Assessment of Antarctic Krill Oil versus Fish Oil Dietary Supplements. Nutrients. 2014;6(9):3382-3402. doi:10.3390/nu6093382.
Several studies have demonstrated that vegetarians and vegans have much lower plasma concentrations of omega-3 fatty acids (DHA and EPA) when compared to those who eat fish. A recent study published in Clinical Nutrition showed low blood omega-3 levels in vegans and the fatty acid analysis data was presented on more than 160 vegans who were not supplementing with DHA and EPA (1). The result of the study showed the average omega-3 index of the vegans in the study was 3.7% with a total of 64% of the vegans having levels lower than 4%; 27 percent had levels lower than 3%; and a small number (about 1%) had very low levels (lower than 2%). It is also important to note that omega-3 index of lower than 4% has been known as a risk factor for heart disease.
As you may already know, omega-3 fatty acids are crucial components of cell membranes in the human brain (2) and I have highlighted in my previous posts that it could even potentially reverse ageing by affecting the telomere lengths.
It is understood that many vegans probably consume a huge amount of flax seeds, walnuts, chia seeds etc to try and boost their omega-3 fatty acid levels. However, what they are actually consuming is actually ALA (Alpha-lipoic-acid) which is the plant based omega-3 fatty acids which then converts to EPA and DHA. This conversion actually varies with different individuals and factors involved includes genetic factors (3). So eating plenty of ALA-rich foods is simply not enough for many people to achieve sufficient DHA and EPA levels—supplementation is often necessary.
In conclusion, if you are vegan (which means you are more prone to omega-3 fatty acid deficiency), please check your levels with a blood test to assure that you are sufficient, or take the supplement as a preventative measure.
1: Sarter B, Kelsey KS, Schwartz TA, Harris WS. Blood docosahexaenoic acid and eicosapentaenoic acid in vegans: Associations with age and gender and effects of an algal-derived omega-3 fatty acid supplement. Clin Nutr. 2015 Apr;34(2):212-8.
2. Higdon J: Essential Fatty Acids. In An Evidence-Based Approach to Dietary Phytochemicals. New York, NY: Thieme; 2006: 78-99
3. Davis BC, Kris-Etherton PM. Achieving optimal essential fatty acid status in vegetarians: current knowledge and practical implications. Am J Clin Nutr. 2003 Sep;78(3 Suppl):640S-646S. Review.
Omega-3 remains one of the most researched nutrition in pregnancy. Omega-3 contains eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) which are uniquely important for our human body. While omega-3 has multiple benefits, from slowing ageing to aiding depression as highlighted in my blog earlier, one should not overlook its usage in pregnancy.
Preterm birth also known as premature birth whereby a baby is delivered before 37 weeks of gestation continues to be the one of the leading causes of infant deaths worldwide. Every year an estimated 15 million babies are delivered preterm. Results from a systemic review published in European Journal of Obstetrics & Gynecology and Reproductive Biology has shown that Omega-3 fatty acids are effective in preventing early and any preterm delivery. They also concluded that this intervention is simple and easily available and has the potential to influence population based strategies in the prevention of preterm birth (1).
Omega-3 fatty acids have also been shown to decrease incidence of pre-eclampsia (disorder of pregnancy characterized by high blood pressure and a large amount of protein in the urine), increase birth weight and aid in postpartum depression. American Pregnancy Association suggests 300mg DHA (docosahexaenoic acid) daily for pregnant and lactating women.
It is well known that the best sources of omega-3 fatty acids are cold water fish such as salmon, tuna, sardines, anchovies, and herring. But in terms of pregnancy, many people are justifiably concerned about mercury and other toxins in fish. For this reason, purified fish oil supplements are often the safest source of EPA and DHA.
1: Kar S, Wong M, Rogozinska E, Thangaratinam S. Effects of omega-3 fatty acids in prevention of early preterm delivery: a systematic review and meta-analysis of randomized studies. Eur J Obstet Gynecol Reprod Biol. 2015 Nov 30;198:40-46. doi:10.1016/j.ejogrb.2015.11.033. [Epub ahead of print] PubMed PMID: 26773247.
All nuts have different nutrition credentials and will offer various health benefits. Frequent nut consumption has been associated with better metabolic status, decreased body weight as well as lower body weight gain over time and thus reduce the risk of obesity (1). Moreover, nut consumption has been linked with reduced risk of certain cancers (such as colorectal, endometrial, and pancreatic neoplasms) and protects against depression, mild cognitive disorders and Alzheimer’s disease.
Here's a rundown of a couple of our favourite nuts:
1. Grosso G, Estruch R. Nut consumption and age-related disease. Maturitas. 2016 Feb;84:11-6. doi: 10.1016/j.maturitas.2015.10.014. Epub 2015 Nov 2. Review. PubMed PMID: 26586104.
2. Wien MA, Sabaté JM, Iklé DN, Cole SE, Kandeel FR. Almonds vs complex carbohydrates in a weight reduction program. Int J Obes Relat Metab Disord. 2003 Nov;27(11):1365-72. Erratum in: Int J Obes Relat Metab Disord. 2004
Mar;28(3):459. PubMed PMID: 14574348.
There is increasingly more evidence that omega-3 supplements (aka. fish oil) plays an important role in depression.
In 2010, a group of researchers did a meta-analytic review comparing the levels of polyunsaturated fatty acids between depressive patients and control subjects (1). The result ---Compared with control subjects, the levels of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and total omega-3 (n-3) polyunsaturated fatty acids were significantly lower in depressive patients. There was no significant change in arachidonic acid (AA) or total omega-6 (n-6) polyunsaturated fatty acids. Thus this implies that omega-3 plays a vital role in pathogenesis of depression. This result is in line with research done back in 1998 and published in Journal of Affective Disorders where researchers noted significantly lower levels of omega-3s in the red blood cell membranes of patients with depression (2).
More recently, a study published in Jan 2016 in Journal of Psychiatric Research shows white matter deficits in depression improved after 6 weeks of fish oil supplementation (3). These therapeutic effects of omega-3 PUFAs may be related to improvements in white matter integrity.
Fish oil is not a definitive treatment of depression, but it may be helpful as an addition to prescribed medications or other treatment. Although more studies are needed to determine exactly what role omega-3s play in depression, it's possible that fish oil supplements high in omega-3s may help lower the risk of depression — and omega-3 has many other health benefits.
1: Lin PY, Huang SY, Su KP. A meta-analytic review of polyunsaturated fatty acid compositions in patients with depression.
Biol Psychiatry. 2010 Jul 15;68(2):140-7. doi: 10.1016/j.biopsych.2010.03.018. Epub 2010 May 10. PubMed
2: Edwards R, Peet M, Shay J, Horrobin D. Omega-3 polyunsaturated fatty acid levels in the diet and in red blood cell membranes of depressed patients. J Affect Disord. 1998 Mar;48(2-3):149-55. PubMed PMID: 9543204.
3: Chhetry BT, Hezghia A, Miller JM, Lee S, Rubin-Falcone H, Cooper TB, Oquendo MA, Mann JJ, Sublette ME. Omega-3 polyunsaturated fatty acid supplementation and white matter changes in major depression. J Psychiatr Res. 2016 Jan 11;75:65-74.
doi: 10.1016/j.jpsychires.2015.12.007. [Epub ahead of print] PubMed PMID: 26802812.
A study in Ohio State University found that Omega-3 supplement (aka Fish Oil) can slow the process of ageing by lengthening Telomeres which are small DNA segments that acts like end caps of chromosomes and protects the chromosome (1). Telomeres play a vital role in human ageing process, they keep the double helix strands of our DNA from unraveling and help our cells divide. As shown in the image above, the more they divide, the shorter they get, and when telomeres get too short it can lead to cell inactivity or death.
In this particular study, 106 overweight or obese adults (average age 51) who live fairly sedentary lifestyles participated in the study. Some were given a placebo, while others took either 2.5 grams or 1.25 grams of active omega-3 polyunsaturated fatty acids. Of those who took one of the two dosages of omega-3 supplements, a definite lengthening in the telomeres was apparent when compared to the telomeres in the placebo group.
According to Jan Kiecolt-Glaser, the study's lead author and professor of psychiatry and psychology at Ohio State University, they find the connection between omega-3 supplements and telomere length exciting because "it suggests the possibility that a nutritional supplement might actually make a difference in aging,"
Interestingly, a past study on mice "engineered to age faster" found that lengthening the rodent's telomeres reversed the aging process. After gene therapy, researchers noticed that the mice's fur went from grey back to its original dark brown and its brain size -- which had decreased by 75 percent much like the brain's of Alzheimer's patients -- returned to normal.
So is Omega-3 supplementation the key to not just slow ageing but to reverse ageing?
1: Kiecolt-Glaser JK, Epel ES, Belury MA, Andridge R, Lin J, Glaser R, Malarkey, WB, Hwang BS, Blackburn E. Omega-3 fatty acids, oxidative stress, and leukocyte telomere length: A randomized controlled trial. Brain Behav Immun. 2013
Feb;28:16-24. doi: 10.1016/j.bbi.2012.09.004. Epub 2012 Sep 23. PubMed PMID:
23010452; PubMed Central PMCID: PMC3545053.
Dr Nicole Ng (MBBS) is a medical doctor with a passion in women's health and medical research