I.Introduction
II.Signs and Symptoms of Omega 3 Deficiency
III. About Omega 3s
IV. Health Benefits
V. Warnings
VI. Best Omega 3 Supplements
I.Introduction
Omega 3s are essential fatty acids. They are required for our overall health, and particularly essential for the brain function, optimal growth and development. Omega 3 fatty acids are found in higher concentration in the brain where they play a key role in memory, performance and behavior functions. They have anti-inflammatory effects, reduce the risk of chronic diseases and help manage autoimmune conditions. The body can’t make them, thus we need to get them from diet and supplements.
II.Signs and Symptoms of Omega 3 Deficiency
Quiz time… Do you have some of the following symptoms: fatigue, poor memory, dry skin, heart problems, mood swings or depression, poor circulation, joint pain, insomnia, skin rashes such as eczema, unexplained weight gain? These are common symptoms of omega 3 deficiency.
Note that you should seek professional advice, since these symptoms can be caused by other conditions and nutrient deficiencies. About 90 percent of Americans are deficient in omega 3, while eating too many omega 6s [1]
III. About Omega 3s
The most important omega 3s are: EPA (Eicosapentaenoic acid), DHA (docosahexaenoic acid) and ALA (alpha-linolenic acid). ALA may be converted into EPA and DHA, however, humans tend to have a poor conversion (Conversion efficiencies of ALA to DHA in human trials range from 0-9%) [2].
Great sources of EPA and DHA are fatty fish like mackerel, sardines, herring and also halibut and tuna. In supplement form, the best ones would be krill oil and fish oil. ALA is found in plants and nut oils (healthy options: flax seeds, flaxseed oil, perilla seed, walnut oils and walnuts).
Omega 6 fatty acids are also necessary for our health, however, our modern diet includes too many of these. High amounts of omega 6 are found in most cooking oils, grains and grain-fed animal products, in the seeds of most plants except for coconut, cocoa, and palm. (My note: it looks like the high lectin foods are also rich in the “bad” omega 6, so two reasons to stay away from them)
Unlike omega 3s that have anti-inflammatory qualities, omega 6s promote inflammation. The best way to evaluate your omega fatty acids intake [3], [4] is to look at the omega 6/omega 3 ratio. Western diet contains up to 25 times more omega 6s than omega 3s (so the ration omega 6s/omega 3s is 25 to 1, and this type of diet created over a century ago appears to be responsible for increased incidence of inflammatory conditions, including depressive disorders. [5]
On the other hand, a healthy diet would have a omega 6/omega 3 ratio of maximum 4 to 1 (ideally the ratio omega 6s:omega 3s would be 1 to 1, as it is closer to our genetic constitution) [6]
In mammals, including humans, the cerebral cortex, retina, testis and sperm are particularly rich in DHA. DHA is also one of the most abundant fats of the brain’s structure. [7]
IV.Omega 3s – Top 7 Health Benefits For MS
1.Omega 3s fight depression, anxiety and cognitive dysfunction
Omega 3 deficiency has been linked with abnormal levels of dopamine and serotonin as well as increased inflammation in the brain, both leading to impaired brain function and depression. [8]. People with MS are at a greater risk of being affected by depression, with a lifetime prevalence of 50% and an annual prevalence of 20% [9].
These numbers will likely get higher, as the incidence in general population of depression will increase – it is estimated that by 2020, depression will be the second leading cause of disease burden worldwide (after heart diseases). Depression alone is a risk factor for significant disability and increased risk of death (especially from cardiovascular diseases). Depression is also linked with sleep disorders, anxiety and an impairment of the circadian rhythm.
Scientists believe that the increase ratio omega 6s/omega 3 is one of the main reasons why depression, as well as heart diseases and autoimmune diseases, is more common now than a century ago [10]. Several studies found an inverse correlation between the intake of fatty fish and the prevalence of depression and bipolar disorders. Research also show that supplementation with fish oil can improve depression. Some meta-analyses further confirmed this fact and suggest that the EPA is more important than DHA for managing depression. To me more specific, the supplements containing 60% or more EPA of the total EPA plus DHA were more effective against depression.
Those who consume more fish are less likely to experience cognitive impairments, mental decline, Alzheimer’s or dementia. DHA is the precursor of the neuroprotectin D1, which decreases neuroinflammation and promotes healthy brain cells. [11]
Considering that the prescription antidepressants don’t work in about half of the cases, it is worth looking into omega 3 supplements. It appears that omega 3s work in a similar way with some antidepressants – by improving dopamine and serotonin levels. Omega 3s also decrease cortisol level (which is too high in depressed people) and reduce inflammation by improving the levels of inflammatory chemicals TNF-alpha and IL-6 [12].
2. Omega 3s modulate the immune system and decrease brain inflammation and neurodegeneration
Healthy levels of omega 3s are linked with a decreased risk of brain degeneration. However, many people have omega 3 deficiency. Furthermore, studies found that omega 3 supplementation can help reverse progression of inflammatory and autoimmune diseases, including MS. Omega 3s are precursors of lipid signaling molecules called oxylipins – and research suggests that both omega 3s and oxylipins should be measured routinely, as they can be used as biomarkers of disease [13]. In MS, the integrity of the blood brain barrier (BBB) is impaired, allowing inflammatory T cells to migrate in the brain and trigger inflammation, loss of myelin, and brain cell death.
Matrix metalloproteinase-9 (or MMP-9) is a protein that plays a key role in the BBB disruption and T cell migration in the brain. MMP-9 levels are higher in MS compared with healthy individuals. For example, one reason why the MS drug interferon-beta (IFN-beta) works is because it inhibits MMP-9 levels. This is one mechanism of action of omega 3s as well. EPA and DHA have been found to significantly decrease MMP-9 and other molecules that promote inflammation [14].
Omega 3s are some of the most well researched supplements. Many placebo controlled trials found that fish oil provides significant benefits, including decreased disease activity and lower need of anti inflammatory drugs in many chronic inflammatory conditions (including MS, rheumatoid arthritis, Crohn’s disease, ulcerative colitis, lupus, and psoriasis) [16].
3. Omega 3s relieve pain
Omega 3s help relieve various types of pain that often occur in MS: chronic pain, joint pain, neuropathic pain: tingling and numbness, and migraine headaches
Omega 3s and 9s (omega 9s are also anti inflammatory) can relieve neuropathic pain (i.e. tingling, numbness) in animal models. The mechanism of action likely involves the ability of these fatty acids to decrease brain inflammation and oxidative stress, while supporting healthy brain cell growth and development and stimulating certain cell survival pathways [17]. A review of 51 research studies suggests that omega 3s supplements moderately improve chronic pain [18].
Omega 3s help relieve joint pain associated with autoimmune conditions such as rheumatoid arthritis [19] . High omega3/low omega 6 fatty diets decrease the frequency of attacks of migraine and other headache disorders according to two randomized controlled trials [20].
4. Omega 3s can effectively treat metabolic syndrome and its possible complications (heart diseases, stroke, diabetes)
Fish oil supplements has been studied extensively in clinical trials and are currently considered effective for treating metabolic syndrome [21] . The benefits of EPA and DHA could be explained by the fact that these fatty acids activate peroxisome proliferator-activated receptors (or PPARs), particularly PPARγ and PPARα. Remember my other blog post about ketogenic diet (KD also activates PPARγ) . PPARγ improves insulin sensitivity and regulates inflammatory and multiple other pathways that are implicated in neurodegeneration. Activating PPARs is a powerful way to treat metabolic syndrome, thus synthetic drugs that act as PPAR agonists are currently researched for various conditions – including high cholesterol, diabetes and cancer. Pioglitazone, a PPARγ agonist can help reverse MS . While synthetic drugs appear to be highly effective, they do carry side effects such as weight gain, edema, bladder cancer, heart failure and increased risk of heart attacks and liver failure [22].
Meanwhile, EPA and DHA do activate PPARγ and have an excellent safety profile [23].
Technical . PPARs are members of a nuclear receptor superfamily. Activation of PPARα decreases lipid levels, PPARγ raises insulin sensitivity, while PPARδ regulates cholesterol and glucose levels. PPAR ligands include fatty acids and eicosanoids [24].
PPARα is expressed mostly in the liver, heart, skeletal muscles, while PPARγ is expressed predominantly in the adipose tissue, as well as in immune and inflammatory cells, mucosa of the colon and placenta. When the concentration of fatty acids is increased, PPARα uptakes and oxidizes fatty acids, while PPARγ improves the storage of fatty acids in the adipose tissue. The end result is improved insulin sensitivity [24].
5. Omega 3s protect against heart diseases and stroke
Individuals with MS are at a higher risk for heart diseases and stroke compared with healthy population [25], [26].
Omega 3s reduce the risk of death, heart attacks, stroke and abnormal heart rhythm through several mechanisms: they improve cholesterol levels, inflammatory markers and blood pressure. Fish oil can help prevent and treat atherosclerosis by slowing the formation of plaques and blood clots. 200 milligrams DHA per day decreases the chance of death from cardiac arrest by 50%, according to one study [27]. Large research studies found you can cut the risk of stroke by 50% if you eat 2 servings of fish per week [28], [29].
While the benefits of ALA had been questioned for a long time, newer studies found that ALA intake has an inverse association with cardiovascular events [30].
6. Omega 3s help manage insulin resistance and diabetes
There is scientific evidence that omega 3s can help manage both insulin resistance and diabetes, both being associated with MS [31]. Fish oil supplements have been found beneficial in both animal and human studies for insulin resistance. ALA rich (plant) foods can also decrease the risk of diabetes [31], [32].
7. Omega 3s help reduce disease activity and relapse rate in MS
One study evaluated almost 2500 individuals, and 60% of them had RRMS. The researchers found that consuming fish more often or supplementing with omega 3 was associated with better quality of life, less disability, lower relapse rate and decreased disease activity. Flax oil supplementation was found extremely beneficial, being linked with over 60% lower relapse rate over the previous year [33].
A new study in animal models shows that the body can make natural cannabinoids from omega 3s without getting high (as the THC from marijuana does) [34].
Cannabinoids have multiple benefits: they are anti-inflammatory, they modulate the immune system, they promote brain health and neuroplasticity, they improve sleep, digestion and circulation, they lower stress and anxiety and much more [35]. They also stimulate PPARs [36].
V. Warnings
Fish oil supplements have an excellent safety profile. Mild side effects include gas, bloating and diarrhea. EPA has blood thinning qualities, thus increases the risk of bleeding (choose a brain that is low in EPA and high in DHA). Fish oil supplements can interfere with certain drugs (thus the dosage of these drugs may need an adjustment, thus you will need to discuss with your doctor). These drugs include blood thinners such as aspirin or warfarin, anti-diabetes medication, cholesterol lowering agents, steroids, cyclosporine and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen.
VI. Best Omega 3 Supplements
Best sources of omega 3s are from animal sources, as some people have lower ability to convert ALA into EPA and DHA.
Krill oil supplements appear to be safer (less likely to be contaminated with heavy metals ). However, I prefer a high quality brain of fish oil with high doses of DHA (to reduce brain inflammation) and low doses of EPA (which means low risk of bleeding).
DHA is present at high concentration in the brain but its levels decrease dramatically in individuals with MS [37]. For brain inflammation a fish oil supplement with high dose DHA (500 mg) would be the best option (recommended dose is 1000 mg DHA , therefore 2 softgels daily).
Buy fish oil supplements only from a reputable brand to avoid harmful contaminants, such as mercury and other heavy metals , dioxins, and polychlorinated biphenyls (PCBs). I like this product.
