OMEGA-3

No benefit of daily omega-3, vitamin D supplementation for AF prevention

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Taking omega-3 fatty acids and vitamin D3 supplements did not increase nor decrease the risk for incident atrial fibrillation over 5 years, according to results of the VITAL Rhythm trial.

Christine M. Albert

“Our findings do not support the use of either [eicosapentaenoic acid/docosahexaenoic acid] or vitamin D3 for primary prevention of incident AF,” Christine M. Albert, MD, MPH, president of the Heart Rhythm Society and founding chair of the department of cardiology in the Smidt Heart Institute at Cedars-Sinai Medical Center in Los Angeles, said during a press conference. The results “also don’t show any increased risk in AF for patients who are using these supplements for other indications.”

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Source: Adobe Stock.

VITAL Rhythm is an ancillary study of VITAL, a primary prevention trial of CVD and cancer conducted in more than 25,000 U.S. adults. The trial evaluated whether daily supplementation with 2,000 IU of vitamin D3 and/or 840 mg of omega-3 fatty acids (Omacor, Pronova BioPharma/BASF; 1 g per day), composed of 460 mg eicosapentaenoic acid (EPA) and 380 mg docosahexaenoic acid (DHA), would reduce risk for incident AF compared with placebo.

No reduction, increase in AF

During a median treatment duration of 5.3 years, 900 participants — 3.6% of the population — had a confirmed AF event. AF events were determined by participants self-reports and CMS claims data, and events were then confirmed by medical record review, Albert said. Seventy-three percent of the AF events observed during follow-up were confirmed by ECG and 27% by medical record reports.

Most events were paroxysmal AF (58.4%) and 62% of patients had symptoms present at diagnosis, but a “good fraction” of participants had no symptoms before their diagnosis, Albert said.

The trial had 92% power to detect a 20% reduction or increase in the observed HR for incident AF. The incidence of AF in the omega-3 fatty acid group, compared with the placebo arm, was slightly greater, but not significantly so (HR = 1.09; 95% CI, 0.96-1.24; P = .19), Albert said. Similarly, the vitamin D group did not show a reduction or an increase in the incidence of AF compared with placebo (HR = 1.09; 95% CI, 0.96-1.25; P = .19).

VITAL Rhythm was a randomized, double-blind, placebo-controlled trial with a 2×2 factorial design. Researchers enrolled 25,119 participants who had no prior history of CVD cancer or AF at baseline. The mean age was 67 years, 51% were women and 20% were Black.

‘Roadmap’ for AF primary prevention trials

“The use of dietary supplements, including fish oil and vitamin D, is popular in the community. The health benefits, however, have not been proven in CVD,” Renate B. Schnabel, MD, MSc, interventional cardiologist, professor in cardiology at University Heart Center Hamburg, Germany, said during a press conference discussion of the VITAL Rhythm results. (See Healio’s previous coverage of the main VITAL trial here.)

There is a lack of randomized controlled trials in AF primary prevention, largely due to concerns of feasibility, according to Albert. Low levels of marine omega-3 fatty acids and vitamin D have been associated with increased risk for incident AF, but large-scale and long-term randomized data, to date, were lacking, she said.

VITAL Rhythm is the “first large-scale, long-term, randomized, placebo-controlled trial to prospectively test the effect of any intervention on incident AF,” Albert said.

“Future research testing other strategies to prevent AF is needed. There are several other strategies that involve lifestyle, weight reduction, blood pressure reduction,” she said. “I hope that this trial can provide a roadmap for how these primary prevention AF trials can be performed.”

VITAL Rhythm “has set the stage for primary prevention trials in AF,” Schnabel said. “In the future, AF detection will be enhanced by wearables and other devices, but it definitely shows us the increasing relevance of more pragmatic trials that are plausible and may provide valid results.”

PERSPECTIVE

BACK TO TOP Annabelle Santos Volgman, MD, FACC, FAHA)

Annabelle Santos Volgman, MD, FACC, FAHA

This was one of several AF trials presented at AHA which showed that preventing AF is harder than just giving fish oils and vitamin D. These trials give us more clarity in how to prevent, treat and detect AF in patients at high risk for strokes and major adverse CV events.

The VITAL Rhythm trial is an ancillary trial of the VITAL trial, a primary prevention trial of CVD and cancer of 25,871 American men and women. The study examined whether daily supplementation with 2,000 IU of vitamin D3 and/or 840 mg of omega-3 fatty acids (Omacor 1 g per day), comprised of 460 mg EPA and 380 mg of DHA, would prevent AF. After a follow-up period of 5.3 years, neither reduced nor increased the incidence of AF. To prevent AF we recommend patients control risk factors such as hypertension, obesity and sleep apnea, and avoid or limit alcohol.

Annabelle Santos Volgman, MD, FACC, FAHA

Cardiology Today Editorial Board Member

Rush University School of Medicine

Governor-elect, American College of Cardiology of Illinois

Chair, American Heart Association Women in Cardiology

Omega-3 Builds Muscle Mass in Cancer Patients

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For cancer patients, supplementation with omega-3 fats could help them maintain and even regain lost muscle mass, according to a new study. Most patients who took a daily supplement for 10 weeks either maintained or gained muscle mass. Patients who didn’t take anything either maintained or lost muscle mass.

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MSNBC reports:

“[Omega-3’s] interfere with inflammation, thereby reducing its effect on muscle … Loss of muscle mass and fat is bad for cancer patients because it hampers their ability to respond to cancer treatments.”

Dr. Mercola’s Comments:

If you’ve known anyone with advanced cancer, chances are they have experienced cachexia, also called catabolic wasting. Cachexia, or more precisely cancer anorexia-cachexia syndrome (CACS), is a clinical wasting syndrome characterized by unintended and progressive weight loss. Both muscle and fat tend to be lost.

More than 80 percent of patients with advanced cancer develop cachexia, especially those with solid tumors. Cachexia is more common among children and elderly patients, and it becomes more pronounced as the cancer progresses.

Patients experience anorexia, chronic nausea, early satiety, and changes in how foods taste to them, making previously enjoyed foods less palatable. If you’ve ever had a friend or family member with cachexia, your loved one may have seemed to “waste away” before your very eyes.

Cancer patients can have other adverse effects, associated with the cachexia:

Anemia Hyperlipidemia and insulin resistance
Fatigue and weakness after minimal activity Psychological distress
Systemic inflammation Diminished quality of life
Edema

Cachexia is a SERIOUS and complex metabolic syndrome—it is estimated to be responsible for one-fifth to one-third of all cancer deaths.

This may be explained, at least in part, by a 2010 study in mice that showed the wasting can result in damage to the heart. This is quite significant because prior to now, most clinicians believed cachexia did not affect the heart muscle in the way it does skeletal muscle.

This study demonstrated that cancer cachexia impairs heart function by causing “increased fibrosis, disrupted myocardial structure, and altered composition of contractile proteins of cardiac muscle.”

What Causes Cachexia?

It used to be thought that cancer increased your metabolic demand and suppressed your appetite, resulting in malnutrition. However, new research shows there is more to it than that.

Cancer actually alters your metabolism from an anabolic one (muscle building) to a catabolic one (muscle breakdown). Recent research shows that cancer raises your resting metabolic rate, and supplemental general nutrition does not alleviate it.

Today, clinicians believe that tissue wasting results from a variety of tumor products, immune factors, and cytokines.

According to an article in Life Extension:

“The cytokines interleukin-1 (IL-1), IL-6, interferon-gamma, tumor necrosis factor-alpha (TNF-alpha), and brain-derived neurotrophic factor appear to increase and play a role in the progression of cachexia in cancer, as well as in other diseases associated with bodily wasting.”

Basically, you end up with an energy deficit, so your body is forced to use your muscles, internal organs and fat for energy. Add to that the ravaging side effects of common cancer treatments, such as chemotherapy and radiotherapy, and it is easy to understand why your loved one looks malnourished and even emaciated.

Numerous Other Studies Show the Positive Effects of Omega-3s on Cachexia

This is not the first study showing that omega-3 fatty acids may help to reverse cancer-induced cachexia. Studies in mice have been very favorable, and studies in humans have been largely favorable.

The “not favorable” human studies often involve treatment with insufficient doses of omega-3 fatty acids, or treatment over too short of a time. Because these studies have been done mostly on late-stage cancer patients (since they are the ones with the worst cachexia), there is a relatively high attrition rate, which skews the results toward “unfavorable.”

The bottom line is, the sooner you bump up your omega-3 levels, the better your long-term outcome will be.

Here are a few of the specific studies:

  • A 2004 study of human patients with advanced malignancy found that, although the majority of patients did not gain weight with the fish oil, a subset of patients had weight stabilization or weight gain. The researchers theorized that the length of time patients receive omega-3 supplementation is a factor—the longer, the more significant the positive effect. They also suggested inadequate dose as the explanation for part of the lack of effect in some patients.
  • A study in 1996 of eighteen human pancreatic cancer patients showed that taking fish oil capsules resulted in less muscle wasting, and many actually gained lean body mass.
  • A 2000 study investigating the effects of a combination of omega-3 fatty acids AND vitamin E found the combination produced a significant immunomodulating effect, and the omega-3 prolonged patient survival.
  • A 1990 scientific study of cachexia-inducing tumors in mice showed that when part of the carbohydrate calories in their diet was replaced by fish oil, their weight loss was inhibited.
  • A 1991 study found that fish oil concentrate inhibited skeletal muscle degradation and even reduced tumor size in mice.

Krill Oil—NOT Fish Oil—Is Your Best Source of Omega-3 Fatty Acids

The time to begin supplementing your diet with these important fatty acids is NOW, rather that waiting until you have cancer or another serious disease.

The average American diet is seriously deficient in the animal based omega-3 fats, DHA and EPA. Except for certain types of fish, there are very few sources of these important fats.

Unfortunately, fish supplies around the world are found more contaminated every year as increasing numbers of fish test positive for mercury, PCBs, toxic metals like lead and arsenic, and radioactive substances like strontium. If you have cancer, the LAST thing you want to do is place additional stress on your body by taking in toxic heavy metals.

Your safest and most cost effective choice for bumping up your omega-3 fatty acids is taking a high-quality Antarctic krill oil.

Krill oil is superior to fish oil because it contains phospholipids, a very powerful antioxidant called astaxanthin, and omega-3s bonded together in a way that keeps them safe from oxidation and easily absorbed by your body. Krill oil is 48 times more potent than fish oil. Many popular fish oil brands are already oxidized before you open the bottle.

And harvesting krill is more sustainable and earth-friendly than harvesting fish.

Your risk of getting mercury contamination from krill is extremely low, since krill are so small they don’t have the chance to accumulate toxins before being harvested.

Plant based omega-3 sources like flax, hemp and chia are high in ALA and are important sources of nutrients, as we all need ALA. However, the key point to remember is that ALA has to be converted by your body into far more essential EPA and DHA by an enzyme in which the vast majority of us are deficient.

So, I believe it is essential to get some of your omega-3 fatty acids from animal sources.

There are studies that even show ALA from flaxseed can actually increase your risk of cancer. Personally, I regularly include ALA omega-3 plant based foods in my diet, like flax and hemp, but these are always combined with animal-based omega-3 fats.

Other Important Nutritional Aspects, for Those Who Have Cancer

No one wants to battle cancer.

But if you find yourself in this unfortunate position, many of the lifestyle suggestions for preventing cancer apply to treating it as well.

Besides omega-3 fatty acids, you should also address the following:

  • Optimize your vitamin D. Vitamin D influences virtually every cell in your body and is one of nature’s most potent cancer-fighters. Vitamin D is actually able to enter cancer cells and trigger apoptosis (cell death).

    If you have cancer, your vitamin D level should be between 70 and 100 ng/ml. Vitamin D works synergistically with every cancer treatment I’m aware of, with no adverse effects. I invite you to watch my one-hour free lecture on vitamin D to learn how to best optimize your vitamin D level.

  • Eat the right foods for your Nutritional Type. If you are not familiar with this approach, start by taking my FREE Nutritional Type Test here.
  • Avoid sugar, grains, processed foods, chemicals, and artificial sweeteners. Sugar fuels the growth of cancer cells. Normalizing your insulin creates an environment that is unfriendly to cancer cells.
  • Use organic coconut oil every day. Coconut oil is rich in medium chain triglycerides (MCTs), which offer a wide variety of health benefits and may also be effective in preventing or reversing cachexia.
  • Avoid charring your meats. Charcoal or flame broiled meat is linked with increased cancer growth
  • Avoid unfermented soy products. Unfermented soy is high in plant estrogens, or phytoestrogens, also known as isoflavones. In some studies, soy appears to work in concert with human estrogen to increase cell proliferation, which increases mutations and cancerous cells.
  • Drink a quart of organic green vegetable juice daily. Please review my juicing instructions for more detailed information about this.
  • Avoid drinking alcohol, or at least limit your alcoholic drinks to one per day.
  • Drink plenty of pure water every day.
  • Get some sort of exercise daily. Exercise will help you maintain your muscle mass, thereby slowing down cachexia. Realizing cancer can really diminish your energy level, you may have to experiment a bit to find forms of exercise you can tolerate, but it is important to do it, nevertheless. Exercise has been proven to extend the lives of cancer patients.
  • Avoid electromagnetic fields as much as possible. Minimize cell phone use, and make sure your cordless phone base station is as far from your sleeping area as possible. Keep medical radiation exposure as low as possible. Even electric blankets can increase your cancer risk.

6 Nutrient Deficiencies that Can Cause Depression & Mood Disorders

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Did you know simply nutrient deficiencies can drastically increase your chances of having depression and other mood disorders? Nutrient-related disorders are always treatable and deficiencies are usually curable.

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The good news is that there are ways to confront these deficiencies. You can work with an integrative health physician to determine where your nutrition levels are and how you can counteract the associated effects.

6 Nutrient Deficiencies that Can Cause Depression & Mood Disorders

Vitamin B6

A deficiency of vitamin B6 can also lead to depression and other cognitive disorders. This nutrient is required for creating neurotransmitters and brain chemicals that influence your mood. It even helps keep the nervous system healthy. Furthermore, vitamin B6 helps the body absorb vitamin B12, the deficiency of which is also linked to depression.

Vitamin D

This deficiency has been linked to depression, dementia, and autism. Most of our levels drop off during the fall and winter months, since the sunlight is the richest source. An adequate level of serotonin helps prevent and treat mild depression. In addition, vitamin D is important for the immune system and bone health.

Amino Acids

Amino acids are the special building blocks of protein, some of which gets transformed in our bodies into neurotransmitters. Without adequate amino acids, your brain can’t work and you get sluggish, foggy, unfocused, and depressed. Amino acids are found in meat, eggs, fish, beans, seeds, and nuts.

Magnesium

Magnesium is another important nutrient, the deficiency of which can lead to depression. It helps activate enzymes needed for serotonin and dopamine production. It also influences several systems associated with development of depression. In addition, it keeps your bones healthy, reduces anxiety and lowers blood pressure, to name a few.

Zinc

Zinc is used by more enzymes (and we have over 300) than any other mineral. It is crucial to many of our systems. It activates our digestive enzymes so that we can break down our food and works to prevent food allergies (which, in turn, averts depression, since some of our mood disruptions are triggered by food allergies). It also helps our DNA to repair and produce proteins. Finally, zinc helps control inflammation and boosts our immune system.

Selenium

Selenium is also essential to brain functioning and helps improve mood and depressive symptoms. Moreover, selenium plays an important role in proper thyroid functioning. A healthy thyroid is important for mental health.

12 FOODS THAT ARE VERY HIGH IN OMEGA-3

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Omega-3 fatty acids have all sorts of benefits for your body and brain.

Many mainstream health organizations recommend a minimum of 250-500 mg ofomega-3 per day for healthy adults (1, 2, 3).

You can get high amounts of omega-3 fats from fatty fish, algae and several high-fat plant foods.

Here is a list of 12 foods that are very high in omega-3.

1. Mackerel (4107 mg per serving)

At Finn & Porter.

At Finn & Porter.

Mackerel are small, fatty fish.

In Western countries, they are commonly smoked and eaten as whole fillets at breakfast.

They are incredibly rich in nutrients, and a 3.5 oz (100 g) piece of mackerel provides 200% of the RDI for vitamin B12 and 100% for selenium (4).

On top of that, these fish are quite tasty yet require almost no preparation.

Omega-3 content: 4107 mg in one piece, or 5134 mg per 100 grams (3.5 oz).

2. Salmon (4023 mg per serving)

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Salmon is one of the mostnutrient-dense foods on the planet.

It contains high-quality proteinand a variety of nutrients, including large amounts of magnesium, potassium, selenium and B-vitamins (5, 6).

Studies show that people who regularly eat fatty fish, like salmon, have a lower risk of diseases like heart disease, dementia and depression (7, 8, 9, 10).

Omega-3 content: 4023 mg in half a fillet, or 2260 mg in 100 grams (3.5 oz).

3. Cod Liver Oil (2664 mg per serving)

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Cod liver oil is more of a supplement than a food.

As the name implies, it is oil that is extracted from the livers of cod fish.

Not only is this oil high in omega-3 fatty acids, it is also loaded with vitamin D (338% of the RDI) and vitamin A (270% of the RDI) (11).

Taking just a single tablespoon of cod liver oil therefore more than satisfies your need for three incredibly important nutrients.

However, definitely don’t take more than a tablespoon, because too much vitamin A can be harmful.

Omega-3 content: 2664 mg in a single tablespoon.

4. Herring (3181 mg per serving)

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Herring is a medium-sized oily fish. It is often cold-smoked or precooked, and then sold as a canned snack.

Smoked herring is a popular breakfast food in countries like England, where it is served witheggs and called kippers.

A standard smoked fillet contains almost 100% of the RDI for vitamin D and selenium, and 50% of the RDI for B12 (12).

Omega-3 content: 3181 mg per fillet, or 1729 mg per 100 grams (3.5 oz).

5. Oysters (565 mg per serving)

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Shellfish are among the most nutritious foods you can eat.

In fact, oysters contain more zinc than any other food on the planet. A 100-gram portion of raw oysters (6–7 oysters) contains 600% of the RDI for zinc, 200% for copper and 300% for vitamin B12 (13, 14).

Oysters are usually eaten as an appetizer, snack or whole meal. Raw oysters are a delicacy in many countries.

Omega-3 content: 565 mg in 6 oysters, or 672 mg per 100 grams (3.5 oz).

6. Sardines (2205 mg per serving)

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Sardines are very small, oily fish. They are commonly eaten out of a tin or jar as a starter, snack or delicacy.

Sardines are highly nutritious, especially when eaten whole. They contain almost every single nutrient that the human body needs.

One cup of drained sardines provides over 200% of the RDI for vitamin B12, and over 100% for vitamin D and selenium (15).

Omega-3 content: 2205 mg per cup, or 1480 mg per 100 grams (3.5 oz).

7. Anchovies (951 mg per serving)

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Anchovies are tiny, oily fish that are often found dried or in a jar with oil.

They are usually eaten in very small portions, such as rolled around capers, stuffed inolives or as pizza and salad toppings.

Because of their strong flavor, they are also used to add flavor to many dishes and sauces, including Worcestershire sauce, remoulade and Caesar dressing.

Anchovies are a great source of niacin and selenium, and boned anchovies are also rich in calcium (16).

Omega-3 content: 951 mg per one can (2 oz), or 2113 mg per 100 grams (3.5 oz).

8. Caviar (1086 mg per serving)

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Caviar consists of fish eggs, or roe. It is widely regarded as a highly luxurious food item, and is most often used in small quantities as a starter, taster or garnish.

Caviar is high in choline and exceptionally low in omega-6 fatty acids (17).

Omega-3 content: 1086 mg per tablespoon, or 6789 mg per 100 grams (3.5 oz).

9. Flaxseeds (2338 mg per serving)

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Flaxseeds are small brown or yellow seeds. They are often ground, milled or used to make oil.

These seeds are by far the richest whole food source of the omega-3 fat called alpha-linolenic acid (ALA), and flaxseed oil is often used as an omega-3 supplement.

Flaxseeds are also very high in fiber, vitamin E, magnesium and other nutrients. They have a great omega-6:omega-3 ratio compared to most oily plant seeds (18,19, 20, 21).

You can read more about the different types of omega-3s in this article.

Omega-3 content: 2338 mg per tablespoon of seeds, 7196 mg per tablespoon of oil.

10. Chia Seeds (4915 mg per serving)

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Chia seeds are incredibly nutritious.

They are rich in manganese, calcium, phosphorus and various other nutrients (22).

A standard 1-oz (28 gram) 2-tbsp. serving (24 g) of chia seeds contains 4 grams of protein, including all eight essential amino acids.

Omega-3 content: 4915 mg per ounce (28 grams).

11. Walnuts (2542 mg per serving)

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Walnuts are very nutritious and loaded with fiber. They also contain high amounts of copper, manganese, vitamin E and important plant compounds (23).

However, do not remove the skin, as it contains most of the phenol antioxidants found in walnuts.

Omega-3 content: 2542 mg per ounce, which amounts to 7 about walnuts.

12. Soybeans (1241 mg per serving)

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Soybeans are a good source of fiber and vegetable protein.

They also contain high amounts of other nutrients, including riboflavin, folate, vitamin K, magnesium and potassium (24).

However, soybeans are also very high in omega-6 fatty acids, so they should not be relied on as a sole omega-3 source. We need to get omega-3s and omega-6s in a certain balance.

Omega-3 content: 1241 mg in half a cup, or 1443 mg per 100 grams (3.5 oz).

13. Any Other Foods?

Keep in mind that foods 1-8 contain the omega-3 fats EPA and DHA, which are found in some animal foods, seafood and algae.

Conversely, foods 9-12 contain the omega-3 fat ALA, which is inferior to the other two. You can read more about the different types of omega-3 fats in this article.

Although not as high in omega-3 as the foods listed above, there are many other foods that contain decent amounts of omega-3 fatty acids.

These include pastured eggs, omega-3 enriched eggs, meats from grass-fed animals, grass-fed dairy products, hemp seeds, as well as some vegetables likespinach, Brussel’s sprouts and purslane.

As you can see, getting plenty of omega-3s from whole foods should be relatively easy.