Eggs Don’t Cause Heart Attacks — Sugar Does by Mark Hyman, MD

Mark Hyman, MD, is the author of The Blood Sugar Solution 10-Day Detox Diet: Activate Your Body's Natural Ability to Burn Fat and Lose Weight Fast (2014), The Blood Sugar Solution: The UltraHealthy Program for Losing Weight, Preventing Disease, and Feeling Great Now! (2012), The UltraSimple Diet: Kick-Start Your Metabolism and Safely Lose Up to 10 Pounds in 7 Days (2009), and many other books. By the way, the only way you are losing 10 lbs in 7 days is if you are losing mostly water, so don't be fooled by claims such as that (even though they are literally true, they are deceptive).

This is simply an article reviewing new research that a high-sugar diet raises the risk of heart attack by 400% - even one 20 oz. soda raises the risk by 30%.

Eggs Don’t Cause Heart Attacks — Sugar Does

by Mark Hyman, MD
Last Updated February 7, 2014

It’s over. The debate is settled.

It’s sugar, not fat, that causes heart attacks.

Oops. Fifty years of doctors’ advice and government eating guidelines have been wrong. We’ve been told to swap eggs for Cheerios. But that recommendation is dead wrong. In fact, it’s very likely that this bad advice has killed millions of Americans.

A rigorously done new study shows that those with the highest sugar intake had a four-fold increase in their risk of heart attacks compared to those with the lowest intakes. That’s 400%! Just one 20-ounce soda increases your risk of a heart attack by about 30%.

This study of more than 40,000 people, published in JAMA Internal Medicine, accounted for all other potential risk factors including total calories, overall diet quality, smoking, cholesterol, high blood pressure, obesity and alcohol.

This follows on the heels of decades of research that has been mostly ignored by the medical establishment and policy makers. In fact, the Institute of Medicine recommends getting no more than 25% of your total calories from added sugar. Really?? This study showed that your risk of heart attacks doubles if sugar makes up 20% of your calories.

Yet more than 70% of Americans consume 10% of their daily calories from sugar. And about 10% of Americans consume one in every four of their calories from sugar.

Failed Dietary Guidelines

U.S. Dietary Guidelines provide no limit for added sugar, and the U.S. Food and Drug Administration (FDA) still lists sugar as a “generally regarded as safe” (GRAS) substance. That classification lets the food industry add unlimited amounts of sugar to our food. At least the American Heart Association recommends that our daily diet contain no more than 5% to 7.5% added sugar. Yet most of us are eating a lot more. Most of us don’t know that a serving of tomato sauce has more sugar than a serving of Oreo cookies, or that fruit yogurt has more sugar than a Coke, or that most breakfast cereals — even those made with whole grain — are 75% sugar. That’s not breakfast, it’s dessert!

This is a major paradigm shift. For years, we’ve been brainwashed into thinking that fat causes heart attacks and raises cholesterol, and that sugar is harmless except as a source of empty calories. They are not empty calories. As it turns out, sugar calories are deadly calories. Sugar causes heart attacks, obesity, type 2 diabetes, cancer and dementia, and is the leading cause of liver failure in America.

The biggest culprit is sugar-sweetened beverages including sodas, juices, sports drinks, teas and coffees. They are by far the single biggest source of sugar calories in our diet. In fact, more than 37% of our sugar calories come from soda. The average teenage boy consumes 34 teaspoons of sugar a day, or about 544 calories from sugar. Even more troubling, this isn’t just putting kids at risk for heart attacks at some remote later date in their lives. It’s killing them before their 20th birthday.

This new research syncs with decades of data on how sugar causes insulin resistance, high triglycerides, lower HDL (good) cholesterol and dangerous small LDL (bad) cholesterol. It also triggers the inflammation we now know is at the root of heart disease.

And fats, including saturated fats, have been unfairly blamed. With the exception of trans fats, fats are actually protective. This includes omega-3 fats, nuts and olive oil, which was proven to reduce heart attack risk by more than 30% in a recent large randomized controlled study.

Here’s the simple fact: Sugar calories are worse than other calories. All calories are not created equal. A recent study of more than 175 countries found that increasing overall calories didn’t increase the risk of type 2 diabetes, but increasing sugar calories did — dramatically.

How to Cure Our Sugar Addiction

America lags far behind the rest of the world in addressing this problem. Mexico, for example, responded after learning that when soda consumption increased to 20% of calories for the average citizen, their rates of obesity and type 2 diabetes skyrocketed. Public health officials there researched effective solutions to combat obesity and diabetes from around the world.

The key interventions they implemented included taxing soda, banning junk food television advertising, and eliminating processed foods, junk food and sugar-sweetened beverages from schools. More than 15 countries have targeted sugar-sweetened beverages by taxing them — a strategy that’s proven successful.

Another effective strategy is revamping food labeling to make it clear if a food is good, should be consumed with caution, or is bad for you. In the United States, even someone with a Ph.D. in nutrition has trouble deciphering food labels. How can the average person be expected to know?

Recent and mounting scientific evidence clearly proves that sugar — and flour, which raises blood sugar even more than table sugar — is biologically addictive. In fact, it’s as much as eight times more addictive than cocaine.

The average American consumes about 152 pounds of sugar and 146 pounds of flour a year. It’s imperative that we revamp our outdated and dangerous national dietary guidelines. And we need clear strategies and medical programs to help people understand and address the health risks and addictive nature of sugar and refined carbohydrates.

That’s how we can reverse this tsunami of obesity and chronic disease that is robbing us of our health and crippling our economy.

In my new book, The Blood Sugar Solution 10-Day Detox Diet, which will be released on February 25, I provide an easy, step-by-step plan to rid yourself of sugar addiction and reverse your risk of heart attacks. To download a sneak preview of this book, go to www.10daydetox.com and pre-order the book on Amazon.

Wishing you health and happiness,
Mark Hyman, MD

About Mark Hyman, MD

MARK HYMAN, MD is dedicated to identifying and addressing the root causes of chronic illness through a groundbreaking whole-systems medicine approach called Functional Medicine. He is a family physician, a six-time New York Times bestselling author, and an international leader in his field. Through his private practice, education efforts, writing, research, and advocacy, he empowers others to stop managing symptoms and start treating the underlying causes of illness, thereby tackling our chronic-disease epidemic. More about Dr. Hyman or on Functional Medicine. Click here to view all Press and Media Releases

View all posts by Mark Hyman, MD →

Androgen Depletion Therapy for Prostate Cancer May Make it Worse

Okay, guys, there is one basic rule with prostate cancer - if they want to use androgen depletion therapy (ADT) to eliminate your testosterone in the (false) belief that it will save your life, you need to find another doctor. Period. This article explains examines how ADT can actually INCREASE your risk of developing an aggressive form of the cancer.

Key point:

"Stretching our data even further, these findings suggest that as men age and their testosterone levels decrease, loss of testosterone might actually encourage indolent prostate tumors to become more aggressive," Roberts said. "This suggests that testosterone supplements might be a good thing for the prostate, even though current wisdom suggests the opposite."

If you have an aggressive form of prostate cancer, it will already have metastasized to bone by the time you receive ADT (it happens very early in the process) - and then with ADT you will lose sex drive, muscle mass, and bone density (not to mention developing cholesterol issues, depression, and potential heart disease). Once it gets into the bone, your chances of survival are lower, anyway - so why die impotent and depressed?

Another important issue is that ADT - when it works - only works for a couple of months, while the PCa is androgen-dependent. Eventually, it will become androgen-independent and things get worse form there.

The upshot of this research is that using ADT in men who are in the early stages of benign prostate hypertrophy (BPH) or high-grade prostatic intraepithelial neoplasia, a prostate abnormality that is thought to lead to prostate cancer, should not be deprived of testosterone because it raises the risk of developing a high-grade, aggressive form of the cancer - the opposite of what they intend with this treatment,

The numbers vary, but only around 10% of PCa is aggressive, and the death rate is down to around 3-6% for PCa overall (depending on whose numbers you read). Here is one set of stats, which is a little scary for guys my age (45), who entering the risk years:

Given current screening trends, it is estimated that 16.2% (1 in 6) of American men alive today will be diagnosed with the disease and approximately 3% (1 in 33) will die of the disease (Brawley 2012).

Here is the new research:

Preventing Prostate Cancer Through Androgen Deprivation May Have Harmful Effects

24 December 2012

The use of androgen deprivation therapies to prevent precancerous prostate abnormalities developing into aggressive prostate cancer may have adverse effects in men with precancers with specific genetic alterations, according to data from a preclinical study recently published in Cancer Discovery, a journal of the American Association for Cancer Research.

"The growth and survival of prostate cancer cells are very dependent on signals that the cancer cells receive from a group of hormones, called androgens, which includes testosterone," said Thomas R. Roberts, Ph.D., co-chair of the Department of Cancer Biology at the Dana-Farber Cancer Institute and professor of biological chemistry and molecular pharmacology at Harvard Medical School in Boston, Mass.

Previous findings from two major randomized, placebo-controlled prostate cancer chemoprevention trials revealed that androgen deprivation therapy reduced the overall risk for low-grade prostate cancer. However, both trials also revealed a high cumulative risk for high-grade prostate cancers that has caused concern among experts.

High-grade prostatic intraepithelial neoplasia is a prostate abnormality that is considered to be a major precursor to prostate cancer. Loss of the tumor suppressor PTEN is detected in 9 to 45 percent of clinical cases.

Using a mouse model of PTEN-driven high-grade prostatic intraepithelial neoplasia, Roberts and his colleagues investigated whether surgical or chemical androgen deprivation could prevent the cancer precursor from progressing to more aggressive disease.

"When we castrated the animals, we thought the tumors would shrink and they did initially," Roberts said. "However, they then grew back and became invasive."

The results of this preclinical study suggest that prophylactic reduction of the most active form of androgen, or blocking androgen receptor function, might have unintended consequences in some men.

"Stretching our data even further, these findings suggest that as men age and their testosterone levels decrease, loss of testosterone might actually encourage indolent prostate tumors to become more aggressive," Roberts said. "This suggests that testosterone supplements might be a good thing for the prostate, even though current wisdom suggests the opposite."

Roberts noted that these results should be interpreted with caution because the prostate glands of mice are different from their human counterparts. More data on human tumors are needed to evaluate whether the data from this mouse study are applicable to men.

Source: The American Association of Cancer Research

Citation:
Brawley, OW. (2012). "Prostate cancer epidemiology in the United States." World J Urol 30(2): 195-200.

Maybe Testosterone Replacement Is Not the Answer

I have advocated for testosterone replacement for men with low or even low-normal testosterone levels for many years. More and more doctors have gotten on board with that approach despite a very vocal minority of doctors who consider it dangerous or non-effective.

Some of the symptoms of low testosterone include muscle loss and strength decline, cognitive decline, cardiovascular disease, decreased libido, erectile dysfunction, depression, decreased masculinity, fat gain, metabolic disorders, decreased energy and work performance, and even height loss due to loss of bone density.

Unless the man is concerned about fertility, the usual method of replacement is a transdermal gel or cream, and some of the better known products are AndroGel, Axiron, Testim, and Fortesta. In younger men concerned about fertility, testosterone injections are given every two weeks or up to every three months, depending on the form.

Some of the risks of testosterone therapy include growth of prostate cancer and breast cancer, worsened symptoms of benign prostatic hypertrophy, liver toxicity and liver tumor (only with oral administration), gynecomastia (breast tissue growth), erythrocytosis (thickening of blood due to increased red blood cell production), testicular atrophy and infertility, skin diseases (usually only with the patch), and new or exacerbated sleep apnea.

Most or all of these can be managed with an aromatase inhibitor to prevent the conversion of testosterone to estrogen and with maintaining moderate T levels as opposed to high-normal.

For a good overview of the benefits and risks, The benefits and risks of testosterone replacement therapy: A review by Nazem Bassil, Saad Alkaade, and John E Morley (2009) is a an excellent open access paper (Ther Clin Risk Manag.; 5: 427–448).

All of this brings me to the point of this post - there might be another way to get the benefits while reducing the risks.

Dr. William Llewellyn often researches and writes about hormone manipulation in athletes (body builders mostly) and the general public - his team offers testosterone therapy for aging men. He recently posted an article that summarizes some new research on using aromatase inhibitors to reduce estrogen and increase testosterone, without the risks of t-replacement therapy. Better yet, these can be taken as a daily pill with no liver risks, and no injections to worry about.

Arimidex vs. Femara for increasing testosterone in men (HRT)

June 5, 2012 By William Llewellyn

Testosterone medications like AndroGel, Axiron, Testim, and Fortesta are the products most widely prescribed to treat age related hormone decline in men, a condition know as andropause or adult hypogonadism. However, direct hormone replacement is not ideal for all patients. This often includes men looking to maintain fertility, or those with low testosterone caused by excess estrogen. To better treat such cases, a number of alternate therapies are being investigated. Several of these involve anti-estrogenic or aromatase-inhibiting drugs, which can raise testosterone levels by lowering the activity of estrogen. This works because estrogen is a strong inhibiting signal towards testosterone synthesis in men. When estrogen levels go up, testosterone drops.

Researchers at the Aretaieion Hospital in Athens Greece recently completed a study comparing the use of Femara (letrozole) and Arimidex (anastrozole) in men with low testosterone, which are two of the more potent and modern aromatase inhibitors. The study involved infertile men (n=29), all having testosterone concentrations below 300 ng/dL and a T/E ratio under 10. The men were divided into two groups, each given either 1 mg of anastrozole or 2.5 mg of letrozole per day. The medications were continued for six months. At the end of therapy, basic health markers were compared to baseline, including hormone levels and sperm density. The data is presented in the tables below.

The results in this study appeared to be promising for both drugs. Sperm density was improved in 73.4% of the men taking letrozole, and 78.6% for those using anastrozole. Testosterone was substantially improved for both groups as well. With men taking letrozole, testosterone increased from 275 ng/dL to 495 ng/dL on average, an 80% bump. With anastrozole, the average testosterone level went from 265 ng/dL to 513 ng/dL, or a 94% increase. Side effects were mild and transient, including GI upset, lethargy, headache, and liver enzyme elevations in a small number of patients. Both drugs were deemed “well tolerated”, and none of the participants were forced to discontinue treatment.

No comparative conclusions could be drawn in this study. Letrozole and anastrozole appeared equally effective at treating men with low testosterone, infertility, and low T/E ratio. There are still questions that need to be answered, especially when it comes to the long-term safety of this type of therapy. In particular, there are some concerns with a potential loss of bone mineral density, or elevations in serum cholesterol and cardiovascular disease risk. Still, the results here were promising, and add to a series of other positive studies with men taking AI drugs for low testosterone. The present researchers have furthered this discussion by recommending the use of T/E ratio as an additional diagnostic tool. A ratio below 10:1 would identify those hypogonadal men that might benefit from aromatase inhibitor therapy.

Source: Fertil Steril. 2012 May 11. [Epub ahead of print]

 

What's New in Prostate Cancer

The accepted wisdom for men is that if we live longer enough, we'll all get prostate cancer at some point. There were two stories in the media this week about the second-most common cancer among men in the U.S.

Most people have been talking about the new suggestion that healthy men do not need to get prostate exams, as decided by the U.S. Preventive Service Task Force.

NPR looked at this issue on Talk of the Nation:

Prostate Cancer Screenings Not Recommended

Listen to the Story

Talk of the Nation

[16 min 53 sec]

• Download

 October 12, 2011

 

The U.S. Preventive Service Task Force recommended against screening for most healthy men, concluding that it causes too much anxiety and leads to unnecessarily aggressive treatment including surgery. Many doctors and patients say they will continue the prostate specific antigen (PSA) blood test.

NEAL CONAN, host: Last week, we talked about life after prostate cancer surgery, but since then, prostate cancer's been all over the front page. Late last week, word leaked that the U.S. Preventive Service Task Force would no longer recommend routine screening. This week, the studies to support that conclusion came out, along with op-eds that challenged it. If the new screening recommendation has you scratching your head, give us a call: 800-989-8255. Email: talk@npr.org. You can also join the conversation on our website. Go to npr.org and click on TALK OF THE NATION.

Joining us again to talk about prostate cancer and the recent recommendation is Tara Parker-Pope, editor of The New York Times Well blog. And nice to have you back on TALK OF THE NATION.

TARA PARKER-POPE: Sure. Happy to be here.

CONAN: And as I understand it, the fundamental finding of the task force is that most of the time, prostate cancer grows so slowly, that most men will never know it's there. But if they do find out they have cancer, it is very, very difficult not to do anything about it.

PARKER-POPE: That's exactly right. I've interviewed several men who say that, you know, the moment your doctor looks you in the eye and says you have prostate cancer, you know, you can't really get that thought out of your head. And your sort of fast reaction is, well, we've got to get it out. And what we know is that, often, you probably don't have to get it out. But it's not really about what's happening at that individual patient level. What we're seeing is that when you think about the risk and benefits of a screening program, you have to look at large populations.

You need to see: Are we making a difference? We're finding cancer early, but are we saving lives? And the resounding conclusion I know from several studies is that no, we really probably are not saving lives. If we are, it's so few lives, it's dwarfed by just the enormous pain and suffering we're causing men by testing - by doing this screening test.

CONAN: Enormous pain and suffering, because they then go have procedures of various types, and men end up impotent, incontinent or both.

PARKER-POPE: Right. And it's really from - it's the stress of being told you might have cancer from having a high PSA rating. Men go in and get these biopsies, which are not inconsequential. They can be uncomfortable, and they can actually lead - I've actually heard from several readers where, you know, men have ended up in the hospital with infections from a biopsy. That is a rare complication, but it does happen. And once you get the biopsy, if it's clear and you've still got the high PSA, your doctor's going to say, well, I'm not confident. Come back again. Come back again for repeat biopsies.
And if you do find cancer, you know, a biopsy's 12 or 15 sort of quick samples from the prostate. And if you find cancer in even one of those cores, then you're suddenly in this world of, you know, do I make a decision to undergo treatment, which might leave me incontinent - will probably leave me incontinent and impotent, at least for a little while.

CONAN: And among the controversies here is the fact that the board reached this conclusion two years ago, and because of their experience with the uproar after making similar recommendations on breast screening, breast cancer screening, they waited two years till they could assemble the science. In the meantime, tens of thousands of men may have had procedures they didn't need.

PARKER-POPE: Yeah. And I guess - I mean, I think it is probably prudent to, you know, get the science right, and that's what the chairman of the task force has said. Should we have had this debate two years ago? Maybe. But would people have heard it in the midst of the mammography recommendations? You know, I don't know that we can second-guessed that decision, because the truth is the recommendation is out now, and plenty of men are still going to continue to get PSA screening because they find it very difficult, as do their doctors, to give up this idea that they really truly believe earlier is better. Find cancer early, it's better. It's a really difficult concept to grasp that that's not always the case.

CONAN: And we've seen all kinds of people come out in the past couple of days and say, wait a minute. This is a test that saves lives. Who are you kidding? Why are we stopping this?

PARKER-POPE: Yeah. And it's interesting - I mean, there is a legitimate debate here about what these large studies have shown. The U.S. study pretty clearly showed it did not save lives, but you can, you know, poke holes in that study for sure. The European study, not quite as clear. There was a lot of variations and a lot of problems with the data in that study, as well, that showed that maybe one in 50 men is helped. And the argument is quickly - well, if at least one life is saved, then shouldn't we do it? But you really have to kind of calculate the suffering that is caused over large groups to, you know, to make that decision. You know, one in 50, is that a reasonable trade off for, you know, as Otis Brawley at the American Cancer Society said, the PSA test is 50 times more likely to ruin your life than it is to save your life.

Read the whole transcript.

The other story that hit the media this week was that taking vitamin E increases the risk of having prostate cancer. There had been previous evidence that vitamin E might help prevent or lower the risk of prostate cancer, so this will generate some fear in men (like me) who have been taking 400 iu of vitamin E each day for several years.

Vitamin E Increases Prostate Cancer Risk, New Study Shows

by Catherine Pearson (Huffington Post)



First Posted: 10/11/11

Taking vitamin E supplements may harm men's health, according to a new study that suggests the supplements can significantly increase the risk of prostate cancer.

The findings come from the large Selenium and Vitamin E Cancer Prevention Trial, otherwise known as the SELECT study, the initial results of which were published in 2008. Designed to test evidence indicating that selenium (a trace mineral found primarily in plants as well as some meats and seafood) and vitamin E (an antioxidant found in vegetable oils and nuts) might lessen prostate risk, the study found that there was, in fact, no reduction.

The updated results, published Tuesday in the Journal of the Medical Association, take that finding one step further.

They show that study participants receiving vitamin E had a 17 percent increased risk of prostate cancer, which, according to the Centers for Disease Control, is the second-most common cancer among men in the U.S.

"The observed 17 percent increase in prostate cancer incidence demonstrates the potential for seemingly innocuous yet biologically active substances such as vitamins to cause harm," the study's authors write.

The latest report does not offer any reason why vitamin E supplements may be tied with increased prostate cancer risk.

"This was a surprising finding and, at present, there is no biological explanation for why those who took vitamin E are at higher risk of developing prostate cancer," Dr. Eric Klein, chairman of the Glickman Urological and Kidney Institute at the Cleveland Clinic and the study's lead author, told HuffPost. He added that the trial data have been made available to the wider scientific community, in the hopes that additional research will be conducted to better understand the current findings.

Read the whole report.

Do We Need a Prescription to Get Quality Fish Oil?

I've seen the commercials, you've probably seen them too. Big Pharma has produced a prescription grade omega-3 supplement, er medicine, that they want us to buy instead of eating fish or taking regular fish oil supplements.

Chris Shugart at T-Nation noticed the commercials and asked Mike Roussell, a PhD nutritionist and the founder of Naked Nutrition, for his take on this topic. He offers a good review of the limited comparative research - which shows the isolated prescription formula performed worse than the "normal" fish oil.

I edited out the Biotest advert at the bottom, so here it is, briefly, and up front:

Highly-purified, molecularly distilled fish oil supplements like Flameout^TM (a Biotest product) provide a safe and potentially more effective alternative to prescription omega-3s.

Supplement Research Update: The Truth About Prescription Fish Oil

by Mike Roussell, PhD – 3/22/2011

I couldn't believe my eyes, but there it was: a commercial for prescription fish oil. Why do we need an expensive 'script for something anyone can buy over the counter or online?

Was this stuff better than a high-quality fish oil supplement? Or was this just Big Pharma glomming on to the success of fish oil and other fatty acid supplements?

I asked Dr. Mike Roussell, who's done consulting work with both supplement and pharmaceutical companies, to check into this and give us his honest opinion.

– Chris Shugart

In the Beginning...

In the early days, fish oil supplementation was crude. You couldn't get the high doses needed without suffering the unwelcoming side effects: fishy taste, heartburn, diarrhea, and fish farts. (1)

The purification process for fish oil supplements began to advance as the demand for high-quality products grew. Today you can easily get your hands on the good stuff, but sadly, the shelves of your local discount retailer are still lined with fish oils containing impurities.

Enter Big Pharma

Reliant Pharmaceuticals saw the need for "pharmaceutical grade" fish oil and began to devise a way to make a fish oil product that was +80% EPA/DHA compared to the 30% EPA/DHA that you'd find at the discount retailer. (2, 3) They were able to achieve this through a patented purification process, which housed EPA and DHA as ethyl esters instead of triglycerides.

Now, the triglyceride form is how EPA and DHA are normally found, with three fatty acids connected by a common "backbone."

In Big Pharma's ethyl ester form, EPA and DHA exist individually and not in the naturally occurring triglyceride structure.

Omega-3 ethyl esters were studied extensively, with the largest study containing over 18,000 subjects. (4) As a result of that study, the FDA approved omega-3 ethyl esters for the treatment of high triglycerides.

Thus, the first prescription fish oil supplement was born under the name Omacor. Today it's called Lovaza.

$200 Fish Oil Anyone?

While scientists worked on developing omega-3 ethyl esters, other scientists were optimizing molecular distillation techniques that allowed for 60% EPA/DHA purity – double the discount store's variety.

Despite the different chemical make-up of omega-3 ethyl esters and natural fish oil supplements, I've never heard a researcher refer to omega-3 ethyl esters as being superior to fish oil.

Are they? Does your body process the omega-3 ethyl esters differently than it would if you ate a piece of salmon or took some Flameout^TM? If so, do these differences warrant an omega-3 ethyl ester price tag upwards of $200 a month?

Comparing Purity

The higher percentage of EPA/DHA in your supplement, the less room there is for other fats, and more notably, the less room there is for chemical impurities like dioxins.

Molecularly-distilled fish oil products, like Flameout^TM, have impurities removed. The World Health Organization's standard for dioxins is less than two parts per million.

A molecularly-distilled fish oil product can contain as little as 0.3 parts per million dioxins. Would the 85% pure omega-3 ethyl ester product contain less? Probably. Is this difference going to impact your health? Probably not.

Comparing Effectiveness

So from a contamination standpoint, molecularly-distilled fish oil supplements and omega-3 ethyl esters stack up about the same. How does your body treat them? Up until this year there wasn't that much research to answer this question.

Two studies now point to a difference in bioavailability.

The first study, published in the journal of Prostaglandins, Leukotrienes and Essential Fatty Acids (or what I like to call "light bedtime reading") examined the bioavailability differences between fish oil supplements, including omega-3 ethyl esters. (3)

Researchers found the bioavailability of the omega-3 ethyl esters was -27% compared to the control fish oil (which was basically the equivalent of squeezing the EPA and DHA out of a salmon filet).

The difference wasn't statistically significant, although omega-3 ethyl esters were consistently worse performers in the different tests. Still, the findings didn't support omega-3 ethyl esters as being a superior product.

The European Journal of Clinical Nutrition published a study last month with twice as many subjects as the first one. (5) During the six-month time span, researchers gave subjects either a high-quality fish oil supplement – in the naturally occurring triglyceride form – or an omega-3 ethyl ester.

Researchers even measured subjects' omega-3 index to find the amount of EPA and DHA in red blood cell membranes. This is the best way to measure omega-3s in the body, because when EPA and DHA are in your red blood cell membranes they're locked and loaded, just waiting to be clipped off by the right enzyme and put to use.

The researchers found at months three and six that those receiving the high-quality triglyceride fish oil supplement had a much higher omega-3 index at both time points. Sorry, ethyl esters.

Research:

1) Belluzzi A, Brignola C, Campieri M, Pera A, Boschi S, Miglioli M. Effect of an Enteric-Coated Fish-Oil Preparation on Relapses in Crohn's Disease. New England Journal of Medicine 1996;334:1557-1560.

2) Bays H. Clinical overview of Omacor: a concentrated formulation of omega-3 polyunsaturated fatty acids. The American Journal of Cardiology 2006;98:71i-76i.

3) Dyerberg J, Madsen P, Mller JM, Aardestrup I, Schmidt EB. Bioavailability of marine n-3 fatty acid formulations. Prostaglandins, leukotrienes, and essential fatty acids 2010;83:137-141.

4) Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. The Lancet 1999;354:447-455.

5) Neubronner J, Schuchardt JP, Kressel G, Merkel M, von Schacky C, Hahn A. Enhanced increase of omega-3 index in response to long-term n-3 fatty acid supplementation from triacylglycerides versus ethyl esters. European journal of clinical nutrition 2011;65:247-254.

Tags: health, nutrition, medicine, Chris Shugart, Dr. Mike Roussell, Big Pharma, fish, oil, fatty acids, supplements, omega-3 fats, lipids, Prescription Fish Oil, T-Nation, pharmaceutical grade, fish oil, EPA, DHA, omega-3 ethyl esters, Molecularly-distilled fish oil