Fish Oil Tablets and Omega-3

A place to get your questions answered from McDougall staff dietitian, Jeff Novick, MS, RDN.

Moderators: JeffN, carolve, Heather McDougall

Fish Oil Tablets and Omega-3

Postby Jaggu » Mon Mar 24, 2008 1:22 pm

I have read some experts recommend 3 grams of fish oil capsules daily in order to take essential omega-3 fatty acids. I had also read somewhere that Fish oil is not as effective as Fish oil tablets. Fish has other drawbacks such as PCB, high fat and cholesterol. Also I believe Dr McD doesn't recommend Fish.

Jeff, Can I know what is your take on this? If it has been already discussed let me know and I will go through the posts before I ask questions.

If plant foods gives you 10% fat then does adding 3 grams of fish oil will offset this especially for those who want to reverse CAD?

For those on a reversal diet, who can not consume nuts/seeds/oils/Fish, where should they get enough of omega-3? I have read that green leafy vegetables have omega-3 but you have to eat lots of it in order to get required amount.
Jaggu
 

Postby JeffN » Mon Mar 24, 2008 1:39 pm

Hi Jaggu,

You and I have covered this in several threads including the Goint Nuts and the Why No Oil threads. Our discussions have included the recommended amounts of essential fats and food sources and the difference in total fat & omega 3s, & national recommendations.

It is irrelevant what people "say" as 1000s of people are saying 1000s of different things unless there is reputable scientific evidence to support this.

The prescription dose of fish oil is 3-4 grams and that is only prescribed for extremely high triglycerides. However, even that does not mean it is necessary.

In Health
Jeff Novick, MS, RD
Last edited by JeffN on Wed Mar 26, 2008 8:15 pm, edited 1 time in total.
User avatar
JeffN
 
Posts: 9411
Joined: Tue Jan 08, 2008 5:56 am

Postby Jaggu » Mon Mar 24, 2008 2:55 pm

JeffN wrote:Hi Jaggu,


It is irrelevant what people "say" as 1000s of people are saying 1000s of different things unless there is reputable scientific evidence to support this.


In Health
Jeff Novick, MS, RD


Hi Jeff,

I will go through the threads you mentioned and re-enlighten myself just from this specific angle.

The people who recommended Fish oil capsule was Dean Ornish in his new book Spectrum. And I believe he is scientific guy :-) unless I misunderstood his recommendations.
Jaggu
 

Postby JeffN » Mon Mar 24, 2008 3:06 pm

Jaggu

There is no scientific evidence to support the recommendation of 3-4 grams of fish oil to the general population, or as a general recommendation to people at risk for heart disease as this amount can have serious side effects.

Intake of 3 grams per day or greater of omega-3 fatty acids may increase the risk of bleeding and may increase the risk of hemorrhagic (bleeding) stroke.

Other Known Side Effects and Concerns

High doses have also been associated with nosebleed and blood in the urine. Fish oils appear to decrease platelet aggregation and prolong bleeding time, increase fibrinolysis (breaking down of blood clots), and may reduce von Willebrand factor.

Gastrointestinal upset is common with the use of fish oil supplements. Diarrhea may also occur, with potentially severe diarrhea at very high doses. There are also reports of increased burping, acid reflux/heartburn/indigestion, abdominal bloating, and abdominal pain. Fishy aftertaste is a common effect.

Slight increases in fasting blood glucose levels have been noted in patients with type 2 ("adult onset") diabetes

Fish oil taken for many months may cause a deficiency of vitamin E, and therefore vitamin E is added to many commercial fish oil products. As a result, regular use of vitamin E-enriched products may lead to elevated levels of this fat-soluble vitamin. Fish liver oil contains the fat-soluble vitamins A and D, and therefore fish liver oil products (such as cod liver oil) may increase the risk of vitamin A or D toxicity.

Increases (worsening) in low-density lipoprotein levels ("bad cholesterol") by 5-10% are observed with intake of omega-3 fatty acids. Effects are dose-dependent.

Mild elevations in liver function tests (alanine aminotransferase) have been reported.

Skin rashes have been reported.

There are rare reports of mania in patients with bipolar disorder or major depression. Restlessness and formication (the sensation of ants crawling on the skin) have also been reported.

Even the American Heart Association does not endorse a 3-4 gram recommendation, nor does the National Academy of Sciences.

And, A recent meta-study by the Canadian Medical Association Journal found fish oil supplementation did not demonstrate any preventative benefit to cardiac patients with ventricular arrhythmias.

Should patients with cardiovascular disease take fish oil? Girish M. Nair, MBBS MD and Stuart J. Connolly, MD CMAJ • January 15, 2008; 178 (2).


In Health
Jeff Novick, MS, RD
User avatar
JeffN
 
Posts: 9411
Joined: Tue Jan 08, 2008 5:56 am

"Increases (worsening) in low-density lipoprotein level

Postby gail f » Wed Mar 26, 2008 7:59 pm

Jeff, Can you provide more details about this observation. I am on the McDougall diet in order to lower my LDL, and to raise my HDL2...but I have been under pressure from my acupuncturist, and other health conscious people, to add fish oil capsules. Is your observation tied to a particular amount of oil, was it based on a single study ? I am trying to sort it out. Thank you, Gail
gail f
 
Posts: 68
Joined: Thu Feb 28, 2008 8:56 am
Location: Cape Cod

Re: "Increases (worsening) in low-density lipoprotein l

Postby JeffN » Wed Mar 26, 2008 8:10 pm

gail f wrote:Jeff, Can you provide more details about this observation. I am on the McDougall diet in order to lower my LDL, and to raise my HDL2...but I have been under pressure from my acupuncturist, and other health conscious people, to add fish oil capsules. Is your observation tied to a particular amount of oil, was it based on a single study ? I am trying to sort it out. Thank you, Gail


Hi Gail,

I am confused as I thought I explained why the recommendation for fish oil is inappropriate and even not supported but either the literature of other national health organizations such as the American Heart Association.

So, my question is, which observation are you talking about?

If you have not read them, I think you would benefit from reading the Going Nuts and the Why No Oil threads in this forum as they review the literature and data and recommendations.

Fish oil has become the fad and cure all of the day and that is why everyone is recommending it. However, as I pointed out, there is no reason, in general, for anyone to take fish oil. It is not known to lower LDL or Cholesterol and too much can raise LDL.

There are many misled health conscious people out there. Fish oil is not required or necessary for optimal health.

I would ask your acupuncturist to show you the documentation and supporting evidence to why they are making such a recommendation as there is no evidence that I know of, at all, to support fish oil to lower LDL.

In Health
Jeff Novick, MS, RD
User avatar
JeffN
 
Posts: 9411
Joined: Tue Jan 08, 2008 5:56 am

Postby JeffN » Wed Mar 26, 2008 8:28 pm

PS

Here is a great way to raise your HDL2. Not only it is safe, it has many other known benefits (lower LDL) with no negative side effects

Atherosclerosis. 2006 Jan;184(1):207-15.
Aerobic exercise and HDL2-C: a meta-analysis of randomized controlled trials. Kelley GA, Kelley KS.

PURPOSE: Use the meta-analytic approach to examine the effects of aerobic exercise on high-density lipoprotein two cholesterol (HDL2-C) in adults.

STUDY SOURCES: (1) Computerized literature searches; (2) cross-referencing from retrieved articles; (3) hand-searching; and (4) expert review of our reference list.

STUDY SELECTION: (1) Randomized controlled trials; (2) aerobic exercise > or = 8 weeks; (3) adults > or = 18 years of age; (4) studies published in journal, dissertation, or master's thesis format; (5) studies published in the English-language between January 1, 1955 and January 1, 2003; and (6) assessment of HDL2-C in the fasting state.

DATA ABSTRACTION: All coding conducted by both authors, independent of each other. Discrepancies were resolved by consensus.

RESULTS: Nineteen randomized controlled trials representing 20 HDL2-C outcomes from 984 males and females (516 exercise, 468 control) were pooled for analysis. Using random-effects modeling and bootstrap confidence intervals (BCI), a statistically significant increase of approximately 11% was observed for HDL2-C (X +/- S.E.M., 2.6 +/- 0.9 mg/dl, 95% BCI, 1.0-4.4 mg/dl). With each study deleted from the model once, results remained statistically significant. Increases in HDL2-C were independent of decreases in body weight, body mass index (kg/m2), and percent body fat.

CONCLUSION: Aerobic exercise increases HDL2-C in adults.

PMID: 15907854


Another... Lowers LDL and raised HDL 2 :)

J Womens Health (Larchmt). 2004 Dec;13(10):1148-64.

Aerobic exercise and lipids and lipoproteins in women: a meta-analysis of randomized controlled trials Kelley GA, Kelley KS, Tran ZV.

BACKGROUND: Cardiovascular disease (CVD) in women is the leading cause of mortality in the United States, and less than optimal lipid and lipoprotein levels are major risk factors for CVD. The purpose of this study was to use the meta-analytic approach to examine the effects of aerobic exercise on lipids and lipoproteins in women.

METHODS: Studies were retrieved via computerized literature searches, review of reference lists, hand searching selected journals, and expert review of our reference list. The inclusion of studies was limited to randomized controlled trials published in the English language literature between January 1955 and January 2003 in which aerobic exercise was used as the primary intervention in adult women aged > or =18 years. One or more of the following lipids and lipoproteins were assessed: total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG).

RESULTS: Using a random effects model, statistically significant improvements were observed for all lipids and lipoproteins (TC, +/- SEM, -4.3 +/- 1.3 mg/dl, 95% CI -6.9 to -1.7 mg/dl; HDL-C, +/- SEM, 1.8 +/- 0.9 mg/dl, 95% CI 0.1 to 3.5 mg/dl; LDL-C, +/- SEM, -4.4 +/- 1.1 mg/dl, 95% CI -6.5 to -2.2 mg/dl; TG, +/- SEM, -4.2 +/- 2.1 mg/dl, 95% CI -8.4 to -0.1 mg/dl). Reductions of approximately 2%, 3%, and 5%, respectively, were observed for TC, LDL-C, and TG, whereas an increase of 3% was observed for HDL-C.

CONCLUSIONS: Aerobic exercise is efficacious for increasing HDL-C and decreasing TC, LDL-C, and TG in women.

PMID: 15650348


Even just walking works

Prev Med. 2004 May;38(5):651-61.
Walking, lipids, and lipoproteins: a meta-analysis of randomized controlled trials.

BACKGROUND: The purpose of this study was to use the meta-analytic approach to examine the effects of walking on lipids and lipoproteins in adults.

METHODS: Randomized controlled trials that examined the effects of walking on total cholesterol (TC), high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), the ratio of TC/HDL, and triglycerides (TG) in adults ages 18 years and older were retrieved via computerized literature searches, cross-referencing, hand-searching, and expert review of our reference list.

RESULTS: Twenty-five studies that included 1,176 subjects (692 walkers, 484 controls) and up to 33 outcomes were available for pooling. Using random-effects modeling, statistically significant, walking-induced decreases of 5% and 6% were observed for LDL-C and TC/HDL-C (LDL-C, mean +/- SE, -5.5 +/- 2.2 mg/dL, 95% CI, -9.9 to -1.2 mg/dL; TC/HDL-C, mean +/- SE, -0.3 +/- 0.1, 95% CI, -0.6 to -0.1). No statistically significant changes were observed for TC, HDL, or TG (P > 0.05), although changes were in the direction of benefit. No statistically significant changes occurred in body composition (P > 0.05).

CONCLUSIONS: Walking reduces LDL-C and TC/HDL-C in adults independent of changes in body composition.

PMID: 15066369
User avatar
JeffN
 
Posts: 9411
Joined: Tue Jan 08, 2008 5:56 am

Postby gail f » Wed Mar 26, 2008 9:05 pm

Hi again Jeff,

Sorry about the confusion. I was referrng to your statement (above) that:
"Increases (worsening) in low-density lipoprotein levels ("bad cholesterol") by 5-10% are observed with intake of omega-3 fatty acids. Effects are dose-dependent."

I did not know whether you were talking about 3-4g amounts, and I found myself wanting to know more details (for the past several days I have added a 1000 mg Norwegian deep water fish oil capsule to my diet, otherwise I do not add oils).

I had also noticed the change in the Ornish (Spectrum) diet...as Jaggu mentioned.

My acupuncturist was so concerned about my not taking any added oils that she loaned me her special cardiac training materials last weekend. Among other things, these materials discussed the VAP cholesterol test and made detailed recommendations based on problematic blood findings (like low HDL2, for example). When I received my VAP results this week I reviewed the notes that I had made from the training materials, and I particularly noticed that low HDL2 levels were attributed to low fat diets (among other things). I believe that the training materials referenced work by Mary Enig (not in the particular HDL2 recommendation, but in several other places.). I am not familiar with her work.

Gail
Last edited by gail f on Wed Mar 26, 2008 9:21 pm, edited 1 time in total.
gail f
 
Posts: 68
Joined: Thu Feb 28, 2008 8:56 am
Location: Cape Cod

Postby gail f » Wed Mar 26, 2008 9:10 pm

Jeff, Thank you for posting the reports on exercise and HDL2 increase. Gail
gail f
 
Posts: 68
Joined: Thu Feb 28, 2008 8:56 am
Location: Cape Cod

Postby JeffN » Wed Mar 26, 2008 9:56 pm

Hi Gail,

gail f wrote: Sorry about the confusion. I was referrng to your statement (above) that: "Increases (worsening) in low-density lipoprotein levels ("bad cholesterol") by 5-10% are observed with intake of omega-3 fatty acids. Effects are dose-dependent."


No problem.

This is the result of many studies and is "dose dependent" so the more you take, the more the LDL can go up. There is no exact relationship published that I could give you saying, if you took X amount, your number would go up X percent. But, it is a concern that you should be aware of.

gail f wrote:I did not know whether you were talking about 3-4g amounts, and I found myself wanting to know more details (for the past several days I have added a 1000 mg Norwegian deep water fish oil capsule to my diet, otherwise I do not add oils).


I would not recommend anyone to randomly take a gram of fish oil, and as I pointed out, fish oil has little if any effect on LDL and may even raise it. It has not been shown to lower LDL or Total Cholesterol, independent of concurrent decreases in dietary saturated fat.

While it may raise HDL, that doesn't automatically equate to increased health and even if it was your goal to raise HDL, there are much better ways to raise HDL, as I presented.

Personally, I am more concerned with Total Cholesterol, and LDL than HDL and rarely if ever focus on HDL. I beleive that the focus on HDL and the sub fractions of HDL is very misguided and have posted the supporting material, documentation and references. If you haven't done so yet, please read the other two threads I mentioned, especially page two of Why No Oil.

My recommendation it to do everything you could through proper diet and exercise and focus all your energy on that, before even considering any medication and/or supplements. My experience has been that if most people would just do that, they would have incredible results and will almost always eliminate the need for medication and/or supplements. In all my years I have seen many more people get off all their medications and supplements than those very few who had to go on, or stay on, any. And remember, this is in spite of the fact that most people, by the time they came to me, are usually in the worst shape you can imagine.

Yes, there are some exceptions, and people need to do what they need to do, but ALL medications and supplements have side effects. Diet, exercise, and lifestyle don't and have many other proven benefits.

Having said all that, my main question to you would be, why are you taking it?

gail f wrote: My acupuncturist was so concerned about my not taking any added oils that she loaned me her special cardiac training materials last weekend. Among other things, these materials discussed the VAP cholesterol test and made detailed recommendations based on problematic blood findings (like low HDL2, for example). When I received my VAP results this week I reviewed the notes that I had made from the training materials, and I particularly noticed that low HDL2 levels were attributed to low fat diets (among other things). I believe that the training materials referenced work by Mary Enig (not in the particular HDL2 recommendation, but in several other places.). I am not familiar with her work.


Very familiar. I even have the honor of being misquoted on her site. Mary Enig has been discussed here and is involved with work that promotes high fat, high saturated fat, animal based diet. On those diets, they need all the help they can get. :)

The VAP material is written to promote the VAP test an, depending on results, certain medications (of which fish oil is one), and not a healthy lifestyle. What they give you is marketing material. It is not unbiased. When the VAP people presented their data to me at the last center I was at recently, I presented the evidence of the results of lifestyle and dietary intervention of which they said those results were "impossible.". When I presented them with all the data, they said they were totally unaware of its existence.

Several years ago, if you were on these sites/discussions, everyone was taking Vit E for heart disease (and many other health issues), and the discussions were on which form, how much, what combos, etc etc etc. Endless details.And everyone, from your next door neighbor to your doctor and massage therapist was recommending it. Today, hardly anyone recommends it anymore, especially for heart disease as not only was it eventually shown to not be helpful, it turned out in certain situations to be harmful Same thing happened with Vit A, Beta Carotene, Vit C and most every other one.

Considering the very long history of a variety of supplements that have risen, each to their own short lived glory and fame, only to soon fall rapidly to the wayside and known harm, why would anyone jump on the current bandwagon?

Which supplement do you know that has truly stood the test of time?

Fish oil is the current super-supplment/cure-all of the day.

Caveat emptor!

In Health
Jeff Novick, MS, RD
User avatar
JeffN
 
Posts: 9411
Joined: Tue Jan 08, 2008 5:56 am

Postby gail f » Thu Mar 27, 2008 6:57 am

Hi Jeff,

THANK YOU for staying with me on this issue of "healthy fats"...it has been a huge source of doubt and confusion for me. I am basically still a newbie trying to figure out who to trust with my life.

I want to bring to your attention another, but related, conflicting source of information about oils/fish oils that I have come across in my attempt to figure out what I should do. (I feel that now is the time for me to "get it all out.") Last week I came across the following statement on the Track You Plaque website (Dr.Bill Davis):

" ..... The Ornish Low-Fat Diet: How about ultra low-fat diets like the Ornish program? Some people claim low-fat diets “reverse” heart disease. In our experience, some people do well and reduce LDL cholesterol and lose weight; most enjoy little or none of these benefits. This larger second group doesn’t lose weight and, in fact, drop HDL cholesterol, increase triglycerides, and increase small LDL. We’ve witnessed many people inch closer and closer to the metabolic syndrome the longer they follow this program. Clearly, one size does not fit all. We do not recommend this program or similar programs...."


(In another part of his site, Dr. Davis says:
"Omega-3 fatty acids (a subclass of the polyunsaturated group) are so beneficial that they can be used as a treatment, as well as a preventive strategy. Docosahexaenoic acid, or DHA, and eicosapentaenoic acid, or EPA, are the two primary omega-3 fatty acids. They are the component of diet in fish-eating cultures responsible for reducing heart attack.

Omega-3's lower blood pressure, lower triglycerides, raise HDL and make LDL particles bigger, in addition to lowering risk of heart attack and death. There is evidence that omega-3's can reverse atherosclerosis. When people who've suffered heart attacks eat a diet rich in omega-3's or take fish oil supplements, the risk of dying of heart attack is cut by 35-45%. Evidence suggests that omega-3's have cancer-preventing effects, inhibits Alzheimer's dementia, and help alleviate depression. Omega-3 fatty acids in fish oil are more than preventive agents. They can be used to treat specific lipoprotein abnormalities, as well. Triglycerides can be lowered (up to 50%). Higher doses may be needed for these purposes (usually around 6000-10,000 mg per day of a 30% preparation). Fish oil also lowers fibrinogen and lipoprotein (a). For these reasons, omega-3 sources are a crucial ingredient in your plaque-control program...")

...................

So Jeff, you can see why newbies like me might seem to be stuck on the oil/fish oil issue. It is hard for me to know what to make of Dr. Davis's statement about ultra low fat diets...especially the part about some people moving closer to metabolic syndrome (do you have any clue about what he is relying on ?)

One other thing. I cannot tell from your posting above whether you feel tests like the VAP test, which tests particle sizes and subclasses of both LDL and HDL, are useful tools ? ( I had thought that my low HDL2 reading was significant, but I conclude from what you posted that you do not agree that HDL #'s are useful.) Are there any tests that you find particularly helpful ?.

Incidentally, the author of my acupuncturist's training materials was Dr. Janet Lang.

Best wishes, Gail


 
gail f
 
Posts: 68
Joined: Thu Feb 28, 2008 8:56 am
Location: Cape Cod

Postby JeffN » Thu Mar 27, 2008 9:04 am

Hi Gail,

My response to fish oil is clearly explained both here in this thread and in the other ones I referred you to.

gail f wrote: It is hard for me to know what to make of Dr. Davis's statement about ultra low fat diets...especially the part about some people moving closer to metabolic syndrome (do you have any clue about what he is relying on ?)


Yes.

He is relying on the recent recommendations from the American Heart Association, the same people who, as I posted, do not agree with his fish oil recommendations at all.

The reasons they are saying what they are saying is because they did some studies a little while back. They took people on the typical American diet and then broke them into 2 groups. In the first group, they replaced some of the highly refined, highly processed, low fiber carbs they were eating with mono fat. Lets call this the higher fat group.

In the second group they fed them a lower fat version of the same diet (which is a highly refined, highly processed low fiber, slightly lower fat diet). Lets call this the "lower" fat group.

Both groups were made to continue to consume the same amount of calories. Then the results were compared. On the slightly lower fat, lower fiber, highly refined and processed carb diet, the TGs, went up. On the higher fat diet that replaces some of the highly refined, highly processed, low fiber carbs with some mono fat, the TGs went down in the short term.

That is where these recommendations come from.

However, when the same study is repeated and they add in another group who is allowed to eat a diet like the one recommended here, which is even lower in fat, but eliminates all the highly refined and processed carbs and increases the naturally occurring high fiber carbs, their TGs drop even more dramatically then the group that got the mono fat. In addition, unlike the group that got the mono fat, they also see their weight, their LDL their total cholesterol, their BP and their blood sugar also go dramatically down. One aspect of the Metabolic syndrome doesn't just get better, it all gets better and can even go away. :)

The effectiveness of a program like this on Metabolic Syndrome was also just recently published once again. On a program like the McDougall program (high carb, 10% fat), 50% of the subjects not only controlled their metabolic syndrome but also reversed it in just three weeks. Journal of Applied Physiology, 100: 1657, 2006.

However, they just beleive no one will follow such a diet.

Metabolic Syndrome is unknown amongst the rural Chinese, Japanese, and other native cultures that eat a very high carb (75-80%) very low fat (7-10%) diet. The two biggest known contributors to metabolic syndrome are an excess of calories (from a highly refined, highly processed, calorie dense higher fat diet, which promotes overeating) and a sedentary lifestyle.

Fish oil, can't fix that.

All of this is detailed, along with all references, and charts in a reader friendly CPE course, a colleague of mine wrote. You can read it for free here.

http://www.foodandhealth.com/cpecourses/stanford.php

It will be well worth your time to read it. Let me know if you have any question on the CPE article.

gail f wrote: One other thing. I cannot tell from your posting above whether you feel tests like the VAP test, which tests particle sizes and subclasses of both LDL and HDL, are useful tools ? ( I had thought that my low HDL2 reading was significant, but I conclude from what you posted that you do not agree that HDL #'s are useful.)


I do not consider them useful in 99% of the cases.

I also do not think you are in the 1%. :)

gail f wrote: Are there any tests that you find particularly helpful ?.


Yes. The basic blood lipids are fine. These other tests only really help MDs fine tune which medication to give you. They have little if any effect on dietary and lifestyle changes. I would rather you give an all out effort into getting off your medications through dietary and lifestyle changes, then worrying about which one is best.

But what is more important and what I feel to be the most important test, is what I call the "plate test." Very few people know about it yet it is one of the most effective tests and simple and easy to do and very inexpensive. You can even do it at home.

Here is how you do it.

When you sit down to eat each meal, look at your "plate" and see if it passes this "test", the "Plate Test."

Are at least 95% of the calories on your plate coming from unrefined unprocessed fruits, vegetables, starchy vegetables, intact whole grains and/or legumes? Are there at least 12-15 grams of fiber coming from whole natural foods? Does it meet my guidelines for sodium? Are any "exceptions" being kept to less than 5% of calories?

If your meal passes this "Plate Test", then I think that is the most effective test you can ever have done and the best indicator of your future health and longevity.

:)

In Health
Jeff Novick, MS, RD
User avatar
JeffN
 
Posts: 9411
Joined: Tue Jan 08, 2008 5:56 am

Postby Jaggu » Thu Mar 27, 2008 9:43 am

Some of these high lived population with no CAD or cancer or other deadly disease, I don't think they really worried or even knew about omega 3s, omega3 ratios, HDL etc despite they lived long life. To me that in itself indicates that they ate simple, unprocessed, unrefined food, low fat, low calorie dense food and that was the end of it which they could do without this high tech knowledge and testing procedures that we have today.

But here is the baffling part and believe me it is not easy to sort through all of this.

When HDL on low fat diet goes down we refer to Dean Ornish's article on why and how HDL on low fat diet goes down and why it is not an issue.

When Dean recommends to use Fish oil, we disagree with him.

Some places we agree with AHA, other places we don't.

So it can be very confusing for layman, it's good that Jeff is digging through the research that's been done, studies that have been conducted and making us aware of all this so when we make choices, we are confident about it..a requirement if we are to firmly stick with the lifestyle choices.
Jaggu
 

Postby JeffN » Thu Mar 27, 2008 10:02 am

Jaggu wrote:When HDL on low fat diet goes down we refer to Dean Ornish's article on why and how HDL on low fat diet goes down and why it is not an issue.


I referred to an article he wrote but am more interested in his simple explanation of the included supporting documentation. The supporting documentation was what mattered most and as you can see, there was lots of it.

I also included other supporting documentation from other studies/sources showing sometimes increased in HDL are not always good, and sometimes decreases in HDL are not always bad.

Jaggu wrote:When Dean recommends to use Fish oil, we disagree with him.


I disagree with him only because he has no supporting evidence for his recommendation on fish oil. None. I also presented the supporting evidence showing that his recommendation is not inline with the recommendations and/or the evidence.

Jaggu wrote: Some places we agree with AHA, other places we don't


I do not agree with the AHA on most all things but am using them as an example as they are the accepted standard for these MDs and representing the accepted and traditional view of MDs. I did not agree with the AHAs recommendation for Fish Oil, but showed how different it was then Deans, and that there is evidence to support theirs, but not Deans.

It's the preponderance of the scientific evidence and the quality of it, that matters, not any ones opinion.

However, your question is legitimate to the Dr Davis above who is following the AHA recommendation on fat for metabolic syndrome but not for fish oil for heart disease. That is worthy of a direct inquiry to him.

But, remember most all their recommendations are for people following a slightly healthier version of the typical American diet, which is still an unhealthy diet.

So, here is the real question....

Do you want to follow a slightly healthier diet then the typical American diet and still have to worry about how much fish oil or which statin to take, or would you like to follow the healthiest diet we know and more than likely eliminate the need for that question and/or decision?

Halfway measure produce halfway results.

We deserve, and can do, much better than that!!

Jaggu wrote: So it can be very confusing for layman, it's good that Jeff is digging through the research that's been done, studies that have been conducted and making us aware of all this so when we make choices, we are confident about it..a requirement if we are to firmly stick with the lifestyle choices.


Thanks.

Which only further reinforces my recommendation to spend most all your time, energy, efforts and $$$ into the 91.345 to 97.657 % we know then worrying about the 2.343 to 8.655% :)

In Health
Jeff Novick, MS, RD
User avatar
JeffN
 
Posts: 9411
Joined: Tue Jan 08, 2008 5:56 am

Postby gail f » Thu Mar 27, 2008 10:38 am

Jeff, many many thanks for your detailed response.

I want to share something with you, because I am not sure that you have personally had the experience of a forced overnight diet change. I suspect that I am not the only newbie resisting change.

Just over a month ago, when spring was about to finally return to Cape Cod, my life was turned upsidedown by an extremely high cholesterol test result (I had thought that I was a healthy 62 year old...except for a bad foot.) Being home alone and very scared -I did not get to speak to my doctor for the next 3 weeks- I managed to find the McDougall website and I went onto the diet immediately. My thinking was that if I did have artery disease, I would immediately slow it down as much as I could and then try to find out more facts about my situation (I want to know, but I don't want to know... ). And, I knew that I wanted to avoid medication if at all possible.

It probably goes without saying that my motivation was 100% based on fear....unlike people who chose a vegetarian or vegan lifestyle in a calm and deliberate way. Up until that point I had thought that I was eating fairly carefully...and I was, compared to my friends. (I now recognize there was great room for improvement, especially in the oil department.)

I suppose that I am now looking to numbers and tests in order to see whether I really am at high risk, or whether I can put the bulk of my fear behind me. I will be honest and say that I would like to be able to eat a less restrictive diet. I also want to be able to share in the meals that my friends offer. I live in a shellfishing community and I have a commercial shellfish license myself, which I used occasionally to provide my own shellfish. I love to be out on the tidal flats. We have clean waters and safe shellfish. While, I can easily live without dairy and meat, I am having touble with the thought that I will never be able to return to eating my beloved oysters and clams (and I wouldn't mind eating avocado daily(':?')).

But, I am prepared to do what I have to do to not compromise my health, and if that means no meat, no fish, no oils, then that is what I will continue to do. However, I would rather it be a decision based on reaching out for improved health, than one based 100% on fear.

Thank you again. Best, Gail
gail f
 
Posts: 68
Joined: Thu Feb 28, 2008 8:56 am
Location: Cape Cod

Next

Return to Jeff Novick, RD

Who is online

Users browsing this forum: No registered users and 6 guests


cron

Welcome!

Sign up to receive our regular articles, recipes, and news about upcoming events.