Ohmega 3’S

Ohmega 3’s

Paul Reynolds, MD

Fatty Acids

• Fatty acids

• Are saturated – containing as many hydrogen atoms as possible attached to the carbon atoms

• Or unsaturated – containing at least one double bond and therefore less hydrogen atoms

Trans Fats

In most naturally-occurring unsaturated fatty acids, each double bond has 3n carbon atoms after it, for some n, and all are cis bonds. Most fatty acids in the trans configuration (trans fats) are not found in nature and are the result of human processing (e.g.,hydrogenation).

A cis configuration means that adjacent hydrogen atoms are on the same side of the double bond. A trans configuration, by contrast, means that the next two hydrogen atoms are bound to opposite sides of the double bond. As a result, they do not cause the chain to bend much, and their shape is similar to straight saturated fatty acids.

Unsaturated Essential Fatty Acids

• Are strings of carbon atoms.• The double bonded carbon atom location

at either the 3 or 6 position classifies them in general.

• ‘Essential’ – meaning that without them in the diet, normal growth in children and animals cannot take place.

• Essential fatty acids are found in many foods

Biochemistry

• Ohmega-6 is found in vegetable oils

• Ohmega-3 (18:3n-3) is found in canola, flaxseed and soybean

• Ohmega-3 (20:5n-3 & 22:6n-3) is found primarily in fish

• Both types of essential fatty acids (EFA’s) Ohmega-3’s & Ohmega-6’s are needed.

Conversion of EFA’s

• EFA’s are converted into locally active ‘hormones’ called eicosanoids.

• Eicosanoids are a general term to refer to – Prostaglandins– Leukotrienes– Thromboxanes

Normal Body Function

• Eicosanoids (prostaglandins, leukotrienes and thromboxanes) are required for many different functions.

• Prostaglandins are found in virtually all cells and organs– They work locally or within the cell which

produces them.

Prostaglindins

• cause constriction or dilation in vascular smooth muscle cells

• cause aggregation or disaggregation of platelets • sensitize spinal neurons to pain • decrease intraocular pressure • regulate inflammatory mediation • regulate calcium movement • control hormone regulation • control cell growth

Thromboxanes

• are vasoconstrictors – make blood vessels narrow

• help platelets work (aggregation) – makes them sticky

Leukotrienes

• cause bronchoconstriction – narrowing of the tubes in the lungs

• are a part of the mechanism that causes reaction to foreign substances in the body

• help make blood vessels leaky

• help mediate the inflammatory response

Numbers

• The initial number is the number of carbon atoms and also indicates the length of the fatty acid– 18:3n-3 (a-Linolenic Acid)– 20:5n-3 (EPA)– 22:6n-3 (DHA)

EPA / DHA

• Eicosapentaenoic Acid– 20:5n-3

• Docosahexaenoic Acid– 22:6n-3

• These are the good Ohmega-3’s

Conversion

• The conversion to the longer chain Ohmega-3’s does happen but not 100%

• So, we convert (flaxseed oil) linolenic acid into (fish oil) EPA/DHA

• But only about 5%

• The longer 22:6n-3 Ohmega-3’s are anti-inflammatory

EPA & DHA

• These are primarily found in oily fish

• Sardines and Salmon

• You can get these from capsules– Ultramarine Ohmega-3– www.naturemade.com– www.swansonvitamins.com– Are just a few sites to look into

FDA

OnSeptember 8, 2004, the U.S. Food and Drug Administration gave "qualified health claim" status to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) n−3 fatty acids, stating that "supportive but not conclusive research shows that consumption of EPA and DHA [n−3] fatty acids may reduce the risk of coronary heart disease."

Prevention

In 1999, investigators reported in a medical journal The Lancet, the results of major clinical study in 11,324 patients with a recent myocardial infarction. Treatment 1 gram per day of n−3 fatty acids reduced the occurrence of death, cardiovascular death and sudden cardiac death by 20%, 30% and 45% respectively. These beneficial effects were seen from three months onwards.

More PreventionThere was another study published on the benefits of EPA in The Lancet in March 2007. This study involved over 18,000 patients with unhealthy cholesterol levels. The patients were randomly assigned to receive either 1,800 mg a day of EPA with a statin drug or a statin drug alone. The trial went on for a total of five years. It was found at the end of the study those patients in the EPA group had superior cardiovascular function. Non-fatal coronary events were also significantly reduced in the EPA group. The authors concluded that EPA is a promising treatment for prevention of major coronary events, especially non-fatal coronary events.

N-3’s for neck pain

Research in 2005 and 2006 has suggested that the in-vitro anti-inflammatory activity of n−3 acids translates into clinical benefits. Cohorts of neck pain patients and of rheumatoid arthritis sufferers have demonstrated benefits comparable to those receiving standardNSAID’s. (Motrin, Naprosyn, etc.)

We need to look at inflammation

• Prostaglandins, PGE2

• Thromboxane, TXA2 & TXB2

• Leukotrienes, LTB4

• All result from the Ohmega-6 fatty acids passage through the Arachidonic Acid synthesis pathway by way of enzymes – Cyclooxygenase (COX)– Lipoxygenase (LOX)

NSAID’s

• Prescription strength NSAID’s block this production– Celebrex is specific for the COX-2 enzyme

• All NSAID’s (Motrin, Naprosyn, Relafen, Mobic, Indocin, etodolac, Arthrotec, Daypro, Feldene, Voltaren, etc.) block the production of PG’s and TX’s.

Inflammation

• Some Prostagladins and Leukotrienes promote inflammation

• These come from the arachidonic pathway starting with the ohmega-6 molecules found in some vegetable oils

• The Ohmega-3’s block formation of prostagladins and leukotrienes and form substances that block the resulting inflammatory mediators

Dietary

• Suggested level of Ohmega-6 to Ohmega-3 ratio– 2:1

• Typical North American diet ratio– 8:1 or as high as 20-30:1

• In other words our diet is typically lacking the amount of Ohmega-3’s that can lessen inflammation

Dietary

• Since the industrial age began, the amount of saturated fats, transfats and Ohmega-6 EFA’s has steadily risen.

• Our diet has too many Ohmega-6’s

• Causing more inflammation or promoting inflammation

The Ohmega Plan. Artemis Simopoulos MD and Jo Robinson. Haworth Collins. 1998. pg 35.