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ZOE Science & Nutrition
Omega-3s and brain health: what the science really says | Dr. Bill Harris & Prof. Sarah Berry
01:03:53
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- [00:01]
Jonathan
Welcome to Zoe Science and Nutrition, where world leading scientists explain how their research can improve your health. One in five people have a mental health condition.
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Zoe
Millions are living with dementia.
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Jonathan
Brain health is rightly in the spotlight. These conditions are complex and there's no single cause. But some scientists believe that one nutrient might play an important role.
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Zoe
Omega 3s.
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Jonathan
For this episode, we're lucky to have.
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Zoe
The world's leading expert on Omega 3s.
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Jonathan
With us right here in the studio, Dr. Bill Harris. With over 300 papers published on the topic. He's professor in the Sanford School of Medicine at the University of South Dakota. And most recently, Bill has focused on the links between omega 3s and brain health. Bill is joined by Professor Sarah Berry, a world leader in large scale human nutritional studies, a professor in nutrition at King's College London, and chief scientist here at Zoe. Today we'll explore Bill's latest research on omega 3s and brain health and provide simple tips to make sure you're consuming enough.
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Zoe
Bill, thanks for joining us today.
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Dr. Bill Harris
Glad to be here. Thank you.
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Zoe
And Sarah, it's great to have you as my co host today.
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Professor Sarah Berry
Pleasure.
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Jonathan
So, Bill, we have this thing that.
- [01:27]
Zoe
We always do at the start of the show, which is a set of rapid fire questions and answers that come in from our listeners. Now we have one very strict rule which is very hard for professors. You're allowed to say yes or no or if you have to a one sentence answer, you're willing to give it a go.
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Dr. Bill Harris
Let's try it.
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Jonathan
All right. Are the majority of people in the.
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Zoe
West deficient in Omega 3?
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Dr. Bill Harris
Yes.
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Zoe
Are plant based sources of Omega 3 as good as animal sources?
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Dr. Bill Harris
No.
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Professor Sarah Berry
Is grass fed beef high in omega 3?
- [02:01]
Dr. Bill Harris
No.
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Jonathan
Are supplements the best way to get.
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Zoe
Adequate amounts of omega 3?
- [02:07]
Dr. Bill Harris
They're an adequate way. I prefer food.
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Professor Sarah Berry
Bill, could consuming adequate omega 3s reduce your dementia risk?
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Dr. Bill Harris
Yes.
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Professor Sarah Berry
And what's the biggest myth you've heard about omega 3s?
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Dr. Bill Harris
That plant based omega 3s are the same as fish based omega 3.
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Professor Sarah Berry
Love that one. I hear that all the time and it's not true.
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Dr. Bill Harris
That's a myth.
- [02:30]
Professor Sarah Berry
Absolutely not true.
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Zoe
I remember growing up that my parents always had fish oil supplements and there was also a period that I was being told I should be eating lots of salmon. Then I feel I was told, well, that's not such a good idea. Now I'm just sort of confused about Omega 3s and I suspect there are a lot of listeners who are in the same situation that I'm in. And I understand that you just have some fascinating New research about how omega 3s might affect not just our heart health, but also our brain health, from mental health to dementia. But before we jump into how this affects our health, could we just start with like, what are these omega 3 fatty acids? Why are they essential? Why do we care?
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Dr. Bill Harris
Why do we care? So omega 3 fatty acids are fatty acids typically found in fish oils. They're made primarily by these little single celled organisms in the ocean that convert sunlight and sugar into omega 3 fatty acids. And then the little fish eat the little cells and then the big fish eat the little fish. And so salmon, for example, doesn't really make Omega 3 any better than we do, but they eat it. So their levels are high because they eat a lot. Why are they essential? You know, sitting here with Sarah, I can't really say essential because EPA and DHA, which are the two omega 3s that are most important, that are in fish oils, Fish and fish oils are not actually essential in the diet because strictly speaking, in a nutritionist point of view, if you have an essential nutrient, if you don't eat it, you die. And there are plenty of people on this planet who are vegans who eat no preformed EPA and dha. They eat the precursor and that apparently gives them enough to survive, grow up, reproduce, and live a life. So I think of EPA and DHA, omega 3s as very bioactive, very important for health, but not essential for life.
- [04:34]
Zoe
I've gone from Omega 3s and now you've already mentioned DHA and EPA. Could you just help me to understand that?
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Dr. Bill Harris
Right, right. So Omega 3 is like a class A family. If you look at the chemical structure of it, they all have a similar last name, so to speak, which is omega 3. And then there are four or five fatty acids in that family. The three that we hear most about one is called Ala, which is alpha linolenic acid, which is a plant based omega 3. And then its grown up super cousins are the two that we get in fish which are called EPA and dha. EPA and DHA are the two that are in fish. ALA is the one that's in plants. And those are the three major ones in the family.
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Zoe
Why do they matter at all? You were saying they're not literally essential, so I can live without them. So they're not like sort of vitamin C. I don't get scurvy.
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Dr. Bill Harris
Correct, you don't get scurvy. Right.
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Zoe
But I get the sense that they are doing something of importance.
- [05:29]
Dr. Bill Harris
They are important for many biological factors. They find their home. And when we Eat them, they end up getting into cell membranes. And all of our cells have some or a little or a lot of Omega 3, depending on really how much you eat. And I think the way I like to explain why they're useful, and it's a little difficult sometimes because it's not like you can say for vitamin C, if you don't have vitamin C, your teeth fall out. Okay, that's problem. Omega 3 is more subtle, but as the Omega 3s get into the cell membranes, they sort of act like grease on a hinge on a door, because every cell has doors that let good things in, like nutrients. And the cell also has a door that opens up out to dump the trash. And if you've gotten enough Omega 3 in your cell membranes, those doors swing smoothly. If you don't, they don't swing so smoothly. And some of the good stuff doesn't get in, some of the bad stuff doesn't get out as well. And the cell just gets older and unhealthy.
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Zoe
So they sound quite important.
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Dr. Bill Harris
They're important, they're important.
- [06:40]
Professor Sarah Berry
And Bill, I'd love at this point to pick up on the myth that you said, which is about plant based sources, because you've now talked about epa, dha, which are found in fish, and then ala, the alpha linolenic acid, which we know can come from plant sources. And lots of people say, well, you can get all the EPA and DHA you need from plant sources. But we know that actually how much you can convert is actually quite small.
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Dr. Bill Harris
Quite small.
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Professor Sarah Berry
And so I wonder if you could explain a little bit about that to listeners.
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Dr. Bill Harris
Sure. There is a mechanism in the body. There are processes that will take Ala, which is 18 carbons long. So fatty acids are simply a chain, a linear chain of carbon atoms. And this one's 18 carbons long. And it has three, what we call double bonds in chemistry. Many fatty acids have no double bonds. These have three double bonds. The EPA and DHA are 20 or 22 carbons long, and they have five and six double bonds. So in order to go from the ALA, which is 18 carbons and three, you got to add two or four more carbons to the molecule and you got to add more double bonds. There's a, a lot of processing there, and it's difficult to do. The body is maybe 5% of the ALA you eat might get converted to EPA and less than that goes on to DHA. So it's much more. If you really want to increase your EPA and DHA levels, the important omega 3s eating them preformed is the best way to do it. You don't have to make them.
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Professor Sarah Berry
Yeah, and I think that's a really important point because lots of people, Jonathan, say, well, you can get all of your really good omega 3s, which is what Bill's been talking about, the EPA and DHA from plant sources through this process in the body where it converts the ALA to these longer chain, more desaturated versions. But actually the conversion is really limited. And so it's interesting to estimated only around 5%. And so that's why, as nutrition scientists, we always say if you can get what we call preformed EPA and dha, because our bodies are pretty rubbish at converting it.
- [08:48]
Zoe
Can I just ask one clarification? Because you were describing the way that these omega 3 sort of help my cells let things in and out better. And this is why it's like, better like a more finely performing cell is how I was understanding.
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Dr. Bill Harris
Sure. I think that's fair.
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Zoe
It needs to be the EPA and DHA types of Omega 3, not the ALA that was from plants. Is that what you're saying?
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Dr. Bill Harris
That's correct.
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Zoe
So if I eat all of this stuff from plants, it's got this ala, omega 3. But then my body, I'm thinking about some sort of, like, refinement process, right from crud oil to petrol. Like, it's a lot of hard work to turn this then into these special forms of omega 3. But if I were to eat them directly, then I don't need to do the refinement and it goes straight to helping me out.
- [09:34]
Dr. Bill Harris
Yeah, a fair amount of the ALA we eat just gets burned like other fats, so it doesn't even get a chance to be converted into EPA and DHA in the liver, which is pretty much where that happens. So right away, you're behind the eight ball because you're losing a lot of it just for energy.
- [09:52]
Jonathan
The goal of eating 30 plants a week might sound like a big endeavor, but I wanted to tell you that it isn't actually that hard to achieve. Regular listeners to this podcast know that we often talk about eating 30 plants a week. And we stand by it so much that our gut health scientists actually created Daily 30, which is a gut supplement that makes it really easy to do. With just one scoop, you can add more than 30 plants to your daily diet and benefit from ingredients that support your digestion. Your gut health and Energy Plus Daily 30 can actually help keep you feeling full. Daily 30 also features 4 grams of fiber, a nutrient that over 90% of adults lack. If you follow Zoe on Instagram, you might have seen our post on a nutrition trend called fiber maxing. Fiber maxing, as you can probably guess, is when you max out your fibre intake. Now, plants are full of fibre, so eating over 30 different ones can help you do just that. Now, we don't usually love nutrition trends, but what we love about the idea of fibremaxing is that it's a way to focus on abundance, not restriction, by eating a variety of plants that come in different textures and colours. If you want to try a bit of fibremaxing, simply sprinkle Daily30 on your breakfast meals. I like it with my berries and yogurt every morning. Yes, berries are plants too, and a great source of fiber. Daily 30 also tastes great on salads, vegetable soup, avocado, toast, hummus. The list runs on. And because we're Zoe, we ran a study on Daily 30. As shared in a previous podcast episode. When Zoe first developed it, we ran our own randomized controlled trial to check if a new class of supplements could actually work. The results exceeded our expectations and helped us create the formulation that we sell today. By the way, whenever we talk about Daily 30 as a good source of fiber, we're required to say that it contains 4 grams of total fat per serving. Obviously, that's all amazing healthy fats from plants. Ready to start improving your diet this week? All it takes is a scoop to make every day a good gut day. Just go to zoe.com daily30 so start adding it to your meals and try the fiber maxing trend for yourself. And right now, we're offering our listeners a free Zoe Tin and magnetic scoop with every order. So order yours today@zoe.com daily 30.
- [12:17]
Professor Sarah Berry
Omega 3. Like Bill said, it's a big family of different fatty acids, but each of them have different roles. The ALA has a different role to the dha, to the epa, for example. And so that's why you can't just assume you've got ALA in your nuts that, hey, that's you on Omega three sorted. So, Bill, lots of people are eating less fish now than before. Lots of people are vegan, lots of people are vegetarian. Can you estimate what the prevalence is in the US in the UK of people who are deficient in omega 3?
- [12:48]
Dr. Bill Harris
Oh, who are deficient in omega 3? Well, we need to define deficient. The healthiest level, we think from our research is to be 8%, meaning 8% of the fats in the membrane are EPA and DHA, the level that's fairly common in the US and Western Europe. Is around 5%. We've seen vegans and US military personnel, sorry to say, in the 3.5% level, which is quite low. So under 4% we think is where you don't want to be. Over 8 is where you do want to be. About 90, 95% of Americans are under that 8%. So to call that deficient, I'll say that they're not optimal.
- [13:27]
Professor Sarah Berry
And I think that 8% that I often teach to our students, the Omega index I know you've published a lot on, I always explain to them this is kind of what I would consider optimal. Based on your research, that's optimal in terms of, you know, a lower risk of cardiovascular disease, a lower risk of all cause mortality, those kind of outcomes.
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Dr. Bill Harris
That's true. Right, right. It's linked with many good outcomes. And so 8% is uncommon.
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Zoe
It's achievable if generally you get these best forms of omega 3 from these oily fish. Lots of our ancestors grew up nowhere near a salmon or an oily fish. And you know, I often hear this story, you know, we come from hunter gatherers in Africa. Can you help me to understand, Was there Omega 3 sources there? Is this about saying that as human beings we work fine without them, but we can be much better with them? Could you just help me to understand that?
- [14:22]
Dr. Bill Harris
Well, first of all, let's examine some of those premises. Because human beings have always needed water. Wherever they live, they have water. And of course there's seacoasts and there's rivers. So people have always been able to get fish because they have to be by the water and the fish live in the water. It's interesting, if you look at all the major religions in the world, fish symbols are all over the place. So fish has always been there. You're right. The richest in Omega 3 are the deep sea ocean going fish. But fish in rivers too do have some omega 3 fatty acids too. So I think people have always been getting preformed omega 3 from eating fish. It's not like at one time we didn't have any Omega 3 and then.
- [15:07]
Zoe
We did, because I hear this word, oily fish. It's not just salmon.
- [15:10]
Dr. Bill Harris
Those are the best sources, but not the only sources.
- [15:14]
Zoe
But a lot of other fish had some. So we would have got this in our diet.
- [15:16]
Dr. Bill Harris
Yes, the whole spectrum of omega 3 levels. So all I know is in the current context, pretty much of the western diet, where we have plenty of calories, we have plenty of Omega 6, we have plenty of other nutrients. We know now that this 8% is a healthy target. You go back 200 years, people didn't live past 50 years old. So a lot of these diseases of aging that we see now weren't a problem then because people didn't live to see them. So it's hard to really guess what's going on in human evolution.
- [15:48]
Zoe
That's actually a brilliant transition to my next question, really, which is understanding how these omega 3s are actually affecting our health. And you were describing that with this omega index, if like 8% level, it's much better than 5%, what is that affecting in somebody's health?
- [16:06]
Dr. Bill Harris
Every cell gets these signals from the body, from outside the body, saying, hey, we've got an inflammation we've got to deal with. And the cell has to respond and make certain chemicals. And if it responds properly, the inflammation comes and then it goes away. And that's the way it's supposed to be. Cell membranes become more flexible. Stiff cell membranes don't respond very well. Flexible ones are able to be kind of fleet of foot. You can move quickly. The general idea is just being flexible is a good thing, and the Omega 3s help make that membrane more flexible.
- [16:39]
Zoe
So the first time I'd heard about Omega 3s was related to heart health. I think that was the sort of the story as just a regular member of the public, I had picked up.
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Dr. Bill Harris
That's where it started. Right?
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Zoe
Is that right? And how does that work?
- [16:53]
Dr. Bill Harris
Yeah, 1970s, two investigators from Copenhagen, Dyerberg and Bang heard these stories about these Inuits in Greenland who were apparently not having heart attacks, despite the fact they were eating, by the standards of the day, 1970, this terrible diet, virtually no fruits and vegetables, lots of saturated fat, lots of animal fat, lots of cholesterol, which should be. They should be falling over from heart attacks all the time by our current worldview. But they were not. It was a paradox. So they went over to check it out and they analyzed the food, they analyzed the blood of these people and what's going on. And they found on their analysis of the blood and the food these unusual fats, fatty acids, EPA and dha. And then they started thinking, well, that's different than the Danes back home. They don't have those fatty acids in their blood. What do they do? And then these guys did some experiments to show that actually these fatty acids make the blood thinner, less likely to clot. And they said, aha. That's why they don't have heart attacks, because these fatty acids are reducing the tendency of the blood to clot. And it was believed at the time still somewhat true that a clot in the coronary arteries of the heart will cause a heart attack. And so if you can prevent that, kind of like taking an aspirin, same idea. But this came from food. So it all began in heart disease.
- [18:23]
Zoe
And how do you say that's how we understood it then? Do we still believe it's important for our heart health?
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Dr. Bill Harris
And if so, there's no uncontroversial fatty acid at this point, except perhaps trans fats, I don't know, but they're very complicated. All the fatty acids do different things. And there's again, Omega 6 family, Omega 3 family, a monounsaturated family, a saturated family, and there's subsets of all those. And we are much more understanding of what individual types of fatty acids do, which they didn't know at the time. Back in the 70s, it was animal fat was bad, plant fat was good, end of story. We had this thing called a P to S ratio, the polyunsaturated to saturated ratio, and that. So the Eskimo diet didn't fit well into that paradigm. And so it just didn't make sense until these Danish investigators said these two fatty acids are actually good. And so it kind of opened up the window into, well, individual fatty acids have different roles in biology, and we need to understand them.
- [19:23]
Professor Sarah Berry
And I think in those experiments that they did with the Inuits many years ago, there's a really nice way to visualize it, is if you were to cut your finger. So when the Inuits cut their finger, they bled for a lot longer than the Danes because their blood, very simply put, like Bill said, is thinner. So you're producing, and you're producing less of these kind of clotting factors, etc. So they just keep bleeding. I mean, okay, eventually, to a point.
- [19:50]
Dr. Bill Harris
Yeah. And this is one of the controversies about omega 3s. Now, do they increase risk for bleeding? And the answer really is no in a meaningful way. But nobody's eating the amount of Omega 3 that these Eskimos ate either.
- [20:02]
Jonathan
And you said that there was a.
- [20:04]
Zoe
Theory then about how it helped our heart health, but maybe this has changed. So today, how do we understand that these EPA and DHA are helping our heart?
- [20:11]
Dr. Bill Harris
Yeah, it's that and more. Yes, they still thin the blood and that, yes, that is still a mechanism by which they reduce risk for heart attacks, but they also affect the heart muscle in different ways. One thing they do is, and it's not really clear how they do it, but they actually lower your heart rate, drops Your heart rate from 2, 3, 4 beats a minute, which has long term effects. I mean, some people think you get a certain number of heartbeats per life and that's it. You know, once they're all used up, they're used up. We've looked at animals in slow heart rates, long lives, animals, really fast heart rates, short lives. And so reducing heart rate actually is a good thing. It's helping. It says your body is using oxygen better, the blood is flowing better, the cells are using the oxygen because it doesn't have to beat so fast. So that's one thing it does. It also reduces the chance that you will have what we'll call an arrhythmia, which is when the heart beats irregularly. And that can be fairly innocuous or lethal, depending on where it is and how it happens. So the omega 3s reduce the risk for that, reduce blood pressure to some extent. They reduce levels of one of the blood lipids called triglycerides, which is somewhat of a risk factor for heart disease. They make the blood vessels more elastic so that they're not so stiff. So the blood and the red blood cells can probably move because they're more flexible. They have to kind of line up when they go through a capillary at the end of the arterial system that get into the tissues. They have to line up and go one by one through these little capillaries and they have to compress, which is where they offload oxygen, pick up carbon dioxide and head back to the heart. The Omega 3s make it easier. A rich Omega 3 level in a cell makes it easier to do that. So all these things play together for heart health.
- [22:03]
Professor Sarah Berry
Yeah. And I think it's fascinating when you hear Bill explain so many different mechanisms. Some people just talk about cholesterol or just talk about blood clotting. There's so many different ways that the EPA, the DHA, omega 3s, impact factors related to heart health. What I've seen recently that's been a little bit frustrating is some controversy because of some really big studies that came out saying actually no, omega 3 supplementation doesn't help heart health. And I think it's a really important point of time to kind of clear that up, that there are lots of studies out there consistently show improved effects on these intermediary risk factors. Yes, there has been the odd epidemiological study that maybe questions that, but actually, if you look at the totality of the evidence and you look at depending on dose, you look at depending on who's actually receiving it is. It pre heart attacks, post heart attacks, et cetera. I would love you to give a top line of whether you, as an expert in this, agree that taking as a supplement improves heart health.
- [23:04]
Dr. Bill Harris
Yes, I think it does. And just a short little rabbit trail. You mentioned cholesterol. If I had another shot at a myth is that fish oils lower cholesterol, but they do not. They lower triglycerides, which is another blood method. Right. So anyway, that's off the table now, and that's okay. They still reduce risk for heart disease. So the controversy that you're referring to is about atrial fibrillation. It's called afib. And that's not a fatal kind of rhythm. There's a ventricular arrhythmia, which means the lower parts of your heart go wacky and they stop pumping blood. And that'll kill you right away. That's bad.
- [23:41]
Zoe
Sounds bad.
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Dr. Bill Harris
That's bad. But atrial fibrillation, which is the two upper chambers, when they don't quite beat in synchrony, it doesn't kill you by any means. It's annoying. Feels like fast heartbeat. And it does increase risk for strokes because if your blood is not moving properly through the heart, you can actually have some blood clots in your heart that go to your brain. So that's a concern about afib. And there have been two or three big studies where they gave omega 3 high doses of omega 3 and actually pharmaceutical forms of omega 3 to patients who are at very high risk for heart disease. It was the point of the study, see if they could help. And in both those studies, they saw a small increase in risk for atrial fibrillation from the people that were getting the omega 3, the high dose, roughly 3 or 4 grams of EPA and DHA, which is way beyond what most people would ever supplement. These studies, you have a placebo group that's getting nothing, essentially. And then you have your omega 3 group, the placebo group, say, had developed over this four or five years afib. Say 2% of the people developed afib. On the omega 3 side, 3% developed afib. Well, the way we express that in medicine is that's a 50% increase in risk, because 3% is 50% higher than 2%, but it's only 1%, what we call absolute risk increase. Very small. Actually, this is not published yet, but we've just finished a big meta analysis with summary of lots of studies together that have looked at this, and we found that this only occurs in that particular setting. High risk Cardiovascular patients getting 3 to 4 grams of EPA and DHA, that's the group where this increase happens. Again, it's a small absolute risk. But in people who are just taking dietary supplements or eating fish, there's no increased risk for afib. So it's not a concern for the dietary supplement world or the fish eating world because you're not getting those dose 3 and 4 grams a day of EPA. Most people taking dietary supplements are getting probably between 500 and maybe 1500 milligrams a day of EPA and DHA. That would be a great dose, but it's not the three and four grams. And so it's the high dose, I think, that's causing this concern about atrial fibrillation. Fish oil supplement use is not associated with increased risk for any cardiovascular outcome.
- [26:11]
Professor Sarah Berry
It's so conclusive that fish oil supplementation improves so many aspects related to heart health, except for a very minority of people at very high dose.
- [26:20]
Zoe
Could you clarify then? I guess when you look across all of this, like, what are the benefits for heart health?
- [26:27]
Dr. Bill Harris
Consistently, we see people who have the highest Omega 3 levels live longest. And a good example of that is like Japan. The Japanese, just because of their diet, have a omega 3 index that's about 8 or 9% on average. So it's like twice as high as the West. And they live on average four, four and a half years longer than we in the US live, despite the fact they smoke more, despite the fact they have more high blood pressure than we do, despite the fact they have more stress than we do, they live longer. And I hate to attribute all of that to an omega 3 effect, but. And I can't, but I can say that's one brick in the wall. And when we look at risk for death from heart disease, it's the same story. Higher omega 3, lower risk for death from heart, lower risk for death from cancer, lower risk for death from all other causes combined with high omega 3. So it's doing something across not just heart health, it's helping us stay alive and resilient longer.
- [27:32]
Jonathan
And if you choose to take supplements.
- [27:34]
Zoe
Is there evidence that if you take supplements that that will improve my heart health?
- [27:38]
Dr. Bill Harris
Yeah, they're right. That's again, back to the UK Biobank. There have been several studies that just looked at fish oil supplement use. Yes, no, it's a very crude measure because we don't know how much they're taking, how frequently they're taking, what product they're taking, any of that stuff. It's just a yes, no. But the people who are taking omega 3 supplements in that UK Biobank are lower risk for multiple kinds of heart outcomes. We've looked at stroke and we looked at blood levels of omega 3, which is much better than asking people if they take fish oil, just look at their blood levels. And we find that the higher the blood level, the lower the risk for stroke. Which contradicts that whole atrial fibrillation concern. Because the problem with AFIB is increased risk of stroke. Well, even in the studies, the big studies with the pharmaceutical products where they reported this, you know, 1 or 2% increase in risk for afib, they had like 20% reduced risk for stroke. So the omega 3s are still benefiting heart health in a wide variety of ways. Even in these people with, again with high, high risk for heart disease who are taking high, high dose pharmaceutical products, they're still getting a lot of good heart benefit even if there is a small increased risk for afib.
- [28:58]
Professor Sarah Berry
So I think, Jonathan, the evidence is really clear that Omega 3s beneficially impact heart health. I think it's really important to say as well, for any skeptics out there, one fantastic thing about Omega 3 is because we can't make means that any increase in the blood we know is coming from what you're eating. Because people often say, oh well, how do you know it's because of it's what they're eating. So this is one fact that we can say actually what's in the blood is coming from the food you're eating. And so I think where there's some really exciting new research though is around brain health. And I think this is something certainly when I was teaching, even up until a few years ago, a lot of what I was saying was, oh, we just don't know yet. And I know this is something you focused on more recently in your research. So it'd be great to understand a little bit about what the latest evidence says around omega 3 and brain health.
- [29:50]
Dr. Bill Harris
Sure. And I'm sure when you do your lectures, you start with babies in the womb and the formation of the brain in the first place, which is very important because the brain has a lot of. One of the two Omega 3s called DHA, is part of the structure of the brain and that's important from the very beginning in your eyes too. Actually, the eye is an extension of the brain and the level of omega 3 in the retina, the back of the eye, is one of the highest in the whole body. So there's a real, it's there for a reason. It's Always there for a reason. The Omega 3 story in dementia has been growing over time. We know that when they do autopsies on people who died of dementia compared to controls who died of something else. Those who had dementia have lower omega 3 levels in the brain. That's one piece of the story. We've seen that higher levels of omega 3 in the blood, higher omega 3 index, predicts a lower risk for developing Alzheimer's disease or all cause dementia over time. So that's another important piece of it. If your B vitamin nutrition is good, then the Omega 3s seem to increase, help increase cognition, improve, improve brain health, reduce risk for developing dementia if your B vitamin levels are too low. Actually, I'm talking about homocysteine, which is a particular molecule in the blood that responds to. That's kind of a barometer of how well your B vitamins are working. If that homocysteine level is high, the Omega 3 effect goes away. So there's what we call an interaction here between those two nutrients. And so it's important to get good B vitamin nutrition, good omega 3 nutrition for brain health. But it's been difficult to show in the kind of randomized trial that we're all used to give somebody some Omega 3 for three or four years and then another group not, and then see who develops dementia. We haven't got time. Or either that or you pick people who are already so far down the road you can't do anything about it. So at this point, the omega 3 and brain health connection is mostly, I think, based on these observational data, what we call epidemiology more so than randomized trials, because haven't got that much randomized trial data yet.
- [32:08]
Professor Sarah Berry
And what about in relation to mental health more generally?
- [32:11]
Dr. Bill Harris
Mental health is right. We just got a paper accepted a couple days ago on anxiety and depression as a function of omega 3 levels. And again, higher omega 3 levels are always linked with less current depression and anxiety and less risk for developing it over time.
- [32:29]
Jonathan
And Bill, I think a lot of.
- [32:30]
Zoe
People listening will be really surprised. The shift from like heart health and dementia to like anxiety and depression. Because most of us were brought up with this idea that, like, you know, our mind and our bodies are separate and like the first, like it's like really physical, but anxiety and depression, like, how could that be affected by how much salmon I ate. Do you understand at all what's going on there?
- [32:55]
Dr. Bill Harris
No, I love it. Short answer, I can't tell you what's going on. I mean, some of the cells in the brain are kind of there to reduce inflammation, certain small part, not the big chunks of it, but there are certain cells that are. Their job is to control inflammation and the omega 3s can get into those cells and help reduce inflammatory signaling in the brain. That's good. But at this point we're just seeing associations between a high omega 3 that doesn't, you know, strictly speaking, and Sarah understands this very well, because you have an association doesn't mean you have a cause.
- [33:29]
Professor Sarah Berry
Yeah. So this is what I'm fascinated by now listening to you. Have there been any supplement trials where they give people omega 3 supplements and see whether it reduces levels of depression, levels of anxiety, improves mood, happiness, those kind of things? Should people who are not feeling happy, should people who are suffering from depression, in addition to whatever therapy they have, also be taking Omega 3?
- [33:54]
Dr. Bill Harris
I think yes. The answer to that. There have been studies, particularly in depression, for many years and what they've discovered was somewhat surprising to most people because when you pool together a bunch of studies that were done to try to affect depressive symptoms, some of the supplements that were used in those studies are rich in dha. Some of them are richer in epa. They both have, all the supplements have both, but some heavier epa, heavier dha. And the hypothesis has always been, well, pretty simple. The brain's got a lot of dha, so give it dha. So that ought to be the one. Well, it turns out that when they look at these studies, they say, well, interesting, the studies that have provide a supplement that's richer in EPA are the ones that seem to find a reduction in depressive symptoms, not the ones that have dha. So again, a good hypothesis out the window based on observational research. And the theoretical explanation is that the EPA is more of an anti inflammatory omega 3 than DHA. And that's something about the getting more EPA. EPA doesn't really get into the flesh of your brain, it doesn't get incorporated, but it is in the blood circulation throughout your whole brain and it can be made into some molecules that are anti inflammatory that may help reduce risk for depression.
- [35:25]
Professor Sarah Berry
So your recommendation to people who are suffering from an array of mental health issues would be in addition to whatever therapy, they have to also try fish oil supplements, but focusing on EPA rich ones.
- [35:39]
Dr. Bill Harris
People always ask, is EPA better than dha? And I always say they're both good, they're both in nature, they're always together in fish, we always eat them together. I think you should have all of them in a supplement, maybe for depression. We have evidence that richer and EPA would be better.
- [35:54]
Professor Sarah Berry
And that's because the anti inflammatory effect of EPA rather than the structural effect presumably DHA has in our brain. So that when we're eating, let's say a portion of fish, we've got two things happening. We've got an increase in DHA in terms of, in our brain because of the structural components and then the EPA then helping with the inflammation.
- [36:15]
Dr. Bill Harris
Yeah, and this is complicated because we know that giving more EPA and DHA will raise blood cell omega 3 levels, the omega 3 index. And from other studies we know that you can increase the level of omega 3 in your liver, in your kidneys, in your heart, in your lungs. But brain is not so easily moved. Just take an adult like you and me and start giving us Omega 3 and DHA. We could take a biopsy of the brain. We would probably see that the DHA level's not going up. There is this blood brain barrier that's very specific. And at this point I don't think we can say that taking DHA is actually going to raise your brain tissue DHA levels. It's good for your brain health. It doesn't have to be because it became part of the meat of your brain. It could be doing other things in the brain that could be even just the blood vessels that go through. Improving the circulation of the blood through the brain would be helpful without changing the composition of the brain. So I think that's still an area of active research is trying to figure out why when you give omega 3s, you don't really get a. You can see an increase in cerebral spinal fluid, which is the fluid that flows around the brain and spinal cord. And you can get more Omega 3 in there. But actually as part of the brain, tissue doesn't seem to go up like it does in the liver.
- [37:42]
Professor Sarah Berry
So is there a window of opportunity? Because I know we often talk about making sure during pregnancy you're getting enough because of how important it is for your baby, but also for young children. And I think a lot of parents, Jonathan, don't think about this. Is there a window of opportunity to make sure that you are as pregnant women but also your children are getting it to make sure there is enough DHA in the brain? Very simplistic question, I'm afraid. It's quite confusing.
- [38:05]
Dr. Bill Harris
It's a great question. And it makes the most sense for pregnant women to be sure they're getting enough omega 3, particularly DHA during pregnancy. Because all the omega 3 that your baby's getting is coming from mom, whether it's in utero or from breast milk. Optimizing the amount of omega 3 early in life, it makes the most sense to me. And really, brain development goes up till like 18 or 20 years of age, actually. Right. Most of it is in that first thousand days of life where your brain is really put together. And that's the most important time to get the Omega 3s, get a good standing for the rest of your life. I'm not sure it will stay if you eat cheeseburgers the rest of your life.
- [38:47]
Zoe
So my daughter is six. Are you saying at this point already it's sort of too late to change this DHA in her brain, this barrier that you were describing?
- [38:55]
Dr. Bill Harris
No, I wouldn't throw my hands up in despair. My grandkids and my kids, when I. Back then, we made sure they have Omega 3 all the time. They're growing up, it's safe. We don't know for sure what it's doing all the time. We have good indications that higher levels are good across the lifespan. So why not do it? The risk is zero.
- [39:16]
Zoe
Can I ask a clarification question? Because you were talking about EPA and DHA and saying that for depression, the EPA seemed to be more critical before you were talking about your research around dementia.
- [39:29]
Dr. Bill Harris
I think a mix is always best for overall health above and below the neck.
- [39:34]
Zoe
So I'm definitely sitting here thinking I need to make sure I get enough Omega 3 in my diet. It feels like a very strong pitch from Bill with a lot of support here from you, Sarah. And just before we talk about the advice, I mean, the first question I have now is, well, I'd like to measure my own Omega 3 levels because you've been talking about that. Can I ask my doctor to measure my omega 3 index and see whether I'm at this magic 8% level already?
- [40:00]
Dr. Bill Harris
Yeah, your doctor will be a deer in the headlights.
- [40:03]
Professor Sarah Berry
I was about to say. That'd be pretty cross in England, if you ask me.
- [40:05]
Dr. Bill Harris
Would it be? What's the Omega 3 index? It's a hip. They don't know. They don't know. But yes, it can be done. This is where personalized nutrition, people taking their health in their own hands, I think is really important. In the UK particularly, it's very easy to get the Omega 3 index done, but you just go online and order the test. They'll send you a little kit in the mail. You prick your finger, you drop a blood on it, put it in the mail, and in about a week you get a report of your omega 3 index.
- [40:36]
Professor Sarah Berry
We do actually Measure this in our Zoe predict studies. So we have this big Zoe predict cohort. And then in a subgroup of that 300,000 people, we have measurements of all of the different fatty acids. So not just the saturated, mono and polyunsaturated, but the individual fatty acids, including the EPA, the DHA, the ALA. You have 300,000 people? We have 300,000 people in our predict cohort.
- [41:03]
Dr. Bill Harris
In all women?
- [41:04]
Professor Sarah Berry
No. So they're about 65% women, 35% men. A huge proportion are peri and postmenopausal. And we just have this gold mine of data. It's mind blowing as a scientist, what we have.
- [41:16]
Dr. Bill Harris
How many do you have blood on?
- [41:17]
Professor Sarah Berry
We use a device called Tasso and so we have that on all of them. And then on a subgroup of individuals, which is probably about 10,000 now we have the fatty acids who would be able to do the Omega Index.
- [41:29]
Dr. Bill Harris
10,000 is great. Yeah.
- [41:30]
Professor Sarah Berry
But what's amazing, with this cohort, we can start to really dig down into the kind of things that we've been talking about and the nuances that's so important in nutrition.
- [41:40]
Dr. Bill Harris
That's fantastic. UK only.
- [41:42]
Professor Sarah Berry
UK and us.
- [41:43]
Dr. Bill Harris
And us. Oh, that's fantastic.
- [41:45]
Zoe
I would like to talk about. Okay, what do you do if you want to hit this magic 8% number and you have a suspicion that you're in the 90 to 95% of people you described who don't have that. So could you describe how someone could try and get there?
- [42:02]
Dr. Bill Harris
Sure. I think the most important thing is to start with knowing where you're at. So getting a blood test to know your Omega 3 index to begin with, that's your baseline. We did a study several years ago pooling data from 14 different other studies that we had done where we had measured omega 3 index before and after, and we were able to figure out how much Omega 3. In additional, you need to get EPA, DHA in order to go from where you are now to 8%. And so we've reduced that down to a mathematical equation that's sort of buried in the website. And so if you come back as a 5% or a 4%, 4% would be not atypical. If you put that in the calculator, you're going to find that you need about 1,500 milligrams more a day of EPA and DHA together. That's a place to start. There's a lot of variability in how each individual responds to Omega 3 intake, but on average that's a great place to start. And you could you could eat salmon every day, or you could start taking an omega 3 supplement, red blood cells, which is where we measure the omega 3 index. It takes. You get a whole new crop of red blood cells every four months. And so now you can. If three and four months, you could do another test, see where you're at. We call it titration. You test, you intervene, and then you test again and see what the result was. And if you're where you want to be, keep doing it. If you're not, you need more.
- [43:30]
Professor Sarah Berry
Bill, you've said quite a large amount, as in one serving every day. Something that I hear anecdotally, a lot of people saying to me is, oh, but I'm worried about mercury. I've heard that if you have too much oily fish, it's going to give you mercury poisoning. And I believe it's actually preventing a lot of people from increasing their oily fish intake. I think it's really important to get some clarity on that.
- [43:54]
Dr. Bill Harris
Very important. Mercury has gotten way more a much bigger concern than it really is. It's primarily a concern originally in pregnant women and young children. And back in the early 2000s, the Food and Drug Administration put out this warning about mercury in fish based on some, I think, very narrowly flawed research. And there's good evidence that that advice caused lots of pregnant women to say, I'm not going to eat any fish, even though there's only maybe four fish. Swordfish, tilefish, king mackerel, shark, things that nobody eats anyway. Those are the ones that had high mercury. And that was the warning in the United States and the fda. Stay away from those fish. Well, women stay away from those fish anyway. I mean, salmon has virtually no mercury in it. Sardines, mackerel, herring, virtually no Mercury. Those high Omega 3, just the amount of Omega 3 and the amount of mercury are not related to each other.
- [44:56]
Professor Sarah Berry
So unless it's those quite unusual fish, you're saying, don't worry, don't worry about it.
- [45:02]
Dr. Bill Harris
Absolutely right. And for God's sake, don't avoid eating fish because you're worried about mercury.
- [45:09]
Zoe
Salmon every day is a lot of salmon. Like, I think I don't want to eat salmon every day.
- [45:14]
Dr. Bill Harris
You can mix it up with sardines.
- [45:16]
Zoe
Is that like, to get my very most optimal. Do I really need to eat this every day?
- [45:21]
Dr. Bill Harris
Right. I think I wanted to make the point that you don't have to take supplements to get to an 8%. You can do it with fish. I was just giving an example of salmon every day. Right. You can eat salmon twice a week. You could eat maybe mackerel once a week and you might get up to 8%. It just depends on you. And it's very possible. But if you don't want to do that, supplements are a fine substitute for that. A serving of salmon once a week, maybe 1200 milligrams of EPA and DHA, well that's divided out by seven, that's about 200 milligrams a day. Well, that's twice the average American intake right there of omega 3 fatty, which is around 100. 150 milligrams is on average what Americans eat. So you're, you could double it or triple it by just eating an oily fish once a week. So it's a good thing to do. It's just not going to get you, by and large to 8%. You're going to need to eat more than that.
- [46:20]
Zoe
And that pushes you towards supplements. It sounds like, realistically, if you're going to stay at that, unless you are an Inuit or maybe some of the Japanese that you're describing about the level of fish intake.
- [46:31]
Dr. Bill Harris
Right, right.
- [46:32]
Zoe
Just before we go into supplements, I know that one of the questions we get a lot is about farmed fish. So not about mercury, but I think concerns actually about the overall health. And Sarah, you talk a lot about this, right? About thinking about the overall health of a food rather than just one element and concerns that like their farming might not be very healthy.
- [46:52]
Dr. Bill Harris
2010, 2012, there was a report that got a ton of press about not mercury in salmon, in farmed salmon, but PCBs, dioxins, other industrial organic chemicals that are not good for you. And this has set off alarms all over the world. And most of these fish that they, in this particular study were from the Baltic Sea and North Sea farming. And it turns out that the reason that those salmon that they were feeding had those levels was because the fish food, the oil that they got from other fish that they feed the salmon, because salmon needed to be fed fish oil in order to get the omega 3s up. The fish oils were not that they were feeding them, were not clean. They had those pollutants in them. So it was true. But the industry has cleaned it up tremendously. Our lab in Scotland is also an aquamarine lab, meaning they analyze fish carcasses for the industry. And there are very strict levels on PCBs, dioxins, and they're not there anymore. Now, salmon, which is kind of the classic farm fish, used to be back say 10, 20 years ago when fish oil wasn't so expensive. It's expensive now because people want supplements. There's a demand. So fish oil's gotten expensive. Salmon. Salmon producers have been reducing the amount of fish oil in the feed and increasing the amount of plant oils in the feed, trying to balance cost and health and longevity and nutritional composition. So the Omega 3 level's gone down in salmon. Now it's about the level of wild salmon. It used to be higher. Used to be you get more Omega 3 per serving of farmed salmon than wild. Now they're about the same. So I don't have a problem with farmed salmon. It's still a great source of meat. It's not as good a source as it was maybe 20 years ago, but that doesn't mean it's not a great source today.
- [48:48]
Professor Sarah Berry
It still is, I think, Bill, it really nicely leads us onto another myth that I think is really important to cover briefly while you're here. And this is around the omega 6 to omega 3 ratio. And so one of the reasons people say, oh, farm fish isn't as good is because it's got by being fattier, it's also got a higher amount of omega 6. I'd love to quickly get your perspective if you can give me kind of top line views on the Omega 6 to Omega 3 ratio. Because it's everywhere at the moment in relation to seed oils and so many others.
- [49:19]
Dr. Bill Harris
Yeah. And I think the omega 6 omega 3 ratio is a useless metric for so many reasons. Number one, it assumes the omega 6 fatty acids are bad. And that's not true. Linoleic acid is the one we're talking about. Linoleic is the primary omega 3 and seed oil, omega 6 in seed oils and in our diet. And higher levels of linoleic acid in the blood are associated with lower risk for heart disease, for diabetes, for all cause mortality. Everything is better with higher levels of the major omega 6. So the idea that it's bad is wrong. So there's no reason to have a ratio of something good to good. It doesn't make any sense. Secondly, you can have high levels of omega 6, high levels of omega 3 in a food, or you could have low levels of omega 6 and omega 3 and you have exactly the same ratio. If your ratio is wrong, the thing to do is not to reduce your omega 6, it's to increase your omega 3. So if you increase the denominator, the ratio gets smaller. That's okay. That's a reasonable response. But I think this dependence on the Omega 6 Omega 3 ratio is way outdated. That's from the 80s. It should just be thrown in the trash can and ignored. We need to look at the amounts of fatty acids we're eating, not this ratio.
- [50:34]
Professor Sarah Berry
Thank you. This is exactly what I say and why I get a lot of hate mail. I wonder if we can go back to thinking about how we can increase our Omega 3 levels. You've talked about having oily fish, you've talked about supplements. I think something really important to cover is at what point should we be supplementing through our life course? Is it safe to give young children supplements? Should we be having more, higher doses as we get older?
- [50:59]
Dr. Bill Harris
I think yes, it's safe to supplement children again in that like 1000 milligram a day. EPA, DHA is no question about that being healthy from what age, it's hard to draw a line in the sand. If I could, you know, dictate, I'd say from minus nine months through your life, I don't see any place where all of a sudden, now here is where you need it. Clearly increasing your omega 3 levels is always going to help somewhat. And the earlier you do it, the better, the more you hit. Because these are what we call fat soluble nutrients. So they stay in the body a lot longer than the water soluble things like vitamin C, which kind of come and go, but the fat soluble ones stay in longer. And the longer you feed omega 3s into your cells, the levels just go.
- [51:46]
Zoe
Up, up, up, up and bill. Can you overdose on Omega 3?
- [51:50]
Dr. Bill Harris
Not that we know of. It's kind of self limiting in a sense that people just can't eat that much fish. Again, the Japanese who eat much more than we do are healthier than we are. So we haven't seen it. The other issue that comes up is bleeding, and that was a concern. As you mentioned, cut an Eskimo's finger back in the day and it would bleed a lot or nosebleeds. You would have pictures of blood all over the place. And this scared people. And we did find in early studies that we were doing that you give high Doses of Omega 3, you will increase what's called the bleeding time. It increases, but it increases like aspirin increases it. Not outrageous. Not hemorrhaging, not you're going to die from a nosebleed, none of that stuff. And then we've looked at other studies lately, or not lately, over the last several years of people who are taking blood thinners already or taking aspirin and seen that taking Omega 3 on top of those does not increase the risk for anything that's clinically significant bleeding.
- [52:45]
Zoe
And if I make this change and increase the amount that I'm taking, how long might it take for me to feel some of the effects of this optimal level of omega 3?
- [52:55]
Dr. Bill Harris
Good question. And I'm not sure you can feel an effect of omega 3. The thing that we hear people, you know, people are given omega 3s, say to lower their blood triglyceride levels, for example. That's a pharmaceutical reason to take it. You don't feel a blood triglyceride level. You don't feel a high blood pressure. What you feel is achy joints. And this is the experience, anecdotal experience that we get is that people say, my shoulder just doesn't hurt anymore. My knees feel better now. So that is probably three, four, five months into taking omega 3s after your tissue levels go up.
- [53:31]
Jonathan
I worry about my brain health more than I worry about anything else. I've seen firsthand what can happen when.
- [53:37]
Zoe
The brain goes wrong.
- [53:39]
Jonathan
And it's a pretty horrible experience. If you know anyone who's also focused on keeping their brain healthy, why not share this episode with them right now? Give them facts from the world's leading.
- [53:49]
Zoe
Expert, not some rumors they've heard on the Internet. I'm sure they'll thank you. So I would love to switch to really clear, actionable advice. Now. I think we've had this brilliant description. I think lots of people listening are saying, like, oh, I'd like to eat more food that has his Omega 3 in. Could you just very simply tell us what foods should be in that list?
- [54:10]
Dr. Bill Harris
Well, there is an acronym. We talk about oily fish. SMASH is the acronym. S M A S H. So salmon mackerel. A stands for anchovies. I'm not sure anybody eats, oh, I love anchovies. Except Sarah. Anchovies S will be sardines and H is herring. So those are the smash fish. And those are really very high omega, the highest omega 3.
- [54:39]
Zoe
And is there anything other than oily fish that has higher levels of omega 3 and therefore is worth adding for.
- [54:46]
Dr. Bill Harris
That reason, without being fortified with omega 3. Like you can feed chickens EPA and DHA and in their eggs you'll have more DHA, but they have to. That's not natural because you're feeding it to them.
- [54:59]
Jonathan
Anything natural?
- [55:00]
Dr. Bill Harris
Anything natural, no. We hear about microalgae. Vegetarians or vegans who want no animal products can take EPA and DHA as algal products. Scientists realize that the original source of omega 3 is certain kinds of microalgae, not seaweed. We're not talking about seaweed. These are single celled organisms. So they find the exact species that makes EPA or dha. They put them in a vat in the middle of Iowa, give them sugar and water and sunlight and they will make EPA and dha. And then they harvest lipids out of these and put them in capsules. And that is a perfectly good source of EPA and DHA that does not come from an animal.
- [55:45]
Zoe
And if I understand rightly from what you're saying, that is actually sort of the original source of this EPA and dha.
- [55:50]
Dr. Bill Harris
That's where it all comes from.
- [55:51]
Zoe
So when you're eating fish. Fish, you're actually. It's eaten these little algae.
- [55:55]
Dr. Bill Harris
Got it.
- [55:55]
Zoe
It's inside it.
- [55:57]
Dr. Bill Harris
Right, right, right.
- [55:57]
Zoe
And these days, most honestly, like most time I'm eating a fish, it's probably farmed. So you're describing it sort of being taken and fed sort of manually to these fish and then I'm eating them. Am I understanding that right?
- [56:09]
Dr. Bill Harris
You're right, you're right, exactly.
- [56:10]
Professor Sarah Berry
I think it's really important, Jonathan, to clarify again, thinking back to where we started, the beginning, that when Bill's Talking about Omega 3, he's specifically talking about the EPA and DHA sources. Because I don't want people listening saying, oh well, hold on, you can get these from flaxseeds, from walnuts, et cetera, specifically the EPA and dha.
- [56:31]
Dr. Bill Harris
Yeah. And there's nothing wrong at all with these products that are rich in ala, flaxseed oil, chia seeds. It's fine, they're good for your variety of other things. It's just not the substitute for fish oils. I think that's really the point. Don't expect that to, to meet all your Omega 3 needs if you're just going to do a plant based diet.
- [56:50]
Zoe
So could we maybe wrap up with supplementation? Because I think one of my takeaways from this is that for this sort of optimal level that you're talking about, it's actually quite hard to get there. So it feels like that does push you towards supplementation. So I guess my first question is, do you supplement yourself, Bill?
- [57:06]
Dr. Bill Harris
Yes.
- [57:07]
Zoe
Imagine that someone can't do the testing so they don't know their own baseline. What would you advise?
- [57:14]
Dr. Bill Harris
Yeah, I think not the pregnancy world, but the regular world. You would say? I would aim for about a thousand milligrams a day of EPA and DHA combined. Roughly 50, 50. Could be 40, 60, 70, 30, whatever. But both of them, 1,000 milligrams a day would be fairly typical of the average Japanese intake, at least historical. I mean, the Japanese are now becoming more Westernized. The younger people are not eating, following the traditional diets. But historically the Japanese intake has been around a gram a day. That's a healthy target intake. You can do that with two or three pills a day. Some supplements, one a day. And you just have to look on the back of the label of the product to see how much EPA and DHA is in there per capsule and then take enough to get a thousand a day. And then I think that's a great start.
- [58:08]
Zoe
And final question on this. Supplements are not as well regulated as medicine in almost all countries. Might be a little worse here in the States, I think, than in some others. Is there any concern you might have as you think about these supplements? Is there any way to sort of judge that you're going to. You're going to get what you're looking for?
- [58:28]
Dr. Bill Harris
I mean, commonly, the more you spend, the more, the higher the concentration per capsule and the cleaner it is not to imply that the ones that are fairly cheap are dirty. They're not. You might get more of a fishy burp from some of the cheaper products. The fishy taste doesn't come from the Omega 3. It comes from other oil products, other breakdown products in there. If you get a fishy burp doesn't mean that the Omega 3s are gone. The Omega 3s are still there. I use a product that's got 700 milligrams of EPA and DHA per capsule. That's in a triglyceride form. I think that's important to get a triglyceride form and not an ethyl ester form, which is the drug form as an ethyl ester form, which is not as well absorbed, not absorbed, but it's not as well absorbed as a triglyceride, which is more of a natural form.
- [59:19]
Professor Sarah Berry
I think the really big takeaway, Jonathan, from me listening to Bill on this is that any type of supplement is better than no supplement because you do see such big disparities in cost. And I would hate to think that someone thought, oh, well, I can only get this, like, ridiculously expensive one. Yes. It might not be quite as pure, but it's still going to be beneficial in terms of your health. So I think that's really important.
- [59:45]
Zoe
Bill and Sarah, thank you so much for taking us through what's like sort of quite a tricky and complicated topic. I'm going to try and do a summary and then I'm counting on you to correct me where I've got it wrong. So I start with the fact that fish oil is not a myth, which is surprising because almost everything I was taught about nutrition when I was growing up seems to have been reversed. But here we're saying there really is something magical in it, omega 3. But specifically this EPA and DHA. And I think what I've understood, which I hadn't got before, is Omega 3 is sort of like a family. You described it, and within that there are these different types. ALA is this one from plants. But the one that you're really excited about is EPA and dha. It does some quite magical things. So although you said it does not lower cholesterol, that is a myth. It can improve your risk for heart disease. And now we have this new science suggesting it can lower your risk for dementia. But also, really amazingly, it's linked to sort of less anxiety and depression. And you were saying that you think that might be linked to reducing inflammation in the brain, which is interesting because often on this podcast we talk about research which is looking at sort of the microbiome and gut health and the links to inflammation and other things. So it's just interesting to me to hear you say that you have developed this thing called the Omega 3 index, which actually basically tells me how much of this EPA and DHA is actually in my individual cells. The healthiest is like 8%. You said on average, in America, someone has 5%. And for people who are vegans in the military, which I suspect does not have the best diet, you can get as low as three and a half percent, and you can function in all of this. So it's not like you're going to die by not having this, but you definitely see improvement as you go from average to optimal. You can't visit your doctor and get this measured, which is disappointing. But we will put a link in the show notes for how you can go and get yourself tested. Basically, if you want to get this through food, then you have to go to these oily fish. And you said smash. So I think I wrote down salmon, mackerel, anchovies, sardines, herring. Everything else is much, much lower. So it's not that there's none, but it's not going to really change this percentage in a big way.
- [61:59]
Dr. Bill Harris
Yeah, lower. Much, much is a little strong. Just lower.
- [62:03]
Zoe
You're allowed to add any foods here that you think are critical. And what I heard is there are plants that are high in ala that's definitely better. Than not having it. But it's really hard to turn that into this EPA and DHA and hence these algae products, which sound very exciting to me because that's like the original source of this. Right. So you're just eating the fish in order to get at the plant, basically, or the algae. So that sounds very exciting. We'll see whether we can find any links for that as well where you can get the direct EPA and dha. And therefore, Bill, you are supplementing yourself rather than just trying to solve it with food because you want to be at this optimal level. And the key thing I took away was aim for 1000mg. It's going to be EPA and DHA combined, roughly 50 50. But you weren't too worried about it being 60, 40 or 70, 30. Critically though, you can't just buy something that on the front says 1,000 milligrams of fish oil. You need to turn it around and look on the back. And it sounds like you might find that those amounts of EPA and DHA might be quite a bit lower. So you need to do a little bit of calculation to make sure that you're not buying something that seems good on the front but is low on the back. And that is sort of what you do. And that would be your advice for someone who wants to get to the optimal basis.
- [63:17]
Dr. Bill Harris
Right, right. Well done. Well done.
- [63:21]
Jonathan
I'll leave you with one final thought. What if there was one simple habit that when repeated, could change how you feel for the better? I'd like to tell you about something that I do daily for my own health. It's called Daily 30, the gut supplement developed by our scientists here at Zoe. Daily 30 is made of over 30 hand picked plants, including seaweed, fungi and different types of fiber. It's a source of plant protein, omega 3 and vital minerals. You simply add a scoop to any meal once a day to support your health and increase the plant diversity in your diet. And unlike synthetic supplements, Daily 30 actually tastes great. It's designed to be enjoyed, because when a habit brings you joy, you're far more likely to stick with it. So next time you feel like your plate is missing extra plants, do yourself a favor. Try Daily 30. It's a delicious and healthy habit that you'll feel good about and one that your gut will definitely thank you for. By the way, whenever we talk about Daily 30 as a good source of fiber, we're required to say that it contains 4 grams of total fat per serving. Obviously, that's all amazing. Healthy fats from plants, so order yours today@zoe.com daily 30.
- [64:34]
Zoe
See you next time.