Scientific evidence dating back to the late 19^th century continues to illustrate how food choices can bring us to disease’s door, as well as steer us from its path.

Some of the most exciting findings in disease prevention have circulated around essential fatty acids (EFAs), which not only protect against heart disease but other health conditions as well.

To prevent against these diseases, patients need to get more of these oily fats, specifically omega-3s, in their diets. As physicians, you play a key role in educating patients about this vital nutrient.

A Closer Look at Omega-3s

EFAs are lipids the body is unable to make on its own. They are mostly found and extracted as refined oils from plants and fish. These polyunsaturated fats stand in direct contrast to saturated fats and trans fats, which accelerate the incubation period and pathogenic alteration of coronary arteries. When EFAs are consumed, they are broken down into prostaglandins (hormone-like substances) that regulate a variety of physiologic processes and protect the heart.

EFAs come in two primary classes: omega 3s and omega 6s. The major fatty acids found in omega-3s are alpha linoleic acid (ALA) and its metabolites, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). A lot of research has circulated around omega-3s, specifically EPA and DHA. These metabolites, found mostly in oily fish, produce anti-inflammatory eicosanoids. On the other hand, omega-6s, which are found in vegetable oils, produce inflammatory eicosanoids. However, an equal balance of these two omega classes promotes good health.

Unfortunately, modern diets have skewed this balance over time. Instead of eating fish, we opt instead for processed foods, with vegetable oils, such as canola and corn oils. In fact, studies dating back to the 1960s show that the standard American diet often lacks the critical anti-inflammatory omega-3 fatty acids. Researchers estimate the current ratio of omega 3 to omega 6 fatty acids is between 1:10/1:25 respectively. A healthier ratio would be 1:2 or 1:1 omega 3 to omega 6.

The Omega Discovery

Scientists first discovered the role of omega-3s in heart health in 1978, when they took a closer look at the Greenland Eskimos’ diet. Despite eating primarily fatty fish, Eskimos had less coronary heart disease than Americans, Europeans and even contemporary Japanese. Scientists isolated the role of EFAs within the fish (specifically EPA and DHA) to reduce the risk of developing heart disease.

After years of cumulative data and scores of clinical research, the American Heart Association released a scientific statement citing the same protective benefit of omega-3 fatty acids.

Study after study has supported the role of omega-3s in heart health. For example, a report published last year in the Journal of Cardiometabolic Syndrome showed omega-3 fatty acids found in fish oil reduce the risk of coronary heart disease by decreasing triglyceride levels and blood pressure. They also improved inflammatory markers and endothelial function, as well as prevented cardiac arrhythmias. The study also showed that omega 3s reduced platelet aggregation and vasoconstriction of blood vessels; enhanced fibrinolysis; and reduced fibrin formation, microalbuminuria risk and the incidence of sudden cardiac death.

In another recent review in Clinical Science, epidemiological and case-controlled studies showed that omega-3 fatty acids reduced the risk of cardiovascular mortality. These researchers found that these fats decreased chemoattractants, growth factors, inflammatory eicosanoids (hormone-like substances) and cytokines. It also increased nitric oxide production, which improves vasodilation and endothelial relaxation of blood vessels. Thus, omega-3 fatty acids have the potential to decrease thrombosis as well as cardiac arrhythmias.

Another study, which followed 85,000 women over six years, showed that women who consumed fish only once or twice a month vs. those who consumed fish two to five times a week were less prone to stroke, thrombosis and high blood pressure.¹³ Other research shows that people who predominantly consume nonhydrogenated, unsaturated fats (primarily in the form of omega-3) significantly reduce the risk of developing heart disease.

A Wider Salve

The important role omega-3s play in maintaining heart health cannot be denied. But this lipid is also protective in other disease processes. For example, we now universally accept that omega-3s reduce elevated cholesterol levels, have powerful anti-inflammatory properties and help build the brain. Their ability to help normalize blood sugar and manage diabetes, as well as offer relief to people suffering with osteoarthritis and rheumatoid arthritis also have been well documented. 

Emerging evidence also indicates that alternative sources of omega-3 fatty acids, namely Neptune Krill oil (NKO), provide similar benefits as fish oil.

From the Antarctic waters, NKO is considered the world’s largest animal biomass on earth with an estimated 500 million tons of krill habituating the northern seas. These shrimp-like crustaceans are rich in three phospholipids: phosphyatidycholine, phosphatidylinositol and phosphatidylethanolamine, all which contain high amounts of EPA and DHA. The sea algae that krill consumes gives it and other crustaceans, such as lobster and shrimp, their reddish-pink color.

Researchers are particularly excited about this source of omega-3 fatty acids because studies show it can inhibit inflammatory reactions, as a result of being able to lower C-reactive protein levels. Many physicians use C-reactive protein levels, which indicate systemic inflammation, as biomarkers for detecting disease. In fact, some health officials believe that elevated C-reactive protein levels more strongly indicate the presence of heart disease than elevated cholesterol levels.

Neptune krill oil has an additional benefit: high concentrations of the antioxidant astaxanthin. Astaxanthin is a red pigment found naturally in a variety of caretenoids, which are fat-soluble pigments found in plants and algae. Antioxidants can help to neutralize the free radicals that damage the cells and DNA, cause cancer and accelerate aging.

Cholesterol Modulation

A series of recent studies by Canadian researchers found that krill oil was also effective at lowering cholesterol levels, especially LDL cholesterol (the bad cholesterol) while raising HDL (the good cholesterol) up to 44 percent in some cases.

A current study appearing in Alternative Medicine Review provided a group of 120 participants with Neptune krill oil, fish oil or a placebo. The krill oil reduced LDL cholesterol by 34 percent and raised HDL cholesterol by 13.5 percent, as compared to 4.6 percent and 4.2 percent in respective categories by omega-3 fish oil. These researchers also reported that 1.5 grams of Neptune krill oil was more effective at reducing cholesterol levels than 3 grams of omega fish oils.

The most impressive aspect of this study was that after more than three months on a maintenance dose of 500 mg of Neptune krill oil twice daily, total cholesterol levels dropped by 19 percent. The continued use of Neptune krill oil at 500 mg/day further reduced LDL cholesterol by 44 percent and triglycerides by 25 percent while HDL levels went up 33 percent from baseline. The researchers here concluded that NKO’s rich source of phospholipids, especially astaxanthin, was responsible for its medicinal benefits.³⁴

Based on collective data over the last decades, omega-3 fatty acids play a key role in reducing and reversing heart disease, but also in preventing other diseases. Thus, the health care practitioner now has a viable option to prevent, treat and eliminate the pathogenic alterations associated with a myriad of disorders.

Based on current research, I would suggest 1 gram to 1.5 grams of omega 3 fish oils for patients. Emerging data also suggests a similar daily intake of Neptune krill oil.

While the fatty acids found in omega-3 fish oils remain the pre-eminent and the most widely researched source of essential fatty acids, Krill oil also may serve as viable complementary or adjunct supplemental option.

No matter how you recommend patients get their omega-3, you can play a key role in ensuring these oils become your patients’ predominant sources of fat. All current indicators suggest this extra step could save you—and your patients—from dealing with a life-altering diagnosis years down the road.