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Media Responses

Omega 3: supplement or not to supplement? That is the question.

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Last week we saw the media share their views on the recent Cochrane review, omega 3 fatty acids for the primary and secondary prevention of cardiovascular disease.

In the UK it’s recommended we consume two portions of fish per week, one which should be oily (mackerel, salmon, fresh tuna, herring, sardines to name a few) to enable us to obtain decent levels of omega 3 fats important for cardiovascular health, brain function and reducing inflammation. Omega 3 fats are essential which means our bodies cannot make them, we must obtain them from our diet. There is no UK dietary guideline for consumption levels of these fats however research suggests one portion of oily fish per week provides adequate amounts. But what if you don’t eat fish, for personal or health reasons? Well, you can either choose other sources, such as rapeseed oil, walnuts and soya products, or take a supplement. Or can you?

Once again we are hit by a headline, not wholly representative of the actual study in question. So here’s a short overview:

This study in question was a meta analysis, where a search criteria is provided and many already published studies are collected based on them meeting or not meeting the criteria. In total there were twenty five studies which made the cut.

In this case the criteria included both genders, across many different continents both healthy and some with pre-existing medical conditions. This is a major limitation of this study (but more on that later). Participants were given a supplement rather than obtaining omega 3’s from the diet.

The review claims to compare the effect of omega 3 supplementation on heart disease risk and death as well as mortality from all causes.

The conclusion was supplementation shows no change in mortality from any cause. But don’t stop taking your supplements yet. Whilst supplementation wasn’t successful in these individuals, it may be because they already have cardiovascular disease. There was no sole comparison of what supplementation can do for a healthy individual. In addition, there was no reference made to the impact of omega 3’s coming from your diet either.

Let’s revert back to the title – Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. But it’s not really examining that is it? Because first up it only measures supplementation and secondly prevention would generally mean those without the disease already? Wouldn’t it? It’s quite difficult to claim omega 3 supplements don’t prevent cardiovascular disease if the participants already have it? Perhaps something like “the impact of omega 3 supplementation on cardiovascular risk and all cause mortality in those with pre-existing medical conditions” might be better. Anyway I’m getting a bit sciency now….so moving on!

As always, if you can obtain your omega 3 fats from foods, please do, because you get so many other benefits from them too!

Sources of omega 3

Oily fish: salmon, tuna steak, sardine, herring, mackerel, oysters, anchovies,

Other sources: rapeseed or canola oil, chia seeds, walnuts, flax seeds, soya beans or soybean products

Only resort to a fish oil supplement if you don’t (and can’t) have any of the above in your diet throughout the week. And if you think you may need a supplement make sure you check with your doctor, dietitian or nutritionist for the best one for you. This will depend on your own personal circumstances including things like if you take other medication or think you might be pregnant.

References:

Abdelhamid. A, Brown. T, et al. Cochrane Database of of systematic reviews. Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. 18th July 2018.

Diets

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In the last 10 days the media have saturated us with a few main headlines relating to food and diets. The first being ultra-processed foods and cancer and the second relating to low fat or low carb diets being better for weight loss and the third focussing on millennials and body weight. I just want to clarify a few things:

The thing is, there is no perfect way to eat. There are no good foods and no bad foods. What works for one, won’t for someone else, that’s why it takes time to get it right, for you. We are creatures of habit, we stick to what we know which is why often people struggle to try new things and change habits that have perhaps been there since they were first born. We like our comfort zone and that’s ok. We live in an environment where whatever we want, we can have, almost instantly and that will have detrimental effects in the long term.

ULTRA-PROCESSED, a word, as a nutrition professional that never really entered my vocabulary until last week. In this day and age we’d be hard pressed to find something that’s not ultra-processed and be able to live the lives we do without using them. From coffee, to bread and hummus to tinned tomatoes, these are all processed. We are busy, and often we don’t have time to prep, chop, cut, steam, bake, fry and serve up a dinner for 6, so buy the pre-cooked rice that you can cook in the microwave and if you have the time to cook a roast dinner from scratch on a Sunday then do that too. There is no doubt that many of us do consume too many processed food, some which is ultra-processed, normally from the less nutritionally dense category. When we examine diet and the link between disease there are so many other factors that come into play, physical activity, smoking, stress and alcohol consumption to name a few. So don’t demonise one thing, I thought we were done with that, just try to get it right most of the time, because that’s real life and pretty normal for most. Oh and ultra-processed, I don’t think we need to contend with another word in the food industry, processed is surely enough.

LOW CARB OR LOW FAT – there is no right answer. If weight loss is a goal for you then it’s a consistent calorie deficit and diet quality that’s important. It’s about taking time to assess your diet as a whole and make small and sustainable changes that you can maintain forever. If you want to measure weight loss then you are going to need to measure what you are eating and when you are moving. Every single short term diet you have ever been on will have reduced your calorie intake in some way, more than likely through the companies own clever marketing, however in a way that isn’t sustainable so keeps you returning time and time again. It takes time to work out what a consistent calorie deficit will be for you, enough to keep you feeling satisfied and not so low that you feel hungry and can’t maintain it whilst ensuring you till enjoy food. And you know what, most of the time it’s hard to do this alone, so get professional advice, you might pay an accountant to deal with your finances so why not do the same for your food intake. Even if its just to take a look at your overall diet to make some positive changes.

MILLENIALS – scaremongering was perhaps not the best way to promote this article to the general public, that also included fat shaming which is something I detest. There is no doubt that carrying excess weight can be detrimental to your health and is linked to many health conditions, such as cancer and type 2 diabetes. But using overweight or obese as a general terms isn’t helpful. All we need to do is look at the environment we are surrounded with and it’s no wonder we are where we are. Education is pivotal, awareness is vital but no matter how educated we are if all we have is what’s right in front of us that’s generally what we’ll end up having. We do need more regulation, we need help from the government and we need more businesses supporting the health and wellbeing of their employees and students.

CONSISTENT THEME – eat a bit of everything, keep it balanced, you know your own limits and do not under any circumstance demonise food. EVER.