Fish Oil  or Flax

You may have realised by now – especially if you have bought the new updated edition of my book Let Food be Your Medicine, that my stance on flaxseed oil has done an about turn! Emerging evidence worldwide has now shown that fish oil is the omega-3 of choice, not flaxseed oil. Some people are able to utilise flaxseed oil, but they need to be young, in perfect health and have no shortage of an enzyme (commonly deficient) called delta-6 desaturase, to be able to convert the omega-3 fraction of the oil into usable EPA and DHA. If they don’t this could well become an inflammatory agent in the body.

My advice is to use flaxseed oil if you want to – for taste purposes. If you (like myself) have used it for a long time and found that your elbows and feet are still rough, that your inflammatory conditions don’t abate, and there’s no real difference to your skin – give fish oil a try (at a decent dosage!) and watch the amazing results! I believe this is what we should be doing, and have written an entire chapter in my new edition of Let Food Be Your Medicine to outline my findings, all based on medical evidence and trials. I only recommend pharmaceutical grade fish oil though, or ultra-refined as it will shortly be called. And remember, men shouldn’t be using flaxseed oil in any quantities – it has been shown to enlarge the prostate.

DEPRESSION AND FATS
Increased intake of omega-3 fatty acids has been shown to alleviate symptoms of depression. Researchers at the Erasmus Medical Centre in Rotterdam, Netherlands, created a study to examine how the ratio of omega-6 and omega-3 fatty acids might be associated with depression in older subjects. You may be aware that the optimum omega-6 to omega-3 ratio is 1:1. But because omega-6 is abundant in processed foods (while the primary dietary source of omega-3 is fish) the omega-6 to omega-3 ratio of a typical diet is by some estimates more like 20:1; a ratio that has been shown to be associated with depression.

The Rotterdam team recruited more than 260 subjects with symptoms of depression. Each subject was 60 or older, and 106 subjects in the group were diagnosed with depressive disorders. Blood samples revealing omega-6 and omega-3 levels from all of these subjects were measured against a control group of 461 randomly selected subjects. After analysing the results, researchers found what they called a "direct effect of fatty acid composition on mood." Subjects with depressive disorders had a significantly higher ratio of omega-6 to omega-3 fatty acids. This is not a surprise, of course, but rather a confirmation that a low intake of omega-3 fatty acids may be at the root of depression, especially among older people.
("Plasma Fatty Acid Composition and Depression are Associated in the Elderly: The Rotterdam Study" American Journal of Clinical Nutrition, Vol. 78, No. 1, 40-46, July 2003. "Low Omega-3 Levels Linked to 'Lows' in Elderly" 6/30/03. "Depression may Boost Heart Risk" BBC News, 10/10/00.)

Fish oil has been shown to be the very best source of omega-3 fatty acids on the planet. It also offers the converted form of DHA & EPA, which becomes prostaglandin series 1 and 3, easily assimilated and not channelled into the pro-inflammatory pathway (prostaglandin series 2) at all – which flaxseed oil ends up doing if not converted. It has been shown that only 0.2% of flaxseed oil ends up being converted into an anti-inflammatory form of omega-3 oil – makes much more sense to use fish oil all round!

I am often asked what addition to the diet, outside of increasing the intake of water and fresh green vegetables, I most recommend to fight and prevent disease and live longer. I always recommend pharmaceutical grade fish oil. People in general consume a dangerously insufficient amount of omega-3, a fat essential to good health but only found in fish oil and a few other foods. Meanwhile, our intake of omega-6, another fat found in corn, soy, sunflower and other oils, is far too high. The ideal ratio of omega-6 to omega-3 should be 1:1, but the typical person's ratio ranges from 15:1 to 50:1!

Benefits of omega-3 found in fish oil prevent and fight heart disease, cancer, depression, Alzheimer’s Disease, Diabetes, ADD/ADHD and many others. It gives you enormous energy (so many people ask me where I get the energy to do what I’m doing – I believe this is one of the things which help me personally), enables you to concentrate, improves memory, provides resistance to illnesses, flu and colds, helps pregnant women avoid premature birth, low birth weight and other complications. “While a helpful form of omega-3 can be found in flaxseed, walnuts and a few other foods, the most beneficial form of omega-3 - containing two fatty acids, DHA and EPA, which are essential to fighting and preventing both physical and mental disease - can only be found in fish” (Dr Mercola).

What do the Experts say about Flaxseed oil and Prostate Cancer?
Because I LOVE truth and new discoveries (even when I’m wrong and someone points this out to me!) I believe it’s important to pass truth ON, and help people recover from illness. I’ve seen in my own body, my husband’s – even my dogs! – the benefits of fish oil over flax oil, and have found flaxseed oil not to be the panacea I once believed it was (in fact quite the opposite!). So I happily admit that I was wrong initially about the benefits of flaxseed oil, in the face of the exciting evidence I have found on fish oil’s benefits. Findings need to be scientifically validated - I believe that’s what we see here.

Some articles I have recently come across (there seem to be mountains of these crossing my desk at the moment!) include the following. They are direct quotes from articles, and my comments would be in green! Enjoy!

FLAXSEED OIL & PROSTATE CANCER : By Udo Erasmus
“In their frenzy to boost sales, manufacturers of flax oil have greatly promoted (perhaps even over-promoted) its benefits but have not addressed the down side of flax oil. Flax oil has benefits, but it also has shortcomings. Overlooked, these can lead to serious health problems.

A recent review article points out that prostate cancer is increasing, and is the second leading cause of cancer deaths in the Western world. The etiology of prostate cancer remains unclear, course and progression are unpredictable, and definite treatment is not yet established. Lifestyle and diet could contribute to the progression from small, latent, non-metastatic tumors to clinically significant, invasive, metastatic lesions.

Of six studies done, one showed no correlation. One found a small (not statistically significant) positive correlation. Four studies found a strong positive correlation between ALA (alpha-linolenic acid) and prostate cancer. At least two other studies have also shown a correlation of alpha-linolenic acid with increased prostate cancer.

According to Prostate Forum, several labs have found that ALA is one of the most powerful growth stimulants for human prostate cancer cells. The Prostate Forum has recommended against the use of flax oil by men with prostate cancer. Since flax oil is the richest readily available food source of ALA, the reasoning goes, this oil should cause the most prostate cancer.

Science has become so technical that we’re nearing the Tower of Bable, where everyone talks and no one understands. We get lost in a sea of details, lose our common sense, and only drug manufacturers, whose products suppress symptoms without effecting cure, benefit from the confusion.

High fat fish, which contains more omega-3 than red meat, and in the form of EPA and DHA, that are even more fragile to damage done by light, air, and heat, lowers cancer risk factors. And raw high fat fish, in the form of Japanese sushi or sashimi, correlates with the least cancer.

Too much ALA in relation to LA is a factor that needs to be addressed. Omega-3 and omega-6 EFAs compete in the body for space on the enzymes that convert them into derivatives and eicosanoid hormones. Hence the ratio between them must be such that adequate amounts of both are converted.

A ratio of 2:1 of omega-3 to omega-6 will do this. So will a ratio of 1:4. In healthy people, a wide range of ratios is able to maintain health. In people with degenerative conditions, emphasis on omega-3 seems to be more effective. That’s because omega-3 intake has dropped to 1/6th of what people obtained in their diet 150 years ago, while omega-6 intake has doubled over the past 100 years.

This problem can be caused by flax oil. Flaxseed, used as the exclusive source of fats in the diet, will eventually lead to omega-6 deficiency. Both flax and flax oil have an omega-3: omega-6 ratio of 3.5 or even 4:1. Using such a ratio will result in the omega-6 EFA being crowded out from the enzymes. And that will lead to omega-6 deficiency symptoms.

The list of omega-6 symptoms is long but, relevant here, is the fact that omega-6 deficiency leads to deterioration of immune function, which in turn can lead to increased cancer growth.

A comprehensive list of omega-3 and omega-6 deficiency symptoms is found in the book Fats That Heal Fats That Kill. High omega-3 with low omega-6 can also be seen in other cancers. I have seen a reference in that regard for breast cancer.

What Should we Do to Protect our Prostate Gland?
Born in 1942, I’m in the age group of men that should pay attention to the condition of their prostate gland. I cannot give you medical advice or make decisions for you, but I can tell you what I do. I do not use, and recommend against the use of flax oil except in combination with other, omega-6 oils. It is a great source of omega-3 but a very poorly balanced oil.

I abhor the use of plastics for packaging liquids (water, oil, milk, juices, alcohol, tinctures, etc.). Liquids move all the time, and continually wash the inside of their container. You can taste plastic in water. You won’t likely taste plastic in oils, but they are even more likely to drift into oils than into water, because oils swell plastics. I do insist that my oil blend is packed in brown glass and further protected by a box to keep out all light.” Extracts by Udo Erasmus

Dr MERCOLA says:
“Ground flaxseeds are a useful addition to most people's diet. The unfortunate problem though with using them for most people is that when one has elevated insulin levels, the delta six desaturase enzyme is severely inhibited. This enzyme is responsible for converting the alpha linolenic acid (ALA) in flax to longer chain fats (like EPA and DHA) and it is easy to develop an excess of ALA in one's system, which is counterproductive.

So the flax seeds should be used sparingly and probably alternated with other ground grains, like sunflower seeds, sesame seeds and pumpkin seeds, which will help to balance the omega six and omega three ratios. Pumpkin seeds have other fats in them which are likely to be particularly beneficial for prostate health. The seeds should be freshly ground in a coffee grinder. I don't recommend the use of flaxseed oil however, particularly because of its instability. Five years ago, I used to recommend it to nearly all my patients and I noticed the majority of them could not tolerate it. This is despite the fact that they were using two of the best brands of flax oil in the country. I came to the conclusion that the nausea they were experiencing was a giant clue from their body and subsequently concluded that most people do not do well with flaxseed oil, which is why I no longer recommend it.”

The following article on Flaxseed oil is excerpted from the Prostate Forum (published August 2000) V5:2,7-8
Alpha-Linolenic Acid Charles E. Myers, Jr. M.D.

In previous newsletters we have stressed repeatedly that there are two problems with recommending alpha-linolenic acid to prostate cancer patients. First, there is no evidence that increased alpha-linolenic acid extracts or flaxseed oil provides any benefit to prostate cancer patients. Second, clinical studies that are available suggest that alpha-linolenic acid may actually be dangerous for prostate cancer patients. An epidemiology study that examines the association of alpha-linolenic acid and prostate cancer risk has just been published. Dr. Eduardo De Stefani and colleagues from Registro Nacional de Cancer, Montevideo, Uruguay, examined the association between prostate cancer and alpha-linolenic acid, linoleic acid, total fat, saturated fat, and monounsaturated fat.

This study found that the major risk factors associated with the development of prostate cancer were family history of this disease and intake of alpha-linolenic acid. When the risk was adjusted for intake of linoleic acid, saturated fat, monounsaturated fat, and red meat intake, those with the highest intake of alpha-linolenic acid had a 440% increase in risk compared with those at the lowest level. Also, alpha-linolenic acid from both vegetable and animal sources was associated with an increase in the risk of prostate cancer.

There are now six epidemiology studies that have examined the association between dietary alpha-linolenic acid and risk of prostate cancer. Five out of six of these studies found an increase in the risk of prostate cancer associated with alpha-linolenic acid. The one negative study is from Sweden. It is important to note that the Swedish study found this fatty acid had no impact and therefore did not show any benefit from alpha-linolenic acid. Thus, six out of six studies found no benefit to in-creased alpha-linolenic acid, while five found potential harm! I should also note that our laboratory, as well as others, found that alpha-linolenic acid is one of the most powerful growth stimuli for human prostate cancer cells.

Every time I write about alpha-linolenic acid and flaxseed oil, we receive a flood of E-mails and letters asking if we are really saying that these fats are dangerous rather than helpful. After all, these other experts are all telling us to take flaxseed oil. To this I can only repeat that the evidence currently available certainly fails to document any benefit as far as prostate cancer treatment. Further, laboratory and epidemiology studies continue to suggest that it may be quite dangerous to increase your intake of alpha-linolenic acid as it may well increase the growth and spread of your cancer.

I have been asked to comment on flaxseed compared with flaxseed oil. My major concern is with flaxseed oil, which permits patients to ingest very large a-mounts of alpha-linolenic acid in a short period of time. While flaxseed contains alpha-linolenic acid, it is quite unlikely that someone will eat enough flaxseed to match the alpha-linolenic acid content of even a modest dose of the oil.

While I am not as concerned about the safety of flaxseed, I certainly do not recommend it as treatment for prostate cancer. In preparation for this issue of the newsletter, I have reviewed every paper on the health benefits of flax seed in the National Library of Medicine database, Medline. There is no evidence that flaxseed slows or prevents the growth and spread of prostate cancer. “

Dr Charles E Myers, MD

References
P. K. Pandalai, et al. "The effects of omega-3 and omega-6 fatty acids on in vitro prostate cancer growth" Anticancer Res 16: 815-820, 1996.
E. Giovannucci, et al. "A prospective study of dietary fat and risk of prostate cancer" Journal National Cancer Institute 85: 1571-1579, 1993.
P. Gann, et al. "Prospective study of plasma fatty acids and risk of prostate cancer" Journal National Cancer Institute 86: 281-286, 1994.
S.O. Anderson, et al. "Energy, nutrient intake and prostate cancer risk: a population-based case-control study in Sweden" International Journal of Cancer 68: 716-722, 1996.
P.A. Godley, et al. "Biomarkers of essential fatty acid consumption and risk of prostate carcinoma" Cancer Epidemiology Biomarkers and Prevention 5: 889-895, 1996.
S. Harvei, et al. "Prediagnostic level of fatty acids in serum phospholipids: omega 3 and omega-6 fatty acids and the risk of prostate cancer" International Journal Cancer 71: 545-551, 1997.
J. C. Tou, et al. "Dose, timing, and duration of flaxseed exposure affect reproductive indices and sex hormone levels in rats" Journal Toxicology Environmental Health 56: 555-570, 1999.
L.U. Thompson, et al. "Experimental studies on lignans and cancer" Baillieres Clinical Endocrinology Metabolism 12: 691-705, 1998.
A. P. Simopoulos, et al. "Essential fatty acids in health and chronic disease" American Journal Clinical Nutrition 70: Supplement 3, 560S-569S, 1999.

On a personal note:
I have a very current “testimony” of my own regarding fish oil. My husband and I are both extremely busy, stressed people – and stress raises cholesterol, even if you are eating well! To cut a long story short, my cholesterol fractions (some of them) had risen very slightly though not dangerously, and at my last annual test a few days ago I was astounded to see ALL had gone right down into SUPER-healthy levels! The fish oil is the only change we have made to our regimen, 6 months ago now. My HDL has climbed yet another point, and I’m absolutely thrilled to bits (it’s already fantastically high, but we can’t have too much of this healthy fraction). My husband’s readings were nicely down, looking really good, and his triglycerides, which were through the roof last year are now right down to safe, normal markers! (My dear husband loves sugar.. but has promised to change!) I knew fish oil lowered triglycerides dramatically but this has been astounding to experience first-hand – and it’s always exciting to see it one’s own family. The interesting thing is this - we have both only really swapped from flaxseed oil (which was definitely raising many of our levels if you look at the results of our tests over the past few years) to fish oil which has now lowered and normalised our levels! Once you have your own testimony or personal experience, it’s such powerful proof you can’t be persuaded otherwise. We’ve watched our levels for 13 years now and charted them annually. We noticed with the advent of flaxseed oil about 6 years ago that our levels rose (and many people reported weight gain) – but in just a few months are way back down to more than healthy levels – best we’ve had in 13 years.