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Comment by pvnick | Hacker News Reader

  Omega-3 fatty acids, which are important components of
  many healthy foods, such as seafood, nuts, legumes and
  leafy green vegetables, act to reduce inflammation

Score another point for fish oil supplementation, on top of the already enormous pile of scientific research showing it to be a miracle chemical (and I definitely don't say that lightly) [2]. Seriously, if you aren't getting enough omega 3 fatty acids, either from regularly eating lots of fatty fish or through supplementation, you're seriously missing out on some good stuff. Among supplement enthusiasts, it's consistently declared to be one of the only supplements that's actually useful. I prefer the liquid form [1].

[1] http://www.amazon.com/Now-Foods-Omega-Lemon-Flavor/dp/B001B4...

[2] http://examine.com/supplements/Fish+Oil/

Edit: added [2], a well-written examine.com page summarizing fish oil effects

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It's not that fish oil is an unalloyed good, mind; just that we get way too much Omega-6 in western diets, and it seems that Omega-3 "cancels it out." In cultures with balanced Omega-3/6 intake, like Japan, fish oil has no benefit.

Correct. The alternative to pounding fish oil supplements is simply stop eating so much refined seed and vegetable oils. A ratio can always be fixed in at least 2 ways obviously.

It's harder than that. Our food supply has changed; sixty years ago when cows ate grasses, beef naturally had some omega-3s in it. Now that their diet is largely corn, beef brings virtually all omega-6s.

Ditto for "shelf-stable" foods. Omega-3 fatty acids go rancid at room temperature, so many packaged products have had the omega-3-based fats removed so they'll last longer on the shelves.

Source: my wife, who has a PhD in nutrition.

My understanding (from investigating this a couple years ago) is that grass-fed beef, while higher in O3's than corn-fed beef, is not a particularly significant source of dietary O3.

I think that is accurate. I only meant to use beef as an example of how our food supply has changed, not to suggest that beef is any sort of good source for omega 3s.

Check out http://www.ncbi.nlm.nih.gov/pubmed/16500874

Correct me if I'm wrong, but it's not just that grass-fed beef is higher in Omega 3, but lower in Omega 6. So it's not just about Omega 3 intake, but the ratio between the two.

I believe that is the main reason it is labelled as such and more expensive than regular grain fed beef. Same with free range/cage-free eggs.

Wild Salmon should be a good omega-3 source, while Norwegian grown salmon is probably not.

Here is a link to small study about this.

> The results show a little more of the healthy long-chain marine omega-3 fatty acid forms known as EPA and DHA in farmed salmon than in wild salmon.

> [..]

> “Indeed, there is a larger amount of omega-6 in farmed salmon. You get nine times as much as when you eat wild salmon,” says Research Fellow Ida-Johanne Jensen at the Norwegian College of Fishery Science.

http://sciencenordic.com/farmed-salmon-retains-good-fats

So it says that farmed salmon has slightly more O3 and 9x more O6. But how are the absolute ratios, is the salmon O6 content enough to matter if we want to balance out the presumably much larger O6 already in our bodies?

There's a certain optimal ratio between the various omegas. You could get too much or too little from any particular kind. It just happens that modern diets have too much omega-6 and not enough omega-3.

Plus the Japanese diet tastes better than a fish oil gel cap ... speaking of which, does this mean that the incidence of depression in Japan is low?

Well, according to this article about a recent study:

http://www.washingtonpost.com/blogs/worldviews/wp/2013/11/07...

Japan has the lowest rate of diagnosed cases of depression of any country in the world (<2.5%). Of course, there could be other causes for this, and the accuracy of how well the diagnosed rate represents the actual rate is an open question. In particular, in east asian countries thre seems to be a cultural taboo against admitting mental illness and seeking treatment in order to get diagnosed in the first place. The fact that Japan has one of the highest suicide rates of any country in the world is an especially telling statistic that the diagnosed rate may not be telling us everything.

I work in the pharma industry in Japan and I can confirm that depression is massively under-diagnosed, and that the market for depression treatment is expected to boom in the coming years. So much, that they are now doing TV campaigns to encourage people to be diagnosed. So yeah, don't count on the current statistics to tell you anything significant, there are many cultural barriers at play in Japan, just like for many other aspects of the Japanese life.

> I work in the pharma industry in Japan

I wonder if we've crossed paths in some way before. I also work in the pharma industry (peripherally?).

Maybe we have? :) We should exchange contacts :)

I just realized why your username looks familiar -- we just talked in the Kyoto HN Meetup thread the other day.

Indeed - if you ever come to any HN Kansai event you'll probably see me there :)

How can I get in touch with you?

get on pandoralive.info and hit the "about us" section and there is a contact form there :)

So you will be working hard to make sure that Japan knows that it is depressed, and your pills will solve the problem for them, eh? Sounds honorable, kimosabe.

There's nothing wrong with using pills. I've had severe MDD (clinical depression) since childhood and my mum is the last person who would resort to feeding me pills; they were the only things that were effective enough to let me live my life somewhat normally. They still are.

I tried to substitute them a few times with more exercise, herbs, teas, voodoo, and comedies. I'd be OK for a week or two, but I'd eventually start degrading into a shit state.

Thank the fuck and heavens for the pharmaceutical industry.

First, I don't work on Depression so I can't really answer your comment in any sensible way. I was just sharing my knowledge of the market. Besides, there are conditions where you need treatment. I don't know if you have ever met REAL people suffering from depression but basically when you have that condition you can't function at all anymore. You can't work, you can't have friends, you can't communicate well anymore and when you reach that point I tell you you'd be glad to be able to take some pills to make you a normal person with normal emotions again. Your comment makes me think you don't really know what you are talking about, because depression can lead to suicide and having the right drug at the right time can really save you. I'm not saying the solution is ONLY about drugs, but when you hit the bottom, it's helpful to get back up.

Might be nice if societies didn't develop dependencies on massive, corrupt, for-profit, international pharmaceutical agencies though, wouldn't you think?

While we’re all for disruption here at hacker news, the International Socialist Revolution variant of it seems to not be as popular in these parts.

(Un)fortunately, depending on whether you consider previous implementations the best possible ones or not.

Hey, whatever your -ism, there's still gotta be a Dealer in the addict equation, right? Its not like these things synthesize themselves...

A healthy diet is really not a remotely sufficient substitute for a healthy social context.

One of the reasons there's a link at all is because we often eat with people.

It may not be that deterministic, as if it's either diet or social context. One thing can feed on the other.

It can start as an emotional response, deflagrating an inflammatory process, revealing the nutritional deficiency. Or it can start with a nutritional deficiency, deflagrating an inflammatory process, which the brains reads as depression.

This mechanism is already seen regarding stress and magnesium. High stress -> Mg depletion. Low Mg -> Stress symptoms.

I wonder if we can make the assumption that a suicide must have come from depression. Or at least, I'm not sure if the reasons/depressions experienced in Japan are comparable to other countries. I'd also agree that the admittance of mental illness may be lower than the actual. There are some pretty strange conditions out there, like hikikimori.

Right, I'm not saying that suicide necessarily comes exclusively from depression. Obviously there are other cultural factors at play in Japan that may lead to higher suicide rates. Just that the massive discrepancy between suicide rates and diagnosed depression rates is suggestive of the fact that the actual depression is at least somewhat higher than what we see.

The Cochrane review on omega-3 fats in 2004[1] didn't find any clear benefit concerning Mortality/Cardiovascular problems/Cancer.

[1] http://summaries.cochrane.org/CD003177/there-is-not-enough-e...

Follow-up studies, such as this 12,000 person RCT [1], have not been any more favorable towards omega-3 fatty acids.

When my patients ask me if they should take omega-3 capsules, I tell them that it depends on whether they enjoy paying for them. (Some do.)

1 = http://www.nejm.org/doi/full/10.1056/NEJMoa1205409

FWIW, fish oil demand is driving overfishing.

http://www.wired.com/science/planetearth/magazine/15-06/st_i...

There are environmentally better sources, thought they are, naturally, not as cheap.

In terms of $/gram of Omega3, flax oil is much, much cheaper than fish oil.

http://www.amazon.com/Barleans-Organic-Oils-Lignan-16-Ounce/...

http://www.barleans.com/images/supplemental/ot-lignan12oz-su...

It also has a lot of 6&9. I'm assuming that still moves you towards a good balance. Can someone tell me I'm mistaken?

I am not an expert, but I've read in many places that the omega-3 in flax oil is far inferior, to the point of almost being worthless, compared with fish oil. IIRC the problem is that flax contains omega-3 in the form of ALA, in contrast to fish oil, which contains EPA and DHA -- the forms we actually need. The body can convert ALA to EPA and DHA, but the conversion process is extremely inefficient (something like only 5% get converted).

"The body can convert ALA to EPA and DHA, but the conversion process is extremely inefficient (something like only 5% get converted."

Interesting. I wonder if that would be practical to do synthetically.

There are companies working on growing omega-3 using algae.

It's already being done. Horizon organic milk has DHA and Omega-3 added from algae products. "While some DHA is derived from fish, we use only plant-based, water-extracted DHA": http://www.horizondairy.com/products/milk-plus-dha-omega-3/w...

I have a fish allergy that makes me a bit nervous to take fish oil. I tried fax seed and stopped after reading about its ineffectiveness. How much milk should I be drinking for the Omega-3 benefits?

Edit: let me be specific. According to the web, each serving of this milk contains 32mg DHA Omega-3. The fish oil recommendation seems to be 3 grams of fish oil. How do these equate?

You have been able to buy it at fancy health food stores for several years now.

You can already buy several different kinds of algae-derived omega-3 DHA supplements on Amazon. But the best deal there is Ovega-3, which at $0.29 per pill is about twice as expensive as fish oil.

You are mistaken. The ration of 6&9 to 3 is what you want to reduce. And as the others have said, ALA is a drastically less useful version of o3.

Now..feeding flax seed to the chickens in your backyard and eating those eggs is an even better (and sustainable) way to get omega 3s.

Unfortunately, due to the nature of the 'balance' (preferential binding), anything less than 1-1 in favour of Omega-3 is as useless as nothing. So, something with close to 1-1 ratios, like flax seed won't make any difference unless you eliminate omega-6's from your diet entirely. This isn't just impractical - it's so limiting, you'll have trouble with other nutritional requirements.

Many diets eschew flax seed in general, but something to keep in mind is that unground flax seed itself is a good source of fiber. Mind, I'm not saying it's the best source of EFA's, but it's far better than junk food or fast food. I typically will put a very large spoonful of flax seed into about 3/4cp of Greek yogurt and add a little honey for a tasty treat, but I do also supplement with fish oil pills. I'll also add glazed walnuts to a bowl of plain old oatmeal for a filling and healthy breakfast.

flax has a lot of ALA omega 3's, which are less usable than the EPA/DHA in fish oil

I am not a fan of flax. Let me suggest walnuts as an alternative. Let me also suggest that consuming less of the "bad" oils is a much more effective preventive measure than eating whatever crap and then trying to supplement with a "good" oil.

Due to the nature of the preferential binding, the 3/6 has to be 1-1 or greater to do >any< good, and since walnuts have a 0.24 : 1 ratio in favour of omega-6s, unfortunately, you wont getting any benefits of omega-3s from walnuts.

Apart from algae sources, the alternatives are a couple of pints of flax seed every night, or going without so many things that you run risk of malnutrition. So, nuts/seeds aren't a solution.

I am curious what your background is/where you get this info? Because that does not fit with my personal firsthand experience with getting well in spite of an incurable inflammatory condition that is supposed to kill me and frequently makes me suicidal if I eat the wrong things (especially the wrong oils).

Thanks for the feedback.

Perhaps you had much worse than a 0.24 : 1 ratio.

I've switched from using fish oil capsules to eating sardines as they are quite high in Omega 3 (around 1g per 3oz), low in mercury, in no danger of overfishing, and relatively cheap.

Sardines are also a fantastic source of calcium. They're a super food. And sustainable to boot.

Well, not perfectly sustainable:

http://en.wikipedia.org/wiki/Cannery_Row

Seafood watch says they are ok: http://www.montereybayaquarium.org//cr/SeafoodWatch/web/sfw_...

Costco sells Wild Planet brand -- cheap, tasty, and sustainable.

There exist other places where sardines are fished other than that one place that overfished.

Right, that's the "perfectly" part.

I've heard good things and I'm seriously starting to consider adding them to my diet, how do you prepare them?

Tinned sardines gently mashed on toast with a splash of Worcestershire sauce or similar.

They're also good with lemon juice on top if you're not a fan of Worcestershire sauce. Or you can melt cheese on top for a variation of the classic tuna-melt.

Also, if you want to avoid the extra omega 6 fatty acids, get the sardines that are packaged in water or olive oil (which is mostly monounsaturated fatty acids) rather than soybean oil.

Add an egg or two and make Fisherman's eggs. (Random google recipe: http://thingsmybellylikes.com/2013/03/25/fishermans-eggs/ ) Super high-protein and IMO tasty. Add some cheese on top for a bit more flavor.

Personally, I just eat them as a snack or light lunch straight from the can. Or perhaps chopped into bits over a salad. Sometimes I even mix them with a little brown rice.

Mash up with a fork plus half of a raw shallot (diced), optionally a bit of chili powder or black pepper. Spread on toast. Adding some slices of tomato, cucumber, or hard cheese is nice of you have them.

This is one of our fallback lunches/snacks when we haven't made it to the store recently and/or don't have time to cook.

All you need is a few drops of lemon juice.

I believe that it is certain types of fish oils that are leading over fishing.

For instance if you were to buy salmon oil and the salmon was farmed raised then farmed issues aside you wouldnt be overfishing.

I believe that generic fish oil does lead to overfishing but if you by fish oil from Wild Salmon chances are they arent fishing solely for the oils.

http://www.seafoodwatch.org/cr/SeafoodWatch/web/sfw_factshee...

Farming salmon contributes to overfishing

http://www.bloombergview.com/articles/2014-02-24/your-best-s...

And someone once said, "This farmed salmon tastes like cardboard." To which the old fisherman replied, "That is very unfair. There are some palatable cardboards out there."

... along with a host of other issues.

Farmed salmon doesn't have the useful amounts of omega-3s, since they don't produce actually produce them. Wild salmon eat krill, which eat algae, that are ultimately the source.

Any source on that? Here[1] it says otherwise : "farmed salmon generally has more omega-3s, it is sometimes a more healthful choice than wild."

[1] http://www.washingtonpost.com/lifestyle/food/why-farmed-salm...

how depressing.

"on top of the already enormous pile of scientific research showing it to be a miracle chemical (and I definitely don't say that lightly)"

http://www.badscience.net/category/fish-oil/

The research hasn't held up, but the marketing and supplement industry pretends as if it has.

There is recent research linking fish oil and prostate cancer, especially more aggressive forms of prostate cancer.

http://www.nlm.nih.gov/medlineplus/podcast/transcript090313....

I was going to link that too if someone else didn't. But since the base rate is already about 150/100,000 per year, and 15% over a lifetime, and the survivability for prostate cancer is high, the increase isn't really that much and the benefits outweigh the risks for me.

The great majority of effects tested and listed in the 'Human Effect Matrix' at [2] are either minor in magnitude or non-existent. That would seem to contradict your statement that Omega-3 is a miracle chemical.

Am I reading it wrong?

This is reads as "minor or nonexistent?

  Evidence Level  Effect      Change    Magnitude  Consensus
  A               Depression  Decrease  Notable    100%

No, and I didn't say it did.

The parent to my original comment claimed that Omega-3 is a "wonder chemical", having many beneficial effects, and cited that website as evidence. I was responding to that claim by pointing out that the website does not in fact appear to back up their position.

The problem is you expanded OP's claim. For starters OP never used your interpretation of wonder chemical: "cures many ailments". The article was on depression and OP never broadened the "therapeutic horizon." The linked website did not describe the effects of fish oil on depression as "minor in magnitude or non-existent."

I think we disagree on the interpretation of

> Score another point for fish oil supplementation, on top of the already enormous pile of scientific research showing it to be a miracle chemical (and I definitely don't say that lightly) [2].

I read that as "here is yet another thing that omega-3 treats", rather than "here is yet more evidence that omega-3 treats depression". Especially since it followed a quote from the article about anti-inflammatory properties rather than specifically mentioning depression.

Followed by:

> Seriously, if you aren't getting enough omega 3 fatty acids, [...], you're seriously missing out on some good stuff. Among supplement enthusiasts, it's consistently declared to be one of the only supplements that's actually useful.

Among supplement enthusiasts, not among depression sufferers.

But then it can be so easy to misunderstand the written word; perhaps I missed the intent of the original comment.

Instead of killing fish, here is my favorite nut mix (BY FAR!), which also happens to be chock full of Omega-3:

http://smile.amazon.com/Planters-Nutrition-Omega-3-Ounce-Can...

Cannot recommend enough. A handful for a snack is filling, healthy and not too caloric.

So you might want to do some research on ALA, EPA, and DHA. Our ability to convert ALA to Omega-3 is apparently fairly limited. This link appears to be fairly well researched:

http://lpi.oregonstate.edu/infocenter/othernuts/omega3fa/

Too much sugar and processed seed oils (e.g. sunflower and soybean).

FYI: Ingredients Walnuts, Sweetened Dried Cranberries (Cranberries, Sugar, Sunflower Oil), Candy Coated Dark Chocolate Soynuts (Dark Chocolate {Sugar, Chocolate, Cocoa Butter}, Sugar, Oil Roasted Soybeans {Soybeans, Soybean Oil}, Artificial Color {Includes Caramel Color}, Corn Syrup, Gum Arabic, Confectioner's Glaze {Carnauba Wax, Beeswax}).

Without doing serious research on every ingredient listed above, let me suggest that you (or other interested readers) can just buy Walnuts for the same effect, without being exposed to all this other crap, which may be a problem for some people. Walnuts are unusually high in omega 3. I have a lot of dietary issues and I would be unlikely to eat the above (and I usually do not eat Planter's because most of their nut mixes are made with peanut oil, which is highly inflammatory and tends to make me psychotic and suicidal).

I cannot take fish oil. I am allergic to shellfish and I break out in hives when I take enough fish oil. So I have long eaten walnuts when I want to bump up my Omega 3 intake. But, for my purposes, a) avoiding problem oils does more for me than trying to specifically counteract them by adding other oils and b) eating less acidly also goes a long way to control my inflammatory condition.

Walnuts have more omega-6 than omega-3, so you're probably not getting any of the effect from it. The two cancel each other out.

http://www.hsph.harvard.edu/nutritionsource/omega-3/

Frank Sacks (Prof. of Cardiovascular Disease Prevention, Dept. of Nutrition)

> There are two major types of omega-3 fatty acids in our diets: One type is alpha-linolenic acid (ALA), which is found in some vegetable oils, such as soybean, rapeseed (canola), and flaxseed, and in walnuts. ALA is also found in some green vegetables, such as Brussels sprouts, kale, spinach, and salad greens. The other type, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), is found in fatty fish. The body partially converts ALA to EPA and DHA.

The effect might be that eating walnuts fills you up and makes you eat less potato chips. You're right of course, but don't underestimate how bad a place some people are coming from!

Given that I am supposed to be dead and I have gotten off multiple prescription drugs, my guess is that the approach I am taking is working. Granted, that proves nothing about walnuts per se since I have done a heckuva lot more than just eat walnuts sometimes. (But I also said -- twice -- that I recommend avoiding problem oils and other things as bigger factors.)

Make sure that the nuts you eat are sprouted. I generally try to eat only raw, sprouted, organic nuts, but they are expensive...

What's the advantage of sprouted nuts?

I can never stop at just a handful though

I dole things like this out to myself each day when I fix my lunch. If I'm going out for lunch I pack it anyways and usually eat it between 10:00-10:30am, keeps me from overeating at lunch. Otherwise, yeah, they'd last about 5 minutes.

Sometimes the simplest idea seems like the best solution. Perhaps not having the entire container in my desk drawer (half open) is not the solution.

Bit too much sugar there for my liking...

There is good evidence that supplementing fish oil does nothing to prevent death, but that eating fish does.

I haven't got cites but it was pretty clear on this BBC Radio Four programme - maybe someone else has got better sources?

http://www.bbc.co.uk/programmes/b019dl1b

(They talk about the dangers of Selenium supplementation in regions with plenty of bioavailable selenium in the soil, especially when combined with Vit E supplementation. These are not heroic doses either.)

Fish oil supplementation is, like most other supplementation, really only applauded by the supplement industry.

There's no proof any of it does much, which is why here in the UK all supplement advertising has to include disclaimers like "May benefit the elderly or those on a restricted diet"

There have been some decent clinical trials showing a high does of fish oil (something like 1g a day) improves mood better than placebo in bipolar depresssives. There are some risks to taking really high doses of fish oil every day though - and not just mercury content.

Similar trials for just doing plenty of regular excersise such as walking show a better result. Given that excersise is really good for you, it's probably a better option.

IIRC, you need a 1/5 (Omega 3 / Omega 6) ratio, but our usual diet is so poor in the former that we end up deprived.

Palm oil, which is everywhere, has Omega 6 aplenty, and (virtually?) no Omega 3. In Europe, it is usually listed as "vegetal oil" in the ingredients lists. When it's not palm, they put the full name.

palm oil is only 9% polyunsaturated, as opposed to something like canola which is 20%.

I had never heard of canola oil.

The ratio is ~1/2, which is pretty good to know.

> I had never heard of canola oil.

It is called different things in different places. Canola is actually a specific cultivar of Rapeseed. Canola actually stands for "Canada Oil" and the term probably isn't well known out of North America.

http://en.wikipedia.org/wiki/Canola

http://en.wikipedia.org/wiki/Rapeseed

South America, canola oil is pretty well known

Grass fed beef is apparently also a good source of Omega-3

http://www.ncbi.nlm.nih.gov/pubmed/16500874

Brazilian meat is grass fed. Which countries more export grass fed meat?

I don't know about countries exporting grass fed meat, but in the US there is a growing movement for raising grass-fed cattle and pastured chickens (for meat and eggs) usually within 100 miles of major cities, as opposed to grain-fed livestock raised in large factory farms.

The Omega 3 to 6 ratios of the resulting meat (and eggs) is better than the grain-fed ones. It seems that a lot of these inflammation problems are not only caused by the diet of the average person but also caused by the diet of the average livestock that we're consuming.

They cut down the rainforest to create those pastures which the cows graze on.

New Zealand exclusively produces grass-fed beef.

Also hemp hearts - available from some costco stores and most whole foods are an excellent source of omega 3s. They are good in smoothies too.

I think Andrew Weil's books are a good common sense source on supplements and he recommends fish oils purified to exclude mercury and PCB's. For counterexamples, I've noticed a few people taking quite large dosages of B complex vitamins. Dr. Weil notes that mega doses of B3 and B6 can cause problems including irreversible nerve damage. He also recommends against resveratrol supplements, another trendy thing.

Why do you prefer the liquid form?

try flax, not fish.

Please be aware of the issue of rancidity before taking any fish oil supplements.

http://blog.omega3innovations.com/blog/bid/215649/Is-Your-Fi...

Open a capsule of each new batch and smell it. Then put the package in the fridge, and keep it there. Problem solved.

The fridge alleviates many such issues.

I've had fish oil capsules that were packaged under nitrogen, specifically to reduce degradation before sale. But those are not cheap.

There's an obvious conflict of interest with that link. They discuss the rancidity of fish oil and then pitch their own fish oil product. I've heard rancidity of fish oil discussed before. It seems like a reasonable thing to be concerned with, but I'd like to see an impartial, scientific discussion.

I like Coromega brand because it can't become rancid. The oil is sealed in an air tight packet until you consume it.

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