Omega-3s for vegetarians

Next time you’re in the supermarket, take a look at some of the products fortified with omega-3 fatty acids: waffles, peanut butter, eggs, milk and yogurt, bread, orange juice and fake butter spreads.

 

Are sources of omega-3s for vegetarians as potent as cold-water, oily fish such as salmon and sardines?

 

Fish and fish oil are generally regarded as the best sources of these fatty acids, which we need to get from food, so what’s a fish-shunning herbivore to do? Especially when research has concluded that a diet rich in omega-3s:

 

• Reduces inflammation
• Prevents cardiovascular disease (CVD),
• Improves immune function (autoimmune disorder prevention)
• Reduces allergic reactions
• Staves off depression

 

A study in the Yale Journal of Biology and Medicine analyzed research on fish oil dating back to 1970 and concluded that omega-3s reduce blood cholesterol and triglycerides as well.

 

(The same study also revealed that very high doses may prolong bleeding. Another study, from the University of Connecticut, stated that high doses cause blood vessels to rupture, possibly inducing stroke, so don’t start popping a fistful of fish oil pills.)

 

Strict vegetarians can cut out the middle man, er, fish

Fish aren’t born naturally oozing omega-3s out of their gills. It’s their diet of algae, krill, plankton and other microscopic primordial matter that flush the fish full of fatty acids. In essence, we get omega-3s from the fish because fish eat algae.

 

Strict vegetarians can now take supplements derived from algae that are free of fish oil. It’s best to get an algae supplement that contains both DHA and EPA, which are two of the three omega-3 fatty acids and regarded as the most beneficial fatty acids for health.

 

Fish oils are loaded with DHA and, to a lesser extent, EPA, both of which are found in the human brain and retina. One would assume that since fish get their fatty acid profile from algae, that algae supplements would be just as efficient as consuming a salmon filet.

 

Are DHA/EPA supplements as effective as whole fish?

We don’t know for sure, says, Edward Dennis, a professor at the University of California San Diego and editor-in-chief of the Journal of Lipid Research.

 

“Until researchers run a controlled study, it cannot be concluded that omega-3 supplements are as effective as omega-3-rich fish,” says Dennis, who is part of a "lipidomics" team of researchers, mapping out all the fatty acid molecules in the human body, much like "genomics" researchers a decade ago sequenced and mapped the protein-rich DNA sequences.

 

How many milligrams of omega-3 should I have each day?

Dennis also thinks there’s not enough scientific data for recommended dosages, although many health articles will suggest going for about one gram per day.

 

“Most physicians who give recommendations — either for vegetarians and omnivores — don’t have a basis for the dosage,” he says.

 

Should vegetarians consume more omega-3’s than non-vegetarians?

Not necessarily so, says a fatty acids researcher, who, coincidentally, is allergic to fish.

 

Dr. David Bernlohr of the University of Minnesota says he can’t eat fish because of an allergy, but he can stomach fish oil supplements.

 

“Certain fish have the highest fraction of omega-3s but you can clearly reach an equivalent amount by eating plant-based sources and taking supplements,” he says. “Even strict vegetarians can reap the benefits of the anti-inflammatory and immune-boosting properties that omega-3s offer.”

 

What about walnuts and flax seeds or oil? Aren’t they super rich in omega-3s?

Natural vegetarian sources like walnuts and flax seed and flax oil contain more ALA, the third type of omega-3.

 

Thus the dietary paradox for the strict vegetarian: On one hand, ALAs are the most bioavailable of the omega-3s (the body can metabolize it easier), but ALAs don’t do such a good job converting into DHA and EPA, which are widely regarded as being more potent. Some statistics claim only 5 percent of ALA gets turned into DHA and EPA.

 

According to the American Journal of Clinical Nutrition, walnuts have the highest omega-3 content of any common nut, with 30 percent of it comprised of ALAs. (Only an Indonesian nut — the candlenut — has more.)

 

Flaxseed oil contains the richest amount of ALAs, though it does have a high omega-6 to omega-3 ratio, a common trait of the typical Western diet and a factor that theUniversity of Maryland cites as a possible cause for inflammation.

 

Canola oil (at right) has the best omega-6 to omega-3 ratio: 2 to 1, making it a perfect salad dressing for vegetarians or for light sautéing cooking oil.

 

A final word on omega-3s for vegetarians:

The Vegetarian Nutrition Dietetics Practice Group of the Academy of Nutrition and Dietetics says, “Although vegetarians tend to have lower blood levels of long chain omega-3 fatty acids, it is sufficient to meet the needs of most people … however, certain factors can … adversely [affect] this important conversion process [including] high intakes of saturated fat, trans fatty acids, cholesterol and alcohol, an inadequate intake of energy or protein, or a deficiency of certain nutrients, such as zinc or copper.”

 

Benefits of cocoa

Cocoa, revered centuries ago by the Aztecs and Mayans as the ‘food of the gods,’ is now being worshipped by modern science.

 

Two recent independent studies at Harvard and another from Cambridge, published in theBritish Medical Journal, have found that cocoa is a superfood when it comes to improving, among other things:

 

• Blood pressure
• Blood vessel health
• Insulin sensitivity
• HDL Cholesterol
• Overall prevention of cardiovascular disease

 

But do the benefits of cocoa outweigh the risks of eating too much chocolate?

 

Is chocolate—the combination of cocoa powder, cocoa solids (fats), sugar and other processing ingredients like soy lecithin and milk powders—a powerful medicinal food?

 

Should the two-thirds of American adults who are overweight consume it liberally in hopes of reversing the potential of developing heart disease and diabetes?

 

The answer, according to Eric Ding, a Harvard professor of nutrition and epidemiology, and co-author of a study on cacao in the Journal of Nutrition and another in the Current Cardiovascular Risk Report: you’d have to eat a lot of chocolate to derive the benefits of cacao.

 

Exactly how much?

It would take about eight bars of dark chocolate or 33 bars of milk chocolate to reduce the chance of developing cardiovascular and metabolic diseases, to the level that the study participants achieved, says Ding.

 

For those watching their weight and sugar intake, “obviously, that’s a problem,” Ding tells the Mother Nature Network.

 

What Ding and other researchers have found is that a specific subcategory of the antioxidant group, flavonoids, specifically epicatechin (eh-pee-cat-a-kin), is the compound that gives cocoa (or cacao, as it’s also known) its myriad health benefits.

 

“Cocoa flavonoids are the main beneficial compound of chocolate. Dark chocolate has more flavonoids than milk chocolate and pure cocoa has the most,” Ding says.

 

Ding and his fellow researchers performed a meta-analysis of dozens of studies involving cocoa. The analysis involved 2,575 participants and concluded that the maximum benefits of cocoa were cashed in after consuming 400-500 mg of cocoa flavonoids per day. Subjects were given a combination of fortified shakes or powders or dark chocolate bars (bars being at least 65 percent cocoa; control parameters included keeping the amount of fat, sugar and total calories of the participants the same).

 

Due to both pure cocoa’s bitter taste and its relative lack of availability in the U.S., compared to processed chocolate bars (processing destroys most of the flavonoids), one can assume that most Americans would need to supplement with cocoa flavonoids.

 

Can I take a vitamin to get the health benefits of cocoa?
Sort of. Currently, there are 13 vitamins that are considered essential by the National Institutes of Health. Although some vitamins are antioxidants, the free-radical-damage-fighting flavonoids found in chocolate are not considered essential.

 

So, at the moment, there are no epicatechin vitamins. There are, however, some cocoa supplements on the market, though not many.  It’s also unclear whether supplements are just as effective as naturally-occurring cocoa.

 

Dr. Norman Hollenberg, another Harvard researcher who has studied cocoa extensively, believes drinking pure cocoa is a certain prescription for good health. 

 

Hollenberg has observed for many years the ethnic Kuna group, who typically drink 5-6 cups of minimally-processed cocoa per day, on their offshore Panamanian island habitat.

 

Is drinking cocoa healthier than eating it?
Drinking unadulterated cocoa is certainly healthier than bingeing on a dozen bars of chocolate, thinks Hollenberg.

 

Although his studies of the Kuna were largely observational, compared to the controlled and random studies of Ding and other researchers, Hollenberg believes imbibing in liquid cocoa has kept the Kuna free of modern lifestyle disease.

 

But that begs the question: does the fact that the Kuna’s lifestyle lacks the same stressors as first-world workers bias Hollenberg’s hypothesis? How do we know that it’s not just the chocolate, but a combination of many factors?

 

“We just don’t know the answer to that; it’s very hard to quantify stress,” Hollenberg tells to Mother Nature Network.

 

But Hollenberg is betting on the cocoa. “The Kuna drink 40 cups of cocoa per person per week and manage, for the most part, to avoid getting four of the five most common killer diseases: stroke, heart failure, cancer and diabetes,” he says.

 

Are there other foods that contain the same beneficial compounds found in chocolate?
Yes. Every fruit and vegetable contains flavonoids. Hollenberg describes epicatechin as the ‘all-star’ flavonoid. Many fruits and vegetables contain both epicatechin and its closely-related compound, catechin.

 

So why not just ditch the chocolate all together and eat just fruits and vegetables?

 

“The flavonoids found in chocolate are too important to ignore,” says Hollenberg. “The health benefits are tremendous.”

 

Hollenberg, however, adds this cautionary last note, despite all the latest research on the health benefits of cocoa: “We know that cacao is good for you but we still don’t know if you need anywhere near the amount the Kuna drink; there remains a lot of research to do.”

 

Cinnamon health benefits

Deep within the inner recesses of your kitchen pantry is a spice that’s been prized for thousands of years. It’s even mentioned in the Bible.

 

In the United States, cinnamon is mostly used for baking and flavoring, but recent research suggests that cinnamon health benefits are numerous, though somewhat controversial.

 

Besides sweetening your morning oatmeal or cup of coffee, other benefits of cinnamon may include:

 

• Lowering blood sugar
• Killing bacteria
• Reducing inflammation
• Improving digestion
• Speeding up blood flow and circulation
• Staving off Alzheimer’s Disease
• Lowering cholesterol

 

Can cinnamon cure diabetes? 
By itself, not likely. But cinnamon has demonstrated that it contains compounds that lowers blood sugar after meals and increases insulin sensitivity.

 

A study from VIT University in India examined cinnamon’s effect on diabetic rats and demonstrated that cinnamon bark is effective in reducing post-meal high blood sugar (hyperglycemia) levels. A meta-analysis of clinical studies on cinnamon published in the Journal of Medicinal Food concluded that cinnamon lowers fasting blood glucose levels in people with Type II diabetes.

 

Another study led by the U.S. Department of Agriculture’s Department of Human Nutrition, involved 60 people and concluded that cinnamon reduces serum glucose, triglycerides, LDL cholesterol and total cholesterol in people with Type II diabetes. It also suggested that adding cinnamon to the diet of people with Type II diabetes will reduce risk factors associated with diabetes and cardiovascular diseases.

 

Despite these and other studies, not everyone sees cinnamon as a panacea for blood sugar metabolic disorders.

 

Who’s not buying the hype?
According to the American Diabetes Associaiton, “There is not enough evidence from research to claim that including cinnamon in your daily diet will help regulate blood glucose in people with diabetes.” The ADA points to a study by University of Connecticut and Hartford Hospital researchers that found a lack of efficacy in cinnamon’s ability to reduce blood sugar and fat.

 

New York University’s Langone Medical Center also doubts the usefulness of cinnamon for diabetes and for other health issues. On its website, it says, “At present, it would be premature to consider cinnamon an evidence-based treatment for Type II diabetes or high cholesterol, but it has definitely shown some promise.”

 

The Langone Medical Center points to the aforementioned USDA study involving 60 people, who were given doses of one, three, or six grams of cinnamon. The center concluded: “This study has some odd features. The most important is that it found no significant difference in benefit between the various doses of cinnamon. This is called lack of a dose-related effect, and it generally casts doubt on the results of a study.”

 

The critique continues, “The researchers counter that perhaps even (one gram) of cinnamon is sufficient to produce the maximum cholesterol-lowering effect, and therefore, higher doses simply didn’t add any further benefit. There is another problem with this study as well: no improvements were seen in the placebo group. This too is unusual, and also casts doubt on the results.”

 

‘Hogwash,’ says one researcher

Richard Anderson is the lead scientist at the Human Nutrition Research Center (a branch of the U.S.D.A.) in Beltsville, Md., and author of the study that NYU’s Langone Medical Center concluded was flawed.  Anderson told the Mother Nature Network, “I disagree, vehemently. All doses worked. That’s not a negative. We had 3 groups of 20 people in each group and a corresponding placebo for 1, 3, and 6 grams. In essence it’s three studies in one, so for them to say it’s a weak study is absolutely false. To say cinnamon doesn’t have an effect on humans is wrong.”

 

Anderson adds that some of the studies that failed to prove that cinnamon is effective in lowering blood sugar levels in patients with Type II diabetes has to do with the fact that the studies were done on people who were already taking blood sugar-lowering drugs such as Glucophage.

 

“To give cinnamon to people who are already on blood sugar-lowering drugs is ridiculous,” says Anderson.

 

Studying diabetic rats and mice is easier than humans
“It’s harder to duplicate the studies on cinnamon’s efficacy in humans because you can easily control a rat or mouse’s diet,” says Don Graves, a former distinguished professor at Iowa State University and current adjunct professor at University of California Santa Barbara.

 

“It’s very hard to control the diet of humans, it varies so much,” says Graves, who was Anderson’s graduate advisor.  Nonetheless, Graves concludes, “Both in animals and humans, without a doubt, cinnamon is very effective in helping manage diabetes.”

 

What other benefits?
Israeli researchers at Tel Aviv University have isolated a section of the cinnamon plant capable of delaying the development of Alzheimer’s disease. The findings were published in a peer-reviewed online science journal.

 

Cinnamon also fights the E. coli bacteria in unpasteurized juices, according to research byDaniel Fung, Professor of Food Science at Kansas State University.

 

“Cinnamon has tremendous killing power in controlling some microbes,” Fung tells MNN. “At a minimum, it can preserve food longer, and in some cases it can kill bad organisms,”

 

So, go ahead and relocate cinnamon front and center in your spice rack. It may be good for you.

Caffeine withdrawal symptoms

Reading this with a cup of coffee in your hand? Well, you’re not alone. In North America, approximately 90 percent of adults say they drink a caffeinated beverage every day.

 

But, what happens when you stop?

 

After sudden caffeine cessation, withdrawal symptoms develop in a small portion of the population, according to a research paper by Jasvinder Chawla, M.D. and Amer Suleman, M.D.

 

The study notes that the effects of caffeine withdrawal are often mild and transient but typical symptoms include:

 

• headaches
• fatigue
• weakness
• drowsiness
• impaired concentration and work difficulty
• depression and or anxiety
• irritability
• increased muscle tension

 

Tremor, nausea, and vomiting can also occur in extreme cases of caffeine withdrawal.

 

When do withdrawal symptoms start?

Withdrawal symptoms generally begin 12-24 hours after sudden cessation of caffeine consumption and reach a peak after 24-48 hours, says Daniel Evatt, Ph.D., a psychiatry research fellow at the Johns Hopkins School of Medicine in Baltimore. 

 

For those more sensitive to caffeine, withdrawal symptoms can appear within three hours and last up to a week if no caffeine enters the body to abate withdrawal symptoms.

 

“The most common symptom we see in people who stop using caffeine is headache, and that’s only in about a half the population who abruptly quit,” says Evatt.

 

170 years of medical literature

Roland Griffiths, a professor of behavioral biology at Johns Hopkins University, co-authored a paper in Psychopharmacology that reviewed 170 years of caffeine withdrawal mentions in medical literature.

 

In 57 experimental and nine survey studies, 13 percent of research participants experienced significant distress or functional impairment. The most severe cases of caffeine withdrawal occurred in those subjects who consumed high doses of caffeine.

 

But the study also revealed that it takes only 100 mg of caffeine a day (the typical amount of caffeine in a moderate-strength 8-ounce serving of coffee) to experience withdrawal symptoms.

 

Griffiths’ study, published in 2004, concluded that caffeine withdrawal symptoms are serious enough to merit inclusion in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

 

As of the fourth edition of the DSM, caffeine withdrawal has not been included but caffeine-induced anxiety, sleep disorder and intoxication are included. The fifth edition will be released in 2013. A proposed revision to the DSM-V suggests that caffeine withdrawal may be included in the next edition.

 

Caffeine’s benefits overstated?

Evatt says that feelings of anxiety, irritability, depression, as well as sluggishness are all symptoms that are opposite of what the supposed benefits of caffeine offer. Evatt has found that to enjoy the benefits of caffeine, only a little bit is required.

 

“You can get the benefits in less than 100 milligrams,” says Evatt, also cautioning that above 300-400 mg per day of caffeine may lead to more serious withdrawal symptoms.  

 

Jack E. James, Ph.D., the editor-in-chief of the Journal of Caffeine Research, tells MNN via email that the beneficial effects of caffeine are inflated.

 

“The widely-held beliefs of superior performance and mood after caffeine consumption are simply due to a reversal of adverse withdrawal effects,” James writes.

 

“Overall, there is little evidence of caffeine having beneficial effects on performance or mood under conditions of long-term caffeine use as opposed to abstinence,” adds James, who had a study published in the New England Journal of Medicine concluding that even low to moderate consumption of caffeine resulted in half of the subjects experiencing headaches.

 

Advice for cutting back on caffeine?
According to Evatt, you should not quit cold turkey. Instead, reduce consumption by 25 percent every week and if your goal is total elimination, within three weeks you should be able to abstain.

 

As for the maximum amount of caffeine allowed per day, Evatt says it’s hard to pin down.

 

“Due to the massive differences in how people react and metabolize caffeine, it’s impossible to give one guideline,” says Evatt.

 

Decaf latte, anyone?

Can Calamari Cure Cancer?

Omega-3 Essential Fatty Acids are fattening the wallets of supplement distributors. These sources of healthy fats that we can only get from food are clinically proven to reduce the risk of heart disease and other early death sentences.

It's no wonder Omega-3s are one of the top-selling supplements in the $60+ billion dollar supplement industry.

I've jumped on the Omega-3 bandwagon, having purchased several bottles and capsules...even waffles.

But as mentioned in a previous article for MNN.com I covered on Omega-3s for vegetarians, not all sources of 3s are created equally. Humans tend to absorb plant-sources of 3s (ALAs) pretty easily but ALAs don't efficiently convert into the more potent EPA and DHA forms of Omega-3s that are primarily found in cold water oily fish like wild-caught salmon.

Though plant sources don't contain enough EPA and DHA, can it be concluded that vegetarians aren't as healthy as those who eat cold-water sources of oily fish that are rich in EPA/DHA?

That wasn't meant to be the focus of this week's Fit Friday, but it does pose an interesting question, one that was answered at the end of the blog I linked to earlier on Omega-3s for vegetarians who don't eat fish or pop fish oil pills: Does a vegetarian's health suffer by not consuming EPA/DHA-rich fish?

Not if they:

• Eat several meals a day, all with protein
• Doesn't over-compensate for the loss of animal protein by eating lots of quick-burning carbs
• Combines the right foods to get all essential amino acids 
• The obvious: doesn't smoke or abuse liquor or drugs or eat lots of unhealthy fats (anything hydrogenated or trans fats and too many cooked polyunsaturated fats) and junk food

Although my parents manage to eat salmon the recommended two to three times a week (Good for them!), I don't eat it religiously like they do. So, should I take fish oil supplements? Even if one researcher I interviewed for the Omega 3 for veggies article said until research proves it, supplements aren't necessarily as effective as natural sources. 

I'm banking that DHA/EPA supplements are at least partially as potent as cold water oily sources. We don't need that much to begin with (despite what the health marketers would lead us to believe); we primarily need to make sure we don't consume breads and other baked goods that lead to inflammation throughout the body. 

The overwhelming majority of traditional cultures that have been studied and been documented with very little chronic modern diseases like heart disease have included animal sources of Omega-3s. 

Almost everybody by now has heard about Eskimos being very healthy despite eating whale blubber (not despite; because of!). Eskimos also consume fish oil and krill oil, supplements of which have flooded the markets. 

And before long, you'll likely hear about squid (calamari), particularly wild line caught from Scandinavia. Squid is especially rich in DHA. Although DHA and EPA are often lumped together as especially rich Omega-3s, DHA, some researchers believe, is the body's preferred Omega-3. 

So don't be surprised if you soon see in your local health food store squid in a bottle. 

Just don't eat it fried too often.