Omega-3s in general
1 Can omega-3 acids be effective for multiple sclerosis ?
No one has yet carried out research specifically to measure the effect of omega-3 acids on multiple sclerosis. On the other hand, generally speaking omega-3 acids seem to help alleviate the symptoms of auto-immune diseases by improving the regulation of the immune system. There is also no particular adverse effect to fear with multiple sclerosis. I think you might expect moderate, but possibly significant results, such as a reduction in the dose of anti-inflammatory or immunosuppressant drugs required, after a course lasting several months, and supervised by the doctor treating the case.
2 If someone is physically and mentally fit, and has a diet rich in omega-3 acids, do they need to take dietary supplements containing omega-3 ?
If you are physically and mentally fit, carry on with what you're doing now! If, in addition, your daily diet is already rich in essential omega-3 fatty acids (fish, shellfish, green vegetables and salads, linseed, nuts, rapeseed oil, or even linseed oil), I don't see any reason to take omega-3 dietary supplements. Studies in this area show that a well-balanced diet (often called a Cretan or Mediterranean diet) has an important preventive effect on the development of the most common western illnesses such as cardiovascular disease (coronary disease, hypertriglyceridemia, and some problems with irregular heart beat). It also appears possible, based on epidemiological studies, that such a diet can help prevent depression.
3 How long do you advise taking omega-3 acids ? Do you have to take them all your life ?
At the moment, we don't have sufficient scientific data to respond fully to this question. The renewal of omega-3 acids in neuronal membranes has been observed to take at least three months from the time the supplements start, and some studies, (such as the one by Professor Bourre from INSERM, the French National Institute for Health and Research) suggest it takes two years. After that, the membranes seem to be stabilised. I think it is sensible to take a course for at least three months to see if taking omega-3 dietary supplements has any effect on your emotional stability. (You can evaluate this yourself using the tests available at www.isodisnatura.com, before you start omega-3, then again three months later, so you have a more objective measure of the change in your emotional stability.)
At the same time, you need to change your diet, increasing omega-3 acids and reducing omega-6. Then after three months you can try stopping the supplement and see if you still need it. If your previous problems recur, then you should think about starting the supplement again. If they don't come back, then this must be because taking a dietary supplement for a period and changing your diet have been sufficient.
4 I've been advised to take an omega-3 product for heart disease and for problems with cholesterol, skin and arthralgia. Can OM3 help with these problems as well, or just with emotional stability ? Do I have to take two different products ?
There is no reason to combine a number of omega-3 products, and one is enough. The very high levels of omega-3 fatty acids in OM3 gives it all the beneficial properties of other products based on fish oil. In particular, a high EPA concentration has been used in Japanese studies for its ability to reduce blood triglycerides (a factor as important as cholesterol, or more so, in preventing cardiovascular disease). EPA is also the omega-3 fatty acid that does most to alleviate inflammatory disorders.
5 What are the possible side effects of omega-3 acids?
The most common side effect of omega-3 supplements is a fishy aftertaste, or possibly belching. However, you can prevent this completely, simply by dividing up the dose (for instance, two capsules before each meal, if you take six capsules each day), and by taking them immediately before a meal. Some people may find intestinal passage is temporarily faster, and have more than one bowel movement daily. Rarely, bowel movements may be soft or even liquid during the first week you take the supplement. If so, simply reduce the dose for a week or so, and then try the higher dose again to see if you tolerate it. Very occasionally, omega-3 acids may cause bruising because, like aspirin, they can interfere with some clotting mechanisms (platelet aggregation). This interference is generally considered one of their benefits (like aspirin, omega-3 acids reduce the risks of heart attacks and strokes), but can be a problem for people who bruise easily or take anti-coagulant medication (see below).
6 Can you take omega-3 capsules during pregnancy ?
A Danish study suggests that women who take additional omega-3 during their pregnancies have children with healthier birth rates and are less likely to give birth prematurely. We know that omega-3 acids are involved in the development of the nervous system in the ftus and infant, and that women who take little omega-3 during pregnancy have a greater risk of post-natal depression. A panel of experts associated with the leading American nutritionist Artemis Simopoulos, a specialist in omega-3 acids, has recommended that pregnant women take 300mg of omega-3 acids per day during the last three months of pregnancy, and also while breast-feeding, to ensure the infant is properly nourished and to replace the mother's reserves.
However, higher doses are not recommended since there are no long-term studies proving that there are no disadvantages for the foetus.
However, higher doses are not recommended since there are no long-term studies proving that there are no disadvantages for the foetus.
7 If my diet contains 2 - 3g of omega-3 acids daily (for instance, 100g of mackerel = 2.5g of omega-3 acids, etc.), can I deduce from that that I've ingested 2 - 3g of a mixture of EPA and DHA ?
It is very difficult to say, in our current state of scientific knowledge, if 2 or 3g of omega-3 acids from natural sources give results equivalent to those expected from the same dose taken as a dietary supplement. Studies that have quantified the omega-3 acid content of foodstuffs suggest that the acids have a protective effect against a whole range of illnesses, including depression. On the other hand, they do not say whether or not a change to the diet - without an extra dietary supplement - is enough to treat established depression. One study in particular shows that changing the diet of heart patients to include larger amounts of omega-3 acids does not raise the spirits. Only studies using dietary supplements very high in EPA have shown an enhancement of mood.
8 Could it be dangerous to ingest too much omega-3 acid (that is, eat a diet already rich in omega-3 acids, and add too much extra omega-3 as a supplement) ?
Eskimo living in north Quebec eat up to 16g of fish oil daily, and up until now, no adverse side effect has been observed from this level of consumption.
9 Some nutritionists recommend combining omega-3 acids with selenium. Is this a good idea ? What would be the dose ?
Selenium is a trace element and a powerful anti-oxidiser. It has been associated with a reduction in the risk of cardiovascular disease and of some forms of cancer. The minimum daily dose of selenium recommended in the United States is 70µg for men and 55µg for women. To my knowledge, the maximum daily dose should not exceed 700µg, and most nutritionists recommend a dose of between 100 and 200µg per day to reduce the effects of oxidation. A dose of 200µg has been used in several studies involving thousands of people and followed up over a number of years. The dose has not, as far as I know, been associated with any toxic symptoms at all. On the contrary, it seems likely to have benefits in reducing mortality from cardiovascular disease and from some cancers.
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