How Diet & Supplementation Impacts the Omega-3 Index
OmegaMatters: Episode 33
Hosts: Drs. Bill Harris & Kristina Harris Jackson
Guest: Dr. Laurel Wentz
Background and Key Takeaways:
Dr. Laurel Wentz talks about her deep dive into the Omega-3 Index and supplementation and diet and everything that affects the Omega-3 Index. She recently published a large paper that discusses what it takes to increase the Omega-3 Index with Food and Supplements. Dr. Wentz is an associate professor of nutrition at Appalachian State University. She’s also a registered dietitian and a board certified specialist in sports dietetics, so she’s got a lot of practical knowledge on this and many other topics related to nutrition and health. She focuses on the impact of nutrition, on metabolism, inflammation and immune function during exercise. For more information on OmegaMatters, visit: https://omegaquant.com/omegamatters-broadcasts/
SHOW TRANSCRIPT
Dr. Kristina Harris Jackson: Welcome to another Omega Matters, where we all talk all things Omegas. I’m Kristina Jackson. We have Bill Harris here and today we’re welcoming Dr. Laurel Wentz to talk about her deep dive into the Omega-3 Index and supplementation and diet and everything that affects the Omega-3 Index. She recently published a large paper that we’re going to talk about. Dr Wentz is an associate professor of nutrition at Appalachian State University. She’s also a registered dietitian and a board certified specialist in sports dietetics, so she’s got a lot of practical knowledge. She focuses on the impact of nutrition, on metabolism, inflammation and immune function during exercise, so we’re going to get to all of this. Thank you for coming on Omega Matters. Dr. Wentz or Laurel, what would you like us to call you?
Dr. Laurel Wentz: Laurel, and thank you for having me. I’m so excited to be here. This is my first podcast.
Dr. Bill Harris: Really? Oh, good, good.
Dr. Kristina Harris Jackson: Well, we’re fairly low tech, so it’ll be great. We’re excited to talk to you. We would love you to start off just telling us a little bit about yourself and your research and how you kind of came to this topic.
Dr. Laurel Wentz: Sure. I’ll try to keep it brief because it’s a long story and if you looked, even PubMed searched my name or Google search, you would find a variety of interest and a variety of topics. I’m definitely not an expert in all of those. It’s actually a thing here. They’re like, “Can you please pick a research stream?” It’s just I know a lot of people. Anyway, my background is sports nutrition and I went to Penn State as an undergrad and all I wanted to do was study sports nutrition and luckily we had a [inaudible 00:01:53] at the time when nobody else did, Christine Clark.
Dr. Kristina Harris Jackson: I worked with her. I just have to stop you. I went to Penn State for grad school and worked with Christine Clark.
Dr. Laurel Wentz: Oh, that’s wild. I’m from Pennsylvania originally and my whole family went to Penn State and so I went to Penn State from 2000 and 2004, actually as a biology major. Thought I wanted to go to medical school, realized I did not want to go to medical school, did not want to be an athletic trainer, and did an honors thesis with Chris Clark. I emailed her after and was like, “You were such an inspiration” at the time when they didn’t have full-time dieticians and she had a PhD. She was great.
Dr. Kristina Harris Jackson: Yeah, she was fantastic. She’s really a pioneer.
Dr. Laurel Wentz: Yes. At that time I was looking at grad schools and I wanted sports nutrition and somewhere warm, so I went to University of Florida, which brings Michelle Rockwell into it. She was the director of nutrition at the University of Florida. I was there 2004 to 2006, interned with her, which then Florida State was trying to build their program and they were like, “We want to know what Florida does. What’s going on in Florida?” So I got hired at Florida State, but only as a GA to start, do my PhD under Emily Hames, which I lucked out in so many ways, not financially but academically, and ended up working with Chris Clark and worked with the track and field team and did a lot of vitamin D research.
Then I took a job with special forces in US Army. They were just building up their human performance program and that was my first time in North Carolina. I worked at Fort Bragg. I did that for two years. It was great. The service members were great. I thought when I finished my PhD I was done with research and I was not done with research. So I took a job at East Carolina University and still tried to work with the military, but realized without a postdoc and working in athletics full time through my PhD, I wasn’t really well-equipped. So I, very unorthodox, in 2015, three years into a tenure track role, quit my job at East Carolina University and moved to a small island in Wales, North Wales, United Kingdom, and did a postdoc with Neil Walsh and did exercise immunology and vitamin D with military recruits. We did that study for two years. I learned so much, but one of the things I learned was I definitely wanted to live in the mountains and so that’s why I took the job at Appalachian State, which even pronounced correctly, they’re very uptight about it here.
Dr. Kristina Harris Jackson: How do people mispronounce it?
Dr. Laurel Wentz: Appalachian.
Dr. Kristina Harris Jackson: What did they say? Appalachian?
Dr. Laurel Wentz: You said it correctly. I think you said-
Dr. Kristina Harris Jackson: Oh, good.
Dr. Laurel Wentz: Appalachian.
Dr. Kristina Harris Jackson: I don’t know if I did, but.
Dr. Laurel Wentz: It’s a thing. I’m not from [inaudible 00:04:24], but I know it’s a thing.
Dr. Kristina Harris Jackson: The Ohio State, the Penn State.
Dr. Laurel Wentz: So I got here, worked with David Neiman, exercise immunology, was doing a lot with him, and then was kind of done with vitamin D. It’s interesting, but a lot of stuff’s been done on it. Then I was doing some other small budget studies with wrestling and body composition and climbers, working with David on some bigger studies, and then I had this honors student and we had done some stuff with fat metabolism and she needed to write an honors thesis. I’d always wanted to do Omega-3s. When David and I had talked about it at the North Carolina research campus, we started working with an industry and had written a proposal to do some work with Omega-3s. It did not go through. The funding just fell through. But then the other thing that happened here is David Barker, who actually funded this manuscript, the publication fees, is an alum, not of our nutrition program, but of upstate and he came to visit and was really interested in Omega-3s and we talked more about it and talked about a trial.
I thought this was going to be a small project, this review. I was like, “Let me just look up some papers and see how supplementation effects the Omega-3 Index.” I’m like, “It’ll be a nice little honors thesis.” Well, we looped Michelle in because she and I had run into each other at a conference and I knew she was doing a lot of work in this area and we need an outside reader. So I was like, “Michelle, can you help us with this?”, thinking it’s just going to be this very small thing. It evolved into the paper that we have now. That was kind of my first dive into Omega-3s, but I’ve always worked a lot in Omega-3s. Not on the research side necessarily, but military, traumatic brain, inflammation, so I had done a lot and looking … I had written some grants with traumatic brain injury. They weren’t ultimately funded, but for some nutrition intervention, which was not just Omega-3 but that among other things.
I always wanted to work in it even though my name wasn’t associated with it, I was interested. That’s how we came about this and we pulled in Michelle because I knew I wasn’t an expert and I wanted somebody who was.
Dr. Kristina Harris Jackson: That’s so cool.
Dr. Bill Harris: You’re becoming an expert. This is how [inaudible 00:06:25].
Dr. Kristina Harris Jackson: This is a really good start. It’s just fun to hear how people’s pathways just lead them through the research. It’s jobs, it’s research, it’s life and everything. You just kind of see what you can do and I love that you’ve just gotten to experience so many things. We’ve been super specialized in Omega-3, so it’s always nice for us to talk to people who have more of the breadth and then they pop into the Omega-3 story and then they find it’s nice when they corroborate some things that we’ve already seen but also just have maybe a more clinical view of things.
The paper we wanted to talk about, it’s called the Influence of Dietary and Supplemental Omega Fatty Acids on the Omega-3 Index, A Scoping Review. It is a large paper, very helpful. Megan Dempsey is first author. Michelle Rockwell, like we mentioned is second, and you’re the third, and this is a large review study just trying to get a handle on what’s a affecting the Omega-3 Index. So we would love to … I mean you kind of alluded to it, but just the rationale for this paper was essentially like you needed to write it for your student. Is that right? Is that the primary or …
Dr. Laurel Wentz: Well, that’s part of it, but the question I wanted to answer was how much Omega-3 … because all the time in practice too, they were like, “How much Omega-3 should I be taking?” That is a big question is what is the right dose of Omega-3? The question that we are looking to answer is what is the dose of Omega-3 that we should be recommending in clinical practice? It doesn’t quite read this way, but the goal of it was as a clinical practice guideline. I just did not realize the scale that it was going to involve, but that’s what we were trying to write was something very applicable. As in if you are a sports dietician or a military dietician, it wouldn’t be specific to injury, but if you are a dietician and honestly any type of dietician not specific to athletics, but that’s more the dieticians I would work with. If you are a dietician working and you were like, “How much should I be recommending just for general health?”, we wanted to try to find a way to answer that question.
That’s really how the paper came about and then I pulled a student in and then we had David Barker with the interns and so all of these things just came together at the right time.
Dr. Kristina Harris Jackson: Very good. That is the ultimate question and I struggle with this because we are on the testing side and people will ask me how much I should take and I say, “I don’t know what your levels are, so I’m not going to tell you”, which is not satisfying and it’s not something that you could do all the time, but it is not as easy of a question. We kind of take for granted the old DRIs and finding the other vitamins and minerals and they’ve done a lot of work on those to determine how much we need and for the Omega-3s, it’s kind of newer. There are not DRIs for EP and DHA, so we don’t have that same level of evidence and we have a lot of evidence, but it’s just different. You really went through and you looked at supplement studies, but as well as everything else that people have tried food and fortified foods. I guess can you briefly describe the outline of the paper, how many studies, what you’re looking for, all that stuff?
Dr. Laurel Wentz: Our criteria were we started in 2004 and that was actually recommended by Michelle with the study that, well, you guys had done defining the Omega-3 Index and identifying that it had a correlation with cardiovascular risk. That’s what we were really looking at and that was the start of our criteria. We did anything 2004 moving forward, and this was published the beginning of last year, 2023. Frontiers has a really quick turnaround, so I want to say we submitted it in November of 2022. Our study criteria to be included where they had to have a baseline Omega-3 test, some type of intervention and a follow-up Omega-3 test, but that did not have to be the sole outcome. Some of the people that we included had health like cardiovascular disease, some didn’t. We looked at those separately and there weren’t any major differences, so we included everybody.
I thought we were going to have 20 studies to review. Initially we had 52. I know there are 58 in the final paper because again … So App State is a teaching school. I teach a three course load, which that means three classes every semester. My time for research is not as high as what a lot of other bigger schools have. So this took a while and students are very good at writing, but they need a lot of revisions. So it took a while. Every time we were doing another revision, we’d added papers. I haven’t checked before this, but I bet there are probably more that have come out recently since that 58. So we ended up with 58. Even when we sent it to Michelle, she was like, “I can’t believe there are 58 papers.” We were adding until the month before we sent for publication.
But anyway, they had to have the baseline and the follow-up that did not have to be the primary outcome and they had to define what the supplementation protocol was. As you mentioned, we included food, some were fortified foods. There were only, I think, I want to say nine. I just read the paper again in preparation for this.
Dr. Kristina Harris Jackson: What kind of foods were they, just for examples?
Dr. Laurel Wentz: They were mussels chicken, sausages, eggs. Hold on, I did write some of it down. Those were the main ones.
Dr. Kristina Harris Jackson: Fortified mussels?
Dr. Laurel Wentz: Oh, and margarine. Margarine was another one. Yeah, they did fortified mussels. I don’t remember what country that was out of because we did list that. Some of the foods were surprising, like the sausages. Eggs not so much, but mussels sausages. Then one study was actually with fish itself, but it wasn’t like Norwegian teenagers and they listed they had pretty low compliance. But the margarine was the biggest supplementation one and the rest of them were all for some type of dietary supplement. We included all of those and then looked at what the baseline was, what the followup Omega-3 Index was, what the timeframe was, what the supplementation protocol was, and also the country of origin because they didn’t report a lot of dietary factors, so we did include with that and if they had any underlying health effects. You can see it on the big table. Also just throwing it out there, that is a freely downloadable paper.
Dr. Kristina Harris Jackson: Oh, yeah. That’s fantastic. It’s [inaudible 00:12:57] in nutrition.
Dr. Bill Harris: How did you define the Omega-3 Index for these studies?
Dr. Laurel Wentz: Great question. We defined it as if they listed the Omega-3 Index and that’s what they call it. That’s one of the things we did have to talk about because there were different laboratories. Three of our studies, for example, were out of the combination of Austria and Germany and they all had really high baseline Omega-3 Indexes. Actually, you know sometimes you get frustrated with the review process, the peer review process, but in this case it was helpful. One of our peer reviewers said not all of the Omega-3 Index are measured the same way and follow the same protocol and so you need to account for that in there. We didn’t really do a deep dive, but if they listed it as Omega-3 Index, that’s what they wrote in their methodology.
But there were different laboratories and that could account for some of the variations. Because some of the studies were like a eight or 9% starting and then went up to 13 at the end, and that was just these three laboratories out of Austria and Germany. We did put in there we can’t account for how they did this with the laboratory.
Dr. Bill Harris: But it’s all red blood cell EPA, DHA?
Dr. Laurel Wentz: Yes. Yes. It is all red blood cell EPA and DHA. Yes, sorry. Yes, yes it was.
Dr. Kristina Harris Jackson: That’s usually our big fight is that it’s plasma or it’s EPA, DPA, DHA and it’s so confusing.
Dr. Laurel Wentz: No, no, no, we didn’t include anything plasma EPA and DHA. It was all red blood cell DHA.
Dr. Kristina Harris Jackson: That’s good.
Dr. Laurel Wentz: All of it was that we included in there.
Dr. Kristina Harris Jackson: That’s amazing you found that many studies with pre-post, because that’s something we kind of harp on. So that’s the scope of the study. What were your main takeaways?
Dr. Laurel Wentz: One of them was almost everybody was low. [inaudible 00:14:42] baseline values, with the exception of a few laboratories that are, let’s say, unorthodox because I’m not an expert enough to know how they tested it. The average was, I’d say, about 3% to 5% across regions. That was their baseline Omega-3 Index. It did almost all of them improve with supplementation, at least EPA and DHA, not as much ALA, and that the final-
Dr. Bill Harris: You included ALA?
Dr. Laurel Wentz: We did.
Dr. Bill Harris: That’s right, that’s right.
Dr. Laurel Wentz: We did include ALA, which had really minimal impact on the Omega-3 Index, almost no impact at all. But we did include that because that is the dietary one. I work in the applied world a lot, and you’d be surprised how many dieticians recommend ALA As a good source of Omega-3, which technically it is, but you’re not getting some of the benefits of EPA and DHA. So we did include that.
Dr. Bill Harris: Very important.
Dr. Kristina Harris Jackson: It’s very important.
Dr. Laurel Wentz: We included that and that had almost no impact at all on the Omega-3 Index.
Dr. Bill Harris: How many people were all together in the study? How big is this study?
Dr. Laurel Wentz: Which study?
Dr. Bill Harris: When you pool all of your 58 together, are you talking about 2000, 3000 people?
Dr. Laurel Wentz: I’d have to look at … they did vary a lot in sample size. I’m looking at it now, some of the charts because we have a bunch of tables of it. Of the 58 … because the way we did the tables, we divided it by protocols. I would say on average, most sample sizes were around 50, some were over 100, some were slightly smaller.
Dr. Bill Harris: For any given study, right?
Dr. Laurel Wentz: Yeah, so it’d be hard to pool them all. We didn’t do a meta analysis for a lot of reasons, one of which we’re not good enough at statistics to do that, and two, that wasn’t really the goal of the paper. We are trying to just do with the scoping review, just more of a generalized research question. I’d have to add them all up from all the different tables and some of them are crossover because the way we designed our tables separated not necessarily each study, but each protocol. For example, if one study gave an EPA versus a DHA, we included that as two lines. If they did esters compared to triglycerides, we did that as two lines.
Hold on, I’m just going to get my light back on. We’re in a very energy efficient building. When you look at all those studies, some of them are crossover, but most of them are not and so it looks like we have more than 58 studies across our tables, but we wanted to clearly define each individual protocol with ester, triglycerides, EPA, DHA, and we made a different line for each of those.
Dr. Kristina Harris Jackson: That’s cool. That’s interesting.
Dr. Laurel Wentz: To go back to the original question, the overall findings, and this isn’t actually that novel of other people have suggested this with some more sophisticated calculations, but that it was about 1000 to 1500 milligrams of EPA and DHA to raise the Omega-3 Index, and it was a minimum of 12 weeks.
Dr. Bill Harris: From what to what?
Dr. Laurel Wentz: From below that would be from about 4% to close to 8%, not necessarily over 8%. I will say we got a lot of pushback from the 8% aiming for it when we sent this out, so that that was not a true target from peer reviewed. That doesn’t necessarily get it to 8%. That would just be a statistical improvement from below 4% and so probably just not necessarily a fully to eight.
Dr. Kristina Harris Jackson: That’s an interesting … because it’s the deficiency level, it’s probably like that 4% target and if that’s the main focus, what does it take to get over 4%? This is something we think about a lot. 8%, there’s a lot of evidence around it’s better than six, it’s better than seven. There is a pretty linear relationship, at least up to 8% with better health outcomes. But in the more traditional vitamin mineral sense, it’s usually just deficiency and then you’re within whatever, and then it’s toxicity. Usually there’s not an optimal level defined for the most part.
Dr. Laurel Wentz: We found that that would be … so if you were below 4%, you’d get a statistical improvement probably between 6% and 7%, not necessarily all the way up to eight, though. Because when we were putting this in, a lot of our reviewers said that wasn’t a true target, that they didn’t think it was that high and that that wasn’t necessarily a goal, and so that wouldn’t necessarily bring you over the 8%. One of the questions I have, and I don’t know the answer to this, that was just to raise the Omega-3 Index by a significant amount. I don’t know what the amount would be like … say you got to 7% or 8%, I don’t know what you would do to maintain it.
Dr. Kristina Harris Jackson: It’s about the same.
Dr. Bill Harris: You got to keep doing [inaudible 00:19:36].
Dr. Kristina Harris Jackson: You got to keep that dose to stay at that level. It’ll respond. You said 12 weeks, that’s usually what we also say for the kind of steady state, so that would be, if you’re at that level, that’s when you’re going to know, okay, this is the dose and that’s what it gets me to, and then you can play with it. But it is responsive over time, you can’t decrease your dose that much and maintain that level.
Dr. Bill Harris: What did you find in the different forms of Omega-3, the ethyl ester versus triglyceride?
Dr. Laurel Wentz: That triglycerides were much more effective and there are a lot of studies, well, at least a few that compared them directly, and triacylglycerols were much more effective in raising it than ethyl esters, that you would need a larger dose of ethyl esters to have the same magnitude of increase. The other thing we found is that DHA was much more effective. DHA was actually more effective on its own. That combination with EP and DHA and EPA was minimally effective. Now, I understand it undergoes fewer conversions, and I understand EPA has other physiological functions, so it’s not like people wouldn’t necessarily want to consume EPA, but as far as just an increase in the red blood cells, Omega-3 Index with EPA and DHA, DHA was the most effective that we found and triacylglycerols.
Dr. Bill Harris: Part of that is DHA will actually increase EPA levels, whereas the reverse is not true.
Dr. Laurel Wentz: Right. I knew that. I read a lot about physiology and biochemistry,
Dr. Kristina Harris Jackson: I saw you put in the Metherel paper about retroversion and how it’s actually not a major contributor to EPA levels, and it’s just interesting, even this far into the Omega-3 story, some of the basics about the pathway we still don’t know or we’re correcting ourselves. It’s still really ongoing. You guys really picked out a lot of things that we have noticed or found through other ways, so it’s validating to be able to have you guys completely separately be able to look at this amount of research and come to these same conclusions. Those are nuggets of wisdom that seem to be pretty robust and it’s worth studying why is EPA versus DHA showing up to be so different? Because we didn’t know for a long time because we didn’t have pure EPA and DHA, because in nature they’re together, in fish oil they’re together. It wasn’t until they started to separate them out and give them that we could even see the different effects.
Dr. Bill Harris: Did you see a different effect of food versus supplement?
Dr. Laurel Wentz: The problem with the food is they were really low dose, so most of the food was less effective, but it was also lower dose. I think by dose comparisons it was probably slightly more effective [inaudible 00:22:31] the same dose. So if you took 250-
Dr. Bill Harris: Per gram.
Dr. Laurel Wentz: Per gram. Right. Per gram of APA and DHA. But the food wasn’t as high dose, so as far as raising the Omega-3 Index, food had a much lower impact. With the exception of these very high dose margins, but again, I want to say, I’d have to go back at it, I think those were out in some of the same labs that had the high index to start with. Those studies are kind of just on their own. They used really high dose margin, they had high starting levels, they ended with really high levels. I think you almost have to take those and look at them separately than some of the things because I don’t know necessarily all their laboratory techniques. They might have differed.
Dr. Bill Harris: What’s your opinion as to why there’s no DRI?
Dr. Laurel Wentz: I honestly don’t know. I wrote about that and I was like, “There has to be a DRI by now.” I’ve seen really important big name researchers write papers and I cited them saying there should be a DRI. It’s interesting to me because I teach this, I teach vitamins and minerals and I teach advanced metabolism and macronutrients. This is my curriculum, this is what I teach in our program. It’s weird to stand in front of the class and say, “Here’s the DRI for ALA, but we don’t have one for EP and DHA.” But then I go into a whole tangent about how important they are, especially now that we published this paper. I don’t know and I don’t get really involved with government and lobbying, so I don’t know enough about it. But I can tell you on the practical end, at least in the sports world and tactical world, we don’t care that there’s no DRI. We’re practicing like there is one.
Dr. Bill Harris: When people ask you “What’s a healthy intake, how much should I take?”, what do you say?
Dr. Laurel Wentz: Now knowing this, my recommendation would be at least 1000 milligrams, so at least a gram a day, 1500. I would probably say just like the combination of DHA and EPA, just because I think since they still are important function of EPA and it’s not just Omega-3 Index, I would say definitely, and this is just general health, probably starting out at 1500. The problem is, and I’ve run into this a lot, most of the actual supplements that are available in the market are very low dose of Omega-3. You’re looking at 300 to 500 milligrams per tablet, not fish oil but Omega-3. If you’re asking somebody to take two grams, they either have to get a higher dose one, which is fine, they’re available, but they need to specifically look for that, or they’re taking a lot of pills. Usually just for pill compliance, I usually go around 1500 milligrams to start and maybe higher if they’re boxers, military, then we might go two grams a day.
That’s my own recommendation. But I do recommend it to all my classes and what I was doing in India was I was teaching at the Sport Authority of India Patiala, which is essentially an Olympic training center, and it was training the future dieticians and nutritionists and coaches and boxing’s huge there. We talked a lot about Omega-3s and boxing and for them, like two grams a day because high risk of traumatic brain injury.
Dr. Kristina Harris Jackson: We’re getting more involved in some of the American football studies and trying to do work around that, prevention of bad outcomes. When you are going to hit your head, it is going to get hit, you may get concussed in any of those sports, but can being higher in Omega-3 help decrease those long-term effects is kind of where it’s going, it seems like.
Dr. Bill Harris: Where is the, writ large, the military on Omega-3 these days? I understand you can’t use supplements. There’s something-
Dr. Laurel Wentz: No, they can use supplements, so it depends a lot on the unit. I want to start by saying a lot of my military knowledge is fairly outdated. I worked for the Human Performance Program from 2010 to 2012. Now, I still have a lot of contacts there, but I have not worked in the Human Performance Program for over 10 years. You could absolutely use supplements within special forces. There were certain training schools that prohibited it, but mostly you could. The problem that we ran into with Omega-3s was if you got a doctor’s prescription, they were really low dose, I mean like 200, 300 milligrams. You’d have to take so many pills, so now you’re asking guys to go buy it on their own. I say guys, I don’t mean to be sexist, but I worked with special forces at that time it was [inaudible 00:26:48].
So we were asking them to go out and buy it on their own. We can make multiple brand recommendations, but we couldn’t say that this one has the highest potency because we couldn’t endorse anything as the government. So it’s not that they couldn’t do it, but anytime you ask people to go out and do stuff on their own, they’re just not as likely to do it as if they could get it prescribed and not have to pay for it. But they are allowed to use supplements, they certainly are, and there are some companies that … I think Brain Armor has worked with the military because they have some liquid supplements. So there are some companies that for sure have been working with the military.
We actually wrote a grant, I worked with a physical therapist, and it wasn’t just Omega-3, we wrote a DOD proposal to try to do this huge intervention post-traumatic brain injury with physical therapy and cervical neck pain, a whole nutrition intervention, which was two weeks, maybe four weeks of meeting with a dietician, included Omega-3s but not specifically, but they don’t want something that involved.
Dr. Kristina Harris Jackson: They don’t want to see how well it works and then they have to-
Dr. Laurel Wentz: Well, it’s just a lot of work because now you’re asking people to [inaudible 00:27:52] with somebody and actually eat fruits and vegetables and it would’ve included Omega-3s, but it wasn’t exclusively that.
Dr. Kristina Harris Jackson: Sure, sure, sure.
Dr. Bill Harris: How about the athletic program at App State? Are they into Omega-3?
Dr. Laurel Wentz: They sure are. I am not the sports dietician for App State, but we have two sports dieticians and the students who work for them always report to me for their graduate program because I understand how athletics works and their scheduling pretty well. I have a lot of students undergrad volunteer for them and I meet with the dieticians on occasion too. Actually, I’m in the middle of doing a lot of body comp testing for the wrestling team to see [inaudible 00:28:29]. Anyway, they are using Omega-3 supplements within the athletics department here.
Dr. Bill Harris: Are they tracking Omega-3 Index?
Dr. Laurel Wentz: No. No, they’re not. They absolutely are not.
Dr. Kristina Harris Jackson: We do work with a decent amount of D1 schools at this point, usually like football, basketball that’s getting bigger. But it is interesting and the sports dieticians are really on it. It’s growing so much, but I feel like Michelle Rockwell and of that cohort, they really pushed through because there was a ban on recommending Omega-3s for quite some time and they had to push that.
Dr. Laurel Wentz: And now you can provide them.
Dr. Kristina Harris Jackson: Now it’s okay.
Dr. Laurel Wentz: Now the [inaudible 00:29:14] provide them. Because when I worked, the athletes were allowed to take them, but as dieticians in an athletics department, we could not provide them for them. Now the athletes are allowed to take them bought by the athletics department, but if you would like, I can definitely talk to the athletics dieticians. The problem here is we are Division One, but we are not a Power Five conference, so we don’t have the budget of Virginia Tech or even Florida State or Florida or Penn State. We’re on a much smaller budget here, so that’s why they’re not doing a lot of that. But actually, for the size school that we are, we’re well-supported. I do want to throw that in there.
Dr. Kristina Harris Jackson: Yeah. Ohm, yeah. No, that’s …
Dr. Bill Harris: How big is App State?
Dr. Laurel Wentz: It’s 20,000 students now.
Dr. Kristina Harris Jackson: That’s pretty good. That’s great. Well, that’s really great to hear your perspective about the real world, the dietetics world, the sports world, and where Omega-3s is there. But it is a weird … the lack of a DRI, I know Michelle talked to us a decent amount about that, is that was an issue when she was trying to work within the government or the military, trying to be like, “Well, there’s no DRI, so why should we give it?” It’s a real barrier, but the more of this kind of research, we’re finding more and more consistency and able to provide dieticians with more consistent evidence-based dosing and recommendations, and people can actually get better outcomes, and then [inaudible 00:30:42].
Dr. Laurel Wentz: That’s what we were really trying to do is make some type of … I mean, obviously there’s so many variabilities, and that’s why we chose the scoping review. Again, I had no idea there were going to be that many papers. When you asked what was the biggest surprise, that was by far it, just the sheer number of papers that included this. But that’s what we are really going for, some type of clinical guideline. We have a lot of charts there too of how much different doses raised … We had tables with starting and finishing levels, but we also had a lot of tables of this dose raised it by 4%, this dose raised it by 6% over this timeframe. The other thing I wanted to point out with recommendations, and I’m sure you all could speak to this as well, I think the highest dose was like 4,400 milligrams that they used, and they didn’t report any side effects, at least in the study, so it seemed to be relatively safe in that.
To me, the recommendation of two grams, the biggest downfall with it is just the sheer number of pills, not necessarily the safety concern. But on that side, I had to get my mom … so I got my parents to take Omega-3s, my stepdad has cardiovascular issues. I personally take them, but I had to buy my mom children’s Omega-3s because she couldn’t swallow the bigger pills. So did some of that and some athletes have talked to me about that as well, so that seems to be the biggest issue, not necessarily side effects, is compliance and swallowing. That’s what I’ve seen on the practical side.
Dr. Bill Harris: What’s next for you? You’re going to stick with the Omega-3 story? You’re going to move on to something else?
Dr. Laurel Wentz: So actually no. We have, and this is random because I don’t know if you’ve had him on your podcast or not. Do you know Nick Barringer, Lieutenant Colonel? He’s done some work in Omega-3s with the military.
Dr. Kristina Harris Jackson: I don’t think so.
Dr. Laurel Wentz: Well, he’s another good person to talk about Omega-3s. Nick Barringer. I can email you his name.
Dr. Bill Harris: Is he Tom Barringer’s son or something? You know Tom?
Dr. Laurel Wentz: I don’t know Tom.
Dr. Bill Harris: Tom Barringer, he’s a doctor in North Carolina who’s into Omega-3s.
Dr. Laurel Wentz: Nick’s not in North Carolina. He’s in Texas right now. He is a lieutenant colonel for the Army, did his PhD, so he was a dietician for the Rangers active duty when I was a dietician and back when I did the Human Performance Program, there were not a lot of us. I talked to him then, we kept up through his PhD, he did some Omega-3 research. We’re actually doing … I’m kind of going back to my exercise immunology roots, we’re doing a ginger trial. That’s how I’m starting right now. We just got some funding from him in Pure Green. He helped us orchestrate it and so we’re looking at ginger and the effects of endurance cycling and oxidative stress, which is much more where I’m an expert in. Still interested in the Omega-3s and especially in the military side, if we could ever coordinate with this physical therapist who I know is also in research now and look at traumatic brain injury. The problem, and I’m sure you’ve gotten this from Rashan and everybody else, working with the military is so hard.
Dr. Kristina Harris Jackson: It’s so hard.
Dr. Laurel Wentz: It’s really, really hard to get through. To me, if I did Omega-3s, that would be the angle that I would want to go and I just haven’t found a good in that fits and would work and would be well funded at this point. I brought up Nick because he’s done Omega-3s, but we’re also doing a big study together with ginger and looking at high dose ginger and actual food, ginger root, the food itself is in this beverage. It’s not a supplement. It affects oxidative stress and inflammation post endurance cycling trials.
Dr. Bill Harris: Great. Cool.
Dr. Laurel Wentz: That’s my next big project that we’re starting. We’re just pushing through human ethics and getting … the funding’s there, it’s just getting all this stuff approved and getting everybody trained and the equipment up and ready. That’s what’s next for me in this, and like I said, this is not … This school, I love it here. It’s beautiful, we have amazing quality of life, but our research is on par with some R1 schools.
Dr. Bill Harris: Oh, sure.
Dr. Kristina Harris Jackson: No, I went to a small liberal arts for undergrad, and it’s a teaching university, which I loved. I think it’s great for students, and then big Penn State for grad school.
Dr. Laurel Wentz: I went to Penn State, which was really cool and I learned so much [inaudible 00:34:37] Florida State, so now that I’m at App State, it’s cool. I mean, I know my students really well and that’s why [inaudible 00:34:43]. This student who wrote this with me, we did her honors thesis through her undergrad, and then she stayed with me through grad school. We had a really good experience and she had a great experience and she comes out with a master’s degree, a dietician and a publication. [inaudible 00:34:56]. She wins through all of this as well. I mean, I’m not done with Omega-3s. I didn’t just mean to dabble in it, but I don’t know what’s next. I just keep bouncing around to where the opportunities are. That’s what I’ve learned is just kind of follow the flow of opportunities and right now, ginger. We had a new exercise science faculty who’s a really good cyclist, and this ginger thing just kind of evolved and then we got the money and you can just follow in the research and the money.
Dr. Kristina Harris Jackson: That’s all you can do. That’s really coo.
Dr. Bill Harris: That’s what we do.
Dr. Kristina Harris Jackson: Well, thanks so much for talking with us and your paper’s great, very practical. All the big points really have been … corroborate things that we’ve found as well, so it’s nice to have it all in one place and it was really good to talk to you.
Dr. Laurel Wentz: That makes me feel better. I’m not going to say I was nervous when you all emailed me and read it, and I was like, “Oh, I hope it says [inaudible 00:35:49] and that I did everything correctly.” Well, I think just even still writing, I’ve been practicing for a long time and writing for a long time, but still, I didn’t do this research, it’s a review, so I want to make sure that when I reviewed it, I interpreted everything the best way that I could, and that does make me feel better about that.
Dr. Bill Harris: You did a great job.
Dr. Kristina Harris Jackson: That’s great. Yeah, you did a great job. Great. Thank you so much, Laurel. We’ll be in touch.
Dr. Laurel Wentz: Thank you all for having me.
Dr. Kristina Harris Jackson: Thanks.
Dr. Bill Harris: Take care. Bye-bye.
Dr. Laurel Wentz: Bye.