Evaluating the Different Omega-3 Tests
OmegaMatters: Episode 34
Hosts: Drs. Bill Harris & Kristina Harris Jackson
Guest: Dr. Kevin Maki
Background and Key Takeaways:
Dr. Kevin Maki is the founder and chief scientist of Midwest Biomedical Research where they specialize in designing and conducting clinical trials related to cardiometabolic health, clinical nutrition, and cognitive function. And he’s also an adjunct professor and dean’s eminent scholar at Indiana University in the School of Public Health in Bloomington, and the co-editor-in-chief of the Journal of Clinical Lipidology. For more information on OmegaMatters, visit: https://omegaquant.com/omegamatters-broadcasts/
SHOW TRANSCRIPT
Dr. Kristina Harris Jackson: Alrighty. Welcome to OmegaMatters, where we talk all things Omegas. I’m Kristina Jackson. This is Bill Harris. And today, we are with Dr. Kevin Maki to talk all things omega-3 testing.
So, first let’s hear a little bit about Dr. Maki. He is the founder and chief scientist of Midwest Biomedical Research. They specialize [00:01:00] in designing and conducting clinical trials related to cardiometabolic health, clinical nutrition, and cognitive function. And he’s also an adjunct professor and dean’s eminent scholar at Indiana University in the School of Public Health in Bloomington, and the co-editor in chief of the Journal of Clinical Lipidology. So, with all of that going on, we’re so grateful that you came on to talk with us today on OmegaMatters. Thanks so much.
Dr. Kevin Maki: Thank you. It’s a pleasure to be here.
Dr. Kristina Harris Jackson: Yes. So, we always like to hear a little bit about your background and you have a lot of background, but how did you come to where you are and your connection to the omega-3 world is where we’d like to direct this?
Dr. Kevin Maki: Sure. Well, my training is in epidemiology, nutrition science and exercise physiology. So, I’ve always been interested in preventing and managing cardiometabolic diseases. And so, the very first study I worked on [00:02:00] related to omega-3 fatty acid supplementation was about 30 years ago.
And a little bit of background, I was working in the Department of Veterans Affairs as scientist, happily. Thought I’d worked there for 40 years and then retire. But we got a new director for the center I worked in who had other ideas and he invited me to find other employment. And so, I joined a place called Chicago Center for Clinical Research with Michael [00:02:30] Davidson, a very well-known preventive cardiologist.
And so, we did a study to look at the effects of omega-3 supplementation alone and in combination with simvastatin in patients who had elevated cholesterol and elevated triglycerides. So, that was my introduction to omega-3 fatty acids. And then I’ve been immersed in omega-3s ever since, which accounts for my healthy glow.
Dr. Bill Harris: Boy. [00:03:00] That’s right.
Dr. Kristina Harris Jackson: And you also, I mean, we can bring this up now, but you also have, you’re an entrepreneur in the science space. So, you started out thinking you would probably just be a researcher, get grants, and now you’ve written a book which has affected the course of OmegaQuant, which we have a nice picture of here.
Dr. Bill Harris: That’s right.
Dr. Kevin Maki: [00:03:30] I have this interesting background in the sense that when I was a teenager, I went to work first in a Chinese restaurant and then I went to work for some folks who owned a hotel, worked in the hotel for 10 years. And so, I saw these very successful entrepreneurs who built really nice lives for themselves and built great businesses with happy customers.
And so, [00:04:00] I started down this career path of science and then as I said, was invited to find other employment. So, when I joined Michael Davidson, he had a private research center. And so, I ran the human nutrition and metabolism research unit for his research center for 10 years and learned that business and then went out on my own and did the same thing for my own company. And so, that background working for [00:04:30] entrepreneurs made me really interested in the intersection of science and entrepreneurship and it’s worked out reasonably well.
Dr. Bill Harris: I dare say. Yeah. And if I have to give you a big thanks for this book, because I know when I was starting OmegaQuant back in 2009, you sent me a copy of this and it was like you said, I’m the second person that’s read it after you, but it was really helpful to me because I knew nothing about business. So, [00:05:00] thanks for that. You were there at the very beginning for us.
Dr. Kevin Maki: Well, so glad it was helpful. And actually, do think if someone is interested in starting a business, it’s a good resource. It’s available on Amazon. But I’m not really here to promote-
Dr. Bill Harris: Your own book.
Dr. Kevin Maki: … the book. But I really do think it is a useful resource and has lots of stories in it from successful entrepreneurs.
Dr. Bill Harris: Right.
Dr. Kristina Harris Jackson: And you’ve still been [00:05:30] incredibly prolific and run so many studies and been a part of getting so many studies done. We are constantly talking to your team at OmegaQuant to do samples for another research study. So, it’s neat to be able to do that in a different setting than just maybe traditional academia or.
Dr. Kevin Maki: I really do believe that the randomized control trial is the gold standard for evaluating interventions intended to influence human health. [00:06:00] And so, it’s been great to have a 30 plus year career designing and conducting clinical trials and really moving the science forward in some significant areas. And so, playing some part in that has been very gratifying.
Dr. Bill Harris: Absolutely.
Dr. Kristina Harris Jackson: Yeah. Well, for today, we aren’t talking about one of those studies. It is an intersect between science and industry, I would say that we want to talk about, and you were involved. You’re [00:06:30] the final author, which has been the boss of this paper, but you have a paper called Omega-3 Polyunsaturated Fatty Acid Testing in Humans: A Narrative Review of Commercially Available Options.
And Mary Dicklin is the first author on this paper, and it’s in the Journal of Nutrition, which is one of our best journals in the nutrition world. And it’s a review of all the options people have for omega-3 testing, which is a lot of options. And our [00:07:00] customers will be happy to hear this because they ask us all the time, “What’s the difference? What’s the difference between these different tests? Why am I getting something different from Quest than you?”
And so, you and your team went through and did a deep dive into all the available omega-3 polyunsaturated status, fatty acid testing, all of the options. It’s so helpful. So, I’d like to know first, what prompted you [00:07:30] to do this topic to look into this?
Dr. Kevin Maki: Well, in part, it’s frustration because number one, when it comes to clinical trials, if you’re going to do a clinical trial to test a medication to lower blood pressure or medication to lower cholesterol levels, well, what do you do? You find people who have elevated levels and then you randomly assign them to the intervention or a control condition, [00:08:00] and then you follow them over time and you see how the intervention is changing the level of what you’re targeting.
With studies of omega-3 fatty acids, it’s often been we’re going to take people, not assess their status, some may be high, some may be low. We’re going to give them a supplement and then follow them over time to see what happens. And we’re not going to assess their status during the intervention. Well, I just think that’s a crazy way to do things and [00:08:30] maybe I should be a little more diplomatic and say suboptimal.
And so, what I’d really like to see is number one, many more clinical trials to assess modifying omega-3 status. So, the first part of that is you want to find people with low status and increase their status through an intervention diet or supplementation or a pharmaceutical. And then the question is, well, how high do you need to go?
And [00:09:00] I think we have observational evidence that suggests that low status is associated with unfavorable outcomes. There is a range that is probably optimal and with different tests, that optimal range is probably somewhat different. But I would really like to see more clinical trials assessing status. And I think we’re heading toward a day. It’s been a lot longer coming than I had hoped, [00:09:30] but I think we’re heading toward a day when clinicians will be routinely assessing omega-3 status and for people with low status recommending an intervention to raise the status.
But in order to have a recommendation for widespread testing and intervention, we need more clinical trials to fully evaluate the benefits and potential risks of doing so.
So, in the meantime, we don’t have recommendations from organizations like the American Heart [00:10:00] Association, American College of Cardiology, et cetera. But I hope that we will someday. And in the interim, I think that for interested clinicians and consumers, there are good reasons to consider evaluating your status with a test and then intervening if the status is low.
And I believe that there will be a day sometime, I hope before I die of natural causes when we will be [00:10:30] doing that. But again, we need more clinical trials to support more widespread use.
Dr. Bill Harris: So, you’re saying there’s still a question about the efficacy of omega-3 and a variety of disease conditions? And then there’s the complication of multiple tests that are available. So, can you address those two separately?
Dr. Kevin Maki: Sure thing. So, I think we do have questions. I think the observational evidence looks pretty compelling. So, in observational evidence, we think [00:11:00] about strength, consistency, dose response, biologic plausibility and coherence with other types of evidence. And so, with omega-3s, I think all the boxes are really checked, but the box that is only partially checked right now is the value of interventions.
And so, part of the reason for that, I think is not enough status assessment pre-intervention and during the intervention and [00:11:30] failure to select people with low status. It’s hard to make healthy people healthier. And so, if you start with high status and then you give a bit of a supplement, may not move the needle. On the other hand, if you start with low status and move people up to above average status, you’re more likely to see benefits, I think, and more trials should be evaluated that way.
Now when it comes to the type of testing, it’s no secret to the people here that my favorite [00:12:00] is the Omega-3 Index. And the reason that is my favorite is not just because I like the people I’m talking to a lot, it’s because the Omega-3 Index has the most data behind it to relate the level to outcomes. And so, from that perspective, I think that we have some pretty good evidence that a value between eight and 11% is associated with favorable outcomes, values especially [00:12:30] below 4% with unfavorable outcomes. And so, all things being equal, I’d rather have my status in the eight to 11% range than less than 4% range, even though there are some unanswered questions about the degree of benefit for intervening and in whom and so forth. So, I think those questions will eventually be answered. But in the meantime, for clinicians and consumers who are interested [00:13:00] in maintaining a level in the optimal range, Omega-3 Index is one way to assess that.
Now, I don’t want the perfect to be the enemy of the good. I think any omega-3 testing is better than no testing. And just because for some of the other tests we don’t have as much evidence from observational studies, we have some, and in general, I think there’s going to be a reasonable level of concordance between tests, but [00:13:30] there are some limitations.
One of the limitations is that some of the tests that are measuring plasma levels, for instance of omega-3, may be much more affected by what’s been consumed recently than something like the Omega-3 Index, which is looking at cell membranes. And those cell membranes are not shifting around day to day as much. So, the signal-to-noise ratio is better with the Omega-3 Index than with some of the other tests.
[00:14:00] But with any of the tests, I think you can identify low status and higher status. And then there’s a gray zone in the middle with many of them where I think there’s a little bit less certainty. But you can deal with that by not just looking at the test result one time, but looking at a couple of test results and saying, “Okay. Here’s my status today. I’d like to see it higher, so I’m going to eat more fish, or I’m going to take a supplement in order to [00:14:30] raise it up to a level that’s been associated with more favorable health outcomes.”
Dr. Bill Harris: Certainly, if you are going to be doing testing, you want to stick with the same lab. It’s going to be confusing if you want to go, right?
Dr. Kevin Maki: Yeah, exactly. And so, I do think there are considerations like the availability, the convenience, the cost, insurance coverage and so forth that will maybe make it more likely that the person gets one [00:15:00] test over another. And like I said, any omega-3 status testing I think is better than no testing.
And so, I’m a fan of status evaluation, but I think that clinicians need to be aware of some of the variability. As an example, with some of the tests, if you go out for sushi the night before and get tested the next day with something that is evaluating plasma levels, well, you’ve [00:15:30] got a big contribution of last night’s sushi to the plasma level.
Dr. Bill Harris: That’s right. That’s right. Exactly.
Dr. Kristina Harris Jackson: So, you’re hitting on this, but one of our questions was what should someone look for in the tests available to them or when selecting the lab or the type of omega-3 tests? Are there some specific ones we can compare and contrast?
Dr. Kevin Maki: Sure. Well, there are a couple that I like. And the reason I like [00:16:00] them is because we have some reasonable data to evaluate relationship to either clinical outcomes or other biomarkers that I think are important biomarkers of inflammation.
So, as an example, the arachidonic acid to EPA ratio I think is a useful test and a potentially optimal range. And I put that caveat [00:16:30] in front of optimal because I think we need more research to better define it, but a potentially optimal range is something in the neighborhood of 1.5 to five.
And so, with the arachidonic acid to EPA ratio, you’re basically looking at a ratio of fatty acids that are precursors to leukotrienes and prostaglandins and other compounds that are involved in inflammation, [00:17:00] and also with the balance between coagulation and fibrinolysis. So, I do think that if the ratio is higher than five, it’s reasonable to consider taking a supplement to get that ratio lower than five.
And with the Omega-3 Index, I mentioned eight to 11% being a range that [00:17:30] I think is considered optimal based on observational evidence. And so, when considering what data are available to support a target that you’re shooting for, that’s the most important thing from my perspective, but then of course you have to consider practical things as well, how much is it going to cost? Is it available to me? Where can I get it done?
And [00:18:00] I think that there are lots more options now. And so, the major labs, like Quest for instance offers an omega-3 test, and OmegaQuant, your company offers an omega-3 test that is available to consumers. So, whether it’s through a clinician or direct to consumer, these are the kinds of things to think about.
Dr. Kristina Harris Jackson: Yeah. We know firsthand somewhat [00:18:30] just the logistical issues are major barriers to usage. And the other thing about the research is if in reporting the research, people are not using the same metrics to do baseline and ending omega-3 status, it makes it virtually impossible to compile and compare studies, which is we’re fighting against ourselves [00:19:00] when we do that.
Dr. Kevin Maki: And I just want to make a point that I should have made earlier, and that is, well, why is testing so important? And I think part of the reason is for any level of intake of omega-3s, there’s a wide variation in status. And this was brought home to me by Bill.
So, I was at an advisory board meeting with Bill, and he came around with a Lancet and a piece of paper and said, “[00:19:30] Hey, stick out your finger. I want to get your Omega-3 Index.” And I happily complied and the results came back. And even though I was taking a gram a day of EPA-DHA ethyl esters, so about 840 milligrams of EPA plus DHA, my Omega-3 Index was 4.6, and it was much lower than I expected it to be.
So, again, I was doing what a lot of people do taking a supplement, assuming it was enough, [00:20:00] it wasn’t enough. And so, that brought home to me that you don’t really know unless you test. And in order to get up into the optimal range, I had to triple my intake of omega-3s much to my surprise. And that isn’t necessarily typical. But in my case, it was what happened, even though I was taking a supplement and eating fatty fish pretty regularly.
Dr. Bill Harris: Yeah. [00:20:30] That’s a great point because you just cannot tell by what you’re taking what your level’s going to be. And obviously, you can’t do what your cholesterol is by looking in the mirror either. I mean, it’s like that because if it doesn’t feel different, you have to test it to know it.
Dr. Kevin Maki: Absolutely. So, I learned the hard way that what I’ve been doing for a while was probably not enough.
Dr. Bill Harris: Yeah. So, you’re very involved with the Journal [00:21:00] of Clinical Lipidology, of course. And so, you’re very in tune with what clinical lipidologists are doing these days. Are they doing more omega-3 testing? I mean, it’s a mixture. Who is a clinical lipidologist, first of all? Explain that.
Dr. Kevin Maki: Yeah. So, a clinical lipidologist is someone who has training in management of lipid disorders, so elevated levels of cholesterol, triglycerides, low levels [00:21:30] of HDL, cholesterol, things like that. And mainly, they are dealing with more complicated dyslipidemia cases and their objectives are to reduce the risk of cardiovascular disease and then other risks like pancreatitis and so forth.
And so, the question is, are they measuring status? I think for the most part, the answer is no, they aren’t. Now, [00:22:00] they are in some cases prescribing omega-3 medications mainly to treat severe hypertriglyceridemia, also as a means of preventing cardiovascular disease in people with cardiovascular disease or high risk.
So, there’s a drug, icosapent ethyl, brand name VASCEPA, that has an approved indication for that. And having said that, I don’t think [00:22:30] it’s common among my colleagues in lipidology to be testing omega-3 status. They are using medications, but probably not testing omega-3 status.
And that’s actually something I’d be very interested in having an article for the journal about what are the potential benefits and where are the gaps in the evidence to [00:23:00] have clinicians be more aware of the potential benefit of testing?
Dr. Bill Harris: No. I’ll take that as a suggestion. We can do something like that.
Dr. Kristina Harris Jackson: Yeah. And so, that’s very specific in the cardiovascular metabolic world, but we have started to see the research explode outside of that world, in pregnancy world, in athletics, in eye and brain. [00:23:30] Are you on the pulse of any of those areas in testing?
Dr. Kevin Maki: Yeah. I mean, so we know that omega-3 are necessary for proper neurological function. We know that in certain tissues, so the central nervous system, the retina, the testes, you have a transporter that’s important for getting omega-3s into those tissues.
And so, this is an important area of research. Does the peripheral level, [00:24:00] how well does that predict the level in these tissues where omega-3s play important roles? I think there’s good evidence in pregnancy, for instance, that you have a number of outcomes that are improved if the omega-3 status is optimal or at least not low.
I think that there’s good evidence in depression, clinical depression, for instance, that omega-3 status may be important, and [00:24:30] interventions to increase omega-3 status may be helpful. Other conditions like ADHD, for instance, attention deficit hyperactivity disorder.
So, I think there are a lot of areas where there is a growing body of evidence, but what we have is a lot of small studies. The one place where we have some larger studies is in pregnancy, but we have a lot of small studies and the results are not always completely [00:25:00] consistent. So, I’d love to see more randomized controlled trials.
And to go back to my initial comment, more trials where they recruit people with low status and then have an intervention to increase the status up to what we think may be more optimal levels.
Dr. Kristina Harris Jackson: And we’ve talked about this a decent amount because it flips a lot of the nutritional world when we’re so used to DRIs and everybody depending on age [00:25:30] and sex has this need for the nutrient. And we’re talking about, well, you need whatever you need to get to this level. So, it could be anywhere from 1,000 to 3,000 milligrams. And how do you operationalize that in a clinical trial? It seems like they do it for cholesterol. They test and titrate, right?
Dr. Kevin Maki: Yes and no.
Dr. Bill Harris: That’s tough.
Dr. Kristina Harris Jackson: That’s tough.
Dr. Kevin Maki: So, [00:26:00] the thing is that we used to talk about goals for LDL cholesterol.
Dr. Kristina Harris Jackson: That’s right. Yeah.
Dr. Kevin Maki: And then in 2013, we stopped because the criticism was the trials were not designed to treat to a goal. They were designed to test against placebo or test less intensive versus more intensive cholesterol level. And so, that’s another place where it would be really helpful to have a strategy of treating to [00:26:30] a goal level. We have very few of those trials for cholesterol. We have some of them in blood pressure, like the Sprint trial.
And I’d like to see more of that in omega-3s because I’d like to see omega-3 interventions applied in people who need them with low status and enough intervention given to raise a person to the level, the goal level that you’d like to see. But most trials are not designed that way.
And so, [00:27:00] I hope that I’m not just shouting into the wind here. I hope that some people will listen and start designing trials that way, and then that will be helpful to inform clinical recommendations about how testing can be used.
Dr. Bill Harris: Yeah. That makes sense.
Dr. Kristina Harris Jackson: Do you think with the reporting and the clinical trials that we should all be reporting a certain set of metrics? [00:27:30] We all have to measure plasma. We all have to measure red blood cells. So, everything is being reported in comparison to what’s clinically available. How do we start making them all make sense?
Dr. Kevin Maki: Well, when I’m king, that’s how things will be done, but I have not yet been coronated. And so, in the meantime, I think there are multiple tests available, and I think it’s going to be up to investigators. Again, I’d love to have everybody [00:28:00] using the same test to allow more apples-to-apples comparisons between studies. But that’s unlikely. And there are lots of considerations when designing trials.
So, from that standpoint, my overarching message is, let’s get status testing into trials. Let’s select people for trials on the basis of having low status, and then let’s give them enough intervention to raise the status to a level where we [00:28:30] think there may be a benefit. And whether you use one test or another is less important than using the tests and defining low and defining where you’d like to be.
Dr. Kristina Harris Jackson: Yeah. Within each test.
Dr. Bill Harris: Makes sense, that makes sense.
Dr. Kristina Harris Jackson: Yeah. So, does insurance cover any of these types of tests in your deep dive?
Dr. Kevin Maki: So, that is a question we did not address, and you’re [00:29:00] actually in a better position to answer that question than me. I think there may be some situations where insurance covers it, but I think in many cases, that won’t be true. But please let me know what you think about that issue.
Dr. Bill Harris: What’s your experience, Tina?
Dr. Kristina Harris Jackson: I think you can use HSA funds for our direct testing. So, we don’t do any insurance-based stuff here. We are all cash-based. And [00:29:30] that’s part of the reason we have trouble getting into the big labs because everything is, it’s the insurance, it’s the lab, it’s the medical system, and they’re all insular.
So, people could use their HSA funds to buy the direct test. There are CPT codes for gas chromatography specifically that we have a hospital system here uses in Sioux Falls. [00:30:00] And so, we get liquid samples from them.
But as far as the Quest, Quest and Labcorp, Boston Heart, Cleveland, and they’re all the same thing now when it comes to omega-3 testing, that would probably be more likely to be covered with insurance and then go along with probably a pharmaceutical. But everyone’s insurance is different, so I’m sure that’s like just a grab bag.
Dr. Bill Harris: You’re going to be covered [inaudible 00:30:29] but [00:30:30] the entire testing might not be covered.
Dr. Kristina Harris Jackson: Right. So, that’s where for us, we just try and keep our testing at a cheaper level that’s just cash, so we don’t have to enter the insurance world, which would make everything a lot more expensive.
Dr. Kevin Maki: Yeah. And one of the challenges is that when a clinician orders a test and doesn’t know whether it’ll be covered by insurance, you can have an angry patient coming back. This happens with apoB. So, apoB in some places, $20 [00:31:00] 30, we have seen bills for as much as $700 for an apolipoprotein B, which is classified by some insurance companies as an experimental test. It’s not really an experimental test. But a lot of clinicians are hesitant to order something if they’re afraid they’re going to get an angry patient waving a $700 bill in their face and saying, “Hey, [00:31:30] why are you ordering this crazy expensive test? Do I really need this.”
And so, that is one of the reasons that I think that both clinicians and consumers should be aware of the testing options if they’re wanting to get a test and then understanding is this going to be covered by insurance? And if not, consider getting it with out-of-pocket payment, which is going to be relatively modest.
Just to give you an example of that, a family member [00:32:00] of mine had a test, a coronary calcium test. And she booked it with a local place that does the testing. And then they called her and said, “Your insurance copay on this test is going to be $240. But if you go down the street, you can pay out-of-pocket 79 bucks.”
Dr. Bill Harris: Oh, really?
Dr. Kristina Harris Jackson: The whole thing or just with the copay?
Dr. Kevin Maki: Yeah. She said, “Absolutely not. I want to have the insurance copay.” [00:32:30] No, she didn’t say that. She went and got the $79 test, which was exactly the same test that is cheaper to pay for out-of-pocket than it is to pay the insurance copay. And so, that’s a bit of craziness in our medical care system. And I think you are likely to see the same thing with omega-3 status testing.
Dr. Kristina Harris Jackson: I think so. That’s a major blockade for us because we would love to be able to get into the more mainstream [00:33:00] testing because that also is, like you said, where more people who could benefit more from the tests probably have lower levels. That’s where they’re getting more of their care than the independent doctors that we are mostly working with.
And so, we feel there’s a little mismatch in where the biggest need is and where we can provide testing without completely changing everything, how we do everything. So, it’s frustrating because it’s just logistics and systems that don’t work together and [00:33:30] not really the science.
Dr. Kevin Maki: Sadly, there are so many more considerations than the science.
Dr. Bill Harris: Right.
Dr. Kristina Harris Jackson: Oh, yeah.
Dr. Bill Harris: So, I noticed this paper that’s coming out in Journal of Nutrition was sponsored or hired by GOED. Can you talk about that a little bit and who they are?
Dr. Kevin Maki: Sure. So, GOED is the global organization for EPA and DHA. And so, they are essentially [00:34:00] an organization for groups of companies that produce products related to omega-3s. And so, I guess I would ask you to describe, I think that at one time you were their chief science officer, is that right?
Dr. Bill Harris: No, no, no. I mean, I’ve been friendly with them for a long time. They’re the trade association.
Dr. Kevin Maki: Okay. The trade association. And so, [00:34:30] I think it’s important to say that they did fund this. And the purpose is really to get a reference available for clinicians to say, “If you’re in the United States, we also have some testing that is available outside the United States. But we wanted really to focus on tests that were available to clinicians and consumers in the United [00:35:00] States, and to just put together a list of where you can get testing done and then have a little bit of a background about why you might want to consider testing.”
And so, the final editorial content was left with the authors. And GOED was able to read the paper and comment on it. And [00:35:30] they saw it before it was submitted. But all of the editorial content remained with us. And I will say the paper started out quite a bit longer than it was, and we cut out a fair amount of material just because we didn’t want people to be overwhelmed.
And so, there are lots of areas of controversy or areas where we could have included more detail, but we decided not to just because we wanted to make it a user-friendly paper for clinicians.
Dr. Bill Harris: Yeah. [00:36:00] Do you know how people can get a copy of that?
Dr. Kevin Maki: A copy of the?
Dr. Bill Harris: The paper of your publication?
Dr. Kevin Maki: Oh, the paper. So, I think it’s going to be open access. It’s available now at the Journal of Nutrition website. And it’s currently in a pre-proof form. So, it’s not fully laid out, but it will be available in final form, I believe it’s later this month. We’ve received the galley proofs and we’re reviewing those. [00:36:30] And so, we’ll be getting those back to the journal shortly so that people can see the paper as it’ll appear in the journal probably within the next couple of weeks from the Journal of Nutrition website.
Dr. Bill Harris: Great, great.
Dr. Kristina Harris Jackson: That’s great. Any other questions? Anything else we want to talk about on this topic?
Dr. Bill Harris: We got some stuff I want to talk about offline, but we can do that [inaudible 00:36:51].
Dr. Kevin Maki: No. I think we’ve covered it well. I do want to say that [00:37:00] there was a paper that you published with Clemens von Schacky in 2004. And that was the paper that really got me interested in omega-3 fatty acids at the time, more related to prevention of fatal ventricular arrhythmias than what I’ve subsequently become more interested in, which is related to inflammation [00:37:30] and how a low omega-3 status may be proinflammatory and raising the omega-3 status up into the optimal range may help to maintain a better balance between inflammation and resolution. Just like you have coagulation and fibrinolysis, you have inflammation and resolution.
And I think in particular on the resolution side, omega-3 fatty acids may be particularly important. And so, there, [00:38:00] I want to say thanks to you and Clemens. And I’ll mention also that in Europe, he has a company, Omegametrix, that uses methodology very similar to what OmegaQuant uses. And I don’t know what differences may have evolved in the meantime, but…
Dr. Bill Harris: We certainly started out in the same place. Right.
Dr. Kevin Maki: Yup. So, I’ll just say thanks to both of you for that paper, which launched me on a 30, well, [00:38:30] in that particular paper, the next 20 years of-
Dr. Bill Harris: Twenty years. There you go. There you go.
Dr. Kevin Maki: … interest.
Dr. Bill Harris: Thank you. It’s been a fun ride. Okay. Well, thanks, Kevin. I guess we’ll wrap it up here. And we appreciate your time and your insights and for writing this paper. It’s been very helpful. Thanks a lot.
Dr. Kevin Maki: All right. Thanks so much for having me as a guest.
Dr. Kristina Harris Jackson: Thank you.
Dr. Bill Harris: Bye-bye.