We published more than 50 blogs this year on a variety of topics, from omega-3s and COVID-19, to nutrient deficiencies and pet wellness. Throughout 2021 OmegaQuant.com visitors spoke with their clicks and selected the following as their top 5 for 2021. Read along with us as we recap these impactful blogs and dig into why they became so popular with all of you.
What is most interesting about this particular blog making it into the top 5 is that it was only published a little over two months ago. However, as we all can attest, COVID-19 continues to loom large in our lives, which is probably why this blog captured a lot of clicks.
This blog recaps recent research on the mechanisms behind why and how omega-3s exert their effects in the face of COVID-19. It also talks about a small study published earlier this year featuring the Omega-3 Index (i.e., blood levels of omega-3s EPA and DHA) and COVID-19 where the risk for death was higher in those with a lower Omega-3 Index. A July study then confirmed these findings.
The first Omega-3 Index/COVID-19 pilot study was published in January of 2021 and compared the associations between the Omega-3 Index and risk for death from COVID-19 in 100 patients. Researchers found that patients with an Omega-3 Index of 5.7% or higher were at about 75% lower risk for death than those below that value — an ideal Omega-3 Index is around 8%.
This was the first study to directly test the hypothesis that omega-3 fatty acids, and specifically a higher level of these fatty acids in the blood, could benefit COVID-19 patients. In other words, the closer someone was to an 8% Omega-3 Index, the more “protected” they seemed to be from death related to COVID-19.
A follow-up study published in July 2021 confirmed these findings and found an inverse association between the Omega-3 Index and significant clinical outcomes of severe COVID-19. Subjects in the lowest Omega-3 Index quartile (those below 3.75%) had a 3.1-fold higher risk of dying from severe COVID-19 than patients in the highest Omega-3 Index quartile.
Moreover, those subjects in the highest quartile reduced the risk of mechanical ventilation by half. The authors concluded that omega-3 status might profoundly influence the inflammation resolution and airway mucosal immunity needed in response to COVID-19.
This blog also talked about how omega-3s are related to COVID-19 in the first place.
The health benefits of Omega-3s cover a wide range of different systems, including cardiovascular health, brain health, vision, and neurodevelopment. Omega-3s are also well-known mediators of inflammation and can amplify anti-inflammatory responses.
Since accumulating evidence suggests inflammation-induced lung injury and dysregulated immune responses play roles in the pathophysiology of severe COVID-19, omega-3s may be an attractive approach to preventing and mitigating severe outcomes by resolving the cytokine storm.
Omega-3 fatty acids EPA and DHA are the main precursors of a novel superfamily of molecules called specialized pro-resolving mediators (SPMs). These substances are critically important in the homeostasis of inflammation resolution and airway mucosal immunity.
The conversion of omega-3s to SPMs actively disrupts inflammatory circuits and skews the immune response toward a return to equilibrium. SPMs have also been found to inhibit viral replication and reduce the severity of viral pneumonia in experimental models.
Additionally, omega-3 fatty acids have been found to (1) inhibit the production of pro-inflammatory mediators like IL-6, and TNF-alpha, as well as mitigate cytokine storms; (2) dampen the inflammatory response through T-cell differentiation; and (3) enhance the anti-viral effect by boosting the activity of the innate immune system and inhibiting viral replication.
It is through these actions that omega-3s might present a safe and relatively inexpensive, protective approach for those who are at risk and have contracted the novel virus.
While there is still limited research on COVID-19 patients due to the novelty of the disease, there is data from previous clinical studies supporting the beneficial role of omega-3s in certain aspects of the COVID-19 disease process. For one, research has found that an optimal Omega-3 Index is inversely associated with pro-inflammatory biomarkers and that omega-3s routinely lower cytokine levels.
A recent meta-analysis of 12 randomized controlled trials (including over 1200 patients in total) performed in patients with ARDS concluded that omega-3 supplementation was associated with improvements in lung function, shorter ICU stays, and shorter duration on mechanical ventilation, in addition to a significant reduction in mortality.
This blog was written about a late 2020 study published in the Journal of Clinical Lipidology, which studied the effects of fish oil products containing docosahexaenoic acid (DHA) on LDL-C levels. This research paper was a collaboration between the Fatty Acid Research Institute (FARI) and The Cooper Institute.
There is good evidence that people with very high serum triglyceride levels (>500 mg/dL) who are treated with high doses of omega-3, i.e., 4 g/day of EPA (eicosapentaenoic acid) and DHA commonly see a rise in LDL, but the researchers in this study contend that whether this occurs in the “real world” with generally healthy people taking fish oil supplements for cardioprotection is unclear.
The investigators utilized data from more than 9000 healthy men and women who had at least two preventive medical examinations at Cooper Clinic in Dallas over a 10-year period. These examinations routinely included both blood cholesterol testing and measurement of the Omega-3 Index. Questions about current use of fish oil supplements was also collected.
With this information, the researchers then asked 2 questions: 1) did people who started taking fish oil supplements between visits experience a rise in LDL cholesterol levels, and 2) did LDL cholesterol levels rise in people whose red blood cell (RBC) DHA levels increased between visits?
It turns out that the answer to both of these questions was “no.” In fact, a 1-unit rise in RBC DHA levels was associated with a small (1-2 mg/dL) but statistically significant decrease in LDL cholesterol. And this analysis took into account concurrent changes in background use of cholesterol-lowering drugs like statins. This small decrease in LDL cholesterol is not a clinically-relevant, but this study shows that fish oil supplement use in the general population does not adversely affect LDL cholesterol.
Our blog on omega-3s and dogs was surprisingly popular with our audience this year! Maybe it’s because many of you, while seeking out omega-3s for yourselves, are also doing so for your dogs. And for good reason.
If you’re wondering “can I give my dog omega-3 fish oil?” the answer is “yes.” Not only can you give your dog omega-3s, but you probably should. Because if your dog is anything like you, they are probably falling short of this essential nutrient.
Below are just some of the way omega-3s can benefit your dog. But before you start giving them these important nutrients either through fish or supplements, consider two important things — 1) talk to your vet first about how to safely incorporate them in their diet; 2) consider testing your dog’s omega-3 level with an Omega-3 Index for Pets test.
4 Reasons to Consider Omega-3s for Your Dog
- Heart Health. Chronic, high inflammation is associated with heart disease and omega-3s are known to reduce inflammation. It’s the EPA in omega-3s that are generally viewed as the inflammation warriors and are worth considering as one tool in the toolbox of preventing and maintaining a healthy heart for your canine.
- Brain Health. This is where the DHA in omega-3s takes the lead. DHA helps developmental growth of the brain and helps prevent deterioration as your dog grows older. By all means use those brain twister toys for Fido and Fifi, but don’t discount the virtues of DHA for cognition.
- Joint Health. If you’re noticing that your dog is a little slow, a little stiff, when they get up from a nap or work their way off the couch, omega-3s may be a partial solution. It’s back to the role these nutrients play in reducing inflammation (which causes swelling and pain). And if your dog has arthritis, ask your vet how omega-3s can help.
- Skin and Fur Health. Who doesn’t want their dog to look good? But it’s not just about looking good. If your dog’s skin is supple and their coat is shiny, those are indicators of good health. Omega-3 fatty acids help moisturize your dog’s skin, which in turn may help reduce shedding, prevent dandruff, and lessen itchiness.
You have questions and we have answers, but sometimes maybe not exactly the ones you’re looking for. Part of our duty at OmegaQuant is to distill the science for you so that you can make informed decisions about diet and health. In this case, we decided to tackle the question this blog post poses because A LOT of you are asking the question — Does Fruit Contain Vitamin D?
First and foremost, there are no fruits that contain vitamin D. However, this is not a reason to ditch these healthy foods — they deliver plenty of other important nutrients that are important to your health and wellness. And if “food first” is your thing, you can still find vitamin D in foods like salmon, dairy, eggs, beef liver and mushrooms.
Here are a few nutrient-dense fruits to consider.
1. Apples. The old adage “an apple a day keeps the doctor away” is a testament to the health benefits of this popular fruit. But guess what. When it comes to Vitamin D, it doesn’t matter if you’re eating them raw, baked, or boiled, with or without skin, because apples don’t contain any vitamin D at all. However, they’re rich in fiber (eat the peels) and high in antioxidants like vitamin C.
2. Avocados. Avocados are a healthy fruit, and one of the “good fats.” They’re a great source of several nutrients, including many of the letter vitamins, like vitamins C, E, K and some of the Bs. While you won’t find vitamin D in avocados, they do play an important role in helping your body absorb this important nutrient. So, there’s that!
3. Bananas. Nope, no vitamin D here. But bananas do contain plenty of magnesium. And guess what? Among the many reasons you need magnesium is that once your vitamin D is in your bloodstream, the magnesium puts it to work, making magnesium a must-have in order for you to access the many benefits of vitamin D.
4. Blueberries. By now you’ve no doubt heard that the blueberry is considered a “superfood.” That’s a food that is nutrient-dense, packing a punch when it comes to benefits but one that is also low in calories. They’re chock full of antioxidants (like vitamin C) and high in fiber, vitamin K, manganese and potassium. But vitamin D is neither hiding nor in plain sight in blueberries.
We’ve made it to the #1 blog of 2021 — a post about the relationship between omega-3 and headaches, based in large part on a study published last July.
This study, which appeared in BMJ, showed that eating a diet rich in omega-3 fatty acids reduces the frequency of headaches compared with a diet with normal intake of omega-3 and omega-6 fatty acids.
Modern industrialized diets tend to be low in omega-3 fatty acids (found in marine sources such as cold water fish like salmon) and high in omega-6 fatty acids (found in nuts, seeds and vegetable oils). Both classes of these fatty acids are precursors to oxylipins — molecules involved in regulating pain and inflammation.
Oxylipins derived from omega-3 fatty acids are associated with pain-reducing effects, while oxylipins derived from omega-6 fatty acids worsen pain and can provoke migraine. But previous studies evaluating omega-3 fatty acid supplements for migraine have been inconclusive.
So a team of US researchers wanted to find out whether diets rich in omega-3 fatty acids would increase levels of the pain-reducing 17-hydroxydocosahexaenoic acid (17-HDHA) and reduce the frequency and severity of headaches.
Their results are based on 182 patients at the University of North Carolina (88% female; average age 38 years) who experienced migraine headaches five to 20 days per month. These subjects were randomly assigned to one of three diets for 16 weeks:
- A control diet that included typical levels of omega-3 and omega-6 fatty acids
- An interventional diet with higher omega-3 and low omega-6
- An interventional diet with higher omega-3 and typical omega-6
During the trial, participants received regular dietary counseling and access to online support information. They also completed the headache impact test (HIT-6) — a questionnaire assessing headache impact on quality of life. Headache frequency was assessed daily with an electronic diary.
Over the 16 weeks, both interventional diets increased 17-HDHA levels compared with the control diet, and while HIT-6 scores improved in both interventional groups, they were not statistically significantly different from the control group.
However, headache frequency was statistically significantly decreased in both intervention groups.
The high omega-3 diet was associated with a reduction of 1.3 headache hours per day and two headache days per month. The high omega-3 plus low omega-6 diet group saw a reduction of 1.7 headache hours per day and four headache days per month, suggesting additional benefit from lowering dietary omega-6.
Participants in the intervention groups also reported shorter and less severe headaches compared with those in the control group.
This was a high quality, well designed trial, but the researchers do point to some limitations, such as the difficulty for patients to stick to a strict diet and the fact that most participants were relatively young women, so results may not apply to children, older adults, men, or other populations.
“While the diets did not significantly improve quality of life, they produced large, robust reductions in frequency and severity of headaches relative to the control diet,” the researchers said.
“This study provides a biologically plausible demonstration that pain can be treated through targeted dietary alterations in humans. Collective findings suggest causal mechanisms linking omega-3s and omega-6s to [pain regulation] and open the door to new approaches for managing chronic pain in humans,” they conclude.
These results support recommending a high omega-3 diet to patients in clinical practice, says Rebecca Burch at the Brigham and Women’s Hospital, in a linked editorial.
She acknowledges that interpretation of this study’s findings is complex but points out that trials of recently approved drugs for migraine prevention reported reductions of around 2-2.5 headache days per month compared with placebo, suggesting that a dietary intervention can be comparable or better.
And that does it for our top 2021 blogs! Let’s remember that adding simple but important nutrients to your diet can make a huge difference. But before you even get to that step, talk to your doctor about assessing your nutrient levels first to see where exactly you might need to make up for some shortfalls. Then make a plan to safely make changes where you need to.
Happy New Year to all of you. Let’s make it a healthy one!