Saturday, November 28, 2009

Why DHA/EPA of Omega 3's (like fish oil) are Anti-Inflammatory - Q&A with G.Fear, RD

Perhaps you've heard that one of the benefits of omega 3's like fish oil or algae oil is good for among other things, anti-inflammation. Some folks tend to blend things like glucosamine as well with fish oil to enhance anti-inflammation around joints in particular. Have you ever wondered why this stuff works or what the difference is between glucosamine, omega 3's and even what eric cobb refers to as Vitamin I, the NSAID Ibuprofen?

The following is part of a discussion with Georgie Fear, RD (of, author of the awesomely easy and tasty Dig In recipe book.

The discussion took place on Precision Nutrition's Forum a little over a year ago. (by the way, this exchange is typical of the kind of discussion at PN - here's more about Precision Nutrition if you're interested).

So, the question was to unpack fish oil, glucosamine and NSAIDS. To begin, so how are fish oils anti-inflammatory?
Georgie Fear:

Twenty-carbon long omega 6 and omega 6 fatty acids are metabolized in cells to eicosanoids, which are signaling molecules. Cyclooxygenases and lipoxygenases produce the eicosanoids from either arachidonic acid (omega 6) or eicosapentaenoic acid [EPA] (omega 3). The eicosanoids derived from omega 6 fats are potently inflammatory while those coming from omega 3 oils are antiinflammatory.

Critical Bit for Diet: Because the omega 3 and omega 6 fatty acids compete for the cyclooxygenases and lipoxygenases, the balance of omega 3 to omega 6 fats in the diet will influence the overall inflammatory or antiinflammatory effect. Skewing the diet with more omega 3's and less omega 6 produces fewer inflammatory eicosanoids, becuase the omega3s outcompete the 6s for the metabolizing enzymes.
Aspirin and other nonsteroidal anti-inflammatory agents (NSAIDS, like ibuprofen) work similarly, by inhibiting the cyclooxygenase which converts arachidonic acid to inflammatory prostagandin H2. (Ever heard of COX 2 inhibitors, like vioxx? COX = cyclooxygenase) Acetaminophen (Tylenol) has less anti-inflammatory effect, and the mechanism(s) by which it reduces pain aren't totally known. I've read that it may also involve the cannabinoid system in the central nervous system, but I'm not an expert in that so I cant give much detail.

Glucosamine is totally different. It helps mainly with osteoarthritis because it is a building block for the gycosaminoglycans which make up the cartilage in joints. Taking glucosamine can help rebuild the cartilage and cushion joints where the layer has broken down. But as far as I'm aware it doesn't act so directly on the inflammatory cascade.

mc - so fish oil is competing for the Cyclooxygenases but NSAIDS inhibit their production. is that right? Also, on another point: NSAIDS have some icky side effects - in particular water retention. hate that.

Close, the omega 3's outcompete with omega 6s for the COX enzymes, while the NSAIDS inhibit the cyclooxygenases' activity altogether. (So the production of inflammatory eicosanoids is lessened. )

Of course there are more details, like COX1 vs COX2 vs COX3....hence all the different painkillers with different efficacies and side effects. The specificity of different drugs for each isoform varies.

Another anti-inflammatory group of compounds which can be obtained from foods are anthocyanins, thats what my PhD thesis research actually focuses on. I'll skip the mindnumbing detail, but the blue/purple compounds which give the bright colors to blueberries, blackberries, red cabbage, etc are also great functional foods for combating inflammation. And cancer, and diabetes...and cardiovascular disease......

There has been research done in which consuming about 10 tart cherries a day is equivalent to taking a daily aspirin. Personally, Ive seen remarkable benefits of eating fish (oil) and anthocyanin-rich foods in a few clients with rheumatoid arthritis. Not a scientific study, just my own experience. :)

mc so would you say tho that fish oil is going to "mask" an injury??

No I wouldnt say so. Fish oil does nothing to your pain perception, so its not like you will be fooled into thinking an injury is gone when it isn't. It may reduce the discomfort caused by inflammation such as swelling, and in some cases, inflammation actually makes the injury worse. So perhaps taking fish oils could reduce the severity of the injury. Somewhat like applying ice and compression to a sprain keeps the swelling minimal and it heals faster than if you never iced it. [mc -hmm on the ice analogy - a b2d article in the offing about what we really do know about ice or not...]

I'd say its more part of the healing process than masking an injury.

additional thought: anti-inflammatories don't shut off ALL inflammation, (that would not be good!) they just tone it down a bit.

Timing of ingesting fish oil?

The funny thing here is that fish oils don't work on such a short-term basis. Its not like taking them one day or not would make a difference that day. Fatty acids you eat all the assimilated into the phospholipid membranes of all your bodies cells- the downstream effects of the fatty acids are affected by overall fatty acid pool in your body (in this case the omega 6 to omega 3 ratio) - and that doesnt change in one day of taking or not taking fish oils.

So now you know! Taking omega 3 sources rich in EPA like fish oil is a Good Idea for healing and inflammation processing. For folks taking Algae Oil for omega 3 content, algae is higher in DHA than EPA. Work has also considered the effects of DHA on inflammation, and it's looking very good here too. Very new work considering DHA in the mix with EPA on COX2 in particular is strong. Likewise an article from the future (pub date 2010) equates DHA and EPA for their anti-inflammatory benefits. In other words, you can remain a vegetarian and get all these anti-inflam benefits.

Overall, another take away is that upping the ratio of Omega 3's to Omega 6's (eg eggs) may be a good idea for well-being.

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1 comment:

Georgie Fear, RD, CPT said...

yes, for the vegetarians out there, the best way to get EPA and DHA is algal sources. You can get ALA (alpha linolenic acid) from many more plant sources, such as flaxseed and walnuts, but the conversion rate to EPA and DHA in the body isn't terribly high. Omega 6 fatty acids also inhibit the conversion of ALA to the longer chain DHA and EPA. Drat. (again by competing for enzymes)


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