Chances are good that your patients are already familiar with omega-3 fatty acids. But your patients may have had mixed results in the past. If that’s the case, they shouldn’t give up on omega-3 supplementation – they might simply need a different kind of supplement. And, of course, whether they are currently supplementing with them, or you are considering recommending omega-3s, there are excellent reasons for your patients to include these essential nutrients into a daily routine.

Omega-3s are Essential for the Heart and Cardiovascular System

Cardiovascular health is probably the number one reason to add omega-3s to a daily regimen, and there’s good reason for this.

Individuals with higher intake of eicosatetraenoic acid (EPA) and docosahexaenoic acid (DHA) have better protection against heart disease because they have healthier blood pressure levels, less blood platelet reactivity, lower triglyceride levels, and higher high-density lipoproteins (HDL)2 (good cholesterol) levels as well. They also have reduced inflammatory cytokine activity and healthier heart rates.

An open-label survey study saw dramatic results for cholesterol management.  In this study, 40 healthy volunteers took two tablets of phospholipid-bound omega-3 fatty acids per day without any modifications to diet or exercise habits. After 60 days, the participants saw their triglyceride levels drop by 16 percent, their total cholesterol decrease by 10 percent, and their HDL levels increase by 13 percent.

A Healthy Mind Thrives on Omega-3s

Of course, healthy brain and mood maintenance are also top motivators for practitioners and patients alike for adding omega-3s to any nutritional regimen. And like cardiovascular health, there is solid clinical and scientific support behind it, especially regarding the interaction between omega-3s and phospholipids.

• An Australian review found that DHA improves the blood flow in the brain during cognitive tasks, regulates the way that blood sugars are used in the brain, and reduces inflammation and oxidative stress.
• An Italian clinical study examined the effect of omega-3s on quality of life, phospholipids profile, and effects on depression in elderly female volunteers. At the end of only eight weeks, the participants reported significant improvements in depression and overall quality of life.
• A Portuguese study found that the natural layer of phospholipids in the brain is altered by chronic, unpredictable stress, (as are glutathione ratios). The researchers concluded that low phospholipid levels may be used as markers of depression, because of the way they physically affect the brain. In similar research at Columbia University, researchers found that low DHA levels tended to correspond with increased anxiety levels.

One aspect of omega-3 and mental well-being that has been investigated in recent years is the role of omega-3 and the endocannabinoid system.

Cannabinoids are generally associated with hemp, and specifically to CBD (cannabidiol). But one of the most important factors that determines how the endocannabinoid system will support optimal health is omega-3 intake and DHA status. But omega-3s aren’t just there as a scaffold for anandamide and other endocannabinoids – they may actually contribute their own.

Research shows that levels of DHA are directly related to a metabolite of the fatty acid called N-Docosahexaenoylethanolamine, or by the more easily remembered name, synaptamide. As its name implies, synaptamide is involved with developing and protecting brain cells. While DHA levels have been related to cognitive health and mood for some time, there may be much more direct involvement on the part of this omega-3 fatty acid on cognitive and mood health than was previously understood. More research will determine the exact extent of this, but in the meantime, recommending a source of omega-3s may noticeably bolster your patients’ state of mind.

Omega-3s Enhance Overall Well-Being

Aside from these major health categories, omega-3s can help enhance immunity, protect against intraocular pressure in the eyes, protect the delicate blood vessels in the retina, alleviate the symptoms of ADHD and menstrual pain, and promote brain and vision development in infants and children.

Additionally, other work has found that omega-3 intake significantly improved disease markers of rheumatoid arthritis and reduced inflammatory leukotriene B4, which left to its own devices, could ultimately destroy joints.

Omega-3s may also be another weapon in the war against type 2 diabetes. A clinical study found that in 12 weeks, omega-3 supplementation improved insulin levels, reduced C-reactive protein levels, increased glutathione, and reduced the wound size in patients with diabetic foot ulcers.

Some researchers have also found that women with a higher omega-3 to omega-6 intake have lower risk for breast cancer in the first place, but for those who do get breast cancer, the nutrients also reduce chemotherapy-associated muscle mass loss and weight gain and promote better insulin levels.

Not All Omega-3 Supplements are the Same

However, as positive as all of the evidence is behind omega-3s, it may surprise your patients to learn that there are great differences between the form and quality of omega-3 supplements.

Although omega-3 supplements are readily available almost everywhere, there is very little differentiation for patients as to what they should look for. Unfortunately, the quality of omega-3s, most of which are available in oil forms that may have been harshly processed and have a great likelihood of going rancid, is often open to question.

There are several levels of testing that are required to assure quality of a marine oil and extracts from marine sources. There must be an evaluation of heavy metal content and contaminant exposure, like PCBs and residual pesticide components. All ocean fish have some level of contamination. We have not been good stewards of our environment. Unfortunately, the location of the fish harvest is not a guarantee of purity – the proof is in the testing, no matter where or how a fish is obtained. Ensuring that supplements have been tested is routine in a practice, but if your patients have been picking up their own omega-3s, they might not realize the importance of it.

The Omega-3 Sources, Processing, and Carriers Make the Difference

Fish-sourced omega-3 fatty acids are predominantly found on a triglyceride (glycerol) carrier. In some cases, the oil is further refined and reacted with ethanol (alcohol) to produce an ethyl ester form. Both triglyceride/glycerol and ethyl ester (ethanol) oils are subject to increased risk of rancidity and instability. In fact, tests of these sources of omega-3 have found significant problems with elevated free radical activity and the presence of heavy metals. In contrast, when the omega fatty acids are on a phospholipid carrier, they are not only more readily absorbed, but they are less subject to rancidity and instability and include other beneficial components not found in oils.

Phospholipids are Essential Too

Along with purity, the form of an omega-3 supplement can add value for your patients, too. For instance, DHA is typically connected to phosphatidylethanolamine (PE) and phosphatidylserine (PS) and EPA is associated with phosphatidylinositol (PI) in the brain.

So, a phospholipid-bound omega-3 supplement tested for purity, more stable than oils, and from a single source – salmon – makes the most sense.

Because this form is more stable, it virtually guarantees compliance. This is a real bonus for patients who have struggled with fish oil because they don’t like fishy-tasting burps or are so “hit-and-miss” with their supplementation that the oil goes rancid. The absorption of omega-3s is much better with phospholipids than triglyceride-bound oils as well – it is simply a more natural fit for the body. And dosage levels of this form of omega-3 supplement, because of superior absorption, can remain low – another plus for patient compliance.

So, what goes into making a cleaner form of omega-3s from salmon? A unique process pioneered by French researchers at the University of Nancy. This process uses water and enzymes immediately following the salmon catch – no intensive heat or harsh solvents that would otherwise damage or alter the natural structure of the omega-3s and other beneficial compounds. That means that the supplement supplies a wealth of phospholipids and peptides.²

And that makes a big difference.

Consider this in-vitro study published in the Journal of Neurochemistry. Researchers pre-treated neuronal cells with DHA from this phospholipid-bound omega-3 source for 48 hours before exposing these cells to soluble oligomers of amyloid-beta peptide, which are known to cause the brain cell damage associated with Alzheimer’s.

The DHA pretreatment greatly increased neuronal survival and reduced damage. The researchers concluded that “Such neuroprotective effects could be of major interest in the prevention of Alzheimer’s and other neurodegenerative diseases.”³

Fish oil and to a lesser extent, krill oil, have been a standard for supplementation for a while, so it may be a challenge for patients to consider a different form. But even though fish oil provides DHA and EPA, all fish and krill oil have some level of rancidity, and it can be difficult for people to get the levels they need from that source. And while krill oil can provide omega-3s and some phospholipids, its processing also changes the configuration of the DHA and EPA. It also doesn’t provide the heart and neuron-protecting peptides found in the phospholipid-bound form from salmon.

The benefits of having phospholipids as an inherent part of the supplement really can’t be discounted – it potentially makes what would otherwise be a standard omega-3 recommendation into a multi-nutrient addition to a patient’s regimen. The list of phospholipids provided by the form of omega-3s from salmon reads like a “who’s who” of nutrients:

• Phosphatidylcholine (PC) – Protects cellular mitochondria from oxidative damage, including cells in the brain, heart, and eyes.
• Phosphatidylethanolamine (PE) – Helps build the protective myelin sheath around nerve cells to keep nerve signals firing properly.
• Phosphatidylinositol (Pl) – Plays a major role in nerve and brain signals.
• Sphingomyelin (Sph) – A strong supporter of overall brain health and cellular strength.
• Phosphatidylserine (PS) – One of the most widespread phospholipids, often recommended as a stand-alone supplement for brain health because of its multiple roles in building and maintain healthy brain cells and preserving neural function.

Without a doubt, omega-3 fatty acids have shown remarkable benefits. Getting omega-3s in the diet is truly essential. But they are only valuable if they are not oxidized and if they are bioavailable. If you have patients who have struggled with keeping an omega-3 regimen, it may be time to rethink the delivery of these nutrients with a clean, pure, and effective source for consistent, ongoing benefits. A phospholipid-bound form of omega-3s from salmon can help reset your patients’ experiences and expectations as they notice concrete results on their path to optimal health.