Regarding the hamburgers: Was the blood sugar increase due to some sort of recipe used or did you purchase the ground beef not knowing bread was added to it? A strange place to find it I'd say! I'll probably switch to grinding my own now.

Doctor Davis... YOU ROCK!!

I'm a T1.5... who lost 78lbs, I have normal blood sugar ...for non-diabetics.

NO meds, NO insulin... Keep Spreading the word... to ALL.

Love your blog ...

Steve

I can pretty much count on higher BG readings when I eat at group meal gatherings away from home, unless I bring and eat only my own food.  I don't normally eat much processed convenience food, so I forget that boxed heat & serve breakfast sausage links can be full of sugar.  I also now know to steer clear of table grapes and fruit trays (I used to make sure to have fruit with the bacon or sausage and eggs for breakfast to deflect the comments from others, but now I don't bother with the fruit  because it's always too high-sugar.  

At restaurants I ask for dressing on the side if I use dressing at all.  I dip my fork in the dressing before spearing a bite - that provides enough flavor without all the dressing.  Most of the time I avoid the dressings because they are made with soybean or canola oil anyway.  I ask for Olive Oil and Vinegar - not vinaigrette, which is often sweetened.  

At home I always make salad dressing or simply toss with EVOO and a good vinegar, freshly ground SS & BP.  It's been years since I bought salad dressing.  Homemade is a breeze to make (even Ranch style) and economical, too.

Frozen yogurt is far worse than full fat high quality ice cream.  Frozen yogurt almost always has more sugar and no fat or eggs to slow the absorption of the sugar.  Homemade ice cream is the best because you can control the sweetness level and use more cream and egg yolks (commercial is too sweet-tasting for me anymore, BG notwithstanding).  

OJ - like a glass of pure sugar - absorbs into the blood stream nearly instantly.  I have a valencia orange tree in my garden but I don't dare drink the juice straight.  I put a tiny splash of freshly squeezed OJ or drop a squeezed orange wedge in a tall glass of Gerolsteiner sparkling mineral water (good source of magnesium).

BBQ sauce & catsup - loaded with sugars - watch out for honey mustard sauce, too.

Here is a link to a recent study that says vitamin D has no real link to heart health. Perhaps you can comment on this.

http://www.reuters.com/article/idUSTRE6205AQ20100301

Michael

I looked at the back of my vinegar and it has 5 grams of carbs per tablespoon, 2 of which are sugars. But the only ingredients listed are red wine vinegar and grape musts.

Michael,

That article isn't talking about a new study per se, but rather a review of several select studies. In other words, it's not really providing any new information. It's a (biased) interpretation of a sampling of the existing data.

I found this quote from the article to be pretty funny:

"Now, if there are specific instances of vitamin D or calcium deficiency, then that's a separate issue that should be discussed with a personal physician."

Uh, except it's hardly a separate issue since nearly everyone is deficient in vitamin D.

David

grape musts? That should have given you a clue. Grapes are very high in sugar. It always comes down to the same thing: Always read the labels. Carefully. Never trust anything that is processed. Not even if you buy it in Health Food shops.

You don't need to test your blood sugar.  You can figure whatever your favorite carbs are, those are the ones that are spiking your blood sugar the most.  

Mostly this is because you ingest those in greater quantities since you like them, but partly because you choose those because the blood sugar rushes feel good.

"You don't need to test your blood sugar. You can figure whatever your favorite carbs are, those are the ones that are spiking your blood sugar the most."

No. This is not a reliable way to go about things, as it isn't always true. It's never good to simply trust your feelings. Being objective with a glucometer isn't difficult or expensive. There's nothing to lose.

re hamburgers, also watch out for worcestershire sauce! Just discovered (much to my dismay) that the brand I had been using contains molasses and high fructose corn syrup. Yech!

Michael said...
"Here is a link to a recent study that says vitamin D has no real link to heart health. Perhaps you can comment on this.
Calcium, vitamin D pills don't help heart: study"
The RDA for Vitamin D is set for bone health. Therefore, an RDA dose of Vitamin D makes no difference to anything except bone health. It takes a dose about ten times the RDA to be effective elsewhere.

If you give people one tenth the correct dose of a medication, would you be surprised that the medication is ineffective?

Nige.

so easy to make homemade tomato soup, still a little high in carb's but nowhere near store boguht, handy if you absolutely must have a bowl of tomato soup.  Use tomato paste, water and some heavy cream and salt to taste.  you don't need the cream, but it tastes better.  One of the fastest "homemade' soups.  Keep in mind that tomatoes do have carbs, about 4 per 2 tbsp of paste.  You can add splenda to sweeten a little

It's infuriating that sugar and starch show up in places you would least expect them.  You have to read labels very carefully.  I've been burned by failing to read labels.  Even better, eat real food prepared from scratch.

Thank you for the heads up! Once I exhaust my fish oil, I will switch to the triglyceride form.

I wanted to drop by and thank you for scaring the sh*t out of me regarding a high wheat carby diet and atenolol.

My blood pressure seems to be genetic and quite stubborn, but since taking your advice (plus some supplements) I have been able to lower it from 150/100 to around 128/92 and going down.

Something I have also noticed...my pulse used to be quite high all the time- Around 80-90 (I am 29). Now it is always in the 60s. Could this be due to the supplements? Or low carb? Is this healthy?

Which brands do you recommend?
I can't find where my cotsco fish oil states which type it is?

In case anyone else uses Nature's Answer, I've just contacted their customer services who say
" This product IS the triglyceride form.
Thank you,
Ellen Kamhi PhD RN"
At $14.95 from Iherb 16 fl oz it's good price and tastes fine.
CODE WAB666 saves $5 off initial IHERB purchase. Maybe cheaper elsewhere but IHerb ship cheap to UK.

Hi, Flavia--

Those are all positive changes, including the drop in heart rate. It reflects a reduction in adrenaline. A reduction in heart rate is a powerful marker for overall health.


Anon-

Costco is the ethyl ester. It is a fine brand, just less well absorbed, of course.

I have some vitamin D gelcaps and they smell like fish. Are these oxidized too?

You say not "overly oxidized" at one point in the post.  

I am generally concerned about the fish oil I buy being oxidized.  There is a brand of fermented fish oil which purports to avoid this problem of oxidation with storage.  

Is it your position that concerns about oxidation are sometimes (or at least mine) are overblown?  Or that the oxidation that occurs with normal storage etc. is acceptable?

Hi Dr Davis,

If I eat high omega-3 wild salmon once a week, high omega-3 wild sardines once a week, grass pasture butter with 225mg of naturally occurring omega-3 per serving, and organic eggs that have a bit in there as well, do you think I am getting enough for a healthy ratio? I also take the Green Pastures FLCO and HVBO blend.

I do not eat ANY vegetable oils, ever. I only use coconut oil and ghee to cook, so my O6 intake has got to be pretty low.

What are your thoughts on being able to obtain adequate levels of healthy omega-3 from foods where it is naturally occurring?

Thanks,
Jack Kronk

Dr. Davis (or others): Based on what you say, since my fish oil brand is silent on what kind, I'm assuming it's the ethyl ester form.  But, I just wanted to check to see if anyone knows for sure: the brand I've been using is Carlson ("The Very Finest Fish Oil"), liquid form in a bottle - not the capsules.

I take the Carlson lemon cod liver oil. Is their any disadvantage to this over fish oil?

What about Krill oil?

Dr. Davis said: "Those are all positive changes, including the drop in heart rate. It reflects a reduction in adrenaline."

No wonder every time I take my BP at Walmart my pulse is higher!!

Where does krill oil fit into this?

Natural Factors omega-3 is ethyl ester processed form.

Dr. Davis,

Can you comment on the recommended dose for an ApoE 3/4 like me?  I've been told by a BHL educator not take any, but I don't like the idea of that.  I was thinking I may try just 500-600mg/day.  Of course, I've been using Kirkland's which apparently is less bioavailable anyway...

As a nutritionist who's worked in the fish oil industry for 20+ years, I may be able to add some insight.

Yes, Triglyceride (TG) and Re-esterified triglyceride (rTG) forms are better absorbed than the Ethyl Ester form (EE). At least in the short term. And the Phospholipid (PL) form is roughly 50% better absorbed than rTG.

Then why don't we all take PL form found in Krill oil? Well, there isnt much Omega-3 in Krill to begin with. And the PL-bound Krill Omega-3 are very temperature sensitive, so you won't see anyone concentrating it.

BTW, the folks at Neptune Krill Oil have some unpublished data that shows the difference between TG and EE diminishes to insignificance over time.

TG form is natural, no need for pre-conversion before absorption. That does not mean that your body won't use EE. It will. Just requires another step. It's just that TRUE natural TG is not very concentrated. Usually about 30% Omega-3 or so. Anything above 50% is likely to be EE. But most EU nations only allow TG form, so if you want a concentrated fish oil, you jack it up to 60 or 70% as EE and then re-esterify it. Additional process and can be done, but it will cost you. I'm currently working with some 90% rTG material. This raw material is 10 to 20X more expensive than what goes into Walmart brand fish oil.

I'm guessing (but it's a good guess) but more than 95% of fish oil studies are done on EE form. So all the benefits you've read about don't go out the window if you are taking EE instead of TG. Forget Lovaza, next-gen EPA-based drugs like Epadel, Epanova and still-pending AMR-101 are all EE.

Most fish oils, if not all, sold at retail stores are EE. Because it is cheaper. Specialty and online sources are your best bet for TG and rTG.  Go to 3rd party testing IFOS website and look under product type - it will tell you if it is EE or TG. http://www.ifosprogram.com/ifos/consumerreport.aspx

Issues with the Dyerberg study: 1) 2 weeks is way too short a duration to figure this out. 2) they did not compare TG oil to a placebo (corn oil?). Instead, they compared it to EE. Comparison to placebo would have put things in perspective. The Neubronner paper addresses this issue.

As I understand it, part of the tradeoff involves potency and how much EPA/DHA you can pack into a capsule. Ethyl esters are going to be more "compact" than trigylceride chains. I take Life Extension brand, and I honestly don't know which form it is. Perhaps it is the ester form. I get 3600 mg of combined Omega 3 activity from six capsules a day. If the trigyleride form would mean 10 or 12, I don't know that the trade is worth it in money or hassle. I know some of these other brands like Pharmax are supposed to be good, but I draw the line at doing "shots" of unencapsulated fish oil!

As an aside, does anyone have any suggestions for me? I'm 40, pretty close to ideal weight, non diabetic and I still struggle with high TG, now 292 even with fish oil and 1 gram a day of IR niacin... Not a big wheat eater either although I do have a nasty breakfast cereal habit.

It is worth noting that as little as 38 g of sardines provide more "net" O3, of the "good" type, than 2 fish oil softgels: bit.ly/gsaJI3.

Dr Davis

do you know which is the best KOsher fish oil?
most of brands have vegetarian capsules, but there is a liquid one from Nutri-supreme research

Thank you, thank you. At least there are some honest doctors (as Dr. Davis) who are not robots and don't view the FDA's stamp of approval as divinely authoritative and perfect.

Just to check: Are triglyceride forms always in bottles? Or can we also get them in capsules?

While exploring this subject I came upon this article which clearly expands on the difference between TG and EE fish oil forms.

http://www.ascentahealth.com/health-science/science-articles/fish-oil-triglycerides-vs-ethyl-esters-as-nature-intended

Rick said...
"Just to check: Are triglyceride forms always in bottles? Or can we also get them in capsules?"

To say it lightly, I prefer to get them off the back of my fish like wild caught salmon but especially with sardines like Ned referred to since the mercury content is extremely low to nonexistent.

Also, it may be more beneficial consuming supplements naturally in whole foods, if you can get enough. That in itself is not an easy endeavor. Don't get me wrong, I do take my fish oil capsules especially when consuming high 6:3 ratio foods but am trying to incorporate more nutrient dense foods that contain known rich supplement content.

It would be nice to see more research addressing synergistic effects of nutrients in foods like Dr. Price's findings regarding fermented cod liver oil and high vitamin butter oil.

Hi, Jack--

No, not even close.

It also depends on why you take fish oil and/or obtain omega-3 fatty acids and whether or not you have coronary atherosclerotic plaque, among other things.

The only brand of canned salmon/tuna and canned sardines I eat is from Wild Planet. I am not affiliated with them and this is not an advertisement, but they really seem to do the whole process perfectly. They also do not add any vegetable oil or water. They have very low mercury content and very high natural omega-3 content. The omega-3 in their tuna is even higher than the salmon. Also, they explain the importance of low mercury and how it all works.

Have a look at their site:

Wild Planet

cheers,
Jack Kronk

I often wonder if krill oil is an even more superior source of DHA and EPA simply because they come within the matrix of phospholipids. Phospholipids, of course, are what makes up our cell membranes, making krill oil extremely bio-available to the cells. I guess we will have to wait for tests to confirm.

The triglyceride form is too expensive for me.
I'll pop an add'l ethyl ester gelcap daily and be done with it.

Does the same caveat apply to krill oil or to seal oil?

Great Detailed discussion of fish oil
Can someone please dumb it down for me and just recommend a few brands?

Dr. Davis:

I'm curious to know where GNC's so-called "Triple Strength Fish Oil"
product ranks. It comes in a softgel form, each capsule containing EPA+DHA strength of 900mg. It has only a slight hint of fishy-ness in taste. It's not clear to me from the bottle label whether it's in a triglyceride form. I'm not necessarily an advocate of GNC products which are not generally a bargain by any means, but have been satisfied with their quality.

I am a Technical Representative from Carlson and the following fish oils are all TG or rTG form:

-EPA Gems

-Super DHA Gems

-MedOmega Fish Oil 2800

-All Mothers and Kids products

-All Very Finest Fish Oil products

-All Cod Liver Oil products

-All Salmon Oil products

-Smart Catch softgels

-CalaOmega liquid (calamari oil)


The following products are EE:

-Super Omega-3 Gems

-Elite Omega-3 Gems

-CalaOmega Softgels (calamari oil)

-CalaDHA Sofgels (calamari oil)

"struggle with high TG, now 292 even with fish oil and 1 gram a day of IR niacin... "

1grm just is not high enough in my opinion.  I take 2grms of Now brand Niacin and had a 30% reduction in my Trigs. At C$7 for 100 x 500mg tablets it is a cheap treatment. somewhere between 2-3grms is the level required but you can check studies at www.lipidsonline.org.

btw.  just wanted to announce that my latest HDL is 50 !  I started with a reading of 28 and had been on a low fat no meat diet for years. Added meat, reduced wheat and other grains over the last 6 months. I guess I am a convert.
Trevor

It is nothing more than just another market gimmick -

http://www.doctormurray.com/index.php?option=com_content&view=article&id=52:the-ethyl-ester-vs-triglyceride-form-of-fish-oils

Timothy Johanek,  Do you have any reference to independent test that proof Carlson's products in TG/rTG form?

I'm also interested if Dr. Davis can comment here or in one of his articles about the proper dosing for Apo 3/4 people.

I do notice that lowish doses (1 g or less) doesn't seem to affect my LDL much negatively. However, if I go high, say 3g EPA/DHA or so, then my LDL tends to rise... and it's not the particle size thing giving a false high reading, as it's measured by VAP.

Somewhat oddly, I have noticed that the EE form causes this rise more often than the TG form, but that could be coincidence.

And for those interested:

Barleans (orange, low dose): TG
(high dose): EE
Minami (EE, except for MarineEPA)
Nordic Naturals: rTG
Meg3: Can be either, but unless specified, it's EE
Epax: rTG
Carlson has both forms, as mentioned here
Coromega (rTG Epax oil (I think))
Natural Factors: EE

And pretty much all cheapo store brands are EE.

Krill oil does absorb better than fish oil, as found in a recent study. However, it's like a 50% or so improvement only (at best), and due to price differences between fish/krill, it doesn't make much economical sense. If the esterified astaxanthin provides a specific benefit, then maybe it's worth it... but no data showing it's the EPA/DHA in krill.

That's good news on the Carlson's. I really don't understand why anyone uses fish oil capsules. You get a much better deal with the fish oil in bottles; I order mine online, 4 or 5 bottles at a time.

Which brands of Fish Oils doesn't use Soy Bean oil?

Bob Savage,

I'm not aware of any third party tests that have been done.  I am certain that I am correct though because I write the spec sheets.

A quick test to see whether an oil is EE or not is to put it on polystyrene (styrofoam) because EE will dissolve it but TG will not.  And before anyone gets nervous, this has nothing to do with how EE oils affect your body (unless you eat or are made of styrofoam that is).

Hi readers.  With all this talk about O3 and fish oil I thought that I would chime in with my experience.  I had a heart attack about 1.5 years ago and got a stent placed in one of my arteries.

Since then I have been taking Walmart fish oil because it was so cheap.  My chest pains gradually receded after my heart attack and I was doing really great for awhile.  I was actually working pretty hard, doing aerobics for about 30 minutes and lifting weights for about 20 minutes.  My weight on a low carb diet went from 305 to 260 so far.

I have been on Plavix but my cardiologist told me I could back off from it slowly, so I started taking 6 capsules of Walmart fish oil, 400mg VE, 1000 mg VC, 325 mg aspirin, and only half a 75 mg Plavix.

Then, I went to Walmart and got a new supply of fish oil.  Upon taking it I started to get pretty strong chest pains and had to stop working out.  I did not associate the problem with the fish oil though.

One day I came to this blog and read about rancidity in fish oil.  I broke open one of the fish oil caps from Walmart and was overwhelmed by the spoiled fish smell.  I immediately stopped taking the oil and my chest pains gradually diminished.

My question is whether I am likely right that it was the oxidized fish oil causing the chest pains?  This wasn't a very rigorously controlled experiment. I am not looking for an absolute answer but is it possible that rancid fish oil can cause chest pains?

Farseas that is very interesting. Glad to hear you have been doing better.

in for answer on rancid oil.

I've been using Ascenta fish oil. They're based out of nova scotia. All their oils are in triglyceride form.

Ascentahealth.com....although can be found much cheaper elsewhere like iherb.com

Farseas that is very interesting. Glad to hear you have been doing better.

in for answer on rancid oil.

I've been using Ascenta fish oil. They're based out of nova scotia. All their oils are in triglyceride form.

Ascentahealth.com....although can be found much cheaper elsewhere like iherb.com

Should we worry about this?
Fish Oil Increases Risk of Colitis, Colon Cancer in Mice

http://www.emaxhealth.com/1275/fish-oil-increases-risk-colitis-colon-cancer-mice

Thank you so much for the post. Fish oil is best for our health.This is very informative blog.
-fish oil

Personally, I don't put a lot of faith in studies done on mice. Their biological makeup is different than ours and these studies often give mice mega-doses of whatever they are testing for over very short periods of time, which could have adverse consequences for anyone. I like human trials better.