The Omega Rx Zone by Barry Sears is yet another presentation of the Zone principles of insulin control, 40-30-30 ratioed meals, calorie restriction, and controlling eicosanoids, plus the addition of high dose pharmaceutical grade fish oil. Interestingly, Sears actually recommends fish oil supplementation above the Zone diet's ability to control hormones due to the supplement's powerful impact on our bodies' most basic hormones: eicosanoids.
The book starts at the beginning of man's cerebral development. According to Sears, homo-sapiens developed intricate minds and therefore became human due to eating algae-derived fats found in shellfish. The omega-3 fatty acids allowed us to begin to develop frontal cortexes, our limbs allowed us to find food that supplied our brains with a steady stream of glucose, which accelerated our mental development even further. Sears states that the omega-3 fatty acids found in fish oil are what in fact make us human.
The author then launches into an informative chapter on the basics of fatty acids. The book is primarily concerned with omega-3 and omega-6 polyunsaturated fatty acids, which are categorized as such 3 and 6 due to the position of the double carbon from the end of the molecule. Of the omega-3 fatty acids, Sears is most concerned with EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), and of the omega-6 fatty acids, Sears is most concerned with AA (arachidonic acid).The western diet is woefully deficient in anti-inflammatory omega-3 fatty acids, which used to come from grass fed meat animals and from fish. In the last 50 years or so, our diets have become skewed towards foods high in pro-inflammatory omega-6 fatty acids, such as vegetable oils and grain fed meat animals. The Omega Rx Zone proposes a method to correct this imbalance through the reintroduction of the correct amounts of omega-3 fatty acids.
Next Sears explains eicosanoids, of which the control is the foundation of the Zone. Eicosanoids are the most basic hormones in the body, ephmerally produced by any cell at any time to complete many different tasks. Sears simplifies the varieties of eicosanoids into two categories: good and bad eicosanoids. While our bodies need a balance of both, we want to maximize our production of good eicosanoids to avoid and alleviate chronic disease such as heart disease, hypertension, arthritis, cancer, chronic inflammation, depression, and dementia. We control the balance of these eicosanoids via the most basic drug that we put into our body every day: our diet. If our diet supplies our body with adequate EPA, then we will ultimately produce good eicosanoids, if our diet supplies us with too much AA, then we will ultimately produce an imbalance of bad eicosanoids. High insulin levels, triggered by a diet high in easily digestible or refined carbohydrate, also speed the production of bad eicosanoids. Fish oil is a great source of EPA, which is why Sears recommends that we supplement in high doses.
The book next launches into a discussion on how we can measure our physical overall well-being as a result of our hormonal balance. The book points out that since eicosanoids are made and self destruct as soon as their task is complete, and since they do not have a central point of production like most hormones (serotonin in the brain, insulin in the pancreas), eicosanoids are very difficult to measure. The book gives us a self checklist that subjectively measures our perception of how we feel mentally and physically. Later in the book, Sears discusses several blood tests that one can take to get an idea of how their eicosanoids are balanced. These tests include the HDL to triglyceride ratio, which can be gleaned from a fasting blood lipid profile: a ratio of 3 or greater is an indication of poor health, a 2 is considered generally well and 1 would be ideal. A fasting insulin blood test will let us know how much insulin we have circulating in our system; measured in uU/ml the following numbers provide indicators: 15 or greater is diseased, 13 is on your way to being sick, 10 is fair, 5 is ideal. The gold standard for eiconsanoid balance testing is the AA/EPA ratio: at 15 or more you are sick, at 10 you are on your way to being sick, at 3 you are in fair health, and 1.5 is ideal.
In the section on the treatment of chronic diseases, Sears uses mostly anecdotal evidence to describe how one can use fish oil to treat almost any disease, mental or physical. Dementia and Alzheimer's can be treated with the use of fish oil by decreasing inflammation in the brain. Depression may be alleviated by high dose fish oil, because fish oil increases the production of the "feel good" hormone serotonin. High doses of the DHA in fish oil enable brain function and may assist in curbing the effects of attention deficit disorder and dyslexia. Sears speculates about the mechanisms of fish oil that help treat these conditions and provides nice anecdotal stories for his success dosing fish oil, but there is little citation in the text of actual clinical trials showing these kinds of improvements in a measurable, observable, repeatable test (it is possible that in Sears' many sources in the appendix there is more concrete evidence for the treatment of said diseases, this reviewer concedes that he did not read every study cited as source in the appendix).
There is more evidence; however, for fish oil's ability to help prevent heart disease. Fish oil increases blood flow by increasing blood cell membrane fluidity. Since blood cells can move easier, they are less likely to allow plaque to clot in an artery. Increased good eicosanoids as a result of fish oil supplementation leads to decreased inflammation. Inflammation is a leading cause of heart disease: irritated arteries harden and narrow as a result of a build-up of white blood cells reacting to too much small particle LDL cholesterol. If the tissues harden, it makes them more prone to blockage as they cannot expand to accommodate both blood flow and plaque buildup. The insulin control part of the Zone will allow you to decrease your LDL and VLDL cholesterol and triglycerides, while increasing HDL, which will allow you to increase your triglycerides to HDL ratio, an important predictor of heart disease.
Sears uses more anecdotal evidence to suggest that one can use fish oil for treating cancer. As cancer drugs cause the body to attack itself so as to kill the cancerous parts, fish oil may cause the body to heal itself while the drugs work on cancer. By this method, the good eicosanoids produced by high dose fish oil supplementation may help mitigate the pain of chemotherapy. Again, insulin control may be even more important for the actual reduction of cancerous growths. Without the "take stuff in" hormone circulating in high amounts, tumors may not have the ability to rob nutrients needed to grow.
Chronic inflammation is perhaps one of the most dangerous chronic illnesses not widely recognized. Chronic inflammation irritates and hardens tissues and causes general pain and discomfort. Any "itis," such as gastritis, tendonitis, appendicitis, and arthritis is a type of systemic inflammation. Heart disease and even cancer may in fact be the result of inflammation. The improvement in levels of good eicosanoids and the decrease of insulin found in the Omega Rx Zone will help to decrease pain and inflammation.
Fish oil's ability to decrease inflammation and increase blood flow makes it a perfect supplement for athletes. Athletes, especially anaerobic athletes, like Crossfitters, are constantly putting stress on their bodies and creating micro-tears in their muscle fibers and systemic stress on their bodies. These stresses trigger the body's inflammatory response, causing soreness, and sometimes swelling. Fish oil will help reduce this inflammation while promoting the body's ability to heal itself. This feature makes fish oil preferable to NSAIDs (non-steroidal anti-inflammatory drugs), such as ibuprofen, which inhibit the body's ability to heal itself by suppressing the first response inflammatory process, and not allowing the body to heal itself. Increased blood flow efficiency from fish oil will allow tissues to receive nutrients and healing compounds from the body. This increase in blood flow will also aid athletes during a workout. During the demands of an intense workout, the heart will not have to work as hard to pump red blood cells with the more flexible membranes produced by fish oil, making it easier on your cardiovascular system when you are trying to do more work in less time.
Now that you know why it's good for you the question is how much to take. An important note for this section on dosing is to recognize the difference between fish oil supplement intake and intake of omega-3 fatty acids. A fish oil supplement only yields a certain percentage of the total weight of a dose to EPA and DHA. In The Omega Rx Zone Sear's basic prescriptions are take as fish oil much as is needed to get your TG/HDL ratio to below 2 or your EPA/AA ratio to between 1.5 and 3. Once those ratios are dialed in, Sears recommends scaling back to a maintenance dose of 2.5 grams of omega-3s per day. Depending on your level of disease, metabolic or otherwise, you may need to take very high doses to bring your eicosanoid levels to the correct balance. For pain and inflammation, Sears recommends 5-10 grams of omega-3s per day, he has had cancer patients on doses of 15 grams of omega-3s per day, some patients with mental disorders were treated with as much as 20-25 grams per day of omega-3s. Sears mentions that he prescribed as much as 16 grams of omega-3s per day for some athletes. At his nutrition seminar, Crossfit nutrition guru Robb Wolf recommends .5-1 grams of omega-3s per 10lbs of body weight, with the upper limit being for people with severe autoimmune disease or with metabolic derangement.
Now you know why it's good for and how much to take, you need to know how to buy it. This topic is the subject of endless debate on the Crossfit message boards. Basically, you can find fish oil anywhere, in either liquid or in gel caps. The decision of what to buy comes down to two major considerations: purity and cost. In his book, Sears only recommends "pharmaceutical grade fish oil," which is defined by the following criteria: more than 60 percent of the total fatty acids are omega-3s, that mercury is less than 10 parts per billion, that PCBs are less than 30 parts per billion, and that dioxins are less than 1 part per trillion. Sears lists a grand total of two manufacturers of this grade of fish oil, one of which is his own company, but he concedes that better technology over the years would probably yield more pharmaceutical grade manufacturers (the book was first published in 2002. Since fish oil manufacturers are not required to label their supplements with this kind of detailed information, it is hard to determine whether the fish oil you are buying meets those standards. There are lab-quality test reports available from Consumer Labs, but as you can see they cost money.
There are several practical ways to determine the overall quality of a fish oil supplement. First in the store, note the percentage of a pill that is actual EPA/DHA in milligrams relative to the amount of the weight of the liquid in the pill in milligrams, if the percentage is 25% or less EPA/DHA in a pill, leave it on the shelf; who knows what that remaining weight is? For example, GNC Triple Strength fish oil is 900mg of omega-3s in a 1200mg capsule, putting the percentage at 66%. Another benefit of shopping for these percentages is that higher doses are easier to consume since you ultimately have to swallow less pills.
Another test you can do when the fish oil is home is to do the freeze test. Cut open a few capsules and squeeze the liquid into a cup and put the cup in the freezer for about five hours. After five hours if it's still liquid, it is probably really quality stuff. If the liquid is more viscous, but you can push a toothpick into it without too much struggle, it's still probably good. If it's frozen solid, return it.
There is much concern about mercury concentration in fish these days. This concern has carried over to fish oil supplements as well. Typically mercury accumulates in fish that grow larger and live longer lives, the concern is that when people eat these fish, they are accumulating the mercury that over time will reach toxic levels and poison their system. In his Crossfit Journal Nutrition Lecture Part 2: Optimizing Performance, Greg Glassman points out that people need not be concerned about mercury in fish oil as the metal does not have the same affinity for oil as it does for meat, and it is hard to mix harmful levels into a supplement. Because of these concerns, most fish oil supplements are derived from sardines and other smaller fish that do not accumulate mercury in harmful amounts.
At the store, make sure you are buying just a fish oil supplement. Many manufacturers make "omega-3" supplements that contain alpha-Linolenic acid, a plant based omega-3 fatty acid. There is no benefit to supplementing with this fatty acid as taking just a little too much can reverse desire effects. Also beware of "complete omega supplements," which contain omega-3, 6, and 9 fatty acids. These supplements will have effects counter to just supplementing with the EPA and DHA found in fish oil.
Since omega-3 fatty acids are liquid at room temperature, they are highly susceptible to oxidation. Consuming oxidized fish oil can cause the opposite effects that are desired when consuming fish oil, including increased oxidation and release of free radicals in the body. Even if your fish oil was of high quality when it left the plant, it still could be oxidized or "rancid," due to improper packaging or handling. Avoid clear glass bottles; if the capsules or liquid are packaged in a clear glass bottle that lets in light, the light could have oxidized the fish oil. Try to find brands whose capsules are "cold-pressed" as the heat used to seal capsules may also oxidize fish oil. Try to buy fish oil with the furthest expiration date, so as to ensure maximum freshness. Once you've purchased some fish oil, crack open some capsules and smell them, if they are particularly fishy smelling or they reek, throw the batch out. You can also bite into a capsule every few days you are taking a batch and see if they taste rancid. To maintain freshness, fish oil is best stored in a dark glass bottle in the refrigerator.
After some research on the Crossfit message boards, it appears that several specific brands come recommended for purity and ease of dosing. These brands include: Carlson's, Nordic Naturals, and Costco's Kirkland Signature (the preferred fish oil of Robb Wolf). Google these brands to find a distributor near you or on the internet.
As with any supplement you take, there are potential side effects to taking fish oil. The most common complaint is that fish oil thins the blood and causes excess bleeding by way of preventing blood clots. There is evidence both for and against this claim; my personal experience with the stuff on doses as high as 13.5 grams of omega-3s per day is that it does not cause any excess bleeding, but I cannot say that it won't at higher doses. Another complaint that since fish oil oxidizes and leads to increased oxygen rich blood flow, supplementing with fish oil can speed up the body's oxidative processes and reduce antioxidants in the body. This side effect can be mitigated by eating a diet of antioxidant-rich fruits and vegetables, as well as by using extra virgin olive oil. Good eicosanoids help to suppress the body's immune system's inflammatory response. The final concern is that by overproducing good eicosanoids fish oil will depress the immune system. If one you are overproducing good eicosanoids to the point where your immune system is impair, you should scale back your dose or take a GLA supplement, such as Borage oil, in a dose of about 70 milligrams per week. Some people complain of stomach discomfort and diarrhea when taking fish oil. This could be attributed to taking too much, or to taking low quality fish oil. Sears emphasizes that any side effects complaints cannot be attributed to fish oil before the purity of the fish oil being taken is confirmed.
Sources and more resources: Crossfit Message Boards: Fish Oil Recommendation, Crossfit Journal: Nutrition Lecture Part 2: Optimizing Performance. Get Off the Ibuprofen Peoples. Fish Oil and the Real Cost of Health (read the comments). Oxidized Fish Oil
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