The Hemp Connection [Search results for DHA] 

This is to address some great questions about fish oil that Katie sent in.

Katie asked:
after reading about fish oil and its obvious benefits, I finally bought some Carlson Super Omega-3 Fish Oil Concentrate soft gels yesterday at Whole Foods.

I have several questions I have tried to get answered via this site and the Internet, but can't seem to find clear answers, so I am throwing them out here, in hopes you can help.

1. The bottle says"Each Carlson Super Omega — 3 soft gel contains 1000 mg (1 gram) of a special concentrate of fish body oils from deep, cold-water fish which are especially rich in the important Omega-3's EPA and DHA." However, the Supplemental Facts read EPA 300 mg DHA 200 mg Other Omega-3's 100mg. I believe that adds up to 600mg. Right? There is no mention of the other 400 mg. Where are they? I'm very confused about this. Can you explain this to me? There is also Natural Vitamin E — 10 IU…incase that means something.

2. How many pills/mg am I supposed to take? I read between 1000 mg and 3000 mg. Which makes me confused again because even though the bottle says 1000 mg in each pill I can only find 600 of them! I want to make sure that I am taking enough, but not taking too much! How much do you take? Also, do I work up to that or just dive in?

3. Last question…is there anything else I should be taking with the fish oil? I know that sometimes if you take something you need to supplement with something else. Is that the case here?

Thank you in advance for your advice and information!

My response:
Katie, these are really great questions and something that I am often asked by my clients. Here's the scoop:

1. The dosage on the ingredient list can indeed be very confusing and frankly I believe it is a way in which some supplement companies try to give the impression that you are getting a better product with higher potency, but it can be misleading. When the label states something like…"contains 1000 mg marine oil", you are not getting the complete information.

The critical ingredients and the amounts you need to know about are — how much EPA (eicosapentanoic acid) and DHA (docosahexaenoic acid) are contained in each capsule.

EPA and DHA have been shown to support healthy functioning of the cardiovascular, immune, gastrointestinal, and musculoskeletal systems. EPA is also an excellent anti-inflammatory and helpful in conditions such as insulin resistance, diabetes and auto-immune related inflammation.

DHA is an important factor for those with PCOS as it supports many aspects of health including pregnancy, fetal development, and healthy neurological function.

The other"marine lipids" are simply the total fat of the fish, where the EPA and DHA are the active portions of that fat. It is the"actives" that are providing the therapeutic value. The vitamin E in the capsules is for preservative purposes and helps prevent rancidity of the fat.

2. Regarding the dosage you should take, that is a harder question to answer because it will depend on what you are trying to target. Those with PCOS should be targeting anywhere from 500 — 1000 mg. DHA. So you need to know how much DHA is in each cap, for example if the capsule has only 200mg. of DHA, you'll need to take 3 of them to get approximately 500mg. You can then work up to a higher dose, always start with the lower dose and work your way up. Sometimes it is easier to get a liquid version that is high potency versus taking handfuls of pills to achieve the same dose.

I do not recommend that you take a liquid fish oil that is derived from Cod Liver Oil as the source as it usually has a high amount of Vitamin A and it is possible to get toxic doses of vitamin A. Another thing to note is that in a combination EPA/DHA cap, the dosage EPA will usually be higher than the amount of DHA, that is no problem. The EPA will only be of additional benefit.

Don't hesitate consulting with a registered dietitian knowledgeable both in PCOS and supplements in order to have your supplementation tailored to your specific health needs — remember we are all different, with unique physiology, medical history and requirements.

3. Fish Oil does not have to be taken with anything else to enhance its function. It can be taken all at once, with meals, between meals — it is very flexible this way.

Here are a couple of additional tips:

- if you tend to"burp" back fish oil, make sure to buy a brand that comes in an"enterically coated capsule", they might cost a few cents more, but it's worth it.
- refrigerate your fish oil to protect it and this also can help reduce"burp back".
- contributes to creating beautiful, healthy skin.

One last fun fact about fish oil. Most of it actually comes from the southern hemisphere not as you might think from the deep waters off Norway!

Here's to fish oil!

Carmina McGee, MS, RD, LE
Ventura, California
805.816.2629
info@carminamcgee.com

Since we talk so much about the importance of fish oil for women's health, we get forwarded articles and studies from colleagues who'd like to know what we think.

Late last night, Minh-Hai Tran forwarded me an article entitled,"Healthy and Pregnant: Forget the Fish Oil".

The hairs on the back of my neck immediately prickled on seeing this title…knowing the potential for confusion this could cause with readers like ours, who've heard us talk so much about an opposing viewpoint.

Here's a closer look at what the article says and how it fits into our treatment model.

I've always followed the guidelines established by the International Society for the Study of Fatty Acids and Lipids (ISSFAL) when evaluating studies and formulating recommendations. Here are their recommendations, right off of their website. I comment on the current study's accommodation of these recommendations in italics below each item.

1. Dietary fat intake during pregnancy and lactation, as a proportion of energy intake, should be the same as that recommended for the general population.

I was not able to find if there was any standardization of diet during this study. This is a common error in study design when evaluating the effectiveness of a supplement. Any added chemical in any study is going to respond differently, depending on the biochemistry of the environment into which it is introduced.

The pre-pregnancy weights of the women in the study were not mentioned, either. I would imagine that this would potentially affect the outcome of the study.

2. The n-3 LC-PUFA, DHA, must be deposited in adequate amounts in brain and other tissues during fetal and early postnatal life. Several studies have shown an association between maternal dietary intake of oily fish or oils providing n-3 LC-PUFA during pregnancy and/or lactation and visual and cognitive development as well as other functional outcomes of the infants.Pregnant and lactating women should aim to achieve a dietary intake of n-3 LC-PUFA that supplies a DHA intake of at least 200 mg/d. Intakes of up to 1 g/d DHA or 2·7 g/d n-3 LC-PUFA have been used in randomized trials without occurrence of significant adverse effects.

It appears from the comment of the lead researcher that a dose of 200 mg DHA per day is what was used in the study. Our experience at inCYST is that it can take significantly more DHA than that to see benefit. This is especially true if the diet in which the supplement is included is high in omega-6 fatty acids, which interfere with omega-3 activity. The study size is large--around 2,400 women, which would have given these researchers an opportunity to collect dietary intake data and evaluate if there were different results in women whose diets were high in omega-6 fatty acids vs. those which were higher in omega-9 fatty acids. Huge opportunity lost, and important advice for anyone currently putting together any kind of study regarding omega-3 fatty acids. The entire diet, not just the dosed supplement, is important to standardize and measure.

I would have been interested to see various levels of DHA--200, 500, 750, 1000 mg, to see if the same results resulted. Using the lowest dose possible is going to be the treatment least likely to produce positive results.

3. Women of childbearing age can meet the recommended intake of DHA by consuming one to two portions of sea fish per week, including oily fish, which is a good source of n-3 LC-PUFA. This intake of oily fish rarely exceeds the tolerable intake of environmental contaminants. Dietary fish should be selected from a wide range of species without undue preference for large predatory fish, which are more likely to be contaminated with methylmercury.

I agree, that there may be more to this issue than DHA. For example, much information is coming out about the importance of adequate vitamin D for reproductive health. Is it the fish oil or the vitamin D in the salmon…or the interaction between the two that is important? Future studies need to separate out and explore these questions…in the presence of a controlled diet.

Intake of the precursor, a-linolenic acid, is far less effective with regard to DHA deposition in fetal brain than the intake of preformed DHA.

5. There is no evidence that women of childbearing age whose dietary intake of linoleic acid is adequate need an additional dietary intake of arachidonic acid.

This was not a concern with this study.

6. Some studies have shown that maternal intake of fish, fish oils or n-3 LC-PUFA results in a slightly longer duration of gestation, a somewhat higher birth weight and a reduced risk of early preterm delivery. The clinical importance of such effects with regard to infant health has not been fully elucidated.

This finding was confirmed in the new study. I look forward to future studies understanding why.

7. Screening for dietary inadequacies should be performed during pregnancy, preferably during the first trimester. If less than desirable dietary habits are detected, individual counselling should be offered during pregnancy as well as during lactation.

It does not appear that individual omega-3 fatty acid status was evaluated in the women in the new study. So if the women were deficient, a low DHA dosage likely would not have been enough to elucidate a treatment response. If the women had adequate DHA in their tissues before coming pregnant they likely would not have experienced a treatment response.

All due respect to the well-intended researchers, some important aspects of study design were not incorporated, limiting the conclusions that can be drawn from this study. I hope they include a dietitian in future studies.

All due respect to MSNBC, please consider the damage and suffering you potentially inflict on women who could drastically benefit from a simple dietary intervention, on behalf of titling an article purely with SEO (search engine optimization) in mind. Post partum depression is a serious disorder, hurting many others in addition to the woman whose biochemistry produces it.

From inCYSTER Karen Siegel…contact information for her Houston clinic is listed below.

"Yes. Another reason to keep encouraging the fish oil supplementation."

Public release date: 16-Dec-2009

Contact: Public Affairs Office
public.affairs@apa.org
202-336-5700 202-336-5700
American Psychological Association

New study links DHA type of omega-3 to better nervous-system function
Deficiencies may factor into mental illnesses
WASHINGTON — The omega-3 essential fatty acids commonly found in fatty fish and algae help animals avoid sensory overload, according to research published by the American Psychological Association. The finding connects low omega-3s to the information-processing problems found in people with schizophrenia; bipolar, obsessive-compulsive, and attention-deficit hyperactivity disorders; Huntington's disease; and other afflictions of the nervous system.

The study, reported in the journal Behavioral Neuroscience, provides more evidence that fish is brain food. The key finding was that two omega-3 fatty acids – docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) – appear to be most useful in the nervous system, maybe by maintaining nerve-cell membranes.

"It is an uphill battle now to reverse the message that 'fats are bad,' and to increase omega-3 fats in our diet," said Norman Salem Jr., PhD, who led this study at the Laboratory of Membrane Biochemistry and Biophysics at the National Institute on Alcohol Abuse and Alcoholism.

The body cannot make these essential nutrients from scratch. It gets them by metabolizing their precursor, α-linolenic acid (LNA), or from foods or dietary supplements with DHA and EPA in a readily usable form."Humans can convert less than one percent of the precursor into DHA, making DHA an essential nutrient in the human diet," added Irina Fedorova, PhD, one of the paper's co-authors. EPA is already known for its anti-inflammatory and cardiovascular effects, but DHA makes up more than 90 percent of the omega-3s in the brain (which has no EPA), retina and nervous system in general.

In the study, the researchers fed four different diets with no or varying types and amounts of omega-3s to four groups of pregnant mice and then their offspring. They measured how the offspring, once grown, responded to a classic test of nervous-system function in which healthy animals are exposed to a sudden loud noise. Normally, animals flinch. However, when they hear a softer tone in advance, they flinch much less. It appears that normal nervous systems use that gentle warning to prepare instinctively for future stimuli, an adaptive process called sensorimotor gating.

Only the mice raised on DHA and EPA, but not their precursor of LNA, showed normal, adaptive sensorimotor gating by responding in a significantly calmer way to the loud noises that followed soft tones. The mice in all other groups, when warned, were startled nearly as much by the loud sound. When DHA was deficient, the nervous system most obviously did not downshift. That resulted in an abnormal state that could leave animals perpetually startled and easily overwhelmed by sensory stimuli.

The authors concluded that not enough DHA in the diet may reduce the ability to handle sensory input."It only takes a small decrement in brain DHA to produce losses in brain function," said Salem.

In humans, weak sensorimotor gating is a hallmark of many nervous-system disorders such as schizophrenia or ADHD. Given mounting evidence of the role omega-3s play in the nervous system, there is intense interest in their therapeutic potential, perhaps as a supplement to medicines. For example, people with schizophrenia have lower levels of essential fatty acids, possibly from a genetic variation that results in poor metabolism of these nutrients.

More broadly, the typical American diet is much lower in all types of omega-3 than in omega-6 essential fatty acids, according to Salem. High intake of omega-6, or linoleic acid, reduces the body's ability to incorporate omega-3s. As a result,"we have the double whammy of low omega-3 intake and high omega-6 intake," he said.

###
Article:"Deficit in Prepulse Inhibition in Mice Caused by Dietary n-3 Fatty Acid Deficiency"; Irina Fedorova, PhD, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health; Anita R. Alvheim, PhD candidate, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, and National Institute of Nutrition and Seafood Research, Bergen, Norway; and Nahed Hussein, PhD and Norman Salem Jr., PhD, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health; Behavioral Neuroscience, Vol. 123, No. 6.

(Full text of the article is available from the APA Public Affairs Office)

Norman Salem Jr. can be reached at nsalem@martek.com or at (443) 542-2370 (443) 542-2370. He was with the National Institutes of Health until 2008, when he became the chief scientific officer and vice president of Martek Biosciences Corp. in Columbia, Md., an ingredient supplier of DHA. He states that he and his co-authors conducted this research while with the NIH.

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 150,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting health, education and human welfare.
--
Karen Siegel, MPH, MS, RD, LD, LAc
Acupuncture & Nutrition Clinic
9660 Hillcroft, Suite 202
Houston, TX 77096
713/721-7755 713/721-7755
www.AcupunctureandNutritionClinic.com
or
www.Karensclinic.com

I recently read a blog entry about omega-3 fatty acids, in which it suggested that adequate DHA could be obtained from spirulina and chlorella, two supplements

found in most health food stores. I was surprised to read this, as I'd never run across any information in all the DHA research I've read to suggest that these were appropriate sources.

Total DHA content of pure algae, by percentage total fat, is as follows:

Life’s DHA™ from Schizochytrium – 37%
Life’s DHA™ from Cryptocodidium cohnii — 40.0%
Isochrisis galbana 17.16%
Chlorella vulgaris 13.32%
Spirulina platensis 7.53%

As far as total DHA content, it is clear that the Schizochytrium and Cryptocodidium cohnii provide more bang for the buck; the total volume needed of the former is far less than isochrisis, chlorella, and spirulina. Whichever supplement used, the total amount of DHA consumed is important.

Another benefit to using schizochytrium and cryptocodinium is that Martek has FDA approval to sell their DHA to companies who then incorporate it into foods.

By making a few simple changes in your grocery list, you can increase your DHA intake without having to use a supplement. If you want a supplement, those are available as well. A list of available foods and supplements can be found at this link.

Thanks to colleague Connye Kuratko, Ph.D., R.D. of Martek Biosciences, for being able to find a study (referenced below) that helped clarify this issue. Martek's Life's DHA marine algae supplement, found both in capsules and in foods, contains Schizochytrium or Cryptocodinium cohnii.

Ö. TOKUS¸OGLU AND M.K. ÜNAL Biomass Nutrient Profiles of Three Microalgae: Spirulina platensis, Chlorella vulgaris, and Isochrisis galbana. Journal of Food Science 68:4, 2003, 1144-1148.

Senanayake SPJN and Fichtali J. Single Cell Oils as Sources of Nutraceutical Specialty Lipids: Processing Technologies and Applications. in Shahidi F Nutraceutical and Specialty Lipids and Their Co-products. CRC Press, Taylor and Francis Group, Boca Raton, FL, page 268.

I have heard the following recommendations made by the American Heart Association repeatedly for years now. And I hear them parroted everywhere by well-intended medical experts who, it seems, did not stop to check the math on which the recommendations are based:

Population Recommendation
Patients without documented coronary heart disease (CHD)
Eat a variety of (preferably fatty) fish at least twice a week.
Include oils and foods rich in alpha-linolenic acid (flaxseed, canola
and soybean oils; flaxseed and walnuts).

Patients with documented CHD Consume about 1 g of EPA+DHA per day,
preferably from fatty fish. EPA+DHA in capsule form could be
considered in consultation with the physician.

Patients who need to lower triglycerides 2 to 4 grams of EPA+DHA per
day provided as capsules under a physician's care.

Patients taking more than 3 grams of omega-3 fatty acids from
capsules should do so only under a physician's care. High intakes
could cause excessive bleeding in some people.

Evidence from prospective secondary prevention studies suggests that
taking EPA+DHA ranging from 0.5 to 1.8 grams per day (either as fatty
fish or supplements) significantly reduces deaths from heart disease
and all causes. For alpha-linolenic acid, a total intake of 1.5–3
grams per day seems beneficial.

I couldn't sit back anymore. Ellen Reiss Goldfarb, RD, a member of this blog's inCYST Network for Women With PCOS collaborated with me on hopefully setting the record straight. We hope it helps, especially to get a mathematically-correct set of recommendations out to the public so they can go grocery shopping with a better sense of empowerment.

Regarding the omega-3 recommendations recently discussed, you all may want to consider that there are several contradictions within that make it very difficult (maybe even impossible) for the average American to follow them. As dietitians, it is important that we understand this math so that we help, not confuse or hurt, people who look to us for advice.

First of all, we are telling people that they are not to eat more than 3 grams of omega-3's per day unless they are under a physician's care. However, if you try to get 1.8 mg of combined EPA + DHA combined, in the form of food first, 3 ounces of Alaskan salmon, which contains 384 mg of EPA plus DHA, would have to be eaten in a DAILY QUANTITY OF 14 ounces in order to get there. Are you really saying that if you're eating enough fish to get the amount of omega-3's we recommend, that the MD has to manage it??? You are unnecessarily putting yourself out of business if you are!!!

Secondly, given those numbers for salmon, the densest seafood source of omega-3's, there is no way eating fish just a few times a week is going to get you to the level of omega-3 intake these recommendations are making. It is so frustrating watching colleagues parrot these recommendations and wondering if we're the only ones who've actually sat down and done this math.

We also went to three popular fish oil brands and calculated out how many pills you would need to get the upper level of DHA + EPA recommended. Two of those, Nordic Naturals and Carlson's, if taken at the level needed to get there, would also place your client at levels you say a physician needs to manage.

Realistically and honestly, how many of you are really doing that?

With regards to bleeding, in all of our collective years actively recommending fish oil, only one client encountered a bleeding problem. The people at greatest risk for that are people who are on medications such as coumadin…and if you work closely with a physician who"gets it"--the dose of that medication can be dropped as EPA levels rise and help normalize blood clotting function. Always start low, titrate up, look closely for symptoms in people not on contraindicated medicatoins and let the MD check blood levels in people who are…and work very hard to minimize omega-6 intake. You'll get a lot more bang out of your omega-3 buck if you focus on the omega 6 to omega 3 ratio than if you only think about one.

If you don't know how to use omega-3's to promote health, you may actually CREATE health risks for your clients, which I don't think any of you want to do.

Here are the numbers from our calculations for your reference.

EPA + DHA, total mg
3 ounces salmon 384 mg
Nordic Naturals 550 mg
Carlson's 500 mg
Barlean's 600 mg

Total omega-3 content
3 ounces salmon 3250 mg
Nordic Naturals 690 mg
Carlson's 600 mg
Barlean's 780 mg

Amount needed to meet n-3's needed to meet upper DHA + EPA recommendation/total omega-3 content of that amount
3 ounces salmon 14 oz DAILY/15.2 total gms n-3
Nordic Naturals 3.27 capsules/3.6 gm total n-3
Carlson's 3.6 capsules/6.0 gm total n-3
Barlean's 3.0 capsules/2.3 gm total n-3

Monika M. Woolsey, MS, RD
Ellen Reiss Goldfarb, RD

I hope I got your attention! Because, yes, algae can be a very important part of a diet for PCOS.

It's becoming increasingly clear, as our baby counter ticks up and up and up, that omega-3 fatty acids ARE the answer for a lot of women out there who may not have found fertility success.

But I also know, from being in this business for over two decades, that there are some people, no matter how much you tell them that fish is good for you, simply aren't going to eat it. Whether it's because of taste, allergies, or vegetarian practices.

That's where algae comes in. The innovative people at Martek Biosciences have been culturing a species of algae, Crypthecodinium cohnii, that is naturally high in DHA, one of the omega-3 fatty acids. Don't worry, I stink at Latin, too. Just remember,"omega-3 algae" and you have all you need to know.

Martek has figured out how to take this algae, extract the DHA, and put it into a form that can be incorporated into foods that you and I actually eat. The examples I found today on Martek's website include (in alphabetical order):

Beech-Nut® Stage 2® DHA plus+™ Jars — a product of Beech-Nut
Beech-Nut® Stage 2® DHA plus+™ Cereals — a product of Beech-Nut
Bellybar™ Nutrition bars — for pregnant and nursing women from NutraBella Challenge Dairy Spreadable Butter — a product of Challenge Dairy
DHA plus+™ Yogurt Blends with Juice — a product of Beech-Nut
Crisco® Puritan Canola Oil with Omega-3 DHA — a product of the J.M Smucker Company
Fujisan Sushi — a product of Fuji Foods Products, Inc.
Glucoburst™ Diabetic Drink — a product of PBM Nutritionals Gold Circle Farms® Eggs — a product of Hidden Villa
Horizon Organic® Milk — a product of WhiteWave Foods
Kids-Pro Nutrition Drink — a product of British Biologicals
Little Einstein's Disney Milk — a product of Stremick's Heritage Foods
Minute Maid® Enhanced Pomegranate Blueberry Juice — a product of the Coca-Cola Company
NuGo Organic Nutrition Bar — a product of NuGo Nutrition
Odwalla's Soy Smart™
Oh Mama!™ Nutrition bars — for pregnant and nursing women from Vincent Foods, LLC Oroweat Whole Grain 9 Grain Bread — a product of Bimbo Bakeries USA, Inc.
ProSource NutriPure Supreme — a product of ProSource
Rachel's® brand, Rachel's® Wickedly Delicious Yogurt — a product of WhiteWave Foods
Rico's® Cheese Sauce — a product of Ricos Products Company
Silk® Soymilk — a product of Whitewave
So Good™ Omega DHA Milk — a product of Soyaworld
Stremicks Heritage Foods™ Organic Milk — a product of Stremicks Heritage Foods
Vitasoy® Soymilk — a product of National Foods
Yoplait Kids™ — a product of General Mills
ZenSoy Soy on the Go™ — a product of ZenSoy
Yo on the Go® — a product of Whitney's Foods, Inc.

Bottom line, if you can't or don't do fish, you can still do omega-3's.

One note, it's still important to have a diet that overall, is balanced in fat, carbohydrate, and protein. So if you're loading up on one option here that is sweetened, you may not get the optimal effect of the DHA. It might be worth downloading this list and showing it to your dietitian so the two of you can work out a game plan that incorporates these foods with the best chance of benefitting from them.

Some things simply do not happen by accident.

I was on a flight from Chicago to Boston yesterday and struck up a conversation with the man sitting next to me. It turned out, he is a veterinarian who does a lot of work with horses. He asked about my profession, and I gave him the Cliff Notes version, telling him that I did a lot of work with infertility.

Without even having a chance to mention that my friends think I am obsessed with omega-3 fatty acids to the point of often being teased about being the"Fish Oil Queen," he said to me,"Nutrition is very important for fertility in horses. Especially omega-3's."

Turns out, he said, the process of breeding horses is so expensive (if you thought an in vitro procedure emptied your wallet, start pricing stud services!!), that there is a lot of pressure to"get it right" as quickly as possible. And research has discovered, that omega-3 fatty acids are particularly important as part of the success formula.

I commented that it was interesting that in humans the fertility research seemed to focus on the females, while in equine science, it tended to focus on the males. He just smiled and said…"Your women need to be feeding their priceless stallions as well as they feed themselves!"

Here is an excerpt from an equine article I found at http://www.horses.com/. You will have to register to access their other articles, but it is worth the time. Hopefully some day our own nutrition will be as important as veterinarians have found it to be in animals.

Squires said sperm quality problems can increase when artificial insemination with cooled or frozen semen is involved. The problem stems in part from the fatty acids found in equine sperm. Bull sperm contains high amounts of omega-3 fatty acids that enable them to withstand the rigors involved in freezing. Horses, on the other hand, have sperm that is high in omega-6 fatty acids, which hinders sperm ability to be cooled and frozen, and the sperm is low in omega-3 fatty acids. The most important omega-3 fatty acid is docosahexaenoic acid (DHA). An omega-6 fatty acid found in semen is docosapentaenoic acid (DPA).

Squires said in semen, the fatty acid profile of stallions is similar to that of boars (male hogs). Studies in boars have shown that a high DHA to DPA ratio in semen results in enhanced fertility, whereas higher levels of DPA relative to DHA result in reduced fertility.

He said fresh grass is high in DHA, but unfortunately, a lot of stallions are fed hay and grain.

"Men that have reduced fertility have also been shown to have lower levels of DHA in seminal plasma," Squires noted."The ratio of phospholipids (fats containing phosphorous) to cholesterol in the sperm, and the ratio of unsaturated to saturated fatty acids, determines the ability of sperm to handle the rigors of cooling and freezing. Those species that have high cholesterol to phospholipid ratio have sperm that are very resistant to cold shock and thawing.

"Humans, rabbits, and roosters produce sperm that are very resistant to cold shock and their sperm freezes very well," he continued."Sperm from boars and stallions have very low tolerance to cold shock, and, in general, their sperm freezes poorly. Sperm of bulls have high levels of DHA in the cell, where those of stallions have a high level of DPA. Increasing the ration of DHA to DPA in semen has been shown to increase fertilizing capacity and semen quality. Conversely, reducing the ratio of DHA to DPA was accompanied by a reduction in fertilizing capacity."

He said researchers found that adding omega-3 fatty acids to a stallion's diet resulted in a more fluid condition of the sperm membrane, which, in turn, allowed sperm to handle the stress of cooling and freezing with potentially less damage.

Last week our professional team finally got to hear omega-3 chemist Dr. Doug Bibus share his wisdom about omega-3 fatty acids and the potential benefit from knowing what your personal levels are.

Some of his facts:

1. Adequate omega-3 fatty acids are essential for ovaries and testes to properly function.

2. Babies develop 70% of their brain cells before they're born. Their DHA levels increase 3 to 5 times in their last trimester and again to that degree in the first 12 weeks of life.

3. Unfortunately, US babies have 1/3 the DHA levels of babies in Nigeria and Russia. (Are you as surprised and appalled as I was to learn that?) They have some of the lowest DHA levels in the world.

3. American moms have some of the lowest DHA levels in the world, which is partially related to their fears of getting mercury from eating fish. They consume, on average, less than 25% of the recommended amount of DHA per day. It's a big reason why those babies, who are depending on Mom for DHA, are having a little bit of trouble getting enough to feed those developing brains.

4. Those low DHA levels in moms are also related to the incredible increase in omega-6 fatty acids in our diet. For example, 100 years ago, the US produced.2 lbs of soybean oil per person, per year. Today, the US produces 25 lbs. per person per year and you can bet it's landing in our diets. It interferes with omega-3 metabolism in a huge way.

5. The higher the DHA levels in moms, the higher the IQ in babies, and the lower the incidence of serious behavioral issues.

You can see, it's not just about getting pregnant, but doing everything you can to make sure that baby has the best possible chance of being everything it can be.

The whole reason we have teamed up with Dr. Bibus is because we believe that his home fingerprick test for omega-3 levels could be a very important part of figuring out how to help you become pregnant, stay pregnant, produce healthy milk for baby, and have the healthiest baby possible.

Dr. Bibus has been gracious enough to allow us to offer his home fingerprick test at a discount, and we'd like to pass that discount along to you. Normally, this test sells for $175, and we're able to offer it to you for $140. If you'd like more information, please contact me at monika at afterthediet.com. If you're ready to order, click here.

We're really excited to be able to offer this test and hope to be able to more accurately identify dietary recommendations most likely to help you to meet your goals.

I recently noticed that Starbucks has an apple bran muffin that it advertises contains DHA in the marine algae form. I checked into it, knowing we've got a lot of readers on the lookout for omega-3 options.

I was able to find the ingredients on the Starbucks website:

whole wheat flour, brown sugar, water, whole eggs, apples, wheat bran, honey, dried cherries (red tart cherries, sugar, sunflower oil), soybean oil, dried cranberries (cranberries, sugar, sunflower oil), raisins, rolled oats, unsalted butter (cream [from milk]), quick oats, molasses, nonfat milk powder, salt, baking powder (sodium acid pyrophosphate, sodium bicarbonate, cornstarch, monocalcium phosphate), calcium carbonate, ground cinnamon, sodium bicarbonate, natural flavor, vanilla extract, ground ginger, ground nutmeg, xanthan gum, dha oil (dha algal oil, high oleic sunflower oil, sunflower lecithin, rosemary extract, ascorbyl palmitate).

However, nowhere on the Internet could I find information about how much DHA this muffin actually contained.

So I wrote Starbucks, asking for the information. Starbucks politely wrote me back and told me they didn't have the information to give me.

Coupled with the facts that the primary oil used in this muffin is soybean oil, inCYST readers should know that there is a strong possibility that the omega-6 to omega-3 ratio of this product is likely higher than what you ideally want. Plus, the dried fruits are sweetened, you're going to be better off with another way to get DHA.

If Starbucks would be willing to switch out the oil and provide the DHA information I'm willing to revisit this topic. But given the fact that no one really seems to know if the omega-3 content is comparable to any other choices, the fact that this product contains omega-3's cannot really be considered to be advantageous.

Here's hoping we're educating all of you well enough that companies learn that just because it's not required by law, information on a label must be complete in order to be a selling point.

I was asked to clarify some comments I recently made about chia, as they were questioned for their accuracy. I'm all for revisiting and making sure my information is accurate, so here is my response.

First of all, while the information on this blog should be helpful to anyone regardless of whether or not they have PCOS, it IS targeted toward women who have this hormone imbalance. So some of the information I provide is more geared toward their specific nutritional needs and not the apparently healthy population. This should always be kept in mind when reading what I write.

One of the questions about my post was that I stated that taurine is an essential amino acid. There is actually some debate about this. Some experts say no, we can synthesize it. Others call it a conditional amino acid, meaning in some situations it may be essential.

Women with PCOS seem to have something going on in their brain and nervous systems that interferes with everything from mood and appetite regulation to speech and language function. (Simply read the responses to my question last week about the symptoms I listed and you will see what I mean.) Much of the dietary protocol we have developed is actually derived from epilepsy research at Johns Hopkins University, with the premise that calming nervous system excitability makes it easier for the brain and nervous system to function as they should when not under duress. Taurine is an amino acid showing promise as an anti-seizure compound, which makes me wonder whether or not a hyperexcitable brain blows through available taurine much more quickly than a brain that does not have to live under these conditions.

That being said, I am more comfortable with the premise that for the population for whom this blog is written, as well as anyone living with any kind of condition that places stress on the brain (migraines, epilepsy, OCD, anxiety disorder, bipolar disorder, PTSD, schizophrenia, etc.), taurine may actually be an essential amino acid. Research to support my claim still needs to be done, but I am more comfortable being conservative on this one, especially given the responses to last week's questionnaire and the severity of some of the diagnoses I just listed. Better to be safe than sorry.

Secondly, even if the amino acid profile of chia is complete, the total protein content of chia is relatively low. So if we're advocating for a 30% protein diet in a woman who is being advised to consume 1500 calories a day, she is going to need to consume about 113 grams of protein. That translates into your needing, at this protein level, to consume 700 grams of chia per day, just to get your protein needs. That is also 3,430 calories' worth of chia, more than twice your daily calorie needs. And while its amino acid profile is nearly complete, its nutritional profile is not. It contains no vitamin A, vitamin C, vitamin D, vitamin K, thiamine, riboflavin, niacin, vitamin B6, folate, or iron, to name a few.

From an omega-3 standpoint, I did invert the numbers. There is no consistent order by which omega-6 and omega-3 ratios are reported, and though I usually check to be sure I did not flip them, I did not this time. I do apologize for that.

According to http://www.nutritiondata.com/, chia seed contains an omega-6 to omega-3 ratio of 3.03, which is actually quite good.

The caveat is that the omega-3 this food contains is alpha-linolenic acid (ALA), not EPA or DHA. Most omega-3 experts will contend that in the most perfect of conditions conversion of ALA to DHA is at best 5%. Again, the women this blog serves seem to need a much higher level of DHA than average for a variety of reasons. We find that they seem to do best on 1000 mg DHA daily, the level recommended by Dr. Artemis Simopolous for treating depression. Calculated out, if you are depending on chia seed to get all of your omega-3 fatty acids, from ALA through EPA and DHA, you're going to need to consume about 115 grams of chia seeds per day. Just be forewarned.

Bottom line, I actually think chia is a healthy food--as part of a varied diet. I especially think that for vegans reading this blog it can be a great addition to your diet. However, I do not believe in superfoods. There seems to be a trend toward wanting to find one perfect food that has it all. I have yet to find it. It's understandable when we're surrounded by a lot of confusing information and we live in a culture where over 10,000 new products hit the grocery shelves each year (I saw half of them in Anaheim last month and it was overwhelming!) that we'd want to have just a few foods and a small nutritional comfort zone. Unfortunately that is not really how human nutrition works.

This is an especially important philosophy to stick to on this blog, given the fact that we're learning that a very high percentage of the women we're helping have some kind of history of"veganism gone wrong"…in other words, overzealous veganism with a focus on eliminating foods rather than on learning how to eat to be nutritionally complete with no animal products on the menu. We discourage fanaticism and encourage food curiosity and variety!

We were designed to be omnivores and to eat a variety of foods from a variety of sources. I encourage you, rather than arguing for why you should narrow your choices down to feel more comfortable around food, to learn to negotiate a wider variety of foods you are willing to include in your diet.

Gaby AR. Natural approaches to epilepsy. Altern Med Rev. 2007 Mar;12(1):9-24.

As I mentioned in the first part of this series, vitex has its strongest effect on four hormones: estrogen, progesteron, luteinizing hormone (LH), and the one this post is dedicated to, prolactin.

Prolactin is primarily associated with lactation. It is also important for sexual arousal, sensing orgasms, and libido. So it's safe to say, you have to have good prolactin metabolism in order to successfully conceive and carry a pregnancy through to nursing!

One of the most important, and often overlooked, influences on prolactin function, is medication. I am most familiar with psychotropic medications because of my specialty, and I believe, with the very high incidence of anxiety, depression, and sleep disorders in women with PCOS, it is incredibly important to use these medications with discretion in order to not interfere with fertility, or successful PCOS management in women who are not in pursuit of conception.

Before considering any supplement, make a list of all the medications you've ever been prescribed and show them to a registered pharmacist. Ask them if any of those medications have any potential for disrupting prolactin function. And if you come up with a"yes" for any of them, ask for a list of alternatives that you and your prescribing physician can use to adjust your treatment plan.

When prolactin is out of balance, funny things can happen. You can produce milk when you're not supposed to (I once had a male client who started to lactate, and it turned out to be a symptom of a pituitary tumor.)

You might not be able to produce milk when you want to. Many, many, many women with PCOS find, much to their dismay, that they get pregnant, and cannot feed their babies. I am shocked at how many medical colleagues with PCOS write me to share that until they heard us mention this at inCYST…they never knew it could be a problem. And they themselves could not nurse their babies!!!

This lack of awareness and the incredible importance of healthy prolactin function to the overall health of mother and baby, is precisely why, our first outreach outside of dietitians, with inCYST, has been with lactation consultants. They understand this physiology best, and they are the most likely to pick up on problems as soon as they become apparent.

Bottom line, PCOS is not just about infertility. It is about successful reproduction, which includes being able to successfully create the next generation of healthy people.

But I digress. Back to prolactin.

Prolactin is controlled by the hypothalamus, the part of the brain we at inCYST are obsessed with learning and teaching about. The hypothalamus also regulates estrogen, progesterone, testosterone, cortisol, thyroid, and growth hormone. You can see why it's your BFF as a woman with PCOS. If you have problems with one of those, you likely have problems with more than one.

Most medical treatments address each of those hormone imbalances as if they are separate, requiring a separate medical treatment…better yet…a separate medication. So by the time you've made the specialist rounds, you've been given a birth control pill, an antidepressant, a sleep medication, a lipid lowering medication (since some of these hormones are made of cholesterol, when they're out of balance…cholesterol will be, too).

We like to think we start where the problem starts. Giving the hypothalamus what it needs to work efficiently. And the number one chemical you can focus on, which should help all of these functions, which I call our"Recipe for a Happy Hypothalamus (SM)"…is DHA, one of the fish oils.

1. DHA makes it harder for the hypothalamus to feel stress. Stress is a very selfish thing. It steals energy away from other things your body might need it for. With enough DHA in the system, the hypothalamus can put its energy into healing the functions that are NOT related to stress, mainly reproduction, sleep, and mood.

2. DHA increases dopamine receptor density. Prolactin is dopamine-controlled, meaning the more receptors there are to communicate with the dopamine that is there, the less prolactin your body needs to make.

An interesting aside--dopamine imbalance is common in people who crave and/or binge on sugar. So if you've got cravings AND your prolactin levels are not right…you just might be DHA-deficient.

I have one more post coming on chaste tree berry that will summarize important findings and recommendations.

But, with regards to prolactin, what I will say is that two very important things you can, and should, do, to move yourself back into balance, are:

1. Make sure your medications are not the source of the problem, and
2. Make sure your food choices are promoting healthy dopamine function.

Even if you DO decide to try an herbal formula, it is much more likely to work for you, if you provide it with an environment that allows it to do what it does best.

Quite a bit, it turns out. They're some of the hottest new sources of omega-3 fatty acids available in supplement form.

As the public starts to recognize the importance of omega-3 fatty acids for overall health, the hunt for sustainable sources of this nutrient intensifies. The fact is, there simply is not enough salmon on the planet to nourish every brain on the planet. We're going to have to learn to use other sources for that than relying solely on wild Alaskan salmon.

Here's what we found out about three unique players you're seeing more of: green-lipped mussels, krill, and calamari.

Here's the real reason this shellfish gets its name. As you can see, there is a rim of green pigment on the lip of its shell. This bivalve is a native of New Zealand, and the farming process bringing them to market is sustainable. We love that!

However, there seems to be a bit of hype related to this product. It is related to an anti-inflammatory compound found in these mussels that supposedly helps to relieve arthritis. The studies are sketchy, and seem to concede that the effect is actually due to the omega-3's in these mussels, not any secret special ingredient. The capsules are pretty low dosage wise, about 50 mg EPA and little information about DHA content. Meaning you're going to have to take an awful lot of these capsules to get any effect, and you're going to spend a lot of money in the process. Sixty capsules, in the dose we recommend here, is going to cost you $33. That's more than you need to spend.

This teeny, tiny, shrimp-looking thing is a krill, a creature at the very bottom of the food chain that grows in pretty much all ocean waters. It's an important food source for marine life — 500,000,000 tons are produced each year, and over half of it is consumed by whales, penguins, seals, squid, and fish.

As an omega-3 supplement, it is often touted as the superior source. However, a Norwegian study published in January of this year comparing krill oil to fish oil concluded that the effects of supplementation were comparable. In other words, there was no unique benefit to taking krill that could not be achieved with fish.

The bigger issue is sustainability. Scientists reported an 80% drop in krill supply recently. Given the heavy dependence of much of the rest of the ocean on krill, this is important to note. Whole Foods Market actually stopped selling krill oil over concerns that it was not a sustainable product. One voice countering these arguments is, Dr. Joseph Mercola, the popular natural medicine advocate. It is important to note that Dr. Mercola is personally invested in the krill industry so he has much to lose from consumers heeding the warnings of the National Geographic Society and the well-researched buyers at Whole Foods. He is entitled to his opinion, as you are to yours. All I ask is that you consider the financial influences underlying his opinion before deriving your own.

Bottom line here is, if there are options that are equally as effective that do not create nutritional hardship for such a wide variety of important citizens of the planet, we prefer to use those. Krill is not on our recommended list.

Which brings me to my last, and favorite, of our three profiles. The unassuming squid!

Last fall inCYST intern Sarah Jones and I were at our local Sprouts Market evaluating omega-3 supplements. Sarah noticed a bottle made from calamari. The supplement clerk told us that this is an up and coming concept, designed to bring a sustainable source of EPA and DHA to a market that is starting to feel ecologically strained in trying to meet the consumer demand for fish oil. Calamari is sustainably farmed and has been for a long time. It is only recently that they have been used as a source for the supplement industry.

Since we first saw their capsules, Carlson's has also released a lemon flavored liquid product called CalaOmega. And it is concentrated — one teaspon contains 800 mg DHA and 400 mg EPA. That dose for most of our readers is completely sufficient.

Squid are not exotic. There is nothing mysterious or magical about them. Since omega-3's are omega-3's, whether they come from salmon, mussels, krill, or squid, many marketing schemes use mysterious hype to differentiate their products. It's really not that complicated. Find a good source of DHA or EPA at a reasonable cost per dose, and be sure that in using it you're a responsible planetary citizen. You'll get benefit from all three options here. One is sustainable, but costs a lot of money. One is costly to the overall stability of the marine ecosystem. One is sustainable and economical. We think it sells itself.

Besides, now you have an extra reason to order that really tasty calamari appetizer at your favorite Italian restaurant.

Ulven SM, Kirkhus B, Lamglait A, Basu S, Elind E, Haider T, Berge K, Vik H, Pedersen JI. Metabolic effects of krill oil are essentially similar to those of fish oil but at lower dose of EPA and DHA, in healthy volunteers. Lipids. 2011 Jan;46(1):37-46. Epub 2010 Nov 2.

A significant percentage of the women I counsel, whether their issues are officially related to PCOS or not, are vegetarian. They get in trouble with their vegan lifestyle because it eliminates the essential nutrients DHA and EPA.

Not any more!

Marine algae is an up and comer in the omega-3 world. It's been increasingly incorporated into foods, which I've written about before. Now, the people who developed this ingredient are reporting that this algal DHA is as effective as salmon in increasing the body's DHA levels.

You can either take it as a supplement, or you can find it in popular foods. The best place to go in order to get the list of foods you can use is the Martek website. I'm also including the"Life's DHA" logo here, because it's on the packaging for these products for easy identification.

No more excuses, all you vegans! You can make choices that help you to be healthier while honoring your culinary code of ethics.: )

Arterburn LM, Oken HA, Bailey Hall E, Hamersley J, Kuratko CN, Hoffman JP. Algal-oil capsules and cooked salmon: nutritionally equivalent sources of docosahexaenoic Acid. J Am Diet Assoc. 2008 Jul;108(7):1204-9.

While I was at Walmart today looking for vinegar, I ran across a new product that is perfect for PCOS! Crisco's Puritan brand has released a canola oil with algal DHA. What that is, is regular canola oil blended with marine algae omega-3's.

If you regularly read this blog, you know the"S" and"C" rule about oils; avoid, as much as possible, (with the exception of canola), oils beginning with the letters"S" and"C". For most women, that translates into cooking primarily with olive and canola oils. This new canola also has those hard-to-find marine oils, in the form of marine algae oil.

One tablespoon of this oil contains 32 mg of DHA. Fat is still fat, and you should still moderae fat intake…so this is really not a practical way to get all of your omega-3's. But, if you make simple switches and add a little DHA where before there was none, you can effect big changes. This oil could be used in waffles, muffins, salad dressings…wherever you were using any other kind of vegetable oil.

I especially love that I found this product at Walmart…meaning you don't have to have a lot of money to buy health-promoting foods or take care of yourself.

When working with women who desire very much to conceive, it can be challenging to help them understand the big picture. They want a baby…they want it NOW…and if that's not something you can promise…well, there are a gazillion other people out there who will gladly take their money if they say what these women want to hear.

We're establishing a pretty good track record when it comes to fertility help, but what I want to be sure everyone understands, who comes to this blog, is that we're equally concerned about your long term health, and preventing infertility in the babies you might have.

One of the patterns I'm seeing when evaluating clients, is that they were either formula fed, or breast fed for a short time before being switched to formula. Yes, what happened to you as a child can definitely affect your fertility. We can do a pretty good job of playing catch up, but if you only play catch up long enough to become pregnant, then go back to your former way of eating, you're setting up your babies to have similar problems in THEIR adulthood. Knowing what you've likely gone through yourselves…why would you wish that on anyone? Especially your own child?

So even though you may not really be thinking about the fertility prospects of the baby you may not even have yet, I'm encouraging you to think long-term and big picture. Here's an example of research that tells you why I'd do that.

Seventy-seven healthy babies born to term were compared to each other based on the following: (1) breast fed longer than 6 months, (2) breast fed between 3 and 5 months, and (3) exclusively formula fed.

Baby's DHA levels (that's the omega-3 found primarily in fish oil and marine algae) did not differ much at birth, but DHA significantly decreased between birth and the first year of age in babies who were not breast fed. The researchers concluded that breast feeding for at least months is what is required to prevent this decline.

Because every milligram of DHA a baby gets in breast milk comes from mama's personal supply, it is crucial that mama's diet be adequate in DHA throughout nursing. Fortunately, the very diet we've been encouraging you to consume to become pregnant and stay pregnant…is the diet that facilitates this process. It wasn't that you were healthy and just needed a little push to become pregnant. You were out of balance, and the way you chose to eat restored that balance. Once you get there, the goal is to maintain balance, not go back to being out of balance because you've achieved your important goal and want to get back to the easier way of doing things.

It's about your pregnancy, your baby's health, your brain and baby's brain. And it's not really that hard. Hopefully we're helping you to see that.

Sanjurjo Crespo P, Trebolazabala Quirante N, Aldámiz-Echevarría Azuara L, Castaño González L, Prieto Perera JA, Andrade Lodeiro F. [n-3 and n-6 fatty acids in plasma at birth and one year of age and relationship with feeding.] An Pediatr (Barc). 2008 Jun;68(6):570-5.

If you've been following the blog over the last week, I've been reporting about interesting products and things I learned at the 2011 Natural Products West Expo. It's a huge exposition where food companies hoping to connect with buyers for health food stores have a chance to showcase their products. There were about 2,000 exhibitors there, and in 3 days I didn't get a chance to see and talk to everyone I wanted to. You can imagine, on the exhibitor end, the pressure there is to create a product, packaging concept, and booth display that catches the eye of the people you came to meet!

Unfortunately, not all concepts were on target. I'm sharing one that is a common example of how omega-3 marketing is not always accurate. It's still not regulated well, so there are lots of variations in how facts are presented that can be confusing to the person who knows they want to eat well but doesn't understand all the facts.

Yesterday I pulled a fish oil bottle out of my sample bag and noticed on the label that it was"extra-virgin" fish oil. This is a concept that I'm familiar with when it refers to olive oil, and it means that it is the olive oil from the first press of olives. It's a stronger oil, with a lower smoke point, and more appropriate for recipes where the oil is not heated. But it's not really a concept that has any relevance to fish. (I joked with my Facebook friends about whether or not it really mattered what the fish were doing before we caught them!) This particular product's label was also busy with breakdowns of omega-3's, 5's, 6's, 7's, and 9's, promoting a"perfect complement of 16 omega's". It all sounded very official, but to the average consumer who is still confused about 3's, 6's, and 9's, it only serves to make shopping for fish oil tedious and painful.

One of the reasons for all of this confusion is that fish oil is Mother Nature's patent. Consumers want their foods and supplements to be as unrefined as possible, but the only way to patent and protect a manufactured product, is to alter it. So it is very difficult for fish oil companies to create products that distinguish themselves from other competing products while keeping their customers happy. What is left to distinguish a product is where the fish is caught, what species the fish is, and the total amounts of omega-3 fatty acids. And lots of pretty, irrelevant marketing words.

Even with all my knowledge and training, I can spend hours in the health food store looking at labels on fish oil supplements and keeping up with new and different products. From my perspective, it's the total amount of omega-3's that matters. If you have a hard time with the flavor or the burps, there are several flavored options and packaged forms that can get you around that problem.

Here is my advice to you.

1. First of all, before you spend a lot of money and time, try taking fish oil to see if it works for the problem you're trying to solve. Be sure you take enough of it. For the degree of inflammation seen with PCOS, you're going to need to take the equivalent of 1000 mg DHA. That can be 2 to 3 times the recommended dose on the bottle. Be sure you do your math. It can even be the Costco brand. That is actually my first recommendation to clients. I'm more interested in whether or not adding DHA to the diet is helpful, not where the fish was caught, what the flavor of the fish oil is, yadayadayada. I just want to establish if there is a DHA deficiency.

2. Make a list of the problems that you have that you're looking for relief with that you know are related to omega-3 imbalance: memory, concentration, mood swings, carbohydrate cravings, skin problems, menstrual irregularity. Keep this list in a handy place.

3. If memory problems are on your list, be sure you have a mechanism for remembering to take the fish oil! I swear, this is one of the biggest barriers to PCOS, memory and forgetfulness keeping you from remembering what it is you need to do! If you need to engage your significant other, or set up an alarm on your phone, or a Google calendar reminder…do whatever it takes to be consistent. If you didn't take it, and it didn't work, it didn't work because you didn't take it, not because it's not the issue.

4. Be diligent about reducing your omega-6 intake: soy, safflower, sunflower, sesame, corn, cottonseed. The less of these oils you have in your diet, the better chance omega-3's have of doing the job.

5. Be sure you're reading the dose right on the label. One of my biggest issues I have with one of the most popular brands of fish oil is that their dose is two capsules, not one. Most people never read the fine print, assume a dose is one pill, and end up taking half of what they were thinking they were taking.

6. At the end of your trial period, look at your list and see what improved. Did it work? NOW, and only NOW that you've established whether or not you were DHA deficient, consider if the type of fish oil you take. Would you prefer a flavored, a gel, a capsule, a liquid? All of them are going to give you what you want, you're just deciding which one fits best with your personal taste and texture preference.

Pretty packaging and fancy words are not what are going to help you to feel better. It's what's inside the package, and in what concentration, that you need to focus on!

I was recently asked by a colleague, what I thought about various popular cooking oils…in particular, grapeseed, flaxseed, canola, and pumpkin seed oil. Here is a summary.

First of all, all of these oils are oils, and their caloric content is roughly similar, about 50 calories per teaspoon. You will not save calories by choosing a particular oil, and there is no oil you can eat limitless quantities of without the caloric content eventually catching up with you.

Secondly, as far as omega-3 content, any vegetable oil containing omega-3 fatty acids contains ALA, NOT the EPA and DHA found in seafood. Even though some ALA can be converted to DHA, it does not occur in quantities needed to therapeutically treat PCOS, or to maintain the integrity of brain structure in the general population. The reason ALA is important, is that it helps to protect the body from inflammation and when it is consumed in adequate quantities, it allows DHA to do its job. In other words, if all you are doing is taking a few fish oil capsules but not changing your diet, you are not very likely to benefit from the fish oil.

That being said, when you choose oils to cook with, you want to remember that your overall dietary omega 6 to omega 3 ratio should be 10:1 or less, in order to reduce the possibility of insulin resistance. How do these four oils measure up?

I boldfaced the ones I prefer.

Grapeseed oil 696 to 1
Yikes!

Flaxseed oil 0.238 to 1
Now you know why we love flaxseed so much around here. Here is some information on some flaxseed oils you can cook with that you might find interesting.

Canola oil 2 to 1
Whether or not you want to include canola oil in your diet is part of your own food religion. If it fits for you, know its ratio is excellent. If it does not, you may want to investigate the flaxseed oil option listed above.

Pumpkin seed oil 3 to 1
Not bad!

Lard 10 to 1
This surprised me. It also made me feel better about my love of tamales.: )

Butter 8.6 to 1
Even better than lard!

Margarine, stick 11.4 to 1
Don't go there.

Margarine, tub 4.8 to 1
The only problem here is that in order to make a liquid oil solid…it has to be turned into trans fat. Wrong kind of omega-6 oil.

Last night I settled in to watch the evening news, in time to see an ad for Country Crock's Omega 3 Plus brand margarine. With my reputation as somewhat of an"omega 3 queen," I figured I'd better pay attention. And by the time the ad was over, I knew I had today's post.

This label is a perfect example of why consumers are confused, and why they can have a hard time achieving the benefits of good nutritional choices.

First, the good news.

The margarine has no trans fats, because it contains no hydrogenated or partially hydrogenated oils. For fertility, this is a huge plus--with as little as 2% of your total calories per day coming from trans fats (about 2/3 tsp for the average woman), fertility can drop by as much as 73%.

Secondly, one serving provides 500 mg of omega-3's in the form of ALA.

Now for the confusing and potentially detrimental news.

When the professionals on this blog talk about what we're doing to enhance fertility and reduce inflammation, and we refer to omega-3's, we are primarily referring to EPA and DHA, the omega-3's that, except for omega-3 eggs and foods supplemented with algal DHA, contain either fish or fish oil. (Menhaden oil, which is what is found in Smart Balance Omega 3 Margarine, is a type of fish oil.)

Any other type of omega-3 is likely to be ALA. This type of omega-3 is found in canola oil, and flaxseed oil, among other things. In this margarine, the ALA source is canola oil.

But there is no fish oil or marine algae to provide a similar nutritional feature.

There are some things that flax and canola can do, and there are some that flax and canola simply cannot do.

Many people, nutritionists included, operate on the assumption that since the omega-3 found in canola and flax can be converted into EPA and DHA, that you can get enough of the latter two without having to eat fish. Most respected omega-3 chemists will tell you this is highly unlikely.

On a good day, when your diet is as perfect as it can possibly be (which, even in the case of the person writing this post is never), only about 2-3% of your flax and canola can be converted into the other omega-3's.

Bottom line, it's pretty non-negotiable, you are highly unlikely to get the amount of omega-3's your body needs, especially if you are trying to conceive, if you are assuming you can do it without fish.

Secondly, the primary oil in the margarine appears to be liquid soybean oil. Remember the rule about"S" and"C" oils? Soybean is one of those"S" oils with a tendency to be pro-inflammatory. It was impossible to tell from the label what the ratio of soybean to canola oil was, and I would suspect that it was higher than you're going to want if you're trying to choose fertility-friendly foods.

I immediately became suspicious about this Country Crock product when I went to the website and nowhere, I mean absolutely nowhere, could I find a plainly stated ingredient list. Sure, there's a label to look at, but it's strategically posted in a way that all the nutritional information is there except for the ingredients. Hmmmm…

…so I went to the FAQ section. Couldn't find it there either. I found a lot of long-winded explanations of trans-fat labeling, and that was my second red flag.

Since I had to go to the grocery store anyway, I stopped in and looked at the label. Here, for the benefit of the rest of the people on the Internet, is the list of ingredients from the side of the container of this product:

Vegetable oil blend (liquid soybean oil, canola oil, palm oil, palm kernel oil, water, whey, salt, vegetable mono and diglycerides, soy lecithin (potassium sorbate, calcium disodium EDTA), citric acid, artificial flavor, vitamin A (palmitate), and beta carotene.

For more information on healthy fats, go to http://www.zingbars.com/science-of-zing.html, where my Zing Bar friends describe why they did--and didn't--include certain fats in their new product.

Any fat that is going to be solid at room temperature is going to have to have some saturated fat in its formula. Otherwise, it would melt. So even though the total saturated fat content is low, the type of fat being used to provide the solid quality is not one you want to get much of in your diet.

I'm not really a butter or margarine person so giving those up was not an issue for me. But I did start my career in the Chicago area, and I remember how people used to look at me like I was purple-polka-dotted if I even hinted that dairy intake might need to be adjusted. So I know it's an issue for some of you.

Bottom line--if you choose to use the product, do so only once in awhile and sparingly. I'd rather see people use olive oil-based dipping sauces for breads and cook with either canola or olive oil.

If you're interested in learning more, the authors of the study below also wrote a recently released book in plain English entitled, The Fertility Diet. I'd check it out.

Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstet Gynecol. 2007 Nov;110(5):1050-8.

So you've been told you need to clean up your nutrition act, and you've stopped eating the Fritos. You've decided to stop being the reason the stock price of your local fast food restaurant has weathered the Wall Street willies. Your salad dressing shelf in your refrigerator is now half of what's in your refrigerator.

Still no luck.

Hey, isn't eating better supposed to be the answer?

Depends on how you define eating better.

I'm noticing with my inCYST classes that a disproportionate percentage of women coming for information have adopted vegetarian practices. And I'm beginning to wonder if it isn't part of the problem.

No, the problem isn't that you're vegetarian. It's how you're defining vegetarian, and it's how you go about being one that matters. Here are my simple rules for being the healthiest (potentially fertile) vegetarian you can be.

1. Define your vegetarianism by what you DO eat.

Most people I know who become vegetarian after eating meat, define that practice in terms of what they DON'T eat. They DON'T do red meat. They DON'T do dairy. They DON'T do fish. DON'T, DON'T, DON'T.

Therein lies the problem.

A most important rule of nutrition is, when you eliminate an entire category of food, for whatever reason, be it meat or wheat, you are also eliminating crucial nutrients that this category contains.

My definition of vegetarian is someone who meets all of their complete nutritional needs without using animal products.

Do you know what fertility-related nutrients you're likely short on if all you've done is cut out meat? If not, read on!

2. Zap yourself with zinc!

Zinc is needed for oodles of reactions that keep your body running, from your brain to your ovaries. Are you eating whole grains? Beans? Pumpkin and sunflower seeds? Nuts? Oops…go get your shopping list, right now, and put them down!

3. Forgetting folate can be fatal

You likely know about this nutrient since there has been so much publicity about its role in pregnancy. Put spinach on your sandwich instead of lettuce…make sure your morning cereal is fortified…eat more beans and split peas…and become savvy with sunflower seeds!

4. Cultivate a copper attitude

It's not as famous as folate, but it still is important to remember. Outside of red meat, its vegan sources are rather random: molasses, green olives, cocoa, nuts, avocadoes, black pepper, sunflower seeds…hopefully at least one of these sounds tasty!

5. Try to remember tryptophan

Tryptophan is a building block for serotonin, one of the major neurotransmitters regulating the brain's hormone center. For vegetarians, there are still a lot of options even if you're not using dairy products or eating turkey. Does your pantry have…cocoa, mangoes, sesame seeds, pumpkin seeds, oats, dates, chickpeas, peanuts, bananas, and sunflower seeds? It needs to.

6. Allow for algae

If you're vegan, chances are you're not getting enough DHA and EPA, the omega-3 fatty acids primarily found in fish. Become friendly with an ingredient known as Life's DHA, a marine algae source of DHA (unfortunately not EPA), that is being added to vegan-friendly foods. The link I'm providing gets you to the most recent list of foods containing this ingredient that you may want to become proficient at finding.

7. Not all vegan products are created equally healthy. Be sure if you've gone vegan, that you are aware of oils that can interfere with healthy balance. These oils are all vegan, but tend to be pro-inflammatory: safflower, sunflower, soybean, corn, cottonseed, sesame. (Remember my"S and C" rule from previous posts. If you're eating absolutely no meat at all, but you're eating a salad doused with soybean oil-based dressing…that could be a problem. Become familiar with brands that are made with olive or canola oils, or learn to make vinaigrettes. (Canola is the"C" oil exception, by the way.

8. Be happy without hydrogenated.

Hydrogenated = trans fat. Enough said.

9. Forget the fructose…high fructose corn syrup, that is.

It's been connected to insulin resistance in more than one study. And despite what marketers would really like you to believe, more than one nutrition expert does not endorse its use.

10. Be pro-protein

This is the most obvious one…know your complementary proteins and be sure your diet includes them. One caveat…soy may be hard on your thyroid function and is not a good choice if you have a family history of breast cancer. Be sure you are reading labels, as soy is a filler in many, many foods.

I like to look for patterns that make nutrition recommendations easy to recommend. In this post, it didn't work out that way. A lot of these foods are random. If I'm not giving you ideas that seem easy to work into your food plan…think of consulting with one of our experts! That's what we excel at, and that's what we're waiting to help you with.

After all, you became vegan to be healthy, let's work together to do it correctly.

Way back when I first started studying omega-3 chemistry, I put together a list of DHA contents of a variety of seafoods. I was recently asked for a copy of that list, and since the list was not complete the first time I did it, I decided to update it.

I noticed when looking at the latest list that there were two significant changes: Over half of the seafood given the"green light" are farmed. Meaning we need to be more open to eating farmed fish and better manage our ocean farming habits. Secondly, as a consumer it is also important to know what fishing method was used. Some are sustainable, some are not.

The list below is based off of the Monterey Bay Aquarium Seafood Watch list, most recently updated January 11. As much as I advocate for all of you to eat more fish, I want to be sure that I do my part to encourage responsible use of the ocean's resources. So the only options included on this list are the"green light", or most sustainable options. If you don't see it there, it didn't get a green light. The (F) in front of an item denotes"farmed".

I'll update this from time to time so you all can keep current. I used the national list, but you can also find more specific regional lists at the same website. The downloadable wallet cards or iPhone application are great to keep with you so that you can always make better choices when you're grocery shopping or eating out.

Bottom line, any seafood has omega-3's. Even if they're not as high as what is found in salmon, every time you eat fish, you're not eating a meat higher in saturated fat. There's a"double whammy" benefit over and above that simple DHA.

Hope this inspires you to think when buying or ordering your seafood!

Milligrams of EPA/DHA/total omega-3 per 100 gram (3.5 cooked ounces)

(F) artic char 600/500/1100
(F) US barramundi 900/600/1500
(F) US catfish 200/200/400
(F) clams 100/100/200
(F) US cobia 383/418/801
(F) Pacific cod, bottom longline fished 100/100/200
Dungeness/stone crab 100/200/300
Pacific US halibut 300/100/400
Pacific US spiny lobster 100/100/200
(F) mussels 300/200/500
(F) oysters 200/400/600
Alaska sablefish/black cod 100/100/200
Alaskan salmon 575/500/1075
(F) off-bottom scallops 100/100/200
Pink shrimp 100/200/300
(F) striped bass 600/200/800
*striped bass 200/600/800
(F) US tilapia 130/50/180
(F) US rainbow trout 400/100/500
US/British Columbia albacore tuna (canned white) 100/300/400
Skipjack tuna (canned light) 300/100/400