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Diet Treats Parkinsons Alzheimers Heart Disease?Food As Medicine

Hadley’s intro: I often say that true health care reform begins on the farm and in the kitchen, with the best foods being the best medicine for happy, sexy love and health. Today, discover the best Omega 3 fatty acids found in the best food sources (including flax seeds, walnuts,tofu, spinach) in this guest post from the World’s Healthiest Foods

Foods Rich In Healthy Omega 3 Fats

World’s Healthiest Foods Article:

No type of fat has been getting more recent publicity than omega-3s, and you’re very likely to have seen TV ads or heard radio infomercials about this unique type of fat. However, much of the omega-3 publicity you’ve heard has probably been focused on dietary supplements rather than food. In this profile, we’ll provide you with a fresh look at omega-3s from the perspective of food and the best ways to balance your meal plan for strong omega-3 support.

Omega-3s belong to a broader group of fats called polyunsaturated fats. Sometimes you’ll hear this group called “poly” fats. The specific members of this group are called polyunsaturated fatty acids, or PUFAs. What’s most important about PUFAs—including omega-3s—is one special aspect of their chemical structure. They contain what are called “double bonds”—special connections that make them more flexible and interactive as fatty acids; they also make them more delicate and susceptible to damage. All PUFAs—including all omega-3s—contain at least two double bonds. But the position of the double bonds in omega-3s is unique and simply not found in other fats.

Some omega-3s are simpler than others. The simplest is called alpha-linolenic acid, or ALA. Like most vitamins, ALA is especially important in our diet because our bodies cannot make it from scratch. Either we consume it, or we don’t have enough. Fortunately for us, many commonly eaten plant and animal foods contain ALA.

For other omega-3s, this all-or-nothing scenario is not the case. Under the right circumstances, our bodies can usually take ALA and transform it into other omega-3s. These other omega-3s are more complicated than ALA and contain more double bonds. The best studied are EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). EPA has five double bonds and DHA has six. In a large number of research studies, there are clear health benefits provided by EPA and DHA that are not provided by ALA. These health benefits involve support of many body systems and decreased risk of many chronic diseases.

So without question, our bodies need ALA, EPA, and DHA to stay healthy, and we need to consume ALA-containing foods no matter what because our bodies lack the ability to make ALA. But what about EPA and DHA? Are we absolutely required to eat foods containing EPA and DHA?

The answer to that question is particularly important since it can affect our entire approach to eating. If we only need to eat ALA-containing foods—and can trust our bodies to make all of the EPA and DHA that we need—we become free to choose whatever type of diet we would like, including a strict vegan diet that contains no animal foods whatsoever (including no milk, no cheese, and no eggs). That’s because a wide variety of plant foods contain small-to-moderate amounts of ALA. However, if we need to obtain EPA and DHA directly from food, we become much more restricted in our food choices. For example, if we are trying to implement a strict vegan diet with no animal foods whatsoever and want to obtain DHA from our diet, our choices would most likely be limited to sea plants (which can contain DHA) or some fermented foods (like fermented soy foods) which had been allowed to ferment with the help of specific fungi that were capable of producing DHA. The absence of DHA in land plants is the reason for these very limited options.

Let’s take some other examples. If we wanted to consume a generally vegetarian diet while still allowing ourselves to consume some fish, we would be able to get EPA and DHA from our food since fish can be a rich source of EPA and DHA. Similarly, if we wanted to consume a generally vegetarian diet while still allowing ourselves to consume some cheese, yogurt, milk, or eggs, we could also figure out how to obtain sufficient amounts of EPA and DHA from our food since these foods can contain both EPA and DHA. Or if we chose to eat meat while avoiding all fish, it would still be possible for us to get our EPA and DHA since meats can contain both EPA and DHA. (Their EPA and DHA content require that the cattle to have eaten a healthy amount plants that contain omega-3s.) The table below summarizes some of these basic relationships between omega-3s and diet types.

Diet sources of Healthy Omega 3 Fatty Acids

As you can see from the table above, our food choices can change quite dramatically if we are required to obtain EPA and DHA from our diet. But are we required to do so? Unfortunately, the answer to this question is not 100% clear from the research studies.

In principle, most healthy persons should be able to eat ALA-containing foods (like flaxseeds, walnuts, tofu, and spinach) and then rely on their bodies to convert ALA into EPA and DHA. Yet there is considerable scientific debate about our ability to get optimal amounts of EPA and DHA by relying exclusively on ALA-containing foods. That’s because our body’s ability to make EPA and DHA from ALA can become compromised under a variety of common circumstances.

For example, our body’s ability to make EPA and DHA from ALA partly depends on the other types of fat that we eat. One of those other fat types is omega-6 fat. Omega-6 fats are more plentiful in foods than omega-3 fats. Because they are more plentiful, we often find ourselves consuming much more of them. Yet high consumption of omega-6 fats can directly reduce the amount of ALA that our body converts into EPA and DHA.

Or, to take another example: our body cannot do an effective job of converting ALA into EPA and DHA without a satisfactory supply of certain nutrients. These nutrients include vitamin B3, vitamin B6, vitamin C, and the minerals zinc and magnesium. If we are deficient in one or more of these nutrients, our bodies may not be able to provide us with optimal amounts of EPA and DHA, even when our ALA intake is sufficient.

Different people will want to use different dietary approaches to obtain their omega-3s. But based on a review of the research and on the chart information presented above, here are our basic recommendations:

If you choose to avoid all animal foods (including seafoods), we recommend a discussion with your healthcare practitioner to determine possible supplementation with omega-3s.
If you consume animal foods but avoid seafoods, we recommend extra care in selection of EPA- and DHA-containing animal foods. Animals that have consumed healthy amounts of omega-3s in their diet will be the most likely to contain EPA and DHA. As a general rule, these animals will have been raised in a natural setting throughout their lives and pasture-fed on a variety of grasses, legumes, and other plants.
If your diet includes fish, 2-3 servings per week is a good target level for bringing fish-based EPA and DHA into your meal plan.

Omega-3 fatty acids are a group of polyunsaturated fats found in a wide variety of foods, most famously in fish. Because of recent research suggesting potential cardiovascular prevention and other health benefits, omega-3 fatty acids are currently a hot topic in nutrition research.

Of the World’s Healthiest Foods, two (flaxseeds and walnuts) rate as excellent sources. We rate five of our listed foods as very good sources of omega-3, and 19 as good sources. This should give you plenty of choices to make sure your diet contains good sources of these important fats.
Role in Health Support

ALA, EPA, and DHA all play important roles in support of our health. Yet these roles are somewhat different.
Alpha-linolenic acid (ALA)

A large amount of ALA is sometimes used strictly for energy purposes. Our bodies can take ALA and use it to produce energy for our cells. In some situations, most of the ALA that we consume will get used in this way. ALA is also the primary building block for EPA and DHA. It’s difficult to overstate the importance of ALA in this regard. Our immune, inflammatory, cardiovascular, and nervous systems simply cannot function correctly without sufficient amounts of EPA and DHA. When we don’t have enough ALA, we don’t have enough EPA and DHA (unless we’ve eaten foods that contain them). So ALA has a critical role to play in the health of many body systems as the key building block for EPA and DHA. There are basically two important metabolic roles for dietary ALA. The first is the breakdown of ALA to be used as an energy source. As much as 85% of dietary ALA is broken down to be used as an energy source.

The other major role for ALA is to be elongated to the related omega-3 fats EPA and DHA. The efficiency of this process will be discussed in more detail below.
Eicosapentaenoic acid (EPA)

Proper function of our inflammatory system depends on the presence of messaging molecules called prostaglandins. Many of these prostaglandins are made directly from EPA. Equally important, most of the prostaglandins made from EPA tend to be anti-inflammatory in their effect. Therefore, your risk of excessive inflammation and inflammation-related disease can be lowered through consumption of foods rich in EPA.
Docosahexaenoic acid (DHA)

Proper function of our nervous system—including our brain—depends on the presence of DHA. DHA is particularly important to brain function. Our brain is 60% fat by weight, and DHA makes up an average of 15 to 20% of all fat in our brain. If we tie these two facts together, we arrive at the following conclusion: DHA accounts for 9-12% of our brain’s total weight! Drops in brain DHA levels are known to associate with cognitive impairment or slower neurological development in children. Nervous system deficiencies of DHA have been associated with a wide variety of problems, including neurodegenerative diseases like Parkinson’s disease; cognitive problems including reasoning ability in children; and severity of multiple sclerosis.
A Special Note about Omega-3s and Cardiovascular Support

Prevention of cardiovascular diseases is one of the best-studied and substantiated role for omega-3s in the diet. Especially strong is the research supporting EPA and DHA in lowering heart disease risk. There is less research on ALA and heart disease, but research in this area still shows the ability of ALA intake to decrease risk. Unfortunately, the research we see in this area continues to focus more on dietary supplements than food, and in the future, we hope to see a much stronger emphasis on omega-3s from food.

The most crucial role for omega-3 fatty acids in health is arguably in prevention of cardiovascular diseases like heart attack and stroke. Much of the research in this area looks specifically at total EPA + DHA intake from diet and/or supplements.

Although there is comparatively less research on the topic, ALA intakes are associated with lower risk of cardiovascular disease independently of the other omega-3 fats. Still, the beneficial effects of diets high in ALA are likely to be more modest than diets rich in EPA and DHA.
Summary of Food Sources

Excellent sources of alpha-linolenic acid (ALA) include flaxseeds and walnuts. Very good sources of ALA include sardines and salmon, as well as cauliflower, Brussels sprouts, and mustard seeds. Good sources include a wide variety of vegetables (collard and turnip greens, spinach, kale, green beans, romaine lettuce, summer squash, and winter squash), fish (scallops, shrimp, and cod), legumes and foods made from legumes (soybeans, tofu, and miso), and fruits (strawberries and, raspberries). While seafood is known for its EPA and DHA content, smaller amounts of ALA are provided by numerous seafoods. While not ranked on our Rating System Chart, animal foods including beef, dairy, and eggs may also provide varying amounts of ALA. Outside of the U.S., one study in Britain found that about 25% of ALA intake in the UK population came from fish and meat dishes, with another 8% from eggs and dairy foods. While we do not have a similar study from the U.S., we do know that the quantity of ALA in animal foods depends on the diet consumed by the animals. As a general rule, animals raised in a natural setting throughout their lives and pasture-fed on a variety of grasses, legumes, and other plants will contain more ALA in their bodies, and will therefore provide food that is richer in ALA, eicosapentaenioc acid (EPA) and docosahexaenoic acid (DHA). Seafood is the food group most concentrated in EPA and DHA.

Like all creatures, fish have an omega-3 content that is highly dependent on their diet. If they eat algae, sea plants, and other foods that are rich in omega-3s, they are able to store more omega-3s in their tissue. If they live in a habitat where omega-3s are not widely available, they store much less. The close relationship between their diet and their omega-3 content applies to all specific omega-3s found in fish, including ALA, EPA, and DHA. It also applies to all types of fish including wild-caught and farmed. Some farmed fish are fed processed omega-3 concentrates to boost their omega-3 content. Other farmed fish are fed few omega-3s and have lower-than average omega-3 content.

Land animals are no different than fish in terms of their omega-3 content. Their diet is the key controlling factor—the same as it is for ocean creatures. Cows and chickens consuming diets that are rich in omega-3s tend to produce milk and eggs that are higher in omega-3 fats. Levels of omega-3s in eggs can reach levels of 350 milligrams per egg, depending on the hen’s diet. In cow’s milk, omega-3 levels have been shown to reach 155 milligrams per 8-ounce cup in some grass-fed heifers. About half of these omega-3s are typically present in the form of ALA, with the other half being divided between EPA, DHA, and other omega-3s. As a general rule, the milk, cheese, yogurt, and eggs obtained from land animals that have been grass-fed and have had natural access to pasture plants containing omega-3s are going to be your best bet for omega-3s from land animals.

Other omega-3 fortified foods are becoming available on the market, including margarine spreads, juices, and snack foods. These foods are generally made by adding the fatty acids during the manufacturing process. As with all nutrients, we believe that your omega-3s are best obtained from whole, natural foods. Unless a food is whole and natural, there is no way to guarantee that its nutrients will be found in optimal ratios and balanced proportions, or even incorporated into the food matrix in an optimal way.

We would like to add a special note about one food that does not appear on our ranking list as a good, very good, or excellent source of omega-3s. That food is tuna. In our nutrient analysis, we used baked yellowfin tuna. A 4-ounce serving of this form of tuna provided 140 milligrams of omega-3s and 147 calories. When we put these numbers into our rating system formula, tuna provided too few omega-3s in comparison with its calorie content to rank as a good source of omega-3s. However, we do not believe that this outcome would automatically be true for all tuna. We’ve seen studies on canned light tuna that showed about 345 milligrams of omega-3s in 4 ounces, and in the case of canned albacore tuna, we’ve seen studies showing about 975 milligrams of omega-3s in 4 ounces. Their higher levels of omega-3s would change the status of tuna in our rating system. However, our approach to healthy eating is always focused on fresh, natural, and minimally processed foods rather than canned or other versions.
Nutrient Rating Chart
Introduction to Nutrient Rating System Chart
In order to better help you identify foods that feature a high concentration of nutrients for the calories they contain, we created a Food Rating System. This system allows us to highlight the foods that are especially rich in particular nutrients. The following chart shows the World’s Healthiest Foods that are either an excellent, very good, or good source of omega-3 fats. Next to each food name, you’ll find the serving size we used to calculate the food’s nutrient composition, the calories contained in the serving, the amount of omega-3 fats contained in one serving size of the food, the percent Daily Value (DV%) that this amount represents, the nutrient density that we calculated for this food and nutrient, and the rating we established in our rating system. For most of our nutrient ratings, we adopted the government standards for food labeling that are found in the U.S. Food and Drug Administration’s “Reference Values for Nutrition Labeling.” Read more background information and details of our rating system.

Best Food Sources Omega-3 Fatty Acids

Omega-3 fatty acids are very susceptible to free radical damage. Oxidation of omega-3 fats limits their shelf life and their ability to provide you with the nourishment you need. Damage to the omega-3s in your food can be caused by light, oxygen, or heat. For this reason, foods that are rich in omega-3s should usually be stored in the refrigerator in a sealed container. This rule not only applies to animal foods like fish, dairy, eggs, and meat but also to plant foods like nuts and seeds.

The grinding of nuts and seeds deserves special mention in terms of its impact on omega-3 nourishment. As described earlier, many nuts and seeds contain valuable amounts of omega-3s in the form of ALA. However, in the case of small seeds like flax or chia seeds, it can be very difficult to chew the seeds and grind them sufficiently with your teeth to help increase the availability of their ALA. For this reason, many people choose to grind seeds (for example, in a coffee grinder) prior to eating or incorporating into a recipe. If you decide to grind your omega-3 rich seeds, their shelf life will be reduced and it becomes especially important to store them in a sealed, opaque container in your refrigerator. To give you a more practical idea of shelf life, pre-ground flaxseeds—packaged by the manufacturer in a gas-flushed, light-protective pouch—will typically last for 6-16 weeks before going bad. By comparison, whole flaxseeds will last 6-12 months when stored properly. If you are grinding your own seeds, we recommend a more modest storage time of 1-2 months.
Risk of Dietary Deficiency

If your meal plan resembles that of the average U.S. adult, you are highly likely to be deficient in omega-3s. The reason is simple: the average U.S. adult consumes too few foods that are good sources of omega-3s, and excessive amounts of total fat that contain too many omega-6s.

In the U.S., our ratio of omega-6:omega-3 fat has been estimated to fall between 20:1 and 8:1. (Those numbers mean that we eat at least eight times more omega-6 than omega-3, and perhaps as much as 20 times more.) Most studies suggest that a healthier ratio of omega-6:omega-3 lies between 4:1 and 2:1. Taken as a whole, the dietary circumstances described above leave the average U.S. adult with an insufficient intake of ALA and a compromised ability to convert ALA into other health-supportive omega-3s like EPA and DHA due to excessive intake of omega-6s.

A further problem with the average U.S. diet and omega-3s is deficient intake of nutrients required to convert ALA into EPA and DHA. This list of nutrients includes vitamins B3, B6, and C, and the minerals zinc and magnesium.

Reasons for low omega-3 intake in the U.S. diet vary, but some key reasons that apply to many meal plans are as follows:

Low intake of nuts and seeds. The most commonly eaten nuts in the U.S. are peanuts, and, while healthy and delicious, peanuts technically fall into the category of legumes rather than nuts and are therefore less concentrated in omega-3s. Unlike true nuts (like walnuts) or seeds (like flaxseeds), peanuts do not show up in our Top 25 list of WHFoods that provide you with omega-3s and do not rank as an excellent, very good, or good source of these fatty acids. (Peanuts typically provide you with about 5-10 milligrams of omega-3s per ounce.)
High intake of meat and dairy products from animals that did not graze on plants containing omega-3s. The vast majority of beef, milk, cheese, and yogurt consumed in the U.S. comes from cows that did not have the opportunity to eat pasture plants containing omega-3s. Similarly, the vast majority of chicken and eggs consumed in the U.S. comes from animals raised without the benefit of omega-3 containing plants.
Infrequent intake of fish, especially fish richer in omega-3s like salmon, halibut, and/or sardines.

Your best ways of increasing omega-3 nourishment are to reverse all of the above practices. Consider increasing your intake of nuts (like walnuts) or seeds (like flaxseeds). Consumption of these foods on a daily basis can work well in most meal plans. Also consider fish like salmon, sardines, shrimp, or cod on a more frequent basis. Finally, consider purchase of grass-fed and/or pastured-raised animal foods including meats, cheeses, yogurt, and eggs.

If you are following a fairly strict vegetarian or vegan diet, it may be especially difficult for you to get EPA and DHA you directly from food. (That’s because animal foods are typically richer sources of these omega-3s than plant foods.) For this reason, we recommend that you increase your intake of ALA-containing foods to a level that will provide you with approximately 4 grams of ALA per day. Here are some choices that can help you reach that 4 gram level.
Food ALA Serving Size ALA
Flaxseeds 2 tablespoons 3.19 grams
Walnuts 1/4 cup 2.72 grams
Tofu 8 ounces 1.32 grams
Brussels sprouts 2 cups cooked 0.54 grams
Cauliflower 2 cups cooked 0.52 grams

Although we have partially addressed the following issue earlier in this article, we would like to emphasize one ongoing controversy that continues to hang over omega-3 research related to risk of dietary deficiency. That controversy involves metabolism of omega-3s. Researchers know that humans need all forms of omega-3s—including the forms ALA, EPA, and DHA. Researchers also know that humans can take ALA and convert it into EPA and DHA under favorable circumstances. But researchers still don’t know is exactly how often these favorable circumstances exist. Because the research jury on omega-3 metabolism is still out, we recommend taking one of two approaches to your omega-3 nourishment. A first approach is to focus on including not only ALA-rich plant foods in your meal plan, but EPA-rich and DHA-rich animal foods as well. A second approach is to focus exclusively on ALA-rich foods in your meal plan, but greatly increase your intake to the 4 gram level described earlier.
Other Circumstances that Might Contribute to Deficiency

Since omega-3s are a type of fat, some conditions that involve poor absorption of fats from our digestive tract can increase our risk of omega-3 deficiency. Included in this list of conditions would be inflammatory bowel disease, celiac disease, and cystic fibrosis.
Relationship with Other Nutrients

Since omega-3 fats are delicate and susceptible to damage from oxygen-containing molecules, our need for dietary antioxidants becomes greater as our intake of polyunsaturated fats goes up. Especially important within this increased antioxidant intake is increase intake of vitamin E. Our WHFoods richest in vitamin E include sunflower seeds, spinach, Swiss chard, turnip greens, asparagus, mustard greens, chili peppers, almonds, broccoli, and bell peppers. For more information about vitamin E-containing foods, please see our nutrient profile for vitamin E.

As described earlier, excessive intake of omega-6 fats in comparison to omega-3s can compromise your omega-3 nourishment. In practical terms, excessive intake of omega-6s typically comes from one or more of three places. First is excessive intake of total fat. (Too much overall fat consumption can result in excessive intake of omega-6s because most fat-containing foods provide more omega-6s than omega-3s.) Second is excessive use of cooking oils high in omega-6s (including corn oil, safflower oil, sunflower seed oil, and soybean oil). Third is excessive intake of fried foods. (The oils used for frying are typically richest in omega-6s.) Cutting back in any or all of these three areas can greatly reduce your omega-6 intake.
Risk of Dietary Toxicity

There is no known toxicity risk consistently associated with diets high in omega-3 fatty acids. Like any fatty acids, omega-3s are densely packed calorie sources, and too much dietary fat can be associated with weight gain. However, if you restrict your intake of high-fat foods to foods that are rich in omega-3s, you’re less likely to overdo it on the calories. It’s almost never the omega-3 rich foods that we tend to consume in excess.
Disease Checklist

Cardiovascular disease (prevention in high risk individuals)
Hypertension
High cholesterol
Diabetes
Alzheimer’s disease
Cognitive problems in aging
Parkinson’s disease
Multiple sclerosis
Excessive blood clotting
Brain/nervous system support
Pregnancy / lactation
Depression, including post-partum depression (prevention)
PMS (flaxseed only)
Fibrocystic breast disease (flaxseed only)
Hot flashes (flaxseed only)

ALA forms of omega-3 fatty acids may play a role in the prevention and/or treatment of the following health conditions:

Cardiovascular disease
Hypertension
Excessive blood clotting
Pregnancy/lactation
PMS
Fibrocystic breast disease
Hot flashes

EPA and DHA forms of omega-3 fatty acids may play a role in the prevention and/or treatment of the following health conditions:

Cardiovascular disease
Hypertension
High cholesterol
Diabetes
Excessive blood clotting
Alzheimer’s disease
Cognitive decline
Parkinson’s disease
Multiple sclerosis
Nervous system development
Depression
Bipolar disorder
Pregnancy/lactation

Public Health Recommendations

We’ve found specific omega-3 recommendations from a variety of public health organizations, including the National Academy of Sciences, American Heart Association, American Dietetic Association, World Health Organization, and National Institutes of Health. These recommendations are relatively similar, but by no means identical. We’ve provided you with more details below, but we also want to give you our own WHFoods recommendations based on the research studies that we have reviewed.
Summary of Omega-3 Reccomendations

Total omega-3 fats: at least 2.5 grams per day
EPA+DHA included within your total omega-3s: 400-500 milligrams per day

For total omega-3 fat, we recommend an average of at least 2.5 grams per day. On some days you might get slightly less, but over the course of an entire week, you’ll want to average at least this amount. Our Healthiest Way of Eating Plan averages about 3 grams of omega-3s per day, and it will give you a very practical look at what it takes to provide this amount on a meal-by-meal basis.

Within these 2.5 grams of total omega-3s, we recommend an average daily intake of 400-500 milligrams of EPA and DHA combined. Since you can get over 1,000 milligrams from a 4-ounce serving of fish like salmon, three servings of salmon per week could bring your daily EPA and DHA average to this level all by itself. Grass-fed beef and dairy products cannot usually provide you with amounts of EPA and DHA equivalent to fish, but they can still increase your EPA and DHA intake substantially.

More details about public health organizations and their recommendations are as follows.

The National Academy of Sciences has established a Dietary Reference Intake (DRI) level for ALA at 1.6 grams per day for men ages 19-70 and to 1.1 grams per day for women ages 19-70. An expert working group at the National Institutes of Health (NIH) has suggested an intake of 2.2 grams of ALA per 2000 dietary calories for both women and men.

There are several recommendations for intake of EPA and DHA from different groups. These recommendations include:

The American Dietetic Association recommends an average of 500 mg of total EPA and DHA per day. This would be approximated by having two 4-ounce (after cooking) servings of fatty fish per week.
The American Heart Association recommends two servings of fish per week, preferably fatty fish.
The World Health Organization recommends one to two servings of fish per week, with each serving providing between 200 and 500 mg of total EPA and DHA.
The NIH (National Institutes of Health) working group recommends 220 mg each of EPA and DHA per day in a 2000-calorie diet.

There are also some specific recommendations for target populations. These include:

The Child Health Foundation recommends that pregnant and lactating women should receive an average of at least 200 mg per day of DHA.
The American Heart Association recommends a total of 1000 mg EPA and DHA for people with documented coronary artery disease.

The National Academy of Sciences has not issued a Tolerable Upper Intake Limit (UL) for omega-3 fatty acids. Similarly, none of the other experts listed above have recommended limiting omega-3 intake below a certain standard.
References

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Baux A, Hebeisen T, Pellet D. Effects of minimal temperatures on low-linolenic rapeseed oil fatty-acid composition. Eur J Agron 2008;29:102-7.
Bozan B, Temelli F. Chemical composition and oxidative stability of flax, safflower and poppy seed and seed oils. Bioresource Technology 2008;99:6354-9.
Burdge AC, Calder PC. Dietary alpha-linolenic acid and health-related outcomes: a metabolic perspective. Nutr Res Rev 2006:19:26-52.
Daley CA, Abbott A, Doyle PS, et al. A review of fatty acid profiles and antioxidant content in grass-fed and grain-fed beef. Nutr J 2010;9:10-21
Davis BC, Kris-Etherton P. Achieving optimal essential fatty acid status in vegetarians: current knowledge and practical implications. Am J Clin Nutr 2003;78:640S-646S.
Kitson AP, Patterson AC, Izadi H, Stark KD. Pan-frying salmon in an eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) enriched margarine prevents EPA and DHA loss. Food Chem 2009;114:927-32.
Kris-Etherton PM, Grieger JA, Etherton TD. Dietary reference intakes for DHA and EPA. Prostaglandins Leukot Essent Fatty Acids 2009;81:99-104.
Rodriguez-Leyva D, Bassett CMC, McCullough R, Pierce GN. The cardiovascular effects of flaxseed and its omega-3 fatty acid, alpha-linolenic acid. Can J Cardiol 2010; 26:489-96.
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Sebedio JL, Ratnayake WMN, Ackman RG, Prevost J. Stability of polyunsaturated omega-3 fatty acids during deep fat frying of Atlantic mackerel. Food Res Int 1993;26:163-72
Simopoulos AP, Leaf A, Salem N. Workshop on the essentiality of and recommended dietary intakes for omega-6 and omega-3 fatty acids. J Am Coll Nutr 1999;18:487-9
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Zheng J, Huang T, Yu Y, et al. Fish consumption and CHD mortality: an updated meta-analysis of seventeen cohort studies. Public Health Nutr. 2012 Apr;15(4):725-37

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Hadley Finch

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