Why Theta Pure Algae Oil is a Good Dietary Supplement

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1 Why Theta Pure Algae Oil is a Good Dietary Supplement Steve Haltiwanger, MD, CCN p1

2 Introduction Having been a doctor for 37 years, I am often asked about nutritional supplements. I find a number of questions to be important. Is the product safe? How much does it cost? What are the benefits? What other alternatives are available? This paper will answer these questions and more through a scientific review of algae oil. Algae oil is a marine-based plant extract that contains two long-chain omega-3 fatty acids. Algae oil consists of large amounts of docosahexaenoic acid (DHA) and smaller amounts of eicosapentaenoic acid (EPA). Omega-3 fatty acids are critical fats that play important roles in the health of the organs of the body but are especially important for normal functions of the brain, eyes, and heart. There are three principal omega-3 fatty acids. The first one alpha-linolenic acid (ALA) is considered to be an essential fatty acid, meaning the body cannot make it so it must be obtained from the diet. It is also defined as a parent essential fatty acid, which means that the body can theoretically convert it to the secondary fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). The essential parent fatty acid ALA is found mainly in plant oils such as flaxseed, soybean, walnut, pumpkin seed, olive, and canola oils. ALA can also be found in animal products (meat and eggs) where the animals have consumed plant materials that contain ALA. DHA and EPA are found in marine algae, fish, and fish oils (Arterburn et al., 2006; Gebauer et al., 2006). Both DHA and EPA are now considered conditionally essential fatty acids. A conditionally essential fatty acid is one that can usually be manufactured by the human body. However, when special conditions like stress, illness, premature birth, and lack of other essential nutrients exist; the body is either limited in the ability to make enough of these fatty acids or unable to manufacture them at all. There are a number of other essential nutrients that the body requires to activate the enzymes that convert the parent essential fat ALA into the longer-chain fatty acids DHA and EPA. So, a lack sufficient amounts of the minerals calcium, magnesium, and zinc or the vitamins B6 and biotin will decrease the conversion of ALA to DHA and EPA (Horrobin, 1992; Siguel and Lerman, 1994). p2

3 How does the body create or obtain DHA and EPA? Essential fatty acids are defined as fats that must be obtained from the diet since humans are unable to make these fats in their bodies. Essential fatty acids are defined as parent fats linoleic acid (LA), an omega-6 fatty acid, and alpha-linolenic acid (ALA), an omega-3 fatty acid. The long-chain omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are recognized to be conditionally essential fats that can be obtained in two ways. First DHA and EPA can be manufactured from the dietary intake of the essential fat alpha-linolenic acid (ALA) (Simopoulos, 2000). Alternatively, DHA and EPA can be obtained preformed directly from food in the diet. Unfortunately, in humans, the conversion of ALA to DHA and EPA is relatively inefficient, so clinicians now recommend that the diet contain foods or supplements that already contain premade DHA and EPA (Arterburn et al., 2006). From the supplement point of view, the most common supplements that contain DHA and EPA are fish oil, krill oil, and algae oil. Do the diets most people consume provide enough DHA and EPA? The main human dietary sources of DHA and EPA are fish and seafood although meats and dairy do contain lesser amounts. The only plant sources of the long-chain n-3 fatty acids DHA and EPA come from the ocean microalgae, and seaweed. The primary non-plant dietary sources of DHA and EPA are fish and seafood (Davis and Kris-Etherton, 2003). Individuals in western countries who have low fish consumption or consume excessive amounts of processed foods and fast foods are often deficient in DHA. Vegetarians and vegans who do not eat eggs, meat, dairy or fish are deficient in DHA and EPA (Melchert et al., 1987; Ågren et al., 1995). The diets consumed in many countries have generally become deficient in omega-3 fatty acids such as ALA, DHA, and EPA. Western diets contain excessive amounts of omega-6 fatty acids and are deficient in n-3 fatty acids compared with the diet consumed by our human ancestors (Simopoulos, 2000). Due to the increased consumption of processed and packaged foods over the last century excess amount of omega-6 fatty acids are consumed, which predisposes people to increased inflammation in the body. So, there is a biological need to increase the consumption of omega-3 fats and reduce the dietary intake of omega-6 fats. What are the benefits of omega-3 fats? The omega-3 fatty acids DHA and EPA are needed for the production of healthy cell membranes for every cell in the body as well as for the production of biologically necessary signaling molecules that influence and control the metabolism of cells. DHA and EPA are all required for normal development of the brain, nervous system and retina in both the fetus and young children (Birch et al., 2000; Greenberg et al., 2008). Docosahexaenoic acid (DHA) preferentially accumulates in the heart, the retina of the eyes, the brain, spinal cord and peripheral nerves whereas EPA does not accumulate in the brain and the central nervous system (Salem et al., 2001; Arterburn et al., 2006; Lin and Salem, 2007). DHA is particularly important in that it is now considered to be essential in pregnancy. DHA is reported in scientific studies to be important in mental health, in recovery from brain injuries, in maintaining the health of the heart. DHA is essential for eye health, and a lack of sufficient amounts of DHA will adversely affect the health of the retina and cause vision loss (SanGiovanni and Chew, 2005). p3

4 Who is at risk of not getting enough DHA and EPA? Pregnant and lactating women have increased needs for DHA and EPA. Also, individuals with diabetes, and neurological disorders, as well as premature infants, and the elderly have greater difficulty converting the essential fatty acid ALA into DHA and EPA (Davis and Kris-Etherton, 2003). DHA is often found to be deficient in people with depression, heart disease, visual problems, diabetes, alcoholism and traumatic brain injury (Gebauer et al., 2006; Gódor-Kacsándi et al., 2013; Desai et al., 2014; Grosso et al., 2014). ALA conversion to DHA and EPA does not meet all of the body s needs for DHA and EPA Medical research has now shown that a healthy diet needs some source of preformed DHA and EPA and relying only on plant oils containing ALA will most likely lead to conditional deficiencies of both DHA and EPA. The conversion of ALA (Alpha-Linolenic Acid) to DHA and EPA is not very efficient. In a 2002 women s study when a radioisotope labeled supplement of ALA was provided for 21 days the conversion of ALA to EPA was 21 % and to DHA only 9 % (Burdge and Wootton, 2002). In men, the conversion is even lower. Other studies paint an even poorer picture of the conversion of ALA to the critical omega-3 fats less than 5-10% of ALA is converted to EPA and only 2-5% for DHA (Davis et al., 2003). When both men and women are included in the studies it has been found that conversion of ALA by the liver to DHA and EPA is inefficient: with < 5 10% being converted to EPA and only 2 5% of dietary ALA is converted to DHA (Gerter, 1998; Davis and Kris-Etherton, 2003). These studies indicate the conversion of ALA to DHA is insufficient to provide all of the DHA needed by the body (Gerster, 1998). In summary, medical literature for many years has taught that consumption of ALA would provide needed amounts of the fatty acids DHA and EPA. However, newer studies done over the last 20 years using radioactively labeled fatty acids has determined that the conversion of ALA to DHA and EPA is too small to provide all of the DHA and EPA needed by the body. So, by default additional sources of DHA and EPA must be obtained from foods or supplements that already contain these fats. The problem of adequate intake of DHA and EPA is a serious problem for vegetarians and vegans. These diets provide on small amounts of ALA, DHA and EPA. Clinical studies suggest that tissue levels of long-chain n-3 fatty acids are depressed in vegetarians, particularly in vegans (Davis et al., 2003). The finding of low DHA and EPA in vegetarian and vegan diets indicate the need for a non-animal source of DHA and EPA such as algae oil. Can DHA be converted into EPA? It is well recognized that EPA can be converted from ALA, but it also can be produced from DHA in a process called retroconversion. Algae oil supplements contain significant amounts of both DHA and smaller amounts of EPA. Some of the DHA will also provide 10-11% additional EPA via a process called retroconversion (Kris-Etherton and Hill, 2008). Another study found that supplementation with only DHA without any EPA for six weeks produced 9.4% EPA by retroconversion from DHA (Conquer and Holub, 1997). In 2009 Egert et al. noted that an increase in EPA plasma levels following DHA supplementation could sometimes exceed the increase in DHA plasma levels (Egert et al., 2009). p4

5 Can EPA be converted to DHA? In reviewing multiple studies, the answer is no. In humans, dietary DHA is retroconverted to EPA, while production of DHA from EPA is not observed (Oscarsson and Hurt-Camejo, 2017). This 2017 review of fatty acids DHA and EPA reported that treatment with purified DHA produced an increase in both DHA and EPA. However, treatment with purified EPA resulted in no change of DHA levels (Oscarsson and Hurt- Camejo, 2017). In 1997, Grimsgaard et al. discovered that the dietary supplementation of 3.8 grams of EPA per day in healthy men for seven weeks actually caused a decrease of 15% in DHA levels (Grimsgaard et al., 1997). Benefits of fish oil versus disadvantages of fish oil? Advantages of fish oil Fish oil is easily obtained, it contains high amounts of both DHA and EPA. Cost of fish oil and algae oil are roughly equivalent. Disadvantages of fish oil - Small microscopic plants in the ocean produce the omega-3 fats DHA and EPA. As fish eat these organisms, the fats accumulate in their tissues. Unfortunately, due to increasing levels of pollution in the ocean fish also accumulate many toxins in their tissues. So, unless a person is using a purified fish oil supplement, they are also ingesting many toxins particularly toxic metals. Side effects include fishy aftertaste and in some people fishy smelling burps. Fish oil is not an acceptable supplement for vegans and vegetarians. Is algae oil safe to consume? Algae oil is an ocean plant oil that provides the main source of nourishment for many types of fish. Fish have safely been consumed by humans for thousands of years and are the main source of protein and fats for millions of people on earth. Algae oil does not produce adverse effects in animal studies and does not produce abnormal genetic mutations in either bacteria or animals (Blum et al., 2007; Fedorova-Dahms et al., 2011). Algae oil is included in prenatal vitamins and children s vitamins because of its recognized safety (Vanderhoof et al., 1999; Greenberg et al., 2008). These results support the safety of DHA-algal oil as a dietary source of DHA (Blum et al., 2007). The European Food Safety Authority (EFSA) in 2014 published a scientific opinion that DHA and EPA obtained from algae oil sources could be safely increased from 3 grams daily up to 5 grams daily. The scientific conclusion was that there are no safety concerns for adults (Panel on Dietetic Products, Nutrition, and Allergies, 2014). Why are algae oil a good choice as a fatty acid supplement and for whom? The DHA obtained from algae oil has been found to be nutritionally equivalent to both fish oil and cooked salmon in delivering DHA into the bloodstream and cell membranes of cells (Arterburn et al., 2008). The authors of this study determined that the use of algae oil was a safe and convenient source of DHA. This makes algae oil a good option to obtain DHA for individuals who do not wish to use fish oils or for vegetarians, and vegans who do not choose to include fish in their diet. Both vegetarian and vegan diets do contain adequate amounts of the essential parent omega-6 p5

6 fatty acid linoleic acid but are relatively low in the essential fat known as alpha-linolenic acid (ALA). These diets are also critically lacking in both preformed DHA and EPA (Davis and Kris- Etherton, 2003; Kris-Etherton and Hill, 2008). The blood concentrations of DHA and EPA in vegans are only 29 36% and 49 52% those of nonvegetarians (Ågren et al., 1995). When the fatty acid levels in the blood of vegetarians and nonvegetarians are examined, it has been found that vegetarians had DHA levels < 40% lower than nonvegetarians (Melchert et al., 1987). These studies indicate that both vegans and vegetarians require some supplementation that provides DHA and EPA. Since neither vegans nor vegetarians eat fish nor would they find fish oil acceptable it appears that the best choice would be to use algae oil as a supplement. Other groups of people who could substantially benefit from the daily intake of algae oil include; pregnant and lactating women, people with diabetes, people with visual problems, depression, memory impairment, alcoholism, neurological disorders and the elderly. A question that some people have is whether consumption of Theta Pure algae oil will provide enough EPA? First, the Algae oil product Theta Pure Natural Algae oil already contains 74 mg of EPA per 5 ml serving so some preformed EPA is already provided in this dietary product. Although the conversion of ALA to EPA can vary between 5-21% depending on medical conditions, additional EPA can also be produced from DHA. It has been reported that % of supplemental DHA is retroconverted to EPA (Conquer and Holub, 1996b, 1997; Kris-Etherton and Hill, 2008). Another 1997 study of 234 men, however, found that supplementation of just DHA increased EPA by a 29% indicating a significant amount of DHA was retroconverted to EPA (Grimsgaard et al., 1997). This research demonstrates that substantial amounts of DHA can be retroconverted to EPA. Therefore, if the diet contains sufficient amounts ALA and additional DHA is supplemented (such as algae oil), total EPA production would be expected to be adequate (Conquer and Holub, 1996a). In conclusion, DHA supplementation (as algae oil) markedly enhanced the DHA status (of serum and platelets), provided for the formation of substantial EPA, and lowered the total and LDL-cholesterol: HDL-cholesterol ratios (Conquer and Holub, 1996b). p6

7 References: 1. Ågren J, Törmalä M, Nenonen M, Hänninen O. Fatty acid composition of erythrocyte, platelet, and serum lipids in strict vegans. Lipids. 1995;30: Arterburn LM, Hall EB, Oken H. Distribution, interconversion, and dose response of n-3 fatty acids in humans. Am J Clin Nutr Jun;83(6 Suppl):1467S-1476S. 3. 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 Jul;108(7): Birch EE, Garfield S, Hoffman DR, Uauy R, Birch DG. A randomized controlled trial of early dietary supply of long-chain polyunsaturated fatty acids and mental development in term infants. Dev Med Child Neurol. 2000;42(3): Blum R, Kiy T, Tanaka S, Wong AW, Roberts A. Genotoxicity and subchronic toxicity studies of DHA-rich oil in rats. Regul Toxicol Pharmacol Dec;49(3): Burdge GC, Wootton SA. Conversion of alpha-linolenic acid to eicosapentaenoic, docosapentaenoic and docosahexaenoic acids in young women. Br J Nutr Oct;88(4): Conquer JA, Holub BJ. Supplementation with an algae source of docosahexaenoic acid increases (n 3) fatty acid status and alters selected risk factors for heart disease in vegetarian subjects. J Nutr 1996a;126: Conquer JA1, Holub BJ. Supplementation with an algae source of docosahexaenoic acid increases (n-3) fatty acid status and alters selected risk factors for heart disease in vegetarian subjects. J Nutr. 1996b Dec;126(12): Conquer JA, Holub BJ. Dietary docosahexaenoic acid as a source of eicosapentaenoic acid in vegetarians and omnivores. Lipids Mar;32(3): Davis BC, Kris-Etherton PM. Achieving optimal essential fatty acid status in vegetarians: current knowledge and practical implications. Am J Clin Nutr Sep;78(3 Suppl):640S-646S. 11. Desai A, Kevala K, Kim HY. Depletion of brain docosahexaenoic acid impairs recovery from traumatic brain injury. PLoS One Jan 27;9(1):e Egert S, Kannenberg F, Somoza V, Erbersdobler HF, Wahrburg U. Dietary alpha-linolenic acid, DHA and EPA have differential effects on LDL fatty acid composition but similar effects on serum lipid profiles in normolipidemic humans. J Nutr. 2009;139: Fedorova-Dahms I, Marone PA, Bauter M, Ryan AS. Safety evaluation of DHA-rich Algal Oil from Schizochytrium sp. Food Chem Toxicol Dec;49(12): Gebauer SK, Psota TL, Harris WS, Kris-Etherton PM. n-3 fatty acid dietary recommendations and food sources to achieve essentiality and cardiovascular benefits. Am J Clin Nutr Jun;83(6 Suppl):1526S-1535S. 15. Gerster H. Can adults adequately convert α-linolenic acid (18:3 n 3) to eicosapentaenoic acid (20:5 n 3) and docosahexaenoic acid (22:6 n 3)? Int J Vitam Nutr Res. 1998;68: Gódor-Kacsándi A, Felszeghy K, Ranky M, Luiten PG, Nyakas C. Developmental docosahexaenoic and arachidonic acid supplementation improves adult learning and increases resistance against excitotoxicity in the brain. Acta Physiol Hung Jun;100(2): Greenberg JA, Bell SJ, Ausdal WV. Omega-3 Fatty Acid supplementation during pregnancy. Rev Obstet Gynecol Fall;1(4): Grimsgaard S, Bonaa KH, Hansen JB, Nordøy A. Highly purified eicosapentaenoic acid and docosahexaenoic acid in humans have similar triacylglycerol-lowering effects but divergent effects on serum fatty acids. Am J Clin Nutr Sep;66(3): Grosso G, Pajak A, Marventano S, Castellano S, Galvano F, Bucolo C, Drago F, Caraci F. Role of omega-3 fatty acids in the treatment of depressive disorders: a comprehensive meta-analysis of randomized clinical trials. PLoS One. 2014; 9(5): e Horrobin DF. Nutritional and medical importance of gamma-linolenic acid. Prog Lipid Res. 1992;31: Kris-Etherton PM, Hill AM. N-3 fatty acids: food or supplements? J Am Diet Assoc Jul;108(7): Lin YH, Salem N Jr. Whole body distribution of deuterated linoleic and alpha-linolenic acids and their metabolites in the rat. J Lipid Res Dec;48(12): Melchert HU, Limsathayourat N, Mibajlovic H, Eichber J, Thefeld W, Rottkea H. Fatty acid patterns in triglycerides, diglycerides, free fatty acids, cholesterol esters and phosphatidylcholine in serum from vegetarians and non-vegetarians. Atherosclerosis. 1987;65: Panel on Dietetic Products, Nutrition, and Allergies. Scientific opinion on the extension of use for DHA and EPA-rich algal oil from Schizochytrium sp. as a novel food ingredient: Extension of use for DHA and EPA-rich algal oil. EFSA Journal 2014;12(10): Rosell MS, Lloyd-Wright Z, Appleby PN, Sanders TA, Allen NE, Key TJ. Long-chain n-3 polyunsaturated fatty acids in plasma in British meat-eating, vegetarian, and vegan men. Am J Clin Nutr Aug;82(2): Salem N Jr, Litman B, Kim HY, Gawrisch K. Mechanisms of action of docosahexaenoic acid in the nervous system. Lipids. 2001;36(9): SanGiovanni JP, Chew EY. The role of omega-3 long-chain polyunsaturated fatty acids in health and disease of the retina. Prog Retin Eye Res. 2005;24(1): Siguel EN, Lerman RH. Altered fatty acid metabolism in patients with angiographically documented coronary artery disease. Metabolism. 1994;43: Simopoulos AP. Human requirement for N-3 polyunsaturated fatty acids. Poult Sci Jul;79(7): Vanderhoof J, Gross S, Hegyi T, Clandinin T, Porcelli P, DeCristofaro J, Rhodes T, Tsang R, Shattuck K, Cowett R, Adamkin D, McCarton C, Heird W, Hook-Morris B, Pereira G, Chan G, Van Aerde J, Boyle F, Pramuk K, Euler A, Lien EL. Evaluation of a longchain polyunsaturated fatty acid supplemented formula on growth, tolerance, and plasma lipids in preterm infants up to 48 weeks postconceptional age. J Pediatr Gastroenterol Nutr Sep;29(3): p7

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