Helping Your Child Build Strong & Healthy Bones



As a good parent, you want your child to have strong, healthy bones. Having healthy bones over a lifetime begins in childhood because this is when strong bones are built. In fact, if significant bone mass isn’t developed in childhood, bones are weak and fractures become a problem. Research also indicates that having weak and brittle bones in old age starts in childhood if proper nutrition is missing. Building bone mass and strength requires the right nutrients.

Most of us know that calcium, magnesium, and vitamin D are central to bone health. But did you know that vitamin K is a significant contributor to bone mass and density? Here’s why: calcium and magnesium need help from support nutrients that I call nutrient transporters. Vitamin D3 is one transporter and vitamin K2 is another. Recent research with children showed that those with higher vitamin K2 status had more bone mass, which leads to stronger bones. [1-2]

GillQuoteVitamin K is a fat-based vitamin. Vitamins A, D, and E are the other fat-based vitamins. Vitamin K has several roles in the body, in addition to supporting healthy bones. There are two natural forms of vitamin K: simply stated, K1 works in the liver and K2 also helps with bone and heart health. K2 is found in some foods but the richest sources are fermented cheeses and soybeans.

  •      The more bone mass and density children establish
  •      before age 20, the healthier and stronger their bones
  •      will remain as they age.
  •      Vitamin K2 plays an important role in helping create
  •      dense, healthy bones.
  •      Vitamin K2 in its MK-7 form has a longer-lasting
  •      effect on building bones than other forms.

GretchenGretchen Vannice, MS, RDN

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[1] van Summeren MJ, van Coeverden SC, et al. British Journal of Nutrition, 2008;100(4):852-858.

[2] van Summeren MJ, Braam LA, et al. British Journal of Nutrition, 2009;102:1171-1178.

AREDS2 Cognition Study Response

Education, News

A large, nationwide, government-funded clinical trial designed to measure the effect of select nutrients on visual function – specifically age-related macular degeneration – recently reported that 1,000 mg of EPA and DHA omega-3 a day did not slow loss in cognitive decline. The other nutrients didn’t show benefit, either.

I don’t get why they thought it would. Here’s why.

Results from the second Age-Related Eye Disease Study (AREDS) published last week were not on age-related eye conditions; instead, the findings were on cognitive health. Why would a study designed to investigate eye health publish results on cognitive health? Good question. The researchers realized that they had carefully selected nearly 4,000 subjects to participate in an eye research study and were set up to follow them for 5 years; it made efficient sense to measure additional outcomes.

The subjects were between ages 50-85 and already in early or intermediate stage of age-related macular degeneration (AMD); the average age of the subjects was 72 and over half were women. The 8th decade of life is about when people begin to experience loss in cognitive function.

In the study, the subjects were given omega-3 (350 mg DHA and 650 mg EPA) and/or lutein and zeaxanthin or placebo (blank pill). The researchers completed interviews and tested cognitive function in the subjects at the beginning of the study and then each 2 years. They assessed qualities such as immediate and delayed recall, attention and memory, and processing speed. Because the subjects already had AMD and were at risk for getting worse, they were offered additional vitamins and minerals (vitamin C and E, zinc and copper). At the end of the study, the reported that the supplements did not slow decline in cognitive function.

Here’s why I’m not surprised:

  • Diet matters. Studies consistently report that people who have healthy levels of EPA and DHA omega-3 over their lifetime have better cognitive function as they age. Other studies have shown that around the age of 50, people who have higher DHA levels have better cognitive health compared to those with lower DHA levels.
  • The subjects were already diagnosed with age-related macular degeneration (AMD). That the subjects had AMD suggests that, like many Americans, they had consumed little EPA and DHA in their lifetime because having higher levels of these long-chain omega-3s is associated with lower risk of AMD.
  • The amount of omega-3 was too low. The investigators didn’t measure blood levels of omega-3 or dietary intake of omega-3 foods during the study; that’s understandable since it would be cost prohibitive, but they did measure how many of the subjects actually took the supplements and they measured omega-3 blood levels in a representative group. This is customary in these types of studies and it’s the responsible thing to do. What they found is that about 80% of the subjects (4 out of 5) took the supplements about 75% of the time. So few, if any of the subjects actually got the intended amount of EPA and DHA omega-3 (350 mg DHA and 650 mg EPA). When the investigators measured blood levels, they did see increases in those who took the omega-3. That’s good, it means the supplements actually contained omega-3. Studies show cognitive benefit among adults with at least 1,000 mg DHA. One gram, less than ¼ teaspoon of oil.

Bottom line: Giving a small amount of omega-3 to people already demonstrating the effects of a lifetime of low levels of omega-3 for 5 years won’t reverse cellular damage that’s been done. What we do know, is that consuming omega-3 over the lifetime DOES make a difference, and/or consuming higher levels later in life DOES make a difference.

Further, the research investigators acknowledged that studies that have surveyed people on their dietary habits and health have found that regular consumption of fish is associated with lower rates of AMD, cardiovascular disease, and possibly dementia. “We’ve seen data that eating foods with omega-3 may have a benefit for eye, brain, and heart health,” Dr. Chew, study author, explained.

Adam Ismail, the Executive Director of the Global Organization of EPA and DHA Omega-3 also makes some excellent points in this summary

Perhaps some of the greatest damage done by this study was the article published in Newsweek with the heading “Omega-3 supplements are a waste of money”. I find it unfathomable that a ‘health’ reporter would make such sweeping and inaccurate conclusions from one study. She’s wrong. She’s evidently unaware of the 3 decades of research. What’s most upsetting to me is that she has used her influence to do harm. Yep, to damage public health. There are people who need omega-3 supplements but I bet she doesn’t know who they are. Unfortunately, she’s not available to contact. I tried.


GretchenGretchen Vannice, MS, RDN

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EPA and DHA omega-3s may help people with regular headaches

Education, News

Background: Omega-3 and omega-6 fatty acids are integrally involved with brain function and cellular health. They work in cells (e.g., nerve cells, red blood cells) but they are also the source of “ingredients” that make other important compounds. These other compounds have diverse functions in the body, some of which are related to managing headaches.

Study description: Men and women who reported having headaches that lasted more than 4 hours a day on 15 or more days per month were recruited for this study and then divided into two groups. Both groups consumed diets that contained limited amounts of omega-6 fats (e.g., from vegetable oils), but one of the groups also consumed high amounts of EPA and DHA omega-3s. Blood levels of compounds made from DHA omega-3 and the omega-6 fatty acid, arachidonic acid, were measured. The study lasted 12 weeks.

Significantly fewer headaches and less psychological distress was reported in the group who consumed more omega-3s but not the other group. Although these findings are ‘by association’, they support the need for more research to learn if simple and affordable changes in the diet, such as increasing omega-3s from fish oil, can help reduce headaches and distress.

General summary: Increasing consumption of EPA and DHA omega-3 from fish while limiting the intake of omega-6 fats was related to significantly fewer headaches and less distress.


Reference: Ramsden CEZamora D, et al. J Pain 2015 [Epub ahead of print]


GretchenGretchen Vannice, MS, RDN

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Fish Oil Supplementation Improves Muscle Mass and Strength in Healthy, Older Men and Women

Education, News

Current Research: June 2015

Brief Summary of Findings: During middle age, muscle mass declines at a rate of about 0.5-1% per year. Loss of muscle mass is associated with higher risk of falling, disability, longer hospital stays, and inability to carry out daily activities in older age.  A 6-month, double-blind, randomized control in 60 healthy men and women age 60-85 reported that, compared to the corn oil placebo, supplementing with 3.35 grams (3,350 mg) of EPA and DHA omega-3 from fish oil per day significantly increased thigh muscle mass and upper and lower body muscle strength (measured by hand-grip and weight lifting, e.g., chest press, leg press). Improvement in muscle mass and strength was measured at 3 months but results continued to improve with continued supplementation. Omega-3 blood levels also increased significantly in the supplementing group. These results suggest that supplementing with > 3 grams of EPA and DHA for 6 months can prevent the equivalent of 2-3 years of usual, age-associated muscle loss and function in older, healthy men and women.

Research Abstract

Smith GI, Jullian S, et al. Fish oil–derived n–3 PUFA therapy increases muscle mass and function in healthy older adults. Am J Clin Nutr. Published ahead of print May 20, 2015. doi: 10.3945/ajcn.114.105833


Background: Age-associated declines in muscle mass and function are major risk factors for an impaired ability to carry out activities of daily living, falls, prolonged recovery time after hospitalization, and mortality in older adults. New strategies that can slow the age-related loss of muscle mass and function are needed to help older adults maintain adequate performance status to reduce these risks and maintain independence.

Objective: We evaluated the efficacy of fish oil–derived n–3 (ω-3) PUFA therapy to slow the age-associated loss of muscle mass and function.

Design: Sixty healthy 60–85-y-old men and women were randomly assigned to receive n–3 PUFA (n = 40) or corn oil (n = 20) therapy for 6 mo. Thigh muscle volume, handgrip strength, one-repetition maximum (1-RM) lower- and upper-body strength, and average power during isokinetic leg exercises were evaluated before and after treatment.

Results: Forty-four subjects completed the study [29 subjects (73%) in the n–3 PUFA group; 15 subjects (75%) in the control group]. Compared with the control group, 6 mo of n–3 PUFA therapy increased thigh muscle volume (3.6%; 95% CI: 0.2%, 7.0%), handgrip strength (2.3 kg; 95% CI: 0.8, 3.7 kg), 1-RM muscle strength (4.0%; 95% CI: 0.8%, 7.3%) (all P < 0.05), and tended to increase average isokinetic power (5.6%; 95% CI: −0.6%, 11.7%; P = 0.075).

Conclusion: Fish oil–derived n–3 PUFA therapy slows the normal decline in muscle mass and function in older adults and should be considered a therapeutic approach for preventing sarcopenia and maintaining physical independence in older adults. This study was registered at as NCT01308957.

GretchenGretchen Vannice, MS, RDN

Nutrition Consultant

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What Does Science Say? Bioavailability of Triglyceride vs. Ethyl Ester Forms of Fish Oil


by Chris Speed, MND APD, April 2015


Some sellers of fish oil products make superiority claims about the TG form of fish oil, compared to the EE form. This paper reviews current science on the bioavailability of omega-3s in human health WhatDoesScienceSay


Triglycerides are a form of dietary fat. Most fats in foods—vegetable oils, meats, dairy foods, and fish— exist in triglyceride form. Most of the fat in our blood are triglycerides and this form is the predominant form stored in adipose tissue. A triglyceride (TG) molecule is composed of three (3) fatty acids attached to a glycerol backbone by an ester bond. The fatty acids can be saturated, monounsaturated, or polyunsaturated. In fish, about 20-30% of the triglycerides are omega-3 fatty acids: EPA, DPA, or DHA.

Non-concentrated fish oils and cod liver oils are pressed from fish and from cod livers, so they are also 20-30% omega-3. These oils are in the natural triglyceride formb and are sometimes called nTG oils.

To produce fish oil supplements with meaningful doses of EPA and DHA Omega-3 per serving, omega-3s are concentrated up from the starting 20-30% omega-3 in unprocessed fish oil. Concentrated products contain fish oil in either ethyl ester (EE) form or re-esterified triglyceride (rTG) form.


Consumers and health professionals like concentrated fish oil products. Higher doses of EPA and DHA are often required to achieve desired nutrition and health benefits. Concentrated fish oil products can provide double or more of the amount of EPA and DHA than regular fish oil but not at double the price. Concentrated fish oil products offer more omega-3 in fewer capsules and are often a better value.

Manufacturing concentrated fish oil: EE and rTG forms

To begin, the three types of fatty acids (saturated, monounsaturated, or polyunsaturated) in the triglyceride are liberated from glycerol and attached to an ethyl alcohol and become ethyl ester (EE) fatty acids. The production of the EE form is a necessary first step. Conversion into the EE form allows omega-3 fatty acids to be separated from the saturated and monounsaturated fatty acids without damaging the omega-3s. At this point, EE omega-3s (EPA, DHA, or DPA) can be molecularly distilled, concentrated to the desired level, delicately purified, and encapsulated, or it can be further processed into a rTG fish oil product.

To produce a rTG fish oil, the EE omega-3 fatty acids are enzymatically re-attached to a vegetable glycerol molecule by a process called re-esterification (rTG), and then distilled, concentrated, purified, and encapsulated. Note that not all of the fatty acids are re-attached as triglycerides: according to The European Pharmacopoeia, a rTG must contain at least 60% triglycerides; the rest is di-glycerides and mono-glycerides. Technology has improved; some manufacturers are now able to employ sophisticated processes to produce rTG oils that contain up to 80-90% triglycerides. This additional processing (re-esterification) adds additional cost to the final product.

Currently, no distinctions or labeling is required for natural triglycerides vs. re-esterified triglycerides, and companies generally refer to both forms as ‘natural’. There are, however, distinct differences in the composition of these two TG forms. In fish and in non-concentrated fish and cod liver oils (nTG), the omega-3 fatty acids are typically, naturally bound to the glycerol molecule in the middle position (SN-2) and hence contain about 20-30% omega-3. In other words, about one out of three fatty acids attached to the glycerol molecule is omega-3 (the 20-30%). In contrast, during production of rTG fish oils, the omega-3 fatty acid is randomly attached to any position on the glycerol molecule (SN-1, 2, or 3) and the statistical probability is that more omega-3 will attach at SN-1 and/or SN-3 than at SN-2. It is unknown if any physiological differences exist due to the location of attachment of the omega-3 fatty acids to the glycerol. Though claims are made, a preliminary human study suggests that the location of attachment does not affect absorption. 1

It is often argued that the rTG form of omega-3 is natural and the EE form is not, but in reality, both EE and rTG forms of fish oil are relatively new as concentration of fish oils began in the 1980s. 2


Under normal conditions, humans absorb 85-95% of the fat we consume. 3 Research has also shown that we absorb omega-3 from fish and fish oil capsules equally well. 4 It is the tissue levels of omega-3 that matters most. Regardless of the form (e.g., EE) or source (e.g., fish or supplements), improving tissue levels of omega-3 takes time.


Bioavailability is the degree and rate at which a nutrient is absorbed or made available at the site of physiological activity. There are essentially two definitions of bioavailability:

  • Short-term bioavailability measures the amount and rate at which a nutrient gets absorbed and enters the blood stream.
  • Long-term bioavailability measures how much and how effectively a nutrient reaches its target tissue where it is physiologically active.

There are substantial differences between these two types of bioavailability. For example, the amount of omega-3 fats that enter the bloodstream is different from (and greater than) the amount that reaches target tissues. Measuring levels of omega-3s in the blood is relatively simple and inexpensive, but the conclusions that can be made from this information is limited because omega-3s are not active in the blood stream; omega-3s function in tissue. Blood levels of omega-3s change within hours of intake but this doesn’t reflect tissue, or cellular, levels. It is the amount of omega-3 that reaches ‘steady state’ levels in tissues that matters. Membrane tissue levels are the best measure of omega-3. It takes 8-12 weeks to see meaningful changes in tissue levels, and it takes months of consistent consumption for tissue levels to stabilize, or reach ‘steady state’. Furthermore, individual factors such as age and body weight influence how much omega-3 reaches tissue levels. For example, it takes longer for omega-3 tissue levels to change in overweight individuals, and one study measured faster changes in omega-3 tissue levels in older individuals, compared to younger adults. 5,6,7,8 There are other factors that influence absorption of omega-3 from fish oil, too.

tissueistheissueFor example, enteric coating of capsules can delay or reduce absorption and consuming fat in a meal or snack along with the omega-3 supplement will increase absorption. 9

Clinical Research Review:

Several short-term bioavailability studies have reported no difference between the EE and TG forms:

  • When two doses (35% and 54%) of EPA and DHA from nTG and EE forms were compared, no difference in absorption was measured. 10
  • A comparative study of meals containing omega-3 as EE or TG showed normal absorption of both EPA and DHA. 11
  • It is known that absorption of omega-3 fatty acids is better when consumed with a fat-containing meal. When researchers compared absorption of EE and TG forms in male volunteers consuming a low-fat (8g) versus high-fat meal (44 grams total fat), there was a marked increase in absorption of EE form, but absorption of both TG and EE forms significantly improved. 12
  • A 2-week study in healthy males reported no difference in the absorption between EE and nTG omega-3 when the equivalent amount of EPA and DHA were consumed. 13

One comparative study reported that rTG increased blood levels faster in the short-term:

  •  A 2-week study in healthy adults evaluated absorption of five forms of omega-3 fish oils: EE fish oil; rTG fish oil; free fatty acids; and fish body oil and cod liver oil containing nTG form. 1 Doses ranged between 3,100 – 3,600 mg EPA and DHA.
  • Omega-3 blood levels increased at a faster rate with the rTG than with the EE form but the study didn’t last long enough for blood levels to reach steady state. The different forms of fish oil were well absorbed and this study suggested there may be differences in the rate of absorption in the short-term but it does not show change in tissue levels over time. In addition, it’s unknown if subjects consumed the supplements with fat-containing food or snacks.

Several longer-term bioavailability studies have reported similar benefits between the EE and TG forms:

  •  A 7-week placebo-controlled study that compared the impact of EE and rTG form (3,400 mg and 3,600 mg EPA and DHA, respectively) in healthy male subjects reported similar and beneficial influence from both forms on platelet function. 14
  • A 12-week randomized, double-blind study compared the impact of 2,000 and 4,000 mg of EE and rTG omega-3 in subjects with elevated triglycerides. With both forms, plasma triglycerides were lowered and no differences in assimilation or triglyceride lowering were measured. 15
  • A 6-month double-blind, placebo controlled trial compared the effect of 1,680 mg of EPA and DHA in rTG and EE forms on omega-3 levels in red blood cells (the Omega-3 Index). 8
  • The omega-3 index increased significantly in both rTG and EE groups. It increased more in the rTG group, but again, the study authors noted that whether or not this difference has meaningful impact on clinical outcomes (e.g., reducing triglycerides, reducing risk of sudden cardiac death) is unknown. Faster increases in blood levels don’t imply better efficacy.
  • A 6-month randomized controlled trial in men with documented heart disease compared the effects of EE (7 grams) and rTG (6 grams) omega-3 versus placebo. In both omega-3 groups, plasma omega-3 levels increased significantly and mean triglyceride levels reduced significantly. 16

EE fish oils have an excellent safety profile:

The long-term safety of the EE form of omega-3 fish oil is excellent. Safety has been documented in thousands of human studies. 8,17,18


Based on clinical evidence, there does not appear to be meaningful differences in bioavailability between EE and rTG forms of fish oil.



1 Dyerberg J, Madsen P, et al. Prosta Leuko Ess Fatty Acids 2010;83(3):137-141.

2 von Schacky C. Vasc Health Risk Manag. 2006;2(3):251-262.

3 Essential fatty acids. Linus Pauling Institute, Corvallis, OR.

4 Harris WS, Pottala JV, et al. Am J Clin Nutr 2007;86:1621–1625.

5 Schuchardt JP, Hahn A. Prostaglandins Leukot Essent Fatty Acids. 2013 Jul;89(1):1-8. 6 Neubronner J,

Schuchardt JP, et al. Eur J Clin Nutr 2011;65(2):247-254.

6 Neubronner J. Schuchardt JP, et al. Eur J Clin Nutr 2011;65(2):247-254.

7 Flock MR, Skulas-Ray AC, et al. J Am Heart Assoc. 2013;2(6):e000513.

8 Vandal M, Freemantle E, et al.. Lipids 2008;43(11):1085-1089.

9 Lawson LD, Hughes BG. Biochem Biophys Res Commun 1988;156(2):960-963.

10 Luley C, Wieland H, et al. Akt Ernaehr-Med 1990;15:122-125.

11 Nordoy A, Barstad L, et al. Am J Clin Nutr 1992;53:1185-1190.

12 Raatz SK, Redmon JB, et al.. J Am Diet Assoc 2009; 109:1076-1081.

13 Krokan HE, Bjerve KS, et al. Biochim Biophys Acta 1993; 1168(1): 59-67.

14 Hansen JB, Olsen JO, et al. Eur J Clin Nurt 1993; 47(7):497-507.

15 LA Simons, A Parfitt, J Simons, and S Balasubramaniam. Aust N Z J Med 1990; 20(5): 689-694.

16 Reis GJ, Silverman DI, et al. Am J Cardiol 1990; 66(17): 1171-1175.

17 Harris WS, Ginsberg HN, et al.. J Cardiovasc Risk 1997;4(5-6):385-391.

18 Bays HE, Tighe AP, et al. Expert Reviews Cardiovasc Ther 2008;6(3) 391-409.

What Are Plant Sterols? Why Are They Important?



Sterols are fat molecules in the cell membranes of animals and plants with several functions, including a role in making hormones. Cholesterol is the major sterol in humans. We consume it in our diets and our bodies make it as well. Phytosterols come from plants and we can only get them from our diet, as our bodies don’t make them. Both kinds of sterols circulate in our blood and tissues although we have 100’s of times more cholesterol than phytosterols in circulation.

People who consume foods rich in phytosterols (also called plant sterols) tend to have lower LDL levels but to get measurable reductions in LDL we need to consume at least 800 mg and up to 2,000 mg a day. Most of us consume only 150-400 mg daily. Beta-sitosterol is the most common plant sterol and it’s important to read the label to know what you   are getting.

Plant Sterol Graphic

Plant sterols reduce cholesterol by replacing cholesterol in the intestines and blocking absorption, and there seems to be an additive effect when phytosterols are consumed in conjunction with cholesterol-lowering medications.

Foods rich in plant sterols include avocados, nuts (pistachios, pecans, almonds, cashews), sesame seeds, and dark chocolate. Unrefined corn and vegetable oils also contain plant sterols along with omega-6 fats. Beta-sitosterol is absorbed best when consumed with fat (taking it with fish oil   is a good idea). Plant sterols are effective when consumed once a day or over the course of the day.

In addition to supporting healthy cholesterol levels, beta-sitosterol has been shown to help men who have enlarged prostate, also known as BPH, by improving urinary flow and emptying of the bladder. Beta-sitosterol also supports breast, lung, stomach, and colon health.


GretchenGretchen Vannice, MS, RDN

Nutrition Consultant

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Marine Stewardship Council: The Best Environmental Choice in Seafood


Fishing is hard work; selecting fish shouldn’t be.  

MSC Sustainable SourceFounded in 1996, the Marine Stewardship Council (MSC) was modeled after the Forest Stewardship Council (FSC).  Both the MSC and FSC evolved from coalitions of businesses and environmental organizations that sought to more effectively harness market demand to reward current sustainable harvest practices while creating an incentive to improve practices among less well-managed forests and fisheries. Certified producers work with scientists, fishery managers, and community leaders to responsibly use marine resources now and into the future. The resulting synergy between delivering seafood, producing profits, and protecting ecosystems has changed the game.  Eco-labeling programs, like those from the FSC and MSC, not only give consumers a voice, but they amplify their voice.[i]  They allow us to “vote with our wallets.”

A sign of the MSC’s growing prominence was that the second largest fishery in the world sought their endorsement: Alaska pollock. This already well-managed fishery underwent assessment, and in 2005 became one of the first dozen fisheries globally to be certified. This is the fish sourced by Wiley’s Finest for its omega-3 fish oil. Remarkably, Alaska pollock comprises 30 percent of all U.S. fish landings by weight, and is the fifth most consumed species in the U.S. It was recertified in 2010 (fisheries are required to go through a reassessment process every five years to remain certified).

The MSC abides by three principles:

  1. Sustainable fish stocks:  The fishing activity must be at a level that can be maintained for a fish population. Any certified fishery must operate so that fishing can continue indefinitely and is not overexploiting the resource.
  2. Minimizing environmental impact: Fishing operations should be managed to maintain the structure, productivity, function and diversity of the ecosystem on which the fishery depends.
  3. Effective management: The fishery must meet all local, national, and international laws, as well as must have a management system in place to respond to changing circumstances and maintain sustainability.[ii]

It is different from other seafood eco-labeling or rating programs in several key regards: 

  • It’s not an environmental organization, a seafood or fishing industry group, a federal agency, or a scientific center.
  • It undertakes rigorous, research-based reviews and represents scientific consensus on best international practices for fisheries management rather than special interests.
  • It uses a third-party assessment and certification process that is impartial, transparent and thorough with no influence or interference from the MSC itself.
  • It employs chain-of-custody traceability to combat fraud. In fact, MSC has a mislabeling rate of less than 1 percent compared to the supply chain of non-MSC labeled products of which 18-56 percenthave been found to be incorrect.[iii]

MSC Certified SustainableLike the Consumer Reports ratings or the century-old Good Housekeeping Seal of Approval, the MSC logo assures consumers they’re buying the best. Ask your grocer and nutrition supplier to carry MSC-certified seafood and fish oil supplements. Products bearing the MSC endorsement are good for the ocean, for you, and for the fishing communities worldwide that are committed to protecting fish stocks now and into the future.

About the Author:


Patti Parisi is a Journalist focused on sustainability, fitness, and healthy living. She co-founded Passionfish(.org) and is producing Ocean Tapas, a celebration of seafood from the ocean to the plate. Patti is also a National Academy of Sports Medicine (NASM) certified personal fitness trainer (CPT), senior fitness specialist (SFS), and weight loss specialist (WLS).



[i] Roheim, C. A., Asche, F. and  Santos, J. ‘The Elusive Price Premium for Ecolabeled Products’, Journal of Agricultural Economics, Vol. 62, (2011) pp. 655-668.



ADHD Awareness Month

Education, News

 ADHDawarenessOctober is ADHD Awareness month and this short article is designed to do exactly that – raise awareness by explaining a little about what ADHD is all about from a scientific perspective. 

Attention Deficit Hyperactivity Disorder (ADHD) is by far one of the most pervasive neurodevelopmental disorders worldwide. It is characterized by age-inappropriate symptoms of inattention, hyperactivity (also as in disorganization) and impulsivity. It is thought to affect approximately 6-13% of all children, across cultures, and has an estimated 4:1 higher prevalence in males than females [1, 2]. The term neurodevelopment describes a series of sensitive processes which are both complex and closely interwoven with a number of simultaneous developments such as neuronal migration, neurogenesis, synaptogenesis and myelination, all of which implicate the role of omega-3 highly unsaturated fatty acids (HUFAs).

The process of neural development is mediated by a multitude of factors including genetic and metabolic diseases, immune disorders, infectious diseases, deprivation, physical trauma, toxicity and environmental influences and undoubtedly nutritional factors. Any interruption as a result of any of these factors may result in adverse neurodevelopmental outcomes.

ADHD is highly heritable within families with an estimated 3-5 times greater risk in first-degree relations. So, what this means is if you are a parent with ADHD you will have a better than 50% chance of having a child with ADHD. Similarly, about 25% of children with ADHD have parents who meet the formal diagnostic criteria for ADHD.
ADHD often co-occurs with other behavioral or learning differences such as dyslexia, oppositional defiant disorder and autistic spectrum disorders. There are 3 recognized sub-types: (1) the predominantly inattentive (ADD), (2) the hyperactive-impulsive and (3) the combined. Symptoms are present before the age of 12, commonly manifest around the age of 5-6 years but can be observable in children as young as 2 years.

In regards to the hyperactive-impulsive subtype, characteristic behaviors include an inability to sit still for any period of time, for example on a mat for story time at nursery, fidgeting, tapping, squirming and general restless behavior in particular in a classroom environment. Children with ADHD have immense difficulty following instructions, are prone to talking excessively and make frequent and repetitive interruptions during the conversations of others. In addition, they seem unable to play quietly, are constantly on the go – as if driven by a motor – and can be highly impulsive.

The inattentive subtype can be described metaphorically as the child with their head in the clouds. These children seemingly have an inability to pay close attention to detail unless it is something of immense personal interest. They often make careless mistakes, fail to complete school and homework, struggle to pay attention for any length of time and appear not to be listening even when spoken to directly. Additionally, children with ADD often fail to complete chores around the home and are prone to wondering off, easily distracted. They frequently lose everyday items necessary for everyday functioning, are often messy and disorganized, and have little or no concept of time. This general absent-minded behavior can be utterly debilitating and often lead to chaos in the young person’s life [3].

Children for whom ADHD is not identified, diagnosed or-managed have an even greater risk of adverse outcomes including educational failure, substance misuse and the development of conduct disorder-related and  anti-social related behaviors [2]. The calculated cost of ADHD to society and healthcare systems is substantial in the region of tens of billions of U.S. dollars per annum [4].

According to the National Institute for Clinical Excellence (2008), the first stage of intervention for school children are group-based education programs and parent-training sessions (NICE, 2008). Drug treatment is meant to be reserved for those young people with more severe symptoms and impairment, or those with moderate severity who have declined other non-drug treatments or have not responded sufficiently to group psychological treatment or parent-training/education programs (NICE, 2008). However, for many reasons, parents often seek natural alternatives and a much debated area of research is the potential role of omega-3 in ADHD [5].

Omega3&NervousSystemOmega-3 HUFAs play a critical role throughout the central nervous system and docosahexaenoic acid (DHA) is particularly abundant in neuronal membranes. These fats are involved in complex and varied functions including but not restricted to cell-signaling (e.g., 75% of the myelin sheath coating neurotransmitters is made up of these specialized fats), gene expression and regulation of serotonin and dopamine. DHA is thought to specifically increase neuronal responses by enhancing the flexibility of cell membranes. Several randomized clinical trials have found that supplementation with omega-3 fats can help improve symptoms of ADHD in children [6-8]. Our research team in the Section of Nutritional Neurosciences at the National Institutes of Health are about to test the potential role of omega-3 in reducing clinical symptoms of ADD/ADHD in adults, for further information please visit clinical

DISCALIMER: In no way or form does the content of this article represent any policy or position of the US Federal Government. All material is referenced to its appropriate source or is solely the opinion of the author.


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[1] J. Biederman, S.V. Faraone, Attention-deficit hyperactivity disorder, The Lancet, 366 (2005) 237-248.

[2] R.V. Gow, J.R. Hibbeln, Omega-3 Fatty Acid and Nutrient Deficits in Adverse Neurodevelopment and Childhood Behaviors, Child and adolescent psychiatric clinics of North America, 23 (2014) 555-590.

[3] S. Effat, N. Mohamed, H. Hussein, H. Azzam, A. Gouda, H. Hassan, 670 – ADHD symptoms: relation to omega 3 serum levels before and after supplementation, European Psychiatry, 28, Supplement 1 (2013) 1.

[4] W.E. Pelham, E.M. Foster, J.A. Robb, The economic impact of attention-deficit/hyperactivity disorder in children and adolescents, Ambul Pediatr, 7 (2007) 121-131.

[5] N. Parletta, C.M. Milte, B.J. Meyer, Nutritional modulation of cognitive function and mental health, J Nutr Biochem, 24 (2013) 725-743.

[6] M.H. Bloch, A. Qawasmi, Omega-3 Fatty Acid supplementation for the treatment of children with attention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysis, J Am Acad Child Adolesc Psychiatry, 50 (2011) 991-1000.

[7] A.J. Richardson, J.R. Burton, R.P. Sewell, T.F. Spreckelsen, P. Montgomery, Docosahexaenoic acid for reading, cognition and behavior in children aged 7-9 years: a randomized, controlled trial (the DOLAB Study), PloS one, 7 (2012) e43909.

[8] A.J. Richardson, P. Montgomery, The Oxford-Durham study: a randomized, controlled trial of dietary supplementation with fatty acids in children with developmental coordination disorder, Pediatrics, 115 (2005) 1360-1366.



The Case for Omega-3s has Never Been Stronger!

Education, Uncategorized

Case For Omega3s Has Never Been Stronger!

Recent research findings continue to support the case that EPA and DHA Omega-3s – the omega-3s found in fish and fish oil – are an essential pillar of a properly balanced and healthy diet.

FDA Revises seafood intake during pregnancy – a study by the National Institute of Health (NIH) showed that a deficiency in Omega-3 of the mother’s diet during pregnancy is linked to a lower IQ of the child during later years of childhood.  While many people believe that mercury content of fish is a big concern, in fact Omega-3 deficiency from not eating fish is a much larger and more severe dietary issue. Recent findings indicate that the benefit of getting enough omega-3 for both mother and child is far more important than the potential risk of consuming mercury. An infant needs DHA omega-3 to develop normally and it good for mothers, too. Many well-read dietitians and nutritionists have long known that the challenge is for mothers to get enough seafood, not to worry about them consuming too much!

In June of this year, as a result of a careful review of recent dietary research, the FDA and EPA updated its published guidelines for seafood intake during pregnancy. Instead of previous confusing recommendations that pregnant mothers limit seafood consumption to not more than 12 ounces per week, the FDA and EPA now recommend that mothers eat at least two  (and up to three) servings of fish per week during pregnancy for proper child development. In their official updated advice, FDA notes, “The nutritional value of fish is especially important during  growth and development before birth, in early infancy for breastfed infants, and in childhood.”

EPA and DHA Omega-3s help lower blood pressure – In March, a landmark scientific review of over 70 randomized controlled trials that were designed to study blood pressure was published. The review found significant scientific agreement that consumption of over 2000mg of EPA and DHA Omega-3 per day was just as or more effective at lowering blood pressure as other common lifestyle interventions, such as limiting sodium, getting exercise, or limiting alcohol consumption. This is significant, since about 1 in 3 Americans have high blood pressure, and many don’t even know it.  High blood pressure is a major contributor to heart disease.Blood Pressure Chart


Omega-3 consumption leads to Lower Healthcare costs – a recent study commissioned by the Council for Responsible Nutrition found that nearly 98,000 hospitalizations for heart disease events could be avoided for a combined net savings of $348.8 million per year. These cost savings would be realized simply with enough Omega-3 consumption via supplementation. This is supported by prior research conducted by Harvard School of Public Health researcher Dr. Dariush Mozaffarian, which found that as little as 250mg of EPA and DHA Omega-3s per day would reduce the risk of sudden death due to a heart attack by 1/3 or 35%.

Heart disease is a major issue – it is the number one killer of both men and women. It is estimated that nearly 7% of all adults in the U.S. have heart disease about 1 of every 6 deaths in the US is due to heart disease. The risk sharply increases with age, as over 16% of those over age 55 have heart disease.

The US lags the rest of the developed world by not having a recommended daily intake for EPA and DHA Omega-3 –Research has exploded in the last decade and the National Institutes of Health are behind in setting recommendations. Most countries in Europe recommend at least 250mg of EPA & DHA, and many suggest 500 mg EPA and DHA. Japan and Korea have recommended intakes as high as 2000mg/day of EPA and DHA Omega-3s. In the US, Academy of Nutrition and Dietetics recommends at least 500 mg of EPA and DHA per day for general health. The American Heart Association and American Psychiatric Association suggest 1000 mg per day of EPA and DHA for people with a history of heart disease or mood and impulse control problems.

The source of Omega-3s matters – Plant sources such as vegetable oils, nuts, and grains – like flax and chia seeds – deliver short chain omega-3s, which the body has difficulty efficiently transforming into the long-chain Omega-3s EPA and DHA.  These short chain omega-3s just don’t work the same as premade EPA & DHA from fish, seafood, and fish oils.  EPA and DHA Omega-3s from Marine sources are necessary for good mental health, heart health, healthy eyes and maintaining proper joint health.

How do I get enough Omega-3s – food or supplements?  Food is always the best source– eating oily fish delivers the best forms of Omega-3s, Vitamin D, as well as other nutrients such as iron, potassium, magnesium, calcium, and selenium. It is also a fantastic source of protein for building and maintaining healthy muscles.

However, many people do not like to eat fish, cannot afford to eat fish regularly, or do not have regular access to high quality fish which isn’t breaded and deep-fried.  Unless you eat fish or take fish oil supplements every day, you are probably not getting enough Omega-3s in your diet. Thankfully, fish oil supplements can deliver affordable daily doses of EPA & DHA Omega-3s – a high quality supplement can deliver a meaningful amount for less than $1.00 per day. I try to eat fish several times a week, but I also make sure to take a fish oil supplement every day to fill in the gaps.

If you are planning to rely on eating fish to get all your omega-3s, the kind of fish eaten is very important: fatty ocean fish such as salmon and sardines have high levels of Omega-3s and some freshwater fish, like trout, have a good amount as well, but farmed tilapia, catfish or swai are fed lots of corn and soy and as a result have very little EPA and DHA Omega-3s. Pregnant women should avoid eating shark, swordfish, orange roughy, and eat not more than a can of albacore tuna a week.

Mankind grew up near the sea – civilization developed around eating fish and seafood. Omega-3 fats found in fish, seafood and fish oils. (good fats) are essential for your heart health, brain health, for managing your body’s natural inflammation  process  and most of all for prenatal and infant development.  However you get your Omega-3s, make sure you are getting enough in your diet every day to realize their full potential for making a difference in your health and daily life for you and your family.  Children need them, too.

Omega-3’s and Joint Health




  • EPA and DHA omega-3s are essential nutrients for joint health.
  • Omega-3s help joints stay healthy and flexible in adults of all ages.
  • Individuals with rheumatoid arthritis can benefit from regular consumption of sufficient fish oil.

Everybody needs omega-3s, but people who experience joint pain and stiffness or have rheumatoid arthritis have a special need for EPA and DHA, the long-chain omega-3s. These healthy fats, which are necessary for good nutrition, are specifically helpful for healthy joints, such as hips and knees.  Because our bodies cannot make EPA and DHA, we need to eat them in our diet.

Arthritis is the leading cause of disability

Arthritis is a condition that affects the joints.  There are many types of arthritis but common to them all is joint pain, discomfort, and restricted mobility.  Arthritis affects more women than men and more adults over 45 years of age and older.  Over time, arthritis can seriously impair quality of life. It is the leading cause of disability in the United States[1].

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is an autoimmune disease distinguished by chronic inflammation in multiple joints in the body.  Individuals with RA experience joint pain, swelling, morning stiffness, limited flexibility, and impaired motion, all indicators of joint and tissue inflammation.


How do omega-3s work?

EPA and DHA omega-3s are important for people with joint pain and stiffness and for people with RA because they strengthen the immune system and help lower inflammation in joints and tissues. Research has identified that omega-3s work in several ways. For example, EPA omega-3 is directly and indirectly involved in reducing inflammation while EPA and DHA together help manage joint mobility and restore joint and tissue health. Plus there is an added benefit: people with RA have a higher risk for heart disease and EPA and DHA are well known for supporting good heart health[2],[3],[4].

Many studies using fish oil for joint health and RA have been completed over the past 20 years. Studies have reported improvement in several RA symptoms after daily consumption for several months of at least 3 grams of EPA and DHA omega-3: less joint pain, smaller number of painful joints, less morning stiffness (shorter duration), and less use of non-steroidal anti-inflammatory (NSAID) medications. Research also shows continued improvement with consistent supplementation.  Conversely, it is important to note that studies routinely report no benefit for RA until at least 3 months of regular supplementation and no reduction of symptoms from consuming less than 1000 mg EPA and DHA per day[5],[6],[7],[8],[9],[10].

Regular consumption is key.RA research consistently reports that regular consumption of sufficient amounts of EPA and DHA is key to reducing symptoms and improving quality of life.

How much to consume

It is recommended that individuals with joint pain and stiffness consume 1,000 – 2,000 mg EPA and DHA per day. For individuals with RA, daily doses of at least 3 grams (3,000 mg) of EPA and DHA with relatively more EPA than DHA are suggested4,6,7,8.  (Note: Research has shown good results with up to 6 grams per day, but it’s best to talk with your doctor or dietitian before consuming this much omega-3).

Read labels carefully.The amount of fish oil per serving is not the same as the amount of EPA and DHA per serving.  Be sure to read the label for mg of EPA and DHA.

Because frequent and substantial consumption of omega-3 rich fatty fish, such as salmon and sardines, is essential for improving arthritis, consuming enough omega-3s in the diet can be challenging. For people who don’t like fish or who won’t eat fish, and for those who want the convenience and reliability of a supplement, purified and concentrated fish oil supplements are an effective choice. Fish oil supplements (capsules or liquid) should be taken with food, all at one time (with a meal) or over the day.


Regular consumption of EPA and DHA omega-3s supports joint health and helps reduce joint stiffness as well as symptoms of rheumatoid arthritis when consumed over long periods of time. In addition, omega-3s support the heart and healthy blood pressure levels, improve mood, and provide good nutrition, all attributes that contribute to better health and more youthful aging.


By Gretchen Vannice, MS, RDN ©All rights reserved 2014

About the author: Gretchen Vannice, the Omega-3 RD, is a registered dietitian, nutritionist, and consultant who specializes in omega-3 fatty acids and natural foods. She is a strategist, trainer, speaker, and author. Gretchen is lead author of the “Position of the Academy of Nutrition and Dietetics: Dietary Fatty Acids for Healthy Adults” published January 2014 and author of the Omega-3 Handbook: A Ready Reference Guide for Health Professionals. She can be reached at

Disclaimer:  Written by an independent nutritional expert, this information is provided for educational purposes only.  It is not intended as medical advice.  Always consult your healthcare provider for medical advice.



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