Transcript
WEBVTT
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Welcome to episode 21 of the cancer pod.
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On today's episode, we're talking about omega three fatty acids.
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They're essential nutrients, but how essential are they in cancer care?
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Stick around for today's discussion supplements.
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1 0 1 omega-3 fatty acids.
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I'm Dr.
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Tina Kaczor.
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And my favorite source of omega 3s is a nice piece of salmon.
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And I'm Dr.
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Leah Sherman.
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And my favorite source of omega 3s are sardines,
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And we're to naturopathic doctors who practice integrative cancer care.
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but we're not your doctors.
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This is for education, entertainment, and informational purposes only.
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Do not apply any of this information without first speaking to your doctor,
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the views and opinions expressed on this podcast by the host and the.
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Are solely their own.
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welcome to the cancer pod.
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Hey, Tina,
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Hey, Leah, are you, all done with that oatmeal?
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Y'all well fed?
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I am, I am.
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It was delicious.
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Except I realized that I forgot to add my ground flaxseed.
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Well, the how appropriate
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Right.
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Cause we're talking about omega-3 fatty acids.
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and you just missed your first morning dose.
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I did.
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I'll go back.
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I'll add it to something else.
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So, um, yeah, this is our, it's our second episode in the supplements 1 0 1 pod.
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And it's the first one where we're actually talking about an actual supplement.
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so what we're going to do in this episode is we're going to talk about.
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What are omega-3 fatty acids.
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they are essential nutrients.
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So why are they essential?
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where do you get them?
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you and I are very big proponents of food first.
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So where do, where do you get them in your diet?
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I don't like fish.
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You know, where am I going to get them?
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People ask, you know, all the time.
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what are the specific benefits for cancer patients and cancer survivors?
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And then in terms of supplements, are there any contraindications as to when someone should not take them?
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Anything else?
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Are we going to talk about anything?
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Well, we might, we might talk about other stuff too.
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who knows what tangents we'll go on today?
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All right.
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So Tina Lee, what is an essential nutrient?
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starting with the word essential, I mean, it really is literal.
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These fatty acids are essential to consume in your diet because your cells require them.
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Your systems require these fatty acids, but you cannot create them from any other fatty acids.
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So a lot of times we'll take an, a fat and we can convert it and we can use enzymes and we can snip it here.
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We can, saturate it there.
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We can do all sorts of fun stuff with these fats that we consume and make what we need, the omega three fatty acids we cannot make them.
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We have to take them in through a food source and they are required for function.
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So the word essential, let's start there.
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It's an essential fatty acid or essential oils, no essential oils or something different.
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I'm not using my, omega threes as essential oils.
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I don't want to smell like a fish.
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Essential oils are completely different.
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Essential oils are from plants and they're the center aspect of the plant.
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So not that essential fatty acids, not essential oils.
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So what's kind of interesting to me is your body can make EPA and DHA, right?
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You can take in from plants, the alpha linolenic acid, and then through these enzymes, your body can convert that into EPA and DHA.
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Right.
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that's where, the food sources, right?
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That's where the, the fish get it from.
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And you know, it's in eggs, right?
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You buy these high DHA eggs, and it's because those chickens were fed They're fed flax, probably flaxseeds, and then their little bodies converted it.
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And then they pooped it out into a.
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Yeah.
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So it always starts with plants, whether it's alpha linolenic acid or it's Lin oleic.
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It starts from a plant, a plant has to make it, and then an animal consumes it.
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So that might be a little confusing because, I remember when I was first learning about this, a L a is alpha linolenic acid and that's omega three and then Leno, leic acid is omega six.
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Yes
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And so they both come from plants
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And they're both essential.
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they're both essential.
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Yeah.
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And there is a ratio that is ideal of omega six to omega three.
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And so ideally in our diet, we should be having like a three or a four to one ratio of six to three.
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what actually is happening with more of a more Western diet is it's.
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The ratio is more
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of 12 to 1.
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Right?
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So people are getting a lot more of the omega six.
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And so finding ways of ramping up that omega three in your diet is really important because of what we use omega-3 fatty acids for the processes in our body.
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Right.
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And on the flip side, and I think this is the last we're going to mention the omega six side of the equation.
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A lot of people are getting those mega six fatty acids from soybean oil Safflower sunflower vegetable oils, basically when you do the oil, cook with it, eat processed food that has it.
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That's what ups the omega six consumption
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Right.
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So it's, would you say like a double-edged sword?
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Like, it's a good thing, but it's also a, it could be a bad thing because of the fact that it isn't a lot of processed foods, so they're not necessarily getting the good sources of omega six, like the nuts and the seeds.
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they're getting them from those oils.
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right.
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Instead of the whole food, which limits your consumption of it.
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Right.
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Right?
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So we're not advocates of the vegetable oils in general.
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Oh, I want to say, a couple more cool things about, at least
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the alpha linolenic acids, the
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ALA, It's kind of neat that, you know, it does convert in our bodies to the EPA and DHA.
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Have we mentioned what the EPA DHA stand for.
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no, cause it's a hard to pronounce.
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All right.
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I'll do the honors.
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I Cosa pentameric acid is EPA and
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docosahexaenoic acid D
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a
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So those are the ones that, people will often see on supplement bottles.
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you know, they'll see the EPA and DHA on a supplement bottle.
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And, one of the things I'd always teach my patients was how to read that, that label.
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I know we're talking about food, but I just wanted to kind of jump into like this part of it, because I think it does help to distinguish, what they are and like,
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a supplement
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at least.
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So when you look at a bottle of fish oil and it says a thousand milligrams of fish oil, and then you look at the label on the back, it breaks it down into EPA and DHA.
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And that those numbers, like, I usually have the patient total that amount, and it could be like 300 milligrams of one and 200 milligrams of another.
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So you're basically getting 500 milligrams of those essential fatty acids in a capsule of a thousand milligrams of fish oil,
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Right, right.
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So there's some other oils in there that just aren't
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Right?
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Yeah.
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in general, like I think that's a good way of people kind of being like, oh, there are different kinds of omega three fatty acids.
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And, what I find interesting, cause like you said, like the alpha linolenic acid can be converted into these EPA and DHA.
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And men and women convert these differently.
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And then there are other genetic variabilities to that affect how our bodies convert them.
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So in general, men don't convert it as well as women, women tend to have a higher conversion rate and estrogen plays a role in that, which I thought was kind of cool,
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So more estrogen means better conversion into the EPA DHA.
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yeah.
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Yeah.
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So, and then, yeah, there are, people who have genetic variability and the enzymes, the Delta six and Delta five to saturate enzymes that convert as well.
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So it's really important to eat these whole foods with the, you know, the ALA, but it's a lot harder to get to.
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The recommended doses of the APA and DHA from eating those foods.
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Right.
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So if you want to, you want a sure way to make sure that you're getting enough EPA DHA would be to eat food sources of those which cold water fish are probably the number one source
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Right.
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And for people who are allergic or don't eat, fish or even, or a vegan, you know, that poses a bit of a challenge.
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And so they usually go to the plant source.
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They
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go to the algae.
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Yeah.
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And I think they're making some algae that, intentionally are created to make more DHA and in particular
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Oh, interesting.
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I did not know that.
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So Tina, where, where exactly are we
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getting our ALA from?.
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Well, the healthiest sources are whole nuts and seeds.
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I mean, especially things like the flax seeds that you already mentioned.
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And they do need to be ground.
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If you are a human and you're consuming them.
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I, that was the other thing I would tell my patients, they would be eating foods that had whole flaxseeds.
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And I was like, you don't have a gizzard.
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You can't break that down.
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You can feed that to your chickens.
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Cause they'll break it down, but we'll just poop them out.
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So ground freshly, ground flaxseed.
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yes, freshly ground flax seed, pumpkin seeds also.
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you can get pumpkin seeds when they're in season.
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You can save them if you're buying pumpkin's for the family and, you know, pumpkin seeds are delicious.
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Oh, chia seeds
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Yeah.
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I knew also you get some from other foods like soybeans, but I don't advocate for soybean oil, which has added in everything.
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But if people are eating,
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you know, edamame, then great,
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you're going to get some ALA in that.
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Oh, also green, leafy vegetables,
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oh, sure.
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like dark green, leafy vegetables.
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Yeah.
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We actually talked about that
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in another episode
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Yeah, that's right.
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Oh, and then, the part that I think surprises a lot of people is in the purely grass fed animals.
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Okay, here goes the first tangent, here we go.
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tangential warning.
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so you know, grass fed beef and grass fed animals in general.
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Some people are turned off by them because they're too quote unquote gamey, the gaming business that people taste and meet the fishiness.
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We taste and fish, the flak soil that goes bad on their refrigerator.
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Cause you haven't used it.
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All of it is the omega-3 fatty acids going bad.
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So fresh fish is not fishy.
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It's only fishy when it sits around.
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oils will degrade eventually and become fishy.
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So fresh fish is not fishy pers.
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Because it's fresh.
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The omega-3 fatty acids are intact.
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It's the same thing with grass fed beef and, flax seeds, even flax oil will go bad.
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So if you're in a part of the country where it's sat on the shelf and it's on sale.
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Cause it's about to expire next month.
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It may go bad and it will smell nasty.
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All of
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these are the omega three
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fatty acids They're extremely volatile.
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And they, go bad because they get oxidized.
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So when fatty acids get oxidized, they're stinky and nasty and you
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don't want to eat them.,
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So there are fish that even when they're fresh, they are fishier and those would be the oily fish.
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I'm assuming, right?
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Like the cold water fish may have more than, a lake fish because the lakes are cold too, but it depends on your leg.
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yeah.
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I was going to say depends on the lake, yeah.
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in general, sushi grade, right?
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So Shimi grade fish when people eat
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fish raw in a Japanese restaurant, it's not super fishy.
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Right.
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They're usually pretty
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fresh.
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I mean, I get suspicious when it's the grocery store sushi where you're like, Ooh, that's a little fishy.
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right.
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Because it's been sitting there.
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its surface area is exposed to oxygen.
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And as long as that's happening, it's it's starting to go bad.
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And that's typically why I don't recommend people taking things like flax oil, because it often can be ranted right off the shelf.
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Yeah.
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And then people think that's what it, that's what it tastes like.
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They don't know that it's oxidized.
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It's kind of like the grass fed beef or if it's game meat like venison people are like, oh, that stuff's nasty because it's gamey.
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Well, if it's fresh enough it won't be rancid oils that you're eating.
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So it
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won't be gamey.
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Interesting.
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So why don't we take a break and we'll come back and talk about why exactly omega threes are essential.
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Yeah.
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How are they used in the body anyways?
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Cool.
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Here's a hot tip for keeping ground flaxseeds from going.
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Store them in a container in your refrigerator or freezer that keeps them fresher longer.
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so let's talk about some things that these omega-3 fatty acids do in the body and why we need them.
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Why they're essential?
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Yeah, why they're essential.
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They're essential because our cells are made of what's
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called a by lipid layer, all
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the cells in the body.
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Lipid being fat.
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Right.
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And bi-lipid meaning there's
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two fatty acids, that kind of point at each other.
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I picture like the image upload an image in the show notes, but I picture like the little heads on the outside and then the tails coming in
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yes.
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you have the head on the outside and the tails coming in.
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So you have the hydrophilic and the hydrophobic parts of a fatty acid and the hydro Fillic parts point towards the inside of the cell and the outside of the cell and the hydro phobic parts point toward each other.
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And that's the tail.
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and those hydrophilic and hydrophobic just means like water loving or water hating, I guess it's fearing I, phobic would be fearing.
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Right.
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So, yeah.
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So it's just how it reacts I mean, think about like when you drop a drop of oil into.
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Water and how it comes together.
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Right?
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Right.
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So a cell membrane has this BI lipid layer or two fatty acid layers.
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And there's all different types of fatty acids that Okay.
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I'm finding this a little challenging too.
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Well, you're using your hands.
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I'm seeing you use your hands, right?
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Like to show the tails and it's, it's hard when there's no video.
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This is a podcast.
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So I know that people do not see my hands right now.
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It's very clear if he saw my hands anyways, all you really need to know is the fatty acids are a variety of types of fatty acids.
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And you need a certain amount of these omega-3 fatty acids that are very fluid to be incorporated into the cell membrane.
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So what you want in a good cell membrane is fluidity.
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You want it to be able to move around.
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It's not static.
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So you have all sorts of channels and receptors and sugar molecules hanging off of it.
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But they're not sitting still they're moving at all times.
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And that movement is into.
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To good, proper, robust cellular function so that it reacts to its outside and it communicates with other cells and the immune system and interiorly, it also functions normally because the cell membrane allows things to get through those receptors and channels are functioning properly and it keeps out other things that shouldn't be going through the cell.
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Right?
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So fluidity is the key to a good cell function, which is interesting, right?
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Because resilience is the key to health.
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In general, resilient cells are made with some omega-3 fatty acids incorporated into their membranes.
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Yeah.
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So I always think of it as.
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the cell is less stiff and nutrients and information, everything that needs to come in and out of the cell can do so with the omega-3 is incorporated into it.
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So I think of like, like a blood cell, right?
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Because you need omega-3 is to incorporate into your blood cells and it allows them to be more fluid, And then the blood itself is more fluid.
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that's, that's kind of a really simplistic way of, you know, how I usually describe it to patients.
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Yeah.
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And you can think of fluidity as a literal term with the oil on your counter too.
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Right?
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So saturated fats, aren't fluid.
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You're talking about butter.
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You're talking about lard.
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coconut oil.
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I mean, they solidify at room temperature and depending where you live, coconut oil could be fluid or not.
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in any case, these polyunsaturated
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fatty acids PUFAs omega-3 is
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a polyunsaturated, fatty acid are more fluid in general.
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oh my God, three fatty acids can be put into the freezer and they still won't freeze.
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So that, that fluid, they just don't solidify.
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And that's the same in
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your, for cells..
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The fluidity
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is preserved with these polyunsaturated fatty acids.
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So the cell membrane function all around needs to have a certain amount in there.
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And when you have enough of these omega-3 fatty acids incorporated into the, your membranes of your cells, you have a more anti-inflammatory tendency.
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When your cell goes to break down some of that cell membrane.
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This is part of what happens all the time.
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We have enzymes that go up, grab those little fatty acids from the membrane and break them down.
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And if you have very little omega-3 fatty acids incorporated, that whole process is going to lead to more inflammation.
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if you have a good amount of omega-3 fatty acids incorporated, that same enzyme goes up, pulled down on a mega three fatty acid and the net effect of breaking down that particular type of fatty acid is anti-inflammatory.
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So this is one of the reasons we say omega-3 fatty acids are anti-inflammatory because naturally, if we have enough of them, your body will tend towards less inflammation in the same vein on the anti-inflammatory effects.
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The omega-3 fatty acids can also become resolvins and resolvins are a whole class of compounds that we make to resolve inflammation because inflammation is necessary.
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We have to have inflammation.
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We wouldn't heal from a cut or get over a flu.
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You have to resolve the inflammation and keep it from becoming chronic
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I like that name.
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Resolvins
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Nice and simple.
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Right?
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yeah.
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I guess the last thing I should mention, is that fatty acids are also by virtue of being these long chains of carbon.
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They are taken up into cells and we make energy from them.
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So fatty acids are used to make energy within the cell.
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So they're a source of energy, just like glucose as a source of energy for cells, fatty acids can be a source of energy for the cells in particular, the mitochondria is where that's produced.
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So you mentioned that, fatty acids are made up of carbon.
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So did you want to kind of touch on they're called omega three fatty acids?
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Oh, yeah.
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Let's I don't wanna get into too much detail, but when you have an unsaturated fatty acid, you have what are called, double bonds between the carbons where those double bonds occur has to do with calling it omega-3 fatty acid Omega just has to do with a site on the chain.
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Okay.
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I'm trying to think of like specific things as to like where omega-threes are beneficial in the body.
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And because of their importance in the cell itself, I mean, it's pretty much everywhere because we're made up of cells, right?
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We're a collection of cells.
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And so it's, our eyes, our brains, you know, the developing brain, you think about how pregnant women, their supplements contain DHA and how infant formulas, um, contain DHA.
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You know, like these RMA threes, you know, it's just, it's important for the nervous system it's important for our skin.
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you know, it helps with everything.
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I, I just kind of like trying to think about like, what doesn't it benefit?
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Right.
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They're just, they're, part of ourselves.
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And so they're part of every single part of our body.
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Right.
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So adequate amounts is essential for just good overall health for all systems.
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Right.
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And I mean, I think it's really rare to have an overt deficiency.
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I mean, I'm sure in, a lot of malabsorption cases or, malnutrition, there would be more of an actual deficiency.
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and that's why when patients get TPN, they get, you know, the nutrition through their port that has omega three fatty acids in it.
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Right.
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As do the nutritional drinks that, that people buy,
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So maybe the one, the one group that we do need to mention is anyone who has trouble absorbing fats in general, they're not going to have selective absorption troubles with this particular fat, but if someone has trouble because they have trouble with their pancreatic function, so there's less lipase or there's trouble, or they don't even have their gallbladder, you know, gallbladder has been removed for whatever reason and there's less bile acids.
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There's going to be a little more trouble absorbing fats in general.
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right.
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Or any surgery, because those fats are absorbed in the small intestine.
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And so any surgery that affects that.
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Um, So I think that's a really good time to kind of move on to why omega threes are important for cancer patients and cancer survivors,
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Yeah.
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So let's, let's break it down.
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We'll talk about prevention, like primary prevention of cancer in general, and then during treatment time, and then after cancer
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right?
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Survivorship.
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Yeah.
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Okay.
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Did you know that of all the nuts and seeds, chia seeds have the highest concentration omega-3 fatty acids.
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In fact, the word chia is derived from an ancient Aztec word, meaning oily.
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So one of the things that we know is when there is a systemic chronic inflammatory state for a long period of time, that's not good for health.
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And it seems, although nothing is conclusive, but it does seem that high inflammatory state systemic high inflammation.
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Is a risk factor for various types of cancer.
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and we know this because CRP or C-reactive protein is one way to test that in high CRP has been associated with many, many different cancers.
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Um, cause and effect are a little bit overlapping because once cancer is present, the CRP can go up just because cancer creates these inflammatory compounds, including that CRP, which just a marker of systemic inflammation.
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but in general, anything that dampens inflammation and keeps people in more of a balanced state between inflammation and anti-inflammation states is going to be preventative.
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I think the research is strongest in cancers like colorectal.
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Right for risk reduction.
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You know, I don't like you, you know me, I don't like the word prevention.
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I know because people promise it.
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Right.
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I know, it's it.
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Yeah.
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And you know, when, when you have a patient, who's like, I did all the right things.
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I ate all the right foods, and they still get cancer.
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It's like, we talked about risk reduction here.
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yeah, I know.
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I don't really like the word prevention either.
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I still used in the headlines and it's yeah, it's an over promise to say, you can prevent it.
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we can reduce your risk of it happening,
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Right.
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can't
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But yeah.
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So colon cancer has been one of the cancers that has been looked at with omega-3 fatty acids and risk reduction.
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Yeah.
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So of course that overlaps with where are they getting it and how are their diets in general?
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and in other words, if they're eating more, nuts and seeds or they're eating more cold water fish, then there's more happening than just omega-3 fatty acids, neutral.
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So like always observational studies that show trends in any consumption of a food and an outcome are just that they're trends.
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And they're what we call hypothesis generating.
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They're not proof of anything.
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'cause it's hard to control when it's in a diet, because the diet is so complex
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Yeah.
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So the only way to really know is to take a bunch of people over a long period of time, give them a supplement and then have a placebo group, and see what the rates
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and have them have the exact same diets as well.
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Right.
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I mean, which is like really hard to do.
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not likely.
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Yeah.
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So as far as risk reduction, we have trends that show that it may be beneficial, but we don't have anything conclusive.
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Okay.
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So then what about during treatment?
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You know, the majority of my patients who show up with their bag of supplements, they have some sort of fish oil, some sort of omega-3, they might have krill oil, even, you know, like they have something because they're taking it for their heart.
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You know, their cardiologist recommended it or whatever.
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It may be, their primary care recommended it for their eczema.
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Yeah.
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And so during treatment, whether it's chemotherapy, well, let's just take like a chemotherapy first.
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Let's divide this out a little bit.
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So it depends on the drug.
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First of all.
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So there's, there's evidence that, omega-3 fatty acids, fish oil in particular may lessen neuropathy in some chemotherapies, like the taxane based that paclitaxel and docetaxel,
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And again, we're going to say reduce the risk because as a person, I'm bringing it back to me as the person who took omega-3 fatty acids during their taxane, you're, you're reducing a risk of something.
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You're not going to guarantee anything.
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Right.
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Never.
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And I also ate a lot of omega-3 rich foods during treatment.
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So, you know, I was getting it from all sources.
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Yeah.
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And that, that was one study that was back in 2012, on the taxanes and, it used the word protective.
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it said something like omega-3 fatty acids are protective against paclitaxel induced neuropathy or something like that.
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in any case, There was a trial using omega-3 fatty acids and looking at peripheral neuropathy induced by oxaliplatin.
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And it reduced the risk of that for these folks who took it.
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The irony of that of course, is there's a whole nother mouse study that said don't take fish oils alongside a platinum drug.
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So,
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I know that's.
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In the back of my mind too.
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yeah, that was a mouse study.
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I'm not so sure it's all that relevant for what we do when you have a human trial showing that there could be benefit rather than, you know, any problem with it.
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And I mean, it was a form of an omega-3 fatty acid that I don't remember actually seeing.
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I think we actually contacted the suppliers of the fish oils that we had at the, at the cancer center.
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And they did not find that form in any of the supplements.
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The forum that created resistance in those mice to the drug, the platinum-based drugs
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Yeah.
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So, but, but that did make a lot of headlines.
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yeah.
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the other common use during treatment is if someone has trouble with weight loss, actual trouble, keeping their weight on, whether it's muscle loss or overall weight loss, we'll do higher doses official to try and maintain that.
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Right.
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And yeah, like I mentioned before, it is in TPN formulas.
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it's in,
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tube feedings,
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all of, all of those it's no, it important for helping patients to maintain muscle and to maintain weight.
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Yeah.
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And some of that has to do yes, it has calories in and of itself, but it's also its anti-inflammatory effect because at some point, especially if someone is in kind of that spiral of cookie Mexia, then that is an inflammatory process in and of itself.
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So fish oil can counter that and we use fish oil and higher doses for that during treatment
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Yeah.
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I think there was a study that looked at, specifically the EPA.
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It was like, 2.2 grams of EPA itself.