Why Is Fish Oil Important During Pandemic?
Patients with more Omega-3s in blood were 75% less likely to die from Covid-19
Researchers with Fatty Acid Research Institute (FARI) and collaborators at Cedars-Sinai Medical Center in Los Angeles, and in Orange County, California claimed that people with higher omega-3 index have a lower probability of dying due to Covid-19. Published in journal “Prostaglandins, Leukotrienes and Essential Fatty Acids” Jan 2021, shows the first direct evidence that higher omega-3 blood levels may reduce the risk of death from Covid-19 infection. Arash Asher, MD, the lead author of the study suggested that the anti-inflammatory effects of EPA and DHA from marine fatty acids may help reduce risk for adverse outcomes in COVID-19 patients (Asher et al 2021).
Omega-3 Weathers the Cytokine Storm
Omega-3 fatty acids (DHA and EPA) have potent anti-inflammatory effects, which could dampen the COVID-19’s cytokine storm. Cytokine Storm , an excessive inflammatory response, is a fundamental mediator of severe COVID-19 illness. It is also known as cytokine release syndrome. In this condition, the immune cells decide to attack itself rather than the virus. Serious cytokine storms may develop acute respiratory distress syndrome (ARDS). Many people who develop ARDS do not survive. Other causes of ARDS include sepsis and severe pneumonia (Szabo et al 2020).
The first symptom of ARDS is usually shortness of breath. Other signs and symptoms of ARDS are low blood oxygen, rapid breathing, and clicking, bubbling or rattling sounds in the lungs when breathing. Patients with ARDS are unable to breath on their own and may require ventilator support to help circulate oxygen in the body.
Studies showed that this inflammatory response can be modulated through diets that are enriched with omega-3 fatty acids and antioxidants. Adding omega-3 fatty acids to ARDS patients have positive results in ventilator free days. Amid the COVID-19 pandemic, a new paper published in the American Journal of Epidemiology concluded that healthy levels of DHA were associated with lower risk of hospitalization due to lung diseases. The protective effect of DHA prevented progressive scarring to the lungs (J. S. Kim et al 2021)
Surviving Sepsis in Covid-19 With Omega-3
One of the complications of COVID-19 is sepsis and sepsis-induced acute respiratory. It occurs when the virus reaches and spreads through the bloodstream. As the blood is circulating throughout the whole body, it causes tissue damage everywhere it goes. Sepsis causes life-threatening dysfunction in organs including lungs, brain, kidneys, heart, and liver. In sepsis, the entire organ system shuts down, one after another. Even when a patient survives the condition, it can leave the patient with a lasting damage to the lungs and other organs. 25 clinical trials were accessed for the death rate due to COVID-19. The total death rate in the Omega-3 fatty acid group was found to be lower than that in the control group. A 2018 review paper found that Omega-3 fatty acids supplementation could reduce the death in sepsis (Chen et al 2018).
Fish Oil contains two omega-3s known as DHA and EPA. Because of its many benefits on our health such as the heart, lungs, brain, eyes and joints, it is vital to know if we have sufficient levels of EPA and DHA in the body. The omega-3 index describes the amount of EPA and DHA omega-3 fatty acids in the red blood cells. Simply put, the higher the number, the more EPA and DHA you have in your body. An omega-3 index of 8% or above is considered optimal, while a low omega-3 index indicates a higher risk of sudden cardiac death. A simple estimation on the Omega-3 index can be measured as in the chart below.
Aim For 8
An index of more than 8% is optimal while a level of less than 4% is regarded as a deficiency. The higher the level of omega-3 index, the better it is on the overall health and longer life span. Much of the world’s population exhibits low levels of the omega-3 EPA and DHA. Asian countries such as China and Singapore have low omega-3 index. A low index was found to be significantly related with an increased risk of heart diseases (R.E. Walker et al 2019).
Hitting The Right Note With The Right Fish Oil
In order to reach the omega-3 index of 8%, it is recommended to consume sufficient amounts of fish oil. Unfortunately, there are some studies that suggest that fish oil from supplements does not get into our body as well as fish in food form. A six-week study showed that active ingredients of EPA and DHA in fish oil capsules were not as effectively incorporated into our body's blood plasma fat particles and another study showed that the EPA content in red blood cells increased more rapidly from eating fish rather than taking supplements. These studies seem to suggest that they found that the EPA and DHA levels were better absorbed into our cells using natural (fish) form
rather than synthetic supplement form. One of the most significant differences between natural form and synthetic form, is the molecular form of omega 3 (R.E. Walker et al 2019). The natural form comes in a triglyceride (TG) and the synthetic one is in ethyl ester (EE) form. Furthermore, the EE form of fish oil turns rancid faster.
As mentioned above, the omega-3 index has been suggested as a predictor of the risk of death from Covid-19, coronary heart disease and other cardiovascular events. Consider the results from the following studies(Asher et al 2021, Schacky 2010, Harris et al 2018, Filipovic et al 2018):
People with low omega-3 index levels were 4 times more likely to die from Covid-19.
People with low omega-3 index levels were 10 times more likely to die from sudden cardiac death compared to people with higher omega-3 index levels
People with the highest omega-3 index levels had a 33% reduction in risk of death from any cause compared to the people with the lowest levels. This same study also indicated that the omega-3 index could be a better predictor of death risk than serum cholesterol levels.
Higher omega-3 index levels were associated with lower blood pressure in healthy adults between ages 25 to 41.
Studies are currently investigating the relationship between omega-3 index levels and mental health issues, like depression, cognitive functioning, body weight, and eye health issues, like macular degeneration, to name just a few.
In conclusion, when people get an effective daily dose of fresh, full-spectrum omega-3 oil, it has a measurable impact on their health.
1. Asher et al. Blood Omega-3 fatty acids and death from COVID-19: A pilot study. Prostaglandins Leukotriene and Essential Fatty Acids 166 (2021)102250.
2. Szabo et al. The potential beneficial effect of EPA and DHA supplementation managing cytokine storm in coronavirus disease. Front Physiol. 2020;11:752 2020 Jun 19. doi:103389/fphys2020-00752.
3. New Evidence shows omega-3 DHA may protect the lungs. Omegaquant. Sep 3, 2020.
4. J.S. Kim et al. Associations of omega-3 fatty acids with interstitial lung disease and lung imaging abnormalities among adults. American Journal of Epidemiology, Volume 190, Issue 1. Jan 2021, pages 95-108,
5. Che et al. Correlation analysis of omega-3 fatty acids and mortality of sepsis-induced ARDS in adults: data from previous randomized controlled trials. Nuttitional Journal 17, Article number 57 (2018).
6. R.E. Walker et al. predicting the effects of supplemental EPA and DHA on the omega-3 index. The American journal of Clinical Nutrition, Vol 110, Issue 4, Oct. 2019 pages 1034-1040. doi:10,1093/ajcn/nqz161.
7. Clemens von Schacky. Omega-3 index and sudden cardiac death. Nutrients 2010 Mar, 2(3):375-388.
8. Harris et al. Erythrocyte long-chain omega-3 fatty acid levels are associated with mortality and with incident cardiovascular disease. The Franmingha, Heart Study. Journal of Clinical Lipidology (2018)12,718-727.
9. Filipovic et al. Whole clood omega-3 fatty acid concentrations are inversely associated with blood pressure in young, healthy adults. J. Hypertens. 2018 Jul; 36(7): 1548-1554.