Dr. Patrick: So, you very recently published a study that correlated the omega-3 index to all-cause mortality, it was able to even predict mortality. Very, very interesting study. I shared it on social media, but I would love to talk about it.

Dr. Harris: Well. Yeah, yeah. Sure. It's going to be probably one of my capstone studies, I think. And in hindsight was a collaboration among 17 different cohorts, like the Framingham Study's a cohort. Women's Health Initiative's a cohort. MESA, EPIC. These are all and from all around the world. These are groups that have been recruited at one point in time, blood samples taken, fatty acid levels measured in that blood, and then the investigators follow this group of people over time, see what happens, what kind of diseases they get, you know, who dies, who doesn't. And so we had 17 of those pooled together and around 40,000, 45,000 people altogether where we had omega-3 levels at the beginning and then roughly the total follow-up time when you're looking at risk for death, all-cause mortality, you obviously look in a given window of time because if you wait long enough, it's 100%. Everybody dies.

So you can't wait forever. You got to wait. So we looked basically between ages 65 and 75, who died in that window of time. And we found that the people that had the highest omega-3 levels compared to the lowest were 15% or so less likely to die over that time. And it was very...when you look at quintiles of omega-3, it was very dose-dependent, the higher the omega-3, the lower the risk. And that was for total mortality. We then looked at cardiovascular mortality, cancer mortality, and then everything else, kitchen sink, you know, if it's not cancer, not cardiovascular, it's group three. And we saw the same thing in all groups... It wasn't as strong in cancer. It wasn't as stair-steppy like it was in cardiovascular. But the highest group in omega-3s did have a significantly lower risk of death from cancer. But interesting to me is the non-cardiovascular, non-cancer, all these other causes of death from electrocution to suicide, to car accidents, to kidney failure, you know, everything people die of. The higher the omega-3, just like cardiovascular, lower risk. So there's something very systemic, very protective across many systems in the body. Many diseases I think are just held somewhat in check by having a higher omega-3. It's not just heart disease. And I think that's the message to get out. It's not just heart disease.

Dr. Patrick: Right. And the 15% decrease in all-cause mortality, was that about a five-year? Was it translating to about a five-year?

Dr. Harris: In that study we didn't try to get at that because basically, that meant in that window of time, you were 15% less likely to die. How long you actually lived? We didn't follow people until they died all the time. But in another study we published from Framingham, just one cohort, we did see that there's roughly a five-year difference. If you're at the very lowest omega-3 versus the highest, your odds of dying are about five years earlier.

Dr. Patrick: Can you say again? So the omega-3 index for the lowest was...

Dr. Harris: It's probably under 4% and for the upper level roughly 7%. Again, this is observational and Framingham and nobody's supplementing. So we haven't got people, many people over 8%. This is, you know, people living in Boston. And so they don't have high omega-3 levels, but the highest quintile was about over 7%.

Dr. Patrick: You said the average in the United States was about five.

Dr. Harris: Five-ish.

Dr. Patrick: So five-ish. And what's the average intake of fish in the United States?

Dr. Harris: Fish, well, what is it? Thirteen pounds per person per year. And that's all fish and all...

Dr. Patrick: All fish.

Dr. Harris: Right. So that includes, you know, shrimp which has zero omega-3 and white fish, Pollock, which is the fried fish that people get at McDonald's and salmon itself, which is one of the highest omega-3 fish. One of the highest that people actually eat, you know, that provides about one and a half grams per serving of omega-3. The average intake of EPA and DHA in America is something, you know, 100 to 150 milligrams a day. The median intake is zero. Okay. The average, because some people eat a lot and a whole lot of people eat none. You know, so the median is zero, at least to two decimal places. But the average intake is, say, 120 milligrams a day. In Japan, it's roughly 900 milligrams a day.

Dr. Patrick: Nine hundred milligrams. And...

Dr. Harris: For life, for minus nine months. I mean, because mom's doing it too. Yeah.

Dr. Patrick: And their, if I remember correctly, their average lifespan is about five years longer than the United States average.

Dr. Harris: Right. Despite the fact they smoke more, despite the fact they have more hypertension, despite the fact they have higher stress life, they still live four or five years longer.

Dr. Patrick: Does omega-3, is it known that if it has any effect on smoking in terms of like negating some of the negatives?

Dr. Harris: Well, in our most recent paper in Framingham, we asked the question... In general, we're trying to understand how much of a risk factor is omega-3 compared to things you already know for death. So we know cholesterol is a risk factor. We know blood pressure is a risk factor. We know diabetes, having diabetes. We know being a smoker is a risk factor for bad outcomes. So how does omega-3 compare to that? And we found that in the study we did in Framingham looking at all-cause mortality, that if you're a smoker and you have a low omega-3, you know, over the 10 years of the study, you're 50-50 chance of living. You're going to die at 50% chance of dying. If you have a low omega-3 and you're non-smoker, it's not so bad, your risk of death maybe is 30% over that [period].

If you're a smoker and you have a high omega-3, that's the other flip side, but you're a smoker, your risk is kind of like having a low omega-3 and being a non-smoker. And then if you've, best case you don't smoke and you have a high omega-3, your odds of dying are like 10%. So it's, in a way, having a low omega-3 is like being a smoker from a... I don't mean to say that taking omega-3 erases your risk of being a smoker. Don't want people to think you can do that. "Oh, I keep smoking. I just take some fish oil. I'm good." That's not the deal. We do know that smoking actually lowers the omega-3 index. Smokers have lower omega-3 index than non-smokers from other studies. And it could be because of the hyper-oxidative state of a smoker's blood that could actually destroy omega-3s potentially, or they just don't eat fish oil or they don't eat fish. That's the other explanation. So the general tack of both our study in "Nature Communications" on total mortality with our 17 cohorts and this latest one in "American Journal of Clinical Nutrition" in Framingham point to having a high omega-3 level is protective in the same sense that having a low cholesterol is protective, in the same sense that having low blood pressure is protective. It's about the same predictive value, which is...

Dr. Patrick: Wow. And that's about 8% of omega-3 index around...

Dr. Harris: Yeah. Again, it's over seven in Framingham but in the pooled analysis of those 17 cohorts, it was roughly about 7.8%. The highest quintile was roughly about the 8% target. So we felt that our original 2004 idea that 8% would be the target which is based on much less data back then has been vindicated and continues to be vindicated. It's been seen that that 8%, it's not perfect. I mean, in Japan, you actually get an additional reduction in risk at 10% versus being at 8%. Okay. That's good. But we're now going from this much risk to this much risk, you know?

Dr. Patrick: Well, that was going to be my question too, is like what if we get up into it, you know, 10% to 12% to 13% omega index, is that even greater? I mean...

Dr. Harris: It could be. We at OmegaQuant, we kind of say our target level is 8 to 12. And it's not because above 12 is bad. It's because we just have so little data to say that, if you get to 14, you're better than you're at 12. Or even to say that you're 12, you're better than 10. We don't really know that. It's just a reasonable target level. It's safe. I'm not concerned about that. And it's tough enough for people just to get up to 8, never mind get up to 12. And so we're not trying to say anything above eight, as far as you can go, the higher the better, I don't know, I can't say that. I mean, there may be adverse effects that pop up somewhere out there. You would think in theory, there could be, we just haven't seen them, but that doesn't mean they're not there. So be conservative.