another week and another study has made headlines about the omega-3 fatty acids DHA and EPA during social media with concerns what are the hidden dangers of your fish oil supplements are there any in this video I'll walk you through this latest study and its results focusing on the increased risk of atrial fibrillation that they found we'll also explore the comprehensive evidence on omega-3 fats and cardiovascular disease discussing potential mechanisms behind the results and the importance of dosage these essential fats may have positive or negative effects on your heart at different doses by the end of this video you'll know how to test your omega-3 levels and optimize them through nutrition supplementation or a combination of the two for those who eat seafood I'll share the specific types and amounts of fish to eat weekly to get enough DHA and DPA without supplements what I found here may surprise you certainly surprise me and stay tuned for my take on whether vegans and veget Arians should consider Omega-3 supplements the study was titled regular use of fish oil supplements and course of cardiovascular diseases a prospective cohort study and this was published in the bmj medicine Journal April 2024 this was an observational study featuring the UK bio Bank cohort that followed more than 415,000 subjects aged 40 to 69 for a median duration of about 12 years in this particular paper the researchers were interested in looking at how fish oil supplementation affected different stages of cardiovascular health these stages of cardiovascular health or disease were defined as healthy status which was the primary stage to atrial fibrillation the secondary stage major adverse cardiovascular events the tertiary or third stage and death the end or final stage the hypothesis being that it might be that Omega-3 supplements have a different effect on outcom your health depending on your stage of cardiovascular disease the results were really interesting Topline omega-3 supplementation seemed beneficial for people who had already entered what they deemed the second stage atrial fibrillation a fancy name for an irregular heartbeat however for subjects with a healthy cardiovascular system stage one fish oil supplementation was associated with increased risk of atrial fi a moving to stage two it was reported that there was also an increased risk of stroke but this was actually not a significant finding importantly for those with good cardiovascular health fish oil supplementation was not associated with significantly lower or higher risk of major cardiovascular events or death that is a really important takeaway that I want to underscore here there was no increased or decreased risk of major cardiovascular events or death in subjects with good cardiovascular Health who was supplementing with fish oil in this particular study anyway before we consider how to interpret these results and thus how it may guide our diet or supplement regime this study has a few notable limitations that I want you to be aware of firstly the study only assessed fish oil supplementation at Baseline at the start of the study so we really have no idea if people continued with supplementation over the 12E period or if those who didn't supplement a Baseline started during the follow-up period secondly fish oil supplementation was assessed as a simple yes or no giving us no idea as to how much fish oil subjects were actually taking on average per day and further no idea as to whether this was DHA EPA or combination of the two this is important for a few reasons number one we know that nutrients can be beneficial at a certain dose and harmful at another there's mechanistic evidence to suggest that high concentrations of both EPA and DHA these omega-3 fatty acids in fish oil can impair activity of sodium potassium pumps in the heart which are important for maintaining a regular heartbeat whereas more moderate concentrations optimize sodium potassium pump activity this might be why lowd do omega-3 supplement randomized controlled trials like the vital study did not find an increased risk of atrial fibrillation in subjects supplementing with DHA and EPA we'll come back to this idea of dose being important when we discuss supplement recommendations now number two there is some evidence suggesting that EPA is more specifically beneficial for preventing cardiovascular disease than DHA EPA more readily gets into existing plaque that we have in our artery walls stabilizes that plaque and can even result in plaque regression or shrinkage yes jents a different form of shrinkage one that we should probably welcome With Arms Wide Open the researchers in this latest study seem to conclude that that these results provide more evidence that fish oil may be beneficial as a secondary prevention intervention for people with existing cardiovascular disease but not for primary prevention people without cardiovascular disease I have a different interpretation that I'd like to share with you while I do think the discussion around atrial fibrillation is important it is I'm not convinced that this means DHA and EPA supplementation is not a net positive for people without cardiovascular disease to help unpack my position here I want to share a tweet from anabor on Twitter who I've engaged with online for some years now and respect for her commitment to intellectual honesty and objectivity I think this will help us get to the point that I want to make I shared my personal omega-3 index test results a test that measures the DHA and EPA content in red blood cells and my approach to supplementing on X Twitter which I'll share with you later in this video when I did this Anna challenged me she said do you agree that the idea that this regime will cause atrial fibrillation is based on much stronger evidence versus the idea that aiming for an omega-3 index of 8% is worthwhile Anor is correctly pointing out that it's not just observational evidence that Associates omega-3 supplementation with atrial fibrillation there's also clinical trial evidence that corroborates these findings including a 2021 metaanalysis of seven clinical trials and over 880,000 subjects this meta analysis showed a dose dependent relationship between omega-3 supplementation and atrial fibrillation the higher the dose the higher the risk of atrial fibrillation specifically 11% higher relative risk of developing atrial fibrillation per 1 gram of DHA EPA per day I'm well aware of this data and I'm certainly not ignoring it my response to Ana was this and I quote yes but also atrial fibrillation is an outcome I give less weight to than total cardiovascular disease events or mortality meaning that I care more about someone having a heart attack stroke or dying from a cardiovascular event than I do about atrial fibrillation if I had to prioritize them avoiding atrial fibrillation would be the lowest priority for me on that list so even if I slightly increase my risk of atrial fibrillation but lower my risk of cardiovascular events both fatal and non-fatal that is a risk that I am willing to take it's also a risk that I think I can reduce by being thoughtful with the dose of DHA and EPA that I supplement with so what is it that makes me think that omega-3 supplementation and having a higher omega-3 index in the ballpark of 8 to 12% will lower risk of cardiovascular disease and mortality well a few different lines of evidence firstly we have data from a randomized control trial the vital study showing reduced risk of cardiovascular disease the study's primary outcome in healthy subjects who rarely consumed fish at Baseline supplementing with 840 Mig of combined DHA and EPA per day second large long-term population studies suggest that having a higher omega-3 index of 8 to 12% relative to a low omega-3 index of less than 4% % is associated with 30% lower risk of suffering fatal coronary heart disease and approximately 12 to 15% lower risk of death from any cause one bit of push back that I foresee here is that the results of these observational studies May in fact be affected by confounding variables that is to say that people who eat more fish may be healthier because they're also people who smoke less exercise more eat more fruits and vegetables Etc maybe they have less risk because they're health-seeking folks folks not because they have a high omega-3 index just last week I hopped on another call with previous guest Dr Bill Harris an internationally recognized expert on omega-3 fatty acids and asked him what he thought about this there there have been very few and and I think only one that I can think of study that's been in in people without heart disease primary prevention with with omega-3 versus a placebo and that's the vital study and they found found despite they're saying there was no benefit of Omega-3 that's because they were looking at a composite endpoint of three or four different cardiovascular events all pulled together and what they saw was no difference in the composite but if you look at the individual components of the composite the people that got omega-3 had signif statistically significant less risk for having heart attacks and for dying from heart attacks so those were and people who were reported low fish intake and that study if you look at the effects of Omega-3 and the group that reported a low fish intake there were statistically significant benefits on their composite primary endpoint so to say there's no good evidence from primary prevention for omega-3 is not true people are asking for levels of evidence for that I think they forget that we're talking about a nutrient that has essentially no side effect virtually no downside except for this one thing with aib which has popped up now and kind of muddied the waters anyway people can talk about primary versus secondary endpoints and if they want to throw all the secondary endpoints out then they're not looking at the overall picture of the science I also asked Dr Harris what his thoughts were on the risk of atrial fibrillation stroke and omega-3 supplementation I think that paper is uh misrepresented the the real situation frankly it's a complicated paper uh it's one of 18 papers that have been done looking at fish oil supplement use in the UK biobank and some health outcome interestingly uh the authors of this particular paper which is on cardiovascular disease I think should have in their discussion talked about oh there's 17 other papers that have looked at fish oil supplement use in different diseases one of them in cardiovascular disease and they got completely different answer in the cardiovascular paper and they didn't discuss these things at all because in those other 17 papers I think there were 25 statistically significant associations between fish oil use reported fish oil use and some disease outcome 25 different significant effects one of them was adverse which was a fib and 24 of them were positive were favorable so let's look at the whole picture if we're going to be dissing fish oil supplements because of one small outcome and actually that outcome the aib uh the difference in Risk was 6% meaning people on the people who are not taking fish oil supplement had something like a 4% chance of developing a fib over the follow-up period the people on supplements had like 4.6% chance of so it's very small difference it can be magnified by uh uh using relative risk instead of absolute risk which is what they did which is what we do too I mean all of us do that it's just the way you play the game uh but it should have been uh contextualized I think a lot better the increased risk for apib is 1% if you take the supplements you might be 1% more likely to develop aib and then once you've got the aib you're you're better off than if taking the fish oil than if you weren't and the thing about stroke stroke was not statistically significant in that study they put it in the abstract they put it in the paper but they Define statistically significant as less a p less than .005 and if you look at the table the P value for stroke was not less than 0.005 it was 0.05 so we would say you know a trend almost but it certainly shouldn't have made the uh the final conclusions that increase risk for stroke cuz it wasn't significant the next question you probably have is well how much DHA and EPA do I need to consume every day be it from food or supplements to get to an omega-3 index of 8 to 12% it's going to be difficult if not impossible albeit for genetic outliers to get to an optimal omega-3 index unless you eat fish or supplement with DHA and EPA how much you need to get to an omega-3 index of 8 to 12% will depend on a variety of factors in particular your genetics body weight diet and your Baseline omega-3 index if your Baseline omega-3 index is 4 to 5% where the average person eating a typical omnivorous diet sits studies conducted on humans suggest that you'll need about 1 to 1.5 gram of dhaa and EPA per day to get to 8% this can be achieved with food alone supplementation alone or a combination of the two starting with nutrition the major source of DHA and EPA in human diets is seafood specifically fatty fish like sardines anchovies mackerel and salmon so how much fish would one need to eat to average one gram of DHA and DPA per day the lower end of the recommended range that I just mentioned to help us answer this I have a table that I sourced from Omega Quant there's too much data in this table which is on screen for those watching on YouTube and in the show notes for those listening Along on audio to go over the entire thing but here's a few key takeaways that will be relevant to people who eat seafood firstly to average one gram of DHA and EPA per day one would need to consume about a small serving 3 o or 85 gram of salmon per day or a larger serving 6 oz or 170 G every other day it's worth noting that there is some variation in the DHA and DPA content of different types of salmon with wild Atlantic salmon containing the most it's also typically the most expensive type of salmon but because you need less of it to get the same amount of DHA and DPA it's not as expensive as a first glance may suggest second Herring both Pacific and Atlantic are the most DHA and EPA Rich of the fatty fish four small servings a week 3 o or 85 gr would get you pretty close to 1 gr of DHA and DPA per day lastly sardines you need to have about 100 gr or 3 and a half ounces of sardines per day to get close to the 1 gram of DHA and EPA per day recommendation remember this is just to get to 1 gram of DHA and DPA per day some people will need more than that to get to an omega-3 index of 8% it's safe to say not many people eat this much fish or quite frankly would want to at this point you may be wondering how on Earth would humans have ever eaten this volume of fish that's a good question the likely answer is that outside of Arctic populations they probably didn't but these ancestors of ours were really not living long enough to worry about that they ate to survive and the suboptimal omega-3 index isn't going to kill someone before they get to an age to procreate that's all Evolution cares about here today we're talking about optimizing for health span and Longevity keeping our heart and our brain in good condition when we're old and wrink and want to enjoy time with our grandkids something that is a privilege in a day and age where we rarely need to worry about Predators life-threatening infections famine Etc in short our ancestors except those from the Arctic probably didn't consume much fish however that doesn't mean a higher omega-3 intake wouldn't have been beneficial for them especially if they reached old age this Insight leads us to an important question how can we in our mod World optimize our omega-3 levels the obvious answer might seem to be eat more fish but here's where we encounter a significant challenge our world today faces severe environmental issues including heavy metal contamination in our waterways and rapidly dwindling fish stocks advocating for increased fish consumption on a global scale could lead to negative Health consequences from heavy metal exposure and fairly catastrophic environmental consequences is affecting today's coastal communities that rely on fish's protein and future generations of humans across the world I'll explore these environmental health concerns in depth in a future video with an expert so if eating more fish isn't the answer what is let's shift our Focus to a more sustainable and practical approach testing and thoughtful supplementation imagine your body's omega-3 level as a fuel gauge just as you wouldn't try to fill up your car without checking the fuel level first it's important to understand understand your current omega-3 status before making changes that's where testing comes in by measuring your omega-3 levels with an omega-3 index test we establish a baseline that allows us to tailor our approach to your specific needs once we know your Baseline omega-3 index level we can explore the various supplementation options my omega-3 supplement strategy is as follows it seems sensible to supplement with the minimum dosage of DHA and EPA per day to get us to an optimal omega-3 index so we can optimize for long-term health benefits minimize adverse effects like atrial fibrillation and save some pennies along the way for most people that's going to be in the ballpark of 1 to 1.5 G of active DHA and EPA per day I've personally done this supplementing with about 1.5 gram of DHA and EPA per day and over around 9 months I saw my omega-3 index go from 5.76% to to 9.44% now that I'm above 8% I'm actually going to slightly reduce my dose to approximately 1 G of DHA and EPA per day and then retest 4 months after making that change to see if I'm still above 8% with that slightly lower dose why 4 months well the omega-3 index is based on the fatty acid composition of red blood cells and red blood cells take about 4 months to turn over so if you change your diet or supplement protocol wait at least 4 months before you retest your omega-3 index Omega Quant who I have zero affiliation with but highly recommend for omega-3 index testing actually has a dosing calculator on their website which suggests that someone like me could get to 8% with around 810 milligram of DHA and EPA per day if I could achieve that I'd be very happy you might be thinking why 8% why not 12% this is something that I asked Dr Harris are there continued benefits up for grabs going up above a % to 12% and Beyond in Practical terms it's far more uh important to just at least get to 8% there so few people are at 8% that to try to worry about being at 12% is is almost a Fool's errand um we haven't got very much data on ome on large groups of people with omega-3 levels at 10 11 12% they're just aren't that many people like that so we really don't know that's kind of why we our limit is say 8 to 12 and above 12 12 we just don't know um we're not going to make any promises there is some evidence though from Japan uh that people that were at 11% omega-3 index compared to uh those at 8% they had lower risk of I think myocardial infarction so in Japan you can do things like that you can look at those sort of levels um so that was some evidence and there was a paper recently we not recently but a few years ago that pointed that there might be even additional benefits above 8% for cardiovascular um but I think that's still yet to be really studied well when choosing off the shelf supplements I recommend opting for brands that have gone through third-party testing for Purity oxidation and contamination I've managed to get this information from thirdparty testing that I've paid to access from organizations like consumer lab.com or directly from the brands themselves providing they were happy to make their third party testing reports available I've also ensured that the brands that I recommend contain DHA and EPA not just DHA because as I mentioned earlier there is mechanistic evidence that suggests EPA may be more important for stabilizing existing plaque that we have in our arteries shout out to previous guest and friend Dr Alan Flanigan for bringing that to my attention please note I said the target range for most people should be 1 to 1.5 G of active DHA and EPA per day when you omega-3 supplement labels be careful not to look at the total oil per serve but rather the total amount of DHA and EPA it's the ladder that should add to 1 to 1.5 G per day there can be other oils in the capsule hence it's important to only pay attention to the DHA and EPA content based on all of this criteria the brands that I recommend to help you optimize your omega-3 index are as follows starting with algae oil because it's more sustainable than fish oil and quite frankly I'd love it if everyone adopted an algae oil where possible mindset here three capsules per day of either the AA 3 algae oil or A's optimal Omega Plus at the time of this video Costco has a very good deal on the AA 3 algae oil for those based in America $29.99 for a 2 month supply I'm actually shocked by how cheap this is it's cheaper than almost all high quality fish oils that I've been able to find algae is the original source of DHA and EPA the Omega-3s that eventually make their way up the food chain and are found in fish by going straight to the source we can obtain these vital nutrients without the concerns associated with over fishing or contaminants found in some fish it really is a win-win effective for our health and friendly to our environment and contrary to views that you may encounter on social media algae oil has indeed been shown in clinical studies to reliably raise someone's omega-3 index to an optimal level I asked Dr Harris if there was any difference between the effectiveness of algae oil and fish oil and here's what he had to say in terms of being absorbed and getting into tissues yeah it's absolutely as as well absorbed and as well distributed in the body if you cannot get a Vega 3 in your location or aren't a member of Costco and price is in issue or for whatever reason you would prefer fish oil I personally haven't come across any other reasons than price my recommendation would be Carlson's maximum Omega 2000 two capsules per day will give you a little under 2 G of combined dhaa and EPA so you'll likely only need to take this four times per week an alternative to this is Garden of life's doct formulated Advanced Omega one serving per day provides 1.3 G of combined DHS and EPA Dr Bill Harris recommends a reesterified triglyceride form of fish oil he has his own brand parasol nutrition which provides 1,400 migr of DHA and DPA in a two capsuled dose this is what Bill personally takes each day at $69.95 for a 3mon supply it's more cost effective than Carlson's maximum Omega but surprisingly more expensive than the AA 3 algae oil at Costco I say surprisingly because usually algae oil is more expensive than fish oil but that is not the case here for seeing there will be comments if Dr Harris sells Omega-3 supplements he must be biased could be or it could be that he's so convinced by the evidence for supplementing Omega-3s that he wanted to produce a highquality supplement his positions seem logically consistent at least to me anyway so I'm of the belief it's the lad what about a higher dose is is there a case for taking more than this 1 to 1.5 G dose of DHA and EPA per day perhaps you've seen scientists or influences talk about super high doses for example recently Ronda Patrick in a conversation with Andrew huberman said that she supplements with four grams per day so I take four grams a day I take two in the morning two grams in the morning and I take two grams in the evening I take my EPA in the morning and I take my DHA in the evening you split them I do um I don't know if I don't think it's necessary not necessarily I'm I just happen to buy I happen to get a certain fish oil supplement that's like separates them Dr Gabriel lion also in a conversation with Andrew huberman advocated for 4 grams per day going up to 10 grams per day for some individuals admittedly she did mention that fish oil can thin the blood but despite discussing extremely high doses there was no mention of atrial fibrillation is there a threshold amount that is a wonderful question um there is not the general recommendation is around four grams but some individuals four to 10 grams which would be definitely on the higher end certainly can uh potentially thin your blood if an individual is going for surgery two weeks prior would uh suggest not taking it personally I do not see an evidence-based argument for having a higher dose than this 1 to 1.5 gram per day of dhaa and EPA range unless you have existing cardiovascular disease and high triglycerides and your card ologist recommends 4 G per day split over two serves of icosapent ethyl commonly referred to by its brand name for sea which was shown in the reduc it randomized control trial to reduce risk of cardiovascular disease in patients with existing cardiovascular disease that had high triglycerides most people should get to an omega-3 index of 8 to 12% with that 1 to 1.5 G per day dose of DHA and EPA this is what the literature says and what I've seen personally working clinically as a nutritionist with clients you may be wondering does the form of DHA and EPA matter whether it's triglyceride or ethylester the two most common forms this is something I asked Dr Harris yeah I I take a what's called a restructured triglyceride reesterified some with little a little r TG it's a triglyceride form but it's been enriched with Omega-3s so there are more Omega-3s per per molecule of triglyceride than there are in regular fish oil I think that's probably the best form to take um ethylester if you take them with fatty meal it helps with their absorption regular triglycerides are fine too they're just not as concentrated in omega-3 so you have to take more pills to get the same dose bill and I also spoke about whether or not the DHA to EPA ratio matters when choosing supplements the only data that I'm aware of is related to depression uh and when they've looked at uh meta analyses of studies where they've used omega-3 varying uh DHA EPA ratios in dementia stud I mean not dementia depression studies uh it looked like the ones that were richer in EPA were U better at resolving symptomatology of depression so there may be something there I've also been involved with study where they gave pure EPA to people depressed people who are on anti-depressant and the EPA didn't help so didn't hurt didn't help so I I'm not sure what to say my general answer is they both EPA and DHA should always be taken together they always appear that way in fish um some fish are richer in DHA some fish are richer in in EPA but they're always both there and so I always go for products that are you know if not 5050 epad DHA at least somewhere in the like 60/40 maybe even 37 but both of them are present it is worth noting that whether you choose algae oil or fish oil it is best to take these supplements with a meal to improve absorption that's another little hack to reduce the dosage and perhaps the risk of adverse effects taking DHA and DPA supplements with a meal will mean that for a given dose you see a greater increase in your omega-3 index another little tip is to store your Omega-3 supplements away from direct light and heat which will help prevent the fats degrading going Rd don't store them next to the stove I've also heard mixed recommendations on whether or not you should put Omega-3 supplements in your fridge this was another question that I had for Dr Harris I don't store mine in the fridge I just store them at room temperature yeah some some things that get on the omega-3 block blogger I never read so I that's probably not a a great admission but um I'm not writing them it doesn't hurt to put them in the fridge you not you're not doing any damage to them and you're you're just not um you're not going to get rid of any kind of a fishy burp because of refrigeration but the capsules are I mean these these gelatin capsules are completely impervious to oxygen it can't get in so they're they're not going to oxidize uh in the capsule and may have been oxidized before they got encapsulated but that's a different question and friends if your Omega-3 supplements are past their expiry date do not take them this is not not the supplement you want to stockpile coming up what's the best strategy for vegans and vegetarians to optimize their omega-3 index if you're finding this information valuable so far please let me know in the comments and don't forget to like And subscribe your engagement helps YouTube share this information with more people okay let's talk about plant-based diets I know a number of people are going to be wondering about vegan diets vegetarian diets and omega-3 index optim ation a question I always get is can I just eat chia flax hemp seeds walnuts Etc will that be enough the first thing that I think is important to make clear to acknowledge here is that consistently we see vegetarians and vegans have lower risk of cardiovascular disease compared to non-vegetarians it's one of the biggest benefits of plant-based diets but that doesn't mean they couldn't do better just as I believe such populations could do better by optimizing their protein and calcium in take and doing more resistance training they would also likely do better if they were able to optimize their omega-3 index my rate of the literature is that the cardiovascular disease benefits we see are because vegetarians and vegans consume less saturated fats more unsaturated fats more fiber more plant protein more phytochemicals Etc that is to say that these populations do better when it comes to cardiovascular disease despite their relatively low omega-3 index not because of it it unfortunately we don't have long-term evidence comparing vegetarians and vegans who supplement with DHA and EPA versus those who don't and seeing who's more likely to have a cardiovascular event I'm hopeful that we get this data soon from the Adventist cohort I believe that there is a study underway right now looking at omega-3 index in this population or soon to be underway so for now my advice for vegetarians and vegans is based on extrapolations from the broader body of literature that suggest an optimal omega-3 index is around 8 to 12% and data from the vital trial that showed significant cardiovascular benefit to supplementing with DHA and EPA in subjects who ate less than the recommended number of servings of fish per week for those watching on YouTube you can see on screen now the table from the vital study showing a 19% lower risk of major cardiovascular events and a 40% lower risk of myocardial infection or essentially having a heart attack in people who rarely consumed fish what is the typical omega-3 index for a vegetarian or vegan person a someone not eating fish and not supplementing with the direct source of DHA and DPA we do have studies that have tested the omega-3 index in vegetarian and vegan populations and from this data we know that when you do not have a direct source of DHA and EPA in the diet from fish or supplements and rely on Omega-3s from plant foods like Chia flax and hem seeds your omega-3 index could be about half that of the average omnivore keeping in mind the average omnivore is probably only at 4% presumably because people don't get anywhere close to the amount of fish I mentioned earlier that would need to be consumed to get enough DHA and DPA so a vegetarian or vegan omega-3 index could be as low as 2 to 3% as shown in a study of Dutch omnivores and vegans here's what Dr Bill Harris had to say about the typical omega-3 index on a plant-based diet if you're uh vegetarian vegan it's going to be down probably four 3 and a half% but the the average we've seen across really several thousands of people in in Europe North America eating standard Western diets is around 5 to 6% it is worth noting that there are other studies where vegetarians omega-3 index is not this low more like 4 to 5% presumably because they're able to optimize their conversion of the omega-3 ala into DHA and EPA by keeping Omega 6es in their diet low but even 4 to 5% is still not considered optimal remember if your omega-3 index is around 4% 1 and 1 12 gr of DHA and EPA per day should be absolutely sufficient to get you to 8% in fact one study of vegetarians using 800 migrs of algae oil per day for 8 weeks saw omega-3 index increase on average from 4.8% to 88.4% let's finish with a summary of the main takeaways from today's video on Omega-3s a brand new study supports the existing body of evidence that suggests DHA and EPA omega-3 fatty acids may increase risk of atrial fibrillation in healthy people without cardiovascular disease this is an adverse effect that we should certainly take seriously but I am not convinced it means we shouldn't supplement at all because there is other evidence that suggests supplementation and a higher omega-3 index is associated with with lower risk of non-fatal and fatal cardiovascular disease the outcomes that I personally and probably you too care more about so overall there seems to be a net benefit to consuming an optimal amount of DHA and EPA per day we may be able to reduce the likelihood of experiencing atrial fibrillation by being thoughtful with dose taking the minimum dosage required to get us to an optimal omega-3 index which is about 8 to 12% most people need about 1 to 1.5 G of DHA and DPA per day to achieve this we have three paths to omega-3 optimization nutrition alone supplementation or a combination of the two if you choose nutrition remember it's quite a lot of fish most people aren't going to do that and it would be highly unsustainable if you want to go down the supplement route you can choose a fish oil or algae oil that provides 1 to 1.5 G of DHA and dph per day we went through the brands that I recommend based on third party lab tests refer back to that earlier section of the video for details vegetarians and vegans and really anyone not consuming a significant amount of fish should measure their omega-3 index with a company like Omega Quant and supplement with DHA and DPA as required while some people suggest it is suffice to Simply eat plant-based foods like walnuts cheer and flax it's unlikely enough conversion will occur to get to an optimal omega-3 index unless you are a genetic outlier lastly an important reminder if you have existing cardiovascular disease and high triglycerides speak to your cardiologist about Thea a specific type of EPA that you can supplement with which is different to what you would buy on shelf in supplement stores and with that friends I think we are done if you found this video helpful please check out this video featuring Lane Norton where I discuss another interesting area of nutrition protein and healthy aging