Gettysburg Medical News
 The Clinical View
 by P.E. Hoffsten, MD
9 November 2005

THE VALUE OF FISH OIL AND FLAX SEED OIL: IT ALL BEGAN WITH MARGARINE

            In the first half of the previous century, we fought two world wars associated with massive social upheaval.  By 1950, the age of antibiotics was fast upon us and heart attacks and strokes graduated into the leading cause of death in our population.  The healthcare industry began to study causes of heart attacks and strokes soon discovering that high blood pressure, high blood cholesterol, diabetes and cigarette smoking were the four major contributors to the blood vessel obstructing problems that resulted in heart attacks and strokes.  But along the way, there were some very interesting side stories.

            One of these had to do with margarine.  The dairy industry in the United States has been a potent force over many years time.  Butter was a significant source of revenue for the dairy industry.  Bread and butter was a standard American food.  But then along came the corn farmers and it was recognized that there was a lot of oil in corn.  But corn oil was a liquid at room temperature whereas butter was a solid that you could spread on bread.  People didn’t like spreading oil on bread so bread and butter stayed a staple.  The corn oil people got the idea that if they could make the corn oil into a solid and dye it yellow, they could compete with butter. So that is what they did.  A process called hydrogenation was carried out on corn oil and, low and behold, it became a solid with a consistency of butter.   But it was white, not yellow.  So the margarine people decided that they would dye their hydrogenated corn oil yellow.  The butter people raised a stink.   The corn oil people were accused of being frauds trying to fool the public into buying this ugly margarine.  And believe it or not, there was a law passed that said you couldn’t put yellow dye in the hydrogenated corn oil to make it look like butter.  Those of you who are my age will remember having margarine come with a little yellow pill mixed in with a plastic bag full of margarine.  After you bought the bag of margarine, you had to pop that pill and then mix the yellow dye in with the margarine to make it look yellow like butter.  As a ten year old kid, I thought it was a high privilege to get to mix in the dye with the white margarine and watch it turn yellow.

            To make a long story short, there is a big difference between corn oil and butter.  Butter is “saturated”.  Corn oil is polyunsaturated.  This means that chemically, the two products are really quite different.  Saturated fats such as butter clearly contribute to heart attack and stroke.  Compared to butter, margarine clearly does not contribute to heart attack or stroke.  Thus, eventually, the margarine people got to color their product yellow without the yellow pill and today the margarine industry is huge compared to the butter industry.  But if you notice, the margarine people are still claiming that margarine tastes just like butter.

            So in the 1950’s, it was established that polyunsaturated oils such as corn oil were better for you than saturated fats such as butter.

            But then the story takes a new loop.  Cholesterol itself was discovered as the second step in the butter link to heart disease.  It was noticed that the higher a person’s blood cholesterol, the more likely they were to have a heart attack and thus was born the idea of the low cholesterol diet which as most people already know does not work.

            But then we really got a clinker.  A normal cholesterol is said to be less than 200 mg%.  A really bad cholesterol is 300 mg% and there is a big difference between the heart attack rate for people with 200 mg% cholesterol and those with 300 mg% cholesterol. But, then we look at the Eskimos who live on whale fat and seal fat and lots of fish.  It turns out that their blood cholesterols are 2000 mg%; this is 10 times the blood cholesterol that we believe is good in the United States.  And yet Eskimos have an almost non existent rate of heart attack.  How in the world can cholesterol be that important if Eskimos have the highest cholesterols in the world and they don’t get heart attacks?

            It all goes back to the polyunsaturated thing I talked about above.  It turns out that fish oil has longer carbon chains and a lot more polyunsaturated status.  It turns out that there is a thing called Omega 3 and Omega 6 unsaturation.  These have been shown to be the good parts of polyunsaturated fatty acids.

            As you might imagine, with the information about the Eskimos fat intake and their low heart attack rate, people begin to say that maybe eating fish oil would be good for people in the United States.  Studies were done to compare the heart attack rate on the United States citizens that ate more beef and pork and chicken compared with those that lived along the coastal areas of the United States where they ate more salt water fish.  It turned out that citizens in the United States that ate more fish had fewer heart attacks and strokes also.  The idea of polyunsaturation with Omega 3 and Omega 6 fatty acids being good for you was gaining momentum.

            Then came, the next big step.  Eating ocean caught fish in the upper Midwest is kind of an expensive diet.  Not everyone likes eating fish and so the idea of eating fish oil tablets came to be.  It turns out that about 4 gm a day which is equivalent to 4 of the gelatinous tablets available over the counter does seem to make a difference in the rate of heart attack and stroke in people that use the fish oil.  This is now “evidence based medicine”.  Large numbers of individuals have been allotted either taking the fish oil tablets or not and then following up on the rate of heart attack and stroke.  It turns out that there are fewer heart attacks and strokes in individuals who supplement their diets with fish oil.  This still allows for the standard South Dakota beef intake but the benefits of the polyunsaturated oils available through the fish oil pills.  The pills are tasteless and you really don’t start smelling like a fish two weeks later.

            The next column will review the story of flax seed oil and how it compares with fish oil as a preventer for heart attack and stroke.