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Optimizing Omega-3 Fatty Acids for Pregnancy and Beyond with Kristina Harris Jackson PHD, RDN

In this enlightening episode on the Empowered Nutrition Podcast, we embark on a fascinating exploration of the world of omega-3 fatty acids. Our esteemed guest, Kristina Harris Jackson, the co-founder of OmegaQuant, joins us to unravel the mysteries and marvels of omega-3s.

A little bit about Kristina:
Kristina Harris Jackson received her B.A. degree in Biology from Augustana University in 2008, her Ph.D. and R.D. from the Pennsylvania State University in 2013 and 2014, respectively. Dr. Jackson pursued a post-doctoral fellowship in the area of behavioral and nutritional health at the University of Colorado – Denver at the Anschutz Health and Wellness Center. Wanting to return to biochemical nutrition, Dr. Jackson joined OmegaQuant, the family business, in 2015 and has been working in various roles throughout the company since. She now is a part-owner and Director of Research and Education at OmegaQuant Analytics and an Assistant Professor at the University of South Dakota Sanford School of Medicine. She co-invented the Mother’s Milk DHA and Prenatal DHA Tests and has a patent pending on the Prenatal DHA test. She has published over 30 peer-reviewed journal articles, reviews, and book chapters on multiple aspects of nutrition, in addition to consulting with clients on their fatty acid status.

Omega-3s, particularly the essential fatty acid DHA (Docosahexaenoic Acid), take center stage in our conversation, with a special focus on their pivotal role during pregnancy and breastfeeding. We delve into the profound impact these nutrients have on both maternal and fetal health, shedding light on why they are crucial for overall well-being.

You’ll gain invaluable insights into the optimal consumption of fish, ensuring you strike a balance between reaping the benefits of omega-3s and avoiding potential risks, such as mercury exposure. Discover why omega-3 testing is a game-changer, allowing you to understand and monitor your omega-3 levels accurately.

Kristina shares her wealth of knowledge, providing practical advice and recommendations that make it easier than ever to incorporate omega-3s into your daily life. Whether you’re a soon-to-be parent or simply someone interested in improving their health, this episode offers a wealth of information and actionable steps.

Stay informed about the latest advancements in omega-3 research and testing, and embark on a transformative journey toward enhanced health and nutrition. Don’t miss this empowering and illuminating episode of the Empowered Nutrition Podcast. Join us as we unlock the potential of omega-3s for optimal health and well-being.

Interested in Omega 3 testing? Check out our website!

Our test for Prenatal DHA: https://www.empowerednutrition.health/store/Prenatal-DHA-p551369436

Our test for Mother’s Milk DHA:  https://www.empowerednutrition.health/store/Mothers-Milk-DHA-Test-p551371747

Want to learn more about Omega Quant? Visit www.omegaquant.com.

If you haven’t already, be sure to subscribe to our podcast  so you don’t miss this episode and other exciting content we have in store for you.

Stay healthy, stay empowered, and keep nourishing your body and mind!

Check out the live interview on Youtube! https://www.youtube.com/watch?v=2Ba-5NiDiZY

Ready to dive in? Listen here!

Love it? Hate it? We’d love to hear your feedback!  

SUBTITLES:

Hey Kristina, welcome to the Empower Nutrition Podcast. How are you?  

I’m good. Thank you for having me. Oh  

My gosh, thank you for coming on. Most of our listeners are women and Omega three is basically one of the only most important things to talk about. So you’re just like a perfect guest. So thank you so much.  

Oh, this is great. I, I do, I love, I’ve been in the Omega three world beyond the women health side, but once I found like pregnancy and breastfeeding, I was like, that is so much more important to me than everything else. So it’s been really fun.  

Yeah. Well that’s a perfect lead into what I wanted to ask you of, if people don’t know Dr. Harris that we had in the podcast already on omega threes is your dad, and we talked about omega threes there and obviously you grew up knowing about omega threes and then you went off into the world and did your PhD and worked quite some time in other realms of nutrition. And tell me about what brought you back into the Omega three world.  

Yeah, so I, I went to Penn State for my graduate work in nutrition. I went to Augustine College here in Sioux Falls actually. And I was a biology undergrad and typically that would be like a pre-med. And I was like, I don’t wanna be a doctor. Like I don’t wanna be that kind of doctor. I don’t wanna have people’s lives in my hands and I make one little mistake and it’s done. So that was, that pushed me towards kind of research. And my dad was in nutrition, so I was like, it’s kind of just applied biochemistry, so that seems interesting. Yeah. So I got it to, went to Penn State and I really liked it nutrition, just once you get past kind of the basic classes and you get to the, the nitty gritty biochem, it’s super fascinating. Yeah. And complicated. And so I did that and I was doing human clinical feeding trials, actually focused on whole grains.  

My mentor was Penny, Chris Etherton, and she’s been in the cardiovascular disease nutrition world forever. She just retired. So I was kind of, I was in the clinical realm and then I was able to, I had to take so many nutrition classes to just get caught up to the graduate level. So I actually ended up doing my registered dietician training at the same time as my PhD. And so that kind of got me into being interested in the behavioral nutrition side. So right after graduating, I went to the University of Colorado in Denver and I worked there for about a year in kind of a work site wellness type of place. But life is weird. And so my mentor that I was really excited to work with, he had a heart transplant like the week I got there. So he wasn’t available to be my mentor there.  

But as I, I just kind of was able to busy myself and meet with different types of different potential mentors, different areas. And I just realized this area is so important. It’s like, yeah, blood nutrition, but it’s so, so many more variables and it’s just so much bigger. I just get like stuck and overwhelmed. So I decided to go back to kind of more biochem, nutrition and then my dad had been building OmegaQuant for a few years kind of on the side. He was working at a, at a hospital here in town. And it was kind of getting bigger and it was become, it became a real option for me to be able to work at with him at OmegaQuant. Mostly focused on research, mostly focused on working with researchers to do testing with them, as well as using my registered dietician credentials to really start doing some translation and that. And then I got to also help run a small business, which has been quite the education.  

Yeah,  

Totally. I feel that, yeah, so you know, things just, you don’t really know where it’s going, where life is going.  

Yeah. Yeah. And I mean, I imagine, I mean to, well backstory of my understanding is that you actually were a big part of adding additional panels specific to prenatal health to Omega quant. And so that probably was kind of a risk maybe of is it gonna pay off to add these panels and maybe tell me about why you felt, maybe tell me about these specific, like why you thought these panels needed to be added.  

Yeah, so you know, there’s always kind of this like high-minded thing like, oh yes, we have to have this panel. But really it was like, we know we can measure omega threes in blood on a filter paper very well. We can stabilize the fatty acids. We have this technology, what else could we do? And then the first thing was, well breast milk ’cause it’s, so, it’s easy to collect. And D H A has a known important aspect of breast milk. So I guess just to back up, d h A is do cosa hexa NOIC acid, it’s one of the long chain omega threes that are in fish in our diets. They’re also really critical in pregnancy, breastfeeding and the development of the brain. The brain and eye are just very rich in D H A. And so just structurally we need it and our body makes some of it actually estrogen helps women make a little bit more of it than normal, which is to me just like pointing to its importance in pregnancy and lactation.  

Yeah, so D H A was always kind of our focus. The omega three index is kind of our larger, more global omega three status marker that includes E P A, which is another long chain omega three, both really important, both always really found together in nature. So with the general Omega three index, we have both of those together. For the pregnancy stuff, almost all the research has been on D H A because of that structural component, it’s really important for brain development. So we decided to just do a marker that’s just D H A because that’s gonna respond to D H A and a lot of the trials use only D H a, although many of them use a mixed fish oil as well. So yeah, we decided to just kind of see what, what we could see in the literature around breast milk, d h a.  

And as I was doing that, that was, I was finding a lot of really interesting stuff. But it’s very hard to find studies where they didn’t also supplement during pregnancy where they just started at like lactation. And then the pregnancy levels in the mom’s blood really affect the breast milk levels. It makes a lot of sense, right? Breast milk is like taking the first D H A, it’s always like the primary source where your D HHA is gonna go. But in pregnancy, like I just kept finding all of these studies that were happening in pregnancy. And so after we did the D H A, the mother’s milk, d h A, the breast milk d h A, we’re like, there’s way too much in pregnancy. We have to look at what a D H A level in pregnancy would would be. And so that’s kind of where both of those came from.  

Okay. Yeah. So it sounds like in the research, most of what, when we see outcomes related to omega threes and, and for fetal development, it’s, it seems to be clear that like the D H A is maybe more impactful than the total omega three level or the e p A level. And so that’s why these tests single out the d h A level, you can look at it from blood when you’re pregnant or you can look at it in breast milk when you’re breastfeeding. Is that right?  

Yeah, that’s that’s right. And I would say like it’s never just about one thing in nutrition. And we do think that there are several other omega threes that are playing roles. The D H A is the clearest signal. It moves it and, and it’s usually directly related to what is being supplemented. And so we just, we wanted to make it clearer. It’s, it was also like partially just how do we communicate this in the clearest way that has the most connection to the research? The research, usually they only report A D H A in the, in the, in the milk or blood. So we needed to have research backing for the targets that we set. So that’s another reason. But it isn’t true that it’s the only important thing. Of course, it’s just a good signal. And usually when you have higher D H A your E P A increases too. And so it’s doing something. Yeah. There’s always more to know that we don’t know, but what we do see some pretty good correlations with higher D H A levels and pregnancy outcomes and things like that.  

Yeah. Maybe tell me some of those specific outcomes that are significant with that of like what’s seen in the literature.  

Yeah. So where we got really excited was the preterm birth literature in 2018 or 19. I’m now forgetting which one. A group in Australia headed up by Maria mcc. She’s a, her and Bob Gibson have been doing huge studies with omega three supplementation in pregnancy for decades. It’s their, it’s their careers work. And, and they, their group did something called a Cochrane review. Yeah. Which is a very standardized way to do a meta-analysis of bringing together every, every study where a pregnant woman has been given fish oil or d h a. And they tried to pool everything together and look at these outcomes. And Middleton was the first author Dr. Middleton. And so they found that when they pooled a lot of studies together, that the preterm birth rates for women who were on the omega three arm compared to the placebo were about 10% lower than the placebo arm. So that’s good. But the early preterm birth rates, so preterm is defined as before 37 weeks early preterm, they define as before 34 weeks, although there are other terms, but I’m talking about before 3, 3, 4 weeks gestation. So women who had fish oil, they had a 42% reduced risk in this analysis of having early preterm birth if they were given omega three compared to the placebo. That’s a huge, huge, huge drop.  

Absolutely.  

Yeah. And  

We start, as we’ve looked into this more, there is nothing available to prevent preterm birth specifically. There’s no like drug any, there was a drug that was on the market and it was recently taken off. I can’t remember the name of it, but it’s no longer available. So it was basically kind of a steroid. And the options right now, if you are at risk for preterm birth or early preterm birth, which you don’t even really know that, especially if it’s your first baby, you, there’s just not Yeah. There’s not much there. Yeah. And it’s more, it’s kind of vague. It’s like being very, very old or very young being kind of the extremes of age and weight. And if there’s smoking and drug use, it’s kind of bigger things than a specific biomarker.  

And the other, the other risk factors are have you had a preterm birth before? It’s your first, you don’t know. And so there’s, there’s really a need here to give doctors and pat and wi pregnant women, like if it’s a huge deal to know if someone may be at risk for preterm birth. Yeah. So the, the omega three story came in and found like this intervention, it’s not, it’s not just like we’re, we’re not to the part where we’re showing that levels of omega threes can predict preterm birth, but we are showing that if you give omega threes during pregnancy that you can reduce risk. And it’s during pregnancy, most of these studies don’t actually start supplementing till mid pregnancy. They recruit people that know they’re pregnant. It’s so hard to study pregnancy.  

I know.  

So hard. Yeah.  

Yeah. By time you can go going, you miss half of it.  

Yeah. So it’s really second half of pregnancy. It’s not like folic acid where it’s like if you, once you know you’re pregnant, you, you weren’t taking whatever, like you already missed the boat. Even though we have fortification, which is why we have fortification.  

Yeah.  

Omega threes, it can, it’s great to have it on board prior, but you can use it even 20 weeks gestation after that doing a a dose. So that to me was also like, it’s just kind of a relief as a Yeah. Pregnant person just to know that there’s something that might work. 

Yeah. And what kind of dosing, was it some really high dosing or just kind the typical like thousand milligram dosing or?  

So they looked at, in the meta-analysis, they’re trying to, they separated it by dose low, medium, high. They didn’t see any statistically significant differences. There was kind of a trend. The authors kind of felt like maybe 500 plus would be milligrams of D H A per day would be good. But after this meta-analysis came out, there were two very large studies going on. One was by the McCartys group in Australia and one was by Susan Carlson at the University of Kansas Medical Center. And so we had this big finding from all the previous research. And these other two big studies were designed to test that question specifically on preterm birth, early preterm birth rates. And omega threes, one of them was using a thousand milligrams of D H A dose and one was using 800 milligrams of D H a plus a hundred of epa. So it’s like pretty close. Yeah.  

So the Australian group did not see an effect, overall effect of omega three supplementation on early preterm birth rates. And that one was like 5,000 women. It was huge. And what they did though, a couple of things kind of affect this, is they included any, pretty much any birth. So they included people having multiples. And it’s pretty well established, especially now that if you’re having twins, the D H A or the omega threes don’t elongate pregnancy, they don’t reduce risk for early preterm birth like they do for singletons. Not that it’s not good to have omega threes for other reasons. Yeah. But that would not be an expectation in that setting. Right. So when they just looked at the singleton births, they did see a significant effect of the omega threes. And they also found, which is the other group found, this is the people who benefited the most from the being on the omega three arm of the study were women who started out with low omega three blood levels.  

So low D H A low E P A D H A blood levels at the beginning of the study, which makes a lot of sense. It’s like it’s sort of a deficiency situation. And so when they did that sub-analysis, they did find that that was a significant effect. And then in the Kansas City study, they were giving a thousand milligrams of D H A versus 200, 200 milligrams is kind of that like standard D h a prenatal dose right now. And they found, so they’re running their study with about 1100 women, so still very big. And they found a significant overall effect. They were not test, they weren’t taking in women who were having multiples, so it was just singleton births. So they found the omega three group, the higher dose, omega three, they’re both getting something. The higher dose omega three group had lower omega or had lower pre early preterm birth rates.  

So that was great. And then they did an extra analysis and found that almost the entire effect is happening in women who start off with lower D H A blood levels. Okay. So it’s like this threshold effect to me where you’re kind of, if you’re in this kind of deficiency state Yeah. If you have low levels in your blood as a pregnant person, supplementation can actually help reduce your risk for preterm birth. It can elongate pregnancy. Hmm. If you have good status, if you have a decent amount of D H a, and we’re not talking like the 8% omega three index, we’re just, we’re talking like 5% d h a. Okay. It’s not, it’s, it’s kind of a, it’s more of a threshold. It’s more of a not deficient, a sufficient status. Not an optimal status per se, that those folks, they don’t really benefit from a higher dose. 

200 milligrams is fine. Like they already have enough stores, their status, their diet is probably already bringing in enough. And so, and there are other things that can lower D H A, like smoking cigarettes and I think prenatal alcohol exposure or alcohol exposure, those can kind of lower D H A. So Sure. Having that good status just means, doesn’t mean everybody needs to be on a really high dose of D H A for this effect. And there’s the flip side of sometimes it makes you go later into pregnancy than people want to. Yeah. ’cause it can be so effective at delaying the onset of birth is really what it’s doing. It’s just, yeah. You’re not going into labor as quickly. And so those, those are like the big studies that really solidified for us that this is a really pretty critical marker to have something that could not only it could, it was predicting like the mega three level was predicting who was more at risk or having preterm birth, but also you have an intervention that’s very safe, very affordable, very accessible.  

It would be, it’s kind of, for us, it’s a no-brainer for it to become like, how do we make this port part of practice? This could be like full, like they could talk about this, like they talk about prenatal vitamins, but to have that extra test in there, to have that higher dose, it does take, you probably want some kind of prescription or something. You’re gonna have to do more than just like a standard low dose omega three. So having that protocol is something that I, that’s a whole different world to try and figure out how to,  

Yeah.  

How to break into clinical protocols. But that’s the translational step. Okay. That’s the, we think this, this would be really impactful and targeted. It’s really, we’re not just like everybody needs to supplement so much. It’s, it’s very much based on your personal status.  

And would you say that having that similar type of status is the same for other outcomes related to omega three in pregnancy? And maybe talk about like what those other outcomes that are researched are aside from preterm birth and like Yeah. What kind of omega three status are we talking about with that? With those,  

Yeah. So it’s interesting is with the birth literature, this is a, this is a pattern that there is a status, there’s kind of a deficiency threshold. And then after that, if you’re, if you’re, so if we’re just talking about D H A levels, 0.5% has actually shown up in some of the other outcomes as that’s kind of a threshold. If you’re below 5% and you get a high dose supplementation during pregnancy, you have better outcomes. But if you start out above 5%, you can be on either dose and you’re having better outcomes. So is  

It 5% is your omega three index or 5% is your actual d h a percent  

Actual D H a percent, which is about a 6% omega three index.  

Okay. Okay.  

I see. So it’s, it’s a little more than our or 4%. Yeah. So another study that found what’s the best is when studies actually measured the blood levels at the beginning of the study and publish their data based on that. That doesn’t happen. It’s happening more, but that’s a missing piece. So there was a big study in Denmark, I think it was Denmark, it, it’s called the cop sack study. They gave about two grams of fish oil, which is about a hun a thousand milligrams of D H A to pregnant women. And they, they were looking at asthma and wheeze in their offspring over, they’re following these kids. They, as long as they can. Yeah. But they’re, I think the, they’re at least at six years of age follow up. And they found, I think at three years of age that the women who with low status less than four or 5%, they got the omega three dose.  

They had a significant reduction in their offspring having persistent user asthma. Okay. The other, the group that had low status and got the placebo had the highest rates of that. The women who came in with blood levels that were above 5%, it didn’t matter if they were on either if they’re on placebo or the treatment. So it’s again, like everything’s happening. Yeah. The lowest levels. So the, yeah. You know, and I’m trying to think of, there’s one more that I always point to. There’s been another one that was just looking at fish intake. It was Dr. Olsson, he’s been also a giant in this field. But they were looking at women in China in different kind different areas where some would eat fish a lot and some wouldn’t. So they kind of used that as a proxy for d h A status and found that the women who didn’t eat a lot of fish were the ones who benefited from the supplementation and everyone else really didn’t as, as, as it pertained to preterm birth.  

Yeah. The big research, this area actually probably came about mostly to do the brain development and eye development because it’s so rich and it’s so it omega threes just, it’s just kind of shocking, shockingly rich. And those studies, there have been some good findings and also some very mixed findings. And I think that’s for partially this threshold reason. Yeah. Of if you aren’t testing who you’re bringing in and you’re not analyzing the data based on that, then you might have women who don’t need that extra supplementation. Or there’s another big issue around actually measuring like infant or young childhood cognitive cognition. Yeah. It’s hard. Is really hard. Hard. Yeah. And they’re developing at different rates anyway, so what’s good and what’s bad there is there’s a little stronger data on just looking at epidemiologically like fish intake and iq. There’s a, it’s, those are kind of bigger Yeah. Studies. They’re not those, they’re not randomized controlled trials. So those areas, I think there’s, there’s more bene, there’s more coming out on that, like the WHE and asthma side and also starting some of the neurodivergence and seeing how these fatty acids are playing into those types of developments. But all of that is so much less clear than preterm birth. And part of it is just because the outcome of preterm birth is so much more obvious. It’s like it’s a day. Yeah,  

You can, yeah, exactly. So you don’t have to wait years to be able to measure that. Meanwhile, a thousand things have happened. If you wanna measure like a performance of like the second grader, it’s like there’s been, the whole world has been impacting that child for seven years. Who knows if it was omega three or a thousand other things. Yeah,  

I know. So I have a hard time. I do think it’s very beneficial for just general development in that way. But the data on that to me is not, I, I’m not like Yeah, yeah. I’m more, I feel a lot more convinced by the preterm birth stuff, which would also go along with all the other developmental benefits is if you stay in the womb longer Right. You have more time to develop and a better place. So you wanna get to it’s all works together a little  

Bit. That’s a good point. Yeah. Yeah. I mean it makes me think about, God, nutritional research is just so hard and for almost everything, but if, if maybe if you, if something is critical, well you’re in utero and then it’s, you know, people can’t refer back to the interview I did with your dad or any of his other interviews. It’s obviously critical like midlife and end of life for health then like chances are it’s probably also critical when you’re a child, like a child and an infant. So Yeah,  

I know  

It’s just kind of the oil that your car runs on. So  

It’s, and it’s interesting ’cause like omega threes are more like other micronutrients, even though they’re fats, they’re just, they’re specific structures or what makes them useful in certain ways. They’re like proteins I guess also in that way. Yeah. And so they, they live in the membrane. They create the membrane with all the other types of fats. And then when, I mean it’s a lot is come, it’s mostly around the inflammation pathways where they’re Yeah. Impacting. Yeah. And if there’s a signal that there’s inflammation, then they’re getting pulled out of the membrane and they’re being changed by enzymes and then they’re becoming these molecules that last for minutes and they may have a really important role in the inflammatory process or healing it and not having that primary material in the membrane is kind of messes up the rest of the chain when so much is affected by inflammation.  

It’s just, that’s where it just kind of balloons in its importance. But then also the structure, just like the basic structure of our tissues needs the needs the primary sources. And so that’s why I also think it’s so interesting that there are several ways in pregnancy where the body is optimizing for D H A and arachidonic acid acid actually, which is an omega six to be transported to the fetus. The placenta will pull D H A arachidonic acid over and the baby’s cord blood is often higher than the mom’s LE levels. And if the placenta’s not functioning quite right, then that can really affect how much D h A and arachidonic the baby’s getting. And like I said, estrogen actually increases our ability to make D H A ’cause we can, which is like so cool. It’s really, yeah. And so there are all of these signals of like, this is a nutrient of importance. It’s specific, it doesn’t get used up for energy, it’s, it’s conserved by the body to be in membranes to be available for all of these different Yeah, different things.  

Maybe tell me about who should be considering testing in terms of, so like we do omega three indexes all the time in clinic and it’s super common for me to see people come in at four or 5%. That seems to be pretty much the norm if they haven’t been supplementing. And so if we’re aiming for at least 6% roughly before pregnancy, to me that would almost mean okay, like every woman wants to figure this out. Should she get Yeah it, but tell me why should she think about getting the D H A specific test instead of the omega three index? And then tell me if she’s kind of like really on the fence, what are some things she should think about in terms of like what her diet looks like, if she’s probably good or not.  

Yeah, I think that’s a great question. I am not super precious on, is it the omega three index or the dha? ’cause I know they’re very highly correlated. So if you’re used to doing omega three indexes, I would just use a 6% cutoff in your mind, even though that’s not what’s on the report. Yeah. And then if you have the prenatal D H A report, the 5% cutoff, the only risk to that is if someone is supplementing and they aren’t taking a like an E p A only or a very high E p a Yeah. Product. That’s the only reason I would be like concerned if they’re, that. That just is like if you’re eating fish, you’re getting enough, you’re getting the right amount of D H A in that. Yeah. So typically having two fish meals a week is equivalent to having a 5% D H A on average.  

This is very individual though. If you’re eating tilapia and shrimp every week, that’s not really a good source of D H a. So you’re not gonna have that, not that that’s a bad thing to eat, it’s just not gonna have a lot of d h a. So salmon, trout, sardines, herring, I mean it’s kind of some stinky fire vows. Yeah. Yeah. But a lot of them are, there are ways to prepare it that are becoming a lot more palatable and they’re just, it, you can do, I mean, two or three servings a week out of 21 meals is become, it’s, it’s doable. Yeah. Tuna people are very concerned about tuna albacore white tuna for the mercury content. And so that one’s only recommended to have once a week. And, and that even like the mercury levels, you’d have to have I think three and a half pounds of that kind of tuna per week to hit mercury levels.  

So it’s not, yes, it has mercury, but it’s, it’s a dose issue. And if you like tuna, you can continue to have tuna I think. Yeah, I agree. Go with once a week if, if that’s what you’re comfortable with. Salmon is a, is kind of like do that the easiest best. Yeah. That’s what I mostly have. But the whole conversation around fish and pregnancy is fraught. So it’s, that’s where I really like the testing because it gives you a clear picture of like what you’re doing now. It’s giving you this, we have data that if you bump your, your levels up even just a little bit, we could help with some with, it could elongate your pregnancy. So if you are don’t want to eat fish, you can go get a supplement. You can do, if you’re at below 5%, you should go for the higher dose supplements.  

A lot of them are at like 600 milligrams I feel like for preterm prenatal. But 600, a thousand, you could just do a gram a day. I’m not as worried about it being a thousand of DHA specifically. But if you’re getting a thousand eep and d H a that’s, that dose is usually giving you a really good dose of D H a. Yeah. And that’s a pretty typical supplement you could find. So you can have a normal fish oil. It does not have to be a pre prenatal fish oil. They’re all kind of the same. They’re just slightly different ratios. So that doesn’t matter as much as long as it’s not just super high e p a. And so if you test and you’re low, I would recommend supplementing, especially if you’re already pregnant. If you’re preconception and you’re like, I wanna do this through diet, then you can start increasing your fish through diet. Yeah. If you’re pregnant, you wanna get supplementing as soon as possible.  

How about your, sorry to interrupt your flow, but you guys have this great calculator on your website that kind of says, okay, if your level is this and you wanna get to that, here’s how much you need every day. You just got me thinking about like if someone’s pregnant, I could imagine that calculator not being validated or, or would you still use it  

That is based on data from pregnant.  

Oh it’s,  

But  

Nice.  

It’s, it is just a general guide. ’cause I think one of the issues we run into is someone would be like, I’m a for the omega three index, I’m at 4% and I wanna go to eight, so I’ll start eating fish twice a week. It’s like that’s not gonna  

Yeah. No,  

It’s, you need like two grams. Yeah. And so we did a study, we kind of, we got a a, a good calculator going for that for pregnancy. We have a lot less data. So it is a Yeah. Ballpark. It’s always like at least 200 if you’re low, if you’re below the 5%, you wanna be up towards the 800 or a thousand milligrams a day. If you are above 5%, I would say even make sure you’re getting at least 200 milligrams a day. You can get, you can still take the higher dose, but at least getting a little bit every day is still good. And if you are at 5%, you probably already have it in your diet. Yeah. It’s just making sure that you’re doing it and you’re continuing with your similar diet habits. And it’s a, the problem is there’s not, like, there’s so many different options that mostly all work. So in between 200 and a thousand take your pick kind of Right. It’s like  

Find something you like, whatever you’re used to, whatever you like, whatever you’re able to stomach. Yeah. Whatever you can take is what you should take. Like I, I just am not as worried about the ratio of VP and D H A. It’s all about the, the extremes are not great, but there’s so much available in the middle of it. Yeah. So that’s kind of, it’s not a, it’s a squishy answer if I have, if I have your number, I know I need you to be at a high dose and if I’m a doctor and I know a supplement that I like, then that would be great. Give them that guidance. Sure. But I just can’t personally be like, go for this supplement and this ’cause they just change all the time and there’s too many.  

Yeah, no, I mean, and there’s a ton of great options. So, so yeah. Really. What about, yeah, tell me about, so like let’s say, okay, I’m pregnant, I wanna avoid preterm birth. I get my, my omega three index to 6% or my D H A D H A to 5%, I deliver 40 weeks, I’m breastfeeding. What things am I thinking that omega three well, well status will do for me now and yeah. And why do I think, how do I think about getting another blood test versus like the breast milk test?  

So as you increase, the mom increases blood levels of omega threes, breast milk levels will be elevated, especially in the first six weeks after birth. So even if you kind of stopped supplementing right at birth or you needed to stop supplementing ’cause you were going too far, you’re going like to 42 weeks, then you can, I mean you can always start up again as soon as you’re done, but you’re gonna have a higher store in your body. So the breast milk is getting is a higher level. So d h a levels in breast milk move pretty closely to mom’s status and diet. It’s super interesting because we have a, a study that we collaborated on where the moms were just getting 200 milligrams a day in lactation and like a hundred percent of that d h A was going straight into breast milk and not affecting mom status at all.  

It’s, that’s motherhood in a nutshell right there. Just giving your whole everything to your kids that suck your life outta you. So  

They get all the first round of all the nutrients and moms hopefully maintaining.  

So, but it’s just, it doesn’t really d h a so like fat levels in breast milk change throughout the day and throughout a feed and all like, and, and that, but the, when we look at the percent of d h A in the fat, that is pretty steady and correlated to what mom takes in. So if you’re testing or something, we recommend trying to do the first feed of the day, but that’s like when, when does the day start? If you’re up in the middle of the night and then Right. Maybe doing it in the middle of the feed. But it doesn’t, it it’s very stable in that way because we’re looking at a percentage. If we were looking at an absolute concentration, d h A levels would be low in the four milk and high in the hind milk just because there’s more fat in the hind milk.  

Okay. So that’s a good, yeah, i, I was assuming you would just pump and you would mix up all the milk from the pump and just test that. But you can, you just like drip it onto the, you  

Can just drip it, you can do the, you can pump it and then just mix it up and take a drip. It’s pretty That’s  

So cool because some moms don’t even pump.  

I know. That’s so cool. I didn’t really pump a lot because I was, my child was with me jealous and she didn’t take a bottle forever. So I was like, I’m not gonna pump for this.  

I actually had one of those, the no bottle baby, like what is that?  

It was rough at the, as it went on it was  

Rough. He’s my sweetest one though, so I’m like, it paid off with you.  

I know. No, it’s, it’s so worth it. And it was, it was fine. So the, the same kind of outcomes with breast milk, the brain is still growing quite a bit. Yeah. Like the first two years it’s that first thousand days from conception to two years brain growth is in, is incredible in the first year of life. I mean, and you think about baby has to get out of your body with a pretty big brain, but it can’t be fully developed ’cause that no one would survive that. So it’s, the growth that happens is just huge. And this is where breast milk is a great source formula now typically has D H A and arachidonic acid that doesn’t, you can use some drops, they have like baby drops as you introduce foods you can always introduce fish when it’s appropriate. And, and there’s also like I use some drops just to put in milk and cereal or yogurt.  

There are lots of little ways, but breast milk and the mom having a good, good status, which she can, the breast milk and the blood are usually pretty well correlated. So the breast milk is probably what I’d recommend if you’re mostly breastfeeding testing breast milk, if it’s, you wanna wait at least a month so it’s not transitional milk or colostrum. Okay. So it needs to be mature milk for it to make sense. Yeah. And if you’re kind of low, so the percentages are totally different for this. So 0.3% of the milk fats being D H A is kind of a, a low but it’s a sufficient level again. But we see that women in the US typically are like 0.2, 0.1, 0.5, 0.15 or 0.2%. We’re trying to get 3%. Yeah. It’s very small. It’s like within 0.3 and 1% is where we see the most of the variety. And people who are eating fish in all different kinds of the world, all different parts of the world. That’s kind of the scale in milk. It’s just totally different.  

Yeah. But it sounds like you’re saying like maybe the average American woman could be sitting at like half of the minimum like frequently. Yeah.  

Yeah. And you, and for that 200 milligrams of D H A is typically enough to get you up to 3.3%. So it’s that that 200 is, I think it really is a pretty good number two to 300 milligrams to just cover the bases  

Two to 300 milligrams of DHA every day.  

Yeah. That’s on average usually gets blood levels to where they need to be. Yeah. But we do see good outcomes and women, like women in Japan have a 1% d H a. There’s some interesting studies and some different tribes where mom’s levels are about 8% D H A and breast milk is 1% and they kind of Yeah. Postulate that that is at that level. Mom is not depleting her stores. Oh wow. For that level. She’s actually, if she’s able to maintain 8% and the the breast ones at 1%, then she’s not depleting herself below that. Mom is probably depleting her own source. Like there’s some ev there’s some evidence that like as the pregnancies have you, as you have multiple pregnancies, you have lower and lower D h A levels. So  

I’m understanding research on that and like, and like depression, like  

Yeah. There was one of the big studies by the MCC group was on postpartum depression specifically. It’s a little different if you’re thinking about like long-term Yeah. Depression outcomes ’cause the postpartum depression, there’s some evidence on blood levels. This study did, the study they did with supplementation didn’t affect postpartum depression significantly. But there was like a Dr. Michael Crawford was, is one of the biggest omega three brain researchers. And he was like in the seventies he was like looking at the brains of all these animals on the savanna and like they didn’t have access to fish. Their brains really small and all this stuff. So, but he, his postulation was like if omega threes become very low in the general population and, and for pregnant women, as that happens, brain condi brain issues will start showing up And some of the, and so we’re seeing a lot of different kinds of brain issues for a lot of different reasons. But that was one of his hypothesis. And it seems like it is contributing to it. It’s not probably the only cause. But not having that good base of a omega threes during brain development can have long-term outcomes. But I don’t like, I don’t wanna freak anyone out with that. It’s not like, it’s not like  

Yeah I know  

You’re gonna, you’re guaranteed for this. None of this is like that. It’s all, it’s all just different levels of kind of risk and it’s like you’re maybe a little more likely or a little less likely.  

Yeah.  

With a whole bunch of other variables in there. But it is something that could potentially help if and it’s very safe and it’s a nutrient. So that’s kind of, yeah I try and live on that line ’cause I, I don’t like the stress that nutrition advice can come along with. It’s like we’re trying to help but we just made you feel terrible. So  

At the same time though, I mean I think it’s so important for to help women be well-informed because there’s so much confusion with like say the plant-based diet movement around like okay, I’m just gonna only eat plants and there’s omega three and flaxseed oil, there’s omega three and chia seeds. And so like if I think there’s so much of that around that women can kind of be deceived into thinking that that’s sufficient. And I in fact see that in clinic all the time of like I’m sure my omega three status is good because I make sure to have some, some flax seeds every day. So it is important to kind of get the truth Yes. Into the world that this humans were designed for omega three from animals. Like it doesn’t increase your omega three levels. D H A is not coming from flaxseeds. Yeah,  

Yeah.  

No it’s not. So it’s not the same thing.  

The flaxseed, if you take a ton of it, you can raise your e p A levels just a little bit and typically d h a levels don’t move with that. So that’s, that’s a really important point. If someone is vegan or vegetarian, there’s lgal D H A now. Yeah. Made from the algae. So that to me, if someone’s not having fish,  

Try to get them totally a great vegan alternative because the fish eat it from the algae so it just kinda skips, it skips the fish. And so hopefully that is a good source for individuals who are not replenishing. ’cause we, they’re gonna have stores in their body unless they’ve not touched, I mean they’re gonna have some amount of D H A in their body but they will get depleted so fast. And that’s where we start to see the outcomes happen is when you’re on the edge of deficiency, your body can’t over. Your body is gonna do everything it can to it. It’s robust, it has secondary systems for things. But if you push it to a point where you just aren’t giving it that nutrient, it’s gonna finally have some some outcomes where it’s not what you wanna be.  

Totally. I mean I think some often women are kind of walking in a situation where like without them realizing it, they’re about to get drained of their omega threes. Yeah. They’re, the world is kind of giving ’em these weird messages that maybe just having flax seeds or chia seeds is gonna fit work for it. Then they’re hearing oh, which is true, you shouldn’t be eating raw fish. But oh yeah. That can kind of get simplified I think into a message of like, well just don’t eat fish in general also mercury. So just don’t eat fish. I see that a lot of like, well I just stopped eating seafood as soon as I got pregnant. It’s like, no. So I think it’s just kind of the perfect storm right at this beautiful moment when like you’re building a new brain, you’re building a new human and like everything is forming And so I think it’s just such a like a blind spot. Yeah,  

It is. And I just actually gave a Ted talk on that exact like melding of worlds where this research on d h a fish based nutrient coming up against the years of the mercury story and the sushi issue. Just so much confusion for women. Yeah. And I don’t, and some and a lot of it is like well-meaning like the mercury stuff was well-meaning Yeah. It was just blown way out of proportion. Yeah. Like the original studies were on people who ate pilot whale buber for their traditional foods and that is a very rare thing to eat. And it’s a large fish. A lar I mean not a, it’s a large sea sea animal that has lived in the water forever. So they have really high mercury levels and it’s like that’s not what we’re eating. 

No,  

It’s  

Different.  

No. So it’s so important that clinicians like you have this are able, that’s like that’s again we’re testing might be able to cut through the noise and if a physician doesn’t want to debate a person about their fish  

Choices  

Because it’s stressful. 

Yeah.  

That person, they’re just trying to deal with all this information coming in. It’s like we can test you and then you can take a supplement. Yeah. And it’s fine.  

It works. That’s a I love you testing. It’s so inexpensive and so’s it’s like same, I it’s, it’s like instead of us just trying to sit here and like theorize about what might be happening, let’s just get you this little test. It’s like less than a hundred bucks. Yeah. It could change the course of like your health history. It could help with your prenatal development in the case of pregnancy and breastfeeding it’s like such a no-brainer. And then you have some data to work off of.  

Yeah. Yeah. This is actually one, it’s kind of surprising how strong this data is. Yeah. And nutrition. It’s just never that clear. I know.  

Yeah.  

But it’s been very exciting over the last like five years. These like big researchers Susan Carlson and Maria MCC are currently like in implementation in the hospitals that they’ve done their studies in where they’re trying their darnedest to get testing or at least questionnaires to the OBGYNs to identify women at low status or low intake and provide information to those women to say and and support and be like, this is a good thing. So the next step of educating the clinicians is kind of where the big research is at.  

I think a validated questionnaire would be really good.  

Yeah. That’s what they’re doing at in Kansas City right now. It’s good. Except there is something about having a blood marker. Yeah. That makes it easier.  

Oh yeah.  

You don’t have to have someone fill it out number one because that’s, that’s tricky a thing and it’s a little bit more of a yes no like there is a high correlation but it’s not between blood levels and fish intake. But it’s not a hundred percent. And it also then depends on dietary intake data is always fraught with you don’t really remember.  

Yeah. There’s nothing like a blood level  

Or they’re like trying to answer the way they think they’re supposed. Of course.  

Of course. So  

It could go either way. Yeah. It’s very normal in human. It’s not like oh that’s so bad. So that’s where I just like, let’s just, we already take blood for a bunch of stuff. Just add in fatty acid testing.  

I really wish that it would just be part of like a normal prenatal workup. That would be amazing.  

That’s kind of our next, like that’s our, we’ve been working in kind of the at home testing space and because it’s, it’s very hard to get new tests into the rotation with Yeah. It’s more of an insurance and lab and hospitals store like Yeah. Thing than, and we aren’t really in that world but that’s where I really feel like it needs to be in our bigger systems to have a big effect. ’cause we do see that D H A levels track with socioeconomic status.  

Yeah. The person who’s working with us it’s gonna pay out of pocket for the test is probably the least likely person that’s low.  

Correct.  

So what about everybody else?  

It’s exactly right. So if we aren’t able to put this where it needs to be, what do we expect to happen? It’s going to help status for women and I’m happy about that. But where the real, where the data shows the real impact is, is gonna be women of lower socio-economic status and just getting them the information they need and hopefully the right, like a product to them. Yeah. Early on in pregnancy could really, that’s where it’s most likely to have a pretty big effect on the preterm birth rates. So Awesome. You’re exactly right.  

So if you’re thinking about getting pregnant or if you are pregnant, if you’re breastfeeding it sounds like correct me on any of this. Get two servings a week of fatty fish, maybe max of one on tuna but otherwise cooked salmon and then those little oily, yucky fish. Yeah. Figure out if you can find a way you like eat anchovies or sardines and then consider getting your blood levels tested. Either pre-pregnancy, probably just go with the omega three index during pregnancy. You could do that or the prenatal D hha and then it sounds like you wanna be at least one month postpartum breastfeeding to get the the mother’s milk test and those needle then you can just drip the milk or pump the milk. Yeah. And go from there.  

I would say for the blood levels those usually take two or three months to change. Yeah. So if you kind of find out at like the 12 week mark, if you’re the early first trimester, early second trimester, you could take a first test and then you could take another one at the beginning of the third to make sure if you’re a clinician you can do it to make sure they have been taking anything. If you’re yourself, you can just do it to make sure you’re getting a good enough dose for the breast milk that changes really fast. So if you’re trying to bump levels up, you could test initially and then retest in two weeks or a month. Cool. Easily. So yeah, it’s different timelines.  

I love the repeat test after a couple months just to see if this product is moving the needle. ’cause there are quite a bit around like genetics and as well and like like you said, other inflammatory factors that play a role in like how much this, how quickly the status changes.  

Yeah. Yeah. I mean everyone is different. We see these averages but they are averages. So if something’s weird with your numbers, typically we can figure it out. There can be big absorption issues if you don’t take the supplement with food. Especially with fatty food  

Or any lots of other reasons for fat male absorption. Yeah.  

Yeah. So like you could be being very good and taking your supplement and you’re just not absorbing it. Totally. We have seen that like you can take 202,000 milligrams a day and your blood levels don’t change because of an absorption issue. Yeah. Usually changing the supplement or the taking it with food can usually help that. Yeah. Or dealing with the fat bowel absorption issue as well. Absolutely. Yay. So yeah, lots of fun, lots of things. Oh  

My gosh. So good  

Mess up nutrition studies. 

Yeah. Kristina, thank you so much and I know our audience is gonna be so grateful to hear all this. And maybe real quickly, I know you have to jump off, but where can people go if they wanna learn more about your testing?  

Omegaquant.com is where you can order your own testing if you’re clinician. We also have a healthcare provider ways to work with you. Lots of different ways to work with healthcare providers and we are on all the socials and I just did my TED talk which I think is called the revisiting the ban on fish and pregnancy or something like that that just came out like this last week Congrats. So you can just search my name and TEDx and it should and Phish or something and it should pop up. So that’s  

Congrats on that. That’s amazing.  

Yeah, it was fun.  

Well thank you Kristina, this has been awesome. We’ll make sure to link that in the show notes and definitely be available for questions. And just thank you so much for coming on the show.  

Thank you so much. This was fun. Alright,  

Same. Take care.  

Bye. 

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