By now the many benefits of fish oil and the essential fatty acids (EFAs) in it are common knowledge; in particular, the importance of specific EFAs, particularly DHA (docosahexaenoic acid) for infants and children is so widely acknowledged that it is now added to infant formula and has been a continuous focus of research  for a couple of decades.  The more we learn about these healthy fish oil fats, though, the more clear it becomes that they aren’t just for the littlest ones: ensuring an abundant supply for you and your child, from the moment you even think about conceiving, during pregnancy and throughout all the childhood years, is an intelligent – and intelligence-enhancing – gift that will keep on giving throughout their lives.

DHA in Pregnancy and after – the gift of a “better brain”

During pregnancy the only source of DHA is the mother’s intake from diet and supplements, and many diets are deficient in this nutrient – daily intake of DHA in U.S. women is estimated at about 50 mg., compared to 600-1200 mg. per day for Japanese women.    Several studies have affirmed the ”essential” nature of this fish oil fat for optimal brain growth and function (and for healthy retinal and vision development): mothers who supplemented their diets with DHA during pregnancy gave birth to children who scored higher on early childhood tests of mental processing and had greater head circumference (a measure of brain development), according to one study;  a 2008 Australian study looked at the effects of fish oil supplementation during pregnancy from 20 weeks to delivery, and found significant improvement in eye-hand coordination (a measure of brain function in young children) for these children at age 2 ½; in a third study, children of mothers who took DHA during pregnancy had better neurologic function at age 5.  Infants of mothers supplemented with DHA were calmer and had better sleep, too.

What’s the link between DHA and your baby’s brain?   During the last three months in the womb and during the first months of infancy, the brain has a “growth spurt”, requiring large amounts of the essential fatty acid DHA for incorporation into its tissues.  The more DHA is available to the child from the mother’s blood supply (in utero) and breast milk, the more the brain can soak up, and the better that brain develops and functions.  For mothers-to-be, a good daily dosage is 600-1200 mg. of DHA (there appears to be no toxicity) from dietary and supplemental sources (enteric-coated formulations can be easier on the digestive tract).

Fish Oil: Brain Food for Every Child

While the connection between DHA and brain development in infancy and early childhood is well documented, a 2011 study demonstrates that even at the age of 11, children whose moms take DHA during pregnancy  perform better on memory function and behavioral tests – pointing to a much more extended beneficial effect than has previously been recognized.  Another significant finding of this study was that those 11-year-olds who had higher blood levels of DHA at the time of testing scored even higher – which suggests that continuing to provide plenty of DHA throughout childhood is a very bright idea.  In my practice, I often prescribe child-oriented formulations which provide DHA in amounts of 100-200 mg. per day.

Mood, Behavior,  the “Alphabet Disorders” and EFAs

Brain health isn’t only about IQ, though; the brain is also the center of feeling and behavior – it’s where we “live” as humans.  The poet John Milton spoke of this most eloquently, in Paradise Lost: “The mind is its own place, and in itself/ Can make a Heav’n of Hell, a Hell of Heav’n.”  Too many children’s minds are bleak, unhealthy places where no one should have to live – driven in part by chaotic biochemistry, these beleaguered brains trigger poor behavior and foster emotional climates of chronic anxiety, depression, low self-esteem, mood instability, even rage reactions – an unfortunate recipe for misery in childhood and beyond.  These issues should be the exception in our youngsters but tragically, they are far too commonplace.  Depression, anxiety, dyslexia, OCD, ADD, ADHD, PDDNOS, ASD – there is a growing lexicon of names and acronyms for brain imbalances which, to a greater or lesser degree, have roots in disturbances of biochemistry and metabolism.  An incredible web of interconnection exists between brain centers, stress hormones, neurotransmitters, inflammatory substances and nutritional factors – and EFAs from fish oil are among the most important nutrients for maintaining equilibrium throughout this complex web.  Accumulated research evidence has clearly established the efficacy of fish oil/ EFAs for improving learning, behavior, and social interaction in children with developmental and psychosocial problems.

Supplementing with fish oil is a simple and effective way to begin to heal your child’s brain chemistry.  When prescribing for the vulnerable young groups described above, I may suggest dosages of DHA and its sibling, the anti-inflammatory Omega-3 EPA, which are several times the usual supplemental amounts.

Deficiency Signs

What are some hints that your child is deficient in the Omega-3 fatty acids?  Does s/he have dry skin? Rough elbows?  Even if these signs are only noticeable in winter (when the lubricating effects of the EFAs are most needed), they are telling you that your child’s EFA levels are marginal at best.  Eye irritation, blinking frequently, rubbing the eyes, can all indicate a lack of the lubricating EFAs from fish oil.  Skin problems, from cradle cap to eczema, from seborrheic dermatitis to acne, have a connection to EFA deficiency and warrant supplementation.  Allergies and asthma, similarly, benefit from EFA supplementation and suggest deficiency states.

Does your child have learning, behavioral, developmental or mood issues that may not meet criteria for a specific diagnosis, but are nevertheless limiting his or her potential and negatively affecting your family?  Think EFA deficiency.   And, because the diets & lifestyles which promote such deficiency tend to be familial, think EFAs for the entire family!

Finally, if you really want to get a precise picture of your child’s fatty acid status, testing is available through special laboratories which provide this kind of analysis for naturopathic and other functional medicine physicians.

How to Choose a Fish Oil Product

If there were one supplement I could prescribe for every child, it would be an excellent fish oil, made by a manufacturer using high standards of quality control.  A high-quality fish oil/ EFA supplement will probably cost more than many, but do take care to choose one manufactured in a facility which adheres to pharmaceutical-level production practices; which is third-party assayed for contaminants (mercury, arsenic, cadmium, dioxins, PCBs); and is stabilized with natural antioxidants (such as tocopherol [vitamin E], ascorbyl palmitate [a form of vitamin C], rosemary) to reduce the rate of deterioration in the bottle.  Quality supplements meet or exceed standards for fish oil purity set by IFOS (International Fish Oil Standards), GOED (Global Organization for EPA and DHA), U.S. EPA, and CRN (Council for Responsible Nutrition) organizations.  These products are often molecularly distilled, pharmaceutical-grade, and sustainably sourced; their labels are specific as to the marine animals from which the oils are extracted (eg. salmon, cod, mackerel, calamari, sardines, herring, krill).  A good fish oil supplement can have a slight seafood smell but, in the same way that the fish you buy for dinner can smell cleanly of the ocean but should not smell very “fishy”, it should not smell or taste (or burp) excessively of fish – this suggests rancidity.  And most children’s formulas add natural fruit flavors which make them quite tasty.

Grandma’s tales of being dosed as a child with cod liver oil speak to the long-recognized, powerful benefits of fish oil in many areas of children’s health and growth.  By taking the simple step of adding fish oil supplements to your child’s diet, you are supporting them in becoming the very best they can be.

Is your diet as healthy as you think?

One of the most frequently asked questions in my work as a naturopathic physician is “I eat pretty well, doesn’t my diet give me the nutrition I need?”  The answer is, it all depends:  is your diet really as healthy as you think it is?  What standard are you using to gauge the quality of your food intake?  We now have ample evidence confirming that a nutrient dense, low glycemic burden (blood-sugar stabilizing) diet, rich in plant nutrients, healthy fats and fiber, supports good nutritional status, health and vitality; in contrast, the standard American diet (the so-called SAD diet of refined, adulterated foods which have journeyed from distant processing facilities to reach your table, losing nutrient value along the way) is more and more associated in medical research with the chronic health issues which have unfortunately come to be accepted as part of the aging process.

To the extent that your otherwise good diet contains elements that require your body to make withdrawals from its nutrient supply to metabolize them (the white-flour bagel you grabbed on the way to work this morning, the mid-afternoon cookie to lift your energy, that glass of wine with dinner), nutrient deficits can develop over time. No matter how your diet would measure up on close examination, even the most health-conscious among us has difficulty maintaining dietary perfection 100% of the time (and the pursuit of perfection carries health risks of its own!) – so supplementation to cover our nutritional bases has value from this point of view.

Toxins and Nutrition

Another consideration is the additional burden of toxins we encounter daily in modern times, a nutrient-depleting phenomenon of proportions for which we humans were never physiologically designed.  From the phthalates in  body lotion to the lead in lipstick to the styrene packaging beneath (even organic) chicken breasts and the acetaminophen we may take for aches and pains, each chemical requires a constellation of vitamins, minerals, amino acids and nutrient cofactors to complete its journey through and out of our bodies.  When we lack the nutrient support to make these detoxifying pathways run well, we store toxins in our body tissues, where they can impact health now and over the entire course of our lives.  Supplemental nutrients can support better toxin temoval from the body, providing proactive protection from our brave new toxic world.

How’s your digestion?

Our digestive tracts are beautifully designed to transform your breakfast, lunch and dinner from macronutrients (proteins, carbohydrates and fats) into micronutrients (such as vitamins, minerals, amino acids, and essential fatty acids), and to convey them by elegant mechanisms from your intestines into your blood stream and lymph channels.  “White foods” such as refined sugars and flours, alcohol, food allergens, inflammation, and stress compromise the effectiveness of digestion.  If you belch, or experience odorous flatulence and/ or abdominal bloating, one reason may be maldigestion, or ineffective breakdown of foods into usable nutrients.  If you have had your gall bladder removed, whose function is to store bile for fat digestion, you may not thoroughly digest fat-soluble vitamins (vitamins A, D, E and K),  important fatty acids and other fat-containing nutrients such as phospholipids, essential for healthy brain neuron and cell membrane receptor function.  If like many, your stomach acid production has declined over the decades, if you take antacids or a proton-pump inhibitor, the reduction in gastric acid changes the pH (acid-base balance) not only in the stomach, but throughout the “downstream” digestive tract, interfering with normal activation of digestive enzymes and the breakdown of foods.  Any of these digestion-compromising factors can create significant, multiple nutrient deficiencies.

How’s your absorption?

You may have heard the saying, “You are what you eat.”  This is true, but equally as important, we are what we digest – and what we absorb.

Part of the elegant design of the digestive tract is the refinement of the absorbtive processes for specific nutrients.  An example is the narrow range of acidity required for absorbtion of minerals such as calcium and magnesium, and amino acids such as tryptophan, which in the body is used to make the anti-depressant neurotransmitter serotonin.  Health issues or medications which reduce stomach acid levels (as discussed above) affect not only digestion, but also absorbtion of these and other nutrients.

The lining of the small and large intestine is the interface across which nutrients must travel to be used by the body to nourish cells, manufacture molecules, build muscle, bone and tissue, and help us live our lives energetically and healthfully. If the lining of the intestine becomes damaged or chronically irritated by inflammatory effects of toxic foods (an example of this is gluten intolerance or celiac disease, but any food has the potential to exert inflammatory effects on the membranes of the digestive tract); by immoderate alcohol consumption; stress; medications (such as non-steroidal anti-inflammatory medications and aspirin; or steroid drugs); microbe imbalance in the form of unhealthy bacterial, fungal, or parasite overgrowth; or any combination of these – nutrient malabsorbtion and nutrient deficiency are common effects.  It should be noted that malabsorbtion and the causes for it often exist below the level of our awareness, unless and until the process of inflammation becomes well advanced.

Biochemical individuality and nutrient needs

The biochemist Roger J. Williams, Ph.D. used the term “Biochemical Individuality” in his 1956 book of the same title to describe the uniqueness of each person’s nutrient requirements, based on genetics and other influences.   In contrast to the concept of RDA (Recommended Daily Allowance), which uses a generic calculation based on a review of currently available scientific literature to determine nutrient needs for “most people”, the principle underlying biochemical individuality disputes the idea of an average person, and says that biological diversity even between people who seem physically similar would dictate an individualized approach to determining and meeting nutritional needs.

Even within a given individual’s lifetime, nutrient needs vary widely as circumstances change.   Acute and chronic illness, stress, medications, injury or surgery, dietary changes, and environmental exposure present different nutritional requirements for healthy body function.  If you are fighting a cold or flu, or if you burned your hand making dinner last night, your nutrient requirements increase.  If you have been working longer hours, have been taking a cholesterol-lowering agent, are worried about finances or your child heading off to college, have undergone chemotherapy or radiation, your nutrient requirements are altered.  If in the past there was an extended period of time when your nutritional status was compromised – let’s say in college years when poor diet may combine with “recreational” drug and/or alcohol use – you may have created a “pothole” of ongoing nutritional deficit in the road of your life.  It can be difficult to repair such damage to nutrient status without intensive, “super-dietary” nutrient intake from supplements.

Nutritional Supplements as Therapeutic Tools

Using nutritional supplements in these ways, to repair the effects of present or past deficiency, or to protect against negative health consequences of current dietary insufficiency, digestive incompetence, environmental stressors, or medications, is part of my role as a naturopathic physician.  Beyond prevention and repair, though, is the realm of using nutrients with therapeutic intent, to improve health outcomes in acute illness and chronic disease.  Evaluating current nutritional status using physical signs and symptoms and laboratory testing, identifies of areas of need and appropriate supplementation.

Most of my work with nutritional supplements is in this area, grounded in the extensive and growing body of scientific evidence for the clinical benefits of such use, and the deep awareness that as humans, our physiology is based on biochemistry, not chemistry.  Nutritional approaches to treatment work in alignment with our biology and honor our human nature as biochemical beings.

How healthy do you want to be?

This may seem like a silly question with an obvious answer, but years of working with people and their health concerns has taught me that not everyone has the goal of “optimal health”.  Some seem fairly content with the assortment of illnesses, aches and pains, medications and procedures, and limited “vitality expectancy” which have come to be part of our cultural health standard.  If we define health as “the absence of disease”, nutritional supplements may seem expensive and unnecessary.  If the World Health Organization’s description of health as “a state of complete physical, mental and social well-being” is more compatible with our beliefs, we are more likely to consider nutrient supplementation as one way to preserve and increase our well-being.  For some, the idea of taking supplements feels too much like taking medication, and they prefer to focus on optimizing diet to create wellness.  Certainly, to eat and drink well, exercise, and develop strategies for healing from the stresses and toxic influences of our lives today – these are essential elements to create health and well-being, and supplements alone will not replace them.   However, to use supplements in conjunction with a healthy lifestyle can provide the benefits of each and the synergy of all for greater wellness.