eating for health

A tour around some Omega-3s

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When clients come for an initial consultation they often tell me they’re already taking an omega-3 supplement. Sometimes it’s on the advice of a physio for a painful knee, or a dermatologist for a skin complaint, an optometrist suggesting it may help protect against macular degeneration. Others have read an article, a book, or listened to a podcast explaining how certain omega-3 fatty acids might help heart or brain health, or their rheumatoid arthritis, or even increase life span.

This is all to some degree true.  Either there is evidence showing clear benefits, or at least promising possibilities.  Certainly good reason for these fatty acids to be on everyone’s radar.  If we understand what they are, and how they might support our health, we can make more informed choices about what we eat and whether or not supplementation is right for us.

So here’s a tour – shorter at least than a full-day seminar these fatty acids could easily warrant – focusing on two omega-3s which have held centre stage in the health world for several decades.

What’s in a name? Are omega-3s, fish oils, and EPA/DHA all the same?

Omega-3s are a family of fatty acids (= components of dietary fat).  The name “omega-3” comes from their chemical structure, and not, as someone once suggested, because there are three fatty acids in this family.
These three key family members all have tongue-twister names, thankfully shortened to acronyms:

  • ALA (alpha-linolenic acid): a plant-based omega-3 with excellent health benefits of its own (a topic for another time or else this blog will turn into a book).
  • EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid): two marine-based omega-3s that will be the focus of this tour, owing to their wide-ranging health benefits and the extensive body of research surrounding them.

Where do EPA and DHA come from?

Unlike cholesterol, our bodies can’t make EPA and DHA, which is why they’re called ‘essential’ fatty acids because we have to get them from our diet – from fish.

All fish contain some EPA and DHA because they either eat microalgae – the original source of these fatty acids – or they eat smaller fish, which have eaten microalgae.
Good news for plant-based eaters since microalgae supplements are widely available, and more food products are now being fortified with algae-based EPA and DHA.

Back to fish!  While most species contain some omega-3s, fatty fish are definitely the stars of the show. Cold-water fatty fish like salmon, mackerel, anchovy, sardine, and herring (SMASH, an easy acronym) store more fat, and therefore have more EPA and DHA than lean white fish. They need these fats for energy in cold waters and to keep their cell membranes supple.  EPA and DHA have similar effects in the human body, helping our arteries stay flexible and making blood ‘thinner’ or less sticky. Both actions are part of their bigger heart-protective role.

Given this marine link, it’s easy to see why the names EPA and DHA are often used interchangeably with “fish oils,” but I’m going to nitpick here:   fish oils contain EPA and DHA, but they also contain other nutrients such as vitamin D, vitamin A, and various minerals.
This is important when you’re supplementing.  If it’s specifically these two anti-inflammatory fatty acids, EPA and DHA, that you’re after, do check the supplement label.  A bottle may state “1000 mg fish oil”, but the ingredient list may show it only contains 200mg EPA and 120mg DHA.  Or, as someone recently discovered, as little as 18mg and 25mg.

How much do we need?

General recommendation is around 1000 mg per day, although some sources suggest lower, around 450mg, and some clinical trials use much higher doses.
Acording to Dr Bill Harris in this Zoe interview  an average serving of oily fish contains approx 1200 mg EPA & DHA, so, ideally, we should be eating some sort of oily fish around 4-5x weekly.

In the above podcast interview Dr Harris adds that DHA and EPA in supplement form can be in any ratio; a split like 600mg EPA to 300mg DHA is fine.
The reason for these varying ratios is due to research suggesting the two fatty acids have different qualities.  DHA may be more supportive for brain health, whilst EPA may be beneficial for mental health and depression.  EPA is also thought to have stronger anti-inflammatory effects and also might be better for heart health.
However, as a believer in the ‘whole being greater than the sum of its parts’, and given that fish and microalgae contain both these fatty acids, I usually like to recommend supplements with similar (ish) ratios.

The elephant in the room: contaminants

One concern with fish oil is heavy metal contamination. Mercury often gets the spotlight, but other heavy metals can accumulate too, depending on where fish live.

Large, long-living predatory fish at the top of the food chain tend to build up the highest levels (for example, tuna, swordfish, shark, king mackerel, and marlin), so, avoiding these will help reduce your toxic load.

Here are some useful links on safer fish choices (USA based):

US FDA: Advice about eating fish (PDF) Advice for pregnant women, but with a mercury section

And the NRDC fish guide

High-quality fish oil and microalgae supplements are normally screened for contaminants and companies will often detail their purification processes online.  If not, you should be able to email them and ask if these processes are in place.
You may find IFOS (International Fish Oil Standards) certification on some labels, which means there has been third-party testing for contaminants.

A quick aside here:  not all supplements are created equal.  Price will often reflect quality, although, saying that, you don’t need to buy the most expensive omega-3 supplement on the market.  There are good options that are more affordable.   More important is to be wary of random “special offers” online unless you know the product and its quality control.

As for microplastics and BPA, they are a huge problem we’ve created in our plastic-riddled world.
I read that some supplement companies are using ultrafiltration techniques regarding the removal of micro plastics, but I believe this is more to do with the water where sustainably farmed fish live.  I haven’t found reliable or consistent information about the guaranteed removal of BPA and micro plastics in fish oil supplements sourced from ocean fish.
If you have, please let me know!

Meanwhile, the best we can do is:

  • Minimise new plastic purchases.
  • Reuse and recycle where possible.
  • Stick to the safer oily fish choices mentioned above.
  • Choose supplement brands which are transparent about contaminant testing.
  • And finally, support your body with a high-antioxidant diet, that rainbow-on-your-plate, which is at least 30 different plants, herbs, and spices a week.

Inflammation:

The first time I learned about EPA and DHA at college, it was concerning their anti inflammatory support.
Inflammation is a natural process: we get an infection or we cut ourselves and subsequently have an acute inflammatory response that’s geared to clearing the pathogen, or making us want to remain immobile so we rest and heal.  A temporary inflammatory response.
Chronic inflammation, however, is a prolonged even ongoing response, and it plays a role in many of today’s illnesses, whether it’s something as harmless as hay fever or as serious as heart disease, diabetes, cancer and neurodegenerative disorders.    

There has been considerable research into the effectivement of omega-3s and auto-immune conditions like rheumatoid arthritis, IBD, psoriasis and asthma.   Studies are promising but “still more research needed”.  However, there are convincing results regarding rheumatoid arthritis, with omega-3 supplementation improving joint health and lessening morning stiffness, tenderness and pain.   

Brain and eye health

About 60% of the brain is made of fat, with DHA forming a vital structural part.  It’s therefore no surprise that omega-3s play a significant role in brain health during all phases of life, from pregnancy, where they may lower the risk of preterm birth, to foetal brain development, right through to old age and their potential to lower the risk of dementia.

Here is a link disussing maternal DHA status during pregnancy & its impact on infant neurodevelopment, Nutrients, NLM, 2020

And brain health researcher and neuroscientist, Louisa Nicola, discusses Alzheimer’s and omega-3 near the end of this fascinating podcast with Dr Chatterjee

Dr Bryce Appelbaum, a neuro-ophthalmologist in the US, notes that “good levels of omega-3s are associated with larger hippocampal volume”, which translates to “improved memory, learning, reasoning, and enhanced neural communication, with a lower risk of vascular dementia”.

Interestingly, studies also suggest omega-3s, especially EPA, may support mood disorders such as depression.  The evidence is still mixed, hence ongoing research is needed, but consider how easy it would be to try increasing your oily fish intake to the recommended amount, and see if it helps your depression!

Regarding eye health, many opthalmologists recommend omega-3 supplementation for numerous eye conditions.  These range, a.o. from dry eyes and blurry vision to its possible benefits regarding glaucoma.  Given that the retina, at the back of our eyes, has the highest amount of omega-3s in our body, it makes sense that EPA and DHA play a supportive role in the health of our eyes.

Longevity

“Biological age reversal” has become such a buzzword, with a lot of focus on intermittent fasting, resistance training, nasal breathing, cold water immersion to name but a few.

EPA and DHA appear almost every time there’s a longevity discussion, whether in research, books, or podcasts.  This may be due to their anti-inflammatory role or heart and brain protection, or potential cancer-protective effects.  In addition, some studies have shown that omega-3s may play a role in the biology of our telomeres (the caps on our DNA), slowing cellular ageing, although results regarding this are inconsistent (which could be due, in part, to differing dosages and the types of supplements used, not to mention the exisiting variations in the participants’ diets).

If you’d like to learn more I’d recommend podcasts or interviews with some doctors considered experts in this field, such as Drs Peter Attia, Andrew Huberman, Steven Gundry, and Mohammed Enayat.

Heart health

Omega-3 supports the heart in many ways:  making blood less sticky and reducing clot risk, keeping vessels supple and improving blood flow, stabilizing heart rhythm, lowering triglycerides.

In recent years some studies have raised questions.  Results have been inconsistent or confusing, so more research is needed.  A meta-analysis of a number of clinical trials suggest slight risk of atrial fibrillation among high-risk heart patients taking a very high dose supplementation (3–4g daily).

This Zoe podcast interview with Dr Bill Harris (founder of OmegaQuant omega-3 tests)  gives a good summary of well-researched omega-3 benefits, some of which I’ve incorporated into this blog, as well as some interesting points he expresses relating to the above atrial fibrillation results.
Another link related to this AFib result is also here in this Omegamatters video.

In spite of inconsistencies to do with supplementation, dosages and effectiveness in some trials, when it comes to a heart-healthy diet it’s widely agreed upon that omega-3s from food, such as oily fish or microalgae fortified foods, are safe and very beneficial.

Gut support

Our microbiome influences so many aspects of our health, from our immune system to metabolic health and beyond, so it’s fascinating to read that omega-3s can exert positive changes in our gut.

This abstract discusses how a diet providing 600 mg omega-3 daily boosted production of butyrate, a beneficial short-chain fatty acid with well documented anti-inflammatory effects. (PubMed abstract)

The afore-mentioned benefits of omega-3s to mental health may not simply be about levels of DHA and EPA in our brain and nervous system, but also the beneficial changes these fatty acids bring about in our microbiome.  Another example of the gut-brain axis at work!

Other health benefits

Research is on-going in so many other areas of health, from reducing the risk of cancers to potentially supporting bone health or helping reduce the severity of headaches to name but a few.

  •  Here an article regarding breast cancer  based on the DO-HEALTH trial of over 2000 older people, showing omega-3s’ potential in lowering the risk of breast cancer.  “Vitamin D, omega-3s and exercise may reduce cancer risk in older people”  Breastcancer.org, 2022
  •  And “The influence of PUFAs (polyunsaturated fatty acids) on the deveopment of skin cancers,  Diagnostics, NLM, 2021
  •  And this publication from the Medical Journal of Oncology, looking at the “Benefits of a high omega 3 and low omega 6 diet over a year in reducing a biomarker for prostate cancer progression and metastasis…”; ASCO publications, Medical journal of Oncology 2024
  • Despite observational studies suggesting benefits of omega-3s regarding osteoporosis, clinical trials show mixed results.  Nonetheless, this paper makes for an interesting read indicating how a higher omega-3 intake was inversely associated with osteoporosis risk, Frontiers in Nutrition, NLM 2025.
  •  And here, a video clip on headaches  by Dr Huberman, discussing how omega-3s may help “multiple types of headaches” and reduce their frequency and intensity.  Dr Huberman has many links to omega-3 benefits if you want to do one of his omega-3 tours!

Testing your levels

NHS doesn’t offer omega-3 testing, and medical professionals will probably give you a blank look if you ask to be tested.
There is a home kit test available in UK, The OmegaQuant Index test, founded by Dr Bill Harris (and no, I have no affiliations!)  It’s an easy finger-prick test available to order online, which measures red blood cell levels of EPA and DHA.
The recommended test result is  8% or higher, however average levels are often very poor, closer to 3–5%.  As processed food intake has increased, the consumption of fish appears to have declined.

We are all unique, and will absorb and utilise nutrients differently.  If a group of us took the same daily dose of omega-3s, our blood levels would likely vary.  For this reason it’s useful to have a base line so you know YOUR levels so you can then decide whether you need to increase SMASH fish, or add a supplement or simply continue with your current diet.

Rounding off the tour

This was never meant to be an omega-3 world tour, so I’ll stop now.

There is no magic bullet to better health, no single pill or one food.  However,  with all the comprehensive research and promising outcomes in so many different areas of health, I hope this tour has highlighted how these two omega-3s are worth having in your life.

 

References

  • NIH: Omega-3 Fatty Acids Information Sheet
  • Frontiers in Nutrition (2025): Insight into the effects of omega-3 fatty acids on gut microbiota
  • ScienceDirect (2016–2024): Omega-3s in neuroprotection and inflammation
  • BMJ Medicine (2024): Regular use of fish oil supplements and cardiovascular outcomes
  • NED Nutrition Evidence Database (2020): Effect of Omega-3 on cardiovascular outcomes
  • UK Biobank (2025): Fish oil supplementation and atrial fibrillation risk
  • Nature (2025): Omega-3s and biological ageing
  • MyVisionFirst.com: Which supplements to take for vision
  • American Heart Association Journals (2023): Are you getting enough omega-3s?
  • Huberman Lab resources
  • Healthspan (2024): Omega-3 benefits for heart, brain, and eye health
  • British Heart Foundation (2024): Omega-3 foods and your heart
  • Zoe Podcast (2025): Omega-3s and brain health
  • The Longevity Paradox, Dr Steven Gundry

 

Vegan savoury strudel, gf and df

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This recipe was inspired by Elke’s Austrian take on a Greek spanakopita (spinach pie).  Instead of the usual triangle slices of a traditional spanakopita, she opted for the strudel “log” shape, and added loads more delicious spinach than one normally finds in these pies.
I’ve tweaked the recipe yet again by adding more vegetables to the spinach.  So it’s no longer a spanakopita but a roasted sweet potato, spinach and leek ‘strudel’!  And with a gluten-free puff pastry and dairy-free fetta; a vegan version to see how it works.
Worked a treat!

The store-bought ‘Jus-roll’ gluten-free puff pastry makes it all so very easy and quick.  And Violife’s vegan Greek fetta is delicious and a great option for anyone going vegan, or with a casein (dairy protein) or lactose intolerance.
You can steam the sweet potato cubes, definitely the healthy option, but as I was roasting a lunch the day before I decided to add the sweet potato cubes to the oven; also the pine nuts right at the end.  Less work the following day when I was playing with this recipe.

Ingredients:

For six slices

1 packet Jus-roll gluten free puff pastry (or regular Jus-roll puff; or filo.. shortcrust, whatever you like)
400g packet spinach, roughly chopped
green part of one leek, finely sliced
3 cloves garlic, squeezed (two at the start, one added near the end)
1 large sweet potato, about 250g, cubed, then either roasted or steamed before you start your log
dollop of olive oil for a light fry and to lightly brush onto the log before baking
80g toasted pine nuts
100g Violife ‘Greek white’ (or non vegan, regular Greek fetta)

Method:

If you haven’t roasted your pine nuts, nor your cubed sweet potato, do this first.  When done put aside where no one will be tempted to have a nibble.

For the filling, pour a couple of tablespoons of olive oil in a pan on a medium heat then add the sliced leek and 2 of the pressed garlic.  Gently fry until the leek’s transparent.
Toss in the roughly chopped spinach and wilt.  Hover near the pan otherwise your delicious leafy spinach pile will vanish to an overwilted green sludge.  The same goes for the pine nuts, keep close, for if you leave the kitchen even for a moment they are bound to burn.  Hover.  Keep watch.

Add the roasted/steamed sweet potato cubes to the pan of spinach to warm through, then that last garlic clove.  Stir in the roasted pine nuts.

Wait for everything to cool before adding the crumbled fetta.

With ‘Jus-roll’ you can literally unravel it from the box and start filling it with your cooked veg, so easy.
However, if it’s too thick for your taste roll it thinner and larger.  Whatever you decide, ensure you have parchment underneath it (the paper it comes wrapped in its box), so you can easily lift the filled roll onto the oven tray.

Spoon the filling along the long side of half the pastry, leaving a clear 2-3 cms edge all around so you can seal it without the filling oozing out.  To make your log just fold over the pastry and, with water-wet fingers, press the edges closed then go over them with a fork to create a neater, tighter finish.  Brush with oil and prick the pastry, to stop a gap forming inside as it cooks.

Bake in a moderate fan oven, about 180 C degrees (c350 F), until light golden brown, approx 30 – 45 mins (depending on everyone’s unique oven.  Like us, they have personalities and might decide to take longer to colour your strudel).

Slice and serve with a leafy colourful salad, or as part of a delicious summer garden spread.

Kali oreksi! Bon appetit x

 

Writing about writing

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Writing has always been part of the journey to health, except in the past its benefits weren’t really recognised or appreciated.   It certainly didn’t have the current title journaling, which in my world is still just writing (or in my younger world, was called Dear Diary and generally came with a padlock – perhaps you had one of those too?)

Whether you call it jounaling or writing, by doing it you can start figuring out the triggers that affect you emotionally, the ones that unleash upset or resentment, or a funky mood. Or the triggers to physical symptoms, to your bloating or nausea, your headaches or joint aches.  Just as you can write down triggers for your happiness and well being.  More about that later.
Writing can organise endless mental lists and tidy up an overwhelmed mind because it gives you an accessible way of untangling it all.

Case in point: the next time you wake in the dead of night with niggles circling your mind, write them down straight away with that pen & paper by your bed – and the smallest beam of torch so as to not rock your melatonin levels.  This way you can corrall the mental noise into neat lines of penned words, logged and sorted for you to look at in the clear light of morning.

The same with gratitude lists, or whatever you wish to call them.  That happiness and well-being I mentioned above.
When life’s feeling great it’s invaluable – uplifting! – to think about, and then write down, what’s actually making life feel so good.  A gratitude list can come into its own again when life’s slinging mud at you.  Writing down, and thus reliving, the good in your life can diffuse the intensity of harder times.   It’s not easy when you’re in the thick of it, when those mud-slung quagmires are so sticky.  However, by zooming out of the crabby moments and opening up the wider picture of what’s going well for you and who’s there to support you,  there are new neuronal connections being made, new parts of your brain being fired.  The result is that you feel better.

My gratitude list often starts off as a photo, maybe with a one liner floating in my head; a good to be alive moment when I catch dawn’s pinking sky or see lambs in the neighbour’s field.   At some point those feelings make it onto paper, either as a diary note, or part of a blog or a letter to a friend.

Asking clients to write a food diary is part and parcel of my work.  I email a basic formatted chart asking my client to record a week of meals, snacks, drinks and any symptoms.  It’s necessary because memories can be short or skewed.  There can be an aspect of denial involved, for instance, a piece of chocolate quickly scoffed might be forgotten a moment late.  Just like that morning biscuit which happened to come with the cafe’s coffee, or the bag of crisps with your drink (such a small bag, does it even count, a client joked last week).

Writing about your daily foods and habits can throw up patterns.  Perhaps you’re eating bread or rolls or crackers and pasta every day.  Or eating more fruit than you realize – that fructose sweet hit you think is healthy unfortunately still translates in your body to sugar).
Or perhaps you’re eating the same vegetables every night, all good for you, but not the variety that’s going to give your microbiome a diverse and immuno-supercharged microbial population.

It can be hard recognising your own eating patterns, that’s almost a given.  Food is linked to habits and memories, to comfort and love, as well as to sleep, hormones and whatever else is going on in your life, body and mind that very day, that very moment.   When clients email me the completed week’s food diary I often see: “I didn’t realize how many coffees I was drinking,” or “I don’t normally eat this many snacks.” (Hmmm, but maybe you do…)
Writing is your truthkeeper.

I can’t ignore the obvious act of writing which pops up at this time of year.  New Year Resolutions. For some reason I came across a lot of podcast and media commentaries about how we shouldn’t make resolutions because invariably they fail.
I think this is dependant on how realistic you make them…

I’m not a big fan of  writing a formal list, are you?  The page header alone:  New Year Resolutions, puts me off writing things down.  Just too concrete, too much pressure for a year that hasn’t even begun.  Saying that, I do like to ponder the year ahead, especially during the week between Christmas and New year when there’s a lot of pondering time to be had.

Perhaps I don’t usually make a written list of resolutions aka dreams aka intentions because I don’t have that many to remember (or forget).

This year, however, I did think of a few, all do-able and realistic for me.  And that is key.  It’s a simple thought to share with clients when we talk about changing diets and life patterns, or when clients say they want to lose x amount of body fat by spring, or do x number of hours training each week, or want to give up biscuits (chocolate/cakes/alcohol, take your pick). Make it simple.  Be kind to yourself and start  realistically, start small.  That way you’ll likely stick to it.

As Dr Rangan Chatterjee recommends on his podcast and in his books, build a new habit into your day, into an existing routine, and it’ll be sustainable.

One of my new year non-resolutions – let’s call it an intention – is to do a new walk every week.  But even as that intention popped into my head and I scribbled it down here I’m adding that I’d be happy if it turned into a new-walk-a-month rather than a week.  I know that work and life can get in the way.
Am I backing out?  I’d rather think I’m being realistic, but I’ll let you decide.

I hope you find some writing form that suits you, and wish you all a happy new year!