
Dr. Rhonda Patrick on DHA in Phospholipid Form and the Prevention of Alzheimers - dtawfik1
https://zenpatient.com/blog/dr-rhonda-patrick-on-the-role-of-the-phospholipid-form-of-dha-in-apoe4-alzheimers/
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jmole
Rhonda Patrick is one of my favorite people to listen to. She did a great
interview with Joe Rogan talking all about health, digestion, nutrients,
diets, etc.

[https://www.youtube.com/watch?v=9M8X_bs_fzI](https://www.youtube.com/watch?v=9M8X_bs_fzI)

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MikeCapone
Her podcast has been a great source of interviews with interesting
researchers. Her guest appearances have also been great (she's been on Peter
Attia's podcast).

~~~
udfalkso
Here are some great notes from her talk with Peter Attia:
[https://podcastnotes.org/2018/07/03/attia-
patrick/](https://podcastnotes.org/2018/07/03/attia-patrick/)

(Disclosure, I'm part of the podcastnotes team)

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rhondapatrick
The paper is open access, so the full text is available sans paywall. :) Worth
checking out if for no other reason than to appreciate the figures!
[https://www.fasebj.org/doi/10.1096/fj.201801412R](https://www.fasebj.org/doi/10.1096/fj.201801412R)

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cgh
If APOE4 combined with reduced DHA impairs glucose transport into the brain,
would increasing blood ketone levels help sidestep this issue (along with
increasing dietary DHA of course)?

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gumby
When you eat oily fish you are eating the same oil that is expelled and
inserted into a capsule. So how is the form changed?

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mrob
The natural oil in the fish is found as triglycerides and as phospholipids.

A triglyceride is an ester made from three fatty acid molecules attached to a
glyerol molecule (you get esters by reacting carboxylic acids with alcohols,
and glycerol is a polyol alcohol with three hydroxyl groups). A phospholipid
is very similar except one of the fatty acids is replaced by some hydrophilic
molecule that's attached to the glycerol via a phosphate group.

The problem from a commercial point of view is that the fatty acids are mixed,
but fish oil is only sold by EPA/DHA concentration. Nobody will buy natural
fish oil because the EPA/DHA levels are too low. The solution is
transesterification, where the glycerols are removed and replaced with
ethanol. Ethanol is an alcohol with only a single hydroxyl group, so it can
only form an ester with a single fatty acid. Now that all the fatty acids are
in separate molecules, you can distill off the lower boiling ethyl esters of
short chain fatty acids. EPA and DHA are long chain fatty acids, so their
higher boiling ethyl esters will be left behind.

Theoretically could transesterify the ethyl esters back to triglycerides
again, but when you can just sell the ethyl esters as "fish oil concentrate"
there's no reason to.

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nate_meurer
This is an excellent, concise, clear explanation, thank you.

> _fish oil is only sold by EPA /DHA concentration. Nobody will buy natural
> fish oil because the EPA/DHA levels are too low._

So only free fatty acids are allowed to be listed on the label as EPA/DHA?
They're not allowed to count any esterified fatty acids?

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mrob
I don't know the details of labeling laws, but I believe fish oil is most
commonly sold as ethyl esters, and this is called "fish oil concentrate". Free
fatty acids are considered a defect in edible oils. They taste rancid and make
the oil decay faster. Triglycerides and ethyl esters both get digested in the
small intestine by pancreatic lipase enzymes, releasing free fatty acids where
you can't taste them. Both raise blood levels of free fatty acids, and the
quantity of ethanol released from the ethyl esters is small enough that I
think it's very unlikely to matter.

But as the article points out, phospolipids get digested differently, and
phospolipids are converted to ethyl esters in the transesterification
processing too. By focusing only on blood levels of fatty acids, people
overlooked a potentially important difference between natural and processed
fish oil.

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simplecomplex
Is there any actual clear link between dietary DHA and serum DHA? I’m guessing
no.

Humans survive on quite a wide range of dietary fat sources and composition. I
stopped supplementing with fish oil after realizing there’s lots of “science”
and few facts.

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virtuallynathan
Yes, there is. I have had mine tested as I altered my diet to include more
fish roe, fish liver, and fatty fish. I took my omega6:omega3 ratio from 3.5:1
to 1.5:1 in ~3 months.

Total O3: 10.2% -> 16.5%

DPA: 1.2% -> 3.2%

EPA: 3.4% -> 4.3%

DHA: 5.4% -> 9.2%

I don't have a "before" on the standard american diet, but IIRC the average
american has an omega6:3 ratio of about 15-20:1.

~~~
simplecomplex
Serum levels could mean your body has more DHA than it needs, without an
established level at which some kind of deficiency develops.

I’m not trying to prove a point except this: People who have no regard to
dietary DHA and consume no fish don’t exhibit any of the problems claimed in
articles and by nutritionists. I’ve been vegan for 20 years for example and my
skin is fine, I don’t supplement DHA, I don’t have dementia or other health
problems.

This contrasts pretty strongly with homocysteine/B12 deficiency or iron
deficiency. There’s no good evidence that a clinical syndrome of DHA
deficiency even exists. Whenever I dig into studies serum levels are all over
the place.

There’s quite a lot to be suspect of here. The conclusions drawn from our
limited understanding of fatty acid metabolism just doesn’t match reality.

~~~
virtuallynathan
FWIW, these were not serum levels, this was RBC (red blood cell).

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Jagsz
Dr. Patrick- if DHA/EPA is re- esterized, as it is in Biotest’s Flameout
supplement. Does this re-esterization put it in a phospholipid form to be
absorbed thru the BBB?

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el_don_almighty
Fish Heads Fish Heads rolley polley fish heads

Fish heads Fish heads eat them up... YUM!

