Fish Oil Can Lower Your Risk of Preterm Birth

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Fish Oil Can Lower Your Risk of Preterm Birth

Why and how to get DHA in your diet, with Dr. Kristina Harris Jackson.

You may not have expected fish and pregnancy to go together. But it turns out that fish contain a critical fatty acid called DHA. DHA has been shown in numerous studies to lower women’s preterm birth risk, and supplementing with fish oil is an easy way to get enough DHA in your diet (algae is another option). How much is enough? And what about avoiding mercury? Dr. Kristina Harris Jackson, an expert in omega-3s and measuring DHA in blood, shares everything you need to know about safely optimizing your DHA level.

Episode Intro

Dr. Michael Ruscio, DC: Hi everyone. Welcome to Dr. Ruscio Radio. This is Dr. Ruscio. Today I’m here with Dr. Kristina Harris Jackson. I came across her work in nutrition, which I think is very, very interesting. So she has agreed to come on the show and discuss why DHA, a component of fish oil, is so crucial for pregnant mothers and the healthy development of the child. There are certainly—at least from the brief review I’ve done—some very interesting nuggets here that it looks like mothers really need to be brought up to speed on. Kristina, thank you so much for taking the time to speak with us today.

Dr. Kristina Harris Jackson, PhD, RD: Yeah, thank you for having me.

[Continue reading below]

Dr. R’s Fast Facts Summary

Recommended DHA dose

  • A minimum of 200mg of supplemented DHA per day + 100mg from food (300mg total)
  • Preferably 600mg DHA per day for pregnant women or women trying to become pregnant

Dietary sources higher in DHA

  • Oily fish
    • Salmon
    • Sardines
    • Mackerel
    • Herring

DHA Testing

  • Available direct to consumer here
  • For women trying to become pregnant 5% DHA is optimal

Where to learn more

In this episode…

Episode Intro … 00:00:40
Fish Oil Can Lower Preterm Birth Rate … 00:04:16
DHA an Important Fatty Acid in Pregnancy … 00:06:15
Dosage for Fish Oil in Pregnancy … 00:09:12
What DHA Levels in Blood Actually Mean … 00:11:44
Food Sources of DHA, Avoiding Mercury … 00:19:31
Risks of Low DHA in Pregnancy … 00:25:15
In-Home DHA Test … 00:27:23
Minimum Dose of DHA? … 00:29:44
How Does DHA Work in Our Bodies? … 00:31:50
Episode Wrap-up … 00:36:28

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Hey guys, this is Dr. Ruscio with a huge favor I’d like to ask you. If you could take literally 15 to 20 seconds and fill out a survey that we’re running to help better understand you, our audience, I would deeply, deeply appreciate it. If you’re on the go and you’re just listening to your podcast player conveniently, the link to the survey is located in the description on your podcast player. It’s also of course located in the transcript associated with this sphere if you’re reading this and if you want to know what the direct link to the survey is, it’s This is super short. Five-ish questions will take you 15 to 20 seconds, but it’s very helpful in allowing me to better understand our audience and better serve you guys. So if you would take just a moment, I promise it is super short, super quick, super easy, but it will be very helpful for me. So if you could do that, I would really appreciate it.

Again, the link is in the podcast description on your players. It’s also embedded on the website with the transcript post, and it’s directly accessible through Okay. Thanks

DrMR:   It’s an absolute pleasure. Can you tell people, just in brief, how you wound your way into this niche that you’re currently focusing on?

DrKJ:    Yes. I was actually born into this field. My dad is Bill Harris, who’s been studying omega-3s for about 30 or 40 years now. So I grew up in a household where we ate salmon (some, not every night), and we learned about what my dad did. I never really thought I would go into the same thing, of course.

Then I studied biology at Augustana University, a small school in South Dakota, and knew I didn’t want to be an MD doctor. I didn’t want to have life and death situations on my hands every day. But I liked science. So I started to look into grad schools and nutrition. I thought nutritional sciences was a really neat way to apply biochemistry. So I applied to grad school for nutritional sciences and went to Penn State where I completed my PhD in nutritional sciences and got my registered dietician credentials, and did all my background work for that there.

And then I did a postdoctoral fellowship in something much more applied. I was interested in worksite wellness and trying to do more public health type work. That was at the University of Colorado, Denver. Then I realized that’s pretty hard, and I wanted to come back to biochemistry. So I landed back at OmegaQuant, which is the lab my dad started. So I was able to jump back into biochemistry and fatty acids, and slowly started to take on more of the research in omega-3s around maternal health and pregnancy in particular.

Fish Oil Can Lower Preterm Birth Rate

Fish Oil Can Lower Your Risk of Preterm Birth - DocosahexaenoicacidsupplementationDHAandthereturnoninvestmentforpregnancyoutcomesDrMR:   Mm. And some of the research here seems really alarming. I wasn’t aware—I’m just looking at some of the notes that you sent me here—that a 2016 study found that using at least 600 milligrams of omega DHA daily could save the U.S. healthcare system up to $6 billion by preventing preterm births! That’s amazing not only in the savings, but also, obviously, from the perspective of dealing with preterm birth.

A friend of mine just had a preterm baby, and that is a lot of work and a lot of stress. So tell us a little bit more about this body of research, for those of us who haven’t made this connection yet.

DrKJ:    Yeah. So preterm birth is a huge problem. And it’s unfortunately worse in the U.S. than it is in a lot of other developed countries that are similar to the U.S. Our rate of premature birth in 2018 was 9.9%, and in other countries it’s closer to 5%, like in western Europe.

And our rate keeps going up, which is very depressing. In the African American community, it’s about 13%, in white and Hispanic communities, about 9%. So there’s a disparity there as well.

They estimate that every preterm birth, on average, costs about $50,000 more than a normal birth. You can imagine why, if you’ve ever had anybody or yourself go through a preterm birth where you had to use the NICU.

NICUs are amazing. They’ve advanced so much in being able to treat preterm babies, and to get them to a point where it’s a lot less likely to see deficits long term because they’ve gotten so good at their job. But it’s so much cheaper, safer, and less stressful to carry a baby to term. So, preventing preterm birth is definitely preferable to just getting really good at treating preemie babies in the NICU.

DHA an Important Fatty Acid in Pregnancy

DrMR:   Is there any proposed mechanism as to why the DHA? You were saying offline, and I’d love for you to elaborate on this. It doesn’t seem to be so much so the EPA, or perhaps it hasn’t been directly studied. I’m not sure if they’ve both been studied and only DHA has shown the protection. But why one over the other, in terms of this positive effect?

Fish Oil Can Lower Your Risk of Preterm Birth - 240F2039840970X5KV4r1LexgJkUs83UPK4nmA6XhUtLKDrKJ:    Right. And I didn’t finish the second part of your first question, where they found the huge savings with the study where they gave DHA to pregnant women, and then found a lower rate of preterm births in that group compared to women who didn’t get DHA. That’s where they estimated the $6 billion (major cost savings) across the U.S., if we would give women about 600 milligrams of DHA a day.

And with fish oils, the fatty acids in fish oils that we study are EPA and DHA. And in pregnancy, it seems like DHA is having the effect. So it started off in studies looking at fish intake in pregnancy and fish. EPA and DHA always come together. You can’t have one without the other.

Then we have supplement studies where they’re starting to isolate EPA and DHA. Most supplements have both EPA and DHA. And now we’ve separated out so we can have pure EPA and pure DHA supplements. Especially the algal DHA supplements have been really important for prenatal supplementation.

The big supplement studies have used pure DHA and they’ve found effects on premature birth risk. They’ve also measured blood levels and they often find that the DHA levels are more predictive than the EPA levels. So DHA—for a variety of reasons and in a variety of ways—is having a beneficial effect for pregnancy outcomes.

DrMR:   So are there data looking at a fish oil that has EPA and DHA? The main thing I’m trying to figure out for people is, do we need to make the specific recommendation that women use only a DHA supplement? Or can they continue using their EPA/DHA combination fish oil, but just make sure they’re hitting the minimal threshold for the DHA? Do the data give us a good answer on that question?

DrKJ:    Oh, I would say you’re exactly right on, on your second option. You can continue to take a normal fish oil supplement, no problem whatsoever. The main thing is to make sure you know what you’re taking. So, looking at the nutrition facts panel on the back and making sure that it splits out both EPA and DHA, and you can see how many milligrams of each of those are in your supplement. You also want to check your serving size. Sometimes it’s for one pill and sometimes it’s two.

Dosage for Fish Oil in Pregnancy

Fish Oil Can Lower Your Risk of Preterm Birth - 240F94674431Vz2zg4DKXdfMbQYBq9QJPfZ6B7TmY7huThe general recommendation for pregnancy right now is 200 milligrams of DHA a day. There’s no recommendation for EPA, but it’s certainly not going to hurt. Getting 200 milligrams from your supplement of DHA a day for pregnancy is the current recommendation.

DrMR:   This is looking to be inadequate… according to the one study you mentioned a moment ago. Have there been other additional studies showing that that 600 milligram cutoff seems to be the sweet spot?

DrKJ:    Oh, the dose is really tricky. So there’s been a study at 600. There have been many, many studies done using fish oil and DHA in pregnancy, and the dose is all over the board, from 130 milligrams of DHA and an egg, up to six grams of fish oil. They’ve tested it all. Thankfully, it appears to be very safe. There haven’t been major complications even going up to that six grand mark, but it doesn’t seem to be necessary to be that high.

But the 600 milligram, it worked in a study in Kansas City. It’s called the KUDOS study, and they gave women 600 milligrams for the second half of pregnancy versus women who just had a placebo. They found a reduction in early preterm births and reduced days in the NICU for those preterm babies that did get born. So that seemed to be a good target.

They did another study in Australia, where I believe it was 800 milligrams of DHA, and they found the same pattern. Less early preterm births in the DHA group versus the placebo group.

Now the same groups are redoing these studies, actually, in Kansas City and Australia. The Australian group, I believe, was doing 800 milligrams in one group, zero in the other. And the Kansas City group is doing a 200 milligram group versus a thousand. So they both have a difference of 800 milligrams. Those studies are still being conducted and will be coming out. Hopefully the Australian study comes out soon.

But as you can see, there’s really no rhyme or reason to what dose we’re picking for these studies. And that’s part of the reason that we study blood levels. We think that it’s important to look at how much DHA is in your blood to determine how much DHA you need to take. That’s how we think about the omega-3 literature at OmegaQuant and why we really think blood testing for research is so important.

What DHA Levels in Blood Actually Mean

Fish Oil Can Lower Your Risk of Preterm Birth - 240F100283585kKkL9LwR9VI3TvteBUySk1Vb7QR3ZaA9DrMR:   So in some nutritional markers, there tends to be this (for lack of a better term) reservoir effect, where if someone is deficient you won’t see much show up in the blood until the pools are full, so to speak. And then you can have a spilling-over into the blood. Is that phenomenon seen to happen with fish oil? Or is it more when you look at a blood level, you’re getting an assessment of someone’s day-to-day dietary intake, and not so much getting a window into what they’ve been eating historically?

DrKJ:    That’s a great question. So in our lab, we like to focus on the red blood cell. A red blood cell membrane is made up of fatty acids. We measure each different kind of fatty acid in the red blood cell. We take the DHA that we find in there, over the total number of fatty acids and that gives us a percent. And that’s the metric that we use. So for the omega-3 index, that’s both EPA and DHA. Our target percent for that is 8%. We think that shows that someone has a good amount of EPA and DHA in their blood.

For pregnancy, our target value is 5%. And that’s just DHA alone. Because, like I had mentioned before, the studies have been conducted with just DHA supplementation and found to have an effect. So we want to make sure that people know their DHA levels specifically.

But red blood cells are unique because they reflect tissue membranes. And where omega-3s are really having an effect is being in the tissues. Then the fatty acids in membranes are used by the cell for signaling and for inflammatory pathways. When you have more omega-3s in the cell membrane, those inflammatory pathways become a little bit dampened when the omega-3s are being used in the pathway versus some other fatty acids (sometimes omega-6s). But just having higher levels of EPA and DHA in your blood cells really does change how the cell reacts to inflammation. And it also changes the fluidity. So it makes the cell more fluid, and that also can affect how well the cell functions or how well that tissue functions.

So, thinking about different pools, the membrane really reflects months of eating, is what we say.

DrMR:   So that’s akin to, like, a hemoglobin A1C, that gives you a two- to three-month window of your blood sugar.

Fish Oil Can Lower Your Risk of Preterm Birth - 240F119640203zztel15hMuCn2GWIZFy9MVrtCqBqPoAFDrKJ:    Exactly. So your red blood cells don’t reflect exactly what you ate last night or this morning. They reflect the fatty acids that have been available in your stores, essentially. So when they are created, you have those fatty acids that reflect your overall diet. There is still some interchange between lipoproteins and red blood cells with the fatty acids, but on the whole, it is a very stable marker. It goes up slowly. It goes down slowly based on your diet. And omega-3s are really interesting—EPA and DHA—because we don’t metabolize them very well. So, technically, they aren’t essential fatty acids.

The parent omega-3 essential fatty acid is alpha-linolenic acid. We can’t make that. We have to eat ALA. And that can become EPA and DHA through a variety of metabolic steps, but it’s a really inefficient process. So eating ALA is not a great way to increase EPA and DHA. Their estimate is about 1% of ALA would get converted to DHA all the way down the line. So that’s less efficient.

I will say, as a side note, in pregnancy, the presence of high estrogen actually increases the efficiency of that metabolic pathway so that more DHA can be made by the body. Which, to me, is another sign that DHA is really important to the fetus, because the body ramps up its own production of it. But the red blood cell is able to reflect all the different areas that DHA is coming from.

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This is a great little tidbit, I think, for both clinicians and the lay public. But as a clinician who has various women coming in, either complaining of infertility or letting me know that they’re trying to get pregnant, it would be nice to have a specific marker to be able to guide if they’re getting the appropriate intake of fish oil. Was it 6% you’re looking for on the Omega Index test?

DrKJ:    We’re looking at 5% for DHA alone. We call it prenatal DHA. That’s for women trying to get pregnant and during pregnancy that we’re targeting that level.

DrMR:   If there’s a history of infertility, are there any data there showing that fertility increases with appropriate DHA levels?

DrKJ:    I think the data are fairly mixed on that. And I’m not as well-versed in that piece of literature as I am for the DHA levels during pregnancy, while you’re already pregnant. But interestingly, from the male point of view, the testes is one of the most DHA-rich organs in our body. So DHA, super important for that side of fertility. For women, we would recommend that they try to get to the 5% DHA level as they’re trying to get pregnant. Your adipose tissue stores of DHA are used throughout pregnancy to maintain a steady level of DHA for the fetus, so building up DHA prior to becoming pregnant is a great thing to do so that you have enough stores in your adipose tissue. But whether or not it improves or increases your fertility, I don’t have any data to support that. I don’t think it hurts.

Food Sources of DHA, Avoiding Mercury

DrMR:   Sure, I’d be shocked if it hurt. Are there dietary sources or certain types of fish that are higher in DHA than EPA? If anyone’s trying to be very choosy with what they eat?

Fish Oil Can Lower Your Risk of Preterm Birth - 240F102913339f4OE3U0B2uXwnrbQm1GIrBJXB57uBzzhDrKJ:    That’s a good question. I don’t know about the ratios of EPA and DHA in fish. I don’t worry about that too much because, pretty much, fish is going to have both DHA and EPA. And any fish that’s high in omega-3—and oily fish, like salmon or mackerel or sardines or tuna even—will have both. I think that’s getting a little more nitpicky than we need to.

The thing with fish and pregnancy, as you probably know, is the concern over mercury and PCBs and other environmental contaminants in fish. That’s one of the big reasons, actually, that we wanted to try to find a blood level in pregnancy that would be a good target. So many women stop eating fish when they learn they’re pregnant or when they’re trying to become pregnant because of the concern of getting too much mercury in the diet, which is a real concern. We shouldn’t be flippant about that.

But the FDA and the EPA, who originally made the recommendations for women to reduce their fish intake because of the potential amounts of mercury in fish, have qualified the recommendations to say that women should eat at least one or two servings of fish a week while they’re pregnant, making sure that the fish they choose are lower in mercury. Most all the fish that we eat, if they’re from a grocery store and you’re not catching them yourself, are fairly low in mercury. Tuna is the one that’s really common that you kind of have to watch out for. But once a week, for most, canned tuna is okay. Salmon is great. Sardines, mackerel, herring, those are all super rich in omega-3s, both EPA and DHA, and typically very low in mercury. So that’s the balance that I think most people are worried about, the omega-3s versus the other contaminants.

DrMR:   I’m glad you made that clarifying point. While it has been a couple of years since I’ve reviewed this literature, it does seem that as long as you’re steering away from these bioaccumulator, top of the food chain fish, like shark, whale, and potentially, tuna–

Fish Oil Can Lower Your Risk of Preterm Birth - 240F266176888RhilRiXUZK72ZO3j5W1LjtHCNwmL9AtQDrKJ:    Right. Tilefish.

DrMR:   Yeah. That the risk of doing harm with mercury is pretty low and that some of the studies that looked at women eating fish compared to not eating fish actually had better outcomes. And for those women eating fish, some of the Asian diets would actually eat shark and whale, and that’s when they saw problems. But as long as you were eating the more commonly store-bought oily fish, like you mentioned, health outcomes seemed to improve. I think that’s really important for women to understand. Because you do occasionally come across a woman who says, well, I stopped eating fish because I was afraid of mercury.

DrKJ:    Oh, yeah. I mean, I have a four and a half month old, so I recently went through the pregnancy, the whole spiel, a second time. And there are so many things you have to be careful for. You have to heat up your deli meats and avoid soft cheeses. And there are all these things, it’s just overwhelming. You just say, forget it, I’m not even going to touch fish because I don’t want to think about it. The other thing is the sushi piece of it, which is confusing. That’s because it’s a raw fish, not because it’s fish. So there are a lot of different angles where fish is kind of scary during pregnancy for women, especially in the U.S. And I don’t think a lot of doctors are ready or willing to talk about it either, because it’s very tricky.

So I’m of the mind if you want to do food first and eat fish during pregnancy, I think that’s great. If you don’t want to think about it, I think, take a supplement. You can even have a vegan DHA supplement that’s made from algae and get your DHA in that way and just take care of it. It’s similar to folate, where we’ve fortified foods, we put it in our prenatal vitamins, the doctors ask us about our folate intake, at least in my experience. So I would like DHA to get to that level, where it is a nutrient, it’s playing an important role in development, and it’s a nutrient of concern in the diets of U.S. women.

Fish Oil Can Lower Your Risk of Preterm Birth - Plant animalsubsistenceratiosandmacronutrientenergyestimationsinworldwidehunter gathererdiets 2DrMR:   Yeah. This is one of the things that I am a bit concerned about with certain niches in the paleo community that are so excited about quality grass-fed or pasture-raised beef. I always think back to the great review paper by Loren Cordain where they looked at hunter-gatherer populations worldwide. It always struck me that as the fat content of the diet increased, as hunter gatherers went from more equatorial to more northerly or southerly, essentially going away from the equator, the main food that increased in the diet was fish, not beef.

I think it’s a little bit at odds. I don’t think everyone subscribes to the paleo hypothesis plausibility, but irrespective, I think there are some interesting clues from our history that show that we weren’t eating a bunch of grass-fed meat, necessarily. That the main thing they were having that was more plentiful in their diet was fish. I think, unfortunately, sometimes we get so jazzed about healthy beef. And there is nothing wrong with that, we just want to make sure to bridle that and maintain this balance between fish and fowl, or fish and beef.

Risks of Low DHA in Pregnancy

DrKJ:    Right. Yeah, I completely agree with that. And in the pregnancy world, really, a couple of servings of good high-DHA fish a week should do it. We’re looking at lower intake targets than we do for our aging population and reducing risks for heart disease. We look at much higher doses of one or two grams of EPA and DHA a day, and that’s fine for the general adult.`

But pregnancy is a more delicate situation. The data that I’ve seen shows that it’s really women who are at the low end of DHA in their red blood cells—so less than 5% of DHA in their red blood cells—who are at a higher risk than women above 5% for premature birth. But the risk relationship is not linear. So after 5%, there’s a plateau.

So if you have a DHA level of 7%, you’re not that much better off than those that are at 6%. It’s kind of flat-lined all the way out. So you can have higher levels, but it won’t necessarily increase your benefits as far as premature birth risk goes.

Below 5%, there’s a very steep risk incline. So as you go from 4% to 3%, the risk increases tenfold between 3% and 5%. So those women who have a DHA level of 3% are at tenfold risk of early premature birth, which is before 34 weeks gestation.

Fish Oil Can Lower Your Risk of Preterm Birth - PlasmaConcentrationsofLongChainN 3FattyAcidsinEarlyandMid PregnancyandRiskofEarlyPretermBirth.These are all data from a study that came out of Denmark in 2018 by Dr. S. F. Olson. They looked at blood levels of pregnant women, plasma, EPA and DHA throughout pregnancy, mid- to early-pregnancy, and found that those with the much lower levels of EPA and DHA earlier in pregnancy had a much higher risk of early premature birth. That’s really where we’re taking our blood level data from. That’s why we set our target where we did.

Because it’s the people on the low end that see this increased risk much more than people on the higher end.

In-Home DHA Test

DrMR:   So again, a great screening tool for clinicians or for the savvy health consumer who’s really being proactive and bringing information to their doctor. And is the testing available direct-to-consumer or only through a clinician?

DrKJ:    It is available direct-to-consumer at this point. We just launched it this year and we’re all trying to get clinicians to to use it and understand it. But any person can go on our website and order it. It’s a simple finger stick blood test. So there’s a lancet and you just get a little drop of blood on your finger, put it on a filter paper and send it in to our lab. We analyze it and then we send you your results within a week or two (depending on the mail) usually.

That 5% mark really does match well with the current recommendations of two or 300 milligrams of DHA a day in pregnancy. It’s not a sky-high blood level and those are not sky-high intake levels.

We were just able to analyze blood from a study that was done at Cornell. They were interested in choline intakes during pregnancy. They had nonpregnant women, pregnant women, and lactating women on a controlled feeding diet. So that meant they gave them all of their food for 10 weeks. In that, because they had pregnant women, they had to make sure that they were getting the 200 milligrams of DHA. Each of these groups had 200 milligrams of DHA, and we were able to measure the blood levels in these women. We did see that the nonpregnant women were mostly below 5% to start. 200 milligrams a day got 95% of women above that 5%.

Only about half of the pregnant women in their third trimester were below 5%, and 200 milligrams a day bumped them all up above 5%. Interestingly, in lactating women, about half of them were above 5% at the beginning, and 200 milligrams a day didn’t move the needle. About half still were below, after 200 milligrams a day for 10 weeks. So what that says to me is the lactating group had a much higher need than the pregnant and non-pregnant groups.

Minimum Dose of DHA?

DrMR:   You can make an argument. So, let’s give the worst—or the most challenging—case scenario. Not to say this is an argument I would agree with or I would put money in, but let’s say you’re on a very tight budget. You can’t get to 600. I’ve got to meet this patient where they’re at… would 200 milligrams per day be the minimum hurdle you’d want to have them at?

DrKJ:    Yes. I would say getting at least 200 would be a great step from where we are now. There’s definitely talk that we should be at 600 or 800 milligrams a day, like those studies that we talked about before studying that. And that’s great, those are fine doses, I don’t think there’s anything wrong with them. But the current recommendations are at 200 milligrams, in addition to current intake. They estimate current intake for people is about a hundred milligrams of DHA a day. So it should be around 300, technically.

But in the most recent data that I’ve seen on dietary intake in the U.S. from NHANES (which is our national dietary intake cohort), they see that the average intake for women of childbearing age is about 60 milligrams of DHA a day from diet, and about one in, I think, 14 who are pregnant have reported taking an omega-3 or DHA supplement.

So getting to 200 alone would be a huge step from where we’re at right now. Not to mention getting even higher for some women. Just getting to the recommendations is our first goal.

DrMR:   And that’s 200, including all intakes, dietary, and supplemental together?

DrKJ:    It’s kind of confusing, but I read it as 200 milligrams of DHA, in addition to their diet. But that would be what you would take as a supplement. The problem is they assume people get about a hundred milligrams of DHA a day in their diet, but that’s typically not the case. But just getting the 200 in a supplement form, and you know you’re getting it, is a big step, I think.

How Does DHA Work in Our Bodies?

DrMR:   Okay. Now, what is the mechanism here? Is it neurological? Because at least from what I understand, the DHA has more of an impact on the neurology. Is there some neurological component, perhaps more on the side of the mother, that is controlling the initiation of the water breaking and the whole pregnancy cascade?

DrKJ:    That’s a great question. And I’m knee-deep in reading about this. I feel like I come across a different type of mechanism every day. But some of the ones that I’ve been reading about lately, number one, starting labor can be done through low levels of inflammation. For example, in animals, if they want to stimulate preterm labor, they’ll inject them with LPS, which is a bacterial component that reliably starts all of our inflammatory pathways buzzing. So they’re able to stimulate preterm labor through inflammation. And there is some evidence that low grade inflammation or stress causing that inflammation can cause preterm birth. It starts everything into motion.

And having DHA in the membranes can dampen that inflammatory pathway. What’s interesting is DHA and arachidonic acid are two really important fatty acids for pregnancy. Arachidonic acid is an omega-6 fatty acid. It starts a lot of the most important inflammatory cascades. Typically when you take DHA, you see arachidonic acid levels reduce in the membranes as a percentage. So DHA seems to take the place of arachidonic acid in some membranes, in that arachidonic acid is the source of a lot of the prostaglandins that are responsible for uterine contractions. The uterus has so many methods by which the uterus starts to contract. But that’s the definition of labor, the uterus starting to contract to get the baby out.

We’ve seen that when, if you take DHA, it might lower the amount of arachidonic there. So you have a little less of the very strongly pro-inflammatory fatty acids in the membranes to start those pathways and create those prostaglandins. And then you have some DHA that is taking that place in the inflammatory cascades. So you have less of a strong uterine contraction and the uterus might not start to contract in response to inflammation. So that’s one potential mechanism. And that’s a way that we see omega-3s work on a lot of other membranes: they can replace some arachidonic and they have a less intense inflammatory reaction. That’s one way I think that it is actually affecting the initiation of labor.

There are also hormones. There are some studies that show that DHA can affect oxytocin, which is a very important hormone in labor, but there’s still so much to be learned about it.

DrMR:   Sure. Yeah. The mechanism is often times difficult to fully pin down, and sometimes things can be multi-mechanistic.

DrKJ:    Right. I’m sure it is.

DrMR:   But the more important thing in my mind is we have the outcome data. And we’re still figuring out the what, but we know the why. So that’s what we want to focus on out of the gate here and let you keep digging through the research.

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Episode Wrap-Up

Are there any closing thoughts you want to leave people with? And then, please tell them about the lab and anywhere else you’d want to point a pregnant or soon to be pregnant woman to help her along the road.

DrKJ:    Yeah, absolutely. I guess my closing thoughts are for pregnant women, to feel like they can get DHA in a way that is not stressful for them and makes them feel like they’re doing the best for their baby. Looking at blood levels gives a non-biased way of doing that, and especially having that with their doctor. I think that is just the best combination so they’re both on the same page.

Our lab is called OmegaQuant Analytics. We’re in Sioux Falls, South Dakota. We grew out of a research lab, and so we are continuing to do research all the time, especially in the world of pregnancy. We’re newer into this world, but we’ve been studying humans. We don’t usually do rats and things. We’ve been studying humans for ten years at the lab, so that’s our main focus.

We look at human outcomes, we look at human blood levels. We just want to help people demystify the world of omega-3s, let them know their own personal level, and let them change their diet, see how their blood levels change, and see what works for them. And also, at what blood level do they feel the best? So, being aware of how they feel when they’re taking different supplements or eating different ways. You can go to if you want to learn more. We have lots of blog posts and lots of information, and you can contact us there. You can also order at-home testing kits. We have omega-3 index kits, the prenatal DHA, and it’s all right there on the website.

We hope that it’s helpful to everyone who’s interested in fatty acids.

DrMR:   Yeah, I think this is very interesting to give people that specific number to shoot for, and help pull people out of the vagaries of “eat fish, not too much, but some.”

DrKJ:    Right, right.

DrMR:   I like what you guys are trying to hone in on where, “Okay, let’s give you a specific marker so that if you’re taking the easy way out, not eating fish and taking supplements, now you have a little something to steer you back.” Or, if you’ve been doing a great job, you can pat yourself on the back and keep doing what you’ve been doing.

DrKJ:    Absolutely.

DrMR:   But you have that marker to steer you along the way.

DrKJ:    Right. That’s the goal.

DrMR:   Cool. All right, Kristina. Well, thank you again for taking the time. It was very insightful.

DrKJ:    Thank you so much. Appreciate it.

DrMR:   Yeah, been a pleasure.

What do you think? I would like to hear your thoughts or experience with this.


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