The Nutritional Supplement

What did you do before doing this course?

I completed an MSc in clinical nutrition at Roehampton and my PhD at Cambridge in cell biology and nutrition. My PhD  focused on the development of a non-invasive screening method for colorectal cancer using exfoliated cells derived from stool samples  Unfortunately, I wasn’t able to isolate cells from cancer patients due to technical issues related to stool consistency. I was however able to isolate cells from healthy volunteers  and used these cells to look at genetic changes in relation to different dietary interventions.

Volunteers were allocated to 3 month diets; for example high red meat (≥600g per day), high fibre, alcohol, high omega 6 etc) and I found what is now accepted; that for example there are genetic changes induced in relation to high red meat coupled with low vegetable intake.

What drew you to this research and to specialise in essential fatty acids (EFA’s)? There were two sides to that really. I started my PhD in 2001 and graduated in 2006 as I was writing up whilst raising a family and working full time. After completing my PhD I decided  to take a break from academia and move to industry, joining Igennus early 2007. I was drawn to their natural health approach and really liked what they were doing in regards to practitioner focused nutrition. It was through Igennus that I went on to complete my masters, filling in some of the gaps in my nutrition knowledge, and my knowledge of omega 3’s has grown considerably in the last 9 years with them.

Having been a distant student myself, I really understand how isolating the experience can be. The quality of the course and the support offered to CNELM distant learning students is, in my option, of an exceptional standard. As module leader for PNCI I always ensure that my CNELM students have as much support as they need whilst also emphasising the importance of the support that can be formed within peer support groups.

What is your role at CNELM? As well as being the Personal Nutrition and Chronic Illness module leader, I also supervise some of MSc dissertations.

Tell us a bit about your talk at Food Matters Live last week. I talked about the role of EFA’s in cancer prevention and cancer treatment. Given the complexity of the subject, it was so hard trying to narrow everything down into 20 minutes. I wanted to get across the importance of long chain omega 3’s in cancer prevention, before people even get to cancer care and to relate that back to the fact we are under consuming omega 3’s generally – both from fish and plant sources. Unless we are consuming oily fish regularly the chances are we will be low in long chain omegas. What’s interesting is that an old reference from a 1992 white paper from the British Nutrition Foundation on unsaturated fatty acids stated that we should be consuming a much higher amount of omega 3 than we are today – they recommended 2-3 portions of oily fish (8-10g long chain omega 3’s) a week. That message seems completely different from the recommendations that are set today, which is just 1 portion of oily fish (working out at just under half a gram of omega-3).

I emphasised the role that omega 3 plays in the whole cancer area and also significance of the ratio between omega-3 and omega 6, which is of course the major issue. The individual roles of these two fatty acids are incredibly significant when we consider the downstream products they produce and how they either increase cancer risk and its progression or decrease it. In fact, it’s not simply just down to omega 3 and 6’s at all – it’s the numerous products that arise from them and how these work within the body.

When we think about the role of nutrition, it’s really interesting when we consider how many common drugs are out there that block the pathways or the actions of omega-6 –asthma medication, aspirin, NSAIDs and other cox-2 inhibitors; the list goes on. So the other alternative is of course that we take a nutritional approach – to increase our omega 3’s and balance out the omega-6 to omega-3 ratio, a relatively simple approach to making considerable improvements in health.

The talk received positive feedback – people are always wanting to gather information that they can put into practice.

Who has most inspired you in your work? Professor Philip Calder at Southampton University is the omega 3 guru and of course William Harris and Clement Von Schacky who we can thank for the pioneering work they have done on validating the omega index as a biomarker. We’ve heard so many bad media messages surrounding the potential lack of benefits observed from taking fish oils, but the focus is beginning to shift away from just taking omega 3’s towards understanding the importance of actually raising omega-3 status.

There are so many factors that influence how we respond to omega-3 supplementation with few of large dietary intervention studies measuring omega-3 status pre and post intervention. If we adopt a  biomarker approach to intervention we can identify if the outcome is dependent on successfully incorporating and therefore raising actual cellular levels. Although we need to take relatively high amounts of omega-3 it’s not always necessary to take supplements to do this – although it may be the easiest way. In many cases it can be possible to sustain adequate omega-3 levels through diet alone, if combined with relevant healthy interventions.

I’d like to summarise by saying, there is so much evidence when it comes to omega 3 in cancer prevention and treatment. We know we can improve chemotherapy outcomes, and manage conditions related to cancer such as cachexia but the key is early intervention. It’s a similar story with cognitive decline – it’s essential to go in early as possible with nutrition interventions. If we’re dealing with someone with the early stages of cancer, then that’s the crucial moment to act on the long chain omega 3 levels alongside the 3:6 ratios, so the AA:EPA ratio. I can’t help feeling that as nutritional therapists we have a bit of a battle ahead of us and we’re still a long way off, but hopefully we’ll get there one day.