What if fish oil were changing your

arteries? Well, it's not even a question

because there are multiple studies

indicating that to be the case.

Technically, it's not limited to fish

oil, but to really any omega-3 fat

supplement or just omega-3s as a whole.

While we've gone over the ways that

omega-3 fats affect our heart, we've

never gone into how they affect our

arteries. Specifically, the plaque in

your arteries change when you consume

omega-3s. According to an array of

studies, we know that atherosclerosis,

so the plaque that develops in your

arteries, are a major cause of heart

attack, stroke, and much more directly

and indirectly. But the issue is far

more complex because the quality or type

of plaque makes a massive difference on

your risk. For example, soft plaque,

also known as non-calcified plaque, is

especially dangerous because it's

susceptible to rupturing and lodging in

finer blood vessels. stopping blood flow

to downstream areas, killing those

areas. On the other hand, calcified or

even fibrodic plaque is less dangerous

because it's considered stable or

semi-stable, meaning it generally has a

cap on the top of the soft plaque that

protects from erupting into the

bloodstream. To be clear, it's still not

ideal, but between the two, it's

preferred. So, what happens to this

plaque when we consume omega-3s, fish

oil, or otherwise? In this study, the

researchers are using non-invasive

imaging called CT angography to measure

the plaque within the arteries of two

groups of people. One group consuming

omega-3s, and the other was not

supplementing the control group. As seen

by these data, the left is the control

group, so the non-supplementers, and the

right are the omega-3 group. This

measurement is of houndsfield units,

meaning the higher it goes, the more

fibrous and possibly calcified the

plaque is. Generally, values reaching

100 and above indicate more fibrous

plaque, and values into the higher

hundreds and even thousands indicate

calcified plaque. So, knowing what we

know about plaque, we can clearly see

that the omega-3 condition is reaching

into those higher thresholds, indicating

more solid fibroic plaque. Similarly, if

we look at another metric Gcore, which

tells us on a scale the type of plaque

burden, it looks like this. Notice the

blood vessel. Then notice the four cate

categorization. So, one is calcified

plaque. Uh, good in this context. Two is

mostly calcified plaque, three is mostly

non-calcified plaque, and four is

largely non-calcified plaque, the soft

plaque that we've been trying to avoid.

If uh you're looking for a deeper

explanation on what uh to look for here,

you've got the wrong guy. I too have no

idea what we're looking at here, aside

from what I just outlined. But if we

focus in on the data, we see a

statistically significant effect

indicated by a p value below 0.05 for

the omega-3 group. Those individuals

have lower Gcore around 4.5 while those

not supplementing have a 7.4 four well

into that soft plaque categorization and

likely widespread. Now to be clear, both

of these indicate increased

cardiovascular risk, but relative to one

another, the omega-3 group is doing

better. In short, omega-3s are changing

the composition of the plaque that we

have in our arteries. I think this

finding is absolutely fascinating, but

it leaves me wondering exactly how it

does that, as well as if we can even

trust these results. Why can't we trust

these results? Well, I'm not going to

jump to the conclusion that we can't,

but this type of study has flaws because

it's a cohort study, meaning we're

discussing associations here. The

researchers did match participants

across groups for a number of important

factors here. Even so, this is a small

study, and the participants still didn't

get the omega-3s as an intervention. So,

an actual capsule given by the

researchers. So, there's a high chance

for misleading interpretations. As a

result, we can only say that there's an

association between omega-3 consumption

and favorable arterial plaque changes.

But we don't need to stop there because

there have been randomized control

trials performed like this one, and they

reveal two fascinating findings.

Remember, the title of the video says

quickly, which is odd when we're

discussing something like heart disease,

which takes years, if not decades, to

develop. However, this randomized

control trial only lasted an average of

5 weeks, and yet it provides some cool

data. So, this type of data is

interventional, meaning that it brings

us with much more certainty to actually

implicating omega-3s in changing our

arterial plaque. People were randomly

assigned to the omega-3 group or the

control group given a placebo or a third

condition given sunflower oil. Then they

measured the plaque in the arteries and

they didn't just classify the plaques

based on the calcification and so on

like in the last study. They looked at

the composition of that plaque. Remember

arterial plaque is filled with

cholesterol molecules, fat molecules,

and even proteins. But it's also filled

with something else that makes it more

or less dangerous. We'll come back to

that in just a minute. For now, I'm

going to scare you with the data. Yeah,

it's a lot. And instead of straining

your eyes and boring you, I'll just

point out this one line across the

board. This is an omega-3 fat. And these

data tell us that this omega-3 is

enriched in the arterial plaque when

people consume more omega-3s. That part

is pretty self-explanatory. The more you

eat, the more you could have

incorporated into the plaque. But what

is it doing there? Well, my friend,

that's where we get to look at another

table. But before you groan and say, "I

didn't sign up to this to look at

numbers, you nerd." I'll promise to make

this extremely simple by bringing in

some images to explain the happenings.

Here's the table. And here we're looking

at the three conditions up top. I just

realized I didn't explain that in the

last table. Sorry about that. But we

have three different comparisons.

difference between sunflower oil and

control, which we don't care about in

this story. Then fish oil versus

control, we care. And fish oil versus

sunflower oil, we kind of care about

that, too. Then there's two groups of

cells found inside the plaque. That's

right, cells inside the plaque of your

arteries. They're macrofasages and TE-C

cells. Both of these cells come from

different families. One is part of your

normal defense system called the innate

immune system and the other the tea

cells come from a more specialized

immune system called the adaptive. The

big point being that they are different

immune cells. Then we have three

categories of staining. So 0 1 and two.

And the zero score stands for no

staining detected. Therefore no immune

cells present. The one indicates

moderate staining. So some immune cells

are there. And the two is the heavy

staining indicating the greatest number

of immune cells. By the way, by staining

I mean this we're using fluorescent

proteins that attach to these immune

cells specifically allowing us to

identify them. Okay, that explained. If

the number goes down like here, that

means there's less staining. And if they

go up over 1.0, that typically indicates

more of that staining group. This is all

then confirmed by the statistics the p

values which should be below 0.05 to

indicate an identified effect. So in

short there are no differences for tea

cells across any of the groups and there

are reductions in the group two staining

for the macrofasages in both omega-3

comparisons. In addition, there's more

of group one staining for the same

groups. That suggests to me that the

number of macrofasages in the plaque is

reducing although not completely

disappearing. That all matters because

macrofasages are abundant in the plaque

and they accentuate the inflammatory

response inside the plaque exacerbating

the problems coming from plaque. More

specifically, they're usually involved

in unstable forms of plaque and increase

the risk of rupture. This could be a

mechanism by which omega-3s help the

plaque stability by removing these cells

that destabilize the plaque. How

freaking cool is that? In fact, we see

that further evidenced in other data

that I won't plague you with, but it

shows that more unstable plaques have

fewer macrofasages in them, which also

associates with omega-3 levels in the

plaque. There's more that we need to get

into, including what this means for you

and how to contextualize this because

there's some nuances to be aware of, but

this is actually a pretty bare bones

analysis considering there's more data

on everything that we just went over, as

well as a brand new study on omega-3's

ability to reverse plaque in our

arteries and the differences between

omega-3 types. I'm covering all of that

in the full analysis included with the

Physionic Insiders, which also includes

access to all my analyses in article and

video format, a private podcast, a

private community that I'm highly

engaged in, and even live sessions with

me and the rest of the insider

community. And there's more, but I've

been talking about this for too long.

So, if you're interested, check out the

description and join the Physionic

Insiders. I hope to see you there. Now,

to context. We've covered two studies

and this third corroborates a lot of

what we just went over and we did

include a randomized control trial which

is important and impressive considering

the results. However, even so, it should

be noted that we could really use some

longerterm studies and just more

evidence as a whole. But that context

applied, we also have multiple

intervention studies that indicate

omega-3s are generally beneficial for

heart health by reducing heart disease

related events. So although that doesn't

speak to these specific artery effects,

it speaks to the overall trend of

omega-3 fats improving cardiovascular

health. So where does that leave us?

Well, one quick thing that I need to get

off my chest. Why don't fish do well in

school?

Because they work below sea level.

This has been entirely too serious of a

video, so I had to throw one in there.

Okay, on to the takeaways. I think

overall consuming omega-3 fats have weak

to moderate evidence indicating one of

the ways that they improve our

cardiovascular health is by remodeling

the plaque in our arteries to be less

inflamed and to be more stable. This

paired with outcome data offers evidence

that we should be consuming omega-3s. If

that's through algae, fish, krill oil,

or by eating fatty fish. See, the joke

was related. You know what else is

related? This Omega-3 video right here.

Thanks for hanging out with me and I'll

see you over there.