ethyl esters of fish oil raise fasting #insulin

7.5: web.health/ethyl esters of fish oil raise fasting insulin:
7.5: 12.29: summary:
. the natural form of fish oil
is to bond the EPA and DHA fatty acides
within a triglyceride or phospholipid;
but a more concentrated cheaper way
is by bonding with an ethyl ester;
testing of olive ethyl ester was positive,
but ethyl esters of fish oils
resulted in significantly increased
fasting levels of insulin
(suggesting they cause insulin resistance?)
. the doses of fish oil were rather high;
so does an equivalent dose of natural fish oil
have a similar effect on insulin ?

. high omega-3 polyunsaturates in type 2 diabetes
may sometimes increase blood sugar levels
(A1C and fasting and postprandial glycemia);
in this 6-wk study of mildly hyperlipidemic men
[people who are likely carb intolerant]
there was added 4 g daily of ethyl esters of
EPA, DHA, or olive oil .
. after diet all 3 groups gained weight:
olive, EPA: 0.2kg, and DHA: 0.3 kg .
. the Olive oil capsules slightly lowered fasting insulin
and slightly raised fasting glucose
(the change was not significant).
. fasting glucose was increased
a bit by EPA but not much by DHA .
. fasting insulin was significantly increased
EPA: 18% (P = 0.035)
DHA: 27% (P = 0.001).
DHA also significantly decreased glucose-insulin ratio
by 0.13 ± 0.05 (P = 0.018).
We found that DHA, but not EPA,
provided a small increase in HDL
and a significant increase in HDL2 .
. DHA supplementation significantly increased
LDL cholesterol;
however, this was associated with
an increase in LDL particle size,
which may be a less atherogenic LDL
[Am J Clin Nutr 2000].

omega-3 ethyl esters are concentrated:
. they may have up to 85% EPA and DHA,
whereas natural fish oil is about 30%

The purpose of ethyl ester supplements
and prescription Omega-3 drugs is
to be ultra-concentrated for pill use;
the only disadvantage is that
the natural triglyceride (TG) form
is slightly better absorbed .
. In every single case of
alarm about ethyl ester oils,
the ones raising the alarm are those selling TG oils;
but, in Japan and Australia,
ethyl ester fish oil are used with suspicion:
allowed only under a doctor's supervision;
whereas, any publically available supplements
must be in the TG form.
Pharmaceutical grade TG oils are made by
converting ethyl ester oils back into triglycerides

fda 2013:
. Provinal™ contains ethyl ester forms of [omega-7] fatty acids
isolated from anchovy or menhaden oil.
. fish oil on its way to the ethyl ester form
first undergoes "deacidification" and then bleaching,
before the triglyceride's glycerine backbone
is replaced with ethyl alcohol;
then there are the distillations:
molecular and fractional;
recrystallization involves urea and methyl or ethyl alcohol;
and finally there is a purification process
[likely removing urea and free alcohol].
. Fats and oils from natural sources are predominantly found in the
triglyceride form. Triglycerides, or triacylglycerols,
found in both animal and plant-derived fats and oils,
are comprised of three fatty acids
(which can be saturated, monounsaturated, or polyunsaturated)
esterified to a glycerol backbone.
Fatty acid ethyl esters, on the other hand,
are formed when fatty acids are trans-esterified,
whereby the glycerol backbone of a triglyceride
is removed and substituted with ethanol
. during digestion,
fatty acid ethyl esters are emulsified with bile salts .
They are also hydrolyzed by pancreatic lipase.
This hydrolysis frees the free fatty acids and yields ethanol.
The ethanol released in this process is considered insignificant.
One study reported a theoretical yield of 1.3 grams of
ethanol from the ingestions of 8 grams of ethyl oleic acid,
a similar percentage as that found in common foods such as
vanilla ice cream and orange juice.
The free fatty acids, once released from ethanol,
must then obtain a glycerol molecule within the
enterocyte [cell that is lining the gut]
to become transformed into a triglyceride.
. Triglycerides are then packaged into chylomicrons,
fat carrier molecules that transport the triglycerides
into the lymphatic channel and subsequently into the blood.
It has been demonstrated that
although the hydrolysis of ester forms of fatty acids
may occur at a slower rate than hydrolysis of triglyceride forms,
the uptake of fatty acids into chylomicrons
is similar when the fatty acids are given in either form.