Omega-3 is the last micronutrient that I want to cover before getting into the next part of my talk. There are 3 forms of omega-3. ALA is found in plant foods like flaxseed and walnuts. EPA and DHA come from marine sources and are found in seafood. A Harvard study published around 2009 identified the top 6 preventable causes of death. These were lifestyle-related factors, such as hypertension and smoking. Not getting enough marine omega-3 from seafood was also among the top 6 preventable causes of death.

EPA and DHA were in that top 6. The Harvard researchers estimated that insufficient omega-3 from seafood was responsible for about 84,000 deaths per year. For comparison, consuming trans fats was another leading preventable cause of death and was estimated to be responsible for 82,000 deaths per year, pretty much the same as not getting enough omega-3 from seafood. And, you know, what's funny is that, you know, everybody knows about trans fats. You walk into any supermarket, any grocery store, everything's marketed, oh, zero trans fats, zero trans fats. But nobody is thinking about the fact that they're not getting enough omega-3. They're not eating enough seafood or fish or taking a microalgae or fish oil supplement to get omega-3.

And so I just kind of like to highlight that because, again, I think about food in terms of what we need to feed our bodies and our metabolism. We need cofactors, magnesium, vitamin D, and omega-3. If we focus on what we need to consume, we don't end up eating all the other stuff. People sort of get fixated on what to avoid and don't think about what they're actually supposed to be taking in or eating. So the Omega-3 Index is one of the best measures of omega-3. So this was pioneered by Dr. Bill Harris and his colleague Dr. Clemens von Schacky many years ago, back in 2004. The Omega-3 Index measures omega-3 levels in red blood cell membranes as opposed to plasma phospholipids.

And the reason for that is because it is a long-term biomarker of omega-3. Red blood cells take about 120 days to turn over, whereas plasma phospholipids reflect more recent intake, such as what you ate during the past week. The comparison is similar to fasting blood glucose as an immediate biomarker and HbA1c as a longer-term measure of blood glucose. So, Omega-3 Index is a really important way to measure omega-3, and it's now being increasingly used in many scientific studies.

I think a lot of the conflicting data out there also has to do with the fact that plasma phospholipids were measured. And again, it goes down to this: well, was it just that they didn't eat omega-3 in the last week, or they did, and so we're saying they have high omega-3 because of that just recent dietary choice, right? This Omega-3 Index work came from Dr. Bill Harris's group. He and his colleagues found that people with a high Omega-3 Index, which is defined as 8%, at least 8%, had a 90% reduced risk of sudden cardiac death compared to people with a low Omega-3 Index of 4%. In the United States, the average Omega-3 Index is about 4%, and most people are under 5%. So most people in the United States have a very low Omega-3 Index.

They don't eat enough seafood and fish. Sudden cardiac death is reduced by 90% if you're in that high Omega-3 Index group. Cardiovascular disease is the number 1 killer in the United States and actually most all developed countries. Every 33 seconds, someone dies of a heart attack. Anything you can do to improve cardiovascular health is really on your side in terms of improving healthspan, improving your lifespan. Dr. Bill Harris's group also found that people with an 8% Omega-3 Index had a 5-year increase in life expectancy compared to people with a 4% Omega-3 Index. So that was the low end. And it's interesting because in Japan, their life expectancy on average is about 5 years longer than in the United States.

So our average life expectancy is 5 years less here than in Japan. They happen to have an Omega-3 Index in general above 8%, whereas, as I mentioned, we're below 5%. That is an interesting observation that also correlates with the increased average life expectancy in a country that eats a lot of seafood. But this is what really, I think, is almost— it's just eye-opening. It's part of the same study from Dr. Bill Harris's group, where they stratified these participants and looked at their Omega-3 Index and then also looked at their smoking. So the very, very top curve, the green curve, people lived the longest if they had an 8% Omega-3 Index and were nonsmokers. And the very, very bottom curve, the red one, was people that were smokers and had a low Omega-3 Index, 4%.

So those— they had the lowest life expectancy. But this is what blows my mind. If you look at the orange and blue curves, they're completely overlaid on top of each other. People who had a high Omega-3 Index but smoked had the same life expectancy as people that didn't smoke but had a low Omega-3 Index. Essentially, if you just look at this data alone, smoking was like having a low Omega-3 Index. Again, it's one of those things where, of course, it's observational data, you can never really establish causation, but I just feel like that's really eye-opening. Again, everyone knows smoking is bad for you, but nobody's thinking about how we're not getting enough omega-3. And how easy is it to take a fish oil supplement, for example, or increase your salmon intake?

So to summarize this part of my talk with respect to micronutrients, we talked about vitamin D as low-hanging fruit that can be addressed with a supplement. 4,000 IUs a day is a pretty good start to get most people who are deficient to a sufficient level. That's been shown in several studies. Getting people from a deficient level up to a sufficient level can be done with 4,000 IUs of vitamin D a day. For omega-3 fatty acids, get an Omega-3 Index test. You want your level to be in the 8% range. Studies have shown that it takes around 2 grams of supplemental omega-3 to get from a 4% Omega-3 Index to an 8%. It's really not that hard. Then again, omega-3 is found in prescription form.

I didn't go into all the randomized controlled trials today because that would take the remainder of my time here. But you can get omega-3 in purified ethyl ester form, either in the form of EPA only, Vascepa, or DHA plus EPA, Lovaza. And those are prescribed in 4 grams per day. And so what I said was, you know, sort of conservative. It takes about 2 grams a day, on average, to move from an Omega-3 Index of around 4% to 8%. And again, it's as simple as getting the test done and, you know, supplementing and then testing again and seeing if you're getting your index up to 8%. And then for magnesium, we talked about meeting the RDA, ideally by increasing leafy greens or by combining dietary sources with a supplement. Magnesium glycinate, citrate, malate are all pretty bioavailable sources of magnesium.