The death toll from the terrorist attacks on September 11, 2001, included 343 firefighters and paramedics among the 2,7531 who were exposed to 10 million tons of material released in a caustic dust cloud as the twin towers were reduced to rubble.2
Since then, more than 150 have died. Of the nearly 400,000 who are eligible for the World Trade Center Health Program set up specifically to treat the physical and mental health challenges caused by exposure,3 72,000 are enrolled and 8,000 have been diagnosed with cancer.4
First responders were exposed to toxins, the result of exposure to dust containing chemicals in asbestos, glass fibers, lead and cement.5 Seventeen years later the WTC Health Program addresses care for those suffering from respiratory problems, malignant cancers, digestive problems and reproductive problems associated with the exposure.6
Utility workers, medical examiners, bus drivers and others were also affected.7 Researchers from New York University School of Medicine8 undertook an analysis to determine if there were indications that some first responders may have greater risk than others.9
Omega-3 May Protect Against Lung Damage in First Responders
The team believes their experiment is the first to suggest compounds present in first responders could prevent disease. They measured metabolites, which are chemicals the body makes as it breaks down fat, protein and carbohydrates. Metabolites are natural byproducts that result from the breakdown of these macronutrients.10
The study specifically linked 30 metabolites to first responders who had a lower incidence of obstructive airway disease. Conversely, they found those who had lower levels also had an increased risk of developing pulmonary disease.11
In a press release12 the researchers announced they had analyzed blood samples from 14,000 first responders and their lung function tests. Firefighters are a unique population since pre-exposure lung function testing was available for many of the first responders.13
Lung function testing has been done every year since 9/11. The study found specific chemicals were predictive of disease with a 93.3% accuracy. The two groups of metabolites most associated with lung injury were amino acids and lipids.14
The researchers were unsure of the biological function of the amino acids in relationship to lung injury. Increased concentration supported the hypothesis some firefighters had higher protein intakes and also enjoyed a lower risk of lung injury. However, they also felt it was unlikely that protein deficiency was an issue in active firefighters.
A number of lipid metabolites were found in higher quantities in those who were without lung injury. Eicosapentaenoic acid (EPA)15 in particular acts as a precursor for reducing your inflammatory response and immune response to any injury. This effect may have helped reduce damage in first responders triggered by exposure to toxins.
Lead investigator George Crowley discussed the importance this data could have on prevention. He also shared potential recommendations for first responders participating in disaster relief and suggested that physicians analyze their patients’ blood and use the results to help guide treatment.16
Heart Risk Factors May Be Another Predictor of Lung Damage
The same team published findings in the journal Chest17 showing heart disease risk factors may also predict persistent lung damage in 9/11 first responders.18
The data demonstrated that traits of metabolic syndrome were a stronger predictor of lung dysfunction than tobacco smoking or the amount of exposure that emergency personnel were subjected to at the site of the attack.
The symptoms of metabolic syndrome include high blood pressure, abdominal obesity and high blood triglycerides.19 Dr. Anna Nolan, a senior study contributor from NYU School of Medicine, said,20 “A third of the population in most Western countries has abdominal obesity, insulin resistance and issues with high lipids.”
The researchers also noted the syndrome is linked to an increased risk for Type 2 diabetes, stroke and heart disease. The combination of particulate matter and metabolic syndrome was interesting to the researchers since issues with air pollution and particulate matter are becoming more common.21
The team analyzed data from firefighters enrolled in the WTC Health Program and found that the 1,208 people who developed lung injury by 2017 were more likely to be overweight or obese and to have metabolic syndrome.22 The data indicate that obesity is a greater risk factor than high blood sugar and insulin resistance.
Dr. Anne Dixon from the University of Vermont Medical Center was not involved in the study, but said she found the results highly important because it shows “a clear link” between metabolic syndrome and an increased risk of pulmonary disease.23
Omega-3 Protects Against Secondary Bacterial Infections
Past research24 has also demonstrated omega-3 fatty acids can help reduce bacterial infections in the lungs of those who suffer from chronic obstructive pulmonary disease (COPD).
Research from the University of Rochester School of Medicine and Dentistry demonstrated that derivatives of omega-3 are effective in clearing non-typeable Haemophilus influenzae that may become problematic in those with COPD. Lung infections may put lives at risk in those who suffer from obstructive airway disease, such as first responders who are exposed to multiple toxins.
Richard Phipps, Ph.D., was part of the team who found that omega-3 provides precursors to help shut down excessive inflammation in the lungs. Using mice, the data show that unlike drugs used in the study, omega-3 helps reduce inflammation without stopping the animals’ capacity to clear bacteria. It may have even sped up the process of clearing bacteria overall.25
Omega-3 Fats Affect Your Mitochondrial Function
Your omega-3 levels may also affect your mitochondrial function, or dysfunction. Mitochondrial disease26 is a group of conditions attributed to the dysfunction of mitochondria rendering organelles unable to effectively generate energy. Some of the more profound effects become evident in the brain and muscle, including the heart.
Other organs affected include the liver, eyes and kidneys. Omega-3 fats are among the more promising nutritional components researchers have found that play a crucial role in the management of mitochondrial dysfunction.27 Your mitochondria are important in energy production and calcium signaling, as well as apoptosis and autophagy.28
In one animal study, the oral administration of omega-3 fats demonstrated a positive effect on mitochondrial function and neuroprotection.29 Giving omega-3 fats to cells in a lab setting demonstrated the ability to induce metabolic genes and metabolic rate, increasing mitochondrial content compared with control cells.30
One of the signs of advancing age is remodeling of the cell membranes in the heart.31 One impact on this remodeling is mitochondrial function, which plays a role in sustaining energy production. Some of the changes that occur during aging predispose heart cells to ischemic injury and cell death.
Changes in the mitochondrial membrane are exacerbated by the presence of omega-6 polyunsaturated fats. This has a significant consequence on the efficiency of cell function. Researchers have found that dietary changes involving increased amounts of omega-3 fats help with metabolic issues that affect aging and facilitate mitochondrial energy production.32
Omega-3 Index May Offer Insight Into Your Levels
The featured study points to just one of the benefits of maintaining optimal levels of omega-3 fats. Unfortunately, while most people get more than enough omega-6 from vegetable oils, salad dressings, mayonnaise and nuts,33 they don’t get enough omega-3.
Technically, omega-3 fats are found in plant and animal sources, but as I discuss below, animal sources are the most bioavailable to your body. Maintaining optimal levels of omega-3 is also associated with a reduction in levels of obesity34,35 and in the prevention of chronic diseases such as cardiovascular disease, cancer, autoimmune diseases,36 nonalcoholic fatty liver disease and Alzheimer’s disease.37
Knowing your omega-3 level helps determine the amount of change needed to get your levels in the low risk category. William Harris, Ph.D., developed the omega-3 index, a blood test that measures the amount of omega-3 in your red blood cells. This reflects the amount in the rest of your body and is not influenced by recent meals.
The test has been used to evaluate data,38 the results of which demonstrate a healthy range of omega-3 measured in blood cells is from 8% to 12%.39,40 GrassrootsHealth, an independent research organization with whom we partner, offers an omega-3 and vitamin D at home test kit.
The results are completely private and require no doctor or lab visit. Once your sample and questionnaire are mailed, your results are usually ready within 10 to 20 days after the lab receives your sample. I offer this test kit simply as a convenience and courtesy as I don’t benefit or participate in the test in anyway.
Once you have your results, you have access to knowing how much omega-3 you need to reach a low level of risk. You may use this free calculator41 to help.
Choose Your Omega-3 Source Wisely
Although your body needs both plant and animal sources of omega-3 fats, they are not interchangeable. Plant-based omega-3 provides alpha linoleic acid (ALA), which your body inefficiently converts to EPA and poorly converts to DHA.42 Plant-based sources of omega-3 include flaxseed, walnuts, pumpkin seeds and chia seeds. These help to boost your overall ALA intake.43
Fish and marine oil supplements are a direct source of EPA and DHA.44 EPA and DHA are essential in digestion, blood clotting, memory, learning and functions of cell receptors. You must get these from your diet.45 You may choose to increase your intake of wild-caught Alaskan salmon, mackerel, anchovies and herring to do so.
However, if these are not available, choose to use a krill oil supplement rather than fish oil. Since fatty acids are insoluble in water they need to be packaged in a type of lipoprotein to be transported within your blood. An unprocessed fish oil supplement is bound in triglycerides while krill oil is mostly bound in phospholipids.46
It’s the phospholipids in krill oil that make this form of omega-3 supplement easily bioavailable in the first 72 hours.47 As you consume fish oil, the liver must attach it to a phosphatidylcholine while krill already contains this substance — yet another reason krill oil demonstrates more efficient cellular uptake.48
In addition to these advantages, fish oil has a higher likelihood of oxidative damage, making it less stable than most other supplements.49 In testing 54 of the best-selling supplements,50 one lab found 59.2% of the products had levels of omega-3 that varied by more than 10% of what was labeled on the bottle.
The testing also revealed 92.5% had measurable amounts of mercury, known to damage the nervous system, digestive tract and immune system, as well as on the lungs, skin and kidneys.51