Key Takeaways
- Kidney dialysis patients face extremely high mortality rates, with cardiovascular disease responsible for about 75% of deaths.
- Omega-3 fatty acids significantly reduced cardiovascular death in dialysis patients in a 3.5-year clinical study.
- Participants taking 2.4 g of omega-3s (EPA:DHA ratio of 2:1) experienced a 45% reduction in cardiovascular death and 37% fewer strokes.
- Omega-3 fatty acids rapidly incorporate into cell membranes, helping stabilize arterial plaques and reduce inflammation.
- Achieving an AA/EPA ratio below 2 provides stronger protection against plaque rupture and cardiovascular events.
- Omega-3 intake works best when combined with the Zone Diet, which activates AMPK—the master regulator of metabolism.
- Metabolic Engineering® combines diet, omega-3s, and polyphenols to reduce systemic inflammation and improve long-term health.
Can Omega-3 Fatty Acids Reduce Mortality in Dialysis Patients?
Quick Answer
Yes. A clinical study of more than 1,200 kidney dialysis patients found that 2.4 grams of omega-3 fatty acids daily reduced cardiovascular death by 45% and lowered stroke risk by 37% over 3.5 years. Omega-3 fatty acids help stabilize arterial plaques and reduce inflammation, both of which are major drivers of cardiovascular disease in dialysis patients.
Why Cardiovascular Disease Is So Dangerous for Dialysis Patients
Going on kidney dialysis is essentially a death sentence, as the death rate is about 20 percent per year. Of those deaths, accelerated cardiovascular disease accounts for 75% of the mortality. This rate of cardiovascular mortality is about 20 times as high as that of the general population (1).
What if a “drug” could reduce cardiovascular death by 45 percent as well as reduce fatal and non-fatal stroke by 37 percent over a 3.5-year period (2). It would be considered a “wonder drug,” and billions could be made overnight for such a drug. Fortunately, it is not a drug, but an adequate intake of omega-3 fatty acids. In particular, the exact dosage of total omega-3 fatty acids, using the same EPA-to-DHA ratio I have recommended for the past 24 years since I wrote The OmegaRx Zone (3).
What if a “drug” could reduce cardiovascular death by 45 percent as well as reduce fatal and non-fatal stroke by 37 percent over a 3.5-year period (2). It would be considered a “wonder drug,” and billions could be made overnight for such a drug. Fortunately, it is not a drug, but an adequate intake of omega-3 fatty acids. In particular, the exact dosage of total omega-3 fatty acids, using the same EPA-to-DHA ratio I have recommended for the past 24 years since I wrote The OmegaRx Zone (3).
The Clinical Study on Omega-3 Fatty Acids and Dialysis
What if a “drug” could reduce cardiovascular death by 45 percent as well as reduce fatal and non-fatal stroke by 37 percent over a 3.5-year period (2). It would be considered a “wonder drug,” and billions could be made overnight for such a drug. Fortunately, it is not a drug, but an adequate intake of omega-3 fatty acids. In particular, the exact dosage of total omega-3 fatty acids, using the same EPA-to-DHA ratio I have recommended for the past 24 years since I wrote The OmegaRx Zone (3).
What if a “drug” could reduce cardiovascular death by 45 percent as well as reduce fatal and non-fatal stroke by 37 percent over a 3.5-year period (2). It would be considered a “wonder drug,” and billions could be made overnight for such a drug. Fortunately, it is not a drug, but an adequate intake of omega-3 fatty acids. In particular, the exact dosage of total omega-3 fatty acids, using the same EPA-to-DHA ratio I have recommended for the past 24 years since I wrote The OmegaRx Zone (3).
The Clinical Study on Omega-3 Fatty Acids and Dialysis
This was a well-conducted study with more than 1,200 participants. More than half were taking statins, and nearly 25 percent were taking anti-coagulant drugs. Those in the active group received 2.4 grams of omega-3 fatty acids, with a 2:1 EPA: DHA ratio. Those in the placebo group received placebo capsules rich in omega-6 fatty acids.
The differences in cardiovascular events between the two groups were evident as early as three months. This time corresponded to the rate of EPA incorporation into plasma phospholipids and likely also reflected its incorporation into the arterial cell membranes. What about bleeding, since both groups were using the same levels of anti-coagulant drugs? Those on the placebo had a 1.6 times greater risk of bleeding than those taking the omega-3 fatty acids.
Why the AA/EPA Ratio Matters
Of course, this study raises the question, could even better results be obtained by taking higher doses of omega-3 fatty acids? The answer is yes, because ideally you want your AA/EPA ratio to be less than 2 to reduce the rupture of an existing atherosclerotic plaque, which is the primary cause of cardiovascular events (4,5). To reach that level usually requires a higher intake of omega-3 fatty acids.
However, keep in mind that adequate intake of omega-3 fatty acids is only one component of Metabolic Engineering®. An even more striking impact can be achieved by following the Zone diet to increase AMPK activity, the master regulator of metabolism.
Combining the Zone diet to increase AMPK activity with adequate intake of omega-3 fatty acids dramatically enhances your ability to reduce inflammation in every organ of the body. What that means to you is a longer and better life.
FAQ
Can omega-3 fatty acids help dialysis patients live longer?
Yes. Clinical research shows omega-3 fatty acids significantly reduce cardiovascular mortality and stroke risk in dialysis patients.
What dose of omega-3 fatty acids was used in the dialysis study?
Participants received 2.4 grams per day of omega-3 fatty acids with a 2:1 EPA-to-DHA ratio.
Why are dialysis patients at high risk of cardiovascular disease?
Chronic inflammation and metabolic dysfunction significantly increase cardiovascular risk in dialysis patients.
What is the AA/EPA ratio?
The AA/EPA ratio measures the balance between pro-inflammatory and anti-inflammatory fatty acids in the body. Lower ratios indicate reduced inflammation.
How does the Zone Diet improve metabolic health?
The Zone Diet activates AMPK, the master regulator of metabolism, which improves energy regulation and reduces inflammation.
References
- 1. Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis. 32(5 Suppl 3): S112-119 (1998). doi: 10.1053/ajkd.1998.v32.pm9820470. PMID: 9820470.
- 2. Lok CE, Farkouh M, Hemmelgarn BR, Moist LM, Polkinghorne KR, Tomlinson G, Tam P, Tonelli M, Udell JA; PISCES Investigators. Fish-oil supplementation and cardiovascular events in patients receiving hemodialysis. N Engl J Med. 2025 Nov 7. doi: 10.1056/NEJMoa2513032.
- 3. Sears B. The OmegaRx Zone. Regan Books. New York, NY (2001)
- 4. Hasegawa T, Otsuka K, Iguchi T, Matsumoto K, Ehara S, Nakata S, Nishimura S, Kataoka T, Shimada K, Yoshiyama M. Serum n-3 to n-6 polyunsaturated fatty acids ratio correlates with coronary plaque vulnerability: An optical coherence tomography study. Heart Vessels. 29:596-602 (2014). doi: 10.1007/s00380-013-0404-4.
- 5. Sekimoto T, Koba S, Mori H, Arai T, Yamamoto MH, Mizukami T, Matsukawa N, Sakai R, Yokota Y, Sato S, Tanaka H, Masaki R, Oishi Y, Ogura K, Arai K, Nomura K, Sakai K, Tsujita H, Kondo S, Tsukamoto S, Suzuki H, Shinke T. Association between eicosapentaenoic acid to arachidonic acid ratio and characteristics of plaque rupture. J Atheroscler Thromb. 30:1687-1702 (2023). doi: 10.5551/jat.63806.
Key Takeaways:
- Allulose may naturally stimulate GLP-1 release, helping regulate appetite and fat metabolism without the need for injectable drugs.
- Early research suggests greater fat loss and less rebound weight gain compared to semaglutide in animal studies.
- Unlike traditional sugar, allulose is minimally absorbed and not counted as sugar, making it easier to incorporate into daily nutrition.
- Long-term success depends on body composition—not just weight, with diet (like the Zone Diet) helping preserve lean mass while reducing body fat.
What if there were a simple sugar that was more powerful than GLP-1 drugs in terms of fat loss? What if that simple sugar were already approved as a food additive so it could be added to food products like shakes, bars, oatmeal, and granola, making it realistic to take it for a lifetime?
And of course, what if that simple sugar were less expensive than any GLP-1 drug? If so, it could be a radical change in obesity treatment.
The first injectable GLP-1 drug (semaglutide) was introduced in 2017 for treating diabetes under the tradename Ozempic. The oral version of semaglutide for treating diabetes, under the trademark Rybelsus, was introduced in 2019, but you had to take it daily rather than a weekly injection. Not surprisingly, patient compliance was less than with a weekly injection.
Once injectable semaglutide was approved for weight loss in 2021 (under the trademark of Wegovy), TV advertising took off, and the world never looked back. A slightly altered form of Wegovy for oral use was approved in December 2025, but it has similar side effects to the injectable form[‘;;;.
Unfortunately, more than 50 percent of people who start GLP-1 drugs quit after one year most likely due to its side effects (1). Once you stop taking the GLP-1 drugs, the lost weight rapidly returns, and the metabolic benefits of the initial weight loss quickly erode (2).
Ok, what about that simple sugar? Its name is allulose. It has GRAS status as a food additive since 2012. What makes allulose unique is that it triggers the natural release of GLP-1 from the gut upon ingestion (3). Although 70% as sweet as sugar, allulose is rapidly excreted from the body, so the FDA doesn’t consider it sugar for labeling purposes. Its only drawback is that it can cause potential gut issues when consumed in high amounts.
The simple solution to that problem is to consume it in smaller amounts, three times a day, so you can enhance the release of GLP-1 from the gut each time you eat. The easiest way to do that is to incorporate it into food products that can be consumed at every meal.
Now what about the scientific data? A recent article compared oral semaglutide with allulose for weight loss in diet-induced obese mice (4). Although obese mice are not identical to obese humans, the results are highly suggestive. The appetite suppression in mice receiving allulose was greater, weight loss was greater, and the regain of lost weight after stopping supplementation was slower with allulose than with semaglutide.
A preliminary study in humans indicates that allulose has a dose-dependent effect on fat loss without any decrease in calorie intake (5). Although a direct comparison of high-dose oral allulose with injectable GLP-1 drugs remains to be done, the preliminary data suggests that adding allulose to your diet (or better yet including it in food products that are easily integrated into any diet) may provide a more natural alternative to achieving long-term weight loss than to use of chemically modified hormones (i.e., GLP-1 drugs) with their significant side effects.
However, it’s not just weight loss you want to achieve. Your primary goal if you want to live longer is to lose excess body fat, not just weight. A recent study suggested that your body fat percent is a better predictor of longevity than is your BMI (6).
Using GLP-1 drugs, there is a considerable loss of lean body mass along with the overall weight loss. The result is that your body fat percentage changes more slowly. Thus, your real goal is to lose excess fat and maintain lean body mass.
Published data demonstrate that when type 2 diabetics are put on the a dietary program that was consistent with the Zone diet in both the levels of calorie restriction (1,200 to 1,500 calories per day) and a macronutrient composition (40% carbohydrates, 30% protein, and 30% fat) the result was not only is there complete remission of their diabetes, but also an increase in their lean body mass (7).
So, what does this suggest for the future of obesity treatment? First, incorporating more allulose into your diet makes it far easier to achieve the real goal of changing your body composition to live longer than taking GLP-1 drugs. Second, incorporating allulose into a new generation of ZoneRx® Foods can make it easier to add it to your diet. Third, if you follow a Metabolic Engineering® dietary system using the Zone diet guidelines and incorporating ZoneRx® Foods as a source of allulose, coupled with adequate levels of omega-3 fatty acids and polyphenols, you will likely lose fat, gain lean body mass, and probably live longer.
- References
- 1. Rodriguez PJ, Zhang V, Gratzl S et al. Discontinuation and reinitiation of dual-labeled GLP-1 receptor agonists among US adults with overweight or obesity. JAMA Netw Open. 2025 Jan 2;8(1):e2457349. doi: 10.1001/jamanetworkopen.2024.57349.
- 2. Tzang CC, Wu PH, Luo CA et al. Metabolic rebound after GLP-1 receptor agonist discontinuation: a systematic review and meta-analysis. EClinicalMedicine. 2025 Nov 28;90:103680. doi: 10.1016/j.eclinm.2025.103680.
- 3. Iwasaki Y, Sendo M, Dezaki K et al. GLP-1 release and vagal afferent activation mediate the beneficial metabolic and chronotherapeutic effects of D-allulose. Nat Commun. 2018 Jan 9;9(1):113. doi: 10.1038/s41467-017-02488-y.
- 4. Rakhat Y, Banno S, Zhantleu D et al. D-Allulose reduces weight more persistently than oral semaglutide while both equally elevate grip strength in diet-induced obese mice. Nutrients. 2026 Feb 23;18(4):707. doi: 10.3390/nu18040707.
- 5. Han Y, Kwon EY, Yu MK et al. A preliminary study for evaluating the dose-dependent effect of d-Allulose for fat mass reduction in adult humans: A randomized, double-blind, placebo-controlled trial. Nutrients. 2018 Jan 31;10(2):160. doi: 10.3390/nu10020160.
- 6. Mainous AG, Yin L, Wu V et al. Body mass index vs. body fat percentage as a predictor of mortality in adults aged 20-49 years. Ann Fam Med. 2025 Jul 28;23(4):337-343. doi: 10.1370/afm. 240330.
- 7. Stentz FB, Lawson D, Tucker S et al. Decreased cardiovascular risk factors and inflammation with remission of type 2 diabetes in adults with obesity using a high protein diet: Randomized control trial. Obes Pillars. 2022 Dec 1;4:100047. doi: 10.1016/j.obpill.2022.100047.
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Omega-3 Fatty Acids Reduce Cardiovascular Death in Dialysis Patients
Barry Sears
Founder & President, Zone Labs
Read Time: 10 minutes
Table of Contents
Key Takeaways:
- Kidney dialysis patients face extremely high mortality rates, with cardiovascular disease responsible for about 75% of deaths.
- Omega-3 fatty acids significantly reduced cardiovascular death in dialysis patients in a 3.5-year clinical study.
- Participants taking 2.4 g of omega-3s (EPA:DHA ratio of 2:1) experienced a 45% reduction in cardiovascular death and 37% fewer strokes.
- Omega-3 fatty acids rapidly incorporate into cell membranes, helping stabilize arterial plaques and reduce inflammation.
- Achieving an AA/EPA ratio below 2 provides stronger protection against plaque rupture and cardiovascular events.
- Omega-3 intake works best when combined with the Zone Diet, which activates AMPK—the master regulator of metabolism.
- Metabolic Engineering® combines diet, omega-3s, and polyphenols to reduce systemic inflammation and improve long-term health.
Can Omega-3 Fatty Acids Reduce Mortality in Dialysis Patients?
Quick Answer
Yes. A clinical study of more than 1,200 kidney dialysis patients found that 2.4 grams of omega-3 fatty acids daily reduced cardiovascular death by 45% and lowered stroke risk by 37% over 3.5 years. Omega-3 fatty acids help stabilize arterial plaques and reduce inflammation, both of which are major drivers of cardiovascular disease in dialysis patients.
Why Cardiovascular Disease Is So Dangerous for Dialysis Patients
Going on kidney dialysis is essentially a death sentence, as the death rate is about 20 percent per year. Of those deaths, accelerated cardiovascular disease accounts for 75% of the mortality. This rate of cardiovascular mortality is about 20 times as high as that of the general population (1).
What if a “drug” could reduce cardiovascular death by 45 percent as well as reduce fatal and non-fatal stroke by 37 percent over a 3.5-year period (2). It would be considered a “wonder drug,” and billions could be made overnight for such a drug. Fortunately, it is not a drug, but an adequate intake of omega-3 fatty acids. In particular, the exact dosage of total omega-3 fatty acids, using the same EPA-to-DHA ratio I have recommended for the past 24 years since I wrote The OmegaRx Zone (3).
What if a “drug” could reduce cardiovascular death by 45 percent as well as reduce fatal and non-fatal stroke by 37 percent over a 3.5-year period (2). It would be considered a “wonder drug,” and billions could be made overnight for such a drug. Fortunately, it is not a drug, but an adequate intake of omega-3 fatty acids. In particular, the exact dosage of total omega-3 fatty acids, using the same EPA-to-DHA ratio I have recommended for the past 24 years since I wrote The OmegaRx Zone (3).
The Clinical Study on Omega-3 Fatty Acids and Dialysis
What if a “drug” could reduce cardiovascular death by 45 percent as well as reduce fatal and non-fatal stroke by 37 percent over a 3.5-year period (2). It would be considered a “wonder drug,” and billions could be made overnight for such a drug. Fortunately, it is not a drug, but an adequate intake of omega-3 fatty acids. In particular, the exact dosage of total omega-3 fatty acids, using the same EPA-to-DHA ratio I have recommended for the past 24 years since I wrote The OmegaRx Zone (3).
What if a “drug” could reduce cardiovascular death by 45 percent as well as reduce fatal and non-fatal stroke by 37 percent over a 3.5-year period (2). It would be considered a “wonder drug,” and billions could be made overnight for such a drug. Fortunately, it is not a drug, but an adequate intake of omega-3 fatty acids. In particular, the exact dosage of total omega-3 fatty acids, using the same EPA-to-DHA ratio I have recommended for the past 24 years since I wrote The OmegaRx Zone (3).
The Clinical Study on Omega-3 Fatty Acids and Dialysis
This was a well-conducted study with more than 1,200 participants. More than half were taking statins, and nearly 25 percent were taking anti-coagulant drugs. Those in the active group received 2.4 grams of omega-3 fatty acids, with a 2:1 EPA: DHA ratio. Those in the placebo group received placebo capsules rich in omega-6 fatty acids.
The differences in cardiovascular events between the two groups were evident as early as three months. This time corresponded to the rate of EPA incorporation into plasma phospholipids and likely also reflected its incorporation into the arterial cell membranes. What about bleeding, since both groups were using the same levels of anti-coagulant drugs? Those on the placebo had a 1.6 times greater risk of bleeding than those taking the omega-3 fatty acids.
Why the AA/EPA Ratio Matters
Of course, this study raises the question, could even better results be obtained by taking higher doses of omega-3 fatty acids? The answer is yes, because ideally you want your AA/EPA ratio to be less than 2 to reduce the rupture of an existing atherosclerotic plaque, which is the primary cause of cardiovascular events (4,5). To reach that level usually requires a higher intake of omega-3 fatty acids.
However, keep in mind that adequate intake of omega-3 fatty acids is only one component of Metabolic Engineering®. An even more striking impact can be achieved by following the Zone diet to increase AMPK activity, the master regulator of metabolism.
Combining the Zone diet to increase AMPK activity with adequate intake of omega-3 fatty acids dramatically enhances your ability to reduce inflammation in every organ of the body. What that means to you is a longer and better life.
FAQ
Can omega-3 fatty acids help dialysis patients live longer?
Yes. Clinical research shows omega-3 fatty acids significantly reduce cardiovascular mortality and stroke risk in dialysis patients.
What dose of omega-3 fatty acids was used in the dialysis study?
Participants received 2.4 grams per day of omega-3 fatty acids with a 2:1 EPA-to-DHA ratio.
Why are dialysis patients at high risk of cardiovascular disease?
Chronic inflammation and metabolic dysfunction significantly increase cardiovascular risk in dialysis patients.
What is the AA/EPA ratio?
The AA/EPA ratio measures the balance between pro-inflammatory and anti-inflammatory fatty acids in the body. Lower ratios indicate reduced inflammation.
How does the Zone Diet improve metabolic health?
The Zone Diet activates AMPK, the master regulator of metabolism, which improves energy regulation and reduces inflammation.
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References
- Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis. 32(5 Suppl 3): S112-119 (1998). doi: 10.1053/ajkd.1998.v32.pm9820470. PMID: 9820470.
- Lok CE, Farkouh M, Hemmelgarn BR, Moist LM, Polkinghorne KR, Tomlinson G, Tam P, Tonelli M, Udell JA; PISCES Investigators. Fish-oil supplementation and cardiovascular events in patients receiving hemodialysis. N Engl J Med. 2025 Nov 7. doi: 10.1056/NEJMoa2513032.
- Sears B. The OmegaRx Zone. Regan Books. New York, NY (2001)
- Hasegawa T, Otsuka K, Iguchi T, Matsumoto K, Ehara S, Nakata S, Nishimura S, Kataoka T, Shimada K, Yoshiyama M. Serum n-3 to n-6 polyunsaturated fatty acids ratio correlates with coronary plaque vulnerability: An optical coherence tomography study. Heart Vessels. 29:596-602 (2014). doi: 10.1007/s00380-013-0404-4.
- Sekimoto T, Koba S, Mori H, Arai T, Yamamoto MH, Mizukami T, Matsukawa N, Sakai R, Yokota Y, Sato S, Tanaka H, Masaki R, Oishi Y, Ogura K, Arai K, Nomura K, Sakai K, Tsujita H, Kondo S, Tsukamoto S, Suzuki H, Shinke T. Association between eicosapentaenoic acid to arachidonic acid ratio and characteristics of plaque rupture. J Atheroscler Thromb. 30:1687-1702 (2023). doi: 10.5551/jat.63806.
1 comment
Udo got me on a tsp a day, and your OmegaZone book got me to two tsp a day. Three decades later, I’ve gained decades of healthspan. For example, I have zero chronic conditions and take zero meds of any kind. There is no way I could ever thank you enough, but I’m going try.