Ask Dr. H: How much shill is in krill oil?

Question: What's your opinion of krill oil? Do you think it's better than fish oil?

Answer: There are many manufacturers and distributors that would like you to believe that the oil of krill, a tiny shrimplike creature found in the deep waters of the Southern Ocean near Antarctica, is superior to fish oil in terms of its protection against heart disease, reduction of triglycerides and cholesterol, arthritis pain, menstrual pain, stroke prevention, and a myriad of unsubstantiated benefits like improved energy, memory, and skin, and diabetes prevention. Like fish oil, krill oil contains the omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). It also contains omega-6 fatty acids (researchers cannot agree whether they may be helpful or harmful), an antioxidant in the carotenoid (Vitamin A) family (also of uncertain benefit), and other substances called phospholipids.

Fish oil is a much more potent source of DHA and EPA. In terms of actual human studies to substantiate the bold claims of krill oil's efficacy, there are surprisingly only three: a 12-week study that had to do with lowering LDL "bad" cholesterol and raising HDL "good" cholesterol. It did show krill oil to be superior to fish oil, but it was only a small pilot study. Another small study compared krill oil to fish oil in the treatment of painful menstruation, and a third small study suggested that krill oil might be helpful against arthritis pain. Krill oil's clear superiority over fish oil is as yet not proved.

Q: At what age should a child's cholesterol first be checked?

A: Believe it or not, if there's a family history of high cholesterol or premature heart disease, screening should be done as early as 2 years of age. For all other kids, the just-released National Institutes of Health cholesterol guidelines recommend that a baseline fasting blood cholesterol level be checked between the ages of 9 and 11, and then again between the ages of 17 and 21. These guidelines are endorsed by the American Academy of Pediatrics.

The goal is for a total cholesterol level to be less than 170 mg/dl. If it's not at goal, lifestyle intervention with low-fat diet, increased exercise, and treatment of obesity should be the next steps, with cholesterol "statin" medication to be started as early as 10 years of age for an LDL "bad" cholesterol level of greater than 190 mg/dl (or greater than 160 mg/dl if there's a family history of heart disease or the child has diabetes).

Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at: "Ask Dr. H.," Box 767787, Atlanta, Ga. 30076. Due to the large volume of mail received, personal replies are not possible.