The patient: “Eduardo,” a 55-year-old Chilean involved in international trade.

Why he came to see me: Eduardo was generally in good health, but he developed knee and hip pain that came and went without any apparent reason. (He was referred to me by a good friend in his company, an Ecuadorian, who’d had good results with a prostate problem that I co-managed with a urologist.)

How I evaluated him: Eduardo came armed with a bevy of bloodwork and scans from an “Executive Health Screen” that showed him to be in near-perfect health and offered no explanation for his joint pains. When we discussed his travel and residence locations, a pattern began to emerge. When he was staying in the northeastern US and back home in Chile, his symptoms went away. But when he traveled to and stayed in Florida, the Caribbean and Greece, his pains reappeared.

How we addressed his problem: He explained that his diet was “very boring” and never changed much. Since growing up in Chile, it centered around at least two servings of fish a day. He made a point of mentioning that he always tried to eat the local fish because it would be the freshest. I told him that although this was a wonderful idea in concept, the omega-3 content of fish usually varied with the temperature of the water that they lived in. Usually the colder the water, the higher concentration of omega-3 oils in the food sources for the fish, and therefore the fish themselves are higher in omega-3s. (In that omega-3 oils congeal at a lower temperature than many other oils found in the marine diet, we tend to think of them as, “nature’s antifreeze.”) The water off coastal Chile and New England was quite cold and thus the omega-3 content of the is fish higher than that of fish in the Gulf of Mexico, the Caribbean and the Mediterranean, where the water temperature is warm.

The patient’s progress: With this advice in mind, Eduardo ate fish imported from cold climes when he traveled away from New England and Chile and also took along a bottle of my high-end fish oil to supplement his regime. The rapidity of their effect on joint aches and pains can be quite impressive. Eduardo noticed the benefit of both the cold-water-sourced fish and the omega-3 supplements within a few days. By being more careful about his choice of fish and staying with the supplementation, he believes himself to be “cured” and has been so for six months so far.

To learn more, visit Dr. Andy Rubman’s website,

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