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If you’ve been paying attention to health headlines over the last few decades, you’ve likely heard about essential fatty acids (EFAs) — specifically omega-3s and omega-6s. These nutrients play many vital roles in supporting our overall health, including increasing nutrient absorption, ensuring proper growth and development of the brain and nervous system, and reducing the risk of chronic illnesses, such as heart disease.
Research shows that omega-3s and omega-6s work together to help manage blood pressure and blood clotting, and to regulate the immune system, including the body’s inflammation response. Deficiencies, meanwhile, are linked to a wide range of symptoms and disorders, including depression, sleep disturbances, organ abnormalities, and skin problems.
Termed essential because the body can’t produce them on its own, these fatty acids have to be obtained through diet. “When it comes to fat, we literally are what we eat,” says Mark Pettus, MD, associate dean of medical education at the University of Massachusetts Medical School.
Pettus notes that the quality and quantity of fats we eat directly affect the fluidity and composition of our cell walls. “Fats are the fabric woven into every cell membrane.”
Omega-3s, especially, have earned a “healthy fat” reputation since researchers began digging into their benefits in the early 1980s. Esteemed for their health-promoting powers — such as helping to prevent heart disease and arthritis — omega-3 supplements (typically fish oil) are now the most common natural product used by American adults. According to the National Center for Complementary and Integrative Health, nearly 19 million Americans consumed omega-3-fatty-acid supplements in 2012, the most recent year for which this statistic is available.
Omega-6s, on the other hand, are considered a bad fat by many, despite their complementary role in supporting health. Found naturally in nuts, seeds, and plant-based oils, omega-6s have gained their negative reputation because they’re so often consumed in highly processed forms, including refined cooking oils, which can create excess inflammation in the body. With so much of the standard American diet coming from boxed, packaged, and processed food sources, many of us consume far more poor-quality, pro-inflammatory omega-6s than whole-food, anti-inflammatory omega-3s.
This imbalance negatively affects the efficacy of omega-3s working in the body — so even if you are diligently eating omega-3-rich foods and taking a daily supplement, they’re not able to do their jobs.
To help people strike the right EFA balance, many health and nutrition experts emphasize the importance of consuming more whole-food sources of omega-6s and omega-3s (with supplementation as necessary) while significantly reducing the intake of processed sources of omega-6s. Such diets have proven effective at protecting the heart and brain, among other benefits.
How have we ended up so out of alignment, and what can we do about it? Read on for key information about essential fatty acids, and learn how to strike the right omega balance in your own diet.
Why don’t we get enough omega-3s?
Omega-3 fatty acids include alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). ALA is considered the EFA parent, or precursor. It’s found in flax oil and flaxseeds, walnuts, hemp, and dark leafy greens, and is converted in the body into EPA and DHA.
This conversion, however, is done at extremely low rates: Women of childbearing age convert approximately 21 percent of the ALA they consume to EPA and 9 percent to DHA; these numbers drop significantly by the time they reach their 40s. Young men convert only about 8 percent of ALA to EPA and less than 4 percent to DHA.
Low DHA levels, specifically, are associated with an increased risk of macular degeneration, and cognitive decline or dementia in older individuals.
Some experts trace our poor ALA conversion rates to the fact that we evolved without much need to synthesize DHA and EPA because they were readily available in our food supply.
“The richest source of EPA and DHA is fatty fish,” explains Kara Fitzgerald, ND, a faculty member at the Institute for Functional Medicine. And since many of our prehistoric ancestors lived near lakes, rivers, and oceans, they likely consumed a lot more seafood than we do now.
While the American Heart Association recommends at least two 3.5-ounce servings of fatty fish (salmon, mackerel, herring, lake trout, and sardines) per week, a recent study in Nutrition Journal reports our mean fish intake is less than half the suggested amount — a deficit that comes with a high cost.
“The high amounts of omega-6 fatty acids and low levels of omega-3 fatty acids found in today’s Western diets promote the pathogenesis of cardiovascular disease, cancer, inflammatory conditions, and autoimmune diseases,” says Artemis Simopoulos, MD, president of the Center for Genetics, Nutrition, and Health and author of The Omega Diet. (For guidance on shopping for seafood high in omega-3s, see “How to Choose Seafood That’s Nutritious, Sustainable — and Safe“.)
Why do we get too many omega-6s?
Omega-6s are derived from linoleic acid (LA), which the body converts to gamma-linolenic acid (GLA), and then to arachidonic acid (AA).
Like omega-3s, omega-6s have important metabolic jobs to do. They support brain function and development, stimulate skin and hair growth, maintain bone health, regulate metabolism, and bolster the reproductive system. They also trigger the body’s inflammation response when you’re sick or injured.
Omega-6s and omega-3s are polyunsaturated fatty acids, or PUFAs, a term that refers to their chemical structure. Some public-health organizations say that high-omega-6, PUFA-rich foods like canola oil are heart-healthy alternatives to saturated fats, and they recommend people consume between 5 and 10 percent of their daily calories from omega-6s.
Yet a growing number of researchers argue that processed sources of omega-6 — such as packaged foods, grain-fed meats, and refined oils (including canola) — are largely to blame for the epidemics of heart disease and type 2 diabetes. All PUFAs are susceptible to oxidation via light and heat, the researchers note, which creates free radicals that can wreak havoc at the cellular level. (This is why fish-oil capsules are often sold in dark bottles and refrigerated.) Vegetable and seed oils are not only high in omega-6s; they’re also typically produced using heat, creating oxidized foods that many experts attribute to diet-related illnesses.
Animal research supports the argument that high omega-6 levels are problematic: Studies demonstrate that consuming oxidized vegetable oils can damage brain cells, lead to excess inflammation, and increase type 2 diabetes and cardiovascular-disease risks. (For more about healthy fats, go to “The Facts About Fat“.)
Why are our omegas are out of balance?
When omega-3s and omega-6s are represented more or less equally in the body, they complement each other and govern the immune system. But when that balance is off — when we consume significantly more omega-6s than omega-3s — we create an inflammatory environment that sets us up for trouble.
Omega-3 and omega-6 fatty acids are stored within cell membranes, where they help provide structure and control fluidity. It’s here that various enzymes convert these fatty acids into hormone-like compounds that signal inflammatory or anti-inflammatory activity in the body.
The Journal of Nutrition and Metabolism reviewed numerous studies investigating the effects of this imbalance and concluded that an increased ratio of omega-6s to omega-3s — and an overall rise in omega-6 consumption — damages important mediators and regulators of our inflammation and immune responses.
What’s a good balance? Certainly not one produced by a Western diet high in processed foods and refined oils, which delivers a dietary ratio of omega-6 to omega-3 fatty acids as high as 45:1. “While both of these essential fatty acids are necessary for optimum health, we need to get those ratios back into balance,” says Jeanne Rosner, MD, physician, nutrition educator, and the founder of SOUL Food Salon. She recommends a ratio of 4:1 or even 2:1, and getting those fats primarily from whole-food sources.
Why do whole foods hold the key?
Thinking in terms of ratios may be helpful, but it’s not the entire story. Simply taking a daily fish-oil capsule and expecting it to offset an inflammatory diet misses the point, argues Fitzgerald.
“Having an excess of the main ingredient for inflammatory compounds is the starting point for many diseases,” she explains. “If our enzymes are tied up converting omega-6s, we’ll end up converting those more aggressively, and we won’t have sufficient enzymatic power to convert the lower quantity of omega-3s being ingested.”
The key to balancing your omegas is modifying your consumption on both fronts. “Taking in more high-quality omega-3s and less highly processed omega-6s is one of the most powerful nutritional interventions in our clinical toolkit,” says Kathie Madonna Swift, MS, RDN, LDN, cofounder of the Integrative and Functional Nutrition Academy.
In fact, when you steer clear of processed fare and focus on EFA-rich whole foods, like nuts, seeds, greens, and grassfed beef and dairy, and the two recommended 3.5-ounce servings of fatty fish per week (about 1,500 to 2,100 mgs per serving), you may not need to supplement at all.
Health organizations recommend 250 to 500 mg of DHA and EPA per day; unless you have a health concern like coronary heart disease (in which case the American Heart Association recommends more), you can get your weekly fix in those two servings of fish.
Researchers have observed that eating fish seems to be more effective than taking supplements at elevating levels of DHA and EPA. They suspect this is because fish contains more bioavailable nutrients that fish oil does not — including selenium, zinc, iron, and highly absorbable protein. “Eating whole foods, and healthier sources of food, will help us naturally get our omega-6-to-omega-3 ratios into better alignment,” says Rosner.
And with nutritional forces as influential as essential fatty acids, finding that right balance can make a big difference in your health and well-being.
How to Supplement for Omega Balance
For those who can’t or choose not to eat fatty fish, or who have certain health issues, supplementation is a way to increase omega-3 levels. “There are some conditions that might respond well to supplementation, such as depression or cardiovascular risk factors, including elevated triglycerides,” explains Kathie Madonna Swift, MS, RDN, LDN.
If you decide to supplement, consider these words of advice:
- Choose a cold-pressed supplement, which means the oil has been extracted with limited heat, says Jeanne Rosner, MD. “Always keep supplements in a cool, dark place.” This prevents oxidation from exposure to light and heat.
- Look for third-party certification that indicates fish oil has been purified to remove PCBs, mercury, dioxins, and furans. Mark Pettus, MD, recommends researching products at consumerlab.com and labdoor.com.
- Consider krill oil for its high bioavailability, says Pettus. “It’s a sustainable source of marine omega-3, and its bioavailability is as much as 30 to 40 percent better than other sources.”
- Try blue-green algae supplements or spirulina for a vegetarian option, suggests Rosner.
- Eat more ALA-rich foods like walnuts, flax, chia, hemp, and leafy greens. Rosner also recommends turmeric and black pepper, noting studies that suggest the active ingredients in these spices may together help increase the conversion of ALA to DHA and EPA.
- Pare back on supplements when your diet is dialed in, says Kara Fitzgerald, ND. “If you’re eating more fatty fish some days, you can cut back on your supplements to balance out what you’re getting from your diet.”
Omega-3s and Heart Health
Aiming for a healthy overall balance of omega-6s to omega-3s is a smart way to think about day-to-day food choices. But when it comes to reducing your risk for cardiovascular disease, research shows that the number to watch is your omega-3 index, which reflects actual blood levels (versus dietary intake) of EPA and DHA. An omega-3 index over 5 percent is associated with significantly reduced risk of coronary events, though Jeanne Rosner, MD, recommends targeting 8 percent.
In terms of ratios, researchers in Japan found that a higher EPA (an omega-3) to AA (an omega-6) ratio, in particular, was associated with a lower risk of major coronary events. Many tests for omega-3 index, which your doctor can order, will present both total omega-3 and EPA-to-AA ratios.