The right balance of omega-3 and omega-6 fatty acids is crucial to health, but many people may not be aware of challenges in achieving this balance due to insufficient nutrients or genetic predisposition.
Shifting diets, with seismic consequences
Many of us know by now that regularly eating fish and other seafood, or taking fish oil supplements, has heart-protective and anti-inflammatory effects on our health. This has a lot to do with the omega-3 fatty acid content of these foods or supplements. Unfortunately, the Western diet has seen a much more pronounced rise in consumption of omega-6 fatty acids taken from seed oils, especially ones that are then subject to industrial processing. When the ratio of highly processed omega-6 and naturally-occurring omega-3 fatty acids goes out of whack, with the amounts of omega-6s being roughly 6 or more times greater than omega-3s, things often start to go seriously awry with our health. Our paleolithic ancestors typically had an omega-3 to omega-6 intake ratio of between 1-2:1, whereas the dietary shift in the standard western diet has changed this drastically to between 15-30:1. This is why there are some studies that find no benefit from taking a fish oil supplement: 1,000 mg of fish oil isn’t going to help your heart if you’re also ingesting 20,000 mg of omega-6 fats that push your body into an inflammatory state.
At the heart of this (pun intended), is this tendency for the imbalance in omega fats within our bodies to cause persistent, low-grade, systemic inflammation. This means our bodies become permanently inflamed, and this is one of the key factors driving the steady rise of chronic, inflammatory diseases like heart disease, many types of cancer, type 2 diabetes, obesity, arthritis and the 100 plus autoimmune conditions out there. Not only that, many people have a genetic predisposition that means their requirement for omega-3s is greater because their bodies only have a limited ability to the convert plant form of omega-3 ‘parent oil’ (alpha-linolenic acid) to the long-chain, anti-inflammatory forms needed by the body (EPA and DHA). Other people may lack one or more of the necessary specific enzymes required to perform these important conversions.
Striking a balance
Achieving the right balance is so critical because 1) most Americans get way too much omega-6 in their diet; around 90% of is the essential omega-6 fatty acid alpha-linolenic acid, most coming from from highly processed seed (‘vegetable’) oils, and 2) too much omega-6 in the diet crowds out metabolism of omega-3s pushing people into this systemic, pro-inflammatory state.
Most omega-3s in the diet come from plant foods like certain nuts (e.g., walnuts) and seeds (e.g., flaxseed, rapeseed) in the form of alpha-linolenic acid (ALA), which needs to be converted to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Some also comes from seaweed and other algae. Animal foods like fish and other seafood (e.g., shrimp, crab, lobster, oyster, other shellfish) and fish oils, free-range eggs, and to a lesser extent red meat and dairy from grass-fed animals, all provide Omega-3s, but primarily as DHA and EPA, rather than ALA. Both omega-3 and -6 ‘parent oils’ need to be converted to their bioactive long-chain forms (EPA and DHA) and these conversions are performed by the same set of enzymes. If you eat a lot of processed foods that are high in omega-6s, when you do eat foods like flax seed oil or walnuts, your body won’t be able to convert them efficiently to the anti-inflammatory compounds that benefit health owing to competitive interference with the conversion of ALA to DHA and EPA within the body. A diet with a higher proportion of omega-6 will increase inflammation and make you more susceptible to disease.
Consuming seafood or fish oil is the only way of being sure of getting the all-important long-chain omega-3 fatty acids, EPA and DHA. It is possible for the body to synthesize EPA and DHA from ALA found in foods like walnuts, flax seed, and pumpkin seeds, but this conversion is extremely limited: studies have found that about 8 percent of dietary ALA is converted to EPA and 0-4 percent is converted to DHA. EPA and DHA have been shown to protect against many chronic diseases and reduce overall mortality.
Vegans and vegetarians
The ramifications on our health of recently changing dietary patterns, given our in-built, ancestral omega-3 and -6 metabolism, are enormous. This is especially the case as more people are encouraged to become vegan or vegetarian, who cut out all, or most, animal-derived omega-3 sources, especially fish and other seafood, from their diets, relying only on plant sources. Additionally, the conversion of ALA to DHA depends on the availability of iron, among other nutrients, and the bioavailability of iron from plant sources is also quite low compared to animal sources. This is another reason that vegetarians are often poor converters of ALA to DHA. The conversion of ALA to EPA and DHA also requires B vitamins, calcium, copper, zinc, and magnesium. Populations who are deficient in these vitamins and minerals will have an impaired ability to convert omega-3s into the useful forms. Certain conditions like Crohn’s disease, celiac disease, HIV, and alcohol use disorder prevent the body from absorbing B vitamins, something that also afflicts older adults and pregnant women—so these populations may also have an impaired ability to convert ALA to EPA and DHA.
The arrival on the market of algal forms of DHA and EPA is something of a breakthrough for vegans and vegetarians – although they are expensive by comparison with marine sources.
Genetic variants
Further, certain, common genetic variations called single nucleotide polymorphisms (SNPs) in the FADS genes influence how well the body converts ALA into EPA and DHA. Specifically, the enzyme that converts ALA to EPA and DHA has reduced activity in people who carry the minor allele in FADS1 and FADS2, which means they have lower levels of EPA. For these individuals, it is critical to either eat fish regularly or to supplement with fish or algal oil containing EPA and DHA. Research has found that those with African ancestry tend to have efficient conversion enzymes, and those with Native American ancestry have inefficient enzymes.
Let’s get practical
To get omega fatty acids in balance requires most Americans to reduce intake of omega-6 fats and increase intake of omega-3 fats. Most processed foods contain oils and fats high in omega-6s from highly refined sunflower, cottonseed, soybean, and corn oils. Restaurants also commonly use these fats because they are so cheap. It is theoretically possible to increase omega-3 intake without adjusting omega-6 intake, but this isn’t advisable, as it would require eating about 11 ounces of fish a day, which would likely risk you being exposed to excessive heavy metals like arsenic, cadmium and mercury that have been shown to pose a real risk to health, including cancer.
Rather, most experts recommend both reducing omega-6 intake by reducing or cutting out vegetable oils and other fats high in omega-6, especially ones containing large amounts of refined, highly processed seed soils, and increasing intake of omega-3s by, for example, by eating a 4-ounce portion of salmon or other cold water, oily fish twice a week. It’s important to try to get wild sources, though. For example, the omega-6/omega-3 ratio in farmed salmon is about 14:1, versus about 3:1 for wild salmon. Eating farmed salmon will still raise DHA levels, but wild salmon does this without delivering as many omega-6s. This basic principle is true of most other farmed fish compared to wild counterparts: farmed fish have omega-3s, but also more omega-6s. As a side note, this is why farmed salmon is often dyed pink: wild salmon are naturally pink because of the astaxanthin-rich crustacean phytoplankton they eat in the wild that help impart the higher in omega-3 content as well as providing a healthy dose of natural antioxidants. Farmed salmon is naturally gray because the fish are not fed their natural diet.
Grass-fed beef is another source of EPA and DHA; note that grass-fed beef has seven times as much omega-3 fatty acids than conventional beef, which has almost none. Seaweeds and other algae can be good sources of non-animal derived Omega-3s.
What about foods like avocados, which have an omega-6/omega-3 ratio of about 15:1? Simply put, avocados are still a healthy food because, while it has more omega-6s, the total content of omega fatty acids is relatively low. Most of the fat in an avocado is monounsaturated, and most of that is oleic acid, which has been shown to reduce certain biomarkers of inflammation. If you find all of this too confusing, an integrative practitioner, nutritionist, or health coach can help guide you to achieve the right balance in your diet.
Achieving a 1:1 ratio in today’s world is very difficult, so experts generally recommend achieving a range of between 1 and 5:1.
Getting these ratios in balance is a matter of life and death. One study found that replacing corn oil with olive oil and canola oil to reach an 4:1 omega-6/omega-3 ratio led to a 70 percent decrease in total mortality. Elevated omega-6 intake is associated with an increase in all inflammatory diseases that are killing Americans in record numbers. Getting the right balance of omega-3 and omega-6 fatty acids is often over-looked but a critical pillar of health and resilience.
Our take home for you, Amigos Omigos!
Remember that your body’s omega-3/6 ratio is a function both of your fatty acid intake, the nutrients and cofactors your body currently has, and your genetic predisposition. Many people will benefit greatly from advice from a nutritionist or functional medicine practitioner who can not help sort out an individualized dietary plan for you, often based on the interpretation of a blood test that analyzes the composition of fatty acids in your blood.
If you don’t feel you need the help of a health professional, there are also a number of home test kits available on the market that can test the status of key fatty acids in your blood, including giving you your omega-6/3 ratio at the time of testing. These rely on the analysis of a small sample of blood taken from your finger tip. They include Life Extension’s Omega-3 Index Complete Finger Stick Test, Empower DX’s Omega DX Fatty Acid Balance Test, and OmegaQuant’s Omega-3 Index Test.
