It’s not enough to supplement your diet with fi sh oils or to eat enough omega-3 fats in your diet—it’s merely a good start. The health benefi ts of omega-3 fats depend on the balance of omega-6 fats in your diet. But that’s a big problem in the United States and many other Western nations.

We eat too much of the so-called heart-healthy omega-6 fats, which compete with and even destroy the benefi ts of omega-3 fats. To make matters worse, we don’t eat enough omega-3 fats. Consequently, most of us have a major fat imbalance in the diet.

In thisArticle you will discover why the balance of omega-6 and omega-3 fats really matters to your health. You’ll learn why just about every food you eat is inundated with omega-6 fats, and you’ll discover the impact of eating excess omega-6 fats, including increased risk for Alzheimer’s disease, asthma, cancer, heart disease, vision disorders, infl ammation disorders, learning disorders, rheumatoid arthritis, sleep disorders, and stress.

Mega Omega Problem in Our Food Supply

Today we eat fats that did not exist 100 years ago, including margarine, shortening, and cottonseed oil. As a result, we eat 10 to 20 times the amount of omega-6 fats that our forebears did. How did our fat balance get so out of whack?

It would be easy to point fingers at the food-processing industry, but we can’t only blame this easy scapegoat (although it certainly contributed). A multitude of factors, including industrialization, agribusiness, food manufacturing, and the promotion of “heart-healthy” oils, contributed to fewer omega-3 fats and too many omega-6 fats in our food supply.

Even if you reach for a food that you think contains omega-3 fats, unfortunately it may not. For example, soybean oil is stripped of its naturally occurring omega-3 fats when it is hydrogenated. Farmed salmon has a higher amount of omega-6 fats than wild salmon. Yet how could you know this, since this information is not disclosed on
food packaging?

Let’s take a closer look at these factors, so you’ll have a better idea how almost every food you eat has been penetrated with more omega-6 and shortchanged of its omega-3 fats.

The Case of the Fatted Calf

Before 1850, virtually all cattle in the United States spent four to five years grazing on grass, which naturally contains omega-3 fats, before slaughter. But today feedlot operations get a steer to slaughter in just about one year. As a result, cows have much less omega-3 in their meat today than they used to. A recent study from Ireland underscores this point; it found that the longer the cattle grazed, the higher their DHA content. Dining in the pasture also improved their fat profile, with lower levels of omega-6 fats in their meat.

Feedlot Cuisine. Today, 99 percent of cows in the United States dine in feedlots, exclusively on a corn-grain diet, which is rich in omega-6 fats and practically devoid of omega-3 fats. Consequently modern beef is fatter and has an entirely different fatty-acid profile: lower in omega-3 fatty acids, higher in omega-6 fatty acids, and higher in saturated fat. Wild animals and free-range or pasture-fed cattle do not display this unhealthy fat profile.

Commercially raised chickens, lamb, fish, and pigs also have a much lower omega-3 content in their meat and fat (think bacon here). Reports as early as 1968 showed that range-fed animals have higher amounts of omega-3 fatty acids. Foraging on grass rather than grains increases omega-3 fat accumulation in animals, as shown in Table 3.1.

The Meat (and Dairy Foods) We Eat Reflect the Diet of the Cow. The typical cow fattened on grain has 14 times more omega-6 than omega-3 fatty acids in its meat, far more than the grass-fed cow. This has a trickle-down effect in the food chain. The commercial meat and dairy products we eat also lack omega-3 fats while yielding a much higher load of omega-6 fats. This significance is aptly illustrated when you look at cheeses made from grazing cows versus feedlot-fed cows.

Omega-6 Syndrome and the Okinawa Paradox

The residents of the Japanese island of Okinawa held the bragging rights for the longest life expectancy in the world—until their diet dramatically changed after World War II. Following the war, they ate less fish at meals and ate meat instead. This occurred in part because of exposure to Westernized eating, as Okinawa was under U.S. jurisdiction until 1972. A well-publicized problem of mercury contamination also spurred eating less fish. Consequently, consumption of omega-3 fat dropped. During U.S. rule, there was also a rapid shift to cooking with vegetable oils  instead of animal fats because they were considered superior for health. Consequently, Okinawans more than tripled their omega-6 fat content by 1990.

These changes were followed by a dramatic rise in Okinawans’ health problems, including Western-type cancers, allergic reactions, and heart and blood circulation diseases. Notably, the abrupt rise in health problems paralleled the Okinawans’ increased use of omega-6 fats. When Okinawa lost its longevity status, a scientific investigation began.

Researchers attributed the cause of Okinawans’ health problems to their Westernized diet, which was too low in omega-3 fats and too high in omega-6 fats. Their shift to a diet high in omega-6 fats with the concomitant rise in chronic diseases was strikingly similar to what occurred in the Westernized world.

To solve the panoply of health problems, researchers recommended eating less omega-6 fats and more omega-3 fats, with a balanced ratio of 2 to 1. That ratio means that a person who ate two grams of omega-3 fats should limit intake of omega-6 fats to just four grams for the day—the amount of omega-6 fat found in one granola bar or one tablespoon of mayonnaise. Notably, the scientists emphasized that eating less omega-6 fat without eating enough omega-3 fat is ineffective at lowering the health-damaging compounds made from omega-6 fats.

Keep in mind that the typical American eats an average of 13 grams of omega-6 fats per day. That’s more than four times the quantity of omega-6 fats consumed by a typical Okinawan.

India and Israel: Diets High in Omega-6 Fats and More Chronic Diseases

Israel also made the switch to the so-called healthier oils, resulting in one of the greatest omega-6 fat intakes in the world. Israelis’ average dietary omega-6 fats outnumber omega-3 fats by 22 to 1.

In spite of Israel’s exemplary heart-healthy eating (a diet low in artery-clogging saturated fat, high in polyunsaturated fats, and low in total calories), Israelis have a high prevalence of heart disease, not to mention high blood pressure and diabetes. Now they have a higher cancer rate than in Western countries. Researchers say this is
a consequence of eating too many omega-6 fats.

The prevalence of heart disease is also high in the residents of urban areas in India, despite their low-fat diet in which 15 to 27 percent of calories come from fat. Researchers attribute the higher rate of heart disease to eating too many omega-6 fats. Interestingly, the rural dwellers have a much lower incidence of heart disease, not to mention lower rates of other related chronic illnesses. Why? They dine on “poor man’s food” consisting of mustard oil and grains. Consequently, the rural residents have a diet much lower in omega-6 fat than their urban counterparts.

Omega-6 Fats Increase Risk for Specific Diseases

High levels of dietary omega-6 fat increase the risk for many different diseases and conditions. Here’s a quick look at some of the problems, which will be discussed in more depth throughout this website:

• Increased risk for cancer. A study of 854 veterans showed over the
  course of eight years that those following the corn oil diet (which
  substituted corn oil for the saturated fats in their diet) had twice
  the fatal cancer rate of those eating a standard diet.

• Greater fat storage. Studies indicate that omega-6 fats have a
  remarkable ability to trigger fat storage in the body. Several studies
  show that when animals are fed diets high in omega-6 fats,
  they become fatter than animals fed diets with identical calories.
  While more research is clearly needed in this area, it adds one
  more compelling reason to balance the fats.

• Clogged arteries in susceptible people. High levels of omega-6 fats
  increased damage to the arteries when given to people who have
  high fat levels (triglycerides) in their blood or who make too much
  of a compound called LOX, which promotes infl ammation.

• Poorer recoveries by sick patients. When standard soybean oil
  was fed to patients intravenously, they had more complications
  and more detrimental inflammation compounds in their blood
  than those infused with less omega-6 fat. Notably, the higher the
  omega-6 fat from the intravenous feeding, the longer the patients
  remained in the hospital.

• Worsened brain function and mood. The rise in diagnosed psychiatric
  disorders parallels the rise in omega-6 fat consumption.
  Some experts believe that the skewed high ratio of omega-6 to
  omega-3 fat accounts for the decade-by-decade rise in depressive
  disorders.

• Increased vision problems associated with age. A high intake
  of linoleic acid (the parent omega-6 fat) increases the risk for
  age-related macular degeneration, a serious problem that causes
  decreased vision. Conversely, a diet rich in omega-3 fats and fish
  appears to decrease the risk, if the diet is low in omega-6 fat.

The Most Powerful (and Damaging) Omega-6 Fat: Arachidonic Acid

Arachidonic acid (AA) is the epicenter of all that is problematic with excess omega-6 fat in our diets and ultimately with our health. AA is the fatty acid that creates the compounds that cause inflammation and blood clotting, among many other problems. In fact, many medications (including aspirin, Motrin, naproxen, Depakote, and Singulair) work by blocking the effects of AA. Researchers have just started to scratch the surface of AA’s impact, but here are some striking findings:

• Turned-on cancer genes. Scientists from San Francisco discovered
  that AA turns on a dozen genes involved in cancer. When they
  added AA to human prostate tumor cells, the cells grew twice as
  fast. Notably, over the past 60 years, the rate of prostate cancer
  in the United States has increased steadily along with the dietary
  intake of omega-6 fats.

• More heart attacks. In separate studies from different regions of
  the world, researchers found that people with more AA in their
  body had a higher risk of getting a heart attack.

• Mood disorders. Researchers recently figured out why many
  mood-stabilizing medications are effective for treating mood disorders.
  They work by lowering the level of arachidonic acid in the
  brain.

Balanced Omega-6 Fat Matters for Health and Disease Prevention

From petridishes to human studies, vast and diverse research overwhelmingly demonstrates the need to balance the fat families. A high proportion of omega-6 to omega-3 fat paves the way for many health problems, including mental illness, cancer, cognitive impairment, inflammation, arthritis, asthma, allergies, immunity disorders, heart disease, diabetes, Alzheimer’s disease, and vision and bone health problems, to name just a few examples.

The more omega-6 fat you eat, the higher your risk for disease. Research highlights are summarized in Table 3.6. When the term ratio is used in this table, it refers to the proportion of omega-6 to omega-3 fats.

While many people imagine that the term omega is synonymous with omega-3 fats, that impression is far from correct. It’s easy to get confused, because the fats and their names can be a bewildering tower of Babel, especially for the uninitiated. There are different omega fat families, which have completely different effects on health and disease. Even within the category of omega-3 fats, you’ll find more than one type. Then there are saturated and unsaturated fats(with the latter no longer universally viewed as the healthy class of fats).

How do you keep it all straight? Before we delve into the specifics of omega-3 fats and how to get them to work best for you (let alone get enough of them), let’s get familiar with the various types of fat. Figure 2.1 provides a general overview of how the different fats we eat are interrelated.

Meet the Omega Families

Omega actually refers to the system of how the fatty-acid atoms are counted and named (see sidebar). Each fat family is very different from the other, as in a neighborhood, where families reside on the same street but each at a different address, which signifies a completely different household. (You don’t expect the family living on 33 Main Street to be the same family living on 66 Main Street.) We will focus primarily on the omega-3 and omega-6 families, but you might like to know that olive oil comes from the omega-9 fat family, which is considered healthful.

Each omega family has individual members called fatty acids, each with a different name. Each omega-3 and omega-6 fat family has a parent fatty acid, from which the other individual fats can originate. Notably, each of these parents is considered an essential fat, meaning the body cannot make it and it needs to be supplied by the diet. Table 2.1 identifies dietary sources of the major types of omega-3 and omega-6 fatty acids.

What Is “Omega”?
The term omega refers to how the various fat families are
named, based on a counting system. Fat molecules are long;
the typical fat molecule found in food is between 12 and 22 carbon
atoms long. Think of each carbon atom as a link in a bracelet. We
would represent a 22-carbon “bracelet” this way:

C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C

That’s a lot of carbons to count. To save time, scientists count from
the end of the chain, where the fi rst unsaturated pair of carbons is
located (known as a double-bond arrangement). So that everyone
remembers this counting system, the beginning of the chain is designated
as the alpha side, named after the fi rst letter in the Greek
alphabet. The end of the chain is the omega side, named after the
last letter in the Greek alphabet.

C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C-C

Alpha Omega
In the case of the omega-3 family, the double-bond arrangement
is located three carbons from the end (the omega side):

C-C-C-C-C-C-C-C-C-C-C-C-C-C=C-C-C

Similarly, in the case of the omega-6 family, the double bond is six
carbons from the end:

C-C-C-C-C-C-C-C-C-C-C=C-C-C-C-C-C

This difference may seem inconsequential, but it’s huge. It’s like
the impact the location of a decimal point has on a number (especially
money!). For example, would you rather have $1.500000 or
$1500.000? Both quantities have the same digits, but the values
of these amounts differ considerably, just because of where the
decimal is placed. The one dollar and fifty cents is like the omega-
6 fats; the decimal point is six digits from the end. Likewise, the
fifteen hundred dollars is like the omega-3 fats; the decimal point
is three digits from the end. Just as a decimal point can make numbers
far different, the location of the initial omega bond on a fat
molecule makes a huge biological difference to the body.

The individual fatty acids differ in significant ways. The omega-3 fat found in plants is very different from the omega-3 fatty acids found in seafood. It’s possible to eat plenty of plant-based omega-3 fats but still be deficient in the other omega-3 fatty acids found in marine foods. This is a big source of confusion for consumers. Here’s a brief
description of the key omega-3 fatty acids:

• Alpha-linolenic acid (ALA). The parent of all the fatty acids in
  the omega-3 family is known as alpha-linolenic acid (ALA). Technically,
  all the omega-3 fatty acids can be made or originate from
  ALA, but research shows that this is rarely the case. ALA is one
  of the shortest among the omega-3 fats, making it a short-chain
  fatty acid (see Table 2.2). ALA is found in plants, green leafy vegetables,
  flax oil, canola oil, and hemp.

• Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
  EPA and DHA are known collectively as long-chain fats and are
  found primarily in fish and fi sh oil. Stories about the marvelous
  benefits of omega-3 fats usually involve one (or both) of these
  powerful fatty acids.

Here’s the problem. Although laboratory tests showed that ALA can be made into EPA and eventually DHA, recent studies on humans indicate that this is not what the human body actually does. Therefore, you cannot assume that if you eat the parent form of omega-3 fats, ALA, it will indeed create EPA and DHA. If you take flax seed oil supplements or eat a lot of flax foods as your primary source of omega-3 fats, they provide ALA, but you could still be deficient in
EPA and DHA. In fact, the latest research shows that less than 1 percent of ALA gets made into EPA, and seldom (if ever) does it make DHA. That’s why many researchers believe that all three of these omega-3 fats are essential.

Inflammation as the Cause of Heart Disease: An Old Idea, Newly Embraced

While the notion of inflammation as the cause of heart disease still grabs headlines, the idea is hardly new: it originated nearly 200 years ago!  The inflammation theory went in and out of vogue depending on the medical opinion leaders of the time.

In 1815 surgeon Joseph Hodgson published Treatise on the Diseases of Arteries and Veins, which identified inflammation as the cause of artery damage. But he wasn’t popular, so neither was his
theory. About 40 years later, pathologist Rudolf von Virchow resurrected the inflammation theory. But another prominent doctor disagreed. It would take more than a century for scientists to settle this issue.

Old-School Lipid Theory. In the 1900s, scientists created clogged arteries in rabbits by adding cholesterol to their food, which gave rise to the theory that dominated most of the 20th century. According to this theory, plaque builds up in the arteries, limiting blood flow, resulting in a heart attack. This sounds logical, but there is actually more to the processes causing heart attacks.

New-School Inflammation Theory. Thanks to technology, it became clear that blood clots (which are caused by inflammation) play a pivotal role in heart attacks. Inflammation was widely accepted as the culprit of heart disease in 1999, when Russell Ross published his landmark paper, “Atherosclerosis: A Chronic Inflammatory Disease,” in the New England Journal of Medicine.

What about clogged arteries? Plaque buildup in the arteries is certainly a problem, but it is akin to loading a bullet into a gun—it’s dangerous but not lethal in and of itself. The chronic inflammation process ultimately pulls the trigger by causing plaque to accrue and then rupture, spewing a blood clot and inflammatory compounds into the blood. Let’s take a closer look.

Inflammation of Arterial Highway 101

Inflammation is triggered by a microscopic injury to the artery, which can be caused by high blood pressure, smoking, and oxidized LDL, a more toxic form of cholesterol.

Attempting to self-heal, the injured artery releases a chemical SOS, which initiates the inflammation cascade, resulting in plaque formation. The core region of the plaque consists of fat and immune cells, surrounded by a tough cap (like a scab). The inflammation process ensues, causing the cap to weaken. Consequently, the plaque ruptures like a lethal volcano, spilling its toxic contents into the blood. Your arteries become the inflammation highway, circulating these compounds, one of which is the omega-6 fat arachidonic acid.

I contacted a prominent omega-3 fat researcher at the National Institutes of Health (NIH). He began the interview by asking me a rhetorical question: “Do you know why omega-3 fats affect so many parts of our body and so many diseases?” He continued, “It’s because too much omega-6 fats in our diet prevent omega-3 fats from doing their normal course of work in our body.” Then he proceeded to describe how he balanced the fat in his own diet by cutting out omega-6 fats, food by food. Wow.

If you have never heard of omega-6 fat, you are not alone. When people hear the term omega, they often assume omega-6s are beneficial and related to omega-3 fats. While both groups of fats work together very closely, they have opposite effects in the body, like a seesaw. And as with children on a seesaw, the actions of one affect the other. If these fats are not balanced in your diet, they can dramatically affect your health. That’s the problem. The American diet is bombarded with unhealthful levels of omega-6 fats, which impede the benefits of omega-3 fats.

Omega-6 Fats Promote Disease

The problem with eating too much omega-6 fats is that they are disease promoting. In fact, the NIH’s Essential Fats Education program makes a profound declaration on its website: excessive omega-6 fats in the diet trigger a rise in health problems, including heart attacks, blood clots, arthritis, asthma, menstrual cramps, headaches, and
tumor metastases.

Eating too much omega-6 fat is a predicament affecting most Westernized countries, not just the United States. This quandary has been documented in many cultures and is referred to as a health paradox or omega-6 fat syndrome.

Most Omega-6 Fats Are Found in “Healthy” Oils

The paradox is that omega-6 fats have been indiscriminately promoted as “heart-healthy fats.” Many well-meaning health organizations touted “heart-healthy” oils (including corn oil, soybean oil, and margarine) to lower blood cholesterol and reduce the risk of heart disease. Consumers were (and are) urged to replace artery-clogging saturated fats in their diet with heart-smart polyunsaturated oils, which consist primarily of omega-6 fats.

Unwittingly, this health advice triggered people to eat more of the fats that work against the omega-3s. The so-called heart-healthy omega-6 oils displaced other fats in many people’s diets. Grocery store shelves overflowed (and still do) with foods containing “heartsmart” oils. But it turns out that the idea of eating polyunsaturated fats to prevent heart disease was based on an incomplete picture; emerging studies have shown otherwise.

Countries including Israel embraced heart-healthy eating by eating more polyunsaturated oils (omega-6 fats). Israel is especially notable because it consequently has one of the world’s greatest intakes of omega-6 fats. But with the increase of omega-6 fats came an increase in Western diseases such as cancer and diabetes.

Researchers used the term omega-6 fat syndrome to describe the cause of chronic illness plaguing an unusually healthy group of people in Okinawa, a region of Japan. The scientists discovered that Okinawans were eating too much omega-6 fat at the expense of omega-3 fat, and this imbalance was at the root of their new chronic health problems.

We Eat Fat That Did Not Exist 100 Years Ago

Today, we eat fats that didn’t exist a century ago, including cottonseed oil. Check the ingredients list on some of your favorite foods. More often than not, it will be listed, as it’s among the top four oils consumed in the United States. Our foods are now filled with omega-6 fats because of technology and pressure to eat more heartsmart fats.

Farming Practices Increase Omega-6 Fats in Meats and Plant Foods

Lastly, agricultural practices have dramatically altered the content of omega-6 and omega-3 fats in our diet. Plant foods used to have higher omega-3 fat levels, which had a positive trickle-down effect on the rest of our diet. In the bygone days of cattle grazing, cows used to nibble on plants containing omega-3s. And in the you-are-what-you-eat manner, these cows incorporated omega-3 fat into their own body. Voilà: the cows yielded milk and meat containing omega-3 fats, which in turn would be eaten by consumers. Today the amount of omega-3 fat in commercial beef is virtually undetectable. Instead, feedlot animals eat a grain-based diet, which offers little in the way of omega-3 but is higher in omega-6. Consequently, their meats are also higher in omega-6 fat.

We Need to Fix the Omega Fat Imbalance

Indeed, the typical Western diet delivers a double whammy: insufficient omega-3 fats and too many omega-6 fats. The consequence is many chronic diseases, from osteoporosis to inflammation disorders, which we can’t cure simply by reaching for a fish oil supplement. If you have too much omega-6 fat in the diet, it interferes with the benefits of omega-3 fats! A healthy balance of omega-6 fats and omega-3 fats in our diet is a key health factor that has been ignored for too long. Whereas our ancestors ate equal proportions of these fats, today the omega-6 fats in the American diet outnumber omega-3 fats by 10- to 20-fold!

Vegetarians are not off the hook, because studies show that they eat even more omega-6 fat in their diets than the typical person who eats meat. At the other extreme, those indulging in bacon and cream cheese in the name of weight loss, dieting Atkins style, also have a problem. These fats—saturated fats—also compete against the omega-3s.

The research is quite stunning, showing that omega-3 fats play a key role in preventing many illnesses and conditions:

• Inflammation
• Stroke
• Allergies
• Cancer
• Alzheimer’s disease

They may also be effective in treating:

• Depression
• Attention deficit disorder
• Dyslexia
• Cystic fibrosis
• Asthma
• Arthritis

Lastly, omega-3s have been shown to play a key role in:

• Brain development and function
• Learning and IQ

Alexander Leaf of Harvard University led the landmark study demonstrating omega-3 fats’ ability to prevent sudden death. His lab gave arrhythmia-prone dogs fish oil just before they performed a treadmill stress test. The results showed that fi sh oil prevented sudden death in the dogs.

These remarkable results prompted studies to see if similar benefits could be achieved in people. Hints already existed, as eating fish one to two times weekly was associated with a nearly 50 percent
reduction in sudden death.

Fish or Fish Oil Decreases Sudden Death

A study called the Diet and Reinfarction Trial told heart attack patients to eat two fi sh servings per week. The study’s results indicated a 29 percent reduction in death. Another study, the GISSIPrevenzione Trial, involved over 11,000 heart attack patients. In that study, men given 850 milligrams of long-chain omega-3 fats had a 45 percent reduction in sudden cardiac death compared with the unsupplemented group. The U.S. Physician’s Health Study added a vital piece of evidence: omega-3 fats reduce the risk of sudden death even among men without a history of heart disease.

Omega-3 Fats Prevent Arrhythmia in Heart Surgery Patients

A dangerous heart rhythm, atrial fibrillation, is one of the main complications after open-heart surgery. Italian researchers randomly gave fish oil supplements to 80 of 160 patients scheduled for heart surgery. The supplemented group had a marked reduction in atrial fibrillation and spent fewer days in the hospital. The fi sh oil’s effectiveness was comparable to that of the heart-stabilizing medications sotalol and amiodarone—but without their serious side effects, including assorted problems in the liver, lungs, and heart.

Omega-3 Fats May Prevent Arrhythmia in High-Risk Patients

Researchers are hopeful that omega-3 fats will provide an alternative to anti-arrhythmia drugs for patients with implanted defibrillators. But studies on these patients show conflicting results, so the jury is still out.

Omega-6 Increases the Odds of Developing Heart Disease

Excess omega-6 fats trigger blood clotting, clustering of blood cells, and tightening of blood vessels—a compelling bit of information. When you consider the role of omega-6 fats as a contributor to heart disease, the information is chilling.

In the 1970s, there were clues that excess omega-6 fat hurts the heart. Scientists infused animals with the omega-6 fat arachidonic acid, and it caused sudden death within minutes. The cause of death was thrombosis (blood clots).  This lethal effect did not occur after using the same amount of other fats.

Furthermore, all the eicosanoids made from arachidonic acid, except for one, have been found to be potent arrhythmogenic agents (causes of arrhythmia), according to Alexander Leaf’s research. Based on these and other findings, Leaf in a 2001 scientific editorial urged a lowering of dietary omega-6 fats in order to promote heart health.

Notably, the higher the level of arachidonic acid in your body, the greater your risk of death from heart disease. Let’s take a closer look.

Phospholipids

Oil and water don’t mix, so fats need a shuttle to move throughout your blood, which is mainly water. One of these “shuttles” is a phospholipid, which holds one pair of fatty acids. Phospholipids are a major component of all cells, including heart cells, blood cells, and brain cells.

Each phospholipid is like a hanger in which there are two clamps to hold a long pair of pants (but instead of pants, they are fatty acids). One of the clamps, called position 2, is reserved for long-chain fats. Typically, the coveted position goes to one of three fats: the omega-6 fat arachidonic acid or the omega-3 fats EPA or DHA. Which gets in? Whichever fat is in most abundant supply. The supply is based on the proportion of omega-6 to omega-3 fats in the diet. In the case of the American diet, omega-6 fat wins a great majority of the space in the phospholipids, which is why about 75 percent of the long-chain fats in the American body are omega-6 fats.

A new blood test, called the Omega-3 Index, measures the phospholipid content of omega-3 fats. The higher your omega-3 index, the more protection your heart will have. Researchers believe this test might be one of the best indicators for risk of death from heart disease.

LDL Cholesterol: Special-Delivery Taxi for Omega-6 Fat.

The last L inLDL stands for lipoprotein, which is a protein that serves as a taxi for fat. In its center region is the fat payload, including cholesterol and phospholipids, which it delivers into the artery wall.

LDL carries an enzyme that serves as the release pin for the arachidonic acid tethered to the phospholipid. Once freed, the arachidonic acid can make potent omega-6 eicosanoids that trigger blood clotting, inflammation, and arrhythmias—obviously not good for the heart. An elevated blood level of this enzyme is an independent risk factor for heart disease and indicates the extent of artery damage.

Diets High in Omega-6 Fats Promote Atherosclerosis

Diets that are high in omega-6 fats may be especially harmful to people with a genetic disposition to heart disease (who are just being identified, thanks to robust research from the human genome project). The potent omega-6 eicosanoid made from the LOX enzyme (a known trigger of asthma) is powerfully linked to atherosclerosis, especially in people who are genetically wired to make higher levels of this enzyme.

A profound study published in the New England Journal of Medicine found that eating a diet high in omega-6 fat (typical levels in a Western diet) caused an increase in the production of the damaging LOX-based compounds, leading to atherosclerosis. Both omega-6 fats, linoleic acid and arachidonic acid, were significantly associated with increased severity of artery damage.

In another study, Tufts University researchers reported in the May 2006 issue of Circulation that people who have a variation of a gene called apolipoprotein A5 have a higher risk for heart disease,
especially if they eat a diet high in omega-6 fats.

Diets Low in Omega-6 Fats Reduce Death from Heart Disease

The Lyon Diet Heart Trial was a large study designed to see if eating a Mediterranean-style diet would protect against the recurrence of a heart attack, compared with the standard diet recommended by the American Heart Association. The omega-6 fats in the diet were limited to seven grams a day, about what you fi nd in just one tablespoon of corn or soybean oil. The results surprised even the researchers. After four years on this diet, participants experienced a reduction in all causes of death, including heart disease. The impact of this diet was also refl ected in blood phospholipids, with a lower ratio of omega-6 to omega-3 fats.

In spite of the compelling evidence of omega-3 fat’s detriment to heart health, there is not much “buy-in” from the medical community. Since the late 1980s, respected scientists from around the world have brought attention to the omega-6 fat problem in eloquent editorials and studies, only to seemingly fall on deaf ears.

Instead, many health organizations indiscriminately promote the use of polyunsaturated fats to replace artery-clogging saturated fat. Since omega-6 fats are the dominant fat found in polyunsaturated oils (soybean oil, cottonseed oil, sunflower oil, safflower oil, corn oil)—if you seek them out, you will overwhelmingly increase your dietary load of omega-6 fats, which is counterproductive to health.

Fortunately there are ripples of change. In 2005, Joint British Societies issued guidelines to prevent cardiovascular diseases, which not only recommended regular fish consumption, they urged replacing saturated fat with monounsaturated fats (like olive oil). This is significant, because this is the first health association that does not indiscriminately recommend increasing polyunsaturated fats for saturated fats.

To keep your heart healthy, it’s a great start to eat more omega-3 fats, whether from fish or supplements. But it is not enough. Dietary omega-6 fats need to be lowered to a healthier balance. This balance is also important for the developing brain, which you can find more detail about on this website.

Scientists believe that when the fetus is nutritionally deprived, nutrients have to be allocated. The developing brain gets priority. This leaves important organs like the kidney and heart vulnerable to not developing properly, possibly increasing the risk of diseases related to those organs. Here are some provocative examples.

Protection of Daughters from Breast Cancer

A headline-grabbing study was presented at the 2005 annual meeting of the American Association for Cancer Research. The results indicated that mothers who eat foods rich in omega-3 fats during pregnancy and breastfeeding and continue to feed their babies such a diet (after weaning) may reduce their daughter’s risk of developing breast cancer later in life.

It’s been known that maternal diets high in omega-6 fats increase maternal estrogen levels, which in turn are linked to increased breast cancer among female children. In a study involving rats predisposed to cancer, Elaine Hardman of Louisiana State University gave them a diet high in either omega-3 or omega-6 fats while they were pregnant, breastfeeding, and weaning. All of the offspring exposed to the maternal omega-6 diet developed breast tumors. But the omega-3 offspring had a lower tumor incidence rate of 13 percent. While this study is far from definitive, the results are provocative.

Prevention of Asthma

Children whose asthmatic mothers ate oily fi sh during pregnancy were 71 percent less likely to develop asthma, according to research presented at the 2004 international conference of the American Thoracic Society. In contrast, the researchers also found that children whose mothers ate fish sticks during pregnancy were twice as likely to develop asthma. What gives? Fish sticks are deep-fried and contain omega-6 fatty acids, which are pro-inflammatory.

Prevention of Allergies

Australian researchers examined the effect of fi sh oil supplementation in 40 mothers-to-be on the immune response in their infants. The women all had a history of hay fever or asthma, making their
children at increased risk of developing allergies. At one year of age, the children of mothers who took fish oil were 3 times less likely be sensitized to egg allergen and 10 times less likely to have severe atopic (allergic) disease.

Blood Pressure

While hypertension is unusual during childhood, studies have shown that blood pressure tracks from early childhood (and now the womb) into adulthood. In a recent animal study, omega-3 deficiency during pregnancy caused high blood pressure later in life, even if the offspring were subsequently rehabilitated with omega-3s. Early omega-3 deficiency, regardless of subsequent supply, resulted
in hypertension.

A compelling study on children showed that blood pressure at age six was lower in those who as infants had been fed with a formula supplemented with omega-3s than in children fed formula without omega-3s.

Diabetes

If expectant moms eat enough omega-3 fats, it may prevent their babies from getting diabetes. The Norwegian Childhood Diabetes Study Group found that babies fed cod-liver oil during the first year of life had a 25 percent lower risk of type 1 diabetes. The researchers believe that omega-3 fats influence the genes that cause diabetes.

When it comes to fat, you are what you eat. Unlike carbohydrates and protein, fat is the only macronutrient that does not get broken down into smaller units when you eat and digest it. These intact fats have a tremendous impact on the function of your body. If you eat chiefly omega-6 fats, that’s what you will find in your body: primarily omega-6 fats in your cells. (The same thing happens to the meat of animals raised on feedlot diets of grains rich in omega-6.) Conversely, if you eat a lot of omega-3 fats such as fish, that intake, too, will be reflected proportionately in your cellular makeup—if (and this is a big if ) you don’t have too many omega-6 fats in your diet as well.

The Type of Fat You Eat Shifts Your Body’s Biological State

The preponderance and type of fat in your cells dramatically affects the biological actions in your body. That’s because both omega-3 and omega-6 fats make powerful, hormone-like chemicals that shift the landscape of your body toward promoting either disease or health. The proportion of these fats eaten ultimately infl uences the inner workings of your cells, becoming a predictable biomarker of both your diet and disease. Simply put, show me the amount of omega-6 and omega-3 fats in your diet, and I’ll show you your body’s biological state: pro-disease or pro-health.

The omega-3 and omega-6 fats work like a seesaw moving up and down, trying to achieve a healthy equilibrium for your body. This balance works at keeping your blood pressure normal, maintaining a regular heartbeat, healing wounds, and keeping your mood flowing smoothly. When the amounts of these fats eaten are in balance, this tandem relationship works well.

One of the key reasons omega-6 fats have such sway over omega-3 fats is that these fat families need the same enzymes to make their potent biological compounds in the body. Those indiscriminate enzymes are in limited supply, like taxis on rainy day in New York. It’s harder to get a taxi during inclement weather because so many more people use them (a case of competitive supply and demand). Once the taxis are saturated with people, no cabs are left for others, no matter how great their need.

Doesn’t it seem odd that there would be such an antagonist metabolic environment? Remember, it wasn’t always that way. For thousands of years, our ancient ancestors chomped on a diet that provided equal amounts of omega-6 and omega-3 fats. Therefore, the body had no problem with fats sharing enzymes.

A Diet Rich in Omega-3 Fat Protects Health

The omega-3 fats that make their way from your dinner plate down to your tiny cells can shift the biological state of your body. They do so by making compounds that fight inflammation, prevent blood clots, and reduce stress chemicals, all of which help to prevent chronic diseases, including heart disease and cancer. This biological shift is so profound that heart disease scientists created the “Omega-3 Index” blood test, which refl ects the content of omega-3 fats in your heart cells. Some researchers believe that the omega-3 index may be one of the best predictors of heart disease.

A Diet High in Omega-6 Fat Promotes Disease

Omega-6 fats have distinct and opposite effects in your body. They are in direct competition with omega-3 fats to make their powerful and often opposing biological compounds. When omega-6 fats greatly outnumber the omega-3 fats, they behave like a dietary bully, dominating your body’s cellular playground.

A diet rich in omega-6 fats shifts the biological state in your body to one that sets up the conditions to promote diseases: infl ammation, blood clotting, and increased stress chemicals. The omega-6 fats create damaging compounds associated with arthritis, Alzheimer’s disease, heart disease, stress, mood disorders, and cancer, to name a few. In fact, death from heart disease is predicted linearly from the amount of omega-6 fat in the body.

A brief point needs to be made about the key omega-6 fats, linoleic and arachidonic acids: They are essential fatty acids, too. Yes, they are nutrients—yet archrivals, if you will, of the omega-3 fats. Omega-6 fats are not unlike other essential nutrients, such as vitamins A and D. They are required for your body to function, but when taken in high levels, they can pose dangerous health problems.

Before birth, all of the omega-3 fats accumulated by the developing baby must come from the mother via the ultimate maternal straw, the umbilical cord, where nutrients are transferred to the baby. DHA withdrawals are taken from the mother’s stores to supply the critical building blocks for the baby’s developing brain.

Each pregnancy drains maternal stores of omega-3 fat, and unless they are replenished, the stores get lower with each birth. They continue to drain if a mother breastfeeds her baby. Researchers believe that depleted maternal stores of omega-3 fat are a contributing factor to postpartum depression.

Benefits to Mom During Pregnancy

Omega-3s play a role in a healthy pregnancy, which naturally benefits the baby. They create the powerful cascade of eicosanoids, which activate labor, so they influence the length of the gestation period.

Omega-3s may prolong gestation by blunting one of the compounds that start labor. In 2002 scientists in Denmark found that the risk of premature birth is greatly reduced if mothers eat oily fish during pregnancy. Their research, published in the British Medical Journal, showed that the average birth weight and length of pregnancy appeared to increase in direct relation to the amount of fish eaten. Low consumption of seafood was a strong risk factor for preterm delivery and low birth weight.

In another study, researchers gave high-risk pregnant women either fi sh oil or a placebo. The fish oil group had a significant reductionin preterm delivery.

Benefits to Baby During Pregnancy

Nearly all of the baby’s brain cells are formed in the womb, although they mature after birth. Each brain cell requires DHA to ensure proper brain development. Several studies indicate that if the mother is not eating enough DHA, less DHA is present in the baby’s brain. Consequently, the baby’s emotional and intellectual development can be greatly affected.

Mature Brain Development. The young brain cell is like a sapling that grows into a tree. Brain cells mature by getting longer and branching out. DHA is critical to this process. Pregnant women who eat more DHA give their babies a better chance of mature brain development, according to a fi rst-of-its-kind study reported in the September 2002 issue of the American Journal of Clinical Nutrition. Researchers evaluated sleep patterns of babies because those patterns reflect the brain’s maturity. Mothers with higher DHA blood levels had babies with heartier sleep patterns in the fi rst 48 hours after delivery. Babies born to women with low DHA levels had less advanced sleeping patterns (less brain maturity). Furthermore, the balance of omega-6 to omega-3 fats in the prenatal diet had a signifi cant impact; diets that were higher in omega-6 fats resulted in babies having less advanced sleeping patterns.

Impact on Language and Learning. Pregnant women who ate fish regularly had toddlers with better language and communication skills, according to research on 7,421 children born in 1991 and 1992. Scientists tested each child’s cognitive development at ages 15 and 18 months. Overall, eating fish during pregnancy was consistently linked to children’s higher test scores. (Keep in mind that it is important to choose low-mercury fish.

The largest effect was seen in the children’s ability to understand words at the age of 15 months. Children whose mothers ate fi sh at least once a week recognized 7 percent more words than those whose mothers never ate fish. A similar pattern was seen in another study that evaluated social activity and language development.

Boost to Babies’ Intelligence. Researchers at the University of Oslo found that children whose mothers took cod-liver oil during pregnancy scored higher on intelligence and achievement tests at four years of age. This study is notable because it was randomized and double-blind (the gold standard of a well-designed study).

Better Metabolism of Chemicals Promoting Attention and Memory. DHA plays a big role in creating and storing chemicals involved in mood, memory, and concentration. A decrease of DHA in the developing brain alters the metabolism of the neurochemical dopamine, which is vital to attention, motivation, and child development.

Influence on Genes (Now and Later). Omega-3 fats turn on and off many genes in the brain. Genes are like factories that have the recipe to make proteins. When genes are turned on, the assembly line begins, churning out specific proteins such as a blood cell. Conversely, when genes are turned off, the assembly halts.

Recently, researchers explored whether eating omega-3 fats during the perinatal period could influence brain gene expression later in life. (The perinatal period is generally considered to start at the 20th to 28th week of gestation and ends one to four weeks after birth.) Among 1,600 genes examined in rats, omega-3 deficiency altered the expression of several important genes in the offspring. (Clearly, it’s not ethical to do this sort of experiment on a human.)

The Greenland Eskimos

In the 1980s, the Greenland Eskimos were discovered to have an unusually low rate of heart disease compared with Danes, although both groups had similar blood cholesterol levels. In fact, the Eskimos ate twice as much cholesterol as the Danes, which puzzled the researchers. The healthy difference turned out to be the amount of fish eaten by the Eskimos. Soon the world was buzzing about the benefits of eating fish and omega-3 fats.

In all of the excitement, an important finding was lost. The Eskimo fish diet was also much lower in omega-6 fat than the Danes’ diet (see Table 3.7). The omega-6 dietary factor is quite telling when comparing the diets from Japan, Okinawa, the United States, Denmark, and Greenland. Note how much higher omega-6 fat levels are in the American diet. This was reflected in their blood, too. Lower levels of omega-6 fats in the body meant more health protection. But excitement over the omega-3 fat discovery eclipsed the significance of the low levels of omega-6 fats in the Eskimo diet.

The Mediterranean Diet: It’s Not Just the Olive Oil This oversight happened again in 1994, with the Lyon Diet Heart
Study, which popularized the Mediterranean-style diet for its health benefits. A significant feature of the Mediterranean diet is that it is low in omega-6 fat levels, yet that aspect receives little if any mention, even when leading researchers demonstrate its importance.

In the Lyon Heart Diet Study, French researchers led by Michel de Lorgeril used the key dietary components of the Mediterranean diet and applied them to residents of the city of Lyon. The results of the study, which was supposed to last five years, were so striking that it was halted midway by an ethics committee. Remarkably, there was a complete prevention of cardiac sudden death in participants eating a Mediterranean-style diet; the control group, which followed the classic heart-health diet (which does not distinguish between the types of polyunsaturated fat) had no such benefit.

A subsequent follow-up of Lyon Diet Heart Study participants was even more remarkable—an unprecedented lower death rate from all causes, especially cancer. This was an unexpected finding. The stunning results were published in the American Heart Association’s scientific journal, Circulation, in 1999, accompanied by an editorial, which emphasized that only the diet with the lower omega-6 fat and higher omega-3 fat successfully lowered the death rate from all causes, including cardiac. The classic cardiac diet—which does not distinguish between the types of polyunsaturated fat, therefore mostly omega-6 fat—failed to improve the overall prognosis.

Michel de Lorgeril continues to write extensively on the need to lower dietary omega-6 fat, as it is one of the hallmarks of his famous study. Yet that advice seems to have had little impact. At least he is not alone. In 2000, an international group of scientists that specialize in omega-3 fats issued guidelines to cap omega-6 consumptiontoward a balanced level. Two years later, Japan issued similar public health recommendations to limit the amount of omega-6 fat in the diet. In Australia, patients participating in the Early Arthritis Clinic are advised to reduce their omega-6 fats to keep inflammation at bay. Keep in mind that no health agency or omega-3 fat expert is recommending we get rid of omega-6 entirely—only that we bring it back into balance.

Benefits of Balancing the Omega-6/Omega-3 Ratio

A clever study from Harvard Medical School showed dramatic results when a gene spliced into worms gave them the ability to make their own omega-3 fats. The worms began automatically producing a balanced fat ratio of 1-to-1 in their cells, with incredible benefits:

• Heart cells decreased susceptibility to irregular heartbeats.
• Cancer cells were naturally destroyed (a natural process known as apoptosis).
• Inflammation was reduced in cells that line and protect the entire circulatory system.
• Brain cells were protected from premature death.

In 1993 researchers from Israel tested the optimal balance of omega-6 and omega-3 fats for brain performance, using incremental fat ratios, ranging from 3-to-1 to 6-to-1. They found the ratio of 4-to-1 was the most effective for improved learning, sleep, and pain threshold. Other studies have demonstrated similar results. This same research team also used this ratio on Alzheimer’s disease patients, who experienced significant improvement in quality of life.

Less Omega-6 Fat Dramatically Reduces Artery Clogging

Researchers looked at the impact of balancing fats on preventing atherosclerosis in a particular strain of mice susceptible to clogged arteries. The mice were fed diets with the identical quantity of fat, but the proportions of omega-6 to omega-3 fats varied. The researchers found a dose-dependent effect on the development of heart disease: the lower the ratio, the better the outcome. Notably, the low-ratio group had the best HDL (good cholesterol), lowest blood clotting, and least clogged arteries.

Balanced Ratio in Early Life Prevents Childhood Asthma

The Australian Childhood Asthma Prevention Study (CAPS) found that high-risk kids placed on a balanced omega diet since birth (modest omega-3 supplement with diet low in omega-6 fats) had significant reduction of a type of cough that is a strong predictor of asthma.

Arthritis Improves with Lowering Omega-6 Fat in Diets

Researchers put one group of rheumatoid arthritis patients on a diet low in arachidonic acid (the most potent omega-6 fat) and supplemented them with fish oil. The other two groups of patients either were given fish oil and a regular diet or served as the control, with a regular diet and placebo supplement. The group following the low-AA diet had the most improvement (less pain, less tenderness and swelling of joints). Notably, those on the regular diet with fish oil had improvements, too, but that treatment was less effective than the low-AA diet. Researchers also found that the more AA eaten, the higher the disease activity.

Omega-3 Supplements Do Little Without Balanced Omega-6 Fat Levels

As indicated in the arthritis study, for you to get the most benefit from fish oil supplements, you have to lower the level of omega-6 fat in your diet. Here are more examples:

Volunteers were given 4.4 grams of fi sh oil daily. It effectively suppressed the growth of cells that occur in colorectal cancer, but only if the ratio of dietary omega-6 to omega-3 fat was limited to 2.5-to-1.0. When the ratio was increased to 4-to-1, there was no such benefit.

Australian patients with rheumatoid arthritis were put on a diet containing less than 10 grams of omega-6 fats and were given a fish oil supplement. They had superior improvement in symptoms relative to members of the control groups.

Asthmatic adults took fi sh oil while eating a typical American diet high in omega-6 fats (ratio of 10-to-1), but they still had diminished breathing capacity. However, when the omega-6 fats were lowered to a ratio of 2-to-1, they experienced improved breathing and decreased asthma-triggering compounds.