nless you live in an isolated bubble, you have likely seen the bounty of headline-grabbing studies on omega-3 fats, with their far-reaching benefits from preventing cancer and heart attacks to treating depression and arthritis. Indeed, short of describing these fats as a panacea, the research is quite astounding.

How can one type of fat affect so many different parts of your body (such as your brain and heart) and ultimately influence your health and well-being? There are two key reasons. First, omega-3 fats are really like vitamins (originally called vitamin F when discovered). Unfortunately, the vast majority of Americans are deficient in vitamin F or omega-3 fats.

Second, although few people know it, we have a striking fat imbalance in our diet. The typical American diet dramatically antagonizes the benefits of omega-3 fats in the body. Even if you consider yourself health-conscious, you are not likely free of this problem! The problem of this dietary fat imbalance affects you whether you eat heart-healthy, are a strict vegetarian, have become an Atkins carnivore, or something in between. We eat too much of the so-called heart-healthy fats, which, ironically, interfere with the benefits of omega-3 fats in our bodies. These supposedly healthful fats are the

Copyright © 2007 by Evelyn Tribole. Click here for terms of use.

• 4 The Basics of Omega Fats

omega-6 fats, which have flooded our food(Buy now from http://www.drugswell.com) supply in the forms of margarine, soybean oil, corn oil, safflower oil, cottonseed oil, and sunfl ower oil.

In short, we have two key problems. We don’t eat enough (and the right kinds) of omega-3 fats; call this problem omega-3 fat defi ciency. And we eat too much of the so-called healthy fats that hamper omega-3 fat’s benefits, causing what some researchers call omega-6 fat syndrome. Let’s take a closer look.

Omega-3 Fat Is a Vitamin

In the 1920s, one of the several omega-3 fats was discovered. The researchers determined that it is essential for health and met the scientific criteria to be called a vitamin. Appropriately, this fat was named “vitamin F.” Yet you probably haven’t heard of vitamin F.

Why not? You can rule out omega-3’s fatty nature as the reason it lacks “vitamin status,” because there are other fat-based vitamins: vitamins A, D, E, and K. Instead, chalk it up to a bit of politics and bad timing. At the time of the vitamin F discovery, vitamin E also had just been discovered. Because of the scientific excitement over the newly discovered vitamin E, vitamin F was ignored and disappeared into oblivion (until the last decade). Although research on omega-3 fats has exploded, the name vitamin F never resurfaced.

It’s too bad that the vitamin F nomenclature didn’t stick. That term alone would emphasize how essential these fats are to our body. As with vitamins, our body can’t make these fats (or enough of them), so they are required in our diet. Also, a step up to “vitamin status” could have spurred earlier research on the vital roles that omega-3 fats play in human health and disease prevention.

After the discovery of omega-3 fats, 50 years passed until the fi rst human case of omega-3 fat deficiency was identified. A child too sick to eat was fed intravenously with a mixture that contained no omega-3 fats. Instead of getting better, the child got unexpectedly worse and displayed symptoms of numbness, tingling, weakness, inability to walk, leg pain, psychological disturbances, and blurred vision. Ralph

Omega-3 and Omega-6 Fats 5 •

T. Holman, an expert in omega-3 fats, identified the cause of the child’s problem as a deficiency of omega-3 fatty acids. His discovery put omega-3 fats on the map, beyond an esoteric research interest.

The incredible research into omega-3 fats within the context of their role as an essential vitamin helps to explain omega-3’s sweeping effects on health and disease. A new picture emerges of a nutrient deficiency that wreaks havoc in many different parts of the body, from the inner workings of the brain to the battlegrounds of immunity and inflammation. A vast majority of Americans do not get enough omega-3 fats in their diet.

Different Omega-3 Fats Affect Your Body in Different Ways

Just as there is more than one type of B vitamin (vitamins B₁, B₂, B₁₂, and so forth), there is more than one type of omega-3 fatty acid. Each of these omega-3 fatty acids affects your body in different ways. The types of omega-3 fatty acids found in plant food(Buy now from http://www.drugswell.com)s are very different from those found in fish. So if you are tanking up on plant sources of omega-3 fat, such as flax meal or flaxseed oil, you still could be deficient in the other omega-3 fats that are found primarily in fi sh. For example, many of the food(Buy now from http://www.drugswell.com)s that boast of their omega-3 fat content are fortified with the plant form of omega-3 fat, not the types found in fish. This is not necessarily bad, but some consumers might be under the wrong impression that they are getting enough omega-3 fats when they are actually still deficient in certain types.

Structural Sentries

Omega-3 fats are involved in nearly every key function in the body and are an important structural part of every cell in your body. They are not the kind of fat that sits around for a rainy-day famine, waiting to be utilized. Let’s look briefly at some of these vital roles:

• Biological fence. Omega-3 fats are the gatekeepers of cells. They make up the key architecture of the membrane, the biological fence that surrounds each cell. This affects the fluidity of the cells, which in turn influences a number of activities in your body.

• 6 The Basics of Omega Fats

Notably, the composition and fluidity of cell membranes depend to a great extent on what you eat.

• Brain’s building blocks. Omega-3 fats are the key building blocks of the brain and eyes. They are to your brain as calcium is to your bones. In fact, the majority of the brain (60 percent) is composed of fat—the second highest concentration of fat in the body.

Essential Activities

Omega-3 fats are industrious worker bees throughout your body. Here’s a glimpse at their far-reaching impact on your health:

• Cellular communication. The cells in your body use wireless communication, and omega-3 fats help them stay in touch. It’s a lot like cell phone reception. If you don’t have enough omega-3 fats, your cell-to-cell communication can be “out of range.” This is especially significant to brain function, which affects mood, learning, concentration, and memory.

• Turning genes on and off. Throughout your life, your genes are constantly being regulated, or turned on or off like a light switch. Amazingly, according to a new and dynamic area of research called nutrigenomics, what we eat influences our genes. Omega-3 fats regulate genes in our brain and other parts of our body.

• Potent power brokers. Omega-3 fats help create highly potent substances called eicosanoids. Eicosanoids have an impact on a wide range of functions, including fertility, digestion, kidney function, breathing, blood flow, heart health, and immunity.

• Fighting infl ammation. Like the nutritional equivalent of aspirin, omega-3 fats help fi ght inflammation and infection. This has many implications for autoimmune and infl ammation disorders, including asthma, arthritis, lupus, inflammatory bowel disorders, psoriasis, cancer, allergies, and migraines.

Omega-3 and Omega-6 Fats 7 •

Specific Roles in Your Body

As if these activities were not impressive enough, omega-3 fats play key roles in maintaining the health of your organs. Recall the symptoms of the sick child who contracted omega-3 fatty-acid defi ciency: numbness, tingling, weakness, inability to walk, leg pain, psychological disturbances, and blurred vision. These symptoms illustrate the many different body functions affected by omega-3 fats:

• Brain. Omega-3s help make and regulate key chemicals in the brain that affect your mood. These fats are required for growth and development of the brain, not to mention brain cell communication, which can affect learning and IQ. This role of omega-3s has many implications for mood and learning disorders, dementia, stress, and hostility.

• Vision. Omega-3 fats are critical for vision throughout the life cycle, from eyesight development in the womb to prevention of vision problems in the twilight years. This role has many implications for vision disorders and learning.

• Blood. While blood is supposed to be thicker than water, blood thickness (viscosity) can be hazardous to your health. Omega fats keep your blood flowing smoothly, which allows your heart to pump blood with less effort. Omega-3 fats also protect your arteries by keeping them elastic and fl exible. This role has many implications for heart disease and stroke.

• Heart’s natural pacemaker. Omega-3 fats help the heart maintain a steady and slower beat. This may help prevent sudden cardiac death, which is a frequent consequence of cardiac arrhythmia.

• Sturdy bones. Omega-3 fats help increase calcium absorption and bone formation, and they prevent destruction of cartilage, thus playing a role in preventing and treating osteoporosis.

• 8 The Basics of Omega Fats

It’s not too hard to imagine that inadequate intakes of omega-3 will have some effect on every part of the body, including the brain. Clearly, omega-3s are required for a sound body and mind!

Omega-6 Fat Syndrome

The last reason that omega-3 fats affect so many different aspects of your body and, ultimately, your health involves their interaction with another key group of fats, omega-6 fats. We consume omega-6s in soybean oil, cottonseed oil, safflower oil, corn oil, sunfl ower oil, margarines, and salad dressings.

When I was researching this book, 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(Buy now from http://www.drugswell.com) by food(Buy now from http://www.drugswell.com). 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,

Omega-3 and Omega-6 Fats 9 •

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 food(Buy now from http://www.drugswell.com)s containing “heart-smart” 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. (This is discussed in depth in Chapter 5.)

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.

• 10 The Basics of Omega Fats

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 food(Buy now from http://www.drugswell.com)s. More often than not, it will be listed, as it’s among the top four oils consumed in the United States. Our food(Buy now from http://www.drugswell.com)s are now fi lled with omega-6 fats because of technology and pressure to eat more heart-smart fats.

Farming Practices Increase Omega-6 Fats in Meats and Plant food(Buy now from http://www.drugswell.com)s

Lastly, agricultural practices have dramatically altered the content of omega-6 and omega-3 fats in our diet. Plant food(Buy now from http://www.drugswell.com)s 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-whatyou-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 infl ammation disorders, which we can’t cure simply by reaching for a fi sh oil supplement. If you have too much omega-6 fat in the diet, it interferes with the benefi ts 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!

Omega-3 and Omega-6 Fats 11 •

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.

I wrote The Ultimate Omega-3 Diet to help solve our fat imbalance and its ensuing health problems. I want to be clear, however, that I use the term diet to describe a pattern of eating, not a method for weight loss. I am strongly against weight-loss diets because of the impact on mind and body.¹

The Ultimate Omega-3 Diet is divided into four parts. The fi rst part of the book is a mini primer on omega-3 and omega-6 fats, including how these fats work in tandem and what happens to your health when they are out of balance in your diet. The second part of the book explains the truly astounding benefits of omega-3 fats. (Each chapter stands alone. If you want the scientific info, it’s in Part

2. If you just want to know what and how to eat, you can skip this section entirely.) The research is quite stunning, showing that omega-3 fats play a key role in preventing many illnesses and conditions:

• Infl ammation

• Stroke

• Allergies

• Cancer

• Alzheimer’s disease

They may also be effective in treating:

• Depression

• Attention defi cit disorder

• Dyslexia

1. For more information, see E. Tribole and E. Resch, Intuitive Eating 2nd Ed. New York: St. Martin’s Griffi n, 2003.

• 12 The Basics of Omega Fats

• Cystic fi brosis

• Asthma

• Arthritis

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

• Brain development and function

• Learning and IQ

The key how-to advice in this book comes in Part 3, “How to Omega-Optimize Your Diet.” This section describes how you can get the most benefit out of your omega-3 fats, in four key steps, each delineated in a separate chapter. Chapters 10 and 11 tell you how to eat enough of two categories of omega-3 fats: short-chain and long-chain omega-3s. Chapter 12 offers advice on omega-3 supplements. And Chapter 13 addresses the other side of the fat equation: how to cut your intake of omega-6 food(Buy now from http://www.drugswell.com)s.

The last part of the book, “The Ultimate Omega-3 Lifestyle,” provides makeovers, menus, and recipes balanced in their omega-3 and omega-6 fat content. The makeover section shows how to implement the steps to maximize your omega-3 fats, regardless of your lifestyle. I created menus with different themes to help with your particular eating style, from eating out to “I hate fish.” There are also nearly 40 recipes, each of which describes the omega-optimize technique, so you can apply these strategies to get the most out of omega-3s in your own favorite recipes.

Throughout the chapters, charts and tables will help you fi nd food(Buy now from http://www.drugswell.com)s that are high in omega-3 fats and low in omega-6 fats. Appendix A is a handy listing of specific food(Buy now from http://www.drugswell.com)s’ omega-3 and omega-6 fat content, including the ratio of the two fats. Appendix B offers metric conversions you can apply to the recipes if you prefer to use the metric system. I’ve also included an in-depth references section, which includes the key studies and sources for the information presented in this book.

Omega Fats Are Not Created Equal

“_Ithought all omega fats are healthy.” I can’t tell you how often I hear people saying this. 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 fi nd 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 specifi cs 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.

13 •

Copyright © 2007 by Evelyn Tribole. Click here for terms of use.

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

Omega Fats Are Not Created Equal 15 •

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.

The individual fatty acids differ in significant ways. The omega-3 fat found in plants is very different from the omega-3 fatty acids

Omega potent kids	Eicosapentaenoic acid	Arachidonic acid (AA):
(biological power brokers)	(EPA) and docosahexaenoic	meats and poultry
	acid (DHA): fatty fish and
	their oils, some seaweeds,
	enriched food(Buy now from http://www.drugswell.com)s

Omega Fats Are Not Created Equal 17 •

• 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 fish 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 fl axseed oil supplements or eat a lot of flax food(Buy now from http://www.drugswell.com)s as your primary source of

Docosahexaenoic acid (DHA) Polyunsaturate Long-chain

• 18 The Basics of Omega Fats

Meet the Omega-6 Fat Family

Omega-6 fats, when eaten in excess, can cause a variety of health problems. The omega-6 fat problem is a bit like Americans’ excess consumption of salt (sodium). Sodium is a nutrient that is very easy to get in the diet without ever lifting a saltshaker. Similarly, omega-6 fats are in nearly every food(Buy now from http://www.drugswell.com) we eat, so we really don’t need to make an extra effort to eat them. Here’s a brief description of the key omega-6 fatty acids:

• Linoleic acid (LA). The omega-6 parent, linoleic acid (LA), accounts for the majority of polyunsaturated fats in the American diet and is considered an essential fat. (Yes, you are reading this name correctly; it is remarkably similar to the omega-3 fat parent, alpha-linolenic acid.)

• Arachidonic acid (AA). Arachidonic acid can be found in animal products but is readily made from the parent omega-6 fat, LA. (This is unlike omega-3 fats, where there is limited conversion of the parent to its potent “kids.”) Too much of this fat in the body can trigger inflammation and cause blood clotting. AA is also known as the long-chain omega-6 fatty acid.

Fat Family Rivalry: Omega-6 Versus Omega-3 Fats

Both omega-3 and omega-6 fats make powerful substances in your body that play key roles in the structure and function of every cell and ultimately your health and well-being. But they are chemically distinct families with opposite effects on your body. For example, a diet high in omega-6 fats promotes blood clotting, while omega-3 fats prevent the blood cells from clumping. Omega-6 fats act to raise blood pressure, while omega-3 fats work to lower blood pressure.

Once you eat these fats and they enter your body, they are in direct competition with each other. Like rival gangs, both of these fat families compete for the same limited resources (enzymes) to make their subsequent potent compounds. The bigger family will

Omega Fats Are Not Created Equal 19 •

“win” the resources that ultimately shift your body toward health or disease.

Saturated Versus Unsaturated Fat: A Big Difference to Your Health

No fat that you eat, whether oil or butter, is made up of just one particular type of fatty acid. For example, butter is known as a saturated fat (and indeed has a high level of this fat), but as shown in Table 2.3, it still has a bit of polyunsaturated and monounsaturated fats. Olive oil is known as a monounsaturated fat but contains some saturated and polyunsaturated fat. And canola oil is 7 percent saturated fat, 59 percent monounsaturated fat, and 30 percent polyunsaturated fat. Its polyunsaturated fat consists of 69 percent omega-6 fat and 31 percent omega-3 fat.

Fats commonly thought of as healthful are not necessarily so. Researchers realize that it is no longer adequate to assume that all

Corn oil	13	28	55	98	2
Flaxseed oil	9	20	66	19	81
Olive oil	14	73	11	93	7
Soybean oil	14	23	58	88	12

• 20 The Basics of Omega Fats

Saturated Fats

The saturated fats are the infamous artery-clogging fats that raise blood cholesterol. They are called “saturated” because of how their carbon atoms are connected. (Technically, they are 100 percent saturated with hydrogen atoms.) These fats are found in animal products, including meats, poultry, dairy products, eggs, and butter, and in some plant food(Buy now from http://www.drugswell.com)s, including palm oil, palm kernel oil, and hydrogenated vegetable oil. Our bodies have no need for saturated fat. Saturated fats interfere with the beneficial effects of omega-3 fats in the body.

Unsaturated Fats

Unsaturated fats may be monounsaturated or polyunsaturated. Monounsaturated fats have one pair of carbon atoms that are not saturated with hydrogen atoms (hence the term mono). They include

Omega Fats Are Not Created Equal 21 •

olive oil, which is the dominant type of this fat in the diet. Canola oil also is high in monounsaturated fat. Monounsaturated fats are generally recognized as healthful types of fats.

Polyunsaturated fatty acids (PUFAs) have at least two pairs of carbons that are not saturated with hydrogen. Polyunsaturated fats come in different lengths, known either as short or long chain, based on the number of carbons.

A polyunsaturated fatty acid with at least 20 carbon atoms is a long-chain polyunsaturated fatty acid. For example, the plant source of omega-3 fat, ALA, has 18 carbons and is considered a short-chain PUFA, while EPA has 20 carbons and is considered a long-chain PUFA (DHA has 22 carbons). Omega-3 and omega-6 fats are both polyunsaturated; EPA and DHA are long-chain omega-3 fats, and

poultry fat (skin)
Monounsaturated fat	Positive	Neutral		Olive oil, canola oil
Polyunsaturated fat: omega-3	Positive	Positive		Fatty fish, walnuts, flax, hemp, green leafy vegetables
Polyunsaturated fat: omega-6	Negative when Negative in excess (main contributor to inflammation); lowers cholesterol			Corn oil, safflower oil, sunflower oil, soybean oil, cottonseed oil, traditionally raised meats and poultry
Trans fat	Negative		Negative	Fried food(Buy now from http://www.drugswell.com)s, shortening

In the next chapter we will take a closer look at why the balance between the omega-6 and omega-3 fats is so important to your health.

Omega Fats Are Not Created Equal 23 •

�

ALA eventually gets made into EPA and DHA (ALA⇒EPA⇒ DHA).

�

Omega-3 fats have a positive effect on health.

There are two key fatty acids that make up the omega-6 fat family:

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Linoleic acid (LA) is an essential fatty acid and the parent of the omega-6 fats. It is found in nearly every food(Buy now from http://www.drugswell.com) but especially soybean oil, corn oil, safflower oil, margarines, salad dressings, sunflower oil, and cottonseed oil.

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Arachidonic acid (AA) is the potent long-chain omega-6 fat. Our body easily makes it from LA (LA⇒AA). AA is also found in animal food(Buy now from http://www.drugswell.com)s.

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Omega-6 Fat Syndrome

Why You Need to Balance the Fats

t’s not enough to supplement your diet with fish oils or to eat enough omega-3 fats in your diet—it’s merely a good start. The health benefits 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 benefits 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 this chapter 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(Buy now from http://www.drugswell.com) 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, inflammation disorders, learning disorders, rheumatoid arthritis, sleep disorders, and stress.

25 •

Copyright © 2007 by Evelyn Tribole. Click here for terms of use.

• 26 The Basics of Omega Fats

Mega Omega Problem in Our food(Buy now from http://www.drugswell.com) 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(Buy now from http://www.drugswell.com)-processing industry, but we can’t only blame this easy scapegoat (although it certainly contributed). A multitude of factors, including industrialization, agribusiness, food(Buy now from http://www.drugswell.com) manufacturing, and the promotion of “heart-healthy” oils, contributed to fewer omega-3 fats and too many omega-6 fats in our food(Buy now from http://www.drugswell.com) supply.

Even if you reach for a food(Buy now from http://www.drugswell.com) 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(Buy now from http://www.drugswell.com) packaging?

Let’s take a closer look at these factors, so you’ll have a better idea how almost every food(Buy now from http://www.drugswell.com) 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

Omega-6 Fat Syndrome 27 •

beef is fatter and has an entirely different fatty-acid profi le: 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 profi le.

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 food(Buy now from http://www.drugswell.com)s) 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.

Chicken eggs	.03	9.00
Elk	—	5.00
Pork	0.02	5.90
Salmon	17.00	20.00

SOURCE: For details, see References under Koizumi, Rule, Simopoulos (“Evolutionary Aspects . . .”), and USDA.

Why Too Many Omega-6 Fats in Our Diet?

A convergence of well-meaning health advice, food(Buy now from http://www.drugswell.com) processing, and industrialization resulted in a wide variety of food(Buy now from http://www.drugswell.com)s overfl owing with omega-6 fats, from frankfurters to granola. Many of those fats come from vegetable oils. Today only four oils—cottonseed oil, corn oil, soybean oil, and canola oil—account for 96 percent of the vegetable

TABLE 3.3 Top Four Fats and Oils Used in food(Buy now from http://www.drugswell.com) in the U.S.

Ratio of Omega-6

Oil Millions of Pounds per Year to Omega-3 Fats 1970–1971 2001–2002

Cottonseed oil 805 539 258:1

Corn oil	403	950	46:1
Soybean oil	5,780	17,818	8:1
Canola oil	319*	904	2:1

*Data for 1995, when canola oil was first tracked.

SOURCE: Economic Research Service, USDA, ers.usda.gov/data.

oil consumed in the United States (see Table 3.3). With the exception of canola oil, these oils are particularly high in omega-6 fats and low in omega-3 fats. These oils are used to make margarine, shortening, and salad dressings—which amplify your omega-6 fat intake.

Industrial RevOILution

Advances in technology increased worldwide vegetable oil production and introduced new edible oils, such as cottonseed oil. The large-scale addition of newfangled oils to our food(Buy now from http://www.drugswell.com) supply signifi cantly altered both quantitative and qualitative aspects of fat in our diet, causing our consumption of omega-6 fats to skyrocket. Vegetable oil is inherently higher in omega-6 fats, while being low in omega-3 fats. As our consumption of vegetable oil has grown, it has become our main source of polyunsaturated fatty acids. (Keep in mind that polyunsaturated fats are synonymous with omega-6 fats.) Figure 3.1 shows that in 1909 only 32 percent of our polyunsaturated fats came from oils; by 2000 that share had more than doubled. So if you eat vegetable oil (whether by using it for cooking or eating it in salad dressings, margarine, and mayonnaise), you will almost always increase your omega-6 fat intake. With the exception of olive oil and canola oil, vegetable oil is synonymous with omega-6 fats.

FIGURE 3.1 Sources of Polyunsaturated Fatty Acids in the U.S. food(Buy now from http://www.drugswell.com) Supply

Fats and Oils

Meat, Poultry, and Fish

Grains

Other

32%

10% 19%

4%

32%

14%

17% 72%

1909 2000

SOURCE: Gerrior, S., L. Bente, and H. Hiza. Nutrient Content of the U.S. food(Buy now from http://www.drugswell.com) Supply, 1909–2000, Home Economics Research Report No. 56. Washington, DC: U.S. Department of Agriculture, Center for Nutrition Policy and Promotion, November 2004. Accessed at cnpp.usda.gov/publications/food(Buy now from http://www.drugswell.com)supply/food(Buy now from http://www.drugswell.com)sup ply1909-2000.pdf.

New food(Buy now from http://www.drugswell.com)s Created: Margarine and Shortening

In 1897 the invention of hydrogenation (adding hydrogen to oil) allowed vegetable oils to become solid. Voilà—shortening and margarine were born. The timing was just right, too. The escalating prices and scarcity of butter during World War I paved the way for lower-cost alternatives. Toss in the medical community’s recommendation to replace butter with modern vegetable fats, and margarine’s place at the kitchen table was assured. In the last century, U.S. consumption of shortening quadrupled. The typical American ate about one pound of margarine per year in 1909 and now eats more than 6 pounds per year. Hydrogenated oils also helped extend the shelf life of convenience food(Buy now from http://www.drugswell.com)s, which became popular for saving time in the kitchen, especially as more women entered the workforce.

Heart-Healthy Oils

The “heart-healthy” polyunsaturated fats have a distinguished history. Since the 1950s, the cholesterol-lowering effects of these fats

Omega-6 Fat Syndrome 31 •

dominated research. And for good reason: early studies showed that when polyunsaturated fats replaced the saturated fats, blood cholesterol was lowered. Thanks to the well-meaning “war on saturated fat” to reduce heart disease, polyunsaturated fats were heralded as the lifesaving fat and were indiscriminately promoted. Meanwhile, an important group of polyunsaturated fats—omega-3 fats—were simply ignored.

food(Buy now from http://www.drugswell.com)s with “heart-healthy” oils proliferated, and omega-6-rich fats increased in the American diet. Manufacturers jumped on the heart-health bandwagon, and food(Buy now from http://www.drugswell.com)s were marketed as being cholesterol free and low in saturated fat. But this was achieved by using omega-6-rich oils, many of which were hydrogenated.

Ironically, hydrogenated oils appeared to be the more healthful alternative to saturated fats at that time. Even fast-food(Buy now from http://www.drugswell.com) restaurants replaced the beef fat in the fryers with partially hydrogenated oils (shortening).

You are probably aware that hydrogenation introduced its own set of health hazards. Not only does this process create the infamous trans-fatty acids, which increase the “bad” LDL cholesterol, but hydrogenation also destroys omega-3 fats. For example, when soybean oil (which has 920 milligrams of omega-3 fats per tablespoon) is hydrogenated, its omega-3 fat content drops to 30 milligrams per tablespoon.

Now there is a new twist. In an effort to mitigate the problem of trans fat, food(Buy now from http://www.drugswell.com) manufacturers are using new strains of soybeans to make more stable oil that contains negligible amounts of the omega3 fats and higher levels of omega-6 fats! This is signifi cant because soybean oil is the number-one oil used in the United States.

In December 2005, Kellogg, the world’s largest cereal maker, made headlines when it announced its commitment to using low-linolenic soybean oil (soybean oil that is low in omega-3 fat) to replace trans fat that had been used in its food(Buy now from http://www.drugswell.com)s. That decision has helped fuel a tremendous demand for low-linolenic soybean oil. About 80 million pounds of low-linolenic soybean oil were produced in 2005, with fi ve times that output (400 million pounds) estimated for 2006, according to the Institute of Shortening and Edible Oils. But this trend is double trouble. This oil has an even higher omega-6 fat content than regular soybean oil (see Table 3.4).

TABLE 3.4 Trans-Formation of Soybean Oil: Disappearing Omega-3 Fat

Ratio of Omega-6 Type of Soybean Oil Milligrams per Tablespoon to Omega-3

Omega-6 Omega-3

Basic soybean oil 6,940 920 8:1 (salad or cooking oil)

Mayonnaise, soybean oil 5,200 690 8:1

Spread, 70% vegetable oil 2,060 220 9:1 (soybean and hydrogenated soybean oils)

Margarine, hard stick, 2,740 210 13:1 hydrogenated soybean oil

Low-linolenic (1%) soybean oil 7,620 136 56:1

Partially hydrogenated, industrial, 1,170 30 39:1 all-purpose soybean oil

Shortening, frying, heavy-duty, 30 10 3:1 hydrogenated �1% linoleic

SOURCE: ESHA food(Buy now from http://www.drugswell.com) processor SQL software; Iowa State University.

Meanwhile, manufacturers of cottonseed oil jockey for their market share by offering their product as a more healthful replacement for trans fat in processed food(Buy now from http://www.drugswell.com). But it has a much worse omega-6 profile. In cottonseed oil, omega-6 fats outnumber its omega-3 content by 234 to 1! Of all the fats ranked in Table 3.5, cottonseed oil is the worst in terms of its ratio of omega-6 to omega-3 fats.

Why the Balance of Omega-6 and Omega-3 Fats Affects Your Health

The balance of omega-6 and omega-3 fats affects whether your cells promote health or disease. If you eat too little omega-3 fat and/or too much omega-6 fat, you are setting the stage for health problems, as you will see in the remainder of this chapter.

TABLE 3.5 Proportion of Omega-6 to Omega-3 Fats in Oils

Evening primrose oil	75:1
Low-linolenic (1%) soybean oil	56:1
Corn oil	46:1
Partially hydrogenated soybean oil	39:1
Palm oil	30:1
Chicken fat	19:1
Olive oil	13:1
Lard	10:1
Butter	9:1
Margarine, hard stick, hydrogenated soybean oil	9:1
Basic soybean oil (salad or cooking oil)	8:1
Mayonnaise made with soybean oil	8:1
Walnut oil	5:1
Beef fat	2:1
Canola oil	2:1
Flaxseed oil	0.3:1.0
Perilla oil	0.3:1.0

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

• 34 The Basics of Omega Fats

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 fi sh, 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 influences 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 fl owing 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

Omega-6 Fat Syndrome 35 •

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 fi ght 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 reflects 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.

• 36 The Basics of Omega Fats

The Paradox of Excess: Omega-6 Fat Syndrome

The impact of the fat imbalance gets clearer when you explore different regions of the world. We’ll take a brief look at what happened when Okinawans, Israelis, and urban Indians shifted their diets to high levels of omega-6 fats. Their experiences shed light on the ways that too much omega-6 fat affects your health. The “omega-6 syndrome” documented in Okinawa is particularly telling.

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 fi sh. 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 scientifi c 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

Omega-6 Fat Syndrome 37 •

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(Buy now from http://www.drugswell.com)” 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 Specifi c 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

• 38 The Basics of Omega Fats

problems, which will be discussed in more depth throughout this book:

• 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

Omega-6 Fat Syndrome 39 •

decreased vision. Conversely, a diet rich in omega-3 fats and fi sh 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 infl ammation 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 fi ndings:

• 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 petri dishes to human studies, vast and diverse research overwhelmingly demonstrates the need to balance the fat families. A high

• 40 The Basics of Omega Fats

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.

Asthma	5:1	Twice the ratio (10:1) had adverse consequences on
		asthma.
Bone health	—	A high ratio is associated with lower bone density,
		regardless of hormone replacement status.
Brain function	4:1	A dose-dependent study indicated that optimal learn
		ing occurred at this ratio.
Breast cancer	1:1–2.5:1	A study on French breast cancer patients showed
		that the balance between omega-6 to omega-3 fats,
		rather than the individual amount of fats, had the
		greatest impact on breast cancer prevention. A study
		on five countries reported similar findings.
Cancer	1:1–2:1	A review published in the American Journal of Clinical
prevention		Nutrition concluded that we need to eat a diet with a
		lower ratio of omega-6 to omega-3 fats (1:1 or 2:1) to
		lower the risk of getting cancer.
Cardiovascular	4:1	A ratio of 4:1 has been associated with a 70%
health		decrease in death rates.

Omega-6 Fat Syndrome 41 •

Ratio of Health Omega-6 to Condition Omega-3 Fat

Colon cancer 1:1–2.5:1

Dry-eye Lower ratio syndrome protective

Healing �1:1

Inflammation 1:1

Insulin 2:1 resistance

Pregnancy — complication

Rheumatoid 2:1–3:1 arthritis

Sleep 4:1

Stress 4:1

Comment

Fish oil supplements were beneficial only with a low ratio of 2.5:1.0.

A high ratio is associated with more than double the prevalence of dry-eye syndrome relative to those with a low ratio.

The ratio influences a critical step in healing, collagen production. When the ratio was less than 1:1, collagen formation increased in a dose-dependent manner.

Ratios of 1:1 (or less) decrease inflammation. When patients were supplemented with fish oil, a ratio of

3.5:1.0 had no benefit.

Diets high in omega-6 fats trigger insulin resistance, which is implicated in diabetes, obesity, and heart disease. Animal studies show that a ratio of 2:1 may prevent this problem.

A lower ratio was associated with a 46% reduction in risk for preeclampsia, a condition that can progress to a life-threatening situation for both Mother and Baby.

A lower ratio suppresses the harmful effects of inflammation.

Two studies on students showed significant improvement in sleep at this lower ratio.

A lower ratio reduces the production of stress chemicals.

SOURCES: For details, see References under Simopoulos and Cleland, Weiss, Larson, Chajes, Oddy, Davis, and Ghafoorunissa.

The Benefits of Balanced Diets Low in Omega-6 Fat

The significance of less omega-6 fat in the diet has been overshadowed (and even discounted) by the excitement over the benefits of omega-3 fats. However, two landmark studies—the Greenland Eskimo study and the Lyon Diet Heart Study—indicate its importance.

• 42 The Basics of Omega Fats

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

Omega-6 fat grams Omega-3 fat grams 0.9 1.6 1.1 2.7 1.2

5.3

Ratio of omega-6 to 3:1 4:1 6:1 11:1 3:1 0.4:1.0 omega-3 fats

SOURCE: For details, see References under Okuyama (“Dietary Fatty Acids . . .”) and USDA. Note: The numbers in this chart are rounded.

Omega-6 Fat Syndrome 43 •

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 benefi t.

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 fi nding. The stunning results were published in the American Heart Association’s scientifi c journal, Circulation, in 1999, accompanied by an editorial, which emphasized that only the diet with the lower omega6 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 consumption toward 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

• 44 The Basics of Omega Fats

are advised to reduce their omega-6 fats to keep infl ammation 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 benefi ts:

• 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.

Omega-6 Fat Syndrome 45 •

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 signifi cant 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 fi sh 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 benefi t 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 fish 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 benefi t.

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

Asthmatic adults took fish 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.

• 46 The Basics of Omega Fats

Why It’s Not Enough to Rely on the Ratio

An optimal balance between omega-6 and omega-3 fats has yet to be determined. Many experts believe that a dietary fat ratio in the range of 1-to-1 to 4-to-1 is optimal, but it can differ based on the health condition. Ultimately the quantities of each type of fat do matter, but it’s not that simple or straightforward. Some scientists talk about diet ratios, while others talk about tissue ratios (the proportions of the fats in cells of the body); these ratios are related but very different. Some health organizations have different research agendas, such as heart health, while overlooking cancer prevention. See the sidebar for some recommendations that have been made.

Omega-6 Fat Syndrome 47 •

When a Number Is Not What It Seems

Many researchers don’t like using a “ratio” to describe the fat requirements needed for health, because it is not accurate. There are several reasons why ratios can be misleading.

Decreasing Omega-6 Fat Won’t Fix a Deficiency of Omega-3 Fat. If your diet is deficient in omega-3 fats and you only decrease your intake of omega-6 fats without increasing your intake of omega-3 fats, you still have a problem. Even though your ratio of omega-6 fats to omega-3 fats would be lower, that won’t do you a whole lot of good without enough omega-3s. Remember, the average American does not eat enough omega-3 fats, let alone enough of the right kinds of omega-3 fats.

The Ratio Can Be Misleading When You’re Trying to Balance Dietary Fats. If you rely on the ratio to select food(Buy now from http://www.drugswell.com)s low in omega-6 fats, it can lead you into the opposite result! For example, olive oil has an apparently high ratio of 13-to-1. This is misleading, however; ounce for ounce, olive oil has one of the lowest contents of omega-6 fat for an oil, with 1,320 milligrams per tablespoon.

In contrast, walnut oil has a much lower ratio of 5-to-1. At fi rst glance, it would seem the better choice. But compared with olive oil, walnut oil has more than five times the amount of omega-6 fats per tablespoon: 7,190 milligrams.

Why the disparity? The ratio doesn’t consider the other fats present in the food(Buy now from http://www.drugswell.com) (such as monounsaturated and saturated fats). Olive oil is made up of mostly monounsaturated fats, so the net amount of omega-6 and omega-3 fats is relatively low. Walnut oil, however, is made up of mostly polyunsaturated fats (omega-6 and omega-3 fats), so its ratio packs more of a wallop.

Also, just a small percentage increase in the calories from the most common omega-6 fatty acid in our food(Buy now from http://www.drugswell.com) supply (linoleic acid) halts omega-3 fat metabolism by 50 percent. A ratio would not indi

• 48 The Basics of Omega Fats

cate that signifi cance, which is quite substantial. The more omega-6 fats you eat, the greater your requirement for omega-3 fats can become.

In essence, the goal for omega-3 fat intake can be a moving target, enough to make your head spin.

Lastly, the ratio is incomplete because it does not distinguish between the different types of omega-3 fats, each of which has markedly different effects in the body. Recall that there are several key omega-3 fatty acids, just as there are several types of B vitamins. ALA is the parent omega-3 fat, found in plant food(Buy now from http://www.drugswell.com)s, while EPA and DHA are the biological power brokers, found in fi sh and fi sh oil.

Alternatives to Ratios. A more accurate way to balance the omega-6 and omega-3 fats, rather than using ratios, is to target specifi c amounts. I use the guidelines published in 2000 by the International Society for the Study of Fatty Acids and Lipids (ISSFAL). This group includes scientists from academia, government, industry, and health agencies from around the world.

It’s not as if Americans have been cautioned about their fat imbalance—far from it. There are no policy or scientific guidelines for a balanced omega-3 and omega-6 fat diet in the United States (explained further), yet they exist in other countries, including Japan.

The American Paradox: Institute of Medicine’s 2005 Recommendations

The Institute of Medicine (IOM), an American-based nonprofi t organization that is part of the National Academy of Sciences, issues scientific recommendations on the amount of nutrients we should eat. The IOM’s most recent report, 2005’s Dietary Reference Intakes, did not suggest any guidelines to balance our omega-6 and omega3 fats. The report has been criticized for recommending a diet too high in omega-6 fats and far too low in omega-3 fats, especially the long-chain omega-3s, EPA and DHA.

To make matters worse, the amount of omega-3 fat deemed to be “adequate” for Americans was determined by using the median

Omega-6 Fat Syndrome 49 •

omega-3 fat consumed in the U.S. diet. That’s like taking the median exercise level of the typical American and saying that it’s a healthy amount of activity, even though a majority of Americans are couch potatoes! It is especially unsettling given the abundant research demonstrating the need for more omega-3 fats in our diet. In essence, the report really advocates for the status quo, because the recommendations are based on Americans’ current median consumption of both omega-3 and omega-6 fats. Let’s take a closer look at that diet:

• Not enough omega-3 fat. According to the IOM, the average American needs only 130 to 260 milligrams per day of long-chain omega-3 fats (EPA and DHA). That’s a huge gap with international recommendations, which call for five times as much, or 650 milligrams per day.

• Too much omega-6 fat. The IOM did not recommend a ceiling for omega-6 fat consumption, which is especially frightening, given its dominance in our diet. Instead, the IOM recommends nearly four times the amount of the omega-6 fat linoleic acid (up to 16 grams per day) as in the international guidelines. The range is set so high that you could be eating a whopping 17-to-1 ratio of omega-6 to omega-3 fats—quite lopsided and far from “adequate.”

The IOM 2005 guidelines don’t come close to refl ecting the international recommendations, in spite of the bounty of research and scientists supporting the need for balancing the omegas (see Table 3.8). International guidelines were published in 2000, by a respected group of fatty-acid experts, from a meeting organized by the ISSFAL. They include scientists from academia, government, industry, and health agencies from around the world.¹ Ironically, some of the United States’ best scientists attended the ISSFAL workshop (which

1. Simopoulos, A. P., et al. “Workshop Statement on the Essentiality of and Recommended Dietary Intakes for Omega-6 and Omega-3 Fatty Acids.” PLEFA 63(3) (2000): 119–21.

• 50 The Basics of Omega Fats

took place in Washington, D.C.) to formulate global recommendations. Yet, even when measured up to the IOM’s lax 2005 guidelines, the American diet falls short in omega-3 fats, as you can see in the right column of Table 3.8.

Here’s the clincher: In 2006 a group of U.S. scientists concluded that Americans currently eat so much omega-6 fat that they need to

Upper limit for linoleic acid	6,670	No upper limit
OMEGA-3 FAT ALA (plant-based)	2,200	1,100–1,600	1,300
DHA � EPA (long-chain)	650	130–260	85
DHA minimum	220*	No minimum	57
EPA minimum	220	No minimum	28

*For women who are pregnant or breastfeeding, the minimum recommended DHA level is 300 milligrams.

SOURCE: For details, see References under Simopoulos and IOM.

Omega-6 Fat Syndrome 51 •

• 52 The Basics of Omega Fats

Omega-6 fat syndrome: health problems increase as this fat rises in the diet.

�

Chronic diseases skyrocketed when Okinawans ate more omega-6 fat.

�

Israel has the highest omega-6 fat consumption in the world, with higher disease rates.

�

The Lyon Diet Heart Study researched a low omega-6 fat diet that improved overall mortality.

Omega-6 fats need to be limited and omega-3 fats need to increase.

�

High levels of omega-6 fats can be harmful (like other nutrients, such as vitamin D at high levels).

�

Omega-3 supplements do little good when there is too much omega-6 fat in the diet.

�

When dietary omega-6 fats increase by a small amount, it cuts omega-3 fats’ effectiveness

PART 2

Copyright © 2007 by Evelyn Tribole. Click here for terms of use.

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Dousing Infl ammation

The Hotbed of Chronic Diseases

hat do arthritis, heart attacks, cancer, asthma, and depression have in common? Inflammation! Yes, the same process that occurs when you stub your toe—swelling, pain, redness, and heat—is at the root of many of today’s chronic health problems.

In this chapter we’ll look at some of the basics of infl ammation and how what you eat helps or worsens the process.

Infl ammation 101

Your body’s inner 911 is known as the inflammation response. Without it, a little injury such as a cut on your foot could be life threatening. Your body’s arsenal, from tiny cells to special chemicals, responds in a number of ways—such as forming blood clots to prevent blood loss or raising the temperature of your body—in an effort to destroy bacteria that may have entered your wound.

This type of inflammatory response is essential for healing, but another kind of chronic low-grade infl ammation promotes disease. Consequently, the healing blood clots that prevent bleeding to death can trigger a heart attack or stroke.

55 •

Copyright © 2007 by Evelyn Tribole. Click here for terms of use.

• 56 Omega-3 Fats and the Prevention of Diseases

How Your Body’s Inner First-Aid Kit Became a Slow Weapon of Death

Your body’s inner first-aid kit depends on a wide array of tools that include a powerful class of chemicals called eicosanoids (pronounced eye-CO-suh-noids). These potentially healing compounds are made from fat. Eicosanoids made from omega-6 fats promote infl ammation. Omega-3-based eicosanoids have the opposite effect: dousing inflammation. It is a complicated contradiction—but in a way, no different from the opposing tools used for repairing a house. You might need a demolition ball to tear out a rotten wall and then a crane to deliver wood for building a new wall. Or you might need a scraper to remove paint and a thin, wispy brush to apply paint in delicate corners. Similarly, the inflammation process uses eicosanoids that constrict or dilate blood vessels, prevent blood clots or trigger blood clots, and so forth. These seemingly opposite actions are necessary for maintaining your health.

Imagine, however, that while repairing your house, you received mainly tools for demolition. In a simplified manner, that is the dilemma that takes place in our bodies. Today, via the infl ammation response from the food(Buy now from http://www.drugswell.com) we eat, we have a preponderance of the tools that are destruction-oriented toward our bodies. If you eat too many omega-6 fats, your body makes too many pro-infl ammation tools. This problem is amplified when you don’t eat enough of the counterbalancing omega-3 fats.

The proportion of omega-6 and omega-3 fats eaten will determine the type of fats holstered in your cells, which in turn determines the type of eicosanoids created and ultimately your infl ammation status. Nearly 15 years ago, one researcher concluded that the typical American diet sets the biological stage for a near maximal infl ammation response from eating a chronic excess of omega-6 fats and too few of the omega-3 fats (see Figure 4.1).

Today inflammatory responses from excess omega-6 eicosanoids are at the root of many diseases, including diabetes, heart disease, arthritis, asthma, cancer, and Alzheimer’s disease. People are pop

Eicosanoids are potent chemicals that affect inflammation. They are made from omega-6 and omega-3 fats, with the help of COX and LOX enzymes. Many pain medications work by blocking these enzymes. The three eicosanoid groups are thromboxanes, prostaglandins, and leukotrienes.

• 58 Omega-3 Fats and the Prevention of Diseases

ping a record number of anti-inflammatory medications to block the problems caused by eating too many omega-6 fats.

Anti-Inflammatory Drugs and Omega-3 Fats Work by Blocking Omega-6 Fat

When you have a headache, do you reach for aspirin, ibuprofen (Motrin), or naproxen (Aleve)? These over-the-counter medications are known as nonsteroidal anti-infl ammatory drugs (NSAIDs). They work by blocking the effects of the omega-6 fat arachidonic acid, which creates eicosanoids that trigger pain, fever, swelling, and cramping.

Sometimes, these over-the-counter drugs aren’t enough to combat inflammation, so your doctor might prescribe something stronger, such as Celebrex, which also works by preventing omega-6 fats from making eicosanoids. Omega-3 fats work in a similar manner and can even outperform some medications without their side effects.

COX Inhibitors Halt Omega-6 Fat (Arachidonic Acid)

Anti-inflammatory drugs work by blocking enzymes called cyclooxygenase (COX). When this enzyme is blocked, arachidonic acid (the most potent omega-6 fat) is unable to make its infl ammatory compounds.

Arachidonic acid is like an unlit match. The COX enzymes “light” arachidonic acid, which then creates compounds that trigger infl ammation and blood clotting. Anti-inflammatory medications act like water; they prevent arachidonic acid from being lit. Aspirin and other COX inhibitors work by blocking excess omega-6 fats from creating powerful eicosanoids. Ironically, if you take Motrin for a headache and eat food(Buy now from http://www.drugswell.com)s that are high in omega-6 fats (like corn oil margarine on your toast), you may worsen inflammation. It’s like throwing shredded paper on an inferno that the fi re department is trying to extinguish. Omega-6 fats are fuel for the COX enzymes. More fuel leads to more infl ammation.

Dousing Inflammation 59 •

COX-2 Inhibitors Block Omega-6 Fat, Too

For decades, aspirin has been touted as the wonder drug, but chronic use causes problems. Approximately one-third of patients taking aspirin and other NSAIDs develop ulcers, and over 100,000 patients are hospitalized each year for GI complications.

To alleviate pain and the side effects from aspirin, pharmaceutical companies developed a new class of drugs, called COX-2 inhibitors, which selectively block COX enzymes. These drugs, including Vioxx and Celebrex, became popular for managing a variety of conditions, including arthritis, menstrual cramps, and headaches.

Unfortunately, a deadly side effect was discovered: heart problems. Unlike aspirin, COX-2 inhibitor medications allow the formation of blood clots, a key risk factor in heart disease.

LOX: The Smoking Gun from Asthma to Atherosclerosis

Another enzyme, called LOX, converts omega-6 fat into even more potent inflammatory compounds, called leukotrienes. The leukotrienes include a potent asthma-triggering chemical, which is also linked to clogged arteries.

Aspirin and similar anti-inflammatory medications do not affect the LOX enzyme. But omega-3 fats are able to block the LOX enzyme, as do asthma medications (such as Singulair and Zyflo), which prevent leukotriene formation from omega-6 fat.

Omega-3 fats also work like corticosteroid medications, which block the release of the “holstered” arachidonic acid from the cells. Less AA means the LOX can’t make leukotrienes.

Fish oil not only blocks both COX and LOX enzymes without the side effects of medications, it also confers health benefits. The EPA (one of the omega-3s) in fish oil competes with the powerful omega-6 fat arachidonic acid and lessens its ability to make the infl ammatory eicosanoids. When AA is knocked out of the picture, EPA steps in and uses the same enzymes to generate infl ammation-blunting compounds. In particular, DHA (the other omega-3 in fish oil) uses LOX to make a compound that protects the brain.

• 60 Omega-3 Fats and the Prevention of Diseases

Beyond Medication: Omega-3s Turn Off Infl ammation Genes and More

There’s more to inflammation than the myriad of eicosanoids. Genes must be switched on and off in order to make proteins that play pivotal roles in inflammation and immunity. Omega-3 fats also infl uence these players in the orchestration of infl ammation:

• DHA switches off the genes that make enzymes that trigger infl ammation.

• EPA inhibits cytokines, which destroy bone cartilage. In contrast, NSAIDs increase this destructive response.

While medications have their role in managing diseases, fi sh oil does not have the side effects such as bleeding ulcers from aspirin or adverse cardiac events from COX-2 inhibitors. Fish oil helps reduce

Chemical or Process Affected	Aspirin and NSAIDs (Naproxen, Ibuprofen)	COX-2 Inhibitors (Vioxx, Celebrex)	Medications(Zyfl o, Accolate, Cortico-Singulair) steroids		Fish Oil
COX-1 enzyme (infl ammation)	Inhibit	—	—	—	Inhibits

Dousing Inflammation 61 •

Medication or Nutrient

Asthma Aspirin and COX-2 Medications NSAIDs Inhibitors (Zyfl o,

Chemical or (Naproxen, (Vioxx, Accolate, Cortico-Process Affected Ibuprofen) Celebrex) Singulair) steroids Fish Oil

COX-2 enzyme Inhibit Inhibit — — Inhibits (infl ammation)

LOX enzyme No effect No effect Inhibit — Inhibits (infl ammation)

Omega-6 release — — — Inhibit Inhibits (from cell membrane)

Cartilage Increase — — Inhibits destruction (cytokines)

Blood pressure Increase Increase — Increase Decreases

Blood clotting Inhibit Increase — — Inhibits

Genes (inflammation) — — — — Turns off

Toxicity Gastric ulcers Heart Nausea; Weight gain — and bleeding, problems stomachache diabetes, kidney failure, slowed anemia, liver healing, failure, osteoporosis, asthma, and cataracts, dizziness acne, weak

muscles, infection risk, and stomach ulcers

Collateral health Benefits to Decrease — — Benefits to

benefits the heart in colon heart, (for aspirin cancer mood, only) cancer, and

more

• 62 Omega-3 Fats and the Prevention of Diseases

Powerful Synergy: When Fish Oil and Aspirin Unite

Scientists recently discovered that the combination of aspirin and omega-3 fats creates novel healing compounds. These compounds, resolvins and neuroprotectins, are potent anti-infl ammatory chemicals. The research is in its infancy but is quite promising. The resolvins (made from EPA) dramatically prevented the formation of inflammatory bowel disease in genetically prone mice. When applied topically, the resolvins stopped the destruction of gum and bones in rabbit periodontitis (which is similar to human periodontitis, or gum disease). Neuroprotectins (from DHA) protect the survival of stressed-out brain cells and may help prevent Alzheimer’s disease.

Omega-3 Fats Shorten Hospital Stays and Reduce Complications

Given the vast healing properties of omega-3 fats, researchers have turned their attention to patients who require intravenous feeding, also known as total parenteral nutrition (TPN). Up until the 1980s, a person who was unable to eat could die from malnutrition. But during that decade, scientists developed solutions that could be delivered through a tube into the patient’s vein to provide nutrition. The source of fat in these solutions is typically soybean oil. But a recent critical review of the fats used in TPN indicated that soybean oil might hamper patient recovery because it contains a high level of omega-6 fat.

During Hospitalization

When soybean oil is replaced with fish oil, the effects are striking. Studies showed that omega-3 fats improved outcome in very sick patients by lowering the magnitude of the infl ammatory response:

• The infection rate was lower, so there was less need for antibiotics.

• Complications, including the need to go back into surgery, were less frequent.

• The length of stay in intensive-care units declined by nearly half, from nine to just fi ve days.

• There was a decreased need for mechanical breathing.

Dousing Inflammation 63 •

In contrast, the standard soybean oil infusion increased the infl ammation compounds in the blood and the amount of days spent in the hospital.

Omega-3s: Prevention and Treatment of Infl ammatory Diseases

Omega-3 fats are effective in the management of infl ammatory diseases and offer the added benefit of less need for medication.

Cooling Pain and Stiffness in Rheumatoid Arthritis

Greenland Eskimos and indigenous Japanese have lower rates of rheumatoid arthritis than people in Western countries, which is significant because they have a genetic propensity to this disorder. Researchers attribute their lower disease rates to their diet, which is high in omega-3 fat and low in omega-6 fat.

To date, researchers have reported 15 well-designed fi sh oil studies on the treatment of rheumatoid arthritis patients with marked effectiveness. Benefits of using fish oil included reduced pain and morning stiffness and decreased use of pain medication by nearly 50 percent. A standard therapeutic dose of EPA and DHA is 2.7 grams combined.

Asthma and Respiratory Problems: Omega-3 Fats Help You Breathe

Globally, asthma affects about 300 million people of all ages and ethnicities. While progress has been made in the treatment of asthma, its prevalence is rising, which researchers attribute, in part, to the stellar rise of dietary omega-6 fats.

University of Wyoming researchers gave two groups of people fi sh oil and a diet that was either high in omega-6 fat (a level similar to the typical Western diet) or low in omega-6 fat. Those on the diet that

• 64 Omega-3 Fats and the Prevention of Diseases

was high in omega-6 fat had diminished respiratory capacity. But the group whose diet was low in omega-6 fat had a marked improvement in breathing, as well as a decrease in the asthma-triggering leukotrienes. Notably, fish oil was not effective for those eating a diet high in omega-6 fat.

Eating a diet rich in omega-3 fats is associated with fewer asthmatic problems. One study found that children who eat fi sh more than once a week are one-third as likely to develop asthma, compared with those who do not eat fi sh.

Exercise is a powerful trigger of asthma symptoms. Promising research shows that fish oil supplementation signifi cantly ameliorates the severity of exercise-induced airway narrowing in both elite athletes and asthmatics, with a 30 percent reduction in inhaler use. Researchers are hopeful that using omega-3 fats could result in less medication use.

Omega-3s and Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) is the fi fth leading cause of death worldwide and is characterized by chronic infl ammation in the lungs. Sadly, no medication can slow the progression of this disease. But researchers from Japan gave COPD patients an omega-3 supplement for two years, resulting in improved exercise tolerance and less inflammation (less leukotrienes) compared with the placebo group. The improved exercise tolerance is signifi cant because it improves survival in these patients.

Fish Oil Fights Infl ammatory Bowel Diseases

The inflammatory bowel diseases Crohn’s disease and ulcerative colitis are chronic and incurable diseases of the gastrointestinal tract. Fish oil is promising, as studies show it can lessen medication use and increase remission. An encouraging double-blind study on children with Crohn’s disease found that adding fish oil prevented relapse for eight months. In contrast, 95 percent of the kids in the standard treatment group relapsed by the first month of medical treatment.

Dousing Inflammation 65 •

Cancer: Wounds That Do Not Heal

Many cancers are associated with infl ammation, reflected by elevated COX and LOX enzymes. Many of the drugs used for pain relief and inflammation also suppress cancer formation. The COX inhibitors have a strong preventive effect on colon cancer. Most recently, a Celebrex drug study dramatically prevented the recurrence of adenoma cancer. But there’s a huge catch: there was an increased risk of heart disease.

Omega-3 fats, which inhibit both COX and LOX enzymes, have been shown to block cancer in many studies. Some of the compounds made from omega-6 fat enhance the tumor-making process while suppressing the body’s natural ability to get rid of cancerous cells. Many studies indicate that the ratio of dietary omega-6 to omega-3 fats is associated with the risk of cancer.

The Brain Hardwired for Infl ammation

The immune system is integrally connected to the brain. Psychological stress triggers the production of infl ammatory compounds, which can trigger anxiety. Notably, the type and levels of fat in the blood predict the inflammation response to psychological stress. Major depression has an acute phase response in which infl ammation is increased. The imbalance of omega-6 and omega-3 fats found in major depression may be related to the increased production of infl ammatory eicosanoids.

Bone Health: Beyond Calcium

Omega-6 fat makes compounds that trigger bone loss and prevent bone formation. While most of the studies to date have been on animals, the limited human studies are compelling:

• Diets high in omega-6 fats are associated with lighter bones, which increase the risk of fracture.

• • 66 Omega-3 Fats and the Prevention of Diseases
• Lower bone density is associated with higher proportions of dietary omega-6 to omega-3 fats, regardless of hormone replacement status.

Individuals using NSAIDs to relieve pain have higher bone densities and fewer fractures. These medications inhibit the COX enzymes that make the bone-eroding compounds. There’s no doubt that omega-3 fats, also COX inhibitors, will play a role in maintaining our bone health.

Heart Disease and Infl ammation

It is widely accepted that inflammation is at the root of heart disease. It may be the reason why patients with infl ammation conditions (including rheumatoid arthritis, asthma, allergy disorders, lupus, and depression) have a higher risk of heart disease. In the next chapter, you’ll find out more about how omega-3s protect the heart.

Dousing Inflammation 67 •

The dominating fats in your cells ultimately determine the infl ammation status of your body.

�

High omega-6 fat diets shift your body to a near maximal infl ammation response.

�

High dietary omega-3 fats help fi ght inflammation, if omega-6 fats are kept in balance.

Many medications work by blocking the effects of omega-6 fat.

�

NSAIDs, including aspirin, naproxen, and ibuprofen, work by blocking the COX enzymes that turn omega-6 fat into inflammatory and blood-clotting compounds.

�

COX-2 inhibitors, such as Celebrex and Vioxx, work by preventing omega-6 fats from making damaging eicosanoids.

�

The asthma medications Singulair, Accolate, and Zyfl o prevent omega-6 fats from making the lung-constricting leukotrienes; they inhibit the LOX enzyme.

�

Corticosteroids used in inflammation disorders such as inflammatory bowel disorders prevent omega-6 fats from being released from the cells.

�

Omega-3 fats are natural COX, LOX, and omega-6 fat inhibitors.

Omega-3 fats counteract inflammation in other ways that drugs do not:

�

Omega-3 fats turn off the genes that trigger infl ammation.

�

Omega-3s displace omega-6 fat and prevents it from making its omega-6 eicosanoids.

�

Omega-3 fats decrease other inflammatory compounds, such as cytokines.

�

Omega-3 fats create novel potent healing compounds when used with aspirin.

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Heart Health

Nutrition 911 for Your Heart

mega-3 fats are such powerful heart protectors that the American Heart Association recommends eating fi sh twice a week—and taking daily fish oil supplements if you already have heart disease.

In this chapter you will see the compelling ways omega-3 fats keep your heart healthy: by steadying heartbeat, maintaining fl exible arteries, lowering fats in the blood, smoothing blood flow, and even preventing sudden death. You will learn how eating too much omega-6 fat (such as margarine) can create problems for your heart.

69 •

Copyright © 2007 by Evelyn Tribole. Click here for terms of use.

• 70 Omega-3 Fats and the Prevention of Diseases

Omega-3 Fats and Healthy Blood Vessels: Go with the Flow

Omega-3 fats profoundly benefit your arteries and blood system, including blood pressure and blood clotting.

Flexible and Wide Arteries

Your arteries are like freeways, serving as a transportation corridor for blood cells. Have you ever driven on a freeway in which the lanes narrow to just one? As the cars funnel into one lane, they create a traffic jam. That’s similar to what happens to your blood cells when your arteries constrict. It’s harder for them to travel smoothly. Under stress, your body produces a chemical (norepinephrine) that starts a chain reaction leading to narrower arteries. Omega-3 fats counteract this problem by widening the arteries. This yin and yang of artery widening and narrowing is triggered by eicosanoids, made from omega-6 and omega-3 fats.

Your arteries work best when they are elastic and supple. Stiff arteries diminish blood flow to the heart and increase your risk of heart disease. A recent study showed that fish oil supplements, when taken daily for seven weeks, increased the elasticity of arteries.

Under Pressure: Omega-3 Fats

High blood pressure (hypertension) is the most preventable cause of stroke and a major risk factor for heart disease. Hypertension damages your arteries and makes them stiff. Here’s how hypertension damages your blood vessels:

• Sheer stress. Even diamonds can be cut with water if the pressure is high enough. Similarly, blood flowing at higher pressure erodes the artery, causing injury, which triggers infl ammation. Lesions develop in these areas, especially at points of high wear and tear, where arteries branch out or at curvatures. Notably, these lesions will trigger plaque formation, which clogs arteries.

• Overstretching it. Hypertension stretches out the blood vessel, which makes arteries more permeable. Consequently, infl ammation compounds, including the “bad” cholesterol, LDL, easily get enmeshed in the arterial wall.

• Bursting your bubble. If you fi ll a balloon with too much air, it can burst. Similarly, your blood vessels can burst from high blood pressure. Blood vessels in the eyes can burst or bleed, which may cause vision changes resulting in blindness.

Heart Health 71 •

Shaving even a few points off your blood pressure can help your arteries. More than 60 studies found that fish oil has a modest but significant effect on lowering blood pressure.

Omega-3 Fats Keep Blood Flowing Smoothly

Omega-3 fats help blood fl ow efficiently and prevent blood clots. They do so by preventing blood cells, specifically platelets, from clustering together, which would hamper blood flow. This is like drivers slowing down to gawk at an accident; the clustered cars amplify traffic snarls. This type of traffic jam in the blood is known as platelet aggregation. Omega-3 fats also help break down fibrin, a mesh-like compound that forms a blood clot.

Fish oil also helps keep blood flowing smoothly by lowering a category of fats called triglycerides, which in high levels are a risk factor for heart disease. More than 70 studies clearly show fi sh oil has a potent ability to lower these fats. Consuming just two to four grams of fish oil lowers triglycerides by 20 to 50 percent.

What About Cholesterol?

You probably know that elevated blood cholesterol is a risk factor for heart disease. Yet half of the people with heart disease have normal blood cholesterol levels. Despite changes in lifestyle and the use of medications to lower blood cholesterol, the death rate from heart attacks in the United States is among the worst in the world. The

• 72 Omega-3 Fats and the Prevention of Diseases

explanation? Inflammation, not cholesterol itself, has the most profound impact on heart disease.

Your Arteries: The Super Infl ammation Highway

Heart disease or atherosclerosis is often described as “clogged arteries,” but this is a misnomer. It is an inflammatory disorder, which is much more than the accumulation of plaque in the arteries.

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

While the notion of infl ammation 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 identifi ed infl ammation 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(Buy now from http://www.drugswell.com), 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 fl ow, resulting in a heart attack. This sounds logical, but there is actually more to the processes causing heart attacks.

New-School Infl ammation 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

Heart Health 73 •

his landmark paper, “Atherosclerosis: A Chronic Infl ammatory 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 infl ammation process ultimately pulls the trigger by causing plaque to accrue and then rupture, spewing a blood clot and infl ammatory 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 infl ammation 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.

Omega-3 Fats Keep the Pace and Rhythm of the Heart

The heart is an “excitable” tissue, meaning the heart cells generate electric currents, which trigger the heart to beat regularly. Fatal rhythms occur when the electrical signals get chaotic, which disables the heart’s ability to beat and pump blood. One of the ways omega-3 fats benefit the heart is by stabilizing their electrical action.

Omega-3 Fats Improve Heart Rate Variability

Heart rate variability reflects your heart’s autonomic function, which allows your heart to beat automatically, without you thinking about it. Omega-3 fats, especially DHA, improve this heart function.

• 74 Omega-3 Fats and the Prevention of Diseases

EPA and DHA Are Comparable to Anti-Arrhythmia Medication

A Harvard research team evaluated the effects of the long-chain omega-3 fats, EPA and DHA, on heart rhythm. In every instance, the omega-3 fats stopped violent fibrillation (deadly heart beat rhythm) and helped the heart cells resume a normal beat.

Omega-3 Fats Slow the Pace of Beating Hearts

Lowering your heart rate a few beats may appear trivial, but it may help prevent sudden death, as shown in a French study that followed nearly 8,000 healthy men for 23 years. The men who remained healthy had a slower heart rate by four beats per minute.

A review of 30 studies indicates that omega-3 fats lower heart rate by nearly two beats per minute. This effect occurs after 12 weeks of fish oil supplementation, which is how long it takes omega-3 fats to get holstered into your heart cells.

Clearly, omega-3 fats help maintain a healthy heartbeat, which is why scientists believe they are protective against sudden cardiac death.

Omega-3 Fats: Your Inner Defi brillator

More than half of all sudden cardiac deaths occur in people without any history of heart disease. One of the main causes of sudden death is a sustained abnormal heartbeat called ventricular arrhythmia. (That’s why defibrillators save lives: they jolt the heart into normal rhythm.)

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 fish 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.

Heart Health 75 •

Fish or Fish Oil Decreases Sudden Death

A study called the Diet and Reinfarction Trial told heart attack patients to eat two fish servings per week. The study’s results indicated a 29 percent reduction in death. Another study, the GISSI-Prevenzione 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 fi brillation and spent fewer days in the hospital. The fish 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 defi brillators. 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.

Heart Health 77 •

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).³ 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.

3. Silver, M. J., et al. “Arachidonic Acid Causes Sudden Death in Rabbits.” Science 183 (129) (1974): 1085–87.

• 78 Omega-3 Fats and the Prevention of Diseases

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 in LDL 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 enzyme⁴ 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 signifi cantly 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

4. The enzyme is called lipoprotein-associated phospholipid lipase A-2.

Heart Health 79 •

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 find 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 world⁵ 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 fi rst health association that does not

5. The prestigious scientists include Alexander Leaf, M.D., of Harvard; the principal investigator of the Lyon Diet Heart Trial, Michel de Lorgeril from France; noted biochemist W. E. M. Lands, Ph.D., from the United States; Artemis Simopoulos, M.D.; Les Cleland, M.D., from Australia.

• 80 Omega-3 Fats and the Prevention of Diseases

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 is discussed in the next chapter.

Heart Health 81 •

Excess omega-6 fats worsen inflammation and heart disease.

�

Every omega-6 eicosanoid, except for one, is pro-arrhythmic.

�

LDL, or “bad,” cholesterol delivers omega-6 fat into the arteries.

�

The Lyon Diet Heart Trial showed reduced death from all causes in participants eating a diet low in omega-6 fat.

�

Diets high in omega-6 fats increase artery damage in susceptible individuals.

�

No health organization has addressed the omega-6 fat issue, in spite of urging from scientists.

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The Developing Brain

From Womb to High Chair (Even Rocking Chair)

mega-3 fats (particularly DHA) are vital for development, especially creating the architecture of a baby’s brain. Omega-3s have both immediate and long-term consequences that can affect a baby’s health for the rest of his or her life.

Virtually all brain cells or neurons (nerve cells) in the brain are formed before birth. During the last 12 weeks of pregnancy, omega-3 fat content increases in the baby’s brain three to five times. Therefore, what an expectant mother eats has a significant impact on the baby’s brain, from influencing IQ to determining which genes get turned on. In this chapter, we will explore how omega-3s shape a baby’s development with implications throughout the lifespan.

(A special word to mothers: No guilt allowed if your diet during pregnancy wasn’t ideal. Freud did enough in the guilt department for generations of mothers. It’s best to operate under the assumption that you do the best you can until you learn otherwise. Many diseases and health conditions arise from a variety of factors, and once a child is born, how she or he lives can have a significant impact on overall health. So, please, no blaming the mother here.)

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• 84 Omega-3 Fats and the Prevention of Diseases

Pregnancy: You Are What Your Momma Ate

Before, during, and after pregnancy, omega-3s play a critical role for both mom and baby. Therefore, it’s crucial for mom to build and maintain adequate DHA stores. It’s similar to keeping your checking account in the black by making regular deposits. If your funds are insufficient, your checks will bounce, and you’ll pay a penalty. But it’s a little more complicated with your “DHA checking account”: you don’t get statements indicating your omega-3 balance, and withdrawals can be compounded by many factors, some of which are not obvious.

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 benefi ts 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 fi sh 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 fi sh eaten. Low consumption of seafood(Buy now from http://www.drugswell.com) was a strong risk factor for pre-term delivery and low birth weight.

The Developing Brain 85 •

In another study, researchers gave high-risk pregnant women either fish oil or a placebo. The fish oil group had a signifi cant reduction in 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 first-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 refl ect the brain’s maturity. Mothers with higher DHA blood levels had babies with heartier sleep patterns in the first 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 significant 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 fi sh 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, as described in Chapter 11.)

• 86 Omega-3 Fats and the Prevention of Diseases

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.)

Genes: Fate and Fat

As the embryo grows into billions of cells and differentiates into organs, nutritional adequacy is crucial. More biological milestones are passed before birth than after, and once a critical developmen

The Developing Brain 87 •

tal phase is passed in the womb, you can’t start over. Some of these milestones won’t be evident at birth. For example, you won’t know if a newborn’s adolescent parts are working until children reach their preteen years. And so it goes with diseases that can take decades to develop, such as cancer.

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 food(Buy now from http://www.drugswell.com)s 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-infl ammatory.

The Developing Brain 89 •

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 defi ciency 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 fi rst 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.

Breastfeeding and Nutrition in the First Year of Life

Breastfeeding offers many health benefits, and some of these involve the role of omega-3 fats. In addition to containing nutrients that the baby needs, breast milk has disease-fighting substances that are not found in formulas.

• 90 Omega-3 Fats and the Prevention of Diseases

Disease Prevention

Breastfed infants have a decreased incidence of many health conditions, including obesity, insulin resistance, hypertension, diabetes, cardiovascular disease, and asthma. Notably, many studies show that omega-3 fats have benefits in all of these conditions.

Prevention of Sudden Infant Death Syndrome (SIDS)

DHA deficiency may be a link to sudden infant death syndrome (SIDS); infants who die from SIDS have much lower levels of DHA in their brains. These babies also have less mature nervous system function, in which DHA is critical. Any delay in developing mature brain cells could hamper arousal from sleep, which is believed to be an important survival mechanism likely impaired in SIDS.

Continued Brain-Boosting Benefi ts

As brain development continues, DHA accrues in the brain until the baby is two years old. DHA plays a key role in synapse formation. The newborn has only about 1 percent of the synapses formed in the region of the brain responsible for thought, reasoning, and memory. Synapses are points where the neurons communicate with each other. They are like electrical outlets; the more you have, the more appliances you can plug in and operate. The number of synapses influences the plasticity of the young brain, so the more, the better.

Plasticity, also known as neuroplasticity, is critical to brain development throughout life. Plasticity allows neurons to reorganize and grow based on our experiences (sensory, motor, and cognitive). Even in adulthood, our brains are capable of reorganizing in response to our experiences. Until the late 1990s, it was widely thought that from birth, our brain circuitry is wired and fi xed for life. The discovery that brains continue to develop as neurons reorganize and grow is akin to learning that the earth is round, not fl at.

A higher level of DHA in human milk is associated with better learning, memory, and visual and language development in breastfed infants. Here are examples:

The Developing Brain 91 •

• Sustained attention. Researchers at Baylor College of Medicine in Houston found that when mothers supplemented with DHA for the first four months of breastfeeding, their babies performed better on a test that measured attention.

• Better vision and eye-hand coordination. Breastfed infants of mothers who took DHA supplements during lactation had better eye-hand coordination and visual acuity at two and a half years than did breastfed infants of mothers without supplementation.

• Enhanced general movements. Omega-3s have a positive effect on the quality of general movements of healthy full-term infants. This is significant because the quality of general movements is one of the most accurate ways to assess development of the nervous system. Formula-fed babies supplemented with omega-3s for two months after birth had a significant reduction in the occurrence of mildly abnormal general movements.

The DHA and Breast Milk Problem: Diet Still Matters

While no one would question the merits of breastfeeding, there is a problem. The amount of DHA in breast milk has dramatically declined in nearly every country over the last decade (see Table 6.1). A good example of this phenomenon is in Vancouver, Canada, where the DHA in breast milk has dropped by nearly 50 percent in just 15 years. Why? In a word, diet. What a woman eats is the single most important determinant of DHA content of her breast milk and, consequently, her baby’s diet.

Not Enough Omega-3s. Notably it’s the fish-eating countries that have the higher levels of DHA. Breast milk differs in DHA composition depending on the quantity and type of omega-3 food(Buy now from http://www.drugswell.com)s eaten, especially seafood(Buy now from http://www.drugswell.com).

Plant Versus Marine Omega-3s Make a Difference. The importance of the type of omega-3s eaten is illustrated in vegetarian moms, who

TABLE 6.1 DHA Content of Breast Milk by Country

% DHA of

Europe	0.3
Africa	0.3
Canada	0.2
United States	0.1

SOURCE: Innis, S. M. “Polyunsaturated Fatty Acids in Human Milk.” Protecting Infants Through Human Milk (August 2004): 36.

have very little DHA in their breast milk. (DHA is found mainly in fish and some animal products, which are typically excluded in vegetarian diets.) One study showed that babies breastfed by their vegetarian moms had three times lower DHA blood levels than babies breastfed by nonvegetarian women. Even formula-fed babies fared better, as they had nearly twice the DHA levels of vegetarian moms’ babies. This is significant because breast milk DHA levels are directly correlated with the baby’s DHA blood content and their nervous system development at one year of age.

While there are plant sources of omega-3 fats (alpha-linolenic acid, found in flaxseed oil), its conversion to DHA is nil. Several studies of breastfeeding women who were supplemented with alpha-linolenic acid (the parent omega-3 fat) showed no increase in their DHA levels. (But take heart, vegetarians; there is a new plant-based DHA supplement, discussed in Chapter 12.)

DHA a Nutrient. Many experts believe that DHA warrants the status of an essential nutrient, because plant-based omega-3 fat (alpha

The Developing Brain 93 •

linolenic acid) does not sufficiently create DHA, especially in early life, where it’s critical for eye and brain development.

Too Much Omega-6, Trans Fat, and Saturated Fat. Eating too much omega-6 fat, saturated fat, or trans fat limits the DHA composition of breast milk. The omega-6 fat content of breast milk has substantially increased since the 1950s. Breast milk has also been found to contain manufactured trans fats, which may interfere with DHA and may hamper the baby’s brain and visual development. Trans fats have been shown to blunt postnatal growth in animal studies. (In spite of these problems, there is no question that breastfeeding is superior to formula feeding. Remember, breastfed babies have lower rates of infectious diseases, sudden death, diabetes, asthma, and obesity.)

Balance of Omega-6 to Omega-3 Fats Affects the Developing Brain

Normal brain function depends on the balance between omega-3 and omega-6 fats. Without the proper balance, cognitive and behavioral changes may result, as we will explore in the next chapter.

• 94 Omega-3 Fats and the Prevention of Diseases

Omega-3 fats, especially DHA, play a critical role in the developing brain.

�

DHA is integral to the delicate architecture of the baby’s brain (like calcium for bones).

�

DHA builds the matrix for nerve cell communication.

�

DHA influences many brain chemicals involved in mood, memory, and concentration.

�

DHA plays a role in neuroplasticity (the flexible growth of and communication between brain cells).

What Mom eats during and after pregnancy (if breastfeeding) affects the amount of omega-3 fat the baby receives, which impacts:

�

Baby’s intelligence, attention, and development

�

Genes getting turned on or off in the baby’s brain, which influences risk of disease

�

Strict vegetarian moms, who do not yield enough DHA in their breast milk

Omega-3 fats, especially DHA, play a key role in brain development. Low levels may:

�

Decrease learning and language ability

�

Increase risk of sudden infant death syndrome (SIDS)

�

Decrease eye-hand coordination and vision

�

Increase chronic diseases later in life: high blood pressure, diabetes, and allergies

Too much omega-6 fat in Mom’s diet may:

�

Lower DHA content in breast milk

�

Increase risk of complications with pregnancy

�

Increase risk of breast cancer in baby, if a girl

�

Interfere with brain development in baby (if breastfeeding)

Why It’s Good to Have a Fat Head

Omega-3s, the Brain, and Mood

t may be hard to fathom that one nutrient can play a role that ranges from mood regulation to managing borderline personality disorder, yet that’s what remarkable research shows. Promising studies on conditions ranging from depression to everyday stress show that omega-3 fats may be an effective treatment. The results have been so dramatic that sometimes just fish oil alone has been effective to regulate mood.

When you consider the pivotal role omega-3 fats play in normal brain function and development, it’s not a stretch to imagine the sweeping effects of omega-3s on mood and cognition. This chapter will explore how omega-3 fats affect brain function and their role in various mood disorders, stress, learning, and cognitive decline.

The Brain Connection

The decline of omega-3 fats in the Western diet parallels a large rise in psychiatric disorders over the past century. According to experts, the epidemic rise in depression alone is not attributed to better diag

95 •

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• 96 Omega-3 Fats and the Prevention of Diseases

nosis or a reduction in stigma. A recent review in the American Journal of Psychiatry compellingly points to omega-3 fat deficiency as a key contributor to mood disorders.

There is a strong connection between worldwide rates of depression and fish consumption (the major source of omega-3 fat intake). The lowest depression rate is found in the countries with the highest levels of fish consumption, such as Japan. Conversely, higher rates of

Annual apparent fish consumption (lbs. per person)

SOURCE: Reprinted with permission from Elvesier from the Lancet. For details see References under Hibbeln, 1998.

Why It’s Good to Have a Fat Head 97 •

tive disorder (SAD, a form of depression caused by low exposure to sunlight).

The Membrane Is the Brain

Your brain is 60 percent fat, and neurons have one of the highest concentrations of omega-3 fats. Anything that interferes with getting omega-3s into your body (inadequate diet or too much omega-6 fat) makes brain function especially vulnerable.

The human brain contains about 100 billion neurons—brain cells that carry messages through an electrochemical process. The brain cell membrane is the primary site of action for most of the brain’s vital functions.

The membrane is more than just a border encircling the brain cell; it acts as an air traffi c controller, switchboard operator, amplifier, receiver, and static stabilizer. The inner workings of the membrane are in continual flux; a symphony of chemical communication occurs, affecting learning, attention, and mood.

Omega-3s in the Membrane. The cell membrane looks like two parallel layers of jellyfi sh packed together, with their dangling tentacle toes touching each other (see Figure 7.2). The “tentacles” are actually

SOURCE: National Institute of Standards and Technology, NIST Center for Neutron Research (NCNR), “The Cell Membrane,” NCNR website, ncnr.nist.gov/programs/refl ect/rp/biology /cell_membrane.html, last modified March 18, 2003.

a pair of fatty acids, which include omega-3 fatty acids. This jellyfi shstyle arrangement of the membrane creates optimal fluidity, which is very important for brain cell function.

Omega-3s Enhance Fluidity. You may not feel like a walking vessel of primordial ooze, but your brain cells work best this way. The brain cell membrane needs to be at optimal fluidity for clear communication to take place, just as your blood works best when it is sludge free. Imagine having the choice to swim in water or quicksand; no doubt, the viscosity would greatly affect your performance. The same is true for brain cell function.

Optimal fluidity is required for the electric signals within the cells and for chemicals to bind. For example, the feel-good neurotransmitter, serotonin, docks on the protein ports in the harbor of the brain cell membranes. If serotonin had to sludge through viscous membranes, its soothing effects would take longer to kick in.

Why It’s Good to Have a Fat Head 99 •

Your Brain Fluidity Is Affected by Your Diet

When fluidity goes awry, so does optimal brain function. The presence of omega-3s keeps the membrane fluid like a well-oiled hinge on a door. Anything that impedes omega-3s will affect the fl uidity factor.

Omega-6 Fats Decrease Fluidity. If there are not enough omega-3 fats in your diet, the brain has no choice but to allow for an inferior substitution with an omega-6 fat, which does not work the same way. Therefore, the “tentacle” in the membrane that should be an omega-3 fat gets replaced with an omega-6 fat of similar size but inferior function. It’s like replacing a burnt-out 100-watt lightbulb with a 25-watt bulb. You still get light, but it’s a lot dimmer.

Saturated Fats Harden Brain Cells. Saturated fats are well known for hardening arteries, and they have a similar stiffening effect in our cell membranes. Therefore, their presence in the brain cell literally makes it harder to think.

Cholesterol Clogs Brain Cells. Cholesterol hardens the interior of brain cell membranes (not just arteries). Interestingly, omega-3 fats reduce the level of cholesterol in the brain cell’s membrane, enhancing fluidity. While the competitor omega-6 fats, such as soybean oil, remove cholesterol from the arteries, they do not remove cholesterol from the interior of the cell membrane.

• 100 Omega-3 Fats and the Prevention of Diseases

A balance of omega-3 fat is essential for brain function. Researchers believe that many psychiatric disorders, from depression to schizophrenia, are a result of omega-3 fat deficiency. The nature and severity of symptoms are related to the magnitude of omega-3 fatty-acid deficiency (and related factors, such as too much omega-6 fat).

Mood Spectrum Disorders: Depression, Bipolar Disorder, and Schizophrenia

Mood disorders vary with the degree of symptoms, so they are best described on a continuum. Omega-3 fats are linked with each disorder. Many studies demonstrate the benefits of omega-3s in a diverse range of psychiatric disorders.

The Depression Connection

The World Health Organization (WHO) estimates that depression will become the second leading cause of disability worldwide by 2020. The incidence of depression has increased nearly 20-fold since World War II. This rise in depression parallels the Western diet’s simultaneous decrease of omega-3 and increase of omega-6 fats. Notably, studies show that depressed patients have lower levels of omega-3s in their bodies. Some experts believe that the skew of too much omega-6 fat with too little omega-3s accounts for the decade-by-decade increase in major depressive disorders.

A recent study conducted over a two-year period found that both a high ratio of omega-6 to omega-3 fat and a low level of DHA in the blood predicted suicidal behavior in people with major depression.

Despite advances in medicine, a surprising number of people are not helped by antidepressant medications. The most widely prescribed class of antidepressant medication is the SSRIs (serotonin selective reuptake inhibitors), such as Prozac, Effexor, and Zoloft, but they reduce depressive symptoms by only 50 percent in less than half of patients who start them. There is clearly a need for more treatment options. But there is not much incentive for drug companies to

Why It’s Good to Have a Fat Head 101 •

fund research for a nonpatentable compound, such as the promising omega-3 fats. A recent review in the British Journal of Psychiatry found that omega-3 supplements significantly improved depression in three out of four highly controlled studies.

Researchers believe that omega-3 fats, especially EPA, can help normalize brain cell structure and function in depressed patients. When someone is depressed, the brain actually shrinks and has difficulty making new neurons. EPA may lift depression by helping to form new neurons and connections.

One notable study by Malcolm Peet and David Horrobin recruited 70 clinically depressed patients who continued to have problems in spite of taking antidepressants. They divided the patients into four groups to explore the effects of different daily doses of EPA: one gram, two grams, four grams, and zero (placebo). They found clear benefits at the lowest dose given, and three batteries of depression tests showed improvement in sleep, anxiety, depression, libido, and lassitude. The researchers noted that no drug study has shown such large improvements.

• 102 Omega-3 Fats and the Prevention of Diseases

Because of the mounting evidence that links cardiovascular disease and depression, the researchers suggested that depressed patients would benefit from omega-3 supplementation for better mood and to prevent heart disease.

So far, depression studies show that the effective dose of omega-3s to improve symptoms ranges from one gram to two grams a day. DHA alone has not been shown to improve mood, while both EPA alone and fish oil (which contains both DHA and EPA) have shown improvement. While there is no established clinical dose of omega-3 fats for depression, the American Psychiatric Association recommends fish oil for all patients with mood disorders.

Postpartum Depression. Postpartum depression is associated with low intake of omega-3 fat, especially DHA. Both lower DHA content in breast milk and lower seafood(Buy now from http://www.drugswell.com) consumption are linked with higher rates of postpartum depression in 23 different countries. Surprisingly, there are few treatment studies.

The fi rst reported case of successful treatment was published in February 2003 in the American Journal of Psychiatry. A 34-year-old woman (24 weeks pregnant) had clinical depression, including suicidal thoughts. She refused antidepressant medication because of possible birth defects in her baby. As an alternative, she was given two grams of DHA with four grams of EPA, and by the fourth week of supplementation, her depression began to lift. By the sixth week, her thoughts of suicide disappeared altogether.

Kids Get Depressed, Too. An encouraging study on children ages 6 to 12 diagnosed with depression showed that omega-3 fat supplementation markedly reduced symptoms. By the end of the 16-week study, 40 percent of the kids taking the omega-3s no longer felt depressed. Not a single child in the placebo group had this relief.

Omega-3s and Bipolar Disorder

Arguably, the study that launched interest in mood and the omega3 connection was that led by Harvard psychiatrist Andrew Stoll. In 1999 his group published stunning results in the Archives of Gen

Why It’s Good to Have a Fat Head 103 •

eral Psychiatry, demonstrating that omega-3 fats were effective in the treatment of patients with bipolar disorder. This was a four-month double-blind study on 30 patients with unstable bipolar disorder. They took their prescribed medication and randomly received either placebo or fish oil supplements (6.2 grams EPA and 3.4 grams DHA). In nearly every outcome measure, the fish oil group performed better than the placebo group. The results were so strong that the trial was stopped at four months.

How do omega-3 fatty acids produce this effect? One theory is that bipolar disorder symptoms are caused by an excessive amount of omega-6 fats, which wreak havoc with brain metabolism. Omega-3 fats appear to work in the same way as many of the mood-stabilizing drugs (such as lithium), which prevent interference from arachidonic acid in the brain cells and improve their ability to function. But omega-3 fats go one step further by dampening the effects of inflammation in the brain. Excess inflammation has been found in both mania and depression.

Omega-3s and Schizophrenia

Schizophrenia is one of the most severe mental illnesses, characterized by hallucinations, lack of drive, and loss of normal emotional responsiveness. As is the case with other mood disorders, schizophrenia is associated with alterations in the infl ammation response. One theory (yet to be proven) is that schizophrenia may originate in the womb, when the baby is exposed to a low-grade infection. The infection is theorized to interfere with the omega-3 fats in the brain, which in turn damages neurons and triggers adult onset of schizophrenia. Notably, the gene that regulates omega-3 fat supply to the brain is located on the chromosome linked to the gene predisposing to schizophrenia.

Schizophrenic patients have higher rates of omega-3 fat destruction in their brain. Interestingly, Clozapine, the antipsychotic medication used to treat schizophrenia, appears to work in part by increasing DHA levels.

A scientific review of the effect of omega-3 supplementation and mental disorders (including depression, bipolar disorder, and schizo

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phrenia) found that seven of eight double-blind clinical trials yielded positive results from utilizing EPA.

Omega-3s and Borderline Personality Disorder

Unstable moods are a problem in borderline personality disorder (BPD). Harvard researchers gave women with BPD either one gram of EPA per day or placebo for eight weeks. The EPA group showed marked improvement in aggression and depressive symptoms.

Omega-3 fats not only impact mood, but they also greatly affect stress, learning, and memory, which is discussed in the next chapter.

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While there is no established dose of omega-3 fats for treating mood disorders, studies indicate:

�

Doses of one to two grams per day of long-chain omega-3 fats improve depressive symptoms.

�

DHA supplementation alone has no benefi t.

�

EPA alone, or in combination with DHA, has demonstrated efficacy for mood improvement.

�

Fish oil may benefit patients with mood disorders, as recommended by the American Psychiatric Association.

Excess omega-6 fats have a negative impact on brain function:

�

The excess decreases fluidity of brain cell membranes

�

Excess omega-6 fats are a contributing factor in bipolar disorder.

�

The rise in psychiatric disorders parallels the rise in omega-6 fat consumption.

�

The skewed high ratio of omega-6 to omega-3 fat may explain the rise in depressive disorders.

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The Ultimate Chill Pill

Omega-3s’ Impact on Stress, Learning, and Memory

veryone experiences stress, but we don’t always handle it well. As this chapter explains, ongoing stress not only makes us feel bad, it can damage our health and our ability to learn and remember information. Fortunately, nature has provided us with a dietary “chill pill” in the form of—you guessed it—omega-3 fats.

The Stress Response

We may pedal along more smoothly in life and feel mighty fi ne while doing so, provided the right oil lubes the inner cogs of our brain. At least that’s true according to intriguing studies on stress.

The stress response exerts powerful chemical effects throughout the body to help you survive danger. When you encounter a stressor, your blood pressure increases, your heart pumps quicker, you breathe faster, and you become hyper-alert, instantly ready to fight or fl ee the enemy. When you’re stuck in traffic, you’re not in imminent danger, but the body’s stress response is nonetheless the same. Chemically, your body is geared up for a life-threatening fi ght—even if it’s only

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• 108 Omega-3 Fats and the Prevention of Diseases

battling bumper-to-bumper traffic. The stress response serves you well in an emergency, but it can lead to a host of health problems when chronically activated.

Under Pressure: Your Brain and the Stress Response

When you are stressed out, you likely do not feel your brain cells furling up and closing for business, but in essence that’s what occurs. When stress chemicals remain active for too long, they injure and even kill some of your brain cells. They disrupt communication between neurons, slow the formation of new neurons, cause brain cells to age faster, and weaken the blood-brain barrier, which ordinarily prevents toxins from entering the brain.

These changes make our lives more difficult. You might recognize the stress effect on your brain in the form of learning and memory problems. For some people, the stress response can translate into hostile and aggressive behaviors, because the hyper-vigilant and aroused state triggered by the stress response makes it easier to be provoked. Let’s take a closer look.

Memory and Learning. Have you ever noticed how your memory dwindles when you’re feeling stressed? Too much cortisol, a hormone triggered by stress, can prevent the brain from storing new ideas and retrieving long-term memories, so it becomes difficult to think and remember. That’s why people can get confused in a crisis. Stress also interferes with the chemicals that neurons use to communicate with each other and that enable you to think.

Cortisol damages the area of the brain critical for learning and memory—the hippocampus. Deterioration in this brain region is linked to cognitive decline and Alzheimer’s disease.

Brain Degeneration. Studies by Robert M. Sapolsky at Stanford University demonstrated that lots of stress or exposure to cortisol accelerates the degeneration of the aging hippocampus. It’s a double whammy, because this part of the brain helps turn off cortisol production. During stress, a degenerated hippocampus functions like a

The Ultimate Chill Pill 109 •

car zooming downhill without brakes; the accelerating production of cortisol further impairs memory and cognition.

Inflammation in the Brain. Stress increases the production of the most damaging inflammatory compound found in the brain, interleukin1B, which causes cognitive problems. Consequently, this “brain-itis” results in anxiety, problems with learning and memory, an increase in the production of a protein associated with Alzheimer’s disease, and perpetuation of the cycle of stress.

Omega-3s Put the Brakes on Stress

Omega-3 fats protect against the damaging effects of stress. Conversely, if your diet is low in omega-3 fats and high in omega-6 fats, cognition problems are amplified when you’re stressed out:

• Cortisol impairs the formation of the omega-3 fat DHA.

• Omega-6 fats increase stress-induced infl ammation.

Omega-3 Fats Act like Aspirin (COX Inhibitors). Recall from Chapter 4 that omega-3 fats inhibit production of the COX enzyme, which induces inflammation. When the COX enzyme is inhibited, it prevents the response to pain and the inflammation caused by the

• 110 Omega-3 Fats and the Prevention of Diseases

onslaught of stress hormones, including brain infl ammation associated with cognitive problems. COX inhibitors have shown benefi cial effects on cognitive impairment in Alzheimer’s and neurodegenerative diseases.

Omega-3s Lower Stress Hormones in Stressed-Out Students. Several well-designed studies on stressed-out students during peak academic time demonstrated that fish oil or DHA supplements reduce the fl ood of chemicals triggered by stress.

Omega-3s Lower Stress-Response Chemicals and Aid Learning. In an animal study, omega-3 fats not only reduced the stress response (by lowering cortisol), but also protected the rats in the study from cortisol’s damaging effects on learning, as measured by performance on a maze test.

Omega-3s Ameliorate Stress Response Triggered by Anger and Aggression

In 1942 Dr. Hugh Sinclair persuaded the British government to supplement the diet of all children with cod-liver oil, a signifi cant source of omega-3 fats. Sinclair speculated that poor diets could lead to antisocial behavior. His speculation has since been validated by many studies.

Researchers became interested in the hostility-aggression link because it’s a component of the type A personality, a risk factor for heart disease. Some researchers believe that one of the reasons omega-3 fats prevent heart disease may be that it can lessen hostility.

Stress-related feelings, notably hostility and anger, trigger the release of stress hormones into the bloodstream, amplifying aggressive behaviors. Stress hormones constrict arteries; increase heartbeat, blood pressure, and the tendency for blood clotting; and elevate sugar and fats in your blood. The net result is an increased risk of heart disease.

The observation studies on extreme hostility are fascinating. For instance, in a 26-country study, higher rates of homicide are associated with lower rates of fish consumption. Violent men with antiso

The Ultimate Chill Pill 111 •

cial personality were found to have lower blood levels of DHA and higher levels of omega-6 fats.

Double-blind studies on diverse groups of people, including school-age children, university students, medical students, elderly persons, and even prisoners, show that DHA supplementation markedly lowers aggression and hostility caused by stress. For example, researchers from Japan gave university students either a DHA supplement or a placebo during a stressful period. The students without DHA had a 58 percent increase in stress-induced hostility, while the DHA group had no increase in hostile behaviors.

Omega-3 Fats and Learning Disorders

Even if you are not under stress, omega-3 fats play a remarkable role in learning. Research on children and young animals shows that a deficiency in omega-3 fats triggers learning and memory impairment, which can be reversed by omega-3 supplementation. Symptoms of omega-3 deficiency parallel some of the cognition problems in learning disorders, including disturbances of perception, attention, and behavior.

What Research Tells Us About Omega-3s and Learning

A highly controlled study published in the May 2005 issue of the journal Pediatrics demonstrated impressive benefi ts of omega-3 fats on literacy skills and behavior.

ABCs and Omega-3s: Developmental Coordination Disorder (DCD)

During a three-month period, a team of University of Oxford researchers gave an omega-3 fat supplement to school-age children with developmental coordination disorder (DCD), also known as dyspraxia. The supplemented group experienced marked improvement in reading, spelling, and behavior compared with the placebo group. Notably, the children who received the omega-3 supplement made three times the expected normal gain in reading age and twice

• 112 Omega-3 Fats and the Prevention of Diseases

the normal gain in spelling age, bringing their average scores toward normal values.

Omega-3s and ADHD

While fatty-acid deficiency is associated with attention defi cit hyperactivity disorder (ADHD), two double-blind studies showed no benefit of DHA supplementation on ADHD children. There was, however, a significant lowering of aggression in a study on ADHD using DHA-fortifi ed food(Buy now from http://www.drugswell.com)s.

As of yet, there are no supplementation studies on adults with ADHD, but a recent study found that adults with ADHD have low blood levels of omega-3 fats.

Interestingly, about 75 percent of adults with ADHD also have other disorders that are associated with a deficiency in omega-3 fats, including depression and dyslexia.

Omega-3s and Dyslexia

Dyslexia is a learning disability that causes diffi culty with reading and writing despite the individual having a normal intellect. Omega3s offer hope in this area of learning. A study on 102 dyslexic children, ages 8 to 12 years, showed that omega-3 supplementation improved reading skills relative to the placebo group.

Omega-3s and Autism

Researchers have just scratched the surface on the effects of omega-3 fats on autism. A case report published in the 2003 Journal of Clinical Psychiatry showed that an 11-year-old autistic boy treated with three grams of fish oil daily had notable improvement, whereas medications had failed.

A small but promising study of autistic children found that they had high blood levels of omega-6 fats and lower blood levels of omega-3 fats, particularly EPA. The autistic children were supplemented with EPA-rich fish oil (about 215 milligrams of EPA and 75 milligrams of DHA) for six months. Parents reported improvements in cognitive skills, sleep patterns, eye contact, and sociability, as well as reductions in irritability, aggression, and hyperactivity.

The Ultimate Chill Pill 113 •

Omega-3s as the Cerebral Fountain of Youth

The effects of aging on brain function include a decreased ability to make DHA. And a low blood level of DHA is a signifi cant risk factor for dementia, including Alzheimer’s disease. In a remarkable study, Scottish children born in 1921 and 1936 were followed through age 64. Researchers compared their cognition at the age of 64 with mental-ability test scores from the same subjects at the age of 11 years. Omega-3 fats, especially the ratio of omega-3 to omega-6 in their blood, played a role in the retention of cognitive function in late life, independent of childhood IQ.

In 2005 the U.S. Agency for Healthcare Research and Quality (AHRQ) published a critical review of the impact of omega-3 fats on dementia. According to that report, omega-3 fat consumption, especially DHA, was associated with a significant reduction in the incidence of Alzheimer’s disease.

Rusty Thinking: A High Ratio of Omega-6s to Omega-3s Impairs Cognition

Omega-6 fats are implicated as a contributing factor in age-related cognitive disturbances and Alzheimer’s disease. A study comparing cognition scores over a three-year period in two groups of men, aged 69 to 89 years, found that those who ate a diet high in omega-6 fats experienced more cognitive decline. Conversely, high fi sh consumption was protective against impairment.

Fish: The Antidote to Rusty Thinking

The research on the benefits of omega-3 fats—including their food(Buy now from http://www.drugswell.com)-rich source, fi sh—is remarkable:

• Youthful state of mind. Eating one fish meal a week is equivalent to having the brain function of a person three to four years younger, according to the Chicago Health and Aging Project.

• Dementia prevention. The more fish you eat, the less dementia you have. Many large studies show that eating fish pro

• 114 Omega-3 Fats and the Prevention of Diseases

vides protection against cognitive impairment and Alzheimer’s disease.

• Speedier thinking. Higher seafood(Buy now from http://www.drugswell.com) consumption is linked to faster brain processing speed. Slowed brain processing is one of the early pre-clinical signs of Alzheimer’s disease. In 2004, a study involving nearly 1,600 men and women explored the role of omega-3 fats in the middle-aged brain. Eating marine sources of omega-3 fats was found to be associated with less cognitive impairment and better brain processing speed.

How Omega-3s May Prevent Cognitive Decline

Omega-3 fats may help prevent cognitive decline and Alzheimer’s disease in many ways. For example, they may turn on genes that keep our brain optimized and keep the brain’s cell membranes supple. A recent discovery by Louisiana State University researchers is promising. They found that DHA may protect the brain from the ravages of Alzheimer’s disease. DHA creates a compound called neuroprotectin D1 (NPD1), which promotes brain cell survival and reduces infl ammation. Notably, relative to healthy adults, Alzheimer’s patients have about ¹⁄₂₅ of the protective NPD1 in the brain region critical to memory and cognition. NPD1 also appears to prevent accumulation of a toxin called beta amyloid, which is implicated in Alzheimer’s disease.

Omega-3 fats play an amazing role in protecting the brain from the ravages of stress and inflammation, which impacts hostility, learning, and aging. Unbelievably, these fats may offer more benefi ts from preventing obesity to acquiring better skin, as you will see in the next chapter.

The Ultimate Chill Pill 115 •

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On the Horizon

More Benefits of Omega-3s, from Weight Loss to Clear Skin

merging studies of omega-3 fats show promise in a variety of health matters, such as preventing obesity, slowing vision loss, improving insulin resistance, alleviating PMS symptoms, and reducing the risk of cancer. This chapter will explore these promising roles.

Will Omega-3 Fats Prevent Obesity?

A striking body of research indicates that omega-3 fats may help prevent obesity, while omega-6 fats amplify the problem. Keep in mind that obesity is complicated, with many causes and variables. No supplement will offset overeating and inactivity, nor do I want to give the impression that omega-3 fats are a magic bullet for this complex issue.

Omega-6 Fats Trigger Fat Making

The rise in obesity over the last decades is not due to genetics, because it has occurred in too short of a period. A team of French scientists

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• 118 Omega-3 Fats and the Prevention of Diseases

recently reviewed globe-spanning research, leaving no mechanism or relevant study unexplored, including food(Buy now from http://www.drugswell.com) consumption and obesity trends over the past 40 years. They concluded that omega-6 fats are a “remarkable booster of adipogenesis,” meaning the creation of fat. The researchers predict that a disproportionate amount of omega-6 fat in the diet, in conjunction with sedentary lifestyles, will inevitably lead to an increase in the prevalence in obesity worldwide.

So far, animal studies indicate that the omega-6 factor is quite significant. Animals get fatter eating the same number of calories when fed diets high in omega-6 fats. Even farm-fed salmon get fatter on diets that are higher in omega-6 fats. Exercising did not offset the effects of a diet high in omega-6; the animals still deposited more fat on their bodies! Why would this occur? Omega-6 fats make the eicosanoid prostacyclin, which triggers the cells to make fat, and infl ammation perpetuates this cycle. Also, omega-6 fats increase insulin resistance, which makes losing weight more diffi cult.

Omega-3 Fats Turn Off Fat Making

Studies spanning more than 15 years show ways in which omega-3 fats may help prevent obesity:

• Switching off the genes that make fat

• Lowering insulin (the effects of which are described in the next section)

• Preventing omega-6 fats from creating fat-promoting eicosanoids

• Lowering leptin, a powerful compound produced by fat cells

• Increasing fat burning in the abdominal region of the body