Nutrition

Omega-3 fatty acids —
essential to health and happiness

by Marcelle Pick, OB/GYN NP

Almost every woman I see in my practice is worried about fat. After years of misleading media conditioning, it’s no wonder we remain convinced that eating fat will make us fat. But in all honesty, extreme low-fat diets don’t help regulate our weight or enhance our health. In fact, a shortage of fat makes us significantly less healthy, and sometimes even miserable.

Our culture is beginning to wake up to how essential fats are to our survival — especially omega-3’s. I’m sure you’ve seen the phrase “Good source of Omega-3’s” stamped on food packaging in your grocery store. From eggs to waffles, food manufacturers are figuring out that omega-3 fatty acids sell. But many women are confused about why they are so good for us, especially since we’ve been avoiding fat for all these years.

Studies have shown that omega-3 fatty acids can have a positive impact on or prevent serious degenerative illnesses like heart disease, hypertension, rheumatoid arthritis, Alzheimer’s, diabetes and more. The anti-inflammatory properties of omega-3’s are especially beneficial to menopausal women in preserving heart, breast and bone health, and even help keep our moods on an even keel.

I admit, it almost sounds too good to be true. But it is true. Over the years, I’ve seen omega-3’s — referred to as essential fatty acids — do wonders for women. They contribute to every inch of our bodies. From our hearts to our minds and every cell in-between, I promise omega-3’s are the healthiest fats you can consume! And no matter how busy you are, there are easy ways to include them in your diet.

Let’s take a closer look at omega-3 fatty acids and how they can work for you.

What’s so essential about essential fatty acids?

Many of my patients want to know the difference between regular fat and “essential” fat. Put simply, our bodies cannot make essential fatty acids (EFA’s) on their own, so they must come from our diets. What’s more, both forms of EFA’s (omega-3 and omega-6) are found in the membranes of every cell in our bodies!

At the molecular level, EFA’s protect and keep our cardiovascular, musculoskeletal, GI and immune systems functioning optimally. They help insulate our nerve cells and produce molecular messengers involved in immunity and the central nervous system.

We can obtain omega-3 and omega-6 fatty acids from a range of food sources. Here are some good sources for these special fats. (Many foods have both omega-3’s and 6’s, so you’ll see them on both lists below.)

Omega-3 sources	Omega-6 sources
Seafood (sources both high in omega-3’s and low in environmental contaminants include anchovies, herring, mackerel, oysters, wild salmon, and sardines) Flaxseed Hempseed oil Walnuts Canola oil Eggs Pumpkin seeds Marine microalgae (Most algae-based supplements contain docosahexaenoic acid [DHA], but no eicosapentaenoic acid [EPA] — see our article on vegan sources for more info.)	Borage oil Evening primrose oil (EPO) Sunflower oil Safflower oil Corn oil Canola oil Soybean Eggs

You may wonder why olive oil isn’t on either of these lists. The reason is because its two main fatty acids are oleic acid, an omega-9, and palmitic acid, one of the most common saturated fatty acids found in both plants and animals. In other words, olive oil contains no omega-3’s (or 6’s). But of course, it’s superb for your health nonetheless, due to its bioflavonoid content. (See our pages on omega-3’s and the Mediterranean diet and the differences between 3’s, 6’s and 9’s for more specifics.)

Omega-3’s and omega-6’s — a healthy balance is best

These days, all omega-3’s tend to be being lumped together as “good fats” and all omega-6’s as “bad fats.” This good–bad thinking is probably because we are getting so many 6’s and too few 3’s. And, in broad terms, omega-6’s do favor inflammation, while omega-3’s counter it. And this increase in inflammation is what contributes to the very diseases omega-3’s have been proven to help. But the reality is that both 3’s and 6’s are essential to our bodies.

That said, it’s not so much that we need lots of both, though: it’s the ratio of 6’s to 3’s that we get that is most relevant to our health and longevity. Concerning that ratio, let’s take another look at the foods listed above. Researchers agree that the optimal ratio of omega-6 to omega-3 is somewhere between 2:1 and 4:1. Yet the typical American diet provides a ratio of anywhere between 10:1 and 30:1!

This imbalance, tipped disproportionately in favor of omega-6 over omega-3, stems in part from a diet laden with animal fats, such as corn-fed beef, and other corn-derived products, and lacking in seafood, seeds, and nuts. But it may also stem from overreliance on packaged, fast and fried foods high in hydrogenated oils, or trans fats. We don’t yet fully understand how trans fats upset the scales, but we do know that they’re metabolized very differently from other fats, and interfere with the conversion of all other dietary fats.

While we’re on the subject of good and bad, I would like to explain that the only truly “bad” fats are the ones not found in nature: trans fats. The food industry creates hydrogenated trans fats by pumping extra hydrogen atoms into their molecular configuration, to create a malleable, melt-in-the-mouth, yet solid-at-room-temperature product. Along with prolonging the shelf-life of all sorts of processed foods — cookies, crackers, breads, spreads, sauces, fried foods and snack foods — trans fats have been shown to raise LDL (“bad”) cholesterol and increase the risk of heart disease.

If the words “hydrogenated” or “partially hydrogenated” are listed in the product’s ingredients, do yourself a favor and just don’t buy it. And because federal regulations permit a product’s label to claim “Zero trans fats” if its trans fat content is less than half a gram per serving, be sure to check that the serving size listed hasn’t been minimized to ridiculously small proportions. (For more on trans fats, read the truth about cholesterol and fat.)

Omega-3’s and disease prevention

The more we learn about omega-3’s, the more amazing they seem: how can something so simple, so affordable, and so readily available be so good for us? Because of their anti-inflammatory properties, omega-3’s have been linked with prevention and treatment of a whole host of health problems, including:

Heart disease Stroke High cholesterol High blood pressure Diabetes Obesity Arthritis Osteoporosis

Depression/bipolar disorders Schizophrenia Alzheimer’s ADHD Burns Skin disorders Asthma Breast, colon, and prostate cancers

This list goes on and on. So it’s no surprise that omega-3 fatty acids are quickly becoming one of the most researched topics in the scientific community — and one of the most celebrated among people who care about whole health. Yet data indicate that, for most people, omega-3 fatty acid intake continues to decline!

Omega-3’s and women

In my opinion, supplementing with omega-3 fatty acids is a no-brainer, especially for women. We’ve been using omega-3’s at the clinic for years with great success. From menstrual cramps to menopausal symptoms and breast cancer, omega-3’s can help women of all ages.

Let’s start with women in their reproductive years. Scientists have found a correlation between increased menstrual pain and low omega-3 concentrations in the blood. Dysmenorrhea, or menstrual cramps, occur when cell membranes release omega-6 fatty acids, which then produce proinflammatory eicosanoids. Cramps, nausea, headache and other menstrual symptoms are the result.

Infertility and premature birth are two other women’s health issues where omega-3 research is coming up strong. One study showed increased fertility rates with omega-3 supplementation. Researchers observed that omega-3 supplementation reduced clotting in the endometrial cells lining the uterus, which improved the implantation rates of fertilized eggs. Additionally, an imbalanced omega-6-to-omega-3 ratio has been linked to polycystic ovarian syndrome (PCOS), another cause of infertility in some women.

When pregnant women increase their omega-3 intake, the risk of premature birth plummets by up to 50%. Fetal brain development also benefits from omega-3 supplementation, especially DHA, during gestation as well as after birth. Moms who supplement for the sake of their infants also lower their risk of postpartum depression.

For women with a history of cancer, we now have research on the effect of different types and amounts of fats on tumor growth. Fatty acids can be both protective or harmful depending on the situation, but an excess of the proinflammatory eicosanoids derived from omega-6’s can have a negative effect on the immune system, and may account for accelerated growth of certain cancers.

Since the metabolites of omega-3’s are known to counterbalance those of omega-6’s, scientists are looking for ways to use omega-3’s to block the growth of tumors. Animal studies have already demonstrated that a high-omega-3 diet can slow tumor growth, and people following a Mediterranean diet (rich in omega-3’s and other phytonutrients) have been found to be 56% less likely to develop cancer and 61% less likely to die from it.

Omega-3 fatty acids and menopause

If you’re not convinced about incorporating quality omega-3’s into your diet yet, there’s more. Omega-3 fatty acids can help many of the issues we experience in menopause. As I mentioned before, low blood levels of omega-3’s are associated with inflammation, which is the fire beneath so many health problems arising in menopause — osteoporosis, heart disease, vaginal dryness, thinning skin and hair, joint pain and dry eyes, to name some familiar ones. And o-3’s can calm this inflammation. Let’s take a look at the specifics. Omega-3’s can help with the following:

Insulin resistance. When circulating estrogen levels in the blood decrease, as they naturally do during menopause, one of the ways the body responds to this is by increasing insulin production, which results in more arachidonic acid and other proinflammatory eicosanoids. Omega-3 supplementation is one way to dampen the effects of these proinflammatory substances and encourage stable insulin levels in menopausal women.

Hot flashes. In reporting the results of two small, but well-controlled studies, a team of Italian scientists in 2005 attributed a “progressive and highly significant reduction” in hot flashes to omega-3’s, possibly through their influence on nerve cell membranes or by modulating neurotransmitter function. In fact, a diet high in omega-3’s may be one of the reasons why Japanese women, whose diets are rich in fish, seaweed and soy, have fewer menopausal problems than American women do.

Osteoporosis. Normal bone is constantly being broken down (resorbed) and rebuilt. When resorption exceeds formation, bone mass slowly deteriorates, which can lead to the condition we know as osteoporosis. Derivatives of omega-6 fatty acids are stimulators of bone resorption. Fortunately, it’s never too late to start rebuilding good bones, and we can call on omega-3’s to counteract omega-6’s and help prevent and treat osteoporosis.

Mood, affect and memory. These are all challenges as we grow older. Some research on omega-3’s shows promise for preventing, and possibly treating, depression. Omega-3’s may likewise be helpful for people struggling with personality and behavioral problems such as aggression. Researchers recently found that people with high levels of omega-3’s in their blood had more grey matter in the sectors of the brain associated with positive emotions and moods, while the subjects with mild to moderate depression symptoms showed decreased grey matter in those same areas. More research is needed to determine whether omega-3’s actually cause this phenomenon, but it’s safe to say that healthy omega-3 levels can mean a more positive outlook on life and lower rates of memory loss.

Cardiovascular disease. We know that women, especially those over 40, whose lipid profiles show a high ratio of triglycerides to HDL (“good” cholesterol) are at increased risk for cardiovascular disease. Omega-3-rich fish oil supplements do double-duty in protecting the heart and blood vessels by bringing triglyceride levels down while at the same time increasing HDL. Taking omega-3’s is also a good idea if you’re on conventional hormone replacement therapy, because HRT can increase triglyceride levels to unhealthy levels.

Lower heart rate = longer life? Perhaps longevity is the ultimate omega-3 benefit to reap. Researcher Jørn Dyerberg, known throughout the world for his pioneering work on omega-3’s, was the first to note the virtual absence of heart disease among Greenland’s indigenous people. Attributing this directly to their high dietary omega-3 content, Dyerberg believes that the net effect of lowering the number of heart beats over a lifetime is a heart that beats longer — in other words, a longer lifespan. More research is called for, but studies suggest that DHA is the principal omega-3 fatty acid responsible for lowering heart rate and improving resilience of heart rate variability, which together lower risk of deadly sudden cardiac events significantly.

All told, that’s a pretty essential nutrient, wouldn’t you say? Now that we understand why omega-3’s are so essential, the next questions to explore are What kind of omega-3 is best? and How much omega-3’s should you take?

Getting it right — how to pick your omega-3 supplement

Naturally, getting omega-3 fatty acids fresh from the source in our diets is ideal, but let’s be honest: our busy lives don’t always allow for this. There are loads of companies out there selling omega-3 supplements, and I always tell my patients to base their choices on the quality and purity of the product.

Omega-3 fish oils should be sourced from deep-water fish inhabiting the least polluted waters on earth. Unfortunately, oily fish can contain high levels of toxic pesticides, dioxins, PCB’s, or heavy metals such as lead and mercury, all of which must be removed in the preparation process for omega-3 supplements. Today, highly advanced omega-3 extraction and distillation processes efficiently remove toxins and impurities as well as maintain stability and freshness. If you are concerned about purity, call the manufacturer and request a certificate of analysis, where they show the results of tests for levels of lead, mercury, and cadmium in each batch.

Another consideration is dosage. The American Heart Association recommends consuming 1–3 grams per day of EPA and DHA. For certain medical conditions, however, higher doses of omega-3 products, up to 4 grams per day, can be used safely, and with good effect. A number of recent studies show that higher-dose omega-3 fatty acids can be extremely helpful, for example, for lowering high triglycerides, and that they are usually very well tolerated. We encourage you to talk with a qualified healthcare practitioner before using higher than average doses of omega-3’s (more than 3 grams [>3000 mg] per day).

At Women to Women, we know that the basis of health is balance, not overabundance. Unless your healthcare provider recommends otherwise, your best bet when purchasing omega-3 supplements is to base your choice on the following criteria:

• Look for natural forms that have been purified by molecular distillation, to ensure the product is free of mercury and other contaminants.

• Look for added antioxidants.

• The label shouldn’t suggest more than 3 grams of EPA and DHA per day (see above).

• Look for both EPA and DHA in the supplement. Since they can be interconverted, the ratio of EPA:DHA is not as important as quality and amount are, but both should be present, and a reasonable ratio to look for is 3:2.

• Always check the expiration date, and take note of any bad smell or taste, which may mean the product was poorly purified, has expired, or has already oxidized. (Note that a fishy smell does not necessarily mean the fish oil is bad, just that it has not undergone a process to remove that odor.)

In addition to taking a high-quality omega-3 supplement, one of the best ways to optimize your omega-3 intake is by following a Mediterranean diet. Generous amounts of richly colored fruits and vegetables, virgin olive oil and fresh fish can help your body acquire a healthier balance.

Getting back to omega-3 balance — the Women to Women approach

There’s no question that increasing your omega-3 fatty acid intake promotes better health, especially for women. From PMS to menopause and disorders like Alzheimer’s, heart disease and osteoporosis, they can help women of all ages reduce harmful inflammation and restore the balance we’ve moved away from with our modern, omega-6-heavy diets.

There are many ways to get your omega-6-to-3 ratio back where it’s meant to be. As you begin the process, here are some tips we’ve found helpful in restoring balance:

• Consider testing your omega-6/omega-3 ratio. If you have symptoms of inflammation or some of the other health risks we’ve discussed above, ask your healthcare provider for a fatty acid profile test. It’s not always easy to remember, let alone share the exact details of our diets with our healthcare providers. Testing gives you both you and your provider an objective number to use as your individual starting point.

• Transition to a more Mediterranean style of eating. Carve out some time to plan your weekly menu — you may not even have to spend a lot of time, once you get the hang of it. Look for simple recipes made from fresh whole foods that you can chop up and prepare ahead of time. That way, it will be simpler to serve a wholesome meal when you come home after a long day, and you’ll have time to relax and savor it fully. Stock up every week on a sampling of brightly colored fresh fruits, vegetables, and nuts for quick and easy snacks. Keep your nuts and oils refrigerated.

• Supplement with high-quality omega-3’s daily. For women who eat at least two seafood servings a week and who have no pressing health concerns, 600–650 mg of EPA and DHA per day may be sufficient. Those with health concerns shown to benefit from omega-3’s may want a higher intake, of 1000–3000 mg per day. Up to 4000 mg per day may be used only under a physician’s care. If you supplement with fish oil, always choose natural, stable preparations of the highest quality and purity (like the Omega-3’s we offer through our Personal Program).

• Include a high-quality multivitamin-mineral complex supplement. Pyroxidine, biotin, calcium, copper, magnesium and zinc are all nutrients that help convert the parent omega-3 ALA into EPA and DHA. Getting enough of these nutrients, by planning and preparing perfectly nutritious meals every single day, week after week, is just impossible for most of us. As much as we’d all like to eat this way, you can be certain to replenish your body’s supply of these important micronutrients by taking a high-quality nutritional supplement (like the one we offer in our Personal Program).

A lesson from the past — balance

Thousands of years ago, before the advent of agriculture, the human diet was much closer to the earth and sea than it is nowadays, and provided omega-3 fatty acids in far greater quantities than our modern diets do. For millennia people ate whatever they could hunt, catch, dig or pick without thinking much about nutrition or what was “good” or “bad” for them. They simply wanted to be full and nourished. Their greater challenge was simply to find enough. With the abundance of food choices today, though we still have to “hunt” for what is best, omega-3-rich foods and supplements are readily available.

With all the promising science being released about omega-3’s, it’s refreshing to know that this fat is all it’s cracked up to be. But like everything else, a fish oil pill isn’t a magic bullet. It’s all about balance — on a cellular level with your o-3/o-6 ratio as well as on the level of your life as a whole. No supplement or pill is going to erase all your health problems. But I promise that incorporating good nutrition with a positive outlook will help keep you on the path to the long and disease-free life you deserve.

Our Personal Program is a great place to start

The Personal Program promotes natural hormonal balance with nutritional supplements, our exclusive endocrine support formula, dietary and lifestyle guidance, and optional phone consultations with our Nurse–Educators. It is a convenient, at-home version of what we recommend to all our patients at the clinic.

• To learn more about the Program, go to How the Personal Program works.
• To select the Program that's right for your symptoms, go to Choose the plan that works for you.
• To assess your symptoms, take our on-line Hormonal Health Profile.
• If you're ready to get started, learn about our risk-free trial.

If you have questions, don't hesitate to call us toll-free at 1-800-798-7902. We're here to listen and help.

We’re always happy to welcome new patients to our medical clinic in Yarmouth, Maine, for those who can make the trip. Click here for information about making an appointment.

Related to this article:

References & further reading on the benefits of omega-3’s

 

Original Publication Date: 10/30/2007
Last Modified: 06/15/2009
Principal Author: Marcelle Pick, OB/GYN NP