Omega 6 & 3 data

MrRippedZilla

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This might be a bit OTT for this board but since the topic was brought up in another thread (with the OP not returning, probably due to the awesome welcome he received) so I decided it was worth adding into this forum. The aim is to discuss both sides of the debate around omega 6 intake, from a health perspective, before giving some simple practical advice at the end.


Background


I think it's important to first state that singling out an essential fatty acid (EFA) as being "dangerous" to our health is a bit weird.
Linoleic acid (omega 6 PUFA) is an essential fatty acid because it cannot be synthesized by the body and therefore must be obtained through diet. Alpha-linolenic acid (ALA, an omega 3 PUFA) also fits into the EFA category but, for reasons I'm not going into, there is some disagreement on this. The amount of these EFAs that we need in order to avoid deficiency is pretty low - 17g Linoleic acid & 1.6g ALA for men, 12g Linoleic acid & 1.1g ALA for women.

Now, with that out of the way, it's important to point out that we do have a large body of data suggesting, as the OP did in the original thread, that omega 6 is bad news.
Some examples include back in 1999, data showing that a diet enriched with LDL from Linoleic acid results in higher levels of oxidation. This is important becomes oxidized LDL can lead to atherosclerosis. In a commentary piece, Calder points out that:
1) arachidonic acid is produced from linoleic acid, which is involved in functions like inflammation & platelet aggregation and these functions in excess can lead to the development of arterial plaque = higher cardiovascular risk.
2) Omega 3 is capable of counteracting these pro-inflammatory/pro-thrombotic effects. This suggests that we may need a certain ratio of 6-3 to prevent heart disease - I'll touch on this a little later.

Then the controversy really heated up when the
AHA (American Heart Association) in a review on the relationship between omega 6 & heart disease reached the following conclusion:
"In summary, the AHA supports an omega-6 PUFA intake of at least 5% to 10% of energy in the context of other AHA lifestyle and dietary recommendations. To reduce omega-6 PUFA intakes from their current levels would be more likely to increase than to decrease risk for CHD."
The choice of wording here is what caused the controversy - they are implying that more omega 6 is better, less is worse. The AHA isn't afraid of controversy of course (this is the same group that recommends limiting saturated fats based off of observational data, idiots) but still - going against the data as a whole that preceded you is mighty brave. Or stupid.

So far, we have the data as a whole telling us omega 6 can be bad while the AHA is saying the more the better. Let's continue.


Ramsden goes in hard on the AHA

I mentioned Ramsden's meta-analysis of human RCTs in the original thread but it really does deserve some more recognition because it is so, so good from an investigatory perspective. By looking at this more relevant group of data, Ramsden concludes that increasing omega 6 intake would probably do more harm than good when it comes to heart disease. He then precedes to verbally destroy the AHA on 4 key points:
1) The omission of trials with unfavorable outcomes
2) The inclusion of trials with weak design and major confounders
3) Failing to separate trials that selectively increased omega 6 from those that increased omega 3
4) Failing to acknowledge the large amounts of trans & saturated fatty acids being replaced by omega 6 & 3 in several of the trials.

Ramsden went to insane levels of investigation to create this meta-analysis and it really is a good read for those into this sort of thing. They contacted the original researchers of the older studies to clarify some points, they identified and used food composition data from the same time period as several of the studies (most over 40 years ago) and other huge leaps of detective work.
To illustrate just how superior a meta-analysis this was compared to the AHA's version, look at the Finnish mental hospital study. This was included in the AHA analysis but not Ramsden because 1) the patients were not randomized individually but by hospital, which resulted in a greater use of thioridazine (cardiotoxic drug) in one of the study arms, 2) trans fat consumption different greatly in multiple control & experimental groups and 3) the crossover process involved replacing 6 oldest cohorts with 6 youngest, another major confounder entering the study.

As much as I love this paper (like it wasn't obvious), it isn't without its limitations that are worth pointing out before you decide that yes, omega 6 is bad news:
- They only looked at 7 RCTs and, as the authors admit, you have to be careful interpreting the results of such a small sample.
- The subjects in this analysis included post-myocardial infarction, coronary heart disease and institutionalized patients so the results may not be applicable to the general population or to our community in particular.
- The food source of omega 6 in these studies is another limitation since a very small % of our community uses a bunch of soybean, safflower or corn oil.


The false dilemma


As a result of where the data seemed to be trending, people (including those in our community) decided that it was best to limit omega 6 & increase omega 3.
As I mentioned in the previous thread, this idea of a ratio actually came from research looking at the Greenland Eskimos & Japanese diets - both of whom take in a lot of omega 3 and have a lower rate of cardiovascular disease/autoimmune disorders compared to us in the West. To quote a review paper looking into that data:
"The importance of omega-3 essential fatty acids in the diet is now evident, as well as the need to return to a more physiologic omega-6/omega-3 ratio of about 1-4/1 rather than the ratio of 16-20/1 provided by current Western diets. In order to improve the ratio of omega-6/omega-3 essential fatty acids, it will be necessary to decrease the intake of omega-6 fatty acids from vegetable oils and to increase the intake of omega-3 fatty acids..."
This push to reduce omega 6/increase omega 3 gathered momentum with Cordain (a name that should be familiar with Paleo fans), taking the evolutionary perspective, and recommending a better balance between the two fatty acids in order to optimize health.

Now, I agree that we all need more omega 3 in our lives. However, the idea that we must also limit omega 6 in order to improve the ratio and become healthier sounds counterproductive to me for a number of reasons:

- First of all, the idea of an "optimal" 6:3 ratio is speculative as hell since its reliant on a bunch of inconsistent, uncontrolled, data. Harris is worth quoting here: "Accordingly, the n-6/n-3 FA ratio may be of value in interpreting biomarker data and in making nutritional recommendations. Although initially appealing, there are few human experimental and clinical trial data to support this view...the ratio is, both on theoretical and evidential grounds, of little value. Metrics that include the n-3 FAs alone, especially eicosapentaenoic and docosahexaenoic acids, appear to hold the greatest promise."

- Secondly, we have data showing that an almond-enriched diet lowers inflammatory markers (C-reactive protein, etc) and can also lower LDL cholesterol to a greater degree than walnuts & virgin olive oil.
How is this relevant? Well, the omega 6-3 ratio in almonds is very high (2011:1) but had no negative impact on the positive, healthy effects. Other foods with high omega 6-3 ratios include coconut oil (3293:1), olive oil (20:1) and avocados (15:1). This is what I'm talking about when I say that limiting omega 6 can be counterproductive - you're missing out on a bunch of healthy food sources because of an obsession over 1 particular, essential, fatty acid.


Once you start digging deeper, you find that the "avoid omega 6" advice is anything but a healthy option.


Summary & take home advice

- The AHA's recommendation to increase omega 6 intake should be ignored due to the severe limitations involved in that analysis.

- The minimization of omega 6 foods is a bad idea because it would involve missing out on overall healthy food sources.

- The idea of an "optimal" omega 6-3 ratio lacks solid evidence (human RCTs) and should be treated with a great deal of skepticism.

- The best course of action is to consume an adequate amount of omega 3 and not really worry about omega 6 at all.

For those who are unable to consume fatty fish, the best source of omega 3, on a regular basis (2xweek) I'd recommend supplementing with fish oil. Most fish oil supps are cheap but it is important to keep an eye on the EPA & DHA ratios unless you don't mind knocking down a dozen pills per day. FWIW, I recommend Elite Omega 3 by Carlson (1.25g fish oil, 400mg EPA, 300mg DHA per pill).

As for dosing, I usually recommend 1.2-4g of total EPA & DHA/day depending on the purpose (beyond general health) and that's in line with the research.
The AHA says 0.5-1.8g/day along with 2-4g for those with the specific goal of lowering triacylglycerol levels. They also warn of an increased risk of excessive bleeding for some individuals on doses above 3g but I've never seen such a thing and a lot of my clients take higher doses than that. Might be worth keeping in mind if you're on any sort of blood thinning medication though (I know some here are).

There you go. Don't obsess over omega 6, get yourself some omega 3 and be happy :)
 
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Seeker

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Thanks for the thread. And the fish oil supplement referral. I am planning on going with 4 grams a day.
 

ECKSRATED

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U guys got some links to some good products u suggest? Ones you don't burp up would be nice. I haven't taken any fish oils in a couple years cus the ones I used I would burp up for hous after.
 

MrRippedZilla

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U guys got some links to some good products u suggest? Ones you don't burp up would be nice. I haven't taken any fish oils in a couple years cus the ones I used I would burp up for hous after.

Taking them with a meal, refrigerating them or splitting the dosing might help with the burps. Here is my Carlson recommendation: https://www.walgreens.com/store/c/c...h-oil-1250-mg-softgels/ID=prod6301447-product

I did a lot of research into this a year ago before settling for Carlson. More fish oil per cap means no need to consume a dozen per day, much better EPA/DHA ratio and 3rd party tested so you don't have to worry about it being rancid or whatever. Good stuff.
 
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ECKSRATED

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Thanks guys I'll give those a try for sure.
 

j2048b

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What to do if ur allergic to shell fish? Vegan only omega's??

I didnt touch krill or fish oils for 3 months, added fiber to my shakes and my hdl is at a 61, ehich is outstanding, and my ldl went doen to the lowest ive seen it in 10 yrs, and im not sure Why? Usually krill and omega 3's help hdl, if i had none what could ut have been that helped my hdl go up
 

MrRippedZilla

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What to do if ur allergic to shell fish? Vegan only omega's??

I didnt touch krill or fish oils for 3 months, added fiber to my shakes and my hdl is at a 61, ehich is outstanding, and my ldl went doen to the lowest ive seen it in 10 yrs, and im not sure Why? Usually krill and omega 3's help hdl, if i had none what could ut have been that helped my hdl go up

Avoid fish products with shellfish, no need to go full vegan. Nordic, IIRC, avoid shellfish in their products. An expensive option but an option nonetheless.

Fish oil does increase HDL in some, not all, folks but it's main benefit for lipids comes from the dramatic triglyceride reduction (20% is common). As for your specific situation, I cannot even begin to comment on what may have helped since I have no idea what your lifestyle habits entail :)

A word of warning when it comes to interpreting lipid panels. Do not focus too much on individual markers. Consider the bigger picture.
If you have high HDL, a good TC:HDL ratio, low TG & low TG:HDL ratio then you have nothing to worry about regardless of what so called professionals may say. I've had a few arguments with doctors who wanted to put people (including 1 of my clients) on meds because they lost their ****ing minds over the TC or LDL number - ignoring the stuff I mentioned above along with the overall healthy lifestyles. "Experts" indeed.
 

DieYoungStrong

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All I know is my triglycerides went from the 300s down to the low 80s after I started taking at least 3G a day of quality fish oil. I think I use ultimate omega. Always take after a meal and never get burps or anything.
 

j2048b

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Anyone believe that a higher epa is better than dha especially as we age? Ive felt better with a higher epa, better mood etc,
 

Yaya

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All I know is my triglycerides went from the 300s down to the low 80s after I started taking at least 3G a day of quality fish oil. I think I use ultimate omega. Always take after a meal and never get burps or anything.

Take it easy
 

MrRippedZilla

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Anyone believe that a higher epa is better than dha especially as we age? Ive felt better with a higher epa, better mood etc,
Both are essential in shared & different ways. One may have have a greater effect given an end result but that doesn't mean its overall "better".

No such thing as an ideal ratio and be aware of the strong DHA dominance when it comes to omega 3 fish sources, the best source of omega 3, before thinking that EPA is the way to go.
 
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Is there any proof that Omega 3 supplements have any benefits? All studies I've seen come from the consumption of Omega 3 fatty seafoods. In other words, there is no isolation of Omega 3 but instead a food source with numerous beneficial content.

Could this not be similar to the vitamin supplement argument against their effectiveness?
 

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