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Good Fats as Easy as 3,6,9

Balancing the beneficial omega fatty acids is the key to good health

Steve Myers

References

Omega has many meanings dating back to the original Greek alphabet. From "great" to "the density of the universe," omega often denotes a significant importance. Omega fatty acids are increasingly well-known as important to good health and, as such, have been infusing their importance into a variety of products, from dietary supplements to functional foods. Crucial to the success of the essential fatty acid (EFA) segment is retailer and consumer understanding of what the different omegas are, where they are found in the diet and in what ways they can balance good health.

As in the Ancient Greek language, where it is the last letter in the alphabet, in nutrition science omega denotes the end. Long chain polyunsaturated fatty acids (PUFAs) feature more than one double bond, which eliminates hydrogen and is thus not "saturated" with hydrogen like a saturated fat is; monounsaturated fats have only one double-bond. In PUFAs, where the last double bond is positioned from the tail, or end, of the chain determines the type of omega fat. So a PUFA with a double bond three links from the end is called omega-3; a double bond six spots from the tail is an omega-6. These two PUFAS are considered EFAs, because they cannot be made from the body and must come from dietary sources. Humans do have the enzymes necessary to manufacture omega-9 fatty acids, but this ability can be diminished in certain populations, including seniors, so the 9s are often included in EFA supplements.

Humans may not be able to manufacture EFAs outright but, once digested, certain omega-3s and -6s can be converted to other forms in those categories. For instance, the body uses certain enzymes (desaturases) to change the master omega-3 alpha-linolenic acid (ALA) to the longer-chain PUFA eicosapentaenoic acid (EPA), which can be further "de-saturated" into docosahexaenoic acid (DHA). Likewise, the master omega-6 linoleic acid (LA) can be de-saturated to form gamma-linoleic acid (GLA).

These fatty acids make eicosanoids, which are molecules that help deliver messages in various body systems including the immune, inflammatory and central nervous systems. Each EFA makes a different class of these signaling molecules (prostaglandins, thromboxanes and leukotrienes)—some pro-inflammatory, some anti-inflammatory. The omega-6s tend to produce pro-inflammatory compounds, while omega-3s are more anti-inflammatory. Both types are important, as the body often uses inflammation to address certain acute issues, such as injury or infection. However, when the problem is under control, the body needs anti-inflammatory compounds to return things to normal.

Thus, both types of omegas are important to human health. However, many scientists, including nutritionists, have reported the modern diet has overloaded on omega-6s, which primarily come from vegetable oils—canola, safflower, corn, etc.—and contains less than ideal amounts of omega-3s, which come from marine food sources (fish, krill, etc.) and some plants (flax, kiwi, perilla, chia and others).

The effects on inflammation are the root of many of the health benefits of EFAs. Due to the reported imbalance of omega-6s to -3s, it is widely claimed including more omega-3s in the diet will better balance inflammation, a factor in cardiovascular and brain health, as well as diabetes and immune disorders. Still debated, the range of ratios of omega-6 to -3 EFAs is from 1:1 to 4:1—the modern diet can be 10:1 and sharply higher.

Iichiroh Ohhira, Ph.D., a microbiologist from Okayama University, Japan, settled on a ratio of 4:1:1 (omega-6:-3:-9), based on his research. "The reason Dr. Ohhira, a microbiologist of some renown, developed a 4:1:1 ratio is in recognition of the fact that [omega-6] is readily available in the food Americans consume," said Michael Schoor, Essential Formulas. "He did not see any justification for the formulation of a product that might lend to omega-6 toxicity in some consumers." Schoor also reported consumers do understand the importance of balancing the ratios of omega fatty acids. "This is particularly true in light of potential omega-6 toxicity that is discussed in the news," he noted.

Other manufacturers, such as Jarrow Formulas, base their products on a 1:1:1 ratio.

Consumers definitely seem to be taking notice of these ratios and the average imbalances. The 2009 International Food Information Council (IFIC) Foundation Food & Health Survey reported 74 percent of consumers are aware of omega-3s, and about one-third of shoppers say they are aware of omega-6s. Further, more than half of consumers said they are trying to consume more omega-3 fatty acids.

According to Leatherhead International, consumer awareness of omega-3s is quite high—88 percent in the United States and 92 percent in Europe—although there is less knowledge about the types of omega-3s and specific health benefits.

Similarly, a survey conducted by Equation Research for fish oil omega-3 producer Croda found 63 percent of consumers believe they are missing omega-3s in their diet, although only 26 percent of respondents take omega-3 fish oil dietary supplements to augment their dietary intake. The concerns cited as barriers to purchase include cost, lack of perceived need and quality concerns—94 percent of shoppers look for assurances of purity when selecting dietary supplements.

Ian Newton, Ceres Consulting, noted while lower-quality fish oils troubled the early days of omega-3 fortification, the fish oil manufacturing industry has addressed product quality and effective product formulation to maximize shelf life of finished fish oil products.

The primary complaints on fish and other marine sources are contamination with toxic chemicals and overfishing certain species. Many contaminants (metals, PCB, dioxins, etc.) in fish come from pollution from people and all sorts of industrial practices; because they cannot control the actions of others, fish oil producers combat this problem with technology, including various distillation methods. Two things help these efforts: heavy metal contaminants, such as mercury, tend to collect in the meat, not the oil; and the species used for fish oil are not commonly among those cited for the worst contamination.

The industry banded together to improve the quality, and the results have been positive. In fact, ConsumerLab.com recently conducted its biggest test on fish oils to date, finding all 50 of the tested supplements, foods and beverages containing fish oil ingredients were found safely free from heavy metal and other contamination. Moreover, the products, which contained between 16 mg to more than 1,000 mg per serving, all met label claims for EPA and DHA, without any signs of spoilage.

Also, much of the fish for fish oil come from Peru, which has a very strict fishing policy with regards to overfishing various populations. Still, questions of sustainability hound certain consumers, many of whom seek out more sustainable sources of omega-3s, including vegetarian and algal.

"For vegetarians, and those concerned with sustainable oceans, fish oil is not an alternative," confirmed John H. Maher, D.C., BioPharma Scientific. "The problem is that vegan sources of omega-3 are all short chain ALA. While ALA has good effects in its own right—indeed it is essential to consume it—it only converts reasonably well in the body to one of the two special beneficial long chains found in fish oil, namely EPA, but not DHA." He further added although vegetarians can get ALA omega-3 from flax, walnuts and canola oil, which their bodies can convert to EPA, they are vulnerable to being deficient in DHA. "So there is an ever increasing demand for vegan DHA from sea algae."

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Stephanie Stober, Flax USA, noted flax is the richest plant source of omega-3. "Flax is also a great source of lignans, which is also sorely lacking in the American diet, as are fiber, protein, antioxidants," she said. "Flax is also very affordable; with the economy, people want to stretch their food dollar and at the same time stay healthy."

Similarly, many other vegetable sources such as canola , chia, hemp and salba can also offer robust profiles of nutrients including enzymes, antioxidants, flavonoids, fiber and vitamins/minerals. The taste of most vegetable oils is also considered better than marine oils.

"The salba seed itself is best classified as a functional food, meaning it can be added to any food or recipe without affecting the flavor," said Brian Keyes, Core Naturals, who explained salba is used in commercial dry goods products such as trail mix, cookies, breads and tortillas, but also integrates into yogurt, smoothies, soups, sauces and other liquids. He further reported ground salba can be used in baking, salba oil can be used on salads and for sautéing, and salba whole food bars feature raw salba seed and other low glycemic ingredients.

While scientists debate over the superiority of marine versus plant sources or vice versa, many have advised certain populations that need or want to avoid marine-based omega-3s (vegetarians, eco-conscious, pregnant mothers) can combine algal sources, which primarily supply DHA at the present time, and plant sources, which supply ALA that converts in the body to EPA. In this way, the two primary omega-3 long-chain PUFAs can be boosted entirely from vegetarian sources.

EFAs are good for the organs, namely the heart, brain and eyes. This is largely due to the inflammatory control mechanisms of many EFAs. This starts in the littlest humans. Scientists have found increased DHA in breast-feeding mothers directly correlates to increased brain and eye development.¹ In fact, tests of maternal plasma DHA levels show the ratio of omega-3 to -6 is inversely proportionate to quiet sleep, as infants with moms who have high DHA levels showed significantly less active sleep compared to those with low-DHA mothers.² Research also showed babies given DHA-fortified infant formulas have enhanced visual acuity and cognitive function up to one year of age.³ And babies fed formula supplemented with DHA have demonstrated higher cognitive skills than babies fed regular formula, according to researchers from the Retina Foundation of the Southwest and the University of Texas Southwestern Medical Center, who used a more sensitive test of the babies' cognitive abilities and higher concentrations of DHA than previous research.⁴

Children aged 5 to 12 may benefit from regular supplementation of a combination of omega-3 and -6, which reduced problems with learning, behavior, psychological adjustment and motor function associated with developmental coordinated disorder.⁵ And Swedish researchers found a clear link between fish consumption and higher cognitive scores among teenage males, reporting 15-year old males who ate fish at least once a week had higher cognitive skills at age 18 than those who ate it less frequently.⁶

Despite these studied benefits, it appears North American children are not getting enough EFAs. Researchers from University of Guelph, Ontario, surveyed intake of children between the ages of 4 and 8, finding only 22 percent were getting suggested amounts of EPA and DHA, but 61 percent were getting adequate ALA.⁷

"There are many benefits to fish oil, but the real challenge is to have our kids want to consume fish oil on a daily basis," confirmed Netanel Mazor, Natural Kingdom, which makes an omega-3 gummy product that uses sardines and anchovies. "The equation is simple: kids need more fish oil, but less of a fish taste." He added kids love gummies, but most kids don't like sardines and anchovy. "[Therefore], gummies are an excellent way to supplement the missing fish oil from our kids’ diets."

Brain and eye health benefits from EFAs are not just child’s play. Long-chain PUFAs have been credited with significant anti-depressant activity, although scientists caution more investigative work is needed.⁸ Increased fish consumption among adults has been linked to reduced risk of recurrent depression, and even moderate fish consumption decreases mental disorder by as much as 30 percent.^9,10 Also, older adults in low- and middle-income countries who regularly eat fish have a lower risk of developing dementia than those who consume meat.¹¹

In fact, DHA may protect brain cells by preventing the negative actions of a gene mutation in neurodegenerative diseases like Parkinson's and Huntington's diseases.¹² Administration of PUFAs by Alzheimer’s and Parkinson’s patients may reduce incidence of depression without the need for pharmaceutical antidepressants.¹³

Still another reason for older adults to up their intake of EFAs is research showing older persons at moderate-to-high risk of age-related macular degeneration (AMD) who ate more omega-3s were 30-percent less likely to develop either the wet or dry form of this retinal disease, according to a National Eye Institute study.¹⁴ Similarly, researchers at the Laboratory for Nutrition and Vision Research (LNVR), Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts University, reported omega-3s may protect against progression of AMD, however, the benefits may depend on the stage of disease and the type of omega-3 supplement taken.¹⁵

The heart is another organ that benefits from increased EFA levels, as does the vascular system that supports it. Moderate amounts of omega-3 fatty acids are effective in improving lipid profiles of healthy men and women (ages 19 to 43) with normal lipid profiles.¹⁶ A 2009 study revealed fish oil (as Ultimate Omega™, from Nordic Naturals Inc.) given to professional football players (ages 23 to 41) during a two-month period decreased triglyceride levels, lowered low-density lipoprotein (LDL) cholesterol, while increasing beneficial high-density lipoprotein (HDL).¹⁷

The effects on cholesterol are not just a product of marine omega-3s. A recent study from the Chinese Academy of Sciences, Shanghai, suggested adding just one tablespoon of whole flaxseed to a daily diet significantly reduces circulating total and LDL-cholesterol concentrations.¹⁸ And hempseed oil rich in omega-6 GLA may protect the heart by returning cholesterol-induced platelet aggregation to normal.¹⁹ The researchers noted this normalization of platelet aggregation is not due to a reduction in plasma cholesterol levels, but may be partly due to increased levels of plasma GLA. University of Guelph scientists reported intervention with a combination of GLA with EPA and DHA in healthy women improved blood lipid and fatty acid profiles, thereby reducing the risk of heart attack.²⁰

Marine omega-3s still rule the cardio research segment. A Beth Israel Deaconess Medical Center (BIDMC) analysis showed men who ate fatty fish (herring, mackerel, salmon, whitefish and char) once a week were 12-percent less likely to develop heart failure than were men who ate no fatty fish.²¹ Krill oil is also rich in omega-3 phospholipids and supplementation (with Superba™, from Aker BioMarine) may provide a substantial reduction of fat in the heart and the liver due to a dose-dependent reduction of both liver triglycerides and cholesterol.²²

"Scientific research has revealed so many positive benefits for a variety of health issues for individuals that receive high levels of omega-3s; however, our consumers are most interested in the cardiovascular benefits of fish oil," said John Carlson, Carlson Labs. "The American Heart Association Web site recommends people with documented coronary heart disease consume one gram of EPA and DHA daily, either from fatty fish or through supplementation with fish oils. They also state that people who need to lower triglycerides should take 2 to 4 grams of EPA and DHA per day."

The cardiovascular benefits are most often attributed to the inflammatory control by omega-3s. In healthy individuals, plasma omega-3 fatty acid concentration is inversely related to high sensitivity C-reactive protein (CRP) concentration, a marker of low-grade sustained inflammation and cardiovascular disease (CVD) risk.²³ Richard J. Deckelbaum, M.D., director of the Columbia Institute of Human Nutrition, New York, and his team weighed in on the omega-3 mechanism of action in heart health, reporting fish oil omega-3s inhibit the entry of LDL into the arteries by markedly decreasing lipoprotein lipase, a molecule that traps LDL in the arterial wall.²⁴

The actions of omega-3s in the vascular system have further highlighted anti-inflammatory benefits. University of Birmingham, England, scientists discovered EPA can protect the vascular wall by inhibiting the migration of neutrophils across endothelial cells, thereby controlling the signals for inflammation.²⁵

Controlling inflammation has served EFAs well in arthritis pain management. Omega-3 supplementation for three to four months can curtail joint pain intensity, morning stiffness duration and number of painful or tender joints in rheumatoid arthritis (RA).²⁶ University of Pittsburgh scientists noted omega-3s were as effective as ibuprofen at reducing arthritis pain, but omega-3s were safer than non-steroidal anti-inflammatory drugs (NSAIDs) for nonsurgical arthritis care.²⁷

The battle between omega-3 and -6 on joint inflammation continues. In one animal trial, subjects given omega-6 corn oil developed synovitis, inflammation of the synovial membrane that lines the joints, whereas those given fish oil had no such inflammation.²⁸ Into the mix comes the third EFA, as fish oil combined with omega-9-rich olive oil improved joint pain, grip strength and morning stiffness after 12 and 24 weeks of supplementation.²⁹

However, omega-6 derivative GLA has been shown to decrease joint inflammation in RA patients by reducing interleukin-1beta, an immune cell that contributes to inflammatory pain hypersensitivity.³⁰ Additionally, supplementation with 2.8 g/d GLA, either as free fatty acids or sunflower oil, for six months generated a statistically significant and clinically relevant decrease in signs and symptoms of RA.³¹

Omega-6 GLA has also brought its inflammatory control to immunity. In addition to producing anti-inflammatory compounds, GLA plays a role in immune function and cell death (apoptosis) by affecting the expression of various genes, according to a review published in 2006 by Bioriginal Food & Science Corp. researchers.³²

Immune health is a big concern among consumers, and EFAs have demonstrated some possible benefits. In one of the most immune-challenged stages of life, babies have been the focus of some research on immunity and EFAs. Consumption of EPA and DHA during pregnancy and the first few months after delivery may reduce the risk of allergies in those children, at least for the first year of life.³³

Increased intake of EFAs has also been linked to improved lung function and reduced incidence of asthma, an inflammatory condition.³⁴ In 2006, Indiana University researchers reported fish oil supplementation in subjects with exercise-induced bronchoconstriction (EIB) reduced various inflammatory leukotrienes and cytokines, causing pulmonary function to improve to below the diagnostic EIB threshold, with a concurrent reduction in bronchodilator use.³⁵

These anti-inflammatory actions may also contribute positively to cancer risk management. University of Texas, College Station, suggested fish oil combined with fellow anti-inflammatory compounds curcumin and limonin may reduce chronic inflammation and cancer risk in part by modulating T-cell nuclear factor-B, which is involved in inflammatory and immune response, as well as the development of tumors.³⁶ The National Institutes of Health (NIH) is funding a trial to be conducted by the Harvard Medical School and the Brigham and Women’s Hospital, Boston, on the effect of omega-3 and vitamin D on a person’s risk of cancer, heart disease and stroke. Dubbed the Vitamin D and Omega-3 Trial (VITAL), this research will begin in January 2010 and include 20,000 men (60 and older) and women (65 and older) who have not previously had a heart attack, stroke or cancer.

On tumors, DHA has reduced the size of tumors and enhanced the positive effects of the chemotherapy, while limiting its harmful side effects, according to researchers from Mansoura University, Egypt.³⁷ Not to be outdone, flax has demonstrated some ability to help prevent the development of colorectal tumors, or inhibit their rapid growth after formation, according to recent research from South Dakota State University.³⁸

Still, retailers surely (and justifiably) tread lightly in the area of cancer claims. However, some EFA benefits in this area are less direct and more easily conveyed to customers. EPA given to cancer patients may help limit the amount of weight lost by cancer patients, while also possibly increasing their muscle mass.³⁹ Researchers cautioned the dose that achieved this result was much higher than that found in food sources.

EFAs are being investigated for benefits to many other areas of health, including attention deficit hyperactive disorder (ADHD),⁴⁰ menopause,⁴¹ skin conditions⁴² and insulin activity.⁴³

However, these emerging categories are not immune to some negative results. Despite research showing omega-3s can lower risk of islet autoimmunity in children at increased genetic risk for type 1 diabetes⁴⁴ and can lower glucose intolerance and cardio risk factors in type 2 diabetes patients,⁴⁵ Harvard School of Public Health analyzing Nurse Health Study data reported in late 2009 eating two or more servings of fish a week may increase diabetes risk.⁴⁶

Another negative result in October 2009 was published by researchers from Washington University School of Medicine, St. Louis, who concluded 2 g/d combined EPA and DHA supplementation provided no additional antidepressant benefit in subjects also taking anti-depression medication sertraline.⁴⁷

How do these unfavorable trials and the negative media attention they garner affect sales? Schoor said it is very difficult to determine the impact of these research reports, good or bad. "Clearly, news reports motivate consumers to purchase EFAs, but few studies are reported that focus solely on vegan sources of EFAs," he said, adding his company, which produces vegan EFAs, does not conduct consumer surveys on why they chose a particular EFA product. He further noted science and research is extremely important as a part of positioning and marketing success. The bottom line, he remarked, is "omega fatty acids have been shown by scientific studies to be healthy to consumers and have been validated by various federal agencies, including FDA."

Maher took a similar approach. "Omega-3 products have become one of top supplements purchased because the science is so strong and the need in people of all ages is so great that many doctors now recommend them," he argued, adding another positive in their favor is many people feel the difference in their health when they start taking EFAs.

If demand and research are growing for increased EFA consumption, the challenge becomes offering consumers EFA products that encourage consistent intake. Supplements might be the traditionally preferred way to get the ideal daily dose of various omegas; but, the people seem to be calling for more EFA fortification of foods that are more convenient and palatable.

Packaged Facts further reported thousands of foods and beverages enriched with omega fatty acids have been introduced worldwide since 2003. It said nearly 1,300 new omega-3-enriched products were introduced in Europe and North America in 2007. And in 2008, this food sector was operating under a "healthy halo" defined by three primary parameters—public awareness of omega fatty acids, proven scientific benefit and a willingness by the consumer to purchase these products. The firm estimated the global market for foods and beverages enhanced with omega-3,-6 and -9 ingredients was at $4.6 billion the end of 2007.

Indeed, the market potential for omega-3 enriched foods and supplements is great, according to the market research firm Leatherhead, which projected sales of such foods in Europe and the United States will surpass $9.72 billion by 2012.

Maher confirmed the prevailing desire in the marketplace for more innovative omega products. "Most Americans have enough pills to take already," he declared, noting Omega To Go® offers vegetarian DHA in ready-to-mix packets. "Convenient, good-tasting supplement formats, particularly if they are multi-ingredient with broad spectrum of synergistic nutrients, are usually most welcome."

Convenience and multiple uses are drivers of flax products. Stober reported her company’s flax oil undergoes a proprietary Real Cold Milled process that extends shelf life to 22 months without refrigeration. "The seed enters and exits at room temperature," she explained. "Thus the precious oils of the flax are never heated, so receive the full nutrients of flax and do not have rancidity issues." For this reason, she said the flax oil can be added to yogurt, smoothies, juice, oatmeal, toast and pizza. "[You] can basically sprinkle on any food or drink; the flax takes on the taste of whatever you put it on." She also offers a product for pets that is pure flax that can be added to a pet’s regular food.

With the outpouring of positive research results on the health benefits of EFAs, the challenge seems to be continuing to educate consumers on such benefits and the need for increased intake of omega fatty acids, as well as offering the most innovative EFA products that encourage optimal consumption in a convenient and tasty form.

References

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37. El-Mowafy A et al. "Chemopreventive and renal protective effects for docosahexaenoic acid (DHA): implications of CRP and lipid peroxides." Cell Div. 2009 Apr 2;4:6.

38. Bommareddy A et al. "Effects of dietary flaxseed on intestinal tumorigenesis in Apc(Min) mouse." Nutr Cancer. 2009;61(2):276-83.

39. Ryan AM et al. "Enteral nutrition enriched with eicosapentaenoic acid (EPA) preserves lean body mass following esophageal cancer surgery: results of a double-blinded randomized controlled trial.." Ann Surg. 2009 Mar;249(3):355-63.

40. Belanger SA et al. "Omega-3 fatty acid treatment of children with attention-deficit hyperactivity disorder: A randomized, double-blind, placebo-controlled study." Paediatrics Child Health. 2009; 14(2):89-98.

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