Musings of a family doc starting her own direct primary care practice while fumbling around trying to raise a plant-based family
by Natalie Gentile, MD and Dan Goldstein
Omega Fatty Acids: What They Do And How To Get Them
“Omegas” is one of the biggest buzzwords in nutrition right now. We know we need them, but how do we get them and what good are they? This article will teach you what you need to know about omegas and give you the tools to separate out the fad from the fact.
Overview of Omegas
“Omegas” refers to omega fatty acids, a class of polyunsaturated fatty acids. Omega-3 and omega-6 are considered to be essential fatty acids, which are not manufactured by the body and must be taken in through dietary sources.1 Our bodies use these fatty acids to produce hormone-like substances called eicosanoids, which help regulate bodily functions such as the immune response and muscle contraction. The actions of omega-3 and omega-6 fatty acids often act against each other and omega-3s seem to be responsible for more positive effects in the body. Omega-6s are essential nonetheless, and the focus should be placed on reaching an optimal ratio between these two opposing nutrients. Most of us are getting more omega-6 than we need, and we can limit intake by reducing or eliminating the use of vegetable oils like safflower, sunflower or cottonseed oil.2
Most people are more concerned with their Omega-3 intake. Omega-3s represent a group of fatty acids: ALA, EPA and DHA. ALA, which stands for alpha-linolenic acid, is the only dietary source of Omega-3 we need. When we consume ALA, our bodies can convert it into DHA and EPA so there is no reason for a young, non-pregnant individual to take an independant DHA or EPA supplement. For most young, healthy people, taking in ALA through dietary sources will allow your body to make all of the DHA and EPA that it needs. Keep in mind that high-fat diets interfere with this process. Following a more plant-based diet can help your body optimize these conversions.3
Where do we get ALA Omega-3 fatty acids?
ALA is most effective when obtained through whole foods. Flax seeds, walnuts and edamame are some of the best dietary sources. Flax seeds are especially popular and may be easily incorporated into smoothies, oatmeal and salads. In baking, flax is a great egg substitute that works just as well.
Flax seeds must be ground up for your body to access their nutrients. Most grocery stores sell flax seeds that are pre-ground and it does not seem to make a difference whether they are of the brown or golden variety.
I recommend including one tablespoon of ground flax seeds per day and avoiding flaxseed oil. Flax is extremely nutrient rich, but most of its benefits are lost when it is pressed into an oil. Aside from omega-3, flax contains iron, zinc, copper, calcium, protein, potassium, magnesium, folate and fiber. Flax is also one of the greatest sources of lignans, a potent anti-cancer agent. Eating flax seeds has also been shown to lower blood pressure in hypertensives.4
Demographics that may benefit from an Omega-3 supplement
There are some demographics that may want to consider taking an omega-3 supplement. DHA is important for cognitive and visual development in infants. Therefore, pregnant and nursing women should take at least 200 mg of DHA per day.5
Older men and women should also consider taking a DHA and EPA supplement, which seems to be effective in slowing down cognitive decline. As we age, the body’s ability to convert ALA into DHA and EPA may weaken.6 In order to retain mental acuity as well as brain volume, individuals age 60 and above should consider taking an omega-3 supplement containing DHA and EPA.7
What about fish oil?
It is common for people to get their omega-3s from fish or fish oil, but these sources may be doing more harm than good. Fish oil supplements have been touted to improve cardiovascular health and slow cognitive decline, but these claims have been challenged by the medical literature. Researchers followed 12,536 type 2 diabetics at high cardiovascular risk for an average of 6.2 years and concluded that omega-3 supplements provided no benefits to heart health compared to placebo.8 Fish oil supplements do appear to slow cognitive decline in older adults,7 but do not provide any improvement in Alzheimer’s patients.9 This diminished effect on cognitive health could be related to the high levels of mercury and PCBs that are found in fish. These environmental toxins have been shown to impair cognitive function, which could counter any potential benefit that fish or fish oil may have to brain health.10 While many individuals seek out fish in order to replace red meat and lower their cholesterol, these effects are minimal.11 Following a plant-based diet centered around whole food sources can cut LDL cholesterol levels by 20-35%11 and can help to reduce mercury and PCB exposure.
Take a plant-based omega-3 supplement instead
Older adults and pregnant or breastfeeding women can get all of the benefits of an omega-3 supplement without the nasty baggage of a fish-derived source by taking a plant-based supplement. There are omega-3 varieties that are made from yeast and algae and may be labeled “vegan” or “plant-based” in the grocery store.
For most healthy people, however, omega-3 supplementation is not necessary and may even be harmful if taken in the form of fish or fish oil. For health-conscious people looking to optimize their omega 6:3 ratio, it is best to take a whole food approach, cutting down on added oils and emphasizing plant-based sources of omega-3 like flax, walnuts and edamame.