Fatty acids have many important uses in our bodies.  Fatty acids come in different shapes and sizes, and are named based on their size and chemical structure. Omega-3 fatty acids are a specific class of fatty acids that are utilized by our bodies and are used as the precursors for anti-inflammatory compounds.

Essential Fatty Acids are those that cannot be made by our bodies and must be consumed as part of our diet.  The name Omega -3 Fatty acid describes a class of different length fatty acids which all contain a similar chemical structure.

The most well-known Omega 3 fatty acids are ALA (alpha linolenic acid), EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid).

ALA is found in:

• Flaxseed
• English walnuts
• Brussel sprouts
• Salmon
• Sardines
• Chia
• Hemp
• Tofu
• Spinach
• Other plant foods

The body in theory has the ability to convert ALA into DHA and EPA.  However, this pathway is influenced by dietary intake and does not work optimally in all people.  Therefore, it is often helpful to consume foods with DHA and EPA in case the body is unable to make these compounds in the needed amounts.   There are multiple studies that have shown the health benefits of DHA and EPA and I will describe these in more detail later in this article.

EPA and DHA are more difficult to obtain with a strict vegetarian diet.  Sea plants and certain fermented foods do contain small amounts of DHA, but DHA is not found in land based plants.  DHA makes up about 20% of the brain by weight, and is found in most fish, eggs, and milk and cheeses obtained from grass fed animals.   EPA is found in most fish, especially salmon and sardines.  The amount of EPA and DHA in fish is dependent on their diet.  Farmed fish are sometimes supplemented with processed Omega-3 fatty acids to increase the concentration found in these fish.

Multiple studies have demonstrated the beneficial effects of Omega-3 fatty acids, specifically EPA and DHA, for our general health and well-being.  Below is a summary of my review of the literature, and the findings in various studies:

• Fish oils lower blood sugar and decrease liver fat stores
• Increasing DHA and EPA decreases the incidence of metabolic syndrome by 20%
• EPA and DHA supplementation helps to lower blood pressure (at approx. 1gm/day)
• In obese patients, insulin sensitivity is improved with supplementation of EPA and DHA (at approx. 1 gm/day)
• Higher levels of EPA consumption lower risk of CHF (congestive heart failure) and increase survival in patients with heart failure by 35% – thought to be because of the effect on the heart muscle pumping ability
• Omega-3 fatty acids improve exercise-induced asthma and increase pulmonary function 5-fold based on pulmonary function tests
• Fish oils help to slow neuro-inflammation and may slow progression of neuro-degenerative disorders (eg. Alzheimers, Parkinson’s)
• Mild cognitive dementia improves with supplementation of 900mg of DHA
• Omega-3 Fatty acids may slow or reverse nerve damage from diabetes

So what should you do?   All fish oils are not created equally.  Fish oil in its natural state obtained directly from the diet is probably best, but it is difficult to eat the amount needed by our bodies.   The next best option is supplementing our diet with at least 2.5 grams/day of EPA and DHA in the form of a pharmaceutical grade, highly refined Omega-3 fatty acid supplement (if ok with your doctor).  Unrefined fish oils can have many contaminants such as PCBs and Mercury.   Most fish oils sold over the counter have a very low concentration of EPA and DHA and contain “other Omega-3 fatty acids” which require our bodies to convert them into an active form.    As was stated earlier, ALA intake is important, but this needs to be converted into DHA and EPA in order to be effectively utilized in the anti-inflammatory pathway.

One final note is that while Omega-3 fatty acids such as ALA, EPA, and DHA are the precursors of anti-inflammatory mediators in our body, Omega-6 fatty acids such as AA (arachidonic acid) are the precursors of the pro-inflammatory mediators in our body.  Omega-6 fatty acids are found in many cooking oils such as corn, palm, sunflower, safflower and soybean oil.   The western diet is very high in omega-6 fatty acids and relatively low in omega-3 fatty acids.  By increasing the amount of omega-3 fatty acid consumption and decreasing omega-6 fatty acid consumption, the inflammatory state of the body is improved.  This is thought to have a beneficial effect of chronic inflammatory disease states such as arthritis.