Although the body readily makes most of the fat that it needs from dietary starch or sugar, humans lack the ability to make essential fatty acids (EFAs) and must get them from food or dietary supplements.
Some indications that an EFA deficiency or imbalance are present are: dry skin; the need to use moisturizing creams and lotions; "chicken skin," the presence of tiny rough bumps, usually on the back of the arms; dry hair; dandruff; fraying or brittle nails; menstrual cramps; premenstrual breast tenderness.
Essential fatty acids come in two distinct families, based upon their chemical structure. The two EFA families are not interchangeable and, in fact, tend to compete with one another in the body's metabolic pathways.
Omega-6 Essential Fatty Acids
The larger family, called "omega-six" EFAs, is abundant in many vegetable seed oils, including corn, sunflower and safflower. Deficiency of omega-six EFAs can cause impairment of growth and fertility, hormonal disturbances and immunologic abnormalities.
But an excess of omega-six EFAs may promote the development of cancer. People living in North America and Europe often have relatively high levels of omega-six EFAs in their diets, because of the increased consumption of vegetable oil.
Omega-3 Essential Fatty Acids
The smaller family, called "omega-three" EFAs, is most concentrated in fish oils and in flaxseed oil. It is also found in green leafy vegetables. The human brain is rich in omega-three EFAs; their deficiency causes abnormalities in the development and function of the nervous system as well as immune defects. Consumption of fish, flaxseed meal and soy beans supplied omega-3's for our ancestors.
Learn more about this vegetarian source of omega-3's: Flaxseed and Flaxseed Oil
There has been a systematic depletion of omega-3 EFAs from the typical modern diet because of changes in food choices and in techniques of food processing. Some theorists have traced the origins of numerous different diseases to a lifetime depletion of omega-3 EFAs.
Fish Oil Benefits
Fish oils, the most concentrated source of omega-3's, have made front page news because of their potential ability to help prevent disorders as apparently unrelated to one another as cancer, heart attacks, and migraine headaches, and to help reverse the effects of conditions as different as psoriasis, ulcerative colitis, rheumatoid arthritis and cystic fibrosis.
Many people in the United States and Europe are short on omega-3 EFAs. Omega-3 rich foods include flaxseed, walnuts and salmon.
Fish Oil and Heart Disease
Fish oil can help increase the chances of survival for people with heart disease, according to recent research published in the British Medical Journal.
There have been numerous studies on the potential benefits of fish oil supplements for people who have coronary heart disease. Reviews of the published results indicate that taking fish oil supplements could help decrease the risk of cardiac (heart-related) death by 13-20 percent in people who already have heart problems.
A review done at Thomas Jefferson University in Philadelphia and published in the journal Clinical Cardiology notes that while the mechanism by which fish oil provides this benefit has not been determined, "Dietary supplementation with omega-3 fatty acids should be considered in the secondary prevention of cardiovascular events." (Paul Marik)
A review of published research in the British Medical Journal concluded by stating: "Based on the best currently available evidence, the results of this systematic review show a beneficial effect of fish oil in reducing deaths from cardiac causes. The optimal dose or formulation of fish oil is unknown, but it seems reasonable to use a daily formulation similar to that used in the GISSI-Prevenzione trial, of about 465 mg EPA/386 mg DHA." (Hernando León, et al.)
Discover how fish oil and other supplements can interact with drugs: Mixing Medications and Vitamins: When It Hurts, When It Helps
Fish Oil Keeps Cells Younger
As your cells age, your chromosomes become shorter. Telomeres are the extreme ends of chromosomal DNA that shorten with age. Telomere shortening is seen as an indicator of biological aging.
A study done at San Francisco General Hospital and published in the Journal of the American Medical Association (JAMA) found that for people with heart disease, higher levels of fish-derived omega-3 fats in blood were associated with longer telomeres.
Dr Ramin Farzaneh-Far, lead author of the study, stated that this was an observational study and that a randomized trial will be needed to prove causality. "But in the meantime, the results underscore and reinforce the American Heart Association guidelines that patients with coronary artery disease should be taking 1 gram a day of omega-3 fatty acids."
Fish Oil Side Effects
Although fish oils are a major source of omega-3 fats, there are numerous potential side effects of fish oil supplements.
Some fish oil side effects include:
- Fish oils decrease the tendency of blood to clot. This action can cause side effects like bruising or prolonged bleeding from a cut. Some studies have found that this side effect is more likely to occur in people who take aspirin in addition to fish oils. Fish oil supplements should usually be discontinued about two weeks before elective surgery.
- Fish oils can cause diarrhea, which is the most commonly reported side effect in clinical research studies. Diarrhea may necessitate lowering the dose of fish oil. Taking fish oils with food or with calcium pills (but not magnesium) may decrease this side effect.
- People may burp fish oil, or experience heartburn or reflux, a potentially damaging side effect. The side effect of burping fish oil may be reduced by using a delayed-release or enteric coated fish oil and by taking the capsules on an empty stomach with a large glass of water and a capsule of digestive enzymes.
- Fish oils may cause acne. This is more likely in people with oily skin. Acne as a side effect may be prevented by also taking zinc tablets (about 15 to 30 milligrams per day)
- Fish oils may increase the need for omega-6 fats, especially those found in supplements like evening primrose oil, borage oil or black currant seed oil. Because the omega-3 fats found in fish oil compete with omega-6 fats for use by the cells, it may actually induce a relative deficiency of omega-6 fats by taking fish oils. Signs that this side effect is happening are dry skin or hair, hair loss, brittle nails or menstrual irregularities, that start or get worse when taking fish oil.
- Fish oils may suppress the immune system, rather than strengthen it. This side effect can contribute to having more infections while taking fish oils. Reduction in the amount of fish oils used or taking antioxidant supplements could help.
Like other dietary supplements, fish oil can interact with prescription drugs, over-the-counter medications, and other supplements, as well as food. That is why it is important to tell your health care providers about all of the dietary supplements, such as fish oil, that you use.
To get more information about how fish oil and other dietary supplements can interact with prescription and OTC medications, sign up for free to use my health application: pilladvised.com
Now I'd like to hear from you:
Do you eat food sources of omega fats?
Do you take fish oil or other omega supplements?
How do you feel eating or taking these?
Please let me know your thoughts by posting a comment below.
Leo Galland, MD
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Leo Galland, MD is a board-certified internist, author and internationally recognized leader in integrated medicine. Dr. Galland is the founder of Pill Advised, a web application for learning about medications, supplements and food. Sign up for FREE to discover how your medications and vitamins interact. Watch his videos on YouTube and join the Pill Advised Facebook page.
References and Further Reading
Am J Clin Nutr. 1999 Sep;70(3 Suppl):560S-569S. Full Text: "Essential fatty acids in health and chronic disease." Simopoulos AP. Center for Genetics, Nutrition and Health, Washington, DC 20009
Annu Rev Nutr. 2004;24:597-615. "Dietary n-6 and n-3 fatty acid balance and cardiovascular health." Wijendran V, Hayes KC. Foster Biomedical Research Lab, Brandeis University, Waltham, Massachusetts 02254, USA.
BMJ. 2008;337(2931) Full Text "Effect of Fish Oil on Arrhythmias and Mortality: Systematic Review." Hernando León; Marcelo C Shibata; Soori Sivakumaran; Marlene Dorgan; Trish Chatterley; Ross T Tsuyuki
Clin Cardiol. 2009 Jul;32(7):365-72. "Omega-3 dietary supplements and the risk of cardiovascular events: a systematic review." Marik PE, Varon J.Division of Pulmonary and Critical Care Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA.
JAMA. 2010 Jan 20;303(3):250-7. Full Text: "Association of marine omega-3 fatty acid levels with telomeric aging in patients with coronary heart disease." Farzaneh-Far R, Lin J, Epel ES, Harris WS, Blackburn EH, Whooley MA. Division of Cardiology, Room 5G1, San Francisco General Hospital, 1001 Potrero Ave, San Francisco, CA 94110, USA.
Full Text: "Diet and Inflammation" Leo Galland, MD, Nutr Clin Pract December 7, 2010 vol. 25 no. 6 634-640
Power Healing: Use the New Integrated Medicine to Cure Yourself. Leo Galland, 384 pages, Random House, (June 1, 1998)
The Fat Resistance Diet: Unlock the Secret of the Hormone Leptin to: Eliminate Cravings, Supercharge Your Metabolism, Fight Inflammation, Lose Weight & Reprogram Your Body to Stay Thin Leo Galland, M.D., Broadway Books (2005)
Superimmunity for Kids : What to Feed Your Children to Keep Them Healthy Now, and Prevent Disease in Their Future, Leo Galland with Dian Dincin Buchman, Dell (August 1, 1989)
This information is provided for general educational purposes only and is not intended to constitute (i) medical advice or counseling, (ii) the practice of medicine or the provision of health care diagnosis or treatment, (iii) or the creation of a physician--patient relationship. If you have or suspect that you have a medical problem, contact your doctor promptly.