Omega 3 Fatty Acids

Omega 3 fatty acids are essential polyunsaturated fatty acids that are crucial to various processes of a healthy human body. Although many different types of omega 3 fatty acids exist in nature and are utilised by humans, three omega 3 fatty acids are key:

• ALA or Alpha-Linolenic Acid: Alpha-linolenic acid (ALA) is considered the most essential of all essential fatty acids. It is an 18 carbon long fatty acid that is the building block of the other two omega 3 fatty acids. While Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA) are only found in fish and marine life, ALA is found in plants and is, therefore, a suitable source for vegetarians and vegans. By elongating the carbon atom chain and creating more double bonds between additional carbon atoms, the human body uses Alpha-Linolenic Acid (ALA) to synthesise EPA (20 carbon atom chain) and DHA (22 carbon atom chain). Longer the chain and the more the number of double bonds between carbon atoms, the more beneficial the fatty acid. The ability to create longer chain fatty acids from alpha-Linolenic acid (ALA) reduces with age and is thought to play a possible role in the development of cancer. Sources of Alpha-Linolenic Acid include walnut oil, hemp oil and marine algae. 
• EPA or Eicosapentaenoic Acid: A 20 carbon long omega 3 fatty acid, it is mainly derived from marine life like fish, squid and fish oil. It can be synthesised in the body from Alpha-Linolenic Acid (ALA).
• DHA or Docosahexaenoic Acid: DHA is another long chain omega 3 fatty acid that is found naturally in marine animals, most significantly in fish oil, and can be derived from plant-based Alpha-Linolenic Acid in the body.

Omega 6 fatty acids are essential polyunsaturated fatty acids in which the first carbon-carbon double bond is located between the sixth and the seventh carbon from the omega end of the fatty acid chain. Unlike omega 3 fatty acids, their nutritional value lies in providing energy with an additional role in creating mediators of inflammation. The most important omega 6 fatty acid is Linoleic Acid, which is an essential fat, found in products like vegetable oils such as sunflower, safflower, soybean, corn and canola. Linoleic acid is converted to arachidonic acid (AA) in the body, a fatty acid that gives rise to chemicals like prostaglandins and leukotrienes that cause inflammation. While some inflammatory activity is needed by the body to upkeep the functioning of the immune system, excessive pro-inflammatory chemicals can cause more harm than good. Therefore, even though omega 6 fatty acids in vegetable oils are healthy fats, their overconsumption can cause inflammation in the body.

Although omega 6 fatty acids have their own set of health benefits, omega 3 fatty acids have a more important role. Omega 6 fatty acid to omega 3 fatty acid ratio of a healthy ideal diet should between 4:1 and 1:1. This means the permissible maximum amount of omega 6 fatty acids is 4 times that of omega 3 fatty acids. Most diets and many cultures use vegetable oils rich in linoleic acid (omega 6 fatty acids) generously in their diets. Thus, even though the body needs more omega 6 fatty acids than omega 3 fatty acids, the ratio is skewed towards omega 6 fatty acids such that there is a relative deficiency of omega 3 fatty acids in the body. Most Western diets have a ratio of 15:1 of omega 6 fatty acids to omega 3 fatty acids. This means a relative deficiency of omega 3 fatty acids is rampant and often unrecognised.

While omega 6 fatty acids mainly act as an energy source to the body, omega 3 fatty acids have a host of protective and nutritive properties that make them essential to a healthy diet. These beneficial properties include:

• Cardiovascular heart disease: Omega 3 fatty acids have the property of preventing platelet aggregation and lowering the coagulability of blood. This is especially helpful in preventing the formation of blood clots and providing modest protection against thrombosis and coronary artery diseases (CAD) like heart attacks. 
• High cholesterol levels: High triglyceride levels are shown to be reduced with the use of omega 3 fatty acid supplements. High doses of omega 3 fatty acid supplements per day are required to achieve a beneficial effect and therefore should only be started on a doctor’s advice.
• Inflammation: By maintaining a suitable omega 6 fatty acid to omega 3 fatty acid ratio, a check is kept on the proinflammatory activity brought about by prostaglandins and leukotrienes synthesised from omega 6 fatty acid, linoleic acid. Omega 3 fatty acids supplements have been successfully used clinically for managing inflammation in joints caused by rheumatoid arthritis.
• Cancer: Omega 3 fatty acids have been used previously to manage cancer cachexia or the weight loss that results from cancer, by providing a suitable dietary energy source. New ongoing research suggests it may have broader applications in managing complications brought about by cancer as well.
• Mental health: Omega 3 fatty acid supplements have been used in depression as add on therapy.
• Child development: Although there isn’t sufficient data presently, some benefit of omega 3 fatty acids has been noted in children with Attention Deficit Hyperactivity Disorder (ADHD) and autism.

Although most diets have an omega 3 to omega 6 fatty acid ratio that favours the latter, sometimes overzealous consumption of omega 3 fatty acids, as part of diet or supplements, can pose some complications. The most commonly reported complications of excessive consumption of omega 3 fatty acids are mild and include:

• Unpleasant taste
• Bad breath
• Heartburn
• Nausea
• Gastrointestinal discomfort, bloating or stomach ache
• Diarrhea
• Headache
• Odoriferous sweat that smells foul

A more serious complication that can arise with omega 3 fatty acid dietary supplements, like fish oil, or as medicine is drug interactions with:

• Anticoagulants, or blood thinners, like warfarin: Although the FDA reports no clinically significant episodes of bleeding with the concomitant use of fish oil omega 3 fatty acid supplementation and warfarin, it recommends no more than 3 to 6 gram per day be used while taking anticoagulants. It is also important to monitor the patient’s PT INR (Prothrombin Time and International Normalised Ratio) with the use of fish oil. An elevated PT INR (than what is normal with anticoagulant use) implies that the patient’s blood is clotting too slowly and can lead to bleeding.

Even though most diets do not lack in omega 6 fatty acids, due to routine use of vegetable oils in cooking food in most cultures, omega 3 fatty acids can become deficient in relation. Therefore, omega 3 fatty acid deficiency is best defined as an unideal ratio between omega 6 fatty acid levels and omega 3 fatty acid levels in a person’s diet. Signs and symptoms of omega 3 fatty acids may not be obvious at first but many of the protective properties it awards, superior to that of omega 6 fatty acids, can disappear.

As most omega 3 fatty acid deficiency states have mild signs and symptoms, or none at all, they can easily be managed by increasing intake of foods naturally rich in omega 3 fatty acids. Additionally, due to the beneficial properties of omega 3 fatty acids, they have now become increasingly popular as supplements, in the form of capsules, to be taken either as an adjunct treatment to improve clinical outcomes or to boost one’s overall health.

Competent international authorities have made recommendations on the ideal dietary intake range of omega 3 fatty acids in an individual’s daily diet. It is recommended that omega 3 fatty acids such as Alpha-Linolenic Acid comprise 0.6% to 1.2% of the daily energy requirements of children (older than one year of age) and adults; 10% of this Acceptable Macronutrient Distribution Range (AMDR) of omega 3 fatty acids should be EPA and DHA. Upper limits to dietary intake ranges have not been set but excessive consumption can be associated with mild side effects. Omega 3 fatty acids also pose the potential risk of drug interactions with anticoagulants (blood thinner medicines) like warfarin and hold some risk of causing bleeding disorders.

(Read more: Blood clotting disorders)