Articles

Essential Fatty Acids

By Rita H. Boone, R.Ph., J.D.

Awareness of the nature and amount of dietary fat intake is an important aspect of maintenance of good health. Saturated fat, such as lard and butter, is usually derived from animal sources and is solid at room temperature. Saturated fat contributes to high levels of cholesterol in the blood, and is a risk factor for atherosclerosis and heart disease.

On the other hand, the so-called essential fatty acids ("EFAs") are the primary source of polyunsaturated fat in the diet. EFAs serve multiple beneficial functions in the human body. However, they cannot be constructed by the human body.
There are two families of EFAs; omega-3 and omega-6. The primary omega-3 EFA is alpha-linolenic acid and the primary omega-6 EFA is linoleic acid. These EFAs form the starting point for what are known as long-chain polyunsaturated fatty acids. Together, omega-3 and omega-6 EFAs play crucial roles in brain function and normal growth and development.
Essential fatty acids must be obtained from the diet. They function in the body by, affecting inflammation, affecting mood and behavior, and affecting the life and death of cardiac cells. Also, they maintain the membranes of all cells, have a role in making prostaglandins, enable the fat soluble vitamins A, D, E, and K to be absorbed, and regulate body cholesterol metabolism. Additionally, essential fatty acids are used to produce hormone-like substances that regulate a wide range of functions, including blood pressure, blood clotting, blood lipid levels, and the immune response.
Deficiencies in EFAs can result in several medical conditions, ranging from dermatitis, infertility, lack of ability to fight infections, and inability to heal wounds. Food sources such as fish, shellfish, flaxseed, canola oil, sunflower seeds and leafy vegetables are major dietary contributors of EFAs. Some conditions, such as cardiovascular disease, may require a supplement in addition to dietary intake.
Omega-3 fatty acids are highly concentrated in the brain and appear particularly important for cognitive and behavioral function. Studies have shown that infants who do not get enough omega-3 fatty acids from their mothers during gestation are at risk for developing vision and nerve problems.
Omega-3 EFAs also contribute most importantly with regard to reducing cardiovascular disease. Randomized clinical trials have shown that they work by decreasing triglycerides, decreasing the growth rate of atherosclerotic plaque, and lowering high blood pressure to a limited degree. Placebo-controlled, double-blind, randomized clinical trials are needed to document the safety and efficacy of omega-3 fatty acids in high-risk patients such as those with diabetes, hypertension or smokers.
Changes in the levels and balance of these fatty acids due to a typical Western diet rich in omega-6 and poor in omega-3 fatty acids is alleged to be associated with emotional and behavioral changes, including violence. The actual connection, if any, is speculative and is still under investigation. However, there is some anecdotal evidence that changing to a diet richer in omega-3 fatty acids, or consumption of supplements to compensate for a dietary imbalance, has shown decreases in violence and increases in attention span.
Studies more clearly support, however, that a large excess of omega-6 in relation to omega-3 contributes to long-term diseases such as heart disease, cancer, asthma, arthritis and depression. Omega-6 fatty acids play a key role in stimulating skin and hair growth, maintaining bone health, regulating metabolism, and maintaining reproductive capability. However, food sources include cooking oil, egg yolks, and organ meats.
It is recommended that a healthy diet consist of a ratio of 1:4 omega-3 to omega-6. Typically, Americans consume 11 to 30 times more omega-6 than omega-3 fatty acids.
A Mediterranean diet, on the other hand, consists of more whole grains, fresh fruits and vegetables, fish, olive oil and garlic. Very little meat is consumed which is high in omega-6.
In summary, the essential fatty acids are being studied for potential causative roles in, among other things, anorexia nervosa, ADHD, diabetes, PMS, psoriasis, eczema, rheumatoid arthritis, high blood pressure, and heart disease. Some studies have established clear causative relationships, while others remain unsubstantiated.
What is clear is that a diet balanced with appropriate amounts of omega-3 and omega-6 fatty acids, along with a generally healthy lifestyle, is beneficial with regard to diminishing risk of heart disease, hypertension, and atherosclerosis.
At Bellevue Pharmacy we have omega-3 fatty acid available for patients. All of our pharmacists are available to consult with patients and physicians regarding the use of omega-3.

Sources:

1. www.americanheart.org
2. www.umm.edu
3. www.vegansociety.com