Diabetes Forecast

The A-to-Z of Omega-3

Why this fatty acid is a must for good health

By Tracey Neithercott/Recipes by Robyn Webb, MS, LN ,

Here's a shocker for everyone who believes fat is evil: Some fats aren't only good--they're essential. In fact, those known as omega-3 fatty acids interact with nearly every part of your body's function to prevent cardiovascular disease, improve your memory, aid fetal development during pregnancy, protect against Parkinson's disease, prevent respiratory diseases like asthma, and reduce the risk for Alzheimer's disease and dementia. As if that weren't enough, omega-3s are particularly important for people with diabetes. "[They improve] whatever insulin the person has or gets," says Artemis P. Simopoulos, MD, founder and president of the Center for Genetics, Nutrition and Health, a nonprofit educational organization in Washington, D.C., and author of The Omega Diet. "The omega-3s cut down on the inflammation, which both [people with type 1 and type 2] have."

Since understanding omega-3s involves more than just swallowing a supplement, here's a quick guide to the fundamentals.

The Basics

Omega-3s are polyunsaturated fatty acids that are essential to the function of your body's cells. Since the body can't make omega-3 fatty acids itself, you must consume your daily dose from food. There are three types of omega-3s: eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-
linolenic acid (ALA), which is converted by the body into EPA and DHA.

There isn't a set recommended daily allowance when it comes to omega-3s, but most people should get about 500 milligrams a day--the equivalent of two fish dinners per week. According to Simopoulos, individuals at risk for heart disease, including those with diabetes, should get an even higher dose: between 600 milligrams and 1 gram per day. "People who are diabetic, people who have heart disease, need [a higher dose] because they already have a proinflammatory disease," she says. If you've already had a heart attack, Simopoulos suggests you get 2 grams daily.

The Sources

All omega-3s aren't created equal, so knowing the type you're getting is important. The most potent omega-3s are EPA and DHA; that's why your best bet is to eat plenty of oily fish like salmon, herring, and halibut. (Learn which fish are tops when it comes to omega-3, here)

If you are allergic to fish, are a vegetarian, or just can't stomach the taste, you can still add omega-3 to your diet by eating plant-based ALA-rich foods--you'll just have to eat more to get the same amount of EPA and DHA you'd get from fish because some omega-3s are lost as the body converts ALA to EPA and DHA. Good sources of ALA include flax seed oil and flax meal, walnuts and walnut oil, pecans, olive oil, and canola oil. "The flax meal is one of the easiest things to use. It has a very nice, nutty flavor," says Susan Mitchell, PhD, RD, a registered dietitian, nutrition consultant, and coauthor of Fat Is Not Your Fate. She recommends adding flax to smoothies, yogurt, and oatmeal, or drizzling walnut oil over salads.

Another way to get the essential fatty acids is by eating omega-3-enriched foods. "You have to do just a little more homework," says Mitchell, who recommends checking a product's packaging for sources of omega-3 (some may list DHA-rich algae oil in the ingredients). Simopoulos says omega-3-enriched eggs also provide a good amount of EPA and ALA. Or try hemp-fortified foods (such as certain cereals); according to Evelyn Tribole, MS, RD, a registered dietitian with a private practice in Newport Beach, Calif., and author of the Ultimate Omega-3 Diet, they contain stearidonic acid, which helps increase the concentration of EPA in the body.

If you can't get enough omega-3 from your diet, consider taking a supplement. (Your doctor may even recommend the prescription omega-3 pill Lovaza if you're at a significant risk for cardiovascular disease.) One option for those who do not eat fish is a DHA-enriched algae supplement, but otherwise fish oil is the ideal choice. Even those who are allergic to fish can take a fish oil supplement, says Simopoulos. That's because fish oil supplements don't contain the proteins that cause an allergic reaction. Fish oil supplements don't have any side effects--though some people complain about an aftertaste or fishy-tasting burps. (You can try taking your supplement before a meal to prevent this.)

Before you buy, read the label to guarantee you're getting both EPA and DHA; make sure you're not buying an omega-3-6-9 combination (the additional omega-6 and omega-9 are unnecessary); and find out how many milligrams of omega-3 you'll be getting per capsule. Some brands sell 300-milligram pills that you'll have to take twice a day; others offer 600-milligram pills. You should also keep in mind that the amount of fish oil in a pill (say, 1,000 milligrams) isn't the same as the amount of omega-3s. To be certain you're actually getting fish oil (and not some mystery pill), look for a United States Pharmacopeia (USP) certification seal on the package.

And while we're talking about fish, what about the danger of mercury poisoning? The issue is real, given mercury content in fish today--and women who are pregnant should speak with their doctor before increasing their fish intake--but the risk for most people is outweighed by the benefit you get from omega-3s. A rule of thumb: "Stay away from the bigger fish. If you stay with the smaller fatty fish, these levels [of mercury] are smaller. If you're only having two servings a week, then it's OK," says Mitchell. Small fish include tuna (excluding albacore, which is larger and has more toxins), salmon, bluefish, herring, halibut, sea bass, and white fish. Tribole recommends eating wild fish over farmed (such as Atlantic salmon) since the omega-3 levels may be higher and toxins lower.

The Omega-6 Connection

Another essential fatty acid, omega-6, works in tandem with omega-3 to keep the body functioning properly. Here's the catch: Our bodies require a delicate ratio of omega-3s to omega-6s. Unfortunately, that balance is often off kilter. "We consume 14 times [the omega-6], on average, [than] we used to," says Tribole. "When it's out of balance like that, these two fats compete for the same enzymes. And the more omega-6, [the more] they're going to grab those enzymes," negating some of omega-3s' beneficial effects.

The role of omega-6 fats in the body is a controversial topic. Some experts say that an out-of-whack fatty acid profile can result in inflammation that may lead to heart disease. Others say omega-6--while too much a part of the average American diet--doesn't lead to inflammation and can be consumed in moderation. According to Tribole, you likely get so many omega-6s from your current diet that reducing your intake is beneficial to your health.

The hard part, she says, is knowing which foods contain them. "You won't find it on the food label. It's not in the ingredients," Tribole says. "It's even in foods you'd think are healthy." These would-be health foods include granola bars, veggie burgers, and waffles--and pretty much anything else made from soybean, cottonseed, corn, safflower, and sunflower oils as well as vegetable oil blends.

"The biggest sources of omega-6 in the Western diet are the vegetable oils. Corn and corn oils are everywhere. [Almost] all animals are grain fed. They no longer graze. We have eliminated omega-3 fatty acids out of meat, out of cheese, out of chicken, out of eggs," says Simopoulos. "[People] should make every effort in their diet to avoid omega-6. When they eat out, they should avoid salad dressing because of the oils. They're better off getting olive oil and vinegar."

When it comes to upping omega-3s, it's a type of simple change that can make a big difference to your health in the long run. The best part: Adding omega-3s to your diet is easy. Plus, the foods you can make are not only simple, but delicious.

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