The world of diet and nutrition is ever-changing, confusing, and oftentimes misleading. Chances are if you’re here you’re interested in getting some answers on what to eat to support your long-term health. Despite living in an era of so much misinformation, where all fat used to be villainized, omega-3 fats have rightfully earned their place as a health-promoting nutrient.
In addition to being anti-inflammatory, omega-3 fats are integral to the structure, function, and fluidity of virtually every cell in the human body—they’re a pretty big deal [1]! Our brain, heart, eyes, skin, and hormones all depend on omega-3 fats, specifically EPA and DHA, to function properly [2][3], but most of the world’s population is chronically deficient [4][5]. In the U.S., nearly 100,000 deaths per year are related to omega-3 fat deficiency, making it the sixth biggest cause of preventable deaths per year, outweighing alcohol and low intake of fruits and vegetables [6]. This begs the question, why are we so deficient in omega-3 fats? And can restoring our omega-3 fat levels be a key factor in restoring our health as a population?
Why are we so deficient in omega-3 fats?
Before we dive into my Protocol for increasing your omega-3 fat intake, it’s important to understand why we are so deficient. Since we can’t synthesize omega-3 fats internally, they need to come from our diet or through supplements [4][5]. Seafood is the best food source of omega-3 fats which is why the American Heart Association recommends having two 3.5-ounce servings of oily fish per week, or ≥ 250mg of combined EPA and DHA omega-3 fats per day. Even with these guidelines, less than 20% of Americans are meeting the recommended intake of omega-3 fats [7]. Not only are we not getting enough omega-3 fats, but we’re also overconsuming the wrong kinds of fats. In addition to trans fats, the permeation of omega-6 fats in our industrialized food supply, from things like vegetable oils and conventional animal products, proposes a whole new set of metabolic challenges.
The challenge with plant-based omega-3s
Most Americans are consuming alpha-linolenic acid, or ALA, as their primary source of omega-3 fat. ALA is found in vegetable seed oils, leafy green vegetables, chia seeds, flax seeds, hemp seeds, and walnuts. The problem with ALA is that it can’t be used by the body until it’s converted to EPA and DHA by a series of enzymes [8]. Unfortunately, most of us are pretty inefficient at this process, with a less than 15% conversion rate [9]. Genetics, age, and high intake of omega-6’s can all contribute to that problem. ALA has to compete with linoleic acid (LA), the primary omega-6 fat in the Western diet, for conversion enzymes [8]. LA is in vegetable seed oils, which are used in virtually every processed food, with safflower oil, sunflower oil, corn oil, soybean oil, and cottonseed oil being the biggest offenders [10]. For this reason, ALA loses out to LA every time resulting in exacerbation of omega-3 deficiency, an imbalanced omega-6 to omega-3 ratio, inflammation, and increased risk for chronic disease.
Why a balanced omega-6 to omega-3 ratio is important
Having a balanced omega-6 to omega-3 ratio is fundamental for long-term health and yet, most people aren’t aware of how “off” their ratio is. Eating excessive amounts of omega-6 with little to no omega-3s results in inflammation and an increased risk for chronic diseases like heart disease, diabetes, obesity, metabolic syndrome, IBS, cancer, infertility, autoimmune disease, ADHD, depression, anxiety, mood imbalances like bipolar disorder and schizophrenia, Alzheimer’s disease, and so much more [11][12][13][14][15][16].
I think most people would be surprised to learn how imbalanced their omega-6 to omega-3 ratio is and how that plays into their overall health. I was a life-long vegetarian and my health journey led me to become vegan for several years. Despite taking an algae oil supplement—granted, I was taking them inconsistently—and eating plenty of plant-based omega-3s, I found out I was still severely deficient. Once I realized what I was doing wasn’t working, I added fish back into my diet and made eating it regularly more of a priority.
How I test my omega-3 levels
I’m a firm believer in at-home testing, which is why I’m putting this week’s “Splurge!” first. I think everyone can benefit from knowing their omega-3 index, a measure of the percentage of EPA and DHA in your red blood cells. I use Omegaquant to test my omega-3 levels because it’s quick, easy, and affordable. Plus, you get a detailed report emailed to you, based on your results, with personalized recommendations on how to improve your omega-3 levels.
Here’s who would benefit MOST from testing their omega-3 index:
- Vegans/vegetarians
- Women who want to conceive in the next year
- Anyone with a history of postpartum depression
- Anyone with a history of depression or mood disorder
- Those with skin challenges (i.e., eczema, psoriasis, acne)
- Those with asthma or respiratory issues
- Anyone with a history of chronic inflammation
- Those with high blood pressure or CVD
Whether or not you decide to test your omega-3 index, dive into my Try This Protocol to raise your omega-3 levels naturally and fight inflammation, reduce your risk for chronic disease, and live optimally!
SPLURGE!
I. Measure your Omega-3 Index. Companies like Omegaquant are revolutionizing the ability to test and measure your omega-3 EPA and DHA levels at home. Omegaquant has been used by research institutes like Harvard and NIH and is the gold standard for measuring your omega-3 index.
Your omega-3 index is a measure of your percentage of EPA and DHA in your red blood cells over a 4-month period. The score ranges from 0% to 12% with a score of 4% or less considered low and undesirable, a score of 5-7% considered intermediate, and a score of 8% or higher considered ideal and protective against chronic health conditions. Unfortunately, the majority of the population hovers around 6% and most of the U.S. population scores at 4% or lower, which is considered the high-risk zone.
Omegaquant offers an Omega-3 Index Basic Test (% EPA and DHA), Omega-3 Index Plus Test (omega-3 index, trans fat index, omega-3:omega-6 ratio, AA:EPA ratio), and Omega-3 Index Complete Test (same as Omega-3 Index Plus Test + individual fatty acid levels). All you have to do is order your test kit online and you’ll receive it in the mail within 5-7 days, follow the instructions, and receive an emailed personalized report in 2-4 weeks that includes your omega-3 index score and dietary suggestions for how to optimize your omega-3 levels.
Note: I have no affiliation with Omegaquant. I’m just a fan of the company and doing their test was incredibly helpful in my health journey! A good spend of $100 which is why I placed it under splurge.
The Protocol
I. Increase your omega-3 fat intake. Some telltale signs and symptoms of omega-3 deficiency are itchy, dry, or flaky skin, soft, cracked, or brittle nails, hard ear wax, tiny bumps on the back of your arms or torso, achy or stiff joints, memory problems, ADD, diabetes, weight gain, depression, anxiety, even cancer. Interestingly enough, having adequate omega-3 intake has been shown to reduce your skin’s sensitivity to UV light and reduce your risk of skin cancer [17][18]. Whether your a seafood lover or not, my list has an option for you to incorporate more omega-3s into your diet.
Try This:
1. For fish eaters: Eating fish regularly offers numerous health benefits. There’s no reason to stick to only 2 servings per week if you’re avoiding fish high in mercury, like shark, tilefish, marlin, king mackerel, albacore tuna, and swordfish. My friend and business partner Dr. Mark Hyman recommends eating small, cold-water fish that fit in an 8 to10-inch pan because they’re lowest in mercury and highest in omega-3’s. He calls these the SMASH fish: sardines, mackerel, anchovies, salmon, and herring.
Always opt for wild-caught, sustainably harvested fish when possible:
- Sardines (1 can): 1,700mg omega-3s
- Pro tip: Pick sardines in 100% virgin olive oil or water, as many sardines can be canned with soybean or canola oil. These oils are high in omega-6 which counteracts the anti-inflammatory nature of omega-3.
- Mackerel (3 oz): 1,100mg omega-3s
- Anchovies (2 oz): 1,200mg omega-3s
- Salmon (6 oz): 1,800mg omega-3s
- Pro tip: Swap out canned tuna for wild-caught canned pink salmon. It’s higher in good fats, cheaper, and lower in mercury.
- Herring (3 oz): 1,500mg omega-3s
2. For seafood lovers: mollusks are an excellent source of omega-3s.
- Mussels (6 oz): 1,330mg omega-3s
- Pro tip: Mussels prepared in an olive oil-based white sauce or red sauce can contribute additional healthy fats.
- Oysters (6 oz): 1,170mg omega-3s
- Pro tip: Oysters are also an excellent source of vitamin B12, zinc, and copper.
What about mercury? As long as you’re avoiding large fish like swordfish, tilefish, king mackerel, and albacore tuna, mercury isn’t something to worry about. Mercury is harmful because it binds to selenium-dependent enzymes that help prevent oxidative damage and lower inflammation, especially in the brain. When mercury is higher than selenium, neurological issues can occur. Cold-water SMASH fish are higher in selenium than mercury, so unless you are selenium-deficient, there’s a low risk for mercury toxicity [19].
What about pregnant women? The FDA and EPA recommend pregnant women limit their consumption of fish to 12 ounces per week for concerns of mercury toxicity. Given the critical role of DHA for brain development, mothers who are pregnant or breastfeeding need at least 12 ounces of fish that is high in omega-3s per week, or an EPA/DHA omega-3 supplement [19]. In fact, one study found that mothers with high DHA levels or fish intake during pregnancy had children with higher IQs compared to mothers who consumed corn oil [20].
My friend Chris Kresser dives deeper into this topic here.
3. For seafood skeptics: Here are some ways even the biggest fish skeptics can incorporate more seafood into their diet:
- Anchovies in tomato sauce. Anchovies are one of the most nutrient-dense and affordable food sources of omega-3s, at less than $2.00 a can. Although they’re not a crowd favorite, there are ways to incorporate them into a meal without even knowing they’re there, like adding a can to homemade tomato sauce!
- Caesar dressing. Add minced anchovies to a caesar salad by incorporating them into a homemade caesar dressing made with lemon, garlic, and olive oil—another healthy fat!
- Fish tacos. Everybody loves tacos and this is a great meal for kids and adults to experiment with adding more fish to their diet. Try a mild white fish like cod or pollock with some fresh lime juice and salsa.
4. For non-fish eaters: ALA is present in several plant foods at very high levels, but its conversion rate to EPA and DHA is next to zero, rendering it useless for raising omega-3 levels. One benefit of eating foods high in ALA is that it outcompetes omega-6 for enzymes, which can inhibit the production of inflammatory molecules [9]. Grass-fed beef also contains omega-3 fats (5-33mg per 3.5-oz serving) that increase circulating omega-3 levels [21][22].
Vegans, vegetarians, and those who don’t eat fish MUST supplement regularly with a bioavailable form of omega-3, like algae oil. See recommendation below.
II. Lower your omega-6 intake. As mentioned above, LA is an omega-6 fat abundant in the Western diet that competes for enzymes with ALA, an omega-3 fat with low bioavailability. Traditionally, our ancestors ate a ratio of 3:1 or less of omega-6 to omega-3. Now, the average American eats a ratio of 20:1 or higher! This imbalance results in the overproduction of inflammatory molecules that wreak havoc on our cellular and metabolic health. Below are ways you can reduce your intake of omega-6 fats.
Try This:
1. Be on the lookout! Check ingredient labels for the following vegetable seed oils, and try your best to avoid them:
- Safflower oil (75% omega-6, 0% omega-3)
- Sunflower oil (65% omega-6, 0% omega-3)
- Corn oil (54% omega-6, 0% omega-3)
- Soybean oil (51% omega-6, 7% omega-3)
- Cottonseed oil (50% omega-6, 0% omega-3)
- Canola oil (20% omega-6, 9% omega-3) [8]
2. Increase your intake of bioavailable omega-3s. Using the food suggestions above or one of the supplements listed below.
3. Reduce your intake of processed foods. This will reduce your intake of omega-6 fats and improve your omega-6 to omega-3 ratio.
III. Supplement with omega-3s, your brain needs them! Through my own experience and from having conversations with experts, I’ve learned just how essential omega-3 fats are for brain health and mental health [23]. The roles that DHA and EPA play in brain health date back over 35,000 years ago when hunter-gatherers introduced seafood to their diet, which coincides with the rapid expansion of brain mass and development of personality, memory, and intellect that makes us uniquely human [24][25]. It’s no coincidence that low EPA and DHA are continuously observed in people with depression, anxiety, mood, and personality disorders [26][27][28].
If you face mental health challenges, poor memory, or are pregnant or breastfeeding you need to make sure you’re getting enough omega-3s. Why? Our brains are made up of 60% fat, and 90% of that comes from DHA, an omega-3 fat vital for neurodevelopment, neuroplasticity, cognition, and protection against Alzheimer’s disease [24]. EPA, another omega-3 fat, regulates behavior and mood, has anxiolytic properties, and has neuroprotective properties [26][29][30]. Some studies show an even greater impact of EPA on depression than antidepressants [31].
Getting enough omega-3s from your diet can be difficult, especially if you don’t eat fish. For those who aren’t eating at least two servings of oily fish per week, it’s essential to take a high-quality, bioavailable omega-3 fat supplement. Studies show that supplementing daily with 1-3 grams (that’s 1,000-3,000mg) of combined EPA and DHA dramatically improves anxiety, depression, mood stability, and inflammation [32][33]. A 2:1 ratio of EPA to DHA has shown to have the most benefit [34][35].
Try This:
1. Fish oil: Nordic Naturals Ultimate Omega is the most highly recommended fish oil supplement by doctors for its high-quality and affordable price. It comes in soft gel and liquid form—with no fishy aftertaste!
2. Cod liver oil: I recommend Dutch Harbor Omega, the most powerful marine oil on the market. It’s sourced from Alaskan cod liver, certified sustainable, and contains vitamins A and D to support immune function.
3. Krill oil: Bulletproof Omega Krill Complex is sustainably sourced and has optimal doses of EPA and DHA. It also contains GLA (another type of beneficial fatty acid), antioxidants from astaxanthin, and olive oil extract.
4. Algal oil: For those who don’t eat fish, Performance Lab Omega-3 is the highest quality vegan EPA and DHA omega-3 I’ve seen. Its algae are sustainably harvested and it doesn’t contain any harmful gums, vegetable oils, or preservatives.
Pro tip: Take a vitamin B12 supplement with your omega-3 supplement. Research shows this combination can help increase neuroplasticity by increasing the expression of brain-derived neurotrophic factor [36].
Your omega-3 index can tell you a lot about your health. Modern life makes it difficult to get omega-3 fats from diet alone since the primary source is from seafood with small, cold-water SMASH fish containing the highest and most bioavailable amounts of EPA and DHA. Not only are people eating the wrong kinds of fish, but a rapid surge in plant-based diets, veganism, and vegetarianism make it virtually impossible to get enough omega-3 fats from diet alone. ALA’s low bioavailability combined with how easy it is to consume excess omega-6 fats are a recipe for disaster.
Since most people have a low omega-3 index, it’s safe to assume that everyone can benefit from taking steps to increase their omega-3 fat intake and decrease their omega-6 fat intake. Try my Protocol to increase your omega-3 index and see if you notice any beneficial changes in your mood, cognition, or metabolic health!
If you tried these tips, I’d love to hear from you! Text me your feedback at 302-200-5643, let me know what you liked, didn’t like, and your experience with testing your omega-3 index with Omegaquant!
In health and gratitude,
Dhru Purohit