How much omega-3 is enough? That depends on omega-6.

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In the first article of this series, we discussed the problems humans have converting omega-3 (n-3) fats from plant sources, such as flax seeds and walnuts, to the longer chain derivatives EPA and DHA. In the second article, we discussed how excess omega-6 (n-6) in the diet can block absorption of omega-3, and showed that the modern, Western diet contains between 10 and 25 times the optimal level of n-6.

In this article we’ll discuss strategies for bringing the n-6 to n-3 ratio back into balance. There are two obvious ways to to do this: increase intake of n-3, and decrease intake of n-6.

Many recommendations have been made for increasing n-3 intake. The important thing to remember is that any recommendation for n-3 intake that does not take the background n-6 intake into account is completely inadequate.

It’s likely that the success and failure of different clinical trials using similar doses of EPA and DHA were influenced by differing background intakes of the n-6 fatty acids. In the case of the Lyon Diet Heart Study, for example, positive outcomes attributed to ALA may be related in part to a lower n-6 intake (which would enhance conversion of ALA to EPA and DHA).

This explains why simply increasing intake of n-3 without simultaneously decreasing intake of n-6 is not enough.

Bringing n-3 and n-6 back into balance: easier said than done!

Let’s examine what would happen if we followed the proposed recommendation of increasing EPA & DHA intake from 0.1 to 0.65g/d. This represents going from eating virtually no fish to eating a 4-oz. serving of oily fish like salmon or mackerel three times a week.

The average intake of fatty acids (not including EPA & DHA) in the U.S. has been estimated as follows:

  • N-6 linoleic acid (LA): 8.91%
  • N-6 arachidonic acid (AA): 0.08%
  • N-3 alpha-linolenic acid (ALA): 1.06%

Keep in mind from the last article that the optimal ratio of omega-6 to omega-3 is estimated to be between 1:1 and 2.3:1. Assuming a median intake of n-6 (ALA + LA) at 8.99% of total calories in a 2,000 calorie diet, that would mean a daily intake of 19.9g of n-6. If we also assume the recommended intake of 0.65g/d of EPA and DHA, plus an average of 2.35g/d of ALA (1.06% of calories), that’s a total of 3g/d of n-3 fatty acid intake.

This yields an n-6:n-3 ratio of 6.6:1, which although improved, is still more than six times higher than the historical ratio (i.e. 1:1), and three times higher than the ratio recently recommended as optimal (i.e. 2.3:1).

On the other hand, if we increased our intake of EPA and DHA to the recommended 0.65g/d (0.3% of total calories) and maintained ALA intake at 2.35g/d, but reduced our intake of LA to roughly 7g/d (3.2% of total calories), the ratio would be 2.3:1 – identical to the optimal ratio.

Further reducing intake of n-6 to less than 2% of calories would in turn further reduce the requirement for n-3. But limiting n-6 to less than 2% of calories is difficult to do even when vegetable oils are eliminated entirely. Poultry, pork, nuts, avocados and eggs are all significant sources of n-6. I’ve listed the n-6 content per 100g of these foods below:

  • Walnuts: 38.1g
  • Chicken, with skin: 2.9g
  • Avocado: 1.7g
  • Pork, with fat: 1.3g
  • Eggs: 1.3g

It’s not too hard to imagine a day where you eat 200g of chicken (5.8g n-6), half an avocado (1.1g n-6) and a handful of walnuts (10g of n-6). Without a drop of industrial seed oils (like safflower, sunflower, cottonseed, soybean, corn, etc.) you’ve consumed 16.9g of n-6, which is 7.6% of calories and far above the limit needed to maintain an optimal n:6 to n:3 ratio.

Check the chart below for a listing of the n-6 and n-3 content of several common foods.

Click the thumbnail for a larger version

Ditch the processed foods and cut back on eating out

Of course, if you’re eating any industrial seed oils you’ll be way, way over the optimal ratio in no time at all. Check out these n-6 numbers (again, per 100g):

  • Sunflower oil: 65.7g
  • Cottonseed oil: 51.5g
  • Soybean oil: 51g
  • Sesame oil: 41.3g
  • Canola oil: 20.3g

Holy moly! The good news is that few people these days still cook with corn, cottonseed or soybean oil at home. The bad news is that nearly all processed and packaged foods contain these oils. And you can bet that most restaurant foods are cooked in them as well, because they’re so cheap.

So chances are, if you’re eating foods that come out of a package or box on a regular basis, and you eat out at restaurants a few times a week, you are most likely significantly exceeding the recommended intake of n-6.

Two other methods of determining healthy n-3 intakes

Tissue concentration of EPA & DHA

Hibbeln et al have proposed another method of determining healthy intakes of n-6 and n-3. Studies show that the risk of coronary heart disease (CHD) is 87% lower in Japan than it is in the U.S, despite much higher rates of smoking and high blood pressure.

When researchers examined the concentration of n-3 fatty acids in the tissues of Japanese subjects, they found n-3 tissue compositions of approximately 60%. Further modeling of available data suggests that a 60% tissue concentration of n-3 fatty acid would protect 98.6% of the worldwide risk of cardiovascular mortality potentially attributable to n-3 deficiency.

Of course, as I’ve described above, the amount of n-3 needed to attain 60% tissue concentration is dependent upon the amount of n-6 in the diet. In the Phillipines, where n-6 intake is less than 1% of total calories, only 278mg/d of EPA & DHA (0.125% of calories) is needed to achieve 60% tissue concentration.

In the U.S., where n-6 intake is 9% of calories, a whopping 3.67g/d of EPA & DHA would be needed to achieve 60% tissue concentration. To put that in perspective, you’d have to eat 11 ounces of salmon or take 1 tablespoon (yuk!) of a high-potency fish oil every day to get that much EPA & DHA.

This amount could be reduced 10 times if intake of n-6 were limited to 2% of calories. At n-6 intake of 4% of calories, roughly 2g/d of EPA and DHA would be needed to achieve 60% tissue concentration.

The Omega-3 Index

Finally, Harris and von Schacky have proposed a method of determining healthy intakes called the omega-3 index. The omega-3 index measures red blood cell EPA and DHA as a percentage of total red blood cell fatty acids.

Values of >8% are associated with greater decreases in cardiovascular disease risk. (Note that n-6 intake was not considered in Harris and von Shacky’s analysis.) However, 60% tissue concentration of EPA & DHA in tissue is associated with an omega-3 index of between 12-15% in Japan, so that is the number we should likely be shooting for to achieve the greatest reduction in CVD mortality.

The omega-3 index is a relatively new test and is not commonly ordered by doctors. But if you want to get this test, you can order a finger stick testing kit from Dr. William Davis’ Track Your Plaque website here. It’ll cost you $150 bucks, though.

What does it all mean to you?

These targets for reducing n-6 and increasing n-3 may seem excessive to you, given current dietary intakes in the U.S.. Consider, however, that these targets may not be high enough. Morbidity and mortality rates for nearly all diseases are even lower for Iceland and Greenland, populations with greater intakes of EPA & DHA than in Japan.

All three methods of calculating healthy n-3 and n-6 intakes (targeting an n-6:n-3 ratio of 2.3:1, 60% EPA & DHA tissue concentration, or 12-15% omega-3 index) lead to the same conclusion: for most people, reducing n-6 intake and increasing EPA & DHA intake is necessary to achieved the desired result.

To summarize, for someone who eats approximately 2,000 calories a day, the proper n-6 to n-3 ratio could be achieved by:

  1. Making no changes to n-6 intake and increasing intake of EPA & DHA to 3.67g/d (11-oz. of oily fish every day!)
  2. Reducing n-6 intake to approximately 3% of calories, and following the current recommendation of consuming 0.65g/d (three 4-oz. portions of oily fish per week) of EPA & DHA.
  3. Limiting n-6 intake to less than 2% of calories, and consuming approximately 0.35g/d of EPA & DHA (two 4-oz. portions of oily fish per week).

Although option #1 yields 60% tissue concentration of EPA & DHA, I don’t recommend it as a strategy. All polyunsaturated fat, whether n-6 or n-3, is susceptible to oxidative damage. Oxidative damage is a risk factor for several modern diseases, including heart disease. Increasing n-3 intake while making no reduction in n-6 intake raises the total amount of polyunsaturated fat in the diet, thus increasing the risk of oxidative damage.

This is why the best approach is to limit n-6 intake as much as possible, ideally to less than 2% of calories, and moderately increase n-3 intake. 0.35g/d of DHA and EPA can easily be obtained by eating a 4 oz. portion of salmon twice a week.

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Comments Join the Conversation

  1. John says

    They seem like simple molecules, aren’t omega 3 fatty acids easy to synthesise in bulk, given the state of modern chemistry ?

  2. Thomas Gram says

    I find these numbers for pork and chicken somewhat misleading. These are average figures, based on pigs and chickens that are factory farmed and fed almost exclusively corn and soybeans. Given that diet, of course the fat stores on their bodies are going to be made up of the omega-6 fats that they eat.
    If you get pasture raised pork fed on whey from grass-fed dairy animals, and chickens that eat bugs, chia, purslane and/or well-balanced food scraps, the omega-3 to omega-6 ratio can be very well balanced, WITHOUT the mercury content and serious ecological problems of eating so much seafood.

  3. Ken L says

    I came across this while looking into the subject at hand.

    Organic production enhances milk nutritional quality by shifting fatty acid composition: a United States-wide, 18-month study.
    http://www.ncbi.nlm.nih.gov/pubmed/24349282

    Abstract

    “Over the last century, intakes of omega-6 (ω-6) fatty acids in Western diets have dramatically increased, while omega-3 (ω-3) intakes have fallen. Resulting ω-6/ω-3 intake ratios have risen to nutritionally undesirable levels, generally 10 to 15, compared to a possible optimal ratio near 2.3. We report results of the first large-scale, nationwide study of fatty acids in U.S. organic and conventional milk. Averaged over 12 months, organic milk contained 25% less ω-6 fatty acids and 62% more ω-3 fatty acids than conventional milk, yielding a 2.5-fold higher ω-6/ω-3 ratio in conventional compared to organic milk (5.77 vs. 2.28). All individual ω-3 fatty acid concentrations were higher in organic milk–α-linolenic acid (by 60%), eicosapentaenoic acid (32%), and docosapentaenoic acid (19%)–as was the concentration of conjugated linoleic acid (18%). We report mostly moderate regional and seasonal variability in milk fatty acid profiles. Hypothetical diets of adult women were modeled to assess milk fatty-acid-driven differences in overall dietary ω-6/ω-3 ratios. Diets varied according to three choices: high instead of moderate dairy consumption; organic vs. conventional dairy products; and reduced vs. typical consumption of ω-6 fatty acids. The three choices together would decrease the ω-6/ω-3 ratio among adult women by ∼80% of the total decrease needed to reach a target ratio of 2.3, with relative impact “switch to low ω-6 foods” > “switch to organic dairy products” ≈ “increase consumption of conventional dairy products.” Based on recommended servings of dairy products and seafoods, dairy products supply far more α-linolenic acid than seafoods, about one-third as much eicosapentaenoic acid, and slightly more docosapentaenoic acid, but negligible docosahexaenoic acid. We conclude that consumers have viable options to reduce average ω-6/ω-3 intake ratios, thereby reducing or eliminating probable risk factors for a wide range of developmental and chronic health problems.”

  4. Eric says

    Oh one more thing. There’s some very good stuff on this website and Chris is very knowledgeable and I have learned many important things from him. I’m not at all trying to discredit the entire website I just am very confident we are incorrect in our interpretations of omega-3 and omega six. The ratio of a omega-6 to omega-3 in the body is actually more than 6 to one. Omega-3 primarily gets burned up in beta oxidation and is part of the process of energy production. Omega six makes up over 20% of the content of cell membranes. It’s particularly important in the one cell layer thick vascular endothelium. But damaged omega six in our modern societies is still getting incorporated. It does not have the ability to maintain membrane fluidity which means that it impairs oxygen transport into cells. This makes the cells relatively hypoxic and this is the initial stage of atherosclerosis. Put healthy Omega 6 in there and watch the process reverse. It has been proven. Go to the Cambridge website. There are tons of articles there for free. The chief research officer is named Brian Peskin and he also has a website BrianPeskin.com where you can also get many of these articles. He additionally has three separate books that you can purchase.

    • rw says

      So your bottom line is to get good omega 6’s in the form of organic meat? You still recommend omega 3 right? Is taking the pill form something you do is there a brand that you trust their freshness?

      Thanks for the thoughtful information

  5. Eric says

    I’m sorry but I feel I have an ethical obligation to let you all know that this is completely wrong. All the studies looking at saturated fats and Omega fats did not consider the fact that the omega six polyunsaturated fats were damaged by processing. This is what you get in every store and every restaurant. You have to switch to organic meats in order to get undamaged omega six. Studies on the content of atherosclerotic plaques done in 1994 and again in 1997 confirmed that there were no fatty acids no omega-3 and very little monounsaturated fat in the plaque. There was also very little cholesterol. The main content of the plaques was damaged omega six. That omega six is damaged before it gets esterified which means it gets linked to cholesterol in the liver after consumption before it gets sent out into your system. You need to go look at the extensive research and literature at the Cambridge international Institute for medical science. I’m sorry to say but we physicians as well as many nutritionists have had it wrong for many years. You can debate me all you want but this particular institute has done extensive research and also has reviewed all the literature for over 100 years on these topics and there is no site out there that can compete with this.

    • says

      Hi Eric,

      I’m very interested in your concerns. Can you please share one or two papers where i can read the information you told us? (i’ve searched but nothing so concrete, so as you seem to be more familiarized with the topic you may have them in your bookmarks or something) :)

      Thank you very much

  6. Jeff Winkler says

    Why only fish? I’ve heard that we’ve been steered towards fish only because most other animals are fed corn instead of grass and that grass-fed animals have Omega-3 benefits similar to fish. Haven’t read the book but believe this is Paleo concept. Is that not true or at least partly so? As a vegetarian I find both options out of the question so I guess I have to use the other levers available.

  7. OmegaQuant says

    You can also get an Omega-3 Index test at OmegaQuant. We are also currently running a spring sale!

  8. Charlie says

    This is all great information, but for the layman like myself, it would be a lot more helpful/practical if there were suggested meals to achieve lower n-6 levels and higher EPA/DHA levels. For example, if one was a vegetarian, how could they achieve this? And where can we find a longer list of foods containing a lot of n-6?

  9. leo says

    Gongaratulations on your great site! Im deeply concerned with fish eating and consequently fish oil products. Although I love eating them I think its almost certain that we consume toxic metals if not radioactive materials from fish (wild or farmed its the same, since they both live in the same sea waters and the latter being fed with wild fishmeal) As an example I should say that wild fish caught south of Italy had traces of industrial substances from a leakage from a factory in the north of Holland, substances that could only be found there. Radioactivity from Japan has now crossed the Pacific ocean and is now found in the west side waters of the USA and Canada. If we take into account several other ship wrecks and industrial accidents that we will never know about and as salmon producers are using record amount of pesticides and wild fish fishmeal, Im wondering why not taking a tablespoon of flaxseed oil which provides us with 7.2 gr of Omega 3 and just 1.7 of Omega 6 oil? Whouldn’t that be enough within the framework of a plant based diet, with reduced meat intake?

    Cornel Uni research about salmon:
    http://www.news.cornell.edu/stories/2005/12/riskbenefit-analysis-farmed-versus-wild-salmon

    Guardian article about
    Scottish fish farmers using record amounts of parasite pesticides:
    http://www.theguardian.com/environment/2012/sep/10/scottish-fish-farmers-parasite-pesticide

  10. Vaughan says

    I’d like to know what Dan asked also, but I would also like to point out or ask I should say did you take into consideration with Avocados and Nuts, well because omega-6 linoleic acid from plants (such as avocado and nuts ) does not convert at a high rate to arachidonic acid (aka one of the bad guys) that is found in meats?

    Like for example pigs I have read converted linoleic acid to arachidonic acid for us, whereas the above is not the same case?

  11. Dan says

    Hi Chris,

    You calculated the content of half an avocado, some chicken and walnuts to 7.6% of energy intake. Did you take into account the omega 3 in these three foods?

    Thanks,
    Dan

  12. Marina says

    Dear Chris Kresser,

    Thanks a lot for your articles as I totally agree with you.
    But could you please write me in few words what is better to have and eat especially for woman because its very hard for me to understand totally what you are writing as my native lang is not english.

  13. Kimberly Servello says

    Future tests will conclude that their previous conclusions were incorrect and you don’t actually need a “Maths Degree” to eat healthy.
    As for me, I plan to continue eating all whole foods in a balanced diet and let Mother Nature worry about the rest.

    • says

      Kimberly
      I agree with your attitude of acceptance and trust in nature, but would add that your choices as a conscious being are part of nature too. For myself, and I suspect for many other people here, the main reason we need to do the “maths” is to defend ourselves from all the misinformation that plagues us and reaches into our pocketbooks at every opportunity.

      Someday you might find yourself with a “disease” that seriously effects the quality of your life but refuses to just kill you outright… even if you tried your best to “eat whole foods in a balanced diet.” Will you allow your trust or fatalism then to disempower you? Will you become passive, depressed, and suicidal as a non-participant in your own life… or will you do the math?

  14. Mark says

    Thanks for the article!

    Question:

    Does your body WEIGHT matter also in determining how much Omega-3 to take?

    I understand the Omega-6 intake is crucial, but how about your body weight? Should a person who is 132lbs take as much as someone who’s 264lbs? Is there something like a factor to multiply based on your body weight or similar…??

    Your help is much appreciated.

    Thank you!

    • Ken L says

      It’s a possible step but not really much to talk about.
      “Conclusions: Substantial differences in intakes and in sources of n−3 PUFAs existed between the dietary-habit groups, but the differences in status were smaller than expected, possibly because the precursor-product ratio was greater in non-fish-eaters than in fish-eaters, potentially indicating increased estimated conversion of ALA. If intervention studies were to confirm these findings, it could have implications for fish requirements. ”

      Difference was smaller than expected but still “Substantial”

  15. Donnacha says

    There are far too many flaws in your recommendations in most of your articles (or at least in the many I’ve read). This one especially – the tiny amount of total fat intake your recommending is not enough for a healthy metabolism or necessary fat soluble vitamin absorption. Also walnuts have more omega 3 than 6, not to mention 100grams of which is a huge “handful”… I doubt you’ll even reply to this

  16. Marcus Flores says

    Hi,friends. Are 10grams per day (counting only epa plus dha) of fish-oils with vitamin E,safe to take with prozac sixty mgs daily? Many thanks. Best regards. Marcus

  17. Bobbie says

    Hi Chris,

    Thanks for all the education thus far. Quick question…

    What is your take on supplement Coenzyme Q10? Does it help the heart?

    Thx

  18. ninad says

    Chris,

    What about grass/insect fed pasture eggs vs farm eggs? The omega-6/omega-3 ratio for the two will be significantly different too right? Any article you can point me to?

    Ninad.

  19. Henning N. Troe says

    zinzino’s balance product are the one you guys are searching for:
    http://www.youtube.com/watch?v=sf8xyd5be7M

    I can hook you up if interested, just sayin’.
    Best product in 2013, feel so fine after starting, and i can prove it to myself that its not something placebo feeling, by the test taken at the Norwegian Hospital: St.Olavs, that my balancerato omega 3:6.

    Thank you for now, and have a good year.

    Regards,
    Henning
    [email protected]

    • Melissa Gilmore says

      Henning N. Troe- I second that post. I’ve been taking balance oil from Zinzino and you are 100% correct!
      Visit balance321.com for more information.

  20. Ed Delong says

    We fry with grapeseed, (small amounts) and use extra virgin olive oil for low and no heat dressing. We use butter for baking (rare) and sauces (occasional). We take three caps of cold pressed flax and wild salmon each daily plus sylimarin, turmeric, and ubiquinol. We also never have wine without cheese (drunken mouse diet ;>P )
    Our question: is any component lethal or severely deleterious? Thanks
    PS great detailed examination of fats in diet!

  21. Demetris Nicolaides says

    I’m referring to this article’s recommendations. I agree with what you say. I’ve read that 4:1 is a good ratio and this is what I currently consume. But this article says the optimal is 2.3:1 or less. On the other hand I see by calculating the recommended omega 3 amounts (pasted below) that are based on a 12.6:1 ratio if I’m not wrong!

    “To summarize, for someone who eats approximately 2,000 calories a day, the proper n-6 to n-3 ratio could be achieved by:

    Limiting n-6 intake to less than 2% of calories, and consuming approximately 0.35g/d of EPA & DHA (two 4-oz. portions of oily fish per week).”

  22. Demetris Nicolaides says

    2% of Omega 6 intake in a 2000 calories diet is 40 calories. 40/9 (fat calories) is 4.4 grams of omega 6. The recommended Omega 3 is 0.35 grams. So we have a ratio of 4.4 : 0.35 (12.6 : 1). I thought that the optimal ratio is below 2.3 : 1. Could you please help me understand this? Thank you.

    • MachineGhost says

      Are you sure you didn’t mean 3500mg or 3.5g? 900mg is what most health authority institutions recommend as a daily minimum. Omega-6 is very hard to avoid — it is even in fish oil. Eating nothing but saturated fat and fatty fish / fish oil within the context of a safe carb diet is the only way to minimize Omega-6 intake.

  23. Demetris Nicolaides says

    I have to eat 20% fat from my total 2600 calories. How can I limit my Omega 6 intake to 2%? It seems impossible!

  24. Stefan Stolt says

    Dear Chris

    Some questions regarding cooking with vegetable oil. I saw in the diagram provided that Palm oil or Palm Kernel Oil where significantly lower in N-6 acids than the majority of vegetable oils, even lower than olive oil and only superceded by Coconut oil. Where I live, in Thailand the least expensive vegetable oil is Palm Oil from Pericarp. For cooking purposes, would you suggest choosing Palm Oil from Pericarp as a healthier alternative than other vegetable oils like ricebran, canola or sunflower oils as the N-6 content is lower.

    Do you know of any other drawbacks to health ingesting palm oil? It would make sense using palm oil for cooking as it is the less expensive than for example rice bran, canola or sunflower and at the same time according to the charts contain lesser N-6 acids.

    With best regards, Stefan Stolt

  25. laura says

    All super interesting information.
    Why, on most websites/blogs where the Omega 3/6 ratio is discussed, very few are talking about the Omega 3 rich vegetables that have low Omega 6, and that if you eat a diet rich in veggies and moderate fats and oils, that you are likely getting a healthy ratio? I read so many of these sites, and now on Paleo sites, and this vegetable portion seems to be ignored.

  26. Masood says

    According to the Nutrition and Food Information Center, the daily recommended intake for omega-3 for example for a 45 year old male is 1.6 grams a day, and it is 17 grams a day for omega-6. This gives us a ratio of omega-6 : omega-3 over 10:1. If we want to satisfy this requirement and also satisfy the ratio of 1:1, then a 45 year old male need to take 17 grams of omega-6 and also 17 grams of omega-3 daily (assuming he’s on a 2000 calorie a day diet)

    However I see, you are recommending to lower the omega-6 intake as much as possible, in order to satisfy the ideal ratio. I wonder if you could please explain this in more detail. In other words, is it okay to ignore that 17 grams daily omega-6 requirement? I am a fruitarian, and my omega-6 consumption is close to zero, and the ratio of 1:1 easily is satisfied. Would that be OK, or is there a certain minimum requirement for omega-6 and omega-3 besides the ratio? I appreciate your response in advance.

    • MachineGhost says

      I believe you will find the 17g LA DRI being considered essential from the IOM is flawed, as only AA is actually essential, but not all LA is converted into AA. Similarly with ALA & DHA.

      Also, a 2011 review published in Nutrition & Metabolism entitled “Increasing dietary linoleic acid does not increase tissue arachidonic acid content in adults consuming Western-type diets: a systematic review”, concluded that there is “no evidence to suggest that changes in dietary linoleic will modify tissue arachidonic acid content in an adult population consuming a Western-type diet.”

  27. Debra says

    Hello Chris,
    Great information. dicussion and site. I’m following this thread closely as I have active Ovarian Cancer, Autoimmune Diabetes Type 1 and Hashimoto’s. I used to used olive oil, now most of my oil consumption, cooking etc., is coconut. I have had liver pain, likely inflammation, from lots of meds used to battle diseases, (both traditional and alternative meds.) I just began taking Nigella Sativa oil and am concerned about dosages. It is reputed to have anti-inflammatory impacts internally, and ingredients that help some cancers, especially pancreatic. It is roughly 25% omega-9, 46% omega-6 and .5% omega-3 in composition. Probably I am safe taking 1 tblsp. per day. I would like to gain from its anti-cancer and anti-inflamm properties w/out OD’ing on the omega-6’s. When I take this oil, my liver pain decreases significantly. It seems that I should be OK if I up my cold water fish intake to 2 or 3 4 oz. servings per week to offset the omega-6 consumption. I think the Nigella Sativa oil is by far my most significant source of omega-6’s. I don’t eat that many eggs or that much chicken. Glad to hear that the jury is reconsidering how much is too much omega-6! Any thoughts, comments or suggestions from you, Chris, or readers of this site would be most welcome! Thank you!

  28. David says

    Awesome post. Thank you for taking the time to write this out.

    Question: does it matter how the fish oil doses are divided? For example, if I had an aversion to fish, and wanted to replace 16 oz of salmon per week with Vital Choice brand, is there any benefit/disadvantage to taking fish oil 2x per week vs. taking fish oil every day?

    When I looked over the nutritional info on Vital Choice’s salmon oil, 3 caps = 600 mg of o3. Nutritiondata says that 1 oz of salmon has 600 mg o3. It works out to 48 fish oil caps from VC, 24, 2x a week or 6 per day. Either way it’s a lot of fish pills, but about the only way I can stomach fish (plus, I discovered VC has a lot of Vit A and D which is good since liver is another weak link for me).

    Thoughts?

  29. Hana says

    Chris, I’m just exploring your site for the first time and I’m wondering why no one suggests replacing these vegetable based cooking oils with something as simple as lard? You can get inexpensive skin and fat from pigs that were *actually* raised free-range on pasture, and render it yourself very easily. It won’t give you the omega 3/6 profile of fish, but is probably far better than anything plant-based.

  30. says

    I am eating an 80-10-10 vegan diet and tracking my nutrition with a computer program called Chronometer. On the diet I meet or exceed all nutritional requirements except Omega 6. The targets for omega 6 = 17g. (I’m 46 years old) and omega 3 = 1.6g. seem impossible to attain without adding oils to meals. My situation is unusual because I get 1.0g. ALA and 3.6g. LA in my daily diet. When I add 2g. of cold pressed flax oil to my salad in the evening, the numbers change to ALA 2.0 & LA 3.9. The ratio is excellent (1.922:1) but the amount of LA is far from what is recommended. Is the diet safe with LA so low? Does my body need all of that LA or are the numbers set high to deal with the typical American diet? I hope it’s safe to eat this way ’cause i’ve never felt better.

  31. Tim C says

    Hi Chris,

    I wondered if you could help me with a question about Omega 3 and Omega 6 balance?

    According to the USDA, I should aim for at least 17g of Omega 6 a day. Therefore, to get the 1:1 ratio with Omega 3, I need to eat something like 1.5 kilograms (over 3 pounds) of salmon A DAY.

    Are you suggesting I eat all that fish, or is the Omega 6 requirement off?

  32. Bob Deschner says

    Actually, the optimal ratio of omega 6 and omega 3 essential fats is more dependent on the types or form (natural cis- or artificial trans-) of the omega 6 fatty acids. Type refers to whether the n-6 essential fatty acid is arachidonic acid which is converted to prostaglandin PG E2 (an inflammatory PG); higher up on the metabolic chain such as linoleic acid (LA) (which is easily blocked by n-3 fats); or gamma-linolenic acid (GLA) which is converted 20%/80% to the highly anti-inflammatory PGE1 and inflammatory PGE2).

    The n-3 essential fatty acids can do more harm acting as metabolic blockers of n-6 metabolism then any competitive absorption issue between n-6 and n-3. Furthermore, recommending eating fish without specifying the type and quality of fish (deep ocean cold saltwater fish is much better than others, especially farm-raised); how to avoid toxicity from heavy metals and oil soluble pesticides and excess vitamin A/D; and preparetion of the fish (frying or cooking fish at high temperatures causes the formation of trans-fats which are metabolic poisons) is naïve if not unhealthy.

    Please point out that most of the US studies which have been conducted blindly lumping all omega-6 fatty acids (both inflammatory and anti-inflammatory) into the same bucket and totally ignored the cis- / trans- ratio of the essential fats—therefore these studies are not worth the electrons which are used to store them.

    If you would please go back to the original literature—metabolic and clinical studies which first elucidated the essential fatty acid/prostaglandin metabolism—you will find much higher quality studies, more sophisticated analyses and better understanding of what is actually happening.

    The Best,

    Bob Deschner

  33. Chris says

    Dear Chris,

    the frozen wild salmon (Northwest Pacific) I’m able to get (here in Germany) contains 10,5g (0,37oz.) of fat in 100g (3,5oz.), of which 2,5g (0,088oz.) are saturated. Now I don’t have any idea how much Omega 3 I am getting there (it’s not listed).

    You said that 12-18oz. of fish a week are fine, but I was wondering how that would translate with these values. If I may ask, how high is the fat content in the wild salmon you recommend?

    Another brand for instance, only lists 2g fat (0,07oz.) in 100g (3,5oz.) of their wild salmon.

    How much fat in total should these servings you recommended contain? I’m not sure how to translate this to the 0.65g/day of EPA/DHA you specified.

    Thank you so much
    Chris

  34. Joanne says

    Hi, I too am a fan of chia seeds. I’ve noticed that my hair and nails are stronger and grow faster. Also, they help me stay hydrated and alcohol intake has little or no effect on me the next day. They are also a fantastic source of fiber. Pls, Chris, address the Chia question above when you get a chance. Thank you!

  35. John says

    In your previous article, you discussed the low conversion of ALA to DHA/EPA. But, in this article you take full credit for ALA in determining the O6/O3 ratio. In your example, you add 2.35 g/d ALA to .65 g/d DHA/EPA to get a 2.3/1 ratio based on 7 g/d O6. If I am consuming 7 g/d O6, why wouldn’t I want to consume (via fish or fish oil capsules) 3 g/d DHA/EPA? Unless I am consuming large quantities of flax, seems like I should ignore dietary ALA. Thanks.

  36. Andrius says

    When I eat only fruit and veg , my omega 6:3 ration is usually around 1:1. On these days get around 1 g of omega 3, at least cronometer says so.

  37. Pranay says

    Hey Chris,
    You said that many vegetarians and vegans have low EPA and DHA intakes due to poor conversion from plant-based sources. However, they also probably have low Omega-6 in their diets (assuming they don’t eat a lot of omega-6 nuts), so the ratio is probably close to ideal, right? Is there a minimum amount of polyunsaturates you need, and is the 4% of total calories a good estimate? What do you say the average intake of polyunsaturates is in disease free civilizations (i’m curious to the quantity consumed by those who do not typically live near coastal areas).
    Thanks!

  38. says

    Yes, it’s better than flax. Flax (or hemp seed oil) has ALA, which slowly, inefficiently can be converted to DHA or EPA. There is still some question which of the long-chain n-3s is more important — Chris leans to DHA. The algae supplement is already DHA. No, I haven’t tried it, as I do find with regular fish oil, but I get asked this question a lot.

  39. Osmond says

    Help !! I’m vegan and do not eat fish. How can I best reverse the n-6 : n-3 ratio in my diet back to optimum levels?

    • Chris Kresser says

      The only option you have to increase your DHA levels is algae. I think Dr. Furhman sells some. This is one of many reasons why a vegan diet is not optimal.

    • mitchell says

      I’m eating a vegan diet too and according to my logs I easily achieve a n-6 of under 2% of my calories. The n-3 part comes easily too but I guess I’ve got to depend on my body to convert that into EPA and DHA. So hopefully with such small amounts to work with my body can get er done.

      • Chris Kresser says

        The best way to find out is an omega-3 index test. You can order directly from OmegaQuant. I have no relationship with them, but Dr. Bill Harris who has done a lot of research on EFAs is behind that lab.

  40. Veronica says

    Err, proper form to ‘digest’ isn’t right, is it? Basically is the omega 3 in those eggs going to be useful or not useful.

  41. Veronica says

    I remember a teacher telling me about studies about toxicity (probably only specific toxins, but I forget which ones) in fish being exceptionally bad where I live, New Brunswick Canada. (Of course, we also have a massive cancer rate which is currently being studied, they think it’s the arsenic in the soil…damned no matter what I eat!) Anyways, is there more of a concern for eating too much seafood depending on where it’s caught? Why is farmed fish worse for toxins? Wouldn’t it be better seeing as where it’s farmed, especially if in a man-made area separate from regular waterways, there’s virtually no worry of the dumping of toxins into the water?

    More on topic, I see that eggs are pretty high in omega 6. But currently I usually buy the free range, omega 3 eggs from a local farmer. How much extra omega 3 is in these eggs? Is it enough to perhaps counter unhealthy levels of omega 6? Is it even in a proper form for people to digest, seeing as it’s originally from flax? I certainly notice a taste difference, and I can’t say I like the fishiness, but I buy them because they’re a good price for eggs that I feel are ethical to the chickens.
    And what about organic eggs? Everywhere online says organic eggs aren’t any better health-wise than regular, battery eggs, but organic chickens would eat a lot of grubs and not so much grain, right? If there’s a noticeable difference in grass-fed vs grain-fed cows, and if a chicken’s diet of flaxmeal can create omega 3 eggs, it seems likely the nutritional content would change if they’re eating bugs…

  42. Deneen says

    Hi Chris,

    Thanks for your work. I have read a few of your articles re: omega 3&6 including this one and aren’t seen Chia seeds mentioned. I would rather get my fatty acids from whole foods rather than taking a supplement but I have yet to acquire a taste for sardines (if you know of a palatable way of taking them, please share!) I have heard that Chia seeds have a favorable FA profile but am having a difficult time confirming this. What are your thoughts?

  43. Carly says

    Hi, Great article.
    Obviously I understand eating fish is best but ive always also supplmemented with a good source fish oil (nordic naturals) I did take the omega 3 one but then switched to an omega 3/6 balance thinking it was best. I have hasimotos. Now im thinking prob best to stick with supplmenting just omega 3 again, whilst trying to eat balanced and healthy too? I have a lot of olive oil so im prob getting too much omega 6 already so adding it in a supplement perhaps not a good idea? Thanks Carly

  44. Michael says

    Chris, if you consider walnuts to be okay, what about the oil made from it or sees like sesame? I do like a drizzle added to a stir gry or salad…!

    Cheers

  45. Andrius says

    I am glad you did change your view Chris, because most studies that found omega 6 are harmfull, are done with damaged omega 6, which are added to various foods, spreads etc. These omega 6 are heated , partially hydrogenized, so no wonder their consumption is associated is with diseases. However, omega 6 in their natural state most often are found beneficial. e.g. look at the studies with nuts , almost every study finds benefits of nut consumption, and most nuts are much higher in omega 6 than omega 3.

    And I am afraid the same is with the fructose, people see studies with purified or HFCS and then start telling not to eat even fruits.

  46. Jason Smith says

    Chris–great article (and love your site).

    I noticed the mention of Walnuts in your article as being high in n-6. Unrelated, I recently read the study in the american journal of cardiology which found that the addition of daily walnuts to meals increased artery flexibility by 24%.

    Weighing the arterial benefits against the n-6 downside, what is your general feeling on daily walnuts?

    • Chris Kresser says

      I’ve changed my view somewhat on omega-6 from natural sources since writing this article. I think it’s somewhat unlikely that n-6 from walnuts would cause harm, and of course nuts and seeds have health benefits as you pointed out. Walnuts are also quite high in n-3, which probably explains their effect on arterial flexibility.

    • Chris Kresser says

      Yes, there is quite a bit of conflicting research on the n-6:n-3 ratio. I may need to revise this article based on what I’ve been reading lately, but the jury is still out.

  47. Lisa says

    Hi Chris,
    Was wondering if you had heard of sacha inchi oil and what you thought of it…I have been supplementing with it because you can get 10 grams of omega 3 in 1 tsp a day.
    Thanks

  48. Justmeint says

    a full and supervised elimination diet is what you need to do, anything less will only keep you as sick as you are now. You cannot just reduce gluten and lactose… you need to eliminate them completely. Suppose you are casein intol, how will you know unless you give up all dairy?

    I speak from experience having been down a similar road like you.

    • says

      justmeint, thanks for your reply. i have completely cut down gluten and lactose from my diet.
      chris, would appreciate your thoughts and links for me to follow pls. i have read all the hashimoto link of yours it was very helpful for me. thank you so much chris to give in detail the information.

  49. says

    chris,
    I am 31 and suffer from hashimoto thryroditis but my T3 T4 TSH reports are normal and i am taking the synthroid 25 mg. I have a nodule present in the left. I have gastritis, heaviness in left abdomen after eating food,
    disturbed sleep, burning sensation on the left side of neck area after eating some kind of food and left knee throbbing in the night and pulse in the nodule which wakes me up..no idea when and what food triggers.. tired of noting down the food diary is exhausted now. Difficulty in conceiving. My left side remains inflammed. Have cut down gluten and lactose for last 4 months. the abdomen symptoms have reduced lot like the bloating and gas. but inflammation in the neck remains. have been following and avoiding all goitregenic foods. can you suggest what is the main culprit behind all this problem. what type of oil i should use for cooking. at present i use canola and olive oil. pls provide some dietary guideliness which will help me.

    • Maxwell says

      Rati, the main culprit behind your problem is bacteria. So here’s your best solution: Astragalus, Pau D’Arco, Artichoke Extract, Oregano Oil, Mastic gum, Pure Cranberry Juice, Cranberry tea, Vitamin A, Chickweed, Milk Thistle/Dandelion, and Align. Through no fault of your own, your immune system is lopsided, and it is constantly fighting the craftier, BAD bacteria that dominates. You basically have a systemic bacterial infection. Your not alone on this. There’s millions of us with this problem and the principal symptom is inflammation. Everything that I put in that arsenal of herbs, vitamins, and pro-biotics fights bacteria. Not permanently, but you can repeatedly create an opportunity for your body to push back and allow for the proper absorption of nutrients and the utilization of the Omega 3’s by taking them throughout the day. Before bed, Astragalus, Pau D’Arco, Artichoke Extract, Oregano Oil, Chickweed and Vitamin A and you’ll be able to sleep. We need greater amounts of Omega 3’s and Vitamin A when our body is fighting a systemic infection. In particular, Vitamin A which can get devoured very quickly by too much Vitamin D, found in fish, so be aware of that. Very important, otherwise you’ll be affected by depression and get overall poor results. I don’t believe doctors have even begun to understand this problem with bacteria. You should research “Quorum Sensing.” It’s quite eye-opening to discover that bacteria can behave like a communicating flash mob. Of course, you still have to keep the Omega 6’s at a bare minimum because, until science figures out a way to permanently fortify our immune systems, the bacteria isn’t going anywhere. It’s a part of us. You have to become your own external immune system, so to speak, and help your internal immune system to constantly beat back the BAD bacteria because it simply can’t do it on its own. This is why many of us are spinning our wheels. Don’t fret, the depression and the fog will lift with just the first round of this protocol and you will realize the healthy body that you thought was gone is still there. Just be smart. Don’t get sloppy with your diet when you start feeling better because that bacteria will come back fast and furious. Really fast. Then the fog and depression will come back and you’ll have to dig yourself out again. P.S. That thyroid problem of yours is being caused by bacteria too.

  50. Bob Deschner says

    Chris,
    Excellent articles on fish oils and the omega 3 supplementation, but you left out the problems with increased strokes and colon cancer at high dose levels. In studies of two populations, South Pacific Islanders and Aleutian natives, who had diets with high levels of raw fish, heart disease was dramatically reduced but they had five times the incidence of stokes and colon cancer. Those results were collaborated in clinical studies with pigs at Vanderbilt in the mid-1990s.

    Also, it would help if you would specify which essential fatty acids you (and the researchers) are calling omega 6 fatty acids. Some of the omega 6 fatty acids also make PGE1 which is a powerful ANTI-inflammatory prostaglandin.
    In fact, like the delta-6-desaturase, the delta-5-desaturase is easily blocked by EPA, caffeine, tobacco, alcohol, stress, age, etc. so that further favors the formation of the powerful anti-inflammatory PGE1 from DGLA.
    If you want to suppliment with Evening Primrose Oil (EPO) to enhance GLA/DGLA be sure that you use a supplement with real EPO (like Efamol) instead of diluted black currant oil or borage…those oils do not demonstrate benefits in clinical studies.

    The Best,

    Bob Deschner

  51. JustMEinT says

    at a GP visit yeaterday she told me she had recently attended a conference where it was told that certain patients should limit their intake of fish oil capsules to 1000mg per day. the reason this came up – I have a bleed behind one eye….. she asked how much supplemental fish oil I was taking, and the told me to reduce it to 1000mg per day because I maybe a sussceptible (?sp) bleeder.

    I have stents in and refuse statins. I take the fish oil as an anti inflam medication inseat of the statins….

    Would appreciate your thoughts and any links for me to follow please

    • Chris Kresser says

      Most studies I’ve seen suggest that fish oil doesn’t cause or worsen bleeding even at fairly high doses.

  52. Tania Vera says

    Thanks for the informative series. I’ve been working on changes to reflect the info here. I have a question. If it has already been answered, please forgive me and point me to the right place.

    I was wondering about ALA. In the example you provided, you say,”if we increased our intake of EPA and DHA to the recommended 0.65g/d (0.3% of total calories) and maintained ALA intake at 2.35g/d, but reduced our intake of LA to roughly 7g/d (3.2% of total calories), the ratio would be 2.3:1 – identical to the optimal ratio.”

    How do you maintain ALA at about 2.35g/d, especially if you reduce LA sources likes nuts and seeds? I tend to eat mostly meats, eggs, raw dairy, veggies (including roots/tubers), some fruit, and limited amounts of nuts/grains/legumes. I have recently started to add 2-3 servings of fish a week (mostly salmon, halibut, and ecofish tuna).

    • Chris Kresser says

      You don’t have to worry too much about ALA. Just increase fish intake to 3 servings per week (6-7 oz. each) and reduce LA and that will do it.

      • Tania Vera says

        Thanks. That makes total sense. I’m still wrapping my head around eating fish 3x/week (4oz each), so I think I was worried about bumping it up even more (I cut fish from my diet 5 years ago when I was pregnant due to mercury concerns. Ack.) My family is from coastal Ecuador, so fish was a huge part of my diet when I was younger. Nice to know about selenium’s affinity for mercury.

  53. Max Trynyn says

    …And one follow up question: I feel like I have seen a lot of claims that scientific studies found many health benefits of nut-consumption. Sorry I’m so obsessed with nuts.

    Thanks!
    Max

  54. Max Trynyn says

    Hello and thanks for al the great information!

    I was wondering if you would have different recommendations for a competitive endurance athlete (x-c skiing) training multiple times per day. Does this change anything concerning limits on omega-6 consumption? I eat very close to your recommendations except that it is hard to get enough energy so I like to eat a lot of nuts. I am 22 and generally fit and healthy though I have some trouble with eczema.

    Thanks!
    Max

  55. says

    Hi Chris,

    I heard you briefly mention borage oil once on your podcast. My integrative doctor has me take 1,000 mg twice a day. She did a functional test which tested all of my levels. My omega 3s were great, but I have low levels of DGLA and GLA. Is that something to be concerned about? Isn’t it better to have more omega 3?

    What are your thoughts on borage oil? My omega 6 level overall is pretty low. (no seed oils, nuts etc)
    Amanda

  56. says

    I avoid all seed oils and nuts except macadamia nuts, and I usually eat canned sardines or wild caught salmon four to five times a week, is this going to be too much EPA in light of what Chris Masterjohn has said: “Providing high doses of EPA that interfere with arachidonic acid metabolism, however, is a pharmacological approach, and it is likely to have many adverse consequences.”

  57. says

    OK, I assume you mean Cod Liver Oil, which is rich in Omega-3s (also A and D).

    It is hard to find doctors who listen to their patients, or listen to anything other than what they remembered from medical school. Harder still to find good doctors who take insurance, especially things like Medicare and Medicaid. If you find a good doctor, you will also be dealing with his (or her) pet theories. None of the “alternative medicine” concepts have been rigorously tested (except with the intent to discredit them), and so you will always have trouble getting the right balance for you. Western medicine has never been interested in the individual, only in general treatments (and promoting those treatments as much more universal than they are).

    OK, now that I’ve dug myself into that hole, I hope you will reject the partial thyroidectomy — that makes as much sense as “curing” mental illness with a lobotomy (or electro-convulsive “therapy”). I would suggest you consider lithium orotate — it’s cheap, readily available, and safe. (The only research showing it to be unsafe used thousands of times per body weight over suggested amounts, proving only that minerals are toxic when taken at toxic levels.) I can’t show you any research on lithium (at proper levels) and thyroid, but have several members of my ALT-therpaies4bipolar group who have greatly reduced or eliminated their thyroid meds, often with concurrence from their doctor.

    But this is Chris’ group, and I have no intention of taking over either the group or the conversation. Feel free to contact me off-list, or just think about what I’ve said and accept or reject it as you will.

  58. says

    ahhhhh the other oil I forgot to mention that I consume daily is CLO. Doc said my D levels were fine, so I decided to take a daily CLO capsule to keep them that way. I am photosensitive, so do not spend much time out in the sun, it causes me that wretched butterfly rash on my face.

    NO I have not been prescribed any prescription thyroid meds….. only suggested I take selinium which I had to find without brewers yeast (not suitable for my diet) and aswaganda (?sp) to perhaps help my thyroid and won’t hurt my other autoimmune issues. I am diagnosed SLE with vasculitis.

    Doc is considering a partial thyroidectomy….. I want more information first and a closer look at what my alternatives may well be. I have found this site very informative and helpful. Gut issues do so much damage to the entire body and yet I have not found a GP yet who appreciates that fact.

    Cheer’s

    It is important to me that I provide the right balance of ‘ingredients’ for my system. I work hard at that.

  59. says

    I’ve heard a lot of negative stuff about krill oil… the only positive info comes from Dr. Mercola, who owns most of the company. How much fish are you eating? Three servings per week of dark muscle meat fish are said to be sufficient. But nothing else you are eating has any Omega-3s in it. The nuts are mostly 6 and 9.

    You don’t talk about medications you may be taking… there are a lot of things you can do for the thyroid issues, but the best (and least known) may be lithium orotate. The low levels of lithium in this product appear to be ideal for thyroid issues. Most people see lithium as being damaging to the thyroid, but that is in the light of the toxic levels of lithium carbonate given to many people. Lithium orotate is available over the counter if you can find it, and over the Internet.

    And now we are officially off topic. LOL Hope it helps anyhow.

  60. says

    I am really interested in finding out – on a restricted diet if I am consuming sufficient? the correct balance of 3-6’s. Considering I do not eat processed foods, foods from fast food outlets, packaged and prepared foods from supermarkets etc….. I would consider I was somewhat deficient in the 6’s (grin) according to modern food eating standards.

    What fats are in my diet? hummmmmm If I cook with oil I use Rice Bran Oil in a 50/50 ratio with butter.
    Any other fats come from meats and fish that I buy fresh and cook at home. Nuts….. well yes, a handful once a week maybe of cashews.

    No Milk No cheese No yoghurt, which has my poor dietician tearing her hair out! I refuse soy milk, wont use rice or oat milk etc…… the shop bought pre packaged milk substitues are frankenfoods as far as I am concerned.

    So am I deficient in the reverse? maybe too much 3’s and insufficient 6’s????

    Maybe maybe not. When I cook with chicken all visibly fat and skin is removed. I am NOT misled by the you must eat low fat rubbish, but I don’t over do it either as I have non alcoholic fatty liver, NO gallstones evident on ultrasound, but do get pain in that area sometimes. Only very recently have I read (here I believe maybe) that tyroid problems can interfere with the liver. I have a multi nodular (growing) goitre and seem to fluctualte tween hypo and hyper……. iodine/kelp supplementation did not agree with me.

    So apart from taking a krill oil capsule once a day, all other fats consumed are natural mostly 3’s I believe…… THOUGHTS appreciated.

  61. says

    McHarris, I share a lot of your sensitivities, not all. Milk and I are good buddies. But the legumes, ah yes. Not many vegetables with any protein in them that I should be eating. And sugars are way up my list too. Sugar plus wheat (aka donuts, cookies, etc.) means eczema, sure as the day is long.

  62. says

    I work with a trained dietician on FAILSAFE method of food chemical sensitivities. I did a huge elimination diet, and under dietician care reintroduced foods one at a time. It works if it is done properly. I am salicylate sensitive, soy and msg intolerant, legumes are a no no for me…. even if soaked and prepared WAP way. Gluten intolerant and casein intolerant…… Makes eating out tricky I tell you, but I now know what I can and cannot eat… at what cost etc…… too much broccoil and I pay the price…. milk and products keep me tied to the house and the loo for days after consuming, and gluten causes me immense pain…. not just in the bowel either. I did undergo some skin prick tests years ago, but they were inconclusive, where as using the R.P.A.H – Failsafe diet has worked for me.

  63. says

    Ya know, most of the “science” on a lot of these issues is so sketchy I’d rather listen to experience. With my ALT-therapies4bipolar group, I get the experience of a lot of people (over 400 right now, maybe 1000 in and out of the group over the years), and when it lines up (as it seems to have on the topics of fish oil, magnesium, and lithium orotate to date), I’d trust that a lot more than a doctor who listens to his pharmaceutical rep.

    No, I don’t want to be contentious. But when you find a good doctor, as I did once and as Lisa maybe has, they SHOW you the evidence and let you try it out. I don’t know what tests her doctor ran, so I can’t comment on the science behind them — but a lot of the “science” in allergy testing is about on the level of The Amazing Randi, a person whose job it is to debunk or cast aspersions, with the benefit going to the drug companies and their own debunkable magic. I will also admit that a lot of the “science” that is pro-allergy is nothing more than pet theories.

  64. Lisa says

    An interesting topic – food sensitivity testing. I have to think there’s some gray area between your two opinions. There were some areas on my test results that were questionable to me. For example, I scored high on cow and goat’s milk and low on casein….huh?

    I’ve learned just recently that there are many different types of testing available. The bood testing I had done, I believe is called Cytotoxic food testing….then there’s ACT, Serial End Point Titration & Proactive Neutralization and Electrodermal Titration (VOLS) which is based on orthomolecular medicine.

    I have a good friend who was battling Lyme’s disease and found a treatment approach based on VOLS testing and has been on an amazing road to recovery. This technique is really interesting…it determines your reaction to foods by measuring the electrostatic charge between energy meridians (as in Chinese medicine).

    Anyway, each time I’m sure I’ve found an “answer” I read conflicting sources of information. Makes for an interesting journey for sure, and it’s all good.

    Thanks for your input.

  65. Chris Kresser says

    I’m fine with you “disputing” me, but it would hold more water if there was some scientific evidence that supported what you’re saying. The problem with relying only on experience is that it’s subjective and not reliable. Read this for more on why: http://www.paleonu.com/panu-weblog/2011/1/27/n-1.html

    Don’t get me wrong – I value experience as one piece of the puzzle. But I would never advise others on dietary choices based on my experience or even the experience of a group without more evidence to support my recommendations.

    • Nicole G says

      I use my acupuncturist to clear my allergies. She does a system with the acronym NAET. So far she has helped me clear candidia, animal fat allergy, mold allergy–I breathe better now than I have in 10 years in one treatment, my son’s dad’s dog allergy, which took 2 treatments, and I could go on. Not all acupuncturists do this type of testing and treatment. My family is living proof that it works. Please look into it. It will change your life.

      • SSX says

        I just competed NAET treatment for my allergies. It was done by a chiropractor because there are no acupuncturist in my area that has the treatment. I got ‘cleared’ for gluten. tried it out two days ago to see if my usual symptoms would occur, so far nothing. I’m a believer.

  66. says

    Lisa, I would dispute what Chris says — the standard prick-test allergy tests are pretty rough, give about as many false positives as false negatives (as well as good information), but other testing can be much more accurate. In my own life this has made a great deal of difference, avoiding foods which made me break out into eczema or made me dizzy-ish (anhd other symptoms) instead of taking drugs to “ameliorate” the symptoms. (Any time a doctor prescribes you corticosteroids, he is admitting he doesn’t have a clue.)

    Regular fish oil has a lot less (if any) cod in it, so you might be fine with that.

    Sorry to be “against” you again, Chris, but this is experience for me.

  67. Chris Kresser says

    Lisa: most food sensitivity testing is bogus. There’s no support for it in the scientific literature, and I have colleagues that have drawn their own blood twice on the same day, labeled each container with a different name, sent them in to the same lab, and received completely different results for each sample. It’s not at all reliable in my opinion, and I’d think twice about not eating a superfood like CLO based on food allergy testing results.

  68. Lisa says

    Thank you, Chris for the great information. I was taking Blue Ice fermented cod liver oil but as of today have to stop. I had food sensitivity blood testing done and today received the results: cod fish is on my list of foods to avoid, so I’m assuming that includes cod liver oil.

    Now I’m searching for an alternative – any recommendations? I’ve already cut out all fried foods, etc. and am eating just meat (grass fed or pastured), vegetables and non-industrial oils/fats.

  69. Chris Kresser says

    1. A does not promote bone loss when D & K2 levels are sufficient. Read this: http://www.westonaprice.org/abcs-of-nutrition/172-vitamin-a-on-trial.html

    2. Vitamin A is one of the most important fat-soluble vitamins for immune health, along with D. So I do not understand your claim that A & D “increase” compromised immune system. That doesn’t make any sense.

    3. The liver processes toxins – it does not store them. That’s a common misconception. Toxins are stored in the fat tissue. If you’re worried about toxins, you should avoid eating the fat of conventionally raised animals and farmed fish – not liver, which is the most nutrient-dense foods on the planet.

  70. says

    We’ve seen a lot of compromised immune systems from the drugs doctors give to mental patients, and A and D can increase that; also the fact that large amounts of A can advance bone loss, already a hazard in women as they age. While there is also a large amount of nausea and vomiting, sometimes attributed to A and/or D overdosage, it’s always difficult to pin down exactly what causes it. Further, a lot of the psychiatric drugs cause diabetes or pre-diabetic symptoms, and excesses of cod liver oil exacerbates these symptoms or makes treatment more difficult.

    We also prefer fish oil over cod liver oil, as the liver is the major detoxifying organ and there seems to be no standard method of detoxifying cod liver oil; most fish oil is from dark muscle meat, less likely to harbor toxins.

    • says

      I’ve got to second Moss here. I’ve found high dose fish oil a life saver (literally) for my bipolar, but when I tried taking CLO (I got it as a free sample at the WFM where I work) it made me quite ill. I don’t know that it was the vitamin A, but it sure as heck was something.

      PS: Moss, I’d love to here from you about your practice with alternative mental health – I’m struggling to start that kind of practice myself in the Washington DC area!

  71. Chris Kresser says

    Moss: what do you mean by “toxicity”? And why do you attribute that to A & D in the FCLO? I respect your experience – I’m the last person to think you need to be an M.D. or licensed practitioner to have an educated opinion. I just think we need to be cautious about drawing conclusions from subjective experience without isolating the variables. That’s the value of clinical research, of course.

  72. says

    I am commenting on behalf of a fairly large group of people I represent, including myself, who take 4-6 grams of fish oil per day. I am not a researcher, just a peer trying to help peers make good decisions. We have experienced toxicity from cod liver oil in our group, perhaps it was a sensitive individual but then most of us taking fish oil for mental health concerns ARE sensitive.

    (There are currently over 400 members of the ALT-therapies 4bipolar Yahoogroup, and perhaps as many as 1,000 or more have passed through the group since our founding in 2002.)

  73. Chris Kresser says

    I disagree with Moss on the issue of toxicity of A & D in cod liver oil. A normal dose of FCLO (1/2 tsp/d) would yield approximately 5,000 IU of A and 1,500 – 2,000 IU of D – far below the toxic doses of each. The idea that A is toxic at doses of 20,000 IU per day is incorrect. It’s based on a poorly performed study with results that have been questioned by at least three other groups of researchers. There are many more studies showing that doses as high as 50,000 IU of A are not toxic, especially when D & K2 levels are sufficient (they often are not, which probably explains the toxic effects some experience). Fermented cod liver oil has A, D & K2 which makes it superior to other fish oils in this respect.

  74. says

    Lisa, I think the answer is, follow the money. I have not heard any of the arguments on fermented cod liver oil, but fish liver oils are very high in vitamins A and D, both oil-based vitamins which are not easily eliminated. You can very quickly overdose on these vitamins using regular dosages of fish liver oil.

    As for Dr. Mercola, he owns all or most of the stock in Neptune, the major producer of krill oil. And I believe the disadvantages of krill oil have been stated already in this discussion.

  75. Chris Kresser says

    I agree with the WAPF. Vitamin A is not toxic when D and K2 levels are adequate. I’ll be writing more about this at some point.

  76. Lisa says

    Chris – Any thoughts on Weston Price Foundation’s recommendation of fermented cod liver oil and the debate running between them and Dr. Mercola’s recommendation of krill oil?

    Also, I’m supplementing vitamin D as my levels were just tested to be at 35. Any danger in over supplementing D with the addition of cod liver oil to the D? Should I be worried abou the D/A ratios?

  77. says

    Janet,
     
    You might also investigate CoQ10 — I used it to get my doctor off my back on cholesterol levels.  I have been taking fish oil for many years, but it was not enough; it took about 9 months to get my cholesterol down, but the doctor finally stopped ordering tests.  I was taking 2-100 mg capsules per day.
     
    Moss

  78. Janet says

    Chris, I’m new to all this information. I was referred to your website because i was taking statins for “high” cholesterol. After reading your articles I told my doctor that I’m throwing away those pills, and now i’m trying to educate myself about these fatty acids. I have been using Smart Balance, which says it’s an “excellent source of omega-3″. It doesn’t list how much omega 6 there is. So i think you’d say throw it away and stick with butter?  Also, i take Fish Oil from SAMs, which has EPA to DHA 3:1. So i guess i’d better check out the other fish oil brands you mentioned, correct? thanks for educating us.

  79. Alan Beall says

    Chris, you are doing a great service.  Thank you.
    I am taking 2 capsules per day of Daily DHA from Wellness Resources. In the product’s description it says: Daily DHA™ contains 582mg of mercury-free marine lipid oil per capsule. This provides 250mg of the highly desirable DHA omega-3 oil and 35mg of EPA per capsule! Daily DHA™ (the same compound used in Leptinal®), is molecularly distilled, ensuring no heavy metals or mercury are in the supplement. It is also a modified fish oil that is very high in DHA and low in EPA. Too much EPA may thin blood too much or actually get in the way of DHA doing its job.*
    I am also following the Paleo Diet and following the 5 rules outlined in the Leptin Diet, but have not switched to grass-fed meats, which I plan to do soon.  I’ve lost 38 pounds since March, my BP is about 120/80 and have stopped taking medication. I have also stopped taking statins for cholesterol.  I take no other meds, including aspirin.  I eat almost no sugar, grains, oils, alcohol, sugar substitutes, or dairy other than pasteurized organic butter.  I do eat a lot of smoked meats.  Any recommendations?  Thanks.

  80. says

    Glad to see they came up with LNA… there is another ALA, Alpha Lipoic Acid, which is often found useful in treating adult-onset diabetes… not even in the same class of acids.

  81. ben nguyen says

    Is there a reason why ALA isn’t listed in the chart? http://chriskresser.com/wp-content/uploads/efainfoods.png
    Shouldn’t ALA, like the kind found in Flaxseed, be listed under Omega-3 with the others (LNA / EPA / DPA / DHA ).   Omega 6 shows (LA / AA).
    Does it go by another acronym?

  82. says

    Ben,
     
    The answer is, it’s not a simple 3-6-9-7 issue, and the ratios are theoretical.  Nobody yet knows what ALA is good for, other than to be converted to EPA and DHA (7% conversion according to this string).  On the other hand, GLA is an n-6, but is thought to be quite useful (I mostly deal with mental health issues, and GLA is a definite mood enhancer if nothing else).
    Olive oil contains triacylglycerols and small quantities of free fatty acids, glycerol, pigments, aroma compounds, sterols, tocopherols, phenols, unidentified resinous components and other (Kiritsakis, 1998).  I’m not sure about triacyglycerols, but if I remember right they are n-7s, which takes them clean out of the 3-6-9 thing.

  83. ben says

    So avoiding any polyunsaturated vegetable oils, it’s best to stick with saturated oils for cooking (coconut, animal fats, etc)..
    BUT why is mono-unsaturated Extra Virgin Olive Oil often touted for salad dressings?
    Seems every Mediterranean study concludes that olive oil is the key, yet  the Omega-6 to Omega-3 ratio is horibble, so what is it that  makes it so healthy?
     

    • Chris Kresser says

      Good question. Olive oil is best consumed in moderation, and I don’t recommend cooking with it.

      • Francesca says

        Same question as Carol – what on earth do we cook with? You’re also suggesting we eliminate a ton of foods that benefit our health by providing essential vitamins and minerals (eggs, whole grains, avocados and raw nuts). How do we get all the other vitamins and minerals into our body if we’re turning our whole diet upside down just to avoid omega 6?

    • says

      I think what makes olive oil particularly healthy is the omega 9, which helps control blood sugar and raise HDL. It certainly is beneficial for me, both when eaten and when used topically as a moisturizer.

  84. brauh says

    Have you seen a diet built around low carbs & low omega-6s.  I eat a low carb diet with nuts as snacks.  It is tough to eat LC and give up nuts.  Any thoughts?

    • Chris Kresser says

      That’s a great question, and a controversial one. There are prospective studies that suggest nut consumption is beneficial. On the other hand, we know that an elevated n-6:n-3 ratio is a risk factor for many diseases. One possibility that has been pointed out, which I tend to agree with, is that the n-6 in whole foods like nuts has a different effect on our bodies than the n-6 found in industrial seed oils and processed food. Whole foods like nuts contain antioxidants and n-3 in addition to n-6, which arguably mitigate the pro-inflammatory effects of n-6. Also, if you eat the nuts soaked/raw, rather than roasted, they haven’t been cooked and there’s less of a chance that the n-6 is oxidized, which exacerbates its inflammatory effect.

      I tend to think that nuts in moderation (i.e. a small handful a day, or every other day) are beneficial. However, to play it safe, it may be wise to favor nuts low in n-6 like macadamia and filberts and avoid or limit nuts high in n-6 like walnuts and brazil nuts.

  85. Rick says

    I love the picture of the sardines….chocolate sardines!  Not much of an omega 3 boost there, I would imagine.
    Take home for me  is that the most effective way to get your balance of fats in order is to do a big reduction in intake of omega 6’s.   That seems the most effective way to get the ratios aligned.

    • Chris Kresser says

      Rick,

      It’s still important to get some omega-3 even if you reduce omega-6 significantly, but yes, I think overall it’s more important for most people to focus on reducing n-6.

  86. says

    @ Alfredo – Recent studies are showing that the oversimplification is in what constitutes “good” and “bad” cholesterol.  It is not so simple that HDL=”good” and LDL=”bad”.  The pharmaceutical industry has us believing whatever they want us to, just to sell more anti-cholesterol drugs, all of which have many more effects than they are prescribed to treat.

  87. says

    Hi All. Very interesting information but complicated to be practical in the day to day living. There is a practical blood test that will give an indirect idea of your omega 6/omega 3 ratio: HDL cholesterol/triglycerides.

    Since the consumption of all omega 6 increase triglycerides and decrease hdl cholesterol and omega 3 works in the opposite direction, this ratio gives good information. The ideal ratio HDL cholesterol/triglycerides is close to 1/1.

    Eating fish has no problems, if you don’t do it too often. But if you want to supplement your diet with the proper amounts of omega 3 by just eating fish, it could be a health risk. You would have to eat fish almost every day and that could mean dangerous amounts of mercury in your nervous system.

    It is important to have in mind that there are certain conditions to get the benefits fish oil can bring.

    You need to take a good quality fish oil, free from mercury and other contaminants. That is a molecularly distilled fish oil.

    Then, you need to take a minimum amount of fish oil, krill oil or cod liver oil at a certain frequency.

    There is not an establish amount of omega 3 for any health benefit but I recommend to take at least 900 mg per day of omega 3 fats (close to 3.000 mg of fish oil), EPA plus DHA, per day. You should increase these amounts if you are overweight or you have degenerative disorders, like hypertension or high triglycerides.

    Also, you should lower your intake of omega 6 fats (mostly grains and grain oils) since omega 3 and omega 6 counteract each other in the body. The best way to reduce omega 6 fats is to eliminate all starches from your diet, that is all grains and grain oil.

    Please read more at http://www.omega-3-fish-oil-wonders.com/essential-fatty-acids-eicosinoids.html
    Best wishes,
    Alfredoe

  88. says

    @nicole I totally disagree that fish oil supplements are a waste of money. I’m taking 4 grams of fish oil per day, and they do more for me than any of the psych drugs ever did, with no “side” effects. And I’m taking the cheapest fish oil available (from Puritan’s Pride).
    As for mercury, all of the major sources of fish oil have been tested, and no mercury or other toxins have been found even in parts per billion.

  89. says

    I have recently changed my diet to include oily fish for the fatty acids, but I too am very concerned about toxicity. Looking forward to your post on the toxicity of fish.  I agree 100% on most supplement omega oils being a waste of money.

  90. Robert Jacobs says

    Seems that fish oil would have to be refined to have over 60% PUFA’s.  Not all PUFA in fish oil is EPA and DHA.  Additionally, even COLD water fish have over 20% of fat stored as MFA’s and another 20% plus stored as SFA’s.  With fish oil, you are also going to get some BAD PUFA’s, whose rapid oxidization and damage to your body is likely to interfere with any benefits from the EPA and DHA (were they even to get to your tissues without  oxidizing first!).
    I can’t believe that there are “proper ratios” of these fats.  This just does not make sense for a hunter gatherer environment in a feast/starve/feast/starve cycle or for human survival beyond the ocean.  Omega-3’s are now being promoted by the same health professionals who brought you Omega-6’s, in part, to counteract the damage of the Omega-6’s!
    Since all PUFA’s oxidize rapidly upon entering a mammal, where the body temperature is close to 100 degrees, you need lots of Vitamin E to handle these oils.  Our body temps are not those of fish and we developed in warm climates, where SFA’s and MFA’s are far more beneficial.
    Chris has made his case for DHA.  Even if he is right, he has concluded that REAL food (fish) is the best possible source of this PUFA.  And after you cook the fish, subjecting the PUFA’s to 200 degrees or more, what do you think you get from those oils which can possibly be healthy?
    If only a piece of fish per week and avoiding all possible sources of vegetable oils is what you take away from this discussion, Chris will have done a great job helping you to improve your health.

    • Suzette says

      Aside from the Asians eating their fish raw (not sure how much they cook it, but I know of sushi) I’m sure the latter two countries he named cook their fish. If this is true how are their concentrations so high?

  91. says

    Once again, we’re only comparing two groups of fats.  Dr. Stoll clearly stated that the optimum fat ratios included Omega-9s.  As I recall the stats (and my memory is far from perfect), the typical American diet (at the time of publication) was 1:9:6 (n-3:n-6:n-9) and that optimum was 1:1:1.
     
    Question:  If 1000 mg of fish oil contains 360 mg of EPA and 240 mg of DHA (standard fish oil, not special concentrates), what is the composition of the remaining 400 mg of oil?

  92. Chris Kresser says

    Got it.  I’ll talk more about the relative benefits of fish and fish oil soon.  There is evidence that the EPA &  DHA is better absorbed in whole fish than in purified fish oil.  Still, fish oil is a viable option if it’s a good product (especially if the oil is in the natural triglyceride form).

  93. enliteneer says

    Doh.. I should have stated Omega-3 supplements derived from fish oil.   For example, Life Extension,  Nordic Naturals and Health from the Sun all contain 1.3g of EPA/DHA Omega-3 from fish oil per serving.

  94. Chris Kresser says

    Please read the first article in the series if you haven’t already.  It clearly explains why plant-based omega-3 oils are not acceptable substitutes for EPA & DHA in seafood.  Less than 0.5% of the omega-3 oils in those supplements will be converted into EPA & DHA.  You’d have to take an obscene amount of flax oil each day to get the dose of EPA & DHA you need, but then you’d be taking in way too much polyunsaturated fat which is highly susceptible to oxidative damage.

    Fish oil and DHA oil from algae are alternatives to fish consumption.  I will discuss these in more detail in subsequent posts.

    • Blackstar says

      Hi Chris.

      Studies claim that ALA to EPA /DHA conversion is poor.

      But what are the omega 6:3 ratios in the study diets?

      It would make sense that little ALA is converted to EPA if the omega 6:3 ratio was high.

      eg for omega 6: 3 ratio of 10:1 (LA:ALA)
      If the affinity for the 2 PUFAs were equal, you would expect a ~10% conversion of ALA to EPA – as LA would be dominating the conversion enzymes due to its concentration being ~9x higher.

      It would be interesting to see the conversion rates of ALA to EPA if the study diet omega 6:3 ratio was 1:1 or 2:1.

  95. enliteneer says

    It’s a shame that even when you *think* you’re eating healthy (walnuts, almonds, eggs, white meat), your omega-6 to 3 ration will get out of whack!

    I know nutrients in food form are always better than supplementing single nutrients, but  it seems like taking an omega-3 supplement is the most plausible solution.   Is there a reason why that isn’t mentioned as an alternative to eating 11oz fish every day?
    Anyone have any mercury-free omega-3 supplement recommendations? ( Health From The Sun’s Total EFA?  Nordic Naturals?  Life Extension Omega-3s? Equateq Maxomega-90? )

     
     

    • Tricia says

      I was wondering if you ever found a supplement that you felt good about. I found one that ensures the purity and potency with a multistep molecular distillation process, which:
      • Concentrates and refines the omega-3 fatty acids
      • Removes lead, mercury, arsenic, cadmium, dioxins, and PCBs, and other contaminants
      • Reduces oxidation and formation of trans fats
      • Minimizes odor and fishy aftertaste
      I sound like a commercial, but I’d be glad to tell you about it. Can you contact me through this site?

    • Ken says

      Raw unprocessed omega 6 such as safflower or sunflower oils do not cause inflamation. Only the processed junk does that. A 2 to 1 ratio of 6 to 3 is morer in line with most all needs of the body where this ratio is what is in the body. Fish is to contaminated and most people can convert plant form. The body converts the amounts of dha and epa it needs and taking the pure epa and dha is very toxic. Mix (1) 8 oz. bottle of flax seed oil with 2 8oz. bottle of sunflower oil.

  96. says

    Fish oils and other food sources that have omega 3 are very important for heart health.  The title How much omega 3 is enough does depend on omega 6, but how do you really know if your omega 3 levels are optimal in your blood.  I would suggest getting an at home omega 3 blood test at http://www.omega3test.com.  The report will tell you if you are really taking enough omega 3 and where your omega 3 and 6 levels are at.

  97. tod says

    hi baba,
    what about mercury in the fish?  do you have any concerns?
    i just saw “the cove”…  yikes!
    thanks for doing all the math here.
     

    • Chris Kresser says

      Hey Tod,

      I’ll be addressing the safety of fish consumption in a future post – possibly the next one. In short, the concern has been way overblown and doesn’t take the protective effects of selenium in ocean fish into account. More to come.

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