Omega-3s are a hot topic right now—and no doubt your customers are buzzing about what they've heard and read regarding these essential fatty acids.

To answer some of their top questions on the topic, The Natural Foods Merchandiser talked to two leading experts who've done extensive research on omega-3s. Dr. Joseph Maroon is a board-certified neuro?surgeon at the University of Pittsburgh Medical Center and a professor of neurosurgery at the University of Pittsburgh School of Medicine. He's also the medical adviser for Watsonville, Calif.-based supplement company Nordic Naturals.

Barry Sears, Ph.D., is a former research scientist at the Boston University School of Medicine and the Massachusetts Institute of Technology. For the past 25 years, he has studied lipids and their role in inflammation, and the effects of inflammation in the development of chronic disease.

Here's what they had to say about these common questions:

1. It seems like there's a new study every day about how great omega-3s are, but what do they do when they get into the body to boost brain power and ward off everything from heart disease to the common cold?

Maroon: Because every cell in the body has a cell membrane made mostly out of omega-3 and omega-6 fatty acids, fish oil—a source of omega-3 FA—has the potential to affect every organ system in the body. The fact is our body does not produce FAs; they must be consumed in our diets. Therefore, a dietary deficiency of omega-3 FA can have profound adverse health effects. Not only do FAs help to make up the structure of our cell membranes, they are also used by the body on a cellular level to produce localized hormone-like compounds that can act to increase or decrease the amount of inflammation within our bodies.

Sears: [The question of why omega-3s are] almost universal in terms of their ability to improve health is because they reduce inflammation. That's the underlying cause of virtually every chronic disease, and really the underlying cause of the aging process. If you can reduce inflammation in the body, you've basically cut the Gordian Knot of aging, and you basically have a clinically proven pathway to maintain wellness as long as possible. How do they decrease inflammation? Inflammation is mediated by a group of hormones called eicosanoids. And these eicosanoids are either proinflammatory or anti-inflammatory. If these are in balance … then you are well. But what happens is invariably you start making more proinflammatory eicosanoids and the body begins attacking itself.

2. Is it possible to get sufficient omega-3s from food, or should we supplement for optimal health and benefits?

Maroon: A diet rich in omega-3 FA-containing foods would be an ideal source of these essential fats. Most natural FA sources, such as walnuts, flaxseeds, soy and canola oil, have FAs that can be converted by our bodies to omega-3 FAs, but generally not in very large amounts. FAs from fish are generally very concentrated and also with a high proportion of FAs being the omega-3 type.

But the problem today is that most natural fish sources or other seafood sources, such as shellfish, are subject to high levels of pollution, which actually get concentrated in the fat parts of the animal. This means that daily consumption of fish or seafood would possibly lead to consuming toxic levels of lead, mercury and PCBs. In fact, the federal government has set strict limits on the amount of fish and seafood we should eat due to this pollution. Therefore, this means that fish oil supplements that are certified as purified of potential contaminants are the best way to obtain the omega-3 FAs our bodies need.

Sears: Can you get enough omega-3 FAs [in your diet]? Of course you can. There is one population that is basically the largest consumers of fish in the world. These are the Japanese. And if we ask the question: "Who [lives the longest] today?" The answer is the Japanese. And if we ask a more important question: "Who has the longest health span, that is, longevity minus years of disability?" That's also the Japanese.

Obviously, the Japanese have shown you can eat enough fish. But there was a study at Tufts University several years ago where they paid volunteers $1,500 and they got all their foods free for a six-month period. But the only caveat was that they would contain the same amount of omega-3 FAs as found in the Japanese diet. The experiment was terminated after three days. All the volunteers gave their money back and said, "I cannot eat all this fish." So the answer is yes, you can do it. But the reality for Americans is we won't do it. So, how do you get adequate levels of omega-3 FAs to reduce levels of inflammation? Now we have to supplement the diet.

3. We've heard a lot about the importance of the right ratio of omega-3 to omega-6 in the diet. How can consumers tell if they've achieved that balance?

Maroon: Omega-3 FAs are associated with anti-inflammatory compounds and omega-6 FAs are associated with inflammatory compounds. Our Western diet is generally full of omega-6 FA sources. Safflower oil, sunflower oil, corn oil, sesame oil and soybean oil [which are heavy in omega-6] are just a few of the common vegetable oils found in almost every processed food we eat. We generally have no need for more omega-6 FA in our diets. In fact, research has shown our consumption of omega-6 FA has doubled in recent years and our consumption of omega-3 is reduced to the levels consumed in the 1800s.

Sears: Here are some basic signs that you're taking the right levels of fish oil: You're sleeping better through the night, you're not groggy when you wake up, you're not craving carbohydrates nearly as much, your fingernails become less brittle, you have less anxiety because you can handle stress more effectively. Those are some of the very subjective aspects that indicate that you are seeing a benefit of taking the fish oil.

Arachidonic acid is the omega-6 FA that makes the pro-inflammatory eicosanoids. The other FA is eicosapentaenoic acid, the omega-3 FA that makes anti-inflammatory eicosanoids. If we look at the balance of those two FAs, in the Japanese population the ratio is about 1.5 [meaning three parts omega-6s to two parts omega-3s]. In the Greenland Eskimos, it's about .7, or about half. For comparison, the average American is [at] about 15. We're not only the fattest people on the Earth, we're the most inflamed.

4. With so many foods now enriched with omega-3s, can we get too much of it?

Maroon: The marketing of foods supplemented with omega-3 FAs is generally just hype and a marketing tool. Generally, the level of omega-3 FAs found in these products is infinitesimal compared to what would be a recommended dose. Therefore, in general, the only practical way to consume sufficient levels of omega-3 FAs is through fish oil supplements. The dose requirements vary by age, health status and other omega-3 intake, but in general we don't recommend taking more than 3 grams of EPA/DHA (the most active form of omega-3 FAs) without consultation with your healthcare provider. Other restrictions would be if you are allergic or on blood thinners, since fish oil can also cause some blood thinning in very high doses.

Sears: [Yes], you can. You can get too much water also. Are there some populations that consume even more omega-3 FAs than the Japanese? Yes, the Eskimos. And if you consume too much omega-3 FAs, you may push inflammation down too low. So far, we've said excess inflammation is the underlying cause of chronic disease, but without inflammation you'd be a sitting duck in the real world, because you'd have no way of attacking or repelling microbial invaders, or healing injuries. And so, if you overconsume omega-3s, then there's a good likelihood that your immune response would be depressed [as happens with the Eskimos].

5. What are the safest food sources of omega-3s?

Maroon: Again, fish and seafood sources for omega-3 FAs are limited due to pollution. However, fish that are smaller and not predators are better [like sardines and anchovies]. Larger, longer-living fish that are higher up on the food chain [like tuna] will tend to concentrate the toxins more in their fat and therefore become generally more toxic to eat. Other omega-3 FA sources, such as flax and walnuts, can be consumed daily, but it would be difficult to achieve the levels needed [for optimal health].

Sears: Every fish in the world today is contaminated. You've got the horns of dilemma: To eat enough fish to get all the benefits of omega-3 FAs, like the Japanese, you take the risk of bringing in some very nasty contaminants, like PCBs and dioxins. If you look at the blood of the Japanese, their levels of those contaminants is near the upper limits set by the World Health Organization. So basically, I often opt to take concentrates. Though when I go out to eat, 90 percent of my meals are fish meals.

Bryce Edmonds is a Boulder, Colo.-based freelance writer.

Natural Foods Merchandiser volume XXVIII/number 10/p. 26, 29