Many experts estimate that approximately 80 percent of Americans consume an insufficient quantity of essential fatty acids (EFA’s). As a matter of fact, we here at In Good Health have been concerned about this issue ever since the low-fat craze hit its peak 15 years ago. Fatty acid deficiencies can lead to a variety of serious and degenerative health conditions, including diabetes, depression, irritability, arthritis, obesity or weight gain, eczema (dry skin), allergies, heart disease, stroke, cancer, chronic fatigue, and hormonal imbalances leading to adrenal and thyroid hypofunction.

Over 2,000 studies have demonstrated a wide range of problems associated with EFA deficiencies. Recent studies have shown that omega-3 oil supplementation can lower LDL cholesterol and triglycerides, improve insulin production in diabetics and decrease high blood pressure.

Because many of these studies have come out only in the past several months, and many of them have contradicted earlier studies, we have seen an inordinate amount of media coverage on the topic of EFA’s. Since such a level of media coverage typically generates questions and confusion, we have been very busy answering these questions and thought that perhaps we could save ourselves a considerable amount of time while offering our insights to those of you who may have questions, but just haven’t asked them yet.

So this article reports our responses to the questions we have received most frequently about essential fatty acids, and even some more about not-so-essential fatty acids.

1. What are essential fatty acids and how do they work?
Essential fatty acids (EFA’s) are fatty acids that, like vitamins and minerals, are needed for various essential functions in our bodies, but that our bodies cannot manufacture from other dietary fats or nutrients; therefore, we must consume them in our diets.

In short, these nutrients provide our bodies with energy to perform some of the most basic and essential physiological functions. EFA’s function in our bodies as components of nerve cells, cellular membranes (each cell in the body is surrounding by a layer of fat), and hormone-like substances known as prostaglandins. Prostaglandins and EFA’s keep the body in good working order by performing such functions as:

i. Producing steroids and synthesizing hormones
ii. Regulating blood pressure
iii. Regulating response to pain, inflammation, and swelling
iv. Mediating immune response (implicated in multiple sclerosis and rheumatoid arthritis)
v. Regulating bodily secretions and their viscosity
vi. Dilating or constricting blood vessels
vii. Directing endocrine hormones to their target cells
viii. Regulating muscle and autonomic reflexes
ix. Regulating the rate at which cells divide (mitosis)
x. Maintaining the integrity of cellular membranes
xi. Regulating the flow of nutrients in and out of the cells
xii. Transporting oxygen from red blood cells to the tissues
xiii. Maintaining proper kidney function and fluid balance
xiv. Keeping saturated fats mobile in the blood stream
xv. Preventing blood cells from clumping together (the cause of atherosclerotic plaque and blood clots, a cause of stroke)
xvi. Mediating the release of pro-inflammatory substances from cells that may trigger allergic conditions
xvii. Regulating nerve transmission, especially in the brain
xviii. Being the primary energy source for the heart

2. What Causes Fatty Acid Deficiencies?
Here are several reasons in brief:
i. Daily consumption of refined polyunsaturated oils such as canola, corn, sunflower, soy and other processed vegetable oils;
ii. Consumption of trans fatty acids, such as partially hydrogenated oils found in margarine and baked goods.
iii. Low-fat diets;
iv. High intake of refined sugar which compromises ability to metabolize healthy fats and oils;
v. Inability to break down and assimilate fats because of insufficient stomach acid and/or bile insufficiency; and
vi. Chronic stress because it interferes with the body’s ability to convert certain EFA’s into their usable form.

3. What is the difference between a fat, an oil, a fatty acid, and a lipid?
The technical name for fats and oils, collectively, is lipids. Lipids are basically made up of molecules called triglycerides. If the collection is liquid at room temperature, it is called an oil; if it is solid, it is called a fat. A triglyceride is formed from three fatty acids attached to a glycerol molecule. A fatty acid is an organic molecule made of a chain of carbon atoms. These chains come in varying lengths and configurations, which determines their classification and name. For a more detailed and technical explanation of fats and oils, refer to Mary Enig’s excellent book, Know Your Fats: The Complete Primer for Understanding the Nutrition of Fats, Oils, and Cholesterol.

4. Which fats are considered essential?
Essential fatty acids are those compounds that contain omega-3 and omega-6 fatty acids.

The omega-3 fatty acids are Eicosapentaenoic Acid (EPA), Docosahexaenoic Acid (DHA), and Alpha-Linolenic Acid (ALA). EPA and DHA are found in fatty cold-water fish such as wild (not farm-raised) salmon and in meat from wild game and free-range animals raised on green leafy vegetables, such as grass-fed beef and free-range chicken eggs and in smaller amounts in some green leafy vegetables. Studies show that meat from grass-fed cows has two to six times more omega-3 fats than that from grain-fed cows and free-range chickens have 100 percent more omega-3 fatty acids than do grain-fed chickens, and eggs from free-range chickens have 400 percent more omega-3 fats (see The Fat Flush Plan, Ann Louise Gittleman). ALA is less prevalent in foods because it can actually be converted to EPA by the body, but higher amounts occur in flax seed oil, walnuts, black currant seed oil, pumpkin seeds, and hemp seed oil.

The omega-6 oils are Linoleic Acid (LA) and Gamma Linolenic Acid (GLA). LA is found in most vegetable oils, nuts and seeds. The body may also convert LA to GLA. GLA is found in evening primrose oil, black currant seed oil, borage oil, and hemp seed oil.

Another form of LA is conjugated linoleic acid (CLA), which discovered only 20 years ago and has been credited in more than 300 studies with reducing the body’s ability to store fat and promoting the body’s use of stored fat for energy, thus, being beneficial in the prevention and treatment of heart disease, cancer, and diabetes. CLA occurs in grass-fed cows and other grazing animals and, therefore, is found in meat, whole milk, butter, cheese, and full-fat yogurt from grass-fed farm animals.

5. How do I know I am deficient in essential fatty acids?
The quick and more costly method is a special blood test, which can cost around $400. The other way is become aware of symptoms that may indicate a deficiency. A more acute deficiency may be implicated by eczema (dry, rough, or cracked skin), frequent fatigue, difficulty concentrating, irritability, joint pain or stiffness, or weight gain. More serious conditions can result from chronic deficiencies, which may be implicated by diabetes, depression, arthritis, obesity, allergies, heart disease, stroke, cancer, chronic fatigue, and hormonal imbalances leading to adrenal and thyroid hypofunction.

Aside from these symptoms, if you do not eat any of the foods mentioned earlier that contain EFA’s (e.g. , fatty fish, raw nuts and seeds) on a daily basis or take EFA supplements, it is fairly safe to say that you are deficient in EFA’s and that it is only a matter of time before you begin experiencing one or more of these symptoms.

6. Can I get my essential fats from my diet or do I need to supplement?
Yes, you can get all of the EFA’s you need from foods, but this is not easy. The fact is that if you are deficient or have not been eating enough of the foods that contain these essential nutrients, you will need to supplement, at least initially, in order to address the deficiency. EFA supplement contain higher doses of EFA’s in a form that is easier to digest and assimilate than what you find in food. This is why supplements are used to address deficiencies and imbalances. Food sources of EFA’s should be consumed as a maintenance program once you get your levels back up. And how do you know when that is? When your symptoms go away.

All EFA supplements, whether in liquid or gel-cap form, should be kept refrigerated to prevent rancidity.

7. Is one type of EFA more important than another, or should I supplement with equal amounts of each?
Since most of us are deficient in the omega-3 variety, it is best to supplement with either fish oil or flax oil, initially. Our bodies function optimally with 1:1 omega-3 to omega-6 ratio. Since the typical American consumes far more vegetable oils and meat and dairy products from grain-fed beef and chickens (which are higher in omega-6 fatty acids), we have altered that ratio, in many cases to the degree of 20:1. This represents a deficiency or an imbalance.

If you do not eat much meat at all and very little raw, leafy green vegetables, then chances are you are deficient in both omega-3 and omega-6 fatty acids. In this case, you would begin with a more balanced EFA supplement, e.g., one that contains a blend of borage or evening primrose oil and flax or fish oil.

Ideally, you will only take these supplements until the deficiency has been addressed or balance has been restored. However, if you wish to enjoy the added protection from heart disease, diabetes, and stroke as described in connection with the studies mentioned earlier, you may choose to continue EFA supplementation for life.

8. How important is quality with EFA supplements?
As with most supplements, you basically get what you pay for. Sure, brands are simply overpriced, but this is rare because the market is so competitive. With all of the research coming out lately to support EFA supplementation, virtually every nutritional supplement manufacturer is getting in on the game and quality varies tremendously because manufacturers know that the average consumer will simply buy the cheapest brand without conducting any investigation into the source and/or quality of the supplement.

What you need to be aware of is that if the EFA’s are extracted from a contaminated or inferior source (such as rancid or genetically engineered oils) or they are exposed to inferior processing methods that may expose them to excessive heat and oxygen, your body will not assimilate them properly and you will not derive the same benefit from the oil. In other words, if the supplement is of inferior quality, you are throwing your money away. (For more on the importance and explanation of nutritional supplement quality, see my article entitled Nutritional Supplements – Should You Take Them And Does Brand Name Matter? at http://www.ingoodhealthinc.com

A good quality EFA supplement is made from fresh sources using the cleanest, most minimally invasive extraction process and the purest sterilization process to rid the oils of all pesticides and toxic metals, including mercury (*For specific brand names that meet these standards, contact our office). This sterilization process actually makes the supplements a better source for fish oil than the fish itself because of the mercury and other toxins common in most fish.

9. What are Trans Fats and why are they bad for us?
The refinement process subjects these fats and oils to excessive heat, light, and/or oxygen, which actually alters the molecular structure (denatures) of the fat or oil. The term trans literally means that the formerly C-shaped (cis) polyunsaturated fatty acid is transformed to an unnatural straight-shaped fatty acid molecule. Hydrogenation is caused when liquid polyunsaturated fatty acids are infused with hydrogen molecules causing an occupation of the formerly unsaturated bond with hydrogen. The result is a semi-solid or solid fat substance that does not represent anything in nature. Margarine is the most common example of trans fat substance. Oils are hydrogenated in an attempt to stabilize the then so that they will have a longer shelf life. It is essentially a preservation process. The problem with this thinking is that the resulting compound cannot be assimilated by the human digestive system and there is some evidence to suggest that they may actually promote free radical production and disrupt our immune system and other metabolic processes.

These refined and processed compounds actually inhibit the body’s ability to use the essential fatty acids that are consumed. And because these synthetic fats have been prevalent in our diet for only about a hundred years, our bodies have not yet had time to evolve to the point where they can handle these deadly compounds.

Some studies have shown that trans fats directly damage blood vessels and can dramatically lower HDL cholesterol.

10. What are the differences between saturated, polyunsaturated, and monounsaturated fats and in which category to EFA’s belong ?
A fatty acid is saturated when all available carbon bonds are occupied by a hydrogen atom. They are highly stable and form a solid or semisolid fat at room temperature. Because of their stability, they do not normally go rancid, even when exposed to heat and oxygen. Your body makes saturated fatty acids from carbohydrates, which is why they are not considered an essential fat. In the diet, saturated fatty acids are found in animal fats and tropical oils. However, some animal fats, especially from free range, grass-fed animals consist of more unsaturated than of saturated fatty acids. All natural foods contain a little of both saturated and unsaturated fats. Contrary to popular belief, we do not need to avoid saturated fats in the diet. In fact, saturated fats play a vital role in the health of our bones (for calcium assimilation), they protect the cells from infection, they are also needed for proper utilization of essential fatty acids, and they are rich sources of the fat soluble vitamins A, D, E, & K.

Monounsaturated fatty acids have one double bond in the form of two carbon atoms double-bonded to each other and, therefore, lack two hydrogen atoms. Your body makes monounsaturated fatty acids from saturated fatty acids and uses them in a number of ways. They are relatively stable (not as much as saturated fatty acids) and therefore, do not go rancid easily. They tend to be liquid at room temperature and semisolid when refrigerated. Olive oil is mostly monounsaturated. Some other oils that are high in monounsaturated fatty acids are almond, pecan, cashew, peanut, and avocado, which all make excellent snacks.

Polyunsaturated fatty acids have two or more pairs of double bonds and, therefore, lack four or more hydrogen atoms. Your body cannot make these fatty acids and hence they are called “essential”. They are very unstable and, therefore, go rancid easily. They are liquid, even when refrigerated. Polyunsaturates should never be used for cooking because of their instability. Some foods that are higher in polyunsaturated fatty acids are corn oil, soy oil, safflower oil, sunflower oil, grape seed oil, and most vegetable oils.

11. How much EFA do I need and how often should I take it?
Generally, you need one to two grams of EFA for every 50 pounds of body weight. But before you start pounding bottles of EFA’s supplements, remember that you are getting some of this from the foods mentioned above. The amount you supplement with depends on the degree of your deficiency. The best approach is to begin including the foods that contain these essential oils into your daily diet. If, based on the criteria described earlier, you are deficient in EFA’s and/or you dealing one of health conditions mentioned above, you generally want to begin taking 3-6 grams per day for every 50 pounds of body weight.

12. Should I expect any side effects from supplementing with EFA’s?
If you have difficulty breaking down fats, you may experience nausea, gastric reflux, or indigestion. This means that your stomach does not produce sufficient hydrochloric acid and/or your liver and gall bladder do not produce enough bile. These are essential for emulsifying fats and allowing your body to assimilate them. This problem occurs most commonly among older adults, vegetarians, and chronically stressed people. In this case, you will want to take some betain HCL and whole beet extract supplements with the EFA’s. The products we recommend are Hydrozyme and Beta-TCP (use Beta Plus if you no longer have a gall bladder) by Biotics. These may be obtained from our Wellness shop here at the Lifestyle Center or at our online store at http://www.ingoodhealthinc.com

13. Is it possible to get too much essential fatty acids in your diet?
Yes, but it is difficult to do so through diet alone. In other words, the only way you would overdose on EFA’s is if you were taking too many EFA supplements. Typically, your body will give you warning signs if it is getting too much of such an essential nutrient. You just need to be aware of the signs and address them as they arise. Some things you might experience if you are taking too much EFA’s are gastric reflux, nausea or indigestion. And even in these instances, the symptoms are commonly caused by a stomach acid or bile insufficiency as described directly above, which may be easily addressed with proper supplementation.

14. Does cod liver oil qualify as an EFA supplement?
Yes, cod liver oil is a potent source of omega-3’s. However, it also contains high levels of the fat soluble vitamins A & D. This is acceptable if you know you are deficient in these nutrients, but it is possible to overdose on these nutrients. Fat soluble vitamins in excessive quantities can be toxic to your liver and should only be taken under the guidance of a qualified health professional. It is true that people tend to require more dietary vitamin D in the winter months because there is much less sun exposure (sun is our richest source of vitamin D). And vitamin A deficiencies are more common than most people think because many people have difficulty converting the beta carotene from vegetables into vitamin A due to liver and gall bladder challenges. However, the doses should be monitored by your health care professional (nutritional consultant or physician who is knowledgeable about nutrition) to prevent toxicity. Generally, cod liver oil is not a preferred source of EFA’s for everyone. (For more on the importance of Vitamin D how to make sure you are getting enough, see my article on the topic at http://www.ingoodhealthinc.com )

15. Where can I find EFA supplements and are they expensive?
Most health food stores and even some grocery stores now carry flax seed oil and other EFA oils and capsules. We here at In Good Health also carry professional grade EFA supplements and would be happy to recommend one to you. Remember, quality is extremely important when it comes to this highly unstable nutrient. Consequently, the cost will vary depending on quality.

16. What are triglycerides and where do they come from?
Triglycerides are compounds comprised of three fatty acid chains attached to a glycerol molecule. While elevated triglycerides in the blood have been positively linked to heart disease, these triglycerides do not come directly from dietary fats. They are made in the liver from any excess sugars that have not been used for energy. Someone who eats a lot of refined sugar and white flour products, such as breads, pastas, cereals, or sweets will typically have elevated blood triglycerides.

17. What kinds of fats/oils should I use for cooking?
Polyunsaturated oils, such as flax, corn, soy, and safflower oil should never be used for cooking because of their instability. When polyunsaturated oils are exposed to heat, the chemical structure of the EFA’s are changed to toxic derivatives known as lipid peroxides. In fact, it is generally not good to consume corn, soy, and safflower oil raw because they are very often rancid by the time they reach the store shelves.

The best oils for cooking are extra virgin olive oil, organic butter, and coconut oil because they are more resistant to the damaging effects of heat.

18. Isn’t Canola Oil a healthy and safe oil to cook with?
Contrary to popular belief, canola oil is not optimal for cooking. Although it is more stable than more polyunsaturated oils, it tends to be highly refined and often genetically engineered. One brand of canola oil we can recommend is Spectrum, but we still prefer olive oil for cooking.

19. Do children need these fats? And if so, at what age and how much do they need?
Absolutely! In fact, children need these fats more than adults. This is because the human brain is comprised of anywhere from 65 to 75 percent fat. And since most of our brain’s development and growth occurs during these few several years of life, this is the time when these fats are more essential than ever. A child who is deprived of the necessary amount of EFA’s has an increased chance of experiencing behavioral disorders, such as Attention Deficit Disorder (ADD) and hyperactivity during childhood and even developing more serious conditions such as Autism and Muscular Dystrophy later on. In fact, ADD and hyperactive children have been successfully treated with EFA supplementation.

There is no minimum age to begin introducing EFA’s into a child’s diet. Children who are breast fed will get a natural, high quality form of EFA’s from the mother’s milk. After the child is weaned, it recommended that the child be fed runny egg yolks from free-range chickens several times per week. You may even supplement with EFA oil in liquid form by the teaspoon once or twice per day. When the child reaches preadolescent age, cod liver oil is another good source, but no more than a teaspoon per day.