Ep96: Why The Omega-6 to Omega-3 Ratio is Important • Dr Artemis Simopoulos, M.D

In today’s interview I get to speak with physician, researcher and expert in diet and nutrition, Dr Artemis Simopoulos.

She shares her vast knowledge of essential fatty-acids, (namely omega-6 and omega-3) as well as their key role in our health.

While it is vital that we maintain a balanced ratio of these fatty acids, Artemis explains how the modern diet and the introduction of vegetable oils to our food supply has made this more difficult.

We also get a chance to talk about how an imbalanced ratio causes inflammation which is an underlying cause of numerous chronic diseases we see today.

I really enjoyed this interview as Artemis has given us a thorough overview of the history behind the ratio getting worse over time in Western society and on the important things to be aware of about this ratio.

Her practical tips on how to improve the omega-6 to omega-3 ratio to be better were also super helpful. 

Special thanks to Artemis for joining me on the show.

Enjoy the episode!

Get Dr Artemis Simopoulos’ book: The Omega Diet: The Lifesaving Nutritional Program Based on the Diet of the Island of Crete at Amazon.

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Show Notes with Timestamp Links

Find summarised highlights of what we talk about during the interview.

Use the clickable timestamp links to jump direct to those points in the audio file below:

[00:20] – Introducing Dr Artemis Simopoulos, who has written extensively about genetic variation and nutrition, evolutionary aspects of diets and fatty-acids and on the role omega-3 fatty acids have on our health and disease. She has edited over 50 books and journal supplements, published over 365 scientific papers, is the author of The Omega Diet book, and so much more.

[01:23] – The Omega-3 and -6 are two families of essential fatty acids, which means they cannot be made by the body but have to be obtained in the diet. Artemis explains the importance of maintaining a good omega-6/omega-3 balance for our health.

[03:28] – It is important to keep the ratio at 1:1 (or at most 2:1 omega-6 to -3) as omega-6 is pro-inflammatory and inflammation is at the root of numerous chronic diseases.

[04:15] – An increased amount of cheap vegetable oils in our diets today has resulted in a high intake of omega-6-fatty-acids, throwing off the ratio and increasing the inflammatory effect of human metabolism.

[06:24] – Another reason the use of vegetable oils has increased over the years is due to the linkage of saturated fat and cardiovascular disease in the 1960’s. Artemis talks about Ansel Keys’ study that resulted in the demonisation of cholesterol.

[07:09] – While she was at the National Institute of Health (NIH), Artemis found people in Crete had the lowest rate of heart disease and cancer due to their diets being balanced in omega-6 and -3 fatty acids. She also found omega-3’s can not only be found in fish but also in leafy greens, snails as well as eggs from chickens that ate natural diets.

[13:35] – It is important to know that after the second world war the animal feed had changed to grain and resulted in meat, eggs and milk that is high in omega-6 fatty acids. Animals that graze in the wild have meat that contains omega-3.

[15:02] – Artemis gives us an example of the typical Crete diet which was high in omega-3 fatty acids at every meal. Eating fish twice a week does not have the same effect.

[16:44] – Right now the ratio in the UK is 15 or 18:1 and in the US 20:1. A study has shown that except for a few exceptions the world is deficient in omega-3 fatty acids and has excessive amounts of omega-6s due to the grain fed animals.

[18:22] – While organ meat such as the brain has much higher amount of DHA than the rest of the animal, the muscle of the animal has EPA and DHA if grass-fed. By changing their diet we changed our diet. The source of our food is important.

[19:25] – Artemis explains vegetarians have a high omega-6 to omega-3 ratio and vegetarian breastfeeding women have less omega-3 in their milk. Humans evolved to be omnivores with genes that have adapted to respond to these types of diets.

[20:42] – Vegetarian/vegan diets are too strict to include fish oil. So instead algae omega-3 oil is used as a replacement source of DHA and EPA. In Crete only olive oil was used, no vegetable oil.

[22:21] – It is very hard to have a balanced ratio when using vegetable oil. Artemis explains only oils high in mono-unsaturated fats are OK to use. e.g. macadamia oil. The industry has responded by developing sunflower oils high in mono-unsaturated fats.

[23:13] – Other sources of fats you can use include a combination of butter and olive oil or a combination of cheaper olive oil with canola oil can be used for cooking as canola has a ratio of 2:1.

[24:05] – There are numerous negative effects of having a high omega-6 ratio, including an increased risk of heart disease, stroke, breast cancer, arthritis etc., while omega-3 improves most of the inflammatory aspects.

[25:53] – Genetic variants in some people means that they don’t respond to omega-3 fatty acids. Artemis shares a study showing this effect. She believes eventually all of us will eat according to our genes.

[28:02] – The symptoms from the unbalanced ratio appear after many years. However in the short-term, studies have showed improvements in people with inflammatory diseases such as periodontal disease and rheumatoid arthritis as well as improved healing in people with heart disease. A larger amount of omega-3 is needed in these situations.

[31:07] – Omega-3 oil supplementation can be helpful to bring down the ratio, but also to maintain that ratio as we need to ensure we take in omega-3 everyday.

[33:01] – Often there are concerns over rancidity of fish oil supplements. FDA does not regulate supplements, so it is important to source supplements from a trusted company. A good tip is too look at the capsule and ensure it is not cloudy.

[34:24] – Artemis explains that the omega-3 does not increase bleeding time (it brings it to a normal range), rather it is omega-6 that decreases bleeding time and can lead to thrombosis and coagulation. If you are taking a coagulant the doctor needs to be made aware of your omega-3 supplementation.

[36:26] – There are two different ways we can measure our omega-6/omega-3 ratio. One accurate way is to measure red cell membrane phospholipids (this changes in 6 weeks). Another is to measure the plasma (this can change within 24 hours). Anti-inflammatory benefits also take about a month to show up.

[39:44] – There are also two ways to ask for these tests. One is measuring all the fatty acids and calculating the ratio. Another is the omega-3 index. A result below 8% puts you in the dangerous category for heart disease.

[40:32] – Omega 3 is also important for numerous other factors including cognition, chronic diseases and the ageing process. It is important to know how much is in the body to be able to determine how much EPA and DHA is needed (4g min).

[42:24] – How common is the ratio of 1:1? Everybody in the field maintains this ratio so it is quite achievable. But it is important to stop using certain oils; e.g. soybean has a ratio of 13:1

[43:52] – Artemis shares a study done by the NIH that she considers one of the most important studies ever done. The effects of an ultra processed food diet vs. minimally processed food diet.

[46:28] – For people looking to get their weight down, the type of food matters and getting the ratio down should be the primary focus for everybody. Artemis recommends eating less meat, more fish and lots of green leafy vegetables.

46:56) – Artemis explains that the CBD oil differs from endo-cannabinoid production resulting from omega 6.

[48:11] – Regardless of the seasonality of food sourcing, the ratio should remain balanced. Artemis explains if you are eating natural foods, olive oil, fish, fruits and green leafy vegetables while cutting down on the meat and avoiding vegetable oils high in omega-6, it’s easy to maintain a good ratio.

[49:06] – During pregnancy and while breastfeeding omega-3 is important for growth and development of the baby’s brain. [50:50] – The science has not advanced to the point where we can say what the benefits are of higher amounts DHA or EPA. Get a supplement that contains both.

[52:09] – Omega-3 fatty acids seem to be beneficial for decreasing the rate of age-related macular degeneration, which is why they are often recommended for improving eye-sight.

[53:39] – To contact or find out more, Artemis recommends starting with the book The Omega Diet. Under her name there are also a lot of research papers, with the latest focus being on how the balance in the omega-6/omega-3 ratio decreases the risk for obesity. This is the most cited paper for 2017 published in Nutrients.