Experts are saying that it might not be cholesterol you need to be worried about. Your health hangs in the balance of your omega-3 and omega-6 fatty acids.

I’ll bet my last jar of crunchy that I’ve consumed more peanut butter than you. Throughout my entire school career – from phonics to Pythagoras – I lived off four peanut butter sandwiches every day, bar the one time that rations ran out and I was submitted a day’s worth of Bovril sandwiches. Gross. I gave them away as quickly as possible. After leaving school the only thing that’s changed in my eating habits is that now I have to make the sandwiches myself.

I’ve calculated – with conservative estimates, I might add – based on the average serving of peanut butter on a sandwich that my liver has, over the years, processed a total of peanut butter amounting to 876 kilograms. That’s an entire pack of forwards. Every morning I’ll pry open the lid of a jar with the Herculean strength I have from years of mainlining the stuff, and smudge a dollop of it across my bread. I’ll usually go for the crunchy option, but sometimes you’ve got to have smooth to appreciate the crunchy. (Hey, would you look at that? Peanut butter is a metaphor for life too.) Maybe I’ll slap on some strawberry jam or drizzle some syrup on it. Wallop a slice of bread on top of it. Push down firmly. Cut diagonally. Enjoy. Repeat procedure every day until you die. Which, according to Professor Tim Noakes of the Sports Science Institute, could very likely be from Alzheimer’s.

That got my attention.

An hour before the Tim Noakes diet ruined my day I had been eating my way through the last part of that 876-kilogram story-so-far, digesting the final bit of the hypothetical eighthman of my peanut-flavoured forward pack.
We had been discussing the controversial diet he has been promoting, and I had mentioned that I frequently felt hungry. I’d done this to make chit-chat and not as a precursor to being told to change my lifestyle. He asked me about my diet and I made the mistake of being honest with my penchant for the bronze-coloured elixir.
That’s got to go,” he said, clinically. “Peanut butter is a shocker – it’s all omega-6s.”

Unlucky numbers

Peanut butter is not the root of all evil, per se. The culprit here is omega-6s – more specifically, an improper balance between omega-6s and omega-3s. “These are both essential fatty acids,” says Lila Bruk, registered dietician at Lila Bruk & Associates in Joburg. “This means that the body cannot manufacture these fatty acids themselves and thus these should be taken in through the diet.”

We’ve heard of omega-3s before. They’re the stuff that the stickers on food say is good for us. Omega-6s are the fatty acid that we hardly know about but, it turns out, we can’t get enough of the stuff. A recent study in American Journal of Clinical Nutrition examined the changes in diets between 1909 and 1999, and how this has affected the tissue concentration of fatty acids. One of the most significant changes in food consumption during those 90 years was a 1000-fold increase in soybean oil, which upped the sixes and downed the threes within us. The results revealed a the ratio of omega-6 to omega-3 fatty acids increased by 77%, according to practices common in 1909, while the estimated amount of omega-3 fatty acids in human tissues was estimated to have decreased by 38%.

“The omega-6 and the omega-3 compete for the cell membrane,” says Prof Noakes. This, he says, is where hormones are produced. “When you produce hormones in your body, they are made in proportion to how much omega-3 and omega-6 is circulated. Now, it turns out that omega-6 makes hormones slightly differently and that causes negative consequences.”

Generally speaking, omega-6 fatty acids are pro-inflammatory, says Bruk, with the exception of one omega-6, GLA, which is anti-inflammatory.
Bruk says that a high omega-6 intake may increase the risk of inflammatory conditions and blood clots, adding that research suggests an increase in the risk of certain cancers.

Noakes’s suggestion that my enthusiasm for peanut butter may increase my risk of Alzheimer’s Disease has been examined by Neurology journal, that produced a study showing people with a diet characterised by regular use of omega-6-rich foods and a lack of omega-3 rich oils or fish were twice as likely to develop dementia compared to those who didn’t eat omega-6-rich food.

A study in the journal Psychosomatic Medicine found that people whose intake of omega-6 fatty acids far exceed their intake of omega 3 fatty acids may have a higher risk of depression.

State of the Art

Prof Noakes’s interest in the ratios of fatty acids was sparked by the research findings of American biochemist Bill Lands, author of Fish, Omega-3 and Human Health and authority on essential fatty acids. “Bill Lands says if you’ve got omega-6 hormone, they’re like terrorists,” Noakes says. “They’re running around your body, stuffing it up – taking shots here, shots there. Whereas omega-3s are fine – they’re completely bland. They walk around, they just look at the buildings – they don’t do anything.”

Calling omega-6s terrorists is a bit harsh. That’s a tough stereotype to break these days. To explain the fundamentals dynamics of fatty acids with a more forgiving and appropriate metaphor, we’re going to need the help of Art Garfunkel. (I know, but bear with me on this one).

Omega-6s are the Art Garfunkels of the nutritional world, whilst omega-3s are the Paul Simons – they both work fine when they are together, but the former is only truly effective when the latter is around.

Lila Bruk says these fatty acids have been found to help with improving blood circulation, preventing blood clots, improving blood triglyceride levels and reducing risks of strokes, heart disease and inflammatory conditions like rheumatoid arthritis. Bruk adds that research suggests that omega-3s play a role in treating ADHD and may delay the onset of Alzheimers’.

Several studies at the Baylor College of Medicine in Texas have showed that the omega-3 fatty acids work effectively with statins – cholesterol-lowering drugs – to fight dyslipidemia. In keeping with the muso metaphor, this successful collaboration between statins and omega-3s thus makes statins the pharmacological equivalent of Ladysmith Black Mambazo.

So, when it comes to performing dietetic duets, your omega-6s – the gangly, ranging, curly-haired, second-fiddle-playing-troubadours within your body – are only helpful when they’re jamming with omega-3s.

Spread alert

Dr Carl Albrecht, head of research at CANSA, has been investigating the rampant Garfunkelisation – my words, not his – of margarines.
Albrecht and his colleagues had been reading studies on the trans fat epidemic in margarines in America, with reports of incidences of margarines containing up to 15% of trans fat. “ We were wondering what the trans fat situation was in South Africa,” says Dr Albrecht. “So we got 40 of them off the shelves and took them to the CSIR in Rosebank, and they worked out the fatty acid composition of every margarine.”

The results brought good news. “All of the margarines had trans fat level below the critical level of two percent.” Albrecht says this was because the margarine brands had upped their game. “They’d adapted to what was coming.”
The case on the potential dangers of margarines in South Africa was almost closed when Albrecht decide to look beyond the trans fat levels. “We looked a bit further at the analyses of these margarines, seeing we had all of them. I became interested in omega-6 and omega-3 fatty acid composition,” he says. “I’ve never before seen any information anywhere on the omega-6 and omega-3 composition of South Africa’s margarines and there it was, right in front of me. I got the computer to put the best ratios at the top and, lo and behold, these brands reshuffled and I could see this picture. It made perfect sense: the two top margarines are made with canola oil, which is known to contain a hell of a lot more omega-3 than sunflower oil.”
“We did a lot of reading up about omega-6 and omega-3, and you need both,” he says. “They’re both essential but if you’ve got too much omega-6, it’s not good for your health. There are a lot of indications that omega-6 drives inflammation which then drives cancer and heart disease. While omega-3 has the opposite effect, omega-3 pushes it all down. You want a nice balance between the two,” he says.
Dr Dwight Lundell, past chief of staff and chief of surgery at Banner Heart Hospital in Arizona agrees. He’s a veteran of 5 000 open-heart surgeries over 25 years, and he’s convinced it’s not cholesterol that we should be worrying about.
He believes that blood cholesterol is not the cause of heart disease and that recommending cholesterol-lowering diets and drugs is, “no longer scientifically or morally defensible” as it simply doesn’t work and the dietary advice has actually created the current epidemics of obesity and diabetes.
The cause of heart disease, says Lundell, is inflammation in the artery walls. Without inflammation cholesterol simply can’t accumulate. So where is this inflammation coming from? Eating large amounts of simple, highly processed carbohydrates like sugar and flour, and omega-6-rich food found in the vegetable oils like soybean, corn and sunflower.

A healthy diet contains omega-6s and omega-3s in a 3:1 ratio; the typical American diet’s ratio is 15:1 or 30:1 – which causes cells to produce pro-inflammatory compounds called cytokines which are also produced by overloaded fat cells to compensate for the imbalance.

Getting the balance right

This begs the question: how do you stop non-stop Art Garfunkel hits playing on Bloodstream FM? Lundell recommends using olive oil, butter and other fats from grass-fed animals instead of high omega-6 vegetable oils and eating whole, minimally processed foods as much as possible to lower your levels of chronic inflammation.
Fatty fish are a veritable factory of countless overachieving Paul Simons to boost your omega-3 levels, along with your brain power. Bruk recommends eating mackerel, trout, salmon, pilchards, tuna steak, sardines, yellowtail and snoek.
Most people do not have enough of omega-3-rich foods, says Bruk, and in those cases it’s advisable to take omega-3 supplements. “It is not necessary to take an omega-6 supplement though, as most people get enough through their diet,” she says.
The Abstract of Cancer Prevention Research showed just how much difference a change in diet can make. A study showed that eating a low-fat diet supplemented with omega-3-rich fish oil for four to six weeks before prostatectomy was associated with lower prostate cancer cell proliferation in prostate tissue. In the study 48 men were tested, each had prostate cancer and each were about to undergo radical prostatectomy. They were randomly assigned to follow one of two diets for the four to six weeks preceding their surgery. The Western diet got 40% of it’s total kilojoules from fat, had fat sources typical of the American diet, and a high omega-6-to-omega-3 ratio. The low-fat diet got 15% of kilojoules from fat and included fish oil supplements. When researchers examined specimens from the removed prostate tissue they found a lower rate of cell division among men who had been on the low-fat diet with fish oil. Reducing proliferation reduces the chances that cancer will spread beyond the prostate.

It’s been five months since I’ve had a mouthful of peanut butter – the longest lifespan a jar of crunchy has ever had in my cupboard. The affair is still on hold, for now. Although I’ve been seeing other sandwich fillings, I’ve spent a lot of time looking forward to a trembling moment of weakness followed by an indulgent, Garfunkelesque relapse. And then I’ll quickly have a Paul Simon-laden tuna sandwich. The omega-6 and omega-3 reunion is only a motion away.

The best sources of omega-3

Registered dietician Lila Bruk of Lila Bruk & Associates recommends adding these to your shopping list
◦ Fatty fish
◦ Flaxseed or linseed oil
◦ Chia seeds
◦ Eggs from hens fed an omega-3-rich diet
◦ Walnuts

Spread ’em

The top ten margarines with the best six-to-three ratio
1 Blossom Canola
2 Blossom Canola Light
3 Cardin Tub
4 Nuvo Canola
5 Rama Idea
6 Flora Olive Light
7 Flora Proactive
8 Flora Extra Light
9 Flora Light
10 Flora Regular

– By Ian McNaught Davis