Omega 3 Vs. Omega 6 Fatty Acids for PCOS

There are thousands of nutrition studies done on nutrition-related topics, and oftentimes the results of one study seem to contradict the results of another.  Scientists debate which results are relevant.  The media celebrates and sounds the horn when any study results give the slightest hope of an indication that foods long known to promote poor health (bacon, butter) are suggested to be harmless. (By the way, the authors of that 2014 article suggesting butter and saturated fat were wrongfully accused of causing disease had to post a new version of the publication shortly after it appeared on the website of the Annals of Internal Medicine to correct several major errors.  Bacon & butter still don't create health.) *

In 2010 in Nutrition & Metabolism,  Burghardt and colleagues published research suggesting that dietary factors do not affect everyone in the same way.  Most of us have had a friend or family member who could eat anything they want without gaining weight or having an elevated cholesterol level.  While others seem to be very easily affected by the amount of food and type of nutrients consumed.  Their study results suggest that some of us are more sensitive to the type of fat we eat than others.  Specifically, some of us may have worsening insulin resistance when we eat more n-6 fats, whereas some of us may be just fine.  If you have PCOS, then you most likely have insulin resistance.  Eating relatively more n-3 and less n-6 fats can help improve this metabolic condition.

We've known for some time now that n-6 fats tend to be inflammatory, while n-3 fats tend to have anti-inflammatory effects.  This is especially true for individuals who already suffer diseases or conditions related to inflammation, such as the metabolic syndrome, insulin sensitivity, PCOS, and obesity, etc.  More than absolute amounts of fat, dietary ratios of n-3:n-6 have been identified as important in affecting all of the above conditions.  Increasing this ratio can reduce markers of inflammation and improve markers of health such as lowered triglyceride levels, lower heart rate and blood pressure, increased HDL cholesterol, and decreased insulin resistance.

What this research suggests is that the ratio of n-3:n-6 may be much more important for individuals prone to insulin resistance and inflammation than those not prone to such conditions. That could mean that for people with PCOS, pre-diabetes, diabetes, high blood pressure, dyslipidemia, etc., increasing n-3 intake and simultaneously decreasing n-6 intake will improve those conditions.  

So, how exactly can you improve your dietary intake of n-3 versus n-6?  Below is a graph depicting the fatty acid profile of a number of commonly consumed oils.  But, in a nutshell (ha!), the whole plant-based food sources highest in n-3 fatty acids are flaxseeds, flaxseed oil, chia seeds, soybeans and walnuts.  The foods highest in omega 6 fats are almonds, peanuts, cottonseed oil, sunflower oil, sesame oil, and corn oil.  You should choose a diet moderate or lower in fat, and most of that fat should be unsaturated - either mono-unsaturated or poly-unsaturated.  The polyunsaturated fats should be more n-3 and limited n-6.  This is especially true if you are prone to any of the conditions related to metabolic syndrome.

You can increase your n-3 fat intake by adding chia seeds to your morning green smoothie or oatmeal.  
My favorite smoothie recipe is:
1 cup plant-based milk (usually soy, unsweetened, nonGMO--or almond milk, unsweetened)
2-3 cups leafy greens
1 - 1/2 cups frozen blueberries or tart cherries
1 Tablespoon chia seeds OR ground flax seeds

For oatmeal, I like to make overnight oats (ONO) as follows, eating it either cold or hot within 12-72 hours:
1/2 - 1 cup oats (NOT "quick oats")
1 cup plant-based milk
1 Tablespoon chia seeds
1 Tablespoon ground flaxseeds
1 cup berries (frozen blueberries are my go - to choice)
1 chopped medjool date for sweetness 

You can use walnuts for an afternoon snack.  And, though all calories are important in weight management, studies suggest that individuals who eat whole nuts and fruit as snacks do not gain weight... I like LaraBar brand snack bar, because it is made from only fruit and nuts.  Another good snack idea would be 1 pear (or your favorite in season fruit) and 2-4 walnut halves.

To improve those n-3:n-6 ratios, you also need to avoid consuming the n-6 fats.  Typically, bottled salad dressings and sauces are made of those high n-6 oils.  Processed and packaged foods, such as crackers, cookies, and chips are also commonly are high in n-6.  Instead, you can make your own dressing at home using flaxseed oil or olive oil (mostly mono-unsaturated fat), herbs, mustard, lemon juice, vinegar, etc.

"optimal recommendations regarding omega-3 and omega-6 intake may have differing effects in healthy subjects relative to metabolic syndrome patients."

--- Burghardt, et al

Fatty Acid Profile of Nuts & Seeds [SFA=Saturated Fatty Acids, MUFA=Monounsaturated Fatty Acids, n-6=omega6]   Prepared by Kim O. Smith, MS, RD 2016 using USDA Nutrient Database

*http://www.sciencemag.org/news/2014/03/scientists-fix-errors-controversial-paper-about-saturated-fats

Nutrition & Metabolism 2010 7:53  Burghardt et al

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