Is it important to take omega-3 and omega-6 supplements?

We speak with experts in endocrinology and dermatology to understand who really needs these capsules and when

“We age because of our oxidative stress. Had it not been for dietary and other external influences that cause it, we wouldn’t age a day. The way we are born, we would remain that way,” says interventional cardiologist and clinical lead, cardiology, at MGM Cancer Institute, Dr Deepesh Venkatraman, during a discussion on the rise in the popularity of omega-3 supplements. When some cells in our body deteriorate and die, new cells are created. Once we don’t have the ability to make new cells, we become weak, our immunity goes down, we ‘age’, and a lot else follows. But what role do omega-3 and omega-6—otherwise known as essential fatty acids—play here? How are they different and why are they touted as essential? Does that mean consuming omega-3 supplements, like fish oil capsules, becomes essential for optimal health? 

BUILDING BLOCKS OF FAT 

Our body is made up of nutritive components of our diet like carbohydrates, fats and proteins that are fundamental for energy and to maintain the various systems and structure of the body. The basic building blocks of fat—a very important component of the body—are called fatty acids. A lot of fatty acids can be synthesised by the body on its own, but as mammals, we don’t have the ability to synthesise some ourselves. “Those fatty acids, which are essential, but which we cannot produce on our own, become much more essential, and are thus called essential fatty acids,” Venkatraman explains. We commonly know them as omega-3 and omega-6 essential fatty acids.

UNDERSTANDING OMEGA-3

“Every cell in the body is layered by a cell membrane which needs omega-3 fatty acids to function optimally. They help in maintaining healthy triglycerides, support heart health, maintain healthy blood pressure, and promote brain and eye health,” says Dr Lesley Braun, global director of Blackmores Institute, the academic arm of the Australian vitamins and supplements company that recently launched in India. “Our immune cells and the chemicals that they secrete to communicate with each other are manufactured with the help of these fatty acids,” adds Venkatraman.

Omega-3’s anti-inflammatory properties play a role in hormone balance, and in turn, the health of our skin and hair, “They keep the skin's cell membranes in good shape, which allows cells to be hydrated, and help get rid of dry, flaky scalp,” says dermatologist Dr Geetika Mittal Gupta. 

THE SOURCE

Since they aren’t produced in the body, we need to obtain our essential fatty acids from the food we eat. There are three types of omega-3s, with different levels of utility in the body, “eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), which mainly come from fish, especially deep-sea fatty fish, and Alpha-linolenic acid (ALA) found in vegetable oils and nuts (especially walnuts), flax seeds and chia seeds, which can limitingly be converted into EPA and DHA,” explains Braun. She recommends avoiding fish like king mackerel, marlin, orange roughy, shark, swordfish and tilefish, which may contain high levels of mercury. “When it comes to EPA and DHA content, a good rule of thumb is that the oilier the fish, the better, such as mackerel, salmon, cod herring and tuna.” So when choosing your fish oil supplement, it might be a good idea to check which fish it’s being extracted from, too. If you’re vegetarian, look for fruits like kiwis, raspberries and strawberries, along with hazelnuts and small seeds, says Venkatraman. 

SHOULD I TAKE OMEGA-3 SUPPLEMENTS?

It’s clear that omega-3 is an essential fatty acid, but is it as essential in capsule form? The global omega-3 market was valued at US$ 2.43 billion in 2022, with an anticipated compound annual growth rate (CAGR) of 7.8 per cent from 2023 to 2030. Unlike other supplements like those for vitamin D, B12 or folic acid that are taken in particular quantities to overcome deficiencies or conditions, there is limited scientific research and study available, with no standard guidelines in any literature that make omega-3 supplement a ‘must-have’ prescription to improve a certain condition, according to Venkatraman. In his opinion, if someone has a very strong family history of heart problems and they are unsure of what’s causing it, omega-3 supplements could be taken upon consulting a doctor.

But if you are not at high risk or have a strong family history, don’t smoke, are not sedentary or constantly stressed in life, you can skip the pill—until further studies prove otherwise. Venkatraman also believes that other risk profiles like diabetics and people with very high LDL cholesterol and triglyceride levels may benefit from consuming the capsule—a variable in addition to the significant steps taken to treat those conditions. “While there have been studies that talk about its benefits in the form of prevention of cancers, cardiovascular death and stroke, they are not very consistent,” he says.

SO MANY FISH IN THE SEA

In the case of fish oil supplements, the availability of too many can be confusing. “Polyunsaturated fats are highly volatile and vulnerable to oxidation, hence cold press and enzymatic isolation methods are used for extraction of oils,” says Dr Manoj Kutteri, medical director at Atmantan Wellness Centre. Certain key factors help determine their potency and safety, like the level of mercury, which should be the lowest. Look for oils extracted from short-lived fish like sardines; the longer the lifespan of the fish, the higher the mercury levels.

Braun suggests looking for the amount of omega-3 i.e. the EPA and DHA; the purity, by checking if they are sourced from deep sea fish and meet international standards for heavy metals and contaminants; and if they are sourced sustainably. “Choose products sourced from small fish and at the bottom of the food chain, which typically have less challenges around contamination. The fish must be harvested in a sustainable manner,” she says. Blackmores’ primary source of wild anchovies is in the Coast of Peru, “since the anchovies thrive on algae, they are a rich source of omega-3s and support eye, brain, and heart health,” Braun adds.

WHAT ABOUT OMEGA-6?

Let’s not forget the role of omega-6 fatty acids (found in red meats along with nuts and seeds) in relation to omega-3, which can be pro-inflammatory. It’s important that the ratio of omega-3 to omega-6 is maintained. “Under-availability of these essential fatty acids may decrease our immunity or increase some hormones causing ill health; at the same time, over-availability of the wrong ones can increase a disproportionate amount of immunity or oxidation and toxin levels that can harm the structures of the body,” explains Venkatraman. That’s because omega-3 and 6 fight for metabolism in the body, and both are essential to maintain a balance. “When the omega-6 to omega-3 ratio goes higher, inflammation or the oxidative stress in the body goes higher; when the ratio goes lower, we are in a healthy state,” he says. However, tests to determine this ratio are only available in a few labs. Since they are not reasonably priced, the guidelines, which require research tools and huge-scale testing, to prescribe a supplement based on this balance are limited, says Venkatraman. While he believes that these tests are much more at the research level right now, it’s important that they continue to scale.

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