If you’ve been on the planet long enough to remember the low-fat craze in the 80’s, you have experienced the demonization of fat. We were told that all fat (but especially saturated fat) and cholesterol were bad for us. But the low-fat diet did not improve our health as a nation. Instead the rates of obesity, heart disease and type 2 diabetes rose dramatically.

The flawed studies that led to the low-fat trend have since been debunked and more recent studies demonstrated that neither saturated fat nor dietary cholesterol cause harm in humans.

Today, research indicates that what we should focus on is eating a balance of healthy fats (Omega-3, Omega-6 and Omega-9), and eliminating unhealthy trans-fats from our diet. We can also choose grass-fed meat and pastured poultry over animals that are grain-fed to improve the fat-profile in these foods.

As for cholesterol, we now know that total cholesterol is less important than HDL/LDL particle size. Over 50% of those who have a heart attack have normal cholesterol levels. So if you have “normal” cholesterol levels, you’re not necessarily out of the woods. This is why functional medicine practitioners don’t rely on the basic cholesterol blood tests that only provide four numbers: total cholesterol, total triglycerides and HDL/LDL. If you have a family history of heart disease, you need a more complete picture of your lipids and other markers of inflammation. (That is a topic for another post.) Back to balancing healthy fats.

What are Healthy Fats?

Omega-3 Fatty Acids

These polyunsaturated fats are called “essential fatty acids” because they are essential in the human diet and cannot be manufactured in the body. There are many types of Omega-3 fatty acids, but the most common are:

• Eicosapentaenoic acid (EPA): EPA’s main function is to produce eicosanoids, which helps reduce inflammation. Chronic inflammation has been linked to heart disease, diabetes, cancer and Alzheimer’s. EPA has also been shown to help reduce symptoms of depression.

• Docosahexaenoic acid (DHA): DHA is extremely important for normal brain development and function. DHA makes up 8% of brain weight.

• Alpha-linolenic acid (ALA): This fatty acid can be converted into EPA and DHA by your body, but not very efficiently. You body uses ALA mainly for energy.

Omega-3 fats make up part of cell membranes and deliver many important benefits including heart, brain and liver health, reducing inflammation and maintaining a healthy weight. They have been shown to help prevent asthma and dementia and promote healthy bones.

Food sources of EPA and DHA include oily cold-water fish and algae. According to the U.S. Institute of Medicine, adult men should get 1.6 grams and women 1.1 grams per day or eat fish at least twice a week.

Good sources of ALA are walnuts, flax and chia seeds.

Omega-6 Fatty Acids

Like Omega-3s, Omega-6s are also polyunsaturated, essential fatty acids that must be obtained through your diet.

The most common Omega-6 is Linoleic Acid (LA) which can be converted to other Omega-6 fats including arachidonic acid (ARA). ARA is used to produce eicosanoids (like Omega-3 EPA) but these are more pro-inflammatory. In excess pro-inflammatory eicosanoids increase inflammation and the risk of inflammatory disease.

Omega-6 fats are primarily used for energy, but some Omega-6 fats have also shown other benefits. For example, Gamma-linolenic acid (GLA) found in borage oil and evening primrose oil can reduce symptoms of rheumatoid arthritis. Another omega-6, Conjugated Linoleic Acid (CLA) has been show to help achieve a lean body mass.

The U.S. Institute of Medicine suggests that the adequate amount of Omega-6 per day is 17 grams for adult men and 12 grams for women.

Sources of Omega-6s include nuts and seeds, soybean, safflower, sunflower and corn oil as well as mayonnaise made with these oils

Omega-9 Fatty Acids

Omega-9 fats are monounsaturated fats and the most abundant fats in most cells of the body. They are non essential fats as the body can make them. Therefore there are no recommended intakes for omega-9 fats however consuming these fats instead of other types of fats may be beneficial.

Omega-9 benefits include reducing triglycerides and (bad) VLDL cholesterol and improving insulin sensitivity.

Oleic acid is the most common omega-9 fatty acid and the most common monounsaturated fatty acid in the diet.

Good sources of omega-9 fats include: olive oil, avocado oil, almond oil, cashew oil, and peanut oil.

Omega-3 -6 -9 Balance

For us to stay healthy, we need to eat healthy fats in balanced ratios.

Unfortunately the Standard American Diet (aka Western Diet) contains too much omega-6 fatty acids and too little omega-3 fatty acids.

The recommended ratio of Omega-6 to Omega-3 fatty acids in the diet is 4:1 or less. However, the Western diet has a ratio between 10:1 and 50:1. The high amounts of Omega-6 are due to the prevalence of soybean oil and other highly processed vegetable oils used in cooking and processed foods. Therefore, most people eating a Western diet may need to reduce foods that contain Omega-6 fats and increase Omega-3 fats.

To learn where you fall in the omega-6 to omega-3 ratio, there are lab tests available that are useful for anyone who wants to ensure they are in the recommended range. It is especially helpful for anyone with a family history of cardio-metabolic disorders.

Another way to gauge your Omega-3 to Omega- 6 ratio is to take a look at the foods in your pantry, fridge and freezer. Scan the ingredient labels and you’ll probably find the most common fats are soybean, cottonseed, sunflower and corn oil. Then assess the amount of Omega-3s you consume regularly. Do you eat cold water oily fish at least twice a week?

Healthy Swaps to Balance Fats in Your Diet

• Replace cooking oils in your pantry that are high in Omega-6’s (corn, sunflower, soybean oil, cottonseed oil) with high omega-3 oils (flax seed oil) or minimally processed Omega-9 oils (avocado or olive oil) . Check the label for the oil’s “smoke point” to ensure you’re using the right oil for your cooking method. Flaxseed oil has a low smoke point and should only be used for dressings or very mild heating. In general most oils should be kept in a cool, dark place to avoid rancidity. Some oils including flaxseed are best refrigerated to maintain freshness.

• Avoid canola and safflower oil unless they are cold-pressed and organic.

• Most store-bought salad dressings are made with highly processed vegetable oils (soybean, canola, sunflower or corn oil) that are high in Omega-6 fats or overly processed. Switch to healthier brands such as Braggs and Primal Kitchen that make dressings with avocado and olive oils (Omega-9 fats).

• If you are eating out, avoid fried foods as they contain the highest amounts of unhealthy oils. Choose steamed, baked, sauteed or grilled instead.

• Since many processed foods tend to use Omega-6 oils as they are less expensive, check the labels carefully, or better yet, avoid processed foods altogether. Sometimes you can find a healthier option by switching brands.

• Eat wild-caught, oily cold-water fish (sardines, herring, Atlantic mackerel, Alaskan salmon, and cod) at least twice a week to get adequate omega-3 fats. Avoid large species of fish such as Albacore tuna, swordfish, orange roughy, tilefish, shark and marlin as they contain the highest levels of mercury, pcbs and other toxins. If you don’t like fish, consider taking a fish oil supplement. You can find our favorites in this post as well as tips keep your fish oil supplements fresh and avoid fish burps.

• Avoid artificial trans-fats/partially hydrogenated oils. The U.S. ban on artificial trans-fats went into effect in June 2018. However, there may still be products containing trans-fats on the store shelves—or in your pantry. Trans-fats are found in many processed foods such as microwave popcorn, baking mixes, frostings, shortening, as well as refrigerated and frozen foods.