You have probably read hundreds of recommendations to eat more polyunsaturated fatty acids (PUFAs), which in practice means omega-6 and omega-3. If you shop at Whole Foods, you may see Udo’s Blend, a blend of PUFAs which includes both omega-3 and omega-6, as if someone isn’t getting enough omega-6. It is unquestionable that omega-3 is beneficial but there is plenty of evidence that omega-6 is harmful, starting with the Israeli Paradox. Why are they lumped together?
A just-published paper in the British Journal of Nutrition makes several new points about the relation of PUFAs and heart disease. Its main point is a new look at experiments in which one group was given more PUFAs than another group.Â Those experiments — there are only about eight — can be divided into two groups: (a) experiments in which the treated group was given both omega-3 and omega-6 and (b) experiments in which the treated group was given only omega-6. The two groups of experiments seem to have different results. In the “both” experiments the treated group seems to benefit; in the “only omega-6” experiments, the treated group seems to be worse off. Suggesting that omega-3 and omega-6 have different effects on heart disease. They have been lumped together because experiments have lumped them together (varied both at the same time).
Experiments that try to measure the effect of PUFAs usually say they are replacing saturated fats. More PUFAs, less butter. The paper points out that studies of the effect of PUFAs have at least sometimes confounded reduction in saturated fats with reduction in trans fats. Benefits of the change may be due to the reduction in trans fats, not the reduction in saturate fats.
The paper also makes several good points about the Finnish study, a classic in the fat/heart disease literature. Supposedly the Finnish study showed that PUFAs (replacing saturated fats) reduce heart disease. It had hundreds of subjects but they were not randomized separately. The subjects were divided by hospital. Everyone in one hospital got one diet, everyone in a second hospital got a different diet. This meant it was easy for there to be confoundings (i.e., the treatment wasn’t the only difference between the groups). Indeed, there were big differences in consumption of a certain dangerous medication and margarine between hospitals. (Margarine is high in trans fats.)
Perhaps the first author, Christopher Ramsden, who works at NIH, is responsible for the high quality of this paper.
Thanks to Susan Allport.