My father-in-law, a Minnesota dairy farmer, was a man that occasionally enjoyed a little bread with his butter. No meal setting was complete without a generous supply of the smooth, yellow spread. The introduction of oleomargarine upset him greatly.

His dislike of margarine was not based solely upon the potential economic effect on his business. He saw this interloper, cosmetically designed to have a texture and appearance similar to his beloved spread as a threat to the long-term health and well being of those who chose to consume it. It can’t be good for you, he insisted, it’s not a real food.

Time has proven that his assessment was correct. Hydrogenated fats and trans fatty acids, the chemically altered substances that give margarine the appearance and texture of butter are now recognized as significant factors in the atherogenic process – the “hardening of the arteries” that leads to heart attacks, strokes, and other serious threats to health. The latter half of the twentieth century will almost certainly be viewed historically as the era during which the human race, believing that it could eliminate disease by improving upon the foods that had been provided to it, discovered how to effectively create epidemics of diabetes, obesity, atherosclerosis, cancer, ADHD, and a host of other chronic and often fatal illnesses.

In the July 2003 issue of Health By Design I wrote about refined carbohydrates. I explained that refined sugars and starches have lost their nutritive value, having had their mineral and vitamin content stripped away in the refining process. Refining of fats and oils has resulted in a comparable deficiency in the type of fats that are essential to health and survival. Despite eating diets high in overall fat content, surveys have shown that most people in the United States are obtaining only ten percent of the fats they need to maintain optimum health.

The fats the body requires for effective maintenance and repair functions are called essential fatty acids (EFAs). The term “essential” means that we are incapable of manufacturing these substances and must obtain them from our diet. Several factors account for the widespread essential fatty acid deficiencies seen today.

The first is the modification of naturally occurring fats. Essential fatty acids are found in mono and polyunsaturated fats. Because these fats are liquid at room temperature they do not work well as butter substitutes or as ingredients in packaged foods. Adding additional chemical entities to unsaturated fats causes them to become solid at room temperature, making them more acceptable as spreads or as additions to packaged foods.

Unfortunately, these modified fats called “hydrogenated” or “trans” fats cannot be utilized by the body. In addition, they have been shown to play a significant role in the development of atherosclerosis.

The second factor contributing to fatty acid deficiencies is an imbalance of the types of essential fatty acids in the diet. Two categories of essential fatty acids exist. These are referred to as omega-6 and omega-3 fatty acids.

Because the oil products most commonly sold in grocery stores and the oils most commonly added to processed foods are high in omega-6 fatty acids, most people obtain more than enough omega-6 fatty acids from the foods they eat. Very few, however, obtain significant quantities of omega-3 oils from their diet. While a 4:1 ratio of omega-6 to omega-3 oils is considered optimum, most Americans consume more than 20 times more omega-6 oils than omega-3 oils on a daily basis. To understand how this impacts our health it is necessary to know something about a group of substances called prostaglandins.

In the 1930s a Swedish scientist, Ulf von Euler, identified a new chemical in fluid from the prostate gland. He named the chemical prostaglandin. We now know that such chemicals are not unique to the prostate, but are manufactured throughout the body to produce a wide variety of effects. Unlike hormones, which are made in specialized glands and distributed throughout the body, prostaglandins are manufactured on location and act only in that location.

Prostaglandins influence a wide array of body reactions. They affect the amount of protective mucus lining the stomach, trigger the onset of labor, and can cause constriction in bronchial tubes. Some prostaglandins trigger inflammation while others fight inflammation. Certain prostaglandins encourage the formation of blood clots; others keep the blood from clotting.

While the medical community commonly speaks of “good” prostaglandins and “bad” prostaglandins such labels are misleading. Prostaglandins simply do what they are manufactured to do. Whether the end result of their action is beneficial or harmful is not determined by the presence of “good” or “bad” prostaglandins, but by the body’s ability to manufacture the proper prostaglandin in any particular situation.

Viewing prostaglandins as “bad” can lead to undesirable complications. The administration of aspirin and related compounds called non-steroidal anti-inflammatory drugs (NSAIDs) is an example. NSAIDs work by blocking the body’s ability to manufacture a substance called arachidonic acid, which leads to the production of inflammatory prostaglandins. Unfortunately, these drugs also block the body’s ability to manufacture prostaglandins that are responsible for protecting the lining of the stomach from the caustic action of hydrochloric acid. This can have disastrous consequences as demonstrated by a report, published in the American Journal of Medicine, that 16,500 people in the United States died in 1997 as a direct result of the use of these drugs.

Given an adequate supply of raw materials the body will manufacture the proper prostaglandin in every situation. When deficiencies exist, however, the body’s attempt to correct a challenge can result in the production of the wrong prostaglandin for the condition.

Imagine that an architect has designed a building that is to have a fascia composed of four red bricks for each black brick. This calls for sixteen loads of red bricks and four loads of black bricks. If the masons are supplied with 20 loads of red bricks and only one load of black bricks they can still complete the building. Its appearance, however, will not be what the architect intended.

When an individual’s diet contains 20 omega-6 fatty acids for each omega-3 fatty acid the body cannot follow the blueprint it has been given. It will do its best, but the end result may not be what the architect intended.

Platelets and blood clots are an excellent example. The blueprint for platelets calls for an alternating pattern of fats within their membranes. If the body does not have enough omega-3 fats to complete the platelet membrane as designed it will use the fats it has on hand to complete the job. Improperly constituted platelet membranes, however, are “sticky” and tend to cause platelets to clump together.

Certain prostaglandins that are dependent upon the availability of omega-3 fatty acids for their manufacture decrease platelet stickiness and discourage clot formation. If the body does not have an adequate supply of omega-3 fats it will do its best, but the prostaglandins produced with omega-6 oils will increase platelet aggregation and stimulate clot formation.

The lack of omega-3 fats in the American diet forces the body to manufacture platelets that are sticky and prostaglandins that promote the formation of blood clots. The medical community has responded by recommending that people take an aspirin a day. Aspirin prevents platelets from sticking together in situations where a heart attack or stroke could occur, but it also prevents platelets from clumping and clots from forming when bleeding occurs. This increases the risk of bruising or bleeding when bumped or injured. It also significantly increases the risk of a bleed into the brain, an event known as a hemorrhagic stroke. A better approach is to allow the body to build platelets correctly and choose which prostaglandins should be manufactured by providing an ample supply of omega-3 fatty acids.

Signs and symptoms of essential fatty acid deficiencies are quite non-specific. Some are listlessness, fatigue, dry skin and mucus membranes, constipation, depression, forgetfulness, joint pain, elevated blood pressure and cholesterol abnormalities. Low EFA levels have been shown to contribute to the development of over sixty disease states. These range from skin disorders such as acne and eczema to disabling conditions such as arthritis and multiple sclerosis, to potentially fatal diseases including cancer and heart disease.

The mechanisms by which essential fatty acid deficiencies influence disease development are becoming clear. Likewise, the manner in which EFAs support the body’s ability to restore wellness in various situations is now understood.

For example, all malignant cells appear to have specific metabolic defects. Prostaglandin E1 (PGE1), in combination with another chemical, thromboxane A2, is able to reverse these metabolic abnormalities. Cancer cells, however, cannot manufacture PGE1 because they lack activity of an enzyme, delta-6-desaturase, which converts linoleic acid to gamma-linolenic acid.

Delta-6-desaturase activity is blocked by trans-fatty acids, saturated fats, & alcohol. In addition magnesium, vitamin B-6, vitamin C, and zinc must be present for delta-6-desaturase activity to occur. Increasing the intake of omega-3 fatty acids counters the blocking action of the trans-fats and saturated fats allowing the manufacture of PGE1 to resume. This may explain the beneficial effects of flaxseed oil consumption by cancer patients reported by German biochemist Dr. Johanna Budwig and to some degree the beneficial effects of vitamin C reported by Dr. Linus Pauling.

Dr. Budwig advocated a diet free of sugar, animal fat, salad oil, meat, butter, and margarine. She recommended supplementing the diet with a blend of 2 tablespoons of flaxseed oil and ¼ cup of quark, which is similar to cottage cheese and yogurt. She found that combining the oil with the quark made it more bioavailable and therefore more beneficial.

Dr. Pauling advocated high amounts of vitamin C in the presence of cancer and reported improvement in a number of patients. It is now known that vitamin C is able to enhance delta-6-desaturase activity, improving the ability of essential fatty acids to restore normal function in cancer cells.

While cholesterol remains paramount in the minds of most Americans concerned about preventing heart disease, research has shown that inflammation in the lining of arterial walls plays a much greater role in the development of atherosclerosis. Increasing omega-3 intake improves the body’s ability to produce anti-inflammatory prostaglandins. These play an important role in preventing and reversing the inflammation that triggers plaque formation.

In addition, adequate intake of omega-3 fatty acids improves the ratio of LDL to HDL cholesterol. This makes LDL cholesterol less subject to free radical damage (oxidation), further lowering the risk of cardiovascular disease.

Inflammation is also one of the root causes of asthma. Cortisone-like drugs have traditionally been used to calm inflammation in the bronchial tubes and reduce the frequency and severity of asthma attacks. More recently, drugs designed to inhibit the action of certain leukotrienes have been introduced.

Leukotrienes are closely related to prostaglandins. Just as in the case of prostaglandins, the body can produce either inflammatory or anti-inflammatory leukotrienes provided the proper balance of fatty acids is available. Inflammatory leukotrienes dominate when a high omega-6 to omega-3 fatty acid ratio is present.

In addition, when the diet is deficient in omega-3 fatty acids, prostaglandins that cause bronchial tubes to narrow and constrict are produced. Supplementation of omega-3 fatty acids can result in significant improvement in asthma by restoring the body’s ability to manufacture prostaglandins that encourage relaxation and opening of the bronchial tubes and less inflammatory leukotrienes.

The principles surrounding asthma apply to “hay fever” symptoms as well. Because individuals experiencing asthma and other allergic symptoms tend to have poor delta-6-desaturase activity it is important to include additional magnesium, B-6, vitamin C, and zinc to achieve optimum benefits from essential fatty acid supplementation.

One of the greatest essential fatty acid success stories is that of Dr. Roy Swank and his multiple sclerosis regimen. In 1949 Dr. Swank, a physician with a special interest in multiple sclerosis, began recommending that his MS patients eliminate butter, margarine, & shortening, limit their intake of animal fat, increase their daily intake of polyunsaturated vegetable oils, consume at least a tablespoon of cod liver oil daily, and consume fish three or more times each week.

Dr. Swank followed MS patients for 34 years. The results of his study are among the most dramatic ever reported for any disease process. Minimally disabled patients who followed his regimen experienced almost no progression in their disease. Ninety-five percent of them were alive at the end of the study. In contrast, only twenty percent of those who did not follow his recommendations survived the 34-year study and most had progressed to severe disability.

Patients who were moderately or severely disabled when they entered the study also did far better than those who did not follow the dietary regimen. The death rate was lower in those following Dr. Swank’s recommendations, and, in nearly all cases, the diet prevented worsening of the disease process and lessened fatigue.

If we wish to achieve optimum health we must learn the lessons taught by Roy Swank, Johanna Budwig, and others who recognized the importance of consuming an appropriate balance of fats on a daily basis. We must make adjustments to avoid the pitfalls associated with diets in which saturated, hydrogenated, or trans fats are predominant, and we must improve the ratio of omega-6 to omega-3 oils in our daily diet.

This means that we should generally avoid fats that are solid at room temperature. If we do choose to consume them we should stick to “natural” fats such as butter and avoid “manufactured” fats such as those found in margarine. We should consume fats that are liquid at room temperature, such as olive oil.

In addition, we should supplement our diet with oils rich in omega-3 oils. The two major sources of omega-3 fatty acids are flaxseed oil and marine lipids (fish oils). It is important to recognize that the most beneficial oils come from the belly fat of cold-water fishes and not from “liver oils”. While cod liver oil is generally safe it is not as rich in omega-3 fatty acids as those oils commonly referred to as marine lipids. Liver oils of predator fishes such as sharks should be avoided, as many are high in mercury and other toxins.

One or two tablespoons of flaxseed oil daily is optimum. This is the equivalent of 14 - 28 flax oil capsules.  Fish oils, which contain a higher concentration of omega-3 fatty acids, are more efficient.  While the daily amount of most fish oil supplements is 2 to 3 capsules twice daily, more highly refined oils that contain 200 mg of DHA and 300 mg. of EPA per capsule are available.  Only two of the more concentrated capsules are needed each day.

 The oils should have a fresh, light, taste. If a strong, objectionable smell or taste is present the oil has been improperly processed or has become rancid and should be discarded. If buying a brand with which you are unfamiliar or if the expiration date of a bottle is approaching it is advisable to open a capsule and taste the oil to determine its acceptability.

When using flaxseed oil it is important to include supplements of magnesium, B-6, vitamin C, and zinc to insure delta-6-desaturase activity. Individuals with conditions such as cancer and allergies where low delta-6-desaturase activity is typically low may do better using a marine lipid supplement.

Choosing fats wisely can pay huge health dividends over time. Fatty acid balance plays a key role in helping each of us die young . . . as late in life as possible.