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The study of omega-6 and omega-3 fatty acids has fundamentally reshaped our understanding of nutrition and its impact on health. At the forefront of this research are influential scientists and methodologies: William S. Harris and Clemens Von Schacky, co-developers of the Omega-3 Index; William E. Lands, a pioneer in fatty acid metabolism; and innovators like Kevin C. Maki, Sheila Innis, Artemis Simopoulos, and Joseph Hibbeln, who have all contributed unique insights. This article explores the history of fatty acid testing, differing perspectives on the roles of omega-6 and omega-3, and the real-world implications of these approaches, as evidenced by dried blood spot (DBS) testing.

The History of Dried Blood Spot Testing

Dried Blood Spot (DBS) testing originated in the 1960s for neonatal metabolic screening, but its applications have since expanded to include fatty acid profiling. Labs like Vitas Analytical Services developed methods to measure omega-6 and omega-3 fatty acids, including critical markers like arachidonic acid (AA) and the omega-6 to omega-3 ratio. DBS testing’s simplicity, requiring only a finger-prick blood sample, has made it an accessible tool for both clinical and research purposes.

Unlike traditional venipuncture, DBS testing analyzes whole blood, providing a comprehensive fatty acid profile and reflecting the effects of diet on key inflammatory markers over shorter periods (weeks to months). This technology complements research by providing objective data on omega-6 and omega-3 levels and their ratios, which are crucial for understanding inflammation and chronic disease risk.

The Omega-3 Index: A Cardiovascular Health Marker

It’s important to note that William S. Harris is the founder and owner of OmegaQuant, a company known for its Omega-3 Index testing. In 2004, Dr. Harris and Dr. Clemens Von Schacky co-developed the Omega-3 Index, a biomarker measuring EPA and DHA as a percentage of total fatty acids in red blood cell (RBC) membranes. This index reflects dietary omega-3 intake over 3-4 months and has been widely adopted as a predictor of cardiovascular health, with an optimal range of 8-12% linked to lower risk of heart disease.

However, the OmegaQuant Omega-3 Index report does not address omega-6 to omega-3 ratios or arachidonic acid (AA) levels. This omission is striking, given the global consensus on the importance of balancing these ratios. Organizations such as the World Health Organization (WHO) and the National Institutes of Health (NIH) emphasize the critical role of maintaining a proper omega-6 to omega-3 balance to reduce inflammation and mitigate chronic disease risks. By solely focusing on omega-3 sufficiency, the Omega-3 Index provides an incomplete picture of fatty acid dynamics, particularly in addressing the pro-inflammatory effects of excessive omega-6 intake.

This is why I endorse the BalanceTest, which utilizes DBS testing, and the BalanceOil+, a proprietary blend that includes polyphenols and omega-3s (DHA/EPA). Time and time again, validated DBS testing demonstrates significant improvements in omega-6 to omega-3 ratios and arachidonic acid levels. This combination not only addresses omega-3 sufficiency but also directly targets the pro-inflammatory effects of excess omega-6, providing a more holistic solution to fatty acid imbalances.

Lastly, arachidonic acid (AA) is more than just a marker of omega-6 status. It is a critical biomarker that has been associated with increased risk of blood clots, heart attacks, strokes, and arterial narrowing. Addressing elevated AA levels through balanced fatty acid intake is essential for mitigating these risks and promoting cardiovascular health.

William E. Lands and the Omega-6 Debate

Dr. William E. Lands emphasized the need to address the modern diet’s excess omega-6 fatty acids, particularly from seed oils like soybean and corn oil. His research demonstrated how high omega-6 intake promotes inflammation through arachidonic acid pathways, exacerbating chronic diseases. Lands advocated for reducing omega-6 intake while increasing omega-3s to restore a healthier ratio, ideally 1:1 or 3:1, compared to the current 20:1 or higher.

DBS testing supports Lands’s perspective, consistently showing that lowering linoleic acid intake improves both the omega-6 to omega-3 ratio and arachidonic acid levels. This approach directly targets inflammation, offering a more comprehensive strategy than focusing solely on omega-3 sufficiency.

Additional Perspectives in Omega-6 and Omega-3 Research

Dr. Kevin C. Maki

A leading researcher in dietary fats and cardiovascular health, Dr. Maki’s clinical trials highlight the benefits of EPA and DHA supplementation. While his work aligns with Harris’s focus on omega-3 sufficiency, Maki also recognizes the broader implications of fatty acid imbalances, acknowledging the role of inflammatory markers like arachidonic acid in chronic disease.

Dr. Artemis Simopoulos

Dr. Simopoulos is a prominent advocate for balancing omega-6 and omega-3 intake. Her seminal work, including the book The Omega Diet, aligns closely with Lands’s emphasis on reducing omega-6 fatty acids to address chronic inflammation. She highlights the dramatic shift in omega-6 to omega-3 ratios since the Industrial Revolution and its role in the rise of inflammatory diseases.

Dr. Sheila Innis

Dr. Innis’s research focuses on the role of omega-3 fatty acids in neural and brain development. While her work emphasizes the critical importance of omega-3s, it also underscores the need to balance dietary fats for optimal cellular and metabolic function.

Dr. Joseph Hibbeln

Dr. Hibbeln has explored the impact of dietary omega-6 and omega-3 on mental health and inflammation. His work supports reducing omega-6 intake to improve outcomes in mood disorders, cognitive function, and overall inflammatory status. Hibbeln’s research provides additional evidence for the importance of balancing fatty acid intake.

Comparing Testing Approaches

Reconciling the Perspectives

The debate over the roles of omega-6 and omega-3 fatty acids ultimately highlights two approaches:

1. 1. Omega-3 Sufficiency (Harris and Von Schacky):
      • • Focuses on increasing EPA and DHA to improve cardiovascular health.
        • Omits omega-6 levels and their contribution to inflammation.
   2. Balancing Omega-6 and Omega-3 (Lands, Simopoulos, Hibbeln):
      • • Emphasizes reducing linoleic acid and arachidonic acid while increasing omega-3s.
        • Supported by DBS testing, which provides a more comprehensive view of fatty acid dynamics and inflammation.

The evidence from DBS testing suggests that combining these approaches—increasing omega-3 intake while reducing omega-6—yields the greatest health benefits.

Conclusion

The history of fatty acid research reflects the contributions of many brilliant minds. While the Omega-3 Index has advanced awareness of omega-3 sufficiency, it lacks the depth of insights offered by DBS testing, which captures the full spectrum of fatty acid imbalances. The work of researchers like Lands, Simopoulos, Hibbeln, and others underscores the importance of addressing excessive omega-6 intake alongside omega-3 supplementation to optimize health. Ultimately, the proof lies in the data: achieving better omega-6 to omega-3 ratios and lowering arachidonic acid levels delivers measurable, impactful results.

References

1. 1. Harris WS, Von Schacky C. “The Omega-3 Index: A New Risk Factor for Death from Coronary Heart Disease?” Preventive Medicine. 2004.
   2. Lands WE. “Dietary Fatty Acids and Health.” The FASEB Journal. 2005.
   3. Simopoulos AP. The Omega Diet: The Lifesaving Nutritional Program Based on the Ideal Omega-6/Omega-3 Ratio. HarperCollins, 1999.
   4. Maki KC et al. “Omega-3 Fatty Acids and Cardiovascular Health.” Journal of Clinical Lipidology. 2017.
   5. Hibbeln JR et al. “Omega-3 Fatty Acids: Essential Nutrients for Brain Function and Mood.” American Journal of Clinical Nutrition. 2006.
   6. Innis SM. “Dietary Omega-3 Fatty Acids and Brain Development.” American Journal of Clinical Nutrition. 2008.
   7. Vitas Analytical Services. “Dried Blood Spot Testing for Fatty Acid Profiles.” www.vitas.no
   8. American Heart Association. “Dietary Fats and Cardiovascular Disease.” www.heart.org
   9. Mozaffarian D, Ascherio A, et al. “Omega-6 Fatty Acids and Inflammation: Friend or Foe?” Circulation. 2009.
   10. Ramsden CE et al. “Dietary Fatty Acids and Inflammation in Chronic Disease.” British Journal of Nutrition. 2010.
   11. World Health Organization. “Fats and Fatty Acids in Human Nutrition: Report of an Expert Consultation.” FAO Food and Nutrition Paper. 2010.
   12. Calder PC et al. “Omega-3 Polyunsaturated Fatty Acids and Inflammatory Processes: Nutrition or Pharmacology?” British Journal of Clinical Pharmacology. 2013.
   13. Dyerberg J et al. “Arachidonic Acid’s Role in Thrombosis and Cardiovascular Events.” Thrombosis Research. 2007.

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Robert Ferguson is a California- and Florida-based single father of two daughters, nutritionist, researcher, best-selling author, speaker, podcast and television host, health advisor, NAACP Image Award Nominee, creator of the Diet Free Life methodology, Chief Nutrition Officer for iCoura Health, and he serves on the Presidential Task Force on Obesity for the National Medical Association. You can e-mail Robert at robert@dietfreelife.com.