Book & concept review: Omega Balance

The Omega Man: Is omega-6 what happened in 1971?

In his book Omega Balance, Anthony John Hulbert discusses the effects of PUFA ratios on various cells in the body, and what an improper balance can do to us.

If you’re interested but on the fence about getting the book, Tucker Goodrich recently interviewed the author.

In short, Hulbert’s “Omega Balance” take is a good mix between what I’d consider old-school “omega 6/3 ratio” thinking and what I call “Modern Pufa Theory” or MPT.

In short:

• Omega-6/3 ratio thinking considers this ratio all-important, that we get too much omega-6, and that we should therefore supplement tons of fish oil or eat a lot of salmon.

• Modern Pufa Theory is way more concerned with the negative side-effects of excess consumption of omega-6 linoleic acid, the most abundant PUFA in modern diets, found e.g. in seed oils.

• Omega Balance explains how the root causes of many of the downsides of excess omega-6 are caused by the imbalance issue, but that cutting out omega-6 is still a vital step. You can’t just supplement a shitty high-PUFA diet with lots of fish oil and expect great results.

Overall, this is the second PUFA book I’ve read after The Ancestral Diet Revolution by Christopher Knobbe.

I like this one better as it seems more focused and structured. The downside is that I think there are still some effects of excess omega-6 linoleic acid consumption that likely can’t be explained by the Omega Balance concept.

That said, many likely can, including diabetes, auto-immune diseases, and obesity.

What is “omega” (ω) anyway?

A neat thing is that Hulbert explains fatty acids from scratch, including the difference between saturated, monounsaturated vs. polyunsaturated, what “omega” means in fatty acids, and what cis vs. trans fatty acids are.

I realized that I didn’t actually know what the ω-3 or ω-6 number meant.

• ω, being the last Greek letter and often standing for “the end” signifies the end of the fatty acid carbon chain.

• The - is actually a minus sign!

• The number signifies how many carbons from the ω (end) the last double bond in the PUFA sits.

• ω-3 therefore means “the end minus 3”

Let’s look at our old friend linoleic acid. Linoleic acid is an ω-6 PUFA because its last double bond sits 6 carbon atoms away from the end (the ω):

ω-6 linoleic acid or 18:2 (n-6)

Now let’s compare it to an ω-3 PUFA, DHA. This is one of those healthy fish oil ω-3 PUFAs. As you see, its last double bond is only 3 carbon atoms away from the end of the chain (ω):

ω-3 Docosahexaenoic acid (DHA) or 22:6 (n-3)

Also notice that it has way more double bonds than linoleic acid’s 2. It has a staggering 6 double bonds! That’s not relevant for the book or the concept of Omega Balance, but I do think it’s… fishy.

Omega Balance: a slightly better ω-6/ω-3 ratio

The Omega Balance is defined as:

Omega Balance = ω-3 / (total PUFA, effectively ω-3 + ω-6)

Throughout the book, omega balances are expressed in percentages. Higher is better, because it means more ω-3 in relation to ω-6.

For example, the famous ω-3 rich salmon has an omega balance of about 66%. Some random processed pork/beef salami product only has 4.8%. Soybean oil has 11.8%. Safflower oil has practically 0%, a fact addressed in the book - it used to be given intravenously to hospital patients, and they would get ω-3 deficiency symptoms.

(As you can see at the above links, I’ve added the Omega Balance to the automatic calculations in the ExFatloss Foodulator.)

Hulbert would like to see us average just about as high as possible across our diet, probably aiming for at least 25% and trying to get closer to 50%. This would be equivalent to an ω-6:ω-3 ratio of 3:1 to 1:1. (edit: thanks to Tyler for the correction, I had a mistake here)

Why does Hulbert insist on inventing a new concept, the Omega Balance? Why not just stick with the tried-and-not-so-trued ω-6/ω-3 ratio?

The main reason seems to be that ratios have inherent limitations in handling them and doing math. For example, you can’t add ratios up or average them as easily.

Omega Balance in phospholipids

One thing that makes the book very interesting is that it doesn’t just talk about the Omega Balance in foods, or in adipose tissue, but very specifically in blood (and other cell) phospholipids.

Phospholipids are the cell walls, which are built from fatty acids. And we know it’s not just any random fatty acid floating by in the blood stream, the levels of fatty acids are regulated in certain ways.

What apparently happens is that the percentage of total PUFA in phospholipids is pretty tightly controlled, but this regulatory mechanism does not distinguish between ω-3 and ω-6 fatty acids.

If the fatty acids in our blood come in a bad omega balance, then, way more ω-6 fatty acids are being incorporated into new cells than ω-3.

What’s also nice is that we, the enthusiasts and practitioners, can actually measure our red blood cell phospholipids pretty easily. This is the OmegaQuant Complete test that I keep talking about. It can be ordered on Amazon for $99 and done in the comfort of your home. You just prick your finger, let a splotch of blood drip onto an envelope, and drop it in the mail box - postage is even pre-paid for you!

Phospholipids: Omega Balance of 15% or higher

Hulbert performed studies on mice and analyzed many human datasets, and what he came up with was this: as long as the Omega Balance of your diet is roughly in order, phospholipids will be 15% or higher. If it drops beneath 15%, something’s gone wrong and the dietary balance is way out of whack.

In the datasets he analyzed all the bad things started happening once people & animals got their phospholipid Omega Balance under 15%.

The good news is that, if you’re over a certain amount, you don’t have to keep a very tight or narrow balance in your diet - phospholipid composition will automatically be kept at the correct ratio unless your dietary intake is WAY off balance.

Backtesting the Omega Balance concept

Very cool, we have a prediction that is easily testable at home. The fine people at r/saturatedfat have been taking lots of OmegaQuant tests, in fact that’s where I learned about the thing. I’ve done a few of my own.

Plus we have at least 3 “known-good” OmegaQuant tests, that is, of people who’ve been aggressively avoiding PUFAs (or, technically, ω-6 linoleic acid) for 5-10 years.

If Hulbert is right about the 15% Omega Balance in phospholipids, then we should see a trend, right? I should be below 15% because I’m still overweight. And all the long-term PUFA avoiders should be above 15%.

Easy enough to check:

ω-3 ω-6 Omega Balance Comment

Me (March 2023): 6.18 61.48 9.13% Not OmegaQuant, other test
Me (May 2023): 5.69 32.31 14.97% After ex150sardines
Me (August 2023): 3.31 29.29 10.15%
Me (November 2023): 3.82 33.16 10.33%

9 year PUFA avoider: 7.92 30.28 20.73% Never eats fish
8 year PUFA avoider: 13.25 24.65 34.96% Eats lots of fish, cod liver
5 year PUFA avoider: 2.68 10.63 20.14%

Yup, pretty much checks out. Interestingly, I had a near-15% but that was after 2 weeks of eating sardines every day. After that, my omega balance came right back down, although there is a minuscule upward trend.

And we see our prediction confirmed with the known-good tests. All three of them have not even just greater than 15% omega balance, but greater than 20%.

I don’t know how much fish the 5 year PUFA avoider was eating, but I talked to the 9 year one in detail and he hasn’t eaten ANY fish in the 9 years. His main meat intake is grass-fed beef and wild game. That seems to indicate that you don’t necessarily need to eat very high ω-3 to get a great omega balance, you just need to cut out ω-6 enough, and for long enough.

The 8 year PUFA avoider had a dramatically higher omega balance, but then he reports in the linked Reddit thread that he’s been eating lots of fish and even cod liver, which would of course dramatically increase the ratio.

And as per Hulbert, we’re not sure that a higher phospholipid balance is better after a certain amount like the aforementioned 15%.

So far, so good! The Omega Balance seems to backtest well for our n=7 dataset.

High Omega Balance after fish consumption - benefit or ruined diagnostic?

Let’s talk for a second about my one outlier OmegaQuant, where I had a nearly 15% Omega Balance after eating sardines every day for 2 weeks. Similarly, the person eating lots of fish and cod liver had a dramatically higher Omega Balance than the other long-term PUFA avoiders.

You could interpret this 2 ways:

• Higher fish consumption, and therefore higher ω-3 consumption, improved phospholipid Omega Balance and will lead to Good Things

• Higher fish consumption merely tainted the diagnostic value of the Omega Balance

This would really depend: is the omega balance of our phospholipids causal in Good Things/Bad Things happening or just another symptom, a diagnostic tool?

I’m not 100% sure. Hulbert argues for the former, and he makes a pretty convincing case.

But when I did 14 days of daily sardines, I didn’t lose more weight. I lost a bit, but it wasn’t even quite as good a run as the following, regular run of ex150-6. I didn’t notice anything different, either. So what exactly should we be expecting to go better?

Hulbert of course goes into detail about all these in the book. I’m just saying, I didn’t see any benefit to a ~15% omega balance over ~10% during my 14 day sardine experiment.

And if you were to eat a bunch of fish and then do your first and only Omega Quant test, you could walk away with the impression that everything’s fine. Yet within a few months of ceasing fish consumption, your phospholipid omega balance would be back down.

If using the omega balance as a measure of “how PUFA’d” your metabolism is, this might be misleading. You might simply be taping the gas gauge over instead of filling your tank.

Omega Balance vs. linoleic acid

Another measure I like on the OmegaQuant Complete is simply the percentage of linoleic acid (the major ω-6 PUFA) in your phospholipids. Since it makes up the majority of our modern, excess PUFA/ω-6/seed oil intake, it’s not a stretch that it would be overrepresented in a “PUFA’d” person’s phospholipids, and that its percentage would go down as you de-PUFA yourself.

Let’s compare:

LA Omega Balance Comment

Me (March 2023): 15.59% 9.13% Not OmegaQuant, other test
Me (May 2023): 16.66% 14.97% After ex150sardines
Me (August 2023): 15.43% 10.15%
Me (November 2023): 17.06% 10.33%

9 year PUFA avoider: 10.57% 20.73% Never eats fish
8 year PUFA avoider: 10.55% 34.96% Eats lots of fish, cod liver
5 year PUFA avoider: 5.42% 20.14%

As we can see, while the daily consumption of sardines increased my Omega Balance drastically, my linoleic acid (LA) didn’t improve at all - in fact, it went slightly up. It went up in November again, meaning I just seem to fluctuate between 15.5-17%. Of course, I did lose some body fat in that time period, and one could argue that the linoleic acid stored in my adipose tissue was released and then incorporated into my phospholipids, just like if I’d eaten it again.

We also see that all 3 long-term PUFA-avoiders have lower LA, the 8- and 9-year people with just over 10%, and the 5-year person at 5.42%. (By the way, I think there might’ve been some testing error on that one - I’d love to see this person get tested again!)

So maybe, in order to determine your “PUFA-status” it’s more useful to look at total linoleic acid, hoping to see it approach 10%?

It is curious to see that out of the 3 long-term PUFA-avoiders, 2 have nearly identical LA, whereas another 2 have nearly identical Omega Balance. I hope we get a bigger dataset so we can see some more patterns.

In any case, I’ll keep doing my OmegaQuants and see if there is a trend as I hopefully lose more weight & de-PUFA myself further. 1.5 years in, baby!

“Whole-of-diet” approach: cut ω-6, eat more ω-3

What does Hulbert recommend?

Refreshingly, in comparison to the ω-3 gurus of Paleo days past, his recommendation isn’t to chug fish oil until the burps improve.

His argument is clearly that you cannot make up modern excess ω-6 consumption by equally increasing ω-3 fish consumption.

This is easily demonstrated: how much wild-caught salmon do you think you’d need to eat enough ω-3 to balance the ω-6 of a single 1oz serving of walnuts?

That’s right, 2lbs of wild-caught salmon.

That’s because 100g of walnuts contain 33g of ω-6, whereas 100g of wild salmon contain only 1g of ω-3.

And, honestly, I don’t know if it’d be healthy if you could do it. The average American eats 10-25% of his total energy intake as ω-6 fat. Even “diets rich in oily fish” contain maybe 1/10th of that in ω-3, at best. People who “eat fish every day” eat maybe half a pound per day at most. That’s bigger than most salmon fillets at the store.

Do we think increasing the ω-3 PUFA intake to similarly high levels as our current ω-6 intake wouldn’t cause problems?

Remember those 6 double bonds on DHA, one of the ω-3 PUFAs in fish? Do we honestly think all those double bonds wouldn’t bond with… something?

I suggest that the whole reason ω-3 doesn’t cause any damage is because there’s no practical way to eat as much of it.

Similarly, ω-6 was not a useful concern until we invented seed oils. If we somehow made fish oil as cheap as seed oils, and put it into everything, until it was 10-25% of our total energy intake, I think we’d probably see just as many problems.

But back to Hulbert’s recommendation: his “whole-of-diet” approach emphasizes cutting out both ω-6 AND increasing ω-3.

Since eating a “diet rich in oily fish every day” would easily be cancelled out by a few walnuts, or a single teaspoon of seed oil, we need to burn the candle at both ends.

To this end, Hulbert eats mostly grass-fed ruminant meat if possible, and wild-caught fish. He avoids pork, chicken, seeds and nuts, and of course seed oils and products made with them.

He does advocate for eating leafy greens & vegetables. This seem weird because, while he argues they have a great omega balance, it doesn’t matter one iota in the greater scheme of things: you couldn’t possibly eat the pounds and pounds of kale & spinach to make up for a single walnut. There’s so little fat in these that it’s barely measurable, and the USDA database typically lists 0 for both ω-3 and ω-6.

That’s what we have ruminants for: they eat tons of leaves, and concentrate the fatty acids for us.

Does eating ω-3 actually help the balance much?

“Should we eat ω-3?” is a big point of contention within seed oilers. Some say, yes, absolutely, it helps. Some say no, it’s actually deleterious - ω-3 are still PUFAs, after all, and in fact they’re usually severely more unsaturated than ω-6. Remember the 6 double bonds?

I’ll say that Omega Balance swayed me a little from the latter into the former camp. But I think it’s probably pretty nuanced.

1. You definitely still have to primarily focus on cutting out ω-6 (linoleic acid, seed oils) as much as possible.

2. You can’t possibly fix the balance just by upping ω-3: this would involve eating tens of pounds of salmon per day, or drinking shots of fish oil.

3. If you have ω-6 stored in your adipose tissue (which you likely do), the ω-6 fatty acids from lipolysis are probably going to outgun all the salmon you can stomach.

4. As you lose body weight AND as you de-PUFA your adipose tissue, both the absolute AND relative amount of ω-6 coming from lipolysis will go down. This way, losing weight while cutting out ω-6 works in your favor both ways.

5. This means that, at one point, the absolute amount of ω-3 in fish will start to make a difference in your phospholipid omega balance.

Another hypothetical point: as you get closer to dePUFAing yourself, it will become harder and harder to make progress. Starting out on the SAD with maybe 20% of your total energy intake from linoleic acid, you just have to cut out the obvious things to get a huge improvement.

Cut out deep fried food, stop cooking with seed oils, stop eating commercial dressings. Stop eating “ultra-processed foods” made with PUFAs. That’s a huge difference.

But now you might have to cut out commercial (fatty) chicken and pork, cause those are up to 20% LA due to their feeds. Maybe you cut out most nuts too, and olive oil, because it still has 10-20% LA.

Now you’re getting really close, and your approaching a pretty low LA adipose level.

But to get to the ancestrally safe average of 2%, you need to average.. well, less than 2%. And even ancestrally safe foods often have 1-3%. Butter often has more than 2%, so even if your entire diet consisted of butter, you wouldn’t make it below 2%.

At that point, to drive down your average even further, you might have to go to grass-fed beef or wild game, grass-fed dairy, and maybe, wild-caught fatty fish to help you with the last few percent.

Another idea is to go extreme low fat for periods of time. People in r/saturatedfat are experimenting with that. If you eat very little fat, there’s just less of a chance of LA sneaking in there even at 2-3%.

In short, I suspect that:

1. In the beginning of your PUFA journey, focusing on ω-3 intake is a waste of time. You’ll make much bigger strides by cutting out ω-6.

2. As you progress, maybe a few years in, it might start making sense to eat some ω-3. I’d focus on wild-caught, as farmed salmon are fed the same crappy feed that pigs & chickens get.

Overall: great book

I’d say if you’re interested in learning more about PUFAs and the negative health effects they can have on our bodies, I’d get Omega Balance over Ancestral Diet Revolution.

Hulbert’s book isn’t quite as comprehensive, but it’s more structured, streamlined, and it explains more than enough to convince almost anybody.

And, frankly, I prefer Hulbert’s writing. It’s much clearer and less “all over the place” than Knobbe’s in Ancestral Diet Revolution.

He’s even convinced me to give (wild-caught, of course!) salmon a shot. I might do ex115salmon after my current ex150 run is over. Honestly, not sure what to expect - more weight loss? Hulbert lists many other issues that could be fixed, like diabetes or auto-immune issues, but I’m not sure I have any of those.

But hey, maybe it’ll surprise me, like when I accidentally started cutting out PUFAs a little over a year ago.