Arachidonic Acid to EPA ratio

an important biomarker in honor of my father.

It’s the one year anniversary of my Father’s death (he’s #32 in this picture from Brooklyn Tech); and I have done a lot of reflection and shed some tears .

Since he succumbed ultimately to Cardiovascular disease I thought I would do a dive into CV disease factors in his honor; notably the arachidonic acid to eicosapentaenoic acid (AA/EPA) ratio

The arachidonic acid to eicosapentaenoic acid (AA/EPA) ratio is an important indicator in various health conditions, particularly in cardiovascular diseases.

I often measure it as part of an Omega-3 index that can be ordered through Labcorp.

What prompts me to order an Omega-3 index are conditions of aberrant inflammation like Metabolic Syndrome, IBD, Acne, and Psoriasis. Also there are many other conditions that thrive on good Omega-3 levels like Mental health conditions. But is also good for preventative health discussions.

I am always curious at a cellular level if we can tip inflammation in balance by balancing Omega-3 and Omega-6 levels. Since those levels are strongly influenced by diet and supplements; it seems highly actionable.

Studies have shown that maintaining a balanced ratio of omega-6 to omega-3 polyunsaturated fatty acids (PUFA) is crucial for overall health, with an equilibrium ratio close to 1/1 being desirable (Simopoulos, 2008).

EPA, a derivative of omega-3, gives rise to eicosanoids with differing properties from those derived from arachidonic acid, and EPA-derived mediators are generally less biologically active than those produced from arachidonic acid (Calder, 2010; Calder, 2012).

Furthermore, a low ratio of EPA to arachidonic acid has been associated with a greater risk of cardiovascular disease (Okada et al., 2021; Shojima et al., 2020; Okada et al., 2016).

In patients with carotid atherosclerosis, the EPA/AA ratio was reported to be significantly lower (Ishikawa et al., 2021).

Additionally, a high EPA/AA ratio has been linked to a low risk of cardiovascular disease (Okada et al., 2014).

Moreover, the EPA/AA ratio has been associated with major adverse events and death in cardiovascular diseases (Shojima et al., 2020).

Studies have also demonstrated that increased oral intake of EPA and docosahexaenoic acid (DHA) modifies the content of arachidonic acid as well as EPA and DHA (Calder, 2012).

So, it’s obviously important. I don’t have any scientific evidence of its use as a tool in IBD, Psoriasis, Acne, and Mental health but mechanistically it makes sense to me.

People sometimes get carried away with evidence based medicine and forget to think through mechanisms. If all we relied on was Evidence Based Medicine; there would never be any progress.

We must know mechanisms and apply this knowledge to make progress in any frontier.

Being inflamed at a cellular level is influenced by Arachidonic Acid.

Before we get carried away; we need Arachidonic Acid as some inflammation is good for controlling infection and controlling injury . Without inflammation our immune system would be rather inert.

How do you improve EPA/AA ratio without taking a supplement?.

In simple terms:

Eat more from the left two columns and less from the right three columns. Especially less from the right two columns.

It is generally a good rule of thumb to have a serving of cold water fish in your diet twice per week.

If someone is a hardcore Carnivore then they best be supplementing with fish oil. Or at least have fish in their diet twice per week.

If someone, can’t stand fish, then supplementing with flax seed oil might do the trick.

If you are paid member and have more questions send me a chat~!!!

References:

Calder, P. (2010). Omega-3 fatty acids and inflammatory processes. Nutrients, 2(3), 355-374. https://doi.org/10.3390/nu2030355

Calder, P. (2012). Mechanisms of action of (n-3) fatty acids,. Journal of Nutrition, 142(3), 592S-599S. https://doi.org/10.3945/jn.111.155259 Calder, P. (2012). The role of marine omega‐3 (n‐3) fatty acids in inflammatory processes, atherosclerosis and plaque stability. Molecular Nutrition & Food Research, 56(7), 1073-1080. https://doi.org/10.1002/mnfr.201100710

Ishikawa, T., Yamaguchi, K., Funatsu, T., Okada, Y., & Kawamata, T. (2021). Association and implications of blood and plaque n-3 polyunsaturated fatty acid composition in patients treated with oral eicosapentaenoic acid before carotid endarterectomy. International Journal of Angiology. https://doi.org/10.1055/s-0041-1731088

Lane, K. and Derbyshire, E. (2013). Functional foods enriched with an omega-3 nanoemulsion – potential to improve the long-term health of vegetarians?. Proceedings of the Nutrition Society, 72(OCE4). https://doi.org/10.1017/s0029665113002644

Okada, K., Kotani, K., & Ishibashi, S. (2016). Ankle-brachial index and eicosapentaenoic acid/arachidonic acid ratio in smokers with type 2 diabetes mellitus. Tobacco Induced Diseases, 14(1). https://doi.org/10.1186/s12971-016-0068-9

Okada, K., Kotani, K., Yagyu, H., & Ishibashi, S. (2014). Eicosapentaenoic acid/arachidonic acid ratio and smoking status in elderly patients with type 2 diabetes mellitus. Diabetology & Metabolic Syndrome, 6(1). https://doi.org/10.1186/1758-5996-6-85

Okada, T., Miyoshi, T., Doi, M., Seiyama, K., Takagi, W., Sogo, M., … & Ito, H. (2021). Secular decreasing trend in plasma eicosapentaenoic and docosahexaenoic acids among patients with acute coronary syndrome from 2011 to 2019: a single center descriptive study. Nutrients, 13(1), 253. https://doi.org/10.3390/nu13010253

Shojima, Y., Ueno, Y., Tanaka, R., Yamashiro, K., Miyamoto, N., Hira, K., … & Urabe, T. (2020). Eicosapentaenoic-to-arachidonic acid ratio predicts mortality and recurrent vascular events in ischemic stroke patients. Journal of Atherosclerosis and Thrombosis, 27(9), 969-977. https://doi.org/10.5551/jat.52373

Simopoulos, A. (2008). The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Experimental Biology and Medicine, 233(6), 674-688. https://doi.org/10.3181/0711-mr-311