Ann Haibeck, RD, LDN
Renal Dietitian
Decoding Unsaturated Fats
Unsaturated fats are generally healthier than saturated fats and trans fats; the National Kidney Foundation and American Heart Association recommend consuming mostly unsaturated fats. These types of fats are more likely to reduce inflammation and promote heart health than saturated fats. Unsaturated fats can be categorized as monounsaturated and polyunsaturated fats. Polyunsaturated fats can further be classified as omega-3 fatty acids and omega-6 fatty acids. So what do each of these mean for your health as a kidney patient?
Monounsaturated Fats
Kidney patients are known to have a higher risk of cardiovascular disease when compared with people without kidney disease. Monounsaturated fats are known to decrease LDL cholesterol (“bad” cholesterol), thereby lowering the risk of cardiovascular disease and stroke. Sources of monounsaturated fats include olive oil, peanut oil, sunflower oil, and sesame oil. All of these oils are kidney-friendly because they do not contain phosphorus or potassium. They also do not containprotein, which can be good for people which kidney disease who are not on dialysis. Other sources of monounsaturated fats are avocadoes, pecans, and almonds; however, these are less kidney-friendly because they are higher in potassium and phosphorus.
Polyunsaturated fats
Polyunsaturated fats have the same major benefits that monounsaturated fats have, including the effect of lowering LDL cholesterol. Polyunsaturated fats also provide essential fatty acids, including omega-3 and omega-6 fatty acids. Studies show that omega-3 fatty acid intake in dialysis patients is associated with less protein loss in the urine, decreased blood triglycerides, decreased overall inflammation, and better muscle mass.
Omega-3s vs. Omega 6s
Food sources of omega-6 fatty acids include soybean oil, corn oil, and sunflower oil, all of which have no potassium, phosphorus, or protein. Brazil nuts and walnuts also contain omega-6 fatty acids, but are higher in phosphorus and potassium, which is not appropriate for most kidney patients. Omega-3 fatty acids are found in fatty fish such as salmon, mackerel, herring, cod and trout. Oil sources of omega-3s include flaxseed oil and canola oil.
The most recent research shows that consuming more omega-3 fatty acids than omega-6 fatty acids is most beneficial. Most people consume more omega-6s than omega-3s, which can result in increased risk for high triglycerides, cardiovascular disease, Alzheimer’s disease, and non-alcoholic fatty liver disease. The ideal ratio of omega-6s to omega-3s is between 1:1 to 4:1 (the same or just slightly more omega-6 than omega-3). However, the average Western diet results in a ratio of about 10:1 to 20:1 (much more omega-6 than omega-3). This indicates that most people could benefit from incorporating more omega-3 fatty acids into their diet to achieve a better balance.
Omega-3 fatty acids: Food or supplements?
Ask your doctor before starting any omega-3 supplements. Over-the-counter nutrition supplements are not regulated as strictly as prescription medications. There is a risk that fish oils specifically could contain harmful amounts of heavy metals, depending on the source of the oil and how it is processed. In addition, excessive omega-3 intake can thin the blood and therefore increase the risk of internal bleeding, especially if taken with prescription blood thinners. The safest way to get your omega-3 fatty acids is in moderate amounts through food, unless otherwise indicated by your physician.
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Long Story Short…
Great benefits – such as reduced risk for chronic diseases – can result from eating more unsaturated fats than saturated fats. Further, it’s important to consume more omega-3 fatty acids than omega-6 fatty acids to balance our ratio, and reduce inflammation and the risk of developing inflammation-related illnesses. The approximate recommended ratio for omega-6 to omega-3 intake is between 1:1 to 4:1 (the same or just slightly more omega-6 than omega-3). We hope the charts provided will be helpful in helping you choose healthy fats in the right proportions more often.
Disclaimer
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References
American Heart Association. Monounsaturated fats. Updated March 24, 2017. Available from: https://healthyforgood.heart.org/Eat-smart/Articles/Monounsaturated-Fats.
American Heart Association. Polyunsaturated fats. Updated March 24, 2017. Available from: https://healthyforgood.heart.org/Eat-smart/Articles/Polyunsaturated-Fats.
Huang X, Lindholm B, Stenvinkel P, et al. Dietary fat modification in patients with chronic kidney disease: n-3 fatty acids and beyond. J Nephrol 2013; 26(6):960-74. doi: 10.5301/jn.5000284.
Patterson E,Wall R, Fitzgerald GF, et al. Health Implications of High Dietary Omega-6 Polyunsaturated Fatty Acids. J Nutr Metab. 2012: 539426. doi: 10.1155/2012/539426
Wong TC, Chen YT, Wu PY, et al. Ratio of Dietary n-6/n-3 Polyunsaturated Fatty Acids Independently Related to Muscle Mass Decline in Hemodialysis Patients. PLoS One. 2015 Oct 14;10(10):e0140402. doi: 10.1371/journal.pone.0140402.
Yuzbashian E, Asghari G, Mirmiran P, et al. Associations of dietary macronutrients with glomerular filtration rate and kidney dysfunction: Tehran lipid and glucose study. J Nephrol 2015; 28(2):173-80. doi: 10.1007/s40620-014-0095-7.