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Inflammation, Fertility and Essential Fatty Acids (EFAs)

by Beth Heller, MS

Inflammation is our body’s immune response to damaged cells, infection or allergy.  Acute inflammation is our body’s immediate response to injury or infection and is characterized by redness, heat, swelling and pain that are caused by increased blood flow into the inflamed area.  In addition to increased blood flow, the acute phase of inflammation is characterized by the presence of white blood cells and phagocytes (immune cells that clean up cell damage by “eating” it).  In a healthy body, acute inflammation is matched by an anti-inflammatory response that takes over once injury is past and promotes healing in the damaged tissues.  Chronic inflammation results when the acute immune response remains active as a result of stress digestive problems, environmental toxins, allergies, etc.   In the case of chronic inflammation, pro-inflammatory immune cells continue to circulate in the body and damage healthy tissues including blood including vessel linings (atherosclerosis), joint tissue (arthritis) and gut mucosa (food intolerance).  Interestingly, the mediators of inflammation are also implicated in insulin resistance.  Chemical messengers released by the immune cells of the inflammation response actually cause target cells in the fat and liver tissue to lose their ability to respond to insulin.

Acute inflammation is actually a normal part of many reproductive processes – cyclical changes in the ovaries, egg maturation and ovulation, and changes in the endometrial lining all have an inflammatory component.  However, conditions like endometriosis, Polycystic Ovarian Syndrome (PCOS), pelvic inflammatory disease (PID) and premature ovarian failure have been linked to chronic inflammation and adverse pregnancy outcomes.  Researchers hypothesize that chronic inflammation may impair the uterine environment and/or disrupt the specific chain of immune system events that allow an embryo to implant (Levin et al. 2007).

The main chemical mediators of inflammation are prostaglandins, chemical messengers that turn the immune component of acute inflammation on and off. Prostaglandins are made on an “as-needed basis” from long-chain fatty acids present in the cells of an infected/damaged area. There are two main groups of prostaglandins: pro-inflammatory prostaglandins (called Phase 2 prostaglandins) which stimulate acute inflammation at the injury site and the anti-inflammatory prostaglandins (called Phase 1 and Phase 3 prostaglandins) that turn it off.

Arachidonic acid is the main pro-inflammatory Series 2 prostaglandin active in the body. Its role is to signal the acute inflammatory response in injured cells and is released in the presence of injury or irritation. Arachadonic acid is present in our diet in animal products (meat and dairy) and can also be manufactured from linolenic acid (also known as Omega-6 fatty acid found in corn oil, soy bean oil and in the meat of animals that are fed corn).  On the side of the “good guys” is eicosapentaenoic acid (EPA) which is chiefly found in marine plants and animals. EPA is part of a family of compounds called Omega-3 Essential Fatty Acids that also includes alpha linoleic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). EPA is the lipid structure our body uses to make beneficial prostaglandins that reduce inflammation.

The “primitive” human diet contained an estimated 1:1 ratio of omega-6 to omega-3 fats. Today our diet is far more skewed toward the pro-inflammatory omega-6 fatty acids, about 10:1. Unfortunately, since the fatty acids we eat are ultimately incorporated into our tissues, this dietary shift has skewed our physiology toward inflammation.

Strive to decrease intake of omega-6 fats (refined oils like corn and soy, and processed foods made with these oils) and increase the intake of omega-3’s (dark leafy greens, walnuts, seeds, fatty fish). The most bio-available sources of omega-3’s are marine/fish oils. Unfortunately, due to environmental toxicity concerns, intake of fatty fish must be limited in women who are pregnant or trying to conceive. As such, we do recommend a high-quality fish oil supplement that provides ample omega-3s.