One of the most important groups of essential fatty acids are called omega-3-fatty acids, or ù3s ("ù" is the Greek symbol for "omega"). The primary, or "parent" ù3 fatty acid is alpha-linolenic acid, or ALA. It, in turn, can be metabolized in the body into other ù3s, including EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). There is a growing body of research supporting the importance of dietary omega-3s. Studies have shown that intake of ù3s is associated with a decrease in cardiovascular disease. In fact, it was the observation that Eskimos ate huge amounts of fat but rarely got heart attacks. That started scientists questioning whether the kind of fat that was consumed made a difference. Sure enough the Eskimos were eating fat from seafood and marine mammals containing a great deal of ù3 fatty acids. Omega 3s have also been shown to reduce vulnerability to ventricular fibrillation, a life-threatening heart arrhythmia that is a major cause of cardiac arrest.

There are many benefits of omega-3s that are of special interest to people with pemphigus and pemphigoid. Omega 3s are the precursors to prostaglandins, chemicals that regulate nearly every body function. Prostaglandins help control the inflammatory process, the healing and repair process, the immune system, neural circuits in the brain, the cardiovascular system, the digestive and reproductive systems, and temperature regulation. The role of ù3s in regulating the immune system, the inflammatory response, and the body's healing and repair process is of special interest to people with pemphigus.

The relationship between omega-3s and the inflammatory response is significant. Cytokines are a class of substances that can stir up inflammatory ailments. Research has shown how ù3 supplements cuts down the body's production of two cytokines, not just during the study, but for 10 weeks afterward. One study described good results with a small number of rheumatoid arthritis patients who used supplements of ù3s. Another study showed the benefit of ù3s in reducing symptoms of inflammatory bowel disease.

There is also evidence linking healthy skin with omega-3s. Prostaglandins are involved in the cellular activity leading to both inflammation and healing. When an ù3 deficiency occurs it is believed too many inflammation-inciting prostaglandins and too few of the prostaglandins that promote healing are available. Skin ailments that have responded positively to ù3 supplementation include eczema; scaling of the skin on the scalp; discoid lupus, a skin version of lupus producing severe hair loss, scarring and sun sensitivity and; alopecia areata. The effect of ù3s on pemphigus/pemhigoid has not been studied. But the evidence that ù3s are so important for healthy skin should encourage everyone to increase their intake of these essential fatty acids.

Another piece of good news about omega-3s...at least one study has linked increased fish oil intake to an increase in bone density. For those taking prednisone, this could help reduce the risk of osteoporosis associated with prednisone.

Omega-3s are also important in all aspects of brain activity and neurological functioning. Research has linked ù3 deficiency to dyslexia, schizophrenia, even epilepsy. Recent studies have shown that consumption of high ù3 fish oil dramatically improved subjects with bi-polar disorder. Perhaps ù3s can help reduce the mood swings associated with prednisone.

One of the best ways to get the essential omega-3s is by eating foods rich in ALA, the "parent" ù3, or EPA and DHA, metabolites of ALA. Major dietary sources of EPA and DHA are fish and shellfish. Especially good sources are dark, cold-water fish such as tuna, swordfish, American eel, salmon, striped bass, anchovies, herring, mackerel, trout and sardines. These fish also contain minerals and high quality protein.

While there is no RDA for omega-3s, you should try to consume between 1 and 3 grams/day. That translates to about 3-4 ounces of mackerel or herring, or about 8 ounces of salmon, albacore, tuna or lake trout. Clara Felix, a nutritional journalist who spoke at the Foundation's last patient-doctor conference in San Francisco, has a personal favorite...a sandwich piled high with tomatoes, sprouts, and Norwegian sardines smeared on the bread. That provides about 2 grams of essential EPA and DHA. Clara's newsletter The Felix Letter, PO Box 7094, Berkeley, CA 94707, was the source of much of this information in this article.

If you don't like to eat fish, or simply want to vary your source of omega-3s, good vegetable sources of ALA are flaxseeds, walnuts, chestnuts, butternuts, pumpkin seeds, chia seeds, perilla seeds, soybeans, wheat germ, and common beans. Also flaxseed and canola oils are good sources. Once absorbed by our bodies, ALA can be converted to EPA and DHA. The body may not easily metabolize ALA to EPA and DHA. It's best to make sure you also have a certain amount of EPA and DHA in your diet.

Flaxseed is an especially useful source of ALA. In addition to containing high levels of ALA, flaxseed also contains lignin, a dietary fiber that may have an anti-cancer effect. Animal studies show protective effects of flaxseed on both mammary and colon carcinogenesis. Flaxseed is also unique in that it is rich in a viscous fiber that may help regulate blood glucose, especially useful for diabetics. Finally, the fiber in flaxseed may also have a cholesterol-lowering effect.

Health food stores sell ground flaxseed, or flax meal. You can also buy whole flaxseed (it looks like birdseed), and grind it yourself. It will stay fresh for a long time if you keep it in a covered container in the refrigerator. Ground flaxseed can be used in almost anything you eat. It can be sprinkled on breakfast cereal, stirred into yogurt, mixed with peanut butter, combined with salads, combined in sandwiches, added to cooked vegetables or casseroles. One rounded tablespoon provides about 2 grams ALA. Some people report that if they eat too much flaxseed they feel "gassy." Start slowly in the beginning.

Other vegetable sources of ALA are walnuts--1 gram ALA/5 nuts; canola oil--1 gram ALA/2 tsp. oil; cooked soy beans--0.4 grams ALA/1/2 cup cooked soy beans.

If you would like to learn more about omega 3s, you may want to refer to the following books: Omega 3 Oils. Donald Rudin, M.D. & Clara Felix. Avery Publishing Group, Garden City Park, NY. 1996; The Omega Diet. Artemis P. Simopoulos, M.D. and Jo Robinson. HarperPerennial, New York, NY. 1999; Flaxseed in Human Nutrition. Stephen C. Cunnane & Lilian U. Thompson, eds AOCF Press, Champaign, IL. 1995.

Recipes

Lazy Chef's Salmon Salad

Combine the following ingredients in a large bowl:

• One 15 oz. can salmon, bones and all. Drain off liquid. Rinse with cold water to wash away extra salt.
• Any or all of your favorite raw veggies, chopped into small chunks: tomatoes, cucumbers, cabbage, celery, parsley, red peppers, minced garlic, etc.
• Chunks of leftover cooked veggies, if you have any.
• Canola, flax, or soybean oil or mayonnaise.
• Lemon juice, apple cider vinegar or rice vinegar.
• Favorite seasonings.

Mix all ingredients. Serve.

Tastes even better next day. Makes wonderful sandwiches or takeaway salad for work or school lunches.

Quickie Clam-Salmon Chowder

• One can New England style clam chowder.
• Broccoli, frozen peas or any other favorite vegetable(s).
• One can salmon, approx. 15 oz.

Cook vegetable(s) in 1 cup water until tender. Add canned clam chowder, 1/2 can salmon, additional water if needed.

Heat together. Serve. (Use leftover salmon for sandwiches next day, or for eggs scrambled with salmon for breakfast.)

Carrot Muffins with Flaxmeal

1/4 cu. butter
1 cu. shredded carrots
1/4 cu. brown sugar
1 cu. flour
2 eggs
2 tsp. baking powder
1 Tbsp. lemon juice
1/2 tsp. salt
1 Tbsp. water
1 Tbsp. flaxmeal

Beat butter and sugar until creamy.

Add eggs and beat until light.

Stir in water, lemon juice and carrots.

Add remaining ingredients and stir enough to moisten.

Bake 375 degrees F for 20 minutes