Vital Choice readers know that the American diet is high in a type of fat called omega-6, plentiful in soybean and cottonseed oil, and in processed food generally. (For a complete list, see Avoid “The Hateful 8” Dietary Fats.) Cold-water fish like salmon, mackerel and sardines are the best source of omega-3s, which are linked to better health in myriad ways for both children and adults.

The ideal human ratio of omega-3 to -6 isn’t yet pinned down. However, anthropological evidence suggests that we evolved eating about the same amount of these two fats. Today, in a standard American diet, you might be eating 15 or even 17 times as much omega-6 (Simopoulos, 2006).

Omega-3 fats, which we must get from our diet, are part of our cell membranes and help us make the hormones that regulate inflammation, which is tied to pain control.

Now we have new evidence that cutting the omega-6s in your diet and adding omega-3s could help you avoid or reduce pain, such as chronic pain associated with injury or disease (Boyd et al., 2021; Mauck et al., 2021).

What the researchers did

Burn patients often live with chronic pain. In one fascinating study, scientists measured the blood level of omega-3s in burn survivors soon after their injury. When they tracked the patients’ reports of pain over the next year, they found that those with higher omega-3 levels reported less pain (Mauck et al., 2021). 

More extensive research comes from a team in San Antonio, Texas, which spent five years on a series of studies, first with mice and then with humans. Some mice were fed a high omega-6 diet, and others an unusually low one. The mice on the high omega-6 diet reacted more strongly when they were stimulated by heat; an indication of more sensitivity that could increase response to pain signals.

Image of 8 cooking oils
What makes the American diet so high in pro-inflammatory omega-6 fatty acids? Here are the leading culprits. None of these refined, industrially produced oils was part of the American diet a century ago. (Reprinted with permission from

These mice had less-dense nerves in their skin, a marker of nerve damage that triggers pain, as well as other nerve changes associated with pain, diabetes and heart disease in humans, and the change took only a few weeks on the high omega-6 diet.

So actually, it turned out to be a bit cruel to feed mice the way most Americans eat. 

But here’s the good part: Putting these mice on a diet low in omega-6 reversed the effects.

From mice to men

Other researchers have found that people with irritable bowel syndrome, rheumatoid arthritis and headache, all pain ailments, tend to have relatively high levels of omega-6 in their blood. To test this further, the Texas team recruited 28 volunteers, half of whom had diabetes-related pain.

As expected, the volunteers with diabetes had much higher omega-6 levels in their blood and the higher the level, the more pain they experienced. Three-quarters of the volunteers with diabetes and high omega-6 levels were taking medication to manage their pain, including gabapentinoids (a specialized painkiller class used against diabetes-related pain) and the selective serotonin reuptake inhibitors (SSRI) anti-depressants.

Omega-3 and endocannabinoids

One of the key approved uses of medical marijuana is to treat chronic pain. Cannabis sativa plays its helpful role by activating receptors in our bodies that are also activated by natural chemicals called endocannabinoids, which are synthesized from both omega-6 and omega-3  fats. A fast-moving area of research is exploring the role of a variety of these endocannabinoids specifically generated by omega-3s, which seem to be involved with pain (Watson et al., 2019).    

What this suggests for people in pain

It’s likely that we all need to consciously push our omega-6 consumption down as well as pull the omega-3 up. Lowering “6” is apparently not optional: The San Antonio team noted that simply adding omega-3s to the diet of mice that had been gorging on omega-6 didn’t reverse the damage, though it had a partial effect.

fresh raw pacific wild sockeye salmon
When it comes to the omega class of fatty acids, nix the 6s and eat the 3s! Sockeye salmon is a good place to begin.

To get closer to an ideal balance between omega-3s and omega-6s, you’ll have to avoid or reduce the oils listed in “The Hateful 8” above. Safflower and canola oil are the “least bad” of these, but still have more omega 6 than omega 3.

In short, at least two seafood dinners, especially ones featuring salmon, is a start, but high-omega-6 foods are everywhere. Find a way, within your own diet and lifestyle preferences, to eat them less often.  

But I have a great diet and still have pain!

People vary in how well they can absorb omega-3s. The food you eat seems to explain only 40 percent of the variation scientists find in omega-3 levels in red blood cells (McBurney et al., 2021). But given that there are essentially no downsides to seafood and vast potential benefit from its omega-3s and other vital nutrients such as iodine and selenium, there is no reason not to regularly and “eat the 3s.”



Boyd JT, LoCoco PM, Furr AR, et al. Elevated dietary ω-6 polyunsaturated fatty acids induce reversible peripheral nerve dysfunction that exacerbates comorbid pain conditions. Nat Metab. 2021;3(6):762-773. doi:10.1038/s42255-021-00410-x

García-Esquinas E, Ortolá R, Banegas JR, Lopez-García E, Rodríguez-Artalejo F. Dietary n-3 polyunsaturated fatty acids, fish intake and healthy ageing. Int J Epidemiol. 2019;48(6):1914-1924. doi:10.1093/ije/dyz196

Mauck MC, Barton CE, Tungate AS, et al. Peritraumatic plasma Omega-3 fatty acid concentration predicts chronic pain severity following thermal burn injury [published online ahead of print, 2021 Apr 25]. J Burn Care Res. 2021;irab071. doi:10.1093/jbcr/irab071

McBurney, M. I., Tintle, N. L., Vasan, R. S., Sala-Vila, A., & Harris, W. S. (2021). Using an erythrocyte fatty acid fingerprint to predict risk of all-cause mortality: the Framingham Offspring Cohort. The American journal of clinical nutrition, nqab195.   Published June 16, 2021.

Simopoulos AP. Evolutionary aspects of diet, the omega-6/omega-3 ratio and genetic variation: nutritional implications for chronic diseases. Biomed Pharmacother. 2006;60(9):502-507. doi:10.1016/j.biopha.2006.07.080

Watson JE, Kim JS, Das A. Emerging class of omega-3 fatty acid endocannabinoids & their derivatives. Prostaglandins Other Lipid Mediat. 2019;143:106337. doi:10.1016/j.prostaglandins.2019.106337

Zhu Y, Ferrara A, Forman MR. Omega 3 polyunsaturated fatty acids and Healthy Ageing. The BMJ. Published October 17, 2018.