Sorry to those who have been here and are already serious about your health but we have a lot of new people who are trying to understand how to be kinder to their livers and who need to understand things that matter.

Lipid metabolism, big words that mean how does your body use fat.  We see endless articles about fat in our diets.  Endless contradictory claims about special diets, miracle foods, buy my secret pills, doctor invented. blah blah.  Very confusing if you aren't a bio-chemist.

The subject is vastly complex.  In this note I'll try to simplify just one subject that you can have some control over.

There are many paths to the inflammation that is NASH/cirrhosis and a potential killer.  Your food is really a complex soup of chemicals that the body uses to your benefit or tries to defend itself against.  With inflammation or NASH the balance between things that make it worse and those that make it better, in simple terms, determine the outcome of fibrosis and cirrhosis resulting from NASH.

Here we'll take a look at the Omega 6 Omega 3 fatty acids.  You all know of them but do you understand their relationships?  For those who don't, look carefully at this chart. It may be easier to read if you click on it for a larger view.

This is a simplified diagram of processes that the omega 6 and omega 3 fatty acids go through as they are manipulated by your body.  All Fatty acids are involved in a wide array of chemical reactions which depend upon how they are actually made. That is how long they are and do they have kinks in them or not as just two variables.

If you would like to read some research about it here is a link

A couple of points to illustrate.  Look near the top and you will see that omega 6 and omega 3 are both 18 carbon atoms long.  The differences seem trivial as one has a kink at position 6 the other at position 3.  That difference means everything about what happens in the body.  You can see that they are converted into different chemicals by the liver as they are made into products that the body actually uses and the final products are different.

If you are a wise steward of your liver you might wonder if one is better for you than the other.  The short answer, noninflammatory material is easier on liver cells.  OK, but how do we interpret that chart?

You can see at the bottom that some products are more inflammatory and some are less.  Can you influence which kind you get? The interesting answer is yes.  If you look at the center column where it says delta 5, that is the point where you have some influence.

It turns out that both fatty acids use the same enzyme at that step in their chemical processing.  Delta 5 desaturase is a critical step for both processes.  It is also useful that the enzyme prefers to work with the omega 3 oil.  So when you eat both omega 6 and omega 3 your body will tend to produce more prostaglandin 3 and other beneficial chemicals instead of prostaglandin 2 which is more inflammatory.

Why is that important.  In our modern diet, omega 6 is found in the seed oils like cottonseed and soybean oils.  Because those are very inexpensive they have become a main source of calories in modern food manufacture.  To get a sense of that look at this picture of soybean production.

When you overload your body with seed oil like soybean, which is everywhere today, you make it harder for your liver to combat inflammation.  By itself you could probably manage it but there are many sources of inflammatory materials but the more of them you can control the easier it will be for your liver to function.

The dietary strategy, more omega 3 and less omega 6, so more fatty fish and read the labels.  I know this is one more thing to have to pay attention to but as you work to learn how to think about the medicines you consume as food, it is good to have a sense of why you care about things like just what kind of oil are you eating.

Here are some omega oil sources as a reference.