By The Eye PracticePublished On: 20 April 20185.6 min read

Dry eyes are on the increase, with one in four people now complaining of dry eye symptoms to their optometrist. With one of the largest dry eye clinics in the Asia-Pacific, The Eye Practice sees dry eye patients every day.

Everyone’s dry eye is different, but there are some common themes that emerge. Everyone needs to blink more often and more completely. And everyone should be looking at their ratio of omega-3 to omega-6 in their diet. The wrong ratio leads to inflammation in the body, and, more importantly in the tear-producing apparatus of the eye. The result? Dry eyes. The solution? Read on…

Why omega-3?

Every cell in your body has a membrane made from omega-3 fatty acids. These molecules are particularly important in your brain as well as your retina. Omega-3 also has an anti-inflammatory effect on your body. Another type of fatty acid – Omega-6 – when consumed in excess, has the opposite effect on inflammation. An excess of omega-6 fatty acids are implicated in many Western diseases such as high blood pressure, heart disease, diabetes and autoimmune disorders.

Researchers have found a lot of evidence to show that, as a species, we evolved on a diet with omega-3 and 6 in equal parts (or 1:1 ratio). The traditional Mediterranean diet is approximately 4:1 (or four times more omega-6 compared to omega-3). This is still a very healthy ratio. It may come as shock to hear that the modern Western diet consists of a ratio of 16:1, which means we are consuming 16 times more omega-6 compared to 3 fatty acids.

The message we hear to reduce inflammation, including dry eyes, is to eat more Omega-3s in our diet (oily fish, leafy greens etc.) or through supplements or fish oil or krill oil. What many of us don’t realise is that it is relatively easy to improve our omega-3:6 ratio without increasing our omega 3s at all; all we need to do is decrease those omega-6s we are eating so much of.

What foods contain omega-6?

Plant oils such as corn, sunflower, soybean and cottonseed oil are the primary culprits when it comes to omega 6 in our diet. They’re everywhere! Corn and soy are the backbone of the western diet and these oils appear in an extraordinary number of processed foods. At their worst, these oils are chemically modified to make them solid. These trans fats are hiding in most cookies, chips, crackers, baked goods and pasties available from supermarkets.

These same oils are used in salad dressings, mayonnaise and in fried foods such as battered fish, chicken and hot chips. It is also worth noting that many ‘health’ foods contain these oils, including ‘healthy’ crackers, snacks and chips.

Other sources of omega 6 are chicken skin, processed pork, fatty (or grain fed) beef, whole grain or seeded breads, egg yolks, nuts, seeds and cereals. Many of these foods (such as nuts and eggs) have other health benefits and this should be considered when making changes to your diet.

7 quick ways to cut down on omega-6 in your diet

Addressing your 3:6 balance for dry eye relief can be as simple as eliminating the following foods as much as possible from your everyday diet:

Chicken skin: Sure, it’s tasty, but this is where the omega 6 fatty acids are lurking. Take off the skin and fat and stick to the lean white meat where possible. Avoid fried chicken or takeout chicken other than the odd rare treat. The brown meat (the leg) is also fattier, so stick to breast.
Margarine and spreads: Even if it’s made from polyunsaturated oil, margarine is bad news for your Omega 3:6 balance. Butter (small quantities!) is one of the better options but better still is to do as the Italians do and place a bowl of high quality extra virgin olive oil on the table for dipping your bread. Not for you? Try blending a good quality olive oil with a good butter – half and half. Tip: soften the butter first, blend, then refrigerate in a plastic container. Apart from the health benefits over plain butter, this is easier to spread from the fridge.
Chips, popcorn and crackers: Watch out for omega-6 sneaking into your food disguised as butter: buttered popcorn is a serial offender. Packaged chips and crackers are usually fried in oil (or, worse again, trans fats). Save them for the odd holiday treat. Enjoy your dips with carrot sticks, or toasted Turkish bread torn into strips.
Salad dressings: Commercially available salad dressings are often made from Omega 6 rich safflower, sunflower or corn oil. Look for those made from olive or canola oil or make your own:
- 4 parts extra virgin olive oil
- 1 part lemon juice or vinegar (white wine, red wine or balsamic are all delicious)
Fish and chips: This one is hard, but the culprit is the batter, not the fish. Battered fish (like battered chicken above) is packed with omega-6 oils from the frypan. Sadly the chips are too! Save this treat for every now and then and instead choose grilled fish and a baked potato and salad.
If you’re cooking at home, you can cut potato or sweet potato into wedges, sprinkle liberally with olive oil (and a little salt) and bake in a hot oven for a better option. Fish can also be breadcrumbed and fried in a little olive oil or coconut oil.
Peanut butter (and other nut butters):
This is a tricky one, as nut butters made entirely from nuts do offer a good source of fats in our diet. The only trouble is that these fats are very high in omega-6. If you’re getting plenty of omega-3, there’s no reason to cut out your favourite nut butter completely. But if you’re serious about cutting down on Omega-6 in your diet, take it easy on the nut butter.
Vegetable oils: These are usually bad news. Best choices are olive and canola oil. Butter, coconut oil, lard and palm oil are also relatively low in Omega-6. Sunflower, Corn, Soybean and Cottonseed oils are by far the worst.

Realistic expectations

To see any effect on your dry eyes from altering your omega 3:6 ratio, you’ll need to give it at least 6 months, and preferably longer. The initial effects may be on your skin, with less inflammation of the skin around the eyelids and better quality oily tears. Reduced inflammation in the lacrimal gland (which produces your watery tears) will lead to improved tear production.