What does the evidence say about the importance and efficacy of omega-3s

There is a lot of information on Omega 3's these days. This is a long article with vital information for your health. The bottom line is this. Your body needs omega 3 essential fatty acids. You've heard competing claims that red wine is good for the heart — and alcohol causes cancer. Research has shown butter clogs arteries, but then the media tells us “butter is back.” So is fish oil effective against heart disease, or is it not? Thanks to Ocean Robbins for this great and in-depth article.

The best source is from fish oil. Quality matters. Most brands don’t give you enough of the therapeutic ingredients EPA & DHA to make a difference. They also use fish contaminated with dangerous heavy medals like mercury. Or they finish the product with hexane, a petroleum product. Depending on your genetics that can be very damaging. The kind I take is Pro Omega 2000 from Nordic Naturals. If you’ve already created a Fullscript account you can order it there or follow this link and create one. Of course, fish oil and omega-3s, while synonymous in the broad wash of sloppy media coverage, are not the same thing. What, then, does the evidence say about the importance and efficacy of omega-3s? How much do you need to function at your best? And if you don’t eat fish or take fish oil supplements, can you reliably get enough from vegan sources? Heck, what are the best sources of these nutrients anyway? What Are Omega-3s? Omega-3s are a type of polyunsaturated fatty acid (a family of compounds signified by the acronym PUFA, which sounds like a Teletubby or an extremely comfortable chair). They fall into the category of essential fatty acids. In nutrition, “essential” simply means you can’t make them yourself, so you have to source them externally, either through food or supplementation. In chemical nomenclature, the “omega” signifies the location of the double bond in its carbon chain. It has nothing to do with the Omega watches that James Bond wears, although his last name does make me wonder. There are 3 types of omega-3s: ALA, EPA, and DHA. ALA (alpha-linolenic acid) fats are mostly metabolized in your intestines and liver and are needed for energy. ALA is a shorter long-chain fatty acid precursor, meaning your body can also convert ALA into the other two long-chain omega-3s, EPA and DHA. However, research indicates that most of us are not very efficient at converting ALA to EPA and DHA. An average of just 1–10% of ALA is converted into EPA, and 0.5–5% into DHA. The conversion rate can vary significantly between people, depending on factors like genetics, age, and health status. Interestingly, women may be better at this conversion than men, thanks to higher estrogen levels.

  1. EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are long-chain omega-3 fatty acids whose names sound nothing like Teletubbies. Both can be converted from ALA as mentioned above, but you can also get EPA and DHA from food and supplements. These two omega-3s offer more potent health benefits than ALA. For instance, EPA helps manage inflammation in the body, and DHA is crucial for maintaining brain health.

How Much of the Omega-3s Do You Need? The recommended daily intake of omega-3s by age group is as follows : 0-6 months: .5 g 7-12 months: .5 g 1-3 years: .7 g 4-8 years: .9 g 9-13 years: 1.2 g (male), 1 g (female) 14+ years: 1.6 g (male), 1.1 g (female) Pregnancy: 1.4 g Breastfeeding: 1.3 g But aside from babies up to one year old, these omega-3 numbers are only based on ALA intake. Even though there are no official guidelines for DHA and EPA, research suggests that combined EPA and DHA intake should be between 250-500 mg per day, for adults. Meanwhile, surveys have shown that most American adults are only getting around 90 mg per day of EPA and DHA combined, which means that most of us are getting between ⅓ and ⅙ the amount we need for optimal health. A 2019 study published in the journal Nutrients assessed the omega-3 intake of over 45,000 Americans, finding that every age group fell short when it came to meeting daily recommended intakes. If we were doing as badly on protein, vitamin C, or calories, it would be considered a public health emergency. Once you see how important omega-3s are to your health, you might see it that way yourself. Omega-3 Health Benefits. Most of the research on the potential health benefits of omega-3s has focused on fish and fish oil. Observational studies have linked higher intakes of fish and seafood to better outcomes related to heart and brain health, inflammation, cancer, and even IQ scores. In a 2019 review of 44 studies that was published in the highly specialized medical journal PLEFA (“Prostaglandins, Leukotrienes & Essential Fatty Acids” isn’t what most people would call light reading), researchers concluded that children who ate seafood had better school grades, and higher IQs by as much as 9.5 points when compared to their peers who ate no fish. Whoa, that sounds like a huge difference! But the problem is, we don’t know exactly why fish appears to be helpful. Is it because most types of fish are high in omega-3s (which they are), and omega-3s are awesome for us? Or is it because fish is less harmful than the food it replaces, like red meat and heavily processed foods? The jury is still out on whether the healthiest diet contains some fish, or is completely animal-free. To reach clarity on this topic, we would need clinical trials conducted over long periods of time, with highly compliant participants willing to stick to a particular eating pattern for decades. In other words, we may never know with certainty. Still, we do have some research that points to the considerable health benefits of omega-3s — whether or not they are derived from fish. Here are six areas in which omega-3s appear crucial. 1. May reduce your risk for heart disease. Even with all the controversies, there is solid evidence that getting enough omega-3s can protect your heart. In fact, they have been shown to significantly lower your risk for sudden death from heart arrhythmias and all-cause mortality among people with known coronary heart disease. Omega-3s have also been shown to be effective in lowering LDL cholesterol and triglycerides, as well as high blood pressure, which are all risk factors for heart disease. Omega-3s can also raise HDL (“good”) cholesterol, reduce platelet aggregation, prevent coronary artery blockages, reduce the chance of abnormal heart rhythm, lower inflammation, and improve arterial health by helping prevent the buildup of plaque. 2. Support brain health and development. Getting enough omega-3s is particularly essential early in life, as the brain grows and develops. But that doesn’t mean it’s not important later, too. In fact, a 2018 review discussed how omega-3 fats may benefit mild cognitive impairment, such as in the instance of major depressive disorder or Alzheimer’s dementia. Omega-3s have a potent anti-inflammatory and antioxidant effect in the brain. So while extra omega-3s may not turn you or your child into an Einstein, not enough can impair brain development in infancy and childhood, and is associated with higher rates of dementia and depression in adulthood. 3. May have immune benefits. Omega-3 fats are considered immunonutrients, meaning they have a unique role in the cell signaling and cellular structure of the immune system. As such, they’re commonly used as part of treatment protocols for cancer patients. Omega-3 fats are known to suppress inflammatory processes throughout the body. This has notable benefits for reducing cardiovascular disease, rheumatoid arthritis, dementia, and many other serious conditions. But you may wonder whether the anti-inflammatory effect of omega-3s could reduce the effectiveness of the immune system since inflammation is one of its key mechanisms. It turns out otherwise, though. Omega-3s appear to ramp up the actions of the beta immune cells, leading to healthier and more calibrated immune responses. 4. May support eye health. Having enough omega-3s circulating in your body may help prevent age-related macular degeneration (AMD), a common eye condition that can result in vision loss. One 2014 study found that higher levels of EPA, DHA, and markers of long-chain polyunsaturated fatty acid storage were strongly associated with a reduced risk for AMD. 5. May help boost your mood. With the increased prevalence of mental health concerns like depression, the use of supplements like omega-3 have also increased. And it seems like this may be worthwhile for many people. A 2019 meta-analysis found that omega-3 supplements with an EPA concentration of at least 60%, and taken at a dosage of ≤1 gram per day, have beneficial effects on depression. Other studies on omega-3 supplementation have led to mixed results. But it’s generally thought that EPA may benefit people with depression, while DHA may reduce the risk of suicide. 6. Offer anti-inflammatory benefits. Many studies, using a placebo control, have found that omega-3 supplements are as effective as anti-inflammatory medications in terms of reducing symptoms of chronic inflammatory diseases. But instead of negative side effects, they might also provide benefits to your heart, brain, immune system, eyes, and mood! Omega-3 Deficiency. With all these amazing benefits of omega-3s, there’s no question they’re important for your health. And not getting enough can have serious consequences if it’s not identified and properly addressed. Omega-3 fatty acid deficiency may lead to dry scaly rash, decreased growth in infants and children, increased susceptibility to infection, and poor wound healing. Given the activity of omega-3s in your brain, not getting enough of them can also lead to brain impairment, including effects on your memory and ability to think clearly. Fortunately, true deficiency of omega-3s is very rare, at least in the US. It’s more common to experience omega-3 insufficiency, where you’re getting some, but not enough for optimal benefits. As mentioned earlier, in the US, the average intake of EPA and DHA from food sources is about 90 mg in adults. This equates to about ⅓-⅙ of recommended amounts, leaving many of us with EPA and DHA insufficiency. Of course some people are able to convert ALA to EPA and DHA but not always with great efficiency. Getting enough ALA is a concern too, although it’s less of a problem because it’s found in more foods, particularly on a plant-based diet. In adults aged 20 years and older, the average daily ALA intake from foods is estimated to fall around 1.59 grams in females and 2.06 grams in males. Omega-6 to Omega-3 Ratio. Getting enough omega-3s isn’t the only factor to consider, however. It’s also important to understand how much you’re getting in relation to other omega fatty acids — namely omega-6s. You can find omega-6s in most vegetable oils, with sunflower, corn, soybean, safflower and cottonseed oils containing the highest amounts. Olive oil and avocado oil are an exception, as they are not high in omega-6s. But the standard western diet is notorious for giving us way too many omega-6s compared to omega-3s. This is a serious problem because too much omega-6 in your diet can have a pro-inflammatory effect in the body and increase your risk of various chronic diseases. In general, omega-6s are pro-inflammatory, while omega-3s are anti-inflammatory. But it’s not that one is bad and one is good — you need both, just in the right proportion. So what’s the optimal ratio of the two? Ideally, you want an omega-6 to omega-3 ratio somewhere between 4:1 to 1:1. Some sources estimate that the ratio of the average American falls around 16:1. Yikes! If your diet is heavy on the omega-6 side, this can actually reduce how efficiently your body can convert ALA to EPA and DHA which, as we mentioned earlier, is already a fairly low conversion rate for most people. This appears to be because some omega-6s compete for the same enzymes in order to complete these conversions. Reducing your dietary omega-6s can also increase the bioavailability of omega-3s. Who’s Most at Risk of Deficiency? There are certain groups of people at higher risk of omega-3 deficiency. One example is people dependent on feeding tubes, in which nutrition is delivered directly to the stomach, bypassing the mouth and esophagus. Their risk is magnified if they have malabsorption issues and are dependent on feeding tubes long-term. Other populations may have insufficient levels of omega-3, and of EPA and DHA, in particular. Vegans and vegetarians who do not eat seafood may be at risk of deficiency, as fish is high in EPA and DHA. If this is you, don’t despair; we’ll talk about alternative sources below. Adults over 65 years of age can be at a higher risk for nutritional deficiencies in general, due to reduced appetite and less efficient nutrient absorption and metabolism. This may mean a higher risk for fatty acid deficiencies, though more studies are needed to assess omega-3 status in specific age groups. Lastly, people who eat a westernized diet have a higher risk for omega-3 insufficiency even if they do include some seafood in their diets. This is because the western diet includes so many pro-inflammatory foods, such as ultra-processed and highly refined grains, oils, and added sugar. One 2016 study that looked at the EPA and DHA blood levels among various populations found that fatty acid levels are higher in places where people are eating a more traditional diet and haven’t fully adopted a western dietary pattern. Omega-3 Fatty Acid Testing Unlike tests for cholesterol or fasting blood sugar, tests for fatty acid deficiency are not routine diagnostics. Doctors tend to prescribe this test just for pregnant women or people with cardiovascular disease. However, you can request a fatty acid test from your doctor if you’re curious or concerned. The fatty acid test is a fasting blood test, which means you can’t eat or drink anything (except water) the night before (so it’s best to schedule for the morning). The results will tell you your omega-3 (EPA+DHA) index, which generally falls between 1.4-4.9%. Ideally, your results will be greater than 3.2%. Additionally, it can tell you your omega-6 to omega-3 ratio. If you want to get testing done without requiring a doctor’s prescription, find out how to use Ulta Lab to get your omega-3 levels checked, here (USA only). Sources of Omega-3 You can get omega-3 fats from whole foods, fortified foods, and supplements. Depending on your needs and dietary preferences, you can mix and match from these sources to achieve healthy levels of these nutrients. Food Sources ALA Some of the best vegan sources of ALA include flaxseeds, chia seeds, hemp seeds, and walnuts. Try love adding these to smoothies, sprinkling them onto salads, adding them to oatmeal, or mixing them into batters for homemade muffins, waffles, and