From the womb to old age: strategies for effective and safe Omega 3 intake
Omega-3 polyunsaturated fats are allies of health from the womb to old age. This is suggested by numerous scientific studies and confirmed by Efsa, the European Food Safety Authority. But one Omega-3 is not worth the other: for effective intake, it is best to focus on the biologically active forms (EPA and DHA), found in fatty fish and supplements of marine origin (fish, cod liver, krill and microalgae oils). And to avoid running into possible health risks, it is a good idea to limit (or exclude) potentially dangerous sources at certain stages of life (such as pregnancy and lactation) and to choose supplements with certified purity. Not only that, products certified for concentration and freshness offer additional guarantees of efficacy and safety. Finally, vegan certifications also allow those who do not consume animal products by ethical choice to reap the benefits of EPA and DHA.
The benefits of Omega-3s have been on everyone's lips for more than 50 years now. In fact, it was in the 1970s when Danish researchers Hans Olaf Bang and Jørn Dyerberg, intrigued by the low incidence of coronary artery (the arteries that carry blood to the heart) problems in the Eskimo peoples who inhabited Greenland, went there to get to the bottom of what was the elixir that protected their hearts; thus it was that they first emerged the benefits of a diet rich in these fats, abundant in the very foods that characterized the diets of these peoples. "Compared with Danish food," Bang and colleagues wrote back in 1976, "the fatty acid profile of the lipids consumed-obtained, essentially, from mammals of marine origin-showed a higher content of long-chain polyunsaturated fatty acids (especially C20:5) and a lower content of linoleic acid and linolenic acid."
That C20:5 mentioned by the Danish researchers is none other than eicosapentaenoic acid (more commonly known as EPA), i.e., one of the two biologically active Omega-3s that the human body needs both as a structural component of cell membranes and as a precursor of molecules that can regulate inflammatory processes at different levels. And not only that, because-just to mention another of the possible benefits of an adequate intake of these nutrients-Omega-3 has also been associated with modulation of intestinal bacterial flora-thus with aprebiotic action.
The other two molecules mentioned by Bang and colleagues are the EPA precursor (alpha-linolenic acid, or ALA) and the Omega-6 fat precursor (linoleic acid, or LA). Both are considered essential nutrients because the human body is unable to synthesize them and, therefore, needs to be supplied with food. Once ALA and LA are ingested, they are converted into the other fats in the Omega-3 and Omega-6 series, respectively; to do so, however, they compete for the same enzymes-and this, in this day and age, can lead to several problems for human health. Let's find out why.
Omega-3, Omega-6 and inflammation
As mentioned, Omega-3s are involved in the regulation of inflammatory processes. This is due to the fact that they are the precursors of molecules with reduced inflammatory potential, molecules with anti-inflammatory activity, and molecules that promote the resolution of ongoing inflammatory processes; in addition, Omega-3s also regulate the activity of white blood cells at multiple levels.
Omega-6s are also involved in inflammation. However, they are precursors of molecules with greater inflammatory potential than those derived from Omega-3s. This means that when the ratio of Omega-6 to Omega-3 is excessively unbalanced in favor of the former the body has a tendency for sustained inflammation, and more. In fact, Omega-3 and Omega-6 also tend to have opposite activities in the regulation of other processes, such as platelet aggregation and vasodilation; while the former tend to be antiplatelet and vasodilator, the latter tend to be pro-aggregator and vasoconstrictor.
All of this causes an excessively high Omega-6: Omega-3 ratio to promote conditions associated with inflammation, platelet aggregation and vasoconstriction, with deleterious effects on health. The reason why this is an absolutely topical issue is the excess of Omega-6 that characterizes modern so-called "Westernized" eating habits. In fact, estimates speak of an Omega-6:Omega-3 ratio around 16:1, thus more than 3 times higher than the desirable 5:1. Lowering this ratio would help promote health from multiple perspectives.
Omega-3: the benefits
In fact, Omega-3 fats have been associated with several benefits to humans. The evidence from some is so overwhelming that it has led Efsa (the European Food Safety Authority) to approve several nutrition claims that can be associated with foods and food supplements containing Omega-3.
In particular, these fats exert several benefits in the cardiovascular area:
- contribute to normal heart function with daily intake of 250 mg per day of EPA plus DHA (docosahexaenoic acid, the other biologically active Omega-3 the human body needs);
- contribute to the maintenance of normal blood triglyceride values with the intake of 2 g per day of DHA (taken in combination with EPA) or EPA plus DHA;
- contribute to the maintenance of normal blood pressure with the intake of 3 g per day of EPA plus DHA;
- contribute to the maintenance of normal blood cholesterol values with the intake of 2 g per day of ALA.
In addition, Omega-3s are important for brain health from before birth, so much so that Efsa authorizes stating:
- DHA contributes to normal brain function with the intake of 250 mg per day;
- maternal intake of DHA contributes to normal brain development of the fetus and breastfed baby with 200 mg of DHA per day in addition to the recommended 250 mg per day of EPA plus DHA at all ages.
DHA is then considered an ally of vision (again, as early as prenatal life), and Efsa authorizes stating that:
- DHA contributes to normal visual function with the intake of 250 mg daily;
- maternal intake of DHA contributes to normal eye development of the fetus and breastfed infant with 200 mg of DHA per day in addition to the recommended 250 mg per day of EPA plus DHA at all ages;
- DHA intake contributes to normal vision development in infants up to 12 months of age with 100 mg of DHA per day or 0.3 percent DHA of the total fatty acids in formula milk.
Finally, Efsa authorizes stating that ALA is necessary for normal growth and development in children and that its benefits are achievable with an intake of 2 g per day.
Promises from scientific research
In addition to these well-established benefits, scientific research offers insights to go into more detail about the benefits of taking adequate doses of EPA and DHA and suggests other possible useful actions.
In the case of children, several data suggest cardiovascular benefits, the possibility that they exert protective effects against allergies and help promote good sleep, as well as several cognitive and behavioral benefits. For example:
- DHA would promote listening skills and vocabulary acquisition in preschoolers;
- EPA and DHA would improve adolescent behavior;
- increasing DHA in the body would help improve symptoms of attention-deficit/hyperactivity disorder(ADHD).
In addition, Omega-3s have been associated with numerous benefits at different stages of women's lives. It is well established that DHA requirements in pregnancy and lactation increase to meet the needs of the fetus, but not only that. Omega-3 intake has, for example, been associated with:
- to the reduction of menstrual discomfort and problems associated with ovarian polycystosis;
- to increased uterine perfusion (when combined with aspirin) potentially helpful in fertility problems;
- to the reduction of depressive symptoms, for example, in postmenopause and postpartum;
- to the reduction of hot flashes and other symptoms associated with menopause, with similar efficacy to soy-based remedies;
- To the improvement of cognitive and motor skills in old age.
Finally, Omega-3s also appear to be useful in the context ofsporting activity, as they have been associated:
- to improved performance by targeting muscles and neuromuscular function;
- to improving recovery after training and competition by targeting immune response, oxidative stress, and inflammation;
- to reducing the risk of trauma (especially head injury) and disease (especially respiratory disorders).
Further studies will allow these and other benefits (such as the aforementioned prebiotic activity) to be confirmed and the dosages needed to achieve them to be more precisely determined.
How to take EPA and DHA
The benefits mentioned have been associated almost entirely with the intake of EPA and DHA, which, in fact, are considered essential fats on a par with their precursor ALA. In fact, unfortunately, the human body's ability to convert the latter into EPA and DHA is very low, also complicit in the aforementioned competition between Omega-3 and Omega-6 for the enzymes needed to do so. Therefore meeting Omega-3 requirements (equal to at least 250 mg per day of EPA plus DHA at any age, plus additional doses in pregnancy, lactation and the first 2 years of life) with ALA intake is quite difficult. Doing so becomes even more complicated in situations where the doses to be taken increase further (such as when blood triglycerides need to be controlled).
The preferred sources of Omega-3 are, therefore, fatty fish, because they provide ready-to-use EPA and DHA. Those that can be brought to the table to meet Omega-3 requirements include salmon, tuna, mackerel, anchovies, sardines, sardines and herring. Extra help can come from marine-derived supplements (fish, cod liver, krill and microalgae oils) precisely because they are sources of EPA and DHA.
Supplements can be particularly useful in cases of fish allergy, neophobia or forms of food selectivity that lead to not consuming adequate amounts of fish, in cases where fish is not eaten due to health or ethical choices, and when, as in pregnancy, it is necessary to limit fish consumption so as not to consume dangerous amounts of substances that could harm the fetus (such as methylmercury). In particular, microalgae oil is a source of plant-based EPA and DHA that may also be suitable as part of a vegan lifestyle.
To ensure the purchase of safe and effective products, you can rely on certifications, such as that issued by the Ifos program (International Fish Oil Standards), which guarantee:
- That the concentration listed on the label matches the actual concentration in the supplement;
- The absence of contaminants such as PCBs (polychlorinated biphenyls), dioxins, methylmercury and other heavy metals;
- Freshness, hence the absence of oxidized Omega-3s.
Other certifications, such as that issued by the Vegan Society, on the other hand, ensure the standards necessary for consumption by those on a vegan diet. Finally, there is no shortage of brands (such as the Friend of the Sea) that allow people to choose which product to buy based on environmental and social sustainability requirements.
Bibliographic references:
Bang HO et al. The composition of food consumed by Greenland Eskimos. Acta Med Scand. 1976;200(1-2):69-73. doi: 10.1111/j.0954-6820.1976.tb08198.x
Chang JPC et al. Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies. Neuropsychopharmacology. 2018 Feb;43(3):534-545. doi: 10.1038/npp.2017.160
European Community. EU Register of Health Claims.. Last viewed 30/06/24
Dai Y and Liu J. Omega-3 long-chain polyunsaturated fatty acid and sleep: a systematic review and meta-analysis of randomized controlled trials and longitudinal studies. Nutr Rev. 2021 Jul 7;79(8):847-868. doi: 10.1093/nutrit/nuaa103
Dyerberg J et al. Bioavailability of marine n-3 fatty acid formulations. Prostaglandins Leukot Essent Fatty Acids. 2010 Sep;83(3):137-41. doi: 10.1016/j.plefa.2010.06.007
Echeverría González F and Valenzuela Báez R. IN TIME: IMPORTANCE OF OMEGA-3 IN CHILDREN'S NUTRITION. Rev Paul Pediatr. 2017 Jan-Mar; 35(1): 3-4. doi: 10.1590/1984-0462/;2017;35;1;00018
Foiles AM et al. Formula with long chain polyunsaturated fatty acids reduces incidence of allergy in early childhood. Pediatr Allergy Immunol. 2016 Mar; 27(2): 156-161. doi: 10.1111/pai.12515
Freeman MP et al. Omega-3 fatty acids for major depressive disorder associated with the menopausal transition: a preliminary open trial. Menopause. 2011 Mar; 18(3): 279-284. doi: 10.1097/gme.0b013e3181f2ea2e
Gammone MA et al. Omega-3 Polyunsaturated Fatty Acids: Benefits and Endpoints in Sport. Nutrients. 2018 Dec 27;11(1):46. doi: 10.3390/nu11010046
Hsu MC. Omega-3 polyunsaturated fatty acid supplementation in prevention and treatment of maternal depression: Putative mechanism and recommendation. J Affect Disord. 2018 Oct 1;238:47-61. doi: 10.1016/j.jad.2018.05.018
Lazzarin N et al. Low-dose aspirin and omega-3 fatty acids improve uterine artery blood flow velocity in women with recurrent miscarriage due to impaired uterine perfusion. Fertil Steril. 2009 Jul;92(1):296-300. doi: 10.1016/j.fertnstert.2008.05.045
Mohammadi MM et al. The impact of omega-3 polyunsaturated fatty acids on primary dysmenorrhea: a systematic review and meta- analysis of randomized controlled trials. Eur J Clin Pharmacol. 2022 Jan 21. doi: 10.1007/s00228-021-03263-1. doi: 10.1007/s00228-021-03263-1
Politano CA and Jorge López-Berroa J. Omega-3 Fatty Acids and Fecundation, Pregnancy and Breastfeeding. Rev Bras Gynecol Obstet. 2020 Mar;42(3):160-164. doi: 10.1055/s-0040-1708090
Purzand B et al. The comparison of the effect of soybean and fish oil on supplementation on menopausal symptoms in postmenopausal women: A randomized, double-blind, placebo-controlled trial. Complement Ther Clin Pract. 2020 Nov;41:101239. doi: 10.1016/j.ctcp.2020.101239
Roach LA et al. Effect of Omega-3 Supplementation on Self-Regulation in Typically Developing Preschool-Aged Children: Results of the Omega Kid Pilot Study-A Randomised, Double-Blind, Placebo-Controlled Trial. Nutrients. 2021 Oct; 13(10): 3561. doi: 10.3390/nu13103561
Saldeen P and Saldeen T. Women and omega-3 fatty acids. Obstet Gynecol Surv. 2004 Oct;59(10):722-30; quiz 745-6. doi: 10.1097/01.ogx.0000140038.70473.96
Sánchez-Borrego R. Recommendations of the Spanish Menopause Society on the consumption of omega-3 polyunsaturated fatty acids by postmenopausal women. Maturitas. 2017 Sep;103:71-77. doi: 10.1016/j.maturitas.2017.06.028
Shahidi F and Ambigaipalan P. Omega-3 Polyunsaturated Fatty Acids and Their Health Benefits.Annu Rev Food Sci Technol. 2018 Mar 25;9:345-381. doi: 10.1146/annurev-food-111317-095850
Italian Society of Human Nutrition. LARN 2014 Tables
Thielecke F, Blannin A. Omega-3 Fatty Acids for Sport Performance-Are They Equally Beneficial for Athletes and Amateurs? A Narrative Review. Nutrients. 2020 Nov 30;12(12):3712. doi: 10.3390/nu12123712.
Vijay A et al. The prebiotic effects of omega-3 fatty acid supplementation: A six-week randomized intervention trial. Gut Microbes. 2021 Jan-Dec;13(1):1-11. doi: 10.1080/19490976.2020.1863133
