EPA and DHA omega-3s play important roles in both primary and secondary prevention of chronic diseases, as well as general nutrition.
More than 19,000 scientific papers have been published on omega-3s, including 2,000 randomized, controlled trials in humans. They are more studied than any other nutrient or pharmaceutical. The ability of EPA and DHA omega-3s to reduce triglycerides is well-documented, but because EPA and DHA are an integral and structural component of cells, we are still learning about the full extent of the beneficial health effects they exert.
Two presentations from a GOED-funded scientific workshop in 2006 by leading scientists provide an overview of the cardiovascular and neurological research:
The Impact of
Low Omega-3 Intakes
Unfortunately, most consumers do not get enough EPA and DHA in their diet. In the United States alone, it is estimated that between 72 and 96 thousand people die annually from cardiovascular events due to insufficient intakes, more than die from high intakes of trans or saturated fats[1]. Cross-national studies have observed that the countries with the highest intakes of EPA and DHA omega-3s have the lowest rates of all-cause mortality, stroke mortality, cardiovascular and coronary heart disease mortality, homicide, postpartum depression, major depression and bipolar disorder[2].
Recommending EPA and DHA to Patients
Nutrition and Primary Prevention of Chronic Disease
Most regulatory and expert scientific bodies recommend 250-500mg of EPA and DHA per day for primary prevention of chronic diseases, which is roughly the equivalent of one to two fish or algal oil capsules per day. You can download a list of the most recent recommendations worldwide by clicking here.
A recent study established that 250mg should be the minimum daily intake of EPA and DHA for reducing the risk of fatal cardiac events[3]. The American Dietetic Association and other groups recommend 500mg of EPA and DHA consumption, which equates to approximately two servings of oily fish per week[4]. An evidence-based review by the Agency for Healthcare Research and Quality also established that this level reduces the risk of both fatal and non-fatal cardiac events[5].
Another important consideration are the tissue levels of EPA and DHA, since consumption of EPA and DHA ultimately leads to tissue enrichment and the expression and regulation of genetic and metabolic factors. The omega-3 index is a measure of the proportion of fatty acids in red blood cell membranes that are made up of EPA and DHA omega-3s. Studies have shown the omega-3 index to be a powerful risk factor for chronic disease risk, including one that showed the omega-3 index to be a stronger risk factor for sudden cardiac death than traditional risk factors like cholesterol, triglycerides and C-reactive protein. Ask your labs if they offer the omega-3 index test, and if not contact us for more information on obtaining test kits.
Secondary Prevention of Cardiovascular Events
The American Heart Association recommends 1g of daily EPA and DHA consumption for secondary prevention of cardiovascular events from either fish or fish oil supplements. Additionally, a study funded by the predecessor of GOED has shown that EPA and DHA omega-3 supplements can significantly reduce the costs of secondary prevention of cardiovascular events.
Maternal Health and Infant Nutrition
Many countries have now begun recommending that pregnant and lactating women consume 200mg of DHA omega-3s per day to meet the nutritional requirements of both the mother and child.
References
[1] Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, et al. (2009) The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors. PLoS Med 6(4): e1000058. doi:10.1371/journal.pmed.1000058
[2] Hibbeln JR, Nieminen LR, Blasbalg TL, Riggs JA, Lands WE. (2006) Healthy intakes of n-3 and n-6 fatty acids: estimations considering worldwide diversity. Am J Clin Nutr 83(6 Suppl):1483S-1493S
[3] Mozaffarian D. (2008) Fish and n-3 fatty acids for the prevention of fatal coronary heart disease and sudden cardiac death. Am J Clin Nutr 87(6):1991S-6S
[4] Kris-Etherton PM, Innis S. (2007) Position of the American Dietetic Association and Dietitians of Canada: dietary fatty acids. J Am Diet Assoc 107(9):1599-611
[5] Balk E, Chung M, Lichtenstein A, et al. Effects of Omega-3 Fatty Acids on Cardiovascular Risk Factors and Intermediate Markers of Cardiovascular Disease. Summary, Evidence Report/Technology Assessment: Number 93. AHRQ Publication Number 04-E010-1, March 2004. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/epcsums/o3cardrisksum.htm
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