Omega-3 fatty acids, just like omega-6, are fats that the body cannot produce. Therefore, they must be consumed through food or through omega-3 supplements.
There are 3 types of omega-3:
- EPA: Eicosapentaenoic acid
- DHA: Docosahexaenoic acid
- ALA: Alpha-linolenic acid
The importance of omega-3
Omega-3 fatty acids are key components of cell membranes and ensure the proper function of the cell. While omega-3 are important, it’s primarily the omega-6/omega-3 ratio (especially arachidonic acid; AA/EPA) that needs to be monitored closely.
According to some studies, this ratio should be 2.5 or even 2. However, today this ratio is closer to 20 (Simopoulos, 2016). This is a real problem because this ratio determines the intensity of the inflammatory response (Sears, 2018).
In NZ, a recent study on women aged 16 years and + in the third trimester of pregnancy showed that most women did not meet recommended intakes of DHA. This low intake was due to low fish and seafood consumption and no omega-3 supplements (Eickstaedt et al., 2017).
Digestive health & omega-3
In adequate quantities, omega-3s positively influences the microbiota by promoting the growth of beneficial bacteria such as Akkermansia muciniphila or Faecalibacterium prausnitzii. Conversely, they prevent the excessive proliferation of pathogenic bacteria (Yang et al., 2020). They promote optimal diversity, which is a signature of a healthy microbiota (Yang et al., 2020).
Due to their anti-inflammatory action (Durkin et al., 2021), omega-3s regulate the immune system and reduce the perception of pain, which is also reduced through their positive effect on mental health (Sanders et al., 2022).
Excessive omega-6 compared to omega-3 EPA and DHA promotes intestinal hyperpermeability, dysbiosis, and increases the level of LPS, a pro-inflammatory molecule present on the membrane of certain bacteria (Binienda et al., 2020; Usuda et al., 2021; Yang et al., 2020).
Many studies extol the benefits of omega-3s. For example, a 2020 study showed that reducing the AA/EPA ratio in participants with IBS-D is beneficial (Orlando et al., 2020).
Hormonal health & omega-3
The list of benefits of omega-3s on hormonal health is long, but here are a few points.
Generally, omega-3 fatty acids reduces dysmenorrhea, which is pain experienced during menstruation. Primary dysmenorrhea (not related to reproductive system abnormalities) appears to be related to the release of prostaglandins causing strong contractions of the uterus. In addition to causing pain, prostaglandins make the uterus more sensitive to pain.
Inflammatory prostaglandins, secreted at the end of the luteal phase and the first days of menstruation, come mainly from AA. Their secretion is therefore increased in case of AA/EPA imbalance, thus increasing pain.
Studies show that omega-3 supplementation reduces dysmenorrhea (Demirturk et al., 2002; Deutch et al., 2000; Rahbar et al., 2012).
In the case of endometriosis, the AA/EPA ratio is a relevant factor in the severity of the disease (Khanaki et al., 2012). Studies show that supplementation with EPA/DHA reduces pain, and a study in rats even showed regression of endometriotic lesions (Akyol et al., 2016)!
Moreover, omega-3 EPA/DHA have an anti-angiogenic effect, meaning they limit the creation of a vascular network at the level of endometriotic lesions (Spencer et al., 2009).
In the case of PCOS, omega-3s help in insulin resistance (Yang et al., 2018), which affects 75% of women with PCOS (Moghetti & Tosi, 2021). They also regulate the increased testosterone levels in this syndrome (Forouhi et al., 2015).
Omega-3s also promote fertility. A 2022 study of 900 women aged 30 to 44 showed that women taking omega-3 supplements were more likely to conceive than women not supplementing (Stanhiser et al., 2022).
The benefits of omega-3s during pregnancy and breastfeeding directly affect the baby by promoting optimal brain development (Saldeen & Saldeen, 2004).
Finally, omega-3s could prevent postpartum depression, menopause-related disorders, osteoporosis, and breast cancer (Saldeen & Saldeen, 2004).
Symptoms of omega-3 deficiency
The symptoms of omega-3 deficiency are not specific. They may include:
- Depression, lack of energy, difficulty concentrating (Richardson, 2003)
- Dry skin and other nail and hair disorders
- Inflammation (dysmenorrhea, IBS, allergies, …)
- …
Omega-3 dosage
It is possible to measure our omega-3s cell’s profile through a blood test. This analysis maps the composition of our cells (which are mainly made up of fatty acids). They reflect our dietary fat intake over the past 3 months.
Omega-3 dietary sources
Unlike omega-6, dietary sources of omega-3 are limited.
EPA & DHA
We find EPA and DHA in fatty fish mainly.Small fishes (sardines, mackerel, herring) are preferred over large fish which contain pollutants including mercury (Benvenga et al., 2022). To reach the NZ Ministry of Health omega-3s adequate intake, we need to consume fatty fish twice a week (~100 g X2).
Eggs from chickens whose feed has been enriched with flaxseed are richer in omega-3s than “standard” eggs, but cannot meet our needs. For example, 100 g of canned mackerel provides 1.5 g of DHA and 1.25 g of EPA. A boiled egg provides 0.051 g of EPA per 100 g (an egg weighs ~60 g).
ALA
ALA is found in virgin oils of hemp, walnut or flaxseed. Aim for ~ 1 to 2 tablespoons per day. Chia seeds are also a good omega-3 ALA food source.
It is essential to provide these 3 types of omega-3 fatty acids. In the case of a vegetarian diet or low consumption of fatty fish (<100 g twice a week), the use of dietary supplements is essential.
How to choose and take omega-3 supplements
If you opt for a fish oil-based supplement, ensure the quality of the product.
Indeed, a study showed that of the 32 fish oil supplements tested from retail and online stores within NZ, 69% of the products contained less than 67% of the EPA and DHA content specified on the label, and that oxidation levels were higher than recommended international standards (Albert et al., 2015).
However, a more recent NZ study found that 90% of the over-the-counter fish oil supplements analysed were within 10% of the EPA and DHA amount stated on the product labels (Rucklidge et al., 2019). Other good new : mercury was not detected in any sample (Rucklidge et al., 2019).
You will mainly find omega-3 fatty acids from fish oil in capsule. For a vegetarian option, you can find supplements based on algae.
Omega-3 supplements should be taken with meals and stored in the refrigerator. The dosage without blood analysis erythrocyte fatty acid analysis) is 500 mg to 1 g per day.
Take away
Omega 3 fatty acids are a health key element. Because omega 3 fatty acids (especially EPA and DHA) food sources are sparse, the use of omega 3 supplements are often required.
Yet, the quality of the omega 3 supplement used is crucial and it’s important to store and consume them properly.
You wonder if you’re eating enough omega-3 fatty acids? Let’s talk !