Janna
2004-05-18 03:06:42 UTC
http://www.healthandage.com/html/res/com/ConsSupplements/Omega3FattyAcidscs.html
Omega-3 Fatty Acids
Also Known As: essential fatty acids (EFAs), polyunsaturated fatty acids
(PUFAs)
Overview
Uses
Dietary Sources
Available Forms
How to Take It
Precautions
Possible Interactions
Supporting Research
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Overview
Omega-3 fatty acids are considered essential fatty acids, which means that
they are essential to human health but cannot be manufactured by the body.
For this reason, omega-3 fatty acids must be obtained from food. Omega-3
fatty acids can be found in fish and certain plant oils. It is important to
maintain an appropriate balance of omega-3 and omega-6 (another essential
fatty acid) in the diet as these two substances work together to promote
health. Also known as polyunsaturated fatty acids (PUFAs), omega-3 and
omega-6 fatty acids play a crucial role in brain function as well as normal
growth and development.
There are three major types of omega 3 fatty acids that are ingested in
foods and used by the body: alpha-linolenic acid (ALA), eicosapentaenoic
acid (EPA), and docosahexaenoic acid (DHA). Once eaten, the body converts
ALA to EPA and DHA, the two types of omega-3 fatty acids more readily used
by the body. Extensive research indicates that omega-3 fatty acids reduce
inflammation and help prevent certain chronic diseases such as heart disease
and arthritis. These essential fatty acids are highly concentrated in the
brain and appear to be particularly important for cognitive and behavioral
function. In fact, infants who do not get enough omega-3 fatty acids from
their mothers during pregnancy are at risk for developing vision and nerve
problems.
As mentioned previously, it is very important to maintain a balance between
omega-3 and omega-6 fatty acids in the diet. Omega-3 fatty acids help reduce
inflammation and most omega-6 fatty acids tend to promote inflammation. An
inappropriate balance of these essential fatty acids contributes to the
development of disease while a proper balance helps maintain and even
improve health. A healthy diet should consist of roughly one to four times
more omega-6 fatty acids than omega-3 fatty acids. The typical American diet
tends to contain 11 to 30 times more omega-6 fatty acids than omega-3 fatty
acids and many researchers believe this imbalance is a significant factor in
the rising rate of inflammatory disorders in the United States.
In contrast, however, the Mediterranean diet consists of a healthier balance
between omega-3 and omega-6 fatty acids and many studies have shown that
people who follow this diet are less likely to develop heart disease. The
Mediterranean diet does not include much meat (which is high in omega-6
fatty acids) and emphasizes foods rich in omega-3 fatty acids including
whole grains, fresh fruits and vegetables, fish, olive oil, garlic, as well
as moderate wine consumption.
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Uses
Studies suggest that omega-3 fatty acids may be helpful in treating a
variety of conditions. The evidence is strongest for heart disease and
problems that contribute to heart disease, but the range of possible uses
for omega-3 fatty acids include:
High Cholesterol
Those who follow a Mediterranean-style diet tend to have higher HDL ("good")
cholesterol levels. Similar to those who follow a Mediterranean diet, Inuit
Eskimos, who consume high amounts of omega-3 fatty acids from fatty fish,
also tend to have increased HDL cholesterol and decreased triglycerides
(fatty material that circulates in the blood). In addition, fish oil
supplements containing EPA and DHA have been shown to reduce LDL ("bad")
cholesterol and triglycerides. Finally, walnuts (which are rich in ALA) have
been shown to lower total cholesterol and triglycerides in people with high
cholesterol.
High Blood Pressure
Several studies suggest that diets and/or supplements rich in omega-3 fatty
acids lower blood pressure significantly in people with hypertension. Fish
high in mercury (such as tuna) should be avoided, however, because they may
increase blood pressure.
Heart Disease
One of the best ways to help prevent and treat heart disease is to eat a
low-fat diet and to replace foods rich in saturated and trans-fat with those
that are rich in monounsaturated and polyunsaturated fats (including omega-3
fatty acids). Evidence suggests that EPA and DHA found in fish oil help
reduce risk factors for heart disease including high cholesterol and high
blood pressure. There is also strong evidence that these substances can help
prevent and treat atherosclerosis by inhibiting the development of plaque
and blood clots, each of which tends to clog arteries. Studies of heart
attack survivors have found that daily omega-3 fatty acid supplements
dramatically reduce the risk of death, subsequent heart attacks, and stroke.
Similarly, people who eat an ALA-rich diet are less likely to suffer a fatal
heart attack.
Stroke
Strong evidence from population-based studies suggests that omega-3 fatty
acid intake (primarily from fish), helps protect against stroke caused by
plaque buildup and blood clots in the arteries that lead to the brain. In
fact, eating at least two servings of fish per week can reduce the risk of
stroke by as much as 50%. However, people who eat more than three grams of
omega-3 fatty acids per day (equivalent to 3 servings of fish per day) may
be at an increased risk for hemorrhagic stroke, a potentially fatal type of
stroke in which an artery in the brain leaks or ruptures.
Diabetes
People with diabetes tend to have high triglyceride and low HDL levels.
Omega-3 fatty acids from fish oil can help lower triglycerides and raise
HDL, so people with diabetes may benefit from eating foods or taking
supplements that contain DHA and EPA. ALA (from flaxseed, for example) may
not have the same benefit as DHA and EPA because some people with diabetes
lack the ability to efficiently convert ALA to a form of omega-3 fatty acids
that the body can use readily.
Weight Loss
Many people who are overweight suffer from poor blood sugar control,
diabetes, and high cholesterol. Studies suggest that overweight people who
follow a weight loss program including exercise tend to achieve better
control over their blood sugar and cholesterol levels when fish rich in
omega-3 fatty acids (such as salmon, mackerel, and herring) is a staple in
their low fat diet.
Arthritis
Most clinical studies investigating the use of omega-3 fatty acid
supplements for inflammatory joint conditions have focused almost entirely
on rheumatoid arthritis. Several articles reviewing the research in this
area conclude that omega-3 fatty acid supplements reduce tenderness in
joints, decrease morning stiffness, and allow for a reduction in the amount
of medication needed for people with rheumatoid arthritis.
In addition, laboratory studies suggest that diets rich in omega-3 fatty
acids (and low in omega-6 fatty acids) may benefit people with other
inflammatory disorders, such as osteoarthritis. In fact, several test tube
studies of cartilage-containing cells have found that omega-3 fatty acids
decrease inflammation and reduce the activity of enzymes that destroy
cartilage. Similarly, New Zealand green lipped mussel (Perna canaliculus),
another potential source of omega-3 fatty acids, has been shown to reduce
joint stiffness and pain, increase grip strength, and enhance walking pace
in a small group of people with osteoarthritis. In some participants,
symptoms worsened before they improved.
Osteoporosis
Studies suggest that omega-3 fatty acids such as EPA help increase levels of
calcium in the body, deposit calcium in the bones, and improve bone
strength. In addition, studies also suggest that people who are deficient in
certain essential fatty acids (particularly EPA and gamma-linolenic acid
[GLA], an omega-6 fatty acid) are more likely to suffer from bone loss than
those with normal levels of these fatty acids. In a study of women over 65
with osteoporosis, those given EPA and GLA supplements experienced
significantly less bone loss over three years than those who were given a
placebo. Many of these women also experienced an increase in bone density.
Depression
People who do not get enough omega-3 fatty acids or do not maintain a
healthy balance of omega-3 to omega-6 fatty acids in their diet may be at an
increased risk for depression. The omega-3 fatty acids are important
components of nerve cell membranes. They help nerve cells communicate with
each other, which is an essential step in maintaining good mental health.
Levels of omega-3 fatty acids were found to be measurably low and the ratio
of omega-6 to omega-3 fatty acids were particularly high in a study of
patients hospitalized for depression. In a study of people with depression,
those who ate a healthy diet consisting of fatty fish two to three times per
week for 5 years experienced a significant reduction in feelings of
depression and hostility.
Manic/Depression (Bipolar Disorder)
In a study of 30 people with bipolar disorder, those who were treated with
EPA and DHA (in combination with their usual mood stabilizing medications)
for four months experienced fewer mood swings and recurrence of either
depression or mania than those who received placebo. A similar but larger
study is currently underway at the University of California- Los Angeles
School of Medicine.
Schizophrenia
Preliminary evidence suggests that people with schizophrenia experience an
improvement in symptoms when given omega-3 fatty acids. However, a recent
well-designed study concluded that EPA supplements are no better than
placebo in improving symptoms of this condition. The conflicting results
suggest that more research is needed before conclusions can be drawn about
the benefit of omega-3 fatty acids for schizophrenia. Similar to diabetes,
people with schizophrenia may not be able to convert ALA to EPA or DHA
efficiently.
Attention Deficit/Hyperactivity Disorder (ADHD)
Children with ADHD may have low levels of certain essential fatty acids
(including EPA and DHA) in their bodies. In a study of nearly 100 boys,
those with lower levels of omega-3 fatty acids demonstrated more learning
and behavioral problems (such as temper tantrums and sleep disturbances)
than boys with normal omega-3 fatty acid levels. In animal studies, low
levels of omega-3 fatty acids have been shown to lower the concentration of
certain brain chemicals (such as dopamine and serotonin) related to
attention and motivation. Studies that examine the ability of omega-3
supplements to improve symptoms of ADHD are still needed. At this point in
time, eating foods high in omega-3 fatty acids is a reasonable approach for
someone with ADHD.
Eating Disorders
Studies suggest that men and women with anorexia nervosa have lower than
optimal levels of polyunsaturated fatty acids (including ALA and GLA). To
prevent the complications associated with essential fatty acid deficiencies,
some experts recommend that treatment programs for anorexia nervosa include
PUFA-rich foods such as fish and organ meats (which include omega-6 fatty
acids).
Burns
Essential fatty acids have been used to reduce inflammation and promote
wound healing in burn victims. Animal research indicates that omega-3 fatty
acids help promote a healthy balance of proteins in the body -- protein
balance is important for recovery after sustaining a burn. Further research
is necessary to determine whether omega 3s benefit people in the same way.
Skin Disorders
In one study, 13 people with a particular sensitivity to the sun known as
photodermatitis showed significantly less sensitivity to UV rays after
taking fish oil supplements. Still, research indicates that topical
sunscreens are much better at protecting the skin from damaging effects of
the sun than omega-3 fatty acids. In another study of 40 people with
psoriasis, those who were treated with medications and EPA supplements did
better than those treated with the medications alone. In addition, many
clinicians believe that flaxseed (which contains omega-3 fatty acids) is
helpful for treating acne.
Inflammatory Bowel Disease (IBD)
When added to medication, such as sulfasalazine (a standard medication for
IBD), omega-3 fatty acids may reduce symptoms of Crohn's disease and
ulcerative colitis -- the two types of IBD. More studies to investigate this
preliminary finding are under way. In animals, it appears that ALA works
better at decreasing bowel inflammation than EPA and DHA. Plus, fish oil
supplements can cause side effects that are similar to symptoms of IBD (such
as flatulence and diarrhea). Time-release preparations may help reduce these
unwanted effects.
Asthma
Preliminary research suggests that omega-3 fatty acid supplements (in the
form of perilla seed oil, which is rich in ALA) may decrease inflammation
and improve lung function in adults with asthma. Omega-6 fatty acids have
the opposite effect: they tend to increase inflammation and worsen
respiratory function. In a small, well-designed study of 29 children with
asthma, those who took fish oil supplements rich in EPA and DHA for 10
months had improvement in their symptoms compared to children who took a
placebo pill.
Macular Degeneration
A questionnaire administered to more than 3,000 people over the age of 49
found that those who consumed more fish in their diet were less likely to
have macular degeneration (a serious age-related eye condition that can
progress to blindness) than those who consumed less fish. Similarly, a study
comparing 350 people with macular degeneration to 500 without found that
those with a healthy dietary balance of omega-3 and omega-6 fatty acids and
higher intake of fish in their diets were less likely to have this
particular eye disorder. Another larger study confirms that EPA and DHA from
fish, four or more times per week, may reduce the risk of developing macular
degeneration. Notably, however, this same study suggests that ALA may
actually increase the risk of this eye condition.
Menstrual Pain
In a study of nearly 200 Danish women, those with the highest dietary intake
of omega-3 fatty acids had the mildest symptoms during menstruation.
Colon Cancer
Consuming significant amounts of foods rich in omega-3 fatty acids appears
to reduce the risk of colorectal cancer. For example, Eskimos, who tend to
follow a high fat diet but eat significant amounts of fish rich in omega-3
fatty acids, have a low rate of colorectal cancer. Animal studies and
laboratory studies have found that omega-3 fatty acids prevent worsening of
colon cancer while omega-6 fatty acids promote the growth of colon tumors.
Daily consumption of EPA and DHA also appeared to slow or even reverse the
progression of colon cancer in people with early stages of the disease.
However, in an animal study of rats with metastatic colon cancer (in other
words, cancer that has spread to other parts of the body such as the liver),
omega-3 fatty acids actually promoted the growth of cancer cells in the
liver. Until more information is available, it is best for people with
advanced stages of colorectal cancer to avoid omega-3 fatty acid supplements
and diets rich in this substance.
Breast Cancer
Although not all experts agree, women who regularly consume foods rich in
omega-3 fatty acids over many years may be less likely to develop breast
cancer. In addition, the risk of dying from breast cancer may be
significantly less for those who eat large quantities of omega-3 from fish
and brown kelp seaweed (common in Japan). This is particularly true among
women who substitute fish for meat. The balance between omega-3 and omega-6
fatty acids appears to play an important role in the development and growth
of breast cancer. Further research is still needed to understand the effect
that omega-3 fatty acids may have on the prevention or treatment of breast
cancer. For example, several researchers speculate that omega-3 fatty acids
in combination with other nutrients (namely, vitamin C, vitamin E,
beta-carotene, selenium, and coenzyme Q10) may prove to be of particular
value for preventing and treating breast cancer.
Prostate Cancer
Laboratory and animal studies indicate that omega-3 fatty acids
(specifically, DHA and EPA) may inhibit the growth of prostate cancer.
Similarly, population based studies of groups of men suggest that a low-fat
diet with the addition of omega-3 fatty acids from fish or fish oil help
prevent the development of prostate cancer. Like breast cancer, the balance
of omega-3 to omega-6 fatty acids appears to be particularly important for
reducing the risk of this condition. ALA, however, may not offer the same
benefits as EPA and DHA. In fact, one recent study evaluating 67 men with
prostate cancer found that they had higher levels of ALA compared to men
without prostate cancer. More research in this area is needed.
Other
Although further research is needed, preliminary evidence suggests that
omega-3 fatty acids may also prove helpful in protecting against certain
infections and treating a variety of conditions including ulcers, migraine
headaches, preterm labor, emphysema, psoriasis, glaucoma, Lyme disease,
lupus, and panic attacks.
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Dietary Sources
Fish oils and plant oils are the primary dietary source of omega-3 fatty
acids. Another potential source of omega-3 fatty acids is New Zealand green
lipped mussels (Perna canaliculus),used for centuries by the Maories to
promote good health. EPA and DHA are found in cold-water fish such as
salmon, mackerel, halibut, sardines, and herring. ALA is found in flaxseeds,
flaxseed oil, canola (rapeseed) oil, soybeans, soybean oil, pumpkin seeds,
pumpkin seed oil, purslane, perilla seed oil, walnuts, and walnut oil.
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Available Forms
In addition to the dietary sources described, EPA and DHA can be taken in
the form of fish oil capsules. Flaxseed, flaxseed oil, and fish oil should
be kept refrigerated. Whole flaxseeds must be ground within 24 hours of use,
otherwise the ingredients lose their activity. Flaxseeds are also available
in ground form in a special mylar package so that the components in the
flaxseeds stay active.
Be sure to buy omega-3 fatty acid supplements made by established companies
who certify that their products are free of heavy metals such as mercury.
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How to Take It
Pediatric
The precise safe and effective doses of all types of omega-3 fatty acid
supplements in children have not been established.
EPA and DHA
EPA and DHA are naturally found in breast milk; therefore, infants that are
breastfed should receive sufficient amounts of these substances.
Formula for infants should contain less than 0.1% EPA.
Formula for infants should contain 0.35% DHA.
ALA
Infants that are breastfed should receive sufficient amounts of ALA if the
mother has an adequate intake of this fatty acid.
Infant formula should contain 1.5% ALA.
Flaxseed Oil
Flaxseed oil may be added to a child's diet to help balance fatty acids. If
an infant is breastfed, the mother may ingest oil or fresh ground seed to
increase fat content in breast milk. See adult dosage below.
Flaxseed
Children (2 to 12 years): 1 tsp daily of ground flaxseeds or 1 tsp of fresh
flaxseed oil for constipation
Adult
EPA and DHA
The adequate daily intake of EPA and DHA for adults should be at least 220
mg of each per day.
Two to three servings of fatty fish per week (roughly 1,250 mg EPA and DHA
per day) are generally recommended to treat certain health conditions.
Fish oil supplements
3,000 to 4,000 mg standardized fish oils per day. (This amount corresponds
to roughly 2 to 3 servings of fatty fish per week.)
Typically, a 1,000 mg fish oil capsule has 180 mg EPA and 120 mg DHA
ALA
The adequate daily intake of ALA for adults should be roughly 2,220 mg per
day.
Flaxseed oil
One or two Tbsp of flaxseed oil per day is recommended for general health.
Doses up to 3,000 mg per day are recommended to prevent certain conditions
and doses up to 6,000 mg per day may be recommend to treat these conditions.
Flaxseed
1 Tbsp two to three times per day or 2 to 4 tbsp one time per day. Grind
before eating and take with lots of water.
Decoction (liquid prepared by boiling down the flaxseed in water): A rounded
Tbsp of whole seed simmered in 1 cup water for 10 to 15 minutes, strain and
drink.
100 grams of raw flaxseed provides 22,800 mg of ALA
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Precautions
Because of the potential for side effects and interactions with medications,
dietary supplements should be taken only under the supervision of a
knowledgeable healthcare provider.
Omega-3 fatty acids should be used cautiously by people who bruise easily,
have a bleeding disorder, or take blood-thinning medications because
excessive amounts of omega-3 fatty acids may lead to bleeding. In fact,
people who eat more than three grams of omega-3 fatty acids per day
(equivalent to 3 servings of fish per day) may be at an increased risk for
hemorrhagic stroke, a potentially fatal condition in which an artery in the
brain leaks or ruptures.
Fish oil can cause flatulence and diarrhea. Time-release preparations may
reduce these side effects, however.
People with either diabetes or schizophrenia may lack the ability to convert
ALA to EPA and DHA, the forms more readily used in the body. Therefore,
people with these conditions should obtain their omega-3 fatty acids from
dietary sources rich in EPA and DHA.
Although studies have found that regular consumption of fish (which includes
the omega-3 fatty acids EPA and DHA) may reduce the risk of macular
degeneration, a recent study including two large groups of men and women
found that diets rich in ALA may substantially increase the risk of this
disease. More research is needed in this area. Until this information
becomes available, it is best for people with macular degeneration to obtain
omega-3 fatty acids from sources of EPA and DHA, rather than ALA.
Similar to macular degeneration, fish and fish oil may protect against
prostate cancer, but ALA may be associated with increased risk of prostate
cancer in men. More research in this area is needed.
It is best to use lipid extracts rather than the powder form of New Zealand
green lipped mussels because there is less chance of an allergic reaction.
People who are allergic to seafood should avoid New Zealand green lipped
mussels. In some individuals who take New Zealand green lipped mussels,
arthritis symptoms may worsen before they improve.
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Possible Interactions
If you are currently being treated with any of the following medications,
you should not use omega-3 fatty acid supplements without first talking to
your healthcare provider.
Blood-thinning Medications
Omega-3 fatty acids may increase the blood-thinning effects of aspirin or
warfarin. While the combination of aspirin and omega-3 fatty acids may
actually be helpful under certain circumstances (such as heart disease),
they should only be taken together under the guidance and supervision of
your healthcare provider.
Cyclosporine
Taking omega-3 fatty acids during cyclosporine therapy may reduce toxic side
effects (such as high blood pressure and kidney damage) associated with this
medication in transplant patients.
Etretinate and Topical Steroids
The addition of omega-3 fatty acids (specifically EPA) to a drug regimen of
etretinate and topical corticosteroids may improve symptoms of psoriasis.
Cholesterol-lowering Medications
Following certain nutritional guidelines, including increasing the amount of
omega-3 fatty acids in your diet and reducing the omega-6 to omega-3 ratio,
may allow a group of cholesterol lowering medications known as "statins"
(such as atorvastatin, lovastatin, and simvastatin) to work more
effectively.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
In an animal study, treatment with omega-3 fatty acids reduced the risk of
ulcers from nonsteroidal anti-inflammatory drugs (NSAIDs). More research is
needed to evaluate whether omega-3 fatty acids would have the same effects
in people.
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Omega-3 Fatty Acids
Also Known As: essential fatty acids (EFAs), polyunsaturated fatty acids
(PUFAs)
Overview
Uses
Dietary Sources
Available Forms
How to Take It
Precautions
Possible Interactions
Supporting Research
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Overview
Omega-3 fatty acids are considered essential fatty acids, which means that
they are essential to human health but cannot be manufactured by the body.
For this reason, omega-3 fatty acids must be obtained from food. Omega-3
fatty acids can be found in fish and certain plant oils. It is important to
maintain an appropriate balance of omega-3 and omega-6 (another essential
fatty acid) in the diet as these two substances work together to promote
health. Also known as polyunsaturated fatty acids (PUFAs), omega-3 and
omega-6 fatty acids play a crucial role in brain function as well as normal
growth and development.
There are three major types of omega 3 fatty acids that are ingested in
foods and used by the body: alpha-linolenic acid (ALA), eicosapentaenoic
acid (EPA), and docosahexaenoic acid (DHA). Once eaten, the body converts
ALA to EPA and DHA, the two types of omega-3 fatty acids more readily used
by the body. Extensive research indicates that omega-3 fatty acids reduce
inflammation and help prevent certain chronic diseases such as heart disease
and arthritis. These essential fatty acids are highly concentrated in the
brain and appear to be particularly important for cognitive and behavioral
function. In fact, infants who do not get enough omega-3 fatty acids from
their mothers during pregnancy are at risk for developing vision and nerve
problems.
As mentioned previously, it is very important to maintain a balance between
omega-3 and omega-6 fatty acids in the diet. Omega-3 fatty acids help reduce
inflammation and most omega-6 fatty acids tend to promote inflammation. An
inappropriate balance of these essential fatty acids contributes to the
development of disease while a proper balance helps maintain and even
improve health. A healthy diet should consist of roughly one to four times
more omega-6 fatty acids than omega-3 fatty acids. The typical American diet
tends to contain 11 to 30 times more omega-6 fatty acids than omega-3 fatty
acids and many researchers believe this imbalance is a significant factor in
the rising rate of inflammatory disorders in the United States.
In contrast, however, the Mediterranean diet consists of a healthier balance
between omega-3 and omega-6 fatty acids and many studies have shown that
people who follow this diet are less likely to develop heart disease. The
Mediterranean diet does not include much meat (which is high in omega-6
fatty acids) and emphasizes foods rich in omega-3 fatty acids including
whole grains, fresh fruits and vegetables, fish, olive oil, garlic, as well
as moderate wine consumption.
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Uses
Studies suggest that omega-3 fatty acids may be helpful in treating a
variety of conditions. The evidence is strongest for heart disease and
problems that contribute to heart disease, but the range of possible uses
for omega-3 fatty acids include:
High Cholesterol
Those who follow a Mediterranean-style diet tend to have higher HDL ("good")
cholesterol levels. Similar to those who follow a Mediterranean diet, Inuit
Eskimos, who consume high amounts of omega-3 fatty acids from fatty fish,
also tend to have increased HDL cholesterol and decreased triglycerides
(fatty material that circulates in the blood). In addition, fish oil
supplements containing EPA and DHA have been shown to reduce LDL ("bad")
cholesterol and triglycerides. Finally, walnuts (which are rich in ALA) have
been shown to lower total cholesterol and triglycerides in people with high
cholesterol.
High Blood Pressure
Several studies suggest that diets and/or supplements rich in omega-3 fatty
acids lower blood pressure significantly in people with hypertension. Fish
high in mercury (such as tuna) should be avoided, however, because they may
increase blood pressure.
Heart Disease
One of the best ways to help prevent and treat heart disease is to eat a
low-fat diet and to replace foods rich in saturated and trans-fat with those
that are rich in monounsaturated and polyunsaturated fats (including omega-3
fatty acids). Evidence suggests that EPA and DHA found in fish oil help
reduce risk factors for heart disease including high cholesterol and high
blood pressure. There is also strong evidence that these substances can help
prevent and treat atherosclerosis by inhibiting the development of plaque
and blood clots, each of which tends to clog arteries. Studies of heart
attack survivors have found that daily omega-3 fatty acid supplements
dramatically reduce the risk of death, subsequent heart attacks, and stroke.
Similarly, people who eat an ALA-rich diet are less likely to suffer a fatal
heart attack.
Stroke
Strong evidence from population-based studies suggests that omega-3 fatty
acid intake (primarily from fish), helps protect against stroke caused by
plaque buildup and blood clots in the arteries that lead to the brain. In
fact, eating at least two servings of fish per week can reduce the risk of
stroke by as much as 50%. However, people who eat more than three grams of
omega-3 fatty acids per day (equivalent to 3 servings of fish per day) may
be at an increased risk for hemorrhagic stroke, a potentially fatal type of
stroke in which an artery in the brain leaks or ruptures.
Diabetes
People with diabetes tend to have high triglyceride and low HDL levels.
Omega-3 fatty acids from fish oil can help lower triglycerides and raise
HDL, so people with diabetes may benefit from eating foods or taking
supplements that contain DHA and EPA. ALA (from flaxseed, for example) may
not have the same benefit as DHA and EPA because some people with diabetes
lack the ability to efficiently convert ALA to a form of omega-3 fatty acids
that the body can use readily.
Weight Loss
Many people who are overweight suffer from poor blood sugar control,
diabetes, and high cholesterol. Studies suggest that overweight people who
follow a weight loss program including exercise tend to achieve better
control over their blood sugar and cholesterol levels when fish rich in
omega-3 fatty acids (such as salmon, mackerel, and herring) is a staple in
their low fat diet.
Arthritis
Most clinical studies investigating the use of omega-3 fatty acid
supplements for inflammatory joint conditions have focused almost entirely
on rheumatoid arthritis. Several articles reviewing the research in this
area conclude that omega-3 fatty acid supplements reduce tenderness in
joints, decrease morning stiffness, and allow for a reduction in the amount
of medication needed for people with rheumatoid arthritis.
In addition, laboratory studies suggest that diets rich in omega-3 fatty
acids (and low in omega-6 fatty acids) may benefit people with other
inflammatory disorders, such as osteoarthritis. In fact, several test tube
studies of cartilage-containing cells have found that omega-3 fatty acids
decrease inflammation and reduce the activity of enzymes that destroy
cartilage. Similarly, New Zealand green lipped mussel (Perna canaliculus),
another potential source of omega-3 fatty acids, has been shown to reduce
joint stiffness and pain, increase grip strength, and enhance walking pace
in a small group of people with osteoarthritis. In some participants,
symptoms worsened before they improved.
Osteoporosis
Studies suggest that omega-3 fatty acids such as EPA help increase levels of
calcium in the body, deposit calcium in the bones, and improve bone
strength. In addition, studies also suggest that people who are deficient in
certain essential fatty acids (particularly EPA and gamma-linolenic acid
[GLA], an omega-6 fatty acid) are more likely to suffer from bone loss than
those with normal levels of these fatty acids. In a study of women over 65
with osteoporosis, those given EPA and GLA supplements experienced
significantly less bone loss over three years than those who were given a
placebo. Many of these women also experienced an increase in bone density.
Depression
People who do not get enough omega-3 fatty acids or do not maintain a
healthy balance of omega-3 to omega-6 fatty acids in their diet may be at an
increased risk for depression. The omega-3 fatty acids are important
components of nerve cell membranes. They help nerve cells communicate with
each other, which is an essential step in maintaining good mental health.
Levels of omega-3 fatty acids were found to be measurably low and the ratio
of omega-6 to omega-3 fatty acids were particularly high in a study of
patients hospitalized for depression. In a study of people with depression,
those who ate a healthy diet consisting of fatty fish two to three times per
week for 5 years experienced a significant reduction in feelings of
depression and hostility.
Manic/Depression (Bipolar Disorder)
In a study of 30 people with bipolar disorder, those who were treated with
EPA and DHA (in combination with their usual mood stabilizing medications)
for four months experienced fewer mood swings and recurrence of either
depression or mania than those who received placebo. A similar but larger
study is currently underway at the University of California- Los Angeles
School of Medicine.
Schizophrenia
Preliminary evidence suggests that people with schizophrenia experience an
improvement in symptoms when given omega-3 fatty acids. However, a recent
well-designed study concluded that EPA supplements are no better than
placebo in improving symptoms of this condition. The conflicting results
suggest that more research is needed before conclusions can be drawn about
the benefit of omega-3 fatty acids for schizophrenia. Similar to diabetes,
people with schizophrenia may not be able to convert ALA to EPA or DHA
efficiently.
Attention Deficit/Hyperactivity Disorder (ADHD)
Children with ADHD may have low levels of certain essential fatty acids
(including EPA and DHA) in their bodies. In a study of nearly 100 boys,
those with lower levels of omega-3 fatty acids demonstrated more learning
and behavioral problems (such as temper tantrums and sleep disturbances)
than boys with normal omega-3 fatty acid levels. In animal studies, low
levels of omega-3 fatty acids have been shown to lower the concentration of
certain brain chemicals (such as dopamine and serotonin) related to
attention and motivation. Studies that examine the ability of omega-3
supplements to improve symptoms of ADHD are still needed. At this point in
time, eating foods high in omega-3 fatty acids is a reasonable approach for
someone with ADHD.
Eating Disorders
Studies suggest that men and women with anorexia nervosa have lower than
optimal levels of polyunsaturated fatty acids (including ALA and GLA). To
prevent the complications associated with essential fatty acid deficiencies,
some experts recommend that treatment programs for anorexia nervosa include
PUFA-rich foods such as fish and organ meats (which include omega-6 fatty
acids).
Burns
Essential fatty acids have been used to reduce inflammation and promote
wound healing in burn victims. Animal research indicates that omega-3 fatty
acids help promote a healthy balance of proteins in the body -- protein
balance is important for recovery after sustaining a burn. Further research
is necessary to determine whether omega 3s benefit people in the same way.
Skin Disorders
In one study, 13 people with a particular sensitivity to the sun known as
photodermatitis showed significantly less sensitivity to UV rays after
taking fish oil supplements. Still, research indicates that topical
sunscreens are much better at protecting the skin from damaging effects of
the sun than omega-3 fatty acids. In another study of 40 people with
psoriasis, those who were treated with medications and EPA supplements did
better than those treated with the medications alone. In addition, many
clinicians believe that flaxseed (which contains omega-3 fatty acids) is
helpful for treating acne.
Inflammatory Bowel Disease (IBD)
When added to medication, such as sulfasalazine (a standard medication for
IBD), omega-3 fatty acids may reduce symptoms of Crohn's disease and
ulcerative colitis -- the two types of IBD. More studies to investigate this
preliminary finding are under way. In animals, it appears that ALA works
better at decreasing bowel inflammation than EPA and DHA. Plus, fish oil
supplements can cause side effects that are similar to symptoms of IBD (such
as flatulence and diarrhea). Time-release preparations may help reduce these
unwanted effects.
Asthma
Preliminary research suggests that omega-3 fatty acid supplements (in the
form of perilla seed oil, which is rich in ALA) may decrease inflammation
and improve lung function in adults with asthma. Omega-6 fatty acids have
the opposite effect: they tend to increase inflammation and worsen
respiratory function. In a small, well-designed study of 29 children with
asthma, those who took fish oil supplements rich in EPA and DHA for 10
months had improvement in their symptoms compared to children who took a
placebo pill.
Macular Degeneration
A questionnaire administered to more than 3,000 people over the age of 49
found that those who consumed more fish in their diet were less likely to
have macular degeneration (a serious age-related eye condition that can
progress to blindness) than those who consumed less fish. Similarly, a study
comparing 350 people with macular degeneration to 500 without found that
those with a healthy dietary balance of omega-3 and omega-6 fatty acids and
higher intake of fish in their diets were less likely to have this
particular eye disorder. Another larger study confirms that EPA and DHA from
fish, four or more times per week, may reduce the risk of developing macular
degeneration. Notably, however, this same study suggests that ALA may
actually increase the risk of this eye condition.
Menstrual Pain
In a study of nearly 200 Danish women, those with the highest dietary intake
of omega-3 fatty acids had the mildest symptoms during menstruation.
Colon Cancer
Consuming significant amounts of foods rich in omega-3 fatty acids appears
to reduce the risk of colorectal cancer. For example, Eskimos, who tend to
follow a high fat diet but eat significant amounts of fish rich in omega-3
fatty acids, have a low rate of colorectal cancer. Animal studies and
laboratory studies have found that omega-3 fatty acids prevent worsening of
colon cancer while omega-6 fatty acids promote the growth of colon tumors.
Daily consumption of EPA and DHA also appeared to slow or even reverse the
progression of colon cancer in people with early stages of the disease.
However, in an animal study of rats with metastatic colon cancer (in other
words, cancer that has spread to other parts of the body such as the liver),
omega-3 fatty acids actually promoted the growth of cancer cells in the
liver. Until more information is available, it is best for people with
advanced stages of colorectal cancer to avoid omega-3 fatty acid supplements
and diets rich in this substance.
Breast Cancer
Although not all experts agree, women who regularly consume foods rich in
omega-3 fatty acids over many years may be less likely to develop breast
cancer. In addition, the risk of dying from breast cancer may be
significantly less for those who eat large quantities of omega-3 from fish
and brown kelp seaweed (common in Japan). This is particularly true among
women who substitute fish for meat. The balance between omega-3 and omega-6
fatty acids appears to play an important role in the development and growth
of breast cancer. Further research is still needed to understand the effect
that omega-3 fatty acids may have on the prevention or treatment of breast
cancer. For example, several researchers speculate that omega-3 fatty acids
in combination with other nutrients (namely, vitamin C, vitamin E,
beta-carotene, selenium, and coenzyme Q10) may prove to be of particular
value for preventing and treating breast cancer.
Prostate Cancer
Laboratory and animal studies indicate that omega-3 fatty acids
(specifically, DHA and EPA) may inhibit the growth of prostate cancer.
Similarly, population based studies of groups of men suggest that a low-fat
diet with the addition of omega-3 fatty acids from fish or fish oil help
prevent the development of prostate cancer. Like breast cancer, the balance
of omega-3 to omega-6 fatty acids appears to be particularly important for
reducing the risk of this condition. ALA, however, may not offer the same
benefits as EPA and DHA. In fact, one recent study evaluating 67 men with
prostate cancer found that they had higher levels of ALA compared to men
without prostate cancer. More research in this area is needed.
Other
Although further research is needed, preliminary evidence suggests that
omega-3 fatty acids may also prove helpful in protecting against certain
infections and treating a variety of conditions including ulcers, migraine
headaches, preterm labor, emphysema, psoriasis, glaucoma, Lyme disease,
lupus, and panic attacks.
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Dietary Sources
Fish oils and plant oils are the primary dietary source of omega-3 fatty
acids. Another potential source of omega-3 fatty acids is New Zealand green
lipped mussels (Perna canaliculus),used for centuries by the Maories to
promote good health. EPA and DHA are found in cold-water fish such as
salmon, mackerel, halibut, sardines, and herring. ALA is found in flaxseeds,
flaxseed oil, canola (rapeseed) oil, soybeans, soybean oil, pumpkin seeds,
pumpkin seed oil, purslane, perilla seed oil, walnuts, and walnut oil.
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Available Forms
In addition to the dietary sources described, EPA and DHA can be taken in
the form of fish oil capsules. Flaxseed, flaxseed oil, and fish oil should
be kept refrigerated. Whole flaxseeds must be ground within 24 hours of use,
otherwise the ingredients lose their activity. Flaxseeds are also available
in ground form in a special mylar package so that the components in the
flaxseeds stay active.
Be sure to buy omega-3 fatty acid supplements made by established companies
who certify that their products are free of heavy metals such as mercury.
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How to Take It
Pediatric
The precise safe and effective doses of all types of omega-3 fatty acid
supplements in children have not been established.
EPA and DHA
EPA and DHA are naturally found in breast milk; therefore, infants that are
breastfed should receive sufficient amounts of these substances.
Formula for infants should contain less than 0.1% EPA.
Formula for infants should contain 0.35% DHA.
ALA
Infants that are breastfed should receive sufficient amounts of ALA if the
mother has an adequate intake of this fatty acid.
Infant formula should contain 1.5% ALA.
Flaxseed Oil
Flaxseed oil may be added to a child's diet to help balance fatty acids. If
an infant is breastfed, the mother may ingest oil or fresh ground seed to
increase fat content in breast milk. See adult dosage below.
Flaxseed
Children (2 to 12 years): 1 tsp daily of ground flaxseeds or 1 tsp of fresh
flaxseed oil for constipation
Adult
EPA and DHA
The adequate daily intake of EPA and DHA for adults should be at least 220
mg of each per day.
Two to three servings of fatty fish per week (roughly 1,250 mg EPA and DHA
per day) are generally recommended to treat certain health conditions.
Fish oil supplements
3,000 to 4,000 mg standardized fish oils per day. (This amount corresponds
to roughly 2 to 3 servings of fatty fish per week.)
Typically, a 1,000 mg fish oil capsule has 180 mg EPA and 120 mg DHA
ALA
The adequate daily intake of ALA for adults should be roughly 2,220 mg per
day.
Flaxseed oil
One or two Tbsp of flaxseed oil per day is recommended for general health.
Doses up to 3,000 mg per day are recommended to prevent certain conditions
and doses up to 6,000 mg per day may be recommend to treat these conditions.
Flaxseed
1 Tbsp two to three times per day or 2 to 4 tbsp one time per day. Grind
before eating and take with lots of water.
Decoction (liquid prepared by boiling down the flaxseed in water): A rounded
Tbsp of whole seed simmered in 1 cup water for 10 to 15 minutes, strain and
drink.
100 grams of raw flaxseed provides 22,800 mg of ALA
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Precautions
Because of the potential for side effects and interactions with medications,
dietary supplements should be taken only under the supervision of a
knowledgeable healthcare provider.
Omega-3 fatty acids should be used cautiously by people who bruise easily,
have a bleeding disorder, or take blood-thinning medications because
excessive amounts of omega-3 fatty acids may lead to bleeding. In fact,
people who eat more than three grams of omega-3 fatty acids per day
(equivalent to 3 servings of fish per day) may be at an increased risk for
hemorrhagic stroke, a potentially fatal condition in which an artery in the
brain leaks or ruptures.
Fish oil can cause flatulence and diarrhea. Time-release preparations may
reduce these side effects, however.
People with either diabetes or schizophrenia may lack the ability to convert
ALA to EPA and DHA, the forms more readily used in the body. Therefore,
people with these conditions should obtain their omega-3 fatty acids from
dietary sources rich in EPA and DHA.
Although studies have found that regular consumption of fish (which includes
the omega-3 fatty acids EPA and DHA) may reduce the risk of macular
degeneration, a recent study including two large groups of men and women
found that diets rich in ALA may substantially increase the risk of this
disease. More research is needed in this area. Until this information
becomes available, it is best for people with macular degeneration to obtain
omega-3 fatty acids from sources of EPA and DHA, rather than ALA.
Similar to macular degeneration, fish and fish oil may protect against
prostate cancer, but ALA may be associated with increased risk of prostate
cancer in men. More research in this area is needed.
It is best to use lipid extracts rather than the powder form of New Zealand
green lipped mussels because there is less chance of an allergic reaction.
People who are allergic to seafood should avoid New Zealand green lipped
mussels. In some individuals who take New Zealand green lipped mussels,
arthritis symptoms may worsen before they improve.
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Possible Interactions
If you are currently being treated with any of the following medications,
you should not use omega-3 fatty acid supplements without first talking to
your healthcare provider.
Blood-thinning Medications
Omega-3 fatty acids may increase the blood-thinning effects of aspirin or
warfarin. While the combination of aspirin and omega-3 fatty acids may
actually be helpful under certain circumstances (such as heart disease),
they should only be taken together under the guidance and supervision of
your healthcare provider.
Cyclosporine
Taking omega-3 fatty acids during cyclosporine therapy may reduce toxic side
effects (such as high blood pressure and kidney damage) associated with this
medication in transplant patients.
Etretinate and Topical Steroids
The addition of omega-3 fatty acids (specifically EPA) to a drug regimen of
etretinate and topical corticosteroids may improve symptoms of psoriasis.
Cholesterol-lowering Medications
Following certain nutritional guidelines, including increasing the amount of
omega-3 fatty acids in your diet and reducing the omega-6 to omega-3 ratio,
may allow a group of cholesterol lowering medications known as "statins"
(such as atorvastatin, lovastatin, and simvastatin) to work more
effectively.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
In an animal study, treatment with omega-3 fatty acids reduced the risk of
ulcers from nonsteroidal anti-inflammatory drugs (NSAIDs). More research is
needed to evaluate whether omega-3 fatty acids would have the same effects
in people.
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