Omega 3

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Omega 3 is a classification of polyunsaturated fatty acids (PUFA’s) (good or healthy fats) known as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). EPA and DHA are known as ‘Essential Fatty Acids’ or EFA’S and this is because these types of fat cannot be manufactured by the body and must be obtained through diet. EFA’s are found in oily fish, flaxseeds, nuts and seeds. There is no official Recommended Daily Amount (RDA) for omega 3 although dosage ranges between 1-3g per day.

What is it needed for?

Fats are our main source of energy and insulation. Omega 3 provides flexibility and stability to the cell walls which supports the transportation of nutrients and hormones around the body. Omega 3 is involved in regulating blood pressure, blood clotting, inflammation, nerve transmission and the synthesis of hormones amongst many other functions.

Deficiency

Deficiency of essential fatty acids is associated with rough, scaly skin and dermatitis. Other signs and symptoms include; fatigue, lack of endurance, dry skin, cracked nails, dry, lifeless hair, gastrointestinal issues such as gas and bloating, maldigestion and constipation. A deficiency is also associated with depression, frequent colds and infections, arthritis, cognitive impairment, and aching joints. A lack of essential fatty acids has also been associated with the development of many chronic degenerative diseases such as heart disease, cancer and strokes.

Evidence

Cardiovascular Health– Strong evidence exists to support the role of omega 3 PUFA’s in cardiovascular health. An analysis of 25 studies found that tissue concentrations of omega 3 PUFA’s, specifically docosahexaenoic acid (DHA) were significantly associated with risk for coronary heart disease (1). The DART study, involving 2,033 men who had experienced recent heart attack found that supplementing with omega 3 fish oil resulted in a 29% reduction in mortality, specifically from coronary heart disease (2). The GISSI study involving 11,323 post-heart-attack patients found that supplementing with 1000mg fish oil significantly reduced the cardiovascular risk resulting in a decreased risk of death by 20% and cardiovascular death by 30% after 1 year (3). Similar benefits were reported in the study at 3 years follow up (4). Furthermore, a meta-analysis of 7 studies involving 825 patients concluded that fish oils significantly improved cardiovascular function in patients with non-ischaemic heart failure (5). Their protective actions have been linked to their anti-inflammatory effects (6) and the positive impact upon cell communication in cardiovascular disease (7). Based upon the evidence to support the role of omega 3 PUFA’s in relation to cardiovascular health, the EU Commission Regulation Panel, 2012 (8) conclude that a cause and effect relationship has been established between the consumption of EPA and DHA and maintenance of normal cardiac function.

Cholesterol– Omega 3 PUFA’s have also been shown to support cardiovascular health in relation to their effect on blood triglycerides and cholesterol concentrations. Supplementation with fish oil at a dose of 1.7g/d EPA and 1.2g/d DHA for 6 weeks reduced serum triglycerides and increased HDL (good) cholesterol concentrations in 28 overweight and obese patients (9). The role of EPA and DHA and blood concentrations of triglycerides has been under review by the EU Commission Regulation, 2012 (8) in order to support the claim that EPA and DHA contribute to the maintenance of normal blood fasting concentrations of triglycerides.

Cognitive function and mental health – Deficiency of omega 3 PUFA’s have been associated with a wide range of mental health disorders. Omega 3 PUFA’s make up a significant proportion of the lipid fraction of the human brain and play important roles in neurological functions including the maintenance of neuronal membranes, neurotransmission, maintenance of membrane fluidity and flexibility and modulation of ion channels and cellular receptors (10). The importance of omega 3 in cognition is demonstrated by its positive association with increased blood flow in the brain during cognitive tasks (11), cognitive performance and memory (12). Several double-blind randomized trials have suggested omega 3 from fish oils may benefit attention-deficit/ hyperactivity disorder, anxiety, autism, childhood depression, dyspraxia, dyslexia, aggression, bipolar disorder, schizophrenia, borderline personality disorder, mild cognitive impairment and dementia (14) however the most robust evidence to date relates to mood and anxiety, in particular, major depressive disorder. A systematic review of 21 clinical trials found an antidepressant effect with omega 3 PUFA (EPA or DHA alone or in combination) supplementation (15). A further meta-analysis of 10 clinical studies in 2007 found a significant antidepressant effect of omega 3 PUFA’s in patients with depression or with bipolar disorder. In 2006 a further meta-analysis reported significant antidepressant effects in uni bipolar and bipolar depression with omega 3 PUFA supplementation (16).

Skin Health (Psoriasis, Eczema and Acne)-Research has also found a correlation between omega 3 intake and skin health. EPA has been shown to improve psoriasis (17). Intake of omega 3 PUFA during pregnancy has also been shown to reduce the risk of food allergies and eczema in children at 18 months (18). There is also evidence to suggest EPA and DHA may reduce damage caused by UV light and inflammation in skin cells (19) and also benefit acne (20).

Arthritis- The role of omega 3 PUFA’s in inflammation has been demonstrated in numerous studies. Fish oil exerts anti-inflammatory actions in arthritis (21). A summary of 18 trials showed reductions in tenderness and stiffness in rheumatoid arthritis when treated daily with fish oil (22). A further robust meta-analysis showed reduced pain symptoms in Rheumatoid Arthritis (23).

Our take on how omega 3 may help you, based on EU claims;

High Blood Pressure– DHA and EPA contribute to the maintenance of normal blood pressure. EPA and DHA contribute to the normal function of the heart. Due to its potential blood thinning action omega 3 fatty acids EPA and DHA may help to reduce high blood pressure and therefore may be a valuable supplement for those suffering from hypertension.

Lower the risk of heart attack and stroke– DHA and EPA contribute to the maintenance of normal blood triglyceride levels. Omega 3 fatty acids help reduce harmful cholesterol and triglycerides which help to reduce the risk of heart attacks and strokes.

Based on research;

Arthritis- Omega 3 may be beneficial for those suffering from arthritis due to the anti-inflammatory properties of these fatty acids.

Brain Health– Due to the widely researched role of omega 3 in brain health, a supplement may be beneficial for those looking to improve cognitive function including memory and concentration and for those with depression and/or anxiety.

Skin- Omega 3 is important for the health of the skin. Omega 3 has been shown to improve skin conditions such as psoriasis, eczema and acne and so a supplement may be useful for anyone looking to address these skin conditions.

Safety and side effects

Side effects of omega-3 supplements are usually mild and can include; unpleasant taste, bad breath, heartburn, nausea, gastrointestinal discomfort, diarrhoea and headaches. Whilst no Tolerable Upper Intake Level has been officially established, long term combined doses of EPA and DHA of up to according to 5g per day appears to be safe according to the European Food Safety Authority. Omega 3 has been reported to have blood thinning properties and so should be used with precaution by those taking blood thinning medications.

References

  1. Harris WS, Poston WC, Haddock CK. Tissue omega 3 and omega 6 fatty acids and risk for coronary heart disease events. Atherosclerosis. 2007 Jul; 193(1):1-10. Epub 2007 May 15.
  2. Burr ML, Fehily AM, Gilbert JF et al. Effects of changes in fat, fish and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet. 1989 Sep 30;2 (8666): 757-61
  3. Dietary supplementation with omega 3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo studio della sopravvivenza nell’infarto miocardico. Lancett. 1999 Aug 7; 354 (9177):447-55
  4. Marchioli R, Barzi F, Bomba E, et al, for the GISSI-prevenzione Investigators. Early protection against sudden death by omega 3 PUFA’s after myocardial infarction: time course analysis of the results of the Gruppo Italiano per lo studio della sopravvivenza nell’infarto Miocardico (GISSI)-Prevenzione. Circulation 2002:105:1897-903
  5. Xin W et al. Effects of fish oil supplementation on cardiac function in chronic heart failure: a meta-analysis of randomized controlled trials. Heart. 2012 Nov;98 (22):1620-5
  6. Calder PC. The role of marine omega 3 polyunsaturated fatty acids in inflammatory processes, atherosclerosis and plaque stability. MolNutr Food Res. 2012 July;56(7): 1073-80
  7. Zaklad F K et al. Polyunsaturated fatty acids omega 3 as modulators of intracellular signalling pathways. PostepyBiochem. 2012;58(2):149-54
  8. Commission Regulation (EU) No 432/2012 of 16 May 2012 establishing a list of permitted health claims made on foods, other than those referring to the reduction of disease risk and to children’s development and health, O.J.o.t.E. Union, Editor. 2012. p. 40
  9. Bragt MC, Meensink R.P. Comparison of the effects of omega 3 long chain polyunsaturated fatty acids and fenofibrate on markers of inflammation and vascular function, and on the serum lipoprotein profile in overweight and obese subjects. NutrMetabCardiovasc Dis 2012 Nov;22(11):966-73
  10. McLean CH, et al. Effects of omega 3 fatty acids on lipids and glycemic control in Type 2 diabetes and the metabolic syndrome and on inflammatory bowel disease, rheumatoid arthritis, renal disease, systemic lupus erythematosus and osteoporosis. Assessment NO 89,04-E012
  11. Jackson PA et al. Docosahexaenoic acid-rich fish oil modulates the cerebral hemodynamic response to cognitive tasks in healthy young adults Biol Psychol. 2012 Jan:89 (1):183-90
  12. Lamandei GL et al. Omega 3 fatty acids and acetylcysteine diet supplementation effects on learning performance). Rev Med Chirsoc Med Nat lasi. 2010 Julp-sep:114(3):808-12
  13. Parris M. Kidd: Omega 3 DHA and EPA for Cognition, Behaviour, and Mood: Clinical Findings and Structural-Functional Synergies with Cell Membrane Phospholipids; Alternative Medicine Review Volume 12, Number3 2007
  14. Kraguljac NV, Montori VM, Pavuluri M, et al. Efficacy of omega 3 fatty acids in mood disorders- a systematic review and meta-analysis. Psychopharmacol Bull. 2009; 42 (3):39-54
  15. Freeman MP, Hibbein JR, Wisner KL et al. Omega 3 fatty acids: evidence basis for treatment and future research in psychiatry. J Clin Psychiatry 2006; 67: 1954-1967
  16. Mayser, P. Grimm, H. Grimminger, F, omega 3 fatty acids in psoriasis. British Journal Of Nutrition 2002; 21:87 Suppl 1: S77-82
  17. C Furuhjelm, et al. Fish oil supplementation in pregnancy and lactation may decrease the risk of infant allergy, ActaPaediatrica
  18. Storey A, McArdle F, Friedmann PS, et al. Eicosapentaenoic acid and docosahexaenoic acid reduce UVB and TNF- alpha-induced IL-8 secretion in keratinocytes and UVB induced IL8 in fibroblasts. J Invest Dermatol. 2005 Jan; 124 (1)248-55
  19. Rubin MG, Kim K, Logan AC, Acne vulgaris, mental health and omega 3 fatty acids: a report of cases. Lipids Health Dis. 2008 Oct 13;7:36
  20. McLean CH, et al. Effects of omega 3 fatty acids on lipids and glycemic control in Type 2 diabetes and the metabolic syndrome and on inflammatory bowel disease, rheumatoid arthritis, renal disease, systemic lupus erythematosus and osteoporosis. Assessment NO 89,04-E012
  21. Calder PC. Omega 3 PUFA’s, inflammation, and inflammatory diseases. Am J ClinNutr.2006;83 (6 suppl):1505S-1519S
  22. Goldenburg RJ & Katz J. Meta-analysis of the analgesic effects of omega 3 PUFA supplementation for inflammatory joint pain. Pain 2007;129:210-223