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. Numerous scientific studies suggest this, and it is confirmed by EFSA, the European Food Safety Authority. But not all Omega-3s are equal: for effective intake, it's best to focus on biologically active forms (EPA and DHA), found in fatty fish and marine-based supplements (fish oil, cod liver oil, krill oil, and microalgae oil). To avoid potential health risks, it's advisable to limit (or exclude) potentially dangerous sources during certain life stages (such as pregnancy and breastfeeding) and choose supplements with certified purity. Additionally, products certified for concentration and freshness offer further guarantees of efficacy and safety. Finally, vegan certifications allow those who avoid animal products for ethical reasons to benefit from EPA and DHA as well.

The benefits of Omega-3 have been widely discussed for over 50 years. It was in the 1970s when Danish researchers Hans Olaf Bang and Jørn Dyerberg, intrigued by the low incidence of coronary artery problems (the arteries that supply blood to the heart) among the Inuit populations of Greenland, traveled there to uncover the elixir protecting their hearts. This was how the advantages of a diet rich in these fats, abundant in the foods characteristic of these populations, first came to light. «Compared to Danish food», Bang and colleagues wrote in 1976, «the fatty acid profile of the consumed lipids—obtained primarily from marine mammals—showed a higher content of long-chain polyunsaturated fatty acids (especially C20:5) and a lower content of linoleic and linolenic acid».

That C20:5 mentioned by the Danish researchers is none other than eicosapentaenoic acid (more commonly known as EPA), one of the two biologically active Omega-3s the human body needs both as a structural component of cell membranes and as a precursor to molecules that regulate inflammatory processes at various levels. And not only that—to cite another potential benefit of adequate intake of these nutrients—Omega-3s have also been linked to modulating gut microbiota, thus exerting a prebiotic effect.

The other two molecules mentioned by Bang and colleagues are the precursor to EPA (alpha-linolenic acid, or ALA) and the precursor to Omega-6 fats (linoleic acid, or LA). Both are considered essential nutrients because the human body cannot synthesize them and must obtain them through diet. Once ingested, ALA and LA are converted into other fats in the Omega-3 and Omega-6 series, respectively. However, they compete for the same enzymes—and today, this can lead to various health problems. Let's explore why.

Omega-3, Omega-6, and Inflammation

As mentioned, Omega-3s are involved in regulating inflammatory processes. This is because they are precursors to molecules with reduced inflammatory potential, anti-inflammatory molecules, and molecules that promote the resolution of ongoing inflammation. Additionally, Omega-3s regulate white blood cell activity at multiple levels.

Omega-6s are also involved in inflammation. However, they are precursors to molecules with a higher inflammatory potential compared to those derived from Omega-3s. This means that when the Omega-6 to Omega-3 ratio is excessively skewed toward the former, the body tends toward sustained inflammation—and more. In fact, Omega-3s and Omega-6s have opposing effects in regulating other processes, such as platelet aggregation and vasodilation: while the former are generally anti-aggregatory and vasodilatory, the latter tend to promote aggregation and vasoconstriction.

All this means that an excessively high Omega-6:Omega-3 ratio promotes conditions linked to inflammation, platelet aggregation, and vasoconstriction, with detrimental health effects. The reason this is a pressing issue today is the excess of Omega-6 in modern, so-called "Westernized" diets. Estimates suggest an Omega-6:Omega-3 ratio of around 16:1—over three times higher than the desirable 5:1. Lowering this ratio would help promote health in multiple ways.

Omega-3 Benefits

Indeed, Omega-3 fats have been associated with numerous benefits for humans. Evidence for some is so overwhelming that EFSA (the European Food Safety Authority) has approved several health claims for foods and supplements containing Omega-3.

In particular, these fats provide several cardiovascular benefits:

1. They contribute to normal heart function with a daily intake of 250 mg of EPA plus DHA (docosahexaenoic acid, the other biologically active Omega-3 the human body needs);
2. They help maintain normal triglyceride levels with a daily intake of 2 g of DHA (taken with EPA) or EPA plus DHA;
3. They help maintain normal blood pressure with a daily intake of 3 g of EPA plus DHA;
4. They help maintain normal cholesterol levels with a daily intake of 2 g of ALA. 

Additionally, Omega-3s are crucial for brain health even before birth, to the extent that EFSA authorizes claims that:

• DHA contributes to normal brain function with a daily intake of 250 mg;
• Maternal DHA intake contributes to the normal development of the fetal brain and breastfed infants with 200 mg of DHA per day in addition to the 250 mg of EPA plus DHA recommended for all ages.

 DHA is also considered an ally for vision (starting from the prenatal stage), and EFSA authorizes claims that:

• DHA contributes to normal visual function with a daily intake of 250 mg;
• Maternal DHA intake contributes to the normal development of the fetal eye and breastfed infants with 200 mg of DHA per day in addition to the 250 mg of EPA plus DHA recommended for all ages;
• DHA intake contributes to the normal visual development of infants up to 12 months with 100 mg of DHA per day or 0.3% of DHA in the total fatty acids of formula milk.

Finally, EFSA authorizes the claim that ALA is necessary for normal growth and development in children, with benefits achievable at a daily intake of 2 g.

Promising Research Findings

Beyond these well-established benefits, scientific research provides insights into the advantages of adequate EPA and DHA intake and suggests other potential benefits.

For children, various studies suggest cardiovascular benefits, potential protective effects against allergies, improved sleep, and cognitive and behavioral benefits. For example:

• DHA may enhance listening skills and vocabulary acquisition in preschoolers;
• EPA and DHA may improve adolescent behavior;
• Increased DHA levels may help alleviate symptoms of attention deficit/hyperactivity disorder (ADHD).

Omega-3s have also been linked to numerous benefits for women at different life stages. It is well-established that DHA requirements increase during pregnancy and breastfeeding to meet fetal needs, but the benefits extend further. Omega-3 intake has been associated with:

• Reduced menstrual pain and polycystic ovary syndrome symptoms;
• Improved uterine perfusion (when combined with aspirin), potentially aiding fertility;
• Reduced depressive symptoms, such as in postmenopause and postpartum;
• Fewer hot flashes and other menopausal symptoms, with efficacy comparable to soy-based remedies;
• Enhanced cognitive and motor function in old age. 

Finally, Omega-3s also appear beneficial for athletic performance, as they have been linked to:

• Improved performance due to targeted effects on muscles and neuromuscular function;
• Faster recovery post-training and competition by modulating immune response, oxidative stress, and inflammation;
• Reduced risk of injuries (particularly head trauma) and respiratory disorders.

Further studies will confirm these and other benefits (such as the aforementioned prebiotic effect) and establish precise dosages for optimal results.

How to Take EPA and DHA

The benefits mentioned are almost entirely linked to EPA and DHA intake, which are now considered essential fats alongside their precursor ALA. Unfortunately, the human body's ability to convert ALA into EPA and DHA is very low, further hindered by the competition between Omega-3s and Omega-6s for the necessary enzymes. Thus, meeting Omega-3 requirements (at least 250 mg/day of EPA plus DHA at any age, plus additional doses during pregnancy, breastfeeding, and the first two years of life) through ALA intake is quite difficult. This becomes even harder when higher doses are needed (e.g., for managing blood triglycerides).

The preferred Omega-3 sources are fatty fish, as they provide ready-to-use EPA and DHA. Salmon, tuna, mackerel, anchovies, sardines, and herring are excellent choices. Marine-based supplements (fish oil, cod liver oil, krill oil, and microalgae oil) are also valuable sources of EPA and DHA.

Supplements are particularly useful for those allergic to fish, with food neophobia, or dietary restrictions that limit fish consumption, as well as for those avoiding fish for health or ethical reasons. Microalgae oil, a plant-based source of EPA and DHA, is suitable for vegans.

To ensure safe and effective products, look for certifications like IFOS (International Fish Oil Standards), which guarantee:

1. Accurate label claims regarding Omega-3 concentration;
2. Absence of contaminants like PCBs, dioxins, methylmercury, and heavy metals;
3. Freshness, meaning no oxidized Omega-3s.

Other certifications, like those from the Vegan Society, ensure compliance with vegan dietary standards. Sustainability certifications (e.g., Friend of the Sea) help consumers choose environmentally and socially responsible products.

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