Omega-3 deficiency: pregnant women and children are the ones who pay the price

Omega-3 intake is often insufficient compared to the amounts recommended by the World Health Organization, highlighting the need to promote its consumption especially among the most vulnerable population groups, such as children, women of childbearing age, and the elderly. For example, among Americans, the amount of EPA and DHA consumed by pregnant women is five times lower than the recommended 520 milligrams, and in children it reaches only 40% of the optimal dose.

These are the results published in the journal Nutrients by researchers from the University of Nebraska Medical Center, Pennsylvania State University, and the University of California Riverside (USA).

The right omega-3 intake is especially important for pregnant women and children

The main omega-3 fatty acids, EPA and DHA, play key roles related to health and the development of certain diseases, and their benefits have been well established by numerous scientific studies.

In early childhood, omega-3s are essential for growth, particularly for the development of vision and the brain. In children, these fatty acids are crucial for cellular maintenance and renewal throughout the body and have shown a positive impact on brain activity, learning, and cognitive development.

Increased consumption of EPA and DHA during pregnancy has been associated with a lower risk of maternal depression, reduced intrauterine growth restriction and preterm birth, and a decrease in allergies and asthma in children.

In adults, a higher intake of these fatty acids is associated with cardioprotective effects: anti-cholesterol, anti-thrombotic, anti-inflammatory, anti-hypertensive, and anti-arrhythmic.

Regarding cardiovascular disease risk factors, there is strong evidence that EPA and DHA can positively modify blood lipids, inflammation, and endothelial function. In the elderly, omega-3s have also been shown to help modulate depression and cognitive decline.

The mechanisms behind these effects appear to be varied; for example, eicosanoids and other bioactive lipid mediators derived from omega-3 metabolism are signaling molecules with a variety of functions in the cardiovascular, pulmonary, immune, and endocrine systems.

Fatty fish consumption is the primary dietary source of EPA and DHA, with alpha-linolenic acid conversion serving as an additional but limited source. Supplementation with fish liver oil, krill oil, cod liver oil, as well as other products derived from algal sources, can also improve omega-3 fatty acid status.

Nonetheless, intake among populations following a typical Western diet, rich in animal fats, is severely inadequate and poses a health risk, especially for women of childbearing age or who are pregnant.

Based on data analysis from the National Health and Nutrition Examination Survey (NHANES) 2003-2012, it emerged that omega-3 intake in pregnant women and women of childbearing age is lower compared to males of the same age.

A subsequent NHANES analysis using data collected from 2001 to 2014 found that 100% of women of childbearing age and pregnant women did not meet the weekly fish consumption recommendation (at least two to three servings per week).

Regarding the 2015-2020 Dietary Guidelines for Americans, over 95% of women in this age group do not meet the recommended EPA and DHA intake of 250 milligrams per day.

The American population consumes insufficient amounts of omega-3

To identify US population groups at greatest risk of omega-3 deficiency, the primary goal of the study was to estimate EPA and DHA intake in population subgroups and assess differences by age, sex, and pregnancy status, using NHANES data as a nationally representative sample.

Results showed that children and adolescents consumed lower doses of omega-3 compared to adults; women consumed lower amounts compared to men.

The small percentage of individuals who took EPA and DHA supplements showed significantly higher levels compared to those who did not use supplements.

One of the most alarming results is that the amount of EPA + DHA consumed by pregnant women was less than one-fifth of the recommended 520 milligrams per day and that children aged 1 to 8 years only reached 40% of the EPA + DHA intake recommended by the National Academy of Medicine.

Although these population groups are the “most delicate,” the results showed concerning evidence even for adults and the elderly, whose omega-3 intake was below 60% of the recommendation.

In general, intake of these important fatty acids was insufficient across all age groups, highlighting a condition that could increase the risk of health problems, particularly in vulnerable populations such as youth, children, and pregnant women.

Regarding omega-3 supplement use, only 0.6% of women of childbearing age reported taking a supplement containing EPA and/or DHA, and only 7.3% of pregnant women.

Since supplement use is associated with increased intake of polyunsaturated fatty acids, it could be an important source of EPA and DHA, particularly for pregnant women.

Some study details

Fish and EPA and DHA fatty acid intakes were calculated for 45,347 people of all ages by analyzing the latest NHANES study data.

Specifically, data showed that in children aged 1 to 5 years, total EPA + DHA intake (32.4 mg per day) represents less than a quarter of the World Health Organization's recommended amount of ~150 mg per day. Similarly, omega-3 amounts consumed by children up to 11 years old were insufficient.

Adolescents (12-19 years) also had low EPA + DHA intake with 59.2 mg per day, well below the WHO recommendation of 200-500 mg per day.

Average intakes in adults and the elderly were below the minimum recommended dose of 200 mg/day EPA + DHA provided by many organizations, reaching only 16% and 21% of the recommended 325 mg per day per 1000 Kcal.

Further studies are needed to define populations at risk of omega-3 deficiency.

According to the researchers' data, omega-3 intake among different American population groups is below recommended intake levels and insufficient to guarantee health status and modulate risk factors for protection from chronic diseases.

Ellen Schutt, Executive Director of the Global Organization for EPA and DHA, stated that this study confirms the importance of increasing omega-3 consumption in the United States.

Previous research had already shown that 95% of the US population was omega-3 deficient, and this study further helps define the at-risk groups, particularly the most vulnerable.

Source: M. Thompson et al. Omega-3 Fatty Acid Intake by Age, Gender, and Pregnancy Status in the United States: National Health and Nutrition Examination Survey 2003–2014”, Nutrients.