What are the effects of low omega-3 (fatty acid) levels?

From the Guidelines

Omega-3 fatty acids, particularly EPA and DHA, have been shown to be beneficial for heart health, but they are not low in fat themselves, and their benefits are most pronounced when consumed in moderate amounts as part of a balanced diet. Omega-3s are essential fatty acids found primarily in fatty fish like salmon, mackerel, and sardines, as well as in plant sources like flaxseeds, chia seeds, and walnuts. For heart health benefits, aim to consume at least two servings of fatty fish per week, or consider a supplement providing 250-500 mg of combined EPA and DHA daily, as supported by the American Heart Association's science advisory on seafood and cardiovascular disease 1.

• Key points to consider:
  • The REDUCE-IT trial, a high-quality study published in 2021, demonstrated that 4g of EPA daily reduced the primary composite endpoint of cardiovascular death, nonfatal MI, nonfatal stroke, coronary revascularization, or unstable angina by 25% 1.
  • Low doses of a mixture of EPA and DHA showed benefit in the GISSI-Prevenzione study, but multiple large studies conducted since then have failed to show any significant reduction in cardiovascular endpoints 1.
  • Plant-based omega-3s (ALA) can be included in your diet, but they're less efficiently converted to the active forms in the body.
  • While omega-3s are fats, they're considered healthy fats that can help reduce inflammation, lower triglycerides, and support brain function.
  • If you're looking to reduce overall fat intake while increasing omega-3s, focus on lean fish options, take purified fish oil supplements, or incorporate moderate amounts of plant-based omega-3 sources while reducing other fat sources in your diet.
  • Always consult with a healthcare provider before starting supplements, especially if you're on blood-thinning medications.

From the Research

Omega 3 and Low Fat Diets

• The relationship between omega-3 fatty acids and low-fat diets is complex, with some studies suggesting that low-fat diets may not provide adequate amounts of omega-3s 2.
• A low-fat diet is not a no-fat diet, and dietary fat serves essential functions, such as providing energy and supporting the absorption of vitamins 3.
• Omega-3 fatty acids, particularly EPA and DHA, are important for heart health and may be obtained through dietary sources, including fatty fish, flaxseed, and walnuts 4, 5.

Sources of Omega-3 Fatty Acids

• Vegetarian sources of omega-3 fatty acids, such as flaxseed and walnuts, contain alpha-linolenic acid (ALA), which may be converted to EPA and DHA in the body, although this conversion is not always efficient 4, 6.
• Microalgae oil is a promising vegetarian source of EPA and DHA, with some studies suggesting that it may be as effective as fish oil in reducing cardiovascular risk factors 5.
• Other plant sources of omega-3 fatty acids, such as spirulina and Chlorella, may also have benefits for cardiometabolic health, although more research is needed to fully understand their effects 6.

Dietary Recommendations

• The majority of the population does not consume adequate omega-3 fatty acids, leading to global deficiencies and poor omega-3 status 2.
• Practical recommendations to improve omega-3 status include consuming 1,000-1,500 mg/d of EPA plus DHA as triglycerides for at least 12 weeks 2.
• A balanced diet that includes a variety of whole foods, such as fatty fish, nuts, and seeds, can provide adequate amounts of omega-3 fatty acids and support overall health 3, 6.