21. OMEGA-3 SUPPLEMENTS, OFTEN NO NEED TO TAKE THEM (health project99+)

Somewhere in the East of Venezuela

Summary: 1. Omega-3 fatty acids are important for your health; all your cells use them. 2. Most people are deficient, but the solution is easy for most (change of diet, not taking supplements). 3. Taking high amounts of Omega-3 fatty acids is recommended by many on internet, but this is something you really should check with your doctor. 4. Many supplements are of low quality and can work counterproductive. 5. Higher amounts of Omega-3 fatty acids can have unexpected health consequences like atrial fibrillation.

Your body needs the different Omega-3 fatty acids, especially the EPA, DHA and ALA types. They are essential for a broad range of health benefits. These benefits start with the heart and brain and extend to a healthy cellular structure and function. All your cells use them on a constant basis.

The good news is that you get enough if your diet includes fatty fish twice per week (herring, salmon etc) for the EPA and DHA. For the ALA flax seed or a handful of walnuts daily should be sufficient. The half-life ( = time a compound stays active in your body) of EPA and DHA is approximately 3-4 days. This is excellent. It explains why a few helpings of fatty fish per week give you sufficient Omega-3. This is as suggested by health authorities.

So do you need to take supplements? They are among the most promoted and sold supplements by the industry. However, just like vitamin C, they are easy enough to get through a balanced diet. Really think twice and look at your diet before you decide to take a supplement.

If you do not like fish or are allergic to nuts, supplements might be necessary. I say this with some caution. Omega-3s supplements can be of bad quality, and they often are. They might even cause unwanted effects like triggering attacks of heart rhythm issues. These issues include atrial fibrillation, which has happened to me. 

In blogs like these it is standard practice to refer the reader to his/her doctor. This is often done as part of one’s “cover your ass” policy. However, in the case of Omega-3, it is advisable to do so. Of course, we hope that your doctor is open-minded. We hope they look at supplements and other alternatives in a welcoming way. Which is not always guaranteed.

The Omega-3 index

Experts typically recommend targeting an Omega-3 index between 8% and 12%. Most Americans have on average 4%, much too low and up to 80% are below the 8%. The Omega 3 index is a blood test. It measures the amount of EPA and DHA found in the membranes of red blood cells. A test above 8% is desirable. The solution of course is not taking a supplement, but to improve one’s diet.

Recommended Intake of Omega-3 fatty acids

Various health organizations suggest around 250 to 500 mg combined EPA and DHA per day for adults. This supports heart health. Of course there are differences between children, men, women, patients etc. The figures I use are rough estimates only.

There is no established upper limit for EPA and DHA from dietary sources. However, supplementation guidelines often recommend not exceeding 3,000 mg (3 g) per day. This is to avoid potential side effects. Some go to 5,000 mg (5 g) per day.

Discuss with your doctor what “excessive” means in your case. Taking up to 5000 milligrams per day is considered safe for most people. However, it is definitely not safe for everyone. If you are like me and are susceptible to atrial fibrillation, more than 1000 mg of combined EPA and DHA per day might already be too much.

For ALA there isn’t a specific recommendation. However, on internet I see the following suggestion: 1,600 milligrams per day for adult men. For adult women, it is 1,100 milligrams per day.

Why take more?

Why should you take more than the recommended least quantities? There is a lot of interesting research going on that indicate (not proven!) that higher amounts of Omega-3 fatty acids can contribute to a longer and more healthy life.

One example from reliable internet sources

According to new research Omega 3 and Vitamins D and exercise slows biological aging by several months. Older adults who took 1 gram of polyunsaturated omega-3 fatty acids from algae slowed biological aging. They mixed it with vitamin D (2,000 international units per day) and 30 minutes of exercise three times a week. This combination slowed biological aging by approximately 2.9 to 3.8 months over 3 years.

While omega-3 alone reduced biological age, the combination of all three interventions had an even greater impact. A reduction of a few months in biological aging may seem modest. However, this could have meaningful public health benefits. These include a lower prevalence of certain age-related conditions.

Further research has also suggested that a combination of omega-3, vitamin D, and exercise may lower the risk of cancer.

But as always, approach these conclusions with caution as further research is needed. Very few claims are 100% scientifically proven. 

What I saw on internet are interesting discussions, a lot of promises, but little proven. Treatments are accepted to slow down aging at the molecular level. However, there is no 100% proof that this leads to a longer life. Similarly, there is no guarantee of better health. Still, many hopeful signs.

If you take Omega-3 supplements

Omega-3 supplements are best consumed with meals, particularly meals containing dietary fats, as this enhances absorption.

Check which brands are reputable. Many are not and the supplements they sell are often oxidized and can be damaging to your health. Preferably buy fish oil, not in capsules, in a dark bottle. Store the oil (or capsules) in the fridge, especially when open. You can do that only for 4 weeks. Fish oil is rich in omega-3 fatty acids, which can easily oxidize in heat, light and air

Oil tends to be absorbed better but can be very expensive. You rely on your digestive system to effectively break down the capsule before it can absorb the omega-3. Most brands use pork or beef gelatin, which is very tough and thus harder to break down.

Best sources for Omega-3s fatty acids.

Natural sources should suffice. For EPA and DHA especially cold water fish like herring and wild salmon. Also eggs can contribute. For ALA flax seed, chia seeds, walnuts.

As I said, it is important to know what was the food of the herring or salmon you eat. The nutrition of farmed salmon is very different from the food of wild salmon. As a result, it has much less EPA and DHA.

The same applies to eggs. Eggs from pasture-raised chickens contain 120 mg of DHA and 23 mg of EPA per large egg. This is more than six times the amount provided by the eggs of grain-fed chickens.

For herring (Atlantic), a 100-gram serving typically contains approximately 770 mg of EPA and 1,000 mg of DHA. For salmon (Atlantic, farmed), a 100-gram serving usually provides around 400-700 mg of EPA and around 700-1,000 mg of DHA.

All easy to calculate. Consuming 300 grams of fatty fish per week provides approximately 5,000 milligrams of EPA/DHA. This amount easily puts you above the minimum needed, which is approximately 2,000 to 3,500 milligrams for the week. Add a few eggs and one can be sure not to be Omega-3 deficient.

Half-life

I already mentioned the long biological half-life of EPA and DHA. This means the time it takes for half of a substance to be eliminated from the body. 

For EPA the half-life is estimated to be around 37 to 82 hours. Half-life of DHA is much longer ranging approximately from 72 to 144 hours.

Often you read about a preferred ratio of EPA and DHA of 2:1. Achieving this ratio is difficult, especially if you rely on natural sources only. However, it is more important to ensure adequate overall intake of both omega-3 fatty acids. This is more crucial than focusing on the precise ratio of EPA to DHA. The half-life of ALA is not known.

Bio-availability

The bio-availability of nutrients refers to the extent and rate at which they are absorbed and utilized in the body. For EPA and DHA Omega-3 fatty acids EPA and DHA the natural sources tend to have very high bio-availability. When consumed as part of whole foods, they are present in the form of triglycerides, which are well absorbed. (note: Triglycerides are a type of fat (lipid) found in your blood).

Potential Risks of Excessive Intake

Bleeding Risk: Doses at the high end of omega-3 fatty acids (over 3,000 mg per day) can increase bleeding risk. This is because of their blood-thinning effects. This is especially important for individuals taking anticoagulant medications. Like many people I take these.

Immune Function: Some studies suggest that very high doses of EPA and DHA might suppress the immune system. However, this is not typically reached through diet or normal supplementation. A dysfunctional immune response can lead to a viral or bacterial infection.

Gastrointestinal Effects: Not surprisingly excessive amounts may lead to gastrointestinal discomfort, such as diarrhea, indigestion, or fishy aftertaste. This is the case with many supplements.

Vitamin E and Oxidative Stress: High doses of fish oil may increase oxidation levels. This effect is because of EPA/DHA. This can deplete vitamin E. Some supplements include vitamin E to counteract this.

Pregnancy and Breastfeeding: Pregnant or breastfeeding women should be cautious with fish oil supplements to avoid excessive intake. They should also aim to meet recommended levels for fetal and infant development.

Interactions with Medications: Those on blood thinners, aspirin, or high-dose anti-inflammatory drugs should consult with a healthcare provider. Omega-3 can exacerbate their effects.

What is the use of EPA, DHA and ALA?

EPA (Eicosapentaenoic Acid) plays a crucial role in reducing inflammation and is involved in the production of signaling molecules called eicosanoids, which have various important effects on cardiovascular health and immune system regulation.

DHA (Docosahexaenoic Acid)  is a vital structural component of cell membranes, particularly in the brain, eyes, and nervous system, where it supports cognitive function, vision, and overall neural development.

ALA (Alpha-Linolenic Acid) serves as a precursor to EPA and DHA, providing an essential source of omega-3s in plant-based diets, and is involved in energy metabolism and various physiological processes, although its conversion to EPA and DHA in the body is relatively inefficient.

This is it. A long one, but it helped me a lot.

Enjoy a happy and healthy life and stay critical!

Robert, your health friend

When I still had to wear ties