Health Education

Omega 3 Fatty Acids

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A diet high in Omega 3 fatty acids (O3FA) should be a consideration for everyone from pregnancy to the elderly but particularly for children being treated or at risk for mood disorders (anxiety, depression and bipolar disease) and ADHD. 

The chart below outlines how much O3FA is recommended based on age and sex:

Omega 3 FA chart

  • The higher the BMI, the less O3FA absorption.  While there are no established standards, we recommend increasing O3FA by double in patients with BMIs over the 85%.
  • Flaxseed oil has one of the highest O3FA concentrations. It is reasonable to add 1-2 tsp of flaxseed oil to salads and smoothies to increase daily O3FA intake
  • It is hard to exceed the amount of O3FA that is safe for children and young adults.  The European Food Safety Authority has found that up to 5g/day are safe.  The FDA recommends up to 3g/day.  Many clinical trials have used up to twice that amount. 
  • Breastfeeding mothers should consume between 8 -12 ounces of seafood per week, from choices that are lower in methyl mercury (salmon, anchovies,  sardines, Pacific oysters, trout, and Atlantic and Pacific mackerel)
  • Due to the benefits, parents should consider adding O3FA to their children’s diet in either natural or supplemental forms

What are O3FA? 

  • There are 2 categories of polyunsaturated fatty acids, Omega 3 (O3FA) and Omega 6 (O6FA).  O3FA found in leafy vegetables and fish oils (because fish eat algae which is a leafy vegetable) and while O6FA found in seed vegetables (wheat, corn and soy) when taken in excess, produce nonbeneficial substances.
  • O3FA form non-inflammatory or beneficial eicosanoids while O6FA form inflammatory or detrimental eicosanoids. As recently as 60 years ago, the ratio between O3FA:O6FA was 50:50 but because of a reduction in intake of leafy vegetables and an increase in processed foods containing wheat, soy and high fructose corn syrup, that ratio is now 10:90.
  • There are 3 primary forms of O3FA – ALA, DHA and EPA. ALA is found primarily in plants and must be converted to DHA and EPA in the liver.  Often, only 15% is converted.  DHA and EPA are found primarily in fish oils

Why are O3FA important for your children? 

  • Infant outcome: During pregnancy and breastfeeding, maternal intake of 1000 grams of O3FA has been associated with improved infant outcomes including better language scores, improved visual development and, in some studies, a lower incidence of prematurity. 
  • Mood disorders: A 2016 meta-analysis (which looks at all published studies) showed a 17% decrease in depression in adults as well as teenagers in patients taking 1000-2000 mg of O3FA per day. 
  • ADHD – A small but significant improvement in oppositional behavior and emotional lability was found in children with ADHD being treated with 1000-2000 mg of O3FA per day.
  • Childhood allergies – A systematic review of 15 studies found protection against childhood food and seasonal allergies in women who took O3FA supplementation during pregnancy and while breastfeeding.
  • Cardiovascular health – A recent large scale study showed a correlation between O3FA intake and reduced systolic blood pressure and increased HDL (the good type of fat) in youth ages 8-15 years.

What foods are highest in O3FA? 

  • Cold water fish (salmon, trout, herring and sardines) have the highest O3FA content. However, because seafood can also contain methyl mercury, pregnant and nursing women should avoid white tuna, mackerel and swordfish.   The O3FA content of fish is as follow:

Salmon, farmed cooked, 3 oz                     1.830g  

Herring, cooked, 3 oz                                    1.710g

Salmon, wild cooked, 3 oz                            1.570g

Sardines, 3 oz                                                  1.290g

Mackerel, 3 oz                                                 1.030g

Salmon, pink canned, 3 oz                            0.970g

Trout, cooked 3 oz                                          0.880g

Sea bass, cooked, 3 oz                                    0.650g

  • Approximately 8-10 ounces of the following vegetables the following amounts of O3FA. Remember that vegetables contain primarily ALA.  Divide by 6 to get the approximate amount converted to DHA and EPA.

Spinach frozen or fresh                                 2.183g

Cauliflower, cooked                                        1.452g

Romaine lettuce, raw                                     1.329g

Pinto or kidney beans                                    1.280g

Zucchini                                                            1.029g

Broccoli                                                             0.921g

  • Omega 3 content of other foods:

Flaxseed oil, 1 tbsp                                          7.260g

Chia seeds, 1 oz                                                5.060g

Flaxseed, whole 1 tbsp                                    2.350g

Canola oil, 1 tbsp                                             1.280g

Mayonnaise, 1 tbsp                                         0.740g

What about supplements?

  • O3FA supplements come in several forms. The phospholipid and triglyceride forms are best absorbed, the ethyl ester form is not well absorbed
  • Natural fish oils are the ideal supplements. They are the closest you get to real fish and contain vitamins A and D which aid in absorption
  • Krill oil is naturally low in contaminants and contains high amounts of phospholipid O3FA
  • Mammalian oil is made from seal blubber. It is high in DHA and EPA and contains a rare O3FA called DPA which is very beneficial.
  • Algal oil is derived from algae and is exceptionally high in beneficial O3FA. It is also ideal for vegetarians and those who keep kosher
  • O3FA supplements are prone to turn rancid. Check the expiration date and periodically cut one open and smell it.  Always look for the GOED standard for purity.

The best supplements of 2017 (disclaimer – this is a rapidly changing field and not everyone tolerates every supplement equally) 

  • Antarctic Krill Oil Platinum– high krill content, high DHA and EPA content, low contamination
  • Omega 3- MD – high DHA and EPA content, no fishy aftertaste
  • Omega Via – High DHA and EPA content, low contamination, more pricey than others
  • Nature’s Bounty – Good value, available at local drugstores, extra stabilizers
  • Algae Oil Omega 3 – Algae and seaweed based with high DHA and EPA content
  • Ovega Vegetarian softgels – Vegan approved, pills are large and may be hard to swallow