- Omega-3s from land and sea: A key distinction
- Long-chain omega-3s: Truly essential to life and health
- Omega-3 EPA and DHA: Key heart-health allies
- How much omega-3 EPA and DHA do you need?
- Safety considerations & Further reading
- Primary Sources
Note: The U.S. FDA has not evaluated these statements. No product offered for sale at vitalchoice.com is intended to diagnose, treat, cure or prevent any disease.
To survive and thrive, humans need to consume small amounts of two kinds of polyunsaturated fat, called omega-3 fatty acids and omega-6 fatty acids.
We cannot make omega-3 and omega-6 fatty acids in our bodies, so we have to get them from foods or supplements.
The average American gets too many omega-6 fatty acids, primarily from the vegetable oils used in home kitchens and in almost all restaurant, take-out, prepared, and packaged foods.
In fact, most Americans consume omega-6s to unhealthful excess.
This imbalance is the subject of our "Out of Balance" video, featuring top researchers in the field.
In contrast, most Americans don't get enough omega-3 fatty acids to enable and maintain optimal health …in part because of their over-consumption of omega-6 fatty acids.
Note: While wild and farmed salmon have comparable levels of omega-3s, farmed salmon is generally much higher in omega-6 fats.
The imbalance between omega-3 and omega-6 fats in the average American's diet led us to offer a state-of-the-art home test, called "The Vital Omega-3 and 6 HUFA Test™".
This striking map shows the percentage of omega-3s (DHA+EPA) in the red blood cells of people worldwide. Percentages of 8% and higher are proven to reduce the risk for cardiovascular disease, but the average percentage among Americans is only 4% — a level linked to higher risk for cardiovascular disease:
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2. Omega-3s from land and sea: A key distinction
Omega-3 fatty acids come in two basic forms, with distinctly different health impacts:
- Short-chain (polyunsaturated) omega-3 ALA from plant foods.
- Long-chain (highly unsaturated) omega-3s (EPA and DHA) from seafood and fish oil.
The body only needs EPA and DHA, very small amounts of which it can make from plant-source ALA.
Of the three omega-3s, DHA is by far the most important one to get from foods or supplements.
It is absolutely essential to brain, heart, immune, eye, and overall health ... and, for the following reasons, people should get as much DHA as possible directly from foods or supplements:
- The body cannot make enough DHA from dietary ALA. Most people convert less than one-half of one percent of ALA into DHA.
- The body can only can make small amounts of EPA from ALA, and most people don't convert dietary EPA into ample — or even substantial — amounts of DHA. Typically, less than 10 percent of the EPA the body makes from ALA gets made into DHA.
On average, people convert about five percent of the ALA they get from plant foods or oils into long-chain omega-3s — almost entirely EPA. (Most of the ALA we consume is oxidized or "burned" for energy.)
This conversion rate ranges from one to 10 percent, and varies by your gender, genetic profile, and overall diet.
However, two groups of people who convert larger amounts of dietary ALA into EPA, and convert more of that EPA into DHA:
- Pregnant and nursing women convert about 10 percent of their dietary ALA into EPA and DHA, versus one to five percent in their peers.
- People who eat little or no fish, and take no omega-3 fish oil, convert larger amounts of dietary ALA into EPA and convert more EPA into DHA, compared with people who get significant amounts of dietary EPA and DHA from seafood or supplements.
However, studies consistently show that most American women of child-bearing years have inadequate — or barely adequate — blood levels of omega 3 DHA, which mothers must pass umbilically to their fetus to enable both basic and optimal child development.
And people who don't eat seafood or take fish oil would be unwise to rely on their somewhat higher rate of conversion to ensure adequate supplies of DHA, without which their brains, eyes, immune systems, and hearts can't function properly or optimally.
Recent findings revealed genetic variations that affect the conversion of short-chain, plant-source omega-3s and omega-6s into their long-chain, animal-source forms (see Omega-3 Mystery Solved?) ... with large differences seen among geographical regions (see Dramatic Omega-3 Discovery).
Those findings highlight the value of blood testing to monitor your omega-3/omega-6 balance.
High omega-6 intakes limit conversion of ALA into omega-3 EPA and DHA
Your intake of the short-chain omega-6 fatty acid called LA — concentrated in nuts, most seeds, and cheap vegetable oils — exerts a big influence on the conversion of ALA into EPA and DHA.
This is because short-chain omega-6 LA competes with short-chain omega-3 ALA for the body's limited capacity to convert these short-chain fatty acids into their long-chain forms.
Short-chain omega-3s: Necessary only in diets lacking fish fat
Certain plant foods and vegetable oils contain small amounts of short-chain omega-3 ALA (alpha-linolenic acid).
Your body does not need short-chain omega-3 ALA … unless your diet lacks long-chain omega-3 EPA and DHA, in which case it can make very small amounts from dietary ALA.
However, the body makes much more EPA than DHA from ALA, which means that plant foods providing ALA are very poor sources of DHA.
Only one to 10 percent of dietary ALA gets converted to EPA, and only about 0.5 percent of dietary ALA gets converted to DHA … and the body makes very little DHA from dietary EPA.
The body converts from one to 10 percent of dietary ALA into EPA and DHA, with vegans, vegetarians, and women — especially pregnant and nursing women — showing the highest conversion rates.
Vegan and vegetarian diets normally contain no EPA or DHA, because such diets lack any seafood or DHA-fortified animal foods (e.g., special DHA-rich eggs).
Accordingly, vegans and vegetarians must either consume plant foods containing omega-3 ALA — from which their bodies will produce EPA and DHA — or take supplements containing DHA from algae, some of which their bodies will use to make EPA.
These are common sources of ALA, listed in rough order, from most to least ALA content:
Flaxseed oil, walnuts, flaxseed, walnut oil, canola oil, soybeans, soybean oil*, hemp seed, hemp oil, leafy green vegetables (purslane, grape leaves, spinach, kale, chard, collards), cauliflower, radish sprouts, beans, broccoli, Brussels sprouts, seaweed, and green or yellow squash.
*Note: Most soy oil sold in the U.S. is abnormally low in omega-3 ALA. It comes from soybeans modified to reduce their ALA content so as to extend the shelf life of the oil extracted from them. And it's very high in competing omega-6 fats.
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3. Long-chain "marine" omega-3s: Truly essential to life and health
Omega-3 EPA and DHA are essential to life itself, and a very large body of evidence indicates that diets rich in both promote optimal health.
Fish, shellfish, zooplankton (e.g., krill), algae, and certain aquatic plants (e.g., seaweed) are the only food sources of EPA and DHA. This explains why EPA and DHA are sometimes called "marine" omega-3s.
Among marine foods, fatty fish like salmon, tuna, sardines, mackerel, herring, anchovies, and sablefish are the richest sources of EPA and DHA, by far.
How important are omega-3s to health?
A landmark study estimated that, as we reported, America's Omega-3 Deficiency May Cause 84,000 Premature Deaths.
And that disturbing number doesn't include the millions more Americans thought to suffer ill health due a shortage of omega-3 fats and excess of competing omega-6 fats.
Here's why omega-3 DHA and EPA are essential to human life and to optimal health:
Omega-3 DHA (docosahexaenoic acid) is also found in almost all cell membranes, and unlike EPA, it plays essential structural and functional roles in the brain, nervous system, and eyes.
- DHA is essential to development of the growing brain.
- DHA is essential to the human brain and nervous system, and to thinking and memory. Brain tissues average 50 percent fatty acids by weight, and DHA averages about 15 percent of those.
- DHA regulates the expression of dozens of "working" genes in the brain, and stimulates growth of the connections between brain cells (neurons).
- DHA is essential to eye structure and functions, and to infants' eye development.
- DHA is the dominant fatty acid in sperm, and is critical to male reproductive health.
- The body uses DHA to make critical inflammation- and oxidation-regulating chemicals.
- DHA moderates the creation of pro-inflammatory eicosanoids from omega-6 fats.
Omega-3 EPA (eicosapentaenoic acid) is found in almost all cells in the body:
- EPA appears to support and promote healthy mood and good mental health.
- The body uses EPA to make ephemeral, hormone-like compounds (prostaglandins, leukotrienes, and thromboxanes) that play key roles in the regulation of inflammation.
- The body uses EPA to make critical inflammation- and oxidation-regulating chemicals.
The results of a landmark study showed that the body can readily convert significant amounts of dietary EPA into DHA (Metherel AH et al. 2019).
However, although blood levels of EPA rise significantly after consuming DHA, the study found that this rise does not result from conversion of DHA into EPA. Instead, increases in levels of EPA after consuming DHA result from a slowing in the metabolism of EPA already present in the body.
Note: A third, little-known long-chain omega-3 fatty acid called DPA (docosapentaenoic acid) appears to enhance cardiovascular function and other aspects of health, and is the subject of growing research.
Small amounts of DPA occur in fish, shellfish, and other ocean species. The body can make DPA from EPA, and vice versa. Confusingly, there is also an omega-6 fatty acid called docosapentaenoic acid (DPA).
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4. Omega-3 EPA and DHA: Key heart-health allies
The U.S. Agency for Healthcare Research and Quality (AHRQ) is the lead Federal agency charged with supporting research designed to improve the quality of health care, reduce its cost, address patient safety and medical errors, and broaden access to essential services.
In 2003, AHRQ commissioned a group of leading academic researchers to examine the available evidence concerning the impacts of omega-3s from fish (EPA and DHA) and plant foods (ALA) on cardiovascular disease (CVD).
The resulting 2004 AHRQ report — "Effects of Omega-3 Fatty Acids on Cardiovascular Disease" — found ample high-quality evidence for the cardiovascular-health and death-prevention benefits of fish and fish oil, but much less evidence concerning omega-3 ALA in plant foods: "Overall, a number of studies offer evidence to support the hypothesis that fish, fish oil, or ALA supplement consumption reduces all-cause mortality and various CVD outcomes, although the evidence is strongest for fish or fish oil."
This finding was echoed in a 2004 ruling by the U.S. Food and Drug Administration (FDA), in which the agency approved the following qualified health claim for fish and fish oil supplements: "Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease."
The American Heart Association (AHA) agrees with these Federal findings, and says that the long-chain omega-3s from fish fat (EPA and DHA) reduce the risk of cardiovascular disease, thanks to the following effects:
- Moderate blood pressure.
- Promote healthy artery function.
- Lower triglyceride (blood fat) levels.
- Reduce blood stickiness (platelet aggregation).
- Optimize the ratio of HDL to non-HDL cholesterol.
- Help stabilize arterial plaque and inhibit its accumulation.
- Reduce the risk of arrhythmias that can lead to sudden cardiac death.
Omega-3s do not lower total or LDL cholesterol levels, and can in fact raise LDL levels slightly. However, omega-3s also reduce the oxidation of LDL cholesterol and improve the ratio of HDL ("good") cholesterol to non-HDL cholesterol. These two measures are considered more accurate predictors of cardiovascular health risk, compared with total or LDL cholesterol levels.
The AHA makes these recommendations with regard to omega-3s, fish and heart health:
- People without documented coronary heart disease: Enjoy two servings of fish per week.
- Patients with diagnosed coronary heart disease: Consume 1,000 mg (1 gm) of omega-3s daily, preferably from fatty fish or fish oil supplements.
- Patients who need to lower triglycerides: Take 2 to 4 grams (2000 to 4000mg) of omega-3s daily.
- Patients taking more than 3 grams (3000mg) of omega-3s per day from fish oil capsules should do so only under a physician's guidance.
We would add this caution: Persons diagnosed with heart disease — especially those using implanted cardiac defibrillators or taking blood thinning drugs — should consult a physician before taking supplemental omega-3s or any other dietary supplement.
For more information, see "Safety considerations: doses and contraindications", below.
To learn more, visit these American Heart Association pages:
- Fish 101
- Fish and Omega-3 Fatty Acids
- Frequently Asked Questions about Fish
- AHA Scientific Statement: Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease
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5. How much omega-3 EPA and DHA do you need?
Oddly, there are no official U.S. intake recommendations for omega-3 DHA and EPA.
Instead, the U.S. Institute of Medicine (IOM) set Adequate Intake (AI) values for plant-source omega-3 ALA, only small proportions of which the body can convert into the DHA and EPA it needs and uses for essential functions.
The AI values for omega-3 ALA are presented below, along with the IOM’s reason for not setting values for DHA and EPA (see "Official U.S. intake recommendations for omega-3 ALA", below).
Worldwide intake recommendations for DHA and EPA
Most researchers and official bodies recommend these combined amounts of EPA and DHA daily in order to enable optimal health:
- Infants* — 200mg of EPA+DHA per day
- Pregnant/nursing women — 500mg of EPA+DHA per day
- Children aged 12 or younger* — 300mg of EPA+DHA per day.
- Healthy teens and adults — 250-500mg of EPA+DHA per day.
While DHA is the most important, research indicates that it's best to consume about one to two parts EPA to one part DHA.
Conveniently, most fish, shellfish, and fish oils contain roughly equal amounts of EPA and DHA, though most provide more EPA than DHA.
According to US government surveys, only one in four Americans consumes any EPA or DHA, and the average American consumes only 28-40mg of EPA (average 34mg) and 39-75mg of DHA daily (average 57mg).
Those intake levels fall far short of the ones recommended by an expert panel commissioned by the National Institutes of Health (Simopoulos AP et al. 1999), which advised consuming at least 650mg of DHA + EPA per day, including at least 220mg of DHA and 220mg of EPA.
To reach (or closely approach) a daily intake of 650mg of DHA + EPA, you could take 4 capsules of 1,000mg Wild Sockeye Salmon Oil, 8 capsules of 500mg Wild Sockeye Salmon Oil, 3 capsules of 1000mg Vital Red Krill Oil, 6 capsules of 500mg Vital Red Krill Oil, 1 capsule of High Potency Omega-3 Therapy, or 1 capsule of High DHA Brain Therapy.
These the official intake guidelines were issued by the scientific bodies* with the greatest expertise. You could satisfy these recommendations for healthy adults by consuming seafood, supplements, or some combination of the two:
- WHO recommends 250-500mg of omega-3 EPA+DHA per day.
- EFSA recommends 250mg of omega-3 EPA+DHA per day.
- ISSFAL recommends 500mg of omega-3 EPA+DHA per day (at least 220mg of DHA and 220mg of EPA).
- IOM recommends 130-260mg of omega-3 EPA+DHA per day.
- AHA makes no specific EPA+DHA intake recommendation for healthy people, but advises them to eat at least two servings of fatty seafood per week (e.g., salmon, tuna, sablefish, mackerel, or sardines).
- AHA advises heart patients to take 1000mg (1 gram) of omega-3 EPA+DHA per day, and says that heart patients can lower triglyceride levels as needed under a physician's guidance by taking 2000mg to 4000mg grams of omega-3 EPA+DHA per day.
*UN World Health Organization (WHO) • European Food Safety Agency (EFSA) • International Society for the Study of Fatty Acids and Lipids (ISSFAL) • American Heart Association (AHA) • U.S. Institute of Medicine (IOM)
Daily intakes of EPA+DHA that fall under 3000mg — but exceed the minimum intakes recommended by the AHA and others (250-500mg) — may confer additional health benefits, especially in the context of diets high in competing omega-6 fatty acids.
Official U.S. intake recommendations for omega-3 ALA
Intake recommendations for nutrients — known as Recommended Daily Allowances (RDAs) and Dietary Reference Intakes (DRIs) — are established by the U.S. Institute of Medicine (IOM).
Unfortunately, the U.S. IOM has never established official intake recommendations for long-chain, seafood-source omega-3s (DHA and EPA), which — unlike omega-3 ALA — the body actually needs and uses for essential functions.
The IOM made that widely criticized decision because humans can convert small proportions (1% to 10%) of short-chain, plant-source omega-3 ALA into omega-3 EPA, comparably small proportions of which the body can then convert into DHA.
The U.S. IOM established these so-called “Adequate Intake” (AI) values — which are somewhat comparable to Recommended Dietary Allowances (RDAs) — for plant-source omega-3 ALA, from age 14 on:
- Men – 1.6 grams of ALA per day
- Women – 1.1 grams of ALA per day
Confusingly, the IOM decided that intakes of omega-3 DHA and EPA can account for up to 10 percent of its Adequate Intake values for ALA.
Leading researchers believe it’s a mistake to only set Adequate Intake values for omega-3 ALA, given two facts:
- The very low rates at which people can convert ALA into EPA, small proportions of which the body can then convert into DHA.
- The well-documented shortage of any kind of omega-3s in the average American’s diet, and the extreme excess of omega-6 fats, which compete with dietary omega-3 ALA for conversion into the essential long-chain forms of each type of fatty acid.
6. Safety considerations: doses and contraindications
Many clinical trials have used doses of 1000mg to 3000mg of EPA+DHA per day, with no adverse effects other than fishy burps or slight stomach upset in some people.
The U.S. FDA has said that it sees no risk from intakes up to 3000mg (3 grams) of EPA+DHA per day, while the American Heart Association recommends doses up to 4000mg per day under a physician's supervision.
In 2012, the European Food Safety Authority (EFSA) concluded that it is safe for adults to consume up to 5 grams (5,000mg) of supplemental omega-3 EPA+DHA per day. The agency did not set an upper intake limit for children.
Specifically, the European experts found that omega-3 intakes of up to 5 grams a day do not increase the risk of bleeding, impaired regulation of glucose levels, or impaired immune function.
To be safe, we suggest that you consult with a physician before taking more than 4,000mg of supplemental omega-3 EPA+DHA per day, especially if you have been diagnosed with a cardiac or immune disorder.
(To reach an intake of 4,000mg of EPA+DHA, you would need to take 26 capsules of 1,000mg Wild Sockeye Salmon Oil, 52 capsules of 500mg Wild Sockeye Salmon Oil, 19 capsules of 1000mg Vital Red Krill Oil, 8 capsules of High Potency Omega-3 Therapy, or 8 capsules of High DHA Prenatal Therapy.)
The omega-3s in fish oil possess properties associated with blood thinning, but — when taken at recommended doses — do not normally pose a risk to persons taking blood-thinning drugs (e.g., coumadin, warfarin, and aspirin) or undergoing surgery: see Can Fish Oil Cause Bleeding Risks? and Omega-3s May Enhance Post-Surgery Outcomes.
- The Health Benefits of Fish
- Healthy Mom & Baby
- Vital Choices Newsletter Archive
- Know Your Omega-3/6 Numbers
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