Natural Products

Omega−3 Fatty Acids

Alpha-linolenic acid (ALA), Eicosapentanoic acid (EPA), Docosahexanoic acid (DHA)

Efficacy

• Indications with proven efficacy:
  Cardiovascular Protection (ALA - EPA - DHA)
  Hypertriglyceridemia
  
• Indications with possible, but poorly documented efficacy:
  Asthma
  Menstrual pain
  Osteoporosis
  Psoriasis
  Rheumatoid Arthritis (EPA - DHA)
  To boost the effects of antidepressants and antipsychotic drugs
  To improve night vision – in dyslexic children
  
• Also used for other indications
  

Security

• Risk of Drug Interactions: Low
• Adverse Effects: Rare

What is it?

Omega−3 and omega−6 fatty acids are part of the polyunsaturated fatty acids. They play an essential role in the proper development and functioning of the body. Our diet should contain a balanced amount of these fatty acids. Since the body cannot synthesize these acids, they must be obtained from the diet.

These fatty acids play an important role in the formation of the cells and the skin's structure, and they also play a role in the regulation of the inflammatory process and cardiovascular system. They reduce the amount of bad cholesterol and triglycerides found in the blood as well as prevent blood from clotting (coagulation).

There are three types of omega−3 fatty acids: alpha-linolenic acid (ALA), eicosapentanoic acid (EPA) and docosahexanoic acid (DHA). ALA is said to be essential because it must be obtained from food, while the other two can be synthesized in a small amount the body from dietary ALA. EPA and DHA are the main active fatty acids.

In the western diet, omega−6 consumption far outweighs omega−3 consumption. To reach an equilibrium, we need to increase our dietary intake of omega−3 fatty acids.

Dietary sources that provide 1.3 g of omega−3 *
Plant-derived omega−3 (ALA) - ½ teaspoon (2 ml) linseed oil - 2 teaspoons (10 ml) crushed linseeds - 1 tablespoon (15 ml) canola oil - 1/4 cup (60 ml) walnuts - 1½ tablespoon (22 ml) soy oil - 13 g hemp seeds	Omega−3 from marine sources (EPA+DHA) - 50 g of blue mackerel - 70 g of Atlantic salmon (farmed) - 75 g of Atlantic herring - 90 g of pink or red salmon (canned) ** - 90 g of sardines - 120 g of albacore (white) tuna (canned) ***
*   Certain foods are enriched with omega−3 fatty acids (eggs, milk, etc.). **  Keta salmon provides half the amount of omega−3 found in other species. *** Albacore tuna provides half the amount of omega−3 found in other species.

There is no consensus on the recommended dietary intake of omega−3 fatty acids. The recommended daily intakes vary from 0.8 to 2.22 grams for ALA and 0.3 to 0.65 grams for EPA + DHA.

Warning

In 2004, Canada adopted new regulations that control the manufacturing, packaging, labeling and importing of natural health products. The new regulations also include an adverse reaction reporting system. Products that conform to the regulation's criteria are identified with a natural product number (NPN) or homeopathic medicine number (DIN-HM) and can be legally sold in Canada. This number indicates that the product meets specific criteria for safety and purity, not that it is effective for any indication.

Medicinal plants content varies naturally from plant to plant – just as fruits from the same package may vary in taste and texture. There is no standard to measure the active content of each plant. Thus, efficacy of natural products should be expected to vary from brand to brand as well as from bottle to bottle of the same brand.

For more information about the Natural Health Products Regulations, or to check if a product has been assessed, visit the Health Canada website at http://www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php.

Does it work?

Omega−3 fatty acids are effective for cardiovascular protection and to reduce triglycerides. However, they may have some beneficial effects in many indications:

• Cardiovascular protection:
  Some experts suggest increasing the dietary omega−3 intake by eating 1.2 to 2 grams of ALA daily. Several studies were based on a daily intake of 1.8 g of EPA and 0.9 g of DHA, from fish oil.
• Hypertriglyceridemia:
  4 g per day reduce triglyceride levels by 10 to 35%.

• Rheumatoid arthritis:
  Several studies were based on a daily intake of 1.8 g of EPA and 0.9 g of DHA.

Is it safe?

• Omega−3 fatty acids are very well tolerated. Heartburn, bad breath, fish-tasting reflux, nausea, soft stools and nosebleeds have been reported. In addition, there is a possibility of weight gain if the intake of other types of dietary fat is not reduced.
• Diabetes, schizophrenia and excessive alcohol consumption can reduce the body's ability to transform ALA into EPA.
• The intake of dietary omega−3 fatty acids is safe during pregnancy and lactation. However, supplements should probably be avoided, since no safety data are available on their use.
• Patients taking anticoagulants should talk to their doctor before taking fish oil supplements.

Clinical notes

• Due to industrial manufacturing processes, and intensive agriculture and farming techniques, several foods now contain less omega−3 fatty acids.
• According to the American Heart Association, people should eat fish (2 to 3 times a week) and ALA-rich oils and seeds on a regular basis. Fish oil supplements should always be used under medical supervision.

References

1. Natural Medicines Comprehensive Database, Therapeutic Research Faculty, 2007
2. Passeportsanté.net. Poisson (huiles). http://www.passeportsante.net
3. Passeportsanté.net. Oméga-3 et oméga-6. http://www.passeportsante.net
4. The Health Professional's Guide to Popular Dietary Supplements, 2nd edition, American Dietetic Association, 2003
5. Centre de Référence sur la nutrition humaine Extenso, Le point sur les acides gras oméga-3, http://www.extenso.org
6. PM Kris-Etherton, WS Harris, LJ Appel. AHA Scientific Statements: Fish Consumption, Fish Oil, Omega−3 Fatty Acids, and Cardiovascular Disease. Circulation 2002, 106:2747-2757

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