While there is no established Adequate Intake (AI) or Dietary Reference Intake (DRI) in the United States for EPA and DHA omega-3s, a number of expert bodies and health professionals recommend 250 mg to 500 mg of EPA and DHA per day for basic health maintenance. However recent research has shown that many people may need 1000 mg of EPA and DHA per day for cardioprotection.
The best source of EPA and DHA omega-3s is fatty fish such as salmon, mackerel or tuna. Most Americans, however, do not consume enough fatty fish to reap the benefits of omega-3 consumption and in these cases, a high quality supplement or omega-3 fortified food can provide the necessary intake. Learn more about good sources on our consumer site.
ALA (alpha-linolenic acid) is a true “essential” omega-3 because our bodies can’t make it on its own. ALA is a precursor to EPA and DHA, but the conversion rate in our bodies is extremely low. The long-chain omega-3s EPA and DHA are known for supporting heart, brain and eye health at all stages of life so it’s important to encourage your patients to consume preformed EPA and DHA, naturally found in marine based foods and dietary supplements, directly.
Vegetarians and vegans should consider an omega-3 supplement derived from algae. There are many algae supplement products containing both EPA and DHA available on the market.
| A. According to the National Institutes of Health fact sheet for health professionals, there is no upper limit for safety for EPA and DHA omega-3s. Both the U.S. Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA) recognize that long-term intake of 5g/day of EPA+DHA is safe. |
The benefits of fish consumption far outweigh the potential risks when the amount of fish eaten is within the recommendations established by the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA). The most recent FDA and EPA recommendations suggest that pregnant women and children should eat more fish due to its health benefits.
Some fish, like wild salmon, have lower levels of contaminants than fish like swordfish and tilefish, so educating your patients about what fish have low levels of contaminants is important. They can learn more from Monterey Bay Aquarium Seafood Watch (https://www.seafoodwatch.org/).
In terms of omega-3 dietary supplements, manufacturers purify oils to reduce levels of environmental contaminates in finished products. While governmental quality standards exist, most companies follow even stricter voluntary guidelines put forth in the GOED monograph to ensure high quality and safe products.
The risk of bleeding is minimal. In fact, the recent science advisory from the American Heart Association entitled “Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease” reported the risk of bleeding associated with omega-3 supplementation was low in the RCTs of clinical cardiovascular outcomes and presented “no apparent risk. Additionally a substantial body of data from large-scale clinical trials of omega-3 fatty acids has found minimal evidence of increased bleeding risk with doses used for prevention of cardiovascular events. Learn more.
EPA and DHA omega-3s do not lower total or LDL cholesterol. Studies have consistently shown that omega-3s help maintain normal triglyceride levels though.
The source of omega-3s is not important and supplements from fish varieties, krill or algae confer a similar benefit. The important thing is to look at the EPA and DHA content on the Supplement Facts panel of any omega-3 supplement to make sure that you are getting the recommended dosage of total EPA and DHA. Vegetarians and vegans can choose an algae-based supplement.
Patients can have their omega-3 or fatty acid levels to help you understand educate them about their omega-3 status and consumption needs. Below are several omega-3 test kit options: