Are You Getting Enough Omega-3s?

Introductory primer on how to get more omega-3s in your diet.

Do you know your DHA and EPA from an ALA? And, are you getting enough of these important Omega-3 fatty acids?  Not sure? You are not alone. As many as 95% of Americans do not get enough DHA and EPA. This primer outlines how to get the most benefits from Omega-3 fatty acids that may improve your brain health, reduce your risk of high blood pressure and make certain your cardiovascular system has what it needs to function at its best. It’s all about getting the right types of fats in your diet, whether through food or dietary supplements. 

Omega-3 fatty acids are considered essential fatty acids because they are necessary for human health, but your body cannot produce them. Diet is the only way to provide your brain, tissues and cells with these fats – hence the term essential. 

Though there are as many as 11 types of Omega-3 fatty acids, these three – DHA, EPA and ALA – are the most important and each one has a distinct role in the body. Most Americans get enough ALA (alpha-linolenic acid) fatty acids from nuts and seeds and cooking oils. But if you shy away from these foods, consider adding flax and borage seed oil (an omega-6, and good source of gamma-linolenic oil) to your daily intake of healthy fats or look for a dietary supplement that contains a blend of Omega-3 and Omega-6 essential fatty acids, such as Barlean’s. For the sake of this article, we will focus on DHA and EPA because in American culture, we don’t eat enough fish weekly and that should be a concern for you and your health provider. 

Why are DHA and EPA fatty acids so important?

Engin Akyurt from Pexels

Omega-3 fats like DHA and EPA are classified as polyunsaturated fats (PUFA). These fats can reduce inflammation, lower the risk of clogged arteries from platelet aggregation, keep cholesterol at the ideal level, slightly lower blood pressure and regulate heart rhythms. Overall, PUFAs maintain a healthy brain, eye and cardiovascular function. To the body, PUFAs are more flexible and fluid than stiff and sticky saturated fats (like those found in processed foods, dairy fats and red meats), thus allowing for better circulation of lipids in the bloodstream, effective cell signaling and improved smooth muscle-cell function in the vascular system. 

Let’s look more closely at their role in the body. Docosahexaenoic acid (DHA) is an omega-3 fatty acid that provides structure for the brain, skin and retina. DHA may lower harmful LDL levels and raise healthy HDL cholesterol levels, as well as maintain healthy blood pressure levels and play a significant role in nervous system function. Its partner fatty acid, eicosapentaenoic acid (EPA), may reduce cellular and neuroinflammation and improve joint health. 

Watch this video to learn more:

How can I get enough DHA and EPA in my diet? 

The primary food source of DHA and EPA are cold-water fatty fish, such as wild bluefin tuna, anchovies, herring, lake trout, mackerel, sardines and wild salmon. These species contain anywhere from 1,000 mg to 1,500 mg of Omega-3 fatty acids per 3-ounce portion (some farmed salmon contain as many Omega-3s as wild, while others are lower, depending on their feed, so they are not always reliable sources). Fish, such as canned tuna, oysters, bass, tilapia and cod contain about half as much DHA and EPA as those listed above (see a complete list here). 

Photo by Dana Tentis from Pexels

While the American Heart Association recommends eating 3-ounces of cold-water fatty fish at least twice per week, we seldom do. This is why many consider supplements, made from fish oil, krill oil and algal oil (a vegetarian source of DHA and EPA), as an easy option. 

Experts recommend taking 250-500mg of fish oil per day if you do not consume enough fatty fish. Your healthcare provider may recommend a higher dose but please do so on their recommendation. 

When selecting a dietary supplement, look for the following: 

  1. Serving size: Many brands differ so be sure you understand whether the dose is one or two capsules or softgels.
  2. DHA and EPA: Your practitioner may recommend a specific DHA and EPA level, so look for a breakout of milligram weight and percentages on the nutrient facts panel. 
  3. Total Omega-3s: Typically, this number will be slightly larger than the total percentage or weight of the DHA and EPA. 
  4. List of ingredients: Make sure you know all the ingredients in the product, such ingredients used to blend the oil and preservatives. You may see ingredients like rosemary and d-alpha tocopherol (Vitamin E), which are antioxidants used to preserve the supplement. 
  5. What about contaminants in fish? All wild fish contain some level of mercury, PCBs (polychlorinated biphenyls), dioxins and other environmental contaminants. Larger predatory fish, such as swordfish and tilefish typically have higher levels of contaminants than say wild salmon or sardines. Dietary supplement companies purify the oil to make sure all the contaminants are removed. If you are looking for the highest quality standards for a product, find out whether the company follows the guidelines set forth by an organization called The Global Organization for EPA and DHA Omega-3s or GOED.  

Is there a test to know if I am getting enough DHA and EPA? 

In recent years, new testing options have become available. However, this is an important question to discuss with your naturopath or healthcare provider. If your physician is not familiar with how and whether to test for DHA and EPA, you can find a list of licensed naturopathic doctors  through the Institute for Natural Medicine here who can help you. 

In summary, here is what you need to know about DHA and EPA: 

  1. 95% of Americans do not get enough DHA and EPA from their diet.
  2. These essential nutrients can be obtained only through diet, which is why eating cold-water fatty fish is important. If this is not possible, please speak with your healthcare provider about whether a dietary supplement is recommended. See a directory of licensed naturopathic doctors who focus on whole-person healthcare here. 
  3. Omega-3 fatty acids are important for maintaining healthy triglycerides and blood pressure, supporting brain health and promoting eye health. 
  4. For mothers-to-be, getting enough Omega-3 fatty acids for both you and your baby is important for brain and eye health. 

For more information, see these helpful tips and FAQs on Omega-3 fatty acids:

Click image to view more

References: 

  1. National Institutes of Health, Omega-3 Fatty Acids, Fact Sheet for Health Professionals https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/
  2. The Global Organization for EPA and DHA Omega-3s (GOED). https://alwaysomega3s.com/ 
  3. Seafood Health Facts, Making Smart Choices https://www.seafoodhealthfacts.org/seafood-nutrition/healthcare-professionals/omega-3-content-frequently-consumed-seafood-products
  4. Papanikolaou Y, Brooks J, Reider C, Fulgoni VL, 3rd. U.S. adults are not meeting recommended levels for fish and omega-3 fatty acid intake: results of an analysis using observational data from NHANES 2003-2008. Nutr J 2014;13:31. [PubMed abstract]
  5. Wang C, Harris WS, Chung M, Lichtenstein AH, Balk EM, Kupelnick B, et al. n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. Am J Clin Nutr 2006;84:5-17. [PubMed abstract]
  6. Manson JE, Cook NR, Lee I-M, Christen W, Bassuk SS, Mora S, et al. Marine n-3 fatty acids and prevention of cardiovascular disease and cancer. N Engl J Med. 2018 Nov 10. doi: 10.1056/NEJMoa1811403. [PubMed abstract]
  7. Trikalinos TA, Lee J, Moorthy D, Yu WW, Lau J, Lichtenstein AH, et al. Effects of eicosapentanoic acid and docosahexanoic acid on mortality across diverse settings: systematic review and meta-analysis of randomized trials and prospective cohorts. Nutritional Resaerch Series vol. 4. In. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012. [PubMed abstract]
  8. Wen YT, Dai JH, Gao Q. Effects of omega-3 fatty acid on major cardiovascular events and mortality in patients with coronary heart disease: a meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis 2014;24:470-5. [PubMed abstract]
  9. Miller PE, Van Elswyk M, Alexander DD. Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and blood pressure: a meta-analysis of randomized controlled trials. Am J Hypertens 2014;27:885-96. [PubMed abstract]
  10. Casula M, Soranna D, Catapano AL, Corrao G. Long-term effect of high dose omega-3 fatty acid supplementation for secondary prevention of cardiovascular outcomes: A meta-analysis of randomized, placebo-controlled trials [corrected]. Atheroscler Suppl 2013;14:243-51. [PubMed abstract]
  11. Kotwal S, Jun M, Sullivan D, Perkovic V, Neal B. Omega 3 fatty acids and cardiovascular outcomes: systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes 2012;5:808-18. [PubMed abstract]

INM's team is made up of naturopathic doctors and health journalists.

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Deb Hubers

Debra Hubers is a serial entrepreneur and has started seven businesses; ranging from an advanced genomics to an employer health care purchasing cooperative. Deb has over 35 years of experience in healthcare finance, education, technology, and pharmacogenomics.

Ms. Hubers has dedicated her career to measuring and improving healthcare outcomes. Her expertise is leveraging technology to deliver personalized, preventative medicine. Ms. Hubers co-founded La Vita Compounding Pharmacy in 2007. Collaborating with her business partner, physicians and strategic partners, Deb has grown La Vita to be one of the most respected and sought-after personalized medicine providers on the west coast. She is also Co-Founder of EpigeneticsRx, a leading provider of precise, personalized, prevention which positively impacts genetic expression.

Alex Keller, ND

Dr. Alex Keller, ND, AFMCP is a graduate of the University of Ottawa with an Honours Bachelor in Health Sciences and Psychology. Although originally intending to attend conventional medical school, following a three-month volunteer internship at a rural Kenyan hospital where he observed how doctors used local food to treat patients, he shifted his career goals and pursued a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine in Toronto.

After one year of practicing with the esteemed Dr. Chris Pickrell, ND, RH in a community acupuncture setting, in 2015 he and his wife Dr. Jenn Keller, ND moved to rural Ottawa, Canada where they started an organic farm and retreat center. In the same year, Alex and his athletic therapist sister Jess Keller combined their practices to form Keller Active Health, an integrative physical therapy clinic.

Ever curious and passionate about the education of evidence-based natural medicine, in 2017, Dr. Keller joined a fledgling Ottawa-based health tech startup named Fullscript. He serves as its Medical Director and oversees the development of medical education content for practitioners across North America.

Prior to medicine, Alex worked in the renewable energy sector, where he developed a deep passion for sustainable agriculture and environmental stewardship. This connection between medicine and agriculture now drives Alex to focus much of his energy on bringing awareness to the quality and sourcing standards in the supplement and organic agriculture supply chains.

Today, he splits his professional time practicing as a clinician, working for Fullscript, and expanding the farming operation while chasing his kids with Jenn and occasionally running ultra-marathon trail races. He is also currently completing an Executive MBA through the Quantic School of Business & Technology with a focus on supply chain innovation.

Pamela Snider, ND

Pamela Snider, ND, is Executive and Senior Editor for the Foundations of Naturopathic Medicine Project, producing a first of its kind international textbook of Naturopathic medicine through a series of international retreats and symposia. A nationally recognized integrative health and policy leader, she is active in both national and regional integrative health initiatives. Dr. Snider serves on the Board of Directors, was founding Executive Director and co-founder of the Academic Consortium for Integrative Health (ACIH/ACCAHCa consortium of the councils of schools, accrediting agencies and certifying bodies of the licensed, traditional and emerging integrative health professions, and is currently Vice Chair and co-founder of the Integrative Health Policy Consortium (IHPC).  Dr. Snider served as a founding Board Member of the Academy of Integrative Health & Medicine from 2014-2016. Her public policy work includes completing a two year appointment to the DHHS Center For Medicaid and Medicare Services (CMS) Medicare Coverage Advisory Committee (MCAC); serving as a Steering Committee Member for  the HRSA funded American College of Preventive Medicine NCCIM Integrative Medicine in Preventive Medicine Residency program, co-directing in USPHS Region X the Building Bridges Between Provider Communities Group, an exploration of interdisciplinary collaboration and common ground between public health and CAM; serving for 22 years on Washington State’s Health Professional Loan Repayment and Scholarship Program Advisory Committee (HPLRSP); providing technical assistance to and developing key language for the enabling legislation for NIH Center for Complementary and Alternative Medicine (NCCIH/NCCAM); and staffing Joseph Pizzorno ND during his appointment as Commissioner on the White House Commission on CAM Policy.

From 1994-2003, Dr. Snider served as Associate Dean for Public and Professional Affairs and Naturopathic Medicine at Bastyr University, dividing her work between academic and public affairs activities, including chairing the Naturopathic Medicine Program Curriculum Review Committee.  Dr. Snider has been teaching, publishing and lecturing widely on Naturopathic philosophy, theory integrative health, public policy, and other topics for over 30 years. Currently, an Associate Professor at National University of Natural Medicine (NUNM) in Portland, OR, Dr. Snider also continues at Bastyr University in her 22nd year as a faculty member teaching naturopathic medicine history, clinical theory, and global context. Among her Naturopathic medicine professional roles she serves on the Institute for Natural Medicine’s Leadership Council.  In 1989, she co-led the naturopathic profession with Dr. Jared Zeff, in developing a unifying definition of naturopathic medicine and its principles of practice adopted unanimously by the American Association of Naturopathic Physicians (AANP) House of Delegates. She was a co-investigator in the 2004 NIH NCCAM research study, the North American Naturopathic Medical Research Agenda and CAM Advisor in NIHCCAM’s Financing Integrative Health Care (University of Washington).  Her areas of experience include healthcare education; naturopathic and interdisciplinary clinical theory, curriculum development; clinical practice; government and legislative affairs, public policy, interdisciplinary collaboration, and community organizing.  Dr. Snider has received the Ontario Naturopathic Physician of the Year Award, the Physician of the Year Award from the AANP, the President’s Outstanding Vision Award and Distinguished Alumnus Award at Bastyr University, AANP’s President’s Award, an honorary Doctorate of Naturopathic Philosophy from the Canadian College of Naturopathic Medicine (CCNM), the William A Mitchell Vis Award from the AANP and The Gathering – NMSA’s Beacon Award. She received her ND degree in 1982 from Bastyr University of Natural Health Sciences and is a licensed naturopathic physician in the State of Washington. She lives with her husband and children at their homestead in North Bend Washington, in the beautiful mountain to sea landscape and home of The Revival – Restore the Vis, an annual student-led community gathering.

Susan Haeger

Susan Haeger is Founder/Principal of Transformative Health Solutions Inc. She has applied her twenty plus years in executive leadership to help shape and drive adoption of progressive health policy for whole person healthcare. She was a section contributor to the 2021 INM/AANP published professional white paper, Naturopathic Physicians as Whole Health Specialists: The Future is Whole Person Health Care that provides supporting evidence for the profession’s significant and unique contributions to preventive, whole person care and models of integrative clinical practice.

Bruce Barlean

Bruce Barlean is an owner and founder of Barlean’s, a global dietary supplement manufacturer located in the Pacific Northwest in Ferndale, WA. Bruce has been actively involved in the Natural Products industry since 1989 and is passionate about making a difference in the world and positively impacting the lives of others.

Bruce believes that people can make a difference in the world through ordinary purchases. He is committed to improving the quality of life for every person on the planet by making the best products and by using the profits to support outreach programs. Bruce summarizes it simply, “We make good stuff to do good stuff”.

In the late 1980’s Bruce became passionate about how health could be dramatically improved with Flax Oil Supplementation. Bruce along with his entrepreneurial parents saw the potential to improve the lives of many people and in 1989 they began selling Flax Oil under the Barlean’s name. From 1989 – 2000 the business grew an average of 40% year over year. While most companies saw a decline in business in the 2001 recession, Barlean’s continued to grow and soon became America’s #1 selling flaxseed oil and continues to be to the present. The brand has since expanded to include additional oils, green food concentrates and other premium supplements. Bruce continues to drive innovation and over the years his products and company have won countless awards including: Eight consecutive Vity Awards for #1 EFA, Six consecutive Vity Awards for #1 Greens Food Supplement, Natural Choice Award for Best Specialty Supplement, Best Product of the Year, Best New Product, Gold Medal Taster’s Choice Award, Gold Medal American Masters of Taste Award, #1 Health Food Store Brand for Consumer Satisfaction by Consumer Lab, and Manufacturer of the Year.

In 2013 as the company was on the eve of celebrating the 25th year in business Bruce and his parents decided to take their desire to help people to a new level that they call Pathway to a Better Life – which is now seen in the Barlean’s logo. Bruce and his parents had always been generous in their giving and support of charities, but as part of the Pathway to a Better Life they decided to increased partnership with charitable organizations such as: Vitamin Angels, Compassion International, KidsTown International, Autism Hope Alliance, Engedi Refuge, Project 92, and others. And because so many people are unable to meet basic nutritional needs, Bruce created a comprehensive Omega-3 and multivitamin formula that he distributes free-of-charge to local food banks. In addition, Bruce decided the company would supply food banks with organic coconut oil to provide people with a health alternative to standard cooking oils.

Always generous with his time Bruce has served as a youth leader for his local church for several years and continues to mentor youth. He has been on several not for profit boards including; Whatcom County Pregnancy Center (2003-2006), Natural Products Association (dates?), and the Institute for Natural Medicine Leadership Council (presently).

The Barlean family have been avid supporters of Bastyr University since the 1990’s and in 2013 were given Bastyr’s most prestigious honor, the Mission Award, which recognizes their leadership over time in improving the health and well-being of the human community.

Bruce currently resides in Ferndale, WA with his wife Lisa and their two dogs: Heinz & Shadow. When he’s not helping others he can be found fishing (catch & release).

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Michelle Simon

Michelle Simon, PHD, ND

President & CEO

As president and CEO of INM, Dr. Simon brings her passion for working with organizations dedicated to improving the quality and delivery of healthcare. This desire stems from her years of practice as a licensed naturopathic physician. In addition to holding a Naturopathic Doctorate from Bastyr University she also holds a PhD in Biomedical Engineering from the University of North Carolina at Chapel Hill.

She has served on boards for the American Association of Naturopathic Physicians (AANP), the Naturopathic Physicians Research Institute (NPRI), and several advisory boards. Dr. Simon served nine years on the Washington State Health Technology Clinical Committee, as Ambassador to the Academy of Integrative Health and Medicine (AIHM) and was recognized as 2018 AANP Physician of the Year. Dr. Simon shares with her husband a passion for adventure travel, preferably by boat or motorcycle. She also enjoys teaching a women’s off-road motorcycling class.