Video: Nutrition for a Healthy Pregnancy Part 2 with Dr. Gregory Ward
Dr. Gregory Ward explores nutrition research that points to the benefits of docosahexaenoic acid (DHA) omega-3.
By: Chris Mohr, PhD, RD
October 4, 2018
Omega-3s are a type of fat, a fat that is found naturally in the diet. The body of evidence in support of the essential omega-3 fats in the diet continues to grow, for kids and adults alike. There are several different types of omega-3 fats – docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA) and alpha linolenic acid (ALA) – each with its own unique and sometimes overlapping roles.
Omega-3 fats are “essential” meaning they must be obtained from the diet since the body can’t make them in adequate levels on its own. We get omega-3 fats, namely EPA and DHA, in the diet from fatty fish, like salmon, tuna and sardines, for example. On the flipside, we get ALA from flaxseed, chia seed, nuts, leafy greens, fortified eggs and milk, among others. High quality fish oil supplements also contain a combination of essential fatty acids, most notably EPA and DHA, which are two of the most studied omega-3s for their health benefits. All omega-3s are important, but they’re not interchangeable and each is needed in the diet.
Consumption of EPA and DHA from food contributes a very small amount – about 40 mg daily – to total daily omega-3 intakes of kids and teens, according to the US Department of Agriculture (1). As you’ll see, this is far less than most of the data demonstrate as being optimal. ALA is more prevalent in the diet (1.32 mg and 1.55 mg, for 2 to 20-year-old females and males, respectively), but it’s important to note that just getting ALA isn’t enough as it cannot be readily converted to the other two omega-3s. Therefore, families need to consider options to increase their kids’ regular intake of omega-3s.
Omega-3 fats are a necessary part of every single cell in the body, meaning they’re important for heart, skin, joint and brain health, as well as performance and managing inflammation. The latter – inflammation – is important in terms of sport, exercise and recovery. A significant amount of research focuses on the brain health benefits of EPA and DHA omega-3s.
DHA accumulates primarily in the brain and retina where it plays important structural and functional roles. DHA is essential for brain development in infants and children and cognitive function throughout the lifespan. It also plays a pivotal role in executive function, working memory, sustained attention and problem solving (2, 3). It is also found in significant amounts in the hippocampus, which is responsible for spatial learning, and memory formation (ability to recall facts and events). There is mounting evidence that DHA may play a role in the reduction in risk for concussions, which is certainly a growing concern in youth sports (4).
EPA supports multiple aspects of heart health as well as regulating overall inflammatory levels throughout the body. EPA also specifically supports triglyceride reduction and support for arterial and myocardial function(5). Together, EPA and DHA work synergistically, along with many other nutrients, to help optimize overall health and more specifically cardiovascular health and brain. Further, their importance cannot be understated in terms of the potential role in athletic performance.
It is worth considering the role of omega-3s in athletic performance as research continues to emerge in this area (6). Exercise may cause muscle soreness (called delayed onset muscle soreness). This is a normal, healthy response for working muscles. However, it can hinder physical performance if an athlete is struggling with overly sore and tired muscles. A study published in the Journal of Dietary Supplements found fish oil supplementation may alleviate this soreness, thereby allowing young athletes to perform at their peak (7). Another study, examining similar outcomes in elite soccer players, but using lower doses of fish oil than the previous study (1100 mg combined EPA plus DHA) with whey protein and carbohydrates post exercise found that this combination significantly reduced muscle soreness and creatine kinase (a marker of muscle breakdown) (8).
Another study examined the effects on DHA on head trauma in American football, which is the sport associated with the highest incidence of concussion. In this study, athletes were supplemented with either 2, 4 or 6 g DHA or placebo for the duration of the study. The athletes then had a specific marker of head trauma measured to determine if fish oil could make a positive change. The authors found that DHA, at a dose of 2 grams per day, had a positive influence on the blood marker measured, suggesting this supplemental dose may play a role in protecting the brain in athletes (9). While concussions are particularly high in American football, other sports such as soccer, hockey, basketball and lacrosse are certainly not immune to head trauma, suggesting there certainly is carry over to other sports as well.
As mentioned earlier, fatty fish and other seafood sources are the best way to get Omega-3s – namely EPA & DHA – from the diet. The plant based and fortified sources mentioned earlier provide mostly ALA, but they are not a good source of the much-needed EPA and DHA. These are especially helpful for picky eaters who don’t want to, or can’t eat seafood or fish. The challenge here, however, is there is a very low conversion of ALA to EPA or DHA, meaning other options need to be explored as well.
The best option in this situation or for those following a vegetarian or vegan diet is to consider taking an algal EPA and DHA supplement to get the omega-3s typically found in seafood. Often vegetarians and vegans think that consuming an ALA plant-based food or supplement such as flax or chia, provides sufficient omega-3s. As mentioned earlier, however, this doesn’t hold true.
Seafood is always going to be a great, first recommendation. Fatty fish like salmon and tuna are usually the more common options among most, though sardines, anchovies and mackerel are all solid choices too. Including a serving of any of those options at least twice per week is wise. In addition, read labels and look to fortified foods, like milk, eggs, and yogurt, for example, all which may have added DHA as well. Finally, consider a supplemental source of DHA and EPA to fill in the gaps from the diet.
To achieve the health benefits from omega-3s, it’s necessary to consume it as preformed EPA and DHA – the same that are naturally found in fish. It’s important to remember that more than 30 percent of the brain is made up of fat, with at least 7 percent of total brain fat being made of DHA. By not consuming adequate amounts of EPA and DHA regularly, the body is likely going to be left deficient, which can ultimately impact overall health and performance of young athletes. Think about those growing brains, sitting in school, for hours on end, day after day, trying to focus and grow. Or consider the young athlete, trying to perform his or her best on the soccer field. Making sure young athletes get adequate levels of omega-3 fats, along with a wide variety of other key nutrients, is important for optimal health.
1. U.S. Department of Agriculture, Agricultural Research Service. What we eat in America, 2011-2012.2015.
2. Yurko-Mauro K1, McCarthy D, Rom D, Nelson EB, Ryan AS, Blackwell A, Salem N Jr, Stedman M; MIDAS InvestigatorsBeneficial effects of docosahexaenoic acid on cognition in age-related cognitive decline.Alzheimers Dement.2010 456-64
3. Abdelhamid AS, Brown TJ, Brainard JS, Biswas P, Thorpe GC, Moore HJ, Deane KH, Al Abdulghafoor FK, Summerbell CD, Worthington HV, Song F, Hooper L. Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease.Cochrane Database Syst Rev. 2018 Jul 18;7 Review.
4. Lewis MD.Concussions, Traumatic BrainInjury, and the Innovative Use of Omega-3s.J Am Coll Nutr. 2016 Jul;35(5):469-75. Review.
5. Petrova D, Bernabeu Litrán MA, García-Mármol E, Rodríguez-Rodríguez M, Cueto-Martín B, López-Huertas E, Catena A, Fonollá J. Еffects of fortified milk on cognitive abilities in school-aged children: results from a randomized-controlled trial.Eur J Nutr. 2018 Jun 7
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