The benefits of Omega-3 fatty acids for brain, heart, hormonal, and digestive health

Walnuts are a great source of omega-3 fatty acids

Walnuts are a great source of omega-3 fatty acids

Omega-3 fatty acids found in fish oil are probably one of the best-studied nutrients. They can be helpful in a number of health conditions, including cardiovascular, eye, and hormonal health.

Omega 3 supports brain health

Omega-3 fatty acids also play a pivotal role in brain function and development, and also in all stages of life. Because the brain is made up of 60 percent fat, omega-3s are important building blocks needed to support cell membranes in the brain.

As an anti-inflammatory, omega-3 is thought to have positive effects on our neurotransmitter systems and promote neuroplasticity in the brain. Inflammation is a key mechanism in mood disorders like anxiety, depression, post-partum depression, and in neurodegenerative conditions like Alzheimer’s disease.[1]

Omega-3 fatty acids can be broken down into eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), both of which are regulators of the inflammatory response. DHA, in particular, supports brain development and neurological function. As a naturopathic doctor, I regularly recommend an omega-3 supplement with a high DHA content to pregnant women, as DHA is imperative for fetal brain development.[2]

EPA, compared to DHA, appears to be more beneficial in reducing anxiety and depression.[3] In fact, research supports that omega-3 with at least 60 percent EPA was the most effective for depression.[4] But there’s more to it than just the percentage of EPA versus DHA (keep reading to learn more about the effective dose).[5]

Beyond the brain: omega-3s for hormones, digestion, and cardiovascular health

Hormones. Dietary cholesterol is the precursor of our steroid hormones including estrogen, progesterone, testosterone, as well as vitamin D (yes, we need dietary fats in order to synthesize our own vitamin D!). When a patient’s symptoms suggest a hormonal imbalance, one of the first questions I ask is whether they are consuming enough dietary fats.

Research suggests that increasing omega-3 dietary fats may help reduce insulin resistance that is related to obesity, polycystic ovarian syndrome (PCOS), and gestational diabetes.[6,7] Similarly, including omega-3 fatty acids in the diet, particularly those with a high DHA content, is associated with a lower risk of missed periods (or anovulation) in women.[8]

Digestion. Omega-3 fats can also support various aspects of our digestion. An interesting study in female twins at the University of Nottingham and King’s College London found that taking omega-3 fatty acids as part of a healthy diet can improve the diversity of the gut microbiome.[9] The diversity of species in one’s gut microbiome is paramount for overall health. Disruptions to the gut microbiome have been found to be associated with digestive issues such as bloating, gas, and irritable bowel syndrome.[10]

Heart health. Omega-3s found in fish oils may be best known for their benefits to the cardiovascular system. They have been found to support our heart and arteries in many different ways, from lowering blood pressure to decreasing triglycerides. The latest talk is about a placebo-controlled randomized control trial called the REDUCE-IT trial that was published earlier this year, which looked at over 8,000 patients who were on statin medications (i.e., cholesterol-lowering medications like Lipitor/atorvastatin and Crestor/rosuvastatin).[11]

The key conclusion: Among patients with elevated triglyceride levels despite the use of statins, the risk of ischemic cardiovascular events, including cardiovascular death, was significantly lower among those who received the fish oil supplement compared to placebo. What all this means is that the fish oil supplement, at the correct therapeutic dose and form, was able to reduce the risk of damaging outcomes like non-fatal heart attack, non-fatal stroke, and cardiovascular death.

What makes a good fish oil supplement?

The key ingredients to review when choosing a dietary fish oil supplement are the total content of omega 3s and the breakdown of EPA to DHA. Below are some key take-away points:

  • Fish oil dose: Like I mentioned above, the dose and the form can make or break the effectiveness of a fish oil supplement. And, it is true; you get what you pay for. I typically recommend at least 2 grams of combined EPA and DHA per day, but this depends on the health condition. The above study on cardiovascular health, for example, used 2 grams twice a day of an “ethyl ester” form of EPA.

  • Fish oil form: Dietary fish oil supplements provide omega-3 EPA and DHA in three distinct forms: as either ethyl ester, triglyceride, or as a phospholipid from krill oil. There is some debate that the triglyceride form is more superior than the ethyl ester form, but in my opinion this is still inconclusive.

  • The EPA-to-DHA ratio. This all depends on the health condition. Typically, I recommend a standard fish oil supplement that has an EPA-to-DHA ratio of 2-to-1. However, for patients who are suffering from a traumatic brain injury, for example, I may use fish oil that has a high DHA content, whereas for those who are suffering from depression, I may use fish oil that has a high EPA content.

  • Timing and meals. The time of day is irrelevant, but taking it with a meal is crucial. Taking a fish oil supplement with food (in particular, dietary fat) enhances its absorption.

  • Quality, purity, and stability. Fish oil supplements have the potential to undergo oxidation, which means that their anti-oxidant properties start to degrade and can actually cause more harm than good.[12] This is one of the reasons why it is imperative to choose a good quality fish oil that is not only free of heavy metals, PCBs, pesticides, volatile organics, and other impurities, but is also third-party tested by an independent testing organization for quality according to the industry’s most stringent guidelines.

Omega 3s in the Diet

Because our bodies do not produce omega-3 on their own, omega-3s are an essential fatty acid that must be obtained from diet (and sometimes supplemented with a dietary fish oil supplement, although I should note that supplements cannot replace dietary fats).

Here you can find a list of some great sources of omega-3 fatty acids that can be obtained in the diet:

  • Salmon – Ranges from 700 mg to 1.5 grams in a standard 3.5-ounce serving of fish (the fat and omega-3 content varies from one species to another)

  • Albacore tuna – 1.5 grams of omega-3s  in 3 ounces of tuna

  • Walnuts – 2.6 grams of omega-3s in 1/4 cup

  • Chia seeds – 2.4 grams of omega-3s in 1 tbsp

  • Flax seeds (ground) – 1.6 grams of omega-3s in 1 tbsp

  • Hemp seeds – 1.0 gram of omega-3s in 1 tbsp

Fish oils can be expensive, which is why I recommend a good quality supplement with an effective dose that targets my patient’s health condition. As a naturopathic doctor, I regularly use testing in order to monitor a treatment, such as running blood labs for patients with high cholesterol. When supplementing with any natural health products, it is always important to work with a qualified health practitioner.

- Dr. Dominique Vanier is a registered naturopath in Burlington with a clinical focus on digestion and women’s hormones. Naturopath Burlington. This article is for information purposes only. It is not intended to treat or diagnose any health conditions.

References:

[1] Larrieu, Thomas, and Sophie Layé. "Food For Mood: Relevance Of Nutritional Omega-3 Fatty Acids For Depression And Anxiety". Frontiers In Physiology, vol 9, no. 1047, 2018. Frontiers Media SA, doi:10.3389/fphys.2018.01047. Accessed 12 July 2019.

[2] Greenberg JA, Bell SJ, Ausdal WV. “Omega-3 Fatty Acid supplementation during pregnancy.” Rev Obstet Gynecol. 2008;1(4):162–169.

[3] Martins, JG. "EPA But Not DHA Appears To Be Responsible For The Efficacy Of Omega-3 Long Chain Polyunsaturated Fatty Acid Supplementation In Depression: Evidence From A Meta-Analysis Of Randomized Controlled Trials". Journal Of The American College Of Nutrition, vol 28, no. 5, 2009, pp. 525-542. Informa UK Limited, doi:10.1080/07315724.2009.10719785.

[4] Sublette ME, Ellis SP, Geant AL, Mann JJ. “Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression.” J Clin Psychiatry. 2011;72(12):1577–1584. doi:10.4088/JCP.10m06634

[5] Sublette, M. Elizabeth et al. "Meta-Analysis Of The Effects Of Eicosapentaenoic Acid (EPA) In Clinical Trials In Depression". The Journal Of Clinical Psychiatry, vol 72, no. 12, 2011, pp. 1577-1584. Physicians Postgraduate Press, Inc, doi:10.4088/jcp.10m06634. Accessed 12 July 2019.

[6] Ramel, A. et al. "Beneficial Effects Of Long-Chain N-3 Fatty Acids Included In An Energy-Restricted Diet On Insulin Resistance In Overweight And Obese European Young Adults". Diabetologia, vol 51, no. 7, 2008, pp. 1261-1268. Springer Science And Business Media LLC, doi:10.1007/s00125-008-1035-7. Accessed 12 July 2019.

[7] Juárez-López, Carlos et al. "Omega-3 Polyunsaturated Fatty Acids Reduce Insulin Resistance And Triglycerides In Obese Children And Adolescents". Pediatric Diabetes, vol 14, no. 5, 2013, pp. 377-383. Wiley, doi:10.1111/pedi.12024. Accessed 12 July 2019.

[8] Mumford, Sunni L et al. "Dietary Fat Intake And Reproductive Hormone Concentrations And Ovulation In Regularly Menstruating Women". The American Journal Of Clinical Nutrition, vol 103, no. 3, 2016, pp. 868-877. Oxford University Press (OUP), doi:10.3945/ajcn.115.119321. Accessed 12 July 2019.

[9] Menni, Cristina et al. "Omega-3 Fatty Acids Correlate With Gut Microbiome Diversity And Production Of N-Carbamylglutamate In Middle Aged And Elderly Women". Scientific Reports, vol 7, no. 11079, 2017. Springer Nature, doi:10.1038/s41598-017-10382-2.

[10] Menees, Stacy, and William Chey. "The Gut Microbiome And Irritable Bowel Syndrome". F1000research, vol 7, 2018, p. 1029. F1000 (Faculty Of 1000 Ltd), doi:10.12688/f1000research.14592.1. Accessed 12 July 2019.

[11] Bhatt, Deepak L. et al. "Cardiovascular Risk Reduction With Icosapent Ethyl For Hypertriglyceridemia". New England Journal Of Medicine, vol 380, no. 1, 2019, pp. 11-22. Massachusetts Medical Society, doi:10.1056/nejmoa1812792. Accessed 12 July 2019.

[12] Cameron-Smith, David et al. "Fishing For Answers: Is Oxidation Of Fish Oil Supplements A Problem?". Journal Of Nutritional Science, vol 4, no. e36, 2015. Cambridge University Press (CUP), doi:10.1017/jns.2015.26. Accessed 12 July 2019.