New chapters in the omega-3 narrative are being written, with recent research indicating a greater need for omega-3 fatty acids to protect heart health than previously thought. Current recommendations may fall short of what's necessary for optimal heart protection.
The Omega-3 Index, measuring the amount of EPA and DHA in the blood, is a crucial risk factor for fatal heart attacks. However, with health authorities like the American Heart Association recommending only 1-2 seafood meals per week, many individuals likely do not achieve the omega-3 levels needed for heart protection.
Even the Dietary Guidelines for Americans 2015-2020 provide recommendations that might not be sufficient, suggesting an intake of about 8 ounces per week of a variety of seafood, equating to an average consumption of 250 mg per day of EPA and DHA, to reduce deaths from heart diseases among people with or without pre-existing cardiovascular disease.
The advice from the American Academy of Nutrition and Dietetics also suggests an increase in polyunsaturated fat consumption, with a focus on omega-3 intake, aiming for at least two servings of fatty fish per week to provide a minimum of 500 mg of EPA and DHA daily.
Previous discussions have covered various ways to enhance the Omega-3 Index, including consuming more fatty fish like salmon or taking omega-3 supplements containing EPA and DHA. With new data now supporting these suggestions, a more proactive approach may be necessary.
New data for consideration
A study published in Prostaglandins, Leukotrienes, and Essential Fatty Acids indicates that consuming more fish and taking an omega-3 supplement is likely necessary to reach a cardioprotective Omega-3 Index level of 8% or higher.
According to the lead researcher Kristina Harris Jackson, PhD, RD, the study aimed to determine which combination of non-fried fish consumption and omega-3 supplementation correlates with a cardioprotective Omega-3 Index level of 8% or higher.
In 2018, the American Heart Association updated its fish and seafood intake recommendations, potentially downgrading the previous advice. This change, despite evidence suggesting that consuming fish more frequently could offer even greater cardioprotection, prompts a reevaluation of omega-3 intake guidelines.
Louis Kuller, MD, in an online comment accompanying the new AHA guidelines, questioned whether the revised fish intake recommendations would achieve cardioprotective omega-3 levels in the blood, advocating for intake recommendations based on achieving a specific blood level target.
Implications for future guidelines
Dr. Jackson and her team analyzed omega-3 EPA and DHA blood levels from nearly 3,500 individuals, alongside questions about their fish and supplement intake. Individuals reporting no fish intake and no omega-3 supplementation had an average Omega-3 Index around 4.1%, reflective of the average American and considered "deficient."
At the other extreme, individuals reporting supplement use AND consuming three fish meals per week had an average Omega-3 Index of 8.1%, the level defined in research as "cardioprotective."
Dr. Jackson suggests that achieving an 8% Omega-3 Index is most likely among those consuming at least three non-fried fish meals per week and taking an omega-3 EPA/DHA supplement, indicating that the current AHA recommendation may not suffice to reach this protective level. Adopting dietary recommendations aiming to achieve a specific blood level target could be more effective in reducing heart disease risk.
Omega-3 beyond cholesterol: A predictor for heart disease
Subsequent studies, such as The Physicians Health Study and The Framingham Heart Study, have indicated that omega-3 levels are better predictors of heart disease than traditional markers like cholesterol. These findings support the significance of omega-3 as a critical factor in heart health and suggest a need to focus more on omega-3 intake rather than solely on cholesterol levels.
As research on omega-3 continues to evolve, the importance of achieving an adequate Omega-3 Index for overall health and longevity becomes increasingly clear. For individuals aiming to improve their heart health, considering omega-3 intake in addition to traditional risk factors could provide a more comprehensive approach to cardiovascular wellness.
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