Omega-3 types and their health effects on the body: Why supplementation is important

Omega-3s are widely known for their health benefits throughout the human lifespan, and supplementation with omega-3s can provide support to areas such as the brain and heart. The main forms of omega-3s are alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). ALA is an essential fatty acid that cannot be produced by the human body, while EPA and DHA are longer-chain omega-3s that the body can synthesize from ALA, although the rate of conversion can be low.

Formulating products with omega-3s can help consumers achieve the recommended levels to support brain, heart and eye health, as well as tackle other health issues that are important for a healthy lifestyle.

Each omega-3 has particular health benefits. DHA tackles brain and eye health more so than EPA and ALA, and is crucial throughout the lifespan, starting from infancy. DHA is the most abundant poly-unsaturated fatty acid (PUFA) in the brain, whereas EPA and ALA are present in small quantities.¹

In infants, DHA supports optimal brain and eye health development.² Since a baby's brain grows the fastest during the first six months of infancy, breastfeeding moms need to have adequate levels of DHA to supply enough fats for the baby's developing eyes, brain and immune system.2 DHA’s role in healthy development is underlined by recommendations directing pregnant and nursing women to achieve 200 to 300 mg/d of DHA, according to Kerri Marshall, director, global lipid science and advocacy at DSM Nutritional Products, and by a claim approved by the European Food Safety Authority (EFSA) supporting DHA supplementation during pregnancy for infant development. DHA during pregnancy (600 mg of algal DHA) also reduces the risk of preterm birth before 34 weeks of pregnancy.²

Beyond the early stages of life, DHA is also important in the later years. Dementia affects around 50 million people worldwide, according to the World Health Organization (WHO), and DHA has been shown to help reduce the risk of dementia. In a cohort from the Framingham Heart Study, high plasma DHA concentrations in 32 subjects who had a mean fish intake of three servings a week was associated with a 47% reduction in the risk of developing all-cause dementia.³ In addition, research indicated a higher risk of cognitive decline in people in the lower quartile of omega-3 PUFA intake or blood levels, according to Tal Offer, Ph.D., carotenoids category manager, Lycored.⁴

Observational studies suggest a correlation between blood levels of DHA and cognition in healthy adults.^5,6 One study found higher serum DHA levels were associated with better non-verbal reasoning, mental flexibility, working memory and vocabulary in people ages 35 to 54 with no neuropsychiatric disorders and no supplemental fish oil use.⁵ A similar study reported improvement of episodic and working memory in people ages 18 to 35 who were provided with a high-DHA supplement containing 1,160 mg DHA and 170 mg EPA daily for six months compared to placebo controls.⁶ A review pointed out that, interestingly, the effect on episodic memory was driven primarily by the women in the study, whereas the men were largely responsible for the effect on working memory.¹

Additionally, omega-3s have been shown to help improve eye health, largely attributed to DHA's properties. "Omega-3s play an essential role in eye health, as the body’s highest concentration of the omega-3 DHA is found in the retina of the eye with concentrations of up to 65%," Marshall explained. One study from the National Eye Institute (NEI) used data from Age-Related Eye Disease Study (AREDS) and found participants who reported in the AREDS having the highest level of omega-3s in their diets were 30% less likely than their peers to develop macular degeneration during a 12-year period.⁷

Managing inflammation can be an onerous task, and supplementation with omega-3s has potential to help reduce inflammation. This is especially true for people suffering from rheumatoid arthritis (RA), which is an auto-immune disease. One study found RA patients who consumed omega-3s showed significant reductions in the number of tender joints, duration of morning stiffness and delayed onset of fatigue.⁸ Interestingly, improvements deteriorated after treatment ceased in many of the cases, according to Marshall.⁸ In addition, a meta-analysis of studies reported significant reductions in pain measures after three to four months of omega-3 treatment with patients suffering from inflammatory joint pain.⁹ Recent studies have also confirmed individuals with diets low in fish or omega-3s carry a significantly higher risk of developing RA.¹⁰

ALA has been shown to have anti-inflammatory properties, as well. Recent meta-analyses suggested risk reductions of cardiovascular disease (CVD) from the consumption of ALA were similar to those of marine-derived EPA and DHA.¹¹ One study found a 1 g/d increase of ALA intake has been associated with a 10% decrease in fatal coronary heart disease (CHD) risk.¹² "It should also be noted that flaxseed has been found to significantly reduce blood pressure and cholesterol, although it is not yet clear whether that effect is solely due to its ALA omega-3 content, or whether it is the ALA omega-3 working in combination with flaxseed’s other components including lignans and fiber,"¹³ said Julie Faber, director of marketing and compliance, Pizzey Ingredients. In the United States, manufacturers can make structure/function claims such as “ALA omega-3s in flaxseed support heart health,” Faber noted.

Another meta-analysis found EPA and DHA positively affected serum markers of CVD risk by reducing triglycerides and increasing high-density lipoprotein (HDL, or “good”) cholesterol.¹⁴ EPA has been studied extensively for its benefits on heart health, uncovering EPA’s potential to benefit people with heart failure.¹⁵ A review and meta-analysis in patients with heart failure concluded fish oils are associated with improved cardiac performance.¹⁶ The evidence supporting EPA and DHA’s impact on the heart prompted another claim approved by EFSA supporting EPA and DHA for heart health. Furthermore, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) stated intakes of EPA and DHA between 2 g/d and 4 g/d are needed to reach claimed effects such as the maintenance of blood pressure and triglyceride levels, further postulating 250 mg/d is an adequate intake for the maintenance of general cardiovascular health among healthy adults and children.

Where to get omega-3s?

EPA and DHA omega-3s are commonly derived from marine sources, which can lend formulation challenges caused by marine, or “fishy,” tastes. Marshall noted "the organoleptic of marine taste can be difficult to hide in various formulations." She added formulating a high-quality product takes precision in the manufacturing process to mask that fishy taste, and it also takes precision to protect the product from oxidation from the beginning to the end of production for the final product.

“There are many ways to formulate omega-3s in products and delivery systems, and innovative ways continue to be discovered on a regular basis," she explained. "In addition to traditional liquids and capsules for omega-3 products, both fish and algae oil are now found in gummies, soft chews, powders and even smoothie-like blends—all because of new emulsification technology."

It's also crucial to consider what the actual content of omega-3 is in the oil, as well as the other components of the oil. For instance, when it comes to marine oils, it's imperative to look at the content of EPA and DHA, the ratio between these, and whether the oil is in triglyceride, ethyl ester or phospholipid form, said Sarah Christianslund, product marketing manager, EPAX Omega-3 at Pelagia. Typically, a fish oil will not contain more than 30 to 35 percent of EPA and DHA unless it has been concentrated, she explained. Ethyl esters of EPA and DHA (ethyl-EPA and ethyl-DHA), Offer said, are concentrated sources of long-chain omega-3 fatty acids that provide more EPA and DHA per gram of oil.

It's also crucial to consider the polyunsaturated oils for products, and how that will be affected during the manufacturing process. "Polyunsaturated oils are less stable than saturated fats, and will require more attention to detail when formulating," Christianslund said. "Applications high in fat which are chilled or frozen are preferable to those with long shelf life in ambient temperature when formulating with omega-3s."

In contrast, dietary sources of ALA include mainly plant oils, such as flaxseed and chia. Sources such as flaxseed have been formulated into ready-to-mix drinks, as well as in bars and in baked goods, Faber said. "ALA omega-3 is also the only omega-3 that has been recognized by the Institute of Medicine as being essential, as our bodies cannot produce it," Faber added.

Supplementation is an easy way to obtain sufficient levels of omega-3s, but consumers looking for dietary sources of EPA and DHA can seek foods central to the Mediterranean diet. "The long-chain omega-3 fatty acids, EPA and DHA, can be synthesized from ALA, but due to low conversion efficiency, it is recommended to obtain EPA and DHA from additional sources,” Offer explained. “Foods that are rich in omega-3 fatty acids include marine fish which are central in the Mediterranean diet."

Outside of diets that naturally carry EPA and DHA, functional foods and beverages are also a good option for consumers looking for alternatives to naturally rich food sources and supplements. Mohammed Marzuk, research scientist, KGK Sciences, pointed to examples of food commonly enriched with omega-3s, including mayonnaise, salad dressings, milk products, yogurt products and fitness bars. “Additionally, liquid oil delivery methods which offer benefits of quicker absorption are becoming more commonplace," he said.

According to Marzuk, "A review of the National Institutes of Health (NIH)-maintained Dietary Supplement Label Database (DSLD) revealed there to currently be 2,101 products containing EPA; 2,340 products containing DHA; and 442 products containing ALA." However, future products may consider formulating more DHA in products, as Marzuk explained the ratio of EPA and DHA in omega-3 products is not optimal. "In order to boost omega-3s in the products without significantly increasing the cost, most fish oil products contain much more EPA than DHA," he said.

It is evident that there are empirically more products that can be developed to improve omega-3 intake among consumers. Given that ALA products can be formulated in products with sources like flaxseed or chia seeds, more products can explore how to get this essential fatty acid in consumer's diets. Additionally, products can explore more DHA in supplements, however, there will be challenges to overcome in manufacturing. "Overall, the undesirable bioavailability, low yield of DHA in supplements and impurities encountered in omega-3 sources during the manufacturing and processing of products are challenges faced by the manufacturers," Marzuk said.

Despite these manufacturing challenges, the benefits of omega-3s have been shown to aid the fight for a healthy, functioning body throughout the human lifespan. It's important to formulate innovative products—whether they be supplements or functional food and beverages—where consumers can receive the adequate amount of the different types of omega-3s in the body necessary for a healthy lifestyle.

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Courtney Johnson graduated from the University of Arizona with a bachelor's degree in journalism, and is currently pursuing her master's degree in media and communications. She has always been passionate about health and wellness. She also has past experience as an Natural Products Insider editor, where she interviewed industry experts and wrote blogs and articles on the health and nutrition industry. You can connect with her on LinkedIn.