Latest GOED review reveals omega-3 intake shortage and pinpoints resources

25 Apr 2024 --- The Global Organization for EPA and DHA Omega-3s (GOED) has published its latest review on the status of omega-3 diagnostics testing, providing an overview of the best options available for measuring long-chain polyunsaturated fatty acids (LCPUFA) via dietary assessments and commercially available analytical tests of blood and breast milk samples.

“Seeing the overview of scientific evidence on omega-3 levels and health outcomes really gives you a sense of where the strongest evidence exists and where there might be gaps. A review like this will undoubtedly be invaluable during a discussion on dietary reference intakes for EPA and DHA,” says Harry Rice, vice president, regulatory and scientific affairs at GOED.

The review also highlights evidence linking increased omega-3 LCPUFA intake to improved health, prioritizing cardiovascular, neurological, pregnancy and eye health outcomes. While evidence mounts that there is a link between a low intake of LCPUFA and the onset of serious diseases, many people do not reach the necessary levels of fish and seafood EPA and DHA requested by international dietary guidelines.

Omega-3 diagnostic testing
GOED commissioned the paper, “Omega-3 Polyunsaturated Fatty Acid Status Testing in Humans: A Narrative Review of Commercially Available Options,” published in the Journal of Nutrition, as part of its work to support diagnostics as a key tool for increasing omega-3 consumption globally.

An investigation of the Omega-3 Index found that Scandinavia, the Sea of Japan inhabitants and areas where indigenous people do not follow a Western diet had the highest EPA and DHA values. The lowest values were found in North and South America, parts of the Middle East and India. The average Omega-3 Index in the US in healthy populations was 5–6%.

The review also identifies the broader arena of available omega-3 tests and the value of diagnostics testing to improve EPA and DHA consumption. Adipose tissue is the reference biospecimen for measuring tissue fatty acids, but less-invasive methods such as whole blood, plasma, serum and red blood cell membrane measurements are used, as well as breast milk.

Commercial laboratories provide fatty acid testing of blood and breast milk samples by different methods and present their results in a variety of reports such as a complete fatty acid profile, omega-3 and omega-6 fatty acid profiles, fatty acid ratios, the Omega-3 Index, the Holman Omega-3 Test, OmegaScore and OmegaCheck, among others. 

According to GOED, clinicians and healthcare professionals are taking a heightened interest in LCPUFA intake because of a growing body of evidence about adverse cardiovascular health associations from low intake.GOED’s review highlights the best available options to measure omega-3 LCPUFA. 

Traditionally, dietary intake survey methods have been used as a surrogate for measuring omega-3 LCPUFA tissue status, but these are limited by omega-3 polyunsaturated fatty acids (PUFA) digestion, absorption and metabolism. Analytical tests of biological samples are preferred for accurate estimations.

The GOED review shows women have lower omega-3 LCPUFA intake levels than men because they eat less fish. Pregnant women eat less fish than women who are not expecting. The review suggests that the FDA’s 2001 guidance on fish consumption citing mercury contamination concerns might be at the root of the omega-3 levels.

According to the review, more recent investigations into associations between fish and mercury intake during pregnancy show that regardless of mercury intake levels, the higher the fish intake, the better the cognitive performance of the offspring. 

Meanwhile, scientists have discovered new omega-3 index biomarkers to trace levels of the fatty acids in the blood, making it easier to extract information critical to cardiovascular and cognitive research.

Global supply chain
The 200 members within GOED represent the whole supply chain of EPA and DHA omega-3s, from fisheries and crude oil suppliers to refiners, concentrators and finished product brands. Evaluating omega-3 LCPUFA status is necessary to reap the health benefits of higher intake.

Omega-3 LCPUFA and its metabolites have physiologic functions related to blood pressure, platelet function and coagulation, triglyceride metabolism, cardiac rate and rhythm, inflammation and the central nervous system. Insufficient tissue levels contribute to physiologic dysfunction. 

The European Food Safety Authority (EFSA) Panel on Dietetic Products, Nutrition and Allergies stated in 2010 that there was insufficient data to derive an average requirement, lower threshold intake or population reference intake for alpha-linolenic acid (essential fatty acid).

EFSA proposed an average energy level of 0.5 %, based on the lowest estimated mean intakes of various population groups from several European countries. The scientific community recently called for an optimal level of omega-3 LCPUFA that does not simply prevent deficiency but supports optimal health. The USDA’s Dietary Guidelines for Americans 2020–2025 recommends more than two servings per week of fish or seafood, about 250–500 mg daily of EPA and DHA. 

In 2022, GOED stated that the future of omega-3s was brimming with potential in personalization, novel foods and new research potential when it launched a new database to aid scientific inquiry.

By Inga de Jong