How much Omega-3 do you need daily? New global review reveals DHA and EPA requirements

How much Omega-3 do you need daily? New global review reveals DHA and EPA requirements

A new global review reveals major gaps and inconsistencies in omega-3 guidelines and shows why many populations are still not meeting recommended EPA and DHA goals for lifelong health.

A study recently published in the journalNutrition Research Reviewssummarized national and international recommendations for the consumption of long-chain omega-3 polyunsaturated fatty acids (LC n-3PUFAs).

Global variability in the omega-3 direction

The LC n-3PUFAs docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA) and docosapentaenoic acid (DPA) are known to have a wide range of beneficial effects. Higher intake and tissue and circulatory status of these fatty acids support cognitive and visual development in early life, promote immune function and cardiovascular health, and may reduce the incidence of preterm birth (PTB) and the risk of depression, cognitive decline, or Alzheimer's disease. However, most evidence remains observational and causality is not clearly established.

Various global and national health authorities, expert groups and ministries recommend including LC n-3PUFA-rich foods in the diet. However, recommendations vary by country and region and are absent or limited in some life stages and regions of the world, with significant differences in reporting intake levels (e.g. mg per day, percentage of total fatty acids, or mg per kilogram of body weight). To date, there is no current global overview of LC n-3PUFA intake recommendations from technical and scientific documents (TSDs) underlying the food-based dietary guidelines (FBDGs) or other expert group reports.

Review of global technical documents

In the present study, researchers examined FBDG-TSDs and reports from expert groups to provide an overview of the intake recommendations for LC n-3PUFAs for healthy populations at all life stages. They used the Food and Agriculture Organization's global online repository for FBDGs to identify countries with healthy population guidelines. To identify additional TSDs, structured Google searches were conducted.

The study included 42 TSDs for review; Most TSDs (71%) were quantitative intake recommendations for LC n-3PUFAs. 26 TSDs contained health messages, 12 provided advice about the safety or high intake of LC n-3PUFAs, and 14 discussed dietary supplements. Five TSDs were categorized as international nutritional reference value (DRV) TSDs, three as national DRV TSDs, 15 as national FBDG TSDs and 19 as expert panel TSDs.

Most TSDs (54%) affected generally healthy populations of all ages and genders. Others were gender or life stage specific, covering only adults (14%), only infants and children (10%), only older adults (5%), and only pregnant or breastfeeding individuals (12%). Eleven TSDs provided recommendations for LC n-3PUFA intake for infants and young children. A TSD recommended that DHA intake should be 0.32% of total fatty acid intake in the first six months of life.

Variability of intake in children and adolescents

A TSD provided an adequate intake (AI) of 200 mg DHA per day for Korean infants up to 5 months of age. For young children aged 1–3 years, intake recommendations ranged from an AI of 40 mg/day EPA + DHA + DPA to 250 mg/day DHA + EPA. Twelve TSDs provided recommendations for older children aged 4–12 years, ranging from an AI of 55 mg/day EPA + DHA + DPA at age four to 500 mg/day DHA + EPA at age ten.

In addition, 11 TSDs provided recommendations for adolescents aged 13 to 18 years, with significant heterogeneity in recommended levels of LC n-3PUFAs. The AI ​​ranged from 70 mg/day DPA + DHA + EPA at age 13 years in Australia and New Zealand to 500 mg DHA + EPA for those ≤ 18 years in South Africa and France. Eighteen TSDs provided recommendations for adults aged 18 years and older. Seven of these, including three international TSDs, recommended 250 mg DHA + EPA per day.

Pregnancy, breastfeeding and older adults

Seventeen TSDs provided recommendations during pregnancy, with AI ranging from 110 mg/day EPA + DHA + DPA in Australia and New Zealand to 250 mg/day DHA or 500 mg/day DHA + EPA in France. Six TSDs recommended a minimum DHA + EPA intake of 250 mg/day for adult health. An international TSD defined 300 mg EPA + DHA per day as optimal for fetal and infant development and adult health.

Higher intakes of up to 1 g/day have been specifically recommended for pregnant individuals with low LC-n-3PUFA status to reduce the risk of PTB. For older adults, five TSDs made recommendations, with AIs ranging from 90 mg/day DHA + EPA + DPA in older women over 51 years of age to 250 mg/day for adults over 65 years of age. Twenty-six TSDs contained health messages focusing on chronic disease prevention, pregnancy, and early infancy.

Safety instructions and upper limits

Several TSDs recognized the association between LC n-3PUFA intake and outcomes related to fetal and infant cognition, brain health, and retinal function. An international TSD recognized a critical role of DHA in brain and retinal development in people aged 0 to 24 months. Three TSDs provided guidance on high LC-n-3PUFA intakes specifically for infancy, childhood, and adolescence.

An international TSD reported no upper limit for DHA intake in infants 0–6 months of age. Recommendations from Australia and New Zealand also stated that it was not possible to set an upper limit for DHA + DPA + EPA intake in infants, although an upper limit of 3 g/day was established for other childhood age groups. For adults over 18 years of age, the upper limit of EPA + DHA intake was 2–5 g per day.

Global patterns and policy implications

Overall, the study provided an overview of global and national dietary recommendations for LC n-3PUFA intake at all life stages for healthy individuals. TSDs included quantitative intake targets, health messages, and guidelines for high intake. The most commonly recommended intake was 250 mg DHA + EPA per day, with an additional 100-200 mg DHA per day during pregnancy. Dietary intake alone may not meet these needs, and therefore dietary supplementation and, in some cases, the development of sustainable alternative sources of EPA and DHA are warranted, particularly given that population intakes in many countries are well below recommended thresholds.

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