Omega-3 For LifeOmega-3 For LifeApplication through Life’s StagesApplication through Life’s Stages

Mark Lange, PhDMark Lange, PhD

Director, Quality ControlDirector, Quality Control

Market AmericaMarket America

DisclaimerDisclaimer

The statements contained in the The statements contained in the following presentation have not been following presentation have not been evaluated by the Food and Drug evaluated by the Food and Drug Administration. The ingredients Administration. The ingredients discussed are not intended to discussed are not intended to diagnose, treat, cure or prevent any diagnose, treat, cure or prevent any disease.disease.

Essential Fatty AcidsEssential Fatty Acids

ALA deemed “Essential” because of its ALA deemed “Essential” because of its apparent benefits in animal studies.apparent benefits in animal studies.

Later found that DHA provides the Later found that DHA provides the health benefits to eye and brain.health benefits to eye and brain.

ALA is converted to DHA (<1% efficient).ALA is converted to DHA (<1% efficient). Therefore, DHA is “Conditionally Therefore, DHA is “Conditionally

Essential” because the body can make it Essential” because the body can make it – but not enough.– but not enough.

Plant and Marine Sources of Plant and Marine Sources of Omega-3Omega-3

Vegetable oils contain significant ALA, Vegetable oils contain significant ALA, but no EPA/DHA.but no EPA/DHA.

Fish oils have concentrated EPA/DHA Fish oils have concentrated EPA/DHA and trace ALA.and trace ALA.

Typical America diet provides 2-3 g/day Typical America diet provides 2-3 g/day ALA and 50-80 mg/day EPA/DHA. ALA and 50-80 mg/day EPA/DHA.

Omega-3 Health BenefitsOmega-3 Health Benefits

DHA is required at high levels in the DHA is required at high levels in the brain and retina for optimal learning brain and retina for optimal learning ability and mental development and ability and mental development and visual acuity. visual acuity.

DHA/EPA support cardiovascular DHA/EPA support cardiovascular health.health.

Pregnancy StagePregnancy Stage

Taken to support the health of the Taken to support the health of the baby during neonatal period.baby during neonatal period.

Particularly important during last Particularly important during last trimester.trimester.

Consuming fish is risky because of Consuming fish is risky because of mercury contamination.mercury contamination.

Take at least 300 mg DHA per day.Take at least 300 mg DHA per day.

Pregnancy StagePregnancy Stage

Clinical trials show that women with Clinical trials show that women with higher DHA intake have infants with higher DHA intake have infants with higher cognitive development scores higher cognitive development scores and children with higher IQ scores.and children with higher IQ scores.

Daniels, J.L. Fish intake during pregnancy and early cognitive development Daniels, J.L. Fish intake during pregnancy and early cognitive development of offspring. Epidemiology. 15:394-402, 2004of offspring. Epidemiology. 15:394-402, 2004

Cohen, J.T. A quantitative analysis of prenatal intake of n-3 Cohen, J.T. A quantitative analysis of prenatal intake of n-3 polyunsaturated fatty acids and cognitive development. Am. J. Prev. Med polyunsaturated fatty acids and cognitive development. Am. J. Prev. Med 29(4):366-374, 200529(4):366-374, 2005

Pregnancy StagePregnancy Stage

Evidence that mothers with higher intake Evidence that mothers with higher intake of DHA give birth to infants with improved of DHA give birth to infants with improved sleep patterns.sleep patterns.

Cheruku, S.R. Higher maternal plasma DHA during pregnancy is Cheruku, S.R. Higher maternal plasma DHA during pregnancy is associated with more mature neonatal sleep-state patterning. Am. J. Clin. associated with more mature neonatal sleep-state patterning. Am. J. Clin. Nutri. 76:608-613, 2002Nutri. 76:608-613, 2002

Low Omega-3 Intake Linked to Low Omega-3 Intake Linked to Depression in PregnancyDepression in Pregnancy

Women consuming 1500 mg omega-Women consuming 1500 mg omega-3 from seafood per week were less 3 from seafood per week were less likely to have depressive symptoms likely to have depressive symptoms than those consuming none.than those consuming none.

Avon Longitudinal Study of Parents and Children. Avon Longitudinal Study of Parents and Children. Epidemiology 2009, Jul; 20(4); 598-603Epidemiology 2009, Jul; 20(4); 598-603

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Postpartum Depression and Fish ConsumptionHibbeln, J.R. (2002) Journal of Affective Disorders 69(1-3) 15-29

Israel

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Netherlands

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UK

United States

Australia

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r = - 0.76p < 0.0001

Pregnancy StagePregnancy Stage

Higher intakes of DHA/EPA during Higher intakes of DHA/EPA during pregnancy (150+ mg/day) have pregnancy (150+ mg/day) have increased birth weights and reduced increased birth weights and reduced risk of preterm delivery.risk of preterm delivery.

Lucas, M. Gestational age and birth weight in relation to n-3 fatty acids Lucas, M. Gestational age and birth weight in relation to n-3 fatty acids among Inuit. Lipids. 39:617-626, 2004.among Inuit. Lipids. 39:617-626, 2004.

Olsen, S.F., Low consumption of seafood in early pregnancy as a risk factor Olsen, S.F., Low consumption of seafood in early pregnancy as a risk factor for preterm delivery. BMJ. 324:1-5, 2002for preterm delivery. BMJ. 324:1-5, 2002

Lactation/Infancy StageLactation/Infancy Stage

The level of DHA in breast milk is very The level of DHA in breast milk is very low because fish is only consumed low because fish is only consumed about every 10 days. (80 mg/day about every 10 days. (80 mg/day average.)average.)

Women consuming 11,000 mg ALA/day Women consuming 11,000 mg ALA/day still have very low DHA in milk.still have very low DHA in milk.

Taking 300 mg DHA/day elevates Taking 300 mg DHA/day elevates breast milk levels from 0.14% of total breast milk levels from 0.14% of total milk fats to 0.39%. milk fats to 0.39%.

Lactation/Infancy StageLactation/Infancy Stage

Supplementing with 200 mg/day DHA Supplementing with 200 mg/day DHA for four months after delivery for four months after delivery resulted in higher scores on the resulted in higher scores on the Bayley Psychomotor Development Bayley Psychomotor Development Index at 30 months of age.Index at 30 months of age.

Jensen, C.L. Effects of maternal DHA intake on visual function and Jensen, C.L. Effects of maternal DHA intake on visual function and neurodevelopment in breastfed term infants. Am. J. Clin. Nutr. neurodevelopment in breastfed term infants. Am. J. Clin. Nutr. 82:125-132. 200582:125-132. 2005

Lactation/Infancy StageLactation/Infancy Stage

There is a positive correlation There is a positive correlation between mother supplementing with between mother supplementing with fish oil EPA/DHA during lactation and fish oil EPA/DHA during lactation and their child’s visual acuity at 4 months their child’s visual acuity at 4 months age.age.

Lauritzen, L. Maternal fish oil supplementation in lactation: effect on Lauritzen, L. Maternal fish oil supplementation in lactation: effect on visual acuity and n-3 fatty acid content of infant erythrocytes. visual acuity and n-3 fatty acid content of infant erythrocytes. Lipids. 38(3): 195-206, 2004Lipids. 38(3): 195-206, 2004

Pregnant and Lactating Pregnant and Lactating WomenWomen

World Association of Perinatal Medicine, World Association of Perinatal Medicine, the Early Nutrition Academy, and the Child the Early Nutrition Academy, and the Child Health Foundation support:Health Foundation support:

– Pregnant and lactating women should get at Pregnant and lactating women should get at 200 mg DHA per day.200 mg DHA per day.

– Infant formula contain 0.2 – 0.5% DHA of total Infant formula contain 0.2 – 0.5% DHA of total fat.fat.

– Baby should continue taking omega-3 after Baby should continue taking omega-3 after first 6 months of life.first 6 months of life.

J. Perinat. Med. 2008; 36(1);5-14J. Perinat. Med. 2008; 36(1);5-14

Infancy StageInfancy Stage

Infant formulas containing 0.36% Infant formulas containing 0.36% DHA provided 8% improved DHA provided 8% improved performance on the Mental performance on the Mental Development Index, a measure Development Index, a measure of memory, problem solving, of memory, problem solving, vocalization, and math.vocalization, and math.

Birch, E.E. A randomized controlled trial of early dietary supply of Birch, E.E. A randomized controlled trial of early dietary supply of long-chain polyunsaturated fatty acids and mental development in long-chain polyunsaturated fatty acids and mental development in term infants. Dev. Med. And Child Neur. 42:174-181,2000term infants. Dev. Med. And Child Neur. 42:174-181,2000

Childhood StageChildhood Stage

ADHD children have low blood levels of DHA.ADHD children have low blood levels of DHA. A study using functional food sources of A study using functional food sources of

omega-3 providing 514 mg DHA + 100 mg omega-3 providing 514 mg DHA + 100 mg EPA showed significant reduction in EPA showed significant reduction in aggression.aggression.

Hamazaki, T. The effect of DHA-containing food administration on symptoms of Hamazaki, T. The effect of DHA-containing food administration on symptoms of ADHD – a placebo-controlled doubled blind study. Eur. J. Clin. Nutr. 58:838,2004ADHD – a placebo-controlled doubled blind study. Eur. J. Clin. Nutr. 58:838,2004

Voight, R.G. A randomized, double-blind, placebo-controlled trial of DHA Voight, R.G. A randomized, double-blind, placebo-controlled trial of DHA supplementation with AD/hyperactivity disorder. J. Ped. 138(2): 189-196,2001supplementation with AD/hyperactivity disorder. J. Ped. 138(2): 189-196,2001

Omega-3s Help Prevent All-CauseOmega-3s Help Prevent All-Cause Adult Mortality and CVD Events Adult Mortality and CVD Events

Placebo controlled study of 563 men Placebo controlled study of 563 men aged 64 – 76 years for three years.aged 64 – 76 years for three years.

Diet counseling plus 2.4 g EPA+DHA Diet counseling plus 2.4 g EPA+DHA per day.per day.

Omega-3 reduced all-cause mortality Omega-3 reduced all-cause mortality by 47% and heart attack risk by 11%.by 47% and heart attack risk by 11%.

Einvik, G. et al. Euro. J. Cardiovas. Prev. & Rehab. Einvik, G. et al. Euro. J. Cardiovas. Prev. & Rehab. 10 April 2010 (online)10 April 2010 (online)

Management of Adult Management of Adult HypertriglyceridemiaHypertriglyceridemia

Fish oil effective at lowering triglycerides.Fish oil effective at lowering triglycerides.

2-4 g total EPA/DHA per day lower TGs 30-50%.2-4 g total EPA/DHA per day lower TGs 30-50%.

Can be used in combination with statins with Can be used in combination with statins with doctor’s supervision.doctor’s supervision.

Bucher  HC, Griffith  LE, Guyatt  GH.  Systematic review on the risk Bucher  HC, Griffith  LE, Guyatt  GH.  Systematic review on the risk and benefit of different cholesterol-lowering interventions. and benefit of different cholesterol-lowering interventions.   Arterioscler Thromb Vasc BiolArterioscler Thromb Vasc Biol.  1999;19:187–95..  1999;19:187–95.

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Apparent Fish Consumption (lbs./ person/year)

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Japan (0.12%)

New Zealand (5.8%)

United States (3.0%)

Puerto Rico (3.0%)

Taiwan (0.8%)

Korea (2.3%)

Canada (5.2%)

France (4.5%)

W. Germany(5.0%)

Fish Consumption and the Annual Prevalence of Major Depression

Hibbeln, The Lancet, 1998

Age Related Eye Disease Age Related Eye Disease StudyStudy

An average intake of 64 mg/day DHA An average intake of 64 mg/day DHA and 42 mg/day EPA associated with and 42 mg/day EPA associated with 27% reduction in age-related 27% reduction in age-related macular degeneration.macular degeneration.

Omega-3s and InflammationOmega-3s and Inflammation

The application of omega-3 FA’s for The application of omega-3 FA’s for long-term pain relief and long-term pain relief and management of inflammation is management of inflammation is warranted. warranted.

Dose for analgesia effect is 3 grams or Dose for analgesia effect is 3 grams or more daily of EPA plus DHA.more daily of EPA plus DHA.

Nutrition & Dietetics. 2009:66;4-6Nutrition & Dietetics. 2009:66;4-6

ConclusionConclusion DHA is essential for the growth and DHA is essential for the growth and

functional development of the brain in functional development of the brain in infants. infants.

The visual acuity of healthy, full-term, The visual acuity of healthy, full-term, formula-fed infants is increased when their formula-fed infants is increased when their formula includes DHA. formula includes DHA.

Decreases in DHA in the brain are associated Decreases in DHA in the brain are associated with cognitive decline during aging. with cognitive decline during aging.

Strong correlation between fish consumption Strong correlation between fish consumption and reduction in sudden death from and reduction in sudden death from myocardial infarction. myocardial infarction.