Omega-3 Supplements: How to Know if You Need Them

For years, we’ve been told that supplementing with omega-3 fatty acids, with their naturally high levels of EPA and DHA, may lead to lower rates of age-related macular degeneration, better heart health, and a possible reduced risk for cognitive decline and dementia.

But does everyone need a supplement?fish oil capsules spilling out of a white medicine bottle on a black surface

Two Studies Suggest Omega-3 Supplementation Offers No Protection Against Cognitive Decline

The Alpha Omega Trial is a groundbreaking study that revealed omega-3 supplementation did not reduce the risk of cognitive decline in coronary heart disease patients. Here’s what the researchers did and what they found:

  • For 40 months, researchers followed 2,911 patients who had previously had a heart attack.
  • The patients supplemented with either a placebo, 400 mg of omega-3 EPA-DHA, or 2 g of omega-3 ALA a day.
  • At the start and end of the study participants completed the Mini Mental State Examination (MMSE) that tests: orientation to time and place, registration, attention and calculation, recall, language, and visual construction.
  • The average cognitive function score declined in all groups by 0.67 points, showing no protective benefit of omega-3 supplementation.

In 2015, the Journal of the American Medical Association published a study from the National Institutes of Health (NIH) that suggests omega-3 supplementation may not slow cognitive decline in the elderly. For 5 years, researchers followed 4000 patients of an average age of 72 with early or intermediate age-related macular degeneration (AMD). They were given either a placebo or one of the following combinations of nutrients:

  • Omega-3: 350 mg of DHA and 650 mg of EPA
  • Lutein and zeaxanthin
  • Omega-3 and lutein
  • Omega-3 and lutein and zeaxanthin

Average cognition scores declined a similar amount regardless of nutritional combination.

Short-term vs. Long-term Benefit

people-running_mediumLooking further at six randomized, controlled trials, one showed cognitive benefit, one showed cognitive harm, and four showed no effect at all. Let’s look at the specifics:

In 2013, DHA supplementation was shown to improve memory and reaction time in young adults who infrequently consumed fish. The other trials demonstrated no such benefits in adults between 18 and 45 years of age. And one study showed that supplementing with DHA for 50 days might make brain function worse. However, other studies suggest long-term benefit when it comes to supplementing with omega-3s.

The Framingham Heart Study is now on its third decade, and according to collated data, lower DHA levels are linked to smaller brain volumes. And a 2014 study published in Cerebral Cortex suggests that supplementing with EPA and DHA over the long term is essential to preserving cognitive function and brain volume. People who supplemented for 6 ½ months had dramatically less brain shrinkage and greater structural integrity overall than did people taking a placebo.

How Much Is Enough?

The Framingham Heart Study suggests that an omega-3 index of 4.4 is the optimal measure for EPA and DHA levels. Having more than 4.4 hasn’t been shown to do much good, as evidenced by the Alpha Omega Trial made up of individuals who already received an adequate amount of omega-3s from fish.

Those who follow a plant-based diet, such as vegetarians and vegans, however, may be in danger of scoring much lower on the omega-3 index. For reference, the average American has an omega index of 4.5. But vegans can boost their omega-3 levels by supplementing with a contaminant-free, algae-derived EPA and DHA supplement.

A 2014 study published in Clinical Nutrition demonstrated how vegans were able to push their omega-3 index from 3.1 to 4.8 in just 4 months by supplementing with an algae-derived EPA and DHA…plant-based and cruelty free!

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