[Omega 3 Episode 4] People with heart disease or high triglycerides should eat more omega-3 | Dr. Esther Lyuh

[Omega 3 Episode 4] People with heart disease or high triglycerides should eat more omega-3 | Dr. Esther Lyuh

Omega-3, how much should I eat?

If you are a healthy adult, DHA+EPA 500mg daily!

So how much omega-3 should we consume?  No textbook guidelines have yet been established here. According to the 2014 National Health and Nutrition Examination Survey, Koreans consume an average of 1.6g of omega-3 per day. Coincidentally, Americans also consume an average of 1.6 grams of omega-3s per day. Here, 1.4g is ALA and only 0.2g is DHA+EPA, essential for our health. The important thing is that you should pay attention to your DHA+EPA intake rather than your total omega-3 intake. Expert groups differ, but healthy adults generally recommend 500 mg of DHA+EPA daily.  The International Society for Regional Studies (ISSFAL), the American Society for Nutrition (AND), the French Society for Nutrition (AFFSA), and the Brazilian Society of Cardiology (BSC) have all adopted this criterion. Japan's Ministry of Health and Welfare recommends at least 1g of DHA+EPA daily for healthy adults.

But if you're sick...

However, if you have a medical condition, you may need a higher dose.  The American Heart Association has announced that people with heart disease should consume 1 gram of DHA + EPA per day. If you have high triglycerides, you need to consume more DHA+EPA. The American Heart Association officially recommended omega-3 supplements in 2011, saying that 31% of Americans are high in triglycerides. Suggested amounts are 0.5 to 1 g daily for fasting triglycerides between 150 and 199 mg/dl, 1 to 2 g daily for 200 to 499 mg/dl, and 2 to 4 g daily for levels above 500 mg/dl. Consuming 4 grams of omega-3s per day can reduce triglyceride levels by as much as 40%.

Why should you take it in supplement form?

Of course, there is an opinion that omega-3 is better to eat fish than nutritional supplements. However, to get 500 mg of DHA+EPA from fish, you would need to eat one piece of mackerel (50 g) daily.  Leaving aside the heavy metal contamination problem, it's not easy to eat fish every day. This is why you should take omega-3s in supplement form.

If you eat it as a nutritional supplement, like this!

Everyone should consume 500 mg of DHA+EPA daily. A typical commercially available omega-3 capsule weighs between 500 and 1,000 mg. But we have to think about the concept of purity. Remember in Chapter 2, when we talked about nutritional quality, that purity matters? When you catch and boil fish and put DHA+EPA into capsules, oil called an emulsifier is used. At this time, the more emulsifiers we don't need, the lower the purity. It should be at least 50% pure. It's simple to check. It is to check that the DHA+EPA content is at least 250mg per 500mg capsule. If the product is 50% pure, it means that you need 2 pills to get 500mg of DHA+EPA per day.

Note whether the purity is high or whether it is a plant-based omega.

Of course, the higher the purity of Omega-3, the better. I would also like to highlight the recent emergence of plant-based omega-3s.  Since DHA and EPA are extracted from marine microalgae, it has the advantage of not having fishy smell and heavy metal concerns.

What are the side effects of omega-3?

But are there any side effects of omega-3? Tufts University in the United States, through 148 research papers, investigated people who ate 0.3 to 8 g of omega-3 supplements daily for up to 7 years. As a result, there was no case of serious sequelae such as death, disability, or increased bleeding.  About 7% complained of mild, nonspecific discomfort such as diarrhea. Patients receiving thrombolytic agents, such as aspirin and warfarin, have an increased tendency to bleed from wound sites or the gastrointestinal tract, but to a lesser extent. The American Heart Association announced a guideline in 2015 that it is recommended to consult with a doctor before taking it, as the bleeding tendency increases when a large intake of 3g or more per day (equivalent to 6 capsules of 1,000mg based on 50% purity). If you are about to undergo surgery with a lot of bleeding, you can reduce your intake of omega-3 pills to 1-2 pills 2-3 days before surgery.

When Taking Omega-3 Supplements Helps

-Those who are at high risk of heart disease or who have had a myocardial infarction

- People with high triglyceride levels, especially those with diabetes

- Those suffering from rheumatoid arthritis or degenerative arthritis

- Patients with allergic diseases such as asthma, psoriasis, and atopy

- People with mild cognitive impairment, a pre-stage of dementia

- Women who are at high risk of breast cancer or who have experienced breast cancer


Esther Lyuh, Doctor of Preventive Medicine, Seoul National University

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