Omega 3 - what is it, where can we get it and why is it important in IBD?

You may have heard of omega 3 and fish oils but have you ever wondered what it actually is and why we need it?

There has been growing interest in omega-3 and IBD and in this weeks blog we are going to look at this in more depth.

 

So, what is omega 3?

Our body has the ability to make several fats. However, omega 3 fats are a special, essential fatty acid that the body is unable to produce so we need to get this from our diet (hence the name ‘essential’).

 

What does omega 3 do and where can we find them?

Omega 3 is a family of polyunsaturated fatty acids. They are an integral part of every cell in our body, are important in inflammation and for heart and brain health. They also play a key role in genetic function. Consequently, omega 3 fats can protect against illnesses such as breast cancer, depression, ADHD, and other inflammatory diseases (1).

 

The three most important types of omega 3 fatty acids are:

ALA (alpha-linoleic acid)

DHA (docosahexaenoic acid)

EPA (eicosapentaenoic acid).

 

ALA can be converted into EPA and DHA. However, this conversion is inefficient, with only between 0 and 15% of ALA converting to EPA and DHA, so ideally we want to be getting EPA and DHA sources directly from our diet rather than relying on this conversion.  

 

ALA is

  • found mainly in plants

  • the most common omega 3 fatty acid in the diet

  • mainly used for energy, but it can also be converted into EPA and DHA.

  • found in flaxseeds, canola oil, chia seeds, walnuts, hemp seeds and soy beans

 

EPA and DHA

  • are mainly found in animal foods and algae

  • are the biologically active form of omega 3 fatty acids

  • Part of EPA can be converted to DHA

  • DHA is the most important omega 3 fatty acid in the body

  • DHA is a key structural component of the brain, retina of the eyes and plays a role in other bodily functions

  • are found in highest amounts in fatty fish, fish oil, and algae oil, and can also be found in meat, eggs, and some found in dairy from grass-fed animals.

 

If we do not get enough omega-3 fatty acids from our diets, we may need to take supplements, but always consult a health professional before starting any new supplement as some may not be suitable alongside some medications.

 

What are the recommendations?

To meet omega 3 requirements, the NHS recommended we eat two portions of fish per week, one of which should be oily (salmon, mackerel, sardines) (2). One portion is 140g of fresh fish or 1 small can of oily fish.

 

If dietary sources of omega 3 are not enough, it is recommended we take a supplement either in the form of fish oil or micro-algae supplements for vegetarians/vegans.

 

Although there are no current guidelines for omega 3 intake in IBD, the general consensus is 400-500 mg of EPA and DHA combined per day. Therefore, omega 3 intake from foods or taking a supplement may need to be higher than the NHS recommendations reach this amount.

 

What type of supplements are available?

Supplements are not needed for everyone so its really important to work with a nutrition professional to work out whether you need to take one or not. There are many different omega 3 supplements available online and in the shops but few are high quality so always seek advice before buying so you can make sure you are taking a good quality supplement at the correct dose.

 

Where is the evidence that omega-3 could be important in IBD?

Studies have suggested that an imbalance of omega-6 to omega-3 fatty acids in the western diet may increase the risk of IBD (4). Other studies have suggested that EPA and DHA could help to reduce inflammation in UC (5), could favorably alter the intestinal microbiota (6) and aid in the healing of the inner lining of the intestinal tract (7, 8). These studies suggest the importance of omega-3 and the ratios of omega 3 to omega 6 and their pro- and anti-inflammatory effects, creating potential targets for intervention.

 

Although there are currently many studies looking at the effects of fatty acids, alongside medication, in the treatment or prevention of UC or CD, limitations must be noted. Some studies performed with a small number of patients and intervention studies may have other biases like variations in the mode of consumption, the type of food, or the type of formulation used but what is clear is that omega 3 intake matters in IBD. 

 

Take away tips for omega 3 and IBD:

  • Omega 3 is an essential fatty acid that plays a key role in many bodily functions.  

  • It is an integral part of the cell membrane and has anti-inflammatory effects.

  • Research shows that omega 3 may have a beneficial effect on IBD prevention, symptom alleviation and may aid treatment.

  • It is important to consider omega 6 to omega 3 lipid ratios with regards to their pro- and anti-inflammatory effects

  • Omega 3 has shown promising results in healing the intestinal lining, hence showing anti-inflammatory characteristics.

  • Omega 3 alongside routine treatment may help improve quality of life for people with IBD.

  • Remember to always check with your GP, IBD team, or Dietician/Nutritionist before considering whether to take an omega-3 supplement.

 

References

1.       The Nutrition Source. 2022. Omega-3 Fatty Acids: An Essential Contribution. [online] Available at: <https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/types-of-fat/omega-3-fats/#:~:text=That%20isn't%20the%20case,flaxseed%20oil%2C%20and%20leafy%20vegetables>

2.       Bda.uk.com. 2021. Omega-3. [online] Available at: <https://www.bda.uk.com/resource/omega-3.html>

3.       Hopp, C. and Shurtleff, D., 2022. [online] National Center for Complimentary and Integrative Health. Available at: <https://www.nccih.nih.gov/health/omega3-supplements-in-depth>

4.       Schreiner, P., Martinho-Grueber, M., Studerus, D., Vavricka, S., Tilg, H. and Biedermann, L., 2020. Nutrition in Inflammatory Bowel Disease. Digestion, 101(Suppl. 1):120-135.

5.       Scaioli, E., Sartini, A., Bellanova, M., Campieri, M., Festi, D., Bazzoli, F. and Belluzzi, A., 2018. Eicosapentaenoic Acid Reduces Fecal Levels of Calprotectin and Prevents Relapse in Patients With Ulcerative Colitis. Clinical Gastroenterology and Hepatology, 16(8): 1268-1275.e2.

6.       Prossomariti A, Scaioli E, Piazzi G, Fazio C, Bellanova M, Biagi E, Candela M, Brigidi P, Consolandi C, Balbi T, Chieco P. Short-term treatment with eicosapentaenoic acid improves inflammation and affects colonic differentiation markers and microbiota in patients with ulcerative colitis. Scientific reports. 2017 Aug 7;7(1):1-0.

7.       Marton LT, Goulart RD, Carvalho AC, Barbalho SM. Omega fatty acids and inflammatory bowel diseases: an overview. International journal of molecular sciences. 2019 Jan;20(19):4851.

8.       Ungaro F, Tacconi C, Massimino L, Corsetto PA, Correale C, Fonteyne P, Piontini A, Garzarelli V, Calcaterra F, Della Bella S, Spinelli A. MFSD2A promotes endothelial generation of inflammation-resolving lipid mediators and reduces colitis in mice. Gastroenterology. 2017 Nov 1;153(5):1363-77.

 

Clemmie Macpherson