In the last few years, there has been much coverage in the press about the importance of omega 3 essential fatty acids (EFAs) for many areas of health, including cardiovascular disease, immune health, as well as healthy development in babies and children. In fact, DHA a type of omega 3 EFA is key throughout our lives from infancy to old age for brain development and cognition, as well as retinal development in the eye.
Omega 3 deficiencies
In my clinic, I often find that people just aren’t consuming enough of the dietary sources of omega 3 on a regular basis. Many people find it difficult to eat the recommended 3-4 portions of oily fish per week to maintain levels of omega 3 EFAs. But recent research has uncovered why this may lead to omega 3 deficiencies, a particular problem for pregnant women.
A review of more than 70 clinical trials has found that increased intake of omega 3 essential fatty acids during pregnancy is linked to a lower risk of premature births.
The recent Cochrane review of over 20,000 women compiled over 70 randomised trials and compared supplementation of fish oils containing omega 3 EFAs and dietary intake of oily fish with placebo. Increasing omega 3 EFAs specifically:
- Lowers the risk of premature baby (less than 37 weeks) by 11% (from 134 per 1000 to 119 per 1000 births).
- Lowers the risk of having an early premature baby (less than 34 weeks) by 42% (from 46 per 1000 to 27 per 1000 births).
- Reduces the risk of having a small baby (less than 2500g) by 10%.
Every year, 15 million babies are born prematurely world wide – that’s 29 babies every minute. Premature birth is a leading cause of death for children under 5 yeas old worldwide with one million premature babies born annually not surviving. The global statistics can make for grim reading and the numbers unfortunately only continue to rise.
What is premature birth?
Babies are classed as premature when they are born below 37 weeks. Premature babies often face immediate health and developmental challenges, with the risks and challenges increasing the earlier in the pregnancy the baby is born. Premature babies are also at a higher risk of a range of long-term conditions including visual impairment, developmental delay and learning difficulties.
The causes of premature birth are relatively poorly understood, though lifestyle, diet and health of the mother-to-be is a key place to start. This is why the Cochrane review is so important, as it provides a relatively simple and easy starting point of the diet to address factors during pregnancy to support the health of the mother and that of her developing foetus.
Can we get enough omega 3 from the diet?
It’s very simple why omega 3 is called an essential fatty acid – we can only get it from the diet, as our body is not able to make them. The major dietary source of the all important EPA and DHA forms of omega 3 are found in oily fish including tuna, mackerel, salmon, herring and trout. However, eating enough fresh oily fish (the canning process removes many of the beneficial nutrients including omega 3 fats) on a weekly basis is a challenge for many people, not to mention the issues around toxic contamination found in some fish chain supplies.
Our oceans are currently suffering from some of the worst human-made contamination from plastics, chemicals and other industrial pollution and that can be reflected directly in the food chain from less reputable and managed sources. Over consumption of deep water fish (e.g. more than 1-2 portions a month), such as tuna and swordfish, is also not advised during pregnancy (or to my mind should also be limited at other times) due to mercury contamination.
This can make high quality fish oil supplements seem a more attractive prospect, as oils can be carefully purified to remove any unwanted contaminants – leaving the pure bioactive EPA and DHA containing fish oil ready for consumption.
It’s worth noting that you can also find different forms of omega 3 EFAs (namely ALA) in nuts, seeds and certain plant-based oils like flaxseed oil. These forms of fatty acids are not in the readily bioactive EPA and DHA form but the body can convert ALA into the bioactive components.
Omega 3 supplements & pregnancy
The Cochrane review also commented on the safety of fish oils when supplemented during pregnancy. The review found that daily supplementation containing between 500 and 1000 milligrammes (mg) fish oils starting at or before 12 weeks of pregnancy supplied the pregnancy term benefits.
But which supplement to choose from? I’ve already mentioned contamination of wide areas of the ocean’s food chain, which requires choosing a fish oil supplement from a reputable company that has certified purification processes. But there’s also the serious issue of intensive fish farming and overfishing in many sea and ocean areas leaving fish stocks dangerously low.
The Marine Stewardship Council is dedicated to sustainable fishing, protecting the oceans, respecting the habitats and also ensuring people who depend on fishing can maintain their livelihoods. Their blue label can be found on products, including food supplements that adhere to these sustainable fishing practices.
Of course, if you are unable to take fish products or choose not to consume animal products then organic flaxseed oil is an excellent concentrated source of the parent ALA omega 3 EFAs that the body can convert to EPA and DHA. There are now also algal omega 3 food supplements that also provide alternatives for vegetarian and vegan diets.
Omega 3 during pregnancy can reduce risk of childhood allergy
But there’s more to shout about omega 3! We now also know that not only taking omega 3 EFAs during pregnancy lowers the risk of premature birth, but also positively influence the baby’s genome. Whilst, this may sound like science fiction, and even something that is a risk for the unborn baby, it’s actually mostly a positive event.
Let me backtrack for a moment and give a basic overview of epigenetics: While the genetic content of your baby’s DNA is fixed at the moment of egg and sperm fusion, its development and growth depends on particular genes being activated and amplified or suppressed at key points during pregnancy. The changes in these genetic messages can have far reaching consequences on the developing foetus, as well as its development through infancy and even for the rest of their life.
The relatively new science of epigenetics considers what the mechanism and triggers are for this control. Triggers include a wide variety of natural, environmental and even toxic substances. Epigenetic factors that trigger positive health outcomes for mother and child include nutrients such as positive health changes include omega 3 EFAs.
An exciting recent study has shown that maternal intake of DHA (in fish oil also containing EPA) during pregnancy influences the foetal genes that improves the baby’s subsequent metabolic health and reduces the risk of developing infant allergies. In fact the positive changes to these individual genes were still detected at in the children at 5 years old.
The accumulation of positive maternal-foetal health outcomes surrounding supplementing omega 3 fish oils in pregnancy is mounting and this is why I believe is a solid recommendation for many pregnant to avoid any deficiency.
Article by Dr Elisabeth Philipps PhD BSc(Hons) BSc Nutr Med NNA
Elisabeth achieved a BSc Hons and PhD in neuropharmacology and from her own personal health experiences extended her training in the area of nutritional therapy, studying for a BSc in Nutritional Medicine at Thames Valley University (now called University of West London). She is a busy nutritional therapist and health coach who is passionate about nutrition education for the public and practitioners alike, which she shares through her work writing courses, blogs and education articles and as lead tutor at nutrihub.org, as well as technical adviser and product developer at Nutrigold (www.nutrigold.co.uk).