Many of us will be able to identify the important role of omega-3 fatty acids for heart health, lowering your cholesterol or even for promoting memory and brain health.
However, more and more research continues to emerge on the role of omega-3 fatty acids before and during pregnancy and its impact on a multitude of factors relating to conception and women’s health issues.
So, are omega-3s one of the “magic (nutritional) ingredients” for falling pregnant and carrying a healthy pregnancy? Let’s dive into the science!
What is an omega-3 fatty acid?
Omega-3s are one of two types of polyunsaturated fatty acids, the other being omega-6s. A polyunsaturated fatty acid is a fat that has multiple double bonds (a type of chemical bond) which leads it to be a liquid at room temperature (much like monounsaturated fats). Omega-3s have their first double bond occurring at the third position from the end of the fatty acid “tail”. Okay, enough with the chemistry! Within the category of omega-3 fats there are two main types:
(1) Alpha-linolenic acid (ALA)
(2) Long-chain n-3 (omega-3) fatty acids
(There are also omega-9s but we won’t talk about those today!)
Recently, I’ve been getting a whole heap of questions about ALA (often known as “plant-based omega-3s”) and their absorption compared to long-chain omega-3s (typically from marine sources) known as EPA & DHA.
Here’s the deal, ALA does require more steps to be converted into an active form for use and absorption by the body. However, it is important to continue to include ALA sources in your diet, as it helps to compete with omega-6 fatty acids as they utilise the very same metabolic pathway in the body. Unfortunately, the omega-6s (linoleic acid) usually outcompetes ALA! Therefore, it is sensible to reduce omega-6 fatty acid sources in the diet and increase both ALA and long-chain omega-3 fat sources to optimise absorption.
Once omega-3s are in the preferred form, the body utilises the fatty acids to help combat inflammation, works to reduce clotting and has also been shown to protective against cardiac arrhythmia!
Where are they found?
ALA is found primarily in plants, so if you’re a vegetarian or vegan, you want to be including these daily and potentially consider an omega-3 supplement, especially if you’re trying to conceive.
- Chia seeds
- Pumpkin seeds
- Flaxseed oil
- Tofu & other soy products
EPA & DHA (or the long-chain omega-3 fats) are primarily found in marine sources:
- Cod Liver Oil
Regularly including both sources, ideally with 2-3 fish meals (~150 g serving of oily fish) per week. But what about mercury, you may be asking?! The key marine sources of mercury should be avoided, especially during pregnancy, which include: flake (shark), orange roughy, catfish, marlin and broadbill/swordfish (more information about pregnancy nutrition from me & the Australian government). As well, if you are pregnant, ensure your fish and seafood is cooked through and it can still be enjoyed regularly!
Seek advice from an Accredited Practising Dietitian to review your omega-3 intake and how it can be improved before considering supplementation.
What is the role of omega-3s in fertility?
Did you know that couples who eat fish about twice a week have a higher likelihood of falling pregnant than those who ate fish less frequently? (Gaskins, et al., 2018) And could it be the omega-3 fatty acids found in fish that is aiding fertility? Whilst we may not have the exact reason, for now, other research supports the importance of omega-3 fatty acids in the diet when trying to conceive.
One study showed that diets rich in omega-3 fatty acids over a lifetime can prolong female’s reproductive function into advanced maternal age, compared to a diet rich in omega-6 fatty acids. And bonus, diets rich in omega-3s also improves egg quality! Again, omega-6s came out second-best with a short-term treatment of omega-6 rich dietary sources contributing to poor egg quality (Nehra, et al., 2012).
What is the role of omega-3s in pregnancy?
What inspired me to write this blog for you is some of the latest research which showed that women with low omega-3 intake during their pregnancy were at increased risk of early or pre-term delivery. In this case-control study, 376 preterm cases were compared to 348 random controls and compared plasma concentrations of EPA and DHA throughout pregnancy. Women in the lowest group of omega-3 intake were at 10-fold increased risk of pre-term delivery, before 34 weeks (Olsen et al., 2018). This supports the meta-analysis conducted in 2016 which showed that omega-3 fatty acids are effective in preventing early and preterm delivery.
Early delivery can, of course, be very dangerous for baby, depending on how early bub is delivered. It is important to carry baby as long as you can toward full-term, and even in those early critical periods, each day on the inside can improve their chances in the big wide world, buying more time for vital organs to mature and develop.
Another study has also shown that omega-3 fatty acid levels (specifically) DHA were associated with a higher birth weight, and higher omega-6 fatty acids later in pregnancy were higher in low birth weight babies (Meher et al., 2016). Associations do not mean this is the cause, but given we have lots of other research highlighting the benefits of long-chain omega-3 fatty acids and reducing omega-6 fatty acids, it is a good idea to optimise your fatty acid balance in your diet with the assistance of an Accredited Practising Dietitian.
What is critical to take away from this study, is that starting to think about omega-3 status when pregnant may not be soon enough and we must improve the omega-3 status of all women of child-bearing age, particularly those actively trying to conceive to ensure EPA & DHA status is optimised before and during pregnancy, a bit like folate and vitamin D.
You can now get your omega-3 tested with a simple fingerprick, using different kits.
Aside from birthweight and early delivery, it has long been known that DHA (one of the bio-active marine long-chain omega-3s) is critical in pregnancy for baby’s brain & nervous system as well as eye development (Coletta, et al., 2010).
So, get some fish on your plate for baby’s brain and their gorgeous little eyes!
How much do I need?
Only 20% of Aussies meet the omega-3 targets and an even smaller 10% meet their DHA recommendations (Meyer, 2016).
However, you will see different recommendations for omega-3s which just depends on your source, so I’ve summarised some of the key ones below:
Non-pregnant women (19 years+)
Suggested Dietary Targets for the prevention of chronic disease:
- 410 mg/day for women
- 630 mg/day for men
- 90 mg/day for non-pregnant women (long-chain omega-3s) & 0.8 g/day (ALA)
- 115 mg/day for pregnant women (long-chain omega-3s) & 1.0 g/day (ALA)
- 160 mg/day for men (long-chain omega-3s) & 1.3 g/day (ALA)
American Pregnancy Association
- 300 mg DHA daily for pregnant & breastfeeding women
- 500 mg EPA & DHA for all adults
These are MINIMUM recommendations are based on the International Society for the Study of Fatty Acids & Lipids.
Should I be supplementing with fish oil?
12% of Australians take a fish oil supplement, which makes it one of the most common supplements that Aussies are popping on the daily! Be sure to check the company is being transparent about the quality of their fish oil regarding mercury content. Most of the manufacturing process will remove the mercury in a fish oil supplement.
It is – of course – best to get your omega-3s from your diet, if you can, by including oily fish 3 times week to get a good dose of marine long-chain omega-3s. If you do not eat fish due to an allergy, cultural or ethical reasons it may be appropriate to supplement if you’re trying to conceive or you’re pregnant to help with egg health, plus baby’s brain & eye development, respectively.
Consult your physician and dietitian before starting any kind of supplementation for correct dosages.
Want to know whether your diet and supplement regime stacks up when it comes to omega-3s? The Dietologist now offers omega-3 testing through OmegaQuant, so you know how much omega-3s are in your red blood cells with an easy fingerprick! We can then implement a personalised plan to boost your numbers and re-test in 4-6 months! Get in touch today for more information.
Looking for a dietitian to help boost your omega-3 status and learn more about the role of food in your fertility & pregnancy journey? Book yourself in for a virtual or face-to-face appointment in one of my Sydney offices for personalised advice.