By Dr. Robert Curtis
(Doctor
of Chiropractic, Certified Medical Examiner (U.S. Dept. of
Transportation), A.C.E. Certified Health Coach and Fitness Nutrition
Specialist)
Published: 8/20/21
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Newer research is supporting full omega-3 health benefits from plants. Omega-3s are important to our overall health for number of reasons, and though typically with standard western diets they're often lacking, they're readily obtained on a plant-based diet.
Omega-3s are simply a kind of fat. Apart from being a storable source of nine calories per gram, fats are of different types and our bodies make use of them for various essential purposes.
One function of fats is that they make up the membranes surrounding each cell and are specifically crucial in the brain and nerves. They are capable of not only mediating the effect of our immune cells but can also significantly influence the production of neurotransmitters as well as hormones.
Omega-3s provide numerous health benefits to our brain (including our mental health), heart, and are even anti-inflammatory.
Some health care professionals believe that one of the factors responsible for the increase in the cases of chronic diseases in society is a result of the reduction in the consumption of omega-3s in the past few generations.
This discussion will delve into exactly what omega-3s are, look closer at various reasons why they are essential to our health, and ways to acquire a sufficient amount of these fats from plant sources that can be fully supportive of our health.
We have different types of fats and they are generally regarded as fatty acids. Two major groups of fats include:
Also, unsaturated fat comes in two different forms – polyunsaturated (PUFAs) and monounsaturated (MUFAs).
Omega-3s are among the types of PUFAs, along with omega-6s. [1]
Omega-6s are not as popular as omega-3s and this is because we tend to consume far more of them in our diet than is typically healthy.
For instance, popular sources of omega-6s include most common seed oils such as sunflower and corn, as well as higher amounts that we get from poultry and meat.
What health experts have been trying to achieve is to inform people to replace some of the common omega-6s with more omega-3s, just the way our ancestors did, for a better balance between the two.
The major types of omega-3s that are essential to our health include:
As noted, the omega-3 ALA is an essential fatty acid in that it’s literally essential for health and we need it just the way we need essential minerals and vitamins.
Perhaps the greatest reason why it is essential is that our body is unable to create it from other nutrients.
Further, it is essential in that our body needs this particular omega-3 (ALA) to create the biologically active EPA and DHA.
Interestingly, data from research reveals that the primary role that ALA plays is to serve as the building block for EPA and DHA.
Being “biologically active” implies that the two forms of omega-3s (EPA and DHA) are the ones that provide several health benefits. These two are the active ones in our system.
So, where can we find ALA? Regarded as the plant-based omega-3, it is mainly found predominantly in various seeds such as chia, flax, and hemp, nuts like walnuts, to a lesser extent vegetables, particularly cruciferous, to the green purslane (a high amount exception), and in oils of soy, canola, and olives.
The process of converting plant-based essential ALA into the biologically active EPA and DHA is quite complex, involving several enzymatic steps.
It has been widely reported though, based on certain research results, that this process is not efficient. [2]
For instance, the conversion rate of ALA to EPA had been calculated to be between 8-12 percent and the conversion to DHA at just 1 percent, though with results from some studies indicating that the conversion rates for women possibly slightly higher when compared to men. [3]
However, another recent study demonstrated sufficient conversion, noting the seeming limitation of DHA production was actually a natural limitation by the body, in essence the body communicating that it had reached a sufficient level of DHA. [4]
Accordingly, another study noted that plant-based eaters, exclusively getting their omega-3s in the form of ALA, and in sufficient quantity, demonstrated no deficiencies of EPA nor DHA. [5]
Additionally, one other study determined that intake of ALA and its conversion to EPA and DHA is enhanced by sufficient intake of ALA while simultaneously reducing or limiting omega-6 intake that otherwise competes with the same pathways that ALA needs. [6]
In an instance where ALA may not be readily available for someone pursuing a plant-based diet, or other factors prevent them consuming adequate amounts of plant-based food sources containing ALA, or there are physiological or medical conditions present countering ALA absorption and or conversion, the biologically active forms of omega-3s, EPA and DHA, may be obtained from algae.
Though technically not plants, algae are generally considered within the realm of a plant-based diet, as they're not animals either.
Accordingly, algae may be consumed as a whole food, usually as an additive to other foods, such as in powder form added to a smoothie, and EPA and DHA extracts from algae exist in supplement form as well.
Moving beyond the biochemistry, what exactly are the health benefits of omega-3s and how do they work in the body?
The scientific community has carried out numerous studies regarding omega-3 fatty acids and their health benefits.
This includes their impact on three major aspects of our health – heart health, brain health (which includes better moods) and their anti-inflammatory properties.
In detail ...
One of the things that made omega-3s popular for heart health was the attention they were getting from researchers back in the 1970s.
During that time, researchers assessed that Greenland Inuit had a lower rate of heart disease as well as other lowered risk factors despite consuming a lot of fat.
They concluded that what was unhealthy for the heart wasn’t the amount of fat consumed. Instead, it had to do with the type of fat consumed. [7]
Following, several other early studies on the consumption of fish and omega-3 supplementation discovered that they had a lot of heart-healthy effects. [8] These researchers observed that the risks of heart disease for individuals who ate fatty fish many times a week was lower compared to those who didn’t eat any fish. [9]
Also, when it’s come to supplements, a large study observed that persons who have heart disease experienced a reduced risk of heart attack, stroke and death after taking ALA or fish oil capsules on a daily basis compared to others who took a placebo. [10]
Over time, several studies have also revealed that higher levels of EPA and DHA in the blood were linked with lower risk factors for heart issues. [11]
In fact, a good number of studies showed many health benefits related to omega-3s. It is believed to have:
However, as time has gone on there has been an increasing amount of evidence to show that the improved heart health effects of omega-3s may not be as much as we initially thought.
According to some researchers, the reason for these conflicting results could be the decline in the number of individuals who smoke as well as the improving standard of care for people with heart disease which has significantly improved over the decades. [13]
When it comes to omega-3s and heart health, there is some evidence to show that omega-3 supplements slightly cut down on a few of the risk factors of heart disease. [14]
However, the available evidence isn’t as overwhelming as was initially believed.
Nonetheless, they’re still as essential for optimal health.
Apart from water, our brain comprises about 60 percent fat. The main fatty acid in the human brain’s grey matter is DHA.
On the other hand, EPA makes up about 1 percent of the brain fatty acids. So, the most crucial PUFA in the central nervous system is DHA.
In addition to being the most abundant component of the membrane of nerve cells, DHA also plays a vital role in structure and function. It assists nerve cells in stabilizing their membranes, insulating their electrical signals and lowering inflammation. [15]
It’s crucial to have sufficient omega-3s during pregnancy and beyond for optimal brain health and the brain development of a baby. [16] During pregnancy, the last trimester often portrays the greatest need for DHA for the baby.
It is at this stage that the brain and eyes of a baby begin to mature. During the last trimester, more DHA is moved to the infant than the first two trimesters. [17]
Kids that are born preterm are more vulnerable to deficiency and available results from studies have revealed that when compared to infants born at full term, kids born preterm have lower levels of omega-3s in their blood.
Preterm infants that were given formula that contained omega-3s exhibit small positive results in neurodevelopmental outcomes compared to preterm infants that were fed with a formula that didn’t contain omega-3s.
However, it’s also crucial to point out that this doesn’t appear to affect full-term infants.
The breast milk contains DHA and there is a reduction in the amount of omega-3s it contains when mothers cut down on the amount of omega-3s they consume.
Also, studies recently carried out have provided evidence that there are positive effects in cognition (one’s ability to think) as well as brain connectivity in young children whose DHA intake in their infancy was high.
When it comes to neurodegeneration, one of the greatest risk factors for Alzheimer’s Disease (AD) is age. Several types of research have been carried out on how omega-3s affect AD. For instance, the levels of DHA in the blood of individuals with AD tend to be low, while those with higher levels of omega-3s have a lower risk of AD.
Considering the effects of DHA on some brain cells (glial cells), experts are of the view that supplementing with DHA may actually help with AD.
When this was tried in animal models, it boosted an enzyme that assists in clearing the harmful Aβ plaques common in AD. For animals that received a diet that was enriched with omega-6s, they had higher levels of Aβ plaques in addition to having more mood issues. [18]
The review of some recent and high-quality clinical studies explored supplementation with omega-3 to assist with moderate AD.
After those trials which researchers combined, they discovered that at the end of six months, there was no consistent benefit in mental health, cognition (the ability to think) as well as in the quality of life.
However, a study revealed that among individuals who took omega-3 supplements, there was a little improvement in activities of daily living. But a more recently concluded study concluded that people might enjoy a small benefit of taking omega-3 supplements if it’s taken early in the development of AD.
It’s also crucial to point out that other studies failed to show the same benefit. [19]
A recent study looked at two groups of people aged 63-79. One group was provided 30-60 g of walnuts (an omega-3 source) per day to supplement their diet. After 2-years, there was no difference in cognition between the groups, however the researchers found that brain imaging tests suggest that walnuts may delay cognitive decline in those at risk. [20]
By the way, visual dysfunction is one of the symptoms of deficiency of the essential omega-3 ALA. This is a clear indication of its importance not just for our brain but for the retina of the eye too.
Overall, to fully understand the role omega-3s plays in helping people with AD, there is a need for more research.
Those with higher blood levels of omega-3s and those who eat it regularly are likely to feel less depressed or anxious.
According to a randomized, double-blind study which examined depressed undergraduate students; there was a remarkable decline in symptoms for the students who took omega-3 supplements compared to others who were merely taking placebo. [21]
Also, in other studies, there was a mild to moderate benefit in symptoms for individuals who took omega-3s versus placebos. [22]
Interestingly, the results of some of these studies were comparable to some antidepressant medications.
However, these studies concluded that the evidence wasn’t sufficient and there is a need for higher-quality studies.
Is it possible for omega-3 supplements to help reduce aggression? Well, one double-blind randomized study that was recently published tried to ascertain whether we could reduce aggression by taking omega-3 supplements.
Two groups were created and one group was given a supplement with EPA and DHA while the other received a placebo. Those who took the omega-3s noticed a significant decrease in their aggressiveness after six weeks. [23]
There are several links between mental health and inflammation. Some medications that cause inflammation are capable of inducing mental health symptoms, while some antidepressant medications are anti-inflammatory.
In fact, taking antidepressant medications along with omega-3s offers an improved effect over antidepressant medications alone.
Apart from being useful due to its anti-inflammatory abilities, there is also evidence to prove that omega-3s deficiency can result in impaired function of the neurotransmitters serotonin and dopamine. This, could lead to several mental health issues.
Omega-3s can also help us to deal with stress. For instance, there is usually a higher level of the stress hormone cortisol in the blood of those who feel depressed. The intake of omega-3 EPA can help to cut down on the production as well as the release of stress hormones. [24]
Apart from some of the common inflammatory diseases such as arthritis, allergies, autoimmune disease and asthma, other diseases may not really be regarded as inflammatory. However, such diseases have a significant inflammatory component.
Some of them are cancer, depression, obesity, and neurodegenerative diseases like Alzheimer’s. [25] Most of these health issues are becoming more rampant and this is caused by factors such as environmental and dietary toxins, infections as well as stress.
One common reason also is the inflammatory diet we eat. We can either increase or decrease the amount of inflammation in our body by what we eat.
The intake of omega-6s is higher than omega-3s in an inflammatory diet and the higher the consumption of certain omega-6s, the more the production of some inflammatory molecules. [26]
Based on several animal and clinical studies, there is evidence to show that inflammation was reduced with the intake of omega-3 supplements.
In fact, a review of 30 studies showed that there was a significant reduction in the pain of arthritis, especially rheumatoid arthritis with supplementation. [27] [28]
So, in what ways can omega-3s help to cut down on inflammation? They can achieve this in two ways. They can help to prevent several mechanisms or enzymes that lead to the creation of inflammation molecules in the first place. [29] [30]
Also, they can cut down on the expression of certain inflammatory genes. [31] Omega-3s are actually used to create anti-inflammatory molecules such as prostaglandins, resolvins and several others. Several animal studies have provided evidence to prove that omega-3s can reduce inflammation simply by assisting to reduce obesity. [32]
One of the best ways to enjoy the numerous health benefits of omega-3s is to regularly eat foods that contain a high amount of omega-3s.
Some health experts believe that the diets of our ancestors comprised an equal amount of omega-6s and omega-3s. But based on the typical western diet, our intake of omega-6s is now 20 times higher than that of omega-3s.
This explains why there is an increased emphasis on the need for us to eat enough omega-3s.
Perhaps the best sources of plant-based omega-3s are flax and chia seeds since each’s total fatty acids are primarily made up of the essential omega-3, ALA.
They (along with walnuts, too) are also sources of other nutrients such as fiber, potassium and magnesium. [6]
Other plant-based sources such as soy and canola are less concentrated sources of ALA. About 10 percent of their fatty acids are the essential omega-3s ALA.
And as mentioned before, algae are also notable sources of plant-based omega-3s. [6]
Several processed foods are also fortified with omega-3s.
For instance, there are foods such as dressings, pasta, and baked goods that may contain added flax, oils, and algae.
Omega-3 supplements can help support your intake in cases of insufficiency and or challenges with adequate food sources consumption.
Omega-3s have a proven history of safety, but like any supplement, health and condition issues are advisedly addressed with one’s primary health care provider.
In particular, omega-3s have an impact for people taking anti-inflammatory or pain medications, cholesterol or blood-clotting medications, or in preparing for or recovering from surgery, among others.
Though no official level of omega-3 consumption has yet been established the United State Institute of Medicine's Food and Nutrition Board advises adequate intake of ALA to be at 1.6 grams per day for males and 1.1 grams for females, both of 19 years of age and older.
In the instance of seeking to consume EPA and DHA specifically, 250–300 milligrams per day is advised, per a general consensus of experts, and can be obtained from whole algal sources and are available in supplement form as well.
Omega-3s offer us numerous health benefits. They can help to improve mental health and brain function and lower the risk of heart disease. They’re also shown to reduce inflammation, and even the pain of rheumatoid arthritis. [33]
The best plant-based source of the beneficial essential omega-3 ALA is flax. Also, algae is the best ‘plant-based’ source of the two biologically active omega-3s, EPA and DHA, and may be more suitable where ALA conversion is challenged.
Though necessary for our health, it is advisable to be aware of how much omega-3s you consume when it comes to any medication regimens or health conditions, and accordingly discussing this with your primary health care practitioner.
1. Calder P. C. (2017). Omega-3 fatty acids and inflammatory processes: from molecules to man. Biochemical Society Transactions, 15, 45(5):1105-1115. doi: 10.1042/BST20160474. https://www.ncbi.nlm.nih.gov/pubmed/28900017 https://eprints.soton.ac.uk/415428/1/Calder_BST_Revision.pdf
2. Novotny, K., Fritz, K., & Parmar, M. (2020). Omega-3 Fatty Acids. In StatPearls. StatPearls Publishing.
3. Baker, E. J., Miles, E. A., Burdge, G. C., Yaqoob, P., & Calder, P.C. (2016). Metabolism and functional effects of plant-derived omega-3 fatty acids in humans. Progress in Lipid Research, 64, :30-56. doi: 10.1016/j.plipres.2016.07.002. Retrieved on December 6, 2020, from https://www.ncbi.nlm.nih.gov/pubmed/27496755
4. Metherel, A.H. and R.P. Bazinet, Updates to the n-3 polyunsaturated fatty acid biosynthesis pathway: DHA synthesis rates, tetracosahexaenoic acid and (minimal) retroconversion. Prog Lipid Res, 2019. 76: p. 101008.
5. Welch, A.A., et al., Dietary intake and status of n-3 polyunsaturated fatty acids in a population of fish-eating and non-fish-eating meat-eaters, vegetarians, and vegans and the product-precursor ratio [corrected] of alpha-linolenic acid to long-chain n-3 polyunsaturated fatty acids: results from the EPIC-Norfolk cohort. Am J Clin Nutr, 2010. 92(5): p. 1040-51.
6. Santos, H. O., Price, J. C., & Bueno, A. A. (2020). Beyond Fish Oil Supplementation: The Effects of Alternative Plant Sources of Omega-3 Polyunsaturated Fatty Acids upon Lipid Indexes and Cardiometabolic Biomarkers-An Overview. Nutrients, 12(10), 3159. https://doi.org/10.3390/nu12103159 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7602731/
7. Watanabe, Y. & Tatsuno, I. (2017). Omega-3 polyunsaturated fatty acids for cardiovascular diseases: present, past and future. Expert Review of Clinical Pharmacology, 10(8):865-873. doi: 10.1080/17512433.2017.1333902. https://www.ncbi.nlm.nih.gov/pubmed/28531360
8. Siscovick, D. S., Barringer, T. A., Fretts, A. M., Wu, J. H., Lichtenstein, A. H., Costello, R. B., Kris-Etherton, P. M., Jacobson, T. A., Engler, M. B., Alger, H. M., Appel, L. J., & Mozaffarian, D. (2017). Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease: A Science Advisory From the American Heart Association. Circulation, 135(15), :e867-e884. doi: 10.1161/CIR.0000000000000482. Retrieved on December 6, 2020, from http://circ.ahajournals.org/content/circulationaha/135/15/e867.full.pdf
9. Mori, T.A1. (2017). Marine OMEGA-3 fatty acids in the prevention of cardiovascular disease. Fitoterapia, 123, :51-58. doi: 10.1016/j.fitote.2017.09.015. Retrieved on December 7, 2020, from https://www.ncbi.nlm.nih.gov/pubmed/28964873
10. Chaddha, A. & Eagle, K.A. (2015). Omega-3 Fatty Acids and Heart Health. Circulation, 132, :e350-e352. https://doi.org/10.1161/CIRCULATIONAHA.114.015176. Retrieved on December 5, 2020, from http://circ.ahajournals.org/content/132/22/e350.long
11. Balk, E. M., & Lichtenstein, A. H. (2017). Omega-3 Fatty Acids and Cardiovascular Disease: Summary of the 2016 Agency of Healthcare Research and Quality Evidence Review. Nutrients, 9(8), 865. http://doi.org/10.3390/nu9080865. Retrieved on December 6, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579658/
12. Bäck, M. (2017). Omega-3 fatty acids in atherosclerosis and coronary artery disease. Future Science OA, 3(4), FSO236. http://doi.org/10.4155/fsoa-2017-0067 Retrieved on December 7, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674268/
13. Langlois, K. & Ratnayake, W.M. (2015). Omega-3 Index of Canadian adults. Health Rep. 26(11):3-11. Retrieved on December 5, 2020, from http://www.statcan.gc.ca/pub/82-003-x/2015011/article/14242-eng.pdf=
14. Abdelhamid, Asmaa S et al. “Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease.” The Cochrane database of systematic reviews vol. 3,2 CD003177. 29 Feb. 2020, doi:10.1002/14651858.CD003177.pub5
15. Zárate, R., el Jaber-Vazdekis, N., Tejera, N., Pérez, J. A., & Rodríguez, C. (2017). Significance of long-chain polyunsaturated fatty acids in human health. Clinical and Translational Medicine, 6, 25. http://doi.org/10.1186/s40169-017-0153-6 Retrieved on December 6, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5532176/
16. Carlson, S. E., & Colombo, J. (2016). Docosahexaenoic Acid and Arachidonic Acid Nutrition in Early Development. Advances in Pediatrics, 63(1), 453–471. http://doi.org/10.1016/j.yapd.2016.04.011 Retrieved on December 6, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5207030/
17. Rogers, L. K., Valentine, C. J., & Keim, S. A. (2013). DHA Supplementation: Current Implications in Pregnancy and Childhood. Pharmacological Research: The Official Journal of the Italian Pharmacological Society, 70(1), 13–19. http://doi.org/10.1016/j.phrs.2012.12.003. Retrieved on December 6, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3602397/
18. Whittington, R. A., Planel, E., & Terrando, N. (2017). Impaired Resolution of Inflammation in Alzheimer’s Disease: A Review. Frontiers in Immunology, 8, 1464. http://doi.org/10.3389/fimmu.2017.01464 Retrieved on December 7, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5681480/
19. Burckhardt, M., Herke, M., Wustmann, T., Watzke, S., Langer, G., & Fink A. (2016). Omega-3 fatty acids for the treatment of dementia. Cochrane Database of Systematic Reviews, 11, ,4:CD009002. doi: 10.1002/14651858.CD009002.pub3. Retrieved on December 6, 2020, from https://www.ncbi.nlm.nih.gov/pubmed/27063583
20. Sala-Vila, A., Valls-Pedret, C., Rajaram, S., Coll-Padrós, N., Cofán, M., Serra-Mir, M., Pérez-Heras, A. M., Roth, I., Freitas-Simoes, T. M., Doménech, M., Calvo, C., López-Illamola, A., Bitok, E., Buxton, N. K., Huey, L., Arechiga, A., Oda, K., Lee, G. J., Corella, D., Vaqué-Alcázar, L., … Ros, E. (2020). Effect of a 2-year diet intervention with walnuts on cognitive decline. The Walnuts And Healthy Aging (WAHA) study: a randomized controlled trial. The American journal of clinical nutrition, 111(3), 590–600. https://doi.org/10.1093/ajcn/nqz328
21. Gintya, A.T. & Conklinb, S.M. (2015). Short-term supplementation of acute long-chain omega-3 polyunsaturated fatty acids may alter depression status and decrease symptomology among young adults with depression: A preliminary randomized and placebo-controlled trial. Psychiatry Research. 229(1–2); 485–489. Retrieved on December 7, 2020, from http://www.sciencedirect.com/science/article/pii/S0165178115003844
22. Rapaport, M. H., Nierenberg, A. A., Schettler, P. J., Kinkead, B., Cardoos, A., Walker, R., & Mischoulon, D. (2016). Inflammation as a Predictive Biomarker for Response to Omega-3 Fatty Acids in Major Depressive Disorder: A Proof of Concept Study. Molecular Psychiatry, 21(1), 71–79. http://doi.org/10.1038/mp.2015.22 Retrieved on December 7, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4581883/
23. Bègue, L., Zaalberg, A., Shankland, R., Duke, A., Jacquet, J., Kaliman, P., Pennel, L., Chanove, M., Arvers, P., & Bushman, B.J. (2017). Omega-3 supplements reduce self-reported physical aggression in healthy adults. Psychiatry Research, 261, :307-311. doi: 10.1016/j.psychres.2017.12.038. Retrieved on December 5, 2020, from https://www.ncbi.nlm.nih.gov/pubmed/29331711
24. Martínez-Cengotitabengoa, M. & González-Pinto, A. (2017). Nutritional supplements in depressive disorders. Actas Esp Psiquiatr, 45(Supplement):8-15. Retrieved on December 5, 2020, from https://www.actaspsiquiatria.es/repositorio//suplements/19/ENG/19-ENG-947497.pdf
25. Rutkofsky, I. H., Khan, A. S., Sahito, S., & Kumar, V. (2017). The Psychoneuroimmunological Role of Omega-3 Polyunsaturated Fatty Acids in Major Depressive Disorder and Bipolar Disorder. Advances in Mind- Body Medicine, 31(3):8-16. Retrieved on December 5, 2020, from https://www.ncbi.nlm.nih.gov/pubmed/28987035
26. Bowen K. J., Harris, W. S., & Kris-Etherton, P. M. (2016). Omega-3 Fatty Acids and Cardiovascular Disease: Are There Benefits? Current Treatment Options in Cardiovascular Medicine, (11), :69. Retrieved on December 5, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5067287/
27. Health Canada, Natural and Non-prescription Health Products Directorate, Single Monographs, Fish Oil. Accessed March 2, 2018. Retrieved on December 6, 2020, from http://webprod.hc-sc.gc.ca/nhpid-bdipsn/atReq.do?atid=fish.oil.huile.poisson&lang=eng
28. Senftleber, N. K., Nielsen, S. M., Andersen, J. R., Bliddal, H., Tarp, S., Lauritzen, L., Furst, D. E., Suarez-Almazor, M. E., Lyddiatt, A., & Christensen, R. (2017). Marine Oil Supplements for Arthritis Pain: A Systematic Review and Meta-Analysis of Randomized Trials. Nutrients, 9(1). pii: E42. doi: 10.3390/nu9010042. Retrieved on December 6, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295086/
29. Abdulrazaq, M.1, Innes, J. K.1, & Calder, P. C2.(2017). Effect of ω-3 polyunsaturated fatty acids on arthritic pain: A systematic review. Nutrition, 39-40, :57-66. doi: 10.1016/j.nut.2016.12.003. Retrieved on December 5, 2020, from https://www.ncbi.nlm.nih.gov/pubmed/28606571
30. Molfino, A., Amabile, M. I., Monti, M., & Muscaritoli, M. (2017). Omega-3 Polyunsaturated Fatty Acids in Critical Illness: Anti-Inflammatory, Proresolving, or Both? Oxidative Medicine and Cellular Longevity, 2017, 5987082. http://doi.org/10.1155/2017/5987082 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5488236/
31. Calder, P. C. (2013). Omega‐3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology? British Journal of Clinical Pharmacology, 75(3), 645–662. http://doi.org/10.1111/j.1365-2125.2012.04374.x https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3575932/
32. Jayarathne, S., Koboziev, I., Park, O. -H., Oldewage-Theron, W., Shen, C. -L., & Moustaid-Moussa, N. (2017). Anti-Inflammatory and Anti-Obesity Properties of Food Bioactive Components: Effects on Adipose Tissue. Preventive Nutrition and Food Science, 22(4), 251–262. http://doi.org/10.3746/pnf.2017.22.4.251 Retrieved on December 6, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758087/
33. Gioxari, A., Kaliora, A. C., Marantidou, F., & Panagiotakos, D.P. (2018). Intake of ω-3 polyunsaturated fatty acids in patients with rheumatoid arthritis: A systematic review and meta-analysis. Nutrition, 45, :114-124.e4. doi: 10.1016/j.nut.2017.06.023. Retrieved on December 6, 2020, from https://www.ncbi.nlm.nih.gov/pubmed/28965775
Images:
1. Chia seeds are a good plant-based omega-3 source. Image by ValeriaLu from Pixabay (CCO license)
2. The heart and brain benefit from omega-3s in the diet. Image by GDJ from Pixabay (CCO license)
3. Flax seeds, the greatest plant-based food source of ALA omega-3s. Image by Pezibear from Pixabay (CCO license)