Abstract
Scientific societies recommend increasing intake of docosahexaenoic acid (DHA) by 200 mg/day during pregnancy. However, individually, clinical events correlate quite strongly with levels of eicosapentaenoic acid (EPA) and DHA in blood, but these levels poorly correlate with amounts ingested. EPA and DHA in erythrocytes (Omega-3 Index) have a low biologic variability. If analyzed with a standardized analytical procedure (HS-Omega-3 Index®), analytical variability is low. Thus, the largest database of any fatty acid analytical method was provided. Pregnant women in Germany had a mean Omega-3 Index below the target range suggested for cardiovascular disease of 8–11%, with large interindividual variation, and quite independent of supplementation with EPA and DHA. In Germany, premature birth is a major health issue. Premature birth and other health issues of pregnant women and their offspring correlate with levels of EPA and DHA in blood and can be reduced by increasing intake of EPA and DHA, according to individual trials and pertinent meta-analyses. Very high intake or levels of EPA and DHA may also produce health issues, like bleeding, prolonged gestation, or even premature birth. While direct evidence remains to be generated, evidence from various scientific approaches supports that the target range for the Omega-3 Index of 8–11% might also pertain to pregnancy and lactation.
Highlights
In many countries, pregnant women or women of child-bearing age rarely consume foods suitable as sources for the long-chain Omega-3 fatty acids eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA) [1,2,3,4]
Premature birth and other health issues of pregnant women and their offspring correlate with levels of EPA and DHA
The percentage of EPA and DHA of a total of 26 fatty acids measured in erythrocytes (Omega-3 Index) is a long-term parameter, has a low biologic variability, and correlates with EPA and DHA in tissue [17,23]
Summary
Pregnant women or women of child-bearing age rarely consume foods suitable as sources for the long-chain Omega-3 fatty acids eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA) [1,2,3,4]. Vegetarian and vegan pregnant women have low plasma levels of EPA and DHA [5] Against this background, many authoritative bodies and expert scientific organizations recommended that pregnant women consume an extra 200 mg/day DHA, for example, as fatty fish from the sea once a week [7,8,9]. The percentage of EPA and DHA of a total of 26 fatty acids measured in erythrocytes (Omega-3 Index) is a long-term parameter, has a low biologic variability, and correlates with EPA and DHA in tissue [17,23]. Among these tools are placebo-controlled intervention trials using a uniform dose without determining baseline and on trial levels of EPA and DHA, and their pertinent meta-analyses. To define the necessary intake of EPA and DHA, not a dose but a target Omega-3 Index is decisive
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