Total Long‐Chain n‐3 Fatty Acid Intake and Food Sources in the United States Compared to Recommended Intakes: NHANES 2003–2008

Abstract

The American Heart Association recommends consuming fish (particularly oily fish) at least two times per week, which would provide ≈ 0.5 g/day of eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA) for cardiovascular disease risk reduction. Previous analyses indicate that this recommendation is not being met; however, few studies have assessed different ethnicities, subpopulations requiring additional n-3 fatty acid intake (i.e., children and pregnant and/or lactating women), or deciles of intake. Data from the National Health and Nutrition Examination Survey 2003-2008 was used to assess n-3 fatty acid intake from foods and supplements in the US population, according to age, sex, and ethnicity. A unique "EPA equivalents" factor, which accounts for potential conversion of shorter-chain n-3 fatty acids, was used to calculate total long-chain n-3 fatty acid intake. Data are reported for 24,621 individuals. More than 90% consumed less than the recommended 0.5 g/day from food sources (median = 0.11 g/day; mean = 0.17 g/day). Among the top 15% of n-3 fatty acid consumers, fish was the largest dietary contributor (71.2%). Intake was highest in men aged 20 years or more, and lowest in children and women who are or may become pregnant and/or are lactating. Among ethnicities, intake was lowest in Mexican-Americans. Only 6.2% of the total population reported n-3 fatty acid supplement use, and this did not alter median daily intake. Additional strategies are needed to increase awareness of health benefits (particularly among Mexican-Americans and women of childbearing age) and promote consumption of oily fish or alternative dietary sources to meet current recommendations.

n‐3 Docosapentaenoic Acid Intake and Relationship with Plasma Long‐Chain n‐3 Fatty Acid Concentrations in the United States: NHANES 2003–2014

“…Similar to previous findings for EPA and DHA in this population (Thompson et al, ), DPA intake was lower in women and younger age groups (<19 years), even when adjusting for differences in caloric needs between age groups. This pattern of DPA intake was also found in Norway (Johansson et al, ) and similar trends have been reported for EPA and DHA (Papanikolaou et al, ; Richter et al, ; Thompson et al, ). These differences may have implications for dietary recommendations and should be further explored.…”

“…Based on these potential health benefits, it is important to assess the usual DPA intake of the US population compared to habitual EPA and DHA intakes. The majority of the population in the United States (US) consume far less than the recommended amount of EPA and DHA (Papanikolaou et al, 2014;Richter et al, 2017; U.S. Department of Agriculture, Agricultural Research Service, 2014a; Zhang et al, 2018). For instance, an analysis of National Health and Nutrition Examination Survey (NHANES) data (2003)(2004)(2005)(2006)(2007)(2008) found that in US adults the mean intake of EPA and DHA from foods was 20 and 60 mg/day, and 40 and 70 mg/day when accounting for foods plus supplements (Papanikolaou et al, 2014).…”

“…We previously reported that the mean total n-3 fatty acid intake (including EPA, DHA, and EPA-equivalents accounting for potential conversion of alpha-linolenic acid and stearidonic acid) was 170 mg/day (NHANES 2003(NHANES -2008 (Richter et al, 2017). Even when accounting for the potential endogenous, albeit limited, conversion of shorter-chain plant-based n-3 fatty acids, over 90% of the study population (n = 24,621) consumed less than the recommended 500 mg/day (Richter et al, 2017). A recent analysis that included the most current NHANES cycles (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014) also found similarly inadequate EPA and DHA intake (Thompson et al, 2019).…”

Projected Long‐Chain n‐3 Fatty Acid Intake Post‐Replacement of Vegetables Oils with Stearidonic Acid‐Modified Varieties: Results from a National Health and Nutrition Examination Survey 2003–2008 Analysis

“…Data from Richter et al reproduced with permission for direct comparison with the two oil replacement scenarios (Richter et al, ).…”

“…In particular, median intakes were the lowest among Mexican Americans (0.09 g/day) and groups with higher EPA and DHA requirements (e.g. children [0.06–0.09 g/day] and women who were pregnant/lactating or of childbearing age [0.09–0.11 g/day]) (Richter et al, ).…”