Medically Verified By: Dr Vithal Bagi
One of the common questions that patients would raise is whether being a vegetarian means that one would be deprived of valuable nutrients. Omega-3 fatty acids are one of the concerns. The fats are necessary because of their ability to maintain heart rhythm and triglycerides, development of the brain and eyes, mood regulation and control of inflammation, among others.
Speaking to Dr Vithal Bagi, Cardiologist, Bengaluru, he said, "The most common sources of EPA and DHA, which are biologically active forms of omega-3 and are used by the heart, brain and eyes, are found in fatty fish and marine microalgae. Notably, the fatty fish like sardines, mackerel, and salmon or algae are the only ones that have significant levels of EPA and DHA. Even non-vegetarians who include chicken, eggs, or lean fish in their diet and who do not consume fatty fish regularly can be deficient in omega-3 as vegetarians. In that regard, omega-3 deficiency is not only a vegetarian problem but also a contemporary dietary problem."
The Omega-3 fats exist in three forms. Plant foods that contain ALA include flaxseeds, chia seeds, walnuts, and mustard oil. The long-chain fats, EPA and DHA, are consumed directly by the heart, brain and eye. Fish do not produce their omega-3s they receive them through algae.
ALA is a nutritionally essential omega-3 fatty acid, as the body is unable to synthesise it. The EPA and DHA are not technically vital as they are synthesised by converting ALA to them but in humans this conversion is restricted and highly variable.
One of the main factors that have contributed to this is through enzyme competition. The enzymes involved in the transformation of omega-3 (ALA to EPA/DHA) are also the ones involved in the transformation of fats of omega-6. The Indian diets of today are usually excessively rich in omega-6 due to the intensive use of sunflower, safflower, and soybean oils. In case of high levels of omega-6, these enzymes are diverted towards the omega-6 pathway and little ability remains to convert ALA into EPA and DHA. This is the reason why one may not just eat flaxseeds.
With vegetarians of the non-fatty fish-eating kind, there must be two tactics combined:
The ratio of omega-6 to omega-3 is as significant as the intake of omega-6 and omega-3. A decreased ratio enables more efficient ALA to be converted to EPA and DHA and less inflammatory signalling.
Despite proper dietary practices, some groups are prone to be low on omega-3 such as pregnant and lactating women, the elderly, individuals with heart disease, diabetes, elevated triglycerides, dry eye, arthritis, depressed mood, or cognitive issues. Omega-3 supplementation is usually helpful to these people.
Non-vegetarians and vegetarians who do not consume fatty fish ought to use directly-sourced algal oil as the source of EPA and DHA and avoid the conversion and shelfability issues associated with fish and krill oils. Capsules of flaxseed oil contain only ALA and require still small amounts of enzyme conversion.
To promote health in general adults, the doctor recommends an intake of 250-500 mg of EPA + DHA per day in addition to ALA in food. Only medical supervision should be used in cases of people on blood thinners when taking higher doses.
One should also bear in mind that supplements cannot substitute a healthy diet. Whole foods contain fibre, antioxidants and phytochemicals which are not found in capsules. The most basic interventions such as adding ground flaxseed to roti dough or curd, consuming a handful of walnuts and evening out cooking oils, can go an extra mile in improving omega-3 status and metabolic health as a whole.
In short, omega-3 deficiency is widespread in vegetarians as well as non-vegetarians who lack the consumption of fatty fish. To optimise intake, it is necessary to reduce omega-6, consume ALA-rich vegetable foods, and, as prescribed by a doctor, EPA/DHA supplements made of algae should be used sustainably.
