Health care costs associated with EPA and DHA omega-3s

Lucy Jones, RD12/21/16

A new study has shown that getting people aged 55 and over to regularly consume omega-3 supplements could save health care systems and providers in the EU a total of €12.9 billion a year1The study, commissioned by Food Supplements Europe (FSE) and carried out by Frost and Sullivan, is featured in a report called The Health Care Cost Savings of Omega-3 Food Supplements in the European Union1.

People aged 55 and over represent 157.6 million people or 31% of the total EU population. This age bracket of individuals is considered to be at a higher risk of developing cardiovascular disease (CVD), including heart attacks and strokes1. So much so, it is predicted that in the EU, 24 percent of people aged 55 and over (i.e., 38.4 million people) will experience a CVD-related hospital admission between 2016 and 2020. This is expected to cost as much as €1.328 trillion over this five-year period1.

The study demonstrates that increased consumption of the omega-3s EPA and DHA at a dose of 1000 mg daily could prevent 1.5 million cases of heart disease requiring hospital admission over the next five years. This would generate a savings of €64.5 billion – or €12.9 billion per year1. On an individual level, each person would reduce their risk of suffering a CVD-related event by almost 5% simply by taking 1000 mg of EPA and DHA every day. While the study recognizes that up to 20% of people over 55 are already taking omega-3 supplements1, this still leaves the vast majority falling short of the critically important nutrient.

In Europe, EPA and DHA omega-3s have approved health claims for reducing blood pressure2, reducing triglycerides (a type of blood fat)2, and overall heart function3.

Omega-3 fatty acids are essential nutrients for health. Humans can’t make omega-3 fatty acids at optimal levels, therefore we must consume them in our daily diet. While we are able to convert the shorter chain omega-3 ALA, found in plants such as flax and chia, into the important long chain omega-3s EPA and DHA4, studies have shown we are not particularly good at it. Studies show conversion rates of ALA to EPA and DHA to be so minimal that only 0.01% to 8% of ALA is able to convert to EPA and even less converts to DHA .4, 5 Because of the poor conversion rate, food or supplemental sources of EPA and DHA are essential for meeting our nutritional needs.

Unfortunately, as well as being very important, the food sources of these two nutrients are also pretty restricted. EPA and DHA are only found in oily fish and other marine sources like algae and as such, intakes tend to be wholly dependent on a person’s consumption of oily fish, which includes salmon, fresh tuna, mackerel, sardines, trout and herring.

Intake of oily fish is typically much lower than the recommend intakes. In the UK, for example, intake of oily fish is woefully low with the average adult in the UK eating only 56 g per week6, or just over a third of a portion (140 g)6, leaving us a long way behind in achieving the benefits for heart health.

This means that supplements have an important role to play in helping people to achieve intakes that support overall heart health. People should feel reassured that omega-3 supplements are safe. In fact, the European Food Safety Authority (EFSA) has assessed the safety of these fatty acids at high levels and found that supplemental intakes of EPA and DHA (including algae-based supplements) combined at doses up to 5 g/day, and supplemental intakes of EPA alone up to 1.8 g/day, do not raise any safety concerns for adults7. With big potential gains and minimal risks, omega-3 supplements are quite often at the top of my recommendation list.

References

1. Shanahan C (2016) Healthcare Cost savings of omega 3 food supplements in the European Union. Frost and Sullivan.

2. EFSA Panel on Dietetic Products, Nutrition and Allergies (2009) Scientific Opinion on the substantiation of health claims related to EPA, DHA, DPA and maintenance of normal blood pressure (ID 502), maintenance of normal HDL-cholesterol concentrations (ID 515), maintenance of normal (fasting) blood concentrations of triglycerides (ID 517), maintenance of normal LDL-cholesterol concentrations (ID 528, 698) and maintenance of joints (ID 503, 505, 507, 511, 518, 524, 526, 535, 537) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal vol 7(9):1263 [26 pp.].

3.  EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) (2010)  Scientific Opinion on the substantiation of health claims related to eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), docosapentaenoic acid (DPA) and maintenance of normal cardiac function (ID 504, 506, 516, 527, 538, 703, 1128, 1317, 1324, 1325), maintenance of normal blood glucose concentrations (ID 566), maintenance of normal blood pressure (ID 506, 516, 703, 1317, 1324), maintenance of normal blood HDL-cholesterol concentrations (ID 506), maintenance of normal (fasting) blood concentrations of triglycerides (ID 506, 527, 538, 1317, 1324, 1325), maintenance of normal blood LDL-cholesterol concentrations (ID 527, 538, 1317, 1325, 4689), protection of the skin from photo-oxidative (UV-induced) damage (ID 530), improved absorption of EPA and DHA (ID 522, 523), contribution to the normal function of the immune system by decreasing the levels of eicosanoids, arachidonic acid-derived mediators and pro-inflammatory cytokines (ID 520, 2914), and “immunomodulating agent” (4690) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal vol 8(10):1796. [32 pp.].

4. Brenna JT. Efficiency of conversion of alpha-linolenic acid to long chain n-3 fatty acids in man. Curr Opin Clin Nutr Metab Care. 2002;5:127–132.

5. Plourde M, Cunnane SC. Extremely limited synthesis of long chain polyunsaturates in adults: implications for their dietary essentiality and use as supplements. Appl Physiol Nutr Metab. 2007;32:619–634.

6.  Public Health England (2016) National Diet and Nutrition Survey results from years 5 and 6 combined of the rolling programme for 2012 and 2013 to 2013 and 2014: report. Accessed from https://www.gov.uk/government/statistics/ndns-results-from-years-5-and-6-combined Last accessed: 31st October 2016

7.  EFSA Panel on Dietetic Products, Nutrition and Allergies (2012) Scientific Opinion on the Tolerable Upper Intake Level of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and docosapentaenoic acid (DPA). EFSA Journal. Vol 10(7):2815 [48 pp.].

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