HONOLULU, HAWAII. Dr. Joseph Pepping, a consulting pharmacist at the Kaiser Permanente, provides a comprehensive review of the many benefits of omega-3 fatty acids and their derivatives, including EPA and DHA.
Fish Oils and EPA and DHA
He cites evidence that eicosapentaenoic acid and docosahexaenoic acid (EPA and DHA, respectfully) which are found in fish oils are helpful in the prevention and treatment of cardiovascular disease, arrhythmias, diabetes, breast cancer, and arthritis. While EPA is readily synthesized in the body from alpha-linolenic acid (found in flaxseed oil), Dr. Pepping states that the synthesis of DHA is much more difficult than EPA, and DHA must be obtained directly from fish, certain algae or green, leafy vegetables. He also points out that the body’s optimal balance between omega-6 (linoleic) and omega-3 (linolenic) fatty acids is a 2:1 to 4:1 ratio. Unfortunately, the typical Western diet contains these acids in ratios of 20:1 to 25:1. An excess of omega-6 fatty acids can lead to formation of blood clots, allergic and inflammatory disorders, and the accelerated growth of certain cancer cells. Dr. Pepping recommends two servings of cold-water fish (e.g. salmon, mackerel or herring) per week, 2-4 grams of fish oil capsules (which contain both EPA and DHA) per day or 15-30 ml of flaxseed oil (which contains alpha-linolenic acid [ALA]) per day as a preventive measure. He points out that it is important to add 200 IU of vitamin E to the daily diet if supplementing with fish oils. He also advises caution regarding fish oil supplementation in patients taking warfarin, heparin, low-molecular weight heparin, ticlopidine or clopidogrel.
Pepping, Joseph. Omega-3 essential fatty acids. American Journal of Health-System Pharmacy, Vol. 56, April 15, 1999, pp. 719-24