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Long Story Short: Americans Don’t Get Enough Omega-3s

Clinicians are strategically positioned to help patients address this nutrient gap

by Ashley Jordan Ferira, PhD, RDN

You may have heard that many Americans are not getting enough vitamin D, calcium, potassium, etc. from their diet. But do you think about omega-3s as a nutrient gap? You should. Research from the National Health and Nutrition Examination Survey (NHANES) demonstrates that> 90% of Americans are not meeting recommendations for omega-3 intake,with key differences observed in age, sex, and ethnicity subgroups.1

Although the cardiovascular benefits of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been demonstrated in observational and interventional studies,2-3 research clearly reveals that the majority of the US population is not meeting recommended levels for fish or omega-3 fatty acid intake.4 Aside from purified omega-3 supplements, the richest dietary source of EPA and DHA is oily fish, including salmon, mackerel, herring, lake trout, sardines, and albacore tuna.5

The American Heart Association (AHA) recommends:2

  • Heathy individuals: consume a variety of oily fish at least 2 servings per week, which provides about 500 mg/day of EPA + DHA
  • Patients with coronary heart disease (CHD): 1 g/day of combined EPA + DHA, from oily fish and/or fish oil supplementation in consultation with a physician
  • Patients needing triglyceride-lowering: 2 – 4 g/day of supplemental EPA + DHA under physician’s care

The present study investigated the long-chain omega-3 intake (EPA and DHA) across key age, sex, and ethnicity subgroups in the US.1 NHANES 2003-2008 data for 24,621 individuals was used, capturing EPA and DHA intake from both foods and supplements.

Study findings for long-chain omega-3 intake:

  • Over 90% of the US population consumed < 500 mg/day of EPA+DHA from food
  • Median intake from food was only 110 mg/day
  • For the top consumers, fish was the #1 dietary contributor
  • Men ≥ 20 years old had the highest intake
  • Children, women of childbearing age, pregnant women, and lactating women had the lowest intake
  • Mexican-Americans were the ethnicity with the lowest intake
  • Only 6.2% reported omega-3 supplement use, which did not significantly alter the median daily intake from food

Why is this Clinically Relevant?

  • EPA and DHA are heart-healthy, long-chain omega-3 fatty acids that are one of the most prevalent nutrient gaps in the US
  • Children, women of childbearing age, pregnant/lactating women, and Mexican Americans are subgroups consuming the lowest levels of EPA and DHA
  • Through targeted dietary and supplement recommendations, clinicians can help patients address their omega-3 “gap” and meet AHA guidelines


Link to abstract


  1. Richter CK, Bowen KJ. Total long-chain n-3 fatty acid intake and food sources in the United States compared to recommended intakes: NHANES 2003-2008. Lipids. 2017;52(11):917-927.
  2. Kris-Etherton PM Harris WS and Appel LJ for the American Heart Association Nutrition Committee (2002). Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease [published correction appears in Circulation 2003;107:512]. Circulation 106:2747–2757.
  3. Del Gobbo LC, Imamura F, Aslibekyan S, et al. ω-3 polyunsaturated fatty acid biomarkers and coronary heart disease: pooling project of 19 cohort studies. JAMA Intern Med. 2016;176(8):1155-1166.
  4. Papanikolaou Y, Brooks J. US adults are not meeting recommended levels for fish and omega-3 fatty acid intake: results on an analysis using observational data from NHANES 2003-2008. Nutr J. 2014;13:31.
  5. American Heart Association. Fish and omega-3 fatty acids. Accessed December 8, 2017.

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