TABLE 1-1 Summary of American Heart Association Recommendations for Omega-3 Fatty Acid Intakea



Patients without documented coronary heart disease (CHD)

Eat a variety of (preferably fatty) fish at least twice a week. Include oils and foods rich in alpha-linolenic acid (flaxseed, canola, and soybean oils; flaxseed and walnuts).

Patients with documented CHD

Consume about 1 g of EPA+DHA per day, preferably from fatty fish. EPA+DHA supplements could be considered in consultation with the physician.

Patients who need to lower triglycerides

2 to 4 g of EPA+DHA per day provided as capsules under a physician’s care.

aPatients taking more than 3 g of omega-3 fatty acids from supplements should do so only under a physician’s care. High intakes could cause excessive bleeding in some people.

SOURCE: AHA, 2005.

in 2000 (Krauss et al., 2000). The AHA recommendations are aimed at reducing risk for cardiovascular disease by altering dietary and lifestyle factors among the general population, although there are individualized approaches for specific subgroups with medical concerns such as lipid disorders and diabetes. The AHA dietary guidelines include a recommendation that healthy adults eat fish at least twice a week. Altogether, the AHA has three recommended intake levels for EPA and DHA, corresponding to research findings on associations between EPA/DHA intake and cardiac risk reduction. The AHA (2005) recommendations, posted on its website (Source:, are shown in Table 1-1.

The basis for the AHA recommendations is research suggesting that adopting healthy food habits that include eating two 3-ounce servings of seafood per week can help reduce three major risk factors for heart attack—high blood cholesterol, high blood pressure, and excess body weight (see Chapter 3 for discussion). Reducing blood pressure may also help reduce the major risk factors for stroke. Recognizing the importance of primary prevention, i.e., preventing the development of cardiovascular risk factors before symptoms arise, the American Heart Association also endorses the recommendation that children aged 2 years and above increase consumption of “oily” fish prepared by broiling or baking (Gidding et al., 2005).

The American Dietetic Association

The American Dietetic Association and the Dietitians of Canada (ADA, 2003) published a position paper on vegetarian diets that addressed inclusion of omega-3 fatty acids. Vegetarian diets, which are rich in omega-6

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