Omega-3 (EPA and DHA)
The essential fatty acids with most cardiovascular, neurological, and anti-inflammatory evidence
Definition
The omega-3 fatty acids EPA (eicosapentaenoic) and DHA (docosahexaenoic) are long-chain polyunsaturated fatty acids essential for human health because the body cannot efficiently synthesise them. EPA has predominant anti-inflammatory and cardiovascular effects; DHA is the main structural fatty acid of the brain and retina (representing 40% of the brain's lipid weight). Main sources are oily fish (sardines, mackerel, anchovies, wild salmon) and marine algae (Schizochytrium, a complete plant source).
Detailed explanation
The omega-3 index (percentage of EPA+DHA in erythrocytes) is one of the most underrated longevity biomarkers. Optimal values >8% are associated with the lowest all-cause mortality in population studies (Harris 2018, J Clin Lipidol). In the Western population the average is 4-5%, well below traditional populations with Mediterranean or Arctic diets.
Clinical evidence: Cardiovascular: the REDUCE-IT trial (2018, NEJM, 8,179 patients) showed that 4 g/day of pure EPA (icosapent ethyl, Vascepa) reduced major cardiovascular events by 25% in patients with high triglycerides. Cognition: the MIDAS study (2010) showed improved episodic memory with 900 mg/day DHA for 6 months in older adults. Inflammation: consistent reduction of IL-6, TNF-α, hsCRP. Mental health: meta-analyses show antidepressant effect of EPA-predominant (EPA:DHA ratio >2:1, dose ≥1 g/day). Eye health: protects against macular degeneration and dry eye.
Protocols: 2-4 g/day combined EPA+DHA from high-quality sources. Verify oxidation with TOTOX index <10 (IFOS-certified brands are the most rigorous). In vegetarians/vegans, algae oil (DHA-predominant) at equivalent doses. ALA conversion (flaxseed, chia, walnut) to EPA/DHA is only 5-10%, insufficient for therapeutic use.
Monitoring: omega-3 index (erythrocytes) every 6-12 months. Available in Spain through OmegaQuant via several private laboratories.
Scientific sources
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