OMEGA-3 and Women’s health

OMEGA-3 and Women’s health

“There are many well documented studies confirming the cardio-vascular benefits of omega-3s for both men and women. But there are many additional benefits that apply exclusively to women, such as reducing hot flushes during menopause, helping reduce osteoporosis and easing menstrual pain.”

Rafat-Abbasi
Rafat Abassi MD, Partner Columbia Fertility Associates, Washington DC. Clinical Assistant Professor, Department of Family Medicine, Georgetown University, Washington DC.

Omega-3 fatty acid supplements and women’s health

BY RAFAT ABBASI, MD – PARTNER, COLUMBIA FERTILITY ASSOCIATES. WASHINGTON DC. CLINICAL ASSISTANT PROFESSOR, DEPARTMENT OF FAMILY MEDICINE, GEORGETOWN UNIVERSITY HOSPITAL WASHINGTON DC.

Omega-3 fatty acids cannot be produced by the human body. They must be provided by the diet and by adding supplements. The most common essential fatty acids are Eicosapentaenoic acid (EPA), Docosahexaenoic acid (DHA) and Alpha linolenic acid (ALA) which is converted to EPA and DHA.

OMEGA-3 FATTY ACIDS IN MENOPAUSAL WOMEN

A. Heart Disease
As women age, their incidence of cardiovascular disease increases. In some studies, it has been shown to be equal to that of men in the same age group. This is due to the absence of the cardioprotective effect of estrogen. There are well documented studies confirming the benefits of Omega-3 fatty acids on the cardiovascular system. These include lowering of triglycerides, blood pressure, and plaque formation. Omega-3 fatty acids also prevent platelets from clumping together, thus decreasing the risk of strokes.

B. Hot flashes
One of the most common and troublesome effects of decreased estrogen production in menopause are hot flashes. In 2005, Italian scientists demonstrated a significant decrease in hot flashes and night sweats in patients who had been prescribed high doses of Omega-3 supplements. This is a result of the effect on the nerve cell membranes and the anti-inflammatory properties of the Omega-3 fatty acids.

C. Osteoporosis
Omega-3 fatty acids are known to improve bone strength and increase bone formation in older women.

D. Mood and age-related memory decline
Declining memory and cognitive function are some of the side effects of aging, but these are compounded by the estrogen deficient state in menopause. Omega-3 fatty acids have been shown to decrease this age-related decline as well as improve mood and depression. Higher intake of these supplements, in controlled studies, have been associated with positive moods.

OMEGA 3 FATTY ACIDS IN PRE-MENOPAUSAL WOMEN

A. Menstrual pain
Proinflammatory factors produced during menstruation cause increased menstrual cramps. High levels of Omega-3 supplements have been shown to be successful in alleviating menstrual pain.

B. Pre-menstrual Syndrome (PMS)
This is a monthly occurrence in some women that can be incapacitating. It affects about 40% of women, the combination of mood changes and pain has been shown to affect the quality of life in about 10% of women who suffer with PMS. A randomized, double blinded controlled trial published in 2012 (Sohrabi, N. et al). This showed the significant impact of high doses(2g) daily of omega-3 supplements within 45 days of starting the pills. Both the psychiatric and somatic symptoms were improved.

C. Polycystic ovary syndrome and Metabolic syndrome
Polycystic ovarian syndrome (PCOS) is associated with increased weight gain, increased androgen production and insulin resistance. Type II diabetes is found in about 25% of patients with PCOS. Haiianfar H et al in 2013, published a study showing the positive effect of Omega-3 supplements in decreasing insulin resistance and increasing the antioxidant capacity.

OMEGA-3 FATTY ACIDS IN REPRODUCTIVE AGED WOMEN

A. Improved egg and sperm quality
Omega-3 fatty acids can lower inflammation by reducing the production of inflammatory molecules such as eicosanoids and cytokines. Increased Omegs-3 intake preconception can improve egg quality, by reducing leptin levels. Sperm parameters are improved by reducing sperm DNA damage and increasing anti-oxidant levels.

B. Reduced risk of miscarriage
During pregnancy the maternal immune system coverts to a low inflammatory state. This allows a tolerogenic response allowing implantation to occur. Increased blood flow, improved vascular endothelial development and deceased inflammation have all been shown to occur with high doses of Omega-3 fatty acids.

C. Reduction in preterm birth
During pregnancy, omega-3 supplementation was associated with a significant reduction in early preterm birth (<34 weeks) and preterm birth. (<37 weeks). A Cochrane review of 70 controlled trials documented that fish oil supplementation reduced the risk for low birth infants and the risk of perinatal deaths. EPA and DHA play important roles in preventing pregnancy complications.[/et_pb_text][et_pb_text disabled_on="on|on|on" _builder_version="4.7.4" text_font="|300|||||||" text_font_size="12px" header_2_font="|300||on|||||" header_2_text_color="#ba1a19" header_2_font_size="24px" header_3_font="|||on|||||" header_3_text_color="#434444" header_3_font_size="16px" header_3_letter_spacing="2px" disabled="on"]

References

1. Østerud B, Elvevoll E, Barstad H, Brox J, Halvorsen H, Lia K, Olsen JO, Olsen RL, Sissener C, Rekdal O, et al. Effect of marine oils supplementation on coagulation and cellular activation in whole blood. Lipids. 1995; 30:1111-8.
2. Walquist MJ, Stormo SK, Østerud B, Elvevoll EO, Eilertsen KE. Cold-pressed minke whale oil reduces circulating LDL/VLDL-cholesterol, lipid oxidation and atherogenesis in apolipoprotein E-deficient mice fed a Western-type diet for 13 weeks. Nutr Metab (Lond). 2018; 15:35. doi: 10.1186/s12986-018-0269-8. eCollection 2018
3. Arnesen, H, Seljeflot, I. Studies on very long chain marine n-3 fatty acids in patients with atherosclerotic heart disease with special focus on mechanisms, dosage and formulas of supplementation. Cell Mol Biol 2010; 56:18–27.
4. Eilertsen KE, Mæhre HK, Cludts K, Olsen JO, Hoylaerts MF Dietary enrichment of apolipoprotein E-deficient mice with extra virgin olive oil in combination with seal oil inhibits atherogenesis. Lipids Health Dis. 2011;10:41. doi: 10.1186/1476-511X-10-41.
5. Akiba S, Murata T, Kitatani K, Sato T. Involvement of lipoxygenase pathway in docosapentaenoic acid-induced inhibition of platelet aggregation. Biol Pharm Bull. 2000; 23:1293-7.
6. Saber H, Yakoob MY, Shi P, Longstreth WT Jr, Lemaitre RN, Siscovick D, Rexrode KM, Willett WC, Mozaffarian D. Omega-3 Fatty Acids and Incident Ischemic Stroke and Its Atherothrombotic and Cardioembolic Subtypes in 3 US Cohorts. Stroke. 2017; 48:2678-2685.
7. Del Gobbo et al. -3 Polyunsaturated Fatty Acid Biomarkers and Coronary Heart Disease: Pooling Project of 19 Cohort Studies. JAMA Intern Med. 2016 Aug 1;176(8):1155-66. doi: 10.1001/jamainternmed.2016.2925. Erratum in: JAMA Intern Med. 2016; 176:1727-1728. JAMA Intern Med. 2016; 176:1728
8. Leng GC, Horrobin DF, Fowkes FG, Smith FB, Lowe GD, Donnan PT, Ells K. Plasma essential fatty acids, cigarette smoking, and dietary antioxidants in peripheral arterial disease. A population-based case-control study. Arterioscler Thromb. 1994; 14:471-478.
9. Mozaffarian D, Lemaitre RN, King IB, Song X, Huang H, Sacks FM, Rimm EB, Wang M, Siscovick DS Plasma phospholipid long-chain -3 fatty acids and total and cause-specific mortality in older adults: a cohort study. Ann Intern Med. 2013; 158: 515-25. doi: 10.7326/0003-4819-158-7-201304020-00003.
10. Yang ZH, Bando M, Sakurai T, Chen Y, Emma-Okon B, Wilhite B, Fukuda D, Vaisman B, Pryor M, Wakabayashi Y, Sampson M, Yu ZX, Sakurai A, Zarzour A, Miyahara H, Takeo J, Sakaue H, Sata M, Remaley AT Long-chain monounsaturated fatty acid-rich fish oil attenuates the development of atherosclerosis in mouse models. Mol Nutr Food Res. 2016; 60 :2208-2218. doi: 10.1002/mnfr.201600142.
11. Aung T, Halsey J, Kromhout D, Gerstein HC, Marchioli R, Tavazzi L, Geleijnse JM, Rauch B, Ness A, Galan P, Chew EY, Bosch J, Collins R, Lewington S, Armitage J, Clarke R; Omega-3 Treatment Trialists’ Collaboration. Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks: Meta-analysis of 10 Trials Involving 77917 Individuals. JAMA Cardiol. 2018; 3:225-234. doi: 10.1001/jamacardio.2017.5205.
12. Abdelhamid AS, Brown TJ, Brainard JS, Biswas P, Thorpe GC, Moore HJ, Deane KH, AlAbdulghafoor FK, Summerbell CD, Worthington HV, Song F, Hooper L. Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2018; 11:CD003177. doi 10.1002/14651858.CD003177.pub4
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