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Global Recommendations for EPA and DHA Intake (Rev 16 April 2014)

Country/Region

Organization

Org. Type

Target Population

Recommendation

Global

World Health Organization (WHO)1

Authoritative Body

General adult population

  • n-3 PUFAs: 1-2% ofenergy/day

Food and Agriculture Organization of the United Nations (FAO)2

Authoritative Body

0-6 months

§    DHA: 0.1-.018%E

6-24 months

  • DHA: 10-12 mg/kgbw

2-4 years

§    EPA + DHA: 100-150 mg

4-6 years

§    EPA + DHA: 150-200 mg

6-10 years

§    EPA + DHA: 200-250 mg

Pregnant/Lactating Women

  • EPA + DHA: 0.3 g/d of whichat least should be 0.2g/d

International Society for the Study of Fatty Acids and Lipids (ISSFAL)

Expert Scientific Organization

General adult population for cardiovascular health3

  • at least 500 mg/day ofEPA+DHA

Pregnant/Lactating Women4

  • DHA: 200mg/day

NATO Workshop on w-3 and w-6 Fatty Acids5

Workshop

General Adult Population

  • 300-400 mgEPA+DHA/day

World Association of Perinatal Medicine6

Working Group

Pregnant and Lactating Women

  • 200 mg DHA/day

Infants, when breastfeeding is not possible

 

World Gastroenterology Organisation7

Expert Scientific Organization

General Adult Population

  • 3-5 servings/wk offish

Australia

National Heart Foundation of Australia8

Expert Scientific Organization

General adult population to lower risk of CHD

  • 500 mg EPA + DHA per day, obtained through fish, fish oil capsules, or enriched foods& drinks

Patients with documented CHD

  • 1000 mg EPA + DHA per day, obtained through fish, fish oil capsules, or enriched foods& drinks

Patients with hypertriglyceridemia

  • 1200mg of EPA + DHA perday, obtained through fish, fishoil


Country/Region

Organization

Org. Type

Target Population

Recommendation

       

capsules or enriched foods & drinks as first-line therapy

  • Increase to 4000 mg of EPA +DHA per day, asneeded.

Australian & New Zealand Health Authorities (Department of Health & Ageing, National Health & Medical Research Council)9

Authoritative Bodies

Infants (0-12 mo)

 

Boys & Girls (1-3 yrs)

  • 40 mg total LC n-3 (DHA+EPA+DPA) / dayadequate intake

Boys & Girls (4-8 yrs)

  • 55 mg total LC n-3 (DHA+EPA+DPA) / dayadequate intake

Boys & Girls (9-13 yrs)

  • 70 mg total LC n-3 (DHA+EPA+DPA) / dayadequate intake

Boys (14-18 yrs)

  • 125 mg total LC n-3 (DHA+EPA+DPA) / dayadequate intake

Girls (14-18 yrs)

  • 85 mg total LC n-3 (DHA+EPA+DPA) / dayadequate intake

Men (19+ yrs)

  • 160 mg total LC n-3 (DHA+EPA+DPA) perday adequateintake

Women (19+ yrs)

  • 90 mg total LC n-3 (DHA+EPA+DPA) / dayadequate intake

Pregnancy (14 -18 yrs)

  • 110 mg total LC n-3 (DHA+EPA+DPA) /day

Pregnancy (19-50 yrs)

  • 115 mg total LC n-3 (DHA+EPA+DPA) /day

Lactating (14-18 yrs)

  • 140 mg LC n-3 (DHA+EPA+DPA)/ day


Country/Region

Organization

Org. Type

Target Population

Recommendation

     

Lactating (19-50 yrs)

  • 145 mg LC n-3 (DHA+EPA+DPA)/ day

Men-Suggested dietary target to reduce chronic disease risk

  • 610mg LC n-3 (DHA+EPA+DPA) / day

Women-Suggested dietary target to reduce chronic disease risk

  • 430mg LC n-3 (DHA+EPA+DPA) / day

Defence Science and Technology Organisation, Australian Government Department of Defence10

Authoritative Body

Male soldiers

  • 610mg EPA+DPA+DHA/day

Female soldiers

  • 430mg EPA+DPA+DHA /day

Europe

Expert Workshop of the European Academy of Nutritional Sciences11

Expert Scientific Organization

General Adult Population

  • People who do not eat fish should consider obtaining 200mg EPA + DHA from othersources

European Food Safety Authority12

Authoritative Body

General Adult Population

  • 250mg EPA+DHA/day

Pregnant & Lactating Women

  • 100-200 mg DHA / day in addition to general adult requirements

Children 7-24 months

  • 100 mg DHA /day

Children 2-18 years

  • 250mg EPA+DHA/day

The PeriLip and EARNEST projects of the European Commission4

Expert Scientific Organization

Pregnant & Lactating Women

  • 200mgDHA/day

Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical

Practice (constituted by representatives of nine societies and by invited experts)13

Expert Scientific Organization

General Adult Population for Cardiovascular Disease Risk Reduction

  • Fish at least twice a week, oneof

which to be oily fish.

Task Force on

Expert

 
  • Increase consumption ofomega-


Country/Region

Organization

Org. Type

Target Population

Recommendation

 

the Management of ST-

Segment Elevation Acute Myocardial Infarction of

the European Society of Cardiology14

Scientific Organization

 

3 fatty acid (oily fish)

  • Supplementation with 1 g of fish oil in patients with a low intake of oilyfish

Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS)15

Expert Scientific Organization

General Adult Population for Cardiovascular Disease Risk Reduction

  • At least two or three portions of fish perweek

Secondary prevention of CVD

  • 1 g/day n-3 unsaturated fats, which is not easy to derive exclusively from natural food sources, and use ofnutraceutical and/or pharmacological supplements may beconsidered

France

AFFSA16

Authoritative Body

General Adult Population

  • 500 mg EPA + DHA /day
  • 250 mg EPA /day
  • 250 mg DHA /day

Metabolic Syndrome- Diabetes-Obesity Risk Reduction

  • 500 mg EPA + DHA /day

Cardiovascular Risk Reduction

  • 500-750 mg EPA + DHA /day

Breast & Colon Cancer Risk Reduction

  • 500 mg EPA + DHA /day

Neuropsychiatric Risk Reduction

  • >200-300 mg EPA + DHA /day

Age-Related Macular Degeneration Risk Reduction

  • 500 mg EPA + DHA /day

Infants (0-6 months)

  • EPA <DHA


Country/Region

Organization

Org. Type

Target Population

Recommendation

     

Infants & Toddlers (6 months to 3 years)

  • 70mg DHA/day

Children (3-9 years)

  • 125mg DHA/day
  • 250mg EPA+DHA/day

Adolescents (9 to 18 years)

  • 250mg DHA/day
  • 250mg EPA+DHA/day

Pregnant & Lactating Women

  • 250mg DHA/day
  • 250mg EPA+DHAday

Austria

Austrian Society for Nutrition17

Expert Scientific Organization

General adult population

  • 250mg LCPUFA / day for primary prevention ofCVD

General adult population

 

CHD Patients

  • 1g LCPUFA / day for secondary prevention ofCVD

Pregnant & nursing women

  • At least 200mg DHA /day

Germany

German Society for Nutrition17

Expert Scientific Organization

General adult population

  • 250mg LCPUFA / day for primary prevention ofCVD

General adult population

 

CHD Patients

  • 1g LCPUFA / day for secondary prevention ofCVD

Pregnant & nursing women

  • At least 200mg DHA /day

Healthy Start - Young Family Network25, 45, 57

Expert Scientific Organization

Pregnant women

  • to supply the recommended 200mg/day of DHA, consume 2 servings/wk of marine fish, including at least one serving of fatty sea fish (such asmackerel, Herring, sardines,salmon)
  • pregnant women who do not regularly consume fish, the useof supplements with the Omega-3 fatty acid DHA isrecommended

Switzerland

Swiss Society for Nutrition Research

Expert

General adult population

  • 250mg LCPUFA / day forprimary


Country/Region

Organization

Org. Type

Target Population

Recommendation

 

/ Swiss Nutrition Association17

Scientific Organization

 

prevention of CVD

General adult population

 

CHD Patients

  • 1g LCPUFA / day for secondary prevention ofCVD

Pregnant & nursing women

  • At least 200mg DHA /day

Belgium

Superior Health Council of Belgium18

Authoritative Body

Pregnant & nursing women

  • 250mg DHA /day

General adult population (primary cardioprevention)

  • Two servings of fattyfish/wk

secondary cardioprevention

  • 1g EPA+DHA perday

Netherlands

Health Council of the Netherlands

Authoritative Body

0-5 months19

§

  • DHA: 20mg/kg/day

6-11 months19

  • N-3 fatty acids from fish: 15-20 mg/kg/day

1-18 years old19

  • N-3 fatty acids from fish: 15-20 mg/kg/day

19 years +19

  • N-3 fatty acids from fish: 20 mg/kg/day

Pregnant women19

  • N-3 fatty acids from fish: 20 mg/kg/day

Lactating women19

  • N-3 fatty acids form fish: 20 mg/kg/day

Adults20

  • n-3 fatty acids from fish: 450 mg/day

Scandinavia

Nordic Council of Ministers21

Authoritative Body

6-11 months

  • n-3 fatty acids shouldcontribute at least 1E%

12-23 months

  • n-3 fatty acids shouldcontribute at least 0.5E%

Adults and children from 2 yrs of age

  • n-3 fatty acids shouldcontribute at least 1.0E%

Pregnant & Lactating Women

  • 1 E% from n-3 fatty acids of which 200 mg/d should beDHA

United Kingdom

British Nutrition Foundation22

Expert

Adults, 19-50 yrs

 


Country/Region

Organization

Org. Type

Target Population

Recommendation

   

Scientific Organization

 

fish per week, which will provide around 2-3g of the very long chain n-3 fatty acids

  • weekly intake of 1.5g of EPA+ DHA

Committee on Medical Aspects of Food Policy (COMA)23

Authoritative Body

Adults

  • at least two portions of fish, of which one should be oily,weekly
  • n-3 PUFA intake: 0.2g/day

Scientific Advisory Committee on Nutrition (SACN)24

Authoritative Body

Adults

  • at least two portions of fish, of which one should be oily,weekly
  • n-3 PUFA intake: 0.45g/day

National Institute for Health and Clinical Excellence (May 2008)26

Authoritative Body

People at high risk of or with CVD

  • consume at least two portions of fish per week, including aportion of oilyfish

Joint British Societies27

Expert Scientific Organization

General Adult Population

  • Regular intake of fish and other sources of omega 3 fatty acids (at least two servings of fish per week)

Irish Heart Foundation54

Expert Scientific Organization

General Adult Population

  • 200 mg/day long-chain fattyacids

National Collaborating Center for Primary Care28

Expert Scientific Organization

General Adult Population

  • At least two servings of omega-3 fatty acid containing fish per week

People with Established CVD

  • At least two servings of omega-3 fatty acid containing fish per weekweek)

Italy

Italian Ministry of Health52

Authoritative Body

Pregnant and Nursing Women

  • Vegan women shouldconsume foods rich inDHA

Spain

Spanish Society of Intensive Care Medicine and Coronary Units and Spanish Society of Parenteral and Enteral Nutrition29

Expert Scientific Organization

Individuals with acute coronary syndrome and patients with chronic heart failure

  • Administration of 1 g/day of omega-3 (EPA+DHA) in theform of fish oil can prevent sudden death in the treatment ofacute


Country/Region

Organization

Org. Type

Target Population

Recommendation

       

coronary syndrome and can also help to reduce hospital admission for cardiovascular events in patients with chronic heart failure

Spanish Society of Intensive Care Medicine and Coronary Units and Spanish Society of Parenteral and Enteral Nutrition30

Expert Scientific Organization

patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS)

  • An enteral diet enriched withω-3 diet fatty acids may have a beneficialeffects

Brazil

Brazilian Society of Cardiology31

Expert Scientific Organization

Patients with coronary artery disease

  • supplementation of 1 g / day of omega-3 (EPA + DHA)capsules

United States

Institute of Medicine32

Authoritative Body

Boys & Girls 1-3 yrs

  • ALA: 0.7 g/day of which ~ 10% EPA+DHA

Boys & Girls 4-8 yrs

  • ALA: 0.9 g/day of which ~ 10% EPA+DHA

Boys 9-13 yrs

  • ALA: 1.2 g/day of which ~ 10% EPA+DHA

Boys 14-18 yrs

  • ALA: 1.6 g/day of which ~ 10% EPA+DHA

Girls 9-13 yrs

  • ALA: 1.0 g/day of which ~ 10% EPA+DHA

Girls 14-18 yrs

  • ALA: 1.1 g/day of which ~ 10% EPA+DHA

Adult men ³ 19 yrs

  • ALA: 1.6 g/day of which ~ 10% EPA+DHA

Adult women ³ 19 yrs

  • ALA: 1.1 g/day of which ~ 10% EPA+DHA

American Diabetes Association55

Expert Scientific Organization

Individuals with diabetes

Eat fish (particularly fatty fish) at least two times (two servings) per week.

       


Country/Region

Organization

Org. Type

Target Population

Recommendation

 

Academy of Nutrition and Dietetics (formerly American Dietetics Association)

Expert Scientific Organization

General Adult Population56

  • 500 mg EPA+DHA perday

Varied53

Those with increased requirements (e.g., pregnant and lactating women or those with diseases associated with poor essential fatty acid status) or those at risk for poor conversion (e.g., people with diabetes) may benefit from direct sources of long- chain n-3 fatty acids, such as DHA- rich microalgae

March of Dimes34

Expert Scientific Organization

Pregnant and Nursing Women

  • 200 mgDHA/day

National Heart, Lung, and Blood Institute, National Cholesterol Education Program35

Authoritative Body

Persons with CHD or multiple risk factors for CHD

  • Supported AHA recommendation to include fish as part of a CHD risk reduction diet. Higherdietary intakes of n-3 PUFAs are an option for reducing CHDrisk

Omega-3 Fatty Acids Subcommittee, assembled by the Committee on Research on Psychiatric Treatments of the American Psychiatric Association (APA)36

Expert Scientific Organization

Adults

  • Eat fish >/=2X/wk

Patients with mood, impulse control, or psychotic disorders

  • 1 g EPA + DHA /day

American Heart Association

Expert Scientific Organization

All adults without CHD37

  • Eat fish (particularly fatty fish)at least two times a week; include oils and foods rich inALA

General adult population58

  • Fish with 500 mg or more of EPA+DHA per 85 g (3 oz cooked) can apply for the AHA Heart- Check food certification program atheartcheckmark.org.

Patients with CHD37

  • Consume approximately 1 g/day of EPA+DHA preferably fromoily


Country/Region

Organization

Org. Type

Target Population

Recommendation

       

fish. EPA+DHA supplements could be considered in consultation with the physician

Patients with high triglycerides37

  • 2-4 g/day EPA+DHA ascapsules under a physician’scare

Patients with high triglycerides51

  • …increasing consumption of marine-based omega-3 products,…, will further optimize triglyceride-loweringefforts.

Cardiovascular Disease Risk Reduction in Women38

  • Consume fish, especially oilyfish, at least twice aweek
  • Consumption of omega-3 fatty acids in the form of fish or in capsule form may be considered in women with hypercholesterolemia and/or hypertriglyceridemia for primary and secondaryprevention

Patients with Coronary and Other Atherosclerotic Vascular Disease39

  • For all patients, it may be reasonable to recommend omega-3 fatty acids from fish or fish oil capsules (1 g/d) for CVD riskreduction


Country/Region

Organization

Org. Type

Target Population

Recommendation

 

U.S. Dept of Agriculture and U.S. Department of Health and Human Services40

Authoritative Body

General adult population

  • Increase the amount andvariety of seafood consumed by choosing seafood in place of some meat andpoultry

Pregnant or breastfeeding women

  • consume at least 8 and up to12 ounces of a variety of seafood perweek

Executive Office of the President50

Authoritative Body

General population

  • Dietary Guidelines and Food Guide Pyramid should be revised to emphasize the benefits of…increasing consumption of foods rich in omega-3 fattyacids

Agency for Healthcare Research and Quality49

Authoritative Body

General population

  • Fish and fish oil supplements reduce the risk of cardiovascular disease

American Academy of Pediatrics41

Expert Scientific Organization

Nursing Women

  • The mother’s diet should include an average daily intake of 200 to 300 mg of the ω-3 long-chain PUFAs (DHA) to guarantee a sufficient concentrationof


Country/Region

Organization

Org. Type

Target Population

Recommendation

       

preformed DHA in the milk. Consumption of 1 to 2 portions of fish (e.g., herring, canned light tuna, salmon) per week will meet this need. The concern regarding the possible risk from intake of

excessive mercury or other contaminants is offset by the neurobehavioral benefits of an adequate DHA intake and can be minimized by avoiding the intake of predatory fish (e.g., pike, marlin, mackerel, tile fish, swordfish). Poorly nourished mothers or those on

selective vegan diets may require a supplement of DHA as well as multivitamins

Canada

Minister of National Health and Welfare, Canada42

Authoritative Body

General adult population

 
 

Dietitians of Canada33

Expert Scientific Organization

General adult population

  • 500 mg n-3 long-chainPUFAs/day

India

Cardiology Society of India59

Expert Scientific Organization

For patients with high triglycerides and patients after MI for secondary prevention

  • Omega-3 acid ethyl esters(2- 4g/day)

Japan

Ministry of Health, Labour and Welfare43

Authoritative Body

General adult population

  • >1g EPA+DHA perday

0-5 months – boys and girls

 

6-11 months- boys and girls

 

1-2 years – Boys and Girls

 


Country/Region

Organization

Org. Type

Target Population

Recommendation

     

3-5 years – Boys and Girls

 

6-7 years – Boys

 

(6-7 years) –Girls

 

8-9 years – Boys

 

8-9 years – Girls

 

10-11 years – Boys

 

10-11 years – Girls

 

12-14 years – Boys and Girls

 

15-17 years – Boys

 

15-17 years – Girls

 

Adults (18-29 years) – Men

 

18-29 years – Women

 

30-49 years – Men

 

30-49 years – Women

 

50-69 years – Men

 

50-69 years – Women

 

Over 70 years – Men

 

Over 70 years – Women

 

Pregnant Women

 

Nursing Women

 

Malaysia

Ministry of Health

Authoritative Body

Acute ST Segment Elevation Myocardial Infarction46

  • Increased intake of omega 3 – fatty acids (1g daily) isbeneficial.
  • Eat fish at least twice aweek.

Women with CHD47

 

Management of Dyslipidemia48

  • A dose of 3-9 gm/day to lowerTG levels

Country/Region

Organization

Org. Type

Target Population

Recommendation

       
  • A dose of 0.75-1 gm/day as secondary prevention toprevent suddendeath

Israel

Israel Heart Society44

Expert Scientific Organization

For people with high risk or secondary prevention

  • 1000 mg EPA + DHA/day as supplement for people who don’t eatfish

For the general public or primary prevention

  • 500-1000 mg EPA + DHA/dayas fish

References

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