REVIEW

CURRENT
OPINION Is the world supply of omega-3 fatty acids
adequate for optimal human nutrition?
Norman Salem Jr a and Manfred Eggersdorfer b

Purpose of review
To delineate the available sources of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) for
human consumption and to determine if the available supply is capable of supplying the nutrient levels
recommended by expert bodies.
Recent findings
There are converging opinions among experts, professional organizations and health professionals that a
recommendation for a daily individual consumption of 500 mg of EPA/DHA would provide health benefits,
and this translates to an annual human consumption of 1.3 million metric tons. Current human consumption
of EPA/DHA is estimated to be only a small fraction of this amount and many people may suffer from
suboptimal health as a result of low intake. EPA and DHA originate in the phytoplankton and are made
available in the human food chain mainly through fish and other seafood.
Summary
The fish catch is not elastic and in fact has long since reached a plateau. Aquaculture has grown rapidly,
but most of the fish oil produced is currently being used to support aquaculture feed and so this would
appear to limit aquaculture growth – or at least the growth in availability of fish sources of EPA/DHA.
Vegetable oil-derived alpha-linolenic acid, though relatively plentiful, is converted only at a trace level in
humans to DHA and not very efficiently to EPA, and so cannot fill this gap. Microbial EPA/DHA production
can in the future be increased, although this oil is likely to remain more expensive than fish oil. Plant
sources of EPA and DHA have now been produced in the laboratory via transgenic means and will
eventually clear regulatory hurdles for commercialization, but societal acceptance remains in question. The
purpose of this review is to discuss the various sources of omega-3 fatty acids within the context of the
potential world demand for these nutrients. In summary, it is concluded that fish and vegetable oil sources
will not be adequate to meet future needs, but that algal oil and terrestrial plants modified genetically to
produce EPA and DHA could provide for the increased world demand.
Keywords
fish oil availability, microbial eicosapentaenoic acid/docosahexaenoic acid production, supply of omega-3
fatty acids

INTRODUCTION DHA have been selected as top priority nutrients

There is a robust literature suggesting the health for DRI reviews based on public health and policy
benefits of the long-chain omega-3 fatty acids, eico- importance. It may be anticipated that such recom-
sapentaenoic acid (EPA, 20 : 5n3) and docosahexae- mendations will be made in the future and that this
noic acid (DHA, 22 : 6n3), for human use. Many will lead to an increased demand for these nutrients.
different recommendations have been made for The context for the present analysis will therefore be
the daily intakes of these nutrients, as will be dis-
cussed below, but all have agreed that median levels a
Nutritional Lipids, DSM Nutritional Lipids, Columbia, Maryland, USA and
of intake in the Western world should be increased. b
Nutrition Science & Advocacy, DSM Nutritional Products, Basel,
Nevertheless, it must also be stated that official Switzerland
bodies such as the (US) Institute of Medicine or Correspondence to Manfred Eggersdorfer, Nutrition Science & Advo-
the USDA have not promulgated a daily recom- cacy, DSM Nutritional Products, P.O. Box 2676, 4002 Basel, Switzer-
mended intake (DRI) or even adequate intake values land. Tel: +41 61 815 8196; e-mail: manfred.eggersdorfer@dsm.com
for EPA or DHA. Recently, the US Food and Drug Curr Opin Clin Nutr Metab Care 2015, 18:147–154
Administration (FDA) announced that EPA and DOI:10.1097/MCO.0000000000000145

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Lipid metabolism and therapy

human beings to perform this metabolism. Finally,

KEY POINTS possible solutions to projected inadequacies in the
 Many expert bodies have recommended increased EPA/DHA supply will be considered, including
intakes of the omega-3 essential fatty acids, EPA and expanded algal production and genetically modified
DHA, at a level of 500 mg/day for optimal nutrition. plant sources.
 For about 7 billion humans, this would equate to a
current demand of about 1.3 million metric tons of EPA/DHA INTAKE RECOMMENDATIONS
EPA/DHA.
FROM EXPERT BODIES
 The present fish/aquatic sources of EPA/DHA can Many expert bodies in various countries have made
supply about 0.2 million metric tons for human statements concerning the recommended intake
consumption.
[1–9] of the nutrients EPA/DHA, generally as a total
 The vegetable oil omega-3 ALA cannot support of these two fatty acids since they generally occur
increased levels of human DHA. together in food sources. These recommendations
have been discussed in more detail recently [10].
 The large gap in omega-3 nutrition security may be
made up by greatly increased algal oil fermentation or Examination of a list of such recommendations
in the near future by vegetable oil sources after suitable (Table 1) indicates that most recommendations
genetic modification. are in the range of 250–1000 mg/day. In the USA,
two of the most prominent dietary recommen-
dations are from the American Dietetic Association
[11] and the American Heart Association, which
the recommended levels of dietary intake for these recommend an intake of about 500 mg/day. Both
essential fatty acids as prescribed by various expert the World Health Organization/Food and Agricul-
bodies. An estimated worldwide demand for EPA ture Organization (WHO/FAO) and European Food
and DHA can then be calculated for the world Safety Authority (EFSA) recommend 250 mg EPA/
population. Various sources of these fatty acids will DHA daily intake, whereas the Japanese Ministry
then be considered in order to estimate the current for Health opts for 1000 mg/day, either as a capsule
supply and to evaluate when necessary growth that or daily fish intake. One may consider a median
can be realized in the near future, also taking devel- expert body recommendation to be 500 mg EPA/
opment of new technologies into account. It will be DHA per day. In contrast to these recommen-
necessary to estimate both fish catch and fish oil dations, however, the daily intake of EPA/DHA in
annual production, as well as to consider algal, krill most of the world is considerably lower than
and other additions to the EPA/DHA supply. 500 mg/day. It seems that only Japan, some Scandi-
Additionally, alpha-linolenic acid (ALA, 18 : 3n3) navian countries and some coastal areas where fish
production from terrestrial plant sources will be is plentiful have median intakes that are greater
considered since it is the metabolic precursor to than this level. Thus the individual intake would
EPA and DHA in conjunction with the ability of be 365 days
0.5 g/day or 182.5 g/year. For a world

Table 1. Omega-3 PUFA intake recommendations of expert international bodies for adults

Expert body Year Target population Daily recommendation Reference

American Heart Association 2011 Heart health Two fish meals for primary protection [1]
Heart Foundation Australia 2008 Heart health 500 mg EPA/DHA for primary prevention [2]
FAO/WHO Expert Consultation 2010 General health 250 mg EPA/DHA [3]
European Food Safety Authority 2010 General health 250 mg EPA/DHA [4]
Japanese Ministry of Health 2009 General health >1 g EPA/DHA [5]
Health Council Netherlands 2006 General health 450 mg EPA/DHA from fish [6]
Australia New Zealand National 2006 Chronic disease n-3 LC-PUFAs: 610 mg for men 430 mg for women [7]
Health and Medical Research
Council
Belgian Superior Health Council 2009 Heart health Daily fatty fish or 1 g capsule [8]
Agence Francais de Securite 2014 General health 500 mg EPA/DHA [9]
Sanitaire des Aliments

DHA, docosahexaenoic acid; EPA, eicosapentaenoic acid; LC, long chain; PUFA, polyunsaturated fatty acid.

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 Sources of omega-3 fatty acids Salem and Eggersdorfer

zooplankton and then enter the fish food chain.

100,000,000
90,000,000
Sources of dietary EPA/DHA for humans are princi-
80,000,000 pally composed of fish and fish oil. Figure 1 depicts
70,000,000 the yearly fish catch since 1950 as well as the rapid
60,000,000
MT fish

increase in fish obtained through aquaculture.

50,000,000
40,000,000 These data are taken from FAO FishStat and a report
30,000,000 of these data is also available [12]. The wild capture
Wild capture
20,000,000 Aquaculture of fish peaked in the early 1990s and has been fairly
10,000,000
0
constant since at about 90 000 000 metric tons of
1950 Year 2011 fish. The yield of fish via aquaculture has grown
linearly since the early 1990s and has now reached
FIGURE 1. Global fish production. Rapid rise of aquaculture nearly the same level as the wild fish catch. As
and plateauing of wild fish catch. Data from [12]. sources for EPA/DHA, anchovies are the largest
single species of wild fish and much of this is
obtained from the Peruvian fishery. Menhaden,
population of 7.2 billion people, the total global cod, whiting, carp, mackerel, tuna, salmon, pol-
intake requirement would be 182.5 g/year
7.2 lock, capelin and sardine, in roughly that order,
billion or 1314 billion g/year. This equates to about are significant species of fish harvested (Fig. 2).
1.3 billion kg/year or 1.3 million metric tons of Much of the anchovy catch is consumed in the
EPA/DHA per annum. extraction fishery for fish oil and fish protein,
and so on. Our best estimates of the total EPA/
DHA produced is about 530 000 metric tons and
FISH/MICROORGANISM SOURCES OF this estimate comes from the fish industry trade
EPA/DHA association – the Global Organization for EPA and
Now that we have an estimate of how much EPA/ DHA omega-3s (GOED) (Fig. 3). The portions of this
DHA is required, let us turn to the issue of where we that contribute to human usage break down as
can obtain these essential fats and what quantities follows:
are available from different sources. EPA, DHA and
other long-chain n-3 fatty acids are biosynthesized (1) 125 000 metric tons consumed directly from
mainly by phytoplankton, which are consumed by seafood

EPA/DHA Capacity (Metric Tons)

0 15000 30000 45000

Anchoveta
Other anchovy
Menhaden
Cod liver
Whiting
Carp
Jack Mackerel
Tuna
Selmon
Pollack liver
Capelin
Sardine
Catfish
Sandeel
Sardinella
Squid
Herring
Chub mackerel
Horse mackerel
Antarctio krill
Other soombridae
Thread herring
Atlantio mackerel
Sprat
Hold
Shad
Pout
Indian mackerel

FIGURE 2. Major fish species which contribute to EPA/DHA production. Data compiled by the Global Organization for EPA
and DHA Omega-3s (GOED) and based on a calculation of FAO FishStat data [12]. DHA, docosahexaenoic acid; EPA,
eicosapentaenoic acid.

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Lipid metabolism and therapy

325 205 3
Thousand Thousand
metric tons Thousand
metric tons Reduction fisheries metric tons
Fish and seafood producing fish oil
consumption Algal, yeast, etc.
and wastage microbial sources

500 7.2
× Billion
mg people

EPA/DHA
= 1.3 million EPA/DHA
metric tons per annum

Total supply

GAP
533 thousand
metric tons
1.1 million Human consumption
metric tons 200 thousand
metric tons

FIGURE 3. Summary slide of worldwide EPA/DHA requirement and available supplies for human consumption. Source is
DSM Nutritional Products, Nutrition Science & Advocacy, 2014. DHA, docosahexaenoic acid; EPA, eicosapentaenoic acid.

(2) 9000 metric tons utilized by humans of the ALPHA-LINOLENIC ACID AS A SOURCE OF
200 000 tons derived from seafood industry cut- EPA/DHA
tings The vegetable oil source of omega-3 fatty acids as
(3) 63 000 metric tons utilized by humans of the ALA has been proposed as another possible source of
205 000 metric tons from fish oil extraction EPA and DHA. Vegetable oils are relatively abundant
(4) 197 000 metric tons total human use from fish and Table 2 lists the United States Department of
sources Agriculture (USDA) estimates of major global pro-
(5) 3000 metric tons from nonfish sources includ- duction in 2013–2014 [14]. Soybean and rapeseed
ing algae, yeast, krill, and so on oil are the major sources of ALA, and the total
(6) 200 000 metric tons EPA/DHA grand total use calculated ALA produced this year is estimated to
be over 6100 metric tons. Flax oil (not included in
The total is already likely an overestimate since the USDA estimate) is high in ALA content, with a
it assumes that all of the seafood is consumed, range from about 40 to 60% of fatty acids, and
although food wastage is frequently one-third or worldwide production of flax seed was estimated
more. Very little (less than 5%) of the seafood cut- in 2010 to be about 525 thousand metric tons per
tings total is utilized for human consumption and year [15]. The seed is about 23 wt% ALA and this
would appear to present an opportunity to signifi- then yields an additional 121 thousand metric tons
cantly increase its use. However, such processing is of worldwide ALA production. The total worldwide
done in a decentralized fashion such that there is ALA production from vegetable oils can therefore be
little economic incentive to process the oil appro- estimated to be about 6220 metric tons.
priately for this purpose. In extraction fisheries, Contributions of ALA, however, as a source of
205 000 metric tons of fish oil are produced, and EPA/DHA presupposes that humans can efficiently
most of it goes to supply the aquaculture industry metabolize the ALA to EPA and DHA. The rate of this
with a source of EPA/DHA since salmonids and other conversion may be examined in two ways: by feed-
fish require this nutrient for optimal growth [13]. ing humans ALA and measuring any increases in
Nonfish sources of EPA/DHA come mainly from bloodstream levels of EPA and DHA, or by determin-
fermented algal oils and secondarily from Krill oil, ing endogenous human ALA metabolism in vivo
but at present contribute a very small percentage of through metabolic tracers. Pawlosky and Salem per-
the total available EPA/DHA. The total EPA/DHA formed a tracer experiment wherein deuterated-ALA
available for human consumption (200 000 metric was given to human adults on a controlled Western
tons) represents only about 15% of the above diet and in vivo metabolism monitored via the
calculated human requirement (1.3 million metric bloodstream, reviewed in [16]. These authors, work-
tons). ing at the National Institutes of Health, concluded

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 Sources of omega-3 fatty acids Salem and Eggersdorfer

Table 2. USDA estimate of global major vegetable oil and calculation of alpha-linolenic acid production in 2013–2014

Global production Oil quantity Percentage of Quantity of ALA

of oils (millions of metric tons) ALA (thousands of metric tons)

Coconut 3.74 0.1 3.7

Cottonseed 5.25 0.1 5.2
Olive 3.28 0.6 19.7
Palm 58.08 0.3 174.2
Palm Kernel 6.8 0.2 13.6
Peanut 5.32 0.3 16.0
Rapeseed 24.48 9.6 2350.1
Soybean 44.62 7.8 3480.4
Sunflower 14.89 0.3 44.7
Totals 166.44 – 6108

ALA, alpha-linolenic acid.

From: http://www.ers.usda.gov/data-products/oil-crops-yearbook.aspx [14].

that only about 0.2% of the absorbed plasma ALA erythrocyte ALA, a nonsignificant increase (0.12%)
was destined for EPA synthesis. Moreover, less than in EPA and a slight decrease in DHA. The EPA-
0.05% of the plasma ALA was destined for DHA supplemented group exhibited only a significant
synthesis. This is consistent with many human increase in EPA, which was much more substantial
supplementation studies in which large doses of (4.41%). DHA supplementation produced signifi-
ALA are given, and the bloodstream shows no cantly increased EPA (1.56%), as well as a large
change in DHA and generally significant but small increase in DHA (7.5%). It thus appears that veg-
increases in EPA [17]. Representatives of the Inter- etable oil ALA can support a small increase in human
national Society for the Study of Fatty Acids and bloodstream EPA, but cannot support DHA and
Lipids – a group of international experts of lipid therefore will not provide a solution to the world-
scientists – have published a position paper con- wide shortage of EPA and DHA.
cerning ALA metabolism, indicating that neither
dietary ALA (see [17] for review, Table 1) nor EPA
(see [17] for review, Table 2) is a good source of DHA STEARIDONIC ACID AS A SOURCE OF
in humans due to the extremely low level of in-vivo EPA/DHA
metabolism [16,17]. ALA can support a higher level Another possible contributor to the EPA/DHA
of bloodstream EPA, but is not nearly as effective as supply for humans is stearidonic acid (SDA,
is preformed EPA in this respect. EPA supplement- 18 : 4n3). Large commercial concerns have devel-
ation is also not able to increase the level of DHA in oped a genetically modified soybean that contains
the human bloodstream [17,18]. a large proportion of this omega-3 fatty acid, and it
A recent study (Table 3) in which ALA, EPA or has been declared safe for human consumption by
DHA was supplemented for 6 weeks to humans the US FDA (http://www.fda.gov/ForConsumers/
confirms these conclusions [18]. The ALA supple- ConsumerUpdates/ucm185688.htm.). The advan-
mentation produced a very small (0.24%) increase in tage of this approach is that it bypasses the delta-6

Table 3. Alpha-linolenic acid vs. eicosapentaenoic acid vs. docosahexaenoic acid supplementation and human bloodstream
content of n-3 fatty acids: Increase in percentage of total erythrocyte n-3 fatty acids after 6 weeks of supplementation
Fatty acid supplemented ALA diet group EPA diet group DHA diet group

ALA 0.24 0.05 0.00

EPA 0.12 4.41 1.56
DHA 0.92 0.90 7.5
Total omega-3 fatty acids 0.56 3.38 9.08

 Indicates statistically significant difference. ALA, alpha-linolenic acid; DHA, docosahexaenoic acid; EPA, eicosapentaenoic acid.
Data taken from [18].

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Lipid metabolism and therapy

desaturase enzyme, often considered a rate-limiting principle be potentially increased enormously. At

step, and leads to greater conversion to EPA relative to present, algal oil represents less than 2% of human
ALA. James and Cleland compared directly the effi- EPA/DHA consumption, but this source has grown
cacy for increasing long-chain omega-3 fatty acids in appreciably due to several socially desirable proper-
the human bloodstream after feeding encapsulated ties including its environmental friendliness, the
ALA or SDA for 3 weeks, reviewed in [19]. They absence of ocean borne contaminants, its vegetarian
observed that both plasma and erythrocyte EPA, as nature, as well as the possibility to manufacture
well as its elongation product, docosapentaenoic acid under kosher or halal conditions. However, fermen-
(22 : 5n3), were both increased with SDA and more so tation and refining of algal oils is at present more
than with ALA intake; however, there was no increase expensive to produce than fish oils and likely to
in DHA. It was quite interesting to note that they remain so for some time. Thus, microorganism-
observed the relative effectiveness for increasing tis- based production of EPA/DHA-enriched oils can
sue EPA for supplemental EPA, SDA and ALA was accommodate greater demand for these nutrients
1 : 0.27 : 0.07, respectively. Harris also performed a albeit at a higher price.
similar study and found that SDA was somewhat less
efficacious in increasing human erythrocyte EPA
than in the study by James as it was only about KRILL OIL
17% as effective as was EPA, reviewed in [19]. Again, Krill oil has been another more recent contributor to
SDA was unable to increase human bloodstream the supply of EPA/DHA. The trade association,
DHA. Although there is as of yet no current commer- GOED, estimated krill oil catch (in 2013) was
cial production of this oil, the SDA may in the future 202 000 tons, which is consistent with an estimate
have utility in supporting human blood levels of EPA. of 212 000 tons given by Kwantas and Grundman
[22]. GOED calculated that the total EPA/DHA oil
available from this was about 625 tons. Using the
ALGAL OILS figure above of a total human consumption of about
What viable alternatives are there then for future 200 000 tons, the krill oil contribution would
increases in EPA and DHA production? One candi- represent 0.3% of the total. However, the present
date will certainly be heterotrophic microorganisms krill oil harvest is estimated to be below 0.1% of the
(Fig. 4) such as algae. Commercial operations have available biomass, which has been estimated to be
for some time been performed employing Crypthe- more than 300 million tons in the Antarctic Ocean
codinium cohnii as a source of DHA for infant formula [22]. The Commission for the Conservation of
[20]. Several species of Schizochytrium are also used Antarctic Living Resources has estimated that
to make commercial oils for supplements and the 5.6 million tons could be sustainably harvested
food and beverage markets and variants can make [22]. Thus, it appears that the krill oil supply could
mainly DHA or both EPA and DHA [21]. Such pro- be increased substantially to a level where it would
duction is somewhat capital-intensive, but the raw supply 8–9% of the present human consumption.
materials, that is, sugar and various vitamins and One would surmise, however, that the whole catch
minerals, are plentiful and thus production can in could not come from a particular area, but must be

Crypthecodinium (DHA) Schizochytrium (DHA and EPA) Mortierella (ARA)

Thraustochytrid algae,
Dinoflagellate, marine, marine or euryhaline,
Zygomycete fungi, soil,
unicellular, flagellated, unicellular, obligate
filamentous, lipid,
obligate heterotroph, heterotroph, high
unique fatty acid
high lipid, unique fatty biomass and high lipid,
profile (ARA)
acid profile (DHA) unique fatty acid
profile (EPA and DHA)

FIGURE 4. Three important commercial organisms used for making long chain polyunsaturated fatty acids for human nutrition.

152 www.co-clinicalnutrition.com Volume 18  Number 2  March 2015

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 Sources of omega-3 fatty acids Salem and Eggersdorfer

spread out over the ecosystem, and this represents a and a limited supply of these essential nutrients, the
challenge for the industry so as not to disrupt a genetically modified sources of EPA/DHA will
fragile environment. Krill oil has been marketed become more widely available in the future.
as more efficacious than fish oil purportedly due
to its differing lipid class form. Some species of krill
oils have large proportions of phospholipid forms of CONCLUSION
EPA/DHA [23], although this is variable. However, The major sources of EPA and DHA are from fish and
the claims of greater bioavailability of krill oil are fish oils, and there is not nearly enough of it avail-
not founded on controlled clinical studies and have able to supply commonly recommended levels of
&
been criticized [24 ]. intake for these nutrients in the human population.
Unfortunately, ALA, although relatively abundant,
cannot substitute for its longer chain and more
GENETICALLY MODIFIED VEGETABLE OIL unsaturated n-3 family members since humans have
AS A FUTURE SOURCE OF EPA/DHA only a trace level capacity to perform this conver-
Finally, the potential production of EPA and DHA by sion in vivo. Microbial oil production may theoreti-
land-based plants must be considered. Several cally be expanded in an almost unlimited fashion,
groups have made considerable progress in produc- but at a higher price point. Eventually, lower-priced
ing transgenic oil seed crops that can produce EPA or plant-based DHA oils will become available, but
DHA. Petrie et al. [25] have demonstrated insertion from a genetically modified organism. Economic,
of various desaturase and elongase genes into Ara- social, regulatory and political issues will thus be the
badopsis thaliana in order to produce oils containing main determinants of the availability of EPA and
12–15% of fatty acids as DHA. They state that one DHA in the future.
hectare of a Brassica napus crop employing this
technology producing 12% DHA oilseed would be Acknowledgements
equivalent to that produced from 10 000 fish. Dow The author gratefully acknowledges the input of Adam
Agro Sciences and DSM Inc. have similarly
Ismail and the GOED organization in making available
announced a program to produce DHA in canola
data on fish catch and fish oil production and for
oil [26]. Ruiz-Lopez et al. [27] have recently demon-
Figures 1 and 2.
strated transgenic variants of Camelina sativa that
produce seeds with up to 31% EPA and also one with
up to 12% EPA and 14% DHA. Financial support and sponsorship
Another very interesting development in the Financial support for this review was provided by DSM
genetically modified arena is the introduction of Nutritional Products.
domestic animals that have cloned enzymes such
that their meat is enriched in omega-3 fatty acids. Conflicts of interest
An example of this is given by the transgenic pig rich Norman Salem, Jr and Manfred Eggersdorfer are
in EPA/DHA after introduction of a humanized Cae- employed by DSM, a manufacturer of omega-3 fatty
norhabditis elegans gene, fat-1, which encodes for the acids.
&
omega-3 fatty acid desaturase [28 ]. With this
approach, they were able to increase the content
of omega-3 fatty acids from 2.2% in wild-type pigs to REFERENCES AND RECOMMENDED
8.6% in the transgenic ones, with substantial READING
Papers of particular interest, published within the annual period of review, have
increases in EPA especially but also in DHA. Pro- been highlighted as:
duction of domesticated animals on a large scale & of special interest
&& of outstanding interest
with these genes is a potential significant source of
EPA/DHA in the future human diet, although no 1. Miller M, Stone NJ, Ballantyne C, et al. American Heart Association Clinical
Lipidology, Thrombosis, and Prevention Committee of the Council on Nutri-
such commercial enterprise has yet developed. tion, Physical Activity, and Metabolism; Council on Arteriosclerosis, Throm-
Thus, it seems that the long delayed technical suc- bosis and Vascular Biology; Council on Cardiovascular Nursing; Council on
the Kidney in Cardiovascular Disease. Triglycerides and cardiovascular dis-
cess of transgenic terrestrial plants and animals that ease: A scientific statement from the American Heart Association. Circulation
contain DHA has finally come. Of course, these 2011; 123:2292–2333.
2. Australia – Position statement. Fish, fish oils, n-3 polyunsaturated fatty acids
products must undergo a lengthy registration with and cardiovascular health. 2008. www.heartfoundation.org.au.
various regulatory bodies in various countries before 3. FAO. FAO report of an expert consultation on fats and fatty acids in human
nutrition. 2010 Bulletin 91. Report from Joint FAO/WHO Expert Consultation
they can be commercialized. At present, there is on fats and fatty acids in human nutrition 10–14 November 2008, Geneva,
considerable resistance to the use of genetically Switzerland.
4. EFSA: Scientific opinion on dietary reference values for fats, including
modified foods in the Western world in particular. saturated fatty acids, polyunsaturated fatty acids, monounsaturated fatty
It may be expected though that with price pressure acids, trans fatty acids, and cholesterol. EFSA J 2010; 8:1461.

1363-1950 Copyright ß 2015 Wolters Kluwer Health, Inc. All rights reserved. www.co-clinicalnutrition.com 153

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.

Lipid metabolism and therapy

5. Japanese Ministry of Health, Labor and Welfare, 2009. Dietary reference 18. Egert S, Lindenmeier M, Harnack K, et al. Margarines fortified with a–linolenic
intakes for Japanese (2010 edition). MHLW Website 2010. http://www. acid, eicosapentaenoic acid, or docosahexaenoic acid alter the fatty acid
mhlw.go.jp/shingi/2009/05/s0529-4.html. [Accessed 14 June 2011] composition of erythrocytes but do not affect the antioxidant status of healthy
6. Netherlands – English translation, Health Council of the Netherlands. adults. J Nutr 2012; 142:1638–1644.
Guidelines for a healthy diet 2006. The Hauge: Health Council of the 19. Walker CG, Jebb SA, Calder PC. Stearidonic acid as a supplemental source
Netherlands, 2006; publication no. 2006/21E. http://www.gr.nl/pdf.php? of w-3 polyunsaturated fatty acids to enhance status for improved human
ID ¼ 1481andp¼. health. Nutrition 2013; 29:363–369.
7. ANZ – reference values for Australia and New Zealand including recom- 20. Kuratko C, Abril R, Hoffman J, Salem N Jr. Enrichment of infant formula with
mended dietary intakes. 2006. www.nhmrc.gov.au/publications/synopses/ omega-3 fatty acids. In: Jacobsen C, Nielsen NS, Horn AF, Sorensen A-DM,
_files/n35.pdf. editors. Food enrichment with omega-3 fatty acids. Woodhead Publishing
8. Belgium – Superior Health Council. Recommandations Nutritionnelles Pour Ltd; 2013. pp. 351–386.
La Belgique. CSS No. 8309. Revision 2009. 21. Kuratko CN, Salem N Jr. Long chain omega-3 fatty acids from algae:
9. ANSES. l’actualisation des apports nutritionnels conseille?s pour les acides composition, stability, metabolism and health effects. Eur J Lipid Sci Technol
gras. Rapport d’expertise collective. 2011. http://www.anses.fr/Documents/ 2013; 115:965–976.
NUT2006sa0359Ra.pdf. [Accessed 16 December 2014] 22. Kwantas JM, Grundmann O. A brief review of krill oil history, research, and the
10. Kuratko C, Salem N Jr. Standards for preventing and treating omega-3 fatty commercial market. J Dietary Supp 2014. doi: 10.3109/19390211.2014.
acid deficiency. In: Robert McNamara, editor. The omega-3 fatty acid 902000.
deficiency syndrome: opportunity for disease prevention. Nova Science 23. Arujo P, Zhu H, Breivik JF, et al. Determination and structural elucidation of
Publishers NY; 2013. pp. 399–420. triacylglycerols in krill oil by chromatographic techniques. Lipids 2014;
11. ADA Vegetarian Nutrition Evidence-Based Nutrition Practice Guideline 2011. 49:163–172.
ADA Evidence Analysis Library. http://www.adaevidencelibrary.com/topic. 24. Salem N Jr, Kuratko CN. A reexamination of krill oil bioavailability studies.
cfm?cat ¼ 4021andauth ¼ 1. [Accessed 7 October 2011] & Lipids Health Dis 2014; 13:137–142.
12. FAO. The state of the world fisheries and aquaculture. Rome: Food and An important review as it clarifies that krill oil has not been shown to be more
Agriculture Organization of the United Nations; 2014. bioavailable than fish oil or other sources of EPA/DHA as has been claimed.
13. Naylor RL, Hardy RW, Bureau DP, et al. Feeding aquaculture in an era of finite 25. Petrie JR, Shrestha P, Zhou X-R, et al. Metabolic engineering plant seeds with
resources. PNAS 2009; 106:15103–15110. fish oil-like levels of DHA. PLOS One 2012; 7:1–7.
14. http://www.ers.usda.gov/data-products/oil-crops-yearbook.aspx. [Accessed 26. Walsh TA, Metz JG. Producing the omega-3 fatty acids DHA and EPA in
December 2013] oilseed crops. Lipid Technol 2013; 25:103–105.
15. Goyal A, Sharma V, Upadhyay N, et al. Flax and flaxseed oil: an ancient 27. Ruiz-Lopez N, Haslam RP, Napier JA, Sayanova O. Successful high-level
medicine and modern functional food. J Food Sci Technol 2014; 51:1633– accumulation of fish oil omega-3 long-chain polyunsaturated fatty acids in a
1653. transgenic oilseed crop. Plant J 2014; 77:198–208.
16. Turchini GM, Nichols PD, Barrow C, Sinclair AJ. Jumping on the omega-3 28. Zhou Y, Lin Y, Wu X, et al. The high-level accumulation of n-3 polyunsaturated
bandwagon: Distinguishing the role of long-chain and short-chain omega-3 & fatty acids in transgenic pigs harboring the n-3 fatty acid desaturase from
fatty acids. Crit Rev in Food Sci Nutr 2012; 52:795–803. Caenorhabditis briggsae. Transgenic Res 2014; 23:89–97.
17. Brenna JT, Salem N Jr, Sinclair AJ, Cunnane SC. a–Linolenic acid supple- A demonstration that it may be possible to introduce genes into domestic animals
mentation and conversion to n-3 long chain polyunsaturated fatty acids in so that they may convert omega-6 fatty acids to omega-3 fatty acids for subsequent
humans. Prost Leuk Essential Fatty Acids 2009; 80:85–91. human consumption.

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