A plethora of fatty acid supplements (whether fish oil, krill oil or algae) offer varying ratios of EPA and DHA long-chain omega-3 fatty acids, with numerous applications. When addressing specific ailments or conditions related to inflammation however, the ratio of EPA to DHA becomes very important and can determine the efficacy of any outcome because their physiological actions are quite distinct. Whilst these fatty acids are both essential for good health, their structures are very similar and they compete for binding sites as well as essential enzymes. EPA and DHA are found together in most supplements, but their competitive relationship means that the anti-inflammatory beneficial action of EPA is derived from the excess EPA over DHA.
Many recent clinical studies, especially those focusing on the benefits of omega-3 in inflammatory conditions, have investigated the actions of pure EPA owing to its dual protection against excess inflammation in the body. EPA displaces the omega-6 AA content of cell membranes, reducing the inflammatory products that can be produced from AA – effectively regulating inflammatory pathways – and it also enhances the production of anti-inflammatory products that are directly converted from EPA.
Supplementing the diet with pure EPA without DHA maximises the beneficial actions of this important nutrient for inflammatory conditions because it is unopposed by the competing actions of DHA for binding sites and enzymes. A successful treatment regime for inflammatory conditions therefore necessitates pure EPA oil, with no DHA. With DHA recognised for its role as an important structural fatty acid, EPA in contrast has quite profound and different effects within the body. EPA is not only the precursor to the manufacture of DHA (thus supporting DHA levels), but also has the ability to modulate inflammation, immunity and various aspects of cardiovascular processes, as well as playing a significant role in brain health. The unique properties of EPA in health and disease are giving rise to a plethora of clinical studies that indicate that EPA may be superior to DHA as a neuroactive agent, as an anti-inflammatory lipid, in specific areas of cardiovascular modulation and through its unique ability to modulate biological pathways relating to pain, stress response (HPA-axis), apoptosis and carcinogenesis. As such, EPA may be the more physiologically ‘active’ of these two important omega-3s. Not surprisingly, the turnover of EPA is generally much higher than that of DHA and unless supplies are regularly replenished, this can lead to deficiencies, with DHA levels staying relatively constant. In addition, it is becoming widely accepted within the scientific community that, when using an omega-3 supplement as an add-on treatment for inflammation based conditions, it is vital that the EPA within the oil is in greater quantity than that of DHA. For example, studies using omega-3 as an add-on treatment for conditions such as depression or ADHD consistently show that the presence of DHA within the oil effectively ‘cancels out’ the potential therapeutic benefits of EPA. Optimal efficacy can only be achieved by using a pure EPA oil.
- The prevention or treatment of inflammatory conditions requires taking pure EPA without DHA
- You can get more EPA in a capsule meaning therapeutic doses can more easily be achieved even though you can take less capsules and less unnecessary fat
- EPA is the precursor to DHA in the body and so any excess EPA can be converted to DHA. This process in most people is, however, inefficient (much like the inefficiency of short-chain omega-3s to long-chain) and thus we still recommend eating oily fish at least once each week to provide a natural source of DHA. Fish are also a good source of vitamins and minerals needed to process fats, so eating fish will also support the natural EPA to DHA conversion!
- Allows high concentrations of EPA to be achieved Maintains DHA levels:
- Raises both EPA and DHA levels (if DHA is needed) thus improving ‘omega-3 index’
- Protects DHA loss from cell membranes
- Enhances mitochondrial function
- Maintains cell integrity including neuronal systems
- Counteracts inflammation/oxidative stress
- Powerful antidepressant
- Improves immune function
- Prevents the death of healthy cells
- Improves cardiovascular function
Whilst EPA is increasingly being shown to be of benefit when taken in isolation for a range of clinical conditions, it is not suitable for everyone to take pure EPA throughout their life. The roles of EPA and DHA change throughout life and thus the optimal amounts of both also shift.
Children under the age of 5 require DHA for growth and development,and the brain, CNS and retina rely heavily on the adequate supply of DHA during growth in the womb. Thus women should switch to DHA-containing supplements when they become pregnant and continue to take this until they cease breastfeeding. Children continue to need DHA up until the age they start school, so if giving fish oil to children under the age of 5, it should contain DHA also. The exception is for children with developmental problems – where pure EPA has been shown to be most effective for supporting cognitive function.
After the age of 5, the development of the brain and CNS starts to reduce and the body’s need for DHA reduces. This is a good time to switch to an EPA-rich supplement, as studies show that EPA can help with childhood behaviour and academic performance, as well as focus, attention and reducing aggression. Dry skin conditions, asthma and allergies are also common in children and good levels of EPA at this time can help reduce the inflammation associated with these issues.
Between the ages of 5 and 65, the majority of the body’s needs can be met by using pure EPA oils and eating fish, marine products, organic greens and pastured animal products. EPA levels are under constant demand and low EPA levels in adolescents and adults correlates strongly with development of mental health issues, including depression, dyslexia and dyspraxia, heart problems, joint and bone conditions, as well as neurodegenerative diseases such as MS and Parkinson’s. EPA also protects our genes and cell cycle, as well as helping to keep our stress response regulated, so an adequate supply of EPA throughout adult life can help prevent a range of chronic illness.
In later life, cognitive function and brain deterioration may become a concern. Once again, maintaining high levels of EPA has been shown to lower the risk of developing and worsening cognitive decline and dementia. If, however, you know someone who already has a diagnosis of dementia or Alzheimer’s, their brain has already been damaged and needs structural support. At this point, DHA becomes important again and taking a high-EPA product that contains 250mg of DHA also is important to prevent further loss of brain tissue.
For more information on the conditions that EPA can help prevent and reduce see health concerns.