Products
In many countries, omega-3 fatty acids are marketed as drugs, foods, and dietary supplements. Some products are marketed specifically for pregnancy and lactation, such as Elevit Omega 3. Many multivitamin preparations for pregnancy do not contain omega-3 fatty acids.
Structure and properties
Among the most active omega-3 fatty acids are docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). They are essential polyunsaturated fatty acids that are not produced by the body and must be ingested with food. Omega-3 fatty acids are found in high concentrations in fish oil. Other possible sources are vegetable oils such as rapeseed oil and linseed oil. These contain α-linolenic acid (ALA), which can be converted to EPA and from EPA to DHA. However, this metabolic pathway is inefficient because only a few percent is biotransformed. Therefore, a direct DHA supply is more beneficial.
Effects
Omega-3 fatty acids (ATC C10AX06) are particularly significant for the normal development of the fetal brain and retina in the third trimester and play important roles in the hormonal and immune systems, among others. DHA is an important component of the cell membranes of the corresponding organs. Adequate intake is also thought to provide various health benefits to mother and child, such as a lower rate of preterm birth.
Indications for use
Adequate supply of omega-3 fatty acids before and during pregnancy and while breastfeeding.
Dosage
Pregnant women are recommended to consume at least 200 mg of DHA per day. The required amount can be achieved by consuming fatty fish 1-2 times a week, corresponding to about 280-300 g of fish. However, some fish may contain harmful substances such as the neurotoxin methylmercury, polychlorinated biphenyls (PCBs), dioxins and synthetic estrogens. It is particularly advised against larger predatory fish at the bottom of the food chain, such as shark, swordfish, king mackerel and tilefish. The Federal Office of Public Health recommends eating canned trout, redfish, whitefish, sardines, white halibut or tuna. The contradictory facts lead to uncertainty among many pregnant women and not every woman likes fish. For this reason, omega-3 fatty acids from purified fish oil of controlled quality are also offered as dietary supplements, for example in the form of capsules. They should be taken immediately before or during meals to increase absorption and avoid adverse effects. Contrasting opinions on supplementation can be found in the scientific literature. While some authors clearly advocate it, others point out the insufficient data.
Contraindications
Omega-3 fatty acids are contraindicated in hypersensitivity and in disorders of fat digestion in the small intestine. Refer to the drug label for complete precautions.
Interactions
Bleeding time may be prolonged in combination with anticoagulants. Omega-3 fatty acids may lower elevated blood pressure over time, requiring a reduction in the dose of concomitantly administered antihypertensive agents.
Adverse effects
Possible adverse effects of taking fish oil capsules include belching, fish taste, nausea, and vomiting. Therefore, it is recommended to take the drugs with food and liquid.