Omega-3 deficiency is a complex of symptoms and disorders of the body that occur with an absolute or relative lack of PUFA. Pathology is observed with insufficient consumption of fish and seafood, gastrointestinal diseases, low levels of transport lipoproteins in the blood. The deficiency condition is manifested by psychoemotional disorders, asthenic syndrome, deterioration of the skin and its appendages. For diagnosis, a special test for the omega-3 index and PUFA profile, tests for fat-soluble vitamins, a biochemical blood test are used. Treatment includes the selection of a balanced diet, taking medications with unsaturated fatty acids.
ICD 10
E63.0 Deficiency of essential fatty acids
Meaning
The lack of nutrients occurs in at least 70% of the population, and many have a simultaneous deficiency of several substances important for the body. Such essential compounds include omega-3 acids, the main of which are eicosapentaenoic (EPA) and docosahexaenoic (DHA). Substances are not produced in the body. They should regularly come from outside. Omega-3s are vital for the functioning of the cardiovascular, nervous, reproductive and other organ systems, so their deficiency is a multidisciplinary problem.
Causes of omega-3 deficiency
According to etiological factors, all cases of omega-3 deficiency are divided into exogenous (primary) and endogenous (secondary). Exogenous forms occur with an unbalanced diet and a low intake of unsaturated acids into the body. This type of pathology occurs in people who consume few fish dishes and seafood, which is typical for most residents of central Russia. Endogenous predisposing factors include the following:
- Malabsorption and maldigestion. Digestive disorders are the main reason for the lack of omega–3 acids in people who follow a fortified and balanced diet. The problem occurs with chronic diseases: cholecystitis, pancreatitis, gastritis and enteritis. All these pathologies are characterized by insufficient digestion of fats and their excessive excretion with feces (steatorrhea).
- Hypoproteinemia. For the transport of omega-3 in the blood, special proteins are needed, which are synthesized in the liver and then create complexes with lipid molecules. With fatty dystrophy, hepatitis, fibrosis and other pathologies, the synthetic function of the organ is disrupted, so fatty acids are not delivered to the tissues even if they are sufficiently absorbed into the body.
- Increased need. Children during periods of active growth, pregnant and lactating women, physical workers need more nutrients, including omega-3 and vitamins. If such categories of people consume standard amounts of fatty acids, they have a relative deficiency of nutrients.
Pathogenesis
Omega-3s are polyunsaturated fatty acids (PUFA), which are not able to be synthesized in the body. After being received from the outside, they undergo a number of biochemical transformations and become a substrate for the formation of biologically active substances. They produce prostacyclin 3, which has a vasodilating effect, thromboxane 3, which has a powerful antiplatelet effect, leukotriene 5, which inhibits inflammatory processes.
Omega-3 polyunsaturated acids are part of the phospholipids of cell membranes of various organs and tissues, including structures of the nervous system. Substances are actively involved in lipid metabolism, inhibit the formation of cholesterol, increase the production of bile and the breakdown of fats in the intestine. Omega-acids have a positive effect on carbohydrate metabolism, increasing the sensitivity of tissues to insulin. PUFA also has antioxidant and neuroprotective effects.
Omega 3s are of particular importance for the health of pregnant women and fetal development. With a normal level of nutrients, the risk of defects of the nervous system, eyes and other organs is significantly reduced. Substances support the plasticity of brain cells, increase their resistance to lack of oxygen. Omega-3s begin to accumulate in the baby’s brain from the 30th week of gestation, which is important for postnatal neuropsychological development.
The effect of fatty acids on the body of athletes and people who are engaged in heavy physical labor has been well studied. In sports pharmacology, it is noted that the normal level of omega-3 reduces muscle damage and inflammatory response after intense training, enhances the anabolic effect of other bioactive substances. PUFAs stimulate protein and carbohydrate metabolism, thereby accelerating muscle growth and increasing endurance.
Omega-3 deficiency symptoms
This condition is characterized by nonspecific and poorly expressed clinical signs, so it can go unnoticed for many years. Often people do not pay attention to a slight malaise or associate it with fatigue, chronic diseases and other factors. This explains the low level of diagnosis of deficiency conditions, despite their prevalence in the population.
One of the most common signs is a decrease in cognitive abilities: slow thinking, problems with memorization and concentration. Forgetfulness and absent-mindedness occur in patients of any age, reaching maximum intensity among the elderly, in whom omega-3 deficiency is superimposed on natural changes in the nervous system. Also, many complain of constant fatigue and fatigue even after a long night’s rest.
Since omega-3 affects the higher centers of the brain and mental processes, a characteristic sign of their lack is called psychoemotional instability. Patients with deficient conditions are more likely to suffer from anxiety, unreasonably low mood, rapid change of emotions. When the problem is combined with other provoking factors, it is possible to develop a depressive disorder.
Against the background of fatty acid deficiency, skin problems arise: dryness, dull and uneven complexion, frequent allergic reactions and inflammation. The lack of omega-3 affects the appendages of the skin, so the nail plates grow too slowly and break down quickly, the hair loses its healthy shine and actively falls out. Since PUFA is important for immunity, with a lack of these components, frequent colds and other types of infections are observed.
Complications
The effect of omega-3 deficiency on the degree of cardiovascular risk has been best studied. A decrease in the omega index by 2% correlates with an increase in the probability of cardiovascular pathologies by 15% at once. In the group of patients with long-term deficient conditions, the risk of myocardial infarction, stroke, and thromboembolic complications sharply increases. There is also a rapid progression of atherosclerosis, decompensation of hypertension.
The lack of nutrients is especially dangerous for pregnant women, since it correlates with a higher frequency of congenital brain defects, retinal development disorders and the appearance of other abnormalities in the newborn. If omega-3 deficiency persists in a child after birth, it is fraught with disorders of psychomotor development, delayed formation of speech skills, difficulties with concentration.
Diagnostics
Patients who are concerned about nonspecific symptoms mainly seek advice from a general practitioner. To make a diagnosis, a detailed collection of complaints and anamnesis of the disease will be required, a study of medical history, clarification of concomitant pathologies and health problems that could cause similar symptoms. If there is a suspicion of a deficiency condition, the following studies are prescribed:
Analysis for omega-3. Determining the omega-acid index is the main way to confirm the presence of a deficiency. During the study, the percentage ratio of EPA + DHA to the total amount of fatty acids in the blood is calculated. Normally, the indicator exceeds 8%. At a value from 4% to 8%, a moderate nutrient deficiency is diagnosed, less than 4% is a sign of a serious lack of PUFA and a high risk of cardiovascular crises.
The profile of fatty acids. The analysis is prescribed as part of a comprehensive diagnosis to assess the intake of different types of omega-acids into the body. The study allows us to identify the most important compounds from the omega-3, omega-6 and omega-9 groups in order to more accurately assume the risk of cardiovascular diseases, to find the right approach to correcting the diet.
Additional analyses. Since omega-3 deficiency is often accompanied by hypovitaminosis of fat-soluble nutrients (vitamins A, D, E), a comprehensive study of the level of vitamins in the blood is recommended. An extended biochemical blood test is necessarily carried out with the determination of a lipidogram and a proteinogram, according to the indications, a coagulogram is prescribed.
Treatment for omega-3 deficiency
The consumption rates of omega-3 differ in different countries and range from 0.5 g to 3 g per day for an adult. The total amount of all types of polyunsaturated acids in the daily diet should be at least 10% of the total caloric content. While there are no clear international recommendations that regulate the use of drugs with EPA and DHA, therefore, most doctors begin therapy with diet correction and the addition of fatty varieties of sea fish to the diet.
If diet therapy does not have an effect, it is recommended to take omega-3 acids in the form of bioactive additives. They should be prescribed by a doctor after examination and consultation. When choosing a drug, the amount and ratio of EPA and DHA, their concentration, relative to the total volume of the capsule, the presence of additional nutrients such as vitamin E, vitamin D and other fat-soluble nutrients are taken into account. The standard course of treatment is 1-2 months, if necessary, it is extended.
Prognosis and prevention
Deficiency of omega-3 fatty acids is not a life-threatening condition, unlike some vitamin deficiencies, however, a prolonged shortage of nutrients has long-term adverse consequences. The lack of PUFA is especially dangerous for people with a burdened heredity for cardiovascular diseases or with existing cardiovascular pathology. To prevent a deficiency condition, it is necessary to regularly consume sea fish, algae and seafood.