In a recent review published within the journal Nutrients, researchers evaluated the evidence on the consequences of two omega-3 polyunsaturated fatty acids (n-3 PUFAs), namely eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on the health of athletes. Additionally they discussed the risks and advantages related to DHA and EPA supplementation on this population.
Study: Athletes Can Profit from Increased Intake of EPA and DHA—Evaluating the Evidence. Image Credit: UfaBizPhoto / Shutterstock
Athletes should approach complement use cautiously, prioritizing safety and efficacy evaluation. The Australian Institute of Sport (AIS) framework classifies dietary supplements, placing fish oil (EPA and DHA) in Category B. It indicates a supportive scientific background but emphasizes the necessity for further research to know its advantages for athletes fully.
n-3PUFAs are essential for the human body but can’t be produced de novo. Plant sources like nuts and seeds provide a precursor named alpha-linolenic acid (ALA), but its conversion to EPA and DHA is restricted. The omega-3 index (O3I), reflecting EPA and DHA levels, is taken into account optimal above 8%. Athletes, like the final population, often have a suboptimal O3I, emphasizing the potential advantages of EPA and DHA supplements for inflammation control, cognitive function, neuroprotection, muscle maintenance, and training adaptations. Subsequently, researchers in the current review aimed to debate the consequences, pros, and cons of EPA and DHA supplementation in athletes.
Effects and underlying mechanisms
EPA and DHA have unique molecular structures and exert multifaceted effects on human physiology. Acting through various receptors and transcription aspects, they modulate inflammation while influencing cell membrane structure and the production of bioactive oxylipins. Their conversion to specialized pro-resolving mediators (SPMs) plays a pivotal role in resolving inflammation, impacting immunity, tissue repair, and homeostasis. Moreover, these fatty acids form bioactive molecules like endocannabinoids, influencing appetite, inflammation, and cognition. DHA, constituting 10–20% of the human brain’s lipid content, plays an important role in nerve impulse transmission, neuroplasticity, membrane stability, and cell communication. Its neuro-supportive functions may provide advantages in sports-related traumatic brain injury, cognition, neuromuscular performance, training-induced muscle adaptations, and recovery from injury.
Subsequently, inadequate levels of EPA and DHA may compromise inflammation resolution, affecting health conditions starting from arthritis to aging-related disorders.
EPA and DHA are primarily present in oily fish, resembling mackerel, salmon, and certain algae. Nevertheless, the variability, taste preferences, and concerns about heavy metal contamination in these sources contribute to their insufficient consumption, impacting EPA and DHA intake. Despite these challenges, the health advantages of fish consumption appear to outweigh the associated risks.
Microalgae species like Schizochytrium spp., Crytthecodiniumcohnii, and Phaeodactylumtricornutum function plant sources for the production of EPA and DHA supplements. While current guidelines suggest an adequate intake of 250 mg/day for adults, studies propose that optimal EPA + DHA intake, essential for an O3I ≥ 8%, may require doses higher than existing recommendations. Backing this notion, scoping reviews suggest 1000–1500 mg/day for 12 weeks or longer. Currently, the International Olympic Committee (IOC) suggests a each day dose of roughly 2 g of EPA + DHA for potential health and performance advantages in athletes.
Status and use of EPA and DHA in athletes
Studies conducted on skilled and amateur athletes practicing football, basketball, and other winter sports show suboptimal O3I levels in them, indicating the necessity for potential EPA and DHA supplementation. There are several potential advantages of this supplementation. Studies indicate improved response time, cognitive performance, and reduced negative mood. In sports-related traumatic brain injury, DHA supplementation is shown to lower the biomarkers related to head trauma. Furthermore, during recovery from injury, EPA and DHA may attenuate muscle atrophy and enhance skeletal muscle volume and mass, demonstrating promising application in athletes undergoing recovery. Over a variety of doses, supplementation consistently reduces muscle soreness after exercise-induced damage, with potential dose-dependent effects on power and strength recovery. Moreover, recent studies suggest that supplementation of DHA and EPA enhances resistance training adaptations and increases muscle strength without affecting lean body mass. Improvements in running economy and peak oxygen uptake have also been observed, indicating potential advantages for athletes in each resistance and endurance-based sports.
Potential opposed effects of supplementation
The opposed effects of EPA and DHA supplementation include gastrointestinal disturbances like fishy aftertaste, altered platelet function (increased bleeding risk), and concerns about lipid peroxidation. Nevertheless, evidence suggests that these effects could also be minimal or absent at standard doses, with several health authorities considering EPA and DHA supplementation protected at beneficial doses for the final population.
The recommendations for athletes regarding EPA and DHA supplementation involve considerations of dose, timing, chemical formulation, and the relative concentration of those fatty acids. Optimal intake should align with specific athletic goals. Further, bioavailability could also be enhanced when supplements are taken with meals. Each EPA and DHA offer similar qualitative advantages, and complement selection should prioritize high content of EPA, DHA, or each.
In summary, considering the various advantages of EPA and DHA, their supplements at beneficial doses appear reasonable to be used in athletes without opposed effects. Nevertheless, further research is crucial to find out optimal doses, durations, and consistent effects relevant to athletes before categorizing them as sports supplements above AIS category B.