These issues are all addressed in the threads on Fish, Essential Fats, Flax, etc.
This topic was also recently addressed on a professional list-serve made up of all the professionals in vegan/vegetarian health and most did not agree with the above conclusions.
Let me quote one of the responses...
"I think we need good evidence before recommending that vegans consume an expensive supplement of substances (EPA/DHA) that do not naturally occur in any diet of land plants.
The balance of evidence for specific benefits of the longer omega-3s for heart health is rather weak (see for example the BMJ review http://www.bmj.com/cgi/rapidpdf/bmj.38755.366331.2Fv1 ) Those recommending EPA and DHA have, in my opinion, been too quick to dismiss the DART-2 results showing increased risk in angina sufferers.
http://www.ncbi.nlm.nih.gov/pubmed/17343767
Research on omega-3s and adult mental function favours EPA rather than DHA and little DHA is retro-converted to EPA. ALNA is effective in raising EPA levels.
In terms of DHA supply to nervous tissue during pregnancy, ALNA reduces signs of omega-3 deficiency (e.g. elevated levels of Osbond acid) indicating that it acts as a source of DHA even if little conversion is evident in blood samples.
The evidence for adverse effects of ALNA is either sparse (eye) or contradictory (prostate).
I therefore see no need for vegans to consume any omega-3 other than the plant omega-3 alpha-linolenic acid (ALNA).
A good source of ALNA is ground flaxseed. In the UK, organic flaxseed can be purchased for under £4 per kilo (£1 per 1,000 kcal) making it a not particularly expensive food rather than an expensive supplement. A heaped tablespoon of flaxseed a day (about 10 grams) combined with cutting down high omega-6 oils and seeds will give a good balance between omega-6 and omega-3 (about 4:1) without excessive polyunsaturated fat intake."
There have been a number of recent reviews of omega-3 fatty acids and depression.
For example,
The role of omega-3 fatty acids in mood disorders. http://www.ncbi.nlm.nih.gov/pubmed/18183532 and
Omega-3 fatty acids as treatments for mental illness: which disorder and which fatty acid?
http://www.pubmedcentral.nih.gov/picren ... id=2071911 <http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2071911&blobtype=pdf> &blobtype=pdf
These reviews provide no basis to recommend the use of pure DHA (as per most veg*n supplements) to combat depression.
I think it is also important to note that a recommendation of EPA and DHA as nutritional supplements for veg*ns would imply that humans are adapted to require dietary components that are not found in plants. If the evidence pointed to such a conclusion, I would go with the evidence but I have no desire to leap beyond the evidence into such problematic territory: if one such adaptation were demonstrated the likelihood that other such adaptations exist would increase. So far, I don’t think the evidence points that way.
In the collaborative analysis of studies comparing vegetarians with other dietary groups, fish-eaters and vegetarians showed very comparable results (Table 7 http://www.ajcn.org/cgi/reprint/70/3/516S ). The fish-eaters will have had higher intakes of EPA and DHA than the vegetarians but this does not seem to have conferred an advantage. Once again, evidence to recommend EPA/DHA seems lacking."I agree.
In addition, a recent article in the AJCN agreed with this position.
Do vegetarians have to eat fish for optimal cardiovascular protection?1–3
Am J Clin Nutr 2009;89(suppl):1S–5S.
Iqwal Mangat
ABSTRACT
Interest in the cardiovascular protective effects of n–3 (omega-3)
fatty acids has continued to evolve during the past 35 y since the
original research describing the low cardiovascular event rate in
Greenland Inuit was published by Dyerberg et al. Numerous in vitro
experiments have shown that n–3 fatty acids may confer this benefit
by several mechanisms: they are antiinflammatory, antithrombotic,
and antiarrhythmic. The n–3 fatty acids that have received the most
attention are those that are derived from a fish source; namely the
longer-chain n–3 fatty acids eicosapentaenoic acid (EPA; 20:5n–3)
and docosahexaenoic acid (DHA; 22:6n–3). More limited data
are available on the cardiovascular effects of n–3 fatty acids derived
from plants such as a-linolenic acid (ALA; 18:3n–3). Observational
data suggest that diets rich in EPA, DHA, or ALA do reduce cardiovascular
events, including myocardial infarction and sudden cardiac
death; however, randomized controlled trial data are somewhat
less clear. Several recent meta-analyses have suggested that dietary
supplementation with EPA and DHA does not provide additive
cardiovascular protection beyond standard care, but the heterogeneity
of included studies may reduce the validity of their conclusions.
No data exist on the potential therapeutic benefit of EPA, DHA, or
ALA supplementation on those individuals who already consume
a vegetarian diet. Overall, there is insufficient evidence to recommend
n–3 fatty acid supplementation for the purposes of cardiovascular
protection; however, ongoing studies such as the Alpha
Omega Trial may provide further information.
Also...
While I try to keep the discussion/threads on the health issues and the available evidence, the point of having an article end in the sale of the product recommended in the article, take away from the credibility of the article, regardless of who writes the article.
As I have said here many times, supplements can and do play a role, but should only be recommended on an individual basis on an as needed basis, with informed consent. In addition, as a health professional, (and as the ethical guidelines of most all health professions agree) it is a compromise of the doctor/patient relationship for me to directly sell supplements to a patient. My role is to evaluate their health situation and if a supplement (or medication) is necessary, to tell them which one and which brand I may recommend, and/or where to get it the cheapest for the highest quality. And, I should refrain from any sales of promotions of specific brands unless I am fully disclosing all my financial relationships with the brand and making them available at my cost as a added benefit to the patient.
In other words, if I thought someone needed B12, it is my job to discuss the various forms of B12, which I would recommend and why, and where they could get it for the best price. And, if I was to make it available, it would be only to offer it at or below cost as a service to you.
Anecdotal stories of isolated cases of disease and death from an evidence based professional, only makes their position worse, not better.
Personally, I won't even go near the personal sales of these products as I feel it compromises my ethics, integrity and professionalism. After over 5 years of being "in charge" of the supplement program for a former employer, my total commissions equaled "0" because I refused to sell them. However, when they were appropriate, I did recommend them on occasions to specific patients for specific reasons, but I also told them where was the best place for them to buy them.
In Health
Jeff