Papanikolaou · Nutrition journal 2014 · Cross-sectional survey analysis · n=?

U.S. adults are not meeting recommended levels for fish and omega-3 fatty acid intake: results of an analysis using observational data from NHANES 2003-2008.

Cited 239 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional survey analysis of population dietary data (NHANES).

PubMed 24694001 · doi:10.1186/1475-2891-13-31 · record verified 2026-08-29

What was done

Researchers analyzed usual intake of total fish, fish rich in omega-3 fatty acids, alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) among U.S. adults aged 19 years and older. Data were drawn from the 2003–2008 National Health and Nutrition Examination Survey (NHANES), and usual intakes from food alone and food plus supplements were estimated using National Cancer Institute methods.

What was found

Mean usual intake was 0.61 ± 0.03 oz/day (median 0.43 oz/day) for total fish and 0.15 ± 0.03 oz/day (median 0.07 oz/day) for high-omega-3 fish. From food alone, mean intakes were 1.5 ± 0.01 g/day for ALA (median 1.4 g/day), 23 ± 7 mg/day for EPA (median 18 mg/day), and 63 ± 2 mg/day for DHA (median 50 mg/day). When dietary supplements were included, mean intakes reached 1.6 ± 0.04 g/day for ALA, 41 ± 4 mg/day for EPA, and 72 ± 4 mg/day for DHA. Intakes of high-omega-3 fish were significantly higher in adults aged 51+ compared to 19–50 years (0.19 ± 0.02 vs 0.13 ± 0.01 oz/day; p < 0.01) and in males compared to females (0.18 ± 0.02 vs 0.13 ± 0.01 oz/day; p < 0.05). Combined food and supplement EPA and DHA intakes were higher in males than females (EPA: 44 ± 6 vs 39 ± 4 mg/day; DHA: 90 ± 7 vs 59 ± 4 mg/day; p < 0.05) and higher in older versus younger adults (EPA: 58 ± 9 vs 34 ± 3 mg/day; DHA: 81 ± 6 vs 68 ± 4 mg/day; p < 0.05).

Why it matters

This study provides national benchmark data showing that the vast majority of U.S. adults fall short of the American Heart Association's target of at least two 3.5-ounce fish servings per week, with EPA and DHA intake remaining low even among supplement users.

Limits

The abstract does not report the total participant sample size. The analysis relies on self-reported dietary recalls from NHANES, which are subject to recall bias and misreporting. Biological omega-3 status (blood or tissue biomarkers) and longitudinal clinical outcomes were not measured.

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