Topic / Blog

Omega-3 and MS: The fatty acids that may help your symptoms

What is omega-3, where can you get it in your diet and how will it help your MS symptoms?

omega 3 rich foods

Overview

Omega-3 is often mentioned when we talk about brain health and anti-inflammatory diets, but what is it? And where can you get it from in your diet? 

‘Fatty acid’ is a scientific term referring to what are more commonly known as fats and oils. Fat is necessary in your diet for cell growth, hormone production, absorbing fat-soluble vitamins and for energy and heat production.

Unsaturated fats are often thought of as ‘healthy fats’. Omega-3s are a type of polyunsaturated fatty acid (meaning it has multiple double bonds) and are named for the location of the first double bond (the third carbon from the omega end of the molecule chain). 

Many of these polyunsaturated fatty acids (healthy fats) are what we call essential fatty acids. That is, they cannot be manufactured in the body, but are vital for health. They must be consumed through our diet, and can be thought of in the same way as vitamins.

What types of Omega-3 are there? 

There are three types of omega-3 fatty acids: ALA, EPA and DHA. 

  • Alpha-linolenic acid (ALA) is mainly found in plant foods. It is converted by the body into EPA and DHA. 

  • Eicosapentaenoic acid (EPA) is mainly found in oily fish (some microalgae).

  • Docosahexaenoic acid (DHA)  is also mainly found in oily fish. It’s a key structural component of your brain, the retina of your eye, and numerous other body parts. 

Good sources of Omega-3

Omega-3 Supplement options 

  • Flaxseed oil is our recommended source of Omega-3

  • Mainly ALA (short-chain)

  • 3 - 6 times richer in omega- 3 than fish oil 

  •  less saturated fat in oil 

  • Fish oil / high potency fish oil  

  • Contains DHA and EPA  (long-chain) 

  • Cod liver oil 

  • High in DHA and EPA  (long-chain) 

  • Also contain vitamin A and D 

  • Algal oils

  • Are a vegan source of DHA; some also contain EPA.

  • Krill oil

  • Contains EPA and DHA 

The HOLISM study found that the benefits of taking flaxseed oil were significantly greater than regular or high potency fish oil in terms of relapse rate reduction and disability levels.

Dietary Sources 

The best dietary source of omega-3 is found in cold water oily fish (e.g. sardine, mackerel, anchovy, salmon and herring).They are high in DHA and EPA (long-chain). 

Other sources of omega-3 include: 

  • Flax seeds

  • Hemp seeds

  • Chia seeds

  • Walnuts

  • Avocados 

  • Some leafy green vegetables

How much Omega-3 should I have? 

We recommend between 20ml and 40 ml cold-pressed flax oil daily (about three tablespoons) and recommend eating oily fish no more than 3 times a week. You should avoid cooking with omega-3 fats, as they are extremely fragile. Instead add oils to a dish after it’s cooked.

Benefits of omega-3 when you have MS

The HOLISM study by the NEU found those consuming fish more frequently and those taking omega-3 supplements had significantly better quality of life, in all domains, and less disability. It also showed a 60% relapse rate reduction over the previous 12 months with 20-40ml flaxseed oil daily in a real world setting.  

Omega-3 can help in two ways: suppressing inflammation and because of its anti-degenerative effect on cells. 

What is inflammation? 

Inflammation is a natural immune system response, where white blood cells and substances they produce protect a body against harmful stimuli (such as bacteria and viruses) in order to begin the healing process. The immune system in people with multiple sclerosis shifts towards a pro-inflammatory immune response. 

Chronic inflammation is slow, with long-term inflammation lasting for prolonged periods of several months to years. 

  1. Suppressing inflammation 

Certain foods tend to trigger the inflammatory process while others inhibit it. 

  • Omega-3 fats promote anti-inflammatory and “turn down” pro-inflammatory signals. 

  • Omega-6 on the other hand is pro-inflammatory so these foods should be limited. 

  • Saturated fats which are very pro-inflammatory should be avoided.

  • Processed and refined foods contain synthetic oils that are extremely pro-inflammatory and are linked to many chronic Western diseases. 

This is because fatty acids are the building blocks of the immune system chemical messengers (cytokines, eicosanoids, interleukins), telling the body to fight or repair.

  1. Resisting degeneration

Cell membranes are made from the fats in our diets. Omega-3 keeps cell membranes soft, pliable and resistant to degeneration (due to low melting points). If you have a diet low in saturated fat (like the OMS Program) you don’t need a lot of extra Omega-3 to get these benefits. 

Other health benefits of Omega-3: 

  • Diets rich in Omega-3 reduce risk of death from any cause by 33%

  • People who eat seafood one to four times a week (rich in omega-3) are less likely to die of heart disease 

  • Reduced risk of depression and anxiety

  • Reduced risk of age-related mental decline and Alzheimer’s disease

  • Improved sleep 

  • Healthy skin and hair

  • Benefits in cardiovascular disease —  less likely to have a second cardiac event 

Most research has focussed on EPA and DHA. 

How long does it take for Omega-3 to work?

Levels of omega-3’s build up quickly in the body once you take supplements. After four weeks on a low saturated fat diet, you can measure the difference in cell membrane structure. 


We cannot tell you how long it might take before you see a reduction in inflammation, or benefits to your MS or general health, as in practice the benefits may not be fully felt until after three to five years. A commonly-used analogy is that rebuilding the cellular structure throughout the body is like “ turning around an oil-tanker”.

This is not a constantly-improving process as there will be minor setbacks, but in the long-term, symptoms and quality of life should improve with time.

What other vitamins should I take for MS?

Several major well-conducted studies have shown that taking antioxidant and multivitamin supplements potentially does harm rather than good. A wholefood plant-based diet should provide all the necessary vitamins and minerals you need. The only vitamin supplements we advise in addition to omega-3 are:  

  • Vitamin D supplements in spray or pill form (up to 10,000 IU in the winter months) 

  • B12 and Iron (if following a fully vegan diet) 

Further reading:

We have lots more great information, infographics and guides on this topic, so take a look: 

Pages 133-134 of Prof. Jelinek’s book “Overcoming Multiple Sclerosis, the evidence-based 7 step program” also covers this in detail. 


References

  • https://nccih.nih.gov/health/omega3/introduction.htm 

  • George A. Jelinek, Emily J. Hadgkiss, Tracey J. Weiland, Naresh G. Pereira, Claudia H. Marck & Dania M. van der Meer (2013) Association of fish consumption and omega 3 supplementation with quality of life, disability and disease activity in an international cohort of people with multiple sclerosis, International Journal of Neuroscience, 123:11, 792-801, DOI: 10.3109/00207454.2013.803104

  • Erasmus U. Fats that heal, fats that kill: the complete guide to fats, oils, cholesterol and human health. 3rd ed. Summertown, TN: Alive Books; 2010

  • Vivekananthan DP, Penn MS, Sapp SK, et al. Use of antioxidant vitamins for the prevention of cardiovascular disease: meta-analysis of randomised trials. Lancet 2003; 361:2017-2023

  • Bjelakovic G, Nikolova D, Simonetti RG, et al. Antioxidant supplements for preventing gastrointestinal cancers. Cochrane Database Syst Rev 2004:CD004183

  • Bjelakovic G, Nikolova D, Simonetti RG, et al. Antioxidant supplements for prevention of gastrointestinal cancers: a systematic review and meta-analysis. Lancet 2004; 364:1219-1228

  • Miller ER, 3rd, Pastor-Barriuso R, Dalal D, et al. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Ann Intern Med 2005; 142:37-46

  • Lawson KA, Wright ME, Subar A, et al. Multivitamin use and risk of prostate cancer in the National Institutes of Health-AARP Diet and Health Study. J Natl Cancer Inst 2007; 99:754-764

  • Bjelakovic G, Nikolova D, Gluud LL, et al. Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis. Jama 2007; 297:842-857

  • Millen AE, Dodd KW, Subar AF. Use of vitamin, mineral, nonvitamin, and nonmineral supplements in the United States: The 1987, 1992, and 2000 National Health Interview Survey results. J Am Diet Assoc 2004; 104:942-950

  • Bjelakovic G, Gluud C. Surviving antioxidant supplements. J Natl Cancer Inst 2007; 99:742-743

  • Appleton KM, Sallis HM, Perry R, et al. Omega-3 fatty acids for depression in adults. Cochrane Database of Systematic Reviews. 2015;(11):CD004692. 

diet OMS diet omega 3
Hide commentsShow comments

Femke Oosterloo (not verified)

Is there some-one who can advice me how much of omega 3 / flaxseed-oil I could give to my 1,5 year old daughter?
Thank you very much in advance.
Femke, Netherlands

Lucy-OMS

Hi Femke - I can't seem to find much dietetic guidance on this for children - particularly for those who are so young. I will look into this further and write a blog if this will be useful? I would strongly suggest speaking to a dietitian who has knowledge of paediatrics.

Some information I have found:
- If you are breastfeeding or using formula, breast milk will contain omega-3s and many formulas are fortified with DHA so worth bearing this in mind.
- In one scientific paper (children aged 2.5 - 8 years old) the dose was 722mg daily (equivalent to approximately three servings of fatty fish per week) and it also references another study where no side-effects have been reported in children with a dose of 600 mg DHA/day. 700mg DHA & EPA would be equivalent to 1 tablespoon of flaxseed oil.

Reference: https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-016-142…
https://www.health.harvard.edu/heart-health/why-not-flaxseed-oil