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The Natural Standard states that the "average" dietary intake of EPA and DHA is only 0.1
to 0.2 g per day, so omega 3 products should be counted assuming a zero baseline. The
World Health Organization and governmental health agencies in “several countries”
recommend consuming 0.3 to 0.5 g. per day of EPA and DHA. If you have heart disease,
the American Heart Association recommends that everyone get one g (1,000
milligrams) per day of EPA and DHA from fatty fish or fish oil supplements. It advises
two to four g of EPA and DHA per day from supplements for people with high
triglycerides.
The clinical studies thus far have generally used fish oil (about 3:2 EPA to DHA). There is
no clear evidence of the relative contribution of EPA and DHA to the observed
outcomes. Stoll asserts that EPA appears to be “the most mood stabilizing component”
in fish oil, and cites anecdotal data that suggest that too much DHA relative to EPA may
actually worsen mood.^53
Brown et al. note that most consumers cannot tolerate the gastrointestinal side effects
of using over 6 g. per day of omega-3 essential fatty acid. People also have a hard time
with the number of pills required. However, Brown et al. explicitly recommend 8-10 g.
per day of EPA and DHA in a 2:1 ratio for consumers who can tolerate it.^54
If you are healthy, the standard advice is to eat fatty fish twice a week. But if you don’t
eat this much fish, you can consider taking a fish oil supplement—500 to 1,000
milligrams per day EPA/DHA, on average. And to get 9.6 g per day, the dosage used by
Stoll in his 1999 clinical trial, you would have to go on a daily ration of fatty fish. At that
point, use of a fish oil supplement becomes essential.
Weil recommends two to four g per day of omega-3s in fish oil for prevention and
treatment of depression. Stoll originally recommended one to two g per day of total
omega-3s (EPA plus DHA) for health, mood or cognitive enhancement, and clinical
doses of from two to five g per day. However, in his chapter in Mischoulon and
Rosenbaum, Stoll upped his recommendation to between one and six g per day of EPA
alone, accompanied by a lesser dose of DHA. At the top end, this would approximate
the 9.6 g. per day used by Stoll in his 1999 clinical trial. Stoll adds that: "The effective