Omega-3 Fatty Acids and Mental Health: Assessment of Pharmacists’ Knowledge and Educational Needs
DOI:
https://doi.org/10.53103/cjess.v5i4.370Keywords:
Omega-3, Fatty Acid, Pharmacist, Mental Health, Brain Health, Cognitive HealthAbstract
Introduction: There has been a growing interest in Omega-3 fatty acids (FAs) for mental/cognitive health. Cognitive impairment, a global problem affecting millions of people, is frequent among elderly, and it influences the individual’s ability to function independently. Omega-3 FAs are natural health products (NHPs), and pharmacists are the front-line healthcare practitioners who provide counselling to patients. Purpose: To identify the current knowledge status of pharmacists on Omega-3 FA NHPs and their confidence levels in counselling patients on these products via a study done in pharmacies in Ontario, Canada. Methods: To identify areas for improvement we assessed knowledge and understanding of Omega-3 FA NHPs of community and hospital pharmacists via a survey. Results: Seventy-six percent of pharmacists were enquired about Omega-3 FA at least once per month. Pharmacists have good knowledge of Omega-3 chemistry, major components, and differences between Omega-3 and -6 FAs. Sixty-four percent of responders identified brain health as benefits; the other health benefits are less widely recognized. Sixty percent of pharmacists were concerned about the increased risk of bleeding; however, only 6% felt confident in counselling patients on Omega-3 FA NHPs. Previous training on Omega-3 was associated with better knowledge of Omega-3 and had positive impact on pharmacists’ confidence in counselling. Conclusion: There are gaps in pharmacist’s current knowledge on Omega-3 FA health benefits and there is unsatisfactory confidence in providing patient counselling. Thus, there is a need for comprehensive education on Omega-3 FA NHPs in addition to traditional medical, naturopathic, and pharmacy formal education.
Downloads
References
Alexander, D.D., Bassett J.K., Weed D.L., Barrett E.C., Watson H., & Harris W. (2015). Meta-analysis of long-chain omega-3 polyunsaturated fatty acids (LCω-3PUFA) and prostate cancer. Nutr Cancer, 67(4), 543-554.
Andriambelo, B., Stiffel M., Roke K., & Plourde M. (2023). New perspectives on randomized controlled trials with omega-3 fatty acid supplements and cognition: A scoping review. Ageing Res Rev, 85, 101835.
Begtrup, K.M., Krag A.E., & Hvas A.M. (2017). No impact of fish oil supplements on bleeding risk: a systematic review. Dan Med J, 64(5), A5366.
Beutler, J. (2000). Life in the balance. The critical need for Omega-3 supplementation. Natural Medicine Online, Jul,1-8.
Boston, P.F., Bennett A., Horrobin D.F., & Bennett C.N. (2004). Ethyl-EPA in Alzheimer's disease--a pilot study. Prostaglandins Leukot Essent Fatty Acids, 71(5), 341-346.
Bradbury, J. (2011). Docosahexaenoic acid (DHA): an ancient nutrient for the modern human brain. Nutrients, 3(5), 529-554.
Clark, C.M., Monahan K.D., & Drew R.C. (2018). Omega‐3 polyunsaturated fatty acid supplementation reduces blood pressure but not renal vasoconstrictor response to orthostatic stress in healthy older adults. Physiol Rep, 6(8), e13674.
DeFilippis, A.P. & L.S. Sperling. (2006). Understanding omega-3's. Am Heart J, 151(3), 564-570.
Emery, S., Häberling I., Berger G., Walitza S., Schmeck K., Albert T., Baumgartner N., Strumberger M., Albermann M., & Drechsler R. (2020). Omega-3 and its domain-specific effects on cognitive test performance in youths: A meta-analysis. Neurosci Biobehav Rev, 112, 420-436.
Farrell, J., Ries N.M., & Boon H. (2008). Pharmacists and natural health products: a systematic analysis of professional responsibilities in Canada. Pharm Pract (Granada), 6(1), 33-42.
Food and Drug Administration. Petition for a health claim for eicosapentaenoic acid and docosahexaenoic acid and reduction of blood pressure in the general population (docket no. FDA-2014-Q-1146). Available online: www.fda.gov/media/128043/download (accessed on 06 June 2025).
Freund-Levi, Y., Basun H., Cederholm T, Faxén-Irving G., Garlind A., Grut M., Vedin I., Palmblad J., Wahlund L-O., & Eriksdotter-Jönhagen M. (2008). Omega-3 supplementation in mild to moderate Alzheimer's disease: effects on neuropsychiatric symptoms. Int J Geriatr Psychiatry, 23(2), 161-169.
Fu, Y.Q., Zheng J.S., Yang B., & Li D. (2015). Effect of individual omega-3 fatty acids on the risk of prostate cancer: a systematic review and dose-response meta-analysis of prospective cohort studies. J Epidemiol, 25(4), 261-274.
Gebauer, S.K., Psota T.L., Harris W.S., & Kris-Etherton P.M. (2006). N-3 fatty acid dietary recommendations and food sources to achieve essentiality and cardiovascular benefits. Am J Clin Nutr, 83(6 Suppl), 1526S-1535S.
Grew, B., Schneider C.R., Mirzaei A., & Carter S.R. (2019). Validation of a questionnaire for consumers’ perception of service quality in community pharmacy. Res Social Adm Pharm, 15(6), 673-681.
Harris, W.S. (2010). Omega-3 Fatty Acids. In: Encyclopedia of dietary supplements (second ed). Edited by Coates P.M., Betz J.M., Blackman M.R., Cragg G.M., Levine M., Moss J. & White J.D. Informa Healthcare.
Health Canada. (2018). Natural Health Product. Fish Oil. September 2018.
Health Canada. (2024a). Natural Health Product. Fixed Oil Products – Oral. March 28, 2024. Available online: https://webprod.hc-sc.gc.ca/nhpid-bdipsn/atReq?atid=multiple.oil&lang=eng (accessed on 06 June 2025).
Health Canada. (2024b). Natural Health Product. Fish Oil. March 28, 2024. Available online: https://webprod.hc-sc.gc.ca/nhpid-bdipsn/atReq?atid=fish.oil.huile.poisson&lang=eng (accessed on 06 June 2025).
Hooper, C., De Souto Barreto P., Coley N., Cantet C., Cesari M., Andrieu S., & Vellas B. (2017). Cognitive changes with omega-3 polyunsaturated fatty acids in non-demented older adults with low omega-3 index. J Nutr Health Aging, 21(9), 988-993.
Irving, G. F., Freund-Levi Y., Eriksdotter-Jönhagen M., Basun H., Brismar K., Hjorth E., Palmblad J., Vessby B., Vedin I., Wahlund L-O., & Cederholm T. (2009). Omega-3 fatty acid supplementation effects on weight and appetite in patients with Alzheimer's disease: the omega-3 Alzheimer's disease study. J Am Geriatr Soc, 57(1), 11-17.
Khan, S.U., Lonea A.N., Khanb M.S., Viranic S.S., Blumenthald R.S., Nasir K., Millerh M., Michos E.D., Ballantynec C.M., Bodeni W.E., & Bhatt D.L. (2021). Effect of omega-3 fatty acids on cardiovascular outcomes: a systematic review and meta-analysis. EClinicalMedicine, 38, 100997.
Kheir, N., Gad H.Y., & Abu-Yousef S.E. (2014). Pharmacists’ knowledge and attitudes about natural health products: a mixed-methods study. Drug Healthc Patient Saf, 6, 7-14.
Kwan, D., Hirschkorn K., & Boon H. (2006). U.S. and Canadian pharmacists’ attitudes, knowledge, and professional practice behaviors toward dietary supplements: a systematic review. BMC Complement Altern Med, 6, 1.
Lane, K., Derbyshire E., Li W., & Brennan C. (2014). Bioavailability and potential uses of vegetarian sources of omega-3 fatty acids: a review of the literature. Crit Rev Food Sci Nutr, 54(5), 572-579.
Mozaffarian, D. (2024). Fish oil: Physiological effects and administration. UpToDate. Available online: www.uptodate.com/contents/fish-oil-physiologic-effects-and-administration/print (accessed on 06 June 2025).
Phillips, M.A., Childs C.E., Calder P.C., & Rogers P.J. (2015). No effect of omega-3 fatty acid supplementation on cognition and mood in individuals with cognitive impairment and probable Alzheimer's disease: a randomised controlled trial. Int J Mol Sci, 16(10), 24600-24613.
Quinn, J.F., Raman R., Thomas R.G., Yurko-Mauro K., Nelson E.B., & Van Dyck C., Galvin J.E., Emond J., Jack Jr C.R., Weiner M., Shinto L., & Aisen P.S. (2010). Docosahexaenoic acid supplementation & cognitive decline in Alzheimer disease: a randomized trial. JAMA, 304(17), 1903-1911.
Sinn, N., Milte C.M., Street S.J., Buckley J.D., Coates A.M., Petkov J., & Howe P.R.C. (2012). Effects of n-3 fatty acids, EPA v. DHA, on depressive symptoms, quality of life, memory and executive function in older adults with mild cognitive impairment: a 6-month randomised controlled trial. Br J Nutr, 107(11), 1682-1693.
Spector, A.A. (1999). Essentiality of fatty acids. Lipids, 34 Suppl, S1-3.
US National Institutes of Health. (2024). Omega-3 fatty acids. fact sheet for health professionals. Available online: https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/ (accessed 06 June 2025).
Vakhapova, V., Cohen T., Richter Y., Herzog Y., & Korczyn A.D. (2010). Phosphatidylserine containing omega-3 fatty acids may improve memory abilities in non-demented elderly with memory complaints: a double-blind placebo-controlled trial. Dement Geriatr Cogn Disord, 29(5), 467-474.
Venegas-Caleron M., Sayanova O., & Napier J.A. (2010). An alternative to fish oils: Metabolic engineering of oil-seed crops to produce omega-3 long chain polyunsaturated fatty acids. Prog Lipid Res, 49(2), 108-119.
Wei, B.Z., Li L., Dong C.W., Tan C.C., Alzheimer’s Disease Neuroimaging Initiative, & Xu W. (2023). The relationship of omega-3 fatty acids with dementia and cognitive decline: evidence from prospective cohort studies of supplementation, dietary intake, and blood markers. Am J Clin Nutr, 117(6), 1096-1109.
World Health Organization. (2022). World Mental Health Report. Transforming mental health for all. Available online: www.who.int/publications/i/item/9789240049338 (accessed on 06 June 2025).
Yang, C.P., Chang C.M., Yang C.C., Pariante C.M., & Su K.P. (2022). Long COVID and long chain fatty acids (LCFAs): psychoneuroimmunity implication of omega-3 LCFAs in delayed consequences of COVID-19. Brain Behav Immun, 103, 19-27.
Yurko-Mauro K., McCarthy D., Rom D., Nelson E.B., Ryan A.S., Blackwell A., Salem Jr N., Stedman M, & MIDAS Investigators. (2010). Beneficial effects of docosahexaenoic acid on cognition in age-related cognitive decline. Alzheimers Dement, 6(6), 456-464.
Xie, R. & Zhang Y. (2023). Association between 19 Dietary fatty acids intake and rheumatoid arthritis: results of a nationwide survey. Prostaglandins Leukotrienes and Essential Fatty Acids, 188, 102530.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Alina Kotchetkov, Magdy Kamel

This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles published by CJESS are licensed under the Creative Commons Attribution 4.0 International License. This license permits third parties to copy, redistribute, remix, transform and build upon the original work provided that the original work and source is appropriately cited.