Evidence for Nutrition Recommendations: DHA & Prostate Cancer
A reader sent me a link to this study, DHA inhibits differentiation of prostate fibroblasts into myofibroblasts and tumorigenesis, and asked me if it changed my recommendations that vegans (under age 60) don’t need to supplement with DHA every day.
The study is in vitro and animal research, and indicates that DHA can prevent prostate cancer growth. I told him that it did not change my recommendations and he asked me to make a blog post to explain why.
Creating nutrition recommendations is not something that should be taken lightly. The United States government calls upon the National Academy of Sciences to make nutrition recommendations for the nation. This is done through the Institute of Medicine’s Food and Nutrition Board and the recommendations are referred to as the Dietary Reference Intakes (DRI).
All known essential nutrients are given a DRI. In most cases, these are based on a large body of research and arrived at by a panel of experts in the area. The research they have reviewed for most nutrients has been based on acute symptoms of deficiency and toxicity; they are rarely based on long-term, chronic disease prevention. This may be changing as more research becomes available and acute deficiencies are no longer the problem they once were.
So, with that background, a very good reason would be needed for me to overrule the Institute of Medicine and set my own “DRI.” But because the DRI are not set with vegans in mind, we have to fill in the gaps and most of my recommendations are to get vegans in compliance with the spirit of the DRI.
The study on DHA and prostate cancer, mentioned above, is only a test-tube and animal study. The results may or may not translate for humans, and even if they do, there is no way to know how much humans need to take to achieve such results or if there are negative side effects from taking whatever level of DHA we might determine is appropriate. The Food and Nutrition Board would not make recommendations based on one in vitro or animal study. There are many studies looking at DHA intake and levels in humans and associated diseases and these studies are fraught with confounding variables with no clear answer as to how much DHA humans should be taking on a regular basis to prevent overall chronic disease.
Some vegan RDs do not think it’s necessary to recommend DHA for vegans; I choose to do so, but err on the conservative side. The Food and Nutrition Board has not created a DRI for DHA, but given that studies have shown that vegans have much lower levels of DHA in the blood than your average person, I recommend DHA to make sure that we are not at a disadvantage compared to non-vegans. If you want to see the reasoning behind my DHA recommendations, you can read it in Omega-3 Fatty Acid Recommendations for Vegetarian.
For more information on the types of studies that provide more evidence for nutrition recommendations than others, please see my article Basics of Nutrition Research.
In conclusion, I try not to supersede the Food and Nutrition Board in formulating nutrition recommendations and I do not change recommendations based on in vitro or animal studies.

January 21st, 2013 at 7:30 am
I think your previous link is also relevant here:
http://www.motherjones.com/kevin-drum/2013/01/sad-story-fish-oil-and-small-sample-sizes
May 16th, 2013 at 6:15 am
Jack, I was wondering if you could explain the rationale behind your recommendation to dose DHA q2d rather than qOD (at least, for those under the age of 60). Appreciate your thoughts on this.
Dan
May 16th, 2013 at 8:34 am
Dan,
I don’t have any good mathematical analysis for these recommendations other than to say that based on the entirety of the research, I think this is an amount that will provide insurance for vegans in case DHA is, indeed, necessary for cognitive function. If you look at Table 9 on this page http://veganhealth.org/articles/omega3 you will see that 1,600 mg provided more than enough to raise blood levels. And, that’s a lot more than I recommend. Hopefully, there will be more evidence in years to come.
May 16th, 2013 at 8:45 am
Heh Jack,
The papers I saw in medline all used daily dosing in veg*ns. I wonder if you know what the half-life of DHA is? Likely higher in the tissues (ie as incorporated phospholipids in cell membranes) than in the blood, where we can measure it.
Reason I ask is that vegan DHA is so expensive. If every-other-day dosing is a reasonable extrapolation of the data, it would be half the price!
May 16th, 2013 at 4:57 pm
> The papers I saw in medline all used daily dosing in veg*ns.
What papers – the ones I mention in my article that use about 1,600 mg? If you know of others, I’d like to see the citations so I can check them out.
No, I have no idea what the half-life of DHA might be.
May 16th, 2013 at 5:05 pm
If you pop the following search string into Pubmed, n=22 articles come up, some of them quite interesting -
(“Docosahexaenoic Acids”[Mesh] AND “Diet, Vegetarian”[Mesh])