How Vegetarians and Vegans Get Enough Omega-3s Without Fish

This review looks at how people who eat vegetarian or vegan diets handle omega-3 fatty acids, even though these diets contain very little EPA and DHA — the long-chain omega-3s typically found in fish. Plant-based diets do provide ALA (alpha-linolenic acid), a shorter-chain omega-3 found in foods like flaxseed and walnuts, which the body can convert into EPA and DHA, though this conversion is generally inefficient.

The authors explain that despite lower blood levels of EPA and DHA, people eating plant-based diets often still show favorable cardiometabolic health markers. This suggests the body may have adaptive ways of preserving DHA in tissues, and that the overall pattern of a plant-based diet may help offset lower direct intake of these fatty acids.

The review also highlights practical strategies for improving omega-3 status on a plant-based diet, particularly increasing ALA intake and using algae-derived EPA/DHA supplements, both of which were shown to meaningfully raise omega-3 biomarkers.