Objectives: To assess the validity of FAO data on the availability of fish and vegetable oils as an indicator of national n-3 fatty acid (FA) intake and to estimate the worldwide population living in countries with low n-3 FA intake.
Design: Levels of the essential FA α-linolenic acid (ALA) and DHA, measured by GC in adipose tissue from participants in the present study and from published studies in eleven other countries, were used to validate ALA and fish availability estimated from FAO food balance sheets. On the basis of the validated FAO data for ALA and fish availability, we estimated the global prevalence of low n-3 FA availability.
Setting: Rural and urban areas of Bulgaria.
Subjects: Fifty men and fifty-eight women.
Results: Adipose tissue ALA and DHA levels (0·34 % and 0·11 % of total FA, respectively) in Bulgaria were lower than those of the eleven other countries with available data. A strong positive correlation was found between adipose tissue DHA and fish availability (r = 0·88) and between adipose tissue ALA and ALA availability (r = 0·92). Approximately half of the world's population lived in middle- and low-income countries with limited access to n-3 FA (fish < 400 g/week and ALA < 4 % of total vegetable oils), with the largest proportion being in South-East Asia (53·6 %), followed by Africa (27·1 %) and Eastern Europe (8·5 %). Of this half, 33 % lived in countries such as Bulgaria where n-3 FA was almost unavailable (fish < 200 g/week and ALA < 2 % of total vegetable oils).
Conclusions: Very low availability of n-3 FA is extensive worldwide.