Most prenatal supplements lack the amount of omega-3 fatty acids that could help prevent preterm birth, meaning delivery before 37 weeks’ gestation. This is a key finding of a new study, published by a team from the Eastern Virginia Medical School in the American Journal of Perinatology.

Omega-3 fatty acids are essential nutrients that are found largely in fatty fish. They help prevent inflammation and, by doing so, decrease the risk of preterm birth.

The study, however, showed that roughly 1 in 6 prenatal supplements on the market in the US that contain omega-3 fatty acids provide the amount that is needed by most pregnant women.
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The researchers used the US Department of Agriculture’s Dietary Supplement Label Database to identify prenatal supplements that contained omega-3 fatty acids. They then compared the stated amount of omega-3s on the product labels with the recommended amounts in the new guidelines published in the American Journal of Obstetrics and Gynecology Maternal-Fetal Medicine by a team of experts representing international obstetric and child health organisations. 

The guidelines recommend different doses of omega-3 fatty acids depending on whether a woman’s baseline intake prior to pregnancy was adequate or inadequate.
They found that 70% of the prenatal supplements that contained omega-3s provided the amount that is recommended for women with adequate intakes. However, previous research has shown that only 5% of pregnant women and women of childbearing age consume adequate amounts of omega-3 fatty acids. Thus, for women with insufficient intakes, a prenatal supplement with a higher amount of omega-3s would be helpful.
    
Why it matters
Preterm birth is the leading cause of infant mortality worldwide. It is also the leading cause of infant illnesses that lead to costly stays in neonatal intensive care units. And then there is the heavy emotional toll that it has on parents and families.

Preterm birth also significantly increases a child’s risk for long-term health consequences such as intellectual disability, chronic diseases such as hypertension and diabetes and psychiatric illness in adulthood.
Yet there are few treatment options for preterm birth. This is where omega-3 fatty acids come in. They lower risk of preterm birth by decreasing production of the signalling molecules that kick-start labour.
A Cochrane review of 26 randomised controlled trials demonstrated that 1,000 milligrams of supplemental omega-3 fatty acids per day can decrease risk of preterm birth by 11%, and risk of early preterm birth – delivery before 34 weeks’ gestation – by 42%.

Considering that prenatal supplements often don’t contain the required amount of omega-3s, one option is to simply take an additional omega-3 supplement alongside a prenatal vitamin to supply the difference and obtain the benefit.

Nevertheless, omega-3 supplements are not always necessary. The new guidelines recommend that all women of childbearing age should consume 250 milligrams of omega-3s per day. This amount can be obtained from roughly two 3-ounce servings per week of fatty fish such as salmon, mackerel, herring, sardines and anchovies.

When women increase their intake of omega-3 fatty acids prior to pregnancy, the recommended intake levels during pregnancy are lower. This is a way to eliminate the need for supplements in the first place.

However, women of childbearing age must also consider levels of mercury in fish because of its adverse effects on fetal neurodevelopment. While most species of salmon are low in mercury, certain fish that are rich in omega-3s can be moderately high in mercury. It’s important to consult local public health guidelines on mercury levels in fish to ensure safe consumption levels.

What still isn’t known
Omega-3 fatty acids are chemically unstable molecules that are inherently fragile, and thus prone to oxidation, a process whereby oxygen degrades the molecule, rendering it ineffective. Studies have shown wide variation in the oxidation levels in commercial omega-3 supplements. Worse yet, there are few predictors of omega-3 supplement quality.

Nevertheless, despite their high risk for oxidation, commercially available omega-3 supplements have exhibited demonstrable benefits in clinical trials.

What’s next?
Taking into consideration the inconsistent levels of omega-3 fatty acids in prenatal supplements, their instability and the potential for dietary sources prior to pregnancy offsetting the need for supplements, more research is needed to understand how to motivate increased omega-3 intakes in women of childbearing age.

Recognising that many women will still require omega-3s from supplemental sources, longitudinal studies tracking omega-3 levels in prenatal supplements will be crucial.

In addition, ongoing efforts are needed to foster the translation of this information into clinical settings to ensure that pregnant women, and the health care professionals who care for them, are able to make use of the great potential for omega-3 fatty acids in the prevention of preterm birth. Agencies

The Cooperative is planning to lease 100 acres of state land to expand cultivation

Lhakpa Quendren

Trongsa—With a growing appetite for healthier beverages, Black Mountain Green Tea, a cooperative in Samdrupcholing, Trongsa, offers a range of organic teas, from traditional Suja to green tea.

The Cooperative introduced oolong and black tea earlier this year and plans to launch Bhutanese Matcha and white tea in 2025.

Rinchen Lhamo, 34, chairperson of Samdrupcholing Ngoja Tshonglay Detshen, said that since Matcha tea production requires shade for the plants, the cooperative plans to secure green netting for the plantation. “We also plan to propose training in white tea production,” she said.

The Queen’s Project, through the Thailand International Cooperation Agency, supported training in 2022 to launch new brands.

The Cooperative has 34 women members

The Department of Agricultural Marketing and Cooperatives has facilitated packaging solutions, while the Join Together Society Korea, a non-governmental organisation under the Jungto Society founded by Korean Buddhist master Pomnyun Sunim, provided advanced tea-bagging equipment.

“He has also assured us of marketing support if our packaging meets international standards,” Rinchen Lhamo said.

Crafted from high-quality Camellia sinensis leaves, the Cooperative’s small-batch organic teas have garnered a growing following. Available in loose-leaf and bagged varieties, these teas are seeing increase in demand for its unique flavours.

“Since launching the brands, our products have been well received by consumers,” Rinchen Lhamo said.

Social media has played a pivotal role in promoting the products. “Social media has supported our marketing efforts, and we expect our products to stay top of mind for consumers,” she said.

Last year, packaging challenges caused delays in payments to members, as the products could not be sold by the end of the year. “We only finished the products recently. While we struggled to meet external demand, there was a lack of customers in the local market,” Rinchen Lhamo said.

But hope is not lost. The market has now expanded both locally and internationally, including to the US, Canada, and the Netherlands.

The products are also available at the CSI Market in Thimphu and marketing links have been established with local businesses.

Despite its successes, the Cooperative faces obstacles, particularly exports of its products to international markets. High air freight costs significantly raise the price of exports, deterring potential buyers.

“Some foreign agents have suggested sea freight as a cheaper alternative, but we need government support to overcome these barriers,” Rinchen Lhamo said.

The cooperative is a lifeline for its 34 women members across eight villages in Dragteng gewog. Many rely entirely on tea cultivation for their livelihood, with annual earnings ranging from Nu 40,000 to Nu 700,000, depending on land size and labour availability.

“My three-acre plot is fully dedicated to tea, leaving no space even for a kitchen garden,” Rinchen Lhamo said.

The tea plantation, which started on 47 acres in 2009, now covers about 100 acres. The Cooperative also plans to lease 100 acres of state land to help members expand cultivation.

The Cooperative also plans to remodel the two-storey government building, currently used as an outlet, into a café to create employment opportunities for its members.

Members bring the harvested tea to the outlet, where it is processed and packaged.

The Cooperative was launched in April 2009 with 27 founding members, following the tea plants initially planted by the Department of Forest and Park Services to prevent landslides. About 40 members deregistered due to the labour-intensive nature of work and minimal returns.

Residents believe that tea plants were sourced from Samdrupcholing Palace, where the Second Druk Gyalpo, Jigme Wangchuck, personally nurtured the tea brought from Sikkim.

With government support, members have received training in Nepal, Japan, China, and India. In 2018, the cooperative was honoured with the prestigious Best Green Tea Producers Award by the Indian government.

The Cooperative sells Oolong and black tea at Nu 200 per packet, green tea at Nu 180, and Suja at Nu 120 while tea is also available at Nu 3,380 per kilogramme (kg).  Members receive Nu 2,780 per kg, while Nu 600 is deposited into the Cooperative’s account for maintenance, bills, packaging, and transportation.