India has one of the longest coastlines in the world. That fact would lead you to expect reasonable omega-3 intake across the population.

It does not reflect reality. A 2016 global survey published in Progress in Lipid Research (Stark et al.) found approximately 70% of Indian adults had sub-optimal EPA and DHA blood levels — below what is associated with cardiovascular and cognitive benefit.

The reasons are worth understanding, particularly if you live in an urban area.

The Diet Factor

EPA and DHA — the two omega-3 fatty acids with meaningful health evidence — are found almost exclusively in fatty marine fish: sardines, mackerel, anchovies, salmon. Most Indian diets, even non-vegetarian ones, lean towards poultry, eggs, and dairy rather than oily sea fish.

India also has one of the world’s largest vegetarian populations — estimates suggest 20–40% of adults, concentrated in states like Gujarat, Rajasthan, and Uttar Pradesh. For these populations, dietary EPA and DHA is effectively zero.

Plant-based omega-3 sources — flaxseed, walnuts, chia — provide ALA, a precursor. The problem is conversion efficiency. Research in the American Journal of Clinical Nutrition found the body converts ALA to EPA at less than 10%, and to DHA at less than 0.5%. Flaxseed oil is useful for many things. It is not a substitute for marine EPA and DHA.

The Urban-Coastal Divide

Coastal communities in Kerala, Bengal, Goa, and coastal Andhra Pradesh consume oily fish regularly and show meaningfully better omega-3 status. This is the population the coastline statistic applies to.

The deficiency is concentrated inland — Pune, Delhi, Bengaluru, Hyderabad, Ahmedabad. Urban diets here are processed-food-heavy and fish-poor. These are also, not coincidentally, the cities with the fastest-rising rates of cardiovascular disease and type 2 diabetes.

What the Deficiency Actually Costs

Low EPA is associated with elevated triglycerides — a primary cardiovascular risk marker. The American Heart Association’s 2019 omega-3 advisory cited 1,200mg combined EPA+DHA per day as the threshold for meaningful triglyceride reduction.

DHA makes up approximately 60% of the brain’s fatty acid content, according to research in Acta Neurologica Taiwanica (Chang et al., 2009). Low DHA is consistently associated with slower processing speed, reduced working memory, and higher rates of low mood in population studies.

For a country where cardiovascular disease is the leading cause of death, omega-3 deficiency is not a peripheral concern.

Frequently Asked Questions

Can I eat my way out of this without supplementing?
If you eat fatty fish — mackerel, sardines — two to three times per week, yes. For vegetarians or those who rarely eat oily fish, meeting evidence-based EPA+DHA thresholds through diet alone is difficult.

Does flaxseed oil count as omega-3 supplementation?
Not as an EPA/DHA equivalent. ALA conversion rates are too low to rely on for cardiovascular or cognitive benefit. Flaxseed has other merits, but this is not one of them.

What about omega-3-enriched eggs?
They contain some EPA and DHA — typically 100–150mg per egg. Useful as part of a varied diet, but not sufficient as a sole omega-3 source.

Is algae-based omega-3 suitable for vegetarians?
Yes. Algae is where fish get their EPA and DHA from in the first place. Algae-derived supplements provide DHA comparably to fish oil. EPA content varies more by brand.