The American Heart Association (AHA) recommends at least two 3.5 oz servings of non-fried fish (preferably fatty fish) per week to receive the necessary omega-3 fatty acids in our diet. For people with heart disease or cardiac risk factors, some experts recommended doubling that.
However, while I advocate getting nutrients from food sources over supplements, there are some risk factors to consider when consuming fish.
1. Mercury content can be high depending on the fish (i.e. swordfish, king mackerel and tuna for example) and can damage the nervous system.
2. Potential risks of developing cancer from consuming radiation contaminated fish in the pacific due to the Fukushima Daiichi nuclear disaster.
3. GMO fish were approved in the US in 2015 and have been shown to wreak havoc on your health.
In addition, not everyone is a fan of fish! Whether due to taste preference, allergies or diet lifestyle. And while there are other omega-3 fortified foods on the market – many have been shown to not contain the claimed value of omega-3’s listed. That’s where taking a supplement can really help fill the gaps in your diet to receive this beneficial nutrient.
Taking an Omega-3 fatty acid fish oil supplement offers a wide range of potential benefits for mental health, inflammatory diseases, maintaining muscle, cardiovascular and cognitive health and even cancer prevention.
In this article – I aim to discuss what omega-3 fish oil is and it’s various components, benefits, provide dosing and administration tips and advise of any potential safety and side effects. Lastly, I will provide some third party tested and approved products!
WHAT ARE OMEGA-3 FATTY ACIDS?
Omega-3 fatty acids are widely distributed in nature, being important constituents of animal lipid metabolism, and they play an important role in the human diet and in human physiology. They can be found in fatty layers of cold-water fish and shellfish, plant and nut oils, English walnuts, flax seed, algae oils, and fortified foods. You can also get omega-3’s as supplements. Food and supplement sources of these fatty acids differ in the forms and amounts they contain.
There are the two main types of omega-3 fatty acids:
⦁ Long-chain omega-3 fatty acids are EPA (eicosapentaenoic acid), DHA (docosahexaenoic acid) and DPA (docosapentaenoic acid). These are plentiful in fish and shellfish. Algae often provides only DHA.
⦁ Short-chain omega-3 fatty acids are ALA (alpha-linolenic acid). These are found in plants and seeds.
THE MAIN COMPONENTS OF OMEGA-3 FATTY ACID
1. Alpha-Linolenic acid (ALA) – A polyunsaturated shorter-chain omega-3 fatty acid found in seeds (chia, flax seed, hemp), nuts (notably walnuts), dark green leafy vegetables and many common vegetable oils.
ALA is the parent in the omega-3 family and is considered an essential nutrient because our body cannot produce it on its own. Being the head of the family, ALA can technically be converted into other long-chain omega-3 fats such as EPA and DHA.
However, studies found that the ALA conversion rate in the body is very low. In fact, only about 1% of ALA is converted to EPA and negligible amount is turned into DHA. The conversion of ALA is even lower if your intake of omega-6 fats is high. A more direct and efficient way to boost your levels of long-chain omega-3 fats, as research has found, is by taking EPA and DHA-rich foods or supplements.
Your body mainly uses ALA for energy.
Note: Alpha-linolenic acid is not the same as alpha-lipoic acid, an antioxidant that helps the body turn glucose into energy. This can be confusing because both alpha-linolenic acid and alpha-lipoic acid are sometimes abbreviated as ALA.
2. Eicosapentaenoic acid (EPA) – A polyunsaturated long-chain omega-3 fatty acid found mainly in fish and certain species of marine algae such as spirulina.
EPA is a precursor to docosahexaenoic acid (DHA).
EPA is converted into hormone-like substances called prostaglandins by the body to regulate cell activity and maintain healthy cardiovascular function.
EPA helps to maintain a healthy inflammation response in the body, supports a healthy heart and has also been shown to improve mood.
3. Docosahexaenoic acid (DHA) – A polyunsaturated long-chain omega-3 fatty acid that is a primary structural component of the human brain, cerebral cortex, skin, and retina. In the body, it is the predominant omega-3 fatty acid in the brain and the retina, so an adequate supply of DHA is essential for proper brain, eyes and nerve functions. Low levels of DHA have been associated with Alzheimer’s disease and dementia.
DHA can be synthesized from alpha-linolenic acid (ALA) or obtained directly from maternal milk (breast milk), fish oil, or algae oil.
DHA is critical during pregnancy and fetal development.
Did you know? Vegetarians and vegans often lack DHA and should take microalgae supplements to make sure they get enough of this omega-3.
4. Docosapentaenoic acid (DPA) – A polyunsaturated long-chain omega-3 fatty acid that shares structural similarities with EPA and DHA. This omega-3 fatty acid is gaining traction among both scientists and consumers as an important contributor to the beneficial effects of fish oil intake.
Most fish oils contain less than 2% DPA by weight, roughly one-third to one-fifth of the EPA or DHA content. However, the levels of DPA in human milk are higher than those of EPA and comparable to those of DHA, implicating it as potentially important in human development.
Future randomized controlled human trials with purified DPA will help clarify its effects on human health. They may confirm the available evidence pointing to its nutritional and biological functions, unique or overlapping with those of EPA and DHA.
CLINICALLY PROVEN BENEFITS OF OMEGA-3 FISH OIL
*Eating non-fried fatty fish twice per week as part of a healthy diet continues to be recommended to help reduce the risk of cardiac death, coronary heart disease and ischemic stroke.
*DHA-enriched foods have been shown to cause significant reduction in the average number of tender and swollen joints in adults.
*EPA and DHA have been tried in the treatment of symptoms of rheumatoid arthritis with considerable success. Preliminary research also suggests they may inhibit the inflammatory response inolved in gout as well.
*The anti-inflammatory effects of EPA and DHA have also caused researches to investigate possible benefits of fish oil for the treatment of menstrual cramps, inflammatory bowel disease, ulcerative colitis, crohn’s disease, lupus and lgA nephropathy. And because of it’s great anti-inflammatory benefits, it has been shown helpful for other inflammatory issues such as acne.
*Some evidence on Omega-3 fatty acids have shown it to possibly help reduce the risk and or outcome of colon/rectum and breast cancer.
*Consuming EPA and DHA from the diet (i.e fish) is associated with lower risk of eye disease and has been shown to help with dry eye.
*In large doses, fish oil has been shown to help with depression, mood, anxiety and stress.
*A multi-year study of several hundred older individuals found that cognitive function and brain volume were better preserved among those who reported using fish oil supplements than those who did not. Note: in those not already suffering with cognitive decline.
*In a small study of healthy, young adults, better working memory performance has been found to correlate with higher levels of DHA.
*Evidence from several studies suggest that fish oil can help maintain muscle mass and modestly improve muscular strength and/or endurance and enhance the effects of training.
*DHA is important for normal development and functioning of the brain and retina in the fetus and infants. The use of fish oil in pregnancy may also help to reduce the risk of pre-mature birth as well as colds in infants and asthma and allergy in children.
OMEGA-3 VS. OMEGA-6 – A BALANCE ACT FOR OPTIMUM HEALTH
Omega-6 fatty acids also have important roles in your body similar to those of omega-3s.
Both are used to produce signaling molecules called eicosanoids, which have various roles related to inflammation and blood clotting.
Yet, omega-3s are anti-inflammatory, and scientists hypothesize that eating too much omega-6 counteracts these beneficial effects.
The fatty acid in omega-6’s known as Arachidonic acid (AA) is more readily converted to inflammatory compounds. Excess AA has been associated with increased inflammation and reduced anti-inflammatory effects of omega-3 fatty acids.
In the Western diet, omega-6 intake is very high compared to that of omega-3s (as much as 200:1!), so the ratio is currently skewed far towards the omega-6 side.
Maintaining a balance between these two fats — often termed the omega-6 to omega-3 ratio — may be important for optimal health.
So, how do you do that?
First, you need to reduce your omega-6 fatty acid intake and then increase your omega 3 fatty acid intake. Follow the tips below!
DOSING AND ADMINISTRATION
There is no established Adequate Intake (AI) or Dietary Reference Intake (DRI) in the United States for EPA and DHA omega-3s. A growing number of expert bodies and health professionals recommend 250 milligrams (mg) to 1,000 mg of EPA and DHA per day depending on your height, weight, current health and specific needs. Consult your physician to determine what dose is right for you. You can also reference the charts below as a general guideline.
A serving size of omega-3 rich fish is considered 3.5 ounces cooked, or about ¾ cup of flaked fish. Two servings of fatty fish – for example, salmon, mackerel, herring or tuna – per week will provide approximately 650 mg to 3,340 mg of EPA and DHA, fulfilling your daily recommendation.
If you do not consume significant amounts of fish on a regular basis due to dietary preferences or a vegetarian lifestyle, there are EPA and DHA supplements on the market that are made from fish, krill and vegetarian marine algae.
Individuals with coronary heart disease may need to consider daily intakes as high as 1,000 mg (1 gram) of EPA and DHA per day, according to the American Heart Association.
If you need a high daily dose – dividing the dose over the course of the day may reduce any unpleasant aftertaste.
Taking fish oil with a meal containing other fats may improve absorption.
DIFFERENT FISH OIL SUPPLEMENT SOURCES
There are a number of EPA and DHA supplements available. The most popular and most extensively researched is omega-3 fatty acids derived from fish oil (i.e, fish, krill or calamari).
Fish – Omega-3 fatty acid oil derived from fish such as tuna, salmon, mackerel etc.
Krill– A shrimp-like crustacean that contains a significant amount of DHA and EPA.
Calamari – A squid that contains an even higher amount of EPA and DHA than from fish.
There are also plant-based EPA and DHA supplements that are extracted from algae, an aquatic organism.
If you are primarily interested in DHA or are vegetarian, algal oil supplements – although more expensive – are a good option and are typically low in contaminants since algae is low on the food chain.
You can take fish oil in an encapsulated soft gel form, enteric coated pill form or purchase it in liquid form depending on your preference.
Some products even come flavored!
Tip: To ensure freshness and to get the best quality fish oil for price, I recommend an unflavored encapsulated product.
WHAT TO LOOK FOR WHEN BUYING A FISH OIL SUPPLEMENT
Labeling: When reading labels, be aware that to distinguish themselves, some products will sport terms which, in actuality, are meaningless and misleading, such as:
“Pharmaceutical grade” – This is inaccurate as the FDA has not defined what would constitute a pharmaceutical grade fish oil product.
“Tested in FDA approved laboratories” – While laboratories may be FDA registered and inspected, the FDA does not approve analytical laboratories.
“Daily Value of EPA and DHA” – DV’s are developed by the USDA and FDA and related to the recommended daily allowance of a required nutrient. However, no DV has been established for EPA and DHA.
Forms of Fish oil: EPA and DHA in fish oil naturally occur in the form of Triglycerides (fatty acids attached to glycerol). However, in most supplements, fish oil is not in this natural form, but rather in a semi-synthetic form known as ethyl esters. The ethyl ester form is created by exposing the fish oil to ethanol, which replaces the glycerol molecule. This allows the fish oil to undergo molecular distillation which helps to remove contaminants and concentrate the EPA and DHA. This distillation process may, however, reduce levels of some potentially beneficial compounds found in fish oil.
Another form of fish oil known as re-esterified triglycerides, is made by chemically converting ethyl esters back to triglycerides, so that most of the omega-3 fatty acids are, once again, Triglycerides.
While a sufficient dose of any of these forms can significantly raise the levels of EPA and DHA in your blood – the natural form, Triglycerides and the re-esterified Triglycerides have been shown to provide better absorption of EPA and DHA.
Avoid contaminants: To help avoid fish oil contaminants from unrefined supplements, be sure to choose those made from small, oily fish that are low in the food chain such as anchovy, sardines or menhaden.
Third Party Testing: Choose a product that has undergone third party testing and has been approved to contain the labelled amount of EPA/DHA, has limited contaminants and are in the highly bio-available form trigylcerides or re-esterified triglycerides.
Omega-3 fatty acids can spoil, so it is best to keep products out of heat and light. Refrigeration can help prolong freshness and is particularly important with bottled liquids.
You can also freeze fish oil to extend it’s freshness without worrying about damaging or negatively affecting the oil. This can also help diminish fishy burps after consumption!
Some products contain added antioxidant ingredients, such as vitamin E, rosemary or ascorbic acid, which can help keep fish and marine oil fresh.
SAFETY AND CONCERNS
The most common side effects of consuming fish oil is “fishy burps” and diarrhea as well as other G.I. upsets such as gas and bloating.
Up to 20 grams of fish oil can be consumed safely daily by healthy Adults. However, such high doses may not be beneficial and the FDA recommends that consumers not exceed more than a total of 3 grams per day of EPA and DHA omega-3 fatty acids, with no more than 2 grams per day from a dietary supplement. Unless medically necessary, such high doses should be avoided, particularly by immune compromised individuals. The potential for immune suppression was highlighted in a review of several studies in animals.
Be aware that cod or other liver fish oils contain high amounts of vitamin A and D – which in excess amounts can be toxic.
Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable health care provider.
Fish oil may have a blood thinning effect and cause complications in those with bleeding disorders or taking prescription blood thinners. In addition, due to the risk of increased bleeding, you should stop taking omega-3 fatty acid supplements before surgery. Tell your surgeon in advance that you have been taking the supplements.
People with diabetes or schizophrenia may not be able to convert alpha-linolenic acid (ALA) to EPA and DHA, the forms the body uses more easily. They should get omega-3 fatty acids from foods rich in EPA and DHA.
Be aware that fish oil may lower blood pressure and cause complications in those with low blood pressure problems or who are on medications to lower blood pressure.
Some people may be allergic to proteins in fish, krill, and calamari/squid. Read labels carefully. While those with allergies may benefit with refined oils, use caution.
Fish oil may interfere with Chemotherapy. It is advised to temporarily avoid fish oil from the day before chemo and the day thereafter in the 48 hours surrounding chemotherapy.
Omega-3 fatty acids are essential to optimal health – from development, to mood, to fighting chronic inflammation which leads to chronic disease. Unfortunately, it has been proven that in the western diet, we just don’t get enough omega-3!
Taking a supplement is an easy way to fill the gaps. I personally keep mine in the fridge and take it in the morning with breakfast.
Do you have any experience with or questions about omega-3 fatty acids? Drop a comment below and I will respond asap!
TOP RECOMMENDED HUMAN PRODUCT – SOFT GEL
*EPA: 756 mg
*DHA: 228 mg
*DPA: 30 mg
*Total Omega-3’s: 1,080 mg
*Contains 1,000 IU Vitamin D
*Made from deep-sea fish – anchovy, sardine and mackerel
*Consumer Lab Approved
TOP RECOMMENDED HUMAN PRODUCT – LIQUID
*EPA: 730 mg
*DHA: 505 mg
*DPA: 83 mg
*Total Omega-3s; 1420 mg
*Made from 100% wild-caught sardines and anchovies
*Consumer Lab Approved
TOP RECOMMENDED VEGETARIAN OPTION (ALGAE)
*EPA: 135 mg
*DHA: 270 mg
*DPA: 59 mg
*Consumer Lab Approved
TOP RECOMMENDED CHILDREN’S PRODUCT
*EPA: 20 mg
*DHA: 30 mg
*DPA: 2.6 mg
*Derived from Cod Liver Oil
*Contains Vitamin A, D and E
*Consumer Lab Approved
TOP RECOMMENDED PET PRODUCT
*EPA: 105 mg
*DHA: 116 mg
*DPA: 18.5 mg
*Total Omega-3’s: 613 mg
*Made in the USA
*Consumer Lab Approved