By now you understand the myriad health benefits of omega-3 fish oils. You may have seen fish oil supplements at your local health food store, drugstore, or supermarket. You may have even bought a fish oil supplement because you know it is good for you. But did you know that not all fish oil supplements are alike? This chapter will highlight the important factors to consider when looking for a fish oil supplement.
Before I talk about that, however, I want to talk about how to measure your own omega-3 levels. Earlier I mentioned that most people have insufficient levels of omega-3s and too much omega-6. If you want to find out for yourself how much of these fatty acids are in your blood, you can do just that with the Omega-3 Index test.
Your Omega-3 Index
The Omega-3 Index is a blood test that detects omega-3 levels. The Omega-3 Index is an easy finger prick test that determines the levels of omega-3 EPA+DHA in red blood cell membranes. Detecting EPA and DHA in red blood cell membranes is thought to more accurately reflect heart tissue levels of EPA and DHA.
A high Omega-3 Index has been associated with lower risk of death from heart disease.*An index of 8 percent or more was found to offer the greatest protection, and an index 4 percent or less was associated with the least protection. In one study, coronary heart disease patients taking omega-3 fish oil supplementation (3 grams EPA+DHA daily for 3 months followed by 1.5 grams daily for 18 months) experienced a slower rate of heart disease progression in association with a raise in their Omega-3 Index from 3.4 percent to 8.3 percent.*
The Omega-3 Index test can be purchased by mail order and done from home, or it can be requested from a doctor. LabTestingDirect.com offers the Omega-3 Index test by OmegaQuant.
Some types of fish contain high amounts of methylmercury (a particularly toxic form of mercury), polychlorinated biphenyls (PCBs), dioxins, and other contaminants.* These contaminants are present in freshwater and oceans and concentrate up the food chain: Medium-size fish eat small fish, accumulating the toxins from the small fish (especially in fat cells); large fish eat medium fish, accumulating yet more toxins up the food chain. This is why older, larger, fatty fish tend to be the most toxic. In humans, these toxins, especially PCBs and methylmercury, accumulate in the body. Indeed, increased mercury levels in adults have been found to be directly associated with heart attack risk, while increased levels of omega-3 DHA in these adults are associated with decreased heart attack risk.*
Because of the health risk posed by the mercury content of fish, the Environmental Protection Agency recommends that children and pregnant or nursing women limit their intake of fish.* Pregnant or nursing women are advised to limit their consumption of fish to one 6-ounce portion per week, and young children are advised to eat 2 or less ounces of fish weekly. The FDA also recommends that women and children limit fish consumption by eliminating shark, swordfish, king mackerel, and tilefish from their diets completely, and limit other fish to 12 ounces per week.* For men, and women after menopause, these agencies view the benefit of fish consumption outweighs the health risk of methylmercuryntake. They may be underestimating the risk from mercury, however.
Purified Fish Oil
The best way to obtain the benefits of omega-3s from fish while avoiding the toxic contaminants they may contain is to consume a purified fish oil supplement. Not all fish oil supplements are without toxins, however, so be sure to read the label. Look for the International Fish Oil Standards (IFOS) icon on the bottle to be sure you are getting a purified, high-quality fish oil. ALA or EPA/DHA?
Although not all studies agree, alpha-linolenic acid (ALA), sometimes called the parent omega-3 because of its conversion to EPA and DHA (although in limited amounts), has also been found to have beneficial heart-health effects. Some trials have found a beneficial effect from ALA* and some have not.* These benefits are often attributed to the conversion of ALA into EPA and DHA in the body. Both EPA and DHA are considered more biologically potent than ALA.* Due to the low conversion rate, however, in addition to the large volume of research supporting EPA+DHA, most experts recommend that omega-3 come from EPA+DHA for heart health protection. EPA, DHA, or Both?
The beneficial effects of fish oil were originally attributed to EPA, even though more DHA accumulates in all tissues of the body, and DHA has many similar effects as EPA.* Although one large trial (the JELIS trial) administered only EPA, most studies have used a mixture of both EPA and DHA, or have evaluated fish intake (which contains both EPA and DHA). Because of this, both EPA and DHA together are recommended for optimal heart health.*
What to Look for in a Fish Oil Supplement
Fish oil supplements provide the heart-healthy omega-3s EPA and DHA in an easy delivery method for obtaining the amounts recommended by the American Heart Association and other omega-3 experts worldwide. Not all fish oil supplements are created equal, however. There some important factors to consider when purchasing an omega-3 fish oil supplement.
Purity As mentioned previously in this chapter, fish contain varying amounts of contaminants. To obtain the recommended amounts of omega-3s by eating fish alone, the accumulation of these harmful contaminants is a risk, so much so that pregnant or nursing women and children are cautioned to limit the amount of fish consumed. To avoid potential accumulation of toxins, taking a purified fish oil supplement is the best option. Not all fish oil supplements are purified, however. Look for a product sourced from smaller, wild, cold-water fish that are naturally lower in environmental toxins such as mercury and dioxins. To ensure the highest-level of purity & potency look for the IFOS (International Fish Oil Standards) seal on the bottle to be sure you are getting a high-quality fish oil supplement that exceeds world standards for purity and quality.
How do you know your fish oil is concentrated? Look at the total amount of omega-3s per softgel—don’t be fooled if there are 2 softgels per serving. A standard fish oil softgel (which tends to be on the large size) should contain at least 800 to 1000 milligrams omega-3 EPA+DHA per softgel. To obtain the same amount of omega-3s from a standard non-concentrated fish oil, you would have to take almost three times the amount of softgels as one concentrated fish oil softgel.
Enteric-coated, Look for an enteric-coated fish oil supplement to ensure maximum absorption and minimum fish repeat (belching). Dark colored softgels made of fish gelatin are the highest quality softgels, protecting the fish oil from light, which can induce oxidation. Added Vitamin D3 Some fish oil supplements include vitamin D3 for bone, immune, and mood support.
Recap of what to look for in an Omega-3 f ish oil supplement
✔ At least 800 to 1000 milligrams total omega-3 per softgel
✔ International purity standard (IFOS seal)
✔ Enteric-coated softgel
✔ Added vitamin D3