Supplement: Fish Oil

What:

What is fish oil and what is the reason for taking it?  Fish oil has many health benefits; you could even say it benefits every system of the body.  One of the main benefits fish oil is known for- is helping to decrease inflammation in the body.  To understand this, we first need to understand what the word inflammation means.  Inflammation is something that commonly happens on the inside of the body due to the typical American diet (processed sugars/flours/oils/salts- basic ‘junk food’) that most of us are consuming.  A visual of what inflammation is- is if you were to rub a spot on your arm continually until it was irritated and turned red this is inflammation.  Inflammation on the inside of the body creates a need for cholesterol to try and patch up inflamed veins/arteries, leading to a potentially higher cholesterol level.  A body that has substantial inflammation will also make it more difficult to lose excess body fat, and excess body fat is inflammatory in itself, so it creates an endless inflammatory cycle.

In short, one of the main benefits of consuming fish oil is that it contains a healthy type of omega-3 anti-inflammatory fat in a readily absorbable form for the body to use as compared to non-fish sources of omega-3, which usually need next to perfect conditions in the body in order to turn the fatty acid into the most absorbable forms.  Non-fish sources of anti-inflammatory omega-3 fats are very healthy as well but provide more of a general anti-inflammatory benefit or different specific benefits as compared to fish oil.  In no particular order, the following are general non-fish foods in the omega-3 fatty acid category that are known to be more anti-inflammatory in nature but do not contain EPA/DHA in a readily absorbable form: hemp seeds, flaxseeds, walnuts, chia seeds, grass-fed meats/dairy products, along with a few other food sources that have lesser amounts of omega-3.

Again, the general benefit of consuming these types of foods is that they are anti-inflammatory since they are higher in a type of fatty acid called ‘linolenic acid’ (in the anti-inflammatory omega-3 fatty acid category).  The anti-inflammatory linolenic acid then further converts to EPA and DHA in the body, which are the readily absorbable forms of the fatty acid and where a lot more benefits are said to be seen.  In fish products and fish oil, the Linolenic acid is already in the EPA/DHA form and therefore is the best way to get the benefits that EPA/DHA provide.  There are possible interactions when taking fish oil with medications so as with mixing any supplement with medication, speak with your doctor firstFish oil is known to have a blood-thinning effect as well as possibly decreasing blood pressure so caution when taking with any medications.

 Benefits of EPA/DHA found in fish oil

  • Brain function– DHA particularly can be found in the brain and is essential for normal mental function (also, if you have an allergy to fish, you may find benefit from a non-fish derived DHA supplement such as ‘algal’ oil derived from algae)
  • Heart health– helps to decrease inflammation within the veins/arteries and potentially even helps to decrease bad triglycerides, blood pressure, inflammatory homocysteine levels and risk of atherosclerosis, as well as possibly increasing HDL (good cholesterol) and potentially reducing risks of heart attacks, stroke and chest pain (1)
  • Potentially helping to supply the body with added vitamin A and D (depending on quality of supplement)
  • Diabetes support- improved glucose response and other diabetes parameters
  • Reduced symptoms of depression- decreased psychological distress
  • Enhanced eye health- reduced age related sight loss as well
  • Reduced body weight (if overweight)- due to anti-inflammatory properties
  • Increased skin health- good for acne and psoriasis
  • Pain reduction due to muscle aches/arthritis (3)

How:

After speaking with your doctor to see if supplementing with fish oil is right for you, then you may be posed with the task of finding a quality supplement- keep the following information in mind:

  • Fish oil supplementation is supposed to have the most benefit and best absorption into the body when it is combined with a saturated fat such as grass-fed butter.
  • The best and most pricey options of the supplement will have the fish oil fermented combined with a high vitamin butter oil to help with absorption as well as supply the body with beneficial amounts of vitamin A and D in the correct ratios.
  • The fermented part of the oil will also provide the animal form of vitamin K (known as K2), which is needed in the correct ratio as well for proper absorption and assimilation in relation to the other two vitamins mentioned above. (Most of the common store brand fish oils are very processed to the point that the natural vitamin A and D are destroyed and then artificially added in, but most of the times in the incorrect)
  • Carlson fish oil is a brand that has the vitamin A and D in the correct ratios, although this brand does not offer the oil fermented or combined with any other type of saturated fat, which is why it is listed in the ‘good’ category on the last page of this handout instead of the ‘best’ category.

The main dilemma when searching for a fish oil supplement is that a lot of them can be higher in mercury or other contaminants like PCB’s, which are toxic to the body- all fish oil should be listed as being free of contaminants:

  • The flip side of this, however, is that the supplement may become too processed in an effort to remove all contaminants and then no longer have benefit to our health. Some fish oils may even be rancid (bad oil) since fish oil by itself is unstable unless it is combined with a saturated fat (it should always be in a dark colored bottle to help preserve it as well).  This is especially true in fish oil that is in capsule form since you wouldn’t be able to taste the difference.
  • Also, some capsules are ‘enteric coated’ (to prevent ‘fish burps’) which can affect the absorption rate since if the capsule breaks down too late, the oil may not get absorbed sufficiently. These kinds of capsules may also contain too many additives.
  • We also should be aware of any other ingredients in the supplement that don’t seem natural. There are plenty of detrimental additives added to our food and supplements, that if taken continually- such as is the case when taking supplements- can accumulate and harm the body.  A quality fish oil should be low in additives.

Neither the FDA or any other State or federal agency routinely test nor regulate supplements, therefore, many are put on store shelves without consumers really knowing whether they are safe or not.  There are organizations such as ‘consumer lab’ that will test certain products for safety- these products are listed on the following page.  There are also individual supplement companies that ensure their products have  been tested regularly (such as the recommendations from the westonaprice foundation on the last page of this hand-out).

Labeling ‘Fishy’ products

  • Pharmaceutical Grade: Although some products are labeled as being ‘pharmaceutical grade’ this term doesn’t mean anything since the FDA hasn’t determined any guidelines for what ‘pharmaceutical grade’ could even mean for fish oil.
  • Tested in FDA laboratories: The FDA does not approve analytical laboratories to analyze fish oil but a certain laboratory may indeed be FDA registered and inspected.
  • Krill Oil: Although there are a few decent krill oils out there, be aware that the term ‘krill oil’ in a product does not necessarily mean it is all krill oil.  Sometimes, if you look at the ingredients in these krill oil products, the first ingredient may be fish oil, of which you wouldn’t know the quality of that particular fish oil used.  Even the ‘astaxanthin’ giving real krill oil its red color is many times added from a seaweed source instead, which most times isn’t disclosed on labels.
  • EPA/DHA daily value: There is no established EPA/DHA daily value
  • Range of EPA/DHA: The concentration of EPA/DHA in supplements can vary drastically from 8% to 80% – the goal is to get an adequate amount of EPA/DHA concentration per serving size of supplement since receiving adequate EPA/DHA is one of the main points behind taking the supplement.  Higher quality capsules often have 500-600 mg EPA/DHA per capsule, whereas lower-quality fish oil supplements usually have about 300 mg of EPA/DHA per 1 gram capsule.  (Salmon oil and algal oil often contain several times more DHA than EPA, which may be more of a focus during pregnancy.)  A typical salmon steak provides about one gram of combined EPA/DHA.  If your omega-3 fish oil capsule provides 600 grams of total EPA/DHA, two to four capsules are usually recommended, but some people have found additional benefits with even more- It’s best to talk with a knowledgeable Health practitioner. (3)
  • Ideal range of vitamin A and D: Ten or fewer units vitamin A to one unit vitamin D, an example would be: 2,500 IU’s of vitamin A and 250 IU’s of vitamin D per teaspoon.  The vitamin D from cod liver oil and butter fat from pastured-raised animals is supposed to provide more protection against vitamin A toxicity, which is part of the benefit of consuming fish oil with a butter oil such as seen on the last page under the westonaprice ‘best’ recommendations. (4)
  • ‘Natural’: Just as this term is used widely in the ingredient list on foods and drinks, it is also used commonly for supplements- be aware of this ‘natural’ term since you cannot rely on it to determine how truly natural a product really is.  The term ‘natural’ is used more as a marketing ploy than anything else- and with fish oil this term may be used to point out that the fish oil was initially ‘natural’ but then goes through a chemical process to remove contaminants and also alters the molecular structure of the fish oil, making it less beneficial.  (Fish oil may afterwards then be put back into its ‘natural’ triglyceride form again- but keep in mind, some type of processing was used to do this).  If processed fish oil is not put back into a triglyceride form, then it will remain in the ‘ethyl ester’ form, which will be a slightly less absorbable form.  If a supplement doesn’t list EPA and DHA in triglyceride forms, it most likely is not in the triglyceride form.

*All other listed info under ‘labeling’ sourced from Consumer Lab Reports

Quality vs. Price

The price range of approved products varies greatly per serving, with product price per serving costing mere cents to whole dollars.  This variation in price range depicts all of the different varieties that fish oil supplements can come in.  All of the products listed below in the chart have been tested for contaminants by consumer labs and came up clear.

The below listed products are just a sample list of some consumer lab tested fish oil supplements. Products containing soy oil are not listed below since they are very processed and can work against thyroid health.  When searching for a product, always read the ingredients and if there are too many words you’ve never heard of before, continue with caution (since many supplements contain too many additives for their own good).  Another guideline when purchasing a fish oil supplement is that it contains at least some omega-7 (palmitoleic acid).  Supplements that contain omega-7 can further help to lower triglycerides and bad cholesterol and usually aren’t super concentrated with EPA/DHA.

Palmitoleic acid amounts range in supplements from zero to 500mg per daily serving- most supplements don’t list amounts of palmitoleic acid content but each of the ones listed in the chart below have at least some omega-7 content.  The products in the table are there because they did not exceed contamination limits and each of them contain a portion of omega-7.  The supplements vary only in their ratios of EPA/DHA, the form they come in- (triglyceride or ethyl-ester and regular capsule or liquid), price, and any additional additives in the supplement- however, I did not list any supplements that had additives known to be of danger to the health.

Be aware that all fish oil supplements listed in the chart below are processed oils.  Although the fish oil brands listed below in the chart do supply you with benefits specific to fish oil, they all consist of processed oils and mainly synthetic forms of vitamin A and D.  Although more pricey, if you wanted the ‘best’ fish oil out there,  you’d need to invest in a fermented fish oil listed under the ‘best’ category under the Westonaprice foundation recommendations on the last page of this hand-out.

This part is up to you, it is always best to work within your financial budget (rememberthe quality of your food should always come first)- just focus on the best choice for you.  If you are not able to purchase a fermented fish oil due to the higher cost, the fish oils listed in the below chart will definitely still have great health benefits, but just remember to take them with a meal that has some sort of saturated fat for them to give you the benefits you are seeking.

For further questions regarding this break-down of supplements, ask our staff Dietitian.

[Cost break-down is listed per 100mg EPA/DHA]

Krill oil products Decent products Products in Triglyceride form(more absorbable)
Dr. Mercola                       $0.45 Arrix Omega-Q                 $0.21 Carlson                                $0.03
NutriGold                           $0.24 GNC                                     $0.02 CVS Pharmacy                    $0.16
Minami Nutrition             $0.07 Finest Nutrition                 $0.25
OmegaBrite                       $0.11 Kirkland Signature            $0.01
Trader Joe’s                       $0.02 New Chapter                       $0.14
Twin lab                             $0.02 Nordic Naturals                  $0.06
Xtend Life                          $0.08 Nutrigold                             $0.03
Pure Alaska Omega           $0.06
Rexall                                  $0.02
Solgar                                  $0.04

 

*Here are other quality fish oil options according to the westonaprice foundation:

 BEST (Available Online/Mail Order):

  • Green Pasture Products: Blue Ice High-Vitamin Fermented Cod Liver Oil (google it)
  • Nature’s Answer liquid cod liver oil
  • NutraPro International virgin cod liver oil com
  • Rosita Real Foods extra virgin cod liver oil corganic.com

(Also see list of local chapter leaders and members on westonaprice.org who sell fermented cod liver oil)

GOOD (and available in Stores):

  • Carlson liquid or soft gel Cod Liver Oil
  • NOW Foods double strength Cod Liver Oil capsules
  • Sonne’s Cod Liver Oil
  • Swanson double strength Cod Liver Oil capsules
  • Twin Labs non-emulsified liquid Cod Liver Oil

1.)  Omega-3 Fatty Acids: Fish Oil Benefits for Heart Health. (n.d.). Retrieved May 29, 2015, from http://www.webmd.com/vitamins-and-supplements/lifestyle-guide-11/supplement-guide-omega-3-fatty-acids

2.)  Fallon, S. (2000). Tripping Lightly Down the Prostaglandin Pathways – Weston A Price. Retrieved May 29, 2015, from http://www.westonaprice.org/health-topics/tripping-lightly-down-the-prostaglandin-pathways/

3.)  Nikkola, T. (2009, November 6). “Mega” Benefits of Omega-3 Fish Oil – Articles – LifeTime WeightLoss. Retrieved May 29, 2015, from http://www.lifetime-weightloss.com/blog/2009/11/6/mega-benefits-of-omega-3-fish-oil.html

4.)  Fish Oil Supplement Review by ConsumerLab.com, Including Krill, Algal, Calamari, and Green-lipped Mussel Oil Supplements. (n.d.). Retrieved June 8, 2015, from https://www.consumerlab.com/reviews/fish_oil_supplements_review/omega3/

5.)  Nikkola, T. (2009, November 6).  “Mega” Benefits of Omega-3 Fish Oil – Articles – LifeTime WeightLoss.  Retrieved June 8, 2015, from http://www.lifetime-weightloss.com/blog/2009/11/6/mega-benefits-of-omega-3-fish-oil.html

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