Fish Oil 101: Demystifying Omega-3 Fatty Acids

Written by Dr. Laura Jones

The words “fish oil” lead people to visualize a less than pleasant childhood memory of their mother pushing a tablespoon of cod liver oil into their mouth, insisting that it would keep them healthy.

As usual, our mothers were right! I know, it sounds too slimy and smelly to be good for you. However, fish oil has more to offer than most people realize. Fish oil is rich in omega-3 fatty acids which are essential fatty acids (EFAs) that our bodies are unable to create on their own. Since we cannot create them, we must obtain EFAs from nutritional sources. Most people do not get enough of these polyunsaturated fats from their food, even those of us who prioritize fish in our nutrition plans. Therefore, supplementation with fish oil can be quite valuable. EPA and DHA are two omega-3 fatty acids particularly beneficial to our health. Both play critical roles in cognition and learning, immune system function, combating inflammation, brain development in children and in pregnancy. Both fatty acids are the subject of 1000s of studies, identifying their roles in the prevention of dementia, heart disease, high blood pressure, arthritis, cancer, mental illness and so much more. They affect every one of the hundred trillion cell membranes in your body.

A large amount of research on omega-3s has focused on their effects on heart disease. EPA and DHA consumption are linked to lower triglyceride levels, decreasing one’s risk for atherosclerosis. A more recent meta-analysis, published in The Lancet (July 2021), looked at 38 randomized controlled trials involving 150,000 patients and summarized that omega-3 fatty acids reduced cardiovascular mortality and improved cardiovascular outcomes. These two fatty acids can also decrease inflammation in the body, improve how well our immune system keeps us healthy, and promote skin, hair, and nail health.

Recent clinical research has shown that not only the quantity of fat in the diet, but also the type of fat affects body weight and metabolism. Diets rich in omega-3 oils result in healthier body weight and metabolism as well as the best body composition in terms of fat/muscle ratio. In addition, fish oils function as strong antioxidants throughout the body and improve the oxygen delivery to cells thus improving aerobic performance. If purchasing fish oil, make sure it is from a reliable source, free of environmental contaminants (pesticides and heavy metals), and contains vitamin E to protect and preserve the oil. It is important to store your oil in a cool location, away from direct light. It is critical to make sure the company producing the supplement is committed to clean sourcing of the fish oil as any contaminants in the fish will end up in those consuming the oil.

Excellent quality fish oils come in various formulations with different ratios of DHA and EPA. While both oils are very important for idea health, DHA has greater affinity for the brain and nervous system while EPA plays more of a role in reducing inflammation in the body. A formulation higher in DHA may be better suited for mood support in a person struggling with anxiety or depression, or a student challenged with difficulty focusing on their schoolwork. Formulas higher in EPA tend to be better for inflammatory conditions such as autoimmune disease, arthritis, or for an athlete in active training and recovery.

Some ask, what about if I eat fish a couple times a week? Should I still consider a supplement? The answer is yes. Therapeutic doses of omega-3 fatty acids start at around 1000mg per day but can go up as high as 6000-8000mg per day in divided doses. For many of my patients, I am recommending 1000-2000mg twice daily. Referencing the chart below, you can see that even with a sizable amount of salmon weekly, it would be hard to eat sufficient amounts of EPA and DHA. It is also important to consider the toxic load of the fish. Wild Alaskan salmon or Sockeye salmon is a much cleaner fish to frequently work into your nutrition plan than a fish like halibut, haddock, or swordfish. Smaller fish such as anchovies, sardines and mackerel are small and do not live long enough to accumulate toxins. You’ll notice I didn’t include tuna on this list, as it tends to be a very toxin laden fish due to its size, and I’d rather my patients eat it on rare occasion for this reason.

Amount of Omega-3 (grams) per 3.5oz. serving of fish

Mackerel2.6
Salmon1.5
Sardines, canned1.5
Anchovies1.4
Bass, striped0.8
Trout, rainbow0.6
Halibut, Pacific0.5
Flounder0.2
Haddock0.2
Snapper, red0.2
Swordfish0.2

At times, we hear people report that fish oil has been difficult to take because it upsets their digestion, or it causes reflux or eructation. In most of these cases, the person is either taking a poor-quality omega-3 supplement or has poor digestion that needs to be corrected prior to taking a higher potency omega-3. Whole Health Concord’s Wellness Shop has many different omega-3 supplements for adults and children. You are welcome to come peruse our shelves and ask us for help if you are not on a superior quality supplement already.

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