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Fish Oil Supplements and Omega-3 Fatty Acids

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Omega-3 fatty acids are a family of essential fatty acids that are important for various reasons. These fatty acids can play a huge role in numerous health benefits. Unfortunately, omega-3 fatty acids are fatty acids that the body does not naturally produce, thus, they must be obtained from a diet.1,2 There are three types of fatty acids which include alpha-linolenic acid (ALA), docosahexaenoic acid (DHA) and eicosatetraenoic acid (EPA).1,3 The most important omega-3 fatty acid within the body is DHA because it is responsible for structural components of the brain, retina in the eyes and many more functional parts of the body.4 This is often found in fatty fish but can also be found in meat, eggs and dairy from grass-fed animals.1 Supplementation with omega-3 is often recommended to individuals that do not obtain an adequate amount of omega-3 in their diet.

To date, there are two prescription products, called Lovaza and Vascepa, which are omega-3 fatty acids that are used for lowering of triglycerides.5 However, there are many over-the-counter fish oil supplements that can be used by those who do not have a prescription for these two products.  In the United States today, over-the-counter fish oil supplements are not approved by the Food and Drug Administration (FDA). Always consult a healthcare provider first to ensure that taking a fish oil supplement is beneficial for you.

Fish Oil vs Omega-3 Fatty Acid

Fish oil is a fat or oil that has been extracted from the tissues of a fish and can be found in oily fish such as tuna, trout, mackerel and many more.2 Fish oil is rich in omega-3 fatty acids, which provide many benefits for the body. Omega-3 fatty acids are not naturally produced in the body, and therefore, these fatty acids must be obtained from a diet that includes items such as flaxseed oil, fish oil, and fatty fish.3 Consuming fish oil can have many benefits including supporting heart health and fighting inflammation.2 Fish oil supplementation can be beneficial in individuals that do not eat 1-2 portions of oily fish per week.2

Potential Benefits of Fish Oil Supplementation

There are many benefits for taking fish oil supplements which can improve overall health. One of the primary reasons for use of fish oil supplementation is that it can support heart health.1 Studies have shown that fish oil supplementation is associated with lower rates of heart diseases.6,7 This can also be due to the fact that fish oil supplements have shown to reduce many risk factors that can lead to heart diseases. For example, fish oil supplementation has been linked to improving blood levels of the “good” cholesterol in the body, also known as high-density-lipoprotein (HDL).1,8-10 Additionally, fish oil has been linked to a reduction in triglycerides and blood pressure.11,12

Omega-3 fatty acids, such as DHA, are essential for the development of the structure of the brain.1,3 In fact, about 60% of the brain is made up of fat, with a majority of this fat coming from omega-3 fatty acids.1 Therefore, omega-3 fatty acids are crucial for brain function.1 Some studies have shown that individuals with mental disorders have a lower makeup of omega-3 blood levels.13,14 Therefore, studies were conducted to determine the potential benefit for fish oil supplementation in individuals with mental disorders.14 These studies have determined that there was an improvement in the onset of symptoms and there was an overall improvement in  symptoms of the mental disorders.15

Additional benefits that have been reported with the use of fish oil supplementation also include possible eye health benefits, weight loss, and reduction of inflammation.1 Studies have supported all of the findings listed above as well.1

How Do You Take Fish Oil?

Individuals that do not take the appropriate suggested amount of 1-2 servings of oily fish per week may benefit from a fish oil supplement. Fish oil can be taken at any time of day. Evidence from studies has shown that the potential benefits of fish oil supplements occur with long-term use.16 It is important that regardless of when the fish oil supplement is taken, it is taken with a good source of fat in order to ensure optimal absorption.17

When it comes to dosing, there are no strict recommendations on the amount of fish oil supplementation to consume. In fact, dosing will depend on a variety of factors such as age, diseases, and individual health. Some individuals may be recommended to take 2 capsules twice daily, while others may be recommended to take up to 2 capsules three times daily. It is important to discuss the appropriate starting dose recommendation with your primary care provider prior, as this dose can range from very low to very high doses. Regardless of the dose, it is highly recommended to take fish oil supplements that contain both DHA and EPA.

Always choose a supplement that has a third-party seal of purity to ensure that the content is similar for all of the capsules.  

Safety of Fish Oil

Fish oil supplements have shown in various investigative studies there are many health benefits. As a natural product, this may seem like a wonderful option to try for many individuals. However, fish oil supplements may not be for everyone.

Side Effects

Side effects of fish oil supplements are typically very mild. Some of the side effects can include unpleasant taste, unpleasant breath, heartburn, belching, diarrhea and headaches.16 Fish oil supplements can also have some potential drug interactions with medications. Therefore, before starting a fish oil supplement it is important to speak to your doctor. Some doctors may recommend increased intake of natural fish into your diet rather than supplementation. Additionally, due to the risk of side effects, it is important to start with a low dose recommended by your doctor and increase or decrease the dose per your tolerance.

References:

  1. How Much Omega-3 Should You Take Per Day? Healthline. https://www.healthline.com/nutrition/how-much-omega-3#1. Last Reviewed on December 15, 2019. Accessed on October 21, 2020.
  2. 13 Benefits of Taking Fish Oil. Healthline. https://www.healthline.com/nutrition/13-benefits-of-fish-oil. Last Reviewed on December 15, 2018. Accessed on October 21, 2020.
  3. What Are Omega-3 Fatty Acids? Healthline. https://www.healthline.com/nutrition/what-are-omega-3-fatty-acids. Last Reviewed on May 23, 2019. Accessed on October 21, 2020.
  4. Guesnet P, Alessandri JM. Docosahexaenoic acid (DHA) and the developing central nervous system (CNS) – Implications for dietary recommendations. Biochimie. 2011 Jan;93(1):7-12. doi: 10.1016/j.biochi.2010.05.005. Epub 2010 May 15. PMID: 20478353.
  5. Ito MK. A Comparative Overview of Prescription Omega-3 Fatty Acid Products. P T. 2015;40(12):826-857.
  6. Kromhout D, Bosschieter EB, de Lezenne Coulander C. The inverse relation between fish consumption and 20-year mortality from coronary heart disease. N Engl J Med. 1985 May 9;312(19):1205-9. doi: 10.1056/NEJM198505093121901. PMID: 3990713.
  7. He K, Song Y, Daviglus ML, Liu K, Van Horn L, Dyer AR, Greenland P. Accumulated evidence on fish consumption and coronary heart disease mortality: a meta-analysis of cohort studies. Circulation. 2004 Jun 8;109(22):2705-11. doi: 10.1161/01.CIR.0000132503.19410.6B. PMID: 15184295.
  8. Petersen M, Pedersen H, Major-Pedersen A, Jensen T, Marckmann P. Effect of fish oil versus corn oil supplementation on LDL and HDL subclasses in type 2 diabetic patients. Diabetes Care. 2002 Oct;25(10):1704-8. doi: 10.2337/diacare.25.10.1704. PMID: 12351465.
  9. Warner JG Jr, Ullrich IH, Albrink MJ, Yeater RA. Combined effects of aerobic exercise and omega-3 fatty acids in hyperlipidemic persons. Med Sci Sports Exerc. 1989 Oct;21(5):498-505. PMID: 2691812.
  10. Oelrich B, Dewell A, Gardner CD. Effect of fish oil supplementation on serum triglycerides, LDL cholesterol and LDL subfractions in hypertriglyceridemic adults. Nutr Metab Cardiovasc Dis. 2013 Apr;23(4):350-7. doi: 10.1016/j.numecd.2011.06.003. Epub 2011 Sep 15. PMID: 21924882.
  11. Eslick GD, Howe PR, Smith C, Priest R, Bensoussan A. Benefits of fish oil supplementation in hyperlipidemia: a systematic review and meta-analysis. Int J Cardiol. 2009 Jul 24;136(1):4-16. doi: 10.1016/j.ijcard.2008.03.092. Epub 2008 Sep 6. PMID: 18774613.
  12. Minihane AM, Armah CK, Miles EA, Madden JM, Clark AB, Caslake MJ, Packard CJ, Kofler BM, Lietz G, Curtis PJ, Mathers JC, Williams CM, Calder PC. Consumption of Fish Oil Providing Amounts of Eicosapentaenoic Acid and Docosahexaenoic Acid That Can Be Obtained from the Diet Reduces Blood Pressure in Adults with Systolic Hypertension: A Retrospective Analysis. J Nutr. 2016 Mar;146(3):516-23. doi: 10.3945/jn.115.220475. Epub 2016 Jan 27. PMID: 26817716.
  13. Bazinet RP, Layé S. Polyunsaturated fatty acids and their metabolites in brain function and disease. Nat Rev Neurosci. 2014 Dec;15(12):771-85. doi: 10.1038/nrn3820. Epub 2014 Nov 12. PMID: 25387473.
  14. Tiemeier H, van Tuijl HR, Hofman A, Kiliaan AJ, Breteler MM. Plasma fatty acid composition and depression are associated in the elderly: the Rotterdam Study. Am J Clin Nutr. 2003 Jul;78(1):40-6. doi: 10.1093/ajcn/78.1.40. PMID: 12816769.
  15. Amminger GP, Schäfer MR, Papageorgiou K, Klier CM, Cotton SM, Harrigan SM, Mackinnon A, McGorry PD, Berger GE. Long-chain omega-3 fatty acids for indicated prevention of psychotic disorders: a randomized, placebo-controlled trial. Arch Gen Psychiatry. 2010 Feb;67(2):146-54. doi: 10.1001/archgenpsychiatry.2009.192. PMID: 20124114.
  16. Omega-3 Supplements: In Depth. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/omega3-supplements-in-depth. Last Reviewed on May, 2018, Accessed on May 1, 2020.
  17. Von Schacky C. (2015). Omega-3 fatty acids in cardiovascular disease–an uphill battle. Prostaglandins, leukotrienes, and essential fatty acids, 92, 41–47. https://doi.org/10.1016/j.plefa.2014.05.004. Accessed on May 1, 2020.
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