The Best Fish Oil Supplement

Fish Oil Supplements FAQ

What are the health benefits of fish oil?

EPA and DHA have been said to assist brain function and support normal growth and development, but fish oil is typically consumed to treat the following:

  • Inflammation
  • Heart disease
  • High blood pressure
  • Rheumatoid arthritis
  • Mood disorders
  • Skin health
  • Bone and joint health
  • Fatigue
  • Some cancers

The only afflictions that fish oil is clinically proven to relieve: high triglycerides and cholesterol.

Which foods are good sources of omega-3s?

Most experts agree that whenever possible, it’s best to get nutrients from whole foods rather than vitamins. “As is almost always the case with all nutrients, they are better absorbed as food, because that’s what our body was created to process,” says Abrams, “omega-3 from whole fish is better absorbed than from fish oil capsules.” Plus, whole fish provides nutrients fish oil supplements can’t, like protein, vitamin D, and selenium, the last of which helps protect against mercury toxicity.

Dr. Andrew Weil, famous for his writing on holistic health, recommends eating “oily fleshed, wild-caught, cold-water fish” two to three times per week. He lists his favorites as salmon, mackerel, sardines, herring, and black cod. Kressler agrees that this amount, combined with a lower omega-6 intake, would be enough for most people.

Abrams recommends checking FishWise for a list of the most sustainable, least-toxic species to eat. FishWise used to be known for its wallet-sized buying guides, but it now also has its own free app.

Even if you don’t eat animal protein, you can get omega-3s from food. This is where the third omega-3 comes into play — alpha-linoleic acid (ALA). It’s found in vegetable oils, nuts, seeds, leafy greens, and grass-fed animals, and our bodies convert it into EPA or DHA in order to be used. Some of the best sources: chia seeds and flax seeds, which contain 2,600 mg and 2,300 mg of omega-3s per tablespoon respectively.

What are the risks of eating fish?

Fish are only as healthy as the ocean they swim in, and increasingly reflect alarmingly high levels of mercury and plastics. The answer: Eat lower on the food chain. When it comes to toxins, not all fish are created equal. Picture a little fish with low levels of mercury in its system. If a medium-sized fish eats these little fish every day, its body will fill up with mercury. And if a big fish eats those medium-sized fish regularly, its body will be even more stuffed with toxins. This is called biomagnification, and it continues all the way up the food chain, straight to us.

Biomagnification is the reason why Abrams recommends eating sardines, which offer high levels of omega-3s and, because they’re low on the food chain, have very low levels of toxicity. They’re also a more sustainable source, adds Dr. Michael Murray, a doctor of natural medicine and director of product science and innovation at Natural Factors, a Canadian supplement company.

Why take fish oil?

There are a couple of reasons why getting all of your omega-3s from whole fish might not be the best or most practical way to go. Sears cautioned that because fish contain contaminants like PCBs and mercury, eating enough for a therapeutic dose of EPA+DHA could be dangerous. Abrams said that while nutrients may be better absorbed from whole foods, buying all the fish you need could get expensive, too — and, of course, some people just don’t like eating fish.

What are common side effects of taking too much fish oil ?

Despite their health-boosting properties, if consumed in excess, fish oil will cause some unwanted side effects and major discomfort. Other side effects include:

  • Upset stomach
  • High blood sugar
  • Low blood pressure
  • Acid reflux
  • Difficulty sleeping
  • Bleeding(gums, nose)

Can fish oil go bad?

When unsaturated fats, like EPA and DHA, are exposed to heat, light, or oxygen, they can oxidize, or go “rancid.” This can happen during production or even afterward, once the oil has already been packaged, if it’s stored improperly or kept for too long. Because of its molecular structure, fish oil is especially vulnerable to oxidation, so most supplements will come in dark brown or opaque bottles. If they don’t, stay away from them.

Oxidation doesn’t just mean going stale or becoming less effective either. It actually turns a healthy, anti-inflammatory substance into a harmful, pro-inflammatory one that might contribute to the diseases you’re trying to avoid in the first place. Rancid fish oil “increases inflammation, just like rancid cooking oils,” said Abrams. “That’s why you want to make sure you’re taking fish oil that is outside-tested for quality, for purity, for cleanliness, and that has an expiration date on it so it’s pulled off the shelf prior to becoming rancid.”

If you practice the proper storage and handling, most fish oil capsules state they will stay fresh up to 24 months.

How to get rid of the fishy aftertaste?

The fishy aftertaste, including those terrifying fish-burps, that comes along with swallowing fish oil is a big turnoff for many people. In order to combat that strong aftertaste, we suggest taking your fish oil supplement following a meal, rich in dietary fats like avocados, eggs, fatty fish (like salmon or tuna), dairy yogurt, dark chocolate, or nuts (almonds, walnuts, pistachios), etc.

You can also try the fish oil capsules with an enteric coating, like our top pick Life and Food’s Omega-3 Supreme. The extra-thick coating will help bypass the aftertaste because the pill won’t begin to dissolve until it reaches the stomach.

Our Other Nutritional Supplement Reviews

We are always looking for pure and safe supplements that bolster well-being. And we’ve tackled a lot of ingredient lists in the process. Check out some of these related reviews:

  • Fiber Supplement
  • Iron Supplement
  • Multivitamin
  • Pre-workout Supplement
  • Prenatal Vitamin
  • Probiotic Supplement
  • Vitamin C Supplement
  • Vitamin D Supplement

3 Ways to Prevent “Fish Burps”

Dr. Laurie Steelsmith June 4, 2015 Dr. Laurie Steelsmith , Supplements Email Print Twitter Pinterest Facebook

This post was most recently updated on March 16th, 2018

You’re taking fish oil to increase your intake of important omega-3 essential fatty acids—and that’s a good thing. What’s not so good is that awful taste or burning sensation that comes back and lingers after you swallow the capsules or a spoonful of the liquid. “Fish burps,” as they’re sometimes called, are not only uncomfortable, they’re a reason many people stop taking these healthy supplements—or hesitate to try them in the first place. Before you cast aside your bottle, try these tips for taming your fish oil experience.

Stick with liquids

This may sound like the exact opposite of the advice you’d expect for preventing a fishy taste in your mouth, but liquid fish oils won’t repeat on you the way capsules do. Just be sure to brush your teeth after you take it to avoid any residual, lingering oil. Most liquid fish oils, such as Nordic Naturals Omega-3, are flavored and don’t have a fishy taste. It just tastes like lemon!

Catch a meal first

Omega-3 fats occur naturally in fish, which, when eaten as a food, seldom causes intestinal discomfort. If you take fish oil with food, your body will absorb it better, as your digestive system is turned on to digest the wide variety of nutrients—protein, carbohydrates and fats—in your meal. It’s best to eat something, then take your capsules, then eat a little more in order to “sandwich” your pills between layers of food.

Enzyme action

Another way to ease any potential discomfort is to take digestive enzymes with your fish oil supplements, to support healthy digestion. Lipase, specifically, is an enzyme that helps your body to digest fat. It can be found in many products that support digestion, such as Vitacost Mega Digestive Enzymes with Pancreatin 10X. Two tablets provide 10 milligrams of lipase, enough to help you digest not only the fat in your meal, but also in your friendly fish oil fats.

Dr. Laurie Steelsmith

Laurie Steelsmith, ND, LAc, is a naturopathic physician and licensed acupuncturist who specializes in women’s health. She is the co-author of Great Sex, Naturally: Every Woman’s Guide to Enhancing Her Sexuality Through the Secrets of Natural Medicine and co-author of Natural Choices for Women’s Health: How the Secrets of Natural and Chinese Medicine Can Create a Lifetime of Wellness. Visit her website at www.DrSteelsmith.com.

Laurie Steelsmith, ND, LAc, is a naturopathic physician and licensed acupuncturist who specializes in women’s health. She is the co-author of Great Sex, Naturally: Every Woman’s Guide to Enhancing Her Sexuality Through the Secrets of Natural Medicine and co-author of Natural Choices for Women’s Health: How the Secrets of Natural and Chinese Medicine Can Create a Lifetime of Wellness. Visit her website at www.DrSteelsmith.com.

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THE QUESTION

I don’t like fish, but I want to make sure I am not missing out on its healthy oils. What’s the difference between omega-3 capsules, fish oil and krill oil? Is one better for you than another?

THE ANSWER

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There’s good reason to up your intake of omega-3 fatty acids. Research suggests that doing so is good for your heart, brain, joints, vision, even your mood.

A higher intake of omega-3 fats is also thought to help guard against Type 2 diabetes, stroke, Alzheimer’s disease and possibly prostate cancer.

If you don’t eat fish, a key source of these healthy fats, it’s important to know how to navigate the supplement aisle. Depending on the potential health benefits you’re searching for, some types of omega-3 pills won’t deliver.

What are omega-3 fatty acids?

The body can’t make omega-3 fats on its own, so you have to get them from food or supplements.

Omega-3 fatty acids are vital components of cell membranes, allowing nerve impulses to pass easily between cells. They’re also the building blocks for hormones that control inflammation, blood clotting and relaxation and contraction of artery walls.

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The strongest evidence for the beneficial effects of omega-3 fats revolves around heart disease, and that’s especially so for DHA and EPA in fish and seafood. Higher intakes and higher blood levels of DHA and EPA appear to help lower elevated blood pressure, prevent arrhythmias (abnormal heart beats), improve blood vessel function and lower triglycerides (blood fats).

Fish oil versus krill oil

Fish oil and krill oil supplements both provide heart-healthy DHA and EPA, but there are differences. Fish oil supplements are derived from salmon or a blend of fatty fish, including sardines, mackerel, herring, anchovies and/or menhaden. Krill oil doesn’t come from fish; it’s made from tiny shrimp-like crustaceans.

Perhaps the more meaningful difference, though, is the chemical structure of krill and fish oil and how it affects the absorption of omega-3 fatty acids.

Much of the DHA and EPA in krill oil is bound to phospholipids – fatty substances that dissolve easily in water and, therefore, may enhance the absorption of DHA and EPA into the bloodstream. The omega-3 fats in conventional fish oil supplements, on the other hand, are attached to triglycerides, fats that don’t readily dissolve in water.

Despite claims by manufacturers, the absorption of DHA and EPA from krill oil has not been proven to be superior to omega-3’s in fish oil. Recent studies have found little or no difference in blood levels of omega-3 fats after consuming identical amounts of the two supplements.

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It seems that both krill oil and fish oil, when provided in equal doses, are equally effective at raising DHA and EPA levels in the body. Keep in mind, however, that the krill oil supplements typically provide smaller amounts of DHA and EPA than fish oil products.

Supplementing with krill oil may prevent “fishy burps,” a side effect that often occurs with fish oil. If you take fish oil and experience a fishy aftertaste, freezing the capsules can reduce the problem. Taking fish oil at the beginning of a meal, rather than after, can also help.

What about “omega-3” capsules?

A supplement labelled “omega-3” may contain omega-3 fats from fish oil or krill oil (DHA and EPA) or flax oil (ALA). If the source of omega-3 fatty acids is not clear on the front label, check the ingredient list.

While there is less research on the health benefits of ALA compared with fish oil, higher intakes of ALA have been tied to a lower risk of hypertension and heart attack.

It also may protect against Type 2 diabetes.

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That said, it’s easy to add ALA to your diet without resorting to supplements. One tablespoon of ground flax delivers 1,200 milligrams of ALA, one teaspoon of flax oil has 2,400 mg and seven walnut halves supply 1,280 mg. Not bad considering women require 1,100 mg per day and men need 1,600 mg.

Flax oil is not a substitute for fish or krill oil, though.

EPA and DHA in fish and seafood are better known for supporting heart, brain and eye health.

How much DHA & EPA?

There are no official recommended intakes for DHA and EPA.

Heart experts typically recommend consuming at least 500 mg of DHA plus EPA (combined) each day, an amount obtained by eating six ounces of salmon a week.

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The American Heart Association advises people with heart disease to consume a combined 1,000 mg of DHA plus EPA a day from fish, omega-3 supplements or a combination of the two.

Read the ingredient list on fish and krill oil supplements to determine the amount (in mg) of DHA and EPA contained in one 500 mg or 1,000 mg capsule.

Bottom line

If you like fish, include it in your diet twice a week. In addition to DHA and EPA, oily fish – such as salmon, trout and sardines – is an excellent source of protein, B vitamins, vitamin D, magnesium, potassium and selenium.

(Yes, smoked salmon counts, too. It’s higher in sodium than fresh salmon, but it’s still an excellent source of omega-3 fats.)

If you don’t eat fish, consider taking a fish oil or krill oil supplement each day. Fish oil capsules vary in the amount of DHA and EPA they contain. Most 1,000 mg fish oil capsules contain 300, 500 or 600 milligrams of DHA and EPA combined. Liquid fish oil can contain as much as 1,300 milligrams of DHA and EPA a teaspoon.

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DHA supplements made from algae are also available for vegans and people who are allergic to fish.

Fishing for omega-3s

Healthy people should consume at least 500 milligrams of DHA and EPA (combined) each day; individuals with heart disease are advised to get 1,000 mg daily. Since omega-3 fats store in the body, it isn’t necessary to eat fish every day.

Daily recommended intakes for ALA are 1,100 mg for women and 1,600 for men.

DHA + EPA (milligrams), per 3 ounces

ALA, milligrams

Leslie Beck, a registered dietitian, is based at the Medisys clinic in Toronto.

The omega-3 industry is in a twist. Again. Last week, Cochrane, an organisation that compiles and evaluates medical research for the general public, released a meta-analysis – a study of studies – to determine whether or not omega-3 pills, one of the world’s most popular dietary supplements, reduced the risk of coronary heart disease. After comparing 79 trials involving 112,059 people, the researchers could find “little or no difference to risk of cardiovascular events, coronary heart deaths, coronary heart disease events, stroke or heart irregularities”.

I can’t say that I was particularly surprised. Over the past 15 years, more than 20 studies have shown a similar lack of effect. But what does surprise me is how we continue to look at the world of fish and seafood through the amber lens of a fish oil capsule. Omega-3s do something in our bodies – and probably something important. But without the larger context of the marine organisms that contain them, omega-3s get lost in the noise of human metabolism and modern marketing.

The confusion arises in part from the historical baggage of fish oil and the $30bn (£23bn) industry associated with omega-3 extraction. Once upon a time, fish oil solved a major human health problem. But it had nothing to do with coronary heart disease. During the Industrial Revolution, a disease became increasingly prevalent throughout northern Europe: rickets. Malnourished children in sunlight-poor urban slums often ended up bowlegged by adolescence. Researchers eventually pieced the puzzle together and concluded that the disease was caused by a deficiency in vitamin D, which the body naturally generates in the presence of sunlight. And, as it turned out, vitamin D is stored in high amounts within the liver of codfish.

A Norwegian pharmacist named Peter Möller seized upon this finding (and many other anecdotal stories about the curative properties of cod-liver oil). Using a patented chemical process, he arrived at a product that, he announced to the world, “didn’t taste fishy”. Möller and his advertising team then launched a campaign to institutionalise the regular use of cod-liver oil, regardless of whether you were at risk of rickets or not. The campaign was a success: a spoonful a day became common practice. Möller built his company into an international presence and died in 1869 with 70 cod-liver oil steam factories to his name, churning out 5,000 barrels of the stuff a year. By the time omega-3s started to be a focus of medical research, there was already a rosy feeling around fish oil.

In the early 1970s, the chemist Hans Olaf Bang read in a Danish journal that there were extremely low incidences of cardiovascular disease in Inuit communities of Greenland. He and his assistant, Jørn Dyerberg, travelled to Uummannaq on the north-west coast of Greenland to investigate. At the time of the expedition, Bang didn’t quite know what he wanted to test for. They probed and palpated 130 local people, measured height and weight, and came home with a lot of blood.

“We had these 130 precious samples of blood,” Dyerberg told me in his lab in Copenhagen recently. They estimated that in 20 years, the traditional Inuit diet would have changed to the western diet, and Dyerberg remembers Bang saying: “‘There will never be anyone who can do this again, so let’s do whatever we can!’ And we decided to do fatty acid analysis.”

The result of their analysis was a hypothesis that is an exemplary “association study”. In an association study, multiple factors are logged and a hypothesis of correlation is drawn from the findings. In the case of the Bang and Dyerberg Inuit study, they found that: 1) Inuit people in Greenland had a diet high in omega-3 fatty acids and blood lipid levels of omega-3s much higher than their western contemporaries. 2) Inuit people also had, according to public health records, markedly lower rates of coronary heart disease. They hypothesised that therefore 3) omega-3s might reduce the risk of coronary heart disease.

This was backed up by further laboratory studies that did show, in vitro, that omega-3s were involved in anti-inflammatory reactions. But – and this is a big but – while correlations abound for omega-3s and heart disease, the real trouble has always been in showing causation. That is where this latest round of studies comes in.

The Cochrane study and the others that preceded it have one thing in common: they are meta-analyses of “randomised control trials” (RCTs). That is, trials where patients are given a supplement at random and tracked over time against another set of patients given a placebo. Most statisticians consider these trials to be the very top of the evidence pyramid. But it is these studies that have at times proven troublesome for Omega World. Each time RCTs come to light that show little or no effect, Omega World tends to blend its counterargument with evidence from association studies because, as a recent industry reply to the Cochrane report put it, “it’s all connected”.

When it then turns to the RCTs, the industry, as would be expected, looks for different explanations as to why positive health outcomes weren’t reported. In the burst of RCTs preceding Cochrane, the Omega World line was that these most recent trials did not show benefits because things such as statins, stents and other forms of cardiovascular intervention masked the anti-inflammatory effect of fish oil pills; earlier RCTs had shown a fairly significant effect, but none of those treatments existed at the time of those trials.

The industry also, and I believe rightly, pointed out that studies often failed to look at omega-3 blood lipid levels before and after supplementation. In other words, it’s not really a fair trial if you don’t know where the patients started with respect to the omega-3 levels in their blood. If we only measure effect without looking at omega-3 levels in the blood at the outset, aren’t we doing the dietary equivalent of testing how far a car can drive without checking how much petrol is in the tank at the start?

With Cochrane, the latest industry argument is that the study’s authors cut out a number of different forms of cardiac ailments, thus skewing the stats. In particular, it notes that Cochrane failed to include “sudden cardiac death” and “sudden cardiac mortality” in its list of outcomes. Since nearly half of all patients first report heart disease to their doctors by suddenly dropping dead, this is not an insignificant exclusion.

But the fact that the industry’s arguments shift with each new, damning meta-analysis gives you pause. What is going on? Is there an international conspiracy to discredit omega-3s? Or does Omega World keep moving the goalposts? When I posed this question to Ellen Schutt, the executive director of the Global Organization for EPA and DHA Omega-3s, probably the world’s most prominent omega-3 advocacy organisation, she made it seem as if the problem didn’t even exist. “As a matter of fact, we track media sentiment … and have found many more positive omega-3 stories than negative, in general. Of course, the negative stories are the ones that catch people’s attention. As we both know, negative stories are much more interesting and the media is definitely guilty of sensationalist ‘clickbait’ headlines such as: ‘Omega-3s don’t work.’”

As sympathetic as I am to the trials of Omega World, as studies continue to poke holes in aspects of the omega-3 cardiovascular argument, I can’t help thinking there is something else going on. Because, while the fish oil supplement business is a big deal, it is also a sheen on the surface of a much deeper pond. Long before omega-3 supplements became popular, an industry arose that used the same omega-3-rich creatures not for medicine, but for an odd array of agricultural and industrial purposes.

Ultimately, it was this so-called “reduction industry” that created the oily-fish extraction system that now consumes millions of tonnes of marine wildlife every year. Today, one in every four kilograms of fish caught is reduced into oil and meal and used for agriculture, land animal husbandry and, most recently, fish farming, AKA aquaculture.

The reduction industry has appeared in different forms under different ownership over centuries of human history. In the 18th century, it targeted whales, reducing northern hemisphere cetacean populations into isolated pockets of endangered species in order to make lamp oil and lubricants. In the 19th and early 20th centuries, it shifted to the southern hemisphere, reducing 390,000 of the 400,000 great whales that once roamed the Southern Ocean to margarine, nitroglycerine and other “marine ingredients”.

In the latter half of the 20th century, it shifted again and targeted small, oily fish such as anchovies, sardines and herring. In the late 1940s and early 1950s, the largest reduction operation in human history arose off the coast of Peru in pursuit of the Peruvian anchoveta. The Peruvian anchoveta is by far the largest single species catch by tonnage in the world, some years comprising as much as 10% of all fish caught. And although Peruvian anchoveta are as delicious as any anchovy on Earth, an industry-influenced Peruvian law dictates that more than 95% of the catch must go to the reduction industry.

Each decade brings a different use for all those anchovies. In the 1940s, they were used for fertiliser. In the 50s and 60s, chicken feed. In the 70s, pet food and pig feed. In the 80s and 90s, aquafeed for salmon and other carnivorous fish. And now, the most elite product of the reduction industry: dietary supplements.

And it is not just Peruvian anchoveta that are reduced into fish meal and oil. All told, the reduction industry removes from the ocean 20m-25m tonnes annually – the equivalent of the combined weight of the population of the United States. The omega-3 industry argues that some vendors are turning to much more sustainable options, such as algae-based omega-3s and fish oil reclaimed from recycled byproducts.

Nevertheless, the reduction industry marches on into new territory. Most recently, it has begun targeting Antarctic krill, the keystone prey species of the entire Antarctic ecosystem. Two years ago, when I asked the then chief executive of the largest krill extractor in the world why it had launched a $200m fishing operation in the Southern Ocean to take food out of the mouths of whales, he noted that krill oil is a “phospholipid” and making it much more “bioavailable” means that consumers can take a much smaller pill. Why was this important? Consumers who chose krill oil over fish oil would be much less likely to suffer the horrors of a fishy burp.

Amid all the conflicting reports, there is one bit of data that shines out: fish and seafood can bring considerable health and environmental benefits. Fish, in addition to providing us with omega-3s, delivers protein with far fewer calories than meat: 100g of salmon contains 139 calories and 23g of protein. By comparison, 100g of beef contains 210 calories and 20g of protein.

Harvesting wild fish from well-managed stocks requires a fraction of the carbon as farming terrestrial livestock. Similarly, fish farming puts a lesser burden on the Earth in terms of carbon and freshwater use than pretty much any form of terrestrial animal husbandry. We could make the farming of fish even more carbon- and resource-efficient if we used alternative ingredients for fish food based on algae and food waste. And if you consider growing “filter feeders” such as mussels, clams and oysters, the benefits are even more extreme. These bivalves don’t have to be fed anything, and make water cleaner even as they grow fatter. They provide protein 30 times more efficiently than cattle.

Is the epidemiological evidence for fish-eating better than simply taking a fish oil pill? Again, we are stuck with the problem of correlation versus causation. It is very difficult to feed someone a fish in such a manner that they don’t know they are eating a fish. Hence an RCT of seafood-eating hasn’t really ever been done. Most of the studies around seafood are association studies. And, while one such study associated eating fish twice a week with a possible reduction in mortality of 55,000 lives a year, we don’t know what a fish-eater does with the rest of their life beyond eating fish.

But what we do know is this: the omega-3 industry and the reduction industry that bred it removes fish from the water in a way that doesn’t put protein on our plates – it just puts pills in our cupboards. Is this the way we want to continue to do business with the planet?

Paul Greenberg is the author of The Omega Principle: Seafood and the Quest for a Long Life and a Healthier Planet (Penguin Press).

• The subheading of this article was amended on 25 July 2018 to clarify that it was for heart health or strokes that the study found omega-3 had little or no benefit.

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Omega 3 Bursts

The body needs an adequate intake of healthy fats in order to support the health of the brain, cardiovascular system, skin, and joints. This is particularly important for children and adolescents who are growing and rapidly forming new tissues. Omega 3 is one of the families of healthy fats that are essential, meaning the body cannot produce them, therefore they must be obtained from the diet by eating fatty fish several times a week, or by taking supplements. The active compounds in omega 3 are DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid) and they are primarily found in fish. DHA, because of its link to brain and behaviour, is of particular interest to children and adolescents. Many children do not eat the amount of oily fish, such as salmon, tuna and mackerel, necessary to supply their needs.

Sisu Kids Omega 3 Bursts is specifically formulated for children and is an easy and reliable way to ensure kids are getting guaranteed amounts of these crucial nutrients when their growing bodies and minds need them the most.

Product Highlights

  • High-potency, wild tuna fish oil standardized to contain a minimum of 105 mg DHA and 34 mg EPA
  • Molecular distillation to concentrate the active ingredients and eliminate contaminants such as mercury, lead, PCBs, and dioxins
  • DHA and EPA in omega 3 are vital to many aspects of heart health
  • EPA and DHA help to control inflammation, support skin health, and may be useful against mild allergic reactions
  • May help reduce behaviour problems in children with omega 3 deficiency
  • Omega 3 supports brain health and provides support against depression and migraines
  • Sweetened with natural xylitol, no artificial colours
  • The soft, fruit-flavoured chewable capsule bursts in the mouth to release a pleasant, fruit punch flavoured, lightly sweetened oil
  • The capsule shell can be chewed and eaten like a gummy candy
  • Children who do not like the chewy texture of the capsule can discard it after it bursts or the tail can be cut off the fish capsule and the oil squeezed into food or juice
  • Every lot meets strict limits for environmental contaminants such as PCBs, dioxins, furans, and heavy metals including, mercury and lead

Omega-3 Supplements: In Depth

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  • Casula M, Soranna D, Catapano AL, et al. Long-term effect of high dose omega-3 fatty acid supplementation for secondary prevention of cardiovascular outcomes: a meta-analysis of randomized placebo controlled trials. Atherosclerosis. Supplements. 2013;14(2):243-251.
  • Chowdhury R, Stevens S, Gorman D, et al. Association between fish consumption, long chain omega 3 fatty acids, and risk of cerebrovascular disease: systematic review and meta-analysis. BMJ. 2012;345:e6698.
  • Chua ME, Sio MC, Sorongon MC, et al. Relationship of dietary intake of omega-3 and omega-6 fatty acids with risk of prostate cancer development: a meta-analysis of prospective studies and review of literature. Prostate Cancer. 2012;2012:826254.
  • Clarke TC, Black LI, Stussman BJ, Barnes PM, Nahin RL. Trends in the use of complementary health approaches among adults: United States, 2002–2012. National health statistics reports; no 79. Hyattsville, MD: National Center for Health Statistics. 2015.
  • Cooper RE, Tye C, Kuntsi J, et al. The effect of omega-3 polyunsaturated fatty acid supplementation on emotional dysregulation, oppositional behaviour and conduct problems in ADHD: a systematic review and meta-analysis. Journal of Affective Disorders. 2016;190:474-482.
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  • Daviglus ML, Bell CC, Berrettini W, et al. National Institutes of Health State-of-the-Science Conference statement: preventing Alzheimer disease and cognitive decline. Annals of Internal Medicine. 2010;153(3):176-181.
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Yes, you can reap all the benefits from your inflammation-fighting fish oil supplements without the fishy taste.

Don’t let your fish oil supplements linger on a kitchen shelf because it causes fishy burps. Follow these five tips to minimize this unpleasant problem and still get your helping of omega-3 essential fatty acids:

Keep the Bottle in the Freezer
When a fish oil capsule is frozen, the fish oil is broken down in the stomach more slowly, which can reduce the aftertaste.

Choose Enteric Coating
Some brands, such as Kirkland Signature and Nature’s Way, offer capsules with enteric coating, which prevents them from being digested until they reach the small intestine.

Eat and Divide
Take your fish oil capsules with a meal, and try dividing your daily dose in two so your stomach has less to process at once.

Stick to Quality Brands
“Cheap fish oil is just as likely to be rancid as cheap fish,” says nutritionist Jonny Bowden, PhD. Break open a capsule; if it smells like rotting fish, it’s rancid.

Look for Lipase
Products containing lipase, an enzyme that helps digest fats, may help prevent the annoying fishy reflux.

The answer is more friend than foe, if the fish oil comes from food sources rather than supplements.

Omega-3s in balance

What’s so special about fish oil? It’s loaded with omega-3 fatty acids. These must come from food, since our bodies can’t make them.

The two key omega-3 fatty acids are docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Fatty fish like salmon, mackerel, and sardines are rich in these omega-3s. Some plants are rich in another type of omega-3 fatty acid, alpha-linolenic acid, which the body can convert to DHA and EPA. Good sources of these are flaxseeds, chia seeds, walnuts, pumpkin seeds, and canola oil.

Omega-3 fatty acids play important roles in brain function, normal growth and development, and inflammation. Deficiencies have been linked to a variety of health problems, including cardiovascular disease, some cancers, mood disorders, arthritis, and more. But that doesn’t mean taking high doses translates to better health and disease prevention.

Fish oil supplements have been promoted as easy way to protect the heart, ease inflammation, improve mental health, and lengthen life. Such claims are one reason why Americans spend more than $1 billion a year on over-the-counter fish oil. And food companies are adding it to milk, yogurt, cereal, chocolate, cookies, juice, and hundreds of other foods.

But the evidence for improving heart health is mixed. In November 2018, a study reported in the New England Journal of Medicine found that omega-3 fatty acid supplements did nothing to reduce heart attacks, strokes, or deaths from heart disease in middle-age men and women without any known risk factors for heart disease. Earlier research reported in the same journal in 2013 also reported no benefit in people with risk factors for heart disease.

However, when researchers looked at subgroups of people who don’t eat any fish, the results suggested they may reduce their cardiovascular risk by taking a fish oil supplement.

Evidence linking fish oil and cancer has been all over the map. Most research, including the 2018 study cited above, has not shown any decreased risk of cancer. However, some earlier research suggested diets high in fatty fish or fish oil supplements might reduce the risk of certain cancers.

Take home message

How food, and its component molecules, affect the body is largely a mystery. That makes the use of supplements for anything other than treating a deficiency questionable.

Despite this one study, you should still consider eating fish and other seafood as a healthy strategy. If we could absolutely, positively say that the benefits of eating seafood comes entirely from omega-3 fats, then downing fish oil pills would be an alternative to eating fish. But it’s more than likely that you need the entire orchestra of fish fats, vitamins, minerals, and supporting molecules, rather than the lone notes of EPA and DHA.

The same holds true of other foods. Taking even a handful of supplements is no substitute for wealth of nutrients you get from eating fruits, vegetables, and whole grains.

What should you do if you currently take fish oil? If your doctor prescribed them—they are an approved and effective treatment for people with high blood triglyceride levels—follow his or her instructions until you can have a conversation about fish oil.

If you are taking them on your own because you believe they are good for you, it’s time to rethink that strategy. If you don’t eat fish or other seafood, you might benefit from a fish oil supplement. Also you can get omega-3s from ground flaxseed or flaxseed oil, chia seeds, walnuts, canola oil, and soy oil. One to two servings per day can help you avoid a deficiency of omega-3s.

Following food author Michael Pollan’s simple advice about choosing a diet may be the best way forward: “Eat food. Not too much. Mainly plants.”

Fish oil supplements are immensely popular these days. According to the New York Times, 10 percent of Americans consume fish oil supplements regularly. In the United States, fish oil supplements accounted for $1.2 billion in sales for the year 2014. Most commonly people take these supplements for cardiac health, but many claims have been made for benefits besides protection of the heart. Claims for substances that act as panaceas are familiar to skeptics. Skeptics may take interest in the variety and boldness of claims made for fish oil supplements—particularly since fish oil is not a “miracle drug” but a nutritional supplement.

Conditions for which fish oil supplements have been claimed to be helpful include cardiovascular disease, depression, anxiety, seasonal affective disorder, postpartum depression, bipolar disorder, ADHD, Alzheimer’s disease, arthritis, cancer, eczema, psoriasis, sunburn, diabetes, eye disorders, polycystic ovarian syndrome, and endometriosis. They have also been claimed to help increase a child’s intelligence and help people achieve weight loss. Clearly an extensive analysis of all these claims is beyond the scope of this article, yet a summary is still possible.

Where do we begin? How did fish oil supplements become so popular in the first place? First off, “fish oil supplements” should be disambiguated from cod liver oil, which has long been used as a source of vitamins A and D. The fish oil under consideration here contains high amounts of omega-3 fatty acids, primarily DHA (docosahexanoic acid) and EPA (eicosahexanoic acid), not vitamins A and D. Omega-3 fatty acids are like vitamins and minerals in that they are required for human nutrition and can’t be manufactured by the body. They are considered “essential fatty acids.” The designation “omega” refers to one end of the fatty acid molecule, and the “3” indicates a double bond three carbon atoms away from that end. Unlike other fats, these molecules are not “burned” for caloric fuel but function to modulate biochemical processes such as inflammation.

The current fascination with these molecules largely began in the 1970s, when two Danish researchers—Bang and Dyerberg—began investigating Inuit Eskimos living in Greenland. They wanted to understand the consequences of this unique population eating so much fat. The Inuit’s diet consisted “mostly of meat of whales, seals, sea birds, and fish” according to the researchers. Bang and Dyerberg suspected that the omega-3 oils in the fish they ate acted to protect against cardiac disease, which would be expected to result from a diet rich in saturated animal fat. Bang and Dyerberg were clinical chemists, not epidemiologists, yet their research was epidemiological in nature as they analyzed records maintained by Greenland’s chief medical officer. In addition, they drew blood from 130 natives of the small town of Uummannaq. Compared to their control population of Danes, the Inuit had lower levels of triglycerides and cholesterol, as well as higher levels of omega-3 fatty acids. Bang and Dyerberg published their findings in 1971 in the British journal The Lancet, one of the preeminent medical journals in the world. By 1980, they began to publicly suggest that omega-3 fatty acids in the diet might help prevent cardiac disease in populations besides the Inuit.

According to George Fodor, a cardiologist at the University of Ottawa Heart Institute, the number of individuals that died of cardiac disease may have been significantly underrepresented in the Lancet study. Since this was a remote area, with people living far from urbanized medical centers, the exact cause of death may have not been precisely determined. In any event, this was the birth of the meme that fish oils may help prevent cardiac disease. Since that time, a wide variety of studies have been done regarding heart health. It’s fairly well established that fish oils can lower LDL or “bad” triglyceride levels, which is a valid risk indicator for heart disease.

In fact, the FDA has approved several drugs, including Lovaza and Vascepa, which are semi-synthetic versions of fish oil, meaning that the natural fatty acid has been slightly chemically modified. These drugs are indicated for people with very high levels of blood lipids. In addition, fish oil has an anticoagulant effect, much like aspirin, that may reduce the risk of blood clots.

The problem is that a “risk indicator” is not the same as the risk itself. The important question is whether fish oil supplements actually lower risk of cardiac disease, not just bad triglyceride levels. Between 2005 and 2012, at least two dozen large scale studies of fish oil were conducted in high-risk populations. All but two found no benefit, including one published in the New England Journal of Medicine, which included 12,000 people. The evidence simply doesn’t support the claim that fish oil supplements can reduce the risk of cardiac disease, at least in high-risk individuals.

What about other claims for fish oil supplements, besides amelioration of cardiac disease? Perhaps the most encouraging findings are those related to rheumatoid arthritis. Essential fatty acids within fish oil act as anti-inflammatories by blocking the action of prostaglandins and cytokines. Multiple studies have demonstrated significant pain relief for rheumatoid arthritis sufferers, in some cases enabling individuals to completely discontinue use of conventional non-steroidal anti-inflammatory drugs.

Fish oil supplementation has also been studied for its potential to prevent dementia in the elderly. Study findings have been mixed, some suggesting benefit while others show no benefit. Thus, unambiguous evidence that fish oil can prevent the onset of dementia is lacking. If there is a silver lining to this unfortunate state of affairs, it’s that studies of longer duration should be undertaken in order to observe greater mental changes in study participants. It’s possible that positive benefits of fish oil may appear over greater time spans.

An interesting set of claims surrounds the use of fish oil for exercise recovery. The idea is that exercise induces some degree of inflammation and oxidation in the body, and fish oil can help suppress these negative processes. There are studies that support this. Even more suggestive is the claim from a popular bodybuilding website, Bodybuilding.com, that fish oil can help add muscle mass: “Perhaps more interesting for people looking to build muscle, EPA and DHA supplementation has been suggested to support muscle protein synthesis and limit muscle protein degradation. This can mean less muscle breakdown and more muscle growth.” Note this claim hinges on the word suggestive. Indeed, a number of studies point in the direction of fish oil having at least some positive impact on muscle building for those who exercise. It should be noted that how positive an effect is often not overtly stated and only inferred.

The story of fish oil is not unusual. There are many drugs and nutritional supplements for which the evidence of efficacy is marginal or for which the effect is minimal. For most people, the choice to buy and consume fish oil is a simple binary; Should I take this? Yes or no? If I spend money on this supplement, will it provide a benefit commensurate with the money spent? The bulk of studies for a wide range of conditions indicate either no effect or a mildly positive effect. In many cases, the evidence is “suggestive,” which really means there is a physiological mechanism why fish oil could work. The exception seems to be rheumatoid arthritis, for which the evidence of benefit is fairly compelling. Unless one is on anticoagulant drugs, introduction of fish oil supplements to the diet has not been shown to be negative and may provide a positive benefit for a variety of conditions, though this benefit is likely mild. A decision to supplement one’s diet with fish oil is therefore reasonable, though ironically not for what many people take it for, which is prevention of cardiac disease.

Chewable fish oil for adults

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