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- Herausgeber: Foodwatch Nutrition Centre
- Kategorie: Ratgeber
- Sprache: Englisch
Confused about which fish oil capsule to buy? Not sure if you even need omega-3s? The handy Foodwatch Guide to Fish Oils and Omega-3s has the answers plus a convenient buying guide.
Fish oil capsules are one of the biggest-selling supplements. They have much research behind them and have been used in clinical trials to treat a wide range of health problems such as
heart disease, arthritis, loss of vision, chemotherapy side-effects and even mental disorders like
depression, schizophrenia and
ADHD.
But just how useful are they? And do you really need to take them?
The handy Foodwatch Guide to Fish Oils and Omega-3s answers these questions and more. It addresses the need for different dosages for different health conditions and importantly contains a
comprehensive buying guide to make your choice easier.
Das E-Book können Sie in Legimi-Apps oder einer beliebigen App lesen, die das folgende Format unterstützen:
Veröffentlichungsjahr: 2020
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About Fish Oils and Omega-3
Confused about which fish oil capsule to buy? Not sure if you even need omega-3s? The NEW handy Foodwatch Guide to Fish Oils and Omega-3s has the answers plus a handy buying guide.
Fish oil capsules are one of the biggest-selling supplements. They have much research behind them and have been used in clinical trials to treat a wide range of health problems such as heart disease, arthritis, loss of vision, chemotherapy side-effects and even mental disorders like depression, schizophrenia and ADHD.
But just how useful are they? And do you really need to take them? The NEW handy Foodwatch Guide to Fish Oils and Omega-3s answers these questions and more. It addresses the need for different dosages for different health conditions and importantly contains a comprehensive buying guide to make your choice easier.
Contents
Dedication
For former dietitian Penelope Stone who always orders fish whenever we eat out. This is for you.
Thought for the book
“Take care of your body. It’s the only place you have to live.”
Jim Rohn 1930 –2009
American author and motivational speaker on success and a recognized expert in the fields of motivation and personal achievement.
Introduction
Hello from Catherine
Thank you for buying this book.
As one of the biggest-selling supplements, fish oil capsules are, and have been, used in clinical trials to treat a wide range of health problems such as heart disease, arthritis, cancer and even mental disorders like depression, bipolar disorder and ADHD.
But the questions I want answered (and I suspect you do too) are:
How useful are they?Do you really need to take them?How many should you take?What’s the best brand to buy?Many of the clinical trials that gave positive results used quite large doses of fish oil and made sure that the baseline intake was quite low (in other words, that the subjects in the starter group consumed little oily fish or no fish oil supplements). The trials wanted to see an effect that was due only to the capsules they gave.
Obviously fish itself is the best way to get these all-important omega-3s but if you can’t eat fish or if you require large amounts to help manage a condition, then the capsule supplements become an important source of these nutrients.
When I wrote my first guide to fish oils, there was very little standardisation and much less research. Today the situation is very different with the Therapeutic Goods Authority (TGA) having published guidelines based on the British Pharmacopoeia. In this new Foodwatch handy Guide to Fish Oils, I take a look at all the options open to you when you’re out shopping.
My comprehensive review
I found it most interesting to review many of the capsules now on the market in Australia. In addition to objectively reviewing the available options, I wanted to offer a personal view as I tested the various supplements to see if they could help the osteoarthritis which I have now in both my thumb joints. I suspect I also have arthritis in the joints of my big toes as occasionally I get flare-ups and pain there too.
Over the years, I have tried lots of things to reduce the inflammation and soreness including:
Seeing rheumatologists (doctors who are specialists in arthritis) who don’t seem at all interested in my sore joints as their existing patients are far worse me. I can see them – poor things, crippled and in pain – when I sit in the waiting room ready to go in.Taking glucosamine, chondroitin and fish oil for years. I have taken so many that I like to joke that I’m a “walking glucosamine tablet”. Sadly, they don’t seem to have slowed the progression of my arthritis. From what I have learnt while writing the Guide, I suspect that the dose of fish oil I’ve been taking has been too low. I have only been taking one standard capsule a day (too low to help) whilst I think I should have been taking 10 or 12 capsules! After writing this, I now see it will be easier for me to gulp down a liquid oil rather than swallow all those capsules.I have been to hand physiotherapists who have given me exercises to do to strengthen my thumb joint and have made me moulded casts for when I’m doing strenuous hand work such as gardening or cleaning.I have been to Chinese doctors and have had lots of acupuncture with needles inserted into my forehead and legs as well as my wrists while I lie still for 45 minutes and try to meditate. The acupuncture did reduce the pain by about 30 per cent but I’ve now stopped going as it takes so much time out of your day.I also have been to a hand surgeon (last resort!) for advice on what to do when things get worse (which I’m sure they will over time). The only thing they have to offer is a new wrist construction where they take an unused tendon from your arm and build it into a new wrist. The downside? I have to have 12 weeks off with only one hand in action.My arthritis, small as it is, does limit what I can do. For instance, I can’t:
Grasp the end of sticks such as tennis racquets or golf sticksDo any exercise involving placing my body weight onto my flat wrist such as push-ups or planks (have to roll my fingers up into a ball and do the exercise on a soft surface for support)Play pianoHold heavy platters where you require an opposing thumbCatch a larger ball like a basketball with any force.So, I need to consume more fish oil. I can see that. Now I need to find out how much, which delivery method, strength and brand I need and which works best for me. Plus, I give you the low-down on the brands available in Australia and the information to decide what suits you for quantity, strength and your wallet! So, read on for how to do that…
Here’s to healthy eating! I hope you enjoy reading this book and put the strategies into practice for yourself.
Regards Catherine
Reminder
No single nutrient, not even omega-3s, will ever be a panacea for good health and longevity. I’m sure you’ve heard it before. Eating a balanced diet with all the food groups really is the key. You can’t swallow a fish oil capsule as a replacement for nutritious meals.
Chapter 1
All about fish oil
What actually is fish oil?
Fish oil is extracted from the flesh and skin of oily fish such as anchovy, salmon, tuna, herring, cod and menhaden (a Northern hemisphere fish species). Generally natural antioxidants, like tocopherols or vitamin E, are added to protect the oil from oxidative damage (see below), which ensures the unstable omega-3 fatty acids don’t deteriorate and become rancid. The capsule itself, usually made from gelatine, is the main protection for the oil. Apart from fish oil, there are other minor ingredients which I’ll cover later.
What about oxidation and rancidity?
All oils are susceptible to oxidation, and fish oils are no exception. Unlike fresh fish, it’s difficult to tell whether or not a supplement is rancid. The only way I know is to slice open a fish oil capsule and if it smells odd, don’t take it. It should have a normal fishy odour and be pale yellow in colour.
If the oil becomes oxidised (which can happen after exposure to heat, ultraviolet light, heavy metals or air during processing), it can become rancid, making it more likely to cause inflammation in the body. Not something you want! Mostly this rancidity is controlled by the addition of antioxidants such as tocopherols and by the processing which is designed to minimise any contact with oxygen.
Freshness standards
In Australia, fish oil supplements are regulated by the Therapeutic Good Administration (TGA). The standard for natural fish oil, for instance, lists two criteria that specify a maximum of oxidation namely that the peroxide value must be less than 10 milliequivalents O2 per kg while the para-anisidine value must be less than 30.
How oxidation is measured
The Peroxide Value (PV) is the traditional and most widely used way to measure any oxidative degradation. It is considered a leading indicator. It determines the concentration of hydro-peroxide, the primary product of oxidation. The PV of an abused or air-exposed oil will rise over a few months.
The Peroxide Value must be less than 10 milliequivalents O2 per kg
The Anisidine Value (or strictly, the para-Anisidine Value or p-AV) measures the breakdown products of peroxides, which is what gives the rancidity. The cascade of reactions that first produced the peroxides then shifts to produce conjugated dienes and trienes.
The para-Anisidine Value must be less than 30.
Any oil production aims to produce oils with peroxide values as low as possible, without the formation of any secondary reaction products.
Negative publicity and the real story
A lot of negative publicity about fish oil supplements being oxidised came from a single piece of research from 2014 claiming that of the 32 Australian and New Zealand fish oil brands tested, most did not contain the levels of EPA and DHA stated on the label and some had alarming levels of oxidation.
However, when these products were subsequently retested by credible researchers including the CSIRO, the initial research was de-bunked once the correct testing methodologies were undertaken. Despite this, a fishy smell has hung around fish oil capsules – one that is not warranted.
What to look for to ensure freshness and high quality
Look for fish oil capsules that are intact and in containers that will not expose the capsules to light. Keep the capsules in the container and store them according to the recommendations on the pack. (I still put mine in the refrigerator for long term storage).
Check the expiry date on the bottle or tub, particularly if you are buying in bulk, to ensure the supplement is still fresh by the time you consume it all. Be realistic with your time frame – if you know you won’t take them all by the date they expire, it’s not a bargain. Don’t buy them.
Where most fish oil comes from
Today many reputable brands manufacture their fish oil from small fish with short lifespans such as anchovies and sardines for three reasons:
they have excellent omega-3 contentsthey are less likely to have issues with contaminants such as mercury — actually methylmercury — dioxins and PCBs than larger fishthey are generally a more sustainable resource, with the fisheries being managed by the countries where they occur.Do I need to take fish oil?
Therapeutic uses for fish oil are numerous as it has the ability to manipulate the structure and fluidity of your cell membranes as well as to reduce inflammation. This is due to the long-chain omega-3s in the oil. Hence it has been used to:
Lower triglycerides, a blood fat like cholesterolLower high blood pressurePrevent arrhythmia (ventricular fibrillation or irregular abnormal heartbeats which can trigger sudden death)Improve blood flow by “thinning” the blood and making the arteries more elastic (talk to your doctor before taking fish oil if you already take blood thinning medication)Reduce the swelling and stiffness of joints in arthritisPrevent loss of vision as we ageTreat skin disorders like eczema and psoriasisPlay a role in brain function and cognitionAssist in the treatment of mental disorders such as anxiety, depression and schizophreniaHelp maintain airways in asthma.Furthermore, Australians are not consuming enough omega-3s for optimal health and we could all do with increasing our omega-3 intakes.
Source: Taken from Meyer BJ. Nutrients. 2016 Feb 24;8(3):111. See References for the full citation. With permission.
Chapter 2
Long-chain omega-3s from fish and meat
Why not just eat fish?
How does a fish oil capsule compare with its parent whole food fish? You can easily see how much omega-3s you’re getting from a standard fish oil capsule compared to a serve of fish by looking over the figures – and below I’ve done this comparison for you.
Basically, one standard fish oil capsule has 300 mg of long-chain or marine omega-3s. What you’ll see on a bottle of fish oil capsules is that a capsule contains 1000 mg of fish oil, equal to 1 gram of fish oil, which gives you that 300 mg of the long-chain omega-3s. In terms of chemistry, this means you are getting a total of 300 mg (it’s just the sum of 180 mg eicosapentaenoic acid EPA plus 120 mg docosahexaenoic acid DHA).
One capsule is around the same as a serve of white fish but only one fifth of what you’ll find in oily fish like salmon or sardines. You can see it easily in this comparison:
If you eat oily fish, it’s relatively easy to obtain your omega-3s. There may well be other things in fish such as its protein, iodine, selenium, zinc or vitamins A and D that also account for its health benefits - you cannot pack the full benefits of real food into a single capsule.
Top 30 food sources of long-chain omega-3s
Have a look at this table. It shows you the best foods for long-chain omega-3 fatty acids – all the figures are for cooked fish or meat and cooked seafood (boiled, microwaved, steamed, poached, grilled or roasted) that has been drained and served without any added fat unless noted.
It is impossible to give a single accurate figure for the omega-3s in a serve of fresh fish such as salmon, trout or barramundi as their omega-3 content varies so much. It is different in winter and summer, whether the fish are fasted or fed, the size of the fish, the time of harvesting, the section filleted and analysed, whether they are from icy-cold water or warmer waters. Hence I have divided them into Rich, Excellent and Good sources.
From the table, you’ll see that:
Oily fish such as salmon, mullet, eel, canned sardines and canned mackerel are the best rich sources of long-chain omega-3. You need to eat them regularly.Seafood such as oysters, mussels, prawns and scallops are also good sources.All fish contributes some omega 3s and so are worth including in your daily diet.Organ meats such as liver rank high up too. These are no longer as popular as they once were. Today they are mainly added to a casserole (think of steak and kidney) or else end up in pet food. Lucky animals! Bone marrow is also rich so suck out that inner gelatinous mass when you eat Osso Bucco.* Serve size varies but generally it’s 150 g for a fillet of fish and 90 or 100 g for seafood. Source: Australian Food Composition Database 2019 plus Nichols PD et al. 2014. Nutrients. 2014 Mar 11;6(3):1063-79 plus manufacturers figures; NHMRC Recommended Dietary Intakes 2006. Labels on cans and packs may list differing values and that it is perfectly okay. There is always biological and seasonal variation when ones analyses a natural product.
How much fish do I need?
Everybody should obtain around 500 mg a day of the long-chain omega-3s. You’ll get this by eating:
A 150 g serve of a rich food source once a week, such as a fillet of fresh salmon or a small can of sardinesOR
A 150 g serve of an excellent food source twice a week, such as or a fillet of morwong or gemfish or a tray of sashimiOR
A 150 g serve of a good food source every second day, such as a fillet of frozen fish or a serve of calamari.Alternatively, take 2 standard fish oil capsules a day so you get about 500 mg.
Chapter 3
Short-chain omega-3 from plants
You need plant omega-3s too
Some plants, such as linseed (also called flaxseed), hemp and canola, naturally produce an omega-3 called alpha-linolenic acid (ALA), and one way to increase the amount of omega-3 in our diet is to eat these plants that contain ALA. All green leafy vegetables contain ALA but at low levels.
While plant-sourced omega-3s belong to the same chemical family as the long-chain types, they are different. They also do different things in the body, so it is important that both types are included in your diet. What’s more, if you don't eat fish, it's essential to maximise your intake of these plant-based sources of omega-3s. However, an important thing to realise is that the omega-3 fatty acid found in plants is nowhere near as effective as the types found in long-chain sources (such as DHA and EPA).
From plants, we do not get the long-chain fatty acids which we need and are present in our body — we only get the precursors of those long-chain omega-3 fatty acids. However, those from oily fish come ready made. So, in order to use plant omega-3 fatty acids, our bodies have to first convert them into long-chain forms but the yield of this process is extremely poor. The conversion rate is estimated to be less than 10 per cent.
Where can I find plant omega-3s?
There’s a limited number of plant foods that contain omega-3s. These include:
Linseed oil Linseeds (flaxseeds) Hemp oil Hemp seeds and hemp hearts (hulled flaked hemp seeds) Chia Walnuts Pecans Canola oil Soybean oil Perilla oil Wheatgerm
Three points to note about the plant sources of omega-3s:
1. There are few foods that are rich sources of plant omega-3s and it’s worth including these regularly in your daily diet, especially if you don’t eat oily fish or take fish oil capsules. To reach the recommended intake of 1,000 mg a day, you’d need to consume one of these three rich foods:
½ teaspoon or about 2 mL of linseed oil 1/3 tablespoon or about 10 mL of hemp oil 1/3 tablespoon or about 10 g of hemp hearts (hulled flaked hemp seeds).
Walnuts are at the top of the Excellent category and easy to incorporate. Just mix 1 Tbsp or 20 grams (around 6 walnut kernels) into snacks or into a muesli.
2. If you eat bigger serves of any of the oils, seeds or nuts listed, you’ll automatically get more of the plant omega-3s. So instead of one tablespoon of hemp hearts over your cereal, say, if you eat twice that by mixing another tablespoon in with a smoothie, you’ll get double the amount.
3. Small amounts add up over the day. So, if you snack on nuts, choose walnuts or pecans as part of the mix to boost your plant omegas. There’s relatively little omega benefit from other types of nuts.
Top 8 food sources of plant omega-3s
* Serve size varies but generally it’s 20 mL for a tablespoon of oil or 20 g for a tablespoon of seeds or 30 g for a small handful of nuts. Source: From Australian Food Composition Database 2019 plus USDA figures plus manufacturers figures. NHMRC Recommended Dietary Intakes 2006.
How much plant omega-3 do I need?
Everybody should aim for 1 gram (1,000 mg) a day of omega-3s from plant sources. You’ll get this by eating:
1 teaspoon of linseeds or LSA (linseed, sunflower and almond ground up into a meal) a dayOR
1/2 teaspoon of linseed oil (a tiny 2 mL) a dayOR
1/3 tablespoon hemp oil (around 10 mL) a dayOR
a small handful of walnuts (a tiny 20 g, around 6 walnut kernels) a day.How to incorporate linseeds into your diet
Linseeds (also called flaxseeds), are small, shiny, dark-brown seeds a little bigger than sesame seeds, and are a storehouse of plant omega-3s. You may also see Golden Flaxseeds for sale. The omega-3 profiles are slightly different, with brown having 59 per cent and yellow 51 per cent omega-3s of the total fatty acids. You only need a tiny amount of linseed oil or else ground linseeds to reach your recommended dietary amount a day. It’s worth knowing that whole linseeds don’t get digested and that you need to grind them up to release their benefits. Linseeds are also rich in lignans and plant oestrogens which have been shown to lower blood pressure and are now thought to minimise the side effects of the menopause like hot flushes. Winning ways with linseeds include:
Toss some into your muesli or over your morning cereal.Choose a bread made from soy and linseed.Scatter linseeds over green salads – even better lightly toasted in a non-stick pan.Add linseeds to muffin mixes and home-made bread dough. Swap ¼ cup of flour for ¼ cup of ground linseeds.Make up an easy Omega Sprinkle by grinding up ½ cup linseeds with 1 cup walnut halves or pieces. Just place the walnuts and linseeds into the bowl of a coffee grinder or food processor. Whirl for 10 seconds or until finely ground. Store in a jar in the freezer to prevent it from deteriorating. Use it within 2 weeks.How to introduce hemp into your meals
Hemp is one of the most versatile and eco-friendly crops in the world. It’s quick-growing and uses less water, land and pesticides than other seed crops.
In 2017, low-THC hemp was approved for use as a food in Australia although it’s been for sale for years in the US and EU. THC stands for TetraHydroCannabinol, which is the psycho-active ingredient of marijuana.
Hemp is a distinct variety of the plant species Cannabis sativa L. It is not marijuana and has low levels of THC (so it won’t make you high). Low-THC hemp or industrial hemp is the term usually used for this type of hemp.
You’ll find this hemp for sale in the form of whole hemp seeds, hemp hearts or flakes, hemp oil, hemp protein (the part leftover after the oil is extracted) and hemp flour (ground hemp seeds).
Hemp typically is around half fat which is more than other seeds like linseeds at 42 per cent and chia at 30 per cent. Technically it’s a nut, so it matches the fat content of almonds (50) but has less than pine nuts (65) or macadamias (70). Of this fat, roughly three-quarters is polyunsaturated with 15 per cent monounsaturated and less than 10 per cent saturated.
Its contribution to plant omega-3s such as alpha-linolenic acid (ALA) is outstanding and is its main benefit.
It’s great to have another plant source alongside linseeds and walnuts, although all scientific circles agree that the conversion to the longer-chain forms such as EPA and DHA that our bodies need is low.
Hemp also adds important vitamins and minerals, such as vitamin E, B group vitamins such as folate and thiamin, along with minerals like phosphorous, potassium, magnesium and iron. So, it’s good to use hemp wherever you can.
Use hemp oil
to make a healthy salad dressing with lemon juice or vinegar (3 parts oil to 1 part acid). Apart from salad, you can drizzle this over cooked legumes (beans) or carrots, broccoli and other vegetables.or splash over grilled zucchini, mushrooms, capsicums and other cooked vegetables.Use hemp flakes and seeds
by adding to your muesli or morning smoothie in just the same way as you’d use linseeds or sesame seeds.Hemp flour or ground hemp can be used
in any baking recipe by substituting about 30 per cent of the white flour with hemp flour e.g. about one-third of a cup plus two-thirds of a cup of flour.in chocolate muffins, cakes, pancakes, muesli bars and other baked items where its dark colour isn’t a problem.How to have ways with walnuts
Walnuts are the best nut for boosting your level of omega-3s:
Combine walnuts or pecans with raisins, dried apricots or apples for a healthy snack.Scatter nuts over a green leaf salad or make a Waldorf Salad from chunks of apples, walnuts, celery and chicken. Or else try a salad from oranges or red grapefruit, walnuts, spring onion and shredded lettuce.Add crunch to a stir-fry or pasta dish with chopped walnuts.Substitute walnuts for the usual pine nuts in pesto.Chapter 5
What’s the best brand to buy?
There are so many brands and variations in strengths on the market, it can quickly become overwhelming. Knowing what to look for and how to read the labels is essential if you want to choose correctly. It’s bit like buying perfume – you get what you pay for. A bottle of 600 capsules for only $20 probably means the quality is not that high.
Firstly, you have to decide first if you can swallow two capsules a day or want the convenience of swallowing only one. This is the main difference currently between brands of fish oil available at supermarkets, pharmacies, vitamin shops and online.
Secondly, you have to decide on the size of the capsule you’re willing and able to swallow each day. You’ll pay more for smaller easy-to swallow capsules.
Once decided, then you can shop around for the best buy within each type.
But first check the expiry date as quality can deteriorate with time – you want to buy a brand with the longest shelf life. And you want to buy from a fast-moving place where there’s quick turnover – like the probiotic drinks in supermarkets. At present, there are four types of fish oil capsules:
1. Standard fish oil capsule (18/12 oils)
A standard capsule contains 1,000 mg of fish oil, which is equal to 1 gram of fish oil, which gives you 180 mg EPA plus 120 mg DHA. At less than 20 cents a dose, these are the cheapest and most widely available of all fish oils.
The figures simply mean you are getting a total of 300 mg of the long-chain omega-3s (180 plus 120), with the remaining 700 mg of the fatty acids present not having any therapeutic value. Remember this figure of 300 when shopping so you can compare. You’ll often see it listed as 300 mg omega-3 marine triglycerides.
You need to take at least two of these capsules.
If you are aiming to take a daily dose of 500 mg omega-3s: you need to take two of these capsules to reach that amount. At 600 mg, you actually get 20 per cent more but there’s no other way.If you are aiming to take a higher daily dose of 2,500 mg: you need to take 8 of these capsules to reach that amount. Ideally divide them throughout the day so take 4 lots of two capsules.Brands (in alphabetical order): Bioglan Blackmores Coles GO Health Herbs of Gold Nature’s Way Nature’s Own Quality Health Sweet Ultiboost Wagner
2. Higher dose fish oil with 50 per cent more (concentrated in EPA and DHA)
Some brands now advertise they are extra concentrated (“Super strength” or “One-a-day”) to enable you to swallow only one capsule yet obtain the same dose as two of the standard capsules. My assessment is that you pay a little more and may have to visit a pharmacy to buy them but you get 50 per cent more omega-3s so these are good value for money and convenient. These are the ones I like. See my table of fish oil brands and compare for yourself. You can always wait until these one-a-day capsules come on special and then buy in bulk as long as they’re not close to their expiry date and you store them correctly.
Brands (in alphabetical order): Bioglan Cenovis GO Health Nature’s Own Nature’s Way Swiss Ultiboost
3. Double or triple strength (more concentrated in EPA and DHA)
This range is more expensive still so you’ll have to weigh up if it’s worth paying the extra against the convenience.
Brands (in alphabetical order): Bioglan Blackmores GO Health Nature’s Own Quality Health
4. Liquid fish oil
Your choices have narrowed but the liquid oil is cheaper – and good for arthritis in many cases. These are a good option if you have to take a lot or don’t fancy swallowing so many capsules. See more in the next item.
Brands (in alphabetical order): Melrose Ethical Nutrients Nordic Naturals
What if I can’t swallow a large one-gram capsule?
It’s hard swallowing those big capsules, even with food. This is often a real problem for the elderly, children and those with swallowing difficulties. The best option is to buy the smaller easy-to-swallow double- or triple-strength capsules as long as you work out that you are getting the equivalent of 500 milligrams a day.
Smaller-sized capsules include:
Any tablets sold a mini or mini-capKrill oil capsulesLyprinol capsulesYour other option is to take your fish oil by the teaspoon. You can compare liquid fish oils in the next section.
Is liquid fish oil any better than the capsules?
Capsules are convenient to take and easy when you’re busy or travelling. However, liquid or bottled fish oil is less expensive and allows you to ingest a higher dose in one go without having to swallow so many capsules. For example, 1 teaspoon (5 mL) of liquid fish oil is equivalent to 5 regular capsules. If you need to swallow 10 or 12 fish oil capsules each day, you’d find it easier and quicker to swallow a tablespoon of the liquid oil. Pour it into a small glass of juice or milk and swallow in one go, like a shot. The bottles usually come with a plastic measure to help you.
For cardiovascular effect 5 mL daily or as directed by your doctor (by measure or equivalent to 1 level metric teaspoon)For anti-inflammatory effect 15 mL daily or as directed by your doctor (by measure or equivalent to 3/4 level metric tablespoon)How should I store fish oil?
Fish oil capsules deteriorate if exposed to light, heat and air which is why they’re sold in dark glass bottles or solid containers. Keep them in a cool dark place. In hot weather, store them in the refrigerator or at least out of warm areas.
With some of the more reputable brands, you can spot an expiry date or batch code which will allow you to see how long a time you have to consume them by.
Just like fish, the omega-3s are perishable, so don’t buy in bulk unless you know you can consume them before the expiry date.
How do they make them odourless?
There are two ways:
1. Some capsules are enteric-coated to pass through the stomach before dissolving in the small intestine, thus helping prevent indigestion and ‘fish burps’. Poorly manufactured enteric-coated products have the potential to release their ingredients too early.
2. Some capsules contain a flavouring which is supposed to ‘mask’ the fishy flavour. Examples are lemon oil, lime oil or a vanilla flavour. Sometimes it works, sometimes it doesn’t. You’ll have to try them out for yourself.
If you’re taking a fish oil supplement, always have it with food as this will reduce the reflux and help the absorption of the omega-3s.
Is there a problem with mercury in fish oil?
Not so far. Fish oil contains virtually no methylmercury and is very low in organochloride contaminants. Mercury binds with fish protein rather than fish oil and so, during the refining process of fish oil, the deodorisation step decreases the level of mercury and other contaminants. In many ways, this makes fish oil safer than eating deep-sea fish, which is important for those patients who need to take a high dose of fish oil for long periods or during pregnancy when mercury must be limited.
Some species of fish may contain significant levels of methylmercury, polychlorinated biphenyls (PCBs), dioxins and other environmental contaminants. These substances are generally highest in older, larger, predatory fish such as shark, mackerel and swordfish.
Unfortunately, no company can say that their fish oil is completely free of mercury. However, manufacturers are required by the Therapeutic Goods Administration (TGA) to have virtually no mercury in any supplements sold (that means a level of less than 0.5 ppm which is very low). There are also limits on lead, arsenic and cadmium.
Is there a problem with iodine in fish oil?
No. Almost all of the iodine naturally present in fish is removed during the purification process. Hence levels of iodine are typically very low or negligible – less than 2 micrograms per gram of fish oil. For reference, the current Recommended Dietary Allowance for iodine is 150 micrograms a day for adult men and women and 90 micrograms a day for children over the age of 1 year.
What other ingredients are in fish oil capsules?
Fish oil capsules contain a small amount of highly refined soybean oil added as a natural source of the antioxidant vitamin E or tocopherols. This is used to control any oxidative rancidity that could develop in the oil and to maintain freshness.
Other compounds that do the same thing (scavenge oxygen and so control rancidity) are rosemary extract, ascorbyl palmitate and green tea extract. These are often present in foods too.
As many soy allergy sufferers know, soy allergies result from exposure to soy proteins. In the capsules, there are undetectable levels of protein so you should be safe with them.
The soft gel shell from gelatine
A soft gelatine capsule or soft gel is typically a gelatine-based outer shell, used to encapsulate the inner fish oil to make it easier to swallow with no taste. It comes in one piece and is hermetically sealed.
Available worldwide for over 100 years, soft gels are primarily composed of gelatine, water, an opacifier (a substance added to make the internal material opaque) and a plasticiser such as sorbitol and/or glycerol. The outer gel capsule securely surrounds the internal fish oil. Soft gels have a well-known safety and toxicity profile.
Keep in mind that such soft gels may post a choking hazard for children, especially those aged under five years. So, keep your fish oils (and all medicines) high up and locked away.
Gelatine is not vegan. It can come from pigs, cows or fish. It is a yellowish, odourless substance that is made by the prolonged boiling of the skin, cartilage and bones from animals.
However, the increasing demand for animal-friendly products means that gelatine is becoming more and more unpopular. Subsequently pharmaceutical businesses are now looking into alternative non-animal gels that will also work.
The non-animal vegan shell
For vegan capsules, the outer capsule shell is generally made from a modified starch matrix plus glycerol, gelling agents such as carrageenan and gellan gum, purified water, sunflower oil, natural flavour and preservatives to maintain freshness (such as vitamin E or tocopherols, rosemary extract, green tea extract, ascorbyl palmitate).
The starch matrix is a smooth transparent substance resembling gelatine, which is neutral in taste and colour, easily digestible but of plant origin. It therefore offers a gelatine-free, non-animal shell for vegetarians and vegans and has no bovine-derived materials from cattle who may come from Bovine Spongiform Encephalopathy (BSE) affected countries. The starch-based capsules are the shells used on all the non-fish algal oils.
Can you take fish oil if you have an allergy to fish or seafood?
Not without testing first. Fish oil capsules are quite refined, undergoing several filtration, purification and deodorisation steps to remove impurities, heavy metals and virtually all protein (which is the compound that triggers the allergic reaction). Because of these processes, theoretically they should be safe, but this may vary from brand to brand.
If you have a documented fish allergy, however, it’s wise to be extra cautious. The Allergy Unit of the Royal Prince Alfred Hospital in Sydney suggests you test your reaction by having your doctor do a skin prick test with the contents of the fish oil capsule you plan to take. Have your adrenalin auto-injector (EpiPen) on hand and resuscitation equipment just in case.
If you have no reaction to the skin prick test, follow it up by swallowing a capsule, but again do it under the supervision of your doctor.
Chapter 6
Other sources of oil instead of fish oil
Is NZ green-lipped mussel oil any better than standard fish oil?
No-one really knows for sure. NZ green-lipped mussel oil (brand name Lyprinol®) made big headlines back in the 1990s. This was because it has a special anti-inflammatory action which can help to reduce joint inflammation and swelling in osteoarthritis and help to maintain breathing passages in asthma.
Green-lipped mussel has a more complex chemical structure than regular fish oil. As well as the well-known EPA and DHA, it includes a number of compounds thought to be anti-inflammatory. These include some unusual fatty acids such as eicosatetraenoic acid (an omega-3 fatty acid with 20 carbon atoms which turns into EPA after elongation). Researchers are still not quite sure how and why it works but in certain cases such as osteoarthritis, it’s considered superior to regular fish oil.
Lyprinol® is an extract of specialised oil derived from the New Zealand green-lipped mussel (Perna canaliculus). Each capsule contains 50 mg of mussel oil. It is the biggest-selling green-lipped mussel extract and is registered under patent by Blackmores Australia.
Lyprinol® does have a couple of benefits. It is extracted using a special process which does not use chemical solvents which could leave harmful residues. Plus, it’s easy to swallow as it’s a small oval capsule which makes it useful for anyone who has to take a large number of capsules each day.
However, it does have downsides. It is quite expensive. There is no generic equivalent. And it’s difficult to reach any health conclusions about it. As Sheila Doggrell, a researcher from Queensland University of Technology in Brisbane, put it:
“As anti-inflammatory agents, there is little to choose between Lyprinol® and fish oil. It does have anti-inflammatory effects in some animal models of inflammation. For example, it may have benefits in dogs with arthritis. Thus, although it is difficult to conclude whether Lyprinol® is effective, any benefit is small. All we can conclude is that Lyprinol probably does no major harm.”
Allergy alert: As Lyprinol® is derived from shellfish, it’s not suitable for anyone allergic to shellfish such as prawns and crab.
What about algal oils containing omega-3 fatty acids?
Algal oils are a much more sustainable source of long-chain omega-3s than fish-based capsules and so there are environmental benefits to choosing algal oil. Think of them as omega-3 without the fish! These algal oils are suitable for vegetarians and vegans because they are of plant origin. In fact, the reason fish contain omega-3s is because they eat the omega-3 containing algae.
Given the low conversion rate from short-chain to longer-chain, it's important for vegetarians and vegans to still include some omega-3 fats from marine sources in the diet. Algal supplements from marine microalgae (Schizochytrium sp.) are a viable method of addressing these low levels.
Most of the beneficial long-chain omega-3 fatty acids are formed in the microscopic algae, plankton and crustacea at the bottom of the marine food chain. They are then passed up the food chain into the higher fish, and of course ultimately to humans.
These oils derived from algae are a good alternative for vegans, are free of fish and environmentally friendly. Many algae supplements have a lower recommended dose than fish oil supplements. Algae and algal supplements tend to have a higher DHA to EPA ratio, with many supplements containing no EPA (see table at the end).
Already you can buy omega-3s from algal oil (brand names Green Nutritionals or Myprotein or Nordic Naturals) but you’ll pay more for these. Think anywhere from 60 cents to $1 per capsule compared to less than 20 cents for a standard or double-strength fish oil capsule.
Algal oils that are sold in Australia must meet the standards set by the TGA. This states that an algal oil must contain “docosahexaenoic acid (DHA) at not less than 24% w/w and eicosapentaenoic acid (EPA) at not less than 12% w/w, and the ratio of DHA to EPA is 2:1. Suitable antioxidants may be added”. However, although their health benefits have been tested in clinical trials, it’s still early days. It’s a case of watch this space.
Algal oil should not be confused with blue-green algae supplements, which I do not recommend.
What about genetically modified plant oils?
In the future, there may be more plant alternatives for omega-3 rather than relying on fish sources. This means less pressure on fish stocks (currently the principal source of omega-3 fatty acids) but it will have to overcome the traditional reluctance of people to have anything to do with genetically-modified crops.
In the long term, fish as the only source of omega-3s is not a sustainable source of omega-3s. The fish population was reduced in recent years due to overfishing (catching fish at rates higher than fish can reproduce). And overfishing negatively affects ocean food chains.
Several attempts have been made to transform oil seed plants into new genetically-modified plants (transgenic or bioengineered plants) that are capable of producing the long-chain omega-3 fatty acids. These include:
Camelina sativa oil seedsGlycine max (Transgenic soybean)Brassica carinata (Ethiopian mustard)Brassica nigra (Black mustard) (once cultivated as mustard seed, though now rarely grown. Work by BASF [a German-based chemical company – apparently the largest in the world] is looking to use it to generate essential fatty acids)A research group, from the University of Southampton, in collaboration with Rothamsted Research, has developed a seed oil plant (Camelina sativa) using genetic modification to produce an enhanced vegetable oil that contains EPA and DHA in similar amounts to fish oil.
For the first time in 2019, the researchers tested in people whether the oil from this genetically modified plant is as good as fish oil in providing these fatty acids. And it was! So that might be available in the next few years, but at the moment the choices are limited.
And another research team, this time based in CSIRO in Australia, has also been looking at ways to produce DHA-rich oils from seeds.
In addition, there’s the question of how such oil seeds may be used in aquafeeds to ensure that farmed fish (aquaculture) remain a healthy component of the human diet.
In the present circumstances, the resultant amount obtained after plenty of experimental studies is still quite low. However, this may change in the future so it’s a case of watching and waiting.
What about krill oil?
Krill oil is often viewed as a viable superior alternative to fish oil – but no-one knows if it really is or not.
Krill (Euphausia superba) oil is extracted from tiny red crustaceans found in the Southern Ocean waters of the Antarctic. Krill look like very small prawns. A rich source of omega-3, krill has a similar overall fatty acid composition to fish oil.
Krill accumulate their omega-3 by feeding on omega-3-rich microscopic algae. These algae also provide krill with a robust source of the antioxidant astaxanthin, which is responsible for its distinct red colour.
Some companies claim that krill oil has a unique molecular structure as the omega-3 fatty acids are incorporated into phospholipids, whereas the omega-3 fatty acids in fish oil are mostly present as triglycerides. Some folks believe that the phospholipid fats in krill make it more effectively absorbed and therefore more powerful than fish oil. They also spruik the benefits of its antioxidant astaxanthin.
Astaxanthin, a reddish-coloured carotenoid, is an antioxidant which is found naturally in krill as well as in algae, yeast, salmon, trout, prawns and crayfish. It is related to the beta-carotene and alpha-carotene found in carrots. Commercially, astaxanthin is made mainly from Phaffia yeast and through chemical synthesis. Astaxanthin gives krill oil its reddish colour which may appear more attractive than the standard yellow.
On the one hand, some researchers believe that ultimately, it’s simply the DHA and EPA levels in a capsule that are important, whether they’re derived from krill or fish. They say krill oil has no demonstrated advantage beyond its levels of omega-3, which are in fact lower than in fish oil.
On the other hand, one krill study reported that six capsules of krill oil (which was 3 grams a day and gave a total of EPA + DHA of 543 mg) or three capsules of fish oil (which was 1.8 grams a day and gave a total of EPA + DHA of 864 mg) for 7 weeks ended up giving the same blood values. No significant differences in any of the blood fats or the markers of oxidative stress and inflammation between the groups were observed.
In one study, the researchers gave 10 women each 5 grams (capsules) a day of krill oil with the analysis: Five grams of KO and FO provided 907 mg and 1441 mg of EPA plus docosapentaenoic acid (DPA) plus DHA, respectively.
These included 542 mg of EPA, 67 mg of DPA, and 298 mg of DHA in KO and 786 mg of EPA, 182 mg of DPA, and 473 mg of DHA in FO.
Krill oil and fish oil thus represent comparable dietary sources of the omega-3s, even if the EPA + DHA dose in the krill oil is only about 60 per cent of that in the fish oil. You can make up your own mind which you prefer to buy. For a comparison, see the short table below.
Side by side: How krill oil stacks up against fish oil
Figures per 1,000 mg of each oil
* this is the same as the figure of total long-chain omega-3s which you may see on some brands.
From Sung HH, Sinclair AJ, Huynh K, Smith AT, Mellett NA, Meikle PJ, Su XQ. Differential plasma postprandial lipidomic responses to krill oil and fish oil supplementations in women: A randomized crossover study. Nutrition. 2019 Sep;65:191-201.https://www.ncbi.nlm.nih.gov/pubmed/31201957
Can I take cod liver oil instead?
It all depends. Cod liver oil contains less EPA and DHA than fish oil so it won’t give you as much omega-3s. For a comparison, see the short table below.
Side by side: How cod liver oil stacks up against fish oil
Figures per teaspoon or 5 mL dose of each oil
* this is the same as the figure of total long-chain omega-3s which you may see on some brands. Source: Data from bottles of cod liver oil and fish oil. More detail at www.melrosehealth.com.au.
However, cod liver oil is high in two fat-soluble vitamins, A and D, which is why it was once routinely spooned out to children in overcast European countries to overcome rickets. It may return to fashion again given the increasing reports of borderline deficiency of vitamin D now appearing due reduced sun exposure.
Where you can get 10 minutes of sunlight every second day, extra vitamin D from cod liver oil is unnecessary. However, there are many who can benefit from extra:
older folk and people in nursing homes don’t make as much vitamin D as younger people;veiled women andanyone who doesn’t get outdoors.Some people take cod liver oil in winter when they spend less time outdoors and so don’t make their own vitamin D from sunshine on their skin, then switch to fish oil in summer so as to not take in more vitamin D than they need.
If you’re pregnant, too much vitamin A can potentially cause birth defects. So, to be on the safe side, stick to the daily limit of no more than 2500 IU – most cod liver oils carry warnings about not exceeding a certain dosage.
For example, a level metric teaspoon, which is 5 mL, of cod liver oil contains:
3,125 IU (938 micrograms) Vitamin A which is over the entire day’s recommended intake for women and on par for men (the recommended dietary intake is 2,310 IU or 700 micrograms a day for women and 3,000 IU or 900 micrograms a day for men and 2,310-2,640 IU or 700-800 micrograms if you’re pregnant).400 IU (10 micrograms) of Vitamin D which is the same as the day’s intake for adults aged over 50 years (which is 400 IU or 10 micrograms a day) and two-thirds that of people over 70 (which is 600 IU or 15 micrograms a day).Remember the safe Upper Limit for vitamin A is 10,000 IU or 3,000 micrograms a day. During pregnancy, the upper limit is still set at 3,000 micrograms or a little lower at 2,800 micrograms for young mothers aged 14 to 18 years.
Chapter 7 Appendix
Content of omega-3s, EPA, DHA and cost in capsules and liquid fish oils
Listed in alphabetical order in each category
