Fish oil and Omega 3 supplements are one of the most widely used globally with the market estimated to be worth over 12 Billion dollars (1). At the average price of $30 a jar, that’s around 400 million jars per year or 1.3 million per minute.
Taking fish oil or omega 3 supplements may be beneficial to support a wide range of conditions including:
cardiovascular health
· reducing triglyceride levels by up to 50% (2)
· lowering blood pressure (3)
Mental health
· reducing symptoms of depression and anxiety (5 & 6)
· delaying cognitive decline (4)
Inflammation
· reducing joint pain and stiffness (7)
· reducing inflammation in autoimmune conditions including eczema & psoriasis (8 & 9)
Eye health
· alleviating dry eye syndrome (10)
· preventing or delaying the progression of advanced macular degeneration (11)
Pregnancy & Development
· supporting cognitive development (13)
· reducing the risk of preterm birth (12)
It is no wonder fish oil has become one of the most popular supplements of the past few decades!
So what exactly are omega 3s and how do I get it?
Put simply, Omega 3s are good fats our body needs for optimal health. There are three types of Omega-3 fatty acids including:
alpha-linolenic acid (ALA)
ecosapentaenoic acid (EPA)
docosahexaenoic acid (DHA)
ALA contains 18 carbon atoms, whereas EPA and DHA are considered long-chain omega-3s because they contain more (EPA contains 20 carbons and DHA contains 22 (19). EPA and DHA can be found fish, seafood and micro-algae products whereas ALA can be found in plant based products (19).
EPA and DHA are both researched extensively for their health benefits and believed to be where the benefits of fish oils come from. Plant based ALA can convert into EPA and DHA in the human body however the rate of which varies from person to person and research shows rarely at the quantities needed to exert a therapeutic effect (20). In theory, ALA therefore is inferior to EPA and DHA however they all collectively play an important role as components of the phospholipid structure that forms the outer membranes of our cells (19).
EPA specifically has been shown to positively support cardiovascular health, reducing high triglycerides in the blood, lowering high blood pressure and cholesterol. EPA has also been shown to reduce production of inflammation and modulates inflammatory pathways (21).
DHA conversely has been shown to support nerve tissue, ocular health, cognitive function and learning with positive benefits shown in children with ADHD and infant brain development (21).
So how much total omega 3 should we be having?
The Australian & New Zealand Nutrient Reference Guidelines reference ALA stipulating adults aged 18+ should be aiming to consume 0.8g of ALA, 90mg combined EPA & DHA per day for women. For men, it is 1.3g of ALA and combined 160mg EPA & DHA (14).
If we quantify this by food, this is what it looks like:
Food | ALA (g) | DHA (g) | EPA (g) |
Salmon, farmed (100g cooked) | - | 1.24 | 0.59 |
Tuna canned (100g cooked & drained) | - | 0.17 | 0.02 |
Flaxseeds whole (1 tablespoon) | 2.35 | - | - |
Walnuts whole (30g) | 2.57 | - | - |
Chia seeds (5g) | 1.01 | - | - |
Avocado (100g) | 0.11 | - | - |
*references from Food Data Central (15).
Based on this, the heart foundation recommendations Australians consume 2-3 serves of fish per week to meet these daily nutritional requirements (16) however equivalence in plant based alternatives is suitable for those that do not consume fish. A lack of omega 3 essential fatty acids can be characterised by rough, scaly skin, dermatitis, increased trans-epidermal water loss, reduced growth (19).
If you aren’t getting enough omegas in your diet, then I would highly recommend adjusting your diet or investing in an omega supplement. It helps to support optimal wellbeing, where your body functions in good health as it has been designed. Having enough Omega 3 may also help to lower the risk of developing several cancers (22) and Alzheimer’s (23).
So which fish oil / algae / omega 3 should I take?
This is the million dollar question and unfortunately there is not one formula perfect for everyone as I’ll explain below. But first, I’m going to explain what NOT to take.
Have you ever walked down the vitamin isle at chemist warehouse and seen fish oil from random brands discounted to $15 for a huge tub that looks like it would take you a year to get through? That exactly my friends are the products you DO NOT want to buy.
Now leaning into by product development background, I’ve created a number of omega supplements in my career for a variety of brands and have had the opportunity to visit all the leading facilities across Australia that manufacture them.
So let me share some insider knowledge...
Lets start with the raw material, Omegas are produced by a wide range of biotech companies globally including leaders GC Reiber, BASF, DSM, OLVEA and Lysi.
Each of these companies offering different grades or concentration of the oils some being higher in EPA targeted for inflammation, some balanced in the ratio found naturally in fish (18 EPA : 12 DHA) and some higher in DHA targeted for children, brain and eye health.
The fresher the oil the better with the more reputable manufacturers processing the oil within 24 hours of harvest to prevent oxidisation of the oil. Oils are typically refined and processed to remove any impurities and then concentrated to the ideal ratio. The oils are then packaged in airtight drums to transport for further manufacturing to prevent oxidisation.
A good manufacturer of fish oil would possess a sustainability certification including MSC, friends of the sea and or GOED certification, ensuring that the product is sustainably and ethically harvested. Whereby a good manufacturer of algal oil would possess IAOS certification. Algal oils are more sustainable than fish oil and are the future of the omega market however very expensive at this current point in time.
A good brand of either would declare where the oil is from ie. AlaskOmega and stipulate their levels of mercury, anisidine and peroxide whilst having logos for MSC and GOED certification. You can look up the oil yourself and check if the supplier is transparent in their harvesting and processing.
Here is a below example of what to look for on a label where a brand has done all the work for you:
How oils are then processed into a finished product:
The next consideration is where is that oil being processed ie. into a capsule or as a liquid into a bottle. Better brands will always use a quality, reputable supplier of oil that is also fresh, not old stock. The raw material and the product would never smell fishy when you first open the bottle or tub. If it does smell fishy in anyway, the product has already started to oxidise or is rancid and I'd suggest sending it back!
I’ve walked through manufacturing facilities processing fish oil where the whole place smelled horrendously like old fish and on closer inspection of their production lines, they did not have quality bottling or capsulation equipment which resulted in the fish oil being heated, accelerating the oxidisation.
Despite the stringent quality standards of manufacturing in Australia, there are still some facilities that in my opinion should not be making fish oil because their equipment isn't as good. These facilities tend to be more ‘budget’ manufacturers.
So what happens if you do take an oil that has oxidised?
According to research, it can potentially:
1. increase inflammation (17)
2. Increase your LDL (bad) cholesterol levels (24)
As a clinician, I have also seen this in real life, where clients have come to see me because their eczema, psoriasis, joint pain etc have not improved despite all the wonderful expensive supplements they were taking and great diet they were following. As soon as we take them off their cheap fish oil and swap them onto something better quality, their symptoms improve significantly or disappeared altogether!
So essentially taking oxidised omega 3 can make you sicker and is counterproductive. I’m all for value for money and saving a dollar where possible but if you are going to take omega 3, buy the best quality you can afford or just don’t take it at all.
Some other hot tips when looking for an oil:
1. Look for a reasonable shelf life, with at least 18-24 months left otherwise it is old and likely started to oxidise in the bottle
2. Buy a product manufactured in Australia or New Zealand – we have the most stringent manufacturing and testing requirements in the world
3. Check the EPA / DHA content is right for your needs
If you are still unsure and want some guidance, book a consultation and we can go through your specific needs. I'll only recommend products I know for certain are good quality that I would comfortably take myself.
References
2. Shearer, G.C., Savinova, O.V. and Harris, W.S., 2012. Fish oil—how does it reduce plasma triglycerides?. Biochimica et Biophysica Acta (BBA)-Molecular and Cell Biology of Lipids, 1821(5), pp.843-851.
3. Geleijnse, J.M., Giltay, E.J., Grobbee, D.E., Donders, A.R. and Kok, F.J., 2002. Blood pressure response to fish oil supplementation: metaregression analysis of randomized trials. Journal of hypertension, 20(8), pp.1493-1499.
4. Ghasemi Fard, S., Wang, F., Sinclair, A.J., Elliott, G. and Turchini, G.M., 2019. How does high DHA fish oil affect health? A systematic review of evidence. Critical reviews in food science and nutrition, 59(11), pp.1684-1727.
5. Stahl, L.A., Begg, D.P., Weisinger, R.S. and Sinclair, A.J., 2008. The role of omega-3 fatty acids in mood disorders. Current Opinion in Investigational Drugs, 9(1), pp.57-64.
6. Larrieu, T. and Layé, S., 2018. Food for mood: relevance of nutritional omega-3 fatty acids for depression and anxiety. Frontiers in physiology, 9, p.362236.
7. James, M., Proudman, S. and Cleland, L., 2010. Fish oil and rheumatoid arthritis: past, present and future. Proceedings of the Nutrition Society, 69(3), pp.316-323.
8. Chen, X., Hong, S., Sun, X., Xu, W., Li, H., Ma, T., Zheng, Q., Zhao, H., Zhou, Y., Qiang, Y. and Li, B., 2020. Efficacy of fish oil and its components in the management of psoriasis: a systematic review of 18 randomized controlled trials. Nutrition Reviews, 78(10), pp.827-840.
9. Adelman, M.J., Sivesind, T.E. and Dellavalle, R.P., 2022. From the Cochrane Library: Dietary Supplements for Established Atopic Eczema. JMIR dermatology, 5(3), p.e33178.
10. Bhargava, R., Pandey, K., Ranjan, S., Mehta, B. and Malik, A., 2023. Omega-3 fatty acids supplements for dry eye-Are they effective or ineffective?. Indian Journal of Ophthalmology, 71(4), pp.1619-1625.
11. Jiang, H., Shi, X., Fan, Y., Wang, D., Li, B., Zhou, J., Pei, C. and Ma, L., 2021. Dietary omega-3 polyunsaturated fatty acids and fish intake and risk of age-related macular degeneration. Clinical Nutrition, 40(12), pp.5662-5673.
12. Abdelrahman, M.A., Osama, H., Saeed, H., Madney, Y.M., Harb, H.S. and Abdelrahim, M.E., 2023. Impact of n-3 polyunsaturated fatty acid intake in pregnancy on maternal health and birth outcomes: systematic review and meta-analysis from randomized controlled trails. Archives of Gynecology and Obstetrics, 307(1), pp.249-262.
13. Sherzai, D., Moness, R., Sherzai, S. and Sherzai, A., 2023. A systematic review of omega-3 fatty acid consumption and cognitive outcomes in neurodevelopment. American Journal of Lifestyle Medicine, 17(5), pp.649-685.
14. NHMRC, 2017, Nutrient Reference Values for Australia and New Zealand, Version 1.2
15. U.S. Department of Agriculture, Agricultural Research Service. FoodData Central , 2019.
16. Heart Foundation, 2024, Fish and Seafood Nutrition Position Statement, https://www.heartfoundation.org.au/for-professionals/nutrition-position-statements
17. Albert BB, Cameron-Smith D, Hofman PL, Cutfield WS. Oxidation of marine omega-3 supplements and human health. Biomed Res Int. 2013;2013:464921. doi: 10.1155/2013/464921. Epub 2013 Apr 30. PMID: 23738326; PMCID: PMC3657456.
18. Rodriguez-Leyva D, Dupasquier CM, McCullough R, Pierce GN. The cardiovascular effects of flaxseed and its omega-3 fatty acid, alpha-linolenic acid. Can J Cardiol. 2010 Nov;26(9):489-96. doi: 10.1016/s0828-282x(10)70455-4. PMID: 21076723; PMCID: PMC2989356.
19. National Institute of Health, Omega 3 Fatty Acids – health Professional Factsheet, Office of Dietary Supplements, 2024
20. Harris WS. Omega-3 fatty acids. In: Coates PM, Betz JM, Blackman MR, et al., eds. Encyclopedia of Dietary Supplements. 2nd ed. London and New York: Informa Healthcare; 2010:577-86.
21. Swanson D, Block R, Mousa SA. Omega-3 fatty acids EPA and DHA: health benefits throughout life. Adv Nutr. 2012 Jan;3(1):1-7. doi: 10.3945/an.111.000893. Epub 2012 Jan 5. PMID: 22332096; PMCID: PMC3262608.
22. Cancer Council, Information Sheet: Fish, Omega-3 fatty acids and cancer, viewed 4th June 2024, https://www.cancer.org.au/about-us/policy-and-advocacy/prevention-policy/national-cancer-prevention-policy/obesity/related-resources/fish-omega-3-fatty-acids-and-cancer
23. B.-Z. Wei, L. Li, C.-W. Dong et al, The Relationship of Omega-3 Fatty Acids with Dementia and Cognitive Decline: Evidence from Prospective Cohort Studies of Supplementation, Dietary Intake and Blood Markers, American Journal of Clinical Nutrition 2023; 117: 1096-1109.
24. Rundblad A, Holven KB, Ottestad I, Myhrstad MC, Ulven SM. High-quality fish oil has a more favourable effect than oxidised fish oil on intermediate-density lipoprotein and LDL subclasses: a randomised controlled trial. British Journal of Nutrition. 2017;117(9):1291-1298. doi:10.1017/S0007114517001167
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