8 Best Omega 3 Supplement Consumer Reports Review of 2024
Omega 3 supplements are some of the most useful supplements out there. This is because they provide so many essential nutrients. These nutrients help with pain relief, lung health, joint health and all manner of health benefits.
Global Omega-3 market is valued at USD 2.27 Billion in 2021 and estimated to reach a value of USD 3.86 Billion by 2028 at a CAGR (compound annual growth rate) of 7.9 % during the forecast period, 2022–2028. (R)
However, it’s important to know that there are various problems with omega-3 supplements. The main problems are the following:
- Often omega-3 fatty acid supplements are too oxidized
- Some supplements don’t contain enough EPA and/or DHA
- Often supplements contain less ideal forms of omega-3 fatty acids
BEST OMEGA 3 SUPPLEMENTS OF 2024
Listed below are the top fish oil supplements on the market. This short-list should help you narrow down your choices when it comes to fish oil supplements.1. Nordic Naturals Omega-3
Amazon Reviews: 4.8 out of 5 - more than 48,000 global ratings
Amazon Best Sellers: #1 in Omega 3 Nutritional Supplements.
Note: TOTOX value stands for total oxidation value. The omega 3 fatty acids EPA and DHA from fish oil are highly sensitive to oxidation. This means that they are rapidly affected by contact with oxygen. Oxidised fatty acids are not beneficial to our health. For this reason, a good fish oil supplement has a low TOTOX value. The maximum TOTOX value is set at 26 by the Global Organization for EPA and DHA omega-3.
Best Fish Oil Supplements Consumer Reports:
"Nordic Naturals did meet every other quality measure in our study. The pills, which cost about 67 cents per day, or $243 per year, contained their labeled amount of omega-3 fatty acids and met other U.S. Pharmacopeia (USP) and European Union standards, including those for contaminants such as lead, mercury and dioxins. They also met the stricter California Proposition 65 standard for total polychlorinated biphenyls (PCBs)." - Consumer Reports
NovosLabs.com:
"Ideally, you take an omega-3 oil supplement that contains both fish-derived triglycerides and krill-derived phospholipids. Examples of such brands are (not sponsored) Omega3 Innovations (sells fish oil with very low oxidation / TOTOX values) and Nordic Naturals." - NovosLabs.comRelated: Many common omega-3 fish oil supplements are ‘oxidized’
2. Sports Research Omega-3 Wild Alaskan Fish Oil
Amazon Reviews: 4.7 out of 5 - more than 40,000 global ratings
Amazon Best Sellers: #1 in Fish Oil Nutritional Supplements.
- Sourced from Wild Alaskan Pollock
- 90 day money back guarantee
- Maximum total oxidation of 5
- Comes in fish gelatin capsule
This is a fantastic fish oil supplement, and it easily won out against the other supplements on this list. The source is proudly displayed, and it is sustainable which is a big plus for environmentally conscious people. The more practical benefits are even better. The soft capsules are easy to swallow, even if they are a little too big. They also do their job quickly thanks to the high absorption rate. It is also surprising that these capsules are so cheap. Usually products of this caliber are a lot more expensive than the market average. These capsules are so cheap that pretty much anyone would be able to afford them.
They are also very long lasting. Under the right conditions they end up surviving for long periods of time. This is great for people that want to stock up on them, and helps make them even more affordable. We were hard pressed to find anything that we didn’t like about this product.
Pros
- Suitable for pescatarians (do not eat meat but do eat fish).
- Sustainably sourced from wild fish, not farmed
- Highly long lasting capsules under reasonable conditions
- Soft capsules that are usually easy to swallow
- Quickly has an effect on the body
- Surprisingly affordable
Con
- Capsules are slightly large
3. Dr. Tobias Omega 3 Fish Oil Triple Strength
Amazon Reviews: 4.6 out of 5 - more than 30,000 global ratings
Amazon Best Sellers: #3 in Omega 3 Nutritional Supplements.
- Enteric coating for fast absorption
- Purified through molecular distillation
- 180 soft gel capsules per bottle
- Includes access to healthcare and diet videos
The supplement isn’t exactly perfect, though. The bottle is kind of fragile which can be a nuisance. Also, some consumers have reported that the capsules are weak too and that they frequently leak. Both these issues could potentially make a huge mess that you would have to clean up.
Pros
- Absorbed quickly into the body resulting in fast benefits
- Highly purified formula through molecular distillation
- Completely tasteless
- Sustainably sourced
- Free of genetically modified components
- Several complaints of leaking capsules
- Somewhat fragile
4. Antarctic Krill Oil 1000mg (Per Softgel) with Omega-3s EPA & DHA + Astaxanthin & Phospholipids - Best krill oil supplement consumer reports
#3 in Krill Oil Nutritional Supplements (more than 13,000 ratings)
#8 in Omega 3 Nutritional Supplements (more than 13,000 ratings)
#8 in Omega 3 Nutritional Supplements (more than 13,000 ratings)
About this item
- More Krill for your dollar: Contains 1000 mg of Krill oil per SOFTGEL with more naturally occurring EPA, DHA, Phospholipids and Astaxanthin than any other Krill brand.
- Omega-3 Support: Made with Superba2 Krill Oil, a new advance formula clinically proven to increase omega-3 fatty acid levels in the body*.
- Less Krill smell with No Aftertaste: The new Superba2 has substantially reduced the Krill smell. The phospholipid-bound omega-3 fatty acids are water dispersible, making them easier to digest than fish oil. Goodbye gross, fishy aftertaste!
- Sustainably Sourced: Superba Krill is sustainably harvested and 100% traceable from sea to shelf. Certified by the Marine Stewardship Council (MSC) and IKOS 5 star certified Krill Oil.
- Money Back Guarantee.
5. NOW Foods Omega-3 1000mg
NOW Foods Omega-3 is available in 2 dose strengths:
- Omega-3 (180 EPA / 120 DHA) > Check Price on Amazon
- Ultra Omega-3 (500 EPA / 250 DHA) > Check Price on Amazon
Amazon Reviews: 4.7 out of 5 - more than 6,000 global ratings
Amazon Best Sellers: #12 in Omega 3 Nutritional Supplements.
While these capsules are easy to swallow, they don’t taste very good. This spoils the experience a little and might make them tough to swallow for some. A few consumers have also reported some of the capsules containing visible impurities. You should bear all of this in mind before you buy the product.
- 200 softgels
- Molecularly distilled
- 1000mg per capsule
- Cholesterol free
- High dosage means daily requirement is easily met
- Soft capsules are easy to swallow
- Does not cause any gastric distress
- Capsules last quite a long time under right conditions
- Strong fishy smell makes capsules tough to swallow
- Reports of some capsules containing impurities
6. Wiley's Finest Wild Alaskan Fish Oil - 3X Triple Strength Peak EPA DHA, 1000mg Omega-3s
Amazon Reviews: 4.7 out of 5 - more than 1,700 global ratingsAmazon Best Sellers: #34 in Omega 3 Nutritional Supplements.
GOED (Global Organization for EPA and DHA omega-3) study affirms AlaskOmega® Wild Alaska Pollock Fish Oil has Lowest TOTOX Score for Unflavored Omega-3 Oils:
7. Nature Made Burp-less Fish Oil 1000 mg
Nature Made Fish Oil is available in 3 dose strengths:
- Nature Made Burp-Less Fish Oil 1000 mg with 300 mg Omega-3 per softgel
- Nature Made Burp-Less Fish Oil 1200 mg with 360 mg Omega-3 per softgel > Check Price on Amazon
- Nature Made Burp-Less Fish Oil 1400 mg with 500 mg Omega-3 per softgel > Check Price on Amazon
This is a great fish oil supplement for people that are particular about natural products. First of all, it is free of artificial colors and flavors. These chemicals often have an impact on the supplement so it’s good that this supplement doesn’t have them. This is also a gluten free formula which is great for people that suffer from gluten allergies. If you have a pet that needs Omega 3 fatty acids these capsules will work perfectly well for the animal a well. Unlike the Best Triple Strength capsules that came in at number four, these supplements are unlikely to cause any gas.
However, the pills are a little too hard. This makes them tough to swallow. Another problem you might have with this product is that it takes a long time for it to have a complete effect on your body, although that’s reasonable considering the additive free formula.
However, the pills are a little too hard. This makes them tough to swallow. Another problem you might have with this product is that it takes a long time for it to have a complete effect on your body, although that’s reasonable considering the additive free formula.
Pros
- Suitable for people with gluten allergies
- Mid strength formula means relaxed dosage regimen
- Pure formula free of artificial elements
- Suitable for animals as well as humans
- Does not cause fishy burps or other kinds of gassiness
- Free of preservatives and yeast
- Takes a long time to have effect
- Pills are slightly hard, makes them slightly difficult to swallow
8. OmegaXL® 60 Count – Omega 3 Essential Fatty Acid
- Blend of 30 fatty acids
- Sourced from Green Lipped Mussel
- Contains Extra Virgin Olive Oil
- Small capsules
Amazon Omega XL Reviews: 4.7 out of 5 - more than 28,000 global ratings
Amazon Best Sellers: #4 in Omega 3 Nutritional Supplements.
All of that being said, while this capsule does offer benefits it has its drawbacks too. For example, it is not quite as effective as the other products on this list. This also a fairly expensive fish oil supplement, so a lot of people might go for better options especially since they are more affordable than this one.
Pros
- Small capsules are easy to swallow
- Neutral taste (no fishy after-taste)
- Source of fatty acids clearly displayed
- Does not work as effectively as other products
- High price per dose
- According to Consumer Lab Review Report on Omega XL: "Omega XL (distributed by Great Healthworks) is described on its website as a "highly concentrated Omega-3 'Super Oil' supplement," for joint pain and inflammation that is "better than standard fish oil." However, when ConsumerLab.com tested this product, it discovered surprisingly little omega-3 fatty acids (EPA and DHA)."
- On June 31, 2021 the FDA issued a warning letter to Great Healthworks, Inc. following a review of the company's website, which found statements made about Omega XL and ProbioticXL supplements to be drug claims. OmegaXL was promoted with statements such as "[S]hown to help relieve joint pain due to inflammation" and "OmegaXL is widely recognized as a leader in natural relief from pain due to inflammation."
Health Benefits of Taking Omega 3 Supplements
Omega-3 and Omega-6 fatty acids are essential fats, meaning you must get them from the food you eat, as your body can’t make them. They’ve been associated with numerous health benefits, such as a reduced risk of heart disease (Eur Rev Med Pharmacol Sci. 2015), reduced inflammation (Biochem Soc Trans. 2017) and improved mood (Front Physiol. 2018).
Fish oil and flaxseed oil each contain an impressive amount of omega-3 fatty acids. The main types of omega-3s in fish oil are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (NIH).
On the other hand, flaxseed oil contains the omega-3 fatty acid known as alpha-linoleic acid (ALA) (Source). Flaxseed oil also contains linoleic acid, an omega-6 fatty acid. Linoleic acid and arachidonic acid (AA) are the Omega-6 fatty acids that have been found to possess potential cancer protective properties. The human body converts linoleic acid into GLA (Gamma-Linoliec Acid), and the latter get converted into AA.
On the other hand, flaxseed oil contains the omega-3 fatty acid known as alpha-linoleic acid (ALA) (Source). Flaxseed oil also contains linoleic acid, an omega-6 fatty acid. Linoleic acid and arachidonic acid (AA) are the Omega-6 fatty acids that have been found to possess potential cancer protective properties. The human body converts linoleic acid into GLA (Gamma-Linoliec Acid), and the latter get converted into AA.
EPA and DHA are predominantly found in animal foods like fatty fish, while ALA is mostly found in plants.
However, ALA isn’t biologically active and needs to be converted to EPA and DHA to be used for something other than just stored energy like other types of fat (Source).
While ALA is still an essential fatty acid, EPA and DHA are linked to many more health benefits (Trusted Source). Additionally, the conversion process from ALA to EPA and DHA is quite inefficient in humans (Trusted Source). For example, one study found that only 5% of ALA is converted to EPA and less than 0.5% of ALA is converted to DHA in adults (Source).
However, ALA isn’t biologically active and needs to be converted to EPA and DHA to be used for something other than just stored energy like other types of fat (Source).
While ALA is still an essential fatty acid, EPA and DHA are linked to many more health benefits (Trusted Source). Additionally, the conversion process from ALA to EPA and DHA is quite inefficient in humans (Trusted Source). For example, one study found that only 5% of ALA is converted to EPA and less than 0.5% of ALA is converted to DHA in adults (Source).
EPA and DHA can reduce inflammation, which causes swelling and pain. Research has indicated that both acids might suppress the body’s immune system. However, a 2016 study suggests that DHA might enhance immune function instead. DHA is more effective at reducing inflammation than EPA, but both have a role.
Omega-3 and Heart Health
Omega-3s - particularly EPA and DHA - are important for overall health, including heart health. Most people do not get enough EPA and CHA omega-3s, and new research suggests you may need even more than you think.
According to the research published in Mayo Clinic Proceedings in September 2020, EPA and DHA supplementation is associated with a reduced risk of:
- Fatal Heart Attack - 35%
- Heart Attack (myocardial infarction)- 13%
- Risk of death form Coronary Heart Disease - 9%
Your goal should be to take at least 1,000 mg of EPA and DHA per day. Dietary / Food supplements, prescription omega-3s and eating fish regularly will help you meet this goal.
Omega-3 and Knee Pain
EPA and DHA can reduce inflammation, which causes swelling and pain. Research has indicated that both acids might suppress the body’s immune system. However, a 2016 study suggests that DHA might enhance immune function instead. DHA is more effective at reducing inflammation than EPA, but both have a role.
For the omega-3 fatty acids in fish oil to work against arthritis, it’s necessary to consume a fairly large quantity of it each day. Fish oil — or cod liver oil — enclosed in capsules makes this fairly easy.
On the other hand, because cod liver oil contains very high amounts of vitamin A and vitamin D, taking too much can be toxic. For the purpose of treating arthritis, fish oil is the safer choice.
Related: 9 Best Ways for Treating Knee Arthritis
Omega-3 and Diabetes
Omega-3 fats are important for many reasons. While their brain and cardiovascular benefits are well-established, a lesser known benefit has to do with autoimmune diabetes. According to research, published in December 2020, adults who test positive for glutamic acid decarboxylase (GAD65) antibodies — a marker for Type 1 diabetes3 — can significantly reduce their risk of adult-onset diabetes by eating omega-3 rich fatty fish.
The study looked at data from 11,247 cases of adult-onset diabetes and 14,288 diabetes-free controls that participated in the Epic-InterAct case-cohort study conducted in eight European countries. As explained by the authors:
“Baseline plasma samples were analyzed for GAD65 antibodies and phospholipid n-3 PUFAs. Adjusted hazard ratios (HRs) for incident diabetes in relation to GAD65 antibody status and tertiles of plasma phospholipid n-3 PUFA or fish intake were estimated using Prentice-weighted Cox regression …
The hazard of diabetes in antibody-positive individuals with low intake of total and fatty fish, respectively, was significantly elevated (HR 2.52 and 2.48) compared with people who were GAD65 antibody negative and had high fish intake, with evidence of additive (AP 0.44 and 0.48) and multiplicative interactions.
Individuals with high GAD65 antibody levels (≥167.5 units/mL) and low total plasma phospholipid n-3 PUFAs had a more than fourfold higher hazard of diabetes …”
Omega-3 Fatty Acids and Life Span
The Framingham study group is one of the longest-running longitudinal health data sets in existence. Since 1971, the residents of this small Massachusetts town have given us everything from heart health data to their knee annual MRI images. That’s where the data for this new Omega-3 research originates.The study, published in The American Journal of Clinical Nutrition (Oct 2021), used data from a long-term study group, the Framingham Offspring Cohort, which has been monitoring residents of this Massachusetts town, in the United States, since 1971.
The research looked at 2,200 people who were monitored for 11 years for their blood fatty acid levels. The researchers found that omega-3 levels in red blood cells are very good mortality risk predictors. That means that higher levels of Omega-3 in the blood from regularly eating oily fish, increased life expectancy by almost five years.
This research comes a few months after a meta-analysis of 17 prospective cohort studies was published in Nature Communications. The analysis linked higher circulating omega-3 fatty acid levels to longevity. In a pooled analysis of the studies, participants in the highest fifth of combined blood DHA and EPA were 15 to 18 percent less likely to die from any cause over the follow-up period (median follow-up time is 16 years in these studies). Higher blood omega-3s were also associated with a reduced risk for death from cardiovascular disease and cancer.
Omega-3 Fatty Acids and Dry Eyes
In a study with more than 450 participants, a daily dose of 360 mg eicosapentaenoic acid (EPA) and 240 mg docosahexaenoic acid (DHA), helped reduce symptoms of dry eye in people whose condition was aggravated by computer use. At the end of the three-month trial, the individuals taking the omega-3 supplement enjoyed significantly fewer symptoms and reduced abnormal tear evaporation.
In another study using fish oil and flaxseed oil, nearly 70% were asymptomatic after three months as the supplement appeared to increase tear production.
A study presented at the 2012 Association for Research in Vision and Ophthalmology (ARVO) meeting in Ft. Lauderdale, Fla., and sponsored by ScienceBased Health (Houston) focused on omega-3 and gamma-linolenic acid (GLA) therapy (HydroEye) taken for 6 months by 38 postmenopausal women who had keratoconjunctivitis sicca. The double-blind, placebo-controlled, prospective, randomized, multi- center trial found that patient self-reported symptoms by OSDI (Ocular Surface Disease Index) as well as conjucnctival impression cytology CD11c and HLA-DR inflammation biomarkers statistically significantly improved after the study duration, said lead investigator John D. Sheppard, M.D., professor of ophthalmology, microbiology, and immunology, Eastern Virginia Medical School, Norfolk, Va. The study did not seem to detect differences in corneal staining or tear breakup time, but topographic corneal surface regularity stabilized significantly with the study supplementation compared to placebo.
Vitamin D and Omega-3 Lower Autoimmune Disease Risk
Once people had been taking vitamin D for at least two years, the prevention rate from autoimmune disorders rose to 39%, according to the study, published in the journal BMJ.Vitamin D and omega 3 fish oil capsules may protect against autoimmune disease, but more research is needed.
The study also found a possible link between taking 1,000 milligrams of omega-3 fatty acid (fish oil) and a reduction in autoimmune disorders. The study found that taking both vitamin D and omega-3 fatty acid supplements, versus the placebo alone, decreased autoimmune disease by about 30%.
Study of 29,000 blood samples finds higher omega-3 levels associated with lower marker of inflammation
A research (Feb 2022), published in the journal Prostaglandins, Leukotrienes and Essential Fatty Acids, revisits data collected years ago for an earlier study. The data arose from blood testing done in 2011 and 2012 at a now defunct laboratory as part of routine clinical assessments.
The neutrophil-lymphocyte ratio (NLR) is a biomarker of systemic inflammation and measures innate-adaptive immune system balance. Elevated NLR are associated with increased risk for chronic disease and death rate, including cardiovascular diseases and cancer.
In this 29,000 blood samples of healthy population, a low omega-3 levels was associated with increasing NLR whereas NLR remained low when omega-3 levels are higher, suggestive of a balanced immune system.
Best Omega 3 Supplements Consumer Reports
Most omega-3 supplements are too oxidized
Most omega-3 supplements — and we really mean almost all of them — are not of good quality. They are too oxidized.This should not really come as a surprise given omega-3 fatty acids are very prone to oxidation. Oxidized omega-3 fatty acids are unhealthy, and can lead to oxidation of other molecules in our cells.
There are very few brands that have cracked the problem of oxidation of omega-3 fatty acids.
Most brands try to add antioxidants to their omega-3 fatty acids, like vitamin E (alpha-tocopherol) or rosemary extract, but they often do that when it’s already too late, when omega-3 fatty acids have been too oxidized already.
So, despite adding these antioxidants, for most supplements the TOTOX values (Total Oxidation) are too high.
Most brands try to add antioxidants to their omega-3 fatty acids, like vitamin E (alpha-tocopherol) or rosemary extract, but they often do that when it’s already too late, when omega-3 fatty acids have been too oxidized already.
So, despite adding these antioxidants, for most supplements the TOTOX values (Total Oxidation) are too high.
TOTOX value stands for total oxidation value. The omega 3 fatty acids EPA and DHA from fish oil are highly sensitive to oxidation. This means that they are rapidly affected by contact with oxygen. Oxidised fatty acids are not beneficial to our health. For this reason, a good fish oil supplement has a low TOTOX value. The maximum TOTOX value is set at 26 by the Global Organization for EPA and DHA omega-3.
There are not a lot of brands that try to keep TOTOX levels as low as possible. Some examples of brands that offer high-quality omega-3 fatty acids are (not sponsored) Omega3 Innovations or Nordic Naturals.
Some scientists believe that omega-3 fatty acids derived from krill are less oxidized than omega-3 fatty acids from fish oil.
Krill are tiny shrimp-like animals that contain a strong antioxidant called astaxanthin which protects their omega-3 fatty acids against oxidation. However, further research still has to bear this out.
Some, but not all, large-scale randomized controlled trials (RCTs) investigating the effects of marine omega-3 fatty acids supplementation on cardiovascular outcomes have reported increased risks of atrial fibrillation (AF). The potential reasons for disparate findings may be dose-related.
In a Systematic Review and Meta-Analysis, published in Circulation 2021, 7 studies were included in the meta-analysis.
Reference: Omega-3 Fatty Acids - Health Professional Fact Sheet (nih.gov)
"Yes, there are two natural forms. The omega-3s are found in triglycerides, which we classically think of as oils. A triglyceride has three fatty acids on each molecule. Typically, in most fish that are rich in omega-3, one of those three will be EPA or DHA, so about 30% of the fish oil will be omega-3. That's the triglyceride.
The other natural form that marine omega-3s are found in is phospholipids. Phospholipids are the primary constituents of cell membranes, and it's in the cell membrane where the omega-3s do their primary work.
There are two spots for fatty acids on a phospholipid, and it depends on the fish, but typically about maybe 20% to 30% of the phospholipids have EPA and DHA. Those two forms are natural. You get both triglycerides and phospholipids when you eat a salmon steak or any other 'oily' fish; these are the highest in omega-3.
The ethyl ester is a completely synthetic product. It starts out as a raw fish oil. That's where that EPA and DHA molecules come from in the first place, but at the refinery, all the fatty acids get chopped off of the triglyceride backbone. Then they throw away the monounsaturates, the saturates and the small amount of omega-6s, and that leaves the omega-3s by themselves.
The omega-3s have to be hooked to something before encapsulation, and so the favorite thing is to hook them up to ethanol (alcohol) to make 'ethyl esters.' When all they have in the vat is now omega-3 ethyl esters, then they can pack more EPA and DHA into each capsule, so the concentration is higher.
Virtually all of the pharmacologic products that are omega-3-based are ethyl esters, and they have been used since the mid-1990s. But there is nothing 'natural' about an ethyl ester. I guess there's debate on how effective they are. We do know that if you take the ethyl ester on an empty stomach, you're not really going to absorb it. They're very poorly absorbed.
Their absorption can be improved if you take the ethyl ester with a fatty meal, because that will stimulate the digestive juices and allow some of it to be absorbed, but it's not the best form for absorption. Triglycerides and phospholipids are much better forms for absorption."
Related:
There are not a lot of brands that try to keep TOTOX levels as low as possible. Some examples of brands that offer high-quality omega-3 fatty acids are (not sponsored) Omega3 Innovations or Nordic Naturals.
Some scientists believe that omega-3 fatty acids derived from krill are less oxidized than omega-3 fatty acids from fish oil.
Krill are tiny shrimp-like animals that contain a strong antioxidant called astaxanthin which protects their omega-3 fatty acids against oxidation. However, further research still has to bear this out.
Safety of Omega-3s
The IOM (Institute of Medicine) did not establish a UL (Tolerable Upper Intake Level) for any omega-3s, although it noted that high doses of DHA and/or EPA (900 mg/day of EPA plus 600 mg/day DHA or more for several weeks) might reduce immune function due to suppression of inflammatory responses. Doses of 2–15 g/day EPA and/or DHA might also increase bleeding time by reducing platelet aggregation.
We recommend taking a maximum of 1 gram of omega-3 per day. Higher amounts could be risky, because EPA and DHA are both polyunsaturated fats (PUFAs) and, like linoleic acid (LA), are susceptible to oxidation and the production of dangerous aldehyde metabolites.
Make sure you buy high-quality omega-3 fatty acid supplements, meaning that the omega-3 fatty acids are pure and have not oxidized much (having low “TOTOX” value).
Make sure you buy high-quality omega-3 fatty acid supplements, meaning that the omega-3 fatty acids are pure and have not oxidized much (having low “TOTOX” value).
However, according to the European Food Safety Authority, long-term consumption of EPA and DHA supplements at combined doses of up to about 5 g/day appears to be safe. It noted that these doses have not been shown to cause bleeding problems or affect immune function, glucose homeostasis, or lipid peroxidation. Similarly, the FDA has concluded that dietary supplements providing no more than 5 g/day EPA and DHA are safe when used as recommended.
Two large clinical trials completed after these assessments found that taking 4 g/day of omega-3 supplements for several years slightly increased the risk of atrial fibrillation in people with CVD or at high risk of CVD.
In RCTs examining cardiovascular outcomes, marine omega-3 supplementation was associated with an increased risk of AF. The risk appeared to be greater in trials testing >1 g/d.
Commonly reported side effects of omega-3 supplements are usually mild. These include unpleasant taste, bad breath, heartburn, nausea, gastrointestinal discomfort, diarrhea, headache, and odoriferous sweat.
Commonly reported side effects of omega-3 supplements are usually mild. These include unpleasant taste, bad breath, heartburn, nausea, gastrointestinal discomfort, diarrhea, headache, and odoriferous sweat.
Guide to Choosing a High-Quality Source of Long-Chain Omega-3 Fatty Acids
Various forms of fish oil and marine algae products in the marketplace provide sufficient concentrations of long-chain omega-3 fatty acids. The first criterion in selecting quality fish oil is purity. The product should be a highly concentrated form of long-chain omega-3 fatty acids free from lipid peroxides, heavy metals, environmental contaminants, and other harmful compounds. These “pharmaceutical grade” fish oil products are preferred and generally contain at least 60% EPA+DHA content.
As it relates to krill oil, wild salmon oil, and other marine lipids, the key is supplying the recommended levels of EPA+DHA associated with health benefits, i.e., generally 1,000 mg combined of EPA+DHA. In regard to marine algae sources of long-chain omega-3 fatty acids, it is essential to point out that many products provide only DHA and not EPA. This is not as ideal as those that provide both EPA and DHA in equal concentrations. Again, to gain health benefits, ideally, the daily intake should be 1,000 mg combined of EPA+DHA.
Omega 3 triglyceride vs ethyl ester: What's the Difference?
While most reach for fish oil to increase their omega-3 level, this isn't the best choice. In fact, most “fish oils” on the market today are actually synthetic ethyl esters, which are different from the triglyceride and phospholipid forms omega-3 found in sea foods, which are roughly 50/50 triglycerides and phospholipids. Krill oil also delivers omega-3 primarily in the phospholipid form. Harris explains:
"Yes, there are two natural forms. The omega-3s are found in triglycerides, which we classically think of as oils. A triglyceride has three fatty acids on each molecule. Typically, in most fish that are rich in omega-3, one of those three will be EPA or DHA, so about 30% of the fish oil will be omega-3. That's the triglyceride.
The other natural form that marine omega-3s are found in is phospholipids. Phospholipids are the primary constituents of cell membranes, and it's in the cell membrane where the omega-3s do their primary work.
There are two spots for fatty acids on a phospholipid, and it depends on the fish, but typically about maybe 20% to 30% of the phospholipids have EPA and DHA. Those two forms are natural. You get both triglycerides and phospholipids when you eat a salmon steak or any other 'oily' fish; these are the highest in omega-3.
The ethyl ester is a completely synthetic product. It starts out as a raw fish oil. That's where that EPA and DHA molecules come from in the first place, but at the refinery, all the fatty acids get chopped off of the triglyceride backbone. Then they throw away the monounsaturates, the saturates and the small amount of omega-6s, and that leaves the omega-3s by themselves.
The omega-3s have to be hooked to something before encapsulation, and so the favorite thing is to hook them up to ethanol (alcohol) to make 'ethyl esters.' When all they have in the vat is now omega-3 ethyl esters, then they can pack more EPA and DHA into each capsule, so the concentration is higher.
Virtually all of the pharmacologic products that are omega-3-based are ethyl esters, and they have been used since the mid-1990s. But there is nothing 'natural' about an ethyl ester. I guess there's debate on how effective they are. We do know that if you take the ethyl ester on an empty stomach, you're not really going to absorb it. They're very poorly absorbed.
Their absorption can be improved if you take the ethyl ester with a fatty meal, because that will stimulate the digestive juices and allow some of it to be absorbed, but it's not the best form for absorption. Triglycerides and phospholipids are much better forms for absorption."
Fish and Mercury
Numerous studies indicate that fish consumption offers significant health promotion and protection against many chronic diseases, primarily as a result of the fish being a source of long-chain omega-3 fatty acids. However, nearly all fish contain trace amounts of mercury. In most cases, the mercury content in fish is of little concern because the level is so low, but if you are eating a lot of fish, it could pose a problem. Two to four servings per week is a good goal, but going above that may be counterproductive. The fish most likely to have the lowest level of methylmercury are salmon, cod, mackerel, cold-water tuna, farm-raised catfish, and herring. Swordfish, shark, and other large predatory fish usually contain the highest levels of mercury.
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