Fish Oil (Omega-3) 101: Benefits, Heart Health, Diabetes and Knee Pain (2024)

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Fish oil 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. Listed below are the top seven fish oil supplements on the market. This list should help you narrow down your choices when it comes to fish oil supplements.

fish oil vs krill oil

OMEGA-3 SUPPLEMENTS BENEFITS

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) (Trusted 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 (Trusted 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 (Trusted 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.

All of these effects makes fish oil potentially beneficial for people with arthritis.

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.


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, 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.

Study of 29,000 blood samples finds higher omega-3 levels associated with lower marker of inflammation

The new 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 FISH OIL SUPPLEMENTS OF 2023

1. Nordic Naturals Omega-3


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Amazon Reviews: 4.8 out of 5 - more than 40,000 global ratings

Amazon Best Sellers: #1 in Omega 3 Nutritional Supplements.

The fish oils used in Nordic Naturals’ products typically range between TOTOX values of 5 and 14. Recent tests of Nordic Naturals raw fish oils report TOTOX values of 7.0.

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.com

Related: Many common omega-3 fish oil supplements are ‘oxidized’


2. Omega-3 Wild Alaskan Fish Oil


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Amazon Reviews: 4.7 out of 5 - more than 33,000 global ratings

Amazon Best Sellers: #2 in Omega 3 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


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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
This is a great all round solution for people that need fish oil supplements. The pills absorb very quickly thanks to the enteric coating, which means that the capsules are fast acting as well. They also don’t have a bad or strong taste to them. The molecular distillation process also makes sure that the formula is extremely pure. This is one of the purest supplements that the market has to offer. Another fact that we liked is that the formula has not been genetically modified in any way, nor does it contain any GMO ingredients.

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
Cons
  • 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


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Amazon Best Sellers Rank: 
#3 in Krill Oil 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:
Amazon Reviews: 4.7 out of 5 - more than 6,000 global ratings
Amazon Best Sellers: #12 in Omega 3 Nutritional Supplements.

The first thing you will like about these capsules is that they are quite potent. We also appreciated how easy these capsules are on the stomach. There are no signs of gastric distress when you take this fish oil, and the capsules can be kept for a long time.

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
Pros
  • 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
Cons
  • 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 ratings
Amazon 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.

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
Cons
  • 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

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  • 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.

This fish oil supplement has made a name for itself which has earned it a place on this list. The primary benefits are quite solid. The capsules are quite soft. They are small too. This combination makes them very easy to swallow. We also appreciated that the manufacturer mentioned the source of the fatty acids in these capsules. Most pills just say fish oil. Knowing the source makes this capsule more trustworthy.

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
Cons
  • 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)."

Best Fish oil Supplements Consumer Reports



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