How to choose the best fish oil?
Fish oil is one of the most well-known and commonly prescribed natural supplements. When you walk into any health food shop, pharmacy or even supermarket there is an abundance of fish oil supplements ranging in price, formulation, and potency. As a clinical naturopath my clients often ask me which is the best fish oil to take?
This guide has been written to help clear any confusion regarding fish oil supplementation and help you establish whether you need to take a fish oil supplement, as well as key factors to consider when selecting a fish oil.
Fish oil is a form of fatty acid that is derived from the fat of oily fish. It contains the omega-3 essential fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
Essential fatty acids
Essential fatty acids are important nutrients required for proper biological function. The body can create all essential fatty acids except for two: linoleic acid (LA), an omega-6 fatty acid, and alpha-linolenic acid (ALA), an omega-3 fatty acid. In a healthy individual ALA is converted into the two active eicosanoids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Food sources of omega-3 can be found in both wild salmon, wild sardines, grass-fed or pastured beef and pastured eggs.
Benefits of fish oil
Essential fatty acids are often used to treat a wide variety of inflammatory conditions such as joint inflammation and arthritis. They may also benefit conditions associated with mood regulation, cognitive function, cardiovascular health, skin health, and hormonal imbalances. Deficiency signs and symptoms of essential fatty acids can include eczema, dry skin, brittle nails, and learning difficulties.
Why take fish oil supplements?
With a wide range of food sources of essential fatty acids, why take a supplement? In my clinic I always recommend a ‘food as medicine’ approach to health and wellness and always encourage people to derive their nutrients from food sources. However, there are some reasons and occasions that a fish oil supplement may be indicated. Some of these are listed below:
- Vegetarian diet:
Individuals who choose to exclude beef, fish and animal products may be deficient in essential fatty acids. Some vegetarians are comfortable taking a fish oil supplement, but for those who adhere strictly to a vegetarian/ vegan diet there are other sources of ALA such as flaxseed, hemp, walnuts and pumpkin seeds. However, some research indicates that the conversion of ALA to EPA and DHA is extremely limited. Less than 5 per cent of ALA gets converted to EPA, and less than 0.5 per cent of ALA is converted to DHA. The conversion of ALA to DHA depends on zinc, iron and B6, which is even more difficult if you are nutrient deficient or have a compromised diet.
- Modern farming and agriculture:
According to the world review of nutrition and dietetics, ‘Modern farming methods with its emphasis on production’ has decreased the amount of omega-3 fatty acids in many foods. Beef and fish were once great natural sources of omega-3 essential fatty acids but a shift towards grain-fed agriculture sees a decrease in the amount of omega-3 in our meat as well as our vegetables, fruits and eggs. Wild salmon naturally feeds off microalgae and small fish instead of wheat byproducts and soybean meal, which contain a higher level of omega-6.
- Medical Conditions:
There are specific conditions such as cardiovascular disease, arthritis and even pregnancy that sees and increase in the need for Omega-3 essential fatty acids. Supplementation in this case can be a practical way to optimise levels of the essential fatty acids.
Things to consider when purchasing a fish oil supplement.
A statement you will often hear, is that not all fish oils are created equally and indeed that is correct. When selecting a fish oil supplement there are are things that are worth considering. These include the dosage, quality, sourcing, purity and value of the supplement.
There are different dosages of EPA + DHA required for each individual and specific condition. EPA is often associated with inflammatory conditions whilst DHA is often used to assist cognitive function and first stages of pregnancy. I always recommend seeing your local health care practitioner to find the correct dosage and ratio of essential fatty acids that you should be taking.
The purity is important when taken in supplement form and, ideally, you want to ensure that the oil is free of impurities, pesticides, persistent organic pollutants and heavy metal toxins (you can read more here and here). When selecting a fish oil, always check the brand and product for the amount of environmental and heavy metal contaminants. There are some fantastic practitioner-only brands that use independent testing to ensure purity exceeds international and Australian standards.
Have you ever purchased a fish oil and had it taste fishy? This is most likely because the quality of the fish oil is poor and that the oil has oxidised. The highest grade of fish oil is called ‘pharmaceutical grade’ fish oil. Whilst most retail brands of fish oil are approved by the Therapeutics Goods Association (TGA), those that are graded ‘pharmaceutical’ have to go through strict and rigorous quality testing.
Another important factor to consider is the sustainability of the fish oil that you are purchasing. Sourcing the raw materials for fish oil can be damaging to the environment. I only recommend brands that support sustainable and eco-friendly fishing practices.
Once you have established your fish oil dosage, you can consider which supplement is the best value for you. Different brands and supplement types come in varying degrees of concentrations. The higher concentration fish oil, may seem more expensive but if you can get your therapeutic dosage in one capsule, rather than four of a cheaper supplement of a lower concentration it may be more economical. Liquid fish oil supplements tend to be the best value for money.
Types of fish oil supplements
Fish oil supplements generally come in liquid of capsule form. It comes down to personal preference as to which form works best for you. Liquid fish oils are generally stronger in dosage and more economical, however the taste and texture of the oil can be off-putting. If you suffer from reflux I would recommend a high quality, enteric coating capsule, which only break down once in the small intestine. Alternatively, ensure that you take your fish oil supplement with a full meal to help minimise an aftertaste or reflux.
When not to take fish oil
Fish oil supplements are generally a safe supplement to take on a regular basis (when taking a high quality source). It is contraindicated for people taking anticoagulant medication and anyone with a bleeding disorder due to its blood-thinning properties. If you are unsure about taking a fish oil supplement consult a qualified health care practitioner
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