The Low Down on Fish Oil

Few people would dispute the benefits of having omega-3 fatty acids in their diet. Even people that might not understand why fat is good usually agree that omega-3s are good for you. But SAYING they're good for you and know WHY and HOW are two different things. So, without further ado, I present my version of Fish Oil FAQs.

UPDATE 10/10/2011: Robb Wolf's Fish Oil Revision

What is fish oil and where can I find it?

Fish oil is a great source for omega-3s fatty acids. You can get fish oil simply by eating cold water fish! Or you can buy it in capsule form or straight liquid. Capsules seem to be the most popular form of concentrated fish oil. You can find fish oil in any drugstore, supermarket, or bulk store. There is even prescription level fish oil, but most people say this is a rip off. (see interesting fact at bottom of post)

Why should I take fish oil?

Taking fish oil will help reduce the risk of heart disease, stroke, lower triglyceride levels, lower blood pressure, reduce joint stiffness, and help prevent diseases of the brain. Pretty cool, right? It does this by basically improving blood circulation and reducing inflammation...

Why should I be concerned about inflammation? 

When you think of inflammation, you might think of stubbing your toe and it swelling. Well, a typical western diet (think: grains, grain-fed meat, vegetable oils, soybeans, butter replacements, etc) is like stubbing your toe, except it is INTERNAL and GRADUAL and results from an imbalance of fatty acid ratios: omega-3s to omega-6s, with an overload of omega-6s. "Silent inflammation" is the big reason for things like heart disease, strokes, obesity, and all of those other things associated with a bad diet.  The omega-3:omega-6 ratio for a western diet is around 1:30, but we should be around 1:2 or 1:1! We can improve this ratio by taking in more omega-3s aka eating more fish. Since most people do not have fish, such as salmon or mackerel, multiple times per week, we can supplement with fish oil. We are basically taking something missing from most of our diets.

What if I eat fish during the week?

If you do consume fish such as salmon, sardines, etc. more than twice a week, you can probably reduce your intake of fish oil. But chances are that you are not consuming grass-fed meats, nor keeping grains completely out of your diet. In addition, fish oil improves insulin sensitivity, so it is still a good thing to have.  

What is EPA AND DHA and why are they important?

Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) play vital roles in brain development, retinal development (eye), and cardiovascular regulation. Knowing this, you can imagine just how many diseases may be prevented by taking enough EPA/DHA.  Here is just one of many studies showing a link to decreases in Alzheimer's, schizophrenia, depression, dementia, and possibly cancer. For expecting mothers, you should know that taking EPA/DHA in your diet will help the baby's brain development, especially in the third trimester. It is this EPA/DHA that we want from fish oil pills.

How much should I take?

UPDATE 10/10/2011: Robb Wolf's Fish Oil Amount Revision

It depends. First, you should realize that each pill will only have a portion that is EPA/DHA. For instance, one pill of Kirkland brand fish oil is 1000mg but only has 300mg of EPA/DHA. The rest is other oil that we're not too concerned about. So, I would need to take 4 pills to get a little over 1gram of EPA/DHA. Robb Wolf says if you are relatively healthy (working out at least twice/week, minimal grains) take 0.5 gram of EPA/DHA per 10 lbs. of bodyweight each day. If you are obese and/or sick or have a lot of grains in your diet, take 1.0 gram of EPA/DHA per 10 lbs. of bodyweight each day. Some also say that after a few months of fish oil + good diet, you can drop down to 0.25 grams per 10 lbs. bodyweight. Mark Sisson says to take 1-3 grams EPA/DHA each day.

As an example, I weigh 150 lbs. Using the first formula, I would take 0.5 grams x (150 lbs./10lbs.) = 7.5 grams EPA/DHA. Since each of my pills contain 300mg EPA/DHA, I would need to take 25 pills per day! But since my diet is decent (definitely not perfect) and I've been on fish oil for over 6 months, I take about 15 pills (4.5 grams EPA/DHA) per day. Split up over 3 meals, that's 5 pills per meal. Not bad. As a personal testimony, when I started to take fish oil I noticed in a few weeks that my veins and arteries were more pronounced (not like roid monsters, but more so than before) which I think is the result of better blood flow.Not scientific, but pretty cool.

Getting the liquid fish oil will cut down on the size of your dose significantly since it is more concentrated. Also, getting higher quality fish oil will be more expensive, but will save you the number of pills to swallow. 

update 3/21/10: Here is a Fish Oil Calculator put together by Whole9 and Robb Wolf. It basically uses the guidelines that I summarized above.

 Labels on the back can tell you exactly how much EPA/DHA is in each pill

When should I take it?

With meals, although you can either split them up over all your meals or just have a fish oil feast and have them all at one meal. Fish oil is meant to be taken for the long term, so there is no ideal time of day to take it. Just try not to take it on an empty stomach.


How should I store the fish oil? 

In refrigerator or freezer. Fish oil is sensitive to light and heat (causing bad oxidation) so keep it away from these elements. This is why fish oil comes in dark or opaque bottles.

What brands should I use?

You can use this document to compare prices, but personally I go for the cheapest one (Kirkland) at Costco for cost effectiveness. You can get better concentrations with the more expensive stuff (therefore needing to take less pills) but cost per dosage still goes up so in the long run, you'll be spending more. Another consideration is that the cheaper the fish oil, the more "other" stuff is in it such as soybean oil. Again, I do it for cost, but if you have the money, go for liquid brands such as Carlson's or Nordic Naturals. They have flavored fish oil and it literally tastes like candy. Yum. UPDATE: 3/20/2012 - Now I use Carlson's liquid fish oil (lemon flavor) and yes, it tastes like candy

How do I know if it is a quality fish oil?

In the world of fish oil, there is usually good and better, not necessarily bad. However, if you really want to test to see if the fish oil is quality, cut open two pills and pour the liquid on a small plate. Put it in the freezer for a few hours. It should not be completely solid. (it may be thicker, but it shouldn't be a solid block) For the most part, even the cheaper fish oils are fine.

 

Is krill oil better?

It's not considered better, but it's also not worse. Just don't fall into the trap of marketing saying that it's far superior. (Some companies say krill oil is "48x better!!") Mark Sisson discusses this here.

I've heard of taking flaxseeds or flaxseed oil for omega-3s. Can I do that?

While flaxseed does contain omega-3s, they are of the ALA variety (alpha-linolenic acid) which we don't use very effectively. In a nutshell, your body will convert the ALA to EPA/DHA in very small quantities, so for efficiency's sake stick with the fish oil. If you want more in-depth info, check out Dr. Eades' take on flaxseed oil vs. fish oil. Also, there MAY be a linkage to flaxseeds and prostate cancer, so guys, although this isn't proven, I would just stick with fish oil.

What about omega-3 enriched eggs?

These eggs come from chickens that have been fed flaxseeds. As discussed above, flaxseeds contain ALA omega-3s, but I have heard in Robb Wolf's podcast that chickens will convert those omega-3s to the good stuff that we want. So in the end, I would say go for those eggs, but also keep taking the fish oil or having fish in your diet. 

What if I'm pregnant?

Some of you may be concerned about mercury levels in fish oil, but many studies and tests have been done on all types of fish oil and there is no need to worry about contamination. (see below for question concerning mercury) In fact, there is an urge for expecting mothers to consume fish oil because of the fact that a baby's brain development depends on EPA/DHA, especially in the last trimester. Experts are even recommending eating regular fish despite prior warnings about mercury levels. In the end, it will be up to you, but I would say to do at least the fish oil routine. (improved blood circulation, good baby brain development...)

I'm doing the Zone diet. Should I count the fish oil as my fat for the day?

Nope.

Is there mercury in fish oil?

As mentioned above, there is no need to worry about mercury levels in fish oil for several reasons: mercury is found in bigger fish that are not used for fish oil; mercury tends to be found in the meat part of fish; and studies have been done examining different fish oils and found very little to no levels of mercury.

How do I prevent fish burps?

Freezing the capsules may help. Also, the higher quality fish oil tends to be more pure, therefore reduce the aftertaste. There also is an adaptation period to fish oil; I remember for a few weeks having the burps but then they vanished. Occasionally they may pop up, but for the effects of fish oil, it's worth it!

If I want to get omega-3s from fish, what kinds should I eat?

Here is a table I found from a study done on fish oil. It lists different types of fish and the amount of omega-3s in each. Best are wild caught, cold water, fatty fish such as salmon, herring, sardines, and mackerel.

Who shouldn't take fish oil?

Since fish oil thins your blood out, anyone in the military or job that involves high danger may want to cut off their fish oil intake a few weeks before deployment. If you are on a prescription blood thinner, talk to your doctor first. Those of you who are in Fight Club (I know you can't talk about it) may want to reconsider your hobby. For everyone else, have at it!

Disclaimer
Now you that you are an expert on fish oil, do not think you can take this and eat whatever you want. If I had a choice between healthful food choices and no fish oil OR unhealthy food choices and fish oil, I would choose the former. Remember, fish oil is a supplement for something we do not have regularly in our diets, it is NOT a magic pill that will cure everything.

Interesting fact: Lovaza is a drug for people with high triglycerides. What is the drug? Fish oil! Dr. Davis makes the point that it costs over $3500/year to take this prescription drug, but in reality, people could take store brand fish oil for $150/year!