With topics like inflammation and disease prevention headlining many media sources, the topic of fish oil is something most people have heard of, but do not really understand.

Omega-3 fatty acids are also known as essential fatty acids because the body cannot create them on its own. Essential fatty acids must be consumed from the diet. The three most noted omega-3 fatty acids are eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and alpha-linolenic acid (ALA). EPA and DHA are primarily found in marine life like algae and cold-water fish. ALA is found in nuts and seeds. It is possible for ALA to convert to DHA and EPA, but research shows only a minimal amount of ALA converts to EPA and DHA.

Why do we need omega-3’s?

Omega three fatty acids are necessary for many healthy functions. EPA is shown to improve heart health, lower triglycerides, lower blood pressure, and heart rate as well as lower inflammatory responses. DHA is necessary for cell membranes, eye health, and brain health. ALA is mostly used for energy.

Omega-3’s through the lifespan

Research has shown omega-3 fatty acids to be important at different stages of development. EPA and DHA taken during pregnancy are shown to prevent not only premature deliveries but also overdue pregnancies, therefore leading to an optimal pregnancy duration. Mothers who took omega-3 supplements during pregnancy and while breastfeeding were also shown to have positive outcomes in their children’s brain development. Research shows that children analyzed at nine months had better problem-solving skills than children whose mothers did not take fish oil, and children examined at two and a half years showed to have better hand-eye coordination. Research is also showing children who are given omega-3s during pregnancy and breastfeeding may have a lowered immune response, which may protect them against allergies.

EPA and Heart Disease

Three main studies have taken place supporting the importance of omega-3 fatty acids during adulthood. The GISSI Prevention Trial gave one gram of omega-3 fatty acids daily for three years to participants who had already had a heart attack. The trial showed a 50% less risk of dying from sudden cardiac death compared to those who just took a placebo. In the JELIS study, participants took EPA plus a cholesterol-lowering statin. These participants were shown to be less likely to have a massive coronary event compared to those who only received a statin. This year the REDUCE-IT trial released its findings. Participants who had elevated cardiovascular risk along with other comorbidities, AND elevated triglycerides, took four grams of EPA daily or a placebo. After almost 5 years, there was approximately a 25% relative risk reduction of a cardiovascular event. This 25% relative risk reduction was seen ON TOP of taking a statin. Lowering LDL cholesterol (bad) only reduces risk by 25%-35%.  EPA reduces relative risk by an additional 25%. The REDUCE-IT trials state “this is the single most impressive advance for preventative cardiovascular drug therapy since the advent of the statins.”

DHA and Alzheimer’s Disease

Alzheimer’s Disease, dementia, and decreased cognitive thinking are all brain-based diagnoses where risk doubles every five years after age 65. Due to the commonality of the Standard American Diet in the United States, low DHA levels are common. DHA is protective against many brain mechanisms, especially head trauma, amyloid toxin production, diabetes, and cardiovascular disease. Many clinical trials are underway regarding DHA and age-related cognitive decline. EPA and fatty acids are proving to be a low cost, effective therapy for not only treating, but preventing cognitive decline.

How to choose fish oil?

Not all fish oils are created equal. Here is a list of standards to make sure your omega-3 product is providing:

1. At least 1000mg of EPA+DHA daily. This is a therapeutic dose for healthy individuals. Patients who have a history of cardiovascular disease, elevated triglycerides, diabetes or other inflammatory diseases will require more.
2. Free of heavy metals. Many fish, including certain species of mackerel, contain high levels of mercury, environmental contaminants, and heavy metals. Companies like Nordic Naturals and Xymogen carry certifications that prove they maintain the highest purity possible.
3. Triglyceride or monoglyceride form. Triglyceride form is the natural form found in fish and a form that is easy for the body to ingest and absorb.
4. Free of synthetic fats. No additives.
5. No foul, bad fish odors. The only time fish smells or tastes bad, is when it is rancid. The same theory works for fish oil.
6. Sustainably sourced.

The providers at the Couri Center understand the value of quality omega-3 intake. If you prefer to consume omega-3 foods naturally, look for wild-caught mackerel, salmon, oysters, sardines, and anchovies. Flaxseed, chia seed, and walnuts also contain omega-3 fatty acids, but mostly in the form of ALA. If you are looking to increase your DHA or EPA, cold water fish or vegan fish oil (algae-based) is your best option.

How can I learn more about what supplements are right for me?

Inflammation and chronic diseases are increasing in prevalence. Omega-3 fatty acids are an easily tolerated, cost-effective way to help fight inflammation, improve brain health and lower your risk of cardiovascular events. If you have questions regarding omega-3 fatty acids, how to choose the right product or how they may improve your health, I encourage you to call the Couri Center and schedule a nutritional consultation.

Leslie Rusch-Bayer, RD, LDN CPT