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Wed, Sep-15-04, 13:07
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Product Review: Omega-3 Fatty Acids (EPA and DHA) from Fish/Marine Oils
What It Is:
EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are the two principal fatty acids found in fish and are known as omega-3 fatty acids. DHA can also be obtained from other marine sources, such as algae (algal oil). EPA and DHA are polyunsaturated fats ("good" fats, as opposed to saturated fats which increase the risk of heart disease.) The body has a limited ability to manufacture both EPA and DHA by converting the essential fatty acid, alpha-linolenic acid (ALA) — found in flaxseed oil, canola oil or walnuts. But this ability is lessened if the diet is too high in omega-6 fatty acids from vegetable oils from corn, sunflower, soybean or safflower. (For more information see the separate review of flaxseed oil and omega-6 products.)
What It Does:
Omega-3 fatty acids have been most widely studied regarding their effects on cardiovascular health. It's been discovered that EPA and DHA may help prevent heart disease and atherosclerosis by lowering triglyceride levels, raising HDL ("good") cholesterol and, possibly "thinning" the blood. They may also reduce the risk of one type of stroke and cardiac arrythmias. The U.S. Food and Drug Administration (FDA) now allows products containing omega-3 fatty acids to state: "The scientific evidence about whether omega-3 fatty acids may reduce the risk of coronary heart disease is suggestive, but not conclusive."
By decreasing inflammation, EPA and DHA can also reduce the pain of rheumatoid arthritis, although it appears to be most useful in the early stages of the disease and it is not clear if it affects the progression of the disease itself. Omega-3's may also reduce the pain associated with menstrual cramps.
Fish oils may also be useful in treating a host of conditions including bipolar (manic-depressive) disorder, Raynaud's phenomenon (abnormal sensitivity of hands and feet to cold), lupus, IgA nephropathy, kidney stones, chronic fatigue syndrome, and cystic fibrosis. Although once considered potential therapy for ulcerative colitis and Crohn's disease, more recent research has shown a lack of benefits. Omega-3's may also reduce the risk of premature delivery in pregnant women and prostate cancer in men. EPA specifically may be helpful for schizophrenia, while DHA may be more helpful in reducing high blood pressure. DHA is also important for normal development and functioning of the brain and retina in the fetus and in infants. This may explain the observation that the infants of women who consume fish during pregnancy and while nursing tend to have better vision. Consequently, DHA is often added to formula for premature infants and is also added to some regular infant formulas and foods. DHA may be helpful in the treatment of disorders such as attention deficit disorders, dyslexia, and cognitive impairment and dementia.
Moreover, experts now believe that the American diet contains too little omega-3 fatty acids and too much omega-6 fatty acids, which interferes with the body's production of DHA and EPA and may contribute to an increased risk of heart disease and cancer. While the ratio of omega-6's to omega-3's in the American diet is believed to be as high as 14:1 (14 grams of omega 6's for every gram of omega-3's), a ration of no more than 3:1 (3 grams of omega-6's for every 1 gram of omega-3) is recommended.
For information on dosages see What to Consider When Using.
Quality Concerns:
Because omega-3 fatty acids are obtained from natural sources, levels in supplements can vary, depending on the source and method of processing. Contamination has also been an issue, because fish can accumulate toxins such as mercury, dioxins, and PCBs. The freshness of the oil is also an important consideration because rancid fish oils have an extremely unpleasant odor and may not be as effective. Neither the FDA nor any other federal or state agency routinely tests fish or marine oil supplements for quality prior to sale.
ConsumerLab.com, as part of its mission to independently evaluate products that affect health, wellness, and nutrition, purchased many dietary supplements sold in the U.S. claiming to contain EPA and/or DHA and tested them for their levels of EPA and DHA, mercury, and signs of decomposition.
What CL Found:
ConsumerLab.com purchased and tested a total of 20 supplements, 19 of which were EPA/DHA combination products made from fish oils and one of which was a DHA-only product made from algal oil (see How Products were Selected).
Six of the 20 products failed to pass the review due to inadequate amounts of the DHA, which ranged from 50% to 83% of the amounts stated on the labels (see Testing Methods and Passing Score). Two of these six products were also found to contain only 33% and 82%, respectively, of their labeled amounts of EPA. Interestingly, two of the products that failed made claims on their labels that their "potency" had been "tested" or "verified." By providing less than claimed levels of EPA and DHA, products may have reduced potency. For example, research has suggested that doses of about five grams of omega-3's a day may help protect arteries from clogging for people at high risk. If your supplement is providing less than the dose you expect (say, if you're aiming for five grams and actually get only two and a half), you may not be getting the protection you are hoping for.
None of the twenty products were found to contain detectable levels of mercury [less than 1.5 parts per billion (ppb)]. By comparison, mercury levels in fish generally range from 10 ppb to 1,000 ppb, depending on the fish (see What to Look for When Buying — Getting EPA and DHA from Food for more information). There are several possible explanations for the lack of mercury in the supplements including: the use of species of fish that are less likely to accumulate mercury; the fact that most mercury is found in fish meat and not fish oil; and distillation processes that can remove contaminants. None of the products showed evidence of significant decomposition.
Products That Passed Testing:
Listed alphabetically below, by name, are the products that passed ConsumerLab.com's independent testing of dietary supplements containing EPA and DHA. Also shown are the claimed concentrations of EPA and DHA and, when stated on the label, the amount of fish oil per capsule. Some products may contain other ingredients not shown below.
CONSUMERLAB.COM APPROVED QUALITY OMEGA-3 FATTY ACID (EPA/DHA) FROM FISH/MARINE OIL PRODUCTS
To find retailers that sell some of the listed products click here.
Product Name and Claimed Amount of Fish/Marine Oil, EPA, and DHA Per Pill
Manufacturer or Distributor
EPA & DHA Combination Products:
Carlson Super Omega-3 Fish Oils (300 mg EPA, 200 mg DHA per softgel)*
Dist. by Carlson, Division of J.R. Carlson Laboratories, Inc.
Dale Alexander® Omega-3 Fish Oil Concentrate (234 mg EPA, 125 mg DHA per softgel)*
Twin Laboratories, Inc.
Health From the Sun The Total EFA™ Essential Fatty Acid Dietary Supplement (72 mg EPA, 46 mg DHA per capsule)
Marketed from Health From The Sun, A Division of Arkopharma
Jarrow Formulas™ Max DHA™ Purified by Molecular Distillation 80% omega-3 Fish Oil, 50% DHA, 20% EPA (500 mg fish oil, 100 mg EPA, 250 mg DHA per softgel)
Mfd. By Jarrow Formulas, Inc.™
Member's Mark™ Omega 3 Fish Oil 1000mg Natural Concentrate (1000 mg fish oil, 180 mg EPA, 120 mg DHA per softgel)
Dist. By SWC, Inc. (Sam's Club)
Nutrilite® Omega 3 Complex Dietary Supplement (300 mg fish oil, 65 mg EPA, 45 mg DHA per softgel)
Dist. By Access Business Group International LLC
Pure Encapsulations® EPA/DHA essentials™ (1000 mg fish oil, 300 mg EPA, 200 mg DHA per capsule)
Mfd. By Pure Encapsulations, Inc.
Puritan's Pride® Inspired By Nature™ Salmon Oil 500mg (500 mg fish oil, 40 mg EPA, 60 mg DHA per softgel)
Mfd. By Puritan's Pride, Inc.
Shaklee® EPA Omega-3 Fatty Acid Dietary Supplement (182 mg EPA, 78 mg DHA per capsule)
Dist. By Shaklee Corp.
Solgar Omega-3 "700" EPA & DHA from Cold Water Fish (700 mg fish oil, 360 mg EPA, 240 mg DHA per softgel)
Mfd. By Solgar Vitamin and Herb
Spectrum Essentials® Omega 3 Cold Processed Norwegian Fish Oil (1000 mg fish oil, 180 mg EPA, 120 mg DHA per capsule)
Dist. By Spectrum Organic Products, Inc.
The Vitamin Shoppe EPA-DHA Omega-3 Fish Oil 500 (1000 mg fish oil, 300 mg EPA, 200 mg DHA per softgel)
Mfd. For The Vitamin Shoppe™
Trader Darwin's™ Molecularly Distilled Omega-3 Fatty Acids Dietary Supplement (1100 mg fish oil, 300 mg EPA, 200 mg DHA per softgel)
Dist. By Trader Joe's
Vitamin World® Naturally Inspired™ EPA Natural Fish Oil 1000mg (1,000 mg fish oil, 180 mg EPA, 120 mg DHA per softgel)
Mfd. By Vitamin World, Inc.
ZonePerfect® Omega 3 Molecular Distilled Fish Oil and Vitamin E Supplement (1000 mg fish oil, 160 mg EPA, 107 mg DHA per capsule)
Dist. By ZonePerfect Nutrition Co.
DHA Only Products:
Nature's Way® Neuromins™ Plant sourced DHA (100 mg DHA per softgel)
Dist. By Nature's Way Products, Inc.
Unless otherwise noted, information about the products listed above is based on the samples purchased by ConsumerLab.com for this Product Review. Manufacturers may change product ingredients and information at any time, so be sure to check labels carefully when evaluating the products you use or buy. If a product's ingredients differ from what is listed above, it may not necessarily be of the same quality as what was tested. It also cannot be assumed that other products from a Manufacturer or Distributor listed above are of equal quality to those listed.
*Tested through ConsumerLab.com's Ad Hoc Testing Program after completion and posting of this review.
Copyright ConsumerLab.com, LLC, 2001. All rights reserved. Not to be reproduced, excerpted, linked to, or cited in any fashion without the express written permission of ConsumerLab.com LLC.
ConsumerTips™:
What to Consider When Buying:
Getting EPA and DHA From Supplements:
When buying supplements containing EPA and/or DHA, keep in mind that products vary significantly in terms of the amounts and ratios of EPA and DHA. Many products made from menhaden and other small fish have a ratio of EPA to DHA of 1.5, i.e., a capsule claiming 1 gram (1,000 mg) of fish oil, provides 180 mg of EPA, and 120 mg of DHA, or slightly less than one-third of the fish oil comes in the form of omega-3's. However, a more concentrated product may contain twice that amount of both EPA and DHA. Products made from other types of fish or marine sources can contain a variety of amounts and ratios of EPA and DHA. Some salmon oil products, for example, claim to contain more DHA than EPA and products made only from algal oil will contain only DHA. With a more concentrated product, one may be able to take fewer capsules of the same size. Semi-synthetic ("ester") forms of EPA and DHA are also available and are believed to be as active the natural forms. You will find that many products also contain vitamin E or some other antioxidant, which is added to prevent the oils from becoming rancid. Your daily intake should be based on your reason for taking it (see below) and the amount that you are already getting from your diet.
Getting EPA and DHA From Food:
You may also want to consider getting omega-3 fatty acids directly from fish. For the general population, the American Heart Association (AHA) recommends at least two 3 oz servings of fish per week. Fatty fish, such as the following, have higher levels of omega-3 fatty acids:
Anchovies
Bluefish
Carp
Catfish
Halibut
Herring
Lake trout
Mackerel
Pompano
Salmon
Striped Sea Bass
Tuna (Albacore)
Whitefish
Source: U.S. Department of Agriculture, Agricultural Research Service. 2001.
The total amounts of omega-3's vary among fish, but ones listed above are all good sources. A three-ounce serving of canned tuna, for example, contains about 2.5 grams of fat, about 30% of which is EPA (200 mg) and DHA (500 mg). Note, however, that levels of pollutants, such as mercury, tend to be higher in long-lived, larger fish having more dark meat, particularly shark, swordfish, king mackerel, and tilefish. The FDA has advised pregnant women to avoid eating these types of fish, out of concern that mercury in the meat may harm an unborn baby's developing nervous system. These fish tend average about 1,000 ppb (parts per billion) of mercury — the FDA limit for human consumption — while most other fish tend to have about one-tenth to one-third of this amount. Eating a fish with 1,000 ppb of mercury is not necessarily toxic, but it should not be consumed by young children and pregnant or nursing women, or by anyone on a regular basis. Fish such as salmon and tuna, particularly white meat, are preferred sources of omega-3's and pregnant women may eat up to 12 ounces of such cooked fish per week. The Environmental Protection Agency (EPA) has also advised that fresh-water fish may contain more mercury than commercially caught fish and advises that "If you are pregnant or could become pregnant, are nursing a baby, or feeding a young child, limit consumption of fish caught by family and friends to one meal (about 6 ounces) of fish per week."
Eggs fortified with DHA are also now available in the U.S. and claim to contain 150 mg of DHA in each egg, which is about the amount found in 3 ounces of salmon. Chickens producing these eggs are typically fed algal DHA. Algal DHA has been approved as a food ingredient, so that foods and beverages can be fortified with DHA. Infant formulas in the U.S. do not contain EPA or DHA but have alpha-linolenic acid (ALA) as an ingredient because ALA is an essential fatty acid, from which the EPA and DHA may be made. However, DHA is often added to formulas for premature infants. Because some formula-fed infants may not be converting enough ALA to DHA, DHA is also being considered as an additive to formula in the U.S. — it is already being added to formula for premature infants and is found in some formula in other countries.
What to Consider When Using:
The typical dose of fish oil is 3 to 9 g daily of which about 30% is EPA and DHA. The AHA recommends fish oil capsules for patients with extremely high triglycerides (greater than 1,000 mg/dl), who have not responded well to other treatments. In treating patients with high triglycerides, about 5 grams of combined EPA and DHA is recommended daily. A total of about 3 grams of EPA and DHA is used in treating hypertension, rheumatoid arthritis, Crohn's disease, and ulcerative colitis. About 1 gram per day of combined EPA and DHA may be protective against recurrence of a heart attack. Nine grams per day of combined EPA and DHA, which is a fairly high dose, has been used to treat schizophrenia and relatively high doses have also been used in treating Raynaud's phenomenon. The recommended dose of DHA, from either supplements or fish, for pregnant and nursing women is 100 to 200 mg per day While there is no official recommended intake for omega-3's in healthy people, some experts have said that a total intake of about 650 milligrams a day is a goal to aim for, with at least 220 mg coming from DHA and at least the same amount from EPA. The remaining 200+ mg can come from either DHA or EPA.
Fish oils are best tolerated when taken with meals and should be taken in divided doses, i.e., divide the dose in half and take twice daily, or in thirds and take three times a day.
Caveats and Cautions:
While fish oil supplements are generally considered safe, there are a few caveats and cautions you should take into consideration before you buy:
The most common side effects are fishy smelling burps and diarrhea.
Up to about 20 grams of fish oil can be well tolerated by most adults, though most experts recommend against taking this much because of the possible bleeding problems. Be aware that cod liver oil is not a good substitute for fish oil supplements, because it is high in vitamins A and D. Because these vitamins can be toxic, make sure that you do not exceed safe levels (see Multivitamin Product Review for Tolerable Upper Intake Levels (ULs) for vitamins and minerals).
Fish oil should be used only under a physician's care by hemophiliacs, those taking prescription blood thinners, such as Coumadin (warfarin) or heparin, and those expecting to undergo surgery.
Although rare, interactions may also occur between EPA supplements and aspirin or other non-steroidal anti-inflammatory drugs and herbs such as garlic and ginkgo.
To further assist consumers, ConsumerLab.com licenses its flask-shaped CL Seal of Approved Quality (see The CL Seal) to manufacturers for use on labels of products that have passed its testing. ConsumerLab.com will periodically re-evaluate these products to ensure their compliance with ConsumerLab.com's standards.
Information on this site is provided for informational purposes only. It is not an endorsement of any product nor it is it meant to substitute for the advice provided by physicians or other healthcare professionals. The information contained herein should not be used for diagnosing or treating a health problem or disease.
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Product Review: Omega-3 Fatty Acids (EPA and DHA) from Fish/Marine Oils
What It Is:
EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are the two principal fatty acids found in fish and are known as omega-3 fatty acids. DHA can also be obtained from other marine sources, such as algae (algal oil). EPA and DHA are polyunsaturated fats ("good" fats, as opposed to saturated fats which increase the risk of heart disease.) The body has a limited ability to manufacture both EPA and DHA by converting the essential fatty acid, alpha-linolenic acid (ALA) — found in flaxseed oil, canola oil or walnuts. But this ability is lessened if the diet is too high in omega-6 fatty acids from vegetable oils from corn, sunflower, soybean or safflower. (For more information see the separate review of flaxseed oil and omega-6 products.)
What It Does:
Omega-3 fatty acids have been most widely studied regarding their effects on cardiovascular health. It's been discovered that EPA and DHA may help prevent heart disease and atherosclerosis by lowering triglyceride levels, raising HDL ("good") cholesterol and, possibly "thinning" the blood. They may also reduce the risk of one type of stroke and cardiac arrythmias. The U.S. Food and Drug Administration (FDA) now allows products containing omega-3 fatty acids to state: "The scientific evidence about whether omega-3 fatty acids may reduce the risk of coronary heart disease is suggestive, but not conclusive."
By decreasing inflammation, EPA and DHA can also reduce the pain of rheumatoid arthritis, although it appears to be most useful in the early stages of the disease and it is not clear if it affects the progression of the disease itself. Omega-3's may also reduce the pain associated with menstrual cramps.
Fish oils may also be useful in treating a host of conditions including bipolar (manic-depressive) disorder, Raynaud's phenomenon (abnormal sensitivity of hands and feet to cold), lupus, IgA nephropathy, kidney stones, chronic fatigue syndrome, and cystic fibrosis. Although once considered potential therapy for ulcerative colitis and Crohn's disease, more recent research has shown a lack of benefits. Omega-3's may also reduce the risk of premature delivery in pregnant women and prostate cancer in men. EPA specifically may be helpful for schizophrenia, while DHA may be more helpful in reducing high blood pressure. DHA is also important for normal development and functioning of the brain and retina in the fetus and in infants. This may explain the observation that the infants of women who consume fish during pregnancy and while nursing tend to have better vision. Consequently, DHA is often added to formula for premature infants and is also added to some regular infant formulas and foods. DHA may be helpful in the treatment of disorders such as attention deficit disorders, dyslexia, and cognitive impairment and dementia.
Moreover, experts now believe that the American diet contains too little omega-3 fatty acids and too much omega-6 fatty acids, which interferes with the body's production of DHA and EPA and may contribute to an increased risk of heart disease and cancer. While the ratio of omega-6's to omega-3's in the American diet is believed to be as high as 14:1 (14 grams of omega 6's for every gram of omega-3's), a ration of no more than 3:1 (3 grams of omega-6's for every 1 gram of omega-3) is recommended.
For information on dosages see What to Consider When Using.
Quality Concerns:
Because omega-3 fatty acids are obtained from natural sources, levels in supplements can vary, depending on the source and method of processing. Contamination has also been an issue, because fish can accumulate toxins such as mercury, dioxins, and PCBs. The freshness of the oil is also an important consideration because rancid fish oils have an extremely unpleasant odor and may not be as effective. Neither the FDA nor any other federal or state agency routinely tests fish or marine oil supplements for quality prior to sale.
ConsumerLab.com, as part of its mission to independently evaluate products that affect health, wellness, and nutrition, purchased many dietary supplements sold in the U.S. claiming to contain EPA and/or DHA and tested them for their levels of EPA and DHA, mercury, and signs of decomposition.
What CL Found:
ConsumerLab.com purchased and tested a total of 20 supplements, 19 of which were EPA/DHA combination products made from fish oils and one of which was a DHA-only product made from algal oil (see How Products were Selected).
Six of the 20 products failed to pass the review due to inadequate amounts of the DHA, which ranged from 50% to 83% of the amounts stated on the labels (see Testing Methods and Passing Score). Two of these six products were also found to contain only 33% and 82%, respectively, of their labeled amounts of EPA. Interestingly, two of the products that failed made claims on their labels that their "potency" had been "tested" or "verified." By providing less than claimed levels of EPA and DHA, products may have reduced potency. For example, research has suggested that doses of about five grams of omega-3's a day may help protect arteries from clogging for people at high risk. If your supplement is providing less than the dose you expect (say, if you're aiming for five grams and actually get only two and a half), you may not be getting the protection you are hoping for.
None of the twenty products were found to contain detectable levels of mercury [less than 1.5 parts per billion (ppb)]. By comparison, mercury levels in fish generally range from 10 ppb to 1,000 ppb, depending on the fish (see What to Look for When Buying — Getting EPA and DHA from Food for more information). There are several possible explanations for the lack of mercury in the supplements including: the use of species of fish that are less likely to accumulate mercury; the fact that most mercury is found in fish meat and not fish oil; and distillation processes that can remove contaminants. None of the products showed evidence of significant decomposition.
Products That Passed Testing:
Listed alphabetically below, by name, are the products that passed ConsumerLab.com's independent testing of dietary supplements containing EPA and DHA. Also shown are the claimed concentrations of EPA and DHA and, when stated on the label, the amount of fish oil per capsule. Some products may contain other ingredients not shown below.
CONSUMERLAB.COM APPROVED QUALITY OMEGA-3 FATTY ACID (EPA/DHA) FROM FISH/MARINE OIL PRODUCTS
To find retailers that sell some of the listed products click here.
Product Name and Claimed Amount of Fish/Marine Oil, EPA, and DHA Per Pill
Manufacturer or Distributor
EPA & DHA Combination Products:
Carlson Super Omega-3 Fish Oils (300 mg EPA, 200 mg DHA per softgel)*
Dist. by Carlson, Division of J.R. Carlson Laboratories, Inc.
Dale Alexander® Omega-3 Fish Oil Concentrate (234 mg EPA, 125 mg DHA per softgel)*
Twin Laboratories, Inc.
Health From the Sun The Total EFA™ Essential Fatty Acid Dietary Supplement (72 mg EPA, 46 mg DHA per capsule)
Marketed from Health From The Sun, A Division of Arkopharma
Jarrow Formulas™ Max DHA™ Purified by Molecular Distillation 80% omega-3 Fish Oil, 50% DHA, 20% EPA (500 mg fish oil, 100 mg EPA, 250 mg DHA per softgel)
Mfd. By Jarrow Formulas, Inc.™
Member's Mark™ Omega 3 Fish Oil 1000mg Natural Concentrate (1000 mg fish oil, 180 mg EPA, 120 mg DHA per softgel)
Dist. By SWC, Inc. (Sam's Club)
Nutrilite® Omega 3 Complex Dietary Supplement (300 mg fish oil, 65 mg EPA, 45 mg DHA per softgel)
Dist. By Access Business Group International LLC
Pure Encapsulations® EPA/DHA essentials™ (1000 mg fish oil, 300 mg EPA, 200 mg DHA per capsule)
Mfd. By Pure Encapsulations, Inc.
Puritan's Pride® Inspired By Nature™ Salmon Oil 500mg (500 mg fish oil, 40 mg EPA, 60 mg DHA per softgel)
Mfd. By Puritan's Pride, Inc.
Shaklee® EPA Omega-3 Fatty Acid Dietary Supplement (182 mg EPA, 78 mg DHA per capsule)
Dist. By Shaklee Corp.
Solgar Omega-3 "700" EPA & DHA from Cold Water Fish (700 mg fish oil, 360 mg EPA, 240 mg DHA per softgel)
Mfd. By Solgar Vitamin and Herb
Spectrum Essentials® Omega 3 Cold Processed Norwegian Fish Oil (1000 mg fish oil, 180 mg EPA, 120 mg DHA per capsule)
Dist. By Spectrum Organic Products, Inc.
The Vitamin Shoppe EPA-DHA Omega-3 Fish Oil 500 (1000 mg fish oil, 300 mg EPA, 200 mg DHA per softgel)
Mfd. For The Vitamin Shoppe™
Trader Darwin's™ Molecularly Distilled Omega-3 Fatty Acids Dietary Supplement (1100 mg fish oil, 300 mg EPA, 200 mg DHA per softgel)
Dist. By Trader Joe's
Vitamin World® Naturally Inspired™ EPA Natural Fish Oil 1000mg (1,000 mg fish oil, 180 mg EPA, 120 mg DHA per softgel)
Mfd. By Vitamin World, Inc.
ZonePerfect® Omega 3 Molecular Distilled Fish Oil and Vitamin E Supplement (1000 mg fish oil, 160 mg EPA, 107 mg DHA per capsule)
Dist. By ZonePerfect Nutrition Co.
DHA Only Products:
Nature's Way® Neuromins™ Plant sourced DHA (100 mg DHA per softgel)
Dist. By Nature's Way Products, Inc.
Unless otherwise noted, information about the products listed above is based on the samples purchased by ConsumerLab.com for this Product Review. Manufacturers may change product ingredients and information at any time, so be sure to check labels carefully when evaluating the products you use or buy. If a product's ingredients differ from what is listed above, it may not necessarily be of the same quality as what was tested. It also cannot be assumed that other products from a Manufacturer or Distributor listed above are of equal quality to those listed.
*Tested through ConsumerLab.com's Ad Hoc Testing Program after completion and posting of this review.
Copyright ConsumerLab.com, LLC, 2001. All rights reserved. Not to be reproduced, excerpted, linked to, or cited in any fashion without the express written permission of ConsumerLab.com LLC.
ConsumerTips™:
What to Consider When Buying:
Getting EPA and DHA From Supplements:
When buying supplements containing EPA and/or DHA, keep in mind that products vary significantly in terms of the amounts and ratios of EPA and DHA. Many products made from menhaden and other small fish have a ratio of EPA to DHA of 1.5, i.e., a capsule claiming 1 gram (1,000 mg) of fish oil, provides 180 mg of EPA, and 120 mg of DHA, or slightly less than one-third of the fish oil comes in the form of omega-3's. However, a more concentrated product may contain twice that amount of both EPA and DHA. Products made from other types of fish or marine sources can contain a variety of amounts and ratios of EPA and DHA. Some salmon oil products, for example, claim to contain more DHA than EPA and products made only from algal oil will contain only DHA. With a more concentrated product, one may be able to take fewer capsules of the same size. Semi-synthetic ("ester") forms of EPA and DHA are also available and are believed to be as active the natural forms. You will find that many products also contain vitamin E or some other antioxidant, which is added to prevent the oils from becoming rancid. Your daily intake should be based on your reason for taking it (see below) and the amount that you are already getting from your diet.
Getting EPA and DHA From Food:
You may also want to consider getting omega-3 fatty acids directly from fish. For the general population, the American Heart Association (AHA) recommends at least two 3 oz servings of fish per week. Fatty fish, such as the following, have higher levels of omega-3 fatty acids:
Anchovies
Bluefish
Carp
Catfish
Halibut
Herring
Lake trout
Mackerel
Pompano
Salmon
Striped Sea Bass
Tuna (Albacore)
Whitefish
Source: U.S. Department of Agriculture, Agricultural Research Service. 2001.
The total amounts of omega-3's vary among fish, but ones listed above are all good sources. A three-ounce serving of canned tuna, for example, contains about 2.5 grams of fat, about 30% of which is EPA (200 mg) and DHA (500 mg). Note, however, that levels of pollutants, such as mercury, tend to be higher in long-lived, larger fish having more dark meat, particularly shark, swordfish, king mackerel, and tilefish. The FDA has advised pregnant women to avoid eating these types of fish, out of concern that mercury in the meat may harm an unborn baby's developing nervous system. These fish tend average about 1,000 ppb (parts per billion) of mercury — the FDA limit for human consumption — while most other fish tend to have about one-tenth to one-third of this amount. Eating a fish with 1,000 ppb of mercury is not necessarily toxic, but it should not be consumed by young children and pregnant or nursing women, or by anyone on a regular basis. Fish such as salmon and tuna, particularly white meat, are preferred sources of omega-3's and pregnant women may eat up to 12 ounces of such cooked fish per week. The Environmental Protection Agency (EPA) has also advised that fresh-water fish may contain more mercury than commercially caught fish and advises that "If you are pregnant or could become pregnant, are nursing a baby, or feeding a young child, limit consumption of fish caught by family and friends to one meal (about 6 ounces) of fish per week."
Eggs fortified with DHA are also now available in the U.S. and claim to contain 150 mg of DHA in each egg, which is about the amount found in 3 ounces of salmon. Chickens producing these eggs are typically fed algal DHA. Algal DHA has been approved as a food ingredient, so that foods and beverages can be fortified with DHA. Infant formulas in the U.S. do not contain EPA or DHA but have alpha-linolenic acid (ALA) as an ingredient because ALA is an essential fatty acid, from which the EPA and DHA may be made. However, DHA is often added to formulas for premature infants. Because some formula-fed infants may not be converting enough ALA to DHA, DHA is also being considered as an additive to formula in the U.S. — it is already being added to formula for premature infants and is found in some formula in other countries.
What to Consider When Using:
The typical dose of fish oil is 3 to 9 g daily of which about 30% is EPA and DHA. The AHA recommends fish oil capsules for patients with extremely high triglycerides (greater than 1,000 mg/dl), who have not responded well to other treatments. In treating patients with high triglycerides, about 5 grams of combined EPA and DHA is recommended daily. A total of about 3 grams of EPA and DHA is used in treating hypertension, rheumatoid arthritis, Crohn's disease, and ulcerative colitis. About 1 gram per day of combined EPA and DHA may be protective against recurrence of a heart attack. Nine grams per day of combined EPA and DHA, which is a fairly high dose, has been used to treat schizophrenia and relatively high doses have also been used in treating Raynaud's phenomenon. The recommended dose of DHA, from either supplements or fish, for pregnant and nursing women is 100 to 200 mg per day While there is no official recommended intake for omega-3's in healthy people, some experts have said that a total intake of about 650 milligrams a day is a goal to aim for, with at least 220 mg coming from DHA and at least the same amount from EPA. The remaining 200+ mg can come from either DHA or EPA.
Fish oils are best tolerated when taken with meals and should be taken in divided doses, i.e., divide the dose in half and take twice daily, or in thirds and take three times a day.
Caveats and Cautions:
While fish oil supplements are generally considered safe, there are a few caveats and cautions you should take into consideration before you buy:
The most common side effects are fishy smelling burps and diarrhea.
Up to about 20 grams of fish oil can be well tolerated by most adults, though most experts recommend against taking this much because of the possible bleeding problems. Be aware that cod liver oil is not a good substitute for fish oil supplements, because it is high in vitamins A and D. Because these vitamins can be toxic, make sure that you do not exceed safe levels (see Multivitamin Product Review for Tolerable Upper Intake Levels (ULs) for vitamins and minerals).
Fish oil should be used only under a physician's care by hemophiliacs, those taking prescription blood thinners, such as Coumadin (warfarin) or heparin, and those expecting to undergo surgery.
Although rare, interactions may also occur between EPA supplements and aspirin or other non-steroidal anti-inflammatory drugs and herbs such as garlic and ginkgo.
To further assist consumers, ConsumerLab.com licenses its flask-shaped CL Seal of Approved Quality (see The CL Seal) to manufacturers for use on labels of products that have passed its testing. ConsumerLab.com will periodically re-evaluate these products to ensure their compliance with ConsumerLab.com's standards.
Information on this site is provided for informational purposes only. It is not an endorsement of any product nor it is it meant to substitute for the advice provided by physicians or other healthcare professionals. The information contained herein should not be used for diagnosing or treating a health problem or disease.
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