Whenever healthcare professionals are asked about taking dietary supplements, the most common recommendation is an omega-3 supplement. According to the American Heart Association (AHA), those looking to protect their hearts should eat a variety of fatty fish (such as salmon, tuna, mackerel, sardines, or anchovies) at least twice per week. It is good to know that eating fish (wild, not farm raised) is good for us, but why?
For starters, the Standard American Diet (SAD) is high in animal proteins and fats, cholesterol, solvent-extracted and highly refined fats, and processed foods. Compounding these factors, SAD is low in fiber, complex carbohydrates, and vegetables. Fish is a great omega-3 source, but it is not a significant factor in most Americans’ diets?and we consume far too many polyunsaturated fats (omega-6s) in the form of vegetable oils derived from corn, soy, and sunflower. While omega-6 fats are necessary, dietary guidelines suggest an optimal omega-3 to omega-6 ratio of 1:4 or less. However, SAD typically promotes a ratio in the vicinity of 1:20.
The three principal omega-3 fatty acids are alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). ALA is an omega-3 fatty acid found in plants. Although cold-water fish is the primary source for both EPA and DHA, our bodies also change ALA into EPA and DHA?although not very efficiently.
To me, words such as “eicosapentaenoic acid” and “docosahexaenoic acid” do not mean much. Researchers and physicians may be able to understand the meaning coded in the names of these substances; however, I prefer to have it given to me in plain English. EPA appears to prevent blood clotting because it thins the blood and, thereby, reduces pain and swelling. DHA can be converted to EPA by our bodies, but the health benefits exceed that simple task. DHA decreases the thickness of the blood, lowers blood levels of triglycerides, is important for proper functioning of cell membranes and nerve cells, and serves as raw material for brain development. Now, I have an understanding of why these fatty acids are good for us.
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Omega-3s are one of the most frequently studied nutrients, according to research indexed in PubMed, a national database that holds vast amounts of medical research. Nearly 2,000 articles have been published on the relationship between omega-3s and heart disease. Unlike clinical trials on pharmaceuticals, the benefits of omega-3s are not studied in order to cure disease. Research is actively defining the critical role omega-3s play in maintaining optimal function of the body and by optimal function I mean health. Although they are available as a dietary supplement, there is nothing magical about omega-3s. They simply work as nature designed: a dietary component, necessary for human health, that the body must obtain from food.
A healthy young person eating a whole-food diet and who eats fish one to two times per week should take 1,000 mg of combined EPA and DHA daily. But that dose is only a starting point. If you have cardiovascular or joint issues, you could double that dosage. It is important to discuss the appropriate dosage level of omega-3s with your healthcare provider, particularly if you take pharmaceutical prescriptions.
Two of the most common sources of omega-3 supplements are fish oil and krill oil, and the old saying. You get what you pay for, is certainly true when buying either product. If the product smells fishy or you get fishy-tasting reflex burps, the product you are using may be made from poor-quality sources or from rancid fish. Check the expiration date on your supplement bottle, as omega-3s can also go bad in the bottle because of age or poor manufacturing standards.
Another term we often hear when discussing cardiovascular disease is “triglycerides”. These are a type of fat (lipids) found in the blood. The phospholipid omega-3s found in krill can help to reduce your risk for heart disease by decreasing your bad LDL cholesterol and high triglyceride levels, while simultaneously increasing amounts of good HDL cholesterol. The AHA recommends a triglyceride level of 100 mg/dL (1.1 mmol/L) or lower as ?optimal. The AHA doesn’t recommend drug treatment to reach this level. Instead, for those trying to lower their triglycerides to this level, lifestyle changes such as diet, weight loss, and physical activity are encouraged because triglycerides usually respond well to dietary and lifestyle changes.
The benefits of taking omega-3 supplements do not stop at heart disease. Research has shown that omega-3 supplementation can be effective for ADHD, Parkinson’s disease, autoimmune diseases, rheumatoid arthritis, and general brain health. For those who choose a vegetarian or vegan lifestyle, plant-based options have been growing in popularity.
Whether you eat a standard American diet or a healthier whole-food diet, it is challenging to balance your omega-3 intake with your omega-6 intake, particularly when you consider that we don’t reliably convert the short-chain omega-3s from plants to the long-chain omega-3s EPA and DHA that are preformed in fish. This means that we’re left with only fish and algae to balance our consumption of vegetable oils and animal products. Yikes! This is why supplementing with fish oil or algae oil is a must.
The importance of fish oil begins during pregnancy, where it supports fetal brain and nervous system development, positively impacts labor and delivery outcomes, and supports postpartum mood health. Throughout childhood, it supports mood, behavior, focus, immunity, and body composition. In my adult patients, I use fish oil for healthy triglyceride and blood pressure levels, cognitive function, and mood. It’s also one of my staples for painful periods, hot flashes, skin health, allergies, blood sugar balance, joint health, and body composition.
When choosing a supplement, always look for EPA and DHA content as opposed to total fish oil, and to make sure you are getting a minimum of 1,000 mg of EPA and DHA combined. If you choose to take algae oil instead, you’ll need about twice as much oil to get the same amount of EPA and DHA contained in fish oil.