Omegas-3s are essential to our health and have become increasingly popular as a dietary supplement in recent years for the convenience and ease in which they can be consumed. While having omega-3s in a supplement may seem like a perfect pairing, a closer look tells a different story.

What are Omega 3s?

First, some background on what omega-3s are and why they are so important. Omega-3s are fatty acids that play an essential role in our growth, development, and metabolism. The three types of omega-3s associated with the human body are α-linolenic acid (ALA), which comes from plants, and eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), both found in fish and the more widely used and studied of the three omega types.

Some of the many benefits that omega-3s offer include lowering cholesterol and triglyceride (blood fat) levels, reducing high blood pressure and helping with hypertension, lessening joint pain and possibly even reducing the risk of some forms of cancer.

You may be surprised to learn that despite their significance to our overall health, our bodies cannot produce omega-3s on their own, meaning we must get them from what we eat. This can be a challenge, as naturally occurring sources of omega-3s are only found in select foods and oftentimes in low amounts, making omega-3 supplements an attractive alternative.

Sources:

Visioli, F., et al. Dietary intake of fish v. formulations leads to higher plasma concentrations of n-3 fatty acids. Lipids. 2003 Apr;38(4):415-8.

ORIGIN Trial Investigators, et al. n-3 fatty acids and cardiovascular outcomes in patients with dysglycemia. N Engl J Med. 2012 Jul 26;367(4):309-18. DOI: 10.1056/NEJMoa1203859

Brouwer, I.A., et al. Effect of fish oil on ventricular tachyarrhythmia and death in patients with implantable cardioverter defibrillators: the Study on Omega-3 Fatty Acids and Ventricular Arrhythmia (SOFA) randomized trial. JAMA. 2006 Jun 14;295(22):2613-9. DOI: 10.1001/jama.295.22.2613

Burr, M.L., et al. Is fish oil good or bad for heart disease? Two trials with apparently conflicting results. J Membr Biol. 2005 Jul;206(2):155-63. DOI: 10.1007/s00232-005-0784-1

Freund-Levi, Y., et al. Omega-3 fatty acid treatment in 174 patients with mild to moderate Alzheimer’s disease: OmegaAD study: a randomized double-blind trial. Arch Neurol. 2006 Oct;63(10):1402-8. DOI: 10.1001/archneur.63.10.1402

Quinn, J.F., et al. Docosahexaenoic acid supplementation and cognitive decline in Alzheimer disease: a randomized trial. JAMA. 2010 Nov 3;304(17):1903-11. DOI: 10.1001/jama.2010.1510

Andrieu, S., et al. Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomized, placebo-controlled trial. Lancet Neurol. 2017 May;16(5):377-389. DOI: 10.1016/S1474-4422(17)30040-6

Andreeva, V.A., et al. Cognitive function after supplementation with B vitamins and long-chain omega-3 fatty acids: ancillary findings from the SU.FOL.OM3 randomized trial. AM J Clin Nutr. 2011 Jul;94(1):278-86. DOI: 103945/ajcn.110.006320

Albert, B.B., et. al. Oxidation of Marine Omega-3 Supplements and Human Health. BioMed Research Intl. DOI: 10.1155/2013/464921

Jackowski, S.A., et al. Oxidation levels of North American over-the-counter n-3 (omega-3) supplements and the influence of supplement formulation and delivery form on evaluation oxidative safety. J Nutr Sci. 2014; 4: e30. DOI: 10.1017/jns.2015.21

Rundblad, A., et al. High-quality fish oil has a more favourable effect than oxidized fish oil on intermediate-density lipoprotein and LDL subclasses: a randomized controlled trial . J Nutr Sci. 2017 May;117(9):1291-1298. DOI: 10.1017/S0007114517001167

Wang, W., et al. Chemistry and biology of ω-3 PUFA peroxidation-derived compounds. Prostaglandins Other Lipid Mediat. 2017 Sep;132:84-91. DOI: 10.1016/j.prostaglandins.2016.12.004

Food Sources for Omega-3 Dietitians of Canada. https://www.dietitians.ca/Your-Health/Nutrition-A-Z/Fat/Food-Sources-of-Omega-3-Fats.aspx. Accessed November 2017.

OMEGA-3 SUPPLEMENTS -

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Ultimately, the choice to get your omega 3s from supplements, food, or some combination of the two is yours to make and having the most up to date and accurate information at hand ensures you make the best choice possible for you and your health.

To supplement, or not to supplement: it’s at your discretion.

On the surface it makes perfect sense – In today’s busy world it’s hard to find the right foods and plan enough proper meals to ensure you’re getting your daily recommended intake of omega-3s. At least 2 to 3 servings of fatty fish per week are recommended for healthy individuals.

However, making sure you’re eating this recommended amount to get enough omega-3s probably doesn’t rank highly on your “To Do” list. A pre-measured, easy-to-take supplement such as fish oil presents a quick and simple solution to this problem.

But is taking an omega-3 fish oil supplement the same as eating that serving of fish?

The fine print.

A study done in 2003 at the University of Milan showed that when it comes to absorption into your body and cardiovascular health, you’re better off getting your omega-3s from fish rather than supplements. The study indicated that levels of EPA and DHA were higher in individuals that had been getting their omega-3s from salmon versus those that had been getting them from fish oil supplements. As a result, the omega-3s obtained from salmon appeared to be more effective than those from fish oil.

Other studies have shown that when omega-3s were obtained from supplements they had no effect on cardiovascular health or addressing certain cardiovascular diseases. More alarming, when it comes specifically to heart disease, a study done in 2005 in Cardiff University in Wales appeared to show some conflicting results for mortality.

On one hand, men recovering from a heart attack had a reduced mortality rate when they obtained omega-3s directly from fish or fish oil supplements, when compared to those who didn’t. On the other hand, men who had stable angina who took fish oil omega-3 supplements actually experienced an increased mortality rate. The study did indicate a need to explore this contradiction further.

Brain health doesn't seem to fare much better, with results from other studies suggesting that there is no significant effect on certain measurements of cognitive function or cognitive related diseases when omega-3 supplements were taken alone. One study did show that when omega-3s were taken along with vitamin B there were possibly some positive effects, although age group and/or history of disease seemed to play a role.

Why the variation?

At a first glance, it seems there are many other factors in play that might determine an omega-3 supplement's effectiveness, such as age, disease history, and other nutrients present. One other possible reason for these varied and sometimes conflicting results may be that the oxidation levels were not taken into account.

Fatty acids like omega-3s are very fragile and undergo oxidation when exposed to oxygen, which causes a loss of structure and effectiveness. Surprisingly, there are few studies that have explored oxidation in omega-3 supplements further and the supplement industry, in general, is not regulated well enough to consistently monitor and enforce oxidation levels.

More recently researchers have started to fill this gap, with two studies published in 2013 and 2014 showing that many omega-3 supplements on the market today contain higher than recommended oxidation levels. Oxidation can cause omega-3s to turn rancid, and it’s actually oxidized and rancid DHA and EPA that can cause the unwelcome “fishy” smell that is sometimes noticeably present with fish oil supplements.  

Some researchers have speculated that not only are oxidized omega-3 supplements ineffective but that they may also cause us harm.

The results of another recent study done in May 2017 at the Oslo and Akershus University College appeared to support the notion that oxidized omega-3 supplements were less effective when compared to non-oxidized supplements. More recently, study just published in September, 2017 from the University of Massachusetts concluded that when omega-3s become oxidized they can actually have a pro-inflammatory effect, which could be correlated with an increased risk of developing cancer.

So how should I get my omega-3s?

Based on the information available today the answer to the question - is taking an omega-3 fish oil supplement the same as eating a serving of fish? - appears to be no. There is much to consider and more research that needs to be done to determine the efficacy and, most importantly, the safety of omega-3 supplements, especially when taking them in place of natural sources.

But the fact remains that omega-3s are essential and you do need them. So if you are currently taking omega-3 supplements, here are some helpful tips to keep in mind:

• Always purchase omega-3 supplements from a trusted source. This goes for any supplement you take.
• Store them in a cool place, such as a refrigerator. This can help slow the rate of oxidization.
• Similarly, try to consume omega supplements within a few weeks of purchasing them. Avoid purchasing larger bottles or bulk quantities.

However, like most things, the best source of omega-3s is from foods where they naturally occur. Salmon, mackerel, cod, sardines, trout, tuna, arctic char, and halibut are some of the best sources of DHA and EPA.

If fish isn’t to your taste, many different beans (soy, navy), seeds (ground flax, chia) and nuts (walnuts, almonds) along with tofu and peas contain naturally occurring omega 3s in the form of ALA, which our bodies can turn into DHA and EPA. Increasingly, foods such as yogurt and eggs are also becoming fortified with added omega 3s. Along with getting your omega-3s, you also have the added benefit of  receiving the additional essential nutrients that many of these foods offer.

Ultimately, the choice to get your omega 3s from supplements, food, or some combination of the two is yours to make and having the most up to date and accurate information at hand ensures you make the best choice possible for you and your health.