Best Form of Omega 3 Supplement for Therapeutic Use

Charles Wispert
October 11, 2019

I recommend Omega 3 supplements for all my clients. I take 2000mg of omega 3s daily. I have some client on as much as 5 grams daily. There is overwhelming data to recommend a wide range of therapeutic uses for marine-derived omega-3 fatty acids primarily EPA and DHA. Likewise, there are also an overwhelming number of different forms, sources and ways to deliver these omega-3 fatty acids; which unfortunately, has led to confusion in product selection for both clinician and patient alike. We will walk through the most common issues discussed in selecting the appropriate omega-3 fatty acid product, with the goal to bring clarity to the decision-making process.

For the most part, the marine omega-3 fatty acid category is dominated by products that can be best described as “fish oil.” That is, while there are products available that deliver omega-3 fatty acids from other marine sources, nearly all the available research has been done with fish oil derived fatty acids. This fish oil data has become the benchmark for efficacy and safety, and is the standard to which we compare.

The following are the main sources of marine omega-3 fatty acids

1. Fish Body Oil: The largest biomass used to create marine-derived omega-3 fatty acids comes from small oily fish caught in the cold waters off the coast of Chile and Peru. The fish species most commonly used are mackerel, anchovies, and sardines. Concentrations of these purified oils are the most common therapeutic product used in dietary supplements and pharmaceutical products throughout the world. Other species used to produce fish oil may include salmon, tuna, menhaden, herring and other minor species.

2. Cod Liver: As a by-product of the cod meat market, cod liver can be used to provide a blend of fatty acids similar to un-concentrated fish body oil.

3. Krill: Small crustaceans which feed upon plankton and become feed for many marine mammals, especially whales. Krill is processed by factory ships immediately upon capture in the cold waters off the coast of Antarctica. Krill oil is fairly low in EPA and DHA, but contains small amount of the carotenoid astaxanthin.

4. Calamari: A recent, but small, player in omega-3 fatty acid industry is calamari or squid oil. This oil has a higher ratio of DHA over EPA than typical of fish. This oil is a byproduct of the calamari food industry.

5. Mussels: Shellfish are a very minor source of commercially available omega-3 fatty acids. Nonetheless, several products are currently available from the fatty acids derived from Green- Lipped Mussels (Perna canaliculus). The diverse fatty acid profile of these mussels includes EPA and DHA (in a ratio of about 65:35). Limited research has been done using products derived from mussels for traditional omega-3 related outcomes (mostly arthritis and inflammation studies).

6. Algae: Various species of algae are commercial sources for omega-3 fatty acids. These products are almost exclusively DHA. Most of the pure DHA raw materials, especially pure DHA used for addition to infant formula, comes from these algal sources.

Fatty Acid Forms and Structures

When fatty acids are harvested from their source, they are typically in the form of triglycerides (TG), phospholipids (PL) or free fatty acids (FFA). When these fatty acids are delivered as dietary supplements or pharmaceutical products they can be delivered as triglycerides (in a purified but un- concentrated form or a concentrated re-esterified form [rTG]), as ethyl-esters (EE), as free fatty acids (FFA), or as phospholipids. These differences may alter the bioavailability and, perhaps, the efficacy of the fatty acids used. The most beneficial and bioavailable supplement form according to most studies is the triglyceride form found in most pharmaceutical grade supplements. The form used in prescription fish oils is the less effective ethyl-ester form. This is also form found in most lower grade supplements.

Krill Oil vs. Fish Oil

In the past decade, the market has been flooded with information about the use of, and purported superiority of, omega-3 fatty acids from krill. These claims have primarily come from two properties of krill oil: that it is derived mostly of phospholipids (PL-as opposed to TG) and that it contains trace levels of astaxanthin--a bioactive carotenoid. To date there are no good long term studies that show superiority of one over the other. However, you need to take 14 krill oil tablets to equal the amount of omega-3 you can get from 2 potent fish oil tablets and therefore their low potency and relatively high cost make them a poor therapeutic substitute for the triglyceride form of fish oil.

The evidence is overwhelming for the positive benefits of supplementing with omega-s fatty acids. They can help reduce chronic inflammation and improve cardio metabolic biomarkers. The omega-3 fatty acids EPA and DHA can improve the omega-3 index. The omega-3 index is inversely related to cardiovascular events and mortality. The highest risk group is in subjects with an omega-3 index of less than 4%. For people with shell fish allergies or vegans/vegetarians they may want to consider the omega-3 from algae. Now you see why I recommend omega 3s for all my clients. I take 2 grams daily and I have some clients on 5 grams. There are some studies that show no benefit after 7grams. The omega 3 content of a supplement is not the same as the fish oil content. A supplement may contain 1000mg of fish oil but only 350 mg of omega 3. So make sure you are getting the adequate amount of Omega 3s (EPA and DHA). If you are interested in finding out more about your omega-3 levels or index. Schedule a visit or give me a call and we can run some labs.

Health and happiness,

Charlie