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What It Is:
EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are the two
principal fatty acids found in fish. They belong to a family of
essential nutrients 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 are thought to increase the risk of heart disease). The
body can manufacture both EPA and DHA from another essential fatty
acid, alpha-linolenic acid (ALA) -- found in flaxseed oil, canola oil,
soy oil and walnut oil -- but only to a limited extent. For more
information about ALA see the separate review covering ALA and GLA
products.
What It Does:
Cardiovascular Disease:
Omega-3 fatty acids have been most widely studied regarding their
effects on cardiovascular health. Increased consumption of fish oil
may help slow the progression of atherosclerosis, thereby preventing
heart attacks, and reduce the risk of sudden death due to cardiac
arrhythmias. The omega-3 fatty acids EPA and DHA have a number of
heart-healthy effects, including reducing triglyceride levels, raising
levels of HDL ("good") cholesterol and, possibly, "thinning" the
blood, reducing levels of homocysteine and reducing blood pressure.
Fish oils also appear to enhance the effectiveness of statin drugs
used to improve cholesterol profile. The U.S. Food and Drug
Administration (FDA) permits supplements containing omega-3 fatty
acids to state: "Sup****tive but not conclusive research shows that
consumption of EPA and DHA omega-3 fatty acids may reduce the risk of
coronary heart disease."
Arthritis and Other Inflammatory Diseases:
Increased intake of the omega-3 fatty acids in fish oil alter the
body's production of substances known as prostaglandins, and,
consequently, reduce some forms of inflammation. On the basis of this,
EPA and DHA have been tried in the treatment of symptoms of rheumatoid
arthritis with considerable success (especially in early stages of the
disease). Unlike "disease modifying" drugs, however, fish oil probably
doesn't slow the progression of the disease.
The anti-inflammatory effects of EPA and DHA have also caused
researchers to investigate possible benefits of fish oil for the
treatment of menstrual cramps, inflammatory bowel disease (ulcerative
colitis and Crohn's disease), lupus, and IgA nephropathy. For each of
these conditions, at least one double-blind study has found positive
results. However, in Crohn's disease, a trial of four grams per day of
omega-3 fatty acids (50-60% EPA and 15-25% DHA) was ineffective at
preventing relapses.
Psychiatric and Mental Disorders:
For reasons that are less clear, omega-3s seem to help depression,
bipolar disorder, and schizophrenia according to a limited number of
double-blind trials. The combination of EPA plus the prescription drug
fluoxetine (Prozac) was better than either EPA or fluoxetine alone for
treating major depression in a short-term (8-week) study of 60 people.
Fish oil has also been proposed for attention deficit disorder,
borderline personality disorder, dyslexia and cognitive impairment,
but as yet the sup****ting evidence for these uses remains
preliminary.
Other Diseases:
Other proposed uses of fish oils with some sup****t include asthma,
Raynaud's phenomenon (abnormal sensitivity of hands and feet to cold),
chronic fatigue syndrome, cystic fibrosis, osteo****osis, reducing the
risk of prostate and colorectal cancer and preventing weight loss
during cancer chemotherapy.
DHA is im****tant for normal development and functioning of the brain
and retina in the fetus and in infants. For this reason, it is thought
that pregnant or nursing mothers may benefit from supplementation. DHA
is also often added to formula for premature infants and some regular
infant formulas and foods. Omega-3's may also reduce the risk of
premature delivery in pregnant women.
The balance of current evidence suggests that fish oil is not
effective for migraine headaches, multiple sclerosis, psoriasis, male
infertility and enhancing immunity in people with HIV.
Pet Use:
Fish oil supplements are commonly given to pets to help maintain their
coats and skin. [Reviews of other pet supplements by ConsumerLab.com
include ALA and GLA, Joint Supplements and Multivitamins/
Multiminerals.]
For information on dosages see What to Consider When Using.
Quality Concerns and What CL Tested for:
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
ac***ulate toxins such as mercury, dioxins, and PCBs. Mercury can
damage the nervous system -- particularly in a fetus. Dioxins and
polychlorinated biphenyls (PCBs) may be carcinogens at low levels of
exposure over time and may have other deleterious effects. The
freshness of the oil is also an im****tant consideration because rancid
fish oils have an extremely unpleasant odor and may not be as
effective. Additionally, some capsules are enteric-coated and are
expected to release the oil after the stomach to theoretically reduce
fishy breath odor. If they release too soon they lose that potential
benefit. If they release too late, the oil may not get absorbed.
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 omega-3 fatty acids (EPA, DHA
and, if listed, ALA), mercury, lead, PCBs, and signs of decomposition.
Enteric-coated capsules were tested to see if they properly released
their ingredients. Some of the products were additionally tested for
dioxins at the request of their manufacturers. Among the products
purchased and tested, the majority was for use by people and a few
were for use by pets. Most of the supplements were softgel capsules
but some were liquids and one came in packet form. A variety of
fortified foods and beverages were also tested.
What CL Found:
Tests of omega-3 fatty acid supplements showed that all were fresh and
contained their claimed amounts of EPA and DHA -- key omega-3 fatty
acids. However, the following two products failed to pass all tests:
Kirkland Signature Enteric Coated Fish Oil 1700 mg Concentrated Fish
Oil, released ingredient too quickly for an enteric coated supplement.
Four of six capsules released fish oil during the disintegration
testing in simulated gastric fluid, suggesting that the product may
not provide the benefit of reducing fishy breath.
Lipiderm International Veterinary Sciences Small & Medium Dogs
provided the labeled amounts of EPA and DHA but only 25% of its
claimed amount of the omega-3 fatty acid ALA. It was also found to
contain much more omega-6 fatty acid LA (linoleic acid) than clamed --
593% of the claimed amount.
Labels on several fortified foods or beverages (Tropicana with
Omega-3, Silk Soymilk Plus Omega-3 DHA, Yoplait Kids Yogurt with DHA,
and the Aristo nutrition bar) stated that they supplied certain
percentages of the "Daily Value" of 160 mg for EPA and DHA. However,
these statements are incorrect. A Daily Value has not been established
for EPA and/or DHA. Silk Soymilk Plus Omega-3 DHA also touted "400 mg
beneficial Omega-3" above its Nutrition Facts panel, but only at the
bottom of the other side of the carton did it note, in tiny letters,
that just 32 mg of the total omega-3 is DHA. Testing found the
remainder to be ALA.
None of the products were found to contain detectable levels of
mercury [over 10 ppb (parts per billion) ]. 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). In addition, none of the products
contained unsafe levels of lead or PCBs. PCBs have been found in
several fish including farm-raised salmon. Several of the products
(footnoted below with a "D "in the "Purity" column) were additionally
tested for dioxins, which can be found in some fish. However, none of
these supplements contained unsafe levels of dioxins. (See Testing
Methods and Passing Score for more information about how products were
evaluated.)
There are several possible explanations for the lack of contaminants
found in the supplements: the use of species of fish that are less
likely to ac***ulate mercury; the fact that most mercury is found in
fish meat and not fish oil; and distillation processes used in
processing fish oil that can remove contaminants.
None of the products showed signs of spoilage -- although spoilage may
occur, particularly after products are opened and exposed to air (see
Keeping It Fresh for storage tips).
Test Results by Product:
Listed alphabetically below are the test results for 49 supplements,
foods or beverages containing omega-3 fatty acids. Twenty-three were
selected by ConsumerLab.com and twenty-six others (each indicated with
an asterisk) were tested at the request of their manufacturers/
distributors through CL's Voluntary Certification Program. Also listed
are seven products similar to ones that passed testing but sold under
different brand names.
The full list of ingredients is available for each product by clicking
on the word "Ingredients" in the first column. All "Approved" products
met their label claims for omega-3's, lacked contamination by mercury,
lead and PCBs, and, if labeled as "enteric coated," passed the
relevant USP disintegration testing. Several of the products (each
indicated with a "D" in the second to last column) also passed
optional dioxin testing undertaken at the request of their
manufacturer/distributor.
RESULTS OF CONSUMERLAB.COM TESTING OF OMEGA-3 SUPPLEMENTS
Advocare OmegaPlex Omega-3 Fatty Acid (300 mg EPA and 200 mg DHA per
softgel, 4 per day)
Ingredients Dist. by Advocare EPA: 1200
DHA: 800
APPROVED
Berkley & Jensen Natural Extra Strength Fish Oil 1200 mg with Omega-3
fatty acids (216 mg EPA and 144 mg of DHA per softgel, 2-4 per day)
Ingredients Dist. BJWC [BJ's Wholesale Club] EPA: 432-864
DHA: 288-576
APPROVED
Carlson Super Omega-3 Fish Oil Concentrate 500 mg EPA & DHA (300 mg of
EPA and 200 mg of DHA per softgel, 1 per day)*
Ingredients
Dist. by J.R. Carlson Laboratories, Inc. EPA: 300
DHA: 200
APPROVED
CVS Pharmacy Natural Fish Oil Concentrate 1000 mg ( 180 mg EPA and 120
mg of DHA per softgel, 3 per day)
Ingredients Dist. by CVS EPA: 540
DHA: 360
APPROVED
Eniva Nutraceutics Efacor (Natural Omega-3 Essential Fatty Acids)
Concentrated EPA and DHA (340 mg of EPA and 170 mg DHA per softgel, 2
per day)*
Ingredients Dist. by Eniva Cor****ation EPA: 680
DHA: 340
APPROVED
GNC Fish Body Oils 1000 (180 mg of EPA and 120 mg DHA per softgel, 3-6
per day)*
Ingredients
Dist. by General Nutrition Corp. EPA: 540-1080
DHA: 360-720
APPROVED
Health from the Sea PFO Pure Fish Oil Natural Juicy Orange Flavor (180
mg EPA and 120 mg DHA per softgel, 1-3 per day)*
Ingredients Dist. by Arkopharma EPA: 180-540
DHA: 120-360
APPROVED
Iceland Health Omega- 1000 mg (300 mg EPA and 200 mg DHA per softgel,
1 per day)*
Ingredients Dist. by Nutrition 21 EPA: 300
DHA: 200
APPROVED
Integrative Therapeutics, Inc. Tyler Eskimo-3 Natural Stable Fish Oil
Supplement (70 to 90 mg EPA and 43 to 58 mg DHA per softgel, 3-9 per
day)
Ingredients Mfd. by Cardinova International EPA: 210-810
DHA: 129-522
APPROVED
Jarrow Formulas Max DHA 600 mg Omega-3 per gram 420 DHA per gram (36
mg EPA and 250 mg DHA per softgel, 1-6 per day)1*
Ingredients
Dist. by Jarrow Formulas EPA: 36-216
DHA: 250-1500
APPROVED
Master Omega-3 Natural lemon Flavoring 1200 mg Omega-3 (EPA/DHA) in
just 2 softgels (360 mg EPA and 240 mg DHA per softgel, 2 per day)
Ingredients Dist. by. Great American Products EPA: 720
DHA: 480
APPROVED
Mega Smarts for Kids Omega-3 (54 mg EPA and 37 mg DHA per softgel, 2
per day for children 5 - 12 years of age)
Ingredients Dist. by Medexus USA Inc. EPA: 108
DHA: 74
APPROVED
Minami Nutrition MorDHA OMEGA-3-I.Q.High DHA Formula + Lemon Flavor
(64 mg EPA and 465 mg DHA per softgel, 1 per day)
Ingredients
Dist. by Minami Nutrition Inc. EPA: 64
DHA: 465
APPROVED
Mommy's Bliss Omega-3 DHA Plus (100 mg EPA and 250 mg DHA per softgel,
1 per day)
Ingredients
Dist. by Bliss by Mom EPA: 100
DHA: 250
APPROVED
Natural Factors RxOmega-3 Factors Pharmaceutical Grade EPA 400mg/DHA
200 mg (400 mg EPA and 200 mg DHA per softgel, 1-3 per day)
Ingredients
Mfd. by Natural Factors, Canada EPA: 400-1200
DHA: 200-600
APPROVED
Nature Made Omega-3 Fish Oil 1200 mg (216 mg EPA and 144 mg DHA per
softgel, 2-4 per day)*
Ingredients
Dist. by Nature Made Nutritional Products EPA: 432-864
DHA: 288-576
APPROVED
Nature's Bounty Omega-3/Omega-6 Fish Oil 1200 mg (216 mg EPA and 144
mg DHA per softgel, 3 per day)*
Ingredients
Mfd. by Nature's Bounty, Inc EPA: 648
DHA: 432
APPROVED
Nature's Sun****ne Super Omega 3 EPA (380 mg EPA and 190 mg DHA per
softgel, 2-3 per day)*
Ingredients Dist. by Nature's Sun****ne Products, Inc. EPA: 760-1140
DHA: 380-570
APPROVED
New Chapter Supercritical DHA 100 (100 mg DHA per softgel, 1 per day)*
Ingredients
Dist. by New Chapter, Inc EPA: Listed as part of 50 mg of other
omega-3's.
Found: 36 mg EPA.
DHA: 100
APPROVED
D
Nordic Naturals Omega-3 Purified Fish Oil (165 mg EPA and 110 mg DHA
per softgel, 2 per day)*
Ingredients
Mfd. by Nordic Naturals EPA: 330
DHA: 220
APPROVED
D
Now Omega-3 180 EPA/120 DHA (180 mg EPA and 120 mg DHA per softgel,
2-6 per day)
Ingredients
Mfd. by Now foods EPA: 360-1080
DHA: 240-720
APPROVED
Nutramax Laboratories, Inc OmegaMint (155 mg EPA and 103 mg DHA per
softgel, 2-4 per day)*
Ingredients Dist. by Nutramax Laboratories, Inc. EPA: 310-620
DHA: 206-412
APPROVED
D
Nutri-Supreme Research Omega 3 EPA/DHA Fish Oil 1000 mg (158 mg EPA
and 122 mg DHA per softgel, 4 per day)
Ingredients Dist. by Nutri-Supreme EPA: 632
DHA: 488
APPROVED
OmegaBrite (350 mg EPA and 50 mg DHA per softgel, 3 per day)*
Ingredients Dist. by OmegaBrite EPA: 1050
DHA: 150
APPROVED
D
OmegaGel Concentrate High Potency Omega-3 (400 mg EPA and 200 mg DHA
per softgel, 1 per day)*
Ingredients Mfd. by Gel-Tec Division of Tishcon Corp. EPA: 400
DHA: 200
APPROVED
Origin Natural Fish Oil Omega-3 1200 mg (216 mg EPA and 144 mg DHA per
softgel, 3 per day)
Ingredients Dist. by Target Cor****ation EPA: 648
DHA: 432
APPROVED
Pharmanex MarineOmega (150 mg EPA and 100 mg DHA per softgel, 4 per
day)*
Ingredients Dist. by Nu Skin Enterprises EPA: 600
DHA: 400
APPROVED
Pure Encapsulations EPA/DHA essentials (300 mg EPA and 200 mg DHA per
softgel, 2 per day)*
Ingredients
Dist. by Pure Encapsulations EPA: 600
DHA: 400
APPROVED
Shaklee Omega Guard (181.7 mg EPA and 120 mg DHA per softgel, 3-6 per
day)
Ingredients Dist. by Shaklee EPA: 545 -1090
DHA: 360-720
APPROVED
Sundown Cholesterol Free Fish Oil 1000 mg (180 mg EPA and 120 mg DHA
per softgel, 3 per day)*
Ingredients
Mfd. by Sundown, Inc. EPA: 540
DHA: 360
APPROVED
Swanson EFA's Superior Essential Fatty acids ecOmega Super EPA (300 mg
EPA and 200 mg DHA per softgel, 1 per day)*
Ingredients Dist. by Swanson EPA: 300
DHA: 200
APPROVED
Twinlab Omega-3 Fish oil (234 mg EPA and 156 mg DHA per softgel, 3 per
day)*
Ingredients
Dist. by Ideashpere, Inc. EPA: 702
DHA: 468
APPROVED
USANA Biomega (290 mg EPA and 235 mg DHA per softgel, 2 per day)*
Ingredients Dist. by USANA Health Sciences, Inc. EPA: 580
DHA: 470
APPROVED
Vitamin World Triple Omega 3-6-9 Flax, Fish and Borage Oils (120 mg
EPA and 80 mg DHA per softgel, 3 per day)*
Ingredients
Mfd. by Vitamin World, Inc. EPA: 360
DHA: 240
APPROVED
Weil -- Andrew Weil, M.D. Omega-3 Complex (333 mg of EPA and 167 mg
DHA per softgel, 1 per day)*
Ingredients
Mfd. by Ideasphere EPA: 333
DHA: 167
APPROVED
Similar to Approved Regular Softgels:**
Nature's Bounty Omega-3 Fish Oil 1000 mg (180 mg EPA and 120 mg DHA
per softgel, 3 per day)*
Ingredients
Mfd. by Nature's Bounty, Inc EPA: 540
DHA: 360
Similar to: Sundown Cholesterol Free Fish Oil 1000 mg
PharmAssure Fish Oil Omega-3 Fatty Acid 1000 mg (180 mg of EPA and 120
mg DHA per softgel, 3-6 per day)
Ingredients
Dist. by PharmAssure, Inc. EPA: 540-1080
DHA: 360-720
Similar to: GNC Fish Body Oils 1000
Puritan's Pride Cholesterol Free Natural Omega-3 Fish Oil 1000 mg (180
mg EPA and 120 mg DHA per softgel, 3 per day)
Ingredients
Mfd. by Puritan's Pride, Inc EPA: 540
DHA: 360
Similar to: Sundown Cholesterol Free Fish Oil 1000 mg
Puritan's Pride Omega-3 Fish Oil 1200 mg (216 mg EPA and 144 mg DHA
per softgel, 3 per day)
Ingredients
Mfd. by Puritan's Pride, Inc. EPA: 648
DHA: 432
Similar to: Nature's Bounty Omega-3/Omega-6 Fish Oil 1200 mg
Puritan's Pride Triple Omega 3-6-9 Flax, Fish and Borage Oils (120 mg
EPA and 80 mg DHA per softgel, 3 per day)
Ingredients
Mfd. by Puritan's Pride, Inc. EPA: 360
DHA: 240
Similar to: Vitamin World Triple Omega 3-6-9 Flax, Fish and Borage
Oils
Vitamin World Naturally Inspired Omega-3 Fish Oil 1000 mg Cholesterol
Free (180 mg EPA and 120 mg DHA per softgel, 3 per day)
Ingredients
Mfd. by Vitamin World, Inc. EPA: 540
DHA: 360
Similar to: Sundown Cholesterol Free Fish Oil 1000 mg
Vitamin World Naturally Inspired Omega-3 Fish Oil 1200 mg (216 mg EPA
and 144 mg DHA per softgel, 3 per day)
Ingredients
Mfd. by Vitamin World, Inc. EPA: 648
DHA: 432
Similar to: Nature's Bounty Omega-3/Omega-6 Fish Oil 1200 mg
Enteric Coated Softgels:
Kirkland Signature Enteric Coated Fish Oil 1700 mg Concentrated Fish
Oil with 880 mg Omega-3 Fatty Acids per serving (240 mg EPA and 200 mg
DHA per enteric coated softgel, 2 per day)
Ingredients Dist. by Costco EPA: 480
DHA: 400
NOT
APPROVED
Failed enteric-coating test but contained listed EPA and DHA
Spring Valley Enteric Coated Omega-3 Fish Oil 1200 mg (216 mg EPA and
144 mg DHA per enteric coated softgel, 2-4 per day)
Ingredients Dist. by Leiner Health Products, LLC EPA: 432-864
DHA: 288-576
APPROVED
VitalOils 1000 Ultra High Potency Omega-3 Fish Oil (250 mg EPA and 750
mg DHA per enteric coated softgel, 1 per day)
Ingredients Dist. by Vital Remedy MD, Inc. EPA: 250
DHA: 750
APPROVED
Liquids (Bottles and Packets):
Carlson Norwegian Cod Liver Oil (360-500 mg of EPA and 500-590 mg of
DHA per 1 tsp, 1 per day)*
Ingredients
Dist. by J.R. Carlson Laboratories, Inc. EPA: 360-500
DHA: 500-590
APPROVED
Carlson The Very Finest Fish Oil (800 mg of EPA and 500 mg of DHA per
1 tsp, 1-2 per day)*
Ingredients
Dist. by J.R. Carlson Laboratories, Inc. EPA: 800-1600
DHA: 500-1000
APPROVED
Coromega Omega-3 Orange Flavor (350 mg of EPA and 230 mg of DHA per
packet, 1 per day)*
Ingredients
Mfd. by The Coromega Company, Inc. EPA: 350
DHA: 230
APPROVED
D
Vitamin Shoppe Omega-3 Fish Oil Lemon Lime Flavor (735 mg EPA and 480
mg DHA per 1 tsp, 1 per day)*
Ingredients Dist. by The Vitamin Shoppe EPA: 735
DHA: 480
APPROVED
Fortified Foods and Beverages:
aristo body + mind Wellness Nutrition Bar 100 mg Omega-3's Goji Berry
& Orange (100 mg combined EPA and DHA per bar, 1 per day)
Ingredients Dist. by Aristo Health, Inc. 100 mg combined EPA & DHA
Found:
EPA: 55%
DHA: 45%
APPROVED
NA
Silk Soymilk Plus Omega-3 DHA (32 mg DHA per 1 cup, 1 per day)
Ingredients Dist. by WhiteWave Foods EPA: NL
DHA: 32
APPROVED
NA
Tropicana Pure Premium Healthy Heart with Omega-3 100% Pure Orange
Juice with Omega-3 (50 mg combined EPA and DHA per 8 oz, 1 per day)
Ingredients Dist. by Tropicana 50 mg combined EPA & DHA
Found:
EPA: 55%
DHA: 45%
APPROVED
NA
Wegmans Twelve Grain Bread with Omega-3s (45 mg combined EPA and DHA
per slice, 2 slices)
Ingredients Dist. by Wegmans Food Market, Inc. 90 mg combined EPA &
DHA
Found:
EPA: 55%
DHA: 45%
APPROVED
NA
Yoplait Kids Strawberry Vanilla Yogurt with DHA (16 mg DHA per
container, 1 per day)
Ingredients Dist. by Yoplait USA, Inc. EPA: NL
DHA: 16
APPROVED
NA
Pet Supplements:
Lipiderm International Veterinary Sciences Small & Medium Dogs (73.1
mg EPA and 52.2 mg DHA per softgel, 1 to 4 per day)2
Ingredients Dist. by International Veterinary Sciences, Div. of
Micelle Products, Inc EPA: 73.1
DHA: 52.2
(per softgel)
NOT
APPROVED
Met claims for EPA and DHA but contained only 25% of ALA; 593% of
linoleic acid.
Healthy Hide Omega-3 Daily Chewable Treats for Dogs with Natural Fish
Oils (90 mg EPA and 60 mg DHA per treat, 1 to 4 per day)3
Ingredients Dist. by Salix, LLC EPA: 90
DHA: 60 (per treat)
APPROVED
NA
NL - Not Listed
* Tested through CL's Voluntary Certification Program prior to, at
time of, or after initial posting of this Product Review.
** Product identical in formulation and manufacture to a product that
has passed testing but sold under a different brand. For more
information see CL's Multi-Label Testing Program.
D - Product participated in optional dioxin testing at the request of
its manufacturer/distributor through CL's Voluntary Certification
Program and met WHO (World Health Organization) recommendations for
dioxins.
1 For adults suggested serving size is 1-2 softgels with each meal;
for pregnancy or lactation: 1 to 2 softgels per day; for children: 1
softgel per day.
2 Dogs: 1-15 lbs. 1, 16-30 lbs 2, 31-70 lbs 2-3, over 70 lbs 3-4. Cats:
1-15 lbs. 1, 16-30 lbs 2.
3 1 per day for 15 lbs; 2 per day for 15-30 lbs; 3 per day for 30-60
lbs; 4 per day for 60 and over.
Unless otherwise noted, information about the products listed above is
based on the samples purchased by ConsumerLab.com (CL). Manufacturers
may change ingredients and label 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 in this re****t,
it may not be the same as what was tested.
The information contained in this re****t is based on the compilation
and review of information from product labeling and analytical
testing. CL applies what it believes to be the most appropriate
testing methods and standards. The information in this re****t does not
reflect the opinion or recommendation of CL, its officers or
employees. CL cannot assure the accuracy of information provided to it
by third parties. Liability to any person for any loss or damage
caused by errors, omissions, or inaccuracies in this re****t is hereby
disclaimed.
Copyright ConsumerLab.com, LLC, 2008. All rights reserved. Not to be
reproduced, excerpted, or cited in any fa****on 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. Be aware that only about a third of the oil from fish is EPA
and DHA, although a "concentrated" product may contain twice or more
of that amount as EPA and DHA. Second, the ratio of EPA to DHA will
vary. Products made from menhaden and other small oily fish, for
example, tend to have a ratio of EPA to DHA of 1.5:1 so that a capsule
claiming 1 gram (1,000 mg) of fish oil, of which 30% is EPA and DHA,
provides 180 mg of EPA and 120 mg of DHA. Salmon oil naturally
contains more DHA than EPA (often several times more) 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 as the natural
("triacylglycerol") forms -- although a preliminary study in rats
suggests that their actions may not be identical.
Many products also contain vitamin E or other antioxidants to
stabilize the oils and prevent them 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.
Enteric-coated pills:
Some fish oils come in enteric-coated pills, designed to release the
oils in the intestine rather than the stomach -- to help avoid fishy
aftertaste or fishy smelling burps. While oils are not absorbed in the
stomach, they do get emulsified there -- made into smaller droplets --
so they can be more effectively acted on by pancreatic lipase (an
enzyme) and absorbed in the small intestine. If this doesn't happen,
less oil may be absorbed. So while enteric-coated pills may be fine,
if you notice more oily stools, this would be an indication that the
oils are not being well absorbed. Also be aware that some of these
enteric coatings are made with acrylics (such as methacrylic acid
copolymer) that don't break down -- they are like thin latex balloons
intended to pop open under specific conditions. You might find remains
of these pills in your stool, but there is no reason to be concerned.
Unfortunately, as we found in this review, at least one enteric coated
product failed to pass testing by releasing too early.
Getting EPA and DHA From Food:
You may 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. For people
with heart disease or cardiac risk factors, some experts recommend
eating four 3-ounce servings of fatty 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
White Tuna (Albacore) **
Whitefish
Source: U.S. Department of Agriculture, Agricultural Research Service.
2001.
* Farmed salmon may contain more PCBs than other salmon.
** May contain an excessive amount of mercury.
Total amounts of omega-3's vary among fish, but ones listed above are
all good sources. A three-ounce serving (half a can) of canned
albacore "white" tuna, for example, contains about 2.5 grams of fat,
about 30% of which is EPA (200 mg) and DHA (500 mg). "Light" tuna,
contains less than half the omega-3 oils of "white" tuna. A three-
ounce serving of canned salmon contains about 4.5 grams of fat of
which 17% is EPA (166 mg) and DHA (587 mg).
Levels of pollutants, such as mercury, tend to be higher in long-
lived, larger fish, particularly shark, swordfish, king mackerel, and
tilefish. These fish tend to 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. 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." The same limit
is recommended for albacore ("white") tuna, as it may occasionally
contain excessive levels of mercury. A recent study has also shown
that some farm-raised salmon contain higher levels of PCBs than wild
salmon.
If you are concerned about mercury and other potential contaminants,
concentrated fish oil products may be a better choice, provided that
they contain the claimed amount of oils and meet other quality
parameters tested for in this review.
Eggs fortified with DHA are also available in the U.S. and claim to
contain about 150 mg of DHA in each egg. Chickens producing these
eggs are typically fed algal DHA. Algal DHA is also an approved food
ingredient, so that foods and beverages can be fortified with DHA and
be considered vegetarian. Because some formula-fed infants may not be
converting enough ALA to DHA, some formulas are also available with
DHA -- which has been added to formulas for premature infants for many
years.
Amounts of EPA and/or DHA in other fortified foods and beverages, such
as those tested in this review, tend to be about 50 to 100 mg per
serving -- much lower than that found in a serving of fish or in a
traditional fish oil supplement. While omega-3 fortified products can
contribute to your intake of these fatty acids, they are typically not
sufficient in themselves to provide the full generally recommended
amounts of EPA or DHA.
Omega-3 vs. Omega-6 Fatty Acids:
Some experts suggest that the American diet contains too little
omega-3 fatty acids and too much of another essential fatty acid
family called the omega-6 fatty acids. Omega-6's are found in oils
from corn, sunflower, soy, peanut and other plants. The typical 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);
these experts suggest that a ratio of no more than 3:1 (3 grams of
omega-6's for every 1 gram of omega-3) may be preferable. However, the
evidence for this recommendation is sketchy at best.
What to Consider When Using:
Dosage:
In the U.S., there is no official recommended intake for EPA and DHA
in healthy people. However, some other countries recommend from 300
mg to 500 mg per day of a combination of EPA and DHA. This is roughly
equivalent, if not greater than, the amount of omega-3's obtained from
two servings of fish per week, as suggested by the American Heart
Association (See Getting EPA and DHA from Food ).
A typical dose of fish oil for specific therapeutic uses is 6-12 grams
daily. However, as noted above, EPA and DHA represent only part of the
total oil in fish and their levels vary among products. For most
therapeutic uses of omega-3s, the daily dosage of total EPA and DHA
tested in studies has ranged from 1-6 grams daily. Higher dosages have
been tried by some researchers, especially for the treatment of
schizophrenia, Raynaud's phenomenon, and lupus.
The American Heart Association 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. As little as one gram daily of combined EPA and DHA
may be adequate for reducing risk of a recurrent heart attack.
For pregnant and nursing women, the recommended dose of DHA, from
either supplements or fish, is 100 to 200 mg per day.
For depression, 1 gram per day of EPA together with the prescription
drug fluoxetine (Prozac=C2=AE) appears to be more effective than either
EPA or fluoxetine alone.
Fish oils are best tolerated when taken with meals, and, if possible,
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.
Keep It Fresh:
Omega-3 fatty acids can spoil, so it is best to keep products out of
heat and light. Once opened, tightly reseal the container. If
possible, refrigeration can help prolong freshness and is particularly
im****tant with bottled liquids. A slight cloudy appearance of the oil
is normal after refrigeration -- just shake the bottle before use. If
you use a bottled liquid, purchase a size that you will completely use
within a few weeks because once air is introduced into the bottle,
spoilage may begin.
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.
However, such high amounts may not be beneficial and the FDA
recommends that consumers not exceed more than a total of 3 grams per
day of EPA and DHA omega-3 fatty acids, with no more than 2 grams per
day from a dietary supplement.
Be aware that cod liver oil is not always a good substitute for fish
oil supplements as it may be 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).
The only significant safety concerns regarding fish oil involve its
apparent "blood thinning" effect. On this basis, fish oil should be
used only under a physician's care by people with bleeding disorders
such as hemophilia, those taking strong prescription blood thinners,
such as Coumadin (warfarin) or heparin, and those expecting to undergo
surgery.
If you take blood pressure lowering medication, be aware that fish oil
may further lower blood pressure.
High doses (over 3 grams per day) of fish oil may suppress the immune
system. Unless medically necessary, such doses should be avoided,
particularly by immunocompromised individuals.
Contrary to earlier re****ts, fish oil does not appear to adversely
affect blood sugar levels in people with diabetes.
See the Encyclopedia for more information about clinical studies on
Fish and Marine Oil (Omega-3).
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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