In part 1 we looked at the importance of Omega 3 essential fatty acids, and how best to increase our intake of these vital nutrients.
Although there are a number of dietary changes we can make, for the vast majority of us this simply won’t provide us with an adequate supply. This is one of the few cases where supplementing really is essential to health. In this post we’re going to focus on what to look for in a good supplement.
Before we begin, a quick note: there are many cheap Omega 3 supplements available in supermarkets, and some people will decide to get those to save money because “at least it will do something”. However, it’s important to realise that when it comes to Omega 3, poor quality supplements are at best useless and at worst harmful. Buying something that doesn’t work because it’s cheaper isn’t saving money, it’s wasting money. Poor quality supplements are like cardboard shoes – you wouldn’t buy them just because they were 50p a pair! Instead, first find the ones which will actually provide you with a benefit, then let the price help you to narrow it down from there.
Choosing a supplement
Firstly, there are two common types of Omega 3 supplement: cod liver oil and fish oil. Cod liver oil contains lower amounts of Omega 3, but also contains vitamins A and D (be aware not enough vitamin D to replace a Vitamin D supplement – more on this in a future post). Fish oil has more Omega 3 but no Vitamin A and D. Consider alternating with both – we suggest one day of cod liver oil for every 2 days of fish oil.
Both cod liver oil and fish oil supplements can be found either in capsule form or in oil form. Theoretically, capsules should preserve the oil turning rancid as they are airtight. However, this depends largely on how well the oil is preserved before being placed into the capsules. Also, many people find mixing a liquid form into food easier (particularly for infants and young children), so your choice will be based on personal preference. Good quality liquid oils will be vacuum sealed so won’t turn bafd whilst packaged, but once you open them they need to be kept refrigerated and will usually spoil after one month (you’ll be able to smell this quite easily!). As a precaution we would recommend always keeping your supplement in the fridge, even if in capsule form. If you are concerned about not being able to use the oils before they expire, you can always freeze some to prolong their shelf life.
Regarding Vitamin A – in the past concerns were raised about the possibility of overdosing on Vitamin A from cod liver oil supplements, leading some to advise only taking fish oil. However this research was performed using the synthetic form, not it’s natural form. Subsequent studies have shown that this concern does not apply to the natural form – you would have to take several times the recommended doses for a sustained period to come anywhere close to dangerous Vitamin A levels. So make sure to look for naturally sourced cod liver oil.
Once you have decided which oil you prefer, judge the supplement on the following criteria:
1 – Does it contain EPA and DHA in their naturally occurring ratio?
These are the two important types of Omega 3: DHA and EPA. They naturally in a ratio of between 4:3 and 3:2 DHA to EPA. Look for supplements which maintain this ratio to make sure you get enough of both.
2 – Are they in their natural form?
EPA and DHA occur naturally in “triglyceride” form – they are formed by three fatty acid chains attached to a glycerol “backbone”. However some manufacturers use synthetic “Ethyl Ester” form – artificial Omega 3 with an ethanol backbone. These are not absorbed nearly as well and should be avoided. In our experience if a supplement does not state it is in the natural triglyceride form it probably isn’t. But if you are unsure then contact the manufacturer to confirm.
3 – Are they free of contaminants?
As both fish oil and cod liver oil are sourced from ocean fish, there is a risk of mercury, PCB’s and other contaminants accumulating in the oil. Look for supplements which are “third party tested”, meaning they send their supplements to an independent lab to test their quality.
4 – Are they properly preserved?
Omega 3 oils will gradually turn rancid when exposed to oxygen, and quality standards vary hugely between different manufacturers. These “oxidised” oils actually increase inflammation – taking supplements like this is actually harmful! Third party testing can also look for this, but a “quick and simple” test is to just smell the oil (you can cut the capsule open with scissors for this). If it smells like gone-off fish, it’s oxidised and shouldn’t be taken. However it is normal for it to smell a bit fishy, especially if the capsule is formed from natural fish gelatin. Beware that some manufacturers will include flavourings in their supplements – although this helps prevent the oil “repeating” on some people later, very strong smells may be trying to mask a rancid oil!
5 – How is the oil extracted?
Cheaper supplements typically use heat to extract the oil, which breaks down a lot of the Omega 3 and other nutrients. Similar to oxidised oil, these can be harmful to your health and result in an unpleasant smelling oil. “Molecular distillation” or “Cold distillation” methods are preferable, and these preserve the Omega 3 in their whole form. You may need to contact the supplier or manufacturer as not all of them will specify this on the packaging.
6 – Are they from wild or farmed fish?
Farmed fish have naturally lower levels of Omega 3, higher levels of Omega 6, and higher levels of contaminants. Wild caught fish are preferable, although proper processing and third party testing should ensure the fish are contaminant free.
At the Sevenoaks and Beckenham Chiropractic Clinics we recommend only using supplements which satisfy all of the above criteria. Products which don’t meet these standards will likely be at best a complete waste of money, and at worst harmful.
Taking Omega 3 supplements
As well as your choice of supplement, when you take it will also have an effect on whether you’re actually getting all the health benefits of Omega 3. The Omega 3 nutrients are “fat-soluble”, meaning they dissolve in fat not water. Because of this, taking these supplements on an empty stomach means that you won’t actually absorb most of them. Instead, you should take them with a meal which includes some healthy fats to increase their absorption. Some research suggests you will absorb as much as 8 times more Omega 3 as compared to on an empty stomach!
How much should I take?
Calculating appropriate Omega 3 intake is a very difficult thing to do – working out your optimal personal needs for supplement dosage can take some complex mathematics. Fortunately, we have created an easy to use spreadsheet which you can download at the end of this post.
However, you will still need a rough idea of your Omega 6 intake to get an accurate measure – make sure to read the previous article first before using the spreadsheet. It’s also worth factoring in that portions of oily fish can count towards your daily intake. This site give a full breakdown of the EPA and DHA content of different seafoods.
If you just want to get a quick idea of the recommended dose for you, you can use the spreadsheet mentioned above.
If you’re interested in how this is worked out then the calculations are included below. But first make sure you have a rough idea of your Omega 6 intake. Remember, the ratio of Omega 6 to 3 is the important part. Someone eating a typical UK diet has a ratio of 20:1 Omega 6 to 3, and needs roughly the following amount of Omega 3 daily to achieve a healthy balance:
370mg EPA and 240mg DHA per 40 lbs (18kg) of body weight
So a 160lbs person would require 1480 EPA and 960 DHA per day. For most Omega 3 capsules, this equates to between 5 and 8 per day. But bear in mind that oily fish can contribute towards this. For example a 100g serving of wild (not farmed) Atlantic salmon contains approximately 1500mg EPA and 700mg DHA – pretty close to the full daily intake for a 160lb person.
However, if you cook your own food from fresh, rarely eat out, use healthy cooking oils (for example coconut oil, olive oil or avocado oil), and eat healthy grass fed meat, after 3-6 months your Omega 6 to 3 ratio will likely be closer to 6:1 – not perfect, but a lot better. It takes 3-6 months for these levels to fall as Omega 6 is stored in body fat, so we can only get rid of it slowly. After 3-6 months of cutting down on Omega 6, you can safely cut your Omega 3 intake by half to two thirds of the previous recommendation:
120-185mg EPA and 80-120mg DHA per 40lbs (18kg) of body weight
At that point, one portion of wild Atlantic salmon provides close to 3 days worth of Omega 3. This is where the recommendation of “2 portions of oily fish per week” comes from – but it assumes you have already significantly cut down your Omega 6 intake and that you are sourcing high quality (not farmed) varieties of fish.
The big take-away from all this is that if you want to save money on Omega 3 supplements, the most effective long term strategy is to cut down on Omega 6 – over time you will only need to spend a third of what you would otherwise need. This way you will probably spend the same amount as someone buying cheap poor quality supplements, and except yours will actually work!
The two main sources are Cod Liver Oil and Fish Oil. They both have their own strengths and weaknesses, so it’s often a good idea to alternate between them.
Omega 3 supplements can vary wildly in quality, with cheaper oils often having the opposite effects to proper good quality oils. See below for our recommended brand
Make sure to take the supplement with a meal containing some (healthy) fat.
Calculating your dose can be difficult, and requires an understanding of your Omega 6 intake. Read [this post] first.
Download our “dose calculator” spreadsheet. All you need are your weight, and the EPA and DHA content of your chosen supplement (found on the packaging)
From our investigations into the quality of different supplements, the fish oil brand we recommend is Aliment Omega 3 Plus Finest Fish Oil. In terms of Omega 3 content these are the most economical high quality supplement we have found. However the capsules are quite large, so for children we recommend either their liquid form or Eskimo 3 capsules (which are the same quality but more expensive).
For Cod Liver Oil, we recommend either Aliment Finest Pure Cod Liver Oil or Green Pasture’s Blue Ice Royal Fermented Butter oil/Cod Liver Oil Blend. The Green Pastures supplement is a blend of cod liver oil and fermented butter oil, which is a good source of Vitamin K2 as well as the Vitamins A & D from the cod liver oil. Although more research is needed, there is some evidence of additional health benefits from K2.