By now, most of us have heard of essential fatty acids (EFAs) and their
potential health benefits. They're said to sustain cognitive
function and memory, benefit the heart and immune system, aid in cell
reproduction and repair, and even help balance hormones.Fish oil, duly noted by 
the medical community as having similar benefits, contains high levels of 
omega-3 essential fatty acids, thus establishing the link between a daily 
regimen of fish oil and good health. Fish oil is sold in the U.S. as a dietary 
supplement and comes in both liquid and capsule form.

What are essential fatty acids?

Essential fatty acids are unsaturated fats typically found in the oils of 
vegetables, certain nuts and seeds and some fish. They’re said to benefit 
health more than the saturated fats found in meat and dairy products and may 
even have a positive impact on cholesterol and triglyceride levels in the 
blood. Essential fatty acids are referred to as "essential" because they must 
be obtained through diet and are essential to the normal growth and function of 
muscles, nerves, cells and organs in humans. There are two families of 
essential fatty acids, omega-3 fatty acids and omega-6 fatty acids.

Omega-3 fatty acids – the fatty acids found in fish oil

Omega-3 fatty acids are a type of polyunsaturated fat present in many coldwater 
fish including trout, salmon, sardines, anchovies, herring, mackerel, tuna and 
cod. The two most potent forms of omega-3 fatty acids are eicosapentaenoic acid 
(EPA) and docosahexanoic acid (DHA), both known as "good fats" – unlike 
saturated fats, which when consumed in excess can lead to cardiovascular 
problems, neural and brain disorders.

EPA helps to produce the prostaglandins (hormone-like substances) which help 
control blood-clotting and arterial functions. EPAs may also help to lower 
serum triglyceride levels.

DHA is a major component of human brain and retinal tissue and aids the 
transmission of nerve impulses.

The term "omega-3 essential fatty acid" has become synonymous with "fish oil" 
in modern American marketing literature.

Sources of omega-3 essential fatty acids other than fish oil include, but are 
not limited to:

• Avocadoes (whole or oil)
• Brazil nuts
• Flaxseed
• Flaxseed oil
• Fortified milk products
• Hempseeds
• Hempseed oil
• Omega-3 eggs
• Pumpkin seeds
• Sesame seed
• Soybean oil
• Walnuts
• Wheat germ oil

Omega-6 fatty acids – not found in fish oil

Omega-6 EFAs are found in animal products such as dairy and meat and are common 
in cooking oils such as safflower, olive, sunflower, hemp, soybean, pumpkin, 
sesame, walnut and flaxseed oils. Too many omega-6 EFAs, say nutritionists, can 
throw off the balance of prostaglandins and lead to health problems. Experts 
recommend a ratio of three parts omega-3 essential fatty acids to every one 
part omega-6 fatty acid in the diet. Research indicates that Americans consume 
far more omega-6 fatty acids than omega-3 as a result of overindulging in fried 
foods, red meat and cheese.

Omega-6 fatty acids are dependent on interactions with omega-3 essential fatty 
acids in order to benefit good health, which is why a balance of the two is 
crucial in the diet. The American Heart Association cautions against a high 
dietary intake of omega-6 fatty acids as it can lead to the development of 
gallstones and promote tumors.

Prostaglandins

Prostaglandins encompass a number of hormone-like substances found in every 
cell in the body. They’re critical to the dilation and constriction of blood 
vessels, the contraction and relaxation of muscles, the regulation of blood 
pressure and the modulation of inflammation. Prostaglandins are needed for 
overall good health and maintenance and must be replenished constantly. It’s 
easy to understand why having a good balance of prostaglandins in the body is 
essential to well-being.

Where does fish oil come from?

Most fish oil is extracted from the fatty flesh of the fish, unless a product 
specifically states otherwise, as is the case with cod liver oil or shark liver 
oil – extracted from fish liver. Nutritious fish oil is usually derived from 
deep, coldwater fish and those swimming in the wild (wild fish eat other fish 
and marine animals and vegetation to survive, whereas farm-raised fish are 
typically fed some type of less nutritious, less expensive, commercial-grade 
pellet). Some experts say the best fish comes from the deep Atlantic of Norway 
and other Scandinavian countries: the deeper and colder the water, say experts, 
the less chance of toxins such as mercury, lead, dioxins, furans and PCBs 
occurring in the fish oil. Fish from eastern Pacific waters is known to contain 
elevated levels of mercury.

Fish oil supplements – good ones / bad ones

"Product disclosure" is the operable phrase when seeking out nutritious fish 
oil supplements. From what kind of fish is the oil extracted and from where is 
it extracted naturally through pressing or with a centrifuge; or are 
petrochemical solvents such as hexane used to extract the oil from the source? 
How is the fish oil refined? Is it molecularly distilled, which to date is the 
most reliable form of fish oil purification, or does the label read something 
like "extra-distilled" or "super-distilled?" Such terms have no bearing on 
quality or safety. Because the hundreds of thousands of fish oil supplements on 
the market remain unregulated by the FDA, the safety, consistency, efficacy and 
strength of these products varies immensely among brands.

When reading fish oil supplement labels:

• Make sure the type of fish from which the fish oil is extracted is listed.
• Look for terms "coldwater," "deep water" and "wild" as opposed to 
"farm-raised."
• In what ocean or hemisphere was the fish caught? North Atlantic, deep, 
coldwater is said to be the most nutritious.
• Make sure the fish oil is molecularly distilled, which better ensures the 
absence of PCBs, heavy metals and other contaminants.
• What parts of the fish were used? Fish oils extracted from fish liver may be 
higher in heavy metals and contaminants.
• What fish oil extraction method was used? Cold or modified expeller pressing 
means that the oil was produced without damaging temperatures or unnecessary 
pressure.

Marketing claims that have no defined meaning in relation to fish oil 
supplements, and which often mislead consumers, include:

• Ultra-pure
• Professional grade
• Pharmaceutical grade
• High-potency
• Super-distilled
• Natural
• Extra-distilled
• Best
• Finest
• Highest quality
• Pure
• Purest
• Purified

Essential fatty acid health benefits and risks

Few argue the benefits of fish oil and essential fatty acids in the diet. 
Clinical studies have demonstrated that the omega-3 fatty acids can benefit 
cardiovascular health and that "good unsaturated fats" derived from vegetables 
and fish are far more nutritious than "bad saturated fats" which come from red 
meat, animal products and dairy. The cardiovascular benefits to balancing 
omega-3 and omega-6 fatty acids in the diet include lowered serum cholesterol, 
decreased serum trigylcerides and reduced platelet aggregation. Although many 
fish oil supplement companies claim that fish oil supplementation may aid brain 
function and strengthen the immune system, a complete body of evidence has yet 
to be produced.

Along with the health benefits of fish oil come some risks, most associated 
with taking too high doses of fish oil or having dangerously high levels of 
omega-3 and omega-6 essential fatty acids in the blood. Some of these risks can 
include:

• Thinning of the blood and reduced ability of the blood to clot.
• Increased risk of bleeding.
• Too large doses can increase glucose levels in persons with already elevated 
blood sugar levels.
• In excess, fish oil may suppress the immune system.
• Increase the occurrence of nosebleeds and easy bruising.
• Upset stomach, nausea, diarrhea and belching.
• Poisoning from heavy metals, PCBs, dioxins and pesticides.

Experts and nutritionists are convinced that the health benefits of fish oil 
far outweigh the risks. However, many warn that fish oil shouldn’t be taken 
with blood-thinning medication such as warfarin or aspirin and shouldn’t be 
taken by anyone with bleeding disorders or uncontrolled hypertension. It is 
highly advisable to consult a physician before supplementing a diet with fish 
oil.

EPAs, DHAs, efficacy and the FDA

In September of 2004, the FDA announced they would allow a qualified health 
claim for reduced risk of coronary heart disease for conventional foods that 
contain EPA and DHA omega-3 fatty acids as outlined in FDA’s "Interim 
Procedures for Qualified Health Claims in the Labeling of Conventional Human 
Food and Human Dietary Supplements." Notwithstanding inconclusive research at 
the time of release, the FDA said it would exercise its enforcement discretion 
with respect to the following qualified health claim:

"Supportive but not conclusive research shows that consumption of EPA and DHA 
omega-3 fatty acids may reduce the risk of coronary heart disease. One serving 
of [name of food] provides [x] grams of EPA and DHA omega-3 fatty acids. [See 
nutrition information for total fat, saturated fat and cholesterol content.]"

In 2000, the FDA announced a similar qualified health claim for dietary 
supplements containing EPA and DHA omega-3 fatty acids and the reduced risk of 
coronary heart disease (CHD). The FDA recommends that consumers not exceed more 
than a total of three grams per day of EPA and DHA omega-3 fatty acids, with no 
more than two grams per day from a dietary supplement.



References

1. Supplement from the sea: the fat from fish oil can benefit your heart, eyes, 
joints, and brain. Tom Weede. Natural Health. Oct 2007 v37 i9 p105 (2).

2. Omega medicine. Is fish oil good for what ails you? Bonnie Liebman. 
Nutrition Action Healthletter. Oct 2007 v34 i8 p1 (5).

3. The government’s big fish story: Pick the perfect fish oil supplement. Men's 
Health. July-August 2007 v22 i6 p158.

4. Fish oil and brain development. Alan R. Gaby. Townsend Letter: The Examiner 
of Alternative Medicine. Oct 2007 i291 p49 (2).

5. Effects of fish oil supplementation on myocardial fatty acids in humans. 
R.G. Metcalf, M.J. James, R.A. Gibson. Alternative Medicine Review. Sept 2007 
v12 i3 p307 (1).

6. Essential fatty acids. Douglas Dupler and Teresa G. Odle. The Gale 
Encyclopedia of Alternative Medicine. Ed. Jacqueline L. Longe. 2nd ed. Detroit: 
Gale, 2005. 4 vols. Updated July 1, 2006.

7. Mighty omegas (ways to score more essential fats). Nancy Duncan. Women's 
Health. Dec 2006 v3 i10 p47.

8. Essential fatty acids and eicosanoids: their role in preventing 
inflammation, cardiovascular disease and cancer. James Meschino. Dynamic 
Chiropractic. Dec 3, 2007 v25 i25 p28(3).

9. Fish oil. Mai Tran and Teresa Odle. The Gale Encyclopedia of Alternative 
Medicine. Ed. Jacqueline L. Longe. 2nd ed. Detroit: Gale, 2005. 4 vols. Updated 
July 1, 2006.

10. On call: Fish oil revisited. Staying Healthy from the Faculty of Harvard 
Medical School. August 21, 2006 pNA.

11. By the way, doctor: How much fish oil should I be taking? Staying Healthy 
from the Faculty of Harvard Medical School. August 21, 2006 pNA.



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