常常喜樂
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http://health.usnews.com/health-news/blogs/eat-run/2014/02/04/how-to-choose-a-fish-oil-supplement
How to Choose a Fish Oil Supplement
If you’ve considered taking fish oil but are confused about how to start, read on.
We’re far more likely to associate foods like chocolate or strawberries with February than, say, fish and fish oil. Unlike oysters, with their reputation as an aphrodisiac, fish and its oil hardly inspires warm and sexy thoughts – possibly a result of the decidedly unromantic side effect of “fishy burps” that some people may experience from eating fish or consuming rancid or cheaply-coated fish oil capsules. But February is American Heart Month. And as such, the benefits of eating fatty fish (among which tilapia isn’t counted) and taking fish oil supplements merit some attention.
[Read: 9 Aphrodisiacs to Feed Your Valentine.]
Fish oil is among the best sources of biologically-active, heart-healthy omega-3 fatty acids such as EPA and DHA, which play a role in protecting our blood vessels from becoming thickened and narrow from hardened deposits of fat and minerals. Research has shown omega-3s exert their cardio-protective influence through a variety of mechanisms, including interfering with aggregation of clot-forming blood platelets; inhibiting the release of inflammatory compounds that promote plaque formation in the arteries; and helping reduce triglyceride levels in the blood. Omega-3s are one of two “essential fatty acids” that must be obtained from the diet, since we humans cannot manufacture them ourselves. Several plant-based foods, such as flaxseeds and walnuts, contain alpha-linolenic acid, an omega-3 that our bodies are able to convert – albeit inefficiently – into the more biologically-active forms of EPA and DHA.
For people who don’t enjoy omega-3-rich fish like salmon, mackerel, herring, sardines, anchovies or lake trout – or who simply don’t eat these foods regularly – fish oil supplements may be an option worth considering. While researchers continue to debate whether supplemental fish oil offers the same benefits as eating fish regularly, many doctors have become vocal advocates for the supplemental form, particularly for their patients at risk for heart disease. If you’ve considered taking fish oil but are confused about how to start, read on:
1. Talk to your doctor about a dose that meets your therapeutic goals. It’s important to discuss what your doctor or dietitian believes to be an appropriate and safe dose for you, given your individual health profile and any other medications or supplements you use. Since fish oil can have a blood thinning effect at higher doses, it may increase risk of bleeding in people who take other medications with similar effects, such as daily aspirin, vitamin E or certain prescription medications – particularly Plavix (clopidogrel) or Coumadin (warfarin).
If you don’t eat at least two servings of fatty fish per week, an equivalent dose in fish oil currency would be about 400 to 500 milligrams per day of combined EPA and DHA. This is the recommended intake for healthy adults without a history of heart disease to meet their basic needs. The recommendation for people with coronary heart disease, or a narrowing in the arteries as the result of plaque buildup, is 1 gram per day (1,000 milligrams) of combined EPA/DHA. Doses higher than this should only be taken under the supervision of a medical doctor; for example, by people with high triglycerides who may require doses in the range of 2 to 4 grams (2,000 to 4,000 milligrams) of combined EPA/DHA per day for therapeutic benefit. Similarly, for those with high blood pressure, around 3 grams (3,000 milligrams) of EPA/DHA per day has been shown to be a therapeutic dose.
[Read: Is it OK to Eat Fish?]
2. Learn how to decode the supplement label. The two most important numbers on a fish oil label are: the actual omega-3 content, expressed in milligrams of EPA and DHA, respectively; and the number of pills contained in a serving size.
Fish oil (and algae or krill oil) dosing is based on the actual omega-3 content of the product. To determine the actual omega-3 content of a dose, you'll need to read the supplement facts level and add up the listed milligrams of both EPA and DHA to see what dose you're actually getting (remember: one gram is 1,000 milligrams; two grams are 2,000 milligrams). Be aware that these numbers are almost never listed on the front of the label. In fact, fish oil marketers often mislead consumers by claiming a high number of milligrams of total fish oil on the front label – such as "1,200 milligrams fish oil." But this refers to the amount of the oil itself, not the actual omega-3 content.
[Read: Dietary Fat: the Good, the Bad and the Ugly.]
In plant-based omega-3 products such as flaxseed oil or ground flaxseeds, omega-3 content will be listed in terms of ALA, rather than EPA or DHA. As a general rule, 10 percent of the listed ALA will be converted to EPA/DHA. So if you’re seeking a dose of 500 milligrams EPA/DHA, you’ll need to take a vegetarian product with 5,000 milligrams (5 grams) of ALA. For reference, 1 tablespoon of cold-pressed flaxseed oil can have up to 7,000 milligrams of ALA, though some experts suggest that men in particular may be better off getting their plant-based omega 3s from ground flaxseeds rather than flaxseed oil. One tablespoon of ground flaxseeds can have 1,500 milligrams (or slightly more) of ALA.
Next, you’ll need to pay attention to the serving size that corresponds to the listed nutrition content. When you do, you may notice that in some products, a single "dose" that contains your desired amount of omega-3s may consist of anywhere from two to six pills! If you don't read the fine print, you risk getting far less than you think by taking only a single pill. If you require a higher dose of fish oil – anything more than 1,000 milligrams of EPA/DHA daily – you may want to seek out a more concentrated product in order to minimize the number of pills required.
[See: 11 Best Fish: High in Omega-3s – and Environment-Friendly.]
3. Select a reputable product. Fish oils are no different than any other laxly-regulated dietary supplement category, prone to inaccurate label claims and contamination. Indeed, recent testing of 30 leading fish oil products by an independent lab showed that the average omega-3 content varied by 24 percent compared to its label claim, though individual products ranged from having 50 percent less to 90 percent more (!) than promised. While there is the theoretical concern that fish oil could be contaminated with excessively high levels of toxins such as mercury or PCBs, multiple studies that have analyzed a variety of fish oil products have shown levels to be safe by and large, and possibly even below those one would encounter through eating actual fish (see here and here, for example).
Multiple independent lab companies conduct periodic reviews of commercially available supplement products to audit their omega-3 content and assess their purity. Before recommending any products to my patients, I vet them through one such subscription-based service, consumerlab.com. Another company, Labdoor, recently audited more than two dozen fish oil products and released its list of best products online. In my practice, I recommend products from manufacturers whose products have passed the test of purity and label accuracy, and that offer concentrated doses so that only one to two pills is required to meet needs. Of note, the expensive prescription fish oil product Lovaza contains a comparable dose of EPA/DHA (840 milligrams per capsule) to some reputable over-the-counter products, including GNC’s Triple Strength Fish Oil – a product frequently promoted at “buy one, get 50 percent off second one.” This underscores an important point about fish oil pricing: Among reputable manufacturers, the more expensive products are not always better!
Hungry for more? Write to eatandrun@usnews.com with your questions, concerns and feedback.
Review] The Complete Fish Oil Buyer’s Guide – 26 Top Products Reviewed
Fish oil is the most popular supplement in America1; it’s also a market hypersaturated to the point of exhaustion. On Amazon.com a search for “fish oil” returns 28,697 results; Google Shopping sends back a whopping 164,000; and Bodybuilding.com spits out a relatively meager 161 products.
Whether you’re a beginner or seasoned supplement vet (you know it’s really bad when I was personally taking a 1-star fish oil product), shopping for fish oil can be a deceptive, overwhelming, overly complicated process. We’re here to cut through the clutter and help you save cash on one of the most important supplements for your all-around health.
The truth about the fish oil category is that 90% of the top product listings on the major websites above are misleading, overpriced, and frankly, complete gar-báge. They sit under the umbrella of supplement titans and rely on 3 major things to inject themselves into consumer shopping carts:
1. instant brand name recognition & credibility (e.g. Optimum Nutrition, GNC)
2. intentionally deceptive marketing & labeling
3. costumer naivete and impulse buying
Here’s the reality: When you see front-label claims of 1,000 mg, 1,400 mg, 50,000 mg fish oil, this means NOTHING. What matters resides on the backside of the bottle and requires a little savvy investigation: EPA & DHA content, the % of EPA/DHA present, and most importantly, price relative to the rest of the market.
EPA (eicosapentaenoic acid) & DHA (docosahexaenoic acid) are omega-3 fatty acids linked to a number of major health benefits, including: decreased triglycerides and blood pressure234; prevention of inflammatory diseases (arthritis) and atherosclerosis, which can help reduce the risk of heart attack and stroke56789; increased HDL (good) cholesterol levels10; improved cognitive function11; shunted breast cancer development12; and potentially even enhanced muscle protein synthesis13.
Quality of this oil is also CRITICAL, and somewhat paradoxically, the same “big brand” supplement goliaths that we’ve come to trust don’t manufacture high quality fish oils. The top products, and the ones I highly recommend spending your money on, are 5-star IFOS rated. IFOS is an independent ratings agency that tests fish oil products against 5 markers of quality14:
- Purity, safety, and cleanliness (PCBs and highly toxic chemicals like dioxins and furans)
- Heavy metal content (mercury, cadmium, lead, arsenic)
- Accurate labeling (actual DHA & EPA levels vs. labeled claims)
- Oxidation and stability (peroxide, anisidine levels)
- Omega-3 concentration (>60% omega-3-to-total oil)
Given the proliferation of toxin-laced, farmed fish that can actually do more harm than good, THESE are the products that you want 100% of the time — they’re safe, incredibly effective, and actually deliver the health benefits expected from fish oil.
The Top 26 Fish Oil Products Reviewed
Think about the last time you bought fish oil — what did you base your decision off of? I’ll bet for the majority of you that it was either brand name or that lofty front-end total oil claim.
Like shopping for a new smartphone, house, or HDTV, it’s time to become a smarter, leaner supplementeur. We’ve researched, analyzed, and graded 26 of the most popular fish oil products listed on Amazon/BB.com to come up with a definitive ranking based on EPA/DHA content, overall quality, and price (aka bang for your buck). Some notables:
– Our 5 star rated oils, and the ones we highly recommend spending your money on, include:
– IFOS 5 star ratings — often referred to as pharmaceutical grade — are reserved for the upper echelon of fish oil, and should be what you take, but there’s a limit to what’s reasonable price-wise. Products like Barlean’s Fresh Catch Ultra EPA-DHA and NordicNaturals Ultimate Omega-3 are insanely expensive; fortunately Carlson Labs and Life Extension provide value out of the IFOS tier.
– 8 out of 21 products fall into the dirty 30 club (Optimum Nutrition Fish Oil, Bodybuilding.com Fish Oil, Spring Valley Fish Oil 1000). That is, only 30% total EPA/DHA per serving, the rest being useless filler oil. Powerful marketing and lofty numbers on the outside; horrible products without much useful oil on the inside (not to mention unnecessary calories).
– Notice how price per gram of EPA/DHA differs from price per serving — EPA/DHA per serving is what matters, just like % ABV in beer, mg caffeine in your daily triple espresso, % of yellow Swedish Fish per bag, or grams of protein in a post-workout shake are the principal metrics of their respective potency and value. Fish oil from GNC, Optimum Nutrition, and AllMax are laughably overpriced and should be avoided completely.
Click to enlarge each individual frame, or download the printable ‘Complete Fish Oil Buyer’s Guide’ here.15
Nine brands passed all quality measures tested, including:
- Spring Valley Omega-3
- Finest Natural
- Walgreens Omega-3 Concentrate
- Barlean’s Organic Oils EPA-DHA
- Nature Made 1,200 MG
- The Vitamin Shoppe Meg-3 EPA-DHA
- Carlson Super Omega-3 Gems
- Norwegian Gold Ultimate Critical Omega
- Nature’s Way Fisol
