The benefits of fish oil continue to be studied, yet some people struggle with the fish burps associated with these capsules. There are a few simple strategies that can be used to reduce your fish oil supplements repeating on you:
- Take the capsules frozen. The stomach empties relatively quickly and by the time the capsules melt, much of the contents will have been emptied into the small intestine, where omega-3 fatty acids are absorbed.
- Take the capsules with a meal. Fish oil must be taken with food to be effective. Food triggers the release of lipases from the pancreas. These are enzymes that cut fatty acids from their points of attachment. Once the lipase cleaves the omega-3 from its backbone (usually glycerol) it can then be absorbed in the small intestine.
- Try a different brand. Sometimes the ingredients in one brand of omega-3s are different and may make one more tolerable. Often the less fishy brands are a bit more expensive, as more processing means greater expense.
- Try an “odorless” capsule. In this case, the capsule is made to avoid quickly dissolving in the stomach and this can help to avoid the fishy burps.
What are the benefits of fish oil?
First, it’s important to understand fat nomenclature. Saturated fats like coconut, butter, fat in red meat, cheese, and dairy have no double bonds. Monounsaturated fats like those in avocado, olives, olive oil, and macadamias have one double bond. Polyunsaturated fats like those found in many nuts, fish, and in many of the seed oil have more than one double bond. If the first double bond in a fat is located on the third carbon from the end, the fat is called an omega-3 polyunsaturated fat. These are anti-inflammatory fats. If the first double bond is at the sixth carbon from the end of the fat, we call it an omega-6 polyunsaturated fat. These omega-6 fats can be both good and bad.
There are two important omega-3 polyunsaturated fats: EPA and DHA. When purchasing an omega-3 supplement, look at the ingredients label and purchase the supplement that offers the most EPA combined with DHA per serving. Do not be misled by the front of the bottle, which is often deceptive about the amount of active ingredient. For instance, one brand might claim 1200mg of fish oil, but a closer examination of the active ingredients demonstrates only 400mg of EPA and DHA and the rest are other fats.
Most Americans get only 150 mg of omega-3 in their daily diet. This occurs despite an overall total fat intake of 80,000 mg daily (80 grams). In contrast, the Okinawans (longest-lived population on the planet) consume about 2000mg daily, while the Greenland Eskimos consume 6 to 7 grams daily and have very low rates of cardiovascular disease.
There is evidence showing that omega-3 supplementation with higher levels of EPA lowers cardiac risk in high-risk populations. (1) In addition, there is substantial evidence that higher omega-3 red blood cell membrane levels (called the omega-3 index and available direct to consumer) are associated with better health in general. (2)
Studies suggest that EPA omega-3 works by:
- Incorporating itself into the cell membrane, which is made of fats, and making the cell function better metabolically.
- Creating chemicals that reduce inflammation called resolvins.
- Reducing the stickiness of platelets, which can reduce clots.
- Perhaps helping the autonomic nervous system function better (positive impact on pulse and blood pressure).
DHA works similarly with some caveats:
- It seems to be more potent at lowering triglycerides than EPA (though both are used together to lower elevated triglycerides).
- It also creates anti-inflammatory compounds called “protectins.”
- It has a similar effect on the stickiness of platelets.
The brain and the retina of the eye are very rich in DHA. And, several studies suggest that DHA omega-3 is the brain-healthy omega-3.
Of interest, EPA can convert to DHA, which is a longer fat, but not the reverse. In nature, both come together, and nature usually gets the recipe correct. Unless prescribed, I suggest my patients look for a supplement that contains a mixture of both. Always remember to speak with your health care practitioner before starting any vitamin or nutritional supplement program.
As a member of Persona’s Medical Advisory Board, I provide my expert opinion on new supplement formulations. The Persona DHA w/Vitamin D has 225mg DHA and 42mg EPA, while its Omega-3 has 200mg DHA, 50mg DPA, and 275mg EPA. In addition, Persona offers a vegan source of DHA omega-3 that is derived from marine algae.