Are you hooked on fish oil yet The natural wonder drug proven to treat a range of conditions



21:03 GMT, 28 July 2012

The experts reveal everything you need to know about the supplement that can fight heart disease, ease arthritis – and even stave off blindness.

Something fishy: The health benefits gleaned from the fatty acids of our underwater friends are wide-ranging

Something fishy: The health benefits gleaned from the fatty acids of our underwater friends are wide-ranging


Fish oil

All fish oils contain omega-3s, types of polyunsaturated fatty acid which are essential for health.
Fish such as mackerel, salmon, trout, sardines, pilchards and fresh tuna, which are known as oily fish, are the richest sources.Dr Carrie Ruxton, nutritionist for
the Health Supplements Information Service, says: ‘There are different
types of omega-3 fatty acids, but the key health benefits are believed
to come from the very long chain omega-3s, called docosahexaenoic acid
[DHA] and eicosapentaenoic acid [EPA].’The Food Standards Agency (FSA)
recommends we eat a minimum of two portions of fish each week, one of
which should be an oily fish (one portion is about 140g). This provides a
daily intake of 450mg of EPA and DHA.Today many supplements will specify which type they contain and in what concentration.EPA and DHA have different roles in
the body. Dr Ruxton says: ‘Studies suggest DHA is more important for the
brain, retina and infant development, while EPA is more important for
vascular health [blood vessels].’‘The difficulty we have in the UK is that two-thirds of people don’t
eat oily fish,’ she says. ‘The main source of long chain omega-3s in the
diet is oily fish, and if we can’t get them from that, we need to
consider a supplement to top up our diet.’


Fish oil supplements

Supplements fall into three
categories: fish oil, cod liver oil and krill oil. Which one you choose
will depend on how much money you want to spend and what benefit you’re
trying to get. Shona
Wilkinson, head nutritionist at The Nutri Centre, says: ‘Cod liver oil
comes direct from the liver, whereas fish oil comes from the flesh of
oily fish. Krill are shrimp-like crustaceans that live in the ocean. The
oil found in them contains omega-3s similar to those found in fish
oils.’Dr Ruxton says: ‘If you’re on a budget, cod liver oil or a standard
omega-3 are the ones to go for. You don’t need to buy the most expensive
brands to get the basic benefits. If you have a specific condition and
need a high dose or are pregnant and don’t want the Vitamin A, the cost
will go up.’Cod
liver oil generally has lower levels of EPA and DHA but also differs
from fish oil as it naturally provides Vitamin A, which is important for
good eyesight and healthy skin, and Vitamin D for bone and immune
health. Cod liver oil isn’t suitable for use during pregnancy as it
provides too much Vitamin A.Dr Ruxton’s advice is not to look at the total amount of omega-3s when
choosing a supplement, but at the total amount of EPA and DHA combined
that a supplement provides. This should add up to 450mg per day. ‘Algae supplements for vegetarians also contain EPA and DHA – fish
have EPA and DHA in their flesh in the first place because they feed on
algae,’ says Dr Ruxton. Alpha-linolenic acid (ALA) is another omega-3
fatty acid, which is plant-based and found in dietary sources such as
vegetable, rapeseed and flaxseed oils. Our bodies can convert ALA into
EPA and DHA but the process depends on how much EPA and DHA you take as


Supplements may reduce the risk of early birth

Supplements may reduce the risk of early birth


PROOF: Supplementation studies in pregnancy
show fish oils may reduce the risk of early birth. As they may provide
Vitamin A, it’s essential to choose a supplement suitable for pregnancy –
just twice the RDA of Vitamin A early in pregnancy can increase the
risk of birth defects.

The guidelines for eating oily fish
changed recently from once a week to two or three portions a week.
Collins says taking omega-3s while pregnant can have benefits for the
expectant mum, too. ‘It’s a boost for your immune system as well as that
of your baby.’

Dr Ruxton adds: ‘Evidence from Denmark
and Australia suggests the last trimester of pregnancy is the optimum
opportunity for programming IQ and immune functions. Taking omega-3s at
this stage is crucial.’

DOSE: Choose a specific pregnancy supplement.

TRY: Equazen Mumomega – high in DHA for the development of the baby’s eyes, 9.35, 30 capsules,


PROOF: Studies have shown benefits from fish oils for those suffering from rheumatoid arthritis.

Catherine Collins, principal dietician
at St George’s Hospital, London, says: ‘Fish oils have an
anti-inflammatory effect which targets the cause of joint pain and helps
the body deal with the pain.

‘But this effect is irrelevant if
you’re eating a diet full of omega-6 unsaturates [including corn and
sunflower oils], and saturated fats. Such foods counteract and lessen
the effects of the beneficial oils.’

Fish oils work in synergy with monounsaturated fats, together reducing cell inflammation that reduces pain and maintains health.

DOSE: A minimum of 3,000mg of EPA and DHA combined a day for maximum benefits.

‘These doses are more than six times
the daily recommendation, so you must take medical advice,’ says
dietician Helen Bond at the Proprietary Association of Great Britain,
the regulatory body for over-the-counter medicines and supplements.

‘Fatty acids can interact with other medications.’

TRY: RxOmega-3, 400mg EPA and 200mg DHA, 18.95,


PROOF: The anti-inflammatory effects
of fish oils also have benefits for the heart. They reduce the
blood-vessel inflammation that can lead to heart disease. There are
large studies dating back 30 years which show fish oils play a part in
preventative cardiology. ‘They also stabilise heart rhythm, especially
in patients who have suffered a previous heart attack,’ says Collins.

DOSE: A report reviewed the results of
clinical trials involving more than 11,000 survivors of heart attacks
and found that supplementing their diet with a gram a day of fatty acids
reduced the occurrence of cardiovascular death by 30 per cent and
sudden cardiac death by 45 per cent. In a 2009 review, experts
recommended healthy people take a daily dose.

TRY: Nature’s Best Fish Oil, 360g EPA and 240g DHA, 14.50, 180 capsules,


PROOF: Studies have shown there is a
link between omega-3s and staving off the deterioration of sight, such
as age-related macular degeneration (AMD), which damages the centre of
the eye and can lead to blindness. A Harvard University study of 38,000
women found those who ate the most fish oils had a 38 per cent lower
risk of developing AMD compared with those who ate the least. The
highest concentration of DHA in the body is found in the eye. Collins
says: ‘Fish oils also contain Vitamin A which is essential to healthy

DOSE: ‘A supplement providing lutein,
zeaxanthin and omega-3s could protect eyes against future age-related
changes when diet alone fails to deliver,’ says Ian Grierson, professor
of ophthalmology at the University of Liverpool.

TRY: Bausch & Lomb Ocuvite
Complete, which contains high-quality omega-3 fatty acids (of which 360g
is DHA), lutein, zeaxanthin, Vitamins C and E, and zinc, 15.99, 60


Infant development


Omega-3s are
essential for brain development in the first year or two because this is
when the brain is at its most plastic or malleable. Catherine Collins
says: ‘If you’re breastfeeding, your body will produce omega-3s
regardless of the amount of fish oils in your diet, and if you are
bottle-feeding they are added to all formulas.’

studies show no benefit beyond the second year. Collins adds: ‘Iron
deficiency anaemia is more of an issue, affecting verbal learning and
memory in children. It is found in fortified toddler milks, red meat and
fortified cereals but it could be worth giving your child an iron
supplement if they don’t have much of these in their diet.’


dietary influences on cancer are complex, research indicates fish oil
may have an effect on colorectal, prostate and breast cancers. According
to Collins, the reasons are unknown, although it may be to do with
reducing inflammation associated with cell changes or that fish oils
provide Vitamin D that helps immune cells identify rogue cells for

‘We don’t know for sure if fish oils will help with cancer. Evidence is speculative and data is limited,’ says Helen Bond.


A review suggested last month there is
no evidence omega-3 provides a benefit for memory in later life. ‘It’s a
disease of ageing so the notion fish oils can stop its development is
unlikely,’ says Collins. ‘Low levels of omega-3 have been reported in
Alzheimer’s sufferers,’ says Bond. ‘But we don’t know if it’s a cause or
an effect.’


Omega 3 fish fingers

According to the International Cod Liver
Omega-3 Foundation, many fortified foods contain insignificant levels of
omega-3 fats, although 60 per cent of shoppers believe they offer real
health benefits.

For an adult to reach the recommended amounts by
relying on foods fortified with omega-3 fats, the foundation says they
would need to eat 16 slices of fortified bread, five omega-3 enriched
eggs, six omega-3 drinks or a litre of omega-3 enriched milk a day.

Another downside is the lingering after-taste such foods can leave. ‘It
is simpler to eat oily fish every week rather than trying to get all
your needs from fortified foods – and it’s much cheaper,’ says Helen


Fish oils came under scrutiny in 2006 after the Food Standards Agency discovered some exceeded the recommended levels of toxins linked to cancer.

Batches of all the affected supplements were withdrawn. ‘All UK supplements will have a minimum quality that meets European standards,’ says Dr Ruxton.

‘Be cautious buying non-EU supplements over the internet, though, as quality cannot be guaranteed.’


It is possible to overdose but ill-effects are unlikely to be more serious than a tummy upset or nausea. In a six-month trial providing 275 patients with 6.9g of EPA and DHA in ten capsules daily, there was no difference between the fish oil and corn oil control groups for any adverse effect.

American regulators report that prolonged bleeding has never been reported in those taking less than 3mg of the above.

Extremely large doses may increase the risk of blood in the urine or nose-bleeds. ‘Stick to the recommended doses to avoid potential side effects,’ says nutrition scientist Dr Elizabeth Weichselbaum at the British Nutrition Foundation.

‘Just because something is good for you doesn’t mean that having more is better.’