The benefits of omega-3 poly-unsaturated fatty acids (PUFA’s) are widely publicised. When I ask someone why they are taking fish oil most commonly am told that it’s for “cholesterol,” specifically triglycerides although there are a number of reasons why someone may take fish oil. Studies show the greatest benefit from supplementing with fish oil in those who do not already consume fish.

The Standard American Diet (“SAD diet”-the name says it all…) has been found to contain an unhealthy balance of omega-3 (anti-inflammatory) to omega-6 (potentially pro-inflammatory) fatty acids, something like 1:14 or even as high as 1:20. A more beneficial ratio would be 1:4 or less depending on who you ask.

I always recommend “food first” and fish is no exception. An awesome resource for determining how much fish, what type of fish, and from what source (wild caught, farmed, etc.) is the EWG Seafood Calculator. It takes into account your weight, sex, age and if you’re nursing, pregnant or considering becoming pregnant to recommend the safest fish with the highest omega-3 content for you to consume. I was blown away as a lactating female when I used this tool that many of the fish that I think of as “safe” such as salmon contained roughly 30% and sardines had roughly 50% of the weekly limit for mercury intake while nursing for someone my size.

Mercury (methylmercury) has a relatively long half life (it takes about 2.5 months to eliminate half the amount of mercury after a single exposure) and accumulates with multiple exposures (1). The key thing here is don’t over do it! Stick to the smaller fish which are high in omega-3’s and low in mercury and have 2-4 servings per week. Also, it is worth considering other toxins such as dioxins and PCB’s which can be carcinogenic.

All this talk of toxins! Yikes! Make sure that you are eliminating toxins as efficiently as possible on a regular basis through having regular bowel movements, drinking plenty of fluids and sweating (sauna and/or exercise).

The benefits from fish oil are determined primarily from studies that look at the total amount of EPA + DHA. It can be very misleading when you look at a bottle of fish oil- it may say 1000mg of fish oil on the front, but when you read the supplement facts label on the back it requires taking multiple capsules and the EPA + DHA content is much lower than 1000mg.

Krill is another potential source for omega-3’s however I have concerns about the environmental impact and sustainability of using krill so do not recommend it.

Alpha-linolenic acid (ALA) is another source of omega-3 PUFA’s that are found in flaxseed oil. ALA has to be converted in the body to the active forms of EPA then to DHA to exert the benefits of omega-3’s. Our bodies are not efficient at doing this conversion (<10-15%, those with higher estrogen may convert somewhat more efficiently). You may see flaxseed oil advertised that it contains 1000mg or more and “omega-3” on the label, but when you do the math if you have 1000mg of ALA, that’s only about 100-150mg of EPA/DHA on a good day.

I prefer sprinkling freshly ground flax (goes rancid quickly, keep refrigerated and grind fresh) on food or in smoothies for the other health benefits of flax but if you are taking flax oil for the cardiovascular benefits it would be worthwhile to consider other options.

Algae is a good source of DHA for vegetarians and vegans. Micro-algae is actually the base of the food chain and the reason why fish accumulate EPA + DHA in their fatty tissues. The only downfall with algae supplements are that they contain only 100-300 mg of DHA on average and little EPA if any.

You can also get omega-3’s from a variety of foods such as walnuts, chia seeds, hemp seeds, grass fed animals (preferably pasture raised) and pasture raised chicken eggs (often supplemented with flax to boost omega-3’s). Animals who consume their natural diet of plants, bugs, etc. as opposed to corn have been shown to contain more omega-3’s (less omega-6’s).

In the United States there is no official recommendation for how much EPA/DHA someone should consume, although in other countries recommendations are around 300-500mg/day total. At least one study found that consuming amounts higher than this did not confer much additional benefit when it comes to cardiovascular disease and related mortality. Unless you’re being treated for a medical condition I recommend staying under 2,000mg/day of EPA/DHA due to the potential for immune suppression at higher doses. (2) (3)

If you do not consume fish it may be recommended that you consider taking a fish oil supplement. Check out “Omega-3’s Part 2: Does Your Supplement Smell Fishy?” for more information.