About 50 percent of Americans take dietary supplements, and it appears that fish oil is edging out multivitamins as the most popular, according to a recent study carried out by National Institutes of Health. And a recent survey carried out by ConsumerLab.com, which conducts independent evaluations of health and nutrition products, found that 76 percent of the 6,000 respondents regularly take a fish oil supplement. Sales of these supplements have soared to an estimated $1 billion annually in the U.S.
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Inflammation fighters. Numerous studies have linked DHA and EPA, the two components of omega-3 fatty acids commonly found in fatty fish, to many health benefits. 'Omega-3s have a potent anti-inflammatory effect, and this is vital, since inflammation underpins many chronic diseases,' says Adee Rasabi, RD, CDN, CDE, a senior dietitian with NewYork-Presbyterian/Weill Cornell. 'There's evidence omega-3s lower triglycerides (blood fats), reduce the risk of heart attack, heart arrhythmia, and stroke in people with cardiovascular disease, help prevent hardening of the arteries and lower blood pressure slightly.'
Study findings published in the December 2010 issue of Ophthalmology confirmed earlier evidence that omega-3s confer protection against acute macular degeneration, an eye disease that is a leading cause of blindness in the U.S. Some research also has indicated that DHA in particular may help protect against Alzheimer's disease (AD).
Food first. The body doesn't produce its own omega-3s, so dietary intake is important, but the average U.S. diet includes far less DHA and EPA than optimal. It's likely the shortfall is due simply to people not consuming enough fatty fish, which is the main dietary source of DHA and EPA. While many people avoid fish because of concerns about contamination with mercury and other toxins, Rasabi says its benefits outweigh its risks. 'The potential risks from mercury or other contaminants, such as PCBs or dioxins, which are also found in trace amounts in many foods, are exceedingly small relative to the benefits of eating fish,' she says.
The American Heart Association (AHA) recommends 500 milligrams (mg) daily of DHA/EPA combined for healthy adults, and the recently updated 2010 Dietary Guidelines for Americans recommend you get this by consuming 8 to 12 ounces of fatty fish per week. If you prefer not to eat fish, there are other food sources of omega-3s. 'Flaxseed is a good source; choose ground flaxseed, since omega-3s are best absorbed from ground rather than whole seeds,' Rasabi says. 'Other sources of omega-3s include canola oil, broccoli, cantaloupe, kidney beans, spinach, grape leaves, Chinese cabbage, cauliflower, and walnuts.'
Supplementing safely. While the majority of fish oil consumed in the U.S. used to be manufactured domestically, the soaring popularity of fish oil supplements means there are now products on the U.S. market from countries and sources all over the world. While the factories that produce imported oil are supposed to meet FDA manufacturing quality standards, it's possible some don't. How can you be sure that the supplement you take is safe?
Rasabi says fish oil supplements shouldn't have the same contamination problem as some types of fish. 'The fish that are most likely to contain contaminants--including shark, king mackerel, and farm-raised salmon--aren't used in supplement manufacture,' Rasabi explains. 'In processing, contaminants typically cling to the meat of the fish, while the oil is skimmed off and then further purified.' A ConsumerLab evaluation of fish oil supplements bears this out: In an analysis of 43 products, none were found to contain mercury or other contaminants.
Rasabi says it's likely that the safest fish oil comes from Norway, a country that strictly regulates fish oil manufacture. 'As well as being purer, Norwegian fish oil is thought to be higher in omega-3s,' she adds. Brands that are made in the U.S. also are safe, as this indicates the fish were domestic, and virtually all of the processing, manufacturing and other parts of the supply chain are in the U.S.
As well as garden-variety fish oil supplements, algal oil (a good option if you're vegetarian or vegan) and krill oil are growing in popularity, and it's claimed that the omega-3s in these options are more 'bioavailable'--meaning easier to absorb--than those in standard fish oils. However, there is little evidence to substantiate the claims, and Rasabi says they likely aren't worth the extra expense. 'If you're allergic to shrimp, you should avoid krill oil,' she adds.
Special considerations. If you have heart disease, the AHA recommends that you consume about 1 gram (g) of DHA/EPA per day, preferably from fatty fish, with supplementation considered if necessary. If you need to lower your triglycerides, you may be advised to consume more than this, but don't take doses higher than 3g per day without your doctor's agreement, as higher doses may prevent blood from clotting. 'If you're supplementing, account for dietary sources,' Rasabi advises, 'and if you take a blood thinner, check with your doctor before you take a fish oil supplement.'
RELATED ARTICLE: WHAT YOU CAN DO
* Choose a fish oil supplement that contains at least 30 percent EPA/DHA, the active ingredients.
* Check for 'filler oil' by comparing the total milligrams (mg) of omega-3 fatty acids on the label with the per-capsule mg amount on the front of the bottle. A good supplement will contain less than 50 percent filler.
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* If possible, select a brand that identifies the fish source--sardines, anchovies, and wild salmon are less likely to be contaminated. *
* Check where the fish originated. Fish caught in Norwegian waters are thought to be less contaminated, while fish from eastern Pacific waters contain elevated levels of mercury*
* Opt for products labeled 'USP Verified,' which means the product has been tested by the U.S. Pharmacopeia, a non-governmental standards-setting authority, for purity and potency. The terms 'pharmaceutical grade' and 'molecularly distilled' also indicate that the filtration methods used should ensure that mercury and other impurities have been eradicated.
* If your supplement produces a fishy aftertaste, opt for an odorless version, or consider krill oil and algal oil supplements, which are reported to have little or no aftertaste.
* If this information doesn't appear on the label, check the product's website.
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