EPA vs. DHA Omega-3: Is one better than the other?

Uncategorized

EPAvsDHAheader

Summary:

EPA and DHA are nutrients that provide life-sustaining benefits for human health. From conception to old age, humans need EPA and DHA and since we cannot make these fats in our bodies, we must eat them. EPA and DHA are omega-3 fats and the predominant fats in fish and seafood and purified fish oils.

EPAvsDHAsummary

EPA vs. DHA:EPAvsDHAchart

The relative amount of EPA and DHA in fish and seafood differs but EPA and DHA always occur together in fish and seafood. For example, salmon can have more DHA or EPA, depending on the species; pollock has more EPA while sardines usually have about equal amounts of both. The relative amount of EPA and DHA in the human body differs according to diet and supplementation, but EPA and DHA work together in the human body, too.

Since EPA and DHA are biologically active nutrients that occur together and work together, it is difficult to identify distinctly different biological functions. However, here is a summary of what nutrition scientists have learned about EPA and DHA to-date. [1-6]


Healthy Babies:

When babies are in the womb, DHA builds critical brain, eyes, and nerve cells.


Heart Health:

EPA and DHA are instrumental in supporting heart health. Both EPA and DHA reduce triglycerides and support healthy blood pressure levels; they also promote healthy heart rate and normal blood flow. In addition, EPA supports good circulation while DHA helps create a more healthful form of circulating LDL-cholesterol.


Healthy Vision:

DHA is an essential nutrient for eye health and good vision.


Mental Health:

EPA and DHA promote healthy brain function and good mental health. To support healthy mood, research shows that both EPA and DHA with relatively more EPA is helpful.

Among middle-age adults, DHA is associated with clearer mental health. DHA is the source of neuroprotectins, which are thought to   support the health and repair of brain cells.


Healthy Aging:

Both EPA and DHA are associated with greater longevity.


Healthy Balance:

EPA competes with omega-6 fats to redirect and lower inflammation. Both EPA and DHA make compounds called resolvins that restore healthy tissue.


Inside all of our cells:EPAvsDHAquote

EPA and DHA perform many tasks in cells (e.g., blood, skin, muscle, nerve cells) so that they function properly. Inside these cells, they help manage genetic expression and cellular communication; they are involved in transporting nutrients (e.g., calcium and sodium) and in cell walls (membranes) they help determine what flows in and out.


Conclusion:

When it comes to EPA and DHA, is one better than the other? No. That is akin to asking if your left hand is better than your right hand. Both EPA and DHA make core contributions to human health. Supplementing with more of one than the other may be warranted at different stages of life (see Table for examples) but both EPA and DHA are required for optimal health.

Since many Americans consume far too little EPA and DHA in their diet, the best approach for most people is to ensure adequate intake of both.

 

GretchenGretchen Vannice, MS, RDN

Nutrition Consultant

For more information contact:

support@wileysfinest.com

References:

[1] 1Bell GA, et al. Am J Epid 2014;179:710-720.

[2] Carlson SE. Am J Clin Nutr 2009;89:1523S-1529S.

[3] Grosso G, et al. PLOS One 2014;9:e96905.

[4] Hoffman DR, et al. PLEFA 2009;81:151-158.

[5] Mozaffarian D, Wu JH. J Nutrition 2012;142:614S-625S.

[6] Muldoon MF, et al. J Nutrition 2010;140:848-853.
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Serving Suggestions FOR KIDS!

Fish Dish of the Month, Products, Uncategorized

Servingsuggestionsforkidsheader

Have you tried our Omega-3 supplements FOR KIDS? They are delicious on their own, but we’ve found some more delicious ways for kids to get their essential nutrients!

Parents and kids love our new Omega-3 liquids because they are so easy to take! Kids like them served on a spoon or simply added to everyday foods. Here are some suggestions:

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Frozen Fruit Puree with Beginner’s DHABeginnersDHA_LeftFacing

Makes 6 child-size servings

  • 1 cup berries (frozen or fresh, rinsed)
    • we like strawberries but any will work
  • 1 banana, peeled
  • 1 Tablespoon Beginner’s DHA Omega-3 liquid

Combine ingredients and blend until smooth. Pour mixture into frozen treat molds (ice cube trays or small paper cups also work; insert a popsicle stick or plastic spoon), then freeze.

– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –

Frozen Yogurt Popsicles with Elementary EPAElementaryEPA_LeftFacing

Makes 6 ½-cup servings

Mix together:

  • 2 Tablespoons Elementary EPA Omega-3 liquid
  • 3 cups of whole milk grass fed organic yogurt
  • 2 Tablespoons organic fruit jam

Pour mixture into frozen treat molds (ice cube trays or small paper cups also work; insert a popsicle stick or plastic spoon), then freeze.

 

Download and Print:

ServingSuggestionsFORKIDS

Lutein and Zeaxanthin: Two Critical Nutrients for Your Child’s Eyes

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luteinandzeaxanthinforeyesheader

Did you know that your child’s eyes develop and mature over childhood just like the rest of the body? Of course, children need good vision to learn reading, writing, arithmetic and for playtime and sports, but today’s world is also full of screens – computer, TV, and cell phone – for which eye health and good vision are key. For optimum eye health, good nutrition is necessary throughout the growing years. Lutein and zeaxanthin are special nutrients that uniquely support eye health and development. These nutrients, part of group called carotenoids, are found in some plant foods, such as squash and corn, and in egg yolks.

Research shows that lutein and zeaxanthin support healthy vision by:

  •      Improving our eyes’ ability to adapt to changes in light
  •      Enhancing the distance our eyes can see, known as our visual range
  •      Reducing the effects of glare
  •      Reducing the effects of oxidation

Lutein and zeaxanthin are particularly important to the retina of the eye where they form macular pigment. This pigment screens all the light that passes through the eyes. Stronger and denser macular pigment has been shown to improve visual function. Getting abundant amounts of lutein and zeaxanthin increases macular pigment density.

MiniQuoteSome researchers believe that our eyes are most vulnerable to poor nutrition during childhood because they are not yet fully developed. Researchers also believe that declining vision in old age may be related to over-exposure and poor nutrition when we are young. There are many reasons to make sure that your child gets the best nutrition. Including lutein and zeaxanthin supplements will support your child’s eye health now and into the future. [1-4]

Gretchen

Gretchen Vannice, MS, RDN

Nutrition Consultant

For more information contact:

support@wileysfinest.com

 

References:

[1] Johnson E. Nutrition Reviews, 2014;605-612.

[2] Stringham JM, Hammond BR. Optometry and Vision Science, 2008;85:82-88.

[3] Bone RA, Landrum JT, et al. Journal of Nutrition, 2003;133:992-998.

[4] Hammond BR, Fletcher LM, et al. Investigative Ophthalmology and Visual Science, 2014;55:8583-8589.

Helping Your Child Build Strong & Healthy Bones

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strongandhealthybonesheader

As a good parent, you want your child to have strong, healthy bones. Having healthy bones over a lifetime begins in childhood because this is when strong bones are built. In fact, if significant bone mass isn’t developed in childhood, bones are weak and fractures become a problem. Research also indicates that having weak and brittle bones in old age starts in childhood if proper nutrition is missing. Building bone mass and strength requires the right nutrients.

Most of us know that calcium, magnesium, and vitamin D are central to bone health. But did you know that vitamin K is a significant contributor to bone mass and density? Here’s why: calcium and magnesium need help from support nutrients that I call nutrient transporters. Vitamin D3 is one transporter and vitamin K2 is another. Recent research with children showed that those with higher vitamin K2 status had more bone mass, which leads to stronger bones. [1-2]

GillQuoteVitamin K is a fat-based vitamin. Vitamins A, D, and E are the other fat-based vitamins. Vitamin K has several roles in the body, in addition to supporting healthy bones. There are two natural forms of vitamin K: simply stated, K1 works in the liver and K2 also helps with bone and heart health. K2 is found in some foods but the richest sources are fermented cheeses and soybeans.

  •      The more bone mass and density children establish
  •      before age 20, the healthier and stronger their bones
  •      will remain as they age.
  •      Vitamin K2 plays an important role in helping create
  •      dense, healthy bones.
  •      Vitamin K2 in its MK-7 form has a longer-lasting
  •      effect on building bones than other forms.

GretchenGretchen Vannice, MS, RDN

Nutrition Consultant

For more information contact:

support@wileysfinest.com

 

References:

[1] van Summeren MJ, van Coeverden SC, et al. British Journal of Nutrition, 2008;100(4):852-858.

[2] van Summeren MJ, Braam LA, et al. British Journal of Nutrition, 2009;102:1171-1178.

AREDS2 Cognition Study Response

Education, News

A large, nationwide, government-funded clinical trial designed to measure the effect of select nutrients on visual function – specifically age-related macular degeneration – recently reported that 1,000 mg of EPA and DHA omega-3 a day did not slow loss in cognitive decline. The other nutrients didn’t show benefit, either.

I don’t get why they thought it would. Here’s why.

Results from the second Age-Related Eye Disease Study (AREDS) published last week were not on age-related eye conditions; instead, the findings were on cognitive health. Why would a study designed to investigate eye health publish results on cognitive health? Good question. The researchers realized that they had carefully selected nearly 4,000 subjects to participate in an eye research study and were set up to follow them for 5 years; it made efficient sense to measure additional outcomes.

The subjects were between ages 50-85 and already in early or intermediate stage of age-related macular degeneration (AMD); the average age of the subjects was 72 and over half were women. The 8th decade of life is about when people begin to experience loss in cognitive function.

In the study, the subjects were given omega-3 (350 mg DHA and 650 mg EPA) and/or lutein and zeaxanthin or placebo (blank pill). The researchers completed interviews and tested cognitive function in the subjects at the beginning of the study and then each 2 years. They assessed qualities such as immediate and delayed recall, attention and memory, and processing speed. Because the subjects already had AMD and were at risk for getting worse, they were offered additional vitamins and minerals (vitamin C and E, zinc and copper). At the end of the study, the reported that the supplements did not slow decline in cognitive function.

Here’s why I’m not surprised:

  • Diet matters. Studies consistently report that people who have healthy levels of EPA and DHA omega-3 over their lifetime have better cognitive function as they age. Other studies have shown that around the age of 50, people who have higher DHA levels have better cognitive health compared to those with lower DHA levels.
  • The subjects were already diagnosed with age-related macular degeneration (AMD). That the subjects had AMD suggests that, like many Americans, they had consumed little EPA and DHA in their lifetime because having higher levels of these long-chain omega-3s is associated with lower risk of AMD.
  • The amount of omega-3 was too low. The investigators didn’t measure blood levels of omega-3 or dietary intake of omega-3 foods during the study; that’s understandable since it would be cost prohibitive, but they did measure how many of the subjects actually took the supplements and they measured omega-3 blood levels in a representative group. This is customary in these types of studies and it’s the responsible thing to do. What they found is that about 80% of the subjects (4 out of 5) took the supplements about 75% of the time. So few, if any of the subjects actually got the intended amount of EPA and DHA omega-3 (350 mg DHA and 650 mg EPA). When the investigators measured blood levels, they did see increases in those who took the omega-3. That’s good, it means the supplements actually contained omega-3. Studies show cognitive benefit among adults with at least 1,000 mg DHA. One gram, less than ¼ teaspoon of oil.

Bottom line: Giving a small amount of omega-3 to people already demonstrating the effects of a lifetime of low levels of omega-3 for 5 years won’t reverse cellular damage that’s been done. What we do know, is that consuming omega-3 over the lifetime DOES make a difference, and/or consuming higher levels later in life DOES make a difference.

Further, the research investigators acknowledged that studies that have surveyed people on their dietary habits and health have found that regular consumption of fish is associated with lower rates of AMD, cardiovascular disease, and possibly dementia. “We’ve seen data that eating foods with omega-3 may have a benefit for eye, brain, and heart health,” Dr. Chew, study author, explained.

Adam Ismail, the Executive Director of the Global Organization of EPA and DHA Omega-3 also makes some excellent points in this summary https://www.linkedin.com/pulse/omega-3s-cognition-dosage-matters-adam-ismail.

Perhaps some of the greatest damage done by this study was the article published in Newsweek with the heading “Omega-3 supplements are a waste of money”. I find it unfathomable that a ‘health’ reporter would make such sweeping and inaccurate conclusions from one study. She’s wrong. She’s evidently unaware of the 3 decades of research. What’s most upsetting to me is that she has used her influence to do harm. Yep, to damage public health. There are people who need omega-3 supplements but I bet she doesn’t know who they are. Unfortunately, she’s not available to contact. I tried.

 

GretchenGretchen Vannice, MS, RDN

Nutrition Consultant

For more information contact:

support@wileysfinest.com

EPA and DHA omega-3s may help people with regular headaches

Education, News

Background: Omega-3 and omega-6 fatty acids are integrally involved with brain function and cellular health. They work in cells (e.g., nerve cells, red blood cells) but they are also the source of “ingredients” that make other important compounds. These other compounds have diverse functions in the body, some of which are related to managing headaches.

Study description: Men and women who reported having headaches that lasted more than 4 hours a day on 15 or more days per month were recruited for this study and then divided into two groups. Both groups consumed diets that contained limited amounts of omega-6 fats (e.g., from vegetable oils), but one of the groups also consumed high amounts of EPA and DHA omega-3s. Blood levels of compounds made from DHA omega-3 and the omega-6 fatty acid, arachidonic acid, were measured. The study lasted 12 weeks.

Significantly fewer headaches and less psychological distress was reported in the group who consumed more omega-3s but not the other group. Although these findings are ‘by association’, they support the need for more research to learn if simple and affordable changes in the diet, such as increasing omega-3s from fish oil, can help reduce headaches and distress.

General summary: Increasing consumption of EPA and DHA omega-3 from fish while limiting the intake of omega-6 fats was related to significantly fewer headaches and less distress.

 

Reference: Ramsden CEZamora D, et al. J Pain 2015 [Epub ahead of print]

 

GretchenGretchen Vannice, MS, RDN

Nutrition Consultant

For more information contact:

support@wileysfinest.com

 

Fish Oil Supplementation Improves Muscle Mass and Strength in Healthy, Older Men and Women

Education, News

Current Research: June 2015

Brief Summary of Findings: During middle age, muscle mass declines at a rate of about 0.5-1% per year. Loss of muscle mass is associated with higher risk of falling, disability, longer hospital stays, and inability to carry out daily activities in older age.  A 6-month, double-blind, randomized control in 60 healthy men and women age 60-85 reported that, compared to the corn oil placebo, supplementing with 3.35 grams (3,350 mg) of EPA and DHA omega-3 from fish oil per day significantly increased thigh muscle mass and upper and lower body muscle strength (measured by hand-grip and weight lifting, e.g., chest press, leg press). Improvement in muscle mass and strength was measured at 3 months but results continued to improve with continued supplementation. Omega-3 blood levels also increased significantly in the supplementing group. These results suggest that supplementing with > 3 grams of EPA and DHA for 6 months can prevent the equivalent of 2-3 years of usual, age-associated muscle loss and function in older, healthy men and women.

Research Abstract

Smith GI, Jullian S, et al. Fish oil–derived n–3 PUFA therapy increases muscle mass and function in healthy older adults. Am J Clin Nutr. Published ahead of print May 20, 2015. doi: 10.3945/ajcn.114.105833

Abstract

Background: Age-associated declines in muscle mass and function are major risk factors for an impaired ability to carry out activities of daily living, falls, prolonged recovery time after hospitalization, and mortality in older adults. New strategies that can slow the age-related loss of muscle mass and function are needed to help older adults maintain adequate performance status to reduce these risks and maintain independence.

Objective: We evaluated the efficacy of fish oil–derived n–3 (ω-3) PUFA therapy to slow the age-associated loss of muscle mass and function.

Design: Sixty healthy 60–85-y-old men and women were randomly assigned to receive n–3 PUFA (n = 40) or corn oil (n = 20) therapy for 6 mo. Thigh muscle volume, handgrip strength, one-repetition maximum (1-RM) lower- and upper-body strength, and average power during isokinetic leg exercises were evaluated before and after treatment.

Results: Forty-four subjects completed the study [29 subjects (73%) in the n–3 PUFA group; 15 subjects (75%) in the control group]. Compared with the control group, 6 mo of n–3 PUFA therapy increased thigh muscle volume (3.6%; 95% CI: 0.2%, 7.0%), handgrip strength (2.3 kg; 95% CI: 0.8, 3.7 kg), 1-RM muscle strength (4.0%; 95% CI: 0.8%, 7.3%) (all P < 0.05), and tended to increase average isokinetic power (5.6%; 95% CI: −0.6%, 11.7%; P = 0.075).

Conclusion: Fish oil–derived n–3 PUFA therapy slows the normal decline in muscle mass and function in older adults and should be considered a therapeutic approach for preventing sarcopenia and maintaining physical independence in older adults. This study was registered at clinicaltrials.gov as NCT01308957.

GretchenGretchen Vannice, MS, RDN

Nutrition Consultant

For more information contact:

support@wileysfinest.com

What Does Science Say? Bioavailability of Triglyceride vs. Ethyl Ester Forms of Fish Oil

Uncategorized

by Chris Speed, MND APD, April 2015

Introduction

Some sellers of fish oil products make superiority claims about the TG form of fish oil, compared to the EE form. This paper reviews current science on the bioavailability of omega-3s in human health WhatDoesScienceSay

Background

Triglycerides are a form of dietary fat. Most fats in foods—vegetable oils, meats, dairy foods, and fish— exist in triglyceride form. Most of the fat in our blood are triglycerides and this form is the predominant form stored in adipose tissue. A triglyceride (TG) molecule is composed of three (3) fatty acids attached to a glycerol backbone by an ester bond. The fatty acids can be saturated, monounsaturated, or polyunsaturated. In fish, about 20-30% of the triglycerides are omega-3 fatty acids: EPA, DPA, or DHA.

Non-concentrated fish oils and cod liver oils are pressed from fish and from cod livers, so they are also 20-30% omega-3. These oils are in the natural triglyceride formb and are sometimes called nTG oils.

To produce fish oil supplements with meaningful doses of EPA and DHA Omega-3 per serving, omega-3s are concentrated up from the starting 20-30% omega-3 in unprocessed fish oil. Concentrated products contain fish oil in either ethyl ester (EE) form or re-esterified triglyceride (rTG) form.

background

Consumers and health professionals like concentrated fish oil products. Higher doses of EPA and DHA are often required to achieve desired nutrition and health benefits. Concentrated fish oil products can provide double or more of the amount of EPA and DHA than regular fish oil but not at double the price. Concentrated fish oil products offer more omega-3 in fewer capsules and are often a better value.

Manufacturing concentrated fish oil: EE and rTG forms

To begin, the three types of fatty acids (saturated, monounsaturated, or polyunsaturated) in the triglyceride are liberated from glycerol and attached to an ethyl alcohol and become ethyl ester (EE) fatty acids. The production of the EE form is a necessary first step. Conversion into the EE form allows omega-3 fatty acids to be separated from the saturated and monounsaturated fatty acids without damaging the omega-3s. At this point, EE omega-3s (EPA, DHA, or DPA) can be molecularly distilled, concentrated to the desired level, delicately purified, and encapsulated, or it can be further processed into a rTG fish oil product.

To produce a rTG fish oil, the EE omega-3 fatty acids are enzymatically re-attached to a vegetable glycerol molecule by a process called re-esterification (rTG), and then distilled, concentrated, purified, and encapsulated. Note that not all of the fatty acids are re-attached as triglycerides: according to The European Pharmacopoeia, a rTG must contain at least 60% triglycerides; the rest is di-glycerides and mono-glycerides. Technology has improved; some manufacturers are now able to employ sophisticated processes to produce rTG oils that contain up to 80-90% triglycerides. This additional processing (re-esterification) adds additional cost to the final product.

Currently, no distinctions or labeling is required for natural triglycerides vs. re-esterified triglycerides, and companies generally refer to both forms as ‘natural’. There are, however, distinct differences in the composition of these two TG forms. In fish and in non-concentrated fish and cod liver oils (nTG), the omega-3 fatty acids are typically, naturally bound to the glycerol molecule in the middle position (SN-2) and hence contain about 20-30% omega-3. In other words, about one out of three fatty acids attached to the glycerol molecule is omega-3 (the 20-30%). In contrast, during production of rTG fish oils, the omega-3 fatty acid is randomly attached to any position on the glycerol molecule (SN-1, 2, or 3) and the statistical probability is that more omega-3 will attach at SN-1 and/or SN-3 than at SN-2. It is unknown if any physiological differences exist due to the location of attachment of the omega-3 fatty acids to the glycerol. Though claims are made, a preliminary human study suggests that the location of attachment does not affect absorption. 1

It is often argued that the rTG form of omega-3 is natural and the EE form is not, but in reality, both EE and rTG forms of fish oil are relatively new as concentration of fish oils began in the 1980s. 2

Absorption

Under normal conditions, humans absorb 85-95% of the fat we consume. 3 Research has also shown that we absorb omega-3 from fish and fish oil capsules equally well. 4 It is the tissue levels of omega-3 that matters most. Regardless of the form (e.g., EE) or source (e.g., fish or supplements), improving tissue levels of omega-3 takes time.

Bioavailability

Bioavailability is the degree and rate at which a nutrient is absorbed or made available at the site of physiological activity. There are essentially two definitions of bioavailability:

  • Short-term bioavailability measures the amount and rate at which a nutrient gets absorbed and enters the blood stream.
  • Long-term bioavailability measures how much and how effectively a nutrient reaches its target tissue where it is physiologically active.

There are substantial differences between these two types of bioavailability. For example, the amount of omega-3 fats that enter the bloodstream is different from (and greater than) the amount that reaches target tissues. Measuring levels of omega-3s in the blood is relatively simple and inexpensive, but the conclusions that can be made from this information is limited because omega-3s are not active in the blood stream; omega-3s function in tissue. Blood levels of omega-3s change within hours of intake but this doesn’t reflect tissue, or cellular, levels. It is the amount of omega-3 that reaches ‘steady state’ levels in tissues that matters. Membrane tissue levels are the best measure of omega-3. It takes 8-12 weeks to see meaningful changes in tissue levels, and it takes months of consistent consumption for tissue levels to stabilize, or reach ‘steady state’. Furthermore, individual factors such as age and body weight influence how much omega-3 reaches tissue levels. For example, it takes longer for omega-3 tissue levels to change in overweight individuals, and one study measured faster changes in omega-3 tissue levels in older individuals, compared to younger adults. 5,6,7,8 There are other factors that influence absorption of omega-3 from fish oil, too.

tissueistheissueFor example, enteric coating of capsules can delay or reduce absorption and consuming fat in a meal or snack along with the omega-3 supplement will increase absorption. 9

Clinical Research Review:

Several short-term bioavailability studies have reported no difference between the EE and TG forms:

  • When two doses (35% and 54%) of EPA and DHA from nTG and EE forms were compared, no difference in absorption was measured. 10
  • A comparative study of meals containing omega-3 as EE or TG showed normal absorption of both EPA and DHA. 11
  • It is known that absorption of omega-3 fatty acids is better when consumed with a fat-containing meal. When researchers compared absorption of EE and TG forms in male volunteers consuming a low-fat (8g) versus high-fat meal (44 grams total fat), there was a marked increase in absorption of EE form, but absorption of both TG and EE forms significantly improved. 12
  • A 2-week study in healthy males reported no difference in the absorption between EE and nTG omega-3 when the equivalent amount of EPA and DHA were consumed. 13

One comparative study reported that rTG increased blood levels faster in the short-term:

  •  A 2-week study in healthy adults evaluated absorption of five forms of omega-3 fish oils: EE fish oil; rTG fish oil; free fatty acids; and fish body oil and cod liver oil containing nTG form. 1 Doses ranged between 3,100 – 3,600 mg EPA and DHA.
  • Omega-3 blood levels increased at a faster rate with the rTG than with the EE form but the study didn’t last long enough for blood levels to reach steady state. The different forms of fish oil were well absorbed and this study suggested there may be differences in the rate of absorption in the short-term but it does not show change in tissue levels over time. In addition, it’s unknown if subjects consumed the supplements with fat-containing food or snacks.

Several longer-term bioavailability studies have reported similar benefits between the EE and TG forms:

  •  A 7-week placebo-controlled study that compared the impact of EE and rTG form (3,400 mg and 3,600 mg EPA and DHA, respectively) in healthy male subjects reported similar and beneficial influence from both forms on platelet function. 14
  • A 12-week randomized, double-blind study compared the impact of 2,000 and 4,000 mg of EE and rTG omega-3 in subjects with elevated triglycerides. With both forms, plasma triglycerides were lowered and no differences in assimilation or triglyceride lowering were measured. 15
  • A 6-month double-blind, placebo controlled trial compared the effect of 1,680 mg of EPA and DHA in rTG and EE forms on omega-3 levels in red blood cells (the Omega-3 Index). 8
  • The omega-3 index increased significantly in both rTG and EE groups. It increased more in the rTG group, but again, the study authors noted that whether or not this difference has meaningful impact on clinical outcomes (e.g., reducing triglycerides, reducing risk of sudden cardiac death) is unknown. Faster increases in blood levels don’t imply better efficacy.
  • A 6-month randomized controlled trial in men with documented heart disease compared the effects of EE (7 grams) and rTG (6 grams) omega-3 versus placebo. In both omega-3 groups, plasma omega-3 levels increased significantly and mean triglyceride levels reduced significantly. 16

EE fish oils have an excellent safety profile:

The long-term safety of the EE form of omega-3 fish oil is excellent. Safety has been documented in thousands of human studies. 8,17,18

Conclusion

Based on clinical evidence, there does not appear to be meaningful differences in bioavailability between EE and rTG forms of fish oil.

globalorganizationofepaanddha

References

1 Dyerberg J, Madsen P, et al. Prosta Leuko Ess Fatty Acids 2010;83(3):137-141.

2 von Schacky C. Vasc Health Risk Manag. 2006;2(3):251-262.

3 Essential fatty acids. Linus Pauling Institute, Corvallis, OR.

4 Harris WS, Pottala JV, et al. Am J Clin Nutr 2007;86:1621–1625.

5 Schuchardt JP, Hahn A. Prostaglandins Leukot Essent Fatty Acids. 2013 Jul;89(1):1-8. 6 Neubronner J,

Schuchardt JP, et al. Eur J Clin Nutr 2011;65(2):247-254.

6 Neubronner J. Schuchardt JP, et al. Eur J Clin Nutr 2011;65(2):247-254.

7 Flock MR, Skulas-Ray AC, et al. J Am Heart Assoc. 2013;2(6):e000513.

8 Vandal M, Freemantle E, et al.. Lipids 2008;43(11):1085-1089.

9 Lawson LD, Hughes BG. Biochem Biophys Res Commun 1988;156(2):960-963.

10 Luley C, Wieland H, et al. Akt Ernaehr-Med 1990;15:122-125.

11 Nordoy A, Barstad L, et al. Am J Clin Nutr 1992;53:1185-1190.

12 Raatz SK, Redmon JB, et al.. J Am Diet Assoc 2009; 109:1076-1081.

13 Krokan HE, Bjerve KS, et al. Biochim Biophys Acta 1993; 1168(1): 59-67.

14 Hansen JB, Olsen JO, et al. Eur J Clin Nurt 1993; 47(7):497-507.

15 LA Simons, A Parfitt, J Simons, and S Balasubramaniam. Aust N Z J Med 1990; 20(5): 689-694.

16 Reis GJ, Silverman DI, et al. Am J Cardiol 1990; 66(17): 1171-1175.

17 Harris WS, Ginsberg HN, et al.. J Cardiovasc Risk 1997;4(5-6):385-391.

18 Bays HE, Tighe AP, et al. Expert Reviews Cardiovasc Ther 2008;6(3) 391-409.