What to Know About Omega 3 Fatty Acids

What are Omega-3s?
Triglycerides (3 fatty acids and 1 glycerol) make up more than 90% of the fats we consume. Omega-3s, which are unsaturated fatty acids, cannot be synthesized in the human body and therefore must be obtained from the diet. These compounds, considered essential fatty acids, serve very important functions. They are found in cell membrane structure, play a role in cell signaling and gene expression modification, support anti-inflammatory mechanisms, and support the functioning of many biological functions.

What are the Sources of Omega-3s?

Omega-3 fatty acids are primarily found in fish, pasture-fed meat, free-range poultry eggs, and flaxseed oils. Plant-based Omega-3s are not available in the form of EPA and DHA that can be used directly. For EPA and DHA to be formed, both the enzymes must be highly active and the omega-6-rich oils must not saturate these enzymes. In conclusion, to benefit from the benefits of omega-3, it is beneficial to have a diet containing at least 1 gram (1000 mg) of omega-3 fatty acids daily. To protect against many diseases, a minimum of 1000 mg of EPA and DHA should be consumed daily. For maximum effect, consumption of omega-6-containing oils (corn, sunflower, soy, cottonseed) should also be significantly reduced.

Coldwater (bottom-water) fish such as mackerel, herring, tuna, salmon, and sardines are oily and rich in omega-3s. Fish synthesize omega-3 fatty acids from algae and plankton. Omega-3s protect against cold temperatures. Therefore, they are most abundant in coldwater fish. Lean fish contain very little omega-3. You can get 0.5-1 gram of omega-3s daily by eating fatty fish two or three days a week. However, these cold-water fish may not always be readily available today, and heavy metal pollution in the seas poses a risk to bottom-dwelling fish. Therefore, the use of omega-3 supplements is recommended. While various fish oil preparations are available on the market, many products are far from ideal.

Why Should I Use Omega-3 Supplements?
We used to obtain omega-3 from the meat, milk, and oil of animals that consume greenery. By raising fish on farms instead of in their natural habitats and removing animals from pastures (greens), omega-3 has been removed from our food chain. This is a significant loss, and it is a micronutrient that must be included in our diet for our health. Eating a healthy diet and using nutritional supplements, which have become essential due to our modern lifestyle, are crucial for your health.

Regular sleep, adequate nutrition from natural sources, and an active lifestyle are important factors in keeping us healthy and vigorous. However, it may not be possible to consume a diet rich in micronutrients from the right sources every day. Modern society's fast-paced lifestyle, high stress levels, and the decline in micronutrient (vitamin, mineral, and omega-3) content of foods necessitate the use of certain dietary supplements. Omega-3 is at the forefront of these.

What should we consider when choosing an omega-3 supplement?
1) The omega-3 product you will be using as a dietary supplement should be derived from ocean fish living naturally in cold regions unaffected by environmental pollution. Well-established companies operating responsibly use fish oils from regions with clean ocean currents and low chemical pollution to obtain high-quality fish oils, as this is the only way they can obtain clean analysis reports. Be sure to inquire about the quality of the fish oil from which the product you are using is sourced.

2) For effective use, it is crucial that the Omega-3 you are using contains 1000 mg (1g) of EPA and DHA, the recommended daily dose for adults. Some companies may list the total EPA/DHA content of 2 or 3 capsules on the label. There is nothing wrong with this. I also support choosing medium-sized capsules that children can easily use, rather than very large ones.

However, you should check the product label for total EPA and DHA content. What you need to check is whether your recommended daily dose includes 1000 mg of EPA+DHA. If the total EPA+DHA content in the recommended daily dose for adults is less than 1000 mg, buying one box of that product won't be enough for an ideal month's use. Calculate your costs based on how much you'd pay to buy 30,000 mg of EPA and DHA for an ideal month's use. In some cases, a doctor's recommendation may require 2000 or even 3000 mg of omega-3 supplements (not fish oil, but omega-3s, meaning EPA+DHA). Of course, your omega-3 supplement needs to be in triglyceride form for this calculation.

The absorption of the ethyl ester form is approximately half as low at standard dosages, so for ethyl ester form omega 3s, it is useful to calculate 60,000 mg of EPA and DHA for monthly adult use.

For children under 10 years of age, if there is no specific neurological disorder, 1/3 of these doses may be sufficient. Because high doses of DHA are required in specific neurological disorders, special ratios of omega-3s can be used to achieve this amount.

3) Choose Omega-3s in triglyceride form. Omega-3s are commonly available in two forms: triglyceride and ethyl ester. Scientific articles have shown that the triglyceride form offers up to a two-fold advantage in absorption compared to standard doses. However, this difference disappears with very high doses and long-term regular use. No significant difference in blood levels was observed between approximately 4 grams of ethyl ester and 4 grams of triglyceride omega-3s given for scientific studies. However, it's important to note that 4 grams of omega-3s require 24 500 mg capsules.

Because these doses are generally not exceeded, the triglyceride form is advantageous in terms of absorption. Furthermore, since the triglyceride form is the normal form of fish oil, I believe it would be more appropriate to choose an omega-3 in triglyceride form if possible. However, some of my colleagues' claims on the screen that "omega-3s in ethyl ester form are for animals, and only the triglyceride form is for humans" are scientifically incorrect. Let's not forget that 90% of the scientific articles demonstrating the benefits of omega-3s for the human body were previously conducted with omega-3s in ethyl ester form.

Furthermore, of the four preparations approved by the FDA as drugs worldwide (for the treatment of hypertriglyceridemia), one is in the free fatty acid form, and the other three are in the ethyl ester form. The FDA has not yet approved the use of omega-3s in triglyceride form as drugs. Some of the omega-3s currently widely sold in pharmacies are also in ethyl ester form. To avoid misunderstandings, I recommend opting for an omega-3 in triglyceride form, which offers up to a double absorption advantage at standard doses. However, I don't believe it's fair to unfairly disparage the ethyl ester form, despite its absorption disadvantages.

4) Choose fish oil capsules with a high concentration of omega-3s. The higher the concentration of omega-3s in the fish oil you use, the more omega-3s you'll get from one capsule. This is crucial. 18/12 fish oil capsules are often marketed, meaning 18 mg of EPA and 12 mg of DHA per 100 mg, meaning a total of 30 mg of EPA and DHA per 100 mg. This means that approximately 70% of the capsule consists of non-omega-3 fats. If you choose high-density oils, meaning products where 55-60% of the capsule is omega-3 (36/24 or 33/22), you'll get approximately twice as much omega-3 as the same amount of fish oil. By comparing the total EPA and DHA in a capsule on the label to the weight of the fish oil in the capsule, you can determine whether the oil is 30% or 55-60%.

5) Ensure that the capsules are made with high-quality gelatin produced according to GMP standards. The gelatin used in fish oil capsules is often problematic due to its origin in imported products. Because gelatin is sourced from abroad, it can be porcine, which can prevent those with religious sensitivities from using these products. Thankfully, there are now high-quality gelatin production facilities in our country that produce using halal slaughtered cattle according to GMP standards. Products using high-quality, GMP-certified domestic gelatin are preferable for both the reliability of origin and the support of the national economy. If products imported from abroad are labeled as 100% fish gelatin, it's a good choice.

Gelatin is, in fact, gelatin. Its chemical structure doesn't differ depending on its origin, so DNA analysis is the only way to determine its origin. Whether the gelatin is derived from fish or cattle doesn't affect the absorption or stabilization of omega-3s. Important points to consider when choosing gelatin include ensuring that the production technology adheres to GMP standards and, for those with religious sensitivities, that it is a halal-certified product sourced from reliable sources. Omega-3 capsules can be produced as softgels or hardgels. The most widely used technology in our country and globally is softgel technology. Hardgel technology is a new technology, and hardgel capsules are not yet produced in our country. Some omega-3s are imported directly in hardgel capsules.

6) The omega-3s you use should be analyzed for heavy metals, oxidation parameters, and stability. Do not purchase products from companies that don't clearly display their analyses on their websites. Remember, all dietary supplements are approved by the Ministry of Food, Agriculture and Livestock, and any product approved by the ministry can be sold in pharmacies and herbalists. This approval is usually based on international fish oil standards (IFO).

Q: The International Fish Oil Standard (IFOS) is not awarded with the precision required to earn 5 stars.

It is crucial that the product you will use receives an IFOS 5* rating or that analyses demonstrate its performance in all parameters. However, this IFOS certification increases the cost, as it requires thousands of dollars to be obtained annually by a Canadian-based company. In fact, most of these analyses can be performed in our country. It would be beneficial for the Turkish Standards Institution (TSE) or a private local laboratory to establish a similar certification system for Omega-3. Always check for analysis reports on products that do not meet the IFOS 5* certification. It is best to avoid cheap products without certification or analysis reports.

7) It is also crucial that the capsule size is easily swallowable by children. Families who want to use omega-3 supplements to support their children's learning may have difficulty getting their children to swallow large capsules.

However, giving children this strong-smelling oil in pure syrup form is nearly impossible, as it contains numerous additives and sweeteners. Omega-3 supplements are available in capsule sizes (less than 750 mg) that children can swallow. However, since these products typically come in two or three capsules, the adult dose is usually two or three times the child's dose, so pay close attention to label information when calculating daily costs.

8) The packaging in which the fish oil is presented must be suitable for food contact and protected from direct sunlight in a box. Packaging can be blister packs, glass, or suitable hard polyethylene containers (HDPE). Storage conditions, not packaging, are crucial. Whether glass or hard polyethylene suitable for food contact, it must be protected from heat. Heat can cause the gelatin surrounding the omega-3 to stick together, increasing the risk of oxidation. Avoid products that have been stored on the shelf all day without protection from sunlight and heat. Ensure your omega-3 supplements are stored in a box and protected from sunlight. After purchasing your Omega-3s, store them in the refrigerator if possible.

9) It's beneficial to include additional fat-soluble vitamins and vitamin E, a powerful antioxidant, along with omega-3s in your fish oil capsules. In fact, all quality fish oil manufacturers package their fish oils with vitamin E to prevent spoilage. However, adding a small amount of vitamin E, provided it doesn't exceed the daily recommended dose, reduces the risk of oxidation (deterioration) of omega-3s. It's also very beneficial to take vitamin D, a fat-soluble vitamin that almost everyone needs, while taking pre-packaged omega-3s.

Vitamin D deficiency is prevalent in Turkey, with a rate of 70-80%. Regular consumption of this vitamin is essential. Consuming excessive doses—more than 10,000 units per day—can have some negative effects. Therefore, when correcting deficiencies found in tests, a doctor's recommendation can be used in conjunction with 10,000 units of vitamin K2 daily to replenish these reserves. Following this, taking up to 1,000 units of vitamin D daily can help prevent vitamin D deficiency. Using a product that provides 1000 units (25 mcg) of vitamin D along with the adult dose of omega-3 (1000 mg total EPA+DHA) will be very effective in protecting your health.

10) Choose fish oil over krill oil. This is one of the most frequently asked questions: krill oil or fish oil? To reach the recommended 1000 mg total EPA/DHA in krill oil, you'll need to swallow many capsules, and this will be very expensive. Although it's claimed that krill oil is much better absorbed and provides the same effect with a much smaller dose than fish oil, scientific studies don't show this significant difference in absorption.

This difference in cost, especially when evaluated on a per-gram basis, is negligible. Also, remember that every supplement contains antigens that can potentially sensitize our bodies. It would be very difficult to determine whether our bodies have developed sensitization to antigens from a marine organism we don't consume directly. Based on current scientific data, there's no compelling evidence to justify choosing krill oil for the same amount of omega-3 supplements, despite the significant cost difference.

Are There Side Effects of Omega-3 Supplements?
No significant side effects are observed in those taking omega-3 supplements at normal doses (1000 mg EPA and DHA). The main side effects are a fishy odor and, very rarely, gastrointestinal problems such as nausea and diarrhea. Gastrointestinal problems may be slightly more common in those who have had their gallbladders removed. Omega-3 fatty acids prolong bleeding time with increasing doses. However, to date, no serious bleeding has been reported in individuals taking omega-3 supplements, even at high doses or taking other anticoagulants.

More than 2 grams of omega-3 daily

Those taking omega-3 fatty acids should not neglect bleeding time tests, just in case, if they are also taking blood-thinning medications.

Contrary to popular belief, fish oil does not cause weight gain; in fact, it actually helps you lose weight by reducing insulin resistance. Omega-3 fatty acids inhibit the enzyme fatty acid synthase, which converts fat from sugars, thus reducing fat storage.

Consequently, the World Health Organization recommends a minimum of 0.5 grams of fish oil. Recent studies have observed significant positive effects at intakes of 1000 mg or more, while the effect is less pronounced at lower intakes. If you have certain medical conditions or risk factors, you can increase your omega-3 intake to 2-3 grams by consulting a physician who has scientifically researched the use of dietary supplements and, if possible, has training in phytotherapy.

For children and pregnant women who need neurological support, it's best to choose omega-3 forms high in DHA. For adults, unless specifically targeting a neurological condition, it's best to choose forms high in EPA. The standard fish oil ratio of 3 EPA / 2 DHA is the best ratio for general use.