A growing body of evidence points to the benefits of omega-3 fatty acids for the heart, brain, joints, and more. But the results of trials evaluating omega-3 supplements have been mixed. What gives? Popular media reports often omit important discoveries, perhaps because they're difficult to communicate in a sound bite, and we're left scratching our heads.
A study published in Circulation, a journal of the American Heart Association, helps to put things in perspective. Scientists at Johns Hopkins and other U.S. universities evaluated much of the earlier research, and found that benefits correlate more closely with blood levels of omega-3s than with specific supplement doses, because individual responses vary. This helps explain the inconsistencies.
Let's say 100 people take one gram of fish oil. For some, blood levels will rise to a therapeutic level but for others, a gram is not enough. A study that doesn't test blood levels will conclude that the supplement isn't consistently effective-and this has been an all-too-common research flaw according to the study authors.
Genes partially account for these differences, but other, unhealthy fats are also a major problem. Inflammatory omega-6 fats are overabundant in Western diets-found in the corn, soybean, safflower, and grapeseed oils used in processed foods, as well as in meats and dairy products. The research review found the lowest rates of heart disease among people eating a traditional, fish-rich Japanese diet, with an omega-6:omega-3 ratio of nearly 1:1. But in our Western diets, this ratio can be as high as 20:1, with unhealthy omega-6s dominating.
Why Omega-3s Work
"Omega-3s are anti-inflammatory," says Dennis Goodman, MD, a board-certified cardiologist, director of integrative medicine at NYU Langone Medical Center, and author of The Thrill of Krill. "We know the background of so many diseases-atherosclerosis, arthritis, cancer, dementia, leaky gut syndrome-is inflammation, so why wouldn't we use something natural to fight inflammation?"
At least 8,000 human studies support the benefits of omega-3s, in a variety of ways. For the heart, they lower triglycerides, blood fats that are harmful if elevated, and reduce inflammation that leads to plaque deposits in arteries. And virtually all other parts of the body benefit: joints, the brain, the eyes, and skin. Omega-3s improve mood, reduce aggression, enhance pregnancy and children's development, and support a healthy metabolism and sports performance.
Where to Get Them
So far, almost all of the research has tested omega-3s from fish oil, and more recently, krill oil, from miniscule shrimp-like creatures in the Antarctic. Both supply the key beneficial fats but in another respect, they differ.
The EPA and DHA in krill oil are attached to a fatty substance called phospholipids, making them two to three times more absorbable, says Goodman. "The body understands phospholipids because many of the cell membranes contain phospholipids, so they know how to process it."
This, he says, is how theory translates into practice: "Say someone's taking a gram of a fish oil; they can certainly take 500 mg of krill and have an equivalent effect." Because of this mechanism, krill oil is digested more quickly, making fishy burps less likely. And, it naturally contains astaxanthin, an antioxidant, which helps to keep the oil fresh.
However, this doesn't mean fish oil should be avoided. "What's important," says Goodman, "is that you take omega-3s."
What to Take
So, sure you should take omega-3s. But which ones? First, look for high-quality supplements in capsules, oils, or flavored smoothie-style forms, such as Barlean's Omega Swirls. For krill oil, look for at least 40 percent phospholipids. A doctor can test your blood to determine personal needs, but these dosages are effective for most people.
- For health maintenance: 500 mg of krill oil or 1,000-1,500 mg of fish oil.
- For coronary heart disease: 1 gram of krill oil or 2-3 grams of fish oil.
- To lower triglycerides: The American Heart Association and other medical guidelines recommend 2-4 grams of EPA plus DHA from fish oil. Check the Supplements Facts on product packages for EPA and DHA amounts. If taking krill oil, take one-third to one-half this amount of EPA plus DHA.
- For pets: Follow directions on pet supplements or your vet's advice.
- For vegans: Plant-based versions of EPA and DHA also come from algae, as separate supplements rather than in combination. Follow product directions.
- Alpha-linolenic acid (ALA): A different type of omega-3 fat found in plant foods, ALA is converted in the body to EPA and DHA, but does not raise blood levels to the same degree as direct EPA and DHA supplements. However, ALA-rich foods are beneficial and recommended, especially if eaten in place of unhealthy oils. Try substituting walnuts, or chia or flaxseed snacks, for conventional treats made with inflammatory oils.
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