Confused Day Tuesday: How Do I Choose a Fish Oil Supplement?

Working in a supermarket I probably answer the question "which fish oil do you take?" about once a week.  It's a great question, because fish oil supplements are a confusing industry.  Here are some things that seem to confuse customers;

• On the front of most fish oil containers you see the claim "1000 mg fish oil", but the actual amount of the important long chain fatty acids (EPA and DHA) is always much less.  

• No one really knows how much EPA and DHA they should be getting.

• People on TV sometimes report things on his show that (from what I can find....) are just not true.

• Rumors are spread constantly about the "contamination of fish oil" and how fish oil supplements contain mercury and other scary impurities.

Source: iStock Photo

Are you confused about any of these?  Read on, and I'll attempt to clear up the confusion, so the next time you go to choose a fish oil supplement you won't stop in your tracks and stare at the hundreds of options....and get frustrated beyond belief.

• On the front of most fish oil containers you see the claim "1000 mg fish oil", but the actual amount of the important long chain fatty acids (EPA and DHA) is always much less.  

Yes, you will always see the amount of fish oil listed on the front of a fish oil supplement label.  This does not coincide with the amount of EPA and DHA.  What you need to do is look at the nutrition facts on the back and find where it says "Omega-3".  Many times the label will list the amount of Omega-3 (all fish oils should list this) and then break those down into EPA and DHA (types of omega-3).  These are the numbers that truly matter, not the amount of total fish oil listed on the front of the label.  

• No one really knows how much EPA and DHA they should be getting.

Check out the American Heart Association's recommendations to see the amount of EPA and DHA you should aim for, depending on your health status.  The amount for someone with documented heart disease is different than those with high triglycerides, which is also different than that for the general population.  In fact, it's not recommended to take fish oil if you don't have documented heart disease or high triglycerides.  Instead the recommendation is to consume fatty fish (like salmon, mackerel, or tuna) twice a week.  This comes out to about 500 mg EPA/DHA per day.  But, for those of you (like my husband) who see this meal below and cringe, taking fish oil may be your only alternative.

Source: iStock Photo

• People on TV sometimes report things on their show that (from what I can find....) are just not completely accurate.  

I know many people watch Dr. Oz, and assume he knows everything.  While I really do think Dr. Oz is an incredibly smart man, and has done a lot of great things for those who watch his show (I love the way he teaches his viewers about specific topics through the use of props, they often help me understand a certain concept better!) I sometimes have trouble finding evidence to back up what he says on his show.  I wish he gave references for his information, wouldn't that be nice? For example, in this episode of his show he claimed that you should only buy fish oil supplements with at least 600 mg DHA. He also claims that EPA can only be absorbed with DHA.  After countless numbers of customers asking me for fish oil with at least 600 mg DHA, I finally decided to look into where this information came from.  I couldn't find any research to back this up, and I even e-mailed my graduate professor from The Ohio State University, who specializes in fatty acids, and she was also confused.  If you know of any evidence to prove that Dr. Oz is right, I would love to know about it.

If you're a vegetarian or vegan, remember that the converison of ALA (plant based Omega-3, found in chia, flax, and soy) to DHA is slightly weaker than that to EPA (and for both it's only about 3% (DHA) and 6% (EPA)) so maybe that's why Dr. Oz is saying to look for at least 600 mg DHA?  Who knows.

In addition, Dr. Oz says that Krill Oil has more EPA and DHA.  That might be true with some brands of Krill oil, but not all.  One very popular brand contains 74 mg EPA/DHA, total, per serving.  Ummmm....... that's not enough.  In fact, I have yet to find a brand of Krill oil that contains close to 500 mg EPA/DHA (let alone one that contains what 600 mg DHA!!).  So again, I'm very confused.

• Rumors are spread constantly about the "contamination of fish oil" and how fish oil supplements contain mercury and other scary impurities.

Even Dr. Oz agrees, "most brands of fish oil have been proven safe".  But, if you're still not convinced, look for the "USP" (United States Pharmacopeia) symbol on your favorite fish oil, which assures you that your product has been third-party tested for quality and lack of contaminants.  You can also call the company to see if they have been third party tested, as not all companies pay for the USP symbol.  There is always a phone number on the back of fish oil labels (and all supplements). Just give the company a call and ask about their quality assurance practices.  They are almost always happy to share them with you, their paying customer!

QUESTION:  Do you take fish oil supplements? Is there anything else that confuses you when trying to choose a product?

If you're still confused, skip the supplements and just eat fish. Period!  Aim for 2 servings (4 ounces per serving), at least, each week
Source: iStock Photo

Thanks for reading!

The Candid Rd

NOTE: I love comments!  But, be sure to come back to read any replies to questions or comments, as they do not go directly to your e-mail.

Companies Make Money Off Of This?!

Are you taking a fish oil or flaxseed supplement, which also contains high amounts of omega-6 fatty acids (>600-700 mg)???!!

STOP!

Source: iStockPhoto

Lately I've noticed that more and more companies are highlighting the importance of the omega-6 fatty acids (in the form of linoleic acid) in their fish oil and/or flaxseed oil supplements. To me, this is a major problem. I've been trying to explain this to friends and family for a while now, but a recent article in Today's Dietitian Magazine confirmed that I am correct in telling people to steer clear of these types of supplements.

According to the article (page 48), humans evolved on a diet with an omega-6 to omega-3 ratio of 1:1, but now it is closer to 16:1. The reason why we are consuming so much more omega-6 is that it is found in so many of America's favorite foods:

Sources of Omega-6

Vegetable oils

Poultry

Nuts

Seeds

Just that first source alone; vegetable oil, is enough proof that Americans are getting plenty of omega-6 fatty acids. Check out the foods in your cabinet right now and you will see that most of them contain at least one type of vegetable oil. And then we have sources of omega-3 fatty acids;

Sources of Omega-3

Walnuts (vegan source)

Flaxseed (vegan source)

Algae (vegan source)

Soy (vegan source)

Fish

Fish oil supplements

Grassfed beef

Milk from grassfed cow

Fortified eggs

These foods are not in every person's diet, that's for sure. And something you may not know is that most of the foods listed above also contains omega-6 fatty acids, and in some cases they contain more omega-6 than omega-3 (flaxseed, walnuts, soy)!

If you are not a vegetarian or vegan you are less likely to have problems getting enough omega-3 (but trust me, I know plenty of animal eaters who still do not get enough). Many vegans and vegetarians (but certainly not all!) have trouble getting enough omega-3 and reducing their ratio of omega-6 to omega-3 fatty acids. This is especially true when they buy flaxseed or other omega-3 supplements, which also contain high amounts of omega-6 (>600-700mg). Companies like to capitalize on the fact that omega-6 is essential and we can only get it via food and/or supplements. But now you know, you do not need it in your supplements! That is, unless you don't eat any oils, poultry, or snack foods....

Source: iStockPhoto

But I highly doubt that is the case.

Did you know that an abundance of omega-6 in one's diet (especially a vegan or vegetarian) can decrease the already low conversion of ALA to DHA and EPA? So I'm still pondering the idea of omega-6 being added to omega-3 supplements, especially ones meant for vegans. Now that you know it's a waste of money, do yourself a favor and do not buy these. Look for omega-3 supplements that are strictly omega-3, unless of course you aren't getting enough oils and other sources of fat in your diet, which may warrant these types of supplements (for example, if you're on a very low calorie or low fat diet).

Bottom Line

Omega-6 is a natural fat found in many of these products, but some companies provide more of these fats than others. Buy fish oil supplements, or flaxseed supplements, that do not contain more than ~600-700 mg omega-6, which is the lowest I found, and look for at least 1000 mg total EPA/DHA, per serving (or just look for the lowest ratio of the two fats possible). And of course, continue to focus on omega-3 when you eat foods throughout the day.


Question: Have you ever purchased a flaxseed oil or fish oil supplement, which contained high amounts of omega-6? What are your thoughts on this issue??

Fish, Fish, the Magical Food, the More You Eat......

THE BETTER YOUR MOOD!

Yep. It's true! Studies have shown that low omega-3 levels in plasma and red blood cells are associated with depression, and other research suggests eating fish lowers the risk of depression and suicide (Natural Standards Database).


I love fish, but I do still take fish oil supplements. I actually take the pills, but many people don't like the pills so they resort to liquids or powders. This powder below is an orange flavored fish oil supplement powder.

It even contains 1200 IU vitamin D. That's a serious bonus.

Add some water to it and voila! It's a delicious drink. Ok, maybe not delicious, but actually not so bad. If you have kids this may be a winner. It reminded me of weak Tang. That sounds gross, but it wasn't bad, I promise.




When I'm not supplementing my omega-3s, I'm joyfully eating them. I made an "Asian-Inspired Tuna Salad" the other day for a recipe demo at work;

Asian-Inspired Tuna Salad

(serves 2)
Mix all of the following ingredients together in a medium-sized bowl:

6 ounces pouched tuna
3 T Greek yogurt
1.5 t wasabi mustard
1/4 cup chopped cashews
1/4 cup chopped avocado

• Serve on whole wheat bread
• Serve with whole wheat crackers
• Serve on a bed of lettuce or spinach
• Serve in a hollowed-out pepper, then roast it!
  

I don't have any pictures, but it was a huge hit at the store, I promise. People were shocked that I used Greek yogurt instead of mayo, and that it actually tasted good.


At home I love to make medium rare salmon.

Simple Salmon

(Serves 1)

4 ounces skinless wild salmon

2 tsp. extra virgin olive oil

3 cloves garlic, minced

Dash of salt

Lemon wedge (optional)

Directions

Place a piece of foil down on a baking pan and spray with non-stick spray. Place the salmon on top of the foil. Top your fresh salmon with the oil and spices (use your hands to get it all rubbed in nicely!). Broil for about 8 minutes for medium rare, or 12 minutes for medium (the timing really depends on the thickness of the salmon). I always prefer my salmon medium rare, especially if I am planning to freeze it and reheat at a later time (reheating will make it medium).



The salmon can be enjoyed on a spinach salad or alone with a side of sauteed veggies. Serve the salmon with the wedge of lemon for extra flavor if desired.

Question: What's your favorite way to prepare or consume fish?

Choosing the Right Supplement for Your Heart

Do you, or anyone you know, take a supplement or consume some type of functional food for your heart? If so, this post is a must read! My favorite magazine, Today's Dietitian, printed an article in their August edition, which focused on the effectiveness and safety of heart supplements and functional food ingredients. Here are some important highlights from their article;

Plant Sterols and Stanols

- Found naturally in the walls of plants and cell membranes.

- Compete for the same binding sites as cholesterol in the GI tract, therefore they are said to inhibit excessive cholesterol absorption.

- It is recommended to consume 2 grams per day, and no more than 3 grams, in order to reduce LDL cholesterol by as much as 15%.

- While studies have shown they work for LDL reduction, no studies have shown they successfully reduce risk of cardiovascular events.

- Foods like orange juice, chocolate, and breads are poor carriers, so don't waste your money on those types of products. Dairy, mayo, dressings, and margarines are the best carriers.

Fish Oil (EPA/DHA)

- Recommended by the American Heart Association for patients with documented heart disease or high triglycerides.

- Consuming fish oil may help reduce triglycerides by 20% to 30%. Studies have also shown fish oil may help lower blood pressure, slightly increase HDL cholesterol (good cholesterol), and reduce whole body inflammation (a consequence of smoking, unhealthy eating habits, environment, strenuous exercise, etc).

- 2 to 4 grams of fish oil (EPA/DHA) per day is the typical dose for therapeutic means (4 gram doses should only be taken under the care of a physician).

- While fish oil may help lower triglycerides, there is still more research needed to determine whether it can help reduce cardiac events.

- Those without documented heart disease or high triglycerides can support good health by consuming fish twice a week or by taking a fish oil supplement with .5-1 grams EPA/DHA.

- When buying a supplement make sure they have indicated how many milligrams of EPA and DHA are in each dose. Some companies simply write, "1000 mg Fish Oil", but this is not enough information (fish oil contains more than just EPA/DHA). They should also disclose the exact amount of EPA/DHA, since this is what is most important for heart health. Unfortunately, even if they disclose this information it still may not be true, because supplements aren't regulated. Always look for the USP, GMP, or NSF symbol to know whether you're getting what you pay for.

Red Yeast Rice

- Red yeast rice is a yeast grown on fermented rice (sounds....interesting...). It is common in certain Asian foods, such as Peking Duck.

- It is sometimes referred to as "Nature's Statin" because it has been shown to reduce LDL cholesterol by 20% to 50%.

- It works by blocking a key enzyme that is necessary to make endogenous (made in the body) cholesterol. It may also contain other key ingredients such as monounsaturated fats, isoflavanoids, and sterols, which may also add to the cholesterol lowering effect.

- The amount recommended is about 1200mg/day, taken in two doses (600 mg at one time, then another 600mg later in the day).

- Be careful when buying over the counter products because many products have been shown to lack significant amounts of the ingredient. Similar to what I said above, always look for the USP, GMP, or NSF symbol on your supplements.

- Keep in mind that the side-effects of Red Yeast Rice may be very similar to statins. Talk to your doctor before starting this supplement.

Pomegranate Juice

- Claims for this product indicate it may be able to "decrease hardening of the arteries".
- The polyphenols in pomegranate juice are believed to reduce the production of plaque in arteries and may even reduce the production of cholesterol in the liver.

- Research indicates that the juice has the most significant effect on those with severe plaque and/or severe oxidative stress. Healthier individuals see insignificant effects.

- Those on blood pressure medications need to be very cautious because pomegranate juice may potentiate its effect (in other words, it may make it work even better, thus potentially causing dangerously low blood pressure).

- Be weary of some products on the market, as many appear to be of inconsistent quality (even those labeled as 100% juice). Those made with the outer layers and peel are less effective.

QUESTION: What have you done for your heart lately?

I take a fish oil pill everyday, with .5 grams of EPA/DHA combined (the dosage is 1 gram, but I only take half because I'm pretty healthy, no need to waste my money!). I also eat plenty of fiber, do 4-5 days of cardio a week, eat lots of fruits and veggies, and of course I try to relax and stay stress-free (this is the hardest one for me!).

Innovative Ways To Increase Omega-3s!

Recently I was sent some coupons for Tempt Living Harvest Hempmilk. I was also sent a coupon for a free container of hemp ice cream, but even Whole Foods doesn't carry it. So my question is.....who the heck does?!



Here is a little background about the company and their products.



To read more about hemp, visit this page on their website. I love the first line, "It isn't marijuana!". haha

Hemp milk contains two types of fatty acids of which you may have never heard before. GLA is gamma linolenic acid. Is is produced in the body from linoleic acid, which is an essential fatty acid. GLA has been shown to help reduce inflammation. It's sold in supplemental form, but as I always say, I prefer to get my fats, vitamins, and minerals from food.


SDA (Stearodonic Acid) is an omega-3 fatty acid, which efficiently converts to EPA (the omega-3 found in fish oil) more so than ALA (alpha linolenic acid). In fact, some studies have shown that SDA converts to EPA 2.5 times more efficiently than ALA alone! The great thing about SDA is that it's typically found in vegetable oils, not animal sources, therefore it's a great vegetarian source of EPA. The only downside is that there is no conversion of SDA to DHA, which is another important omega-3 found in fish, and which may play a major role in heart health.


Sometimes you have to be careful when you buy different types of milk, such as almond, soy, hemp, or rice, because they are not always fortified with vitamin D, and some aren't even fortified with calcium! This hemp milk didn't disappoint; 30% DV calcium, and 25% DV vitamin D. Did I mention it also tasted fantastic?!


Are you someone who hates swallowing pills? We sell this (below) at Giant Eagle, and it seems to be really popular.



I added it to one of Nick's smoothies and he didn't even notice. In fact, when I asked him how his smoothie was (when I do this he always gets suspicious) he said, "It's great! Very citrusy". HA! I did taste his smoothie and I could sort of taste the lemon, but I think that was because I knew it was in there. I figure it could also be added to yogurt, or if you're daring you could eat it (drink it) alone. One Giant Eagle customer said she likes it in her strawberry milk. That sounded strange to me at first, but strawberry and lemon may actually be tasty!

Supplement Facts

~720 mg EPA/DHA (perfect!)

Sweetened with the sugar alcohol, xylitol

NOT vegetarian

How about some omega-3 in your burgers?!

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Adding flaxseed to this very lean ground beef was the perfect way to increase the moisture without increasing the saturated fat (and with the flaxseed you get some essential omega-3 fats).

You can eat the beef as a burger, or add it to rice and veggies for a nice healthy dinner (this is Nick's poker dinner, which I pack for him on Tuesday nights when he plays poker).

So, we've got liquid fish oil, hemp milk, and flaxseed in burgers, which are all innovative ways to get some essential fats in your diet.

QUESTION: What are some innovative ways you have increased your omega-3 intake?

I'll Have the Fish; No Mercury Please!

Do you ever worry about the contaminants in your fish? I hear these questions a lot, "should I eat tuna? Which fish is highest in mercury? Are fish oil supplements safe?

Here are some answers:

Tuna

• It is advised that adults eat no more than 1 can of tuna per week ( This is the general recommendation, I sometimes eat two cans, personally. The 1 serving per week recommendation is especially important for women who are pregnant).

• Albacore tuna is the richest source of omega-3 fatty acids, and it is also one of the least likely contaminated tunas (light canned tuna actually has the lowest amount of mercury, but it's also much lower in EPA/DHA).
  

Other Fish

• The fish that are generally highest in mercury include swordfish, shark, tilefish, and king mackerel. Again, it's especially important to keep away from these during pregnancy.
  

• The fish that are generally lowest in mercury are haddock, tilapia, salmon, cod, pollock, canned albacore tuna, and most shellfish.

Supplements

• If you take cod liver oil, be aware that many brands are potentially high in mercury and PCBs.

• In a recent review of 52 different brands of fish oil, ConsumerLabs.com found that none of the supplements had detectable levels of mercury or PCBs (yeah!).
  

• Look for the NSF or USP label on your supplements. This means the supplement has been tested for contaminants!

• On a different note, check out this article about the health benefits of fish oil. Basically, there are benefits, but they don't outweigh the benefits of a healthy lifestyle.
  

Quick, Healthy, and Cheap Recipe #16
Tuna Melt

Ingredients

1 slice whole grain bread
3 ounces canned or pouched white tuna
1 slice American Cheese
1 tsp Red Hot

Possible Modifications

• Use any bread you have available
• Use any tuna you have (white tuna has the most EPA/DHA)
• Use any kind of cheese!

Instructions
Add the tuna and the cheese on top of the bread. Pop into toasted oven until cheese is nice and melted.

ENJOY!

Nutrition Facts

EPA/DHA: ~.66-1 gram per serving (The recommendation is 1-2 grams per day)

Coming Up

Tomorrow I plan to show you the two houses that Nick and I are "fighting over". I'll let you be the judge as to which one you like best. I only have two pictures, from the outside. I'll show you more once we by one of the houses! I also plan on doing a product review.

Thanks for reading, and have a great day!