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Just as we are advised to eat several helpings of vegetables each day, we are often told that a healthy diet includes a minimum of two portions of fish a week – one of them oily. This recommendation is not made lightly, since the long-chain unsaturated fatty acids found in fish are associated with an array of health benefits.

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Although fish also contain good amounts of protein, iodine and other vitamins and minerals, it’s fair to say their omega-3 content is the main reason they’re considered staples of a healthy diet. Incidentally, fish isn’t the only source of omega-3: vegetarians can get their quota from plant sources like flaxseed, hemp and chia.

What are Omega-3s, and Why Are They Important?

Omega-3 fatty acids are, for good reason, deemed essential: unlike, say, vitamin D, they cannot be synthesized by the human body and thus we must rely on food for our intake. Known for their anti-inflammatory properties, omega-3s are most often cited for conferring benefits to the heart, brain and eyes.

There are three main forms of fatty acid: docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA) and the shorter-chain alpha-linolenic acid (ALA). ALA can be found in the aforementioned seeds and also in certain nuts, while the former are sourced from fatty fish like salmon, sardines, anchovies and mackerel. At the risk of upsetting non-meat eaters, most of the benefits come from EPA and DHA. Alpha-linolenic acid is itself a precursor of EPA and DHA, although the human conversion rate is disappointingly low.

Fish oil capsule

Fish oil pills have long been a popular supplement among elder generations, but few people appreciate that omega-3s play a key developmental role too. Maternal intake of DHA, for instance, contributes to healthy brain and vision development for both the foetus and breastfed infant. The benefit is obtained from a daily intake of 200mg DHA over and above the recommended omega intake for adults (250mg DHA and EPA). Interestingly a major Brazilian study of 6,000 babies published in 2015 found a statistical correlation between prolonged breastfeeding and intelligence / societal attainment.[1] All breastfed babies had greater intelligence (based on an IQ test), had spent more years in education and earned, on average, £70 a month more. Of course there are myriad benefits of mother’s milk, which is why the World Health Organization recommends six months of breastfeeding for all mothers. But that’s another blog for another day.

Other Evidence-Based Benefits of Omega-3

Although few people would dispute that omega-3s are contributors to overall wellness, it’s still possible to find a minority of naysayers who contend that the benefits have been overstated or oversold. It’s probably worthwhile, therefore, to look at what the EU Register on Nutrition and Health Claims deems permissible. The register allows the following claims to be made about essential fatty acids:

• DHA and EPA contribute to the normal function of the heart;
• DHA and EPA contribute to the maintenance of normal blood triglyceride levels;
• DHA and EPA contribute to the maintenance of normal blood pressure;
• DHA contributes to the maintenance of normal vision/brain function;
• DHA maternal intake contributes to the normal brain and eye development of the foetus and breastfed infants;
• ALA contributes to the maintenance of normal blood cholesterol levels;
• Essential Fatty Acids are needed for normal growth and development of children.

Considering how strict the EU Register is, it’s impressive how many claims are actually approved for omega-3s. This speaks to a long history of clinical trials highlighting their beneficial effects on the body, some of which we intend to summarize in this article.

Can Omega-3 Protect the Heart?

The role of omega-3s in primary and secondary prevention of cardiovascular diseases (CVD) has been well explored in a number of cohort studies and clinical trials. There is strong evidence dating back decades which shows that omega-3s decrease triglycerides, reduce irregular heartbeats, lower blood pressure (slightly) and limit the risk of stroke from plaque buildup and blood clots.

Earlier this year, the American Heart Association, taking these studies into account, released new recommendations stating that omega-3 fish oil supplements “can assist with secondary prevention of coronary heart disease (CHD) and sudden cardiac death in patents with prevalent CHD and in patients with heart failure.” This ended a 15-year impasse stemming from a 2002 review which cautioned that additional studies were needed “to confirm and further define the health benefits of omega-3 fatty acid supplements for both primary and secondary prevention.”

Though the AHA stopped short of making recommendations for primary prevention of CHD, stating that the evidence was not yet compelling, many justifiably believe that omega-3s make such a positive contribution to heart health that even those who are fit and well can enjoy a measure of protection. This is borne out by a recent study showing that regular consumption of naturally-enriched omega-3 chicken and eggs was “likely” to reduce one’s risk of heart attack, stroke, dementia and even depression.[2]

Omega-3 and Gut Diversity

A lesser-explored but no less fascinating link is the one between omega-3 intake and gut microbial diversity, which is increasingly understood to be a major underpinning factor in good health. This comes from a joint study by the University of Nottingham and King’s College of London, published just a few months ago in the journal Scientific Reports.[3]. Researchers determined that people who eat omega-3 rich foods have better biodiversity in the gut. The study sample size was also large, with 876 twins assessed, and the association was independent of whether participants had a fibre-rich diet.

In the years ahead, don’t be surprised to hear about more studies analyzing the connection between omega-3s and gut bacteria.

Omega-3 to Combat Chronic Inflammation

Many functional and integrative doctors believe that inflammation is at the very root of most diseases. Whether this is true or not, few would make the claim that persistent inflammation is a good thing.

Long-chain fatty acids regulate inflammation via a multitude of mechanisms, from decreasing pro-inflammatory eicosanoid mediators and chemotactic responses of leukocytes to increasing anti-inflammatory resolvins and eicosanoids.[4]

One interesting study conducted on mice earlier this year[5] showed that omega fatty acids could “both prevent and treat the inflammation and oxidative stress caused by air pollution, delivering a 30-50% reduction in harm.” Dr. Jing Kang, of the Massachusetts General Hospital (part of Harvard Medical School), led the research and stood behind the results, saying “I would definitely recommend taking omega fatty acids to counter air pollution…the key thing is they are not like a drug, but a nutrient with so many benefits.”[6]

If you are concerned about inflammation in general, it would be wise to redress the balance of pro-inflammatory omega-6 and anti-inflammatory omega-3. The Western diet has top-loaded this formerly healthy balance to the extent that omega-6s now outnumber of omega-3s by a factor of 10 or 15 to one. Anthropological research suggests that our forebears had a ratio of approximately 1:1, a much more natural balance.

Functional medical doctor Chris Kresser sums it up rather well: “Big Pharma is well aware of the effect of omega-6 on inflammation. In fact, the way over-the-counter and prescription NSAIDs (ibuprofen, aspirin, Celebres, etc.) work is by reducing the formation of inflammatory compounds derived from n-6 fatty acids. The same effect could be achieved by simply limiting dietary intake of omega-6, but of course the drug companies don’t want you to know that. Less profit for them.”

Omega-3 for Healthy Vision

According to research published in November’s issue of the Cellular and Molecular Neurobiology journal, omega oils help cells in the eye withstand stress. Unsurprisingly given the corresponding EU-approved health claim, the benefit comes from DHA, which preconditions different types of retinal cell to endure stress.

This dovetails with results of a 2011 study showing that regular consumption of fish corresponds to a 42% lower risk of macular degeneration in women.[7] Not to mention another trial, one year later, linking DHA administration with improvements in visual acuity among those with corrected vision.[8]

If these results surprise you, they shouldn’t. After all, our photoreceptors - the neuronal cells which make vision possible - contain more DHA than any other human cell.

What About Fish Oil?

Fish oil is a reliable source of the fatty acids EPA and DHA and, providing your supplement is of sufficient quality and properly processed, it’s a good alternative for those who wish to avoid the trace environmental toxins (mercury!) in wild-caught fish which can accumulate over time.

Of course some brands are better than others, and as such it’s worth scrutinizing third-party lab results to verify the purity of the fish oil in question. Determining the quality standards of the manufacturing process and verifying the product’s levels of EPA and DHA is also recommended.

If it sounds like a laborious process, it is; but it needn’t be. Labdoor is a wholly independent organisation who assess various supplements for purity, efficacy, nutritional value, ingredient safety and label accuracy. They currently rank WHC’s UnoCardio 1000 as the best-quality fish oil in the world. Of 54 products tested,[9] UnoCardio 1000 - which combines highly pure EPA and DHA with vitamin D - was one of just two to win an ‘A’ for quality, and one of a handful to get an ‘A’ for value. One softgel provides 675mg of EPA, 460mg of DHA and 25mcg of vitamin D3.

Although most fish oils in the rankings are separated by less than a point, UnoCardio 1000 sits head and shoulders above the competition, with 6.3 points separating it from #2 on the list. This is the most significant gap in the whole table.

Perhaps most noteworthy of all is that UnoCardio 1000 scored 80 points in the ‘Projected Efficacy’ category, double the average of 39. The report concluded that the capsule’s EPA and DHA content is “expected to be highly effective based on an estimated 1g recommended daily intake.”

UnoCardio 1000[10] has held the top spot in the fish oil league table since 2015, no mean feat considering the fierce competition between manufacturers. In the UK, it is available from Water for Health, an online store specializing in natural products. Whether you wish to protect the heart, maintain good vision or mental acuity, or improve bacterial diversity, omega-3 fish oil supplements can make a major contribution. Thanks to Labdoor’s exhaustive battery of tests, you can be sure you’re getting the best of the best. 

References

1. https://www.theguardian.com/lifeandstyle/2015/mar/18/brazil-longer-babies-breastfed-more-achieve-in-life-major-study
2. https://www.foodmanufacture.co.uk/Article/2017/11/30/Omega-3-enriched-chicken-and-eggs-shown-to-boost-health-study
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5593975/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257651/#__sec13title
5. http://www.sciencedirect.com/science/article/pii/S0304416516305128
6. http://www.positivehealth.com/article/essential-fatty-acids/15-health-benefits-of-omega-3-fatty-acids
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3134638/
8. https://www.nutraingredients.com/Article/2012/03/15/Omega-3-DHA-may-boost-eyesight-but-fails-to-affect-mental-function-Study
9. https://labdoor.com/rankings/fish-oil
10. https://www.water-for-health.co.uk/uno-cardio-1000.html