Fish oils

Why Fish oil???

Personal Interest
Ganglion cist and because I dont get
enough!

Family
Public Interest
Scientific Research is exploding
Health Benefits are fascinating

Overview of Presentation

Description and History

Nutrient Composition
Health Claims
Roles in the Body
Science Supporting the claims
Recommendations
Conclusion

What is Fish oil?

Omega-3 long chain PUFA

Polyunsaturated Fatty Acids

Essential because it is not synthesized in the

body.

Contains Docosahexaenoic acid (DHA) and

Eicosapentaenoic acid (EPA).
Produced by ALA in the body.

EPA and DHA are considered to be the

most important FA for brain function.
Fish get their high omega-3 content from
eating algae.

History of Fish oil

Omega-3 FA have been a part of the Human Diet for
millennia.
Homo Sapiens evolved in an omega-3 rich
environment.
Omega-3 consumption has declined over the past
century.
1994 the Committee on Medical Aspects of Food Policy
(COMA) published findings of the benefits on
cardiovascular health.
Since 1994, more extensive research has been
conducted.

Nutrient Composition
Rich sources of
omega-3 FA,
particularly
eicosapentaenoic
acid (EPA) and
docosahexaenoic
acid (DHA).
Some supplements
contain Vitamin E.
180 mg of EPA and
120 mg of DHA

Food Sources and Preparation

Considerations
Diet sources are
preferred, but for larger
doses supplementation
may be necessary.
Supplements comparable
to fish consumption.
Cold water, fatty fish such
as salmon, swordfish,
shark, sardines, mackerel,
and herring are richest
sources.
To prevent aftertaste try
freezing the capsules.

To reduce exposure to
contaminants remove the
skin and fat from fish
before cooking them.
Although skinning and
trimming doesnt
reduce mercury
content.

Health Claims

Brain Development
Inflammation
Mental Disorders
Cardiovascular
Disease
Alcoholism
Cancer
Kidney Disease
Menopause
Crohns Disease
Type II Diabetes

Asthma
Dyslexia
Migraine Headaches
Lupus
Suicide
Respiratory Diseases
Multiple Sclerosis
Peroxisome Biogenesis
Disorder
Blindness

Brain Development

DHA and EPA are main components in neurological function and

play a key role in brain development.
DHA deficiency in brain.
uses other PUFA, thus changing brain function.

Increased maternal consumption increasing fetal omega-3 levels

in the brain, thus potentially benefiting the fetus.
Breast milk has high levels of DHA.
Infants whose mothers received fish oil supplementation were
followed up at 4 years of age and tested higher in mental
processing than the control group.
The omega 6:3 ratio has increased from 1:1 to 17:1 (10:1, 2030:1)
Due to increase of vegetable oils and margarine and low fish intake.

Can benefit visual acuity and cognitive development.

Strong human evidence is lacking.

Inflammation
Growing evidence from animal and human
studies suggesting therapeutic properties in
treating inflammatory conditions such as
rheumatoid arthritis.
Studies show a significant reduction in the
number of tender joints and morning
stiffness after 3 months of therapy
consuming 3 g of fish oil per day.
Comparable to NSAIDs.
More severe inflammation in consumers of
omega-6 FA than omega-3.

Mental Disorders
Perhaps one of the most intriguing area for potential
benefits.
High fish oil consumption is linked to lower rates of
depression.
Therapeutic properties for depression, bipolar
disorders and schizophrenia.
Depression rates as high as 21 percent of the general
U.S. population.
Linked with the increase of omega-6 and decrease
of omega-3.
Useful in the treatment of depression at dosages of
0.2 g-9.6 g EPA+DHA.
Very large studies are needed.

Cardiovascular Disease
Widely accepted that it reduces the risk of
cardiovascular disease.
One or two fish meals a week will
significantly reduce the risk for CHD.
Although, some reports have not
confirmed these conclusions.
Possibly because the mercury content
counteracts the benefits of omega-3 FA by
increasing free radical production or by
inactivating antioxidant mechanisms.

Risks and Benefits

Risks/side effects
Fishy aftertaste and
belching
Gastrointestinal
disturbances
Nausea
Mercury content
Pregnant women and
lactating women
advised not to consume
large amount of fish
due to mercury content

Benefits
Similar effects to LDLcholesterol lowering
therapy, lifestyle
change, and vigorous
exercise.
No documented cases
of abnormal bleeding
resulting in fish oil
supplements.
Well-tolerated.
No significant drug
interactions.

Roles in the Body

Major structural component of
phospholipids in neuronal cell membranes.
Predominant structural fatty acids in the
grey matter of the brain.
EPA is a substrate for the initial enzymes in
prostaglandin and leukotriene synthesis.
The breakdown of omega-3 and 6 share
the same enzyme.
Preference for omega 3, but can switch to
omega-6 due to an excess of omega 6
consumption.

Science supporting the

claims
Strong evidence
supporting claims and
is proven to improve
health, but more
research is needed.
More work needs to
be done to update
recommendations.
Results are often
times inconsistent
and different dosage
amounts need to be
tested.

How to use it

Dosage
Evidence suggests 1-2 g/day are required, but cannot be
attained by diet alone.
Capsules usually contain 180mg of EPA and 120 mg DHA
Liquid concentrate: 1 tsp contains approx 1-3 g of EPA plus
DHA
Frequency
AHA Dietary Guidelines recommends consuming at least 2
servings of fish per week for general population and 2 portions
for pregnant or lactating women.
Quality
Diet sources are best, but supplements offer a safe alternative.
Cost
$0.13 to $0.42 per capsule depending on brand.
$0.95 to $9.77 per oz of liquid form depending on brand.

Does it really work???

Safety
Be aware of the risks and benefits for the different
stages of life (ie: pregnant or lactating, mental
disorders, CHD*, etc).
FDA ruled that intakes of up to 3 g/day of omega-3
FA are recognized as safe.
Supplements are mercury free.
Efficacy
Reduces risk for sudden death
Reduces all-cause mortality
Additional studies are needed to confirm the
benefits for cardiovascular primary and secondary
*Coronaryprevention.
heart disease (CHD) is a narrowing of the small blood vessels that supply blood and oxygen
to the heart. CHD is also called coronary artery disease.

Ethics in Marketing

What you should know

Components of fish oil and how it is produced in the
body
Good food sources
What key role does DHA and EPA play in the brain?
What are the AHA Dietary Guidelines for weekly fish
consumption for the general population?
Four health claims focused on
What has changed the Western Diet to increase the
ratio of omega-6:3 PUFA?
What the FDA regulated as a safe daily intake of
omega-3 PUFA

The End

Any Questions?

Fish oil
is oil derived from the tissues of oily fish. Fish oils
contain the omega-3 fatty acids eicosapentaenoic acid
(EPA), and docosahexaenoic acid (DHA), precursors
of certain eicosanoids that are known to reduce
inflammation throughout the body,[1][2] and are thought
to have many health benefits.

Fish do not actually produce omega-3 fatty acids, but instead

accumulate them by consuming either microalgae or prey fish that
have accumulated omega-3 fatty acids, together with a high quantity
of antioxidants as iodide and selenium, from microalgae, where these
antioxidants are able to protect the fragile polyunsaturated lipids from
peroxidation.

Fatty predatory fish like sharks, sword fish, tilefish,

and albacore tuna may be high in omega-3 fatty
acids, but due to their position at the top of the
food chain, these species can also accumulate
toxic substances For this reason, the U.S.
Food and Drug Administration recommends
limiting consumption of certain (predatory) fish
species (e.g. albacore tuna, shark, king mackerel,
tilefish and swordfish) due to high levels of toxic
contaminants such as mercury, dioxin, PCBs and
chlordane

The omega-3 fatty acids in fish oil are thought to be beneficial in treating
hypertriglyceridemia, and possibly beneficial in preventing heart disease.[8] Fish oil
and omega-3 fatty acids have been studied in a wide variety of other conditions,
such as clinical depression,[9][10] anxiety,[11][12][13] cancer, and macular degeneration,
although benefit in these conditions remains to be proven.

Grams of omega-3 fatty acids per 3oz (85g) serving of popular fish
Common name
Tuna

grams
0.211.1

Tuna (canned, light)

0.17-0.24

Pollock
Salmon
Cod
Catfish
Flounder
Grouper
Halibut
Mahi mahi
Orange roughy
Red snapper
Shark
Swordfish
Tilefish
King mackerel

0.45
1.11.9
0.150.24
0.220.3
0.48
0.23
0.601.12
0.13
0.028
0.29
0.83
0.97
0.90
0.36

Health benefits
Cancer
Several studies report possible anti-cancer effects of n3 fatty acids
found in fish oil (particularly breast, colon and prostate cancer).[15][16][17]
Omega-3 fatty acids reduced prostate cancer growth, slowed
histopathological progression, and increased survival in genetically
engineered mice.[18] Among n-3 fatty acids (omega-3), neither long-chain
nor short-chain forms were consistently associated with reduced breast
cancer risk. High levels of docosahexaenoic acid, however, the most
abundant n-3 polyunsaturated fatty acid (omega-3) in erythrocyte
membranes, were associated with a reduced risk of breast cancer.[19] A
recent study of 35,000 middle-aged women found that the women who
took fish oil supplements had a 32% lower risk of breast cancer, although
the authors stress the result is preliminary and falls short of establishing
a causal relationship.[20]

Cardiovascular
A 2008 meta-study by the Canadian Medical Association Journal found
fish oil supplementation did not demonstrate any preventative benefit to
cardiac patients with ventricular arrhythmias.[21]
The American Heart Association recommends the consumption of 1 g of fish
oil daily, preferably by eating fish, for patients with coronary heart disease
although pregnant and nursing women are advised to avoiding eating fish
with high potential for mercury contaminants including mackerel, shark, or
swordfish.[22] Note that optimal dosage relates to body weight.
The US National Institutes of Health lists three conditions for which fish oil
and other omega-3 sources are most highly recommended:
hypertriglyceridemia, secondary cardiovascular disease prevention and
high blood pressure. It then lists 27 other conditions for which there is less
evidence. It also lists possible safety concerns: "Intake of 3 grams per day
or greater of omega-3 fatty acids may increase the risk of bleeding, although
there is little evidence of significant bleeding risk at lower doses. Very large
intakes of fish oil/omega-3 fatty acids may increase the risk of hemorrhagic
(bleeding) stroke."[8]
There is also some evidence that fish oil may have a beneficial effect on
some forms of cardiac dysrhythmia.[23] [24]

Mental health
Studies published in 2004 and 2009 have suggested that the n-3 EPA may
reduce the risk of depression and suicide. One study[25] compared blood
samples of 100 suicide-attempt patients and to those of controls and found
that levels of Eicosapentaenoic acid were significantly lower in the washed
red blood cells of the suicide-attempt patients. A small American trial in 2009
suggested that E-EPA, as monotherapy, might treat major depressive
disorder but failed to achieve statistical significance.[26]
Studies[27][28] were conducted on prisoners in England where the inmates
were fed seafood which contains omega-3 fatty acids. The higher
consumption of these fatty acids corresponded with a drop in the assault
rates. Another Finnish study found that prisoners who were convicted of
violence had lower levels of omega3 fatty acids than prisoners convicted of
nonviolent offenses. It was suggested that these kinds of fatty acids are
responsible for the neuronal growth of the frontal cortex of the brain which, it
is further alleged, is the seat of personal behavior.[citation needed]

A study from the Orygen Research Centre in Melbourne suggests that

omega-3 fatty acids could also help delay or prevent the onset of schizophrenia
. The researchers enlisted 81 'high risk' young people aged 13 to 24 who had
previously suffered brief hallucinations or delusions and gave half of them
capsules of fish oil while the other half received placebo. One year on, only
three percent of those on fish oil had developed schizophrenia compared to 28
percent from those on placebo.[29] A study conducted at Sheffield University in
England reported positive results with fish oil on patients suffering from
schizophrenia. Participants of the study had previously taken anti-psychotic
prescription drugs that were no longer effective. After taking fish oil
supplements, participants in the study experienced progress compared to
others who were given a placebo.[30][31]
The largest controlled study to date found no cognitive benefit after two years in
the elderly.[32][33]

Alzheimer's disease
According to a study from Louisiana State University in September 2005,
Docosahexaenoic acid, an omega-3 fatty acid often found in fish oil, may
help protect the brain from cognitive problems associated with
Alzheimer's disease.[34]
Lupus (a chronic autoimmune disease that can damage any
part of the body or organs inside the body. The immune system
attacks the body's cells and tissue, resulting in inflammation and
tissue damage. It is a Type III hypersensitivity reaction caused by
antibody-immune complex formation.)
In a Northern Ireland study, lupus disease activity, especially in the skin
and joints, was significantly reduced in patients who received fish oil
supplements at both 12-week and 24-week follow-up periods versus
patients who received placebo. There were also changes in the blood
platelets of the patients who took the fish oil supplements, with an increase
in proteins that are considered anti-inflammatory and a decrease in proteins
that promote inflammation; these changes were not evident in the group that
took placebo. The fish oil group showed an increase in FMD, which the
researchers took as a sign that the omega-3 oils were helping the cells in
the blood vessel walls to remain healthy.

Parkinson's disease
A study[35] examining whether omega-3 exerts neuroprotective action in
Parkinson's disease found that it did exhibit a protective effect in mice.
The scientists exposed mice to either a control or a high omega-3 diet
from two to twelve months of age and then treated them with a neurotoxin
commonly used as an experimental model for Parkinson's. The scientists
found that high doses of omega-3 given to the experimental group
prevented the neurotoxin-induced decrease of dopamine that ordinarily
occurs. Since Parkinson's is a disease caused by disruption of the
dopamine system, this protective effect exhibited could show promise for
future research in the prevention of Parkinson's disease.[35]

Depression
Evidence regarding the efficacy of fish oil supplements as a treatment for
depression is inconclusive. Whereas several methodologically rigorous
studies have reported statistically significant positive effects in the
treatment of depressed patients, other studies have found effects to be
insignificant.
An August 2003 double-blind placebo-controlled study published in the
journal European Neuropsychopharmacology found that among 28
patients with major depressive disorder, "patients in the omega-3 PUFA
group had a significantly decreased score on the 21-item Hamilton Rating
Scale for Depression than those in the placebo group."[9] Another study in
the American Journal of Psychiatry reported that the addition of fish oil
supplements to regular maintenance anti-depression therapy conferred
"highly significant" benefits by the third week of the trial.[13]

A 2005 randomized double-blind placebo-controlled study conducted under

the auspices of the New Zealand Institute for Crop & Food Research found "no
evidence that fish oil improved mood when compared to placebo, despite an
increase in circulating -3 polyunsaturated fatty acids."[36] Another study published
in October 2007 found that fish oil supplements conferred no additional benefits
beyond those conferred by standard treatment.[37] However, both of these studies
used omega-3 primary consisting of DHA, not EPA. Dr. Andrew Stoll of Harvard,
published a book and double blind study on Omega 3's that showed lifting of
depression and manic depression within huge study populations, in days, not
weeks or months.
A 2009 metastudy found that patients taking omega-3 supplements with a higher
EPA:DHA ratio experienced less depressive symptoms. The studies provided
evidence that EPA may be more efficacious than DHA in treating depression.
However, this metastudy concluded that due to the identified limitations of the
included studies, larger, randomized trials are needed to confirm these findings.[38]

Psoriasis
Diets supplemented with cod liver oil have shown beneficial effects on
psoriasis.[39
]

Pregnancy
Omega-3 polyunsaturated fatty acids (commonly found in fish oil) protect
against fetal brain injury and promotes fetal and infant brain health. [40] Some
studies reported better psycho motor development at 30 months of age in
infants whose mothers received fish oil supplements for the first four months
of lactation.[41] In addition, five-year-old children whose mothers received
modest algae based docosahexaenoic acid supplementation for the first 4
months of breastfeeding performed better on a test of sustained attention.
This suggests that docosahexaenoic acid intake during early infancy confers
long-term benefits on specific aspects of neurodevelopment. [41]

Docosahexaenoic acid supplementation has also been found to be essential

for early visual development of the baby.[42] However, the standard western diet
is severely deficient in these critical nutrients. This omega-3 dietary deficiency, a
nutrient found in fish oil, is compounded by the fact that pregnant women
become depleted in omega-3s, since the fetus uses omega-3s for its nervous
system development. Omega-3s are also used after birth if they are provided in
breast milk.[43]
In addition, provision of fish oil during pregnancy may reduce an infants
sensitization to common food allergens and reduce the prevalence and severity
of certain skin diseases in the first year of life. This effect may persist until
adolescence with a reduction in prevalence and/or severity of eczema, hay fever
and asthma.[44]
Omega-3 fatty acid supplementation is also beneficial to the mother.[40] It has
been shown to prevent pre-term labor and delivery.[43] It is recommended that
women who are breastfeeding consume fish oil at least twice a week, although
the American Heart Association recommends pregnant and nursing women are
to avoiding eating fish with high potential for mercury contaminants including
mackerel, shark, or swordfish.[44]

Dangers
Maximum intake
The FDA says it is safe to take up to 3000 mg of omega-3 per day.[45] (This
is not the same as 3000 mg of fish oil. A 1000 mg pill typically has only 300
mg of omega-3; 10 such pills would equal 3000 mg of omega-3.) Dyerberg
studied healthy Greenland Eskimos and found an average intake of 5700
mg of omega-3 EPA per day.[46]

Vitamins
The liver and liver products (such as cod liver oil) of fish and many
animals (such as seals and whales) contain omega-3, but also the active
form of vitamin A. At high levels, this form of the vitamin can be dangerous (
Hypervitaminosis A).[47]

Toxic pollutants
Fish oil supplements came under scrutiny in 2006, when the
Food Standards Agency in the UK and the Food Safety Authority of Ireland
reported PCB levels that exceeded the European maximum limits in
several fish oil brands,[48][49] which required temporary withdrawal of these
brands. To address the concern over contaminated fish oil supplements,
the International Fish Oil Standards program, a voluntary review process,
was created at University of Guelph.[50]
A March 2010 lawsuit filed by a California environmental group claimed
that eight brands of fish oil supplements contained excessive levels of
PCB's, including CVS/pharmacy, Nature Made, Rite Aid, GNC, Solgar,
Twinlab, Now Health, Omega Protein and Pharmavite.[51][52] The majority of
these products were either cod liver or shark liver oils. Because the liver is
the major filtering and detoxifying organ, PCB content is much higher in
liver-based oils than in fish oil produced from the processing of whole fish.

An analysis based on data from the Norwegian Women and Cancer

Study (NOWAC) with regards to the dangers of persistent organic
pollutants (POPs) in cod liver came to the conclusion that "in Norwegian
women, fish liver consumption was not associated with an increased
cancer risk in breast, uterus, or colon. In contrast, a decreased risk for
total cancer was found."[53]
However, a report by the Harvard Medical School studied five popular
brands of fish oil, including Nordic Ultimate, Kirkland and CVS. They
found that the brands had negligible amounts of mercury, suggesting
either that mercury is removed during the manufacturing of purified fish
oil or that the fish sources used in these commercial preparations are
relatively mercury-free. [54]

Pharmaceutical Grade Fish Oil?

There is no such thing as Pharmaceutical Grade Fish Oil. It is a term
dreamt up initially by an aggressive marketer and adopted by others. The
US Pharmacopeia does not yet have a monograph to regulate the
specifications and purity of fish oil. In the absence of any strict guidelines the
US Council for Responsible Nutrition (CRN) has developed a voluntary
monograph. The CRN monograph was developed taking into account
various European and World Health Organization (WHO) standards. A
number of responsible fish oil manufacturers worldwide are now working to
this monograph by either equaling it or in some cases, even exceeding it.
It is important to be aware that there is an official sounding organization
called International Fish Oil Standards (IFOS) which a number of fish oil
marketers use for testing. It is actually a private organization. IFOS will
issue star ratings for various manufacturers who are prepared to submit
their products to them in order to get tested for a fee. Some manufacturers
feel that if they meet the specifications of IFOS then they can call their
products pharmaceutical grade fish oil because the IFOS standards are
tougher for some components of the oil.

What about the US FDA? Do they have minimum purity

levels?
Yes. But their levels for mercury and oxidation are so lenient.

What is purity?
Fish oil purity is assessed by measuring the levels of heavy metals, PCBs
and dioxins in the fish oil- polychlorinated biphenyls (PCBs)
At the moment there are four standards of fish oil purity that are used
internationally. These are indicated in the below table. You will note that we
at Xtend-Life ( Company mfg most pure fish oil) have set their own
specification standards which are much more stringent than anyone elses.
They are all set at the lowest limits of detection for most laboratory analytical
equipment. You will also notice that most of them are significantly lower than
the normal international standard.
The COA (Certificate of Analysis) reflects the quality, even at these lower
levels, NO contaminants are detected.