A key benefit of using highly concentrated omega-3 oils (≥80%) is the ability to achieve therapeutic doses (1-4g depending on condition) in very low capsule and oil volumes. Research also highlights the importance of concentration of the active ingredient within the total volume of oil consumed as being of key importance when considering therapeutic potential, as studies show greater omega-3 enrichment of cells (and subsequently, greater health benefits) when high concentration oils are used, even when compared with the same dose delivered from lower concentrated oils.
In a 2006 study, Bryant and colleagues demonstrated that three different concentrations of omega-3 oil, 62.5%, 80% and 85% of total fatty acids, all delivering 5.1g of EPA + DHA per day and taken for two weeks, more concentrated formulations differentially altered lipid profiles, with those patients taking the 85% oil achieving higher levels of EPA and DHA in serum phospholipids and greater reductions in serum triglyceride and VLDL cholesterol levels despite consuming the same total omega-3 dose. When looking for an omega-3 supplement for delivering therapeutic benefits, the content of EPA and/or DHA is clearly of importance, but in addition, ensuring the concentration is ≥80% will offer enhanced clinical outcomes.
Bioavailability no substitute for concentration and dose
Recent additions to the omega-3 market that focus on delivering phospholipids such as those found in krill and calamari based products, market their products on the claim that ‘less is more’. This leads consumers to believe that one, small, low in active omega-3 capsule, can offer the same benefits as those associated with higher doses from fish oils.
In a 2014 study, Laidlaw and colleagues compared the increases in the omega-3 index (EPA plus DHA within red blood cells, a biomarker of CHD risk that accurately reflects fatty acid levels in the body), after consumption of the manufacturer-recommended daily dose of four different omega-3 supplements. Subjects were randomly assigned to consume one of four products, in random order, for a 28-day period, followed by a 4-week ‘washout’ period before moving to the next product.
The products used were:
- concentrated fish oils, as re-esterified triglyceride (rTG) providing 650mg EPA & 450mg DHA
- concentrated fish oils as ethyl ester (EE), providing 756mg EPA & 228mg DHA
- a generic krill oil as phospholipid (PL), providing 150mg EPA & 90mg DHA
- a generic salmon oil as natural triglyceride (TG), providing 180mg EPA & 220mg DHA.
The measured rise in omega-3 index was as follows:
rTG increased the omega-3 index from 4.2 to 6.8 (an increase of 2.6%);
EE from 4.1 to 5.8 (an increase of 1.7%);
krill oil from 4.3 to 4.8 (an increase of 0.5%);
salmon oil from 4.2 to 4.9 (an increase of 0.7%).
An omega-3 index of ≤4% is considered to be reflective of poor cardiovascular health and increasing the omega-3 index to ≥8% is the ideal target for reducing the risk of cardiovascular events.[9,10]
Thus, the marketed ‘superior bioavailability of omega-3 from krill oil’ compared with fish oil, used to convince consumers of the ‘less is more’ concept  is extremely misleading as, compared to the other fish oil formulations, krill falls far short of delivering the significant increases to scientifically-evaluated omega-3 biomarkers needed for optimal health.
What’s in your fish oil?
Generic fish body and fish liver oils deliver around 0.7g excess ‘fish fat’ (the non-omega-3 fraction) for each 1g oil consumed, so to achieve a dose of 3-4g EPA/DHA the user would also be consuming significant amounts of oil in excess of the ‘active’ component. Standard krill oil (including well known brands) delivers 24% EPA+DHA, and so the total amount of oil required to achieve a therapeutic dose would be around 13g including an excess of 10g non-omega-3 fat being consumed. It is this excess of ‘inactive’ fat that seems to override the positive benefits of the omega-3, regardless of total dose consumed. The body’s mechanisms for digestion, uptake and utilisation of fat are shared by all fats consumed and can therefore become saturated. Taking high concentration oils, such as Igennus Pharmepa Restore 90%, which delivers 1g total ‘active’ EPA in just 1.1g total oil volume, ensures these mechanisms are only dealing with one type of fat, therefore optimal uptake, cellular incorporation and subsequently maximum health benefits are achieved.
- Kris-Etherton PM, Harris WS, Appel LJ: Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation 2002, 106:2747-2757.
- Ballantyne CM, Braeckman RA, Soni PN: Icosapent ethyl for the treatment of hypertriglyceridemia. Expert opinion on pharmacotherapy 2013, 14:1409-1416.
- Wei MY, Jacobson TA: Effects of eicosapentaenoic acid versus docosahexaenoic acid on serum lipids: a systematic review and meta-analysis. Curr Atheroscler Rep 2011, 13:474-483.
- Hilleman DE, Malesker MA: Potential benefits of icosapent ethyl on the lipid profile: case studies. Clinical Medicine Insights Cardiology 2014, 8:13-15.
- Sublette ME, Ellis SP, Geant AL, Mann JJ: Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression. J Clin Psychiatry 2011, 72:1577-1584.
- Schuchardt JP, Schneider I, Meyer H, Neubronner J, von Schacky C, Hahn A: Incorporation of EPA and DHA into plasma phospholipids in response to different omega-3 fatty acid formulations- a comparative bioavailability study of fish oil vs krill oil. Lipids in health and disease 2011, 10:145.
- Laidlaw M, Cockerline CA, Rowe WJ: A randomized clinical trial to determine the efficacy of manufacturers’ recommended doses of omega-3 fatty acids from different sources in facilitating cardiovascular disease risk reduction. Lipids in health and disease 2014, 13:99.
- Albert CM, Hennekens CH, O’Donnell CJ, Ajani UA, Carey VJ, Willett WC, Ruskin JN, Manson JE: Fish consumption and risk of sudden cardiac death. Jama 1998, 279(1):23-28.
- Harris WS: The omega-3 index: clinical utility for therapeutic intervention. Curr Cardiol Rep 2010, 12(6):503-508.
- Salem N, Jr., Kuratko CN: A reexamination of krill oil bioavailability studies. Lipids Health Dis 2014, 13:137.