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The Truth About Omega-3 Pills

The fact that people pop nutritional pills–regardless of what they are–concerns me. Not that I’m against supplements; they can be used for good reasons. But often, people take them without much research, without medical supervision, and without a real need.

There’s one thing I am against though; taking the easy way out of eating real good food. While fish oil supplements do work, eating fish can lower the rate of death from heart disease in men and women. Could there be something else in fish?

Here are my thoughts on omega-3’s.

Two Types

Plant-based: alpha-linoleic acid (ALA), found in flaxseeds, canola, walnuts, sunflower oil, and safflower oil.

Marine based: docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), found in fatty fish such as salmon, herring, sardines, tuna, trout, halibut, and anchovies.

Great News

Enough evidence supports EPA and DHA ’s role in reducing the risk of fatal and non-fatal coronary heart disease (CHD), which is the narrowing of the blood vessels that supply the heart. They also lower blood pressure and triglyceride level. Results appear from both taking supplements and eating fatty fish.

Fish oil supplements improve symptoms of rheumatoid arthritis, such as morning stiffness, pain, and joint tenderness.

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Disappointing News

A a recent report published in the Journal of Nutrition reviewed studies on DHA and EPA’s role in preventing cancer. It concluded that they have no effect.

The evidence on EPA and DHA is still not strong in regards to improved memory and cognition, dementia, macular degeneration, depression, asthma, and autoimmune diseases.

Scary News

More than 3 grams of EPA and DHA a day can cause hemorrhagic stroke, a rupture in a brain artery, and uncontrolled bleeding, especially in patients taking blood-thinning medications.

People with diabetes might see increased blood sugar level with high doses of EPA and DHA.

And a high level of ALA in the blood was linked to increased risk of prostate cancer.


Flaxseed oil, containing ALA, is marketed as a good source of omega-3 fatty acids. However, our bodies can only use ALA after it is converted to EPA and DHA through a non-efficient (only 8% conversion) process.

For example, a common flaxseed oil capsule provides 1,000 mg of the oil and 550 mg ALA. This means, you will only get 44 mg EPA and DHA (8% of 550 mg)!

People are falsely assured their omega-3 needs are covered by such supplements

Misleading information is often present on supplement labels. “Double Strength” might only mean taking two pills instead of one. “1,000 mg of fish oil” is only 30% EPA and DHA. And while “Mercury-Free” is great, all major brands are also mercury free, according to Consumer Reports and ConsumerLab.com.

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In Numbers

While no Dietary Reference Intake is established for EPA and DHA, the same report in the Journal of Nutrition recommended a daily intake of 250 to 500 mg.

The American Heart Association recommends:

  • People without CHD eat 2 servings of fatty fish each week
  • People with documented CHD take 1 gram of EPA and DHA a day
  • People who need to lower their triglyceride level take 2 to 4 grams EPA and DHA a day

And supplements must be taken with close medical supervision. You know that’s not happening!

Food First

Yes, you can get enough EPA and DHA from food.

Two servings of salmon a week (3 ounces each) provide 2,180 to 3,650 mg EPA and DHA (depending on the source). That is 311 to 521 mg a day. Besides, many food products are now fortified with EPA and DHA.

There are tons of good fish recipes out there. Try my salmon with pomegranate avocado salsa recipe. And trout is one of the food trends of 2010.

Instead of rushing to a pharmacy to get an omega-3 pill, I suggest you make a trip to the grocery store. Anyone up for fish for dinner?

Nour’s guidance and expertise was the key to dramatically halting our son’s [Crohn’s] disease progression! His pediatric gastroenterologist is now in agreement of our choice to treat solely with diet and supplements. All his labs have improved and his inflammatory markers are so low they are practically nonexistent.

Before working with Nour, I experienced intestinal pain off and on for for 54 years with minimal success on medications. I have benefited 100% from Nour’s program as I am now pain free!

A lot of time and money was wasted on foods that I thought would help my digestive struggles [diarrhea, bloating, hunger], but in fact I was making it worse. The main benefit is getting a handle on what negatively affects my digestive symptom. Doing a total 180 to my eating habits has been pretty amazing.


2 thoughts on “The Truth About Omega-3 Pills”

  1. Thanks for the beneficial article. I read an article at a medicine journal, it clarifies that omega 3 is quite important even if taken by pills. Here in Jordan, we don’t tend to eat much fish or salmon, at max its twice a month and that isn’t enough. But the exciting news is that omega 6-9 provokes cancer cells, especially prostate cancer in men. What do you think? Advise please as I take omega 3 one tab daily 🙂 I stopped taking 6 and 9.

    1. Nour El-Zibdeh, RD


      If you don’t have access to fish on regular basis, then an omega-3 supplement is appropriate. Make sure the type of omega-3 is EPA and DHA, not ALA. Read the label and don’t take more than 500 mg EPA+DHA a day.

      Omega-6 and omega-9 supplements are not recommended. In fact, too much of them is probably related to heart disease, inflammation, cancer, and obesity. A common scientific opinion is that ratio of omega-6 to omega-3 in the diet is behind these conditions.

      Omega-6 is found in many common vegetable oils, eggs, poultry, avocados, bread, and processed food. Omega-9 is found in olive oil. Don’t get confused and think that these foods are bad! The point is, you are getting enough omega-6 and omega-9 in your diet. Focus on omega-3 in your pills.

      I hope this helps!


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