By David H. Rahm, M.D.
Q: I’ve heard about the benefits of taking Omega-3s but I’m not really sure if I should take flax seed oil or fish oil. Or, if I should take both supplements?
Flax seed oil and fish oil belong to a class of supplements called Omega-3s. Taking an Omega-3 supplement can correct imbalances or deficiencies in your diet but fish oil confers different health benefits than flax seed oil. Understanding these differences will help you to determine which or both of these Omega-3s to add to your diet.
Before we talk about the benefits of taking fish oil vs flaxseed oil, let’s make sure that you understand what Omega-3s are and how they benefit your brain, heart, skin and every other organ in your body.
What are Omega-3s, Omega-6s & Omega-9s?
We all need essential nutrients for optimal health and wellness. And, believe it or not, an essential macronutrient we require is fat! But, not just any type of fat. The fats associated with cardiovascular and other disease are saturated and trans-fats. The fats that play a dominant role in our health are unsaturated fats.
Unsaturated fats are classified according to their molecular structure including Omega-3, Omega-6 and Omega-9.
Avocados, peanut butter and olive oil are popular foods that are a good source of the monounsaturated family of Omega-9s. The Mediterranean diet helped to popularize olive oil which is associated with longevity and good health.
Many of the oils widely available in our food supply are derived from beans and seeds such as soybean, corn, sunflower and safflower. These polyunsaturated oils are a good source of Omega-6 fats and in their natural state (without commercial refinement) are part of a health promoting diet.
Finding Omega-3 polyunsaturated fats is more of a challenge because these health-promoting oils are not widely available in the food supply. Excellent sources include flax seeds, chia seeds, walnuts, and deep cold water fish. You can also find foods enhanced with Omega-3s such as DHA eggs.
What are Essential Fats?
Our bodies require two essential fats (EFAs) for normal cell structure and body function. Just like vitamins and minerals, we need to obtain these EFAs through diet or supplementation. One of these essential fatty acids belongs to the Omega-6 family (linoleic acid or LA) and the other belongs to the Omega-3 family (alpha linolenic acid or ALA).
What are Conditionally Essential Fats?
Within the Omega-3 family are two other fats (Eicosapentaenoic acid or EPA and Docosahexaenoic acid or DHA) that are regarded as conditionally essential. While our bodies can manufacture these super polyunsaturated fats from ALA, our diet and lifestyle greatly influence this process, making EPA and DHA essential under certain conditions.
Should I Supplement With Omega-6s?
Given the wide range of foods that contain Omega-6s, most of us don’t need to supplement our diets with the essential Omega-6 fat LA. In fact, most Americans get way too much of Omega-6 oils which have negative implications for our health. Based on this, there is no reason to take an Omega-6 supplement.
Should I Supplement With Omega-9s?
Oleic acid is the Omega-9 fatty acid that is found in olive oil. This monounsaturated fat is associated with elevating HDL or “good” cholesterol levels. The best way to obtain this health-promoting fat is by replacing salad oils (which are predominantly Omega-6s) with olive oil. You can also cook with olive oil but keep in mind that you should only use with low to moderate heat. For cooking that requires high heat (e.g., stir fry), you’ll want to use an oil with a higher smoke point. Good examples include sesame oil or canola oil. For a great reference, download Spectrum Oil’s Kitchen Guide to oils here.
Should I Supplement With Omega-3s?
Due to the short shelf-life of Omega-3 fats, only a limited number of packaged foods contain them. Manufacturers prefer more highly processed seed oils like partially-hydrogenated soybean oil which last longer but are associated with health problems. Combined with the limited number of foods that naturally contain Omega-3s, most of us fall short of ALA, making supplementation with this essential fat necessary. Overconsumption of Omega-6 fats puts a strain on our bodies to synthesize EPA and DHA, so supplementing with these two Omega-3 fats is also warranted.
What’s the Daily Requirement for Omega-3s?
Although Daily Reference Values are established for total fat and saturated fat, they have not been established for Omega-3s. Instead, an Acceptable Intake (AI) has been assigned. In men, the AI for Omega-3s is 1.6 grams a day; in women it is 1.1 grams a day.
How Much Omega-3s Are in Flax Seed Oil & Fish Oil Capsules?
A typical flax seed oil or fish oil capsule is about 1 gram (or 1,000 mg). However, this amount just indicates the total contents of the capsule. It is important to examine the Supplement Facts Panel to determine what proportion of the capsule comprises Omega-3s.
For example, a flax seed oil capsule contains around 570 mg of the Omega-3 alpha-linolenic acid (ALA). The remaining 430 mg are a combination of Omega-6s (180 mg), Omega-9s (160 mg) and even saturated fat (90 mg).
Fish oil capsules vary greatly in terms of their Omega-3 content. To complicate matters, some fish oil capsules contain EPA only or DHA only or a combination of both, with the levels varying widely.
A brand like Whole Foods typically delivers 300 mg of Omega-3s per fish oil capsule (180 mg of EPA and 120 mg of DHA). In comparison, each 1.1 gram softgel of VitaMedica’s Super EPA/DHA Fish Oil contains 750 mg of Omega-3s (500 mg of EPA and 250 mg of DHA), requiring fewer capsules to reach daily requirements.
What are the Health Benefits of Taking Omega-3s?
As mentioned above, given the widespread use of Omega-6 oils in our food supply, most Americans consume far too much of these fats. However, most of us fall short of the Omega-3 requirements.
In fact, it is estimated that the ratio of Omega-6 to Omega-3 fats that we consume is 20:1. Instead, we should be targeting a ratio of 4:1 or four times the amount of Omega-6 fats to Omega-3s fats (example: 4 grams of Omega-6s to 1 gram of Omega-3s).
Why is this important? Because the excessive consumption of Omega-6 oils promotes the production of inflammatory compounds called prostaglandins. These hormone-like compounds regulate a wide range of body functions from inflammation, pain & swelling and blood pressure to kidney function and fluid balance. Over time, these pro-inflammatory compounds promote silent inflammation which is associated with many chronic conditions including cardiovascular disease and even aging.
Taking an Omega-3 supplement promotes the development of non-inflammatory prostaglandins thereby reducing silent inflammation and helps to bring your body back in balance.
What are the Benefits of Flax Seed Oil?
Aside from the anti-inflammatory benefits, a key reason for taking a flax seed oil supplement is to ensure that you’re obtaining sufficient quantities of the essential Omega-3 fatty acid alpha linolenic acid (ALA).
The integrity and structure of cell membranes is dependent upon an ample supply of essential fatty acids like ALA. Without them, you’ll have dry skin, cracked nails, dry, lifeless hair, aching joints and even fatigue.
Supplementing your diet with 1 to 2 capsules per day of a high quality organic flax seed oil like VitaMedica’s Flax Seed Oil will bring your hair back to its luster and promote soft, supple skin.
As a plant based source, flax seed oil is ideal for vegetarians. However, the softgel capsule is made either from a bovine or porcine source, so if you’re a strict vegetarian, you’ll need to buy a liquid source of this beneficial oil.
What About Taking a Flax Seed Supplement?
Flax seeds are small, flat oval shaped seeds that are very hard. In order to obtain just a gram of Omega-3 oils, you would need to consume a large quantity of these seeds. The primary reason for taking ground flax seed is not to obtain Omega-3s but to increase your fiber intake. Ground flax seed is much more palatable than psyllium (e.g., Metamucil). Plus, flax seeds contain lignans, a phytoestrogen which has shown promise in vitro for halting breast cancer cell development.
What are the Benefits of Fish Oil?
From flax seed oil, our bodies can synthesize two other fats: EPA and DHA. However, our ability to make these fats is marginalized with a diet high in Omega-6 fats. Fish oil supplements provide an excellent source of these two important fats.
More than 8,000 studies published over the past 35 years have consistently shown that EPA and DHA are important to health throughout every stage of life. However, EPA is associated with heart health whereas DHA is associated with brain health.
The American Heart Association agrees that Omega-3 EPA and DHA are essential to a healthy cardiovascular system. Specifically, it recognizes the following benefits from these two good-for-you fats:
- Reduced risk of heart attacks and strokes
- Reduction in blood thickness (viscosity)
- Relaxation of blood vessels (vasodilation)
- Lowering of blood pressure
- Reduced risk of blood clots in coronary arteries (thrombosis)
- Protection against heartbeat abnormalities (arrhythmia, ventricular tachycardia, fibrillation)
- Reduction of triglycerides (blood fat levels)
- Protection against hardening of the arteries (atherosclerosis)
- Protection against plaque rupture
- Good overall heart health
Supplementing with fish oil ensures that you obtain sufficient amounts of these Omega-3 nutrients to support cardiovascular health.
Your brain is one of the vital organs that require Omega-3s to perform optimally. In fact, 60% of your brain is made up of structural fat (a large part of which is DHA), and it requires a regular intake of good fats, such as Omega-3, to function properly. Research suggests that DHA may reduce the risk of the following conditions:
- Memory problems, including Alzheimer’s disease and other types of dementia
- Attention Deficit Hyperactivity Disorder (ADHD) and other behavioral problems
- Mental health conditions, including aggression, bipolar disorder, borderline personality disorder, depression, and schizophrenia
Supplementing with fish oil ensures that you obtain sufficient amounts of these Omega-3 nutrients to support brain health.
What About Cod Liver Oil?
Like other fish oils, cod liver oil contains Omega-3s. However, the Omega-3 content can vary significantly and is often lower than a traditional fish oil supplement. For example, Nordic Naturals’ Arctic Cod Liver Oil provides just 202 mg of Omega-3s per softgel (82 mg EPA; 120 mg DHA). While the liquid forms tend to be higher in Omega-3s, many people find this form unpalatable, even if flavored. Cod liver oil is known for its modest vitamin D and high vitamin A content. Postmenopausal women should limit their vitamin A intake as osteoporotic hip fractures are associated with higher vitamin A intake.
What About Taking Krill Oil vs Fish Oil?
Krill, like other crustaceans and wild salmon, have a naturally occurring red pigment called astaxanthin. Astaxanthin is a type of carotenoid, a fat-soluble compound that works as an antioxidant to protect against oxidative damage. While krill oil is a good source astaxanthins plus vitamins A and D, it does not provide appreciable amounts of either EPA or DHA. For example, NatureMade’s Krill Oil supplement contains just 90 mg of Omega-3s per softgel (50 mg EPA; 24 mg DHA). Due to the lower Omega-3 content and higher cost, taking a Krill oil supplement is one of the most expensive ways to obtain Omega-3s.
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.