Search SAFM

Critical Omega-3 Fat Facts

You can’t open a magazine or newspaper without reading about them. Yet Omega-3 Essential Fatty Acids (or Omega-3s, for short) remain one of the top American nutrient deficiencies! And your clients are likely confused about what they do or don’t need – and where to find a high-quality source.

The body needs all sorts of different fats to function properly. Even saturated fats play a critical role for survival. Like a miraculous chemistry set, the body can typically convert most types of fat into whatever type it is missing. Omega-3s, however, are an exception (as are a few of the Omega-6 fats). Help your clients to understand that this is why we call them “essential”: the body cannot make its own supply. Omega-3s must be consumed. Or we suffer.

Omega-3 fats are in the headlines so much today because we’ve discovered just how powerful they are at controlling inflammation. Deficiency of Omega-3s can lead to low energy, depression, weakness, vision and learning problems, dry skin, poor hair and nail growth, impaired digestion, increased risk of auto-immune conditions, cardiovascular disease, cancer, diabetes, weak bones, impaired liver and kidney function, poor glandular performance, poor reproductive performance, and greater likelihood of becoming overweight. Quite a list, huh?

The good news is that Omega-3s are easy to get – in either food or a supplement. The most common source in the American diet is fish. If your clients enjoy a portion of fish every day, they likely have no worries about Omega-3 insufficiency.  It’s uncommon, for example, in much of Asia. Fish (especially fattier varieties like salmon, mackerel, halibut, sardines, anchovies) has an abundance of EPA and DHA, types of Omega-3 which reduce inflammation throughout the body, especially for your heart, arteries, and brain (including depression). Flaxseed has an abundance of ALA, a type of Omega-3 which has been shown to reduce triglycerides and improve blood sugar control. ALA is also found in walnuts. But your clients will need to eat at least a large handful every day. Given the typical American diet (and the inflammation most of your clients suffer from due to stress, toxins, etc.) many of them need an Omega-3 supplement.

So many choices!
I get a lot of questions about what Omega-3 supplement or food works best. Here’s an important concept to understand. In a healthy body, we convert only small amounts of excess ALA to EPA and then DHA. And unfortunately many unwell clients will make this conversion even less efficiently! As a result, I do recommend fish oil over flax oil (or algae oil is a fish-free alternative to fish oil but is usually quite expensive).  While all polyunsaturated fats are vulnerable to oxidation (and can cause inflammation vs. prevent it,)  flax oil is particularly vulnerable to oxidation from heat, light, and air. I think it’s best to get your ALA Omega-3s from flax by eating freshly ground flaxseed. Fish oil is loaded with EPA and DHA and, in my opinion, is the safer and healthier supplement choice.

Where did cavemen buy their fish oil? Yes, I’ve actually had a client ask me this question! And it’s important to be able to explain to them why supplements can be critical. If Omega-3s are so important, how did early humans manage to thrive on a limited diet? Especially inland without fish and with minimal, seasonal food choices? They certainly didn’t zip down to the Vitamin Shoppe to take advantage of a sale! The answer is grass. Fish aren’t high in Omega-3s because of anything endemic in fish; it’s because fish eat seaweeds. And they are efficient at translating that greenery into Omega-3s in their flesh. Early man definitely got Omega-3s from the animal proteins they hunted – and small amounts from wild-crafted plant protein as well. Similarly, meat and eggs today from grass-fed, pastured or wild animals that are allowed to forage for natural foods also contain Omega-3s. Today, we have widespread, “factory farming” practices in the US, and our government subsidizes corn. Thus, almost all animals raised for meat are never allowed on pasture and are fed corn feed soaked in high-fructose corn syrup and other chemical growth-promoters. The impact? No Omega-3s in the meat.

Early man also didn’t struggle with the imbalance of fats the typical American consumes today. Thanks to economic subsidy of corn and soybeans, most of the oil we eat is Omega-6 oils (e.g. corn, soybean, safflower, sunflower, etc). And unfortunately most of these Omega-6s are not gently pressed but rather chemically-extracted (and damaged in the process). This is almost certainly what your clients are eating in convenience, processed snack, drive-thru, and restaurant foods. Thus Americans consume a lot of Omega-6s! Early man likely consumed Omega-3s and Omega-6s in a better balance, often speculated to be near a 1:1 ratio. Today, our average ratio is closer to 30:1. The impact?  The Omega-6s  promote excessive inflammatory, and we suffer from Omega-3 deficiencies.

If your clients aren’t getting a consistent daily dose via food, you might encourage them to start taking an Omega-3 fish oil supplement. This is especially true if they suffer from inflammation (e.g. achy joints/arthritis, dry or flaky skin, and mild depression). Keep in mind that EPA has been shown to be a better systemic anti-inflammatory than DHA. On the other hand, DHA is most effective for neurological issues and inflammation (e.g. ADD/ADHA, dementia, depression). This is important to consider in recommending what kind of fish oil a specific client should take. Different formulas have different ratios of EPA and DHA.

Fish oils are available in capsules and liquids (and gummies for kids). For an otherwise healthy adult, research shows tremendous benefit from 1000mg Omega-3 fats. Note I didn’t say 1000mg fish oil. This is a key concept for your clients to understand. Be careful when they think they’ve found “a bargain”. Many low-end manufacturers dilute their fish oil, so 1000mg fish oil might not get them much actual Omega-3 at all. They might have to take 6 or 8 capsules to get a good dose. Have them bring their supplements to you, so you can teach them how to read the label (or copy and email it to you if you work remotely). Show them how to add up the EPA, the DHA, and other actual Omega-3s; those are the active, anti-inflammatory ingredients you want. Sometimes the seemingly more expensive brands are actually a better deal because they are more concentrated. An effective daily dose is a smaller number of capsules.

Also check to be sure the Omega-3 supplements you recommend are purity-certified by a 3rd party and preferably molecularly distilled. Cheap fish oil capsules will often taste and smell fishy. And your clients risk getting a dangerous dose of contaminants like PCBs and heavy metals, especially mercury. Far worse than not getting enough Omega-3s is getting toxic in the process of getting them.  It is also important to ensure that the fish oil (liquid or capsules) includes antioxidant protection (e.g. mixed tocopherols) and that your client consume plenty of antioxidants from fresh fruits and vegetables to help counter oxidative stress from metabolism (especially Vitamin E, as found plentifully in nuts (e.g. almonds) and seeds (e.g. sunflower)).

I love a bargain too, but I encourage my clients to save their thrifty mindset for other shopping needs. Supplements are generally not where your clients want to choose the cheapest thing they can find. From among widely available brands in stores, I recommend both Nordic Naturals and Carlsons. For my personal clients, I recommend Metagenics, Pure Encapsulations, or Xymogen due to their high quality standards and high Omega-3 content per gram of marine oil (a good financial deal).


P.S. If you know that healthcare must be transformed to be sustainable and effective, and you believe strongly that Functional Medicine is key to making that happen, we urge you to learn about our semester program.

If you haven’t done so already, sign up to receive weekly clinical tips like this via email, and you’ll also get automatic access to a free mini clinical course.

Like us on Facebook to get more great clinical tips and to get notifications of my next Facebook Live!

21 Questions for “Critical Omega-3 Fat Facts”

navigate comments
  1. 11
    Dina Assaad says:

    hi Tracy! what is your input on the damage that vegetable oils cause to the body?

  2. 10
    Julia LC van Opzeeland says:

    What are your thoughts on fermented cod liver oil please? thanks a lot!

    • 10.1
      SAFM Team says:

      FCLO is an excellent source of Omega-3 fats, DHA in particular, as well as bioavailable Vitamin D and Vitamin A – a good alternative to regular Omega3 supplements that are typically a bit more processed. It’s good general support. The only brand we recommend regularly is Green Pastures, as they sell a fermented cod liver oil. This product offers a good ratio of Vitamin A: Vitamin D and is minimally processed.

  3. 9
    Rebecca Pell says:

    Hi Tracey,
    I am curious about the addition of vitamin E oil and rosemary extract to fish oil supplements (Nordic Naturals does this).
    I know they add it in for a longer shelf life, but both seem like bad ideas, especially if the source of the vitamin E oil is synthetic. Any comments or suggestions here?

    • 9.1
      SAFM Team says:

      Indeed, vitamin E oil and rosemary extract are often added to the fish oil supplements to protect those from getting oxidized and rancid. Although this is not a perfect solution, we think this is a necessary practice for maintaining the supplement integrity. The good news that the quantities added are very small and the benefits of adding those antioxidants are critical for rendering this particular supplement not only shelf-stable but also harmless and greatly outweigh any negatives. As you know, consumption of rancid, oxidized oils is one of the reasons why people struggle with oxidative stress and inflammation in the first place.
      Obviously, whenever possible it is best to increase the EPA/DHA via whole, fresh, uncontaminated and sustainably raised/sourced animal products (fish, grass-fed meats and dairy). However, those are more and more difficult to acquire for the general public and also more and more people have food sensitivities, digestive issues or need larger quantities therapeutically at least for some time. In those cases, a good quality fish oil with small amounts of Vit E and rosemary extract is a great solution.

  4. 8
    Daniela Lazzari says:

    Are Omega 3 fats (fish oil ) as a supplement a good choice for a person which gallbladder has been removed ?

  5. 7
    Melissa Heffron says:

    Hi Tracy, I believe you touched on this somewhere, but is Whole Foods farmed salmon okay to eat? Is there a good ratio of omega 3:6 fats? Thanks!

    • 7.1
      SAFM Team says:

      I am a big fan of personal empowerment and investigation. I have said before that I personally would only choose to eat farmed fish it if were offered at WFM. Generally I would recommend that you always check the current quality of sourcing yourself for what you are buying in the moment. If you’re uncertain, ask the attendant employee for more information. Whole Foods Market typically sells animal proteins categorized along a quality scale (1-5) and will list a number for each specific offering. In general salmon has a high content of omega-3 essential fats, but this is highly dependent upon what it eats. Algae intake plays a big role in omega-3 content, hence the importance of natural food sources.

  6. 6
    Carol Adams says:

    Hi Tracy –
    You mentioned for chronic inflammation looking for an Omega supplement with emphasis on a higher proportion of DHA (vs. EPA) if issues are neurological. At least 3000 mg/day. Most of the supplements I’m checking out – Xymogen, Metagenics, Trader Joes, etc. have a higher concentration of EPA. Can you suggest brands that fit the higher DHA concentration profile? Thank you!

  7. 5
    Naami Mashitz says:

    Hi Tracy! Thank you for this great and helpful information!

    A client who plans to get pregnant in the next couple of months chose to start on Zahler’s prenatal vitamins that also has added 300mg of DHA. At this time she is also taking a regular dose of Omega 3 fatty acids (1000mg of EPA/DHA). I am wondering if it will be too much DHA and what would you recommend she do?

    I look forward to starting the core 101 program next week and hope to get a load more insight into recommending supplements.

    Thank you so much!

  8. 4
    Mary Signorelli says:

    Hi Tracy,
    Im hoping you will weigh in on the claims that the triglyceride form of fish oil is better absorbed than the ethyl ester forms?
    I looked for some insights but found varying opinions.

    • 4.1
      SAFM Team says:

      Ah, yes! An oh-so-popular debate in the nutritional world. I have indeed researched this quite a bit, and in summary, here is what I think. The triglyceride form of fish oil is indeed a more natural way to take in fats (and digest them), more quickly absorbed, and better absorbed overall. It is also typically, significantly more expensive (because the process of reassembling the fatty acids into triglyceride form after they have been concentrated does indeed add more cost!). The question is whether this benefit:cost trade-off is worth it. Nearly all studies demonstrating the benefits of omega-3 supplementation have been done with the ethyl ester form. I believe that for the average person without overt liver concerns, a high-quality ethyl ester form is likely going to work just fine, cause no issues, and get them the omega-3 supplementation benefits they seek. Our focus is better put on ensuring a high-quality, refined, and clean (as in not contaminated) sourcing.
      If a person has ethanol intolerance or a persistent gut fungal overgrowth issue or liver disease of some type or does not well tolerate ethyl ester fish oil supplementation (e.g. burping, even if pills are chilled first), then they will likely do better with choosing the triglyceride formula. Ideally, based on how well we understand the science at present, I do agree that everyone would choose the triglyceride formula – in the same sense that everyone would choose the highest-quality supplements with the best ingredient sourcing, no binders, fillers or additives. But this is neither practical nor financially feasible at present. I do think there is an interesting question about whether there is perhaps a *value* in slower absorption of a supplemental nutrient in terms of downstream health effects (vs. giving the body a sudden “glut” at all once – in the same vein that we recommended divided doses of higher intake supplements). I tried to find two good online, credible resources that show some extremes of opinion based on research and physiology (vs. just marketing claims). I hope these are helpful! and .

  9. 3
    John Castella says:

    thanks so much Tracy!

  10. 2
    John Castella says:

    Hi Tracy,

    Clients are asking about the latest controversy regarding coconut oil: healthy or unhealthy. I thought I had seen a post you had made about that, but somehow cannot find it now. Appreciate if you can provide your take on this.

    thanks, John

    • 2.1
      SAFM Team says:

      Hi John – Alas, I think this is another example of the media running wild with their own interpretation and essentially legislating scientific education via headline. So frustrating. There was no new data – just a different cut on which studies were included. It is also yet more conclusion based on the false premise that LDL is evil and that higher levels of LDL independently drive CVD. I remain convinced that the ratio of Trigs:HDL is a much better marker of overt risk out of a conventional lipid profile. But we well know that the full picture is more complex than that. We do definitely need to advise people that combining a diet high in saturated fats along with a high-sugar/refined-carb, inflammatory diet is *not* a good combination! And omega-3 intake is key as well. As always (no news here), the devil is in the detail. I sent out this link to a LOT of alarmed people last week (a blog article by Dr. William Davis, a cardiologist): . Dr. Mark Hyman’s is also well (and provocatively) stated: . For those with a more clinical background who wanted a deeper dive, this one was a great fit (a podcast from Chris Masterjohn, a fantastic nutrition researcher): . Hope that helps!

  11. 1
    Laura says:

    How does a combo of sprouted broccoli seeds, chia seeds, and flax seeds compare to a pill form Omega-3 supplement?

    • 1.1
      SAFM says:

      In order, the three seeds you mention with the highest omega-3 content would be flax, chia, and broccoli. All three of these contain only the ALA form of omega-3, that is alpha linolenic acid (the “other” ALA). The body must convert ALA to DHA and EPA (the latter two being omega-3s typically found in marine oils e.g. algae and fish). As I mentioned in this article, some individuals to not well make this conversion, and especially if chronic inflammation is at play (the case with most of our clients and patients?), I recommend using an algae or fish oil supplement therapeutically for this reason. For a healthy person with no chronic inflammatory issues, consuming only ALA as a source of omega-3s may indeed be sufficient. Another great example of bio-individuality and the need for customized recommendations. This may be of interest: .

navigate comments

Ask a Question

Practitioner clarification questions are welcome! Please do not post personal case inquiries.